NIOSH HEALTH HAZARD EVALUATION REPORT 

HETA #2006-0023-3003 

New Orleans Fire Department 

New Orleans, Louisiana 

June 2006 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health
ii 

PREFACE

The Hazard Evaluation and Technical Assistance Branch (HETAB) of the National Institute for 

Occupational Safety and Health (NIOSH) conducts field investigations of possible health hazards in the 

workplace. These investigations are conducted under the authority of Section 20(a)(6) of the Occupational 

Safety and Health (OSHA) Act of 1970, 29 U.S.C. 669(a)(6) which authorizes the Secretary of Health and 

Human Services, following a written request from any employers or authorized representative of 

employees, to determine whether any substance normally found in the place of employment has 

potentially toxic effects in such concentrations as used or found. 

HETAB also provides, upon request, technical and consultative assistance to federal, state, and local 

agencies; labor; industry; and other groups or individuals to control occupational health hazards and to 

prevent related trauma and disease. Mention of company names or products does not constitute 

endorsement by NIOSH. 

ACKNOWLEDGMENTS AND AVAILABILITY OF REPORT

This report was prepared by SangWoo Tak and Chad H. Dowell of HETAB, Division of Surveillance, 

Hazard Evaluations and Field Studies (DSHEFS). Field assistance was provided by Bruce Bernard, Rick 

Driscoll, Linda Ewers, Tom Hales, Brad King, Andrea Markey, Elena Page, and Lauralynn Taylor 

McKernan. Analytical support was provided by DataChem Laboratories, Salt Lake City, Utah. Desktop 

publishing was performed by Robin Smith. Editorial assistance was provided by Ellen Galloway. 

Copies of this report have been sent to employee and management representatives at the New Orleans 

Fire Department (NOFD) and the OSHA Regional Office. This report is not copyrighted and may be 

freely reproduced. The report may be viewed and printed from the following internet address: 

http://www.cdc.gov/niosh/hhe. Copies may be purchased from the National Technical Information 

Service (NTIS) at 5825 Port Royal Road, Springfield, Virginia 22161. 

For the purpose of informing affected employees, copies of this report 

shall be posted by the employer in a prominent place accessible to the 

employees for a period of 30 calendar days.
iii 

Highlights of Health Hazard Evaluation 

Highlights of the NIOSH Health Hazard Evaluation

In October 2005, the National Institute for Occupational Safety and Health (NIOSH) received a request 

for a health hazard evaluation (HHE) from the New Orleans Fire Department (NOFD) and the 

International Association of Fire Fighters Local 632 (IAFF). They were concerned about exposure to the 

floodwater and sediment and mental health issues among fire fighters following hurricanes Katrina and 

Rita. NIOSH personnel conducted an investigation in October, November, and December 2005. 

What NIOSH Did

 We conducted a questionnaire survey to 

NOFD personnel at all fire houses and 

staging areas 

 We looked at the prevalence of mental and 

physical health symptoms 

 We analyzed relationships between health 

symptoms and factors related to hurricane 

Katrina 

What NIOSH Found

 Fire fighters whose skin and mouth/nose 

were in contact with floodwater reported 

more upper respiratory symptoms and skin 

rash compare to those not exposed to the 

floodwater. 

 Fire fighters with lower respiratory 

symptoms and skin rash reported more 

depressive symptoms than those without 

lower respiratory symptoms and skin rash. 

 Fire fighters involved in gunshot incidents 

and body recovery reported more 

posttraumatic stress disorder symptoms than 

those not involved in these activities. 

What New Orleans Fire Department 

Managers Can Do

 Provide clinical evaluation and appropriate 

medical follow-up for physical and 

psychological health conditions for fire 

fighters 

 Provide specific health and safety protective 

measures for fire fighters during and after 

natural disasters. 

 Strengthen the existing health and safety 

program, and integrate training programs 

specifically for future emergency responses. 

 Establish a committee to encourage 

communication within the NOFD and 

between supervisors and employees. 

What the New Orleans Fire Department 

Employees Can Do 

 Report potential work-related physical and 

psychological symptoms to supervisors and 

participate in clinical evaluation and medical 

follow-up programs. 

 Use appropriate personal protective 

equipment such as goggles when responding 

to future flood emergencies. 

What To Do For More Information:

We encourage you to read the full report. If you 

would like a copy, either ask your health and 

safety representative to make you a copy or call 

1-513-841-4252 and ask for 

HETA Report #2006-0023-3003
iv 

Health Hazard Evaluation Report 2006-0023-3003 

New Orleans Fire Department 

New Orleans, Louisiana 

June 2006 

SangWoo Tak, ScD, M.P.H. 

Chad H. Dowell, M.S. 

SUMMARY

In October 2005, the National Institute for Occupational Safety and Health (NIOSH) received a request 

for a health hazard evaluation (HHE) from the New Orleans Fire Department (NOFD) and the 

International Association of Fire Fighters Local 632 (IAFF). This HHE request concerned health hazards 

from exposure to the floodwater and sediment and the mental health of fire fighters following the 

NOFD’s response to Hurricanes Katrina and Rita. Reported health problems included respiratory, throat, 

and sinus irritation; and symptoms suggestive of depression and anxiety. 

NIOSH representatives conducted a survey to evaluate health concerns among fire fighters; 525 NOFD 

personnel participated in the survey. This self-administered questionnaire contained questions about 

demographics, job characteristics, lifestyle, work duties and location, hurricane-related activities, and 

symptoms that occurred during and after the hurricanes. The Center for Epidemiologic Study-Depression 

scale (CES-D) was used to assess symptoms associated with depression, and the Veterans Administration 

posttraumatic stress disorder (PTSD) checklist was used to define posttraumatic stress symptoms among 

participants. 

Of the 525 fire fighters who completed the questionnaire (77% participation), 201 (38%) reported one or 

more new-onset respiratory symptoms, such as sinus congestion (145 [28%]), throat irritation (92 [17%]) 

and cough (124 [24%]). Skin rash was reported by 258 (49%) of respondents, 414 (79%) reported skin 

contact with floodwater, 165 (32%) reported they had contact with floodwater on multiple days, 133 of 

493 respondents (27%) had major depressive symptoms, and 114 of 518 (22%) showed posttraumatic 

stress disorder (PTSD) symptoms. 

In multivariate analyses adjusting for age, gender, and smoking, fire fighters who had floodwater contact 

with skin and either eyes or nose/mouth (224, 44%) had increased risk of new-onset upper respiratory 

symptoms (prevalence ratio [PR]=1.9; 95% confidence interval [CI], 1.1–3.1) and skin rash (PR=2.1; 

95% CI, 1.4-3.2) compared to those not exposed to the floodwater. Depressive symptoms were associated 

with new-onset lower respiratory symptoms (PR=1.8; 95% CI, 1.2-3.0), skin rash (PR=1.7; 95% CI, 1.2-

2.6) and low supervisor support (PR=1.6; 95% CI, 1.1-2.3). Fire fighters housed with their family were 

less likely to report depressive symptoms (PR=0.7; 95% CI, 0.5-1.0) compared to those not living with 

their family. Higher prevalence of PTSD symptoms were reported from fire fighters involved in one or 

more gunshot incidents (PR=2.4; 95% CI, 1.6-3.7), guard duty (PR=1.8; 95% CI, 1.2-2.7), and body 

retrieval (PR=1.7; 95% CI, 1.1-2.6). 

The results of the questionnaire survey showed that fire fighters who reported floodwater contact with 

their skin and nose/mouth or eyes for longer than a few hours at the time of the hurricanes reported 
v 

significantly more upper respiratory symptoms than those who reported no contact with the floodwater. 

Fire fighters with respiratory symptoms and skin rash also reported more depressive symptoms than those 

without respiratory symptoms and skin rash. Fire fighters involved in gun shot incidents and body 

retrieval in response to the hurricanes were more likely to report PTSD symptoms. Clinical follow-up of 

affected fire fighters for physical and psychological conditions should be implemented. 

This report, along with the environmental survey conducted at the Jackson Barracks temporary staging 

area (Appendix A) should be construed as the final report. The environmental evaluation looked at fire 

fighter activities during simulated apparatus runs, and included air sampling to evaluate fire fighter 

exposures to dust. For the fire fighters working out of the Jackson Barracks temporary staging area, 

airborne exposures to respirable particulates and silica, total particulates, and elements (metals and 

minerals) were below all applicable exposure criteria. 

NIOSH investigators determined that a work-related hazard existed among New Orleans 

fire fighters due to Hurricane Katrina-related exposures. We found that physical and 

mental health symptoms were associated with work-related exposures. This report 

includes recommendations pertaining to these findings. 

Keywords: NAICS 922160, fire fighter, Katrina, Rita, hurricane, depression, floodwater, emergency 

response, natural disaster, respiratory symptoms, skin rash
Table of Contents 

Preface..........................................................................................................................................................ii

Acknowledgments and Availability of Report..........................................................................................ii

Highlights of Health Hazard Evaluation .................................................................................................iii

Summary.....................................................................................................................................................iv

Introduction.................................................................................................................................................1

Background .................................................................................................................................................1

Methods........................................................................................................................................................1

Study Design............................................................................................................................................1

Health Outcomes.....................................................................................................................................2

Factors Related to Hurricane Response................................................................................................2

Statistical Analysis ..................................................................................................................................2

Results ..........................................................................................................................................................3

Characteristics of Study Participants ...................................................................................................3

Factors Related to the Hurricane Responses........................................................................................3

Social support and lifestyle change........................................................................................................4

Prevalence of health symptoms..............................................................................................................4

Health symptoms and floodwater contact ............................................................................................4

Factors associated with depression and PTSD symptoms...................................................................4

Discussion and Conclusions .......................................................................................................................5

Recommendations.......................................................................................................................................6

Reference .....................................................................................................................................................7

Appendix A................................................................................................................................................26
Health Hazard Evaluation Report No. 2006-0023-3003 Page 1 

INTRODUCTION

In October 2005, the National Institute for 

Occupational Safety and Health (NIOSH) 

received a request for a health hazard evaluation 

(HHE) from the New Orleans Fire Department 

(NOFD) and the International Association of 

Fire Fighters Local 632 (IAFF). The HHE 

request concerned health hazards from exposure 

to the floodwater and sediment from Hurricanes 

Katrina and Rita and mental health of the fire 

fighters following the NOFD’s response to the 

hurricanes. Reported health problems included 

respiratory, throat, and sinus irritation; and 

symptoms suggestive of depression and anxiety. 

