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Abstract: Water Clean Up (category III, II) Water Cleanup:
Sewage damage causes backflows that are a serious health threat to humans and pets. The purpose of this paper is to summarize what is known about health effects associated with sewage damage into indoor environments and to make technical recommendations for safe mitigation. Risks to health from specific pathogens (including airborne) are considered, the classes of disinfectants and their properties as well as contaminated material, degree of severity and the length of time of the contamination are addressed.
Water Cleanup is not a matter of "if" Water Cleanup is a matter of "when." All properties will need water cleanup service at some point. Pipes burst, washing machines overflow, and sewage backs up into homes everyday across the nation. Finding the right water cleanup company to perform your water damage restoration can be challenging. It is this challenge that makes dealing with a water cleanup so frustrating.
It is important to know the risks involved with unattended water cleanup situations. Not only can a water cleanup situation cause damage to your property, if left untreated water damage can cause mental and physical harm to both you and your family. If water cleanup situations are not handled properly, they can cause mold, which can cause illness. Contracting a professional, certified water cleanup company to properly cleanup your water will likely nullify the risk of mold and illness. Find your local water cleanup company today.
Abstract for Black Water Cleanup, Water Cleanup, Water Damage Restoration Water clean up (black or category III): Severity of the risk associated with indoors sewage contamination is oftentimes underestimated by uninformed homeowners. Threats to health and effects on weakened immune system associated with sewage backflow and resulting from air-born and other pathogens should be known and addressed when performing mitigation or sewage extraction. Type of contaminated material, degree of contamination and length of time of sewage impact should be considered when choosing disinfectants to ensure safe mitigation or extraction.
When thinking about water cleanup, a common misconception limits definition to a clear, odorless, and tasteless liquid, essential for most plant and animal life (Farlex Dictionary, 2011). What is often forgotten, is that waste waters and any fluids normally secreted from the body are also a part of the definition; thereby, making water the most enduring and continuing damaging matter in the indoor environment.
Water in water cleanup is also the most widely used substance for solvents. Its dissolving quality and associated dangers are well known to professional water and sewage damage mitigators, restorers, extractors, environmental engineers and public health professionals, whose purpose is to guard individuals health from harmful effects of sewage contamination. Their primary goal, simply put, is to immediately prevent individuals contact with sewage (includes toilet overflow), stop further flow of contaminated water, eliminate dangerous matter present in this water, bring indoor environment back to dry state, and extraction fluids.
Potential of negative effect sewage (black water) has on human health depends on various factors ranging from the length of time sewage was left untreated, and the source and content of sewage. The level and intensity of threat to a persons health is contingent on the amount of penetration and type of materials affected and is directly associated with materials' porosity and quantity of sewage.
For instance, a small quantity of sewage (black water) resulting from a limited and disrupted backflow (includes toilet overflow) contained to a specific location and deposited on a tile floor can be easily cleaned up using extraction, cleaning, and disinfection. Still, mitigation should be performed as soon as possible to reduce sewage impact time and prevent contact with absorbent materials. Fast decontamination in this instance will reduce potential health risks effectively.
Here, sewage damage is still confined to a specific area and its quantity is limited, but access to adjacent area may have occurred through the wall and Another example may deal with waste that flows beyond the limits of the sewage system materials, such as carpet or linoleum. Here, sewage damage is still confined to a specific area highly porous materials such as carpet and carpet padding. As in the example above, decontamination off all affected materials is required. Additionally, restoration should consist of decontamination off all affected materials is required. Additionally, restoration should consist of not only disinfection, but also evaluation of the contaminated materials for replacement. If should be removed. Effective restorer must also lift and treat both sides of the carpet, dispose of the carpet padding, and ensure drying of all surfaces post-disinfection.
Safety of the water damage restoration professionals is achieved by proper use of appropriate safety equipment. Additionally, any puncture wounds, scratches and other wounds with broken skin should be avoided and those with open sores and like injuries should not be allowed at restoration site to prevent possibility of dangerous infection.
