How To Prepare For A Flood

Transcription

1 Salvage what you can. Personal property and furnishings that are moist or wet 24 hours after floodwater recedes will have mold growing in or on them. Clothing and linens may be salvaged by washing with chlorine bleach and detergent, or sent to commercial laundries or dry cleaners. Upholstered furniture, mattresses, and furniture made of particleboard or wafer board should be thrown away. Get information on saving valuable papers, books, and photographs from the American Red Cross. Remove contaminants. Make sure that any chemical contamination and hazardous materials have been removed from the building. For proper disposal, contact your local waste disposal service. Make sure that all parts of the building are dry before rebuilding or repairing. Mold will grow on replacement materials if the studs, subfloor or other building parts are not completely dry. The structure should be tested with a moisture meter before you start replacing the damaged parts of your home. Clean and dry the right way: Nonporous materials (materials that don t soak up water) and furnishings and other surfaces should be thoroughly cleaned, disinfected and allowed to dry completely. First, scrub all surfaces with detergent and water and rinse well. (Scrubbing removes mold, mold spores, and the dirt that mold and mildew can grow on.) Then, disinfect everything. Liquid chlorine bleach should be used to disinfect and kill any remaining mold and mildew. Follow the instructions on the label and let the bleach solution remain on the surface for at least 15 minutes before rinsing and drying. After cleaning and disinfecting, you must completely dry each item or mold and mildew will return. To speed drying, keep fresh air circulating. In conclusion, the most important thing you can do to protect yourself is to use common sense and be aware of safety and health risks. Do not enter a building that is clearly unsafe. If you have questions or need assistance, contact your local health department or building inspections office. Other useful information for flood cleanup and health and safety issues can be found at the following web sites: NIOSH: CDC: American Red Cross: EPA: getting back into your home safely building that has been flooded can be a dangerous place. This N.C. Department of Health and Human Services Division of Public Health - Occupational and Environmental Epidemiology (919) N.C. Department of Crime Control and Public Safety Division of Emergency Management (919) State of North Carolina Department of Health and Human Services Division of Public Health Occupational and Environmental Epidemiology Branch (919) North Carolina Department of Crime Control and Public Safety Division of Emergency Management (919) Last Modified: August /10 A brochure will help you understand and protect you and your family from the hazards of flooded buildings. It will also provide you information about cleaning up and making your home safe to live in again. Watch out for these dangers: Never assume that a water-damaged house is safe. Going into a building that has been flooded, even after the water is gone, can present a wide variety of hazards that can cause injury, illness or even death. Do not allow children in the home after the flood or while it is being inspected, cleaned or repaired. getting back into your home safely Electrical hazards - Do not enter a flooded or wet building if the power is on. If any electrical circuits have gotten wet, turn off the power at the main breaker or fuse box and leave it off until the electrical wiring or equipment has been inspected and repaired by a licensed electrician and approved by your local building inspector. Structural damage - Do not enter a building if the framing or foundation is damaged. Look carefully before you enter. Leave immediately if shifting or unusual noises signal a possible collapse of the building. Contact your local building inspector for a safety inspection. Hazardous materials - Dangerous materials found in flooded homes may include pesticides, fuel oil, gasoline, chemicals and other substances that might have been brought in or spilled by flood waters. Damaged buildings may also contain asbestos and lead-based paint, which can cause health problems during cleanup. Practically any building material that is not obviously solid wood, metal, or glass could contain asbestos. Lead-based paint can be found pre-1978 housing and is still used in commercial and industrial buildings.

2 Animal and insect related hazards Look carefully before entering a building to determine if there are displaced animals in the building such as dogs and cats, raccoons and rodents. Watch out for snakes and insects such as wasps, fire ants, and mosquitoes. Injuries - Falling objects, broken or damaged building components and slick surfaces can cause injuries, broken bones, and cuts. Lifting heavy objects can cause back injuries and muscle strains (see Stay safe while you work. ). Biological hazards - Bacteria, viruses, fungi, (mold and mildew) and other microorganisms can cause illness when you breathe them in, take them into your body through your mouth, or take them in through non-intact skin. Bacteria, viruses and other microorganisms may be left indoors by floodwater, while mold and mildew may grow indoors after the floodwater has receded. Bacteria and Viruses and other microorganisms - If you accidentally get floodwater or the dirt it leaves behind into your mouth, you might develop gastrointestinal (digestive tract) illness. Mold and Mildew (Fungi) Mold will grow on many building materials such as, furniture, carpet and other items that stay wet for more than 24 hours. Mold colonies are the fuzzy or patchy white, green, brown or black growths that you will see on wallboard, wood furniture and cabinets, clothing, wall studs, and almost any other surface. Molds releases tiny particles into the air that can cause allergic illnesses like hay fever (coughing, sneezing, eye irritation), asthma symptoms, or other respiratory illness that can be serious. Some molds may also produce toxins that could cause other illnesses. We are exposed to mold every day, indoors and out, but mold contamination can be quite severe in a water-damaged building. Health risks are greater for people with allergies or asthma, people with compromised immune systems and for the very old or very young. Stay safe while you work: getting back into your home safely... Wear a hard hat and safety goggles when there is a danger of falling materials. Wear leather work gloves to protect your hands from cuts, or rubber gloves to prevent exposure to hazardous chemicals. Wear rubber boots or hard-soled boots, preferably with steel toes, when working and lifting. Wear a facemask. When you enter a flooded building, wear a dust mask or respirator to reduce your exposure to mold. At hardware or home supply stores, look for a mask with NIOSH approval and an N-95 rating. Both of these marks should be on the respirator and the container. Read and follow the instructions on the mask package. Remember that dust masks will only provide protection against solid materials such as dusts and liquids. Dust masks provide no protection against gases and vapors. Dust masks are disposable and should be thrown away at the end of the day. Stay alert. Accidents happen when people are tired. Take the breaks you need, and drink plenty of fluids (bottled water, juice, soft drinks) to avoid dehydration. Never drink alcohol when you are working in a flooded building. Stay alert for misplaced animals, snakes and biting or stinging insects. Protect yourself from bacteria, viruses and other microorganisms. To keep from getting sick, wear rubber gloves while working; do not eat, drink, or smoke in the house; wash your hands frequently with soap and rinse with clean water. Wet down mold. Before you touch, move, or clean moldy or mildewed materials, wet the mold with a soapy solution from a spray bottle to prevent the mold from getting into the air. Do this even if the material is already wet because the mold probably won t be wet. Remember that mold can still make you sick even after you have sprayed disinfectants ( mold/mildew killer ) to kill it. Be careful lifting. To avoid back injuries when lifting or handling heavy and bulky loads like furniture or carpet, avoid lifting loads of more than 50 pounds per person. Get help. Before you disturb or remove materials that may be hazardous, take precautions to prevent exposure. If there is a noticeable chemical odor and/or a spilled container of a hazardous material in the building, ask your local health department or fire department for help. If there is asbestos or lead paint in the building, call NC Health Hazards Control at (919) Be prepared. If you get a cut or a puncture wound that is exposed to floodwater or the dirt it leaves behind, see a doctor. Make sure your tetanus immunization is up-to-date before you work on the house. Once immunized, adults should have a routine booster every ten years. Take these steps: If a flooded building is to be safely reoccupied, it must be completely dry. Dirt and trash left by the flood must be removed from building materials and furnishings. Moldy or mildewed items must be completely cleaned and disinfected or must be thrown away. If not, mold and mildew will return and possibly cause health problems for you and your family in the future. Before going back to live in your home, take the following steps: Get the mess out. Remove all floodwater, dirt, and debris left behind by the floodwater. Remove mold and mildew. Any materials or furnishings that soaked up water should be removed from the building. Other moldy or mildewed building materials should be thoroughly cleaned and dried or removed and replaced. Check out the floors. Carpet and padding cannot be cleaned well enough to prevent mold and mildew from growing. Throw them away. Take out the flooring and sub-flooring if they cannot be completely cleaned and dried or if they have started to deteriorate. The remaining floor and/or sub-floor must be dried out completely and disinfected. Make sure no moisture is trapped in or on the sub- floor. Sub-flooring made of particleboard or plywood should be removed and replaced because it can t be completely dried and disinfected. Crawl spaces should also be cleaned out and dried. Dry out walls. Walls that were wet should be stripped to the studs and the insulation removed. Walls must remain open to allow them to completely dry. Other wall cavities should be inspected for visible mold growth. Any area inside a wall cavity with visible mold growth should be opened, cleaned, decontaminated and dried. The exterior of each building (siding, etc.) will need to be evaluated to see if any or all of the exterior materials should be removed. Plaster, brick and concrete block walls can probably be cleaned, disinfected and completely dried. Check Heating Ventilation and Air-Conditioning Systems (HVAC). If the HVAC system or air ducts were flooded, use special care. The inside parts of heating and air-conditioning systems that contacted floodwater are hiding places for mold. If mold grows in the system, mold particles may get into the air and make people sick. The interior components (furnace, air-conditioner cooling coils, and fans) will need to be inspected, cleaned and decontaminated by professionals. Air registers (vents) and diffusers should be removed, cleaned, disinfected and reinstalled. Replace lined air ducts and ductboard that got wet. Bare sheet metal ductwork can be taken apart, washed, disinfected, dried, and put back together. Air duct cleaning services are not very effective in cleaning flooded air ducts and are only useful on bare sheet-metal ducts.

3 Hurricane Fact Sheet Important Precautions During and After a Hurricane Avoid Dangerous Areas If waters continue to rise, evacuate the area immediately. Do not walk in, play in or drive through flooded areas. Flood water contains hidden hazards and may be deeper and faster-moving than it appears. Wear shoes at all times. Stay away from downed power lines. If you get a cut or puncture wound, get a tetanus booster shot if you have not had one in the past 5 years. Drinking Water Public and private wells that have been flooded or have lost electricity may have become contaminated. Water must be treated before use (see below). Contact your health department about well water testing. Use only bottled water for drinking and cooking, if available. Tap water used for drinking, cooking, brushing teeth or making ice must be boiled for at least five minutes before use. Pregnant women and children should use bottled water instead of tap water or boiled water. Baby formula should be made with bottled water. Boiled water is not good for babies and pregnant women. However, if bottled water is not available, do not use untreated water--use boiled water until bottled water becomes available. If you cannot boil your tap water, it can be treated with liquid chlorine bleach, using 8 drops (1/4 teaspoon) to one gallon of tap water. (WARNING! Do not use bleach that is scented or contains soap.) Mix thoroughly and let stand for 30 minutes before using. Do not use floodwaters for any use. Food and Medicines Any foods (including those in cans, plastic or glass), medicines and cosmetics that have come in contact with floodwaters should not be eaten. Throw them away. Food in the refrigerator should be thrown away if the power has been off for more than 4 hours or if food is warmer than 41 degrees Farenheit. Frozen food should be thrown away if it has thawed. Do not re-freeze thawed food. Medicines and cosmetics that have been in flood waters should be thrown away. June 2010

4 Hurricane Fact Sheet: Important Precautions During and After a Hurricane Septic tanks If your septic tank has been flooded, do not use the plumbing system while the septic tank is still under water. Do not use your plumbing system if sewage water has backed up into your home. Try to reduce the amount of debris that enters the septic tank or drains. Avoid contact with sewage from a septic tank that is not operating. For information on repairing or constructing a septic tank system, contact your local health department. Insects and other animals Bees, wasps, fire ants, snakes and other animals have lost their homes and may be very dangerous. Avoid contact with these animals as much as possible. Be cautious in moving items where animals could be hiding. Standing waters are breeding grounds for mosquitoes. Use insect repellant, long sleeves, pants, socks and shoes, if possible. Empty standing water from containers inside and outside the home. Avoid touching dead animals. Cleaning up your home Take extra precautions to protect your health and safety. If your home was flooded during the hurricane, assume that everything touched by flood water is contaminated and will have to be disinfected or thrown out. Most clean up can be done with household cleaning products. Remember to wash your hands frequently during clean up and always wear rubber gloves, a disposable dust/mist face mask (NIOSH approved N-95 type) and, if possible, waterproof boots. If your ceiling was damaged, wear a hard hat and safety glasses. If your home has been flooded, you should: Before turning the power back on, have your home s electrical system checked out by an electrician. If the pilot light on your natural gas furnace, hot-water heater or stove has gone out, have it re-lit by a professional. Throw away flood-contaminated mattresses, upholstered furniture, carpets and padding, wallboard and wallpaper because they can not be cleaned all the way through. Clean plaster or tile walls, hard-surface floors and other household surfaces by scrubbing with soap and water and disinfect them with a solution of one cup of bleach to four gallons of water. Pay particular attention to areas that come in contact with food, or where small children play. After cleaning a room or item, go over it again with disinfectant to kill germs and odors left by flood waters. Dry everything completely after cleaning. Use a two-bucket method when cleaning. Put cleaning solution in one bucket and rinse water in the other. Replace rinse water frequently. 11:13 AM June 2010

5 Hurricane Fact Sheet: Important Precautions During and After a Hurricane Wash all linens and clothing in hot water with a disinfectant, or dry clean them. Throw them away if they are moldy or mildewed. Materials should be completely dry before cleaning, or mold and mildew will grow. If items cannot be completely dried out, throw them away. If materials become moldy or smell musty, they are probably contaminated and should be thrown away. Remove mildew on hard surfaces with household mildew cleaner; a mixture of five tablespoons washing soda or trisodium phosphate to a gallon of water; or 1/4 cup of laundry bleach to a gallon of water. If sewage backed up into your home, wear rubber boots and waterproof gloves during cleanup. Remove and discard contaminated household goods such as wall coverings, rugs, upholstered furniture, cloth and drywall that can't be disinfected. Avoid touching dead animals. Use gloves or a shovel to move dead animals, and then wash hands thoroughly. Contact your local health department about proper disposal of dead animals. Empty standing water out of birdbaths, tires, flower pots and other containers. For more information on cleaning up after a flood, contact your local Emergency Management Office, county health department or Red Cross chapter. You can also get information from the following internet sites: or and 11:13 AM June 2010

6 Environmental Health Emergency Preparedness and Recovery Guidance Manual For North Carolina 2008 Division of Environmental Health NC DENR 2728 Capitol Boulevard 1632 Mail Service Center Raleigh, NC 27699

7 Contents 1. Introduction People at Increased Risk Emergency Supplies 3-1 Car safety 3-1 Emergency supplies for EHS Loss of Power & Food Safety Water Emergencies 5-1 Types of Water Supply Emergencies 5-1 Contamination 5-1 Loss of Water 5-1 Drinking Water 5-1 Flushing Toilets 5-2 Back-Up Water Supplies 5-2 On-Site Wells 5-2 Transported Water 5-3 Types of Notifications 5-5 Recommended Use Restrictions for Food Service Establishments 5-7 Recommended Use Restrictions for Child Care Centers 5-8 Recommended Use Restrictions for Institutions 5-10 Recommended Use Restrictions for Lodging Establishments 5-12 Guidelines for Food Preparation during Water Emergencies Potential Dangers of Re-entering Damaged Buildings 6-1 Electrical Hazards 6-1 Fire and Explosion Hazards 6-1 Slip Hazards 6-1 Animals 6-1 Chemicals 6-2 Mold 6-2 Mosquitoes 6-2 Structural Failure 6-2 Carbon Monoxide 6-3 Asbestos 6-3 Overexertion and Musculoskeletal Injuries 6-4 Heat Stress 6-4

8 Falls 6-5 Contaminated Food and Water Supplies Disinfecting a flooded well Guidelines for Cleaning, Salvaging and Remodeling 8-1 Food Service Establishments and Retail Stores 8-1 Child Care Centers 8-4 Lodging Establishments and Institutions Emergency Shelters Sanitation and infection control Decontamination of Ice Machines Septic Systems Solid Waste Insects 13-1 Stinging Insects 13-1 Mosquitoes 13-1 La Crosse encephalitis (LAC) 13-2 West Nile virus encephalomyelitis (WNV) 13-2 Eastern Equine Encephalitis (EEE) 13-2 Snakes and Fire Ants Animal Information 14-1 Rabies 14-1 Snakes and other Reptiles 14-1 Domestic Animals 14-1 Dead Animal Carcass Removal Resources 15-1

9 1. Introduction This manual has been developed for use by authorized environmental health specialists working in North Carolina. It is intended to give guidance to specialists working after disasters during periods of recovery, most likely in conjunction with a declared state of emergency. It is not intended to be used for small-scale events affecting only limited numbers of permitted establishments. Disasters which may lead to a declared state of emergency include hurricanes, flooding, terrorist acts, or any other event affecting a large area or a large number of individuals. This manual is not intended to replace good professional judgment based on the facts at hand. The specifics of any situation may warrant a different course of action than what is prescribed here. Environmental health specialists should utilize all resources available when making decisions in the field, consulting with other emergency response personnel and their supervisor. This manual is provided as another resource to be considered when making decisions in post disaster situations.

