In Katrina’s Wake Hurricane Katrina has been called the most devastating
natural environmental calamity in U.S. history. Visitors
to the scene say the destruction is worse than anyone can
imagine. Scientists also say that some perceived health threats
have been overblown and others understated. Months after
Katrina roared into the Gulf Coast, the environmental health
implications of the storm are still being assessed.
Katrina presented residents of the Gulf Coast with a bewildering
array of environmental health hazards. Aside from standing
floodwater, hazards included a lack of potable water, sewage
treatment, and electricity; chemical spills; swarms of insects
(with anecodotal accounts of vermin and hungry domestic dogs);
food contamination; disrupted transportation; mountains of
debris; buildings damaged and destroyed; rampant mold growth;
tainted fish and shellfish populations; and many potential
sources of hazardous waste. Some impacts, such as deaths
from drowning and injuries from cleaning up debris, have
been relatively easy to determine. Others, such as post-traumatic
stress disorder from the loss of homes and loved ones, may
never be fully quantified.
![Porch Lady](image/foc1.jpg) |
Comprehending the catastrophe. (above)
Phyllis Howley, 70, sits on what’s left of the
porch of her son’s New Orleans home. (top) The
beach in Biloxi, Mississippi, four days after Katrina.
image: Stephan Savoia/AP Photos |
In the weeks following the storm, federal agencies such
as the NIEHS, the Centers for Disease Control and Prevention
(CDC), and the Environmental Protection Agency (EPA), as
well as state environmental and public health agencies, sent
scientists to the region to begin assessing the environmental
and human health impact of the disaster. Much of what they
found was presented on October 20 at a meeting of the National
Academies Institute of Medicine’s Roundtable on Environmental
Health Sciences, Research, and Medicine (commonly known as
the EHSRT), supported by the NIEHS, the CDC, the EPA, Exxon-Mobile
Corporation, the American Chemistry Council, and the Brita
Water Research Institute. Still more information continues
to emerge today. And much simply remains to be seen.
Katrina Hits
Katrina, rated as a Category 4 hurricane on the Saffir-Simpson
scale, made landfall near New Orleans on 29 August 2005.
Wind damage extended as far as 150 miles inland. Heavy rain
battered the area, and the storm surge--measuring as high
as 30 feet and sweeping several miles inland--breached several
levees intended to protect New Orleans from the waters of
Lake Pontchartrain. Water poured through the breaks in the
days following the storm, covering approximately 80% of the
city with water as deep as three meters. The American Red
Cross estimates that more than 354,000 homes along the Gulf
Coast were destroyed or damaged beyond repair by Katrina
and, a month later, Hurricane Rita. Hundreds of small manufacturers
or businesses using chemicals or fuels also were impacted.
Flooding, wind, and waves caused major damage to buildings
and infrastructure whose integrity is key to the environmental
health of the local citizenry. The EPA estimated that more
than 200 sewage treatment plants in Louisiana, Mississippi,
and Alabama were affected, with almost all the plants around
New Orleans knocked out of action. Loss of power meant lift
stations (which pump sewage uphill) could not work, causing
sewage to overflow into houses and streets.
The region struck by Katrina and Rita is home to a large
number of oil refineries and chemical plants. Prior to Katrina,
the EPA had identified nearly 400 sites in the affected area
as possibly needing cleanup because of their potential impact
on human health. Following the storm, the U.S. Coast Guard
reported numerous oil spills from refineries and tank farms
in South Louisiana. A story in the September 30 Boston
Globe reported that Katrina damaged 140 oil and
gas platforms in the Gulf of Mexico, 43 seriously, including
some that floated away or sank.
Across the Gulf Coast, more than 1.5 million people evacuated
as the storm approached. More than 100,000 stayed behind
in New Orleans, unwilling or unable to leave. As New Orleans
flooded, thousands waded through chest-deep floodwaters to
reach shelters or higher ground. Thousands more remained
trapped in homes, hospitals, and nursing homes. Conditions
in shelters rapidly became unsanitary. Many people were exposed
to the elements for five days or more, living with little
or no food, drinking water, or medicine. As of December 5,
the death toll was reported at 1,071 in Louisiana, 228 in
Mississippi, 14 in Florida, 2 in Alabama, and 2 in Georgia.
