Day and night, victims of Hurricane Sandy have been streaming into ad hoc emergency rooms and relief centers, like the MASH-type medical unit on an athletic field in Long Beach, and the warming tent in the Rockaways the size of a small high school gym.

They complain of rashes, asthma and coughing. They need tetanus shots because — house-proud and armed with survivalist instincts — they have been ripping out waterlogged boards and getting poked by rusty nails. Those with back pain from sifting through debris receive muscle relaxants; those with chest pain from overexertion are hooked up to cardiac monitors.
“I’ve been coughing,” said Gabriel McAuley, 46, who has been working 16-hour days gutting homes and hauling debris in the Rockaways since the storm hit. “I’ve never felt a cough like that before. It’s deeper down.”
It is impossible to say how many people have been sickened by what Hurricane Sandy left behind: mold from damp drywall; spills from oil tanks; sewage from floodwater and unflushable toilets; tons upon tons of debris and dust. But interviews with hurricane victims, recovery workers, health officials and medical experts over the last week reveal that some of the illnesses that they feared would occur, based on the toxic substances unleashed by the storm and the experience of other disasters, notably Hurricane Katrina, have begun to manifest themselves.
Emergency rooms and poison control centers have reported cases of carbon monoxide exposure — and in New Jersey, several deaths have been attributed to it — from the misuse of generators to provide power and stoves to provide heat.
In Livingston, N.J., the Burn Center at St. Barnabas Medical Center had 16 burn cases over about six days, three times as many as usual, from people trying to dispel the cold and darkness with boiling water, gasoline, candles and lighter fluid.
Raw sewage spilled into homes in Baldwin and East Rockaway, in Nassau County, when a sewage plant shut down because of the surge and the system could not handle the backup. Sewage also spilled from a huge plant in Newark. “We tried to limit our presence in the house because the stink was horrible,” said Jennifer Ayres, 34, of Baldwin, who has been staying temporarily in West Hempstead. She said that she felt ill for several days, that her son had a scratchy throat, and that her mother, who lives in the house, had difficulty breathing, all problems she attributed to the two days they spent inside their house cleaning up last week. “I had stomach problems. I felt itchy beyond itchy on my face.”
Coughing — locally known as the Rockaway cough — is a common symptom that health officials said could come from mold, or from the haze of dust and sand kicked up by the storm and demolitions. The air in the Rockaways is so full of particles that the traffic police wear masks — though many recovery workers do not, worrying people who recall the fallout of another disaster.
“It’s just like 9/11,” said Kathy Smilardi, sitting inside the skeleton of her gutted home in Broad Channel, wrapped in a white puffy jacket, her breath visible in the afternoon cold. “Everyone runs in to clean up, and they’re not wearing masks. Are we going to wait 20 years to figure out that people are dying?”
Health officials and experts say the risks are real, but are cautioning against hysteria. Some coughing could be due to cold, damp weather. Lasting health effects from mold, dust and other environmental hazards generally require long-term, continuous exposure, they said. And the short-term effects can be mitigated by taking precautions like wearing masks, gloves and boots and removing mold-infested wallboard. “The reality is that cleaning up both muck and sewage and spills and removing walls and reconstruction and dealing with debris all do in fact pose concerns,” Daniel Kass, New York City’s deputy commissioner for environmental health, said Friday. “Are they vast or uncontrollable? No. But they depend on people doing work correctly and taking basic precautions.”
The Katrina cough was found to be temporary, said Roy J. Rando, a professor at Tulane’sSchool of Public Health and Tropical Medicine. Felicia Rabito, an epidemiologist at the school, said that healthy children exposed to mold after Hurricane Katrina showed no lasting respiratory symptoms when they moved back to new or renovated homes.
Immediately after Hurricane Katrina, lead levels in New Orleans’s soil dropped after the top layers of dirt, where lead from paint and gasoline can accumulate, were washed away. But in the two years afterward, soil testing found extremely high lead levels, Dr. Rabito said, which she theorized came from renovating old homes. “That’s a cautionary tale,” she said. Lead in soil can be tracked into homes and pose a health hazard to children playing inside or outside.
Though at least one outbreak of norovirus, a contagious gastrointestinal virus, occurred in a Brooklyn high school that was used as a shelter, New York and New Jersey health officials said they had not seen any significant spike in respiratory or gastrointestinal diseases related to the storm.
In Broad Channel, most homes on Noel Road, where Ms. Smilardi lives, have outdoor oil tanks that were overturned by the storm. The innards of many homes, built when asbestos was used, lie spilled among major and minor roads.
Ominous red spots covered both sides of Paul Nowinski’s burly torso. After the storm, Mr. Nowinski, a musician, waded into the basement of his childhood home on Beach 146th Street in the Rockaways to try to salvage records, books and instruments. He was up to his chest in water, which he thinks might have been contaminated with sewage. He said that he did not know the cause of the red marks; and that he had been too busy “schlepping” to go to the doctor.
Going into the third week after the storm, Long Beach, a few miles east of the Rockaways, looked and felt like an isolated frontier town. Every wood-frame bungalow, lining row upon row of beachfront streets, had a pile of debris in front of it — waterlogged furniture, wallboard, carpets, insulation.
“The whole city has gutted homes at virtually the same time,” said Jack Schnirman, the city manager.
The federal Disaster Medical Assistance Team has seen more than 500 patients since Nov. 5 in three aluminum-reinforced tents pitched on the athletic field. It is now up to about 75 patients a day, double the usual number who visit the nearby emergency room at Long Beach Medical Center, which was closed by the storm, said the unit commander, William L. Devir.
About 10 percent of the patients have been children, often with respiratory problems, he said. The unit had to replenish its adult nebulizers. Florence Ondre, a performer, arrived with a sliced finger and sore back from cleaning her flooded house. She still had a flashlight strapped to her forehead. The mold had activated her allergies, she said, and she had lost weight since the storm. The medical team served hot soup to her and her fiancé.
“We’ve just been cleaning up, day in and day out, from dawn to dusk,” Ms. Ondre said. Her hazmat suit, ordered on Amazon, had just arrived.
David Liberman, 46, came in with chest and stomach pain. The team put him on a mesh cot in the field tent, administered a stress test, and promised to replenish his supply of insulin, which, Mr. Liberman said, had been thrown out by his frantic landlady as she cleaned her flooded basement.
Theo Kojak Soter came in with scratches and got a tetanus shot.
“Would you like a sucker?” asked Bobbi Gearhardt, a registered nurse, using a term for lollipop more likely to be heard in Casstown, Ohio, where she is from, than in New York.
“Thank God these people are here,” Mr. Soter, 57, said. His hot-rod shop in Oceanside had been flooded, he said, and he lost 12 cars. “My 401(k),” he said. He left holding the lollipop like a lifeline.

