First, a little background about floods….
Between 1959 through 2005, the state of Texas alone, had 760 flood related fatalities, 6846 casualties and 7606 injuries. This number has only expounded as Hurricane’s have torn through the state since 2005.
In the U.S., alone, flood losses average close to $8 billion a year. Flooding itself is destructive and terrifying. However, the danger doesn’t dissipate once the flood waters have receded.
When floodwaters recede, affected areas are often blanketed in silt and mud. The water and landscape can be contaminated with hazardous materials such as sharp debris, pesticides, fuel, and untreated sewage. Potentially dangerous mold blooms can quickly overwhelm water-soaked structures. Residents of flooded areas can be left with mold and left without power and clean drinking water, leading to outbreaks of deadly waterborne diseases like typhoid, hepatitis A, and cholera.
As flooding is one of the main natural disasters that create mold, MAM wanted to take a minute and remind people of some basics to remember; when encountering flood water and some precautions to remember when reentering your home once the flood waters have receded.
During Floods…..
Please Remember the following: 
1. Don’t drive in flooded areas, turn around! (Half of all Flood deaths are vehicle related.)
2. Floodwater can pose a drowning risk for everyone.
3. Swift moving shallow water can be deadly, currents are not only in deep moving water.
Stay out of floodwater because floodwater can contain the following:
1. Downed power lines
“Water is an excellent conductor of electricity and there’s no way to tell if a downed power line is still energized…Any amount of water could become energized. Be careful not to touch water, or anything in contact with the water, when a downed power line is nearby,” Darryl Daves said, senior manager of safety for Entergy Corporation.
Do not drive through standing water if downed power lines are in the water.
2. Avoid electrical hazards inside or outside your home.
After a hurricane, flood or other natural disaster you need to be careful to avoid electrical hazards both in your home and elsewhere.
If you have time, shut off electrical power and natural gas or propane tanks in your home to avoid fire, electrocution, or explosions.
If water is rising near your home or business, turn off electricity at the main breaker. Evacuate and do not return until waters have completely receded. Wait until the water recedes, then have an electrician check the building’s wiring before using electricity.
Don’t go into any room or basement if water is covering appliance cords that are plugged in or if water has reached the wall outlets. If electrical appliances and equipment have been under water, allow them to dry out and have them checked out by a qualified repair person before using them.
If you believe someone has been electrocuted, call or have someone else call 911 or emergency medical help. For more information, visit: Protect Yourself and Others From Electrical Hazards After a Disaster
3. Waste, physical objects and debris; and wild or stray animals.
If you must enter floodwater, wear rubber boots, rubber gloves, and goggles to prevent injuries.
Floodwater may contain sharp objects, such as glass or metal fragments, that can cause injury and lead to infection. Prompt first aid can help heal small wounds and prevent infection. If you receive a puncture wound or a wound contaminated with feces, soil, or saliva, have a health care professional determine whether a tetanus booster is necessary based on individual records.
4. Contaminated flood water can cause wound infections, skin rash, gastrointestinal illness, tetanus, and/or rarely Leptospirosis.
Prevention of infection and of open wounds and rashes, is viable knowledge to grasp. Open wounds and rashes exposed to flood water can become infected (Vibrios, for example, are naturally occurring bacteria that live in certain coastal waters and can cause skin infections when an open wound is exposed to them). In addition, researchers found that E. coli levels, in two of Houston’s major bayou’s, were significantly elevated in the immediate aftermath of Harvey; compared with numbers obtained before the hurricane. They also found that the highest levels of fecal bacteria, human pathogens and antibiotic resistance genes, occurred in homes with stagnant flood water inside.
Additional Helpful Reminders…..
To Help better protect yourself and your family:
• Avoid exposure to flood water if you have an open wound.
• Cover clean, open wounds with a waterproof bandage to reduce chances of infection.
• Keep open wounds as clean as possible by washing well with soap and clean water.
• If a wound develops redness, swelling, or oozing, seek immediate medical attention.
Seek medical attention as soon as possible if:
• There is a foreign object (soil, wood, metal, or other objects) embedded in the wound;
• The wound is at special risk of infection (such as a dog bite or puncture by a dirty object);
• An old wound shows signs of becoming infected (increased pain and soreness, swelling, redness, draining, or you develop a fever).
Returning Home
The black mold grows in the drywall, which must be removed before the building can be inhabited again. The National Geographic states ,“Potentially dangerous mold blooms can quickly overwhelm water-soaked structures.” This is why knowing about returning home to a water soaked structure is necessary.
