ALBERTA

Alberta Flood Clean-Up Comes With Unique Health Concerns, Doctors Warn

07/22/2013 04:07 EDT | Updated 09/21/2013 05:12 EDT
TORONTO - For residents affected by floods in Calgary and Toronto, it appears the worst is over. In parts of Alberta like High River, river waters are receding; in the wake of a pair of significant storms that struck Toronto in the last two weeks, basements are being dried out and downed trees cleared off properties.

But while the process of picking up the pieces has begun, storm-related issues have yet to completely dissipate: health authorities are warning residents returning to their homes about medical concerns arising from the clean-up process.

Siobhan O'Beirne, who has been helping friends in the hard-hit High River community reclaim their home, says the outpouring of support and on-the-ground assistance from volunteers has been heartening. But it's also presented challenges due to inexperience and a lack of knowledge about best clean-up practices.

"The reaction from people who weren't affected was incredible. ... People were excited to help in any way they could," says O'Beirne. "There was just a mass of people going down into these areas who knew very little about what they were doing."

In response, the Alberta government has released an online checklist entitled "Returning Home Safely After Flooding." It's part of the process to prevent the most major concerns — injury, infection and lingering psychological distress — among residents of these flood-ravaged communities.

"Only three people died as a result of the flooding, and it would just be an absolute shame if people were injured — or, worse, die — as they move back into their homes," says Dr. James Talbot, Alberta's chief medical officer. "We understand that need to get back to normal as soon as possible, but if they're admitted to hospital, it's going to be even that much longer."

Talbot says he's seen a 10 per cent increase in people going to hospital emergency departments for various kinds of wounds and abrasions, from stepping on a nail to being struck by falling debris.

Before re-entry is allowed, homes must be approved by public health officials, as water damage can render a property structurally unsound. The document details the importance of the order involved in re-entry: once it's been confirmed that utilities have been shut off and water-saturated soil is dry, residents are advised to work patiently and from the ground-up, starting with the basement.

"People really need to have a little patience and wait until the ground is dry, then they need to get the basement dry, and then they need to let the (other) areas dry completely," Talbot says. "It's going to be a long recovery period here, and you have to get the sequence right, because it's one of those things where you either do it right or you're going to have to do it over again."

Many residents use pumps to clear basements of water, but they must be used correctly. Talbot says he's seen a rise in hospital admissions for carbon monoxide poisoning, as some people have been using the devices indoors without proper ventilation.

Appropriate footwear and clothing is vital, too. O'Beirne says she's seen people wade into flood waters and enter damaged homes in shorts and sneakers, only to get scolded by public health officials. Both she and her friend have stepped on nails, but wearing work boots saved them from serious injury or potential tetanus infection.

"It's all pretty common-sense stuff, but in the rush for people to want to re-establish their normal lives — get back in their homes, get their family back together, be able to interact with their neighbours — sometimes people don't take the time and precaution needed," says Talbot.

He's also seen a 10 per cent increase in tetanus vaccinations, and a hike in the use of tetanus medicines, which suggests many residents have let their immunizations lapse.

"We would like everybody to know their tetanus status and know when they're due for their booster. This provides an opportunity to reinforce that with people."

Tetanus is just one potential infection risk. With sewage backups contaminating water, foot blisters can become infected and gastrointestinal infections can cause diarrhea; with displaced homeowners living in crowded shelters, there's also a potential for respiratory problems.

Talbot says such cases have been extremely rare so far, and are decidedly insignificant when compared to the danger from mould, which has crept under the walls of waterlogged homes.

"We breathe in tens of thousands of spores every hour, but (the body) has systems in place for that," says Talbot. "In wet conditions, you get a lot more mould and a lot more spores, and they can cause irritation anywhere along the respiratory tract. You can end up with sinus irritation or sore throats or lung inflammation, or in some severe situations, pneumonia."

Talbot and Wolf Saxler, manager of healthy environments for Toronto Public Health, agree that whenever possible, residents should hire professionals who know best how to handle and dispose of ruined or mouldy materials.

"If they're not covered (by insurance), they may have to get a private contractor or do the work themselves," says Saxler. "It's nowhere near what it is in Alberta, but it's still worrying and it disrupts people's lives. ... People want to have their lives back to normal as soon as possible. That's why we ask people to phone their insurance company first. That's insurance's role, to get you back what you lost."

But a silent threat looming is the flood's impact on mental health.

On the ground in High River, O'Beirne has seen hope, as well as despair. She says a neighbour who works as a government employee was too busy with work to address his property in the first week and was unable to help with the clean-up process, having "lost all faith in the fact that his house could be saved."

"Something that a lot of the volunteers brought to the families was almost a light-hearted nature to the construction sites," says O'Beirne. "It's really hard for the families to make jokes about what's happening, but it's often what they needed. ... (My friend) just had to joke about everything because if he didn't, it was like, 'I can't deal with this.'"

In Manitoba, where the Red River floods with regularity, mental health is targeted as a priority, advice that the province passed on to the Alberta health authority. Michael Routledge, Manitoba's chief medical officer, says that in the last few years, flood-impact teams have been deploying a mental health worker to encourage regular breaks to avoid burnout, and to provide a person who will listen.

"After the flood, people can really pour themselves into getting their lives back into order, and that can be exhausting," says Routledge. "So not only are you mentally and physically exhausted, but you're dealing with all sorts of stresses you're not used to dealing with."

Previous conditions, like schizophrenia or bipolar disorder, can be made worse, but the fallout from flooding can also leave an otherwise healthy person reeling.

"It's not just the loss of the possessions or their homes, it's the memories, the sense of security you used to have, your retirement plans, your ability to finance your children going to university," says Talbot. "There's just a lot of things that represent significant losses in people's lives, so there's a lot of grieving that's going on."

He says public health inspectors — often the first point of contact for many residents — say many people simply want to share their stories.

Talbot says he was moved when visiting a booth in High River set up for residents to place Post-it notes asking for advice, requesting items for the town, or simply expressing how they were feeling.

"One of the Post-it notes read: 'How long will it be before I can sleep again when it rains?'" he says.

"(Their homes) had been a source of comfort for them, and now some of them for days, weeks, months, potentially years, that fear — that the next time there's a big rain that something bad can happen — is going to be with them for a long time."

Ultimately, says Manitoba's Routledge, cleaning-related health concerns are more anecdotal than scientifically proven, and it's unclear if long-term health problems can develop from flood clean-up. Yet, despite the paucity of in-depth studies around the world, the system in Canada appears to be working.

"There's been the odd effort to try to (monitor long-term effects), but then other priorities have unfortunately eclipsed that," he says. "I think going forward that's going to be something we'll try and do more of."

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