and....

http://www.wasterecyclingnews.com/article/20121113/NEWS01/121119976/long-road-ahead-for-hurricane-sandy-cleanup

Long road ahead for Hurricane Sandy cleanup


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Courtesy, DiMola Brothers Inc.Destruction caused by Hurricane Sandy will keep trash companies busy for weeks and probably months.

Waste companies now face weeks, and probably months, of difficult collection and disposal work dealing with a massive amount of debris created by Hurricane Sandy.
And just as that work was kicking into a higher gear last week, reports out of the New York City area showed that pushing the waste through the transfer and disposal system was becoming more of a challenge.
Transfer stations are the lifeblood for disposal of New York City-area waste, which has limited disposal options.
But lines were reportedly getting longer and longer at sites for solid waste management companies looking to tip their debris and get back to work.
Crews at DiMola Brothers Inc. were among those facing longer lines to dump the waste they are collecting in the Howard Beach section of Queens last week. And that's not all.
DiMola Brothers workers are so busy that they don't even have time to give people estimates for cleanup from the hurricane, let alone take on near the amount of work that's available.
Owner Nick DiMola described fairly primitive conditions with three crews working to demolish and haul away debris from flooded homes in areas still without electricity. Without access to enough fuel to operate generators, workers are resorting to using flashlights to do their work.
"We're ripping out everything down to the concrete. I've got three crews working," he said. "People are begging us to do [work]."
Home after home after home after home, DiMola said, had sustained basement and first-floor flooding in the community.
DiMola Brothers workers have to battle not only darkness in homes but also water that remains from the flooding. "It's a mess. You're working in a dark area. … All day, you're working with wet clothes, and it's starting to get cold," the owner said.

"It's very hard to do business right now, but there's plenty of work out there," he said.
Progressive Waste Solutions Ltd., one of the larger waste companies in the New York City area, is bringing in equipment and manpower from out-of-state to help, said Thomas L. Brown, chief operating officer for the company's U.S. operations.
Progressive Waste operates under the IESI brand in Greater New York City and is running its regional headquarters out of a hotel in Lyndhurst, N.J., due to flooding. The company's headquarters building across the street from the hotel sustained first-floor flooding. The company's operations were spared damage because they are located on the second floor, Brown said. But damage to the building's fire suppression system was keeping tenants out last week.
"The biggest issues seem to be power issues and fuel issues," Brown said. "People are getting to work, for the most part, and we're running trucks, for the most part."
IESI is bringing in manpower, trucks and containers from Baltimore, Florida and Louisiana to help deal with the waste.
"Each day, as people get their power back on and are going back to their homes and assessing damage, the problems just keep getting bigger and bigger," Brown said. "The requests for service are coming in pretty hot and heavy."
Because of a lack of hotel space in the New York City area, Progressive Waste is setting up living quarters at local offices, including cots, showers and food for out-of-state workers.
The company's recycling facility in Jersey City, N.J., sustained flooding damage, but the company was able to move trucks normally parked there ahead of the storm.
"I think it's going to be a while before that material has been collected and processed," said David Biderman, general counsel and safety director for the National Solid Wastes Management Association, a trade group representing private trash companies. "Whether that is a matter of weeks, or months, is unclear right now. This is going to take some time."
Biderman pointed to electricity outages and fuel shortages as two problems haulers are facing. "We've got incredible obstacles created by Sandy. And now, as the debris is starting to be collected, transfer stations are filling up quickly," Biderman said.

Even in the best of conditions, moving waste off of Long Island can be a challenge, Brown said, and Sandy's aftermath is making that job even more difficult.
DiMola, whose company has specialized equipment dedicated to demolition and debris removal, said there are plenty of freelancers out on the street who have rented moving trucks and are picking up some of the work.
"Everybody is trying to earn money because there's that much work," he said.
Complicating matters are flooded and disable vehicles that were blocking easy access to homes that need to be cleaned out, DiMola said. That means crews have to sometimes haul the debris by hand for greater distances.
"Let's put it this way, just between the amount of phone calls and the amount of work to be done, I'll be working nonstop 'til the end of December – guaranteed," DiMola said.
It's a workload that Brown said will get heavier before it subsides.
"As people start getting power back, the real work begins, because then they've got to go in and figure out what to throw away," he said.