10 2. People at an Increased Risk Some people are more vulnerable to contaminants in food and water due to health conditions common to people in their age group or with similar health status. Children are at greater risk for illness due to their immature immune system. They may require greater supervision due to their lack of education and their natural interest in exploring their environment, often involving unsafe food practices. Pregnant women also are at greater risk due to immaturity of defense system in the developing fetus. Elderly people over 65 years of age can lose some of their natural defenses as part of the aging process. Diminished senses of sight, smell and taste can fail to warn seniors of spoiled or unsafe food or water. Reduced stomach acid production, often related to aging, reduces the defense needed to protect a mature adult from contaminated food or water. Slower immune response also makes seniors more vulnerable to the spread of infection. Persons that are immune-compromised due to medical treatment or disease are at greater risk for illness. People with severely compromised immune systems can include people with cancer undergoing chemotherapy, people who have undergone organ transplants, people with HIV/AIDS and people with other immune system disorders. People with alcoholism can also be more vulnerable to infection. During an emergency involving food or water supplies, people with compromised immune systems need to take extra precautions such as boiling water or switching to bottled water for drinking. Foods should be thoroughly cooked, and any food suspected of being contaminated or to have lost refrigeration should be discarded. 2-1

11 3. Emergency Supplies Car Safety Items to have in your trunk. At least one warm blanket or a sleeping bag Cellular phone or an emergency phone Boots and socks or at least extra "rugged" shoes Extra warm clothing like pull-overs, sweatshirts, sweatpants, gloves, etc. as well as a raincoat, water resistant boots in flood prone areas Snack items like crackers with cheese or peanut butter, items that will keep fresh for a winter's season Bottled water and a few items to drink First aid kit Insect repellant Flares Non-clumping kitty litter for traction Small shovel Flashlight with new batteries Heavy gauge jumper cables If you may have kids in the car with you, pack for them as well, and include some travel size games, books or coloring books and crayons to help keep them busy and reduce any fears that they may have about being stuck. Kids may be more comfortable too if they have a couple "car size" pillows they can nap on. It is also a good idea to let others know when you should be expected to arrive. Even if you are just going to be going home--let family or neighbors know ahead of time any plans you have or any changes in plans; if you are not home within a given expected time period, then at least you will be missed that day/night. If a storm or bad weather is expected, also tell someone the route you will be taking. Emergency services will be able to assist you faster if they know where to look. 3-1

12 Emergency Supplies for Environmental Health Staff Prior to event, evaluate staff vaccination status and seek guidance from medical provider. Identification both county and state. Personal Protective Equipment o Gloves single use food grade plastic gloves and leather work gloves. o Safety glasses o Particulate dust masks o Hard hats (if necessary based on response plan) Cell phone with charged batteries or inverter (which will allow cell phones to be charged from car battery). Battery powered radios Emergency contact list with home and cell phone numbers and a current phonebook Emergency contact plan and location Digital or disposable camera Plastic bags, assorted sizes as well as biohazard bags Bottled water Shelf stable food and snacks Clipboard, notebooks, pens and pencils Large flashlight with extra batteries Duct tape Notices that may need to be posted (Do not drink water, boil water, etc.) o Other educational and written materials First aid kit Insect repellant Soap and paper towels, pre-moistened detergent towelettes Cash It is important to remember to make arrangements for 4-wheel drive vehicles if available and to fill vehicles with fuel. Additional Euipment for Food and Lodging Staff: Thermometer / thermocouple Alcohol prep pads Flashlight Food grade plastic gloves Alcohol based instant hand sanitizer Sanitizer test strips 3-2

13 Forms or other pertinent paperwork Spare batteries for equipment as needed Additional Equipment for On-Site Water Protection Staff: Boots appropriate for conditions Outdoor clothing Snake gators / snake bite kit Mosquito repellent Educational materials discussing septic tank maintenance 3-3

14 4. Loss of Power & Food Safety During a complete power loss, it would not be possible for an establishment to continue operating safely, and ultimately, it should close. Whenever power is lost, all refrigerated and frozen food should be evaluated before it is used or re-cooled. The loss of power usually means a loss of refrigeration and freezing capabilities. When this does happen, the food must be examined to determine if it is safe for human consumption. Remember, the bacteria which can make you sick cannot be seen or smelled. Food often appears normal even after it has become dangerous to eat. The only way to assess if it is safe is by using an accurate thermometer to determine if any of the potentially hazardous food has risen above 41 F. The Rules Governing the Sanitation of Food Service Establishments allows food to be stored at 45 F. After a disaster when the cooling equipment has warmed up, a standard temperature should be used, which will allow the equipment to recover before the food actually enters the danger zone. All potentially hazardous food (food requiring refrigeration) which is found above 41 F should be discarded and not served. Potentially hazardous foods those 41 F or below should be returned to operating refrigeration equipment and monitored to make sure the proper temperatures are maintained or cooked to proper temperatures immediately for service or hot holding. REMEMBER When in doubt, throw it out! Frozen, partially-thawed food is safe to cook or refreeze if it still contains ice crystals or has not risen above 41 F. If cooked food has been dripped on by raw meats, discard it regardless of the temperature is as it probably has been contaminated and is no longer safe to eat. It is important to keep the refrigerator doors shut as long as possible to keep the cold air inside the equipment. A refrigerator will keep food cold for a few hours; a full freezer can be expected to keep food for 24 to 48 hours. Make sure all food is looked at and evaluated immediately after power is restored. Re-cooling or re-freezing food that has been out of temperature for over two hours will not make it safe to eat, so if there is any doubt, throw it out. The Food and Drug Administration offers the following food safety information for expected power outages and flooding from a hurricane. In the event of power outages or floods from a hurricane, the U.S. Food and Drug Administration says the most significant food safety challenge consumers will face will be keeping refrigerated foods at or below 41 F and frozen food at or below 0 F. Perishable food such as meat, poultry, seafood, milk and eggs that are not properly refrigerated or frozen may cause illness if consumed, even if they are thoroughly cooked. The FDA says that if flooding is an issue, consumers also will need to evaluate the safety of their stored food and water supply. 4-1

15 Use the following guidelines to keep your food safe when you experience a loss of power. Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. The refrigerator will keep food cold for about four hours if it is unopened. A full freezer will keep the temperature for approximately 48 hours (24 hours if it is half full) and the door remains cold. Buy dry or block ice to keep your refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic foot full freezer for two days. Dry ice produces carbon dioxide, a heavy gas that will remain in low spots without assisted ventilation Ventilate indoor areas well to avoid hazardous carbon dioxide concentrations, and avoid skin contact with dry ice. Symptoms of exposure to carbon dioxide include hyperventilation, headaches, dyspnea and perspiration. If you will be eating your refrigerated or frozen meat, poultry, fish or eggs while they are still at safe temperatures, be sure to cook them thoroughly to the proper temperature to assure that any food-borne bacteria may be present is destroyed. Wash fruits and vegetables with water from a safe source before eating. For infants, if possible, use prepared canned baby formula that requires no added water. When using concentrated or powdered formulas, prepare with bottled water if the local water source is potentially contaminated. Once the power is restored you will need to evaluate the safety of the food. If an appliance thermometer was kept in the freezer, read the temperature when the power comes back on. If the thermometer stored in the freezer reads 41 F or below, the food is safe and may be refrozen. If a thermometer has not been kept in the freezer, check each package of food to determine the safety. Remember, you can t rely on appearance or odor. If the food still contains ice crystals or is 41 F or below, then it is safe to cook or re-freeze. Refrigerated food should be safe as long as the power is out for no more than four hours. Keep the door closed as much as possible. Discard any perishable food items (such as meat, poultry, fish eggs or leftovers) that have been above 41 F for two hours. Do not eat any food that may have come into contact with floodwaters. Discard any food in a nonwaterproof container if there is any chance it has been in contact with floodwaters. Undamaged, commercially canned foods can be saved if you remove the labels thoroughly wash the cans, and then disinfect them with a solution consisting of one cup of bleach in five gallons of water. Re-label your cans, including the expiration date, with a marker. Food containers with screw-caps, snap lids, and home canned foods should be discarded if they have come in contact with floodwaters because they cannot be disinfected. Discard wooden cutting boards, plastic utensils, baby bottle nipples and pacifiers if they have come in contact with floodwaters as sanitation of these items cannot be ensured. Thoroughly wash metal pans, 4-2

16 ceramic dishes and utensils with soap and hot water, and sanitize by boiling them in clean water or by immersing them for 15 minutes in a solution of one teaspoon of chlorine bleach per quart of water. For more information on safe food handling, call FDA s toll-free information line at (888) SAFEFOOD

17 5. Water Emergencies When public water systems have problems, which could cause the water supply to be contaminated with bacteria, water users may be advised or notified that the water should not be used for drinking unless it is first boiled or disinfected with chlorine. This notification can be made either by the water system operator or the N.C. DENR Division of Environmental Health, Public Water Supply Section. Users may also be notified not to use water which may have chemical contamination making it unfit for drinking. During such notifications, the division s Environmental Health Services Section recommends the following guidelines for restricting water use. Types of Water Supply Emergencies Contamination Occasionally water supplies are contaminated or are suspected of being contaminated with microorganisms or chemicals due to a break in a water main or other damage to the distribution system. When contamination of a public water supply is suspected, the water utility operator or the Public Water Supply Section may issue an advisory or notice concerning use of the water supply. A confirmed total coliform sample will result in a Boil Water Advisory issued by the N. C. Public Water Supply Section or/and the owner of the water source. A confirmed Fecal Coliform sample will result in a Boil Water Notice. If a water supply is contaminated with chemicals, the Occupational and Environmental Epidemiology Branch of the N.C. Department of Health and Human Services Division of Public Health will likely be consulted to assess the potential health risk. If the water system is regulated by the Public Water Supply Section, section staff will issue a Do Not Drink the Water notice if the health risk is deemed unacceptable. Loss of Water Water supplies can be lost due to problems with the water source such as chemical contamination or drought emergencies, or with the treatment and distribution systems such as floods, power outages and damaged pipes. If your facility loses its primary water source, it will be necessary to find out why the water is off and how long it might take to restore water pressure. Repair and maintenance of the distribution system which can be completed in a few hours may only require an alternative source of drinking water, while longer-term water losses may require an alternative water supply for flushing toilets, bathing, hand washing, cooking, dishwashing, cleaning and other purposes. Obtaining a back-up water supply to avoid loss of essential services requires prior planning. The following are some of the elements necessary in a back-up water supply plan. 1. Drinking Water Water for drinking must be immediately available during a water supply failure. Facilities/establishments are not required to store drinking water on site but should have a plan to obtain it quickly. The amount of water needed for 5-1

18 drinking should be estimated based on two liters of water per person per day for all people. Canned or bottled soft drinks can be used for a short term, but bottled water will be needed for longer-term water losses. Amount of water for 10 people = 20L, or 5.3 gal, or 21 qt, or 34 (20oz) bottles, or 42 pints per day The emergency plan should identify several nearby sources able to supply sufficient quantities of bottled water and how the water will be transported. Possible sources may include bottled water companies, food stores and wholesalers, and beer or soft drink distributors. Bottled water companies are a good source for drinking water because they also have trucks used to transport their product. Local supplies are limited and can be quickly depleted in a large-scale emergency. The N.C. Department of Crime Control and Public Safety, Division of Emergency Management maintains several warehouses with stocks of bottled water to be distributed by the National Guard during such emergencies. Requests for bottled water must be made through the county or local emergency management coordinator. 2. Flushing Toilets Water used for flushing toilets does not need to be suitable for drinking and can be obtained from any available water source. Some possible sources are boilers, water heaters, swimming pools, fountains and ponds. Some means of moving water, such as buckets and carts will need to be available. Toilets can be flushed by dumping one to two gallons of water from a bucket into the toilet bowl. Do not place water in toilet tanks because they are connected to the potable water supply. The emergency plan should identify the source of water for flushing toilets and where to obtain containers and carts needed to move the water to the restrooms. 3. Back-up Water Supplies A back-up water supply will be needed to maintain essential functions such as food preparation, hand washing, bathing, cleaning, dishwashing, laundry and disposal of bodily waste whenever the primary water source is disrupted for more than one day. Generally, the back-up water supply should be planned to provide 25 gallons of water per day for each person unless the plan includes alternatives to reduce the amount of water needed such as switching to single-service dinnerware to reduce dishwashing or outsourcing laundry operations. Facilities regularly serving 25 or more patients and staff are regulated by the Public Water Supply Section and cannot switch to another water source without prior approval from the Public Water Supply Section. Smaller facilities connected to larger public water systems must obtain approval from the Public Water Supply Section and the water supplier before any physical connection is made to the building plumbing system. 4. On-site wells Some facilities/establishments have on-site wells to provide back-up water in an emergency. To serve as a back-up water supply for a building connected to a public water supply, the back-up well must meet all of the requirements 5-2

19 of the Rules Governing Public Water Systems (15A NCAC 18C). The back-up well and storage tank must be purged and the pump run periodically to limit scale and corrosion and prevent the pump from seizing. Only wells that are approved community water supply wells can be physically connected to a building that has a public water supply connection. Those wells must meet all requirements of the Rules Governing Public Water Systems. 5. Transported water Facilities or establishments without a back-up water well will have to rely on tanker trucks to transport water from an approved water source. Use of a tanker truck to move water from one public water supply system to another requires approval from the Public Water Supply Section of the water source, tanker and connection to the facility. Permission will also be needed from the source water system from which the water will be obtained. A Public Water Supply Section regional engineer will need to be notified as early as possible to assist with the necessary approvals. Some considerations which should be included in the emergency plan are: Where to obtain water You can expect some delay getting another water system to approve filling a tanker and identifying where the tanker can draw the water. Identifying another nearby water system and who to contact to provide permission and designate a filling point could help when an emergency arises. Watering points specifically designed for filling tanks are preferred over hydrants, which may allow contamination. During an emergency, a Public Water Supply Section regional engineer should be able to help identify possible source water systems in your area. Where to get a water tanker This can be the most difficult part of the process particularly if a widespread emergency has created a demand for tankers. Food-grade tanker haulers are the best source of tankers because those haulers are used for carrying food products and have the ability to clean and sanitize a truck for delivery of water. Milk haulers may be able to provide a truck in an emergency. Potable water tanks available at most agricultural supply dealers can also be mounted on trucks to haul water. In an emergency you can request help finding a water hauler through the local director of emergency management. The supply of food-grade tanker-haulers in North Carolina is too limited for all institutions to obtain pre-need contracts. It must be understood that hauling water may not be reliable in large-scale emergencies and facilities may still need to be evacuated. Where to park the tanker Since the tanker will need to be connected to the building plumbing, it will need to be close to the building where connective piping can enter the system without crossing traffic areas. Knowing were the truck might be will also help with planning how much pipe will be needed to make a connection. Isolating the building plumbing Before the building plumbing can be pressurized with water from the back-up water supply, it will be necessary to close the connection to the primary water supply. Some hospitals and other large buildings have more than one service connection to the water system. The emergency plan should include a diagram or written description of where the shutoff valve(s) is located. Usually it is a corporation stopcock at the water meter and may require a special tool to close. 5-3

20 How to make the connection Once a tank of water is on site, there will need to be equipment including a potable water pump, pressure bladder tank, pressure switch, pipes and fittings to make a connection to the building plumbing. Pipes and plumbing will have to meet National Sanitation Foundation International/American National Standards Instituted Standard 61 Drinking Water System Components. Chlorine bleach will also be needed to chlorinate the equipment and water prior to opening a connection. Facilities are not required to purchase equipment before it is needed, but the emergency plan should include a shopping list of necessary parts and equipment and a list of suppliers in your area where the materials can be obtained. Electricity Depending on the emergency, an electric generator may be needed to power the water pump. If water is introduced to a plumbing system that uses a sewage pump for wastewater disposal, the pump will also need electricity to avoid a sewage back-up in the building. Since the water pump will generally have to be located at the tank, electrical wire should be included on the shopping list. Limits on use of transported water Water which has been transported to a site is not usually recommended for drinking because the extra handling increases the risk of contamination and it will need to receive extra chlorination. It may be necessary to label water fountains Do Not Drink and continue obtaining bottled water and bagged ice until the primary water supply is restored and cleared for drinking. 5-4

21 Types of Notifications Boil Water Advisory means there is reason to suspect an increased risk for the water system to be contaminated. Boil water advisories are generally given when testing confirms the presence of total coliform bacteria in the water supply or if a pressure loss or break in the water system increases the risk that water system could have been contaminated with bacteria. Coliform bacteria are generally harmless, however their presence are an indicator that other, potentially harmful, bacteria may be present. Fecal Coliform Bacteria Notice means that there have been confirmed fecal coliform sample results. Fecal coliform bacteria can make you sick. Water should be boiled for one full minute before consuming. Do Not Drink the Water notifications can be issued for either bacteria or chemical contaminants, which indicate the water is so contaminated it should not be consumed and boiling or disinfecting the water may not offer adequate protection. Do Not Use the Water notifications can be issued for contaminants that pose an unknown risk. The water should not be used for drinking, making ice, brushing teeth, washing dishes, washing clothes, bathing/showering, food preparation, or toilet flushing. Bottled water should be used for all of the above necessities. Revised: March

22 Contact List To save time during a water supply emergency it is helpful to keep a contact list of people who may need to be contacted. Following are some suggested contacts: Contact Name Telephone Reason to Contact Water Utility Operator Find out what is wrong and how long it may take to repair Local Health Dept. Environmental Health Specialist Electrician Plumber Local Emergency Management Coordinator Back-up Water Supply Source Water Utility To answer questions about on-site wells If connections for water or sewage pumps are needed. To connect back-up water supply to building plumbing Coordinates all requests for state or federal emergency aid To gain approval to obtain water and identify watering point 5-6

