Dealing with Debris and Damaged Buildings

emergency-disaster-clean-upDisaster debris planning – Sometimes local governments must respond to disasters that destroy large numbers of homes or buildings. They may need to demolish partially destroyed homes and manage disaster debris. If your community does not have a disaster debris management plan, they may want to consider developing one. Cleanup activities related to returning to homes and businesses after a disaster can pose significant health and environmental challenges. People can be exposed to potentially life-threatening hazards from leaking natural gas lines, and carbon monoxide poisoning from using un-vented fuel-burning equipment indoors. During a flood cleanup, failure to remove contaminated materials and reduce moisture and humidity may present serious long-term health risks from micro-organisms, such as bacteria and mold.

General cautions when re-entering damaged homes and buildings

When citizens are authorized by local authorities to return to their homes and businesses, federal authorities urge people to take the following precautions :

Be on the alert for leaking containers and reactive household chemicals, such as caustic drain cleaners or chlorine bleach. Take the following necessary precautions to prevent injury or further damage:

  • Keep children and pets safe. Keep them away from flood water, wet or damaged materials, and leaking or spilled chemicals.
  • Avoid contact with flood water in and around homes. Assume flood water is contaminated with raw sewage or hazardous chemicals.
  • Do not combine chemicals from leaking or damaged containers as this may produce dangerous or violent reactions. Clean up and discard chemicals separately, even if you konw what they are.
  • Do not dump chemicals down drains, storm sewers, or toilets.
  • Do not try to burn household chemicals.
  • Clearly mark and set aside unbroken containers until they can be properly disposed of
  • Leave damaged or unlabeled chemical containers undisturbed whenever possible.
  • Do not turn on drinking water or well water pumps (risk of electric shock) or use the septic system until you can have it inspected.

Use caution when disturbing building materials to prevent physical injury or other health effects. Building materials may contain hazardous materials such as asbestos that when carried by the air can be breathed in and cause adverse health effects. If you suspect asbestos-containing materials may be present, the materials should not be disturbed. Asbestos-containing materials can include the following:

  • boiler/pipe insulation
  • fireproofing
  • floor tiles
  • asbestos roofing
  • transite boards used in laboratory tabletops and in acoustics in auditoriums, music rooms and phone booths

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Contacts

Federal, state and local personnel are often deployed to affected areas to establish debris-management programs, including household hazardous waste collection and disposal programs. These efforts may take days or weeks to come to all communities. In the meantime, EPA urges the public to exercise caution and report concerns to local environmental, health and waste disposal authorities.

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Avoid carbon monoxide poisoning

Carbon monoxide (CO) is a colorless, odorless gas that is produced when any fuel is burned and that can kill you.

  • ALERT: Generator exhaust is toxic. Always put generators outside well away from doors, windows, crawlspaces, orand vents. Never use a generator inside homes, garages, crawl spaces, sheds, or similar areas. Carbon monoxide (CO) is deadly, can build up quickly, and linger for hours. More information about the dangers of carbon monoxide.
  • Never use fuel-burning devices in homes, garages, in any other confined space such as attics or crawl spaces, or within 10 ft. of windows, doors or other air intakes. For example:  gasoline-powered generators, gasoline-powered pressure washers, camp stoves and lanterns, or charcoal grills. Opening doors and windows or using fans will not prevent CO buildup in the home.
  • If you start to feel sick, dizzy, or weak while using a generator, get away to fresh air right away.
  • Listen: Public Service Announcement about carbon monoxide
  • en español: Proteja su vida y la de su familia: Evite el envenenamiento con monóxido de carbono (español) – conozca los síntomas del envenenamiento con monóxido de carbono. | Más: Tormentas de nieve y hielo

Read more: Carbon monoxide poisoning after a disaster, from CDC.gov

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Avoid problems from mold, bacteria, or insects

Standing water is a breeding ground for a wide range of micro-organisms and insects, such as mosquitoes. Mosquitoes can spread diseases such as West Nile Virus. Micro-organisms, including bacteria or mold, can become airborne and be inhaled. Where floodwater might be contaminated, infectious disease is of concern.

  • Remove standing water as quickly as possible.
  • Remove wet materials and discard those that cannot be thoroughly cleaned and dried, ideally within 48 hours.Virtually all building contents made of paper, cloth, wood, or other absorbent materials that have been wet for 48 hours or more may need to be discarded, as they will likely remain a source of mold growth.
  • Dry out the building. Completely drying out a building that has been immersed in contaminated flood waters will take time and may require the extensive removal of ceiling, wall, insulation, flooring and other materials as well as, in some cases, extensive disinfection. The growth of micro-organisms will continue as long as materials remain wet and humidity is high.
  • Reduce your exposure to air and water contaminants. Limit contact with flood water, including touching, wading, or inhaling water vapors. Wear protective clothing if necessary.

