Safe Return of Children to Flood Areas - Joint Statement from AAP and PEHSUs

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Subject: Safe Return of Children to Flood Areas - Joint Statement

from AAP and PEHSUs

On Friday, the American Academy of Pediatrics and the Pediatric

Environmental

Health Specialty Units issued a joint statement

" Clinical Recommendations Regarding the Safe Return of Children to

Areas Impacted by Flooding and/or Hurricanes " . The text is copied

below. The announcement is also posted on the Southwest Center for

Pediatric Environmental Health website at http://www.swcpeh.org.

Clinician Recommendations Regarding Return of Children to Areas

Impacted by Flooding and/or Hurricanes:

A Joint Statement from the Pediatric Environmental Health Specialty

Units and

the American Academy of Pediatrics

Introduction

Children are especially vulnerable to environmental hazards. They

eat, drink, and breathe more than adults on a pound for pound basis.

Children are in a critical period of development when toxic exposures

can have profound negative effects, and their exploratory behavior

often places them in direct contact with materials that adults would

avoid.

Key issues for habitability of an area impacted by flooding and/or

hurricanes include restoration of drinking water and wastewater

treatment facilities, safe road conditions, removal of solid waste

and debris, and replacement or renovation of flood damaged homes.

Before children return, schools and outdoor play areas should be

cleaned and ready for use. Children, and whenever possible teens,

should not be involved in clean up efforts but should return after

the area is cleaned up. In short, children should be the last group

to return to areas impacted by flooding and/or hurricanes.

These recommendations also apply to pregnant women.

Note: This document does not contain specific criteria or a

comprehensive list of environmental hazards. The decision to bring

children and other residents back to areas impacted by flooding

and/or hurricanes rests with local, State, and Federal officials.

Standards for environmental testing and clean up should be adopted by

local health officials drawing upon relevant existing evidence-based

guidelines andain consultation with experts in children's health and

the environment. In the aftermath of a flood, particular attention

should be paid to issues relating to water contamination and mold, in

addition to common pediatric environmental concerns such as physical

safety, lead, asbestos, and chemicals.

Optimal health of children requires completing the following items

before children return to areas impacted by flooding and/or

hurricanes:

1) Basic utilities and public services are reliably re-

established:

a) Water

i) The water supply is re-established, and

ii) Water for drinking and bathing must meet applicable existing

standards for biological, chemical, and mineral contaminants

Electricity and/or gas

i) The supply of electricity and gas is restored, as applicable

ii) Damage to the transmission system and/or gas pipes is

repaired

c) Food

i) A reliable food supply that includes infant formula and food

is reestablished

ii) Appropriate food storage conditions are in place

d) Communications

i) The communication system including 911 access is restored,

reliable, and readily accessible.

ii) Families must be able to contact local authorities and

health facilities when necessary

e) Healthcare

i) Healthcare services, including mental health services, are

available and accessible

ii) Families returning know the location and status of their

nearest medical treatment facility and that the route to reach

it is open and passable

iii) Emergency services are functional

iv) Medications and medical supplies are readily accessible

f) Sanitation

i) The sewage system is functional

ii) Debris and regular trash collection is re-established

2) Living and learning spaces (including homes, schools, and day-

care facilities) are free from physical and environmental hazards to

children

a) Buildings are appraised for damage and, if damaged, a decision

made to either destroy/rebuild or remediate

If renovating, all flood hazards are addressed

i) Grossly contaminated wallboard, insulation, flooring, and

other porous materials have been safely removed and replaced

following existing EPA guidelines

ii) Work should be done by contractors who are properly trained

and qualified

c) If rebuilding, the new structure is completed to the point of

safe occupancy

3) Spaces where children play should be clear of debris and free

from environmental hazards to children

a) Some designated outdoor areas (parks, playgrounds, yards,

etc.) have been cleaned and made free of safety hazards and

environmental hazards

Uncleaned areas are not accessible to children

c) Routes to and from living, learning, and playing places have

been cleaned and made free of safety hazards and environmental

hazards

More detailed information about the return of children to these areas

can be found at the Centers for Disease Control and Prevention web

site (http://www.cdc.gov/ ) and the US Environmental Protection

Agency web site (http://www.epa.gov/).

For additional information, contact the Pediatric Environmental

Health Specialty Unit (http://www.aoec.org/PEHSU.htm) serving your

area or the American Academy of Pediatrics (http://www.aap.org/).

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SOURCE: Occ-Env-Med-L Digest - 9 Oct 2005 to 10 Oct 2005 (#2005-273)