Flooding

Flooding can happen at any time in a wide variety of locations, from a range of sources individually or combined. For example:

• Pluvial flooding can occur due to intense rainfall events and overland flow
• Fluvial flooding can arise from rivers or streams
• Coastal flooding from the sea or estuaries
• Groundwater flooding – in Ireland, typically this is from turloughs
• Other sources e.g. from blocked drains or pipes

Flooding is the most common and widespread of all natural disasters. It poses a number of risks to our health, and can cause us damage, loss or harm in a variety of ways, such as...

• Physical injury, illness, stress and even loss of life
• Damage to home and businesses
• Impacts on critical infrastructure e.g. roads, water supply
• Environmental impacts

 The information under the headings below provides advice to help you prepare for flooding, and to protect your and your loved ones’ health, before, during and after flooding events.

• Prevention and Preparedness
• Response
• Impact on Your Physical and Mental Health
• Further Resources

How You Can Prepare for Flooding

Key Things to Think About

If you live in a flood risk area, it is important to prepare and plan for the potential for a flooding event, so that everyone knows what to do if a flood occurs. If you would like to assess whether your property is at risk of flooding, you can do so by visiting the Office of Public Works website, Flooding.ie

Taking a proactive approach helps you to mitigate the impact of flooding on your health, safety and wellbeing. As part of planning and preparedness for a potential flooding event, you should

• Identify and stay informed via resources that provide regular updates and information on the weather and flooding risk e.g. alerts from local/national weather services, Flooding.ie  
• Create a flood kit that can be easily found if needed, with practical items that will help you if flooding occurs. For example, a first aid kit, clothes that are waterproof and warm, a torch, rubber gloves, waterproof boots, and blankets.
• Develop and maintain a plan for evacuation of your home or business, if required during a flooding event. This should include your evacuation route and destination. You should also consider vulnerable members of your household e.g. the elderly, children, and those with disabilities, and any pets. The plan should also include a list of essential items you would need to take with you e.g. essentials for children (such as sterilised bottles, nappies, milk, baby food), medication.
• Write a list of your most valuable possessions and where they are stored – this will be helpful if you need to move them quickly to safety.
• Consider how to communicate with loved ones or staff in your business in the event of a flood. Emergency numbers should be stored in your mobile phone, or kept close to your phone.
• Practical steps in relation to preparedness for your property can be found here  
• A template flooding preparedness plan can be found via Flooding.ie

Special Considerations for the Elderly

Extra preparation for flooding is important if you are an elderly person, particularly if you are living alone. Here are some key things to consider:

• Plan an evacuation route and destination, especially if you live in a bungalow or basement. You should always keep a key upstairs if you have window locks, so that rescuers can access through these if needed.
• Keep an up to date list of important and useful contact numbers e.g. family, neighbours, your Local Authority, local Garda station, local health services, insurance company and emergency services.

How You Can Protect Your Health during Flooding

Flooding can have major impacts on many aspects of health, including physical and psychological. Drowning and injury present very real hazards, and floodwater can disrupt drinking water supplies as well as destabilise important structural components of homes. It is important to take precautions to protect yourself. Performing careful hand hygiene using soap and clean water is an important and easy way to prevent infection. If in contact with floodwater, wear appropriate personal protective equipment (PPE), such as gloves and a mask, to reduce the chances of catching an infection from the water.

Health threats associated with flooding:

1. Drowning and Injury
2. Infection from Food and Water Biological Contamination
3. Electrical Hazards
4. Chemical Contamination
5. Carbon Monoxide Poisoning

 This section outlines useful advice to help you protect your health from these risks, which include:

Drowning and Injury

Do not underestimate the power and force of floodwater - 150 mm (six inches) of fast flowing water can knock you over and 600mm (two feet) of water will float your car.

Be mindful that you often cannot see the ground through floodwater and that manhole covers may have come off and there may be other hazards and obstacles hidden beneath the water.

Floodwater may also be much deeper than you think, and prolonged flooding can damage the structure of roads and pavements – be extremely careful when walking, or if driving on flooded roads.