A damaged home or building should not be taken lightly. There are environmental factors, such as mold and bacteria; as well as chemicals that could now be residing in your home, which can pose a significant health threat to you and anyone working in the flood damage areas and structures.
Wearing the proper PPE (Personal Protective Equipment) when reentering a water damaged structure is important. Wearing the proper PPE will help prevent a person from not just being injured or exposed to the above listed variables in flood waters; but also to prevent a person from falling victim to the ill health effects, that your home or building may pose, from the abundance of mold; now growing within its walls and throughout the structure.
For a list of PPE, specifically for flooding; please visit: https://www.cdc.gov/niosh/topics/emres/ppe-flood.html
When reentering, also take into consideration who is reentering the home. “Children, the elderly, pregnant women and anyone with an immune compromised system should steer clear of flood damaged areas; due to the elevated levels of mold, bacteria and chemicals.”
What do we mean by elevated levels of mold indoors?
Studies conducted after Hurricane’s Katrina and Rita showed, the mean indoor/ outdoor spore ratios ranged from 4.11 to 8.3 . Indoor spore counts ranged from 6142 to 735,123 spores/m3, whereas outdoor spore counts ranged from >6500 to 102,000 spores/m3. Meaning, indoor environments were 7 times more potent than that of the outdoor environment after a hurricane or flood in water damaged homes and buildings. In Layman’s terms it’s like standing in 1 foot of water outside compared to 7 feet of water inside. This is why it’s so imperative to take the proper precautions and to keep those mentioned above away from water damaged and flood stricken areas and structures.
Inside the Home
Molds are fungi that multiply by releasing spores into the air. These spores settle onto surfaces and begin to grow within 24-48 hours if conditions permit. Molds grow best in warm temperatures (77-86 degrees). Molds need moisture and require oxygen, but not light to thrive and grow. Meaning, flooded structures are a perfect breeding ground for mold to thrive and grow quickly.
Mold grows well on paper products, cardboard, ceiling tiles, and wood products. Mold can also grow in dust, paints, wallpaper, insulation, drywall, carpet, fabric, and upholstery. Not only do you have to worry about mold, when it is growing in your home in areas that are water damaged, but you also have to worry about the VOC’s from the chemicals in substances it is feeding off of such as drywall, paint, insulation, etc.
For more Important instructions on specific information and tips on reentering your home, please see the following link and the MAM in-depth remediation page.
MEDICAL 
Flooding negatively impacts many things, a person’s physical home, financial situation, relationships and physical and emotional health.
There has been much controversy over whether or not mold can cause illness. To date, there is no specific baseline spore count indoor vs. outdoor, that causes illness. Why is that? Well, first mold affects everyone differently, based on their specific genetics and current state of health. An infant that is crawling around on the floor, where the mold spores tend to settle, is going to have an increased chance of being affected; over an adult that is sitting in a chair. Anyone who has a longer duration in the toxic environment, over another family member or anyone that has a health disposition, has a higher chance of becoming ill first.
Two of the most prominent Hurricanes, studied, to have hit Louisiana; were Katrina and Rita.
“Molds, endotoxins, and fungal glucans were detected in the environment after Hurricanes Katrina and Rita in New Orleans, at concentrations that have been
associated with health effects. The species and concentrations were different from those previously reported for non-water-damaged buildings in the southeastern United States.”
The following illnesses and health conditions, have not only been associated with the aftermath of those two Hurricanes; but they have also been associated with exposure to water damaged buildings and the toxic molds that reside in them:
1.Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings
Executive cognitive and neurologic abnormalities are commonly seen in patients with a chronic inflammatory response syndrome (CIRS). Executive cognitive and neurologic abnormalities are often acquired, following exposure to the interior environment of water-damaged buildings (WDB). However, a clear delineation of the physiologic or structural basis for these abnormalities has not yet been defined. Symptoms of affected patients routinely include headache, difficulty with recent memory, concentration, word finding, numbness, tingling, metallic taste and vertigo. Additionally, persistent proteomic abnormalities in inflammatory parameters, that can alter the permeability of the blood-brain barrier, such as C4a, TGFB1, MMP9 and VEG; are notably present in cases of CIRS-WDB.
2. Chronic Inflammatory Response Syndrome (CIRS)
Chronic Inflammatory Response Syndrome (CIRS) is a collection of symptoms, which is also sometimes referred to as Biotoxin Illness, or Mold Illness. CIRS was initially thought to be caused by mold exposure only. However, further research indicates bacteria, fungi and various viral infections are also implicated in the development of CIRS.