First Response
Numerous federal, state, and local agencies, as well as
private individuals and relief groups, swung into action
in the wake of the storm. Troops from the U.S. Army, Coast
Guard, and National Guard as well as state and local officials
and private citizens rescued those they could. The Federal
Emergency Management Agency (FEMA) was assigned the lead
in disaster relief planning and administration, including
provision of emergency food and shelter and contracting for
debris removal. The Department of Health and Human Services
(DHHS) declared a public health emergency in the Gulf states
and directed the CDC to take appropriate action. The CDC
deployed more than 600 professionals into the disaster zone,
including specialists in public health nursing, occupational
safety and health, laboratory science, medicine, epidemiology,
sanitation, environmental health, disease surveillance, public
information, and health risk communication.
The CDC also joined with the EPA to set up a joint task
force to conduct an environmental health needs and habitability
assessment to identify critical public health issues for
the reinhabitation of New Orleans. This city was unique among
the areas hit in that it was the only one left with standing
water. Major urban areas in Mississippi and Alabama, while
devastated, did not remain flooded.
![Water](image/foc3.jpg) images:
Left to right: Chip Hughes/NIEHS; Bill Haber/AP Photos |
![Swimming](image/foc2.jpg) |
Hazards in wading? Initial
reports labeled the floodwaters through which many
New Orleans residents were forced
to wade a “toxic gumbo.” Later testing of
stormwaters found elevated levels of fewer contaminants
than feared, but sampling was limited and the water may
yet present long-term problems. |
In advance of the storm’s arrival, the EPA had predeployed
teams to the area, with the mission of guiding debris disposal,
assisting in the restoration of drinking and wastewater
treatment systems, and containing hazardous waste spills.
Immediately
after the storm, these teams used their 60 watercraft to
help search-and-rescue efforts, rescuing about 800 people,
according to EPA administrator Stephen Johnson. Five days
after the storm, the EPA began testing floodwaters in New
Orleans for biological and chemical contamination.
In coordination with the Louisiana Department of Environmental
Quality (LDEQ), the EPA analyzed floodwaters for more than
100 hazardous pollutants such as volatile and semivolatile
organic compounds, metals, pesticides, herbicides, and polychlorinated
biphenyls. They also tested for biological agents such as Escherichia
coli. Their testing revealed “greatly elevated” levels
of E. coli, as much as ten times higher than EPA’s
recommended levels for contact. According to the EPA, agency
scientists found levels of lead and arsenic at some sites
in excess of drinking water standards--a potential threat
given the possibility of hand-to-mouth exposure. The EPA
posted these and other findings on its Hurricane Response
2005 website (http://www.epa.gov/katrina/), created after
the storm.
Shortly after the hurricane struck, the U.S. Coast Guard
began working with the EPA, the Louisiana state government,
and private industries to identify and recover spilled oil
along the coast. The team identified 6 major, 4 medium, and
134 minor spills totaling 8 million gallons. One of the most
notorious spills occurred at the Murphy Oil Company plant,
which dumped more than 25,000 barrels of oil into the streets
of Chalmette and Meraux, Louisiana. As of December 7, the
Coast Guard reported the recovery of 3.8 million gallons,
with another 1.7 million evaporated, 2.4 million dispersed,
and 100,000 onshore.
Meanwhile, the NIEHS was joining with Duke University Medical
Center, the NIH, and the CDC to provide assistance with relief
and recovery operations along the Gulf Coast, as well as
working at home to establish a website on environmental health
issues related to Katrina [for more information, see “NIEHS
Responds to Katrina,” p. A28 this issue].
Floodwater Hazards
Kevin Stephens is director of the New Orleans Department
of Health. He was in charge of interpreting the EPA data
and advising citizens and responders about the health hazards
presented by the floodwaters. “I struggled every day
to determine what [the data] meant and what to tell our health
workers and the public,” he says. “What does ‘not
an immediate health hazard’ mean when you have people
wading through the water? What does ‘not in excess
of drinking water standards’ mean? Is it a danger if
you get your hands wet and touch your mouth?” Journalists
claimed the floodwaters were a “toxic gumbo” of
dangerous chemicals and microbes, raising fears that any
contact was a health threaten.