Always remember to wear appropriate clothing/footwear and stay visible, especially in the dark.

Children should never play near floodwater or around pumps or sandbags.

Coastal seawater can be very rough during floods and storms – beware of unexpected large waves that could knock you off your feet.

Infection and Biological Contamination

Water Safety

During a flood, water can become contaminated with biological material like sewage. It is important to make sure your drinking water supply is not contaminated and to avoid contact with obviously contaminated water.

The best ways to prevent infection are to avoid contact with floodwater, and to wash your hands well with soap and clean water if you do.

Always remember to wash your hands before preparing or eating food.

If your water supply is contaminated, use alcohol gel/wipes.

If you do need to go into the water, make sure to wear appropriate PPE (rubber boots, waterproof gloves, eye mask/googles) and be careful of hidden dangers.

Any produce grown in a garden exposed to floodwater should not be eaten unless it has been adequately washed and cooked.

Drinking Water

Floodwater can damage the public water supply for drinking water. In the event of contamination of the public water supply, you will be advised by the water services authority, Uisce Éireann, who may issue a “Do not Consume” or “Boil Water” notice.

If your drinking water supply is by private well, check it has not been affected by floodwater.

Consider water unsafe to consume if it has been covered by floodwater or if the smell, colour, or taste has changed.

Water that is considered unsafe to consume (whether from public supply or private well) should not be used to wash dishes, wash food, wash hands, shower or bathe in, make ice with, or used in baby formula.

If you are concerned that the public water supply might be contaminated, contact the water services authority, Uisce Éireann.

If a “Boil Water” notice is issued, always remember to take care boiling water. It is usually safer to boil water in a kettle than with pots and pans. Always keep young children away from pots and pans to avoid scalding injuries.

For infant bathing, bottled water or baby wipes are both safe alternatives – as young children might ingest small amounts of water during bathing.

Those with contact lenses should speak with their optician and take extra care – contact lens saline solution should be used for cleaning lenses, and bottled water for washing hands.

Food Safety

Floodwater can cause harmful infections in food and can contaminate food storage and preparation areas.

Make sure to thoroughly clean food preparation areas and your hands before preparing or eating food. If water supplies are contaminated, do not use water to clean hands or surfaces – instead use alcohol gel/wipes or antibacterial wet wipes.

Clean all utensils, pots, crockery etc before food preparation. Wooden utensils, such as wooden spoons or chopping boards, if contaminated by floodwater should be thrown out.

If power supplies have been disrupted, be mindful that refrigerated or frozen food might have spoiled.

Fresh produce from a garden or allotment that has been contaminated with floodwater should be thrown away and not consumed.

Make sure to clean the inside of your fridge and cupboards if they have been contaminated by floodwater.

Infant Formula

If there is a problem with your drinking water, bottled water can be safely used to make up infant formula.

If you are expecting a baby soon, you may wish to consider breastfeeding until flooding has resolved and conditions are safer. Breastfeeding is good for your baby, including helping to protect your baby from infections.

It is best not to use bottled water labelled as "Natural Mineral Water" for making up formula. This type of water can have higher levels of sodium and other minerals. It can be used if no other water is available as it is important to keep babies hydrated. However, it should be used for as short a time as possible.

Ready-to-use infant formula, that does not need added water, can also be used.

Sewage

When water levels are high, this can cause sewer systems to overflow, and this can be harmful if the water supply becomes contaminated.

The Environmental Protection Agency provides advice for those who may have damaged septic tanks. If your septic tank relies on electrical parts, have the entire system checked by a professional engineer.

Electrical Hazards

If you are being flooded or in danger of being flooded, turn off your electricity supply, if it is safe to do so.

Do not turn on gas or electric systems if there is a chance they have got wet during a flood. These devices should only be turned back on once they have been checked by a registered gas engineer or electrician.

If you think your car battery has got wet, have your car checked by a registered mechanic as car batteries can leak dangerous chemicals.

Carbon Monoxide Poisoning

This risk relates to the cleaning-up and drying-out phase after flooding (see further advice on this phase ). Carbon monoxide can be produced when ANY fuel is burnt, including oil, gas, wood, coal, petrol and diesel. If a person is exposed to carbon monoxide over a period of time it can cause illness and even death.