It is quite a dilemma for both patients and physicians in dealing with such a complex illness as CIRS, which overlaps and can mimic symptoms associated with other conditions such as Lyme Disease, Ehrlichiosis and some AutoImmune Disorders. CIRS may often be misdiagnosed, or under diagnosed.
Outside of these two specific floods, there has been much study composed on the effects of generalized flooding and mold growth/illness.
In 2004 the Institute of Medicine (IOM) investigated the impact of damp indoor environments on health, including health effects associated with indoor mold growth. The report found, “sufficient evidence of an association between the presence of mold in damp indoor environments and upper respiratory tract symptoms, cough, and wheezing.” The investigation also found that healthy children exposed to mold in damp indoor environments have more lower respiratory tract illness.
Mold is a fungus that has many strains: (For a full list of mold strains, see the following https://www.emlab.com/resources/fungal-library/)
One said strain is Aspergillus spp.
Aspergillosis can cause various types of infection:
1. Allergic pulmonary aspergillosis is an allergic reaction to the fungus. This infection usually develops in people who already have lung problems such as asthma or cystic fibrosis.
2. Aspergilloma is a growth (fungus ball) that develops in an area of past lung disease or lung scarring such as tuberculosis or lung abscess. Over time and without treatment, aspergillomas can worsen and potentially cause a cough that brings up blood, wheezing, shortness of breath, unintentional weight loss and fatigue.
3. Invasive pulmonary aspergillosis is a serious infection with pneumonia. It can spread to other parts of the body. This infection occurs most often in people with a weakened immune system. This can be from cancer, AIDS, leukemia, an organ transplant, chemotherapy, or other conditions or drugs that lower the number or function of white blood cells or weaken the immune system.
Note: If you have asthma or cystic fibrosis, consider seeing a doctor if there is a noticeable change.
Aspergillus, is not the only strain of fungus that has been shown to have negative effects on a person’s health.
Asthma and Respiratory Issues
Alternaria, “has been increasingly recognized as a risk factor, for the development and persistence of asthma, asthma severity, and potentially fatal asthma exacerbations.” Dr. John Salvaggio, the late director of the Tulane Section of Allergy and Immunology, studied children at the Charity Hospital Pediatric Emergency Room. The study showed significant sensitization to basidiomycetes, in addition to fungi imperfecti (a fungi not identified) in patients with acute asthma. Although not every case of asthma is related to the inhalation of fungal particles, it should be noted that:
1. According to the CDC and EPA: 1 in 12 children (approximately 6 million children) in the US ages 0-17 have asthma.
2. Emergency Department and Urgent Care center visits related to asthma attacks were highest among children 0-4 years and Non-Hispanic Black children.
3. Asthma is the third-ranking cause of hospitalization among children younger than 15.
There are other, more common, mold strains that reside in water damaged or wet areas (which flooding causes). Cladosporium is another strain that has been associated with respiratory issues.
Cladosporium – Homeowners often find the cladosporium mold inside both cool and warm areas like carpet, wood floorboards, wooden cabinet and older fabrics. Being around the cladosporium mold can leave homeowners with breathing problems and respiratory issues. It is also known to cause: eye infections, ear infections, skin problems, sinus infections, sneezing, dry skin, hives,itchy throat and eyes, watery eyes, coughing, stuffy or runny nose and/or postnasal drip. In some cases, people with untreated mold allergies and prolonged exposure to molds develop allergic fungal sinusitis.
Pneumonia
The 2004 IOM report, found sufficient evidence “for an association between mold exposure and hypersensitivity pneumonitis (an immune response to the inhalation of fungal particles deep in the airways)”. Fusarium is a strain that has been associated with Pneumonia. Fusarium is a mold that tends to grow in colder, wetter areas. The typical homes for the fusarium mold are carpeted areas and similar fabrics. Fusarium can cause the standard allergic reaction as well as respiratory infections and inflammation. Fusarium keratitis is also known for Onychomycosis (nail infection), certain skin infections, Fusarium osteomyelitis (bone and joint infections) and/or Pneumonia. Pneumonia, Fungal particles of various kinds, have also shown to be dangerous for people, specifically children. Although not every case of pneumonia is related to the inhalation of fungal particles, it should be noted that at the time of the 2004 IOM study, Pneumonia and the Flu are the 6th leading cause of death in kids under the age of 9 in the United States. Pneumonia, is not the only illness that is relevant to showing a correlation between mold and illness.
