Safety Risks for Flood Responders

Whew, we made it through, now what?
Floods are a serious catastrophe and are the number one natural disaster in Canada, with both numbers and severity on the rise.

The focus of prevention has mostly been on public early warning systems and preparedness, but floods still happen, and will likely increase with the future effects of climate change – tidal surges, excessive sudden rainfall, and rising rivers. Response workers face many occupational health and safety risks during recovery, clean-up and remediation. They may feel additional pressure to rush the job, in an emotional response to assist the public and resume operations as quickly as possible, at personal risks to themselves.

Why the Big Rush to Respond?
As a whole, we humans are compassionate people who try to help our neighbours when we can – and we often do our best caring and work under pressure.

A devastating flood – with road and bridge blockages, deep water, lengthy power outages and contaminated food and water sources – means human suffering and potential fatality. And so, there is an increased sense of urgency to assist residents, particularly seniors, people with physical and mental disabilities, infants and young children. Reduced access to medical services and pharmacies can be critical to people with chronic illnesses such as diabetes, heart disease, and respiratory conditions requiring oxygen therapy or rechargeable batteries for medical devices. Reduced medical staffing at local hospitals and clinics can mean delays in treatment and cancelled surgeries and procedures during the acute and early recovery phases of flood response. Less critical, but still important factors are school and business closures – the resulting economic losses contribute to the overall sense of urgency to resume normal residential occupancy and operation as quickly as possible once flood waters recede to safer levels.

Who are the Responders?
Other than local residents doing their best to help themselves and their neighbours during flood response, a diverse range of paid and volunteer emergency responders and public safety employees are called upon to assist. Police and firefighters, Search and Rescue (SAR) team members, public utility and transportation workers are often the first on the ground and in the water to deal with detouring roads, bridge washouts, power outages, and sewage failure. Following critical flooding such as in Alberta in 2015, Quebec in 2017, and most recently New Brunswick in the spring of 2018, additional assistance from the Canadian Armed Forces and the Canadian Coast Guard was required.

What you can’t see may hurt you too
In addition to the obvious sudden and fatal risks of drowning in deep water and electrical shock from disrupted power sources, there are many less obvious health and safety risks of flood response for responders. Physical trauma risks are numerous, with potential injuries from accidents responding to flash flooding, instability of road or riverbank surfaces, and walking or driving through submerged culverts, debris, manholes, and rocks. While attempting to assist residents to evacuate or move property, responders risk falls from heights, ladders, and slippery surfaces. Back injuries and manual handling injuries are common with slippery grips and unstable surfaces. As not all responders and workers use inflatable boats or watercraft as part of their regular duties, they may be unfamiliar with boating operations and are thus at increased risk of drowning or collision while attempting to assist and transport others.

With unstable soft ground surfaces and erosion, the removal of trees, spring poles and snags and debris requiring the use of chain saws is extra risky in a wet environment.

Extensive noise exposure from chain saws, generators, and heavy equipment vehicles is also common. Even those who would be required to wear hearing, eye and head protection in similar normal operations, the use of Personnel Protective Equipment (PPE) may be deferred in the interest of speed or change of priority.

Depending on the season and weather conditions, with long hours of urgent response during and post-flood, heat and cold exposure due to lack of air conditioning or heating may result in dehydration or possibly extremes of hypothermia or heat exhaustion.

Livestock, domestic animals, and even wildlife are prone to panic during flooding events, resulting in bites, scratches, and physical injury. All emergency responders should have current Tetanus and Hepatitis vaccination, immediate access to first aid kits, potable water, and appropriate PPE.

Responders operating out of temporary command posts and shelters need to be aware of the risk of contamination of their drinking water, utensils, and food storage and preparation areas. Wet feet require extra warm socks and dry, sealed, puncture-resistant footwear to help avoid immersion or trench foot from prolonged damp conditions.

To breathe or not to breathe
As flood waters begin to recede, residents and responders begin to breathe collective sighs of relief. However, standing water is an incubator for many diseases and contaminants that can enter the human body through inhalation, or ingestion by mouth or through broken skin. Industrial chemical exposure, farming pesticides, fuels and petrochemicals are often released during flooding events, and can be carried long distances from the original source. Human sewage and waste treatment facilities often fail in extreme floods, as well as release of animal waste in agricultural areas such as along the Saint John River Valley in New Brunswick.

As temperatures warm up, mold, fungus, bacteria and viruses may rapidly grow on organic surfaces and become airborne, resulting in respiratory illness and allergies for some workers. In extreme situations worldwide, infectious outbreaks of cholera and typhoid have erupted. Insects such as mosquitoes are also quick to breed in standing water, with the associated risk of mosquito-borne diseases.

In extreme flooding situations such as Hurricane Katrina, the numerous fatalities resulted in responders being exposed to human remains. Responders must remember to practice additional sanitation measures and Universal Precautions with gloves and goggles, trying to avoid splashes and unprotected contact with potentially infectious human remains.  

Carbon monoxide poisoning is a fatal respiratory risk for responders operating diesel generators, tools, fires or stoves, especially in confined areas such as sheds or  vehicle command posts. As breathing cartridges in respiratory protection masks become wet, they quickly lose their effectiveness and should be exchanged often and kept as dry as possible.

Emotional stress can linger after the flood
Finally, it should come as no surprise that severe and prolonged flood response may have emotional and mental health effects on responders. These effects may be felt as acute stress and anxiety, or as a situational depression post flood event. Shiftwork, lack of restorative sleep, and exhaustion take their toll in the days and weeks spent assisting others in urgent situations. Volunteers may be faced with a reduction of work income while dedicating their time to public service.

For emergency responders who have been exposed to extreme trauma, death, or mass casualties, there is a higher risk of Post-Traumatic Stress Disorder. This may not be felt or recognized until much later (after the excitement and action of the flood incident has subsided), even if critical incident debriefing has been provided.

Preparing for future floods
Some flooding risks are obvious, and others are hidden until they cause illness or traumatic injury in unexpected ways. We may not be able to prevent the floods from happening in the years to come, but we can help our emergency responders be better prepared to protect themselves from injury and illness as they do their best to serve and protect the public.

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Theresa McGuire is a certified Occupational Health Nurse and Canadian Registered Safety Professional in Halifax, NS. She is a retired Canadian Armed Forces officer and former volunteer ground search and rescue team member, who now works with the Coast Guard as a Health Officer.