 

NIOSH representatives met with the NOFD and 

the IAFF to discuss the concerns listed in the 

HHE request on October 17, 2005, and October 

19, 2005, respectively. The meetings included an 

overview of the NIOSH HHE program, a review 

of the issues that prompted the HHE request, and 

a discussion of the scope of the NIOSH 

evaluation. 

Between November 29, 2005, and December 5, 

2005, after a joint meeting with NOFD and 

IAFF, NIOSH investigators made site visits to 

all of the fire stations in New Orleans Parish, 

Louisiana and conducted a health survey to 

examine the extent of physical and mental health 

symptoms among NOFD personnel. 

On October 19, 2005, in response to concerns 

about sediment exposures during apparatus 

movement, NIOSH investigators conducted a 

site visit at the Jackson Barracks temporary 

staging area. The site visit included observations 

of fire fighter activities during simulated 

apparatus runs and environmental air sampling 

to evaluate fire fighter exposures to dust. 

Preliminary results for the environmental survey 

were reported in a letter dated December 21, 

2005. The final results of the environmental 

survey are enclosed as Appendix A. 

BACKGROUND

In August and September 2005, Hurricanes 

Katrina and Rita made landfall, passing within 

miles of New Orleans, Louisiana. Heavy winds 

and rain damaged and breached several levees 

protecting the city. The levee breaches flooded 

up to 80% of the city, with water reaching a 

depth of 20 feet in some areas. 1 When the 

hurricanes made landfall in New Orleans, more 

than 600 career fire fighters worked for the 

NOFD. Because of the flooding in sections of 

New Orleans, a number of fire stations were 

closed and relocated to temporary headquarters 

in Algiers, Louisiana. As the floodwaters 

receded, fire fighters were moved back to their 

fire houses or temporary staging areas. During 

and after the hurricanes, fire fighters participated 

in rescue and recovery activities in addition to 

their normal fire suppression duties. Fire fighters 

worked long hours because of the vast 

devastation and limited personnel. During this 

time period, many of the fire fighters were 

separated from their family. 

Following the hurricanes, the NOFD and the 

IAFF received anecdotal reports from fire 

fighters about health effects thought to be related 

to exposure to the floodwater and sediment. Fire 

fighters reported respiratory, throat, and sinus 

irritation. There were also concerns about 

symptoms suggestive of depression and anxiety. 

Fire fighters were dealing with complicated 

issues such as extended working hours, sleep 

deprivation, violent threats, and lack of 

communication with coworkers and families. 

Many also experienced personal stressors such 

as displacement of family members and the 

destruction of their homes.2

METHODS

Study Design 

This cross-sectional survey included fire fighters 

working in all locations throughout New Orleans 

Parish. The survey was confidential and 

anonymous (no personal identifiers were 

obtained on the questionnaire). The self-
Page 2 Health Hazard Evaluation Report No. 2006-0023-3003 

administered questionnaire asked about 

demographics, past medical history, smoking 

history, work duties and location, hurricanerelated activities performed, and symptoms 

experienced during and after the hurricanes. 

NIOSH investigators visited each fire station or 

temporary staging area and were accompanied 

by representatives from the NOFD management 

or IAFF. The questionnaire was distributed to all 

fire fighters who worked in New Orleans Parish 

from November 29, 2005 to December 5, 2005. 

Health Outcomes 

Information was obtained on physical symptoms 

(i.e., upper airway irritation, lower respiratory 

symptoms, gastrointestinal symptoms, and skin 

problems). New-onset symptoms were defined 

by a positive response to the question, “Have 

you had any of the following symptoms after 

Hurricane Katrina?” and having these symptoms 

“Almost everyday or everyday” and “Had no 

symptoms prior to Hurricane Katrina.” “Lower 

respiratory symptoms” were defined as 

wheezing, shortness of breath, or chest tightness. 

“Upper respiratory symptoms” were defined as 

head/sinus congestion or nose/throat irritation. 

Those who had either cough with phlegm or 

cough without phlegm were defined as “Cough.” 

Skin problems included boil, blister, pimple, 

itching, redness, skin cut or laceration, and pain. 

Participants who reported skin problems were 

asked which body parts were affected. 

The Center for Epidemiologic Study-Depression 

scale (CES-D) 3

 was used to assess symptoms 

associated with depression, and the Veterans 

Administration posttraumatic stress disorder 

(PTSD) 4 checklist was used to define 

posttraumatic stress symptoms among 

participants. The CES-D scale has shown high 

levels of reliability and validity to detect both 

clinical and nonclinical symptoms of depressed 

mood for a wide range of study populations,5,6

including psychiatric populations.3

 The CES-D 

was not originally designed for administration to 

those experiencing traumatic natural disaster; 

however there is no available instrument 

specifically designed for a survey in natural 

disasters. Because of the nature of the hurricanes 

and resultant floods, and the likelihood that 

respondents would be experiencing common 

acute symptoms similar to those found on the 

depression scale, we chose to narrow our focus 

to those having major depressive symptoms, and 

used a cut-off score of 22 out of 60 possible. 

Factors Related to 

Hurricane Response 

The questionnaire asked fire fighters about 

locations/activities at the time of the disaster, 

family safety, extent of home devastation, 

evacuation, contact with the floodwater and 

sediment, and job duties during the hurricanes. 

For data analysis, combining the route of 

floodwater exposure and the duration, 

respondents were categorized into one of four 

exposure groups; 1) those whose skin and either 

eyes or nose/mouth were in contact with 

floodwater for longer than an hour up to a few 

days, 2) those whose skin and either eyes or 

nose/mouth were exposed to floodwater for a 

few minutes only, 3) those whose exposure was 

limited to skin only, for longer than a few hours, 

and 4) those with no exposure to floodwater. 

Social support during and after the hurricanes 

was measured by asking the participant’s 

satisfaction with communication and 

supportiveness from co-workers, supervisors, 

and the NOFD. We also asked participants 

whether or not they were staying with their 

families at the time of the survey and about 

changes in lifestyle, such as smoking, alcohol 

consumption, and social interactions. 

Participants were also asked about their 

perceptions of their family’s safety during the 

disaster and the extent to which they were able 

to contact their family. 

Statistical Analysis 

Potential confounding factors, such as age, 

gender, smoking, and prior history of physical or 

mental health diagnoses, were taken into account 

in the multiple regression models. Because prior 

studies have found that persons with physical 

symptoms are more likely to report depressive 

symptoms, 7,8 we also analyzed the depressive 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 3 

symptoms considering physical symptoms as 

covariates. 

Descriptive statistics of demographic 

characteristics such as age, gender, and job title, 

were generated. The post-hurricane prevalence 

of physical, depressive, and PTSD symptoms 

were obtained. The relationships between factors 

related to the hurricanes and symptoms were 

examined. SAS (v.9.12) was used for statistical 

analyses. We employed the generalized linear 

models with LOG link and Poisson distribution 

to estimate prevalence ratios (PR) and the 95% 

confidence intervals for covariates adjusting 

other terms in the models. If the 95% confidence 

intervals (95% CI) excluded one, the PR was 

considered statistically significant at a 

significance level of p = 0.05. The PR represents 

the prevalence of the symptom in the exposed 

group (i.e., floodwater contact) relative to the 

prevalence in the unexposed group (i.e., no 

floodwater contact). A PR of one means that the 

prevalence of symptom in the exposed group is 

the same as the unexposed group, indicating no 

association between the symptom/illness and 

exposure. A PR of greater than one indicates that 

there is evidence of an association. For example, 

a PR of 1.5 would mean that prevalence of 

symptom in the exposed group is 50% higher 

than the unexposed group. 

RESULTS

The questionnaire survey was conducted at 15 

fire stations, eight of which were temporary 

staging areas. Each staging area housed one or 

more fire suppression units. One fire suppression 

unit consists of one captain, one operator who 

operates either a ladder truck or a fire truck, and 

two fire fighters who fight the fire. There were 

774 employees recorded on the latest roster; 59 

employees were out due to on-the-job injury, 20 

employees were on annual leave, and 12 

resigned after the hurricanes. Of the remaining 

683 employees, 525 (77%) completed the 

questionnaire. 

Characteristics of Study 

Participants 

The average age of participants was 42 years 

(range 20 to 64 and median 42); 4% were 

female. The average number of years worked for 

NOFD was 15 (range 0 to 40, median 13). Of 

the 521 respondents, 101 (19%) were fire 

truck/ladder truck operators or engineers, 222 

(43%) were line fire fighters, and 161 (31%) 

were officers (29 chief officers). Thirty-seven 

employees (7%) were in fire service 

administration, including dispatchers, employees 

of the deputy office, and human resource 

personnel. Among participants, 285 (56%) 

reported working in the same fire station as 

before the hurricanes and 107 (21%) reported 

being current smokers at the time of the survey. 

Additional characteristics of study participants 

are given in Table 1. 

Factors Related to the 

Hurricane Responses 

Factors related to the hurricane responses are 

shown in Table 2. Seventy-nine percent reported 

skin contact with floodwater and 51% reported 

nose or eye contact. Among 414 persons who 

reported skin contact with floodwater, 340/414 

(82%) also reported skin contact with sediment 

after the floodwater receded, and 252/414 (61%) 

reported floodwater contact with their nose, 

mouth, or eyes. Of the respondents, 394 persons 

(76%) reported skin contact with sediment after 

the floodwater receded; 165 (32%) reported they 

had contact with floodwater on multiple days. 

Only 105 employees (22%) were able to stay in 

contact with family at least once a day during 

the crisis; 150 (31%) were not staying with their 

family at the time of this survey. Among 

respondents, 69 (13%) were involved in gunfire 

incidents, 77 (15%) in recovery of bodies, and 

217 (41%) reported experiencing hostile 

community situations. Some form of mental 

health service from the NOFD was used by 210 

(40%); 158/495 (32%) participated in 

debriefings held post-crisis (within 1–4 weeks of 

incident conclusion), 107/502 (21%) participated 

in group meetings that were held at shift change 
Page 4 Health Hazard Evaluation Report No. 2006-0023-3003 

or when they left the work-site, and 80/497 

(16%) participated in defusing meetings that 

were held within 72 hours of incident conclusion. 