More about mold safety, cleanup, and health.

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Avoid problems from the use of cleaners, disinfectants, and pesticides

Disinfectants, sanitizers, and other pesticides can contain toxic and potentially hazardous substances.

  • Read and follow all label instructions carefully.
  • Do not mix cleaners and disinfectants or use them together. Combinations of some types of substances can be deadly.
  • Keep all household products locked, out of sight, and out of reach of children.
  • Call the Poison Control Center at 800-222-1222 immediately in cast of poisoning.

Read more: Steps to reduce exposure to volatile chemicals.

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Avoid problems from airborne asbestos and lead dust

Elevated concentrations of airborne asbestos can occur if asbestos-containing materials present in many older homes are disturbed. Pipe or other insulation, ceiling tiles, exterior siding, roof shingles and sprayed on-soundproofing are just some of the materials found in older buildings that may contain asbestos. Buildings constructed before 1970 are more likely to contain asbestos. Airborne asbestos can cause lung cancer and mesothelioma, a cancer of the chest and abdominal linings.

Lead is a highly toxic metal which produces a range of adverse health effects, particularly in young children. Many homes built before 1978 may contain lead-based paint. Disturbance or removal of materials containing lead-based paint may result in elevated concentrations of lead dust in the air.

If you know or suspect that your home contains asbestos or lead-based paint and any of these materials have been damaged or will otherwise be disturbed during cleanup, seek the assistance of public health authorities and try to obtain help from specially trained contractors, if available.

Individuals and homeowners

Business, facilities, or communities

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Properly dispose of waste

Use caution to assure that all waste materials are removed and disposed of properly. Open burning of materials by individuals should be avoided, and may be illegal in your area. Improperly controlled burning of materials not only represents significant fire hazards but can also produce additional hazards from the vapors, smoke, and residue that are produced from the burning.

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Guidance for Structurally Unsound Buildings

Introduction

EPA’s guidance has been requested on the demolition of structurally unsound buildings . Various federal regulations apply to building demolition activities. Areas of primary federal concern include asbestos demolition requirements, the proper disposal of electrical equipment containing PCBs (i.e., distribution transformers and capacitors) and storage tanks. EPA recognizes the difficult circumstances faced in demolishing structurally unsound buildings may make full compliance difficult. However, in any event, you should take the actions set forth below to the extent feasible.

Efforts to restore the damaged areas to their pre-disaster condition often involve removing or repairing damaged structures. There may be a natural tendency at this stage to overlook certain hazards, such as asbestos, that are not immediately life threatening. However, such hazards are serious and may manifest themselves many years from the time of exposure and should be taken into consideration. Given the health hazards associated with asbestos, PCBs, lead, and other harmful substances, it is reasonable that adequate measures be taken during emergency situations to minimize exposure to such materials from the demolition of buildings.

The following guidelines are provided to help minimize the health, safety and environmental risks associated with the demolition of structurally unsound buildings (structures that remain standing but are in danger of imminent collapse). In the case of such buildings it would be unsafe to enter or inspect a structure to determine the amount, types, and location of building materials containing asbestos, PCBs, lead, or other harmful substances. This guidance does not apply to the demolition of hurricane damaged but structurally sound buildings.

To the extent feasible, efforts should be made to perform the following steps:

Underground Storage Tanks and Above Ground Storage Tanks

Releases of petroleum or hazardous substances from underground storage tanks (USTs) and above-ground storage tanks (ASTs) present significant health, safety and environmental concerns and thus should always be addressed with care. If, for example, gasoline pumps, pump station islands or vent pipes are present near a damaged building, or if an unknown tank or cylinder is discovered, halt all demolition activities, seal off the area and call the state environmental agency.

Asbestos

Federal asbestos regulations do not apply to the demolition of structurally unsound buildings by private individuals who contract directly with the demolition contractor for the demolition of a residential building they own having four or fewer units. However, EPA strongly recommends, for health reasons, that anyone conducting demolition activities follow this guidance.