Black Water Cleanup, Sewage Problem: Review Problems with black water back up, return water from septic lines, or dirty outside water sources, like rain water or river overflow, pose a severe threat to the occupants. In some instances, an immediate water damage to materials occurs, while in others, it is only a question of time how soon materials and structure will be damaged expensively.
If all of the above is not addressed in a short Water Cleanup, Water Damage Restoration: In situations when determination of the cause of the period of time, preferably immediately, a number of days may pass before sewage damage mitigation begins. Therefore, allowing for a deep penetration of sewage or other contaminants into porous and highly absorbent materials.
Absorbent or Hygroscopic Materials Some materials are more likely than others to attract water molecules and increase in volume, weight, or otherwise change its physical characteristics. Prolonged presence of moisture in hygroscopic materials also results in microbial growth; that is when many homeowners recognize odor. The most absorbent or hygroscopic (water seeking) materials include paper, carpet, carpet padding, gypsum, and wood. When these and other materials are penetrated with sewage, water, or organic matter, opportunistic microorganisms or bacteria with the potential of causing disease may develop.
Such potentially disease-causing microorganisms present a severe hazard to human health, because toxic and damaging matter may be produced as a result of their growth and development. For example, toxigenic fungi, commonly known as mold, can grow extensively on structural materials or furnishings inside a building as a result of high humidity, causing damage to those with weakened immune system and releasing harmful toxins that pose serious risk to any occupant.
Water Clean Up, Water Damage, Sewage Damage, Black Water Cleanup: Analysis & Plan of Action Following sewage damage or flooding, mitigation professionals or other extraction and water damage restoration parties involved should determine health hazards associated with the problem and the effect of this damage on the structure and contents. The Heating, Ventilating, and Air Conditioning systems should be reviewed for safety and necessity of treatment. Safe and Institute For Inspection Cleaning And Restoration – approved environment testing methods should be used. After determination is made regarding necessity of evacuation of the occupants from a portion of the building or the entire structure, a plan should be drawn on how to extract and repair the damage and what is necessary for this process.
In order to determine scope of work, semi porous materials should be evaluated and decision should be made to restore or replace each affected/contaminated item/surface. During this process, the type of damaged materials, the nature, the source, water volume, and severity of the contamination should be determined.
The sewage or flood-damaged materials may be organic or synthetic, porous, nonporous, or semi porous. The nature of damage may be a natural disaster like flooding or river overflow; septic tank overflow; main sewer line back up, and so on (cause of any of these problems is a different matter).
Sewage-borne microorganisms and bacteria have potential to transmit to occupants Another important aspect of extraction and remediation is the micro flora: pathogens contained in and remediation crew. Potential of risk to human health may be aggravated by the temperature and humidity of the surrounding environment (indoors and out), because it can create a comfortable development and survival environment for these microorganisms and bacteria.
Water is the single most long term destructive substance in the indoor environment. It dissolves or controlling water damage are well known to professional extraction and water cleanup experts and remove harmful substances that enter in the environment with flowing water, restore the environment to a dry state, and salvage valuable fluids or wastes (e.g., raw sewage) or other organic contaminants.
The degree of penetration is dependent on the porosity of contaminated materials, the quantity of sewage, and the amount of time the sewage remains in contact with materials. Consider different in each situation. Penetration of water depends on the content of the sewage and the degree and extent of penetration into the building environment.
Situation 1: An example of this situation might be waste that overflows in a bathroomand is deposited on and confined to a tile floor. In this situation, there is a limited quantity of waste, which is contained and does not contact absorbent materials. Decontamination, which includes water extraction, cleaning, and disinfection, can be effective in reducing this particular potential health risk.
Situation 2: For example, flooding occurs in a men's room of an office building, water flows under a wall and into the carpet of an adjacent hallway. In this case, there is a limited amount of waste that is confined to a relatively small area of the building, but it penetrates regions of the environment that have complex surfaces and are difficult to restore. Effective restoration involves decontamination (as in Situation 1) as above and drying all surfaces that have been in contact with the sewage. In the case of stretch-in carpet, lifting and cleaning the contaminated carpet, disposing of the cushion, and treating both sides of the carpet thoroughly with a disinfectant are all necessary. Affected porous wall materials need to be treated with a disinfectant and evaluated for replacement. Because of the confinement of the sewage spill, aggressive, comprehensive treatment can be effective.
