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ASCR cleanup guidelines for adjusters and volunteers.

Adjusters and volunteers returning from working along the Gulf Coast region have brought more than just the feeling of a job well done with them. They've begun to develop a number of different, and in some cases, unexplainable, health symptoms ranging from what some have called the "Katrina Cough" or "mold cold" to antibiotic resistant injuries and infections, meningitis, and even post traumatic stress disorder (PTSD).

In the inundated quarters around New Orleans, long-term flooding has created a host of contamination problems. Under such conditions improper cleanup can create short-term and long-term problems for both the workers and residents who will reoccupy the damaged structures.

Understand the Dangers

In areas impacted by any sort of natural disaster, there will be a variety of physical hazards to workers. These dangers can include unstable materials, possible gas leaks, and damaged containers of hazardous household chemicals (solvents, lawn fertilizers and pesticides). Working conditions can easily result in slips, cuts, and punctures from broken glass; nails and wood; and cutting dangers from the use of hand and power tools. Because of the conditions and amount of materials being moved, eye injuries are a constant concern.

High levels of bacterial growth have been reported. The flooding deposited a variety of heavy metals such as lead and mercury into porous building materials. Because of the historically high use of pesticides in the New Orleans area to combat termite infestations, significant levels of pesticide residues have been measured, particularly around older houses. The damage to oil refineries and storage locations left many neighborhoods with visible residues. There are also airborne particulates that may be unseen by the human eye, but can still cause illnesses when inhaled.

Health Hazards: Physical and Emotional

Structures unoccupied for extended periods often become the new homes for vermin such as snakes, rats, fire ants, and bees. The risk of animal bites, insect stings and exposure to noxious plants such as poison ivy is very real in all of the areas impacted by the hurricanes. These hazards have lead to a growing number of documented reports of antibiotic resistant infections, Legionella-caused pneumonia, and a host of low grade but persistent symptoms. The dramatic rise in sinus infections, skin rashes, upper airway irritations, and persistent coughing has already been dubbed the "Katrina Cough" by the media.

Finally, volunteers must be prepared for the psychological shock that can result from a combination of stark visual images and physical exhaustion. Cleanup and restoration work as well as adjusting in an area that has suffered the devastation experienced by the Gulf Coast takes an emotional as well as a physical toll on workers. Post traumatic stress disorder is defined as a specific set of symptoms arising from a markedly distressing event. Individuals exposed to victims of a trauma may also develop a unique form of PTSD even though they were not directly impacted by the event. This secondary PTSD is sometimes referred to as compassion fatigue and can affect an entire team after first appearing in one team member.

Marilyn Neudeck-Dicken, Ph.D., an expert in the area of traumatic stress, says the feelings of helplessness from seeing the devastation are normal. She recommends that volunteers keep a journal of their experiences and feelings to give them an outlet to express those emotions. A debriefing session for volunteers with a professional experienced in traumatic stress disorder is also recommended to help them deal with the powerful emotions. The American Academy of Experts in Traumatic Stress ( can provide more information about local critical incident stress debriefings.

Preparation and Prevention

Power still has not been restored to large areas. Dependable sources of clean water are not guaranteed. Sewer systems are still not functional in many communities. With this in mind, the basics need to be considered. Where are you going to stay? Where will you shower? How are you going to eat? How will you travel around the area? How will you manage the work? Who are you partnering with after you arrive?

Volunteers heading into any area should partner with local organizations or churches, since they can provide assistance in navigating the area, securing resources and identifying hazards. Any individuals conducting cleanup work should also have appropriate immunizations. Although a final determination must be made by a physician, many public health organizations are recommending that workers have: tetanus boosters, immunizations against Hepatitis A and B, typhoid, and meningitis.

Personal Hygiene

Workers should be coached in personal hygiene, specifically: avoid scratching uncovered skin and putting fingers in ears and mouth or rubbing eyes. Eating and drinking can be especially hazardous. Careful washing of hands and face should precede ingestion of any kind. (Your own perspiration can be toxic!)

When heading down into a hurricane damaged area, ASCR recommends bringing: first aid kits, antibiotic ointment, baby wipes, hand sanitizer (small individual bottles and bulk sized for refilling), personal hygiene items (shampoo, soap, deodorant, toothpaste), DEET-based mosquito repellent, over-the-counter anti-itch creams for insect bites, diarrhea medication, sunscreen, energy bars, high protein foods (tuna, sardines, peanut butter), and Gatorade or other sports drinks.