Identifying Asbestos Containing Materials

  • Asbestos-containing products, which may be part of this debris, include: asbestos-cement corrugated sheet, asbestos-cement flat sheet, asbestos pipeline wrap, roofing felt, vinyl-asbestos floor tile, asbestos-cement shingle, millboard, asbestos-cement pipe, and vermiculite-attic insulation.
  • All structures (both residential and commercial) built before 1975 may contain significant amounts of asbestos. In particular large structures built before 1975 typically contain asbestos pipe wrap, siding, ceiling tiles, and other building materials high in asbestos content. Additionally, structures built after 1975 may also contain asbestos.

Notification and Expertise

  • Persons conducting demolitions should notify the appropriate state/local air quality management program as early as possible prior to the start of the demolition, but in any event, no later than the following workday after starting the demolition.
  • At least one person, either a government official or private contractor, trained in the asbestos NESHAP regulations should be on site or available by cell phone during the demolition to provide assistance and guidance.

Demolition

  • In all instances, workers should use equipment specifically designed to protect them from asbestos exposures during demolition and handling of debris, especially respirators, as required under OSHA.
  • Heavy equipment that is used to demolish structures or that is run over debris from the hurricane will rupture the building materials and may cause asbestos to be released. Therefore, it is very important to wet the structure before demolition and keep the structure wet during demolition. Wetting the structure is crucial because it reduces the potential for air migration of asbestos.
  • EPA recommends knocking down each structure wall-by-wall, folding it in on itself to minimize excess breakage of asbestos containing material.
  • Keep the debris wetted and covered until it is possible to consult with the asbestos trained person to segregate out asbestos containing material to the extent feasible. If asbestos is known to be present but can not be safely segregated, dispose of all the debris as if it is asbestos containing materials as discussed below.

Removal of Asbestos-Containing Material

  • After you have collapsed the structure, if feasible, place the asbestos containing material into leak proof wrapping. If the volume of the material precludes use of leak proof wrapping, continue to wet the asbestos containing material and use heavy lifting equipment to place the asbestos containing material into waiting dump trucks. Whenever possible, use a plastic liner in the bottom of the bed of the dump truck to minimize the leakage of contaminated water from the dump truck. If the asbestos containing material has been further broken up during the loading process, wet it down again after you load it into the dump truck.
  • Cover the dump truck with a tarp, sealing it so that debris and dust can not be released during transport.
  • Placard (with a large sign) the dump trucks as they are being loaded and unloaded with asbestos-containing building materials. The placard should read:
“Warning: Asbestos Hazard. Stay Away”

Disposal of Asbestos Containing Material

  • Truck the debris to a landfill allowed to receive asbestos. Contact state authorities for a list of asbestos approved landfills.
  • Maintain your waste shipment records.

Polychlorinated Biphenyls (PCBs)

The original guidance for PCBs has been superseded by “Guidance for Addressing Spills from Electrical Equipment“.

Other Hazardous Materials

If other hazardous or unknown materials, such as lead, non-liquid PCBs, solvents, pesticides, herbicides, varnishes, pool chemicals, industrial grade cleaning solutions, etc., are discovered during demolition, please immediately contact the state environmental agency for further guidance on the management of that material.

Disposal of Construction Debris

Other debris created by the demolition of structurally unsound buildings that do not contain asbestos, PCBs, lead, and other harmful substances, should be disposed of in an appropriate landfill or burned pursuant to the Emergency Hurricane Debris Burning Guidance issued by EPA. These guidelines do not supersede emergency orders which may be issued.

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Guidance for Addressing Spills from Electrical Equipment

Introduction

(EPA is providing the following guidance for addressing spills from electrical equipment damaged by Hurricane Katrina or Hurricane Rita, but much of the information is still useful.)

Areas of primary federal concern include the proper disposal of electrical equipment containing PCBs (i.e., distribution transformers and capacitors). EPA recognizes that individuals, contractors or others involved in removing electrical equipment or utilities restoring electrical service face difficult circumstances that may impede full compliance. However, in any event, you should take the actions set forth below to the extent feasible.

Efforts to restore the damaged areas to their pre-disaster condition often involve removing or repairing damaged electrical equipment. There may be a natural tendency at this stage to overlook certain hazards, such as those associated with PCBs, that are not immediately life threatening. However, such hazards are serious and may manifest themselves many years from the time of exposure and should be taken into consideration. Given the health hazards associated with PCBs, adequate measures should be taken during emergency situations to minimize exposure.

To the extent feasible, efforts should be made to perform the following steps:

Identifying Downed Electrical Equipment Which May Contain PCBs

Caution! Downed electrical equipment including transformers may still be energized which could cause injury. De-energized capacitors and batteries may still contain a charge.