Social support and lifestyle 

change 

Many (340) respondents (66%) reported slight, 

moderate, or strong dissatisfaction concerning 

communication within the NOFD (Table 3). 

Fifty (10%) reported dissatisfaction regarding 

communication between coworkers, 143 (28%) 

reported dissatisfaction regarding 

communication with supervisors. Two hundred 

and fifty participants (49%) reported being 

dissatisfied with equipment. Dissatisfaction 

regarding work schedule was reported by 203 

(39%). 

Many of the respondents reported that their 

lifestyle had changed since the hurricanes; 333 

(65%) were exercising less, and 338 (65%) were 

sleeping less. Many of the respondents reported 

no change in smoking (83%) or alcohol 

consumption (62%) (Table 4). 

Prevalence of health 

symptoms 

Of the 525 fire fighters, 201 (38%) reported one 

or more new-onset respiratory symptoms such as 

sinus congestion (145 [28%]), throat irritation 

(92 [17%]), or cough (124 [24%]). Skin 

problems were reported by 328 (63%) of 

respondents, and 258 (49%) reported skin rash 

(Table 5). One hundred and thirty-three of 493 

respondents (27%) had major depressive 

symptoms, and 114/518 (22%) had symptoms 

consistent with PTSD. 

Table 6 lists the prevalence of health symptoms 

since the hurricanes by job title, age group, and 

gender. Prevalence of health symptoms was 

variable between job titles and age groups. 

Women reported a higher prevalence of health 

symptoms than men except for skin rash (43% 

vs. 50%). 

Health symptoms and 

floodwater contact 

Employees who were exposed to the floodwater 

on multiple days had a higher prevalence of 

new-onset lower respiratory symptoms (17%), 

new-onset upper respiratory symptoms (36%), 

and skin rash (60%), compared to those not 

exposed to the floodwater (Figure 1), although 

the differences were not statistically significant. 

Table 7 lists the prevalence and PR of health 

symptoms by types of exposure to floodwater. 

The PR of each health symptom was adjusted 

for age, gender, and current smoking status in 

multiple regression models. Those who had 

floodwater exposure to their skin and either eyes 

or nose/mouth for longer than a few hours 

reported a higher prevalence of upper respiratory 

symptoms (PR=1.9; 95% CI: 1.1–3.1), cough 

(PR=1.9; 95% CI: 1.0–3.3), and skin rash 

(PR=2.1; 95% CI: 1.4–3.2) than those with skin 

exposure only or those not exposed to 

floodwater. The associations between health 

symptoms and the exposure to floodwater were 

essentially unchanged when the analysis was 

restricted to those without depressive symptoms 

(Table 8). Exposure to sediment was not 

significantly associated with physical symptoms 

(results not shown) when adjusted for 

floodwater contact. 

Factors associated with 

depression and PTSD 

symptoms 

In multiple regression analyses adjusting for age 

and gender, PTSD symptoms were more 

prevalent among those who were involved in 

gunfire incidents (PR=2.4; 95% CI: 1.6–3.7), 

guard duty (PR=1.8; 95% CI: 1.2–2.7), or 

recovery of bodies (PR=1.7; 95% CI: 1.1–2.6) 

compared to those not involved in these 

activities during the hurricanes (Table 9). 

The prevalence of depressive symptoms by 

physical health symptoms and psychosocial 

factors is shown in Table 10. In multivariate 

analyses adjusting for all covariates in the 

model, we found that persons with new-onset 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 5 

lower respiratory symptoms had significantly 

higher risk of depressive symptoms (PR=1.8; 

95% CI: 1.2–3.0) compared to those without 

physical health symptoms (Table 11). 

Depressive symptoms were also associated with 

skin rash (PR=1.7; 95% CI: 1.2–2.6) and 

dissatisfaction with supervisory support 

(PR=1.6; 95% CI: 1.1–2.3). Fire fighters who 

answered that they are currently living with their 

family were less likely to report depressive 

symptoms (PR=0.7; 95% CI: 0.5–1.0) than those 

not living with their family. Participation in a 

group counseling service did not show a 

significant association with depressive 

symptoms. Those who had depression before the 

hurricanes were not included in the multiple 

regression models. 

DISCUSSION AND 

CONCLUSIONS

The prevalences of respiratory symptoms, skin 

rashes, and injuries reported by fire fighters are 

similar to those found among relief workers 

reported through the active Centers for Disease 

Control and Prevention (CDC) surveillance 

system in the Greater New Orleans area.9,10,11

New-onset health symptoms reported by fire 

fighters were significantly associated with 

hurricane-related factors. The health survey 

found no significant associations between health 

symptoms and contact with sediment; however, 

elevated risks of new-onset upper respiratory 

symptoms were found among fire fighters who 

directly contacted their skin and nose, mouth, or 

eyes with floodwater for longer than a few 

hours. Fire fighters had reportedly used 

floodwater and contaminated water from the 

municipal supply to suppress fires during the 

flooding. This could have resulted in mucosal 

exposure (through mouth, nose, or eyes) to 

airborne materials from the contaminated 

waters. Mucosal exposure to the floodwater may 

also imply more vigorous engagement in 

activities, which could result in increased 

exposures to substances in the floodwater and 

subsequently more physical health symptoms. 

Early during the rescue period post-hurricane, 

NIOSH provided interim guidance that response 

workers involved with floodwater should avoid 

direct skin contact with floodwater if possible 

through the use of appropriate personal 

protective equipment, such as goggles, safety 

glasses with side shields, or full face shields.12 

An increased prevalence of gastrointestinal 

symptoms was found among fire fighters who 

were exposed to floodwater, but the relationship 

was not statistically significant. 

Previous studies have found increased rates of 

respiratory symptoms among residents after 

flooding in community settings. 13,14,15 Little is 

known about the relationship between 

floodwater exposure and respiratory symptoms 

after a flooding disaster. This investigation 

attempted to explore the differential 

relationships between respiratory symptoms or 

skin rash and floodwater exposure by route of 

exposure (through skin vs. mouth/nose or eye) 

and the duration of exposure (a few minutes vs. 

longer than a few hours). However, the 

contribution of exposure to substances in the 

floodwater to reported symptoms is still 

uncertain. This investigation adds more 

emphasis on the importance of further research 

efforts to obtain more objective exposure 

assessment of occupational exposures to 

floodwater and well-defined evaluation of the 

relationships between intensity or duration of 

floodwater exposure and related health 

symptoms. 

Studies have shown that PTSD and depression 

are among the most common problems for 

populations exposed to natural disasters.16,17 In a 

study involving the general population following 

an earthquake,18 the authors suggested that the 

main risk factor for depression is the amount of 

loss that the person has sustained. Risk of 

depression was also higher among persons 

whose family members were injured. Regehr et 

al. suggested that low social support is an 

important determinant of depressive symptoms 

and PTSD among fire fighters.19,20,21 Consistent 

with the previous findings 22 , 23 psychosocial 

factors such as supervisor support and family 

support were also important factors related to 

depressive symptoms among NOFD personnel. 

Those who reported that they were living with 
Page 6 Health Hazard Evaluation Report No. 2006-0023-3003 

their families had a lower risk of depressive 

symptoms. Those who experienced gunfire 

incidents or recovered bodies had a higher risk 

of having PTSD symptoms. 

We found that those with physical symptoms 

reported two times more depressive symptoms 

than those without physical symptoms. 

Coexistence of depression and physical 

symptoms has been reported in several 

studies. 24 , 25 , 26 , 27 , 28 , 29 However, little is known 

about relationships between depressive 

symptoms and physical symptoms among first 

responders after a natural disaster. It is possible 

that those with depressive symptoms may report 

more physical symptoms than those without 

depressive symptoms, and could over-report the 

exposure to floodwater. It is also possible that 

fire fighters who had physical symptoms may 

have reported more depressive symptoms than 

those without any physical symptoms after the 

disaster. Since we excluded those who had 

preexisting depression from the analysis, it is 

unlikely that preexisting depressive symptoms 

would have contributed to perceiving new-onset 

physical symptoms in a short period (3 months). 

Due to the nature of this cross-sectional survey, 

however, the results from this investigation 

could not confirm that depressive symptoms 

among fire fighters are attributed to persistent 

physical symptoms that limit their normal 

function in their job and personal life. While a 

study showed that workers with physical injury 

are at higher risk of developing acute 

psychological disorders, 30 it is not known 

whether physical health symptoms alone would 

have a similar effect on mental health. 

Nonetheless, considering comorbidity of 

depressive symptoms and physical health 

symptoms, appropriate clinical evaluation 

should address psychological health issues and 

physical health symptoms together. 

A relatively high response rate was obtained 

(77%) for available fire fighters, minimizing the 

potential for selection bias. However, the 

participants included current fire fighters only 

and excluded those who were on sick leave and 

on-the-job injury leave. Therefore, there may be 

a potential selection bias that may lead to 

underestimation of the prevalence of symptoms, 

and relationships between health symptoms and 

exposure related to the hurricanes due to 

selection of healthier people. 

Responses to extraordinary natural disasters, like 

the hurricanes, may provoke a number of 

physical and psychological reactions. Many of 

the symptoms fire fighters experienced may be 

normal and reversible reactions to a traumatic 

event. However, to better prepare for future 

disasters, it is important to understand the 

patterns of occupational illnesses and injuries 

that may result from responding to natural 

disasters. This HHE examined the extent of 

injury and illness reported among fire fighters 

and described contributing factors, knowledge of 

which could be helpful in identifying 

appropriate steps to reduce long term impact 

from these events. Lessons learned from the 

NOFD experience may help other fire 

departments and emergency responders prepare 

for and react to future natural disasters. 

