• Hazard 4 Contact with blood/body fluids and handling animal and human remains.

Disaster sites pose many occupational health and safety concerns. These hazards and exposures are a function of the unstable nature of the site, the potential for worker exposure to unknown hazardous substances and the type of work performed. An accurate assessment of all hazards may not be possible because they may not be immediately obvious or identifiable.

Where possible, NIOSH has made default recommendations for PPE that it believes will meet the probable hazards.

General PPE Guidance

For most work in flooded areas, or areas that have been subjected to flooding, response personnel will need the following personal protective equipment: hard hats, goggles or safety glasses, heavy work gloves, watertight boots with steel toe and insole (not just steel shank), and hearing protection where excessive noise from equipment poses a risk of hearing damage. PPE should be provided in a range of sizes to ensure proper fit.

HAZARD 1: Sharp, jagged debris — Workers handling debris may suffer wounds. Tetanus is a potential health threat for persons who sustain wound injuries. Also, any wound has the potential for becoming infected, and floodwater exposures may add to this concern.

Use heavy gloves to protect the hands when handling debris to minimize the chances of cuts and scrapes.

Gloves designed to protect the skin from chemical exposure are not typically strong enough to protect from debris. Multiple layers of gloves (double gloving) may be necessary. Long pants, long sleeve shirts, boots, eye protection (safety glasses, goggles, or faceshields), and headgear are also appropriate.

Because workers come in all shapes and sizes, it's important that their PPE fit.

"Fit and comfort are crucial elements to the success of a protective apparel program," said Adam Morse, a spokesman with Aramark Work Apparel and Uniform Services. "If a worker isn’t comfortable with the fit of a garment, they may decide not to wear it. Workers should try on protective clothing before deciding on a size."

HAZARD 2: Floodwater exposure — Floodwaters contain bacteria from human and animal wastes. The most likely symptoms from an infection are stomach-ache, fever, vomiting and diarrhea.

While skin contact with flood water does not, by itself, pose a serious health risk, emergency response personnel and the public should avoid direct contact with standing water when possible to minimize the chance for infection.

Chemical contamination of floodwaters can also occur, and contamination levels may be higher nearer to sources such as industrial locations.

Work in and around moving or standing water in flooded areas presents a risk of drowning. Standing or working in water that is cooler than 75° F (24° C) will remove body heat more rapidly than it can be replaced, resulting in hypothermia.

Double gloving with a waterproof glove under a heavy work glove is the best way to protect the hands from both cuts and scrapes and floodwater exposure. Boots and rain gear can be used to prevent lower body skin exposures.

It is important to minimize contaminating the inside of the gloves. Gloves not disposed of should be cleaned with soap and water and dried between uses.

For additional information on what equipment you need for protection against chemical exposures, contact your local OSHA office or consult the NIOSH Pocket Guide to Chemical Hazards.

Wearing wet gloves or PPE can cause dermal irritation. Long exposures to wet conditions can compromise the function of the skin barrier. Repeated use of impermeable gloves, especially in hot and humid conditions, can aggravate skin rashes. Cotton liners are sometimes used under protective gloves to improve comfort and to prevent dermatitis. Latex gloves should be avoided because of the risk of developing skin sensitivity or allergy.

Open wounds and skin conditions such as eczema and psoriasis may increase your risk of infection. Contamination of wounds with water (fresh or sea water) can lead to infections caused by waterborne organisms.

HAZARD 3: Electrical Hazards — Electrical, overhead power lines, power junctions, and downed electrical wires and cables can cause electrocution and burns. Fallen lines can also energize other objects such as fences, ladders, or metal building parts.

Use of improperly sized or operated portable generators during electrical outages can also cause “backfeed” injuries to workers performing repair work in neighboring buildings. Only trained electricians and utility workers should approach or handle electrical lines. All other response workers should avoid going near all downed lines and should treat them as if energized.

Special electrically resistant PPE, including headgear, gloves, boots and appropriate eye protection, should be used by electricians and utility workers. Electrical PPE is only one aspect of electrical safety practice. Special training and practices to test, de-energize, isolate, and/or lockout hazardous energy sources are important.

Hazard 4: Contact with blood/body fluids and handling animal and human remains — 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. However, workers who must have direct contact with human remains can have exposure to blood borne pathogens.

Blood, bloody fluids, body fluids, and tissues are potential sources of bloodborne infections from pathogens including Hepatitis B, Hepatitis C, and HIV. Exposures to medical providers and responders may occur via a cut or puncture wound; through mucous membranes (eye, nose, mouth); and through non-intact skin (dermatitis/rashes, injuries, abrasions).

Workers who will have direct contact with the victims, or surfaces contaminated with blood or body fluids should use universal precautions. These require use of protective barriers such as gloves, face-shields, or protective eyewear.

Organic vapor respirators can be used for nuisance odor control where needed. One option that provides odor control and universal precaution splash and eye protection is to use a full facepiece respirator with N95 and organic vapor cartridges.

For additional information on what equipment you need for protection against exposure to specific hazards, contact your local OSHA office or consult the NIOSH Pocket Guide to Chemical Hazards (http://www.cdc.gov/niosh/npg/npg.html).  FSM