![Submerged Automobile](image/foc4.jpg)
|
![Car Lot](image/foc5.jpg) |
Vehicle slaughter. Vehicles destroyed in
the storm surge of Hurricane Katrina (left) are being
stockpiled north of Gulfport, Mississippi (right). The
thousands of automobiles are just the tip of the iceberg
of waste that communities must deal with as a result
of the hurricane. images: Left to right:
Clayton James Cubitt; Mark Wolfe/FEMA |
These concerns prompted a team of scientists led by John
Pardue, director of the Louisiana Water Resources Research
Institute at Louisiana State University (LSU), to conduct
its own study of the New Orleans floodwaters. The report,
published 15 November 2005 in Environmental Science & Technology,
stated categorically that, contrary to claims in the media,
the floodwater was not a “toxic soup.”
“Chemical oxygen demand and fecal coliform bacteria
were elevated in surface floodwater, but typical of stormwater
runoff in the region,” the report said. “Lead,
arsenic, and in some cases chromium exceeded drinking water
standards, but with the exception of some elevated lead concentrations
were generally typical of stormwater.” The LSU study
also found only low concentrations (less than 1%) of benzene,
toluene, and ethylbenzene even in places where there was
a visible oil sheen. “Collectively, these data indicate
that Katrina floodwater is similar to normal stormwater runoff,
but with somewhat elevated lead and VOC concentrations,” the
report concluded.
However, the LSU study was limited to two areas within
the city of New Orleans, and the authors warned that conditions
could be different elsewhere, particularly in Lake Pontchartrain,
where floodwaters were being pumped. LSU and the University
of Colorado are currently conducting studies of Lake Pontchartrain
looking for a wide range of pathogens. The Colorado team
is measuring aerosols created by pumping floodwater into
the lake, while the LSU team is analyzing the lake water
itself.
More Water Hazards
Still other threats were posed by water. As of December
9, the EPA reported that 99% of the waste treatment and water
supply systems were back online, but some had been out of
operation for weeks. At the October 20 EHSRT, Howard Frumkin,
director of the National Center for Environmental Health
and Agency for Toxic Substances and Disease Registry (NCEH/ATSDR),
said that despite the percentage of sewage treatment plants
already online at that point, the danger wasn’t over. “We
have no guarantees that sewage being flushed is getting to
treatment plants,” he said. “Raw sewage is going
into the Mississippi River.”
Though most water supply systems may be functioning again,
the safety of distribution lines that were flooded can’t
yet be ensured either. “There are possible changes
in pipe ecology due to the intrusion of contaminants,” said
Frumkin. “And we have additional concerns for homes
on wells.” Louisiana officials speaking at the roundtable
said there are dozens of community water systems and tens
of thousands of private wells that need to be tested for
contamination.
Standing water poses a different threat, serving as a breeding
ground for bacteria and mosquitoes. Even prior to Katrina,
Louisiana had the highest number of reported cases of West
Nile virus (66) of any state in the union, according to the
CDC. West Nile virus can be transmitted to humans via mosquito
bites, and the warm, wet weather following the storm was
ideal for breeding of mosquitoes. The U.S. Air Force sprayed
areas of standing water with pesticides to kill mosquito
larvae. The CDC reported on its Update on CDC’s Response
to Hurricanes website that postspraying surveillance at ten
sites found a 91% reduction in total mosquito density compared
to prespraying surveillance results [for more information
on this website, see the EHPnet article, p. A27 this issue].
The Gulf Coast is also known for the presence of the bacterium Vibrio
vulnificus. This relative of the pathogen that causes
cholera thrives in brackish waters in warmer times of the
year. Humans may become infected by eating contaminated
seafood or through open wounds exposed to water. While
not harmful to individuals in good health, it can be fatal
to those with liver damage. Health officials at the roundtable
reported counting 22 cases of illness induced by V.
vulnificus following the storm, including 5 deaths.
In late September, the EPA launched the Ocean Survey Vessel Bold to
conduct water quality testing in the river channels and nearshore
waters of the Mississippi Delta. The agency monitored 20
areas to determine whether fecal pollution from flooded communities
had spread into these waters. All 20 monitoring stations
showed that, at the time, the water was safe for primary
contact, including swimming. The EPA said on its website,
however, that the data “should not be used to assess
the safety of consuming raw or undercooked molluscan shellfish.”
In the wake of the storm, Louisiana, Mississippi, and Alabama
closed their shellfishing waters until testing could be done.
On December 8, the three states issued a joint press release
saying that fish and shellfish samples collected and analyzed
since the hurricanes “show no reason for concern about
the consumption of Gulf seafood.” Louisiana and Alabama
subsequently reopened their waters, while Mississippi’s
oyster reefs remain closed pending additional studies.