RECOMMENDATIONS

The following recommendations are offered to 

reduce the risk of health problems during and 

after the response to natural disasters. The 

NOFD should; 

1. Implement clinical evaluation and 

appropriate medical follow-up to reduce 

the burden of current and possible longterm effects of illness and injury among 

NOFD personnel. The clinical programs 

should address the physical and mental 

health symptoms described within this 

report. NOFD may consider phasing in 

annual medical evaluations of fire 

fighter personnel. These medical 

evaluations should adhere to published 

fire service standards and/or 

initiatives31,32 and be implemented after 

joint approval by management and 

union representatives. 

2. Provide specific health and safety 

protective measures for emergency 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 7 

responders to future disasters. For 

example, ensure that workers have 

current vaccinations, and make proper 

equipment and gear available prior to 

the event. 

3. Develop a training program for 

emergency responders regarding 

potential illness and injuries after the 

response to natural disasters. Disaster 

preparedness training for first 

responders should be incorporated into 

the worker health and safety program 

for fire fighters to reduce the risk for 

illness and injuries in future responses to 

natural disasters. 

4. Regarding organizational support such 

as work schedule modification, establish 

a committee to foster communications 

within the department and between 

supervisors and employees, and the 

quality of supervision. This could be 

done through existing joint 

management/union committees. 

5. Consider repeating a symptom survey to 

estimate the change in prevalence 

compared to the initial NIOSH survey, 

and to estimate the incidence of new 

symptoms. 

REFERENCE

1. Knabb RD, Rhome JR, Brown DP 

[2005]. Tropical cyclone report: Hurricane 

Katrina, 23--30 August, National Oceanic and 

Atmospheric Administration, Editor. 2005, 

National Hurricane Center. Miami, FL: National 

Weather Service. 

2. International Association of Fire 

Fighters [2005]. Reports from the Hurricane 

Frontlines: Katrina. 

[http://daily.iaff.org/Katrina/Katrina.htm?c=Rep

ort]. Date accessed: December 2005. 

3. Weissman MM, Sholomskas D, 

Pottenger M, Prusoff BA, Locke BZ [1977]. 

Assessing depressive symptoms in five 

psychiatric populations: a validation study. Am J 

Epidemiol 106(3):203 214. 

4. Blanchard EB, Jones-Alexander J, 

Buckley TC, Forneris CA [1996]. Psychometric 

properties of the PTSD checklist (PCL). Behav 

Res Ther 34(8):669 673. 

5. Shinar D, Gross CR, Price TR, Banko 

M, Bolduc PL, Robinson RG [1986]. Screening 

for depression in stroke patients: the reliability 

and validity of the Center for Epidemiologic 

Studies Depression Scale. Stroke 17(2):241 245. 

6. Weissman, MM, Myers JK [1978]. 

Rates and risks of depressive symptoms in a 

United States urban community. Acta Psychiatr 

Scand 57(3):219 231. 

7. Stover E, Fenton W, Rosenfeld A, Insel 

TR [2003]. Depression and comorbid medical 

illness: the National Institute of Mental Health 

perspective. Biol Psychiatry 54(3):184. 

8. Katon WJ [2003]. Clinical and health 

services relationships between major depression, 

depressive symptoms, and general medical 

illness. Biol Psychiatry 54(3):216. 

9. CDC (Centers for Disease Control and 

Prevention) [2006]. Injury and illness 

surveillance in hospitals and acute-care facilities 

after Hurricanes Katrina and Rita--New Orleans 

area, Louisiana, September 25-October 15. 

MMWR; 55(2):35 38. 

10. CDC (Centers for Disease Control and 

Prevention) [2006]. Surveillance for illness and 

injury after Hurricane Katrina--three counties, 

Mississippi, September 5-October 11. MMWR; 

55(9):231 234. 

11. CDC (Centers for Disease Control and 

Prevention) [2005]. Surveillance for Illness and 

Injury After Hurricane Katrina--New Orleans, 

Louisiana, September 8–25. MMWR; 

54(40):1018 1021. 
Page 8 Health Hazard Evaluation Report No. 2006-0023-3003 

12. NIOSH [2005]. NIOSH interim 

guidance on personal protective equipment and 

clothing for flood response workers. 

[URL: http://www.cdc.gov/niosh/topics/ 

flood/pdfs/ppe-flood.pdf] Date accessed: April 

18, 2006. 

13. Kunii O, Nakamura S, Abdur R, Wakai 

S [2002]. The impact on health and risk factors 

of the diarrhoea epidemics in the 1998 

Bangladesh floods. Public Health 116(2):68 74. 

14. Biswas R, Pal D, Mukhopadhyay SP 

[1999]. A community based study on health 

impact of flood in a vulnerable district of West 

Bengal. Indian J Public Health 43(2):89 90 

15. Siddique AK, Baqui AH, Eusof A, 

Zaman K [1991]. 1988 floods in Bangladesh: 

pattern of illness and causes of death. J 

Diarrhoeal Dis Res 9(4): 310 314. 

16. Fullerton CS, Ursano RJ, Wang L 

[2004]. Acute stress disorder, posttraumatic 

stress disorder, and depression in disaster or 

rescue workers. Am J Psychiatry 161(8): 1370 

1376. 

17. Ginexi EM, Weihs K, Simmens SJ, 

Hoyt DR [2000]. Natural disaster and 

depression: a prospective investigation of 

reactions to the 1993 midwest floods. Am J 

Community Psychol 28(4): 495 518. 

18. Armenian HK, Morikawa M, Melkonian 

AK, Hovanesian A, Akiskal K, Akiskal HS 

[2002]. Risk factors for depression in the 

survivors of the 1988 earthquake in Armenia. J 

Urban Health 79(3):373 82. 

19. Regehr C, Hill J, Glancy GD [2000]. 

Individual predictors of traumatic reactions in 

firefighters. J Nerv Ment Dis 188(6):333 339. 

20. Regehr C, Hemsworth D, Hill J [2001]. 

Individual predictors of posttraumatic distress: a 

structural equation model. Can J Psychiatry 

46(2):156 161. 

21. Regehr C, Goldberg G, Glancy GD, 

Knott T [2002]. Posttraumatic symptoms and 

disability in paramedics. Can J Psychiatry 

47(10):953 958. 

22. Brummett BH, Barefoot JC, Vitaliano 

PP, Siegler IC [2003]. Associations among 

social support, income, and symptoms of 

depression in an educated sample: the UNC 

Alumni Heart Study. Int J Behav Med 10(3):239 

250. 

23. Park KO, Wilson MG, Lee MS [2004]. 

Effects of social support at work on depression 

and organizational productivity. Am J Health 

Behav 28(5):444 455. 

24. Mustapha A [2005]. Depression can 

cause severe physical symptoms. Br J Nurs 

14(9):482. 

25. Trivedi MH [2004]. The link between 

depression and physical symptoms. Prim Care 

Companion J Clin Psychiatry 6(Suppl 1):12 16. 

26. Lloyd-Williams M, Dennis M, Taylor F 

[2004]. A prospective study to determine the 

association between physical symptoms and 

depression in patients with advanced cancer. 

Palliat Med 18(6):558 563. 

27. Schatzberg AF, chair [2004]. 

Depression and physical symptoms: the mindbody connection [ACADEMIC HIGHLIGHTS]. 

J Clin Psychiatry 65:867 876

28. Greco T, Eckert G, Kroenke K [2004]. 

The outcome of physical symptoms with 

treatment of depression. J Gen Intern Med 

19(8):813 818. 

29. Henningsen P, Zimmermann T, Sattel H 

[2003]. Medically unexplained physical 

symptoms, anxiety, and depression: a metaanalytic review. Psychosom Med 65(4):528 533. 

30. Joy D, Probert R, Bisson JI, Shepherd 

JP [2000]. Posttraumatic stress reactions after 

injury. J Trauma 48(3):490 494. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 9 

31. NFPA [2003]. Standard on 

comprehensive occupational medical program 

for fire departments. Quincy MA: National Fire 

Protection Association. NFPA 1582. 

32. IAFF, IAFC. [1997]. Fire service joint 

labor management wellness/fitness initiative. 

Washington, D.C.: International Association of 

Fire Fighters, International Association of Fire 

Chief. 
Page 10 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 1 

Characteristics of Survey Participants 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Demographic Characteristics N % 

Age (years) 

20–29 82 15.9 

30–39 133 25.8 

40–49 172 33.4 

50–above 128 24.9 

Total 515 100.0 

Gender 

Male 502 96.0 

Female 21 4.0 

Total 523 100.0 

Job title 

Fire fighters 222 42.6 

Officer 132 25.3 

Operator/engineer 101 19.4 

Fire service administration 37 7.1 

Chief officer 29 5.6 

Total 521 100.0 

Job years 

< 5 128 24.9 

5–<15 180 35.0 

15–<25 106 20.6 

≥ 25 101 19.6 

Total 515 100.0 

Smoking status 

Never smoked 308 58.9 

Current smoker 107 20.5 

Former smoker 108 20.6 

Total 523 100.0 

Working in the same fire stationa

Yes 228 44.4 

No 285 55.6 

Total 513 100.0 

a

 Defined as those who were currently working in the same fire station 

as before Hurricane Katrina 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 11 

Table 2 

Frequencies of Factors Related to Hurricane Katrina 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Variables N % 

Stayed in contact with family during the crisis 

Not at all 139 28.4 

A few times only 245 50.1 

About once a day 63 12.9 

More than once a day 42 8.6 

Total 489 100.0 

Home damage 

No damage 14 2.7 

Uninhabitable 306 58.9 

Reparable 192 36.9 

Reparable but uninhabitable 8 1.5 

Total 520 100.0 

Fire station damage 

No damage 79 15.7 

Uninhabitable 230 45.6 

Reparable 181 35.9 

Reparable but uninhabitable 14 2.8 

Total 504 100.0 

Activities during the hurricane response efforts 

Fire suppression 423 80.6 

Rescue of citizens/coworkers 330 62.9 

Driving engine or ladder truck 244 46.5 

Evacuation 225 42.9 

Hostile community situation 217 41.3 

Equipment maintenance 168 32.0 

Inspection 137 26.1 

Guard duty 110 21.0 

Training 88 16.8 

Administration 81 15.4 

Recovery of bodies 77 14.7 

Gunfire incidents 69 13.1 

Other 85 16.2 
Page 12 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 2 (continued) 

Frequencies of Factors Related to Hurricane Katrina 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Variables N % a