Protecting yourself and others

Petrol or diesel generators and other fuel driven equipment should never be used in unventilated spaces:

• The exhaust gases contain carbon monoxide which, without good ventilation, can quickly build up to poisonous levels.
• The same risk is carried by portable grills, camp stoves, paraffin- fuelled heaters or other devices using gasoline, propane or natural gas.  These should only be used in well-ventilated spaces.   

If you experience dizziness, headaches or disorientation, the appliance should be switched off immediately, you should move to a well-ventilated area and seek medical advice.

Chemical Contamination

Chemical contamination can occur during flooding as agricultural chemicals, such as pesticides, can run from flooded farmlands. If you are concerned about chemical contamination of the water supply, contact your local authority.

Oil or petrol films may be visible on floodwater. It is recommended to not disturb these films, as they will generally recede with floodwater. Any remaining oil or petrol can be cleaned with detergent after floodwater has receded. Avoid all smoking and fire sources when near petrol films.

How You Can Protect Your Health after Flooding

This section outlines advice for protecting your health after flooding has occurred, including:

• The clean-up phase
• The drying-out phase
• Living in your flood damaged home

Protecting your health during the clean-up phase after flooding

Key Points

• All flood water should be considered contaminated, i.e. dirty.
• Wash hands with soap and clean water before and after clean-up activities.
• Cover cuts and sores with waterproof plasters.
• Wear waterproof boots and plastic or rubber gloves.
• If hosing or pressure washing, both of which cause a lot of splashing, you may use a face mask and/or goggles.
• Take care with electrics, gas and sharp objects – you can read safety advice on electrical and gas appliances at the following links, by Uisce Éireann and Gas Networks Ireland
• Follow manufacturers' instructions on cleaning products.
• Keep children safe:
  • Store cleaning products, in their original containers, out of sight and reach of children.
  • Empty mop buckets and basins immediately after use.
  • Make sure children don't have access to garages or garden sheds which may be left open to dry them out. Remember that poisons, tools, heavy objects, etc. are often stored there.

Safety when using household bleach

• Keep all cleaning products out of reach of children at all times.
• Use bleach with care and always follow the manufacturer’s instructions.
• Do not mix bleach with other cleaning products or chemicals. This may release dangerous gas.
• Bleach can burn skin and cause permanent eye damage, particularly when it is in concentrated form (straight out of the bottle).
• Avoid touching your eyes when handling bleach. If possible wear goggles. If bleach splashes into your eyes, rinse immediately with lots of cold water (for at least 15 minutes) and consult a doctor.
• Wear rubber household gloves to protect your skin. Take off gloves and wash your hands with soap and water before using the bathroom, eating or smoking.
• To protect your skin against splashes, wear old clothes that cover your arms and legs completely.
• To dilute household bleach, follow the instructions on the bottle - usually 8 capfuls to 5 litres of water.
• To avoid exposure to fumes open the container and prepare the solution outdoors or in a well-ventilated room and make sure the area you are working in is kept well-ventilated.
• It is safer to add bleach into water rather than water to bleach.
• Store household cleaning products in secure overhead cupboards. Use cupboard safety locks.
• Throw away unused bleach solution following cleaning.
• Empty basins and all buckets when finished and put away out of reach of children.
• Brushes and sponges should be discarded when the cleaning is complete.

What and how to clean*

• Remove mud and dust.
• Scrub hard surfaces (including walls, hard-surfaced floors and furniture) with hot/warm soapy water and detergent.
• Then disinfect the surfaces by wiping with bleach solution (follow manufacturer's instructions).
• Do not use bleach on carpets or wooden floors as it can damage furnishings and fabric.
• Clean and disinfect taps using dilute bleach if they were in contact with flood water and then run the taps for a few minutes.
• Wash all delph, pots and pans and cooking utensils.
• All food preparation surfaces and equipment must be cleaned thoroughly and disinfected (following manufacturer's instructions). Always move food out of the way or cover it to prevent chemicals getting into food.
• Dispose of any food and packaging that had contact with floodwater.
• If your electricity has been off for more than 24 hours, the food in your freezer is probably not safe to eat and you should discard it.
• Wash bedclothes and other soft fabric articles, such as children's soft toys, on a hot cycle (60^oC or higher) - this will destroy most germs that may be present.
• When washing clothes used for cleaning, ensure this is on a separate cycle from your other clothes.
• Other contaminated soft furnishings that cannot be put in a washing machine will have to be cleaned professionally.

