Global & Disaster Medicine

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CDC: 3 Types of Post-Disaster Poisonings

CDC

National Poison Prevention Week (March 17-23) was started in 1962 to encourage Americans to “learn of the dangers of accidental poisoning and to take such preventive measures as are warranted by the seriousness of the danger.” Fifty-seven years later, those threats—and probably some new ones—to personal and public health persist. They can also be prepared for and—in many cases—prevented.

Here are three types of post-disaster poisonings that you should be aware of, and three ways to prepare your health for each.

Carbon monoxide poisoning

Carbon monoxide (or CO) is a silent killer. You can’t see it, smell it, or taste it; yet, there it is any time you burn gasoline, natural gas, charcoal, or kerosene in a car, generator, furnace, grill, or space heater.

A portable generator placed outside and in a dry area on the ground.

Unintentional, non-fire related carbon monoxide (or CO) poisoning takes the lives of at least 430 people and sends another 50,000 people to the emergency department in the U.S. every year. Occurrences of accidental poisonings only increase when—in the aftermath of a disaster or emergency—people try to generate power or warmth or to cook.

Articles detailing the personal health threat posed by CO in the aftermath of hurricanes have appeared in the pages of the Morbidity and Mortality Weekly Report for decades–Hurricane Sandy in 2012, Hurricane Ike in 2008, Hurricane Katrina in 2005, and hurricanes Charley, Frances, Ivan, and Jeanne in 2004. Most recently, 16 of the 129 deaths in in Florida, Georgia, and North Carolina related to Hurricane Irma in 2017, were CO poisonings.

Here are three ways you can prepare for and prevent CO poisoning after a disaster.

  1. Learn how to use a back-up generator safely. Place generators outside, in a dry area, and at least 20 feet from any door, window, or vent. Never run a generator inside your home or garage, even if doors and windows are open.
  2. Install battery-powered or battery backed-up CO detectors in your home. The U.S. Fire Administration recommends that you test your devices at least once a month. Change the batteries in your CO detectors every six months. If your detector alarms, go outside for fresh air and call 911.
  3. Know the symptoms of CO poisoning. The most common symptoms of CO poisoning are headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion.

Medication poisoning

Medications are, for the most part, safe when used as prescribed and dosed as directed on the label, but there is the risk of an adverse drug event anytime you bring a medicine into the house. In the wrong hands, medicines are dangerous. More often than anyone would like, the wrong hands belong to kids. About 60,000 young children are taken to emergency rooms each year because they got into medicines.

The threat of medication poisoning in kids and adults is also there in an emergency evacuation when families are forced from their homes and into a shelter, a hotel, or the home of a friend or family. Under stressful circumstances and in unfamiliar surroundings, people can forget to practice safe medication use and storage.

Here are three ways you can prepare for and prevent medication poisoning after a disaster.

  1. Keep all prescription medications and over-the-counter medicines and vitamins, including your emergency supply, Up and Away and out of the reach and sight of children and pets—this includes medicines in suitcases, purses, and “grab and go” bags.
  2. Create an Emergency Action Plan that includes important contact information, such as phone numbers for your physician, pediatrician, pharmacist, veterinarian, and the Poison Control Center: 800-222-1222.
  3. Properly dispose of unused, expired, or contaminated medicines in your medicine cabinet and emergency supply. Discard medications that touched floodwater or have changed in appearance or smell. Contact a pharmacist or healthcare provider if you are unsure about a drug’s safety.

Food poisoning

How to clean and sanitize surfaces that do not soak up water and that may have touched floodwater

Food poisoning symptoms may range from mild to severe and may differ depending on the germ you swallowed. Eating or drinking something contaminated by floodwater, for example, can cause diarrheal disease, such as E. coli or Salmonella infection.

Prolonged power outages can also affect food safety. Perishable foods, such as meats, seafood, and dairy, are unsafe to eat after being in your refrigerator when the power has been off for 4 hours or more. Researchers have identified more than 250 foodborne diseases that can cause a variety of symptoms. Some of the most common symptoms are nausea, vomiting, diarrhea, and stomach cramps.

Here are three ways you can prepare for and prevent food poisoning after a disaster.

  1. When in doubt, throw out any food that may not be safe to eat. That includes foods that have an unusual or unintended odor, color, or texture, foods that may have touched floodwater, and perishable foods that have not been refrigerated properly due to power outages. Never taste food to determine its safety. Food can make you sick even if it looks, smells, and tastes normal.
  2. Throw away wooden cutting boards, baby bottle nipples, and pacifiers if they have come into contact with floodwaters; you cannot properly sanitize them. Clean and sanitize all surfaces in your kitchen, including cutlery and countertops, that come into contact with food.
  3. Handwashing with soap and water is one of the most important practical skills you can learn (and teach to others) to avoid getting sick and spreading germs at all times, including before you handle food—disaster or not. The germs that cause foodborne illnesses can survive in many places around your kitchen, including your hands, utensils, and cutting boards.

Learn more ways to prepare your health for a disaster or an emergency at www.cdc.gov/cpr/prepyourhealth.


CDC: The proper use of generators

Use generators outside, in a dry area, and at least 20 feet from windows, doors, and vents.


3/2/1944: A train stops in a tunnel near Salerno, Italy, and more than 500 people on board suffocate and die.

HxC

“……either the train was unable to pull the overloaded freight cars up the slope or the train stopped to wait for a train descending in the opposite direction. In any case, the train sat idling in the tunnel for more than 30 minutes. While this might not have posed a severe danger in some circumstances, the train’s locomotives were burning low-grade coal substitutes because high-grade coal was hard to obtain during the war and the coal substitutes produced an excess of odorless and toxic carbon monoxide.

Approximately 520 of the train’s passengers were asphyxiated by the carbon monoxide as they sat in the train…..”


Chicago: CO poisoning at Red Robin

ABC

“……Fire officials were called to the restaurant and tested the
atmosphere, which showed high levels of carbon monoxide with readings
of 400 ppm, the fire district said. Customers and employees were
evacuated. In all, 4 people were taken to local hospitals and another
20 were treated by paramedics at the scene…..”

 


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