Situation 3: In this situation, there is extensive risk because humans can be exposed to pathogenic raw wastes that have penetrated and become contained by the building and its furnishings. If flooding is from this kind of primary outside sewage system, occupants should be evacuated, and restoration should begin immediately. In this situation, cleaning and restoration professionals should be protected by using respirators with high-efficiency particulate air (HEPA) cartridges, rubber boots, gloves, splash goggles, and protective garments. Extreme care should be taken to avoid puncture wounds during the restoration process. Restoration staff who have cuts or open sores should not be allowed to work on this kind of restoration project. The principles of restoration of this situation are outlined in the last section of this paper, which contains specific recommendations for techniques. The main discussion of this paper focuses on the potential health risks posed by a sewage backup similar to Situation 3.
Description of the Primary Black Water Cleanup Problem
When the flooding of a building occurs that involves sewage or a heavy load or organic matter, as in the case of river flooding (can appear worse than black water cleanup situations), a serious threat to human health exists. Without appropriate action, extensive damage to materials will occur immediately or in time. Several days may elapse before the cause of the backup is determined, the problem is corrected, and flooding subsides. This allows extensive water permeation and contamination of absorbent (hygroscopic) materials such as wood, gypsum, paper, and concrete to occur. This penetration with water and organic matter leads to the growth of potentially disease-causing (or opportunistic) microorganisms. These Organisms may pose a serious health risk to occupants of the building. Organic matter and water-saturated materials can be used as substrate for growth of microorganisms (such as gram-negative bacteria and toxigenic fungi) that can produce substances toxic to humans and damaging to materials. A large amount of water inside a building will cause high humidity, which can also contribute to microbial growth on structural materials and contents (2).
Questions To Be Raised After Sewage Contamination For Water Damage Restoration Some of the questions to be answered in this situation include the following: What are the effects of the initial contamination of the building, its contents, and the health and welfare of its occupants? What is needed to thoroughly extract and clean up the contamination and repair the damage? Should the entire building or a portion of the building be evacuated and, if so, for how long? Can semi porous materials be decontaminated, or should they be replaced? What are the consequences of using inadequate measures to remediate the damage? What are the indicators that help determine when the building is safe or not safe for occupancy? What methods should be used to test for these indicators? What is the effect of the sewage damage on other systems, especially the air changing systems (ACS) and the heating, ventilating, and air conditioning (HVAC) systems in the build environment?
Issues of Concern Associated with the Problem
There are several factors bearing on the extraction and remediation of the problem. Among these are semi porous, or nonporous), the sewage microflora (pathogens and allergens), organic matter load, water volume, and impact of ambient outdoor temperature and humidity on the indoor environment. Of major concern are the survival of sewage-borne micro flora (viral, bacterial, fungal, parasitic, and their potential transmission to humans. The potential exists for some fungal and bacterial contaminants to establish an ecological niche and present a health risk from chronic exposure for some time after the event.
Scope of These Guidelines
The discussions within this paper will address the immediate and longer term effects of sewage-flooding contamination on the building structural materials and contents; the potential effects on occupants; and the steps to remove contamination to include flushing with clean water and detergent solutions, vacuuming, dehumidification, and disinfection. The potential health threats presented at each stage of remediation will be discussed. These include the production of bioaerosols during removal of gross contamination, the long-term effects of residual moisture and organic matter on the building and occupants, and the colonization and growth of non-sewage-borne species of microorganisms such as molds and other fungi.
Assessment of Water Damage, Black Water Cleanup and Danger to Health
The black water cleanup factors that determine the extent of contamination within the building include the volume and the solids content of the sewage backflow, whether flooding is isolated to the basement or involves other levels as well, and how long the contamination has been in place.
The assumption must be that potential pathogens are present in the contamination. Such microbial contamination includes bacteria, fungi, viruses, and parasites. Table 1 lists the micro flora that maybe found in raw, untreated sewage and the diseases that these organisms have the potential to cause (3). Also, hypersensitivity lung disease has been shown to be caused by repeated flooding of homes with sewer water (4).