23 Recommended Use Restrictions for Food Service Establishments Consumption of Water Discontinue consumption of tap water regardless of the type of advisory or notification. Turn off ice makers, soda fountains, drinking fountains, and any other water-using equipment which requires water which might be ingested. Label all remaining water sources Do Not Drink. Provide bottled water or drinks for staff and patients. Use only bagged ice from an approved water source. During a Boil Water Advisory, water from the water system can be used for drinking only if it is boiled or disinfected with chlorine before drinking. If possible, use bottled water for drinking. During a Boil Water Notice of fecal coliform contamination, water from the water system must be boiled before drinking. During a Do Not Consume notification, water from the water system should not be consumed. Food Preparation During a Boil Water Advisory, serve only food heated to at least 165 F as part of the cooking process, packaged foods, and fruit which is normally peeled before eating. Food service workers should use hand sanitizers after washing their hands. During a Boil Water Notice or a Do Not Consume Notice, discontinue food preparation and serve only pre-packaged foods obtained from approved commercial sources not affected by the boil water notice and fruit which is normally peeled before eating. Dishwashing During a Boil Water Advisory only commercial dishwashers equipped with hot water (180 F) sanitizing cycles should be used for washing dishes. Facilities not equipped with 180 dish machines should use only single-service eating and drinking utensils. During a Boil water Notice or a No Not Consume Notice, discontinue use of multi-use utensils and use only single-service utensils and packaged foods. Hand Washing If contaminated water is used for hand washing, a further step must be taken to inactivate bacteria which the water might leave on your hands. For food service workers, the use of hand sanitizers and food grade disposable gloves is recommended. The use of utensils or other means (such as menu limitations) to reduce bare hand contact should be adopted. 5-7

24 Recommended Use Restrictions for Child Care Centers Consumption of Water Discontinue consumption of tap water regardless of the type of advisory or notification. Turn off ice makers, soda fountains, drinking fountains and any other water-using equipment which requires water which might be ingested. Label all remaining water sources Do Not Drink, and provide bottled water or other pre-packaged beverages for staff and children. Use only bagged ice from an approved water source. During a boil water advisory,, water from the water system can be used for drinking only if it is boiled or disinfected with chlorine prior to consumption. If possible, use bottled water for drinking. During a boil water notification, water from the water system must be boiled before drinking. During a do not consume notification, water from the water system should not be consumed. Do not boil water for infants as nitrate concentration may occur and may cause methemoglobinemia (i.e., Blue Baby Syndrome). Use bottled water from an approved source for all infant feeding and drinking needs. Food Preparation During a boil water advisory, serve only food heated to at least 165F as part of the cooking process, pre-packaged foods, and fruit which is normally peeled before eating. Food service workers must use hand sanitizers after washing their hands. During a boil water notice or a do not consume notice, discontinue food preparation and serve only pre-packaged foods obtained from approved commercial sources not affected by the boil water notice and fruit, which is normally peeled before eating. Dishwashing During a boil water advisory, use only commercial dishwashers equipped with hot water (180F) sanitizing cycles for washing dishes. Facilities not equipped with 180F dishwashing machines should use only single-service eating and drinking utensils. During a boil water notice or a do not consume notice, discontinue use of multi-use utensils and use only single-service utensils and packaged foods. Hand Washing If contaminated water is used for hand washing, a further step must be taken to inactivate bacteria the water might leave on your hands. For food service workers, the use of hand sanitizers is recommended as an extra step. In situations where water is not available (or there is a do not consume notice), child care workers should use premoistened towelettes for cleaning the hands followed by the use of a hand sanitizer. When diapering children, caregivers should follow the above recommendations for hand washing; however, premoistened towlettes should be used for cleaning the children s hands. If caregivers use disposable gloves, the above recommendations for hand washing should still be maintained. 5-8

25 Cleaning and Sanitizing Use bottled water or water that has been boiled (except for do not consume notices) for the soap/water solution and the daily mixing of sanitizer for use on diapering and other surfaces. Other Water Uses Water play activity must be discontinued. Children should not handle or come into contact with any animals. Bathing is not advised since infants and young children often ingest water while bathing. 5-9

26 Recommended Use Restrictions for Institutions Consumption of Water Discontinue consumption of tap water regardless of the type of advisory or notification. Turn off ice makers, soda fountains, drinking fountains and any other water-using equipment which requires water which might be ingested. Label all remaining water sources Do Not Drink. Provide bottled water or drinks for staff and patients. Use only bagged ice from an approved water source. During a boil water advisory, water from the water system can be used for drinking only if it is boiled or disinfected with chlorine prior to consumption. If possible, use bottled water for drinking. During a boil water notification water from the water system must be boiled before drinking. During a do not consume notification, water from the water system should not be consumed. Food Preparation During a boil water advisory, serve only food heated to at least 165 F as part of the cooking process. Food service workers should use hand sanitizers after washing their hands. During a boil water notice or a do not consume notice, discontinue food preparation and serve only pre-packaged foods obtained from approved commercial sources not affected by the boil water notice and fruit, which is normally peeled before eating. Residential institutions which are unable to make use of alternative food sources should contact the local health department for assistance in developing a site specific risk control plan. The risk control plan must be approved by the local health department and should include: 1. Hand hygiene- Method to clean hands, the use of alcohol based hand sanitizer or gloves, and no bare hand contact with ready to eat foods. 2. Utensil cleaning- Method to clean and sanitize utensils necessary for food preparation. Plan should address methods to reduce the number of pots and pans to be washed. 3. Cooking - Method to ensure all foods cooked to an internal temperature of at least 165 F. Foods should be pre-packaged, no complex food preparation, and may need to include menu limitations or menu restrictions. Plan may include use of products which move from freezer to oven or fryer. 4. Single service- Plan should ensure there will be sufficient single service utensils for all food service. Dishwashing During a boil water advisory, use only commercial dishwashers equipped with hot water (180F) sanitizing cycles for washing dishes. Facilities not equipped with 180F dishwashing machines should use only single-service eating and drinking utensils. During a boil water notice or a do not consume notice, discontinue use of multi-use utensils and use only single-service utensils and packaged foods. Hand Washing If contaminated water is used for hand washing, a further step must be taken to inactivate bacteria the water might leave on your hands. For food service workers, the use of hand sanitizers is recommended as an extra step. For 5-10

27 health care workers, it is recommended that hand decontamination include the use of alcohol-based hand antiseptic rubs. In situations where water is not available, health care workers can achieve hand antisepsis by using premoistened detergent towelettes for washing followed by an alcohol-based hand antiseptic. Contaminated water should not be used for surgical scrubs prior to invasive procedures. Waterless surgical scrub kits are available and approved for that use. Bathing Bathing in contaminated water poses a much lower risk of infection than drinking or washing food. During a boil water advisory, people with healthy immune systems and intact skin should be able to use the water for bathing if care is taken not to ingest the water. During a boil water notice, bathing is not recommended. People who have weaker immune systems including those who are infected with HIV/AIDS, cancer and transplant patients taking immunosuppressive drugs should be more cautious and avoid contact with contaminated water if possible. Some elderly people and infants may also be at increased risk of infection. Care should be taken to avoid getting contaminated water on open wounds. 5-11

28 Recommended Use Restrictions for Lodging Establishments Consumption of Water Discontinue consumption of tap water regardless of the type of advisory or notification. Turn off ice makers, soda fountains, drinking fountains and any other water-using equipment which requires water which might be ingested. Label all remaining water sources Do Not Drink. Use only bagged ice from an approved water source. During a boil water advisory, water from the water system can be used for drinking only if it is boiled or disinfected with chlorine prior to consumption. If possible, use bottled water for drinking. During a boil water notification water from the water system must be boiled before drinking. During a do not consume notification, water from the water system should not be consumed. Food Preparation During a boil water advisory serve only food heated to at least 165 F as part of the cooking process, packaged foods, and fruit which is peeled before eating or serving; this includes lemons used for ice tea. Food service workers should use hand sanitizers after washing their hands, and make every effort to reduce bare hand contact of ready to eat foods, such as using gloves or sanitized utensils. During a boil water notice or a do not consume notice, discontinue food preparation and serve only pre-packaged foods obtained from approved commercial sources not affected by the boil water notice and fruit, which is normally peeled before eating. Dishwashing During a boil water advisory, use only commercial dishwashers equipped with hot water (180F) sanitizing cycles for washing dishes. Facilities not equipped with 180F dishwashing machines should use only single-service eating and drinking utensils. During a boil water notice or a do not consume notice, discontinue use of multi-use utensils and use only single-service utensils and packaged foods. Hand Washing If contaminated water is used for hand washing, a further step must be taken to inactivate bacteria the water may leave on your hands. For food service workers, the use of hand sanitizers is recommended as well as the use of gloves or sanitized utensils. Bathing Bathing in contaminated water poses a much lower risk of infection than drinking or washing food. During a boil water advisory, people with healthy immune systems and intact skin should be able to use the water for bathing if care is taken not to ingest the water. During a boil water notice, bathing is not recommended. People who have weaker immune systems including those who are infected with HIV/AIDS, cancer and transplant patients taking 5-12

29 immunosuppressive drugs should be more cautious and avoid contact with contaminated water if possible. Some elderly people and infants may also be at increased risk of infection. Care should be taken to avoid getting contaminated water on open wounds. Guests should be notified of the risks involved in the particular water advisory or notice so that the proper precautions can be taken. 5-13

30 Guidelines for Food Preparation in Water Emergencies Background During water supply emergencies involving loss of water supply or fecal contamination in a water supply, food service operations must typically cease operation. However, there are some situations where food service operations may need to continue in support of confined populations that cannot be relocated. The following guidelines are intended to address facilities such as prisons, local confinement facilities, and institutions with populations that cannot be relocated (or may not be able to be safely evacuated in a timely manner) that serve highly susceptible populations. These guidelines are intended for use for not more than 24 hours. Pre-Approved Procedures The following procedures are pre-approved for use during a water emergency and should be implemented first and in lieu of emergency food preparation procedures if at all possible. Out-sourcing Facilities without water or with fecal-contaminated water should seek to outsource food preparation and service to permitted or approved foodhandling establishments outside the area affected by the water supply emergency. Pre-packaged Foods o Serve individually packaged foods from a commercial food processing establishment operated in compliance with G.S through unaffected by the water supply emergency o Serve only bottled or canned water or beverages o Serve fruit that is typically peeled before eating Emergency Food Preparation Guidelines If none of the above-mentioned procedures are available during a water emergency, the following food preparation procedures may be allowed. All facilities must contact the Environmental Health program of the local health department for prior approval before implementation of these emergency food preparation procedures. The facility requesting approval must develop an Emergency Food Preparation Plan. The local Environmental Health program may approve the plan during an emergency situation if all conditions are met and an on-site assessment by the health department determines that food safety can be assured. The plan must include: 1. Hand hygiene through either washing with soap and uncontaminated running water followed by use of hand sanitizer, or hand cleaning with pre-moistened detergent towelettes followed by use of hand sanitizer. Practices should be planned to limit bare-hand contact with food. Glove use is not 5-14

31 acceptable as a substitution for handwashing, but is recommended as an extra precaution to minimize bare-hand contact with food. 2. Food preparation that is limited to cooking food to a final temperature of 165 F minimum throughout to render the food safe from potential bacteria contamination. A properly calibrated thermometer must be used to ensure final cooking temperature is achieved. 3. The use of single-service utensils or utensils subjected to high heat or other sanitization prior to being used to handle food. 4. The use of only the following food preparation methods: Freezer to Fryer: Food taken from a freezer or refrigerator and submerged in frying oil until heated throughout to a temperature of at least 165 F. Boiling: Canned foods or other ready-to-cook foods heated to boiling temperature exceeding 180. Freezer to oven: Individual ready-to-cook portions of food that require no further preparation other than cooking baked or roasted to an internal temperature of at least 165 F throughout. 5-15

32 6. Potential Dangers of Re-entering Damaged Buildings Electrical Hazards Floodwaters and wet building components near electrical wires and circuits can conduct electricity. Standing on wet ground or floors can also make you more susceptible to electrocution. To avoid electrocution when entering a flooded or damaged building, turn off the power at the main breaker or fuse on the service panel. Do not turn the power back on until a qualified electrician has inspected the electrical equipment. Do not touch electrical equipment if the ground is wet unless you know the power is off and never handle a downed power line. When using a generator to supply power to a building, it is possible for electricity to backfeed from the building and energize power lines possibly electrocuting the utility line workers trying to restore permanent power. Buildings powered by a generator must be disconnected from the utility grid by turning off the main breaker or fuse at the service panel. Unless a qualified electrician has installed a transfer control device in your service panel to prevent backfeeding of electricity, power key appliances with extension cords directly from the generator and avoid energizing the building electrical system. If downed power lines are present, contact the utility company to remove the hazard before doing any clearing work in the area. Be careful of overhead electrical lines when using ladders and other equipment. All switches and motors, which have been in contact with floodwaters, must be thoroughly cleaned, dried and inspected before reusing them. When vacuuming wet materials, use only wet-dry vacuums designed to vacuum water. Fire and Explosion Hazards If flooding has drowned pilot lights on gasoline-powered appliances or structural damage has broken gas pipes, there can be a build up of gas in a building to levels that could cause an explosion. Before entering a damaged building, turn off the gas at the meter. Never use a cigarette lighter or other open flame to see in a dark building. Use a flashlight rather than turning on electrical switches until you have checked for gas. Open doors and windows to allow trapped gas to escape, and pay attention for the smell of gas. If you smell gas, leave the building. Fire can pose an increased risk in a disaster because water supplies and sprinkler systems may not work and firefighting equipment may already be in use or have difficulty traveling to your location. Fire extinguishers should be included in the tools used when rehabilitating damaged buildings. Slip Hazards Floodwaters leave a coating of mud making floors and walkways slippery. Animals Floodwaters will move snakes and other wild animals out of their usual habitats and they may seek refuge in storm debris. Domestic pets can become disoriented and agitated posing a threat to people. Lift debris with sticks to check 6-1

33 for hazards or wild animals before moving it. If domestic animals need to be removed from an area contact the county animal control office or the State Animal Response Team for help. Chemicals Do not permit children to play in floodwaters or mud. Floodwaters entering warehouses and other areas containing chemicals can carry harmful chemicals away from storage areas. Rising water can dislodge chemical storage tanks and piping allowing hazardous materials to flow downstream. Do not attempt to move dislodged tanks, drums or containers without contacting the fire department or hazardous materials team to assess the potential danger. Skin irritation and burning of mucous membranes following exposure to water or mud can be signs of toxic chemical exposure. If these symptoms are encountered, leave the area immediately and wash the affected skin with soap and water. Working in chemically contaminated areas requires special personal protective equipment and knowledge of how to work safely with the hazards present. Mold Following heavy rain or flooding, mold growth can pose a health hazard. Some molds produce toxins and respiratory irritants that can have long-term health effects. Assume any materials still wet more than one day after water recedes are likely to be growing mold. Even if you do not see mold, it can grow inside the cavities in walls and produce toxins and irritants. Walls that were flooded should be stripped to the studs, cleaned, disinfected and allowed to dry thoroughly before being recovered. Clothing exposed to floodwaters needs to be disposed of or cleaned and dried as soon as possible. Heating and air conditioning ducts and equipment exposed to floodwaters can become a continuing source of exposure unless dismantled and thoroughly cleaned and disinfected. Mosquitoes Mosquitoes increase in numbers after significant rain or flooding and in addition to being a nuisance, can carry a variety of dangerous diseases. To reduce mosquito breeding, drain and dry standing water as soon as possible and empty containers of pooled water. To report heavy infestations or get information about controlling mosquitoes, contact your local mosquito control program or county health department. Wearing long-sleeved clothing and using insect repellants containing DEET, picaridin or oil of lemon eucalyptus will help protect you from mosquitoes. For more information, see Section (#), Insects, of this manual. Structural failure Inspect foundations for wash outs or structural cracks caused by moving water. Buildings shifted from their foundations should not be entered. Empty flooded basements and crawl spaces as soon as possible. Take care to assure pressure from saturated soil outside will not cause foundations or walls to collapse when water is removed from basements. Examine buildings for sagging roofs or other signs of structural failure before going inside. 6-2