Skin contact with floodwater

Yes 414 79.0

No 110 21.0

Total 524 100.0

Nose, mouth or eye contact with floodwater

Yes 254 50.8

No 246 49.2

Total 500 100.0

Skin contact with sediment after floodwater receded 

Yes 394 75.8

No 126 24.2

Total 520 100.0

Combination of exposure variables 

Skin contact with floodwater and sediment, and as well as nose, 

mouth or eye contact with floodwater 

230 44.0

Skin contact with floodwater and sediment 110 21.0

Skin and nose, mouth or eye contact with floodwater 22 4.2

Only skin contact with floodwater 52 9.9

Only skin contact with sediment 53 10.1

No contact with floodwater or sediment 56 10.7

Total 523 100.0

Duration of floodwater contact 

Not at all 90 17.5

Few minutes 86 16.7

Few hours 173 33.7

Few days 165 32.1

Total 514 100.0

Currently staying with family 

No 150 30.6

Yes, sometime 138 28.2

Yes, always 202 41.2

Total 490 100.0

Mental health service sought after the hurricane 

Debriefing 158 31.9

Group meeting 107 21.3

Defusing 80 16.1

Individual counseling 64 12.9

Peer support counseling 40 8.4

Counseling follow-up 19 3.8

Family counseling 13 3.6

a

 Denominators range from 489 to 525 due to missing values. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 13 

Table 3 

Perception of Work Organization Factors after Hurricane Katrina 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Social support a

 N % b

Communication within department 

Dissatisfied 340 65.9 

Satisfied 176 34.1 

Total 516 100.0 

Equipment 

Dissatisfied 250 49.0 

Satisfied 260 51.0 

Total 510 100.0 

Quality of supervision 

Dissatisfied 212 41.4 

Satisfied 300 58.6 

Total 512 100.0 

Work schedule 

Dissatisfied 203 39.3 

Satisfied 313 60.7 

Total 516 100.0 

Supervisor support 

Dissatisfied 162 31.4 

Satisfied 354 68.6 

Total 516 100.0 

Recognition of supervisor 

Dissatisfied 156 30.4 

Satisfied 357 69.6 

Total 513 100.0 

Communication with supervisors 

Dissatisfied 143 27.9 

Satisfied 370 72.1 

Total 513 100.0 

Coworker communication 

Dissatisfied 50 9.7 

Satisfied 465 90.3 

Total 515 100.0 

a

 Six scales were dichotomized (very, moderately or slightly 

dissatisfied/very, moderately or slightly satisfied). 

b

 Denominators range from 510 to 516 due to missing values. 
Page 14 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 4 

Lifestyle Change after Hurricane Katrina 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Life style N %a

Exercise 

More 42 8.1 

No change 141 27.3 

Less 333 64.5 

Total 516 100.0 

Alcohol consumption 

More 140 27.8 

No change 311 61.7 

Less 53 10.5 

Total 504 100.0 

Eating 

More 145 28.1 

No change 231 44.8 

Less 140 27.1 

Total 516 100.0 

Social interaction 

More 45 8.7 

No change 183 35.4 

Less 289 55.9 

Total 517 100.0 

Smoking 

More 72 14.8 

No change 405 83.2 

Less 10 2.0 

Total 487 100.0 

Sleeping 

More 35 6.7 

No change 147 28.3 

Less 338 65.0 

Total 520 100.0 

a

 Denominators range from 487 to 520 due to missing values. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 15 

Table 5 

Physical and Mental Health Symptoms Reported among New Orleans Fire Fighters (N=525) 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Health symptoms and injury N Prevalence 

(%)a

New onset respiratory symptoms b 

Any respiratory symptoms c 201 38.3 

Upper respiratory d 162 30.9 

Head or sinus congestion 145 27.6 

Nose/throat irritation 92 17.3 

Cough e

 124 23.6 

Dry cough 89 17.0 

Cough with phlegm 84 16.0 

Lower respiratory f

 55 10.5 

Shortness of breath with minimal activity 36 6.9 

Wheezing/whistling in the chest 29 5.5 

Chest tightness 17 3.2 

Gastrointestinal symptoms g 

Diarrhea 9 1.7 

Abdominal pain 9 1.7 

Nausea or vomiting 7 1.3 

Skin problems 

Any skin problem 328 62.5 

Skin rash h

 258 49.1 

Cut 196 37.3 

Itch 178 33.9 

Pimple 135 25.7 

Redness 112 21.3 

Pain 108 20.6 

Blister 57 10.9 

Swell 53 10.1 

Boil 31 5.9 

Injury 

Sprain/strain 130 24.8 

Laceration 127 24.2 

Fall 54 10.3 

Animal bite/sting 41 7.8 

Burn 21 4.0 

Eye injury 19 3.6 

Vehicle accident 17 3.2 

Assault 2 0.4 

Concussion 1 0.2 

Psychological symptoms 

Depressive symptoms i 133 27.0 

PTSD symptoms j 114 21.7 
Page 16 Health Hazard Evaluation Report No. 2006-0023-3003 

a

 Denominator was 525 except depressive symptoms (n=492). 

b

 New-onset individual symptoms were defined by a positive response to the 

question, “Have you had any of the following symptoms after the hurricane 

Katrina?” and having these symptoms “Almost everyday or everyday” and “Had 

no symptoms prior to hurricane Katrina.” 

c

 Respiratory symptom defined as having any of respiratory symptoms listed 

d

 Upper respiratory symptom defined as having either 1) head/sinus congestion or 

2) nose/throat irritation 

e

 Cough defined as having either 1) dry cough or 2) cough with phlegm 

f

 Lower respiratory symptoms defined as having 1) shortness of breath, 2) 

wheezing, or 3) chest tightness 

g

 New onset gastrointestinal symptoms were defined by a positive response to the 

question, “Have you had any of the following symptoms after the hurricane 

Katrina?” and having these symptoms “Almost everyday or everyday” and “Had 

no symptoms prior to Hurricane Katrina.” 

h

 Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) 

swelling, or 6) redness. 

i

 Depressive symptom was defined using the Center for Epidemiologic StudyDepression scale and above the score of 22. 

j

 The Veterans Administration Posttraumatic Stress Disorder (PTSD) checklist 

was used to define post traumatic stress symptoms among participants. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 17 

Table 6 

Prevalence (%) of Health Outcomes by Participants’ Characteristics 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Characteristics N Health Outcomes 

Upper 

respiratory 

symptoms a

Lower 

respiratory 

symptoms b

Cough c Skin 

rash d

Injury e Depressive 

symptoms f

PTsym

TOTAL 525 30.9 10.5 23.6 49.1 47.8 27.0 h Job title 

Officer 161 39.1 7.3 29.8 52.8 54.0 23.5 Fire service administration 37 35.1 10.5 16.2 46.0 35.1 37.8 Line fire fighter 222 26.1 11.1 21.2 48.2 46.0 31.5 Operator/engineer 101 26.7 10.9 21.8 46.5 46.5 18.3 

Total 521 

Age (years) 

20 - 29 82 19.5 13.0 15.9 40.2 46.3 24.4 30 - 39 133 31.6 10.8 23.3 51.9 43.6 32.3 40 - 49 172 35.5 9.5 27.9 49.4 51.7 25.6 50 - above 128 32.0 8.9 24.2 54.7 48.4 25.0 

Total 515 

Gender 

Female 21 42.9 14.3 23.8 42.9 33.3 50.0 Male 502 30.5 10.4 23.7 49.6 48.4 26.2 

Total 523 

a Upper respiratory symptom defined as having either 1) head/sinus congestion or 2) nose/throat irritation b Lower respiratory symptoms defined as having 1) shortness of breath, 2) wheezing, or 3) chest tightness c Cough defined as having either 1) dry cough or 2) cough with phlegm d Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) swelling, or 6) redness e Injury includes any type of injury, such fall, laceration, animal bite, vehicle accident, concussion, burn, assault, eye injury, sprain, and sf Depressive symptom was defined using the Center for Epidemiologic Study-Depression scale and above the score of 22. g The Veterans Administration Post Traumatic Stress Disorder (PTSD) checklist was used to define post traumatic stress symptoms amonh Total numbers of respondents are 488, 484 and 490 for Job title, Age and Gender, respectively. 
Page 18 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 7 

Prevalence (%) and the Adjusted Prevalence Ratios (PR)a of Physical Symptomsb by Types of Exposure to Flood

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Exposure category N 

Upper 

respiratory 

symptoms c

Lower 

respiratory 

symptoms d

Cough e 

% 39.7 14.3 32.1 

Skin AND either nose or eyes contact with floodwater longer than a few HOURS 

224 PR 

(95% CI) 

1.86 

(1.12, 3.11)

1.85 

(0.78, 4.37)

1.85 

(1.04, 3.30)

% 29.1 8.1 22.1 

Skin AND either nose or eyes contact with floodwater for a few MINUTES 

86 PR 

(95% CI) 

1.34 

(0.73, 2.45) 

1.03 

(0.34, 3.11) 

1.42 

(0.72, 2.82) 

% 21.6 6.4 13.6 

Skin contact only with floodwater for longer than a few HOURS 125 PR 

(95% CI) 

1.06 

(0.58, 1.92) 

0.90 

(0.32, 2.54) 

0.84 

(0.41, 1.70) 

% 23.3 8.9 17.8 

No contact with floodwater 90 

Reference 1.00 1.00 1.00 

a Prevalence ratio adjusted for age, gender and smoking (current smoker/non smoker). b Individual symptoms but skin rash were defined by a positive response to the question, “Have you had any of the following s

the hurricane Katrina?” and having these symptoms “Almost everyday or everyday” and “Had no symptoms prior to hurricane 

c Upper respiratory symptom defined as having either 1) head/sinus congestion or 2) nose/throat irritation d Lower respiratory symptoms defined as having 1) shortness of breath, 2) wheezing, or 3) chest tightness e Cough defined as having either 1) dry cough or 2) cough with phlegm f Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) swelling, or 6) redness. 

