Hurricane Katrina that struck South Eastern Coast of the United States is considered to be one of the biggest natural disasters in recent history. The city of New Orleans, which is rich in cultural and musical tradition, has been devastated beyond recognition during the violent unleashing of the storm. Hence, as the Industrial Hygienist designated with the job of reverting the hospital to usable standards, my task is quite challenging. But meeting this challenge head-on, I would implement various plans of action for my team based on theoretical knowledge and practical experience that I had gained in my career as an Industrial Hygienist.
My primary concern as an Industrial Hygienist deputed to clean up the hospital in the aftermath of Hurricane Katrina would be to prevent or control the spread of infectious diseases such as diarrhea, flu, cold and TB. Because as evidence from similar natural catastrophes suggests, the people returning to New Orleans are likely to suffer from these diseases in the immediate aftermath of Katrina. Gastroenteritis is also likely to be prevalent. Hence I would order my team and also avail of services from other disaster relief personnel and design an basic hygiene awareness program for the hospital. For example, proper hand-washing techniques will be demonstrated to all concerned. Along with practical demonstrations, I would make posters, fliers and email postings to reiterate the proper technique of hand washing. I would place bottles of Gel hand sanitizers at important access points within the hospital. Other infectious diseases that I would try to prevent or control include rashes and skin infections. Once any of these diseases is identified in the surrounding population, it is imperative that diseased individuals are separated from the crowd so as to stop further spread. All the beds and chairs within the hospital will be scanned for fomites. It is advisable to remove soiled cots, mattresses and bed spreads from the premises. (Chew, et. al, 2006)
I would also be concerned about the mold and endotoxin levels in the hospital environment. I will involve the two technicians in my team to bring samples and perform tests for ascertaining mold and endotoxin levels. It is imperative that they wear Personal Protective Equipment (PPE) such as respirators. The advice would be to wear elastomeric respirators. Alongside mold and endotoxin level measurement, I would implement the process of deconstruction, which entails removal of soiled and muddied carpets, removal of insulation, dismantling of lower cabinets in each room. (Chew, et. Al, 2006) It would be prudent on my part to keep in mind the following words of advice from a fellow Industrial Hygienist:
“Using a variety of sampling and analytical methods, one can observe airborne levels of mold and endotoxin, which often increased orders of magnitude during the intervention, and determined that workplace protection factors of some respirators can be suboptimal in such conditions. Although the generally accepted mold remediation protocols reduces bioaerosols in the particular environment, myriad issues including the qualifications of those performing the work (including homeowners), depth and duration of flooding, and the availability of electricity and supplies can affect the feasibility and ultimately the success of flood cleanup efforts”. (Chew, et. Al, 2006)
Here are some of other important PPE that I want my team to wear, starting with “electrically insulated, watertight boots with steel shank, toe and insole; Heavy, waterproof, cut-resistant work gloves; and Goggles, safety glasses with sideshields or full faceshields” (Elledge, et. al, 2007). A few other types of protective gloves might become necessary when dealing with hazardous substances. Wearing a soft or ANSI-approved hardhat may become important if there is any risk of falling debris in the hospital premises. I would not underestimate the importance of wearing “comfortable, form-fitting, lightweight clothing including long pants and long-sleeved shirt or coveralls” (Elledge, et. al, 2007). Under certain environmental conditions wearing NIOSH-approved respirators will be recommended.
I will delegate the responsibility of cleaning up the premises to the Environmental Manager (EM) in the team. The EM would in turn monitor dry and wet cleaning operations by workers. The dry cleaning will be done using ‘bristle brushing studs’, which would remove most of visible molds in the premises. Later the surfaces could be vacuum-cleaned with the help of a HEPA filter attachment. Wet cleaning, on the other hand, would be done using sponge mops and hand sponges to “wash down surfaces with a non-trisodium phosphate solution of sodium sesquicarbonate detergent and 15% dilution of household chlorine bleach” (Smith, 2008). It is important for the EM and workers under his/her charge to ensure that the dry cleaning process is done before wet cleaning begins.
To the Safety Supervisor, I would delegate the task of conducting Biostat treatments. Usually, after the dry and wet cleaning processes are over, it is standard procedure to do biostat treatment with “one of two borate formulations to prevent future emergence of mold” (Smith, 2008). Bora-Car (manufactured by Nusus Corporation) and Termite Prufe (manufactured by Copper Brite Corpration) are quality products to use for this purpose. The disodium octoborate tetra-hydrate present in these products are effective fungicides and will aid in restoring the hospital to its original standards of hygiene. Bleaching powder is another effective disinfectant that I would recommend strongly recommended. (Smith, 2008)
In the chaos ensuing Hurricane Katrina, many people might have taken temporary abode in the hospital. Given that the ground floor was flooded to the height of 6 feet, the first floor space might have helped many from getting drowned. Hence there is bound to have been overcrowding and over usage of basic amenities in the first floor. Amenities such as running water, toilets, sinks and showers would surely have been overused as they were not built to deal with huge numbers of desperate refugees. A properly functioning plumbing system is crucial to the restoration effort, for without it the practice of hand-washing would be impeded, which could spread infectious disease.
And finally, I would like to conclude by saying that having a well-thought out plan of action and list of recommendations is not a substitute for being able to think on the feet. As the plans made for restoring the hospital to minimum hygiene and safety standards is implemented, there will be situations in which ad-hoc plans have to be devised. I would thus assure the Incident Commander that no stone would be unturned and no effort would be spared in cleaning up the hospital and bring it back to minimum requisite standards.
References
Chew, G. L., Wilson, J., Rabito, F. A., Grimsley, F., Iqbal, S., Reponen, T., et al. (2006). Mold and Endotoxin Levels in the Aftermath of Hurricane Katrina: A Pilot Project of Homes in New Orleans Undergoing Renovation. Environmental Health Perspectives, 114(12), 1883+.
Elledge, B. L., Boatright, D. T., Woodson, P., Clinkenbeard, R. E., & Brand, M. W. (2007). Learning from Katrina: Environmental Health Observations from the SWCPHP Response Team in Houston. Journal of Environmental Health, 70(2), 22+.
Smith, S. (2008, May). Young Leaders in Industrial Hygiene: While Their Careers Have Taken Different Paths, These Four Industrial Hygienists Share a Commitment to the Profession, a Passion for Protecting Workers and the Environment and a Positive Attitude about the Future. Occupational Hazards, 70, 25+.