Water Damage >> Cleanup After Hurricane Damage

Health Effects of Exposure to Water-Damaged New Orleans Homes Six Months After Hurricanes Katrina and Rita Objectives.We investigated the relation between respiratory symptoms and exposure to water-damaged homes and Cleanup After Hurricane Damage the effect of respirator use in post hurricane New Orleans, Louisiana. 

Methods. We randomly selected 600 residential sites and then interviewed 1 adult per site. We created an exposure variable, calculated upper respiratory symptom (URS) Cleanup After Hurricane Damage and lower respiratory symptom (LRS) scores, and defined exacerbation categories by the effect on symptoms of being inside water-damaged homes. 

We used multiple linear regression to model symptom scores (for all participants) Cleanup After Hurricane Damage and polytomous logistic regression to model exacerbation of symptoms when inside (for those participating in clean-up).Results.Of 553 participants (response rate=92%), 372 (68%) had participated in clean-up; 233 (63%) of these used a respirator. 

Respiratory symptom scores increased linearly with exposure (P<.05 for trend). Disposable-respirator use was associated with lower odds of exacerbation of moderate Cleanup After Hurricane Damage or severe symptoms inside water-damaged homes for URS (odds ratio (OR)=.51; 95% confidence interval (CI)=0.24, 1.09) and LRS (OR=0.33; 95% CI=0.13, 0.83).

Conclusions.Respiratory symptoms were positively associated with exposure to water-damaged homes, Cleanup After Hurricane Damage including exposure limited to being inside without participating in clean-up. Respirator use had a protective effect and should be considered when inside water-damaged homes regardless of activities undertaken.

In August and September 2005, Cleanup After Hurricane Damage Hurricanes Katrina and Rita caused unprecedented flooding in New Orleans, Louisiana. In the aftermath, visible mold growth occurred in approximately 44% of area homes.1 Air sampling for mold spores conducted in October and November 2005 showed high levels both indoors and outdoors.

2 Similar sampling in October 2005 showed elevated levels of endotoxin, a bacterial cell wall component, Cleanup After Hurricane Damage in water-damaged homes. 

3 A 2004 Institute of Medicine report concluded that sufficient evidence exists for associating the presence of mold or other dampness-related agents in damp buildings with nasal and throat symptoms, Cleanup After Hurricane Damage cough, wheeze, asthma exacerbations in sensitized asthmatics, and hypersensitivity pneumonitis.

4 Since that report, there has been additional evidence to suggest that asthma can develop during childhood 5 Cleanup After Hurricane Damage and in the occupational setting6as a result of exposure to dampness or mold.The conditions in New Orleans after the hurricanes thus posed a potential health risk to thousands of returning residents. 

In light of these circumstances, Cleanup After Hurricane Damage public health officials made recommendations on the use of personal protective equipment. Among these was the recommendation for the general public to use particulate respirators when around mold-contaminated dust, such as might be encountered during clean-up activities.

7,8 The risk of health effects for residents involved in activities less likely to disturb mold-contaminated materials, such as visually inspecting the interior of an affected home or collecting belongings, was thought to be lower. Thus, for such activities, Cleanup After Hurricane Damage the public was advised that respirators were not usually needed.

8 Although respiratory illness and asthma exacerbations have been noted following flooding, Cleanup After Hurricane Damage 9 the contributory role to respiratory disease of postflood exposure to water-damaged homes has not been well documented. We sought to better understand the relation between respiratory symptoms and exposure to water-damaged homes in posthurricane New Orleans. 

Given the recommendation about respirator use Cleanup After Hurricane Damage and the observation that respirator use was common among the public following the hurricanes, 10 a second objective was to determine the effect of respirator use on symptoms. We conducted a population-based investigation to address these issues.

METHODS Participants We randomly selected sampling locations in Orleans Parish (city of New Orleans) using geographic information system software (ArcGIS version 9.1, ESRI, Redlands, California). To focus on residential areas, Cleanup After Hurricane Damage we eliminated 6345 of the parish's 10181 census blocks.

11 Eliminated blocks included those with very low or very high housing density Cleanup After Hurricane Damage and those in neighborhoods that remained uninhabited. We generated 600 random way-points (unique locations on the basis of latitude and longitude) across the remaining 3836 census blocks.Each waypoint served as a starting point to locate participants. 

A survey team navigated to a waypoint using a global positioning system device and identified the nearest home. English-speaking adults (18 years and older) associated with the home as owner, current occupant, or relative or friend of the owner or Cleanup After Hurricane Damage current occupant were eligible. Individuals at a home as paid employees (e.g., remediators) were not eligible. 

However, we did not exclude remediators encountered at their own homes. If unable to conduct an interview at the first encountered home, Cleanup After Hurricane Damage the team proceeded in a systematic fashion to the next home. Once the team conducted one interview at the waypoint, they navigated to the next waypoint and repeated the process.

Questionnaire From March 4 through March 11, 2006, we interviewed participants using a 10-minute anonymous questionnaire regarding respiratory symptoms; physician diagnoses of asthma, eczema, and hay fever; smoking history; race and ethnicity; Cleanup After Hurricane Damage experiences with water-damaged homes; and experiences with respiratory protection. 

Questions on respiratory protection addressed whether, during clean-up since the hurricanes, Cleanup After Hurricane Damage the participant had ever used noncertified dust and surgical masks (hereafter, "masks") or National Institute for Occupational Safety and Health (NIOSH).

Certified disposable and reusable respirators (hereafter, "respirators"), including disposable N-95 filtering facepiece respirators (hereafter, "N-95 FF respirators") and reusable half-face and full-face respirators (hereafter, Cleanup After Hurricane Damage "reusable respirators").12 Participants who had used more than 1 type of respiratory protection could indicate each type. 

We displayed photographs and examples of masks and respirators during the interviews.Questions on respiratory symptoms addressed upper respiratory symptoms (URS; "stuffy, itchy, runny nose," "sinus problems," and  Cleanup After Hurricane Damage "hoarseness or dry, sore, or burning throat") and lower respiratory symptoms (LRS; "wheezing or whistling in chest," 

"Chest tightness," "attacks of shortness of breath," and "coughing attacks"). We asked participants to grade the extent to which they had experienced each respiratory symptom since the hurricanes as "none," "mild," or Cleanup After Hurricane Damage "moderate or severe." 

Those who reported respiratory symptoms were asked how Cleanup After Hurricane Damage being inside a water-damaged home affected symptoms ("same," "worse," or "better"), aggregated as URS or LRS.Statistical AnalysesExposure to water-damaged homes.

We set a "clean-up score" equal to the sum of the reported number of homes cleaned that had less than 50% of walls and ceilings covered with mold Cleanup After Hurricane Damage and twice the reported number of homes cleaned that had 50% or more covered with mold.

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