Note: Bold numbers indicate that the prevalence ratio is statistically significant at a significance level of p = 0.05. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 19 

Table 8 

Adjusted Prevalence Ratios (PR) a of Physical Symptoms b Independent from Depressive Symptoms by Types of Expo

(N=389c) 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Exposure category N 

Upper 

respiratory 

symptoms d

Lower 

respiratory 

symptoms e

Cough f S

Skin AND either nose or eyes contact with floodwater longer than a few HOURS 

160 PR (95% CI) 1.92 (1.03, 3.58) 2.54 (0.57, 11.30) 1.60 (0.81, 3.14) 

(

Skin and either nose or eyes contact with floodwater for a few MINUTES 

60 PR (95% CI) 1.45 (0.68, 3.10) 0.54 (0.05, 5.96) 1.24 (0.53, 2.89) 

(

Skin contact only with floodwater for longer than a few HOURS 99 PR (95% CI) 0.80 (0.37, 1.72) 0.99 (0.16, 5.94) 0.69 (0.30, 1.60) 

(

No contact with floodwater 70 Reference 1.00 1.00 1.00 

a Prevalence ratio adjusted for age, gender and smoking (current smoker/non smoker) b Individual symptoms but skin rash were defined by a positive response to the question, “Have you had any of the follow

symptoms after the hurricane Katrina?” and having these symptoms “Almost everyday or everyday” and “Had no sympto

hurricane Katrina.” 

c Not included those with depressive symptoms d Upper respiratory symptom defined as having either 1) head/sinus congestion or 2) nose/throat irritation e Lower respiratory symptoms defined as having 1) shortness of breath, 2) wheezing, or 3) chest tightness f Cough defined as having either 1) dry cough or 2) cough with phlegm g Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) swelling, or 6) redness. 

Note: Bold numbers indicate a statistical significance at a significance level of p = 0.05. 
Page 20 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 9 

Adjusted Prevalence Ratios (PR)* of PTSD Symptoms for Activities at the Time of Crisis 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Activities N PRa 95% CI 

Inspection 137 0.78 (0.49, 1.22) 

Fire suppression 423 1.01 (0.61, 1.67) 

Evacuation 225 1.08 (0.74, 1.59) 

Administration 81 1.21 (0.75, 1.98) 

Driving engine or ladder truck 244 1.24 (0.85, 1.80) 

Rescue of citizen/coworker 330 1.30 (0.87, 1.96) 

Hostile community situation 217 1.42 (0.97, 2.08) 

Equipment maintenance 168 1.42 (0.97, 2.08) 

Recovery of bodies 77 1.66 (1.06, 2.60) 

Guard duty 110 1.82 (1.22, 2.73) 

Gunfire incidents 69 2.42 (1.58, 3.70) 

a

 Prevalence ratio adjusted for age and gender 

Note: Bold numbers indicate a statistical significance at a significance level of p = 0.05. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 21 

Table 10 

Prevalence of Depressive Symptoms by Covariates 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Variable N Prevalence (%) i Total no. of 

participants 

Lower respiratory a 525 

Yes 54 64.8 

No 438 22.4 

Upper respiratory b

 492 

Yes 159 39.0 

No 333 21.3 

Cough c

 492 

Yes 122 39.3 

No 370 23.0 

Gastrointestinal symptoms d

 525 

Yes 18 72.2 

No 474 25.3 

Skin Rash e

 525 

Yes 250 35.6 

No 242 18.2 

Injury f

 492 

Yes 242 30.2 

No 250 24.0 

Supervisor support g

 492 

Dissatisfied 152 40.1 

Satisfied 340 21.2 

Group counseling h

 492 

Not Received 202 23.8 

Received 290 29.3 

Living with family 459 

Yes 320 22.5 

No 139 36.0 

a

 Upper respiratory symptom defined as having either 1) head/sinus congestion or 2) 

nose/throat irritation 

b

 Lower respiratory symptoms defined as having 1) shortness of breath, 2) wheezing, or 3) 

chest tightness 

c

 Cough defined as having either 1) dry cough or 2) cough with phlegm 

d

 Gastrointestinal symptoms were defined as having 1) diarrhea, 2) abdominal pain, or 3) nausea or 

vomiting 

e

 Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) swelling, or 6) 

redness. 

f

 Injury includes any type of injury, such fall, laceration, animal bite, vehicle accident, 

concussion, burn, assault, eye injury, sprain and strain. 

g

 Six scales were dichotomized (very, moderately or slightly dissatisfied/ very, moderately or 

slightly satisfied) 
Page 22 Health Hazard Evaluation Report No. 2006-0023-3003 

h

 Those who received a group counseling service were defined as those who attended one of the 

following: 1) group meeting, 2) defusing or 3) debriefing after the incident. 

Note: Denominators ranged from 459 to 525 due to missing values. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 23 

Table 11 

Prevalence Ratios (PR) of Depressive Symptoms for Covariates 

New Orleans Fire Department 

HETA #2006-0023-3003 

November 2005 

Crude Adjusted g 

Parameter 

PR 95% CI PR 95% CI 

Age 

20 - 29 0.97 (0.55, 1.74) 1.20 (0.63, 2.27) 

30 - 39 1.29 (0.81, 2.07) 1.43 (0.87, 2.36) 

40 - 49 1.02 (0.64, 1.65) 1.13 (0.68, 1.88) 

≥50 1.00 1.00 

Sex 

Female 1.91 (1.00, 3.64) 1.36 (0.62, 2.95) 

Male 1.00 1.00 

Lower respiratory symptoms a

Yes 2.90 (1.97, 4.26) 1.84 (1.15, 2.96) 

No 1.00 1.00 

Upper respiratory symptomsb

Yes 1.83 (1.30, 2.57) 1.30 (0.86, 1.94) 

No 1.00 1.00 

Gastrointestinal symptomsc

Yes 2.85 (1.61, 5.06) 1.43 (0.74, 2.74) 

No 1.00 1.00 

Skin rash d 

Yes 1.96 (1.36, 2.81) 1.74 (1.17, 2.58) 

No 1.00 1.00 

Supervisor support e

 

Dissatisfied 1.90 (1.35, 2.67) 1.59 (1.10, 2.30) 

Satisfied 1.00 1.00 

Group counseling f

 

Not received 1.23 (0.87, 1.76) 1.22 (0.84, 1.79) 

Received 1.00 1.00 

Living with family 

Yes 0.63 (0.44, 0.90) 0.67 (0.46, 1.00) 

No 1.00 1.00 

a

 Upper respiratory symptom defined as having either 1) head/sinus congestion or 2) nose/throat irritation 

b

 Lower respiratory symptoms defined as having 1) shortness of breath, 2) wheezing, or 3) chest tightness c

 Gastrointestinal symptoms were defined as having 1) diarrhea, 2) abdominal pain, or 3) nausea or vomiting 

d

 Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) swelling, or 6) redness. 

e

 Six scales were dichotomized (very, moderately or slightly dissatisfied/ very, moderately or slightly satisfied) 
Page 24 Health Hazard Evaluation Report No. 2006-0023-3003 

f

 Those who received a group counseling service were defined as those who attended one of the following: 1) 

group meeting, 2) defusing or 3) debriefing after the incident. 

g

 Prevalence ratio adjusted for all covariates in the model (n = 450) 

Note: Bold numbers indicate a statistical significance at a significance level of p = 0.05. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 25 

0

1020304050607080

None

Minutes

Hours

Days

None

Minutes

Hours

Days

None

Minutes

Lower Respiratory Symptoms (a) Upper Respiratory Symptom (b) Skin Ras

Prevalence (%)

Figure 1. Prevalence (%) and the 95% Confidence Intervals of New Onset Physical Symptoms d by the Duration of Floodwater 

Orleans Fire Department HETA #2006-0023-3003. 

a Lower respiratory symptoms defined as having 1) shortness of breath, 2) wheezing, or 3) chest tightness b Upper respiratory symptom defined as having either 1) head/sinus congestion OR 2) nose/throat irritation c Skin rash defined as experiencing 1) bumps, 2) blisters, 3) boils, 4) itching, 5) swelling, or 6) redness. d New onset individual symptoms were defined by a positive response to the question, “Have you had any of the following symptoms after t

and having these symptoms “Almost everyday or everyday” and “Had no symptoms prior to hurricane Katrina.” Note: Each vertical line of the bar indicates the 95% confidence intervals for the prevalence.
Page 26 Health Hazard Evaluation Report No. 2006-0023-3003 

APPENDIX A 

Environmental survey of fire fighter exposure 

to sediment during simulated apparatus movement 

New Orleans Fire Department 

New Orleans, Louisiana 

Introduction 

In October 2005, the National Institute for Occupational Safety and Health (NIOSH) received a request 

for a health hazard evaluation (HHE) from the New Orleans Fire Department (NOFD) and the 

International Association of Fire Fighters Local 632 (IAFF). The HHE request concerned health hazards 

from exposure to the floodwater and sediment from Hurricanes Katrina and Rita and mental health of the 

fire fighters following the NOFD’s response to the huricanes. Reported health problems included 

respiratory, throat, and sinus irritation; and symptoms suggestive of depression and anxiety. 

In response to the concerns about sediment exposure during apparatus movement, NIOSH investigators 

conducted a site visit at the Jackson Barracks temporary staging area on October 19, 2005. The site visit 

included observations of fire fighter activities during simulated apparatus movement and environmental 

sampling to evaluate fire fighter exposures to dust. 

Background 

When the floodwaters receded following the hurricanes, several inches of sediment was left behind in 

many of the flood-affected areas. As the city dried out, the fire fighters reported that dust levels 

significantly increased. At the time of the environmental survey, fire fighters stationed in the Jackson 

Barracks temporary staging area were making approximately one or two responses daily. This number is 

lower than the number during the period before the hurricanes, mainly due to the limited number of 

residents in the city. During a response, three or four fire fighters travel in the passenger cabin of each fire 

apparatus. Responses require a varying number of apparatus (normally one to three). Overall response 

times can vary from a few minutes to several hours; however, the time required to arrive and return from 

a response is usually only a few minutes. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 27 

Following the hurricanes, fire fighters on each shift were required to conduct daily inspection/assessment 

tours in their assigned areas looking for hazardous materials, responding to structure collapses, inspecting 

buildings and fire hydrants, and performing search and recovery activities. These tours were conducted 

from the fire apparatus and by foot and lasted approximately 1–2 hours. 