Toxicants in Sediment and Air
Health officials also anticipated a threat from contaminated
sediment in the days and weeks following the storm. As floodwaters
were pumped out of inundated areas, a dark sludge was found
coating buildings, land, and pavement. E. coli was
detected at elevated levels in many sediment samples taken
from around New Orleans, implying the presence of fecal bacteria.
The EPA has no standards for determining human health risks
from E. coli in sediment, but warned people to
limit exposure, and if exposed, to wash skin with soap and
water.
The EPA was concerned, too, about the region’s Superfund
sites, which include former dump sites of pesticides and
dioxins. The EPA identified 54 Superfund sites in the affected
area. Officials worried that at least some of these sites
might have been compromised, releasing toxic chemicals into
the land or water. Johnson reported at the EHSRT that as
of October 20, the EPA had visually inspected all of the
sites and sampled many. As of December 5, the EPA’s
posted test results for these sites indicated that none were
compromised in a way that would present a human health hazard.
![Oil Spill](image/foc6.jpg) |
|
A slicker picker-upper. Absorbent
pads are used to clean up surface oil at the Bass Enterprises
South Facility in Cox Bay, Louisiana, where Katrina caused
the release of an estimated 3.8 million gallons of oil.
Oil spills may have long-lasting effects on water supplies
and surrounding ecologies.
image: Mike Lutz/USCG |
Elsewhere, as late as November 20, chemical testing of
sediment samples in Louisiana’s Orleans and St. Bernard
Parishes indicated the continued presence of petroleum. However,
the EPA’s website states that exposures of emergency
responders at these levels are not expected to cause adverse
health effects as long as the proper personal protective
equipment is worn, such as gloves and safety glasses. Volatile
and semivolatile organic compounds, pesticides, and metals
including aluminum were found, but at levels below what the
ATSDR and CDC consider to be immediately hazardous to human
health. However, the site continues, “EPA and ATSDR/CDC
continue to recommend that residents avoid all contact with
sediment deposited by floodwater, where possible, due to
potential concerns associated with long-term skin contact.”
The Natural Resources Defense Council (NRDC) and a host
of local environmental groups paint a darker picture of the
contamination situation. In a December 1 press release, the
NRDC stated that tests it had conducted revealed “dangerously
high levels” of industrial chemicals and heavy metals
in the sediment covering much of New Orleans. For example,
tests found arsenic levels in some neighborhoods that exceeded
EPA safety limits by a factor of 30.
“We found arsenic and other cancer-causing contaminants
in sediment all across the entire city,” said Monique
Hardin, codirector of the New Orleans-based Advocates for
Human Rights, at an NRDC press briefing. “We also found
hot spots where there were some nasty surprises, such as
banned pesticides.” The groups urged the EPA to begin
cleaning up or removing contaminated topsoil across the city
and to conduct further testing in certain neighborhoods.
The NRDC also challenged the EPA’s assertion that
the flooded Superfund sites posed no threat. The December
1 press release stated that NRDC’s own assessment of
one of these sites, the New Orleans Agricultural Street Landfill
Superfund Site, showed “visible leachate emerging from
the site and spreading across the street and onto a local
senior center’s property. Sediment testing at this
site found contamination as much as 20 times higher than
the EPA soil cleanup standards for four [polycyclic aromatic
hydrocarbons].”
LDEQ toxicologist Tom Harris responded in press reports
that the NRDC’s findings were fundamentally flawed
because arsenic levels are naturally above the EPA’s
residential standard in Louisiana and elsewhere. “I
have never personally seen soil samples come back below the
residential screening level for arsenic,” Harris told
PlanetArk World Environmental News on December 5. “It’s
a naturally occurring [element] you can find everywhere.” The
state of Louisiana and the EPA continue to perform testing
of sediment to determine when to give an all-clear to residents
with respect to exposure to sediment.
The EPA has also addressed concerns about air quality in
the Gulf region. According to Johnson, most of the agency’s
stationary air quality monitors were knocked out by Katrina.
The EPA reinstalled the stationary monitors and employed
their Airborne Spectral Photometrics Environmental Collection
Technology to undertake airborne monitoring. The EPA also
employed two Trace Atmospheric Gas Analyzer buses, self-contained
mobile laboratories capable of continuous real-time sampling
and analysis.
Air samples were tested for volatile priority pollutants
such as benzene, toluene, and xylene, which are commonly
found in gasoline, as well as other industrial solvents.
The screening results indicated that chemical concentrations
in most areas were below the ATSDR health guidelines of concern.
The EPA stated on its website, “The low level of volatile
pollutants is not surprising as contaminants may be bound
in sediment. Monitoring data directly around Murphy Oil spill
reveal some slightly elevated levels of benzene and toluene
that are associated with petroleum release. Long-term exposure
(a year or longer) at the levels measured would be required
for health effects to be a concern.”
Air may also play a role in an illness known as “shelter
cough,” or “Katrina cough.” Shelter cough
is presumed to be an allergic reaction to some particulate
matter in the air, according to Stephens. However, despite
the presence of shelter cough and earlier concerns about
a wave of infectious diseases in the wake of Katrina, acute
respiratory illness have made up only 8.7% of diagnoses between
August 29 and September 24, according to the October 7 Morbidity
and Mortality Weekly Report. “We have no evidence
of infectious disease outbreaks,” Stephens said at
the EHSRT.
A Mountain of Debris
The amount of debris generated by Katrina is by all accounts
staggering. FEMA estimates there are 39.9 million cubic yards
of debris in Mississippi alone. Mark Williams, administrator
of solid waste policy, planning, and grants at the Mississippi
Department of Environmental Quality (MDEQ), says that state
has enough space for the initial removal of debris to staging
areas, but not for long-term deposition in landfills.
Jimmy Guidry, medical director of Louisiana’s Department
of Health and Hospitals, says Louisiana, too, lacks sufficient
landfill space for all the debris: “We have more than
three hundred thousand refrigerators that need to be disposed
of. All these have freon in them.” Guidry said at the
roundtable that the Louisiana Department of Environmental
Quality has approved dozens of temporary debris disposal
sites, which will have to be carefully monitored.
![Trash Pile](image/foc7.jpg) |
Waves of destruction. (above) A
motorcyclist rides past a mountain of trash, wallboard,
and furniture removed from homes damaged by Katrina.
(inset) Thousands of damaged refrigerators await safe
disposal at a landfill near New Orleans. The freon in
these appliances will need to be handled carefully.
images: Left to right: Nati Harnik/AP
Photos; Don Ryan/AP Photos |
Appliances can be recycled for metal content. Televisions
and household computers pose a different problem. A single
computer monitor contains 4.5 pounds of lead, and computer
processing units contain trace metals that can leach out
of unlined landfills.
As much as one-third of the debris is vegetative matter
that can be burned or chipped for compost. The rest must
be recycled or landfilled. Williams says burning of vegetative
debris has been allowed in Mississippi for some months and
is now largely complete. He adds, “EPA in conjunction
with MDEQ has done some monitoring in the area [of controlled
burns], which has indicated some elevated levels of formaldehyde
and acrolein in certain areas.” In the interest of
minimizing air pollution, the EPA and MDEQ allowed only clean
vegetative debris to be burned and strongly encouraged the
use of air curtain destructors and other combustion units
in the early stages of cleanup.
Williams says another daunting challenge was disposing
of thousand of tons of food--chicken, fish, and beef--rotting
in warehouses on the docks. Officials from Mississippi’s
Natural Resources Conservation Service said more than 6 million
dead animals--poultry and livestock--had to be removed from
farms in the affected area. Now officials are dealing with
wastes in homes, including such items as propane tanks, household
pesticides, and asbestos from roofing, insulation, and other
home sources. The waste is taken to staging areas where hazardous
waste is pulled out for disposal by the EPA. As of October
31, the EPA had collected an estimated 1 million pounds of
household hazardous waste in Louisiana (the agency did not
report on collections in other states).
Injury Protection
One of the major concerns officials have with regard to
the handling and disposal of debris is the safety of workers. “We
have a large number of workers coming to the Gulf seeking
employment, and many of them are not properly trained and
protected,” says Max Kiefer, assistant director of
emergency preparedness and response for the National Institute
for Occupational Safety and Health (NIOSH). High-risk occupations
include debris removal, levee rebuilding, residential refurbishment,
and infrastructure rebuilding.
NIOSH is trying to keep workers apprised of health hazards. “We
have assessed exposure to silica and metals during levee
rebuilding, debris removal, and tasks involving the sediment,” Kiefer
said at the roundtable. “We also worried that people
were wearing protective gear that may induce heat stress.
After assessing certain tasks, we were able to downgrade
our gear recommendations in light of that. Psychological
stress on responders has been significant. But by far the
biggest issue has been injuries--lacerations, falls, and
trips.” NIOSH is providing guidance for responders
and providers on the CDC hurricane response website.
Private citizens also face significant risk of injury during
cleanup. Officials talk of a “second wave” of
injury following a natural disaster as citizens undertake
to remove debris and repair buildings themselves. Will Service,
the industrial hygiene coordinator with the North Carolina
Office of Public Health Preparedness and Response, worked
in a mobile hospital in Waveland, Mississippi, in the days
following the storm. “We saw a lot of injuries from
things like chain saws used during cleanup,” Service
says. “People are tired, their thinking isn’t
clear. They’re doing things they don’t normally
do.”
Illnesses and injuries associated with Katrina are being
tracked by the CDC, with updates posted regularly on its
website. Confirming what public health officials warned about
a second wave of injuries, the most common diagnosis (26.2%)
in reporting hospitals and clinics from September 8 to October
4 was injury. The major cause of injury was falling, followed
closely by vehicle crash-related injuries (likely related
to missing or nonfunctioning traffic signs and signals).
Cutting and piercing injuries ranked third.
Coming Home to Hazards
Mold growth in houses damaged by Katrina is of enormous
concern to health and housing officials. Estimates of the
number of homes suffering water damage range in the hundreds
of thousands. Claudette Reichel, an LSU professor of education
and housing specialist, says that virtually every home that
sustained flood damage will experience mold growth. “Houses
that people were not allowed back into for weeks will all
have mold, and that mold will have had time to multiply,
spread, and get really thick,” she says. Says Frumkin, “The
magnitude of mold exposure in the Gulf region will in many
instances greatly exceed anything we have seen before, adding
to the concern and uncertainty regarding health effects.”
How or even whether mold causes human health problems is
disputed by public health professionals, but most acknowledge
a connection. “It is a very difficult science, because
there is no clear-cut dose-response threshold,” Reichel
says. “It is highly dependent upon the type of mold,
whether the mold is producing a mycotoxin, the susceptibility
of the patient, and the amount of exposure.”
The CDC states that people who are sensitive to mold may
experience stuffy nose, irritated eyes, or wheezing. People
allergic to mold may have difficulty in breathing. People
with weak immune systems may develop lung infections.
Health and housing officials advise homeowners and renters
to throw out any furnishings, insulation, and bedding that
may have gotten wet, to clean walls and floors with soap
and water, to ventilate, and then to close up and dehumidify
the home.
The CDC also reported a spike in post-Katrina carbon monoxide
poisoning in the Gulf Coast in the October 7 Morbidity
and Mortality Weekly Report. From August 29 to September
24, a total of 51 cases of carbon monoxide poisoning, including
5 deaths, were reported in Alabama, Louisiana, and Mississippi.
After the hurricanes, many residents used gasoline-powered
portable generators to provide electricity to their homes
and businesses. These devices produce carbon monoxide, which
can build up to fatal levels if run inside a living space
or garage.
![Mold](image/foc8.jpg) |
![Women Cleaning](image/foc9.jpg) |
Opportunistic attacker. The warm, damp conditions left
in homes following Katrina provided the perfect medium
for the growth of mold. Because mold can be extremely
toxic and hard to eradicate, many homes may not be salvageable.
images: Left to right: Clayton James
Cubitt; Marvin Nauman/FEMA |
A number of other health issues loom as residents begin
returning to New Orleans, where health care services aren’t
widely available, sewer and water services are still spotty,
and structural inspections aren’t complete. Residents
have asked city officials for a health assessment to address
their concerns about oil spills, mold contamination, and
the possible long-term health effects related to mold and
chemical exposures. “We are developing an assessment
tool for this purpose, and we anticipate that it will be
developed for the beginning of [2006],” says Stephens.
Many health care professionals worry that mental health
may be the most serious long-term health issue resulting
from Katrina. Hundreds of thousands of people across the
Gulf region have had their homes destroyed. Thousands are
still living in shelters. Many have no jobs, no health insurance,
and no job prospects. “We are seeing a lot of symptoms
of post-traumatic stress disorder,” says Marty Allen,
a psychologist with the Mississippi Department of Mental
Health. “The trauma was not just the day of the storm.
People are still being traumatized by living in tents, not
having jobs, and having to walk for miles just to get food
and water.”
Lessons Learned?
What lessons have been learned from Katrina with respect
to environmental health? Debate about how to protect Gulf
Coast citizens from hurricanes and storm surge was ongoing
before the storm and will continue with renewed intensity.
In Mississippi, Governor Haley Barbour enlisted the Chicago-based
Congress for New Urbanism to come up with recommendations
for rebuilding the Gulf Coast. The Congress sponsored a week-long
Mississippi Renewal Forum in October attended by some of
the nation’s leading architects, engineers, and urban
planners. Working with local leaders, the teams produced
reports for 11 coastal towns impacted by the storm. Recommendations
include improving the connectivity between towns by moving
the CSX freight line north and transforming the abandoned
right-of-way into a boulevard for cars and transit, connecting
the Gulf region towns with high-speed rail, realigning and
revising U.S. 90 to become a pedestrian-friendly “beach
boulevard,” and creating a Gulf Coast bikeway.
![Testing](image/foc10.jpg) |
Chemical calamity. A worker tests
hazardous household liquids at the Fort Jackson “orphan” tank
and drum staging area in Louisiana.
image: Chuck Burton/AP Photos |
A similar process is under way in Louisiana under the auspices
of the Louisiana Recovery Authority created by Governor
Kathleen Blanco. The authority is developing short-, medium-,
and
long-range plans to guide the rebuilding of Louisiana in
the wake of the hurricanes. At the authority’s request,
the American Association of Architects, in collaboration
with the American Planning Association, presented the Louisiana
Recovery and Rebuilding Conference on November 10-12. The
authority has developed a 100-day plan that includes completion
of an environmental evaluation of damages caused by the
hurricanes and development of recommendations for how to
proceed with
reconstruction.
Discussion will center on how to protect New Orleans from
further flooding and whether certain low-lying parts of the
city should even be reoccupied. Such decisions will be made
in the months and years to come. Meanwhile, environmental
and public health officials have drawn some conclusions about
how to better respond to events like Katrina.
Officials at the EHSRT agreed that communication in advance
and in the wake of natural and man-made disasters is key.
Fears and rumors of disease ran rampant in the days following
Katrina. Citizens, the media, and even public health officials
did not know which factors presented a genuine health threat
and which did not. Federal agencies conducted testing and
provided data, but people often did not know how to interpret
those data with respect to the kinds of exposures they were
encountering.
“The public health community must be actively involved
and articulate key health issues,” said Kellogg Schwab,
an assistant professor at Johns Hopkins Bloomberg School
of Public Health. “We must keep the message simple
and focused. We must develop effective strategies to provide
targeted timely results. We must provide concise and accurate
public health information and advice.”
Officials also agreed that responders must be properly
trained and deployed, provided with proper protective gear
and an effective communications system (land lines and cell
phones were inoperative in much of the area for weeks after
Katrina). Health officials must be able to assess the particular
kinds of exposures that people have been subjected to and
respond accordingly.
“Your response strategy for exposure varies with
each event,” said Paul Lioy, deputy director of the
Environmental and Occupational Health Sciences Institute
at Rutgers University. “The World Trade Center [collapse]
was an instantaneous acute air exposure event like we’d
never experienced. Katrina for the most part involved an
acute water exposure event, but the exposure was over a longer
period of time.”
Lioy pointed out the need for a national review of the
kind of standards and guidelines necessary to ensure that
the correct information is given out to the public about
immediate hazards versus long-term exposures and risks. “Comparison
to general drinking water or ambient air quality standards
are not sufficient for guiding the public or public officials
during an acute exposure event,” he said.
Most of all, roundtable participants agreed, Katrina represents
a chance for officials across all levels of government to
do things better--evacuation planning, urban design, communication,
environmental monitoring, and involvement of citizenry, particularly
minority and low-income residents. John McLachlan, director
of the Tulane/Xavier Center for Bioenvironmental Research,
said that preparing for disasters like Katrina requires the
involvement of virtually every academic discipline. To that
end, Tulane and Xavier are creating a Katrina Environmental
Research and Restoration Network (KERRN) of researchers who
share data and ideas across disciplinary, geographical, and
institutional lines. Paraphrasing one of his colleagues,
McLachlan stated, “This is the mother of all multidisciplinary
problems.”
John Manuel
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