* If items are likely to be the subject of insurance claims, speak to your insurance company first.

Cleaning up outside your home

• Hard surfaces such as tarmac and concrete paths can be washed down with a bleach solution.
• Stay off these surfaces for 3 hours after treating with bleach to allow the product to work.
• Bleach can damage wood and metals so use a regular household detergent (washing up liquid) to clean these materials.
• Do not dig or rake lawns or borders as this can spread the bacteria deeper in the soil. Ultraviolet rays from the sun will destroy bacteria over time. This can vary from 6 days in the summer to 20 days in colder/winter conditions, depending on the soil type. 
• Gardens (grass areas) should not be used for recreational purposes for about 2-3 weeks.
• Make sure garden sheds are not accessible to children during drying out time.
• Do not eat any food grown in a garden that has been flooded unless it has been washed and cooked.

Rats and Pests

• Rats may move in after flooding but they are generally wary of humans.
• Put rubbish in hard bins or keep rubbish away from your home.
• Avoid approaching rats.
• If you are bitten by a rat, seek medical advice.

Protecting your health during the drying-out phase after flooding

Key Points

• Ventilate your home well (open all doors and windows) – ensure all air bricks and vents are unblocked.
• Allow cleaned surfaces to dry completely as germs and mould thrive in wet conditions.
• Dirty water and silt should be removed where possible, including the space under wooden ground floors which may require pumping out.
• Once your heating has been certified safe to use, it can be turned on to help dry out your home.  Keep the temperature around 20-22^oC.
• Rubbish should be placed in hard bins or rubbish bags.

Remember that petrol or diesel generators and other fuel driven equipment should never be used in unventilated spaces:

• The exhaust gases contain carbon monoxide which, without good ventilation, can quickly build up to poisonous levels.
• The same risk is carried by portable grills, camp stoves, paraffin-fuelled heaters or other devices using gasoline, propane or natural gas.  These should only be used in well-ventilated spaces.   
• If you experience dizziness, headaches or disorientation, the appliance should be switched off immediately, you should move to a well-ventilated area and seek medical advice.

Allow cleaned surfaces to dry completely as germs and mould thrive in wet conditions. If mould is present and does not disappear with drying-out, you should contact a specialist cleaner for advice.

How You Can Protect Your Health While Living in a Flood-Damaged Home

Key Points

• Try to have some heating on at all times once it has been checked for safety.
• Consider the use of a dehumidifier.
• Ensure the property is well ventilated.
• Leave windows open as much as possible but be mindful of security.

Flooding and the Impact on Your Physical and Mental Health

Overview

Flooding can be a frightening experience, and often causes significant disruption to your routine, day to day activities. If you feel unwell during a flooding emergency, this does not necessarily mean that you are suffering from any illness associated with flooding itself. Both the physical stress associated with over-exertion in cleaning up premises and the mental stress caused by loss of important personal possessions, temporary relocation and financial loss may make you feel unwell. Remember that tiredness, difficulty sleeping and anxiety are normal in these circumstances and may go away with time.

There are a number of reasons why flooding can be a distressing event:

• It can pose risks to our health and safety
• It can disrupt our everyday activities, such as going to work, school or childcare
• It can result in separation from family and friends for a period of time
• It can disrupt access to essential services such as healthcare
• It can contribute to a sense of loss of control, and concern for flooding recurrence
• Recovery after a flooding event may necessitate unanticipated consequences such as the need to re-build homes, submit insurance claims, and deal with loss of possessions, income and/or education

Actions you can take

Staying in touch with your family, friends and neighbours is crucial to support your mental health during and after a flooding event. In addition, wider supports such as community groups, and other formally involved in flooding recovery (e.g. local authorities) may also be of benefit.