Downed electrical equipment may contain PCBs

  • Generally, transformers that were mounted on utility poles are liquid filled and some may contain PCBs.
  • In the absence of identifying information, it is best to assume a transformer may contain PCBs. To screen transformers for the presence of PCBs, you can use a field screening test kit. A positive test indicates the potential presence of PCBs. A negative test indicates no presence of PCBs.
  • The location of the downed equipment should be identified using e.g., GPS, some kind of visual marker along with a log book with descriptive locations, etc., because this will help you address future clean-up of any spill associated with the downed equipment.

Handling the Electrical Equipment

  • If the electrical equipment is intact, it can be stored for reuse, preferably in a clean, dry area.
  • If the electrical equipment has a small leak that can be controlled so that no additional liquid leaks from the unit, it can be stored for repair and reuse after controlling the leak, preferably in a clean, dry area.
  • Intact electrical equipment and equipment that has small leaks that have been controlled can then be shipped without a manifest to a repair facility for evaluation and repair.
  • If the electrical equipment has significant leaks, any remaining liquid should be drained into a non-leaking container. If the field screening test kit indicates the liquid contains PCBs, the container should be labeled with the PCB M L as containing PCB liquids, and ultimately sent to a chemical or hazardous waste incinerator for disposal. The drained electrical equipment carcass should be disposed properly.

If containers with drained liquids must be stored temporarily, they should be placed on hard surface areas, such as a concrete or asphalt parking lot for no more than 90 days.

  • If the leaking electrical equipment cannot be drained, the electrical equipment should be placed in shipping containers, or covered roll-offs with a poly liner or sorbent material to prevent further spread of the spill, intermodal containers with a poly liner or sorbent material to prevent further spread of the spill, or other weather-tight containers.

If these containers must be stored temporarily, they should be placed on hard surface areas, such as a concrete or asphalt parking lot, for no more than 9 0 days

  • Electrical equipment from parties unable to manage their equipment may be consolidated at electrical utility-owned locations or other temporary storage or staging areas.

Handling the Spill

  • Where possible, temporary measures should be implemented to prevent, treat, or contain further releases or mitigate migration to the environment of PCBs.
  • Where possible, the location of the spill should be identified to determine if it correlates with downed equipment. Where possible, the boundaries of the spill area should be identified with paint or flags to facilitate future clean-up. Generally, after the equipment has been sent to the repair facility, the presence and concentration of PCBs in the equipment is determined. This information can be used to address the spill. If the PCB concentration in the equipment was greater than 50 ppm, you should clean-up the spill.
  • All soil with visible traces of the spill should be excavated and placed in weather-tight containers, such as a covered and lined roll-off or intermodal container.

If these containers must be stored temporarily, they should be placed on hard surface areas, such as a concrete or an asphalt parking lot for no more than 90 days.

  • The excavated material should be disposed in a TSCA or hazardous waste landfill.
  • If the spill is the result of an empty or leaking piece of equipment which has not been tested, some testing of the soil may be necessary to identify if PCBs are present. If PCBs are present in the excavated material, the waste should be sent to a TSCA or hazardous waste landfill.

For further information, please contact the EPA Regional PCB Coordinator for your area.

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Emergency Hurricane Debris Burning Guidance

EPA’s guidance has been requested on the collection and disposal of debris, including vegetative, structural, and mixed debris. Various federal regulations may apply to portions of such debris, although some federal regulations such as the asbestos demolition NESHAP do not apply to debris from structures already demolished by natural disasters (as opposed to human demolition). We recognize that the extraordinary circumstances you face in removing the debris may make full compliance difficult. However, you should take the actions set forth below to the extent feasible.

The following guidelines are provided to help minimize the health, safety and environmental risks associated with burning hurricane debris.

Good faith efforts should be made to segregate wastes prior to burning. Insofar as conditions allow, segregate the following types of materials and stage them for subsequent appropriate disposal:

  • automotive/marine batteries;
  • pesticide cans;
  • explosives;
  • automotive oils;
  • fuels and fluids;
  • solvents;
  • paint thinners and stripper;
  • compressed gas containers;
  • household white goods (refrigerators, washer/dryers and stoves);
  • asbestos containing materials (asbestos shingles, siding and insulation);
  • PCBs (electrical equipment such as distribution transformers and capacitors);
  • electronics (televisions, radios, stereos, cameras, VCRs, computers, microwaves);
  • tires;
  • shingles;
  • domestic garbage; and
  • preserved woods.

