Health hazard evaluation report: HETA-2006-0023-3003, New Orleans Fire Department, New Orleans, Louisiana.
In October 2005, the National Institute for Occupational Safety and Health (NIOSH) received a request for a health hazard evaluation (HHE) from the New Orleans Fire Department (NOFD) and the International Association of Fire Fighters Local 632 (IAFF). This HHE request concerned health hazards from exposure to the floodwater and sediment and the mental health of fire fighters following the NOFD's response to Hurricanes Katrina and Rita. Reported health problems included respiratory, throat, and sinus irritation; and symptoms suggestive of depression and anxiety. NIOSH representatives conducted a survey to evaluate health concerns among fire fighters; 525 NOFD personnel participated in the survey. This self-administered questionnaire contained questions about demographics, job characteristics, lifestyle, work duties and location, hurricane-related activities, and symptoms that occurred during and after the hurricanes. The Center for Epidemiologic Study-Depression scale (CES-D) was used to assess symptoms associated with depression, and the Veterans Administration posttraumatic stress disorder (PTSD) checklist was used to define posttraumatic stress symptoms among participants. Of the 525 fire fighters who completed the questionnaire (77% participation), 201 (38%) reported one or more new-onset respiratory symptoms, such as sinus congestion (145 [28%]), throat irritation (92 [17%]) and cough (124 [24%]). Skin rash was reported by 258 (49%) of respondents, 414 (79%) reported skin contact with floodwater, 165 (32%) reported they had contact with floodwater on multiple days, 133 of 493 respondents (27%) had major depressive symptoms, and 114 of 518 (22%) showed posttraumatic stress disorder (PTSD) symptoms. In multivariate analyses adjusting for age, gender, and smoking, fire fighters who had floodwater contact with skin and either eyes or nose/mouth (224, 44%) had increased risk of new-onset upper respiratory symptoms (prevalence ratio [PR]=1.9; 95% confidence interval [CI], 1.1-3.1) and skin rash (PR=2.1; 95% CI, 1.4-3.2) compared to those not exposed to the floodwater. Depressive symptoms were associated with new-onset lower respiratory symptoms (PR=1.8; 95% CI, 1.2-3.0), skin rash (PR=1.7; 95% CI, 1.2-2.6) and low supervisor support (PR=1.6; 95% CI, 1.1-2.3). Fire fighters housed with their family were less likely to report depressive symptoms (PR=0.7; 95% CI, 0.5-1.0) compared to those not living with their family. Higher prevalence of PTSD symptoms were reported from fire fighters involved in one or more gunshot incidents (PR=2.4; 95% CI, 1.6-3.7), guard duty (PR=1.8; 95% CI, 1.2-2.7), and body retrieval (PR=1.7; 95% CI, 1.1-2.6). The results of the questionnaire survey showed that fire fighters who reported floodwater contact with their skin and nose/mouth or eyes for longer than a few hours at the time of the hurricanes reported significantly more upper respiratory symptoms than those who reported no contact with the floodwater. Fire fighters with respiratory symptoms and skin rash also reported more depressive symptoms than those without respiratory symptoms and skin rash. Fire fighters involved in gun shot incidents and body retrieval in response to the hurricanes were more likely to report PTSD symptoms. Clinical follow-up of affected fire fighters for physical and psychological conditions should be implemented. This report, along with the environmental survey conducted at the Jackson Barracks temporary staging area (Appendix A) should be construed as the final report. The environmental evaluation looked at fire fighter activities during simulated apparatus runs, and included air sampling to evaluate fire fighter exposures to dust. For the fire fighters working out of the Jackson Barracks temporary staging area, airborne exposures to respirable particulates and silica, total particulates, and elements (metals and minerals) were below all applicable exposure criteria. NIOSH investigators determined that a work-related hazard existed among New Orleans fire fighters due to Hurricane Katrina-related exposures. We found that physical and mental health symptoms were associated with work-related exposures. This report includes recommendations pertaining to these findings.
Region-6; Hazard-Confirmed; Respiratory-system-disorders; Pulmonary-system-disorders; Emergency-responders; Lung-disease; Lung-disorders; Epidemiology; Statistical-analysis; Demographic-characteristics; Psychological-effects; Psychological-reactions; Psychological-responses; Dermatitis; Skin-irritants; Eye-irritants; Respiratory-irritants; Fire-fighters