If you are concerned about yourself or a family member you are advised to contact your family doctor.

If you’re feeling overwhelmed, contact friends, relations or your family doctor.

The Samaritans may also be contacted by ringing 116 123 (Freephone day or night, 365 days a year).

If you would like to help someone impacted by a flooding event, there are a number of ways to offer support. You could help them meet their basic needs e.g. for food, water, shelter, and their healthcare needs e.g. medication, healthcare visit. You could also assist them with practical steps in flooding recovery, and signpost them to resources and relevant information if you are aware of any. In addition, supporting them with planning for their next steps in recovery can be of great benefit.

You can find more advice on coping with flooding, including helping children cope, in this leaflet produced by the Psychology Department, HSE Galway.

Further Resources

Leaflets

• Washing your hands - leaflet outlining good hand washing technique
• Advice for flooded homes - a leaflet produced by the HSE Department of Public Health, Midlands and HSE Environmental Health Department, Midlands
• Flooded homes - a leaflet produced by HSE Environmental Health

Websites

• carbonmonoxide.ie - protect your home from the dangers of this deadly gas by taking preventive measures and by learning to recognise the symptoms of carbon monoxide poisoning
• www.epa.ie - FAQs for wastewater treatment systems for single houses, including "What should I do if my septic tank is flooded?" and "Septic tanks - what to do after flooding?"
• www.flooding.ie - from the Office of Public Works
• Advice for use of natural gas in cases of flooding - Gas Networks Ireland
• AA Roadwatch - summary of road conditions throughout the country
• www.rsa.ie - top tips for road users in wet, flooded and windy conditions
• www.met.ie - current national weather warnings
• www.welfare.ie - if you have been affected by flooding and meet a means test you may be eligible for emergency financial assistance
• US Food and Drug Administration – Advice on use of medicines affected by floodwater

Food Safety Authority of Ireland – Advice on food safety after flooding

Flooding can happen at any time in a wide variety of locations, from a range of sources individually or combined. It is the most common and widespread of all natural disasters and is increasingly likely in Ireland as a result of climate change. It poses a number of risks to our health, and can cause us damage, loss or harm in a variety of ways, such as:

• Physical injury, illness, stress and even loss of life
• Damage to homes and businesses
• Impacts on critical infrastructure and services, such as healthcare
• Environmental impacts

Healthcare facilities may suffer damage as a result of a flood event. The following information is intended to support managers and staff working in healthcare facilities with preparedness, response and recovery in relation to flood events. Response and recovery from flooding, and ultimately restoring a facility to its previous level of routine functioning, is a complex multidisciplinary process, often requiring input from manufacturers (e.g. of medical equipment). Safety is of paramount importance at all times, for all staff and service users.

Who is more at-risk from flooding?

Certain population groups are more vulnerable to the health effects of flooding compared to others, and require special consideration in the event of a flood. For example:

• People aged > 65 years of age
• Babies and children < 5 years of age
• People with long-term health conditions, particularly those with chronic cardiovascular and/or respiratory disease, or those receiving complex healthcare interventions
• People with pre-existing mental health conditions
• People taking medication that affects their behaviour or cognition
• People with cognitive impairment, such as dementia, or other physical or sensory impairments
• People who are bed-bound, and those dependent on others for routine activities
• People with drug and/or alcohol addictions
• People in socioeconomically disadvantaged groups
• People with language, cultural or other vulnerabilities
• People experiencing homelessness
• People that are temporary residents of a flood-affected area

Facility Preparedness for Flooding

Action Plan

Providers of healthcare services have a duty of care towards their service users and staff to be aware of the potential impacts of a flood event, and to take steps to ensure preparedness for such events. Protecting the health and safety of service users and staff is paramount at all times. It is also important that providers are aware of more vulnerable service users, who may need additional supports in the event of flooding.