Burning should be conducted by or under the supervision of trained local, state or federal officials or their designees at specifically designated sites in those counties designated as disaster areas. Burning must be done in accordance with all local, state and federal emergency orders. Emergency officials should be notified of the location of burn sites in advance. Regarding location and operation of the burn sites, where feasible:

  • Piles to be burned should be at least 1000 feet from the nearest residence or roadway.
  • Piles should be separated by at least 1000 feet and not be more than 45X45 feet in size.
  • Prevailing winds should be monitored, and burning conducted so that smoke does not create a traffic hazard on roadways or impact nearby citizens.
  • Protective clothing (dust masks or respirators, safety glasses, etc.) should be worn, if available.

Initiative should be taken to keep the local public informed. These guidelines do not supersede emergency orders which may be issued.

Disaster Preparedness and Response

Always call 911 if you are in immediate danger and need emergency help.

debris-disaster

This page lists general information for homeowners, communities, schools, and facilities, that can apply to many different disaster situations. Much of this information is repeated on pages about specific types of natural events or disasters. More about how EPA responds to natural disasters.

On this page:

General:

Individuals, Homeowners:

Communities, Schools, Facilities:


General:

What You Can Do

Planning – Preparing for natural disasters can greatly reduce the risks to health and the environment. Hurricanes or floods can contaminate drinking water sources. Forest fires or volcanoes harm air quality. Tornadoes or earthquakes, by damaging factories or storage facilities, can release contaminants where people live or into the environment.

  • Individuals and homeowners can plan ahead to protect health for themselves and family members.
  • Communities, schools, and businesses can plan ahead to reduce risks and possible costs of storm-related spills or cleanup.
  • Learn about making an emergency plan, from Ready.gov

Recovery – Understanding risks will help speed recovery efforts and help keep problems from becoming worse. Improper use of portable generators or heating devices can release deadly carbon monoxide to indoor air. Ice-melting agents used improperly can pollute waterways. Large amounts of debris can present serious disposal problems for state and local communities. Owners or operators of damaged facilities may be responsible for reporting spills.

  • Individuals and homeowners can learn more about what, and what not, to do to protect health of themselves and family.
  • Communities, schools, and businesses can learn more about address large-scale risks and be aware of any legal requirements they may have under applicable regulations.

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Report suspected spills, contamination, or possible violations.

  • To report oil, chemical, or hazardous substance spills, call the National Response Center 800-424-8802.
  • Report a suspected environmental violation online. When you don’t have Internet access, call the US EPA office for your state.
  • For pesticide poisoning, call 911 if the person is unconscious, has trouble breathing, or has convulsions. Otherwise, call Poison Control at 1-800-222-1222.

Generator Safety

People get sick or die each year from carbon monoxide or “CO” poisoning due to unsafe use of generators.

Learn about government emergency messages before you need them:

  • FEMA Wireless Emergency Alerts – FEMA works with US cell phone carriers to send free emergency texts to cell phones (that can get text messages) within range. You don’t have to sign up to receive the messages.
  • Emergency Alert System – is a public warning system that uses existing TV, radio, cable, and other systems to send critical messages to the general public. Messages are local or national, depending on the situation.
  • NOAA Weather Radio – is a nationwide network of radio stations broadcasting continuous weather information directly from the nearest National Weather Service office. NWR broadcasts official Weather Service warnings, watches, forecasts and other hazard information 24 hours a day, 7 days a week.

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Individuals, Homeowners:

Returning home: Dealing with Debris and Damaged Buildings

Drinking water recovery

Home wastewater

  • What do I do with my home septic system after a flood? Do not drink your well wateruntil it is tested and safe. Do not use (flush) the sewage system until water in the soil absorption field is lower than the water level around the house. If you have a small business and your septic system has received chemicals, take extra precautions to prevent contact with water or inhaling fumes. Proper clean-up depends on the kinds of chemicals in the wastewater.

Limit contact with flood water

Flood water may have high levels of raw sewage or other hazardous substances. Early symptoms from exposure to contaminated flood water may include upset stomach, intestinal problems, headache and other flu-like discomfort. Anyone experiencing these and any other problems should immediately seek medical attention.

Mold

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Communities, Schools, Facilities:

Facility wastewater – Communities or facilities

Disaster debris

Communities should plan ahead to handle exceptionally large amounts of disaster debris from damaged or destroyed buildings, supplies, trees or other green waste, carcasses, or other materials. Disposal problems can result from large amounts of debris but also from hazardous or toxic substances in the debris that can contaminate air, water, land, and food if not handled properly. Burning large amounts of debris to reduce volume may not be an option. More information on disaster debris.