The routes of exposure of the building occupants to these pathogens are contact, ingestion, and inhalation. An incomplete or inadequate job of cleaning and disinfection may leave residue that can be a substrate for disease-causing microorganisms. Occupants may be infected by contacting contaminated surfaces, with inadvertent transmission from hands to mouth, or aerosolization of contamination may result in the inhalation of microorganisms or their products (e.g., endotoxins). Residue and microbial contaminants also can be tracked by occupants feet to other parts of the building.
Another aspect of health impact is that the conditions caused by sewage backflow or flooding are conductive to the growth of non sewage microorganisms. These conditions include wetness, humidity, and organic matter. Microorganisms, which exist in various life stages in both indoor and outdoor environments, would then have the opportunity for exponential population growth. These species(see Table 2) can produce bioaerosols, which are potential sources for disease. For example, mold allergy is a common source of indoor air symptoms and complaints (5). In regard to the susceptibility of building occupants, those individuals whose immune systems are in some way compromised (i.e., immunocompromised), or who are otherwise susceptible due to age, medication, or underlying illness, are considered to be at greater risk of contracting potentially fatal infections from the black water damage than those individuals who are healthy.
Fundamental Considerations for Remediation: Water Cleanup, Water Damage Restoration
The factors to be considered in remediation include the types of materials affected, assessment of the degree of damage, the extent of contaminated absorbent material, the total contact time, the humidity, and the amount of ventilation available. The primary goal of water restoration must be the complete extraction and disposal of water and contamination using the sanitary sewer system if possible. Wet extraction systems should be used to completely remove sewage and water used for cleaning. As part of this phase of the operation, removal of affected contents and structural materials may be necessary. These items could include carpet, wall covering porous wallboard, and insulation, and other substrates with the potential for mold growth. Disposal of non restorable contaminated materials requires that the materials be confined in plastic bags and transported to appropriate disposal facilities. In all cases, extraction experts must be provided with appropriate personal protective equipment such as respirators, boots, gloves, splash goggles, and coveralls, and with equipment with which to remove contamination (6).
In order to speed the drying process from water damage and the need to clean up the water, both mechanical and natural dehumidification should be employed as the gross contamination is removed and during restoration. An indoor humidity target of 40% relative humidity (RH) or less should be attained as quickly as possible (7). If possible, depending on the design of the contaminated space and the outdoor weather conditions, there should be ventilation with fans and evaporation of indoor water by introducing outside air. The use of dehumidifiers for removal of water (moisture) from inside building surfaces and air is recommended. The ACS and HVAC systems may be considered as dehumidifiers, depending on the systems mechanical capacity versus the extent of moisture load over time. Rapid drying that stresses proper management of temperature, airflow, and dehumidification is essential for success during the water cleanup process.
Desiccant dehumidifiers, using silica-gel or lithium chloride, could be employed as an adjunct to disinfection to reduce RH to as low a level as possible (8). Moisture content measurements of reclaimed materials is an important criterion of the success of adequate drying and the remediation process.
Chemical Disinfection To Black Water Clean Up
Even concrete can be colonized and broken down my microorganisms if it is allowed to remain wet and contaminated by organic matter. Chemicals categorized as disinfectants are appropriate in this application. A disinfectant may be defined as an agent that reduces significant numbers of pathogens on inanimate objects to a level below the expected to cause disease. Disinfectants may not kill spores, however, and, because some bacterial and fungal spores will always be present in the environment, it would not be feasible to attempt to kill all of the spores in an affected area. Emphasis instead should be placed on removal of the substrates, water, and organic matter needed for the growth of spores.
Choice of disinfectants depends on the degree of microbial killing required, the nature of surfaces to be treated, application safety, and the cost and ease of use of available agents. It is recommended that disinfectants be used in accordance with the manufacturer instructions for use and dilution.