Maintenance of business continuity should be carefully considered by management of healthcare facilities, as part of preparedness for flood events. In the event of a flood affecting a healthcare facility, if business continuity cannot be maintained a contingency plan that incorporates a system of triage for the facility will be needed, particularly for primary care and acute healthcare settings. Arrangements for diversion of service users to other facilities may need to be considered in the event of emergencies – this is described further below.

In addition, management of facilities should consider any factors that increase the vulnerability of their facility to flooding, and the preventability of these factors. Learning from past experiences of dealing with a flood event may help inform future preparedness. Actions to address any preventable factors should be included in a flood action plan, as noted further below.

The development and maintenance of a service- or facility-specific action plan in place for flooding is the foundation for adequate preparedness for flood events. Preparing an action plan in advance can help ensure awareness among staff of their roles and responsibilities in a flood event, and supports staff training exercises in this regard. This proactive approach can help mitigate the impact of flooding on the facility, staff and service users. www.Flooding.ie provides advice on assessment and management of flood risks. As a general point, it is also important for managers of facilities to identify and stay informed via resources that provide regular updates and information on the weather and flooding risk e.g. Met Éireann.

Key details that should be considered for a flooding action plan*

Named management lead(s)

• For the facility response in the event of flooding

Structural details for the facility

• Including an up to date facility map which details access and egress routes, as well as car parking and loadings zones

Occupancy of the facility

• E.G. Residents of a long-term residential care setting

Contact details

• For key facility personnel/management and next of kin of service users
• For relevant local contacts e.g. Local Authority, local Garda station, local health services, emergency services, insurance company

Location of practical items of particular use acutely in a flood event

• Such as the first aid kit for the facility, a torch, torches, rubber gloves, and blankets

Plans for evacuation and transfers

• The ground floor of the facility is the most vulnerable in a flood event
• Access and egress routes for the facility should be clear on the facility plan for all floors of the facility
• Agreed evacuation routes and destinations of service users and staff should also be included, if required during a flood event. Plans for transfer of patients if required to alternative settings, in the event of evacuation, should also be included
• Plans for evacuation of vulnerable service users should be clear e.g. the very elderly, those with disabilities or mobility issues, those who are bed-bound

Communications plan

• E.G. With staff, and service users’ next-of-kin

Records of medical equipment, devices and medication on-site

• Medical equipment, devices and medication on-site, including manufacturer details – particularly all equipment located on the ground floor of the facility. Measures to mitigate the impact of floodwater on these items should be considered e.g. storage at higher levels of shelving or facility floors, if possible

Food safety management

• Including details of catering company, if applicable

Flooding preparedness training and testing

• Details of historical and latest training and preparedness exercises undertaken with staff, and any testing of potential vulnerabilities (e.g. drain maintenance)

Location of medical records

• E.G. Paper and e-records as applicable

Lessons from previous flood events

• If applicable, including any recommendations made following the event and status

Review of plan

• Dates and interval for regular review of the action plan, and person(s) responsible for this

*Please note this list is suggested and non-exhaustive - any other details considered locally relevant by the facility should be included in the preparedness action plan.

Facility Response after Flooding

Overview

The advice outlined on this page focuses on the assessment and management of contents of a healthcare facility after a flooding event. After such an event, there may be significant contamination of healthcare facility structures, supplies and equipment, with microorganisms such as mould or mould spores, bacteria and/or chemicals. Therefore, prior to re-opening, the facility itself should be evaluated by an appropriate accredited service, in order to determine the extent of structural damage, and whether it may be restored, repaired and re-opened, or condemned.

If the healthcare facility is deemed safe to enter, the process of assessing all medical equipment, devices, records and other items can be commenced to ascertain what can be salvaged, and what should be discarded. Advice to support facility staff in the process of this assessment is outlined under key headings below. Please note however, if any items are likely to be the subject of insurance claims, the insurance company for the facility should be contacted in the first instance.

Reducing risk of infection during assessment

From floodwater

All floodwater should be considered contaminated i.e. dirty.

