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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) Overall health impact assessment Thoughts to ponder
2005 flooding
Case study population
Denton Holme 725 homes <0.01 to 2.25 m Ave velocity
between 0.11 and 0.35 m/s
Case study population
Age profile Health status Long-term illness Occupancy level Housing type
Research areas
Contamination profile
Flood withdrawal & clean-up behaviour
Contamination profile
Contamination profile
Flood withdrawal & clean-up
Quantitative microbial risk assessment (QMRA) of gastrointestinal illness
Reference pathogens
•Campylobacter•Cryptosporidium•Rotavirus
Dose-response relationships
Pathogen levels in floodwater
Exposure scenarios
•Flood phase •Clean-up phase
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
QMRA results
0
0.005
0.01
0.015
0.02
0.025
0.03
0.035
Flood phase Clean-up Flood phase Clean-up Flood phase Clean-up
Campylobacter Cryptosporidum Rotavirus
DA
LY
s
QMRA results
0
0.005
0.01
0.015
0.02
0.025
0.03
0.035
Flood phase Clean-up Flood phase Clean-up Flood phase Clean-up
Campylobacter Cryptosporidum Rotavirus
DA
LY
s
QMRA results
0
0.005
0.01
0.015
0.02
0.025
0.03
0.035
Flood phase Clean-up Flood phase Clean-up Flood phase Clean-up
Campylobacter Cryptosporidum Rotavirus
DA
LY
s
41
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
Research areas
Contamination profile
Flood withdrawal & clean-up behaviour
Media analysis
Mental health study
Media analysis
Don’t let kids go in the water
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
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.
Killer bugs in flood waters
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
Overall health impact assessment
Quantifiable health effects
Overall health impact assessment
Quantifiable health effects
Case study population
HIA results
0
10
20
30
40
50
60
70
80
90
100
Mental health Death Serious harm Minor injuries Asthma GI Earache
Health outcome
DA
LY
s
HIA results
0
10
20
30
40
50
60
70
80
90
100
Mental health Death Serious harm Minor injuries Asthma GI Earache
Health outcome
DA
LY
s
Context
0
0.00002
0.00004
0.00006
0.00008
0.0001
0.00012
Lightening strike Drowning in the bath GI from HIA QMRA results Campylobacteriosis(morbidity & mortality)
DA
LY
s p
er p
erso
n
Context
0
0.00002
0.00004
0.00006
0.00008
0.0001
0.00012
Lightening strike Drowning in the bath GI from HIA QMRA results Campylobacteriosis(morbidity & mortality)
DA
LY
s p
er p
erso
n
Context
0
0.00002
0.00004
0.00006
0.00008
0.0001
0.00012
Lightening strike Drowning in the bath GI from HIA QMRA results Campylobacteriosis(morbidity & mortality)
DA
LY
s p
er p
erso
n
Context
0
0.00002
0.00004
0.00006
0.00008
0.0001
0.00012
Lightening strike Drowning in the bath GI from HIA QMRA results Campylobacteriosis(morbidity & mortality)
DA
LY
s p
er p
erso
n
It really is enough to make you sick
0
2
4
6
8
10
12
14
16
YLL from land transport accidents YLL from breast cancer DALYs Caldew flooding
Day
s o
f li
fe l
ost
It really is enough to make you sick
0
2
4
6
8
10
12
14
16
YLL from land transport accidents YLL from breast cancer DALYs Caldew flooding
Day
s o
f li
fe l
ost
It really is enough to make you sick
0
2
4
6
8
10
12
14
16
YLL from land transport accidents YLL from breast cancer DALYs Caldew flooding
Day
s
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
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
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’ …”
And finally
