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The Katrina Cough

More than a thousand Americans died, entire towns were destroyed and it could be years before America's most unique city, New Orleans, fully recovers from Hurricane Katrina.„

The troubles caused by the hurricane and subsequent flooding extend beyond the immediate devastation, however. Molds, dust and other contaminants are contributing to an ailment that has been informally dubbed "The Katrina Cough."

While the city has begun to recover from the initial devastation of Katrina, countless first responders, residents and clean-up and construction crews are beginning to suffer from the mysterious respiratory-related illness, the severity of which is not yet known.„

Molds are growing in waterlogged homes and areas where water has sat still for months; dusts and debris are churning up with the demolition and reconstruction of buildings; and residual biological contaminants from sewage infiltration may still be present in low-lying areas.

These conditions ƒ combined with a lack of proper personal protective equipment (PPE) ƒ are beginning to cause respiratory-related ailments, much like what was experienced following the World Trade Center's collapse on Sept. 11, 2001.

"It's almost as if the two are working together to create a more serious hazard," said Jeff Stull, president of International Personnel Protection, Inc., which advises the industry on the evaluation, selection and use of protective equipment and clothing. Stull, who has a professional background in PPE and has studied the respiratory-related hazards of Hurricane Katrina and other large-scale disasters, says Katrina presented unique risks to the first responders on the ground.

"Obviously you have a whole lot of water damage and sewage and other atypical contaminants present as a consequence of the flooding itself," he said of the post-Katrina conditions,„ "So that makes it a whole lot more difficult."

"At the onset of an emergency situation, there may also be urgency in providing help where workers forego use of PPE for expediency. Under these conditions, workers can be the most susceptible for exposure to hazards as they may be at their peak severity," Stull wrote in an e-mail to FireRescue1.

Despite the clearly hazardous nature of their surroundings, Stull said too many in the Gulf Coast are ignoring the potential health risks associated with their environment.

"No one's thinking of this situation as having any kind of respiratory hazards," he said. "Here you have a whole city that's become that kind of environment now, so the effects on those in the region have been further intensified."

As cleanup efforts continue and many residents begin to move back into the affected areas, the problem may be exacerbated. With the movement and flow of residents, construction crews and emergency personnel, much of the dust and debris people come in contact with gets stuck to clothes and is unintentionally carried home or to their next destination. "The perimeter of these places expands," Stull said.

It's still too early to tell how widespread the effects of the Katrina Cough are. While residents are the most at risk of contracting the mystery illness due to their sustained exposure, Stull said, emergency workers were probably more exposed to the airborne particles and contaminants during the early clean-up stages, when conditions were at their worst.

"Another problem facing workers at disaster operations is the fact that the distribution and availability of PPE is often unplanned and inconsistent. PPE items may be provided, but in the wrong sizes and not appropriately fit to the individual. For example, if only one size of respirator is provided, certain individuals may have exposure to airborne contaminants because the respirators do not fit properly to their faces," Stull wrote in an e-mail.

For the most part, the symptoms of the ailment are just beginning to come to the surface. "I think they're starting to show up now for people who have been exposed since the summer," he said. "It's been collectively called 'the Katrina Cough', but nobody really knows what these ailments are - just that they're respiratory related."

Some are referring to the illness as reactive airways dysfunction syndrome (RADS), which is a pneumonia-like condition that's created by airborne particles, Stull said.„

Following the collapse of the World Trade Center, RADS and hypersensitivity pneumonitis were diagnosed as the leading causes of what some dubbed "The WTC Cough." Nearly 300 New York firefighters are currently on leave due to asthma, sinus infections, chronic cough and other respiratory ailments, Stull said.„

Two New York EMTs and a detective have„died in the past seven months from ailments associated with their work at Ground Zero in the aftermath of the World Trade Center's collapse. EMT Timothy Keller died in June at 41 years of age and 31-year-old EMT Felix Hernandez died in October.

A former New York City police detective,„James Zadroga, died in early January at the age of 34 from a respiratory disease related to his cleanup efforts at ground zero, according to union officials. Zadroga had developed black lung disease and mercury poisoning as a result of working at ground zero, Michael Palladino, president of the Detectives' Endowment Association told„The Associated Press.

"Though the circumstances are greatly different in the two disasters, certainly the similarity of respiratory problems between the two events bears consideration for the effectiveness of PPE use," he said.

"They should be wearing some form of respiratory protection. They should be considering at least a National Institute for Occupational Safety and Health (NIOSH) certified N95 particulate respirator," he said.

The Centers for Disease Control and Prevention and NIOSH have created a useful PPE guide for workers responding in Hurricane Katrina flood zones, which can be accessed online at:„http://www.cdc.gov/niosh/topics/flood/pe-workers.html.


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