• Wherever possible, try to avoid coming into direct contact with floodwater, especially if it is obviously contaminated with sewage.
• If you have to go into the water, wear appropriate protective clothing, especially waterproof gloves and rubber boots, and remember to be careful of hidden dangers. If hosing or pressure washing, both of which cause a lot of splashing, you may use a face mask and/or goggles.
• Wash your hands before and after any clean-up activities - this is the most important way to get rid of harmful bugs:
  • Use clean, warm water, if available, with soap.
  • Wash and dry your hands:
    • after going to the toilet,
    • before eating or preparing food,
    • after being in contact with floodwater, sewage or with items that have been in the water.
  • Use cold water if there is no warm water.
  • Use wipes or alcohol gel if there is no water or if the supply is contaminated.
• Keep any open cuts or sores clean and prevent them from being exposed to floodwater - wear waterproof plasters.

From a contaminated water supply

• Floodwater can damage the public water supply for drinking water. In the event of contamination of the public water supply, you will be advised by the water services authority, Uisce Éireann, who may issue a “Do not Consume” or “Boil Water” notice.
• If the water supply to the facility is sourced from a private supply, it should be checked that this has not been affected by floodwater.
• Consider water unsafe to consume if it has been covered by floodwater or if the smell, colour, or taste has changed.
• Water that is considered unsafe to consume should not be used to wash dishes, wash food, wash hands, shower or bathe in, make ice with, or used in baby formula.
• If you are concerned that the public water supply might be contaminated, contact the water services authority, Uisce Éireann.

Risk of Carbon Monoxide Poisoning

During the cleaning-up and drying-out phases of responding to flooding, which would be undertaken by the professional accredited service contracted by the facility, there is a risk of carbon monoxide poisoning which all persons involved in responding to flooding must be aware of. Carbon monoxide can be produced when ANY fuel is burnt, including oil, gas, wood, coal, petrol and diesel. If a person is exposed to carbon monoxide over a period of time it can cause illness and even death.

Protecting yourself and others

Petrol or diesel generators and other fuel driven equipment should never be used in unventilated spaces:

• The exhaust gases contain carbon monoxide which, without good ventilation, can quickly build up to poisonous levels.
• The same risk is carried by portable grills, camp stoves, paraffin- fuelled heaters or other devices using gasoline, propane or natural gas.  These should only be used in well-ventilated spaces.   

If you experience dizziness, headaches or disorientation, the appliance should be switched off immediately, you should move to a well-ventilated area and seek medical advice.

Assessment and Management of Facility Contents

Facilities may require structural assessment and restoration. Water and electrical utilities, gas networks, heating, ventilation, and air conditioning (HVAC), and fire safety systems may also need to be evaluated. Affected facilities should be assessed by suitable professionals. HSE Capital and Estates and facilities services might be in a position to advise on building review and restoration and need for emergency water decontamination.

Helpful advice is available on the CDC Website

Medical equipment and devices

All medical equipment and devices should be assessed for their current condition and any potential safety risks arising from flood damage. Ensuring safety for all individuals involved in the assessment should be the first priority before conducting any assessments, particularly for any electronic equipment. Wet electronic equipment should not be connected to an electricity supply. The electricity should not be used by facility staff until deemed safe following formal assessment by the relevant accredited professional service for the facility.

• An inventory assessment should be undertaken with careful and detailed documentation of the nature and extent of damage to each device and item of equipment.
• Undamaged and damaged items should be separated as a starting point.
• Damaged items that are visibly beyond potential salvage should be further separated for disposal.
• The original manufacturer should be contacted and consulted for guidance regarding cleaning, drying and disinfection of any damaged items that are deemed potentially salvageable. The manufacturer should also be consulted regarding any recertification that may be required following cleaning, drying and/or disinfection, and appropriate means of discarding items beyond salvage.

Medical records

• Any medical records maintained in paper format at the facility should be assessed for flood damage. Specialist advice may be required regarding management of flood-damaged records.

