Oh Harvey, what did we ever do to you?

So... I am seeing a whole lot of cleanup activity. It is heartening. It is a testament to the spirit of the people of the Texas and Louisiana Gulf Coast. What I am not seeing is as much health advisory as I would like, so given that I have responded to and endured floods too many times to count. I thought I would provide the following. This is language drawn from post incident advisories offered to responders and civilians after Hurricanes:

Katrina, Rita, Sandy and more.

Feel free to share and use it to protect yourselves.

Recommendations for Respiratory Precautions in Areas Impacted by Hurricane Harvey.

People who are cleaning up or living in affected homes can protect themselves by following these tips:

· Open windows and doors to air out the area as much as possible.

· Keep children and pets away from areas being cleaned.

· Use a dust mask and safety glasses or goggles if cleaning will produce dust. Dust masks that fit the face and nose, as well as respirators (N-95s) provide better protection. Consider vapor cartridges for settings where chemical byproducts, off-gassing or other noxious and toxic materials may be liberated.

· Clean with soap (e.g., dish detergent) and water. Do not use full-strength bleach or mix bleach with other cleaning products, like ammonia. Use only diluted bleach on areas that need to be disinfected.

· If your home has a lot of flood damage, consider hiring a professional to do the cleanup and repairs.

· Never use portable generators or gas-powered tools indoors.

· Wash your hands often with soap and water, especially before eating or drinking. Alcohol based hand sanitizers can be used if water is not available, but this is not a substitute for hand washing as it will not remove certain chemical residues.

Many individuals and patients may be concerned about mold and how to remediate the problem.

· The first step to mold cleanup is to control the moisture problem. The source of the water must be identified and corrected.

· Porous materials with extensive mold growth should be discarded (e.g., drywall, carpeting, paper, and ceiling tiles).

· All wet materials must be thoroughly dried. If that is not possible, they should be discarded.

· Mold growing on hard surfaces (e.g. wood and concrete) can be cleaned. Small areas can be scrubbed with a cleaning rag wetted with diluted detergent. Rubber gloves and a dust mask are recommended for jobs other than routine cleaning. For a large mold problem or if you are highly sensitive to mold, an experienced professional should do the work.

· In areas where it is impractical to eliminate the moisture source, a dluted bleach solution (the CDC website has actual mixing instruction, included in a previous blog on this site)) can be used to keep mold growth under control. In areas that can be kept dry, bleach is not necessary, as mold cannot grow in the absence of moisture. When using bleach, ensure that enough fresh air is available because bleach may cause eye, nose, or throat irritation.

· Continue to monitor the area for new mold growth and signs of moisture. This may indicate the need for further repairs or material removal.

Recognizing Mold

• Mold comes in many different colors, may look furry, slimy, or powdery, and often smells musty, stale, or earthy. The type of mold present does not affect how it should be cleaned. If you can see or smell mold, assume you have a mold problem. Don’t waste your money on air test ng, because mold spores are always in the air.

• Mold can grow on ceiling tiles, wood products, paint, wallpaper, carpeting, sheetrock, clothing, furniture and other materials. Aside from obvious areas where mold is visible, inspect hidden areas for discoloration, mold growth and odors, such as crawl spaces, attics, and behind wallboards or paneling. Look also at carpet backing and padding, wallpaper, moldings (e.g., baseboards), and insulation.

• Check the home’s exterior and under/behind siding to look for damage and wetness. You may have to remove the siding to allow the structure to dry out thoroughly.

What to do About Mold in Flood Damaged Homes

• Protect yourself by wearing an N95 dust mask or better (see above) (available at hardware stores) rubber gloves, and washable work clothes when doing repairs.

• Isolate wet/moldy/work areas from living areas.

• Ventilate the work area with open windows and fans.

• Remove wet sheetrock, carpet ng, furnishings and other building materials to prevent mold growth.

• Reduce dust by wetting down flood and mold-damaged materials before removal and disposal.

Respiratory Concerns and Mold Cleanup

• Clean off mold from metal, glass and other hard surfaces with water and detergent, such as liquid dish detergent.

• Use dilute bleach on surfaces contacted by flood waters or sewage. Use three tablespoons of unscented chlorine bleach per gallon of water. Do not use full strength bleach or mix bleach with ammonia or other cleaning products – this can cause hazardous fumes.

• Dry out your home before replacing walls and flooring. Use dehumidifiers, ventilation and heating.

• Consider getting professional help if you have a large mold problem or are highly sensitive to mold.

Common Symptoms of Mold Exposure:

• Nasal and sinus congestion

• Eye irritation, such as itchy, red, watery eyes

• Respiratory problems, such as wheezing and difficulty breathing

• Cough

• Throat irritation

• Skin irritation, such as a rash

• Headache

Exposure to high amounts of mold is not healthy for anyone. However, some individuals may be more susceptible to health problems from mold exposure.

These include:

• Individuals with current respiratory sensitivities (e.g., allergies, asthma, or emphysema)

• Individuals with a compromised immune system (e.g., HIV/AIDS infection, organ transplant patients, or chemotherapy patients)

About Asthma:

Dust and other indoor irritants can make asthma worse. People may also not be able to take their usual asthma medication due to the storm, which can lead to asthma attacks. If you have asthma or allergies:

• Make sure you or your children take prescribed medications.

• Avoid tobacco smoke, dust and other irritants as much as possible.

• Get your annual influenza vaccine.

• If you have asthma, follow your treatment plan to help keep it under control.

• See your doctor if you are having health problem