34 When entering a building, wet building materials such as sheetrock made heavy by water may fall off of walls or ceilings causing injury. Look for sagging ceilings or bowed walls, and avoid walking under them. If water has risen above the ceiling or the roof has been damaged, large amounts of water and wet insulation above the ceiling can cause the ceiling to fall. To check for water above a ceiling, stand in a doorway and use a stick to poke a hole through the ceiling. If water drips from the ceiling, stay out of the building until the ceiling can be safely drained and removed. Carbon Monoxide Combustion appliances such as gas- or diesel-powered generators and pumps, gas or kerosene space heaters and gas or wood-burning stoves or fireplaces can produce carbon monoxide a poisonous gas that can cause suffocation. Use combustion equipment such as generators and gas grills outdoors, placing them where their exhaust cannot enter the building. Use only heaters designed for indoor use inside the building and assure there is adequate ventilation to allow air into the building. Do not try to use gas stoves designed for cooking to heat the house. Follow the manufacturers instructions on the use of combustion equipment. If you plan to use combustion appliances to heat a home during a power outage, install a battery-powered carbon monoxide detector. Symptoms of carbon monoxide poisoning can be headaches, dizziness, nausea, tiredness or flushed red skin color. If any of these symptoms occur, leave the building immediately and seek medical attention. Asbestos Asbestos was used in more than 3,000 building products and can be found in homes, public, commercial, and industrial facilities. These materials normally present no problem as long as they are in good condition and are not disturbed. However, if asbestos containing building materials are in poor condition or if they are improperly handled during a renovation or demolition activity, asbestos fibers can be released. Exposure to asbestos fibers can cause serious health problems. Breathing airborne asbestos fibers can lead to an increased risk of (1) lung cancer; (2) mesothelioma, a cancer of the lining of the chest or abdominal cavity; and (3) asbestosis, scarring of the lung tissue. Building products that may contain asbestos include: insulation on boilers, steam pipes, water pipes and ducts; cementitious siding or roofing shingles; ceiling tile (all forms); asphalt and felt roofing applications; wallboard and mud joint compound; sprayed-on or trowelled-on surface materials on walls and ceilings: insulation (wall or ceiling), floor tiles and sheet vinyl floor coverings, etc. ****WARNING**** Because of the potential hazards associated with the handling of asbestos containing building materials, there are specific regulatory requirements that must be met prior to renovation or demolition activities occurring 6-3

35 in Food Service Establishments, Retail Stores, Child Care Center and Lodging Establishments and Institutions. These requirements include: having an inspection conducted by an accredited asbestos inspector prior to renovation or demolition activities taking place; using accredited asbestos workers and supervisors to properly remove any asbestos containing materials that have been damaged by floodwaters or will be damaged by the renovation/cleanup activities; applying for permit/notifications for applicable renovation or demolition activities; clearance air monitoring in applicable public areas; and proper disposal of asbestos waste. For more information, contact the N.C. Health Hazards Control Unit at (919) DON T dust, sweep, or vacuum debris that may contain asbestos. DON T saw, sand, scrape, or drill holes in asbestos materials. DON T use abrasive pads or brushes on power strippers to strip wax from asbestos flooring. Never use a power stripper on a dry floor. DON T sand or try to level asbestos flooring or its backing. DO keep activities to a minimum in any areas, such as crawl spaces or attics, having damaged material that may contain asbestos. DO take every precaution to avoid damaging asbestos or materials that may contain asbestos. Overexertion and Musculoskeletal Injuries Recovering a flood-damaged building requires removal of soaked flooring, furnishings, wallboard and insulation. These items, when soaked with water, weigh much more than you would normally anticipate. Be aware that soaked furnishings will be harder to move and lift with your legs instead of your back. It is best to use a two-man crew to move bulky items. Wind damage can topple trees and structures, leaving large amounts of heavy debris to move. Pace yourself, and drink plenty of clean water, eat properly and get plenty of rest. Fatigue is a contributing factor in many injuries. Heat Stress Clean-up workers are susceptible to a variety of heat-related problems, including heat stroke, heat exhaustion, heat cramps and fainting. Taking frequent breaks to cool down and drink fluids will help prevent overheating. Wearing light-colored clothing helps reduce heat absorption from sunlight, and scheduling more physically demanding work during cooler hours will help. Opening windows or using fans indoors can also help reduce heat stress. 6-4

36 Falls A major cause of injury following heavy wind damage is falls off of roofs, ladders or trees. It is important to cover damaged roofs with tarps to prevent water damage to the inside of your house, but if you are not accustomed to working on a roof, it is best to get some help. Even if you have to do the work yourself, having someone nearby to help steady the ladder and call for help if you fall will improve safety. If you must clear limbs out of trees or remove trees from the roof, be aware that trees can kick back when cut and brace yourself for some movement. Contaminated Food and Water Supplies Typically, food that has come in contact with floodwater should be discarded. However, it is possible to remove labels, clean and sanitize the outside of intact cans and use the contents, but it is not recommended. If in doubt, properly discard the food. For more details on addressing food safety issues, see Section (#), Loss of Power-Food Safety. Wells that have been under water are likely to be contaminated with floodwaters. They should be flushed, thoroughly disinfected, flushed again and tested for bacteria before the water is used for drinking. For information about disinfecting wells and getting your water tested, contact the local health department, or visit Section (#), Disinfecting Wells, in this manual. Public water systems can also be contaminated by floodwaters if there have been breaks in distribution piping or the system has lost pressure. In such cases, the water utility or the Division of Environmental Health will issue a boil water advisory or notice and provide information about restricting the use of water from that system. Listen for news about the water supply in your area. Special water use restrictions apply to health care facilities, food-handling establishments, schools and child care facilities, (Section #).. 6-5

37 7. Disinfecting a Flooded Well 1. First, pump your well for about 30 minutes at the wellhead or an outside faucet to remove the most contaminated water. 2. Using one of the charts below, pour the amount of chlorine, either 70 percent calcium hypochlorite (Chart A), or unscented household bleach (Chart B) into the well. The charts indicate the amount of chlorine needed based on the diameter of well casing and depth of water in the well. Calcium hypochlorite is preferred for disinfecting wells, but unscented household bleach containing sodium hypochlorite will work in an emergency. When calcium hypochlorite tablets are used, they should be carefully broken into smaller pieces using proper eye protection and rubber gloves. Chart A: Amount of Calcium Hypochlorite (70 percent available chlorine) Depth of Well 50 Ft. Deep 100 Ft. Deep 200 Ft. Deep 400 Ft. Deep 2-inch casing 4-inch Casing 6-inch Casing 8-inch Casing 10-inch Casing 24-inch Casing 36-inch Casing.2 oz or.6 oz or 1.5 oz or 2.5 oz or 3.9 oz or 22.5 oz or 50.5 oz or 1 tablet 4 tablets 10 tablets 17 tablets 28 tablets 157 tablets 353 tablets.3 oz or 1.3 oz or 3 oz or 5 oz or 7.8 oz or 45 oz or 101 oz or 2 tablets 9 tablets 21 tablets 35 tablets 53 tablets 315 tablets 707 tablets.65 oz or 2.5 oz or 6.1 oz or 10 oz or 15.6 oz or 90 oz or 202 oz or 5 tablets 17 tablets 42 tablets 70 tablets 108 tablets 630 tablets 1414 tablets 1.3 oz or 5 oz or 12.2 oz or 20 oz or 31 oz or oz or 403 oz or 9 tablets 35 tablets 85 tablets 140 tablets 217 tablets 1254 tablets 2821 tablets Chart B: Amount of Unscented Household Bleach (5.25 percent available chlorine) Depth of Well 50 Ft. Deep 100 Ft. Deep 200 Ft. Deep 400 Ft. Deep 2-inch casing 4-inch Casing 6-inch Casing 8-inch Casing 10-inch Casing 24-inch Casing 36-inch Casing 5 ½ T. or 1 cup or 2 ½ c. or 4 c. or 6 ½ c. or 37 c. or.02 gal..06 gal..15 gal. ¼ gal. ½ gal gal. 5 ¼ gal. ½ cup or 2 c. or 4.6 c. or 8 c. or 13 c. or 74 ¾ c. or.03 gal..13 gal..3 gal..52 gal..8 gal. 4.7 gal. 10 ½ gal. 1 c. or 4 c. or 9 ½ c. or 16 c. or 26 c. or.06 gal. ¼ gal..58 gal. 1 gal gal. 9.3 gal. 21 gal. 2.1 c. or 8 c. or 20 c. or 34 c. or 52 c. or.13 gal. ½ gal. 1.2 gal. 2.1 gal. 3 ¼ gal gal. 42 gal. 3. Using a hose, recirculate water back into the well until you smell chlorine in the water 4. Rinse the well casing and all other equipment in the well with the chlorine. 7-1

38 5. Turn on each faucet in and on the house until you smell chlorine, then turn off and let chlorine stand in the well and plumbing systems for at least 24 hours. 6. After 24 hours, connect a garden hose to an outside faucet and run water through the hose away from the house foundation and any septic tank system until the chlorine smell is gone. Do not pump large quantities of highly chlorinated water into a septic system. 7. After the disinfection process is completed, contact your local health department to have the water sampled. Continue to use bottled water or water that has been brought to a rolling boil for one minute until sample results show no coliform bacteria contamination. 7-2

39 8. Guidelines for Cleaning, Salvaging and Remodeling Food Service Establishments and Retail Stores Remember the golden rule of clean-up work Wash your hands thoroughly and do it often. Food and Beverages All flooded food, including sealed and open packages, boxes, cans, produce and fresh meats must be discarded to avoid food-borne illness or injury. Foods that were not flooded and reached temperatures above 41 F must be discarded. Frozen foods which thawed but did not reach a temperature above 41 F may be refrozen. Equipment Thoroughly clean and sanitize all salvageable equipment. Use a detergent and a sanitizing solution made with one tablespoon of regular, non-scented bleach in a gallon of water. You can generally save equipment if: It is made of stainless steel or other nonabsorbent materials. It contains only non-absorbent, closed cell polyurethane insulation. (This material is used in newer refrigerators and freezers. It may require cleaning, so check with the manufacturer.) Refrigerators, freezers and other equipment with fiberglass insulation must be evaluated to see if the insulation has been flooded. If so, the insulation must be removed and replaced. Styrofoam or closed cell polyurethane insulation may be able to be cleaned, so check with the manufacturer. A thorough inspection of the electrical components (wiring, compressors, switches, etc.) must be performed by a professional to judge whether they need replacing. Use a reliable professional for these jobs. Often the cost in materials and time spent in refurbishing flood-damaged electrical equipment exceed the cost of replacement. Check your water heater. It should be replaced if floodwaters got into the gas burner, electrical parts, or insulation. Take the following precautions when salvaging post-mix and beverage machines, coffee or tea urns, ice machines, glass washers, dishwashers and other equipment with water connections: Flush waterlines, faucet screens and waterline strainers, and purge fixtures of any standing water. Clean and sanitize all fixtures, sinks and equipment using detergent, rinsing, then sanitizing with a solution of one tablespoon of bleach in a gallon of water. Also see Section (x), Decontamination of Ice Machines. Discard any equipment that is either damaged and cannot be repaired to American National Standards Institute standards or includes flood-damaged wood, particle board or plastic laminate components (counters, cabinets, bars, etc.) Walk-In Cooler Restoration Guidelines 8-1

40 In general, the walk-in cooler in a flooded food service facility needs to be reviewed on a case-by-case basis. If the inside of the cooler has a quarry tile floor with 6-inch sealed coving and the water did not flood over the coving, the interior surface can be cleaned by scrubbing with soap and water and then sanitized with a solution of one cup of bleach with four gallons of water. Do this with plenty of ventilation. If the inside of the cooler has walls that sit directly on the floor, and the caulking seal is intact, the cooler walls can be cleaned, scrubbed, and sanitized with one cup bleach to four gallons water. The walls of the cooler should be made of wood frame with closed foam insulation for this process to be successful. If the inside of the walk-in cooler was damaged by holes or cuts and the floodwaters rose above those holes or cuts, the entire panel will need to be replaced. On a free-standing walk-in cooler, the panels can be disassembled, cleaned and sanitized to remove the silt below the panel. This would apply when the cooler wall did not have a satisfactory seal at the wall and floor juncture. Flooded walk-in coolers with a permeable wood floor need to have the floor replaced. Walk-in coolers sitting directly on the floor with an aluminum interior floor should have the floor raised and power washed below the floor to remove the river silt. Remediation techniques will not guarantee the absence of odors that may develop in the future. ****WARNING**** Always use extreme caution when restarting equipment with electrical components. Furnishings Furnishings and fixtures that are porous or absorbent will need to be discarded if they have been in contact with floodwaters. Examples are: All upholstered furniture, including chairs, bar stools, benches, booth seats and bar arm rests; Any tables or booths that cannot be effectively cleaned and sanitized; and Books and paper products that cannot be thoroughly cleaned. Clothes and drapes can be washed with potable water containing a sanitizing agent such as bleach or pine oil cleaners. Cloth items which say dry clean may be salvaged by dry cleaning. Walls and Ceilings If floodwaters soaked the sheetrock, insulation or ceiling tiles, remove these items 30 inches above the waterline. Paneling may be removed and saved, but you will still need to get air circulating in the wall cavities to dry the studs and sills. Wet studs and sills do not need to be replaced if allowed to dry properly. Flooded portions of studs and sills should be cleaned and treated with biocides such as a bleach and water solution. For paneling, carefully pry the bottom off each panel away from the wall. Use something to hold the bottom away from the sill so the cavities can be drained, cleaned, checked for mold and dried out. You can nail them back once the panel and studs dry out. Remove and discard flooded insulation. 8-2

41 Undamaged walls, hard surfaced floors and other surfaces should be cleaned and disinfected with a solution of onequarter cup of bleach to one gallon of water. Vinyl wall covering should be removed and discarded if soaked. Floors and Floor Coverings Remove any linoleum or tile that been flooded, so you can clean and dry the wooden subflooring. When placed on a concrete base, only loose linoleum or tile need be removed. Linoleum or vinyl tile can be saved and reused if it can be cleaned and sanitized. Wall-to-wall carpeting, padding and foam rubber should be thrown away if they were soaked with floodwaters. Remove tile or vinyl flooring if it is warped, loose or has a foam-rubber pad. Duct Work Vents and duct work for air conditioning/heating units that were submerged in floodwaters need thorough cleaning and sanitizing. If it is impossible to do this, it will be necessary to replace them. Insulation around ducts or ducts made of compressed fiberglass will need to be replaced. ****WARNING**** Before disturbing building materials damaged by floodwaters, refer to the Asbestos paragraph in the section titles Potential Dangers of Re-entering Damaged Buildings for additional guidance. Materials that may contain asbestos include walls, ceilings, flooring or insulation (on ducts, pipes, mechanical equipment or attic). 8-3

42 Child Care Centers Clean everything that got wet with warm, soapy water and follow with a rinse. Floodwaters have picked up chemicals from roads, farms, and storage buildings, along with animal and human wastes from lagoons, treatment plants and septic tanks. To prevent mold and mildew growth, try to do this job within 24 to 48 hours after the floodwaters recede. Wells If you have your own well serving your child care business and the flood covered the well, it must be chlorinated and tested prior to use. Please contact your local health department for complete instructions on chlorination. It will be important to know the diameter of the well casing and the depth of the well to complete chlorination. Sewage Systems If your septic tank system was flooded, please call your local health department for an evaluation of the system before using it. Flooded systems may malfunction without proper attention. Mold Organic material, bacteria and other microorganisms are deposited onto hard surfaces and into porous building materials and furnishings by floodwaters. Many building materials and furnishings that remain wet for more than 48 hours will develop visible fungal colonies. These colonies are commonly referred to as mold or mildew. Molds and mildews resulting from flooding can create significant health risks for occupants. Unintentional ingestion of floodwaters or sediment can cause gastrointestinal diseases. Inhalation exposure to molds may cause allergy symptoms. These symptoms can often be severe. Some fungi may cause infectious respiratory disease, while others generate toxins that may cause illness. If a flooded building is to be reoccupied, water and the deposited material must be removed. All indoor fungal growth that occurred as a result of flooding must be removed. Clean surfaces first, then apply biocides such as bleach and water to kill molds. Porous materials will need to be replaced. You can disinfect floors or wood surfaces using a solution of one-quarter cup of bleach in a gallon of water. If mold has already begun to grow, use a stronger solution, for example, a half of a cup of bleach per gallon of water. Make sure you have adequate ventilation when using strong chlorine solutions. 8-4

43 Food and Beverages All flooded food, including sealed and open packages, boxes, cans, formula, produce and fresh meats must be discarded to avoid food-borne illness or injury. Potentially hazardous foods that were not flooded and reached temperatures above 41 F must be discarded. Frozen foods which thawed but did not reach a temperature above 41 F may be refrozen. Equipment Thoroughly clean and sanitize all salvageable equipment. Use a detergent and a sanitizing solution made with one tablespoon of regular-strength, non-scented bleach in a gallon of water. You can generally save equipment if: It is made of stainless steel or other nonabsorbent materials. It contains only non-absorbent, closed cell polyurethane insulation. (This material is used in newer refrigerators and freezers. It may require cleaning, so check with the manufacturer.) Refrigerators, freezers, and other equipment with fiberglass insulation must be evaluated to see if the insulation has been flooded. If so, the insulation must be removed and replaced. Styrofoam or closed cell polyurethane insulation may be able to be cleaned, so check with the manufacturer. A thorough inspection of the electrical components (wiring, compressors, switches, etc.) must be performed by a professional to judge whether they need replacing. Use a reliable professional for these jobs. Often the cost in materials and time spent in refurbishing flood-damaged electrical equipment exceed the cost of replacement. Check your water heater. It should be replaced if floodwaters got into the gas burner, electrical parts, or insulation. Take the following precautions when salvaging ice machines, dishwashers, and other equipment with water connections: Flush waterlines, faucet screens and waterline strainers, and purge fixtures of any standing water. Clean and sanitize all fixtures, sinks, and equipment, using detergent first, followed by a solution of one tablespoon of bleach in a gallon of water. Also see Section (x), Decontamination of Ice Machines. Discard any equipment that is either damaged and cannot be repaired to manufacturer standards, or includes flood-damaged wood, particle board or plastic laminate components (counters, cabinets, bars, etc.) Walk-In Cooler Restoration Guidelines In general, the walk-in cooler in a flooded facility needs to be reviewed on a case-by-case basis. If the inside of the cooler has a quarry tile floor with 6-inch sealed coving and the water did not flood over the coving, the interior surface can be cleaned, scrubbed and sanitized with a solution of one cup of bleach with four gallons of water. Do this with plenty of ventilation. 8-5