Medication

• Medication exposed to floodwater may have become contaminated.
• Generally, any medication that has come into contact with floodwater should be discarded, even if in the original container, due to the potential for discrete leakage and direct contact with the medication itself.
• However, for medications used to treat life-threatening conditions, if the medication appears unaltered (e.g. tablets appear dry within a wet container), these may be used if required, only until a replacement is available. Such medications should not be used if they appear wet in any way.
• An inventory assessment should be undertaken of all floodwater-exposed and non-exposed medication, noting discarded and retained items.
• Arrangements to restore medication stocks should be initiated via the usual facility process.

Food stored on-site

Floodwater may have been contaminated with sewage or waste of various kinds. Therefore, there is a risk of harmful bacterial or chemical contamination of food or food preparation/contact surfaces, if either come into contact with floodwater. 

• An assessment of all food that remains stored on-site for service user and/or staff consumption should be undertaken.
• Any food that was in contact with or covered by floodwater should be discarded, even if unopened. Food preparation equipment should also be assessed for damage, and arrangements made to repair or replace equipment as deemed appropriate.
• The original manufacturer may need to be consulted for advice in this regard.
• Any food preparation, contact or storage surfaces, if intact, should be cleaned thoroughly and disinfected.
• The potential for a power outage having occurred during a flood event should also be considered, which may have affected fridges and/or freezers. It can be hard to be sure when a power outage first occurred during a flood event. Because of this, you should check the temperatures of fridges and freezers. Any fully defrosted meat, fish or dairy products should be discarded. However, any food still frozen can remain as is once the temperature remains below -18º C. For food stored in the fridge, this must be kept at 0-5º C. Any chilled food that was likely to have been stored at above 5º C for longer than 4 hours must be discarded. If you are in doubt, throw it out. Lastly, all fridge and freezer units should be checked to ensure they are working properly in case they have been affected by floodwater, before re-use. You can find more advice from the Food Safety Authority of Ireland here .
• The local HSE Environmental Health Service may need to be advised of any issues with food preparation and storage facilities in the context of flood damage.

Facility Recovery after Flooding

Learning for Future Flooding Preparedness

Following the response to a flood event affecting a healthcare facility, learning from the event should be reviewed with key stakeholders, to inform enhanced preparedness for future,and especially with the increasing risk of flooding posed by climate change. The flooding preparedness action plan should be reviewed and updated, and re-training of staff undertaken to ensure all are aware of any changes.

Mental Health Impacts of Flooding

Flooding can be a frightening experience, and often causes significant disruption to our routines, and day-to-day activities. In addition, the physical stress associated with over-exertion in cleaning up premises, and the mental stress caused by loss of important equipment, personal possessions, temporary relocation and financial loss, may make staff or service users feel unwell.

Alongside facility-level impacts, individuals may also be dealing with the adverse effects of flooding on a personal level, such as to their homes or those of their loved ones. Tiredness, difficulty sleeping and anxiety are normal in these circumstances and may go away with time. It is important to remember that flooding can affect mental health in different ways for each individual. Managers should consider the effects a flooding event might have had on staff.

There are a number of reasons why flooding can be a distressing event:

• It can poses risks to our health and safety
• It can disrupt our everyday activities, such as going to work, school or childcare
• It can result in separation from family and friends for a period of time
• It can disrupt access to essential services such as healthcare
• It can contribute to a sense of loss of control, and concern for flooding recurrence
• Recovery after a flooding event may necessitate unanticipated consequences such as the need to re-build homes, submit insurance claims, and deal with loss of possessions, income and/or education

Staying in touch with your family, friends and neighbours is crucial to support your mental health during and after a flooding event. In addition, wider supports such as community groups, and other formally involved in flooding recovery (e.g. local authorities) may also be of benefit.

If you are concerned about yourself you are advised to contact your family doctor.

If you’re feeling overwhelmed, contact friends, relations or your family doctor.

• The Samaritans may also be contacted by ringing 116 123(Freephone day or night, 365 days a year).
• You can find more advice on coping with flooding, including helping children cope, in this leaflet produced by the Psychology Department, HSE Galway.

If you as a staff member are concerned about a servicer user of your facility, you should advise them, or their next-of-kin, as appropriate, to contact their doctor. For residents of residential institutions, it may be appropriate to contact their doctor on their behalf.