Methods 

During the meeting with the NOFD on October 17, 2005, the area serviced by the Jackson Barracks 

temporary staging area (the Ninth Ward) was identified as one of the areas most heavily affected by 

sediment. On October 19, 2005, an environmental survey was conducted to evaluate fire fighter exposures 

to airborne dust from the sediment in this area. The survey consisted of collecting task-based personal 

breathing zone (PBZ) air samples for respirable particulates and silica, total particulates, and elements 

(metals and minerals). Samples were collected for 2–21⁄2 hours during simulated apparatus movement, the 

period when airborne dust exposures were expected to be the highest. 

Respirable Particulates and Silica 

PBZ air samples for respirable particulates and silica were collected on tared 37-millimeter (mm) 

diameter, 5-micrometer (μm) pore size polyvinyl chloride (PVC) membrane filters mounted in 10-mm 

nylon cyclones. Samples were attached via flexible tubing to personal sampling pumps calibrated to draw 

air through the filter at a flow rate of 1.7 liters per minute (Lpm). 

Samples were analyzed for respirable particulates by gravimetric analysis according to a modification of 

NIOSH Manual of Analytical Methods (NMAM) Method 0600.33 The modifications included: 1) filters 

and backup pads were stored in an environmentally controlled room and were subject to the room 

conditions for at least 2 hours for stabilization prior to tare and gross weighing, and 2) two weighings of 

the tare weight and the gross weight were performed and the average of the weights was used for the total 

weight analysis. The total weight of each sample was determined by weighing the sample plus the filter 

on an electrobalance and subtracting the previously determined tare weight of the filter. The limit of 

detection (LOD) for this gravimetric analysis was 0.02 milligram (mg). The corresponding minimum 

detectable concentration (MDC) was 0.08 mg per cubic meter of air (mg/m3

), based on a 240-liter sample. 

After the gravimetric analysis, the samples were analyzed for silica content using X-ray diffraction. 

NIOSH Method 750033 was used with the following modifications: 1) filters were dissolved in 

tetrahydrofuran rather than being ashed in a furnace, and 2) standards and samples were run concurrently, 

and an external calibration curve was prepared from peak heights rather than using the suggested 
Page 28 Health Hazard Evaluation Report No. 2006-0023-3003 

normalization procedures. The LODs for quartz and cristobalite for this method were 0.01 and 0.02 mg, 

respectively. The limit of quantitation (LOQ) for quartz and cristobalite was 0.03 mg for both. The 

corresponding MDCs for quartz and cristobalite were 0.04 and 0.08 mg/m3

, respectively, based on a 240-

liter sample. The corresponding minimum quantifiable concentration (MQC) for both quartz and 

cristobalite was 0.1 mg/m3

, based on a 240-liter sample. 

Total Particulates and Elements (Metals and Minerals) 

PBZ air samples for total particulates and elements were collected on tared 37-mm, 5-μm pore size PVC 

membrane filters. The samples were attached via flexible tubing to personal sampling pumps calibrated to 

draw air through the filter at a flow rate of 3.0 Lpm. Samples were collected adjacent to the respirable 

samples. 

The samples were analyzed for total particulates by gravimetric analysis according to a modification of 

NIOSH Method 0500.33 The modifications used were the same as indicated for respirable dust. The LOD 

for this gravimetric analysis was 0.02 mg. The corresponding MDC was 0.05 mg/m3

, based on a 419-liter 

sample. 

After the gravimetric analysis, the samples were analyzed for 29 elements (metals and minerals) by 

inductively coupled argon plasma atomic emission spectroscopy (ICP-AES) according to a modification 

of NIOSH Method 7300.33 The method was modified to include microwave digestion of the PVC filter. 

The elements analyzed included: aluminum, antimony, arsenic, beryllium, cadmium, calcium, chromium, 

cobalt, copper, iron, lead, lithium, magnesium, manganese, molybdenum, nickel, phosphorus, platinum, 

selenium, silver, sodium, tellurium, thallium, tin, titanium, vanadium, yttrium, zinc, and zirconium. 

Table 1 lists the analytical limits for the individual elements. 

Evaluation Criteria 

As a guide to the evaluation of the hazards posed by workplace exposures, NIOSH field staff employ 

environmental evaluation criteria for the assessment of a number of chemical and physical agents. These 

criteria are intended to suggest levels of exposure to which most workers may be exposed up to 10 hours 

per day, 40 hours per week for a working lifetime without experiencing adverse health effects. It is, 

however, important to note that not all workers will be protected from adverse health effects even though 

their exposures are maintained below these levels. A small percentage may experience adverse health 

effects because of individual susceptibility, a pre-existing medical condition, and/or a hypersensitivity 

(allergy). In addition, some hazardous substances may act in combination with other workplace 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 29 

exposures, the general environment, or with medications or personal habits of the worker to produce 

health effects even if the occupational exposures are controlled at the level set by the criterion. These 

combined effects are often not considered in the evaluation criteria. Also, some substances are absorbed 

by direct contact with the skin and mucous membranes, and thus potentially increase the overall exposure. 

Finally, evaluation criteria may change over the years as new information on the toxic effects of an agent 

become available. 

The primary sources of environmental evaluation criteria for the workplace are: (1) NIOSH 

Recommended Exposure Limits (RELs),34 (2) the American Conference of Governmental Industrial 

Hygienists’ (ACGIH®) Threshold Limit Values (TLVs®),35 and (3) the U.S. Department of Labor, 

Occupational Safety and Health Administration (OSHA) Permissible Exposure Limits (PELs).36

Employers are encouraged to follow the OSHA limits, the NIOSH RELs, the ACGIH TLVs, or 

whichever are the more protective criteria. 

OSHA requires an employer to furnish employees a place of employment that is free from recognized 

hazards that are causing or are likely to cause death or serious physical harm [Occupational Safety and 

Health Act of 1970, Public Law 91–596, sec. 5(a)(1)]. Thus, employers should understand that not all 

hazardous chemicals have specific OSHA exposure limits such as PELs and short-term exposure limits 

(STELs). An employer is still required by OSHA to protect their employees from hazards, even in the 

absence of a specific OSHA PEL. 

A time-weighted average (TWA) exposure refers to the average airborne concentration of a substance 

during a normal 8- to 10-hour workday. Some substances have recommended STEL or ceiling values 

which are intended to supplement the TWA where there are recognized toxic effects from higher 

exposures over the short-term. 

Particulates 

Often the chemical composition of the airborne particulate does not have an established occupational 

exposure limit (OEL). It has been the convention to apply generic exposure criteria in such cases. 

Formerly referred to as nuisance dust, OSHA’s preferred terminology for the non-specific particulates is 

particulates not otherwise regulated (PNOR) and ACGIH’s preferred terminology is particles not 

otherwise specified (PNOS). 
Page 30 Health Hazard Evaluation Report No. 2006-0023-3003 

The OSHA PEL for PNOR is 15 mg/m3 for total particles and 5 mg/m3 for respirable particles. These 

criteria were established to minimize mechanical irritation of the eyes and nasal passages, and to prevent 

visual interference. NIOSH does not have a REL for total or respirable particulate not otherwise 

classified. 

ACGIH does not believe there is enough evidence to establish a TLV for PNOS, however it feels particles 

may have adverse effects. Thus in 2003, ACGIH withdrew the TLV for PNOS. ACGIH currently 

recommends keeping airborne concentrations below 3 mg/m3

 for respirable particles, and below 

10 mg/m3

 for inhalable particles. These recommendations apply for particles that 1) have no applicable 

TLV, 2) are insoluble or poorly soluble in water, and 3) have low toxicity.35

Silica 

Crystalline silica (quartz and cristobalite) has been associated with silicosis, a fibrotic disease of the lung 

caused by the deposition of fine particles of crystalline silica in the lungs. Symptoms usually develop 

insidiously, with cough, shortness of breath, chest pain, weakness, wheezing, and non-specific chest 

illnesses. Silicosis usually occurs after years of exposure, but may appear in a shorter period if exposure 

concentrations are very high. 

The NIOSH RELs for crystalline silica (both quartz and cristobalite), as respirable dust, are 0.05 mg/m3

. 

These RELs are intended to prevent silicosis. The OSHA PEL for quartz is calculated as follows: 

% quartz 2

10 mg/m PEL (mg/m )

3

3

+ =

The calculated OSHA PEL for the two samples with detectable levels of respirable quartz is 0.48 and 

0.63 mg/m3

, based on a 19% and 14% respirable quartz content, respectively. The OSHA PEL for 

respirable cristobalite is half the calculated value for quartz. The corresponding respirable cristobalite 

PELs are 0.24 and 0.32 mg/m3

. The ACGIH TLV for respirable quartz and cristobalite are 0.1 and 

0.05 mg/m3

, respectively. 

Elements 

The toxicity of most elements (metals and minerals) depends on numerous factors including the chemical 

form of the metal, immune status and age of the worker, and lifestyle factors. Most metals affect more 

than one organ system. However, at the lowest dose, each metal targets a primary organ or tissue. Table 2 

lists the detectable elements and applicable OELs. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 31 

Results 

PBZ air samples for respirable particulates and silica, total particulates, and elements (metals and 

minerals) were collected on 10 fire fighters during the simulated movement of three apparatus. Fire 

fighters were asked to drive through the area serviced by the Jackson Barracks temporary staging area in 

the Ninth Ward. At the time of the survey, portions of the Ninth Ward were closed to the general public. 

Many of the streets had not been cleared of sediment in the closed areas. The apparatus were driven as 

they may have been during a response. However, the speed of the apparatus was much slower than before 

the hurricanes due to down power lines, houses and general debris blocking the streets, and street 

barricades. 

During the evaluation, the apparatus were used in the following order: Engine 22, Engine 39, and 

Ladder 4. All fire fighters were seated inside the cabin of the apparatus in their normal positions (driver, 

front passenger, and forward-facing rear passenger on either the driver or passenger side). Windows of 

the apparatus were opened or closed at the choice of the individual fire fighter; all apparatus during the 

simulated movement had a combination of closed and opened windows (at least one window closed). In 

addition to closing windows to limit dust exposure, some fire fighters were observed covering their nose 

and mouth with paper towels. 