Depression
Depression is another illness that is thought to have a correlation to mold. A study in Denmark, stated that “about 40% of the residents (that) lived in visibly damp, moldy households, overall their risk for depression averaged 34-44% higher than that for residents of mold- free dwellings”. Again, it cannot be assumed that all cases of depression are mold related. However, it should be noted that the second leading cause of death for children between the ages of 10-14 is suicide and the second leading cause of death in young adults, between the ages of 25-34 is also suicide; which can be the consequence of depression.
Allergies, Sinus Infections and Sinusitis Asthma, Pneumonia and Depression are three highlighted illnesses. One major common illness is allergies and sinus infections or/and sinusitis. These issues are unique, in that they can be triggered by all of the above listed strains of common mold, as well as other common mold found in flooded areas. Each strain has been known to show an association with health issues:
Chaetomium – Chaetomium mold is found in drywall that has experienced water damage. People typically identify its presence when they smell a musty or old odor in their home. It is most frequently known to produce mycotoxins and recognized human allergens.
Penicillium – Penicillium is a mold that can be found indoors inside insulation, furnishings, water damaged furniture, carpeting and more. Penicillium is known for spreading quickly throughout the home and can cause homeowners to have sinus infections, lung inflammation, as well as allergic reactions.
Stachybotrys Chartarum – “Black mold” or stachybotrys chartarum is also called toxic mold. This is due to the fact that this type of mold creates toxic compounds known as mycotoxins. The compounds cause those that breathe the mold in to develop breathing issues, sinus infections, depression, fatigue, asthma attacks and more. This type of mold can be identified by its musty smell and is found in areas that stay damp, like air conditioning pipes and ducts.
Trichoderma – Trichoderma is another damp area mold. Homeowners often find the trichoderma mold within damp carpeting, wallpaper and similar surfaces. The harm with trichoderma comes from the production of mycotoxins that can cause sinus infection, allergic reactions, and more.
Ulocladium – The Ulocladium mold is found both outside and inside. Ulocladium is typically found in areas that have been severely damaged by water like in the floors and walls of homes that have experienced a flood. This kind of mold causes many homeowners to develop allergic reactions and infections.
For Expecting Mothers 
Another reason to be cautious and to keep any expecting mothers away from flooded homes and or water damaged buildings is because a recent Study confirms that inflammation during pregnancy is linked to a baby’s brain. Inflammation is a normal part of the body’s response to infection, chronic stress or obesity. In pregnant women, it is believed that heightened inflammation increases the risk of mental illness or brain development problems in children.
Flooding and “Toxic” Algae
As Flooding has been associated with various illnesses, we thought it prudent to also discuss a topic in the most recent news;”toxic algae”. HAMB’s or Harmful algal blooms produce damaging toxins. Why are we talking about this with Flooding? When flooding occurs, more land based pollution and fertilized topsoil ends up where it shouldn’t be; thus causing the onset of HAMB’s and damaging toxins.
The National Oceanic and Atmospheric Administration for the US Department of Commerce states,
Harmful algal blooms (HABs) occur when algae — simple photosynthetic organisms that live in the sea and freshwater — grow out of control while producing toxic or harmful effects on people, fish, shellfish, marine mammals, and birds. There are many kinds of HABs, caused by a variety of algal groups with different toxins. The HABs in fresh and marine waters are usually very different, but they overlap in low salinity estuaries (places where rivers meet the sea). The human illnesses caused by HABs, though rare, can be debilitating or even fatal. States have rigorous monitoring programs to ensure that commercially harvested fish and shellfish are safe to eat. HABs have been reported in every U.S. coastal state, and their occurrence may be on the rise. HABs are a national concern because they affect not only the health of people and marine ecosystems, but also the “health” of local and regional economies.”
Video Reference Specific to Flooding
1. Doctor Talks Dangers of Fungi Left Behind After Natural Disasters (Link to video is below) https://foxcharleston.com/news-now/doctor-talks-dangers-of-fungi-left-behind-after-natural-disasters/?fbclid=IwAR3uo-UzuNxncKO5COCJFi-cV0gjuQIO0r0LlfRrUWo8XACZD8ndWan8knk
About The Author
Emily Rachal is co-owner of Texas Mold Inspectors, (or TMI), along with her husband, in the Houston, TX area. After her family’s devastating experience that not only injured her whole family, but also resulted in the loss of their youngest son Malachi, she and her husband have dedicated their lives to now educating and assisting families affected by toxic mold with their state-licensed mold inspection company.
Emily is the founder and owner of MAM. Additionally, she has recently started a non-profit organization in the name of her youngest son, called Malachi’s Message Foundation, to aid in financial support and offer hope to families who feel isolated and are unable to afford all the complex obstacles of overcoming a toxic mold exposure.