The advantages and disadvantages of each of these disinfectants are given in Table 3. For example, the use of iodophores or low-concentration chlorine compounds would require that little organic matter be present on surfaces, a condition that may be difficult to achieve. Caution should be used in mixing some disinfectants. For example, mixing chlorine-containing solutions with ammonia will produce extremely toxic vapors, and could have lethal effects on workers or building occupants. Of critical importance is contact time. Contact time is the length of time that the disinfectant is permitted to work on the contaminated surface. The contact time must be at least 15 min before additional cleaning and removal of the disinfectant is undertaken. Some disinfectants, such as phenolics and glutaraldehydes, leave a residue that continues to suppress microbial growth for some time after treatment. Water cleanup is truly a science, especially black water cleanup, and should be left to qualified professionals.
Health-Based Recommendation for Mitigation, Water Damage Restoration, Black Water Cleanup. The following specific guidelines are presented with a goal of restoring the contaminated area such that the health of occupants is protected from any risk of pathogen-caused disease.
Water Extraction, Water Damage Restoration and remediation should begin as soon as possible. The longer the contamination is allowed to persist, the greater the potential for microbial growth and resultant damage. And just remember, water that starts out as fresh will certainly attract the contaminants in carpet, ect. Fresh water cleanup does not stay that way given the materials to which they contact.
Unprotected occupants and workers should be evacuated from the affected areas during the initial stages of decontamination, cleaning, and disinfection (e.g., until sewage has been removed and disinfectants applied).
Extraction technicians in the vicinity of the sewage during the initial stages of decontamination, cleaning, and disinfection should be equipped with an organic vapor HEPA respirator, rubber gloves, splash goggles, and boots. In the case of overhead contamination, technicians should also be equipped with goggles, hard hats, and protective suits. Technicians should report any wounds that occur during restoration and take care to avoid cross-contamination from affected to unaffected areas by foot traffic or material handling.
After water extraction, all affected materials should be decontaminated by spraying with a disinfectant solution. It is not the intent of this prespray to effect full disinfection because the presence of organics precludes this. The objective is to initiate the reduction and containment of microorganismsas quickly as possible.
All affected materials should be evaluated for porosity (permeance). From this inspection, materials should be rated as highly porous (saturated), semi porous, and nonporous. Some materials may exhibit varying degrees of porosity, depending on the exposed surfaces. For example, the surface of painted drywall has very low porosity, yet the base of the wall may be unpainted or have exposed gypsum paper that is highly porous.
Highly porous (permeance factor >10) materials that have been exposed to sewage backflow and have a value that exceeds the cost of restoration such as high-value rugs and carpet, upholstery, and other textiles should be removed and restored off site. Highly porous materials with low cost orreplacement value, such as carpet cushion, carpet, cardboard, tackless strip, wicker, and straw, should be removed and discarded as soon as possible. Other materials, such as saturated mattresses and cloth upholstery, regardless of value, cannot be restored and should be discarded. If disposal is necessary, these materials should be bagged in plastic for removal to a proper disposal site. Black water cleanup is part of Water Damage Restoration.
Semi-porous (permeance factor of >1 to 10) materials, including items such as linoleum, vinyl wall covering and upholstery, and hardboard furniture, along with construction materials such as wood, restoration process. If these materials are not removed or properly disinfected, they can become reservoirs for growth of microorganisms.
Nonporous materials (permeance factor 1) such as Formica;, linoleum, vinyl, and tile finishing materials can be inspected for subsurface contamination with a non penetration moisture meter. Although these materials may be rated as nonporous, they must be evaluated carefully because contamination can migrate from the perimeter and become trapped below the surface. If migration of contamination below the surface has not occurred, these materials may be fully restored.
Heavy organic matter, especially raw sewage and silt, must be physically removed by any safe means available. This may include the use of shovels, squeegees, septic pump trucks, wet vacuums, and moisture-extraction machines. Water must also be extracted from floor-covering fabrics such as carpet and rugs. All tools and machines, especially recovery tanks, wands, and hoses, must be cleaned and disinfected after use.
Residual organic matter in cracks and crevices can be removed by pressure washing with a disinfectant solution. The solution then must be recovered with an extraction unit, immediately after Additionally, there may be cross contamination caused by pressure washing during the water cleanup process. Be sure the use the lowest pressure needed so that the black water cleanup does not affect other materials.