Respirable Particulates 

Eight PBZ air samples were collected for respirable particulates. Fire fighter exposures to respirable 

particulates ranged from non-detectable (ND) (less than 0.1 mg/m3

) to 0.42 mg/m3, with a mean of 

0.20 mg/m3

. All respirable particulate concentrations were below the relevant occupational exposure 

criteria. 

Respirable Silica 

Eight PBZ air samples were collected for respirable silica, both quartz and cristobalite. Two of the 

respirable silica samples had trace levels (between 0.04 and 0.1 mg/m3

) of quartz; all other samples were 

ND (less than 0.04 mg/m3

). The samples with trace levels of quartz were collected from Ladder 4. All 

respirable silica samples for cristobalite were ND (less than 0.08 mg/m3

). 

Total Particulates 

Nine PBZ air samples were collected for total particulates. Fire fighter exposures to total particulates 

ranged from 0.45 to 2.6 mg/m3

, with a mean of 1.4 mg/m3. All total particulate concentrations were below 

the relevant occupational exposure criteria. 
Page 32 Health Hazard Evaluation Report No. 2006-0023-3003 

Because of the short sampling time (2–21⁄2 hours), the range for trace quartz concentrations (0.04 to 

0.1 mg/m3

) overlaps the NIOSH REL of 0.05 mg/m3 and the ACGIH TLV of 0.1 mg/m3. Also, because of 

the short sampling time, the cristobalite MDC (less than 0.08 mg/m3

) exceeds the NIOSH REL of 

0.05 mg/m3

 and the TLV of 0.05 mg/m3. Assuming fire fighters are not exposed to additional respirable 

silica throughout the day, all respirable silica concentrations were below the relevant occupational 

exposure criteria. 

Elements 

Nine PBZ air samples were collected for elements (metals and minerals). Table 3 lists the concentrations 

of the detected elements. Aluminum, arsenic, calcium, iron, magnesium, manganese, sodium, titanium, 

and zinc were detected in quantifiable concentrations. Molybdenum was detected on one sample and tin 

was detected on two samples; however, the concentrations were not enough to quantify accurately and are 

considered trace concentrations. All other elements were ND. All elemental concentrations were below 

the relevant occupational exposure criteria. 

Discussion and Conclusions 

Airborne exposures to respirable particulate and silica, total particulate, and elements were below all 

applicable exposure criteria for the fire fighters working out of the Jackson Barracks temporary staging 

area. The results of the environmental survey do not warrant changes to apparatus transport activities as 

observed during the NIOSH site visit on October 19, 2005. However, should fire fighter activities differ 

from those observed by NIOSH, the department should reassess the exposures to ensure they remain 

below applicable exposure criteria. 

During the environmental survey, fire fighters were observed covering their nose and mouth with paper 

towels to minimize exposures. Respiratory protection is not required if exposures remain as monitored 

during our site visit. Should the NOFD allow voluntary use of respirators for protection against nuisance 

dust, fire fighters should use NIOSH-approved N-95 filtering facepiece respirators. Paper towels do not 

provide respiratory protection because they do not adequately filter small particles and do not seal with 

the face. Voluntary use of respirators must be addressed in the NOFD’s respiratory protection program, 

and should follow the OSHA regulations (29 U.S. Code of Federal Regulations 1910.134). 

Recommendations 

Results of environmental sampling conducted on October 19, 2005, indicated that monitored exposures 

did not exceed any applicable exposure limit for fire fighters stationed at Jackson Barracks. The following 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 33 

recommendations are offered to further reduce the fire fighters’ exposures while working in floodaffected areas: 

1. Keep the doors and windows of vehicles closed and use the air conditioning system in the 

recirculation mode. 

2. Maintain longer distances between vehicles when conducting inspection/assessment trips, 

when response time is not a factor. This will allow some dust from previous vehicles to settle. 

3. Perform preventive maintenance on vehicles, including changing the filter on air conditioning 

systems, ensuring proper door seals, and replacing broken glass. 

4. Allow the voluntary use of respiratory protection, using NIOSH-approved N-95 filtering 

facepiece respirators for protection against nuisance dust, in accordance with OSHA 

regulations. 

5. Clean the inside and outside of the vehicles regularly to minimize exposure to dust. The 

outside of vehicles should be cleaned using standard washing techniques, i.e., soap and water 

or rinse with water. Inside the vehicles, a damp cloth or a vacuum equipped with a highefficiency particulate air (HEPA) filter should be used to remove dust. Compressed air should 

not be used to remove dust from inside or outside the vehicle. 

References

33. NIOSH [2003]. NIOSH manual of analytical methods. 4th ed. Cincinnati, OH: U.S. Department of 

Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National 

Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 92-100. 

34. NIOSH [1992]. Recommendations for occupational safety and health: compendium of policy 

documents and statements. Cincinnati, OH: U.S. Department of Health and Human Services, Public 

Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety 

and Health, DHHS (NIOSH) Publication No. 92-100. 

35. ACGIH [2005]. 2005 TLVs® and BEIs®: threshold limit values for chemical substances and 

physical agents. Cincinnati, OH: American Conference of Governmental Industrial Hygienists. 

36. CFR [2003]. 29 CFR 1910.1000. Code of Federal Regulations. Washington, DC: U.S. 

Government Printing Office, Office of the Federal Register. 
Page 34 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 1 

Analytical Limits for Elements (Metals and Minerals) 

October 19, 2005 

New Orleans Fire Department 

HETA #2006-0023-3003 

LOD 

(μg/sample) 

LOQ 

(μg/sample) 

MDC 

(mg/m3

) 

MQC 

(mg/m3) 

Aluminum 2 7 0.005 0.02 

Antimony 0.9 3 0.002 0.007 

Arsenic 2 8 0.005 0.02 

Beryllium 0.05 0.2 0.0001 0.0005 

Calcium 5 20 0.01 0.05 

Cadmium 0.2 0.8 0.0005 0.002 

Cobalt 0.9 3 0.002 0.007 

Chromium 0.6 2 0.001 0.005 

Copper 0.1 0.5 0.0002 0.001 

Iron 4 10 0.01 0.02 

Lithium 0.1 0.3 0.0002 0.0007 

Magnesium 1 5 0.002 0.01 

Manganese 0.09 0.3 0.0002 0.0007 

Molybdenum 0.3 1 0.0007 0.002 

Nickel 0.5 2 0.001 0.005 

Lead 1 4 0.002 0.01 

Phosphorus 3 10 0.007 0.02 

Platinum 7 20 0.02 0.05 

Selenium 6 20 0.01 0.05 

Silver 0.2 0.6 0.0005 0.001 

Sodium 3 9 0.007 0.02 

Tellurium 3 9 0.007 0.02 

Thallium 3 10 0.007 0.02 

Tin 2 7 0.005 0.02 

Titanium 0.2 0.6 0.0005 0.001 

Vanadium 0.2 0.7 0.0005 0.002 

Yttrium 0.05 0.2 0.0001 0.0005 

Zinc 0.3 1 0.0007 0.002 

Zirconium 0.2 0.5 0.0005 0.001 

LOD = limit of detection mg = milligram m3 = cubic meter 

LOQ = limit of quantitation μg = microgram L = liter 

MDC = minimum detectable concentration MQC = minimum quantifiable concentration 

The limits of detection (LOD) describe the amount of substance below which it cannot be detected in the 

sample. The limits of quantitation (LOQ) describe an amount of substance above the LOD, but not enough 

to quantify accurately. The LOD and LOQ are values determined by the analytical procedure used to 

analyze the samples, and are not dependent on sample volumes. Minimum detectable concentrations 

(MDCs) are determined by dividing the LODs by air sample volumes for the given set of samples. 

Minimum quantifiable concentrations (MQCs) are determined by dividing the LOQs by air sample volumes 

for the given set of samples, and reflect a concentration above the MDC but not enough to quantify 

accurately. MDC and MQC values are based on a sample volume of 419 liters. 
Health Hazard Evaluation Report No. 2006-0023-3003 Page 35 

Table 2 

Occupational Exposure Limits for Elements Quantified in Environmental Survey 

October 19, 2005 

New Orleans Fire Department 

HETA #2006-0023-3003 

NIOSH 

Recommended 

Exposure Limita

OSHA 

Permissible 

Exposure Limita

ACGIH 

Threshold Limit 

Valuea,b

Aluminum 10 15 10 

Arsenic c,d 0.01 0.01 

Calcium carbonate 10 15 10 

Iron oxide 5 10 5 

Magnesium oxide N/A 15 10 

Manganese 1 c 0.2 

Molybdenum N/A 15 10 

Sodium N/A N/A N/A 

Tin oxide 2 2 2 

Titanium dioxide d 15 10 

Zinc oxide 5 15 2 

a Evaluation criteria reported as mg/m3

. 

b Based on the 2005 TLVs® and BEIs®: threshold limit values for chemical substances 

and physical agents published by the American Conference of Governmental 

Industrial Hygienists (ACGIH®). 

N/A, not applicable, indicates that no evaluation criterion exists. 

c Occupational exposure limit is only available as a ceiling limit value, not applicable 

for the type of sampling conducted during this evaluation. 

d Potential occupational carcinogen, non-quantitative exposure limit labeled “lowest 

feasible concentration.” 
Page 36 Health Hazard Evaluation Report No. 2006-0023-3003 

Table 3 

Concentrations of Elements in PBZ Air Samples 

October 19, 2005 

New Orleans Fire Department 

HETA #2006-0023-3003 

 Range Mean 

Aluminum trace (between 0.005 and 0.02)–0.084 0.050 

Arsenic ND (less than 0.005)–0.0026 0.0020 

Calcium trace (between 0.01 and 0.05)–0.080 0.050 

Iron trace (between 0.01 and 0.02)–0.067 0.042 

Magnesium trace (between 0.002 and 0.01)–0.020 0.012 

Manganese ND (less than 0.0002 and 0.0007)–0.0012 0.00045 

Sodium trace (between 0.007 and 0.02)–0.052 0.026 

Titanium trace (between 0.0005 and 0.001)–0.0029 0.0018 

Zinc ND (less than 0.0007)–0.0032 0.00098 

Trace is defined as a concentration between the minimum detectable concentration and the 

minimum quantifiable concentration. 

ND, non-detectable, is defined as less than the minimum detectable concentration. 
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