Hazardous waste and homeland security

Pesticides, chemical and oil spills, hazardous waste

  • Call the National Response Center 800-424-8802 (24 hours a day every day). For those without 800 access, please call 202-267-2675.
  • Industries and businesses that encounter spills or discharges in the aftermath should contact the National Response Center immediately. You or your organization may have legal requirements for reporting or for taking other actions, depending on the spill.
  • National Pesticide Information Center: 1-800-858-7378. Pesticide contacts
  • Report spills or environmental violations

Renovation and rebuilding

Lead-safe work: By law, contractors need to use lead-safe work practices on emergency renovations on homes or buildings built before 1978. Activities such as sanding, cutting, and demolition can create lead-based paint hazards. Lead-contaminated dust is harmful to adults, particularly pregnant women, and children.

Asbestos: Anyone working on demolition, removal, and cleanup of building debris needs be aware of any asbestos and to handle asbestos materials properly. People exposed to asbestos dust can develop serious lung health problems including asbestosis, lung cancer and mesothelioma. Although the use of asbestos has dramatically decreased in recent years, it is still found in many residential and commercial buildings and can pose a serious health risk.

Underground Storage Tanks

During a flood, underground storage tank (UST) systems may become displaced or damaged and release their
contents into the environment, causing soil, surface water, and groundwater contamination.

Fuel Waivers

EPA works with the Department of Energy to address fuel supply disruptions caused by disasters or emergencies, by issuing fuel waivers for certain fuel standards, in affected areas.

Emergency Preparedness and Response

Chemical Emergency Overview

chemical-emergency-prepareThe CDC has a key role in protecting the public’s health in an emergency involving the release of a chemical that could harm people’s health. This page provides information to help people be prepared to protect themselves during and after such an event.

What chemical emergencies are

A chemical emergency occurs when a hazardous chemical has been released and the release has the potential for harming people’s health. Chemical releases can be unintentional, as in the case of an industrial accident, or intentional, as in the case of a terrorist attack.

Where hazardous chemicals come from

Some chemicals that are hazardous have been developed by military organizations for use in warfare. Examples are nerve agents such as sarin and VX, mustards such as sulfur mustards and nitrogen mustards, and choking agents such as phosgene. It might be possible for terrorists to get these chemical warfare agents and use them to harm people.chemical-emergency-warfare-biological-weapons

Many hazardous chemicals are used in industry (for example, chlorine, ammonia, and benzene). Others are found in nature (for example, poisonous plants).

Some could be made from everyday items such as household cleaners. These types of hazardous chemicals also could be obtained and used to harm people, or they could be accidentally released.

Types and categories of hazardous chemicals

Scientists often categorize hazardous chemicals by the type of chemical or by the effects a chemical would have on people exposed to it. The categories/types used by the Centers for Disease Control and Prevention are as follows:

  • Biotoxins—poisons that come from plants or animals
  • Blister agents/vesicants—chemicals that severely blister the eyes, respiratory tract, and skin on contact
  • Blood agents—poisons that affect the body by being absorbed into the blood
  • Caustics (acids)—chemicals that burn or corrode people’s skin, eyes, and mucus membranes (lining of the nose, mouth, throat, and lungs) on contact
  • Choking/lung/pulmonary agents—chemicals that cause severe irritation or swelling of the respiratory tract (lining of the nose and throat, lungs)
  • Incapacitating agents—drugs that make people unable to think clearly or that cause an altered state of consciousness (possibly unconsciousness)
  • Long-acting anticoagulants—poisons that prevent blood from clotting properly, which can lead to uncontrolled bleeding
  • Metals—agents that consist of metallic poisons
  • Nerve agents—highly poisonous chemicals that work by preventing the nervous system from working properly
  • Organic solvents—agents that damage the tissues of living things by dissolving fats and oils
  • Riot control agents/tear gas—highly irritating agents normally used by law enforcement for crowd control or by individuals for protection (for example, mace)
  • Toxic alcohols—poisonous alcohols that can damage the heart, kidneys, and nervous system
  • Vomiting agents—chemicals that cause nausea and vomiting

Hazardous chemicals by name (A-Z list)

If you know the name of a chemical but aren’t sure what category it would be in, you can look for the chemical by name on the A–Z List of Chemical Agents.

Protecting yourself if you don’t know what the chemical is

You could protect yourself during a chemical emergency, even if you didn’t know yet what chemical had been released