After removing heavy organics, affected materials must be cleaned before a second application of disinfectant takes place. Use of many cleaning agents, such as soaps and detergents, will solubilize most organic matter.
After thoroughly cleaning all contaminated materials, a second application of disinfectant may be applied for black water cleanup.
Chemicals classified as disinfectants are appropriate for use in areas exposed to sewage backflow. These chemicals are defined as being capable of inactivating potential pathogenic microorganisms on inert substrates when it's time to cleanup water that is from toilet overflow.
Fully evaluate all factors that affect the success of decontamination. These include the organic matter present, extent of prior cleaning, type and level of microbial contamination, concentration and time of exposure to the disinfectant, and the nature of the material to be decontaminated.
Sources such as Block (9) provide information about the classes of disinfectants.
Glutaraldehydes: These helpful agents display a broad spectrum of activity and rapid rate of kill against the majority of microorganisms. Glutaraldehydes are capable of destroying all forms of microbial life including bacterial and fungal spores, tubercle bacilli, and viruses present in the black water. They are excellent sporicides and will not corrode most materials. Black water clean up disadvantages include increased peroral, percutaneous, and inhalation toxicity, along with elevated eye and skin irritation.
Iodine and Iodine Compounds (Iodophors): These agents are highly effective, have broad-spectrum antimicrobial capabilities and exhibit some residual properties. Disadvantages cleaning up black water. Some formulations may stain porous materials an orange-yellow color.
Phenolic Compounds: These agents are stable (less inactivated by organic matter), broad spectrum (generally include antiviral properties), and readily available, and leave a residue. Disadvantages include substantially increased peroral, percutaneous, and inhalation toxicity, along with eye and skin irritation.
Quaternary Ammonium Chloride Compounds (Quats): These agents have a limited spectrum of activity but are capable of killing gram-positive bacteria and fungi, and of inactivating gram-negative bacteria and some viruses. Quats have a naturally pleasant odor, counteract offensive odors, and are excellent cleaners. Ammonium chloride compounds are safer to use than most other disinfectants for black water cleanup, because they are less toxic and cause less irritation to the mucus membranes. Quats, when diluted for use, are low in toxicity and irritation. Disadvantages of this class of agents include the facts that they are neither sporicidal nor tuberculocidal and that many formulations exhibit poor results against gram-negative bacteria and some viruses. Also, these compounds are incompatible with anionic cleaners (i.e., mutual neutralization of disinfectant and cleaner) and with the dye blockers in stain-resistant carpet.
The indoor humidity in affected areas should be reduced to 40% RH as quickly as possible. When flooding has been extensive, the drying process may require several days or longer to be effective. Adequate drying should be evaluated with a moisture meter. The humidity caused by the need to cleanup water should be monitored with a hygrometer or a psychrometer.
Because the use of disinfectants such as glutaraldehydes, iodophors, and phenolics for disinfection produce irritating vapors, appropriate personal protective equipment to preclude chemical exposure is required for black water cleanup or water damage restoration. The type of safety equipment used will depend on the disinfectant used, the concentration, and the method of application. The material safety data sheet (MSDS) and label instructions on the chosen disinfectant will provide more detailed information and must be reviewed before use.
Environmental monitoring of the water cleanup process should consist of moisture measurements, rather than surface or air sampling for the presence of viable microorganisms. After the restoration process, surveillance of occupants for sickness, allergy, and sensitivity may also provide a measure of the adequacy of the black water clean-up operation. Do not hesitate to see a doctor.
Small rugs may be restored effectively through commercial laundering. If an effort is made to restore the carpet, extensive cleaning and saturation disinfection ofthe carpet should take place. All organic material must be removed, and the complex fibrous surfaces throughout the carpet must be disinfected. Following treatment, the carpet must be inspected thoroughly for cleanliness and dryness before being reinstalled in the restored environment. Carpet cushion must be removed, disposed of, and replaced with new material, without exception. Sub returned to the environment. Under no circumstances should efforts be made to restore carpet and rugs on site that have been extensively damaged by a Situation 3 sewage backup.
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