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Body and mind: the probable health effects of the 2005 Carlisle flooding Dr Lorna Fewtrell

Body and mind: the probable health effects of the 2005 Carlisle flooding Dr Lorna Fewtrell. Flooding: it’s enough to make you sick Dr Lorna Fewtrell. Structure. Case study population Research areas (part 1) Quantitative microbial risk assessment Research areas (part 2)

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Body and mind: the probable health effects of the 2005 Carlisle flooding Dr Lorna Fewtrell

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  1. Body and mind:the probable health effects of the 2005 Carlisle floodingDr Lorna Fewtrell

  2. Flooding:it’s enough to make you sickDr Lorna Fewtrell

  3. Structure • Case study population • Research areas (part 1) • Quantitative microbial risk assessment • Research areas (part 2) • Overall health impact assessment • Thoughts to ponder

  4. 2005 flooding

  5. Case study population • Denton Holme • 725 homes • <0.01 to 2.25 m • Ave velocity between 0.11 and 0.35 m/s

  6. Case study population • Age profile • Health status • Long-term illness • Occupancy level • Housing type

  7. Research areas Contamination profile Flood withdrawal & clean-up behaviour

  8. Contamination profile

  9. Contamination profile

  10. Flood withdrawal & clean-up

  11. Exposure scenarios Quantitative microbial risk assessment (QMRA) of gastrointestinal illness Reference pathogens Pathogen levels in floodwater • Campylobacter • Cryptosporidium • Rotavirus QMRA • Flood phase • Clean-up phase Dose-response relationships Disability Adjusted Life Years

  12. Disability adjusted life years (DALYs) • Summary measures of health • Combines the length of time lived with a disability with (if applicable) years of life lost through premature death • Different levels of disability are accounted for using severity weights

  13. QMRA results

  14. QMRA results

  15. QMRA results 41

  16. QMRA thoughts • 41 cases of illness – 2.5% of the flooded population • but less than 1% of the whole Denton Holme population • Assumptions • gloves are protective and reduce exposure to zero • rotavirus concentrations

  17. Research areas Media analysis Contamination profile Flood withdrawal & clean-up behaviour Mental health study

  18. Media analysis EXCLUSIVE: Hundreds could die, says scientist HUNDREDS of flood victims could be killed by a brew of terrifying bugs lurking in the murky water. Virus expert Dr Ken Flint said potentially lethal bacteria like e.coli and salmonella would be left behind in the sludge in houses and streets for weeks or even months after the floods recede. And he claimed the elderly, the very young and the infirm were at serious risk from gastroenteritis. Microbiologist Dr Flint added: "I expect to see three to four times the normal rate for these diseases in coming weeks. That would mean the potential for low hundreds of people dying." His stark warning came as scientists found evidence of around a dozen dangerous viruses in flood water samples taken from swamped Gloucestershire streets. Don’t let kids go in the water Killer bugs in flood waters Peril ... kids brave Oxford flood water that contains bacteria and viruses Signs of E. coli in Mud After Cumbria Floods A sample of mud from a house hit by the recent flooding in Cumbria has been found to contain the DNA ‘signature’ of bacterium E. coli 0157

  19. Mental health study • Questionnaire survey • Building on large survey conducted by the HPA • Number of standard instruments • Psychological distress • Anxiety • Depression • Probable post traumatic stress disorder • Three years after flooding

  20. Overall health impact assessment HIA Quantifiable health effects

  21. Overall health impact assessment HIA Quantifiable health effects Case study population Disability Adjusted Life Years

  22. HIA results

  23. HIA results

  24. Context

  25. Context

  26. Context

  27. Context

  28. It really is enough to make you sick

  29. It really is enough to make you sick

  30. It really is enough to make you sick

  31. Thoughts to ponder • Deaths and serious injuries are picked up • Stomach upsets aren’t really a big deal • but something the media can get their teeth into • Mental health problems aren’t immediate

  32. Thoughts to ponder • “Given the relatively mild nature of the flooding, the high prevalence rates [of mental health problems] identified in the present study may be questioned.” Mason et al., 2010 The psychological impact of exposure to floods. Psychology and Health 15, 61-73

  33. Thoughts to ponder • The recovery process has been termed ‘the second disaster’ • “that was the heartbreaking part of it. When they walked down the drive with crowbars in their hands I thought, ‘they aren’t going to be nice about this’ …”

  34. And finally Flooding screws you up!

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