Protective Gear and Practical Tools

The importance of proper personal protective equipment (PPE) cannot be underestimated. ASCR recommends: safety shoes, work boots or rubber boots with steel toes and shanks (not running or tennis shoes), leather work gloves (form fitting, not oversized), eye protection (goggles or safety glasses), rubber gloves for cleaning or when using sanitizing chemicals (disposable nitrile gloves are puncture resistant and non-allergenic), hard hats, and appropriate respiratory protection.

Respiratory protection is mandatory given the conditions. Full body coverings such as Tyvek or Kleenguard suits are also a key piece of protective equipment which will have to be used inside most structures until the demolition and decontamination activities are completed.

Simple dust masks are simply inadequate given the documented hazards that the volunteers face. Respirators with HEPA cartridges or dust masks with an N-95 or N-100 rating should be used by any workers restoring hurricane damaged structures.

Basic Cleanup Procedures

Many structures have surface contamination such as visible mold growth above the high water mark. There are also problems where waterborne contaminants have penetrated porous materials below the high water mark. Studies by the EPA and FEMA report that significant contamination was detected outside and inside wall cavities, so many structures will have to be gutted in order to be saved.

Despite the wide publicity given to bleach as a sanitizing agent for use after flooding, the FEMA recovery advisories related to the New Orleans area break that pattern. Bleach is not recommended for wholesale decontamination of structures because it is not a good cleaner, is deactivated by soil and organic matter, reacts with other chemicals, and is corrosive.

Stay Safe

With the conditions in the Gulf Coast that demand the assistance of thousands of adjusters and volunteers, safety and security cannot be overemphasized.

* All work groups should coordinate their efforts with local law enforcement agencies so that sudden bursts of activity are not mistaken for criminal actions.

* Volunteers should never enter a structure where there is evidence of structural damage such as sagging ceilings, large wall or floor cracks, or walls out of plumb.

* Because of the variety of contaminants identified in hurricane damaged structures, always wear personal protective equipment, despite the heat and the fact that such protection may be uncomfortable.

* Because of the physical demands of the labor and the extra stress on the body that occurs with the use of protective equipment, volunteers should take frequent breaks away from the work area.

* All volunteers should frequently use hand and face washing supplies/facilities. No food or water should be consumed using dirty hands.

* Work team leaders must plan for proper hydration by having plenty of bottled water and other liquids available for volunteers.

Working in any hurricane damaged area involves real dangers for all involved. Education and proper preparation can help reduce the chances of injury or illness.

More Information

* Association of Specialists in Cleaning & (click on Katrina Resources)

* Contractor Orientation to Catastrophic Disaster Work--ASCR Technical Assistance Bulletin (dick on Contractor Preparation Tips)

* The ABCs of Returning to Flooded Buildings--FEMA Recovery Advisory

* Initial Restoration for Flooded Buildings--FEMA Recovery Advisory

* Health Concerns Associated with Mold in Water-Damaged Homes after Hurricanes Katrina and Rita--U.S. Centers for Disease Control and

* American Academy of Experts in Traumatic

* Marilyn Neudeck-Dicken, Ph.D., traumatic stress expert, e-mail: or phone (909) 887-2991


ASCR would like to thank the following individuals who contributed their time and expertise to this advisory: Michael Pinto, Ph.D., Wonder Makers Environmental, Inc.; Martin L. King, CR, ASA, Martin Churchill Associates; Frank Headen, CR, WLS, CMH, First Restoration Services, Inc.; Rusty Amarante, CR, Belfor; Larry Holder, CR, Belfor; Cliff Zlotnik, CR, WLS, CMH, Unsmoke; Marilyn Neudeck-Dicken, Ph.D., B.C.E.T.S, D.A.A.E.T.S., F.A.A.E.T.S, Board Certified expert in Traumatic Stress; and Ron Reese, CR, WLS, Mr. Steam/Ree-Construction.

The Association of Specialists in Cleaning and Restoration (ASCR), located in Columbia, Maryland, is the only international trade association in the cleaning and restoration industry. Its more than 1,100 national and international member firms specialize in cleaning, treating, and repairing damaged buildings and their contents. Three Institutes comprise ASCR: the Environmental Institute, the Restoration Institute, and the Textile Institute. More information is available on the ASCR website:
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Copyright 2006 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Katrina chronicles--then and now
Date:Jun 1, 2006
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