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Health and safety of occupational workers

Cleanup during disaster recovery involves many occupational hazards. Often these hazards are exacerbated by the conditions of the local environment as a result of the natural disaster. While individual workers should be aware of these potential hazards, employers are responsible to minimize exposure to these hazards and protect workers, when possible. This includes a thorough assessment of potential hazards, application of appropriate personal protective equipment (PPE), and the distribution of other relevant information in order to enable safe performance of the work. Maintaining a safe and healthy environment for these workers ensures that the effectiveness of the disaster recovery is affected.

Physical exposures

Flood-associated injuries and conditions: Flooding disasters often expose workers to trauma from sharp and blunt objects hidden under murky waters causing lacerations, as well as open and closed fractures. These injuries are further exacerbated with exposure to the often contaminated waters, leading to increased risk for infection. When working around water, there is always the risk of drowning. In addition, the risk of hypothermia significantly increases with prolonged exposure to water temperatures less than 75 degrees Fahrenheit. Non-infectious skin conditions may also occur including miliaria, immersion foot syndrome (including trench foot), and contact dermatitis.

Biological exposures

Human remains: According to the Center for Disease Control and Prevention (CDC), "There is no direct risk of contagion or infectious disease from being near human remains for people who are not directly involved in recovery or other efforts that require handling dead bodies.” Most viruses and bacteria perish along with the human body after death. Therefore, no excessive measures are necessary when handling human remains indirectly. However, for workers in direct contact with human remains, universal precautions should be exercised in order to prevent unnecessary exposure to blood-borne viruses and bacteria. Relevant PPE includes eye protection, face mask or shield, and gloves. The predominant health risk are gastrointestinal infections through fecal-oral contamination, so hand hygiene is paramount to prevention. Mental health support should also be available to workers who endure psychological stress during and after recovery. 

Flood-associated skin infections: Flood waters are often contaminated with bacteria and waste as well as chemicals on occasion. Prolonged, direct contact with these waters leads to an increased risk for skin infection, especially with open wounds in the skin or history of a previous skin condition, such as atopic dermatitis or psoriasis. These infections are exacerbated with a compromised immune system or an aging population. The most common bacterial skin infections are usually with Staphylococcus and Streptococcus. One of the most uncommon, but well-known salt-water bacterial infections is from Vibrio Vulnificus, which causes a rare, but often fatal infection called necrotizing fasciitis.

Surgical debridement of left leg necrotizing fasciitis.

Other salt-water Mycobacterium infections include the slow growing M. marinum and fast growing M. fortuitum, M. chelonae, and M. abscessus. Fresh-water bacterial infections include aeromonas hydrophila, Burkholderia pseudomallei causing melioidosis, leptospira interrogans causing leptospirosis, and chromobacterium violaceum. Fungal infections may lead to chromoblastomycosis, blastomycosis, mucormycosis, and dermatophytosis. Numerous other arthropod, protozoal, and parasitic infections have been described. A worker can reduce the risk of flood-associated skin infections by avoiding the water if an open wound is present, or at minimum, cover the open wound with a waterproof bandage. Should contact with flood water occur, the open wound should be washed thoroughly with soap and clean water.

Psychosocial exposures

Providing disaster recovery assistance is both rewarding and stressful. According to the CDC, "Sources of stress for emergency responders may include witnessing human suffering, risk of personal harm, intense workloads, life-and-death decisions, and separation from family." These stresses need to be prevented or effectively managed in order to optimize assistance without causing danger to oneself. Preparation as an emergency responder is key, in addition to establishing care for responsibilities at home. During the recovery efforts, it is critical to understand and recognize burnout and sources of stress. After the recovery, it is vital to take time away from the disaster scene and slowly re-integrate back to the normal work environment. Substance Abuse and Mental Health Services Administration (SAMHSA) provides stress prevention and management resources for disaster recovery responders.