44 If the inside of the cooler has walls that sit directly on the floor and the caulking seal is intact, the cooler walls can be cleaned, scrubbed, and sanitized with one cup bleach to four gallons water. The walls of the cooler should be made of wood frame with closed foam insulation for this process to be successful. If the inside of the walk-in cooler was damaged by holes or cuts, and the floodwaters rose above those holes or cuts, the entire panel will need to be replaced. On a freestanding walk-in, the panels can be disassembled, cleaned, and sanitized to remove the silt below the panel. This would apply when the cooler wall did not have a satisfactory seal at the wall and floor juncture. Flooded walk-in coolers with a permeable wood floor need to have the floor replaced. Walk-in coolers sitting directly on the floor with an aluminum interior floor should have the floor raised and power washed below the floor to remove the river silt. Remediation techniques will not guarantee the absence of odors that may develop in the future. ****WARNING**** Always use extreme caution when restarting equipment with electrical components. Call your county building inspector or a licensed electrician if you need guidance. Furnishings Furnishings and fixtures that are porous or absorbent will need to be discarded if they have been in contact with floodwaters. Examples are: All upholstered furniture, including chairs, mattresses, play pens, sleeping mats, cots, stools, benches and booth seats; Any tables or booths that cannot be effectively cleaned and sanitized; and Books and paper products that cannot be thoroughly cleaned. Clothes, bedding and drapes can be washed with detergent and potable water containing a sanitizing agent such as bleach or pine oil cleaners. Clothe items that say dry clean may be salvaged by dry cleaning. Walls and Ceilings If floodwaters soaked the sheet rock, insulation or ceiling tiles, remove these items 30 inches above the waterline. Paneling may be removed and saved but you will still need to get air circulating in the wall cavities to dry the studs and sills. Paneling saved for re-use will need to be cleaned with detergent and water and treated with a biocide. Wet studs and sills do not need to be replaced if allowed to dry properly. Flooded portions of studs and sills should be treated with biocides such as a bleach and water solution. 8-6

45 For paneling, carefully pry the bottom off each panel away from the wall. Use something to hold the bottom away from the sill so the cavities can be drained, cleaned, checked for mold and dried out. It is likely paneling will need to be removed for adequate drying to take place in a timely manner. You can nail them back once the panel and studs dry out. Remove and discard flooded insulation. Undamaged walls, hard surfaced floors, and other surfaces should be cleaned and disinfected with a solution of onequarter cup of bleach to one gallon of water. Vinyl wall covering should be removed and discarded if soaked. Floors and Floor Coverings Remove any linoleum or tile that been flooded, so you can clean and dry the wooden sub-flooring. When placed on a concrete base, only loose linoleum or tile need be removed. Linoleum or vinyl tile can be saved and reused if it can be cleaned and sanitized. Wall-to-wall carpeting, padding and foam rubber should be thrown away if they were soaked with floodwaters. Remove tile or vinyl flooring if it is warped, loose or has a foam-rubber pad. Duct Work Vents and ductwork for air conditioning/heating units that were submerged in floodwaters need thorough cleaning and sanitizing. If it is impossible to do this, it will be necessary to replace them. Insulation around ducts or ducts made of compressed fiberglass will need to be replaced. Re-entering a flooded building For more information on re-entering buildings after a flood, please refer to the section titled Potential Dangers on Reentering a Damaged Building. ****WARNING**** Before disturbing building materials damaged by floodwaters, refer to the Asbestos paragraph in the section titles Potential Dangers of Re-entering Damaged Buildings for additional guidance. Materials that may contain asbestos include walls, ceilings, flooring or insulation (on ducts, pipes, mechanical equipment or attic). 8-7

46 Lodging Establishments and Institutions Food and Beverages All flooded food, including sealed and open packages, boxes, cans, and produce must be discarded to avoid foodborne illness or injury. Frozen foods which thawed but did not reach a temperature above 41 F may be refrozen. Equipment Thoroughly clean and sanitize all salvageable equipment. Use a detergent and a sanitizing solution made with one tablespoon of regular-strength, non-scented bleach in a gallon of water. You can generally save equipment if: It is made of stainless steel or other nonabsorbent materials. It contains only non-absorbent, closed cell polyurethane insulation. (This material is used in newer refrigerators and freezers. It may require cleaning, so check with the manufacturer.) Refrigerators, freezers and other equipment with fiberglass insulation must be evaluated to see if the insulation has been flooded. If so, the insulation must be removed and replaced. Styrofoam or closed cell polyurethane insulation may be able to be cleaned, so check with the manufacturer. A thorough inspection of the electrical components (wiring, compressors, switches, etc.) must be performed by a professional to judge whether they need replacing. Use a reliable professional for these jobs. Often the cost in materials and time spent in refurbishing flood-damaged electrical equipment exceed the cost of replacement. Check your water heater. It should be replaced if floodwaters got into the gas burner, electrical parts, or insulation. Take the following precautions when salvaging post-mix and beverage machines, coffee or tea urns, ice machines, glass washers, dishwashers and other equipment with water connections: Flush waterlines, faucet screens and waterline strainers and purge fixtures of any standing water. Clean and sanitize all fixtures, sinks and equipment, using detergent first, followed by a solution of one tablespoon of bleach in a gallon of water. Also see Section (x), Decontamination of Ice Machines. Discard any equipment that is either damaged and cannot be repaired to manufacturer standards or includes flood-damaged wood, particle board or plastic laminate components (counters, cabinets, bars, etc.) ****WARNING**** Always use extreme caution when restarting equipment with electrical components. Furnishings Furnishings and fixtures that are porous or absorbent will need to be discarded if they have been in contact with floodwaters. Examples are: 8-8

47 All upholstered furniture, including mattresses, chairs, sofas, bar stools or benches; Any tables or other surfaces that cannot be effectively cleaned and sanitized; and Books and paper products that cannot be thoroughly cleaned. Clothes and drapes can be washed with potable water containing a sanitizing agent such as bleach or pine oil cleaners. Clothe items that say dry clean may be salvaged by dry cleaning. Walls and Ceilings If floodwaters soaked the sheet rock, insulation or ceiling tiles, remove these items 30 inches above the waterline. Paneling may be removed and saved, but you will still need to get air circulating in the wall cavities to dry the studs and sills. Paneling will likely need to be removed to allow for adequate drying. Paneling will also need to be cleaned before reinstallation. Wet studs and sills do not need to be replaced if allowed to dry properly. Flooded portions of studs and sills should be treated with biocides such as a bleach and water solution. For paneling, carefully pry the bottom off each panel away from the wall. Use something to hold the bottom away from the sill so the cavities can be drained, cleaned, checked for mold and dried out. You can nail them back once the panel and studs dry out. Remove and discard flooded insulation. Undamaged walls, hard surfaced floors and other surfaces should be cleaned and disinfected with a solution of onequarter cup of bleach to one gallon of water. Vinyl wall covering should be removed and discarded if soaked. Floors and Floor Coverings Remove any linoleum or tile that been flooded, so you can clean and dry the wooden sub-flooring. When placed on a concrete base, only loose linoleum or tile need be removed. Linoleum or vinyl tile can be saved and reused if it can be cleaned and sanitized. Wall-to-wall carpeting, padding and foam rubber should be thrown away if they were soaked with floodwaters. Remove tile or vinyl flooring if it is warped, loose or has a foam-rubber pad. Duct Work Vents and ductwork for air conditioning/heating units that were submerged in floodwaters need thorough cleaning and sanitizing. If it is impossible to do this, it will be necessary to replace them. Insulation around ducts or ducts made of compressed fiberglass will need to be replaced. Re-entering a flooded building For more information on re-entering buildings after a flood, please refer to the section titled Potential Dangers on Reentering a Damaged Building. 8-9

48 ****WARNING**** Before disturbing building materials damaged by floodwaters, refer to the Asbestos paragraph in the section titles Potential Dangers of Re-entering Damaged Buildings for additional guidance. Materials that may contain asbestos include walls, ceilings, flooring or insulation (on ducts, pipes, mechanical equipment or attic). 8-10

49 9. Emergency Shelters Guidelines for sanitation and infection control in shelters. Respiratory Hygiene When emergency shelters are established, precautions should be taken immediately to reduce and prevent the spread of communicable disease. The following measures to contain respiratory secretions are recommended for all individuals with signs and symptoms of a respiratory infection: Cover mouth / nose when coughing or sneezing; Use tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle after use; Perform hand hygiene (e.g. hand washing, alcohol based hand rub, or antiseptic handwash) 1 Cot and Sleeping Mat Spacing As a guideline, cot and sleeping mat spacing recommendations can be made based on the Child Care rules. These rules require spacing of at least 18 inches or a physical barrier between cots or sleeping mats. Food Service / Hand Hygiene Best professional judgment will be critical in making decisions involving food handling in an emergency shelter situation. Guidance should include the following: All individuals with gastrointestinal symptoms such as vomiting or diarrhea must be excluded from handling food or utensils and should be restricted from the food preparation and serving areas. Handwashing should be stressed to the individuals preparing and serving food. If the water supply is questionable, a 60-70% alcohol instant hand sanitizer should be used after any visible contamination has been removed from the hands. Pre-moistened towels can be used for removal of visible contamination. Bare hand contact should be eliminated by the use of clean utensils, proper glove use, or menu restrictions. Potentially hazardous foods (not held >140F, or <45F) should be consumed or discarded within 4 hours if served on-site. Potentially hazardous foods which are not consumed on-site should be discarded after 2 hours. 1 This is a portion of the information available from the CDC. For more information the entire document can be found at the link in the resources section at the end of this manual. 9-1

50 Unless dishwashing equipment is available to wash, rinse, and sanitize multi-use utensils, only single service items should be used. If water supplies are compromised, limit food production and service as specified in the water sections of this manual. Foods which are frozen and move directly to the oven or fryer without further preparation should be used. Areas used for food preparation and all serving utensils should be cleaned and sanitized with a solution of 50 ppm chlorine or equivalent after each use. Foods prepared in domestic, unregulated kitchens and brought to the shelter should not be served. Shelter Assessments Assessments of emergency shelters should be performed periodically to ensure that adequate supplies are available and needs are being met. CDC has developed a shelter assessment tool to assist environmental health personnel in conducting rapid assessments of shelter conditions during emergencies and disasters. See Appendix A. Revised: July

51 10. Decontamination of Ice Machines 1 Do not begin decontamination procedure until the water supply problem has been corrected and the boil water notice has been lifted. 1. Disconnect and unplug the unit. 2. Discard all ice. 3. Disassemble removable parts of the machine that come in contact with the water used to make ice, including any pre-filters on the water supply line to the machine. 4. Thoroughly clean all parts, and check for possible repair needs. 5. Ensure the presence of an air space in the tubing that leads from the potable water inlet into the water distribution system of the ice-making machine. 6. Inspect for insect or rodent infestation under the unit, and treat if necessary. 7. Check the gasket around the door of the ice storage chest for cleanliness and possible leakage or dripping of contaminants into the ice storage chest. 8. Allow the ice storage chest to warm to room temperature. 9. Clean the storage chest with freshly made soap or detergent solution. 10. Use clean materials to scrub all surfaces, door tracks, guides and gaskets. 11. After cleaning, rinse all surfaces with clean tap water and wipe dry with clean materials. 12. Circulate a 50 to 100 parts per million chlorine solution throughout the entire ice-making and storage system of the machine in accordance with the manufacturer s recommended cleaning and sanitizing procedures. 13. Let the 50-ppm chlorine solution stay in the ice-making and storage compartment for four hours or at least two hours if it is a 100-ppm chlorine solution. 14. Flush with clean tap water. 15. Allow ice-storage chest to dry, and then return the unit to service. 16. Clean and sanitize ice scoops and containers used for handling ice. These procedures were adapted from the Centers for Disease Control and Prevention recommendations for sanitary care and maintenance of ice-storage chests and ice-making machines in health care facilities (AJIC Am J Infect Control 1998;26;111-2). 10-1

52 11. Septic Systems Septic tanks contain waste, and people can get sick from being exposed to the sewage found in septic tanks and flood waters. Heavy rainfall can make septic systems function improperly. After such an event, it may take several days for your system to return to normal. Pumping the tank immediately may not help. Use very little household water to prevent backups of sewage in your home. Conserve water Septic systems with a pump need electricity. Without it, sewage can backup into your home. Use very little water from your tap until power is restored. Do not continue to use water if sewage backs up into the house, or if water or sewage is observed surfacing near the septic system. Keep children out of wet areas affected by sewage. Know what to expect When power to the system is restored, repairs may be necessary prior to returning to normal water use. The services of an electrician may also be needed if the sewage system s electrical units were flooded or had any physical damage. Signs of damage Most septic tanks are not damaged by a flood since they are below ground and completely covered. However, septic tanks or pump chambers can become filled wtih debris. Signs of damage include settling or inability to accept water. If you suspect your septic tank has been damaged, call a professional to inspect, service and clean it. After the storm Removal of debris may damage a septic system. Vehicles can crush drainfields, tanks and distribution boxes, especially when the soil is saturated. Make sure no one drives in or around your septic tank and drainfield, and either allow stumps to rot in place or have the stumps ground with a small stump grinder. Remove and discard household goods contaminated with sewage that cannot be disinfected, such as rugs, wall coverings and drywall. Always wear rubber boots and waterproof gloves when cleaning up sewage. 11-1

53 12. Solid Waste Proper disposal of garbage and refuse is necessary to minimize the development of odors, prevent such waste from becoming an attractant for insects and rodents, and prevent the soiling of food preparation and food service areas. Improperly handled garbage creates nuisance conditions, makes housekeeping difficult, and may be a possible source of contamination of food, equipment and utensils. For purposes of this manual, the following recommendations are categorized into two broad types of solid waste: putrescible and non-putrescible waste. Putrescible Waste Putrescible waste is capable of decay and spoilage, which creates an unfavorable environment for public health, and should be addressed promptly. Storage areas for garbage and refuse containers should be kept thoroughly clean in order to avoid attracting insects or rodents. Storage areas should be large enough to accommodate all of the containers needed by the operation in order to prevent the scattering of garbage and refuse. All containers should be maintained in good repair and cleaned as necessary in order to store garbage and refuse under sanitary conditions as well as to prevent the breeding of flies. Garbage containers should be available wherever garbage is generated to aid in the proper disposal of refuse. Outside receptacles should be constructed with tight-fitting lids or covers to prevent the scattering of the garbage or refuse by birds, breeding of flies or entry of rodents. Proper equipment and supplies should be made available to accomplish thorough and proper cleaning of garbage storage areas and receptacles, so unsanitary conditions can be eliminated. All wet food debris should be double-bagged before placing in dumpster. Arrangements should be made with the dumpster maintenance provider to ensure the dumpster can be emptied promptly or as needed. Non-Putrescible Waste For purposes of this manual, non-putrescible waste includes such items as cardboard boxes, dry cans, construction debris and yard debris. Domestic non-putrescible waste, such as cardboard boxes, dry cans and paper, should be stored separately from putrescible waste until disposal. 12-1

54 Avoid placing non-putrescible debris in dumpster in order to conserve as much dumpster space as possible for putrescible debris. Yard debris should be stored separately from domestic and construction debris, and should be disposed of in the designated municipality or county site. Care should be taken when handling yard debris. Protective clothing should be worn to avoid insect stings and exposure to plant allergens. Construction waste should be stored separately from domestic and yard debris and should be disposed of in the designated municipality or county site. Care should be exercised when handling suspected harmful materials, such as asbestos and lead paint. Asbestos and lead-based paint issues should be referred to the Health Hazards Control Unit, N.C. DHHS/Division of Public Health, 1912 Mail Service Center, Raleigh, NC , phone: (919) Disposal of all debris should meet the requirements of the North Carolina Solid Waste Management rules. The North Carolina Division of Waste Management can be contacted at N.C. DENR, 401 Oberlin Road - Suite 150, Raleigh, N.C , phone: (919)

55 13. Insects The most common reasons for emergency room visits following a hurricane are stings and bites. Mosquitoes, stinging caterpillars, snakes, fire ants, wasps and hornets could cause problems as citizens begin the business of cleaning up after a hurricane. Stinging Insects Bees, wasps and hornets may have had their nests disturbed by a natural disaster, especially wind and rain. These insects can become very aggressive while trying to defend their disturbed nests and former nest sites. Before beginning clean-up activities, survey the site to see if bees, wasps or hornets are hovering in the area. If they are present, use a commercially-available pesticide labeled for wasp and hornet control to get rid of them before entering. Stinging caterpillars, like the familiar saddle-back caterpillar, normally live in the canopies of trees and do not come into contact with humans. Toppled trees from excessive winds can put stinging insects into areas frequented by people cleaning up downed limbs. Caterpillar stings are very painful. To avoid them, wear long pants, long-sleeved shirts, socks and gloves when picking up and carrying limbs and leaves. Insect repellants do not work on stinging insects. If prescribed by your physician for insect allergies, make sure you have epinephrine in your emergency kit; its use will help prevent anaphylactic shock if you are stung. Mosquitoes Heavy rains can create breeding areas for mosquitoes, increasing their numbers and the possibility of diseases carried by them. Even water collected in the smallest containers or puddles provide places for mosquitoes to lay eggs and for the eggs to grow into adults. The easiest way to prevent mosquito bites is to use a repellant containing DEET, which is effective against both mosquitoes and ticks. The Centers for Disease Control and Prevention recently added to its recommended arsenal of repellents that prevent the bite. In past years, the CDC only had recommended repellents containing the chemical DEET. The CDC continues to say that DEET is most effective, but CDC experts have added two other repellents to its list of recommended repellents picaridin and oil of lemon eucalyptus. Picaridin has long been used in other countries and is an ingredient in at least one repellent sold in the United States. Oil of lemon eucalyptus has long been sold in a variety of sprays and lotions. Although effective in preventing mosquito bites, both of these products may not be effective against ticks. According to the CDC, oil of lemon eucalyptus should not be used on children under three years old. Always follow label instructions when applying mosquito repellents. In addition to using repellents, follow the following tips to prevent mosquito bites. Wear light-colored clothing with long sleeves and long pants legs whenever outdoors. 13-1

56 Try to reduce outdoor activities at dawn and dusk when mosquitoes are most active. Make the environment less mosquito-friendly by removing any containers that hold water. Keep your gutters unclogged. Change the water in bird baths and pet bowls at least twice a week. Make sure your windows and doors have screens to keep the mosquitoes outside. Mosquito-borne illness in North Carolina La Crosse encephalitis (LAC) Although rarely fatal, La Crosse encephalitis is the most common mosquito-borne illness in North Carolina. It is spread by tree-dwelling mosquitoes and is most common in the western part of the state. Symptoms occur from a few days to a couple of weeks after being bitten by an infected mosquito. These symptoms include fever, headache, nausea and vomiting. In more severe cases, convulsions, tremors and coma can occur. Children under 16 years of age and the elderly are the most susceptible to the disease. West Nile virus encephalomyelitis (WNV) West Nile virus has been found across the state during past mosquito seasons. People typically develop symptoms between 3 and 14 days after being bitten by an infected mosquito, if they develop any symptoms at all. Most people who are infected with West Nile virus - approximately 80 percent - will not become ill. Up to 20 percent of the people who become infected will display mild symptoms, including fever, headache, and body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms typically last a few days. About one in 150 people infected with WNV will develop severe illness. The severe symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis, and often require hospitalization. These symptoms may last several weeks, and neurological effects may be permanent. People over the age of 50 and those with weakened immune systems are more likely to develop serious symptoms of WNV if they do get sick. Eastern Equine Encephalitis (EEE) Eastern Equine Encephalitis is the most serious mosquito-borne illness in North Carolina. About fifty percent of human EEE cases are fatal, with young children and the elderly most at risk. Symptoms can develop from a few days to two weeks after being bitten by an infected mosquito. They include rapid onset of fever and headache and can resemble a case of the flu. Survivors of EEE infections may suffer from long-term effects to the nervous system. Therapy is limited to treating the symptoms of the disease, since there is no specific cure. 13-2

57 People who suspect they may have a mosquito-borne illness should contact their doctor. Snakes and Fire Ants The rain may have also disturbed snake and fire ant habitats, so watch for these creatures as well. Take the necessary precautions to avoid painful bites and stings. If you see snakes displaced by floodwaters, try to avoid them. If you must wade in water, watch out for fire ants floating on debris or in floating balls from disturbed ant nests. If bitten or stung, seek appropriate medical care. Do not put ice on snake bites; however, ice can be used on fire ant stings. 13-3

58 14. Animal Information Before, during and after a natural disaster, both wild and domestic animals may be affected and require special care, handling, or control. Emergency rooms have reported an increase in the number of animal related injuries following disasters. Animals may become disoriented and aggressive when injured or frightened. Care should be used when encountering any animal, especially during or after a natural disaster. Rabies Rabies is now endemic in North Carolina. It is transmitted by exposure to mammals that have been infected with the virus. The infected animal may be able to transmit the disease and not show any symptoms. Specimens will need to be packaged according to federal shipping requirements. Counties should have available wrapping materials including labels, ice packs, insulated containers, and lab submission paperwork. Efforts should be made to hold animals for observation rather than submitting animals that could have been observed to the lab for testing. Exposures to humans should always be evaluated by trained medical staff. For more information, please see (#) and (#) in the appendices. Snakes and Other Reptiles Areas which have been affected by floodwaters frequently become infested with snakes after the waters have receded. When working in areas after a flood, care should be taken to be observant for snakes even inside recently occupied buildings. Protective equipment such as snake gators or high leather boots should be worn. Other reptiles, such as alligators, can also be pushed into populated areas after flooding. Only individuals trained for dealing with these types of animals should attempt to control or contain these animals. Keep people away from these dangers until trained personnel can respond. Domestic Animals Copies of current vaccination records should be available and kept with the animal. If it becomes necessary for the animal to be temporarily relocated, proof of vaccination (especially rabies) will be needed. The N.C. State Animal Response Team was formed after Hurricane Floyd to assist with domestic animal problems during emergencies. Dead Animal Carcass Removal During an emergency, animals may die and their carcasses need to be disposed of properly. Proper disposal is important to prevent the spread of pathogens and ground and surface water contamination as well as for pest control. Guidelines for animal burial following a natural disaster can be viewed online at

59 15. Resources Animals Food Dangers of Re-entering a Flooded Building Memos Embargo Embargo pager number Water supply Emergency form links: (To be added when available) Disinfection of private wells:

60 Matrix for water supply decisions Shelters (To be added when available) Personnel links Food Protection Regional staff: o EHS by county: o

61 Food and Water Safety During Hurricanes, Power Outages, and Floods What Consumers Need to Know Emergencies can happen. When they do, the best strategy is to already have a plan in place. This includes knowing the proper food and water safety precautions to take if hurricanes or other flooding/power outages do occur. FOODFACTS From the U.S. Food and Drug Administration Be Prepared for Emergencies 1. Make sure you have appliance thermometers in your refrigerator and freezer. Check to ensure that the freezer temperature is at or below 0 F, and the refrigerator is at or below 40 F. In case of a power outage, the appliance thermometers will indicate the temperatures in the refrigerator and freezer to help you determine if the food is safe. 2. Freeze containers of water for ice to help keep food cold in the freezer, refrigerator, or coolers in case the power goes out. If your normal water supply is contaminated or unavailable, the melting ice will also supply drinking water. 3. Freeze refrigerated items such as leftovers, milk, and fresh meat and poultry that you may not need immediately. This helps keep them at a safe temperature longer. 4. Group food together in the freezer. This helps the food stay cold longer. 5. Have coolers on hand to keep refrigerated food cold if the power will be out for more than 4 hours. 6. Purchase or make ice cubes in advance and store in the freezer for use in the refrigerator or in a cooler. Freeze gel packs ahead of time for use in coolers. 7. Check out local sources to know where dry ice and block ice can be purchased, just in case. 8. Store food on shelves that will be safely out of the way of contaminated water in case of flooding. 9. Make sure to have a supply of bottled water stored where it will be as safe as possible from flooding. Power Outages: During and After When the Power Goes Out... Here are basic tips for keeping food safe: Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. The refrigerator will keep food cold for about 4 hours if it is unopened. A full freezer will keep the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed. KEEP CLOSED Buy dry or block ice to keep the refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18 cubic foot, fully-stocked freezer cold for two days. If you plan to eat refrigerated or frozen meat, poultry, fish or eggs while it is still at safe temperatures, it s important that each item is thoroughly cooked to its proper temperature to assure that any foodborne bacteria that may be present are destroyed. However, if at any point the food was above 40 ºF for 2 hours or more discard it. Wash fruits and vegetables with water from a safe source before eating. For infants, try to use prepared, canned baby formula that requires no added water. When using concentrated or powdered formulas, prepare with bottled water if the local water source is potentially contaminated. Once Power Is Restored... You ll need to determine the safety of your food. Here s how: If an appliance thermometer was kept in the freezer, check the temperature when the power comes back on. If the freezer thermometer reads 40 F or below, the food is safe and may be refrozen. If a thermometer has not been kept in the freezer, check each package of food to determine its safety. You can t rely on appearance or odor. If the food still contains ice crystals or is 40 F or below, it is safe to refreeze or cook. Refrigerated food should be safe as long as the power was out for no more than 4 hours and the refrigerator door was kept shut. Discard any perishable food (such as meat, poultry, fish, eggs or leftovers) that has been above 40 F for two hours or more. Keep in mind that perishable food such as meat, poultry, seafood, milk, and eggs that are not kept adequately refrigerated or frozen may cause illness if consumed, even when they are thoroughly cooked. Safety n Health n Science n Nutrition December

62 FOODFACTS n n n When Flooding Occurs Keep Water Safe Follow these steps to keep your WATER SAFE during and after flood conditions. 1. Use bottled water that has not been exposed to flood waters if it is available. 2. If you don t have bottled water, you should boil water to make it safe. Boiling water will kill most types of disease-causing organisms that may be present. If the water is cloudy, filter it through clean cloths, or allow it to settle and then draw off the clear water for boiling. Boil the water for one minute, let it cool, and store it in clean containers with covers. 3. If you can t boil water, you can disinfect it using household bleach. Bleach will kill some, but not all, types of disease-causing organisms that may be in the water. If the water is cloudy, filter it through clean cloths, or allow it to settle and then draw off the clear water for disinfection. Add 1/8 teaspoon (or 8 drops) of regular, unscented, liquid household bleach per each gallon of water. Stir it well and let it stand for at least 30 minutes before you use it. Store disinfected water in clean containers with covers. 4. If you have a well that has been flooded, the water should be tested and disinfected after flood waters recede. If you suspect that your well may be contaminated, contact your local or state health department or agricultural extension agent for specific advice. When Flooding Occurs Keep Food Safe Follow these steps to keep your FOOD SAFE during and after flood conditions. 1. Do not eat any food that may have come into contact with flood water. 2. Discard any food that is not in a waterproof container if there is any chance that it has come into contact with flood water. Food containers that are not waterproof include those with screw-caps, snap lids, pull tops, and crimped caps. Also discard cardboard juice/milk/baby formula boxes and home canned foods if they have come in contact with flood water, because they cannot be effectively cleaned and sanitized. 3. Inspect canned foods and discard any food in damaged cans. Can damage is shown by swelling, leakage, punctures, holes, fractures, extensive deep rusting, or crushing/denting severe enough to prevent normal stacking or opening with a manual, wheel-type can opener. 4. Undamaged, commercially prepared foods in all-metal cans and retort pouches (like flexible, shelf-stable juice or seafood pouches) can be saved if you follow this procedure: Remove the labels, if they are the removable kind, since they can harbor dirt and bacteria. Brush or wipe away any dirt or silt. Thoroughly wash the cans or retort pouches with soap and water, using hot water if it is available. Rinse the cans or retort pouches with water that is safe for drinking, if available, since dirt or residual soap will reduce the effectiveness of chlorine sanitation. Sanitize cans and retort pouches by immersion in one of the two following ways: Place in water and allow the water to come to a boil and continue boiling for 2 minutes, or Place in a freshly-made solution consisting of 1 tablespoon of unscented liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available) for 15 minutes. Air dry cans or retort pouches for a minimum of 1 hour before opening or storing. If the labels were removable, then re-label your cans or retort pouches, including the expiration date (if available), with a marking pen. Food in reconditioned cans or retort pouches should be used as soon as possible thereafter. Any concentrated baby formula in reconditioned, all-metal containers must be diluted with clean drinking water. 5. Thoroughly wash metal pans, ceramic dishes, and utensils (including can openers) with soap and water, using hot water if available. Rinse, and then sanitize them by boiling in clean water or immersing them for 15 minutes in a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available). 6. Thoroughly wash countertops with soap and water, using hot water if available. Rinse, and then sanitize by applying a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available). Allow to air dry. Everyone can practice safe food handling by following these four simple steps: Safety n Health n Science n Nutrition December 2007 For more information, contact: The U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition Food Information Line at SAFEFOOD (toll free), 10 AM to 4 PM ET, Monday through Friday. Or visit the FDA Web site at 2

63 Food and Water Safety During Hurricanes, Power Outages, and Floods What Consumers Need to Know Emergencies can happen. When they do, the best strategy is to already have a plan in place. This includes knowing the proper food and water safety precautions to take if hurricanes or other flooding/power outages do occur. FOODFACTS From the U.S. Food and Drug Administration Be Prepared for Emergencies 1. Make sure you have appliance thermometers in your refrigerator and freezer. Check to ensure that the freezer temperature is at or below 0 F, and the refrigerator is at or below 40 F. In case of a power outage, the appliance thermometers will indicate the temperatures in the refrigerator and freezer to help you determine if the food is safe. 2. Freeze containers of water for ice to help keep food cold in the freezer, refrigerator, or coolers in case the power goes out. If your normal water supply is contaminated or unavailable, the melting ice will also supply drinking water. 3. Freeze refrigerated items such as leftovers, milk, and fresh meat and poultry that you may not need immediately. This helps keep them at a safe temperature longer. 4. Group food together in the freezer. This helps the food stay cold longer. 5. Have coolers on hand to keep refrigerated food cold if the power will be out for more than 4 hours. 6. Purchase or make ice cubes in advance and store in the freezer for use in the refrigerator or in a cooler. Freeze gel packs ahead of time for use in coolers. 7. Check out local sources to know where dry ice and block ice can be purchased, just in case. 8. Store food on shelves that will be safely out of the way of contaminated water in case of flooding. 9. Make sure to have a supply of bottled water stored where it will be as safe as possible from flooding. Power Outages: During and After When the Power Goes Out... Here are basic tips for keeping food safe: Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. The refrigerator will keep food cold for about 4 hours if it is unopened. A full freezer will keep the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed. KEEP CLOSED Buy dry or block ice to keep the refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18 cubic foot, fully-stocked freezer cold for two days. If you plan to eat refrigerated or frozen meat, poultry, fish or eggs while it is still at safe temperatures, it s important that each item is thoroughly cooked to its proper temperature to assure that any foodborne bacteria that may be present are destroyed. However, if at any point the food was above 40 ºF for 2 hours or more discard it. Wash fruits and vegetables with water from a safe source before eating. For infants, try to use prepared, canned baby formula that requires no added water. When using concentrated or powdered formulas, prepare with bottled water if the local water source is potentially contaminated. Once Power Is Restored... You ll need to determine the safety of your food. Here s how: If an appliance thermometer was kept in the freezer, check the temperature when the power comes back on. If the freezer thermometer reads 40 F or below, the food is safe and may be refrozen. If a thermometer has not been kept in the freezer, check each package of food to determine its safety. You can t rely on appearance or odor. If the food still contains ice crystals or is 40 F or below, it is safe to refreeze or cook. Refrigerated food should be safe as long as the power was out for no more than 4 hours and the refrigerator door was kept shut. Discard any perishable food (such as meat, poultry, fish, eggs or leftovers) that has been above 40 F for two hours or more. Keep in mind that perishable food such as meat, poultry, seafood, milk, and eggs that are not kept adequately refrigerated or frozen may cause illness if consumed, even when they are thoroughly cooked. Safety n Health n Science n Nutrition December

64 FOODFACTS n n n When Flooding Occurs Keep Water Safe Follow these steps to keep your WATER SAFE during and after flood conditions. 1. Use bottled water that has not been exposed to flood waters if it is available. 2. If you don t have bottled water, you should boil water to make it safe. Boiling water will kill most types of disease-causing organisms that may be present. If the water is cloudy, filter it through clean cloths, or allow it to settle and then draw off the clear water for boiling. Boil the water for one minute, let it cool, and store it in clean containers with covers. 3. If you can t boil water, you can disinfect it using household bleach. Bleach will kill some, but not all, types of disease-causing organisms that may be in the water. If the water is cloudy, filter it through clean cloths, or allow it to settle and then draw off the clear water for disinfection. Add 1/8 teaspoon (or 8 drops) of regular, unscented, liquid household bleach per each gallon of water. Stir it well and let it stand for at least 30 minutes before you use it. Store disinfected water in clean containers with covers. 4. If you have a well that has been flooded, the water should be tested and disinfected after flood waters recede. If you suspect that your well may be contaminated, contact your local or state health department or agricultural extension agent for specific advice. When Flooding Occurs Keep Food Safe Follow these steps to keep your FOOD SAFE during and after flood conditions. 1. Do not eat any food that may have come into contact with flood water. 2. Discard any food that is not in a waterproof container if there is any chance that it has come into contact with flood water. Food containers that are not waterproof include those with screw-caps, snap lids, pull tops, and crimped caps. Also discard cardboard juice/milk/baby formula boxes and home canned foods if they have come in contact with flood water, because they cannot be effectively cleaned and sanitized. 3. Inspect canned foods and discard any food in damaged cans. Can damage is shown by swelling, leakage, punctures, holes, fractures, extensive deep rusting, or crushing/denting severe enough to prevent normal stacking or opening with a manual, wheel-type can opener. 4. Undamaged, commercially prepared foods in all-metal cans and retort pouches (like flexible, shelf-stable juice or seafood pouches) can be saved if you follow this procedure: Remove the labels, if they are the removable kind, since they can harbor dirt and bacteria. Brush or wipe away any dirt or silt. Thoroughly wash the cans or retort pouches with soap and water, using hot water if it is available. Rinse the cans or retort pouches with water that is safe for drinking, if available, since dirt or residual soap will reduce the effectiveness of chlorine sanitation. Sanitize cans and retort pouches by immersion in one of the two following ways: Place in water and allow the water to come to a boil and continue boiling for 2 minutes, or Place in a freshly-made solution consisting of 1 tablespoon of unscented liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available) for 15 minutes. Air dry cans or retort pouches for a minimum of 1 hour before opening or storing. If the labels were removable, then re-label your cans or retort pouches, including the expiration date (if available), with a marking pen. Food in reconditioned cans or retort pouches should be used as soon as possible thereafter. Any concentrated baby formula in reconditioned, all-metal containers must be diluted with clean drinking water. 5. Thoroughly wash metal pans, ceramic dishes, and utensils (including can openers) with soap and water, using hot water if available. Rinse, and then sanitize them by boiling in clean water or immersing them for 15 minutes in a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available). 6. Thoroughly wash countertops with soap and water, using hot water if available. Rinse, and then sanitize by applying a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available). Allow to air dry. Everyone can practice safe food handling by following these four simple steps: Safety n Health n Science n Nutrition December 2007 For more information, contact: The U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition Food Information Line at SAFEFOOD (toll free), 10 AM to 4 PM ET, Monday through Friday. Or visit the FDA Web site at 2

65 Food and Water Safety During Hurricanes, Power Outages, and Floods What Consumers Need to Know Emergencies can happen. When they do, the best strategy is to already have a plan in place. This includes knowing the proper food and water safety precautions to take if hurricanes or other flooding/power outages do occur. FOODFACTS From the U.S. Food and Drug Administration Be Prepared for Emergencies 1. Make sure you have appliance thermometers in your refrigerator and freezer. Check to ensure that the freezer temperature is at or below 0 F, and the refrigerator is at or below 40 F. In case of a power outage, the appliance thermometers will indicate the temperatures in the refrigerator and freezer to help you determine if the food is safe. 2. Freeze containers of water for ice to help keep food cold in the freezer, refrigerator, or coolers in case the power goes out. If your normal water supply is contaminated or unavailable, the melting ice will also supply drinking water. 3. Freeze refrigerated items such as leftovers, milk, and fresh meat and poultry that you may not need immediately. This helps keep them at a safe temperature longer. 4. Group food together in the freezer. This helps the food stay cold longer. 5. Have coolers on hand to keep refrigerated food cold if the power will be out for more than 4 hours. 6. Purchase or make ice cubes in advance and store in the freezer for use in the refrigerator or in a cooler. Freeze gel packs ahead of time for use in coolers. 7. Check out local sources to know where dry ice and block ice can be purchased, just in case. 8. Store food on shelves that will be safely out of the way of contaminated water in case of flooding. 9. Make sure to have a supply of bottled water stored where it will be as safe as possible from flooding. Power Outages: During and After When the Power Goes Out... Here are basic tips for keeping food safe: Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. The refrigerator will keep food cold for about 4 hours if it is unopened. A full freezer will keep the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed. KEEP CLOSED Buy dry or block ice to keep the refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18 cubic foot, fully-stocked freezer cold for two days. If you plan to eat refrigerated or frozen meat, poultry, fish or eggs while it is still at safe temperatures, it s important that each item is thoroughly cooked to its proper temperature to assure that any foodborne bacteria that may be present are destroyed. However, if at any point the food was above 40 ºF for 2 hours or more discard it. Wash fruits and vegetables with water from a safe source before eating. For infants, try to use prepared, canned baby formula that requires no added water. When using concentrated or powdered formulas, prepare with bottled water if the local water source is potentially contaminated. Once Power Is Restored... You ll need to determine the safety of your food. Here s how: If an appliance thermometer was kept in the freezer, check the temperature when the power comes back on. If the freezer thermometer reads 40 F or below, the food is safe and may be refrozen. If a thermometer has not been kept in the freezer, check each package of food to determine its safety. You can t rely on appearance or odor. If the food still contains ice crystals or is 40 F or below, it is safe to refreeze or cook. Refrigerated food should be safe as long as the power was out for no more than 4 hours and the refrigerator door was kept shut. Discard any perishable food (such as meat, poultry, fish, eggs or leftovers) that has been above 40 F for two hours or more. Keep in mind that perishable food such as meat, poultry, seafood, milk, and eggs that are not kept adequately refrigerated or frozen may cause illness if consumed, even when they are thoroughly cooked. Safety n Health n Science n Nutrition December

66 FOODFACTS n n n When Flooding Occurs Keep Water Safe Follow these steps to keep your WATER SAFE during and after flood conditions. 1. Use bottled water that has not been exposed to flood waters if it is available. 2. If you don t have bottled water, you should boil water to make it safe. Boiling water will kill most types of disease-causing organisms that may be present. If the water is cloudy, filter it through clean cloths, or allow it to settle and then draw off the clear water for boiling. Boil the water for one minute, let it cool, and store it in clean containers with covers. 3. If you can t boil water, you can disinfect it using household bleach. Bleach will kill some, but not all, types of disease-causing organisms that may be in the water. If the water is cloudy, filter it through clean cloths, or allow it to settle and then draw off the clear water for disinfection. Add 1/8 teaspoon (or 8 drops) of regular, unscented, liquid household bleach per each gallon of water. Stir it well and let it stand for at least 30 minutes before you use it. Store disinfected water in clean containers with covers. 4. If you have a well that has been flooded, the water should be tested and disinfected after flood waters recede. If you suspect that your well may be contaminated, contact your local or state health department or agricultural extension agent for specific advice. When Flooding Occurs Keep Food Safe Follow these steps to keep your FOOD SAFE during and after flood conditions. 1. Do not eat any food that may have come into contact with flood water. 2. Discard any food that is not in a waterproof container if there is any chance that it has come into contact with flood water. Food containers that are not waterproof include those with screw-caps, snap lids, pull tops, and crimped caps. Also discard cardboard juice/milk/baby formula boxes and home canned foods if they have come in contact with flood water, because they cannot be effectively cleaned and sanitized. 3. Inspect canned foods and discard any food in damaged cans. Can damage is shown by swelling, leakage, punctures, holes, fractures, extensive deep rusting, or crushing/denting severe enough to prevent normal stacking or opening with a manual, wheel-type can opener. 4. Undamaged, commercially prepared foods in all-metal cans and retort pouches (like flexible, shelf-stable juice or seafood pouches) can be saved if you follow this procedure: Remove the labels, if they are the removable kind, since they can harbor dirt and bacteria. Brush or wipe away any dirt or silt. Thoroughly wash the cans or retort pouches with soap and water, using hot water if it is available. Rinse the cans or retort pouches with water that is safe for drinking, if available, since dirt or residual soap will reduce the effectiveness of chlorine sanitation. Sanitize cans and retort pouches by immersion in one of the two following ways: Place in water and allow the water to come to a boil and continue boiling for 2 minutes, or Place in a freshly-made solution consisting of 1 tablespoon of unscented liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available) for 15 minutes. Air dry cans or retort pouches for a minimum of 1 hour before opening or storing. If the labels were removable, then re-label your cans or retort pouches, including the expiration date (if available), with a marking pen. Food in reconditioned cans or retort pouches should be used as soon as possible thereafter. Any concentrated baby formula in reconditioned, all-metal containers must be diluted with clean drinking water. 5. Thoroughly wash metal pans, ceramic dishes, and utensils (including can openers) with soap and water, using hot water if available. Rinse, and then sanitize them by boiling in clean water or immersing them for 15 minutes in a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available). 6. Thoroughly wash countertops with soap and water, using hot water if available. Rinse, and then sanitize by applying a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water (or the cleanest, clearest water available). Allow to air dry. Everyone can practice safe food handling by following these four simple steps: Safety n Health n Science n Nutrition December 2007 For more information, contact: The U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition Food Information Line at SAFEFOOD (toll free), 10 AM to 4 PM ET, Monday through Friday. Or visit the FDA Web site at 2

67 Protección y seguridad del agua y los alimentos en caso de huracán, corte de energía eléctrica e inundaciones Lo que usted necesita saber Las emergencias pueden suceder. Y para enfrentarlas cuando se presenten, la mejor estrategia es tener un plan preparado. Esto incluye saber cuáles son las precauciones adecuadas que se deben tomar para la protección y seguridad del agua y los alimentos ante amenaza de huracán, corte de energía eléctrica o inundaciones. INFORMACIÓN SOBRE ALIMENTOS De la Administración de Medicamentos y Alimentos de los EE. UU. Esté preparado para enfrentar las emergencias 1. Asegúrese de que su refrigerador y su congelador tengan termómetros para equipos electrodomésticos. Compruebe que la temperatura del congelador esté en 0 F o menos, y que la del refrigerador esté en 40 F o menos. En caso de un corte de energía eléctrica, los termómetros para equipos electrodomésticos indicarán la temperatura que hay en ese momento en el refrigerador y en el congelador para ayudarle a determinar si los alimentos están seguros. 2. Congele agua en contenedores para ayudarle a mantener los alimentos fríos en el congelador, el refrigerador o las neveras en caso de que se vaya la electricidad. Si el suministro normal de agua está contaminado o no está disponible, el hielo que se derrita también le proporcionará agua potable. 3. Congele los productos refrigerados que posiblemente no vaya a necesitar de inmediato, tales como sobras, leche y carne y pollo frescos. Esto ayudará a mantenerlos a una temperatura que los proteja durante más tiempo. 4. Agrupe los alimentos en el congelador. Esto ayudará a que se conserven fríos por más tiempo. 5. Tenga neveras a mano para conservar fríos los alimentos refrigerados en caso de que vaya a faltar la electricidad por más de 4 horas. 6. Compre o haga cubitos de hielo con anticipación y almacénelos en el congelador para usarlos en el refrigerador o en una nevera. Congele con anticipación los paquetes de gel refrigerante, para conservar el frío en las neveras. 7. Por si acaso, ubique los lugares cercanos donde podría comprar hielo seco o bloques de hielo. 8. Almacene alimentos en estantes que estén fuera del posible alcance de aguas contaminadas en caso de una inundación. 9. Asegúrese de tener un suministro de agua embotellada almacenado en un lugar donde esté lo más protegido posible si ocurre una inundación. Corte de energía eléctrica: Durante y después Cuando se vaya la electricidad... Los siguientes son algunos consejos básicos para proteger los alimentos: Mantenga las puertas del refrigerador y del congelador cerradas el meyor tiempo posible para que la temperatura se mantenga fría. Si no se abre, el refrigerador conservará fríos los alimentos durante alrededor de 4 horas. Un congelador lleno mantendrá la temperatura durante aproximadamente 48 horas (24 horas si está medio lleno) si la puerta permanece cerrada. Compre hielo seco o bloques de hielo para mantener el refrigerador lo más frío posible si la electricidad va a faltar por un período de tiempo prolongado. Cincuenta libras MANTENER CERRADO de hielo seco deben mantener frío un congelador de 18 pies cúbicos, bien lleno, por dos días. Si piensa comer carne, pollo, pescado o huevos refrigerados o congelados que aún se conservan a temperaturas seguras, es importante que cada producto se cocine muy bien y a la temperatura adecuada correspondiente para asegurarse de que se destruya cualquier posible bacteria de origen alimentario. Sin embargo, si en algún momento los alimentos estuvieron a una temperatura superior a los 40 ºF por un período de 2 horas o más, deséchelos. Lave las frutas y las verduras con agua procedente de una fuente segura antes de comerlas. Para los niños pequeños, trate de usar fórmulas para bebé preparadas y enlatadas, a las que no haya que agregarles agua. Cuando vaya a usar fórmulas concentradas o en polvo, prepárelas con agua embotellada si hay riesgo de que el suministro de agua local pudiera estar contaminado. Cuando regrese la electricidad... Si mantuvo un termómetro para equipos electrodomésticos en el congelador, compruebe su temperatura cuando regrese la electricidad. Si la lectura del termómetro del congelador es de 40 F o menos, los alimentos están en buenas condiciones y se pueden volver a congelar. Si no mantuvo un termómetro en el congelador, revise cada paquete de alimentos para determinar si está en buenas condiciones. No puede confiarse por su aspecto o su olor. Si los alimentos todavía tienen trocitos de hielo o están a una temperatura de 40 F o menos, están en buenas condiciones para volverlos a congelar o para cocinarlos. Los alimentos refrigerados deben mantenerse en buenas condiciones siempre que la electricidad no haya faltado por más de 4 horas y que la puerta del refrigerador haya permanecido cerrada. Deseche cualquier alimento perecedero (tales como carne, pollo, pescado, huevos o sobras) que haya permanecido a una temperatura superior a 40 F durante dos horas o más. Tenga presenta que los alimentos perecederos como la carne, el pollo, los mariscos, la leche y los huevos, que no se mantienen refrigerados o congelados de manera adecuada, pueden causar enfermedades si se consumen, aunque se cocinen bien. Seguridad n Salud n Ciencia n Nutrición diciembre de

68 INFORMACIÓN SOBRE ALIMENTOS n n n Cuando ocurre una inundación Proteja el agua Siga estos pasos para mantener PROTEGIDA el AGUA durante y después de una inundación: 1. Si dispone de ella, use agua embotellada que no haya estado expuesta a las aguas de la inundación. 2. Si no tiene agua embotellada, debe hervir agua para potabilizarla. Al hervir el agua mueren la mayoría de los tipos de organismos causantes de enfermedades que pudieran estar presentes. Si el agua está turbia, fíltrela pasándola por paños limpios o deje que se asiente y luego extraiga el agua transparente para hervirla. Deje que el agua hierva durante un minuto, espere a que se enfríe y viértala en recipientes limpios y con tapa. 3. Si no puede hervir el agua, puede desinfectarla usando cloro doméstico. El cloro matará algunos tipos, aunque no todos, de organismos causantes de enfermedades que pudieran estar presentes en el agua. Si el agua está turbia, fíltrela pasándola por paños limpios o deje que se asiente y luego extraiga el agua transparente para desinfectarla. Agregue 1/8 de cucharadita (u 8 gotas) de cloro líquido doméstico normal, sin aroma, por cada galón de agua. Revuelva bien el agua con el cloro y espere al menos 30 minutos antes de usarla. Guarde el agua desinfectada en recipientes limpios y con tapa. 4. Si tiene un pozo que se haya inundado, debe hacerle pruebas al agua y desinfectarla después que las aguas de la inundación se retiren. Si sospecha que las aguas de su pozo podrían estar contaminadas, comuníquese con el Departamento de Salud local o estatal, o con su agente de extensión agrícola, para que lo asesoren en su caso específico. Cuando ocurre una inundación Proteja los alimentos Siga estos pasos para mantener PROTEGIDOS los ALIMENTOS durante y después de una inundación: 1. No ingiera ningún alimento que podría haber estado en contacto con las aguas de la inundación. 2. Deseche cualquier alimento que no esté en un contenedor impermeabilizado si hubo alguna posibilidad de que el mismo haya estado en contacto con las aguas de la inundación. Entre los contenedores de alimentos que no son impermeables se incluyen aquellos con tapa rosca, los que tienen tapas que se abren a presión o se tiran, y los de tapas plegables. Deseche también las cajas de jugo, leche o fórmulas para bebés y los alimentos que haya guardado en latas si han estado en contacto con las aguas de la inundación, porque no se pueden limpiar e higienizar bien. 3. Inspeccione los alimentos enlatados y deseche cualquier alimento que esté en latas dañadas. Se sabe si una lata está dañada si tiene abultamiento, derrame, pinchazos, perforaciones, roturas, oxidación profunda y extensa, o aplastamiento o abolladura lo suficientemente graves como para impedir que se apile normalmente o que se pueda abrir con un abrelatas manual. 4. Los alimentos preparados comercialmente en latas que son completamente de metal y en envases flexibles que no estén dañados (como envases flexibles para jugos o mariscos que se pueden colocar con estabilidad en los estantes) se pueden salvar si se sigue el procedimiento a continuación: Quíteles las etiquetas si es posible, ya que pueden contener impurezas y bacterias. Cepille o limpie con un paño cualquier suciedad o sedimento que haya. Limpie bien las latas o los envases flexibles con agua y jabón, usando agua caliente si tiene. Enjuague las latas o envases flexibles con agua potable, si tiene, ya que la suciedad o el residuo de jabón reduciría la eficacia de la higienización con cloro. Higienice las latas o los envases flexibles de una de las dos siguientes maneras: sumérjalos en agua y deje que el agua hierva durante 2 minutos, o sumérjalos dentro de una solución recién preparada consistente en 1 cucharada de cloro líquido sin aroma por cada galón de agua potable (o el agua más limpia y transparente que tenga) y manténgalos sumergidos durante 15 minutos. Deje que las latas o los envases flexibles se sequen al aire durante 1 hora como mínimo antes de abrirlos o guardarlos. Si pudo quitar las etiquetas, entonces identifique el contenido de las latas o los envases flexibles con un marcador, incluyendo la fecha de vencimiento (si la tiene). Los alimentos en latas o envases flexibles reacondicionados se deben usar lo más pronto posible. Cualquier fórmula concentrada para bebés, que se encuentre en contenedores reacondicionados que sean completamente de metal, se debe diluir en agua potable limpia. 5. Lave bien con agua y jabón las cacerolas metálicas, la vajilla de cerámica y los utensilios de cocina (incluyendo los abrelatas), usando agua caliente si tiene. Enjuáguelos y luego higienícelos dejándolos hervir en agua limpia o sumergiéndolos durante 15 minutos en una solución de 1 cucharada de cloro líquido sin aroma por cada galón de agua potable (o el agua más limpia y transparente que tenga). 6. Lave bien la superficie de la cocina con agua y jabón, usando agua caliente si tiene. Enjuáguela y luego higienícela aplicándole una solución de 1 cucharada de cloro líquido sin aroma por cada galón de agua potable (o el agua más limpia y transparente que tenga). Espere a que se seque al aire. Todos pueden manipular la comida de manera segura si siguen estos cuatro pasos simples: Seguridad n Salud n Ciencia n Nutrición diciembre de 2007 Para obtener más información: Administración de Medicamentos y Alimentos de los EE.UU. Centro para la Seguridad Alimentaria y la Nutrición Aplicada. Llame gratis a la Línea de información de alimentos al SAFEFOOD, de 10 AM a 4 PM hora del este, lunes a viernes. O visite el sitio Web de la FDA 2

69 Release No Contact: Diane Van (301) USDA OFFERS FOOD SAFETY TIPS FOR HURRICANE PREPAREDNESS WASHINGTON, July 22, As the peak of the 2009 hurricane season approaches, USDA's Food Safety and Inspection Service (FSIS) is providing recommendations to minimize the potential for foodborne illnesses due to power outages and other problems often associated with severe weather. "In the hours after a tropical storm or hurricane, food safety can become a critical public health issue," said USDA Deputy Under Secretary for Food Safety Jerold Mande. "With a little bit of advance planning, people can make sure they have access to safe food and water even in the aftermath of severe storms." Steps to follow to prepare for a possible weather emergency: Keep an appliance thermometer in the refrigerator and freezer. An appliance thermometer will indicate the temperature inside the refrigerator and freezer in case of a power outage and help determine the safety of the food. Make sure the freezer is at 0 F or below and the refrigerator is at 40 F or below. Freeze containers of water for ice to help keep food cold in the freezer, refrigerator or coolers after the power is out. Freeze refrigerated items such as leftovers, milk and fresh meat and poultry that you may not need immediately - this helps keep them at a safe temperature longer. Plan ahead and know where dry ice and block ice can be purchased. Have coolers on hand to keep refrigerator food cold if the power will be out for more than 4 hours. Purchase or make ice cubes and store in the freezer for use in the refrigerator or in a cooler. Freeze gel packs ahead of time for use in coolers. Group food together in the freezer - this helps the food stay cold longer. Store food on shelves that will be safely out of the way of contaminated water in case of flooding. Steps to follow after the weather emergency: Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. The refrigerator will keep food safely cold for about 4 hours if it is unopened. A full

70 freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) and the door remains closed. Discard refrigerated perishable food such as meat, poultry, fish, soft cheeses, milk, eggs, leftovers and deli items after 4 hours without power. Food may be safely refrozen if it still contains ice crystals or is at 40 F or below when checked with a food thermometer. Never taste a food to determine its safety! Obtain dry or block ice to keep your refrigerator and freezer as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic-foot full freezer for 2 days. If the power has been out for several days, check the temperature of the freezer with an appliance thermometer. If the appliance thermometer reads 40 F or below, the food is safe to refreeze. If a thermometer has not been kept in the freezer, check each package of food to determine its safety. If the food still contains ice crystals, the food is safe. Discard any food that is not in a waterproof container if there is any chance that it has come into contact with flood water. Discard wooden cutting boards, plastic utensils, baby bottle nipples and pacifiers. Thoroughly wash all metal pans, ceramic dishes and utensils that came in contact with flood water with hot soapy water and sanitize by boiling them in clean water or by immersing them for 15 minutes in a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water. Undamaged, commercially prepared foods in all-metal cans and retort pouches (for example, flexible, shelf-stable juice or seafood pouches) can be saved. Follow the Steps to Salvage All-Metal Cans and Retort Pouches in the publication "Keeping Food Safe During an Emergency" at: Use bottled water that has not been exposed to flood waters. If bottled water is not available, tap water can be boiled for safety. For more information on drinking water safely during weather emergencies, access the FSIS publication "Keeping Food Safe During an Emergency" at When in Doubt, Throw it Out! News organizations and power companies can obtain hard copy (Beta and DVD) versions of the PSA by contacting the Food Safety Education Staff in FSIS' Office of Public Affairs and Consumer Education by calling (301) Consumers with food safety questions can "Ask Karen," the FSIS virtual representative available 24 hours a day at The toll-free USDA Meat and Poultry Hotline MPHotline ( ) is available in English and Spanish and can be reached from l0 a.m. to 4 p.m. ET Monday through Friday. Recorded food safety messages are available 24 hours a day. Podcasts and SignFSIS video-casts in American Sign Language featuring text-captioning are available online at #

71 FOR ADDITIONAL INFORMATION ON FDA AND USDA HURRICANE PREPARENESS TIPS PLEASE SEE LINKS BELOW:

72 Hurricane Fact Sheet After the Storm: Food and Water Safety Severe storms often result in extended power losses and flooding. If you lost power for an extended period of time or your home flooded, then you need to take the following precautions: Safe Food Do not open freezers or refrigerators until you plan to use or discard the contents. An unopened refrigerator will keep foods safely cold for about 4 hours without power. Most freezers will keep food safe for 36 to 48 hours if left closed. Once you open the refrigerator, discard any foods that have been above 41 degrees for more than four hours. Also discard any food that has an unusual odor, color or texture. Thawed food can usually be used immediately if it is still at 41 degrees or colder. Do not refreeze completely thawed foods. Foods containing ice crystals may be refrozen. Cans of food exposed to flood water should be thrown away. Cans of food exposed to rain water may be washed and sanitized, using a teaspoon of household bleach to one gallon of water. If fresh fruits and vegetables or food in plastic, cardboard or paper containers have been under floodwaters, do not eat them; throw them away. If you must discard food, try to bury it at least 48 inches deep. If burial is not possible, place the food in a sealed plastic bag or container for disposal in your local landfill. Safe Drinking Water If you rely on a public or private well for drinking water and it was flooded or you lost electricity, then you should boil your water for at least five minutes at a full rolling boil before using it for drinking, cooking, making ice or brushing teeth. Infants under six months and pregnant women should not drink boiled water, because boiling water may concentrate nitrates that could harm them. They should drink bottled water. However, if bottled water is not available, it is better for them to drink boiled water than to drink untreated water and then to switch to bottled water when it becomes available. You should continue to use bottled water or to boil your well-water until tests on samples taken since the last flooding or loss of electricity show the water is safe. Customers of public water systems should contact their utility or operator for information on the water quality. Private well users should contact their county health department for advice. For more information about food or drinking water safety, call your local health department. June 2010

73 Hurricane Fact Sheet After the Storm: Injury Prevention A severe storm can leave many problems in its wake. The media is usually filled with stories of people who are injured after a storm passes by. Don't become a statistic: Follow orders of any emergency service personnel. Drive cautiously. Do not drive through flooded roads. Water may be deeper than it appears. Twenty-four of the 52 deaths attributed to Hurricane Floyd in 1999 occurred when motorists attempted to navigate flooded roads. An additional nine Floyd-related deaths occurred in other motor vehicle accidents. Wear Life Jackets. In the event of rising flood water, children and adults who are not strong swimmers should wear U.S. Coast Guard approved life jackets--personal flotation devices (PFDs)--whenever they are in or around the water. Everyone, including strong swimmers, should wear a Coast Guard approved PFD when in a boat used for rescue or escape. Select the PFD for the person's weight and size (printed on the label). For workers, NIOSH recommends that they avoid working alone and wear a Coast Guard approved life jacket when working in or near flood waters. Watch out for loose or dangling power lines; stay away from them and report them immediately to the proper authorities. Do not leave children unattended. Do not allow them to play in or explore damaged or flooded areas. Keep chemicals used for cleaning and disinfecting, fuel for generators, and pest-control substances out of reach of children. Wear sturdy shoes or boots and protective clothing such as heavy pants, long sleeves and gloves when cleaning up debris. Use an insect repellent containing DEET to reduce chances of mosquito bites and to reduce risk of mosquito-borne illnesses such as West Nile Virus and Eastern Equine Encephalitis.Stinging caterpillars andinsects such as bees and wasps can become very aggressive after a storm. Survey the area before beginning cleanup and use a commercially available pesticide if needed. Poisonous snakes may also seek shelter in flooded homes; take precautions to avoid snakebites. Seek medical help if attacked by large numbers of insects, as reactions can be severe. Animal bites have increased after past storms. Animals may become frightened and act oddly after a storm. Be cautious when dealing with domestic animals like dogs and cats, especially those that you don t know, and avoid any contact with wild animals. Don t get burned. During past storms, reports of burn injuries have increase. If you are using camp stoves or fires to cook with, pay attention and don t get burned. Protect your eyes. Eye injuries have increased during past storms. Make sure to wear eye protection if you are handling chainsaws and watch where you are going a storm may have placed materials at eye level that could be harmful. Fight the bite. Mosquitoes, caterpillars, bees and other stinging pests may have lost their homes during a storm. They are likely to be buzzing about and could hurt you. Apply insect repellant according to the label directions. June 2010

74 Hurricane Fact Sheet: After the Storm: Injury Prevention Watch out for snakes. They, too, have lost their habitat and make be in places where they don t normally occur. Exercise particular caution in using power tools or tackling large debris, which can shift suddenly. Chain saws are particularly dangerous; get proper safety training before using one. Inexperienced individuals are routinely injured when using chain saws in poststorm cleanup. Falls are common; use safety equipment and get trained help with large or difficult jobs. Don't take chances. If the electrical power to your home is off and you cook on a charcoal or gas grill, carbon monoxide is a threat. A odorless, colorless gas produced by combustion, carbon monoxide can be deadly. Use a grill only in an open, well-ventilated area, never inside the house, and keep it away from flammable materials. The exhaust fumes from gasoline-powered generators are another source of carbon monoxide poisoning. Never use a generator in an enclosed area such as a basement or garage. Make sure the area is well-ventilated, dry and preferably covered. Generators also pose electrical hazards. Do not connect the generator to your home's electrical system. Instead, connect appliances directly to the generator with properly sized polarized extension cords. Do not overload the generator or the cords, and place the cords where no one will trip over them. Be sure the generator is properly grounded (follow the manufacturer's directions). Before refueling, let the engine cool for at least two minutes to prevent fires. Store extra fuel in a safe, dry area. If you are returning to a storm-damaged house, be particularly careful. Before entering the building, check for structural damage to be sure there is no danger of collapse. Turn off any outside gas lines at the meter or tank and let the house air for a few minutes. Even if the electricity is off in the neighborhood, make sure the electrical power is turned off at the main breaker or fuse box. Electricity and water are a dangerous combination--if you have to step in water to get to the breaker box, call a professional electrician first for advice. Don't turn on any lights, appliances, or gas systems until they've been tested. If you must enter the house at night, use a battery-operated flashlight, never an open flame as a light source, and do not smoke. If the house has been flooded, electrical wires and appliances will have to be cleaned and throughly dried, inside and outside, before they can be safely used again. Contact your electrical power company, the North Carolina Cooperative Extension Service, or a professional electrician for advice. A study of 2,090 hurricane-related emergency department visits during and after Hurricane Hugo in 1989, conducted by the Centers for Disease Control and Prevention in Atlanta and the North Carolina Department of Environment, Health and Natural Resources, found that 88 percent of the patients were treated for injuries. Insect stings and wounds accounted for nearly half of the total cases. Nearly one-third of the wounds were caused by chain saws. Motor vehicle accidents and falls were also major causes of hurricane-related injuries. Many such injuries can be prevented by being aware of hazards and by avoiding potentially dangerous situations. 11:13 AM June 2010

75 Precautions Avoid Dangerous Areas If waters continue to rise, evacuate the area immediately. Do not walk in, play in or drive through flooded areas. Flood water contains hidden hazards and may be deeper and faster-moving than it appears. Wear shoes at all times. Stay away from downed power lines. If you get a cut or puncture wound, get a tetanus booster shot if you have not had one in the past 5 years. Food and Medicines Any foods (including those in cans, plastic or glass), medicines and cosmetics that have come in contact with floodwaters should not be eaten. Throw them away. Food in the refrigerator should be thrown away if the power has been off for more than 4 hours or if food is warmer than 41 degrees Farenheit. Frozen food should be thrown away if it has thawed. Do not re-freeze thawed food. Medicines and cosmetics that have been in flood waters should be thrown away. Clean Up and Home Safety Cleaning up your home Take extra precautions to protect your health and safety. If your home was flooded during the hurricane, assume that everything touched by flood water is contaminated and will have to be disinfected or thrown out. Most clean up can be done with household cleaning products. Remember to wash your hands frequently during clean up and always wear rubber gloves, a disposable dust/mist face mask (NIOSH approved N-95 type) and, if possible, waterproof boots. If your ceiling was damaged, wear a hard hat and safety glasses. If your home has been flooded, you should: Before turning the power back on, have your home s electrical system checked out by an electrician. If the pilot light on your natural gas furnace, hot-water heater or stove has gone out, have it re-lit by a professional. Throw away flood-contaminated mattresses, upholstered furniture, carpets and padding, wallboard and wallpaper because they can not be cleaned all the way through. Clean plaster or tile walls, hard-surface floors and other household surfaces by scrubbing with soap and water and disinfect them with a solution of one cup of bleach to four gallons of water. Pay particular attention to areas that come in contact with food, or where small children play. After cleaning a room or item, go over it again with disinfectant to kill germs and odors left by flood waters. Dry everything completely after cleaning. June 2010

76 Precautions, page 2 Use a two-bucket method when cleaning. Put cleaning solution in one bucket and rinse water in the other. Replace rinse water frequently. Wash all linens and clothing in hot water with a disinfectant, or dry clean them. Throw them away if they are moldy or mildewed. Materials should be completely dry before cleaning, or mold and mildew will grow. If items cannot be completely dried out, throw them away. If materials become moldy or smell musty, they are probably contaminated and should be thrown away. Remove mildew on hard surfaces with household mildew cleaner; a mixture of five tablespoons washing soda or trisodium phosphate to a gallon of water; or 1/4 cup of laundry bleach to a gallon of water. If sewage backed up into your home, wear rubber boots and waterproof gloves during cleanup. Remove and discard contaminated household goods such as wall coverings, rugs, upholstered furniture, cloth and drywall that can't be disinfected. Avoid touching dead animals. Use gloves or a shovel to move dead animals, and then wash hands thoroughly. Contact your local health department about proper disposal of dead animals. Empty standing water out of birdbaths, tires, flower pots and other containers. For more information on cleaning up after a flood, contact your local Emergency Management Office, county health department or Red Cross chapter. You can also get information from the following internet sites: or 11:10 AM June 2010

77 Hurricane Fact Sheet After a Flood: Returning to Your Home Safely A building that has been flooded can be a dangerous place. This brochure will help you understand and protect you and your family from the hazards of flooded buildings. It will also provide you information about cleaning up and making your home safe to live in again. Watch out for these dangers: Never assume that a water-damaged house is safe. Going into a building that has been flooded, even after the water is gone, can present a wide variety of hazards that can cause injury, illness or even death. Do not allow children in the home after the flood or while it is being cleaned, inspected or repaired. Electrical hazards - Do not enter a flooded or wet building if the power is on. If any electrical circuits have gotten wet, turn off the power at the main breaker or fuse box and leave it off until the electrical wiring or equipment has been inspected and repaired by a licensed electrician and approved by your local building inspector. Structural damage - Do not enter a building if the framing or foundation is damaged. Look carefully before you enter. Leave immediately if shifting or unusual noises signal a possible collapse of the building. Contact your local building inspector for a safety inspection. Hazardous materials - Dangerous materials found in flooded homes may include pesticides, fuel oil, gasoline, chemicals and other substances that might have been brought in or spilled by flood waters. Damaged buildings may also contain asbestos and lead-based paint, which can cause health problems during cleanup. Practically any building material that is not obviously solid wood, metal, or glass could contain asbestos. Lead-based paint can be found pre-1978 housing and is still used in commercial and industrial buildings. Animal and insect related hazards Look carefully before entering a building to determine if there are displaced animals in the building such as dogs and cats, raccoons and rodents. Watch out for snakes and insects such as wasps, fire ants, and mosquitoes. Injuries - Falling objects, broken or damaged building components and slick surfaces can cause injuries, broken bones, and cuts. Lifting heavy objects can cause back injuries and muscle strains (see "Stay safe while you work."). Biological hazards - Bacteria, viruses, fungi, (mold and mildew) and other microorganisms can cause illness when you breathe them in, take them into your body through your mouth, or take them in through non-intact skin. Bacteria, viruses and other microorganisms may be left indoors by floodwater, while mold and mildew may grow indoors after the floodwater has receded. o Bacteria and Viruses and other microorganisms - If you accidentally get floodwater or the dirt it leaves behind into your mouth, you might develop gastrointestinal (digestive tract) illness. June 2010