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Heath Issues

If you have building health realted problems or allegies  (email) or call 08700 789 999

  • News
    In 2006 we started ourtraining courses in the UK with a blood trauma scene training seminar for BDMA (click here).
  • We and have become International trainers for various building health issues
  • Bird flu latest. Various government laboratories and agencies have stated that conventional masks and respirators provide no protection against avian bird flu. See download data (click here)

Introduction to Blood Pathogens

Any spill or residue of a spill either wet or dry which could contain body secretions must be presumed to be infected with pathogenic material. Pathogens are micro-organisms which can cause harm to people, examples are hepatitis and HIV. They can be found in blood and any body fluid from urine to vomit. Blood borne pathogen is a generic term used to describe various possible infections generally, including those carried by the blood and by other body fluids or leaks which may present a health threat.

The various control and protection measures are enshrined in what is known as the "Universal Procedures" which effectively presumes all body spills are contaminated unless known and or proven to the contrary. Various international procedures are recommended for the containment and cleaning, sanitation of these situations. Special training, equipment and prophylactic care, (inoculations) is required for people undertaking the clean up of body spills

Typically this type of contamination is known as a ‘Blood borne pathogen‘. Associated infection is usually associated with Hepatitis, HIV. All contaminates can remain a possible threat for many days and HIV can remain active for several weeks. It is essential that only trained and suitably protected personnel are engaged in this type of work. Typically ppe may include special work wear, in addition to prophylactic inoculation. Emergency action in the event of mishap is a fundamental requirement. This may include procedure for needle stick or penetrative cuetaneous injuries.

Death scene clean-up can encounter other hazards such as bone or flesh particulate. Special consideration should be given to inhalation, ingestion, oral and dermal contact.

Source removal must be accomplished with due care to avoid aerosolisation and cleaning should be followed with sanitation using appropriate sanitation techniques.

Flooding

Floodwaters travel over soil, through drains and sewers. This journey can result in the collection of a variety of contaminates ranging from chemicals, sewage, up to 1500 bacterial and 120 viral infections. Although possibly diluted some may amplify or remain as permanent contamination if not removed and decontaminated properly. See water damage

Sewage

Sewage contamination must be considered as a serious health hazard. While most would recognise raw sewage from it‘s odour or appearance, the reality is that contamination can be very diluted and have little or no odour and appear to be fresh water. The source is a main indicator coupled to sampling for enteric organisms such as E.coli 0157 the infamous bug which has claimed so many lives and made so many sick.

Source of contamination

The International organisation, Institute of Inspection Certification, Restoration and Cleaning have published a definitive guide in IICRC S500. It categorises black or unsanitary water as any water, which has entered a building from an outside source. This could include a drain, toilet, floodwater or any water, which ‘‘may‘‘have been in contact with soil or other possibly contaminated surface. This guide estimates that over 120 viral infections and up to 1500 bacterial infections may be present in black water.

This can obviously include burst water mains, river or seawater, heavy rainfall or localised flooding. The reasoning is that flood water will enter drains and sewers, travel over soil contaminated with dog or animal fouling, picking up pesticides, industrial waste, which can include hospitals, butchers, even mortuaries.

Cleaning is the priority and this should be followed by sanitation and drying procedures which do not move air until all contamination has been removed. Certification is recommended to ensure the sanitation has been successful. The use of an independent surveyor is recommended. The role of the Environmental Hygienist should be to visually assess the cleanliness and follow this with adequate sampling to assess hygiene by accepted procedures to identify the possible presence or reservoirs of pathogenic material.

Hot tips

Unfortunately unless brown lumps or toilet paper are seen floating in a flooded building the usual presumption is "it‘s just water". This attitude simply exposes everybody to unnecessary risk or illness. There are several indicators for sewage or pathogenic ingress.
  • ATP is Adenosine Tri Phosphate and is capable of instantaneous generic analysis of bacteria or more importantly sanitation. It is a monitoring tool which is capable of immediate assessment of contamination but not specific organisms.
  • Swabs and culture plates should be used where time allows but certainly for clearance purposes.
  • Sore throat, headache, and absenteeism and of course a sulphur odour are all late identification methods.
  • The ingress of water from outside must be considered as contaminated with a form of pathogenic material from rats’ urine to sewage, it is therefore essential that good housekeeping practice is followed.
  • No eating or smoking on site. This is to prevent hand to mouth infection. Always wash hands after leaving site.
  • Many people are more susceptible to infection than others they include, under 2 over 60 years of age, those on long term prescription drugs, immune compromised from chemo therapy etc.
  • Sanitation is best achieved by cleaning and not by chemical flooding.

Personal hygiene practice should include the following a minimum requirement;

  • Wash hands constantly,
  • No smoking because of hand to mouth contact.
  • No eating on site, and wash hands.
People engaged in sewage clean up should also be aware of other potential health risks such as Hepatitis and other blood or body fluid contaminants such as HIV. Prophylaxis is a word for inoculation or preventative medicine; it makes very good sense that workers engaged in these operations are well protected by both medicine and protective clothing. Special care should be exercised regarding cuts and abrasions, which should be totally protected. Some Hepatitis infections can result in liver cancer and may be untreatable.

Clean up Procedures

Remove all standing water by pumps; wet vacs should not be used internally as they eject various aerosols through their inefficient filter capture. Place wet vacs outside and use a long hose. Shovel up any solids and dispose of properly. Cleaning is the single most important issue and only after thorough cleaning should the application of sanitising products be considered. Household bleach is as good as anything, and a 5% solution only is recommended. If the bleach smells strong it probably is, so wet it down to dilute. This solution should be left in contact for at least 20 minutes to allow the disinfecting action to take effect. Quite often the clean up will require a multi phase operation as total clean up is almost impossible on the first attempt. Generally household bleach should be mixed 1 part bleach to 9 parts water.

Drying Out

Following sewage or flood damage some contamination may exist and there may be a requirement to dry the property quickly. Air movement is often used by contractors to assist in the drying process but fans should not be used until the areas are clean as the action of fans may aerosolise contamination which could result in inhalation.

Monitoring

There may be a need to ensure that the post flood area has been sanitised properly and the first stage may be a visual inspection to identify the presence of dirt, this may be followed by clean cloth wipes to asses cleanliness and finally an environmental hygienist may be requested to take samples for analysis of samples. Sampling using swabs and cultures can take 3 days or more for confirmed clearance.

Sanitation and Odour

Bad odour is natures warning of hazard.

Typically, sewage odour warns us of possible health hazards, and humans have a built in library of warning odours. Masking odours with fragrance should be seen as unacceptable and possibly dangerous.

Bad odour generally means something is not clean and trigometric nerves in the nose can detect minute levels in parts per million, to confuse the odour with fragrance can create other malaise as body reactions are confused. Sanitation or hygiene must today revolve around cleaning to remove the contamination.

Biocides are seen to be ineffective and usually harmful to humans. Paradoxically, some disinfectants can actually make hygiene matters worse as competitive microbes can be destroyed, leaving the more pathogenic bacteria to flourish. Almost all disinfectants are neutralised by organic soiling, commonly known as dirt, therefore cleaning is a first choice followed by sanitation in a multi-phase operation. Testing of cleanliness can be achieved in a variety of methods, such as:
  • Swabs and cultures, which require accepted sampling techniques and laboratory inspection followed by assessments.
  • A.T.P. Adenosine Tri Phosphate, a site measurement tool, which where used properly can identify possible health issues.
  • Clean or sticky wipes
  • The use of thermal or wet fogging should be restricted or proven prior to use and may be limited to inaccessible areas.
  • Sealing surfaces to contain odour should be discouraged.
  • Masking agents or fragrance should never be used!
For additional information see Mould and IAQ sections

What we providePost

incident inspection, detailed scope of works and contractor assistance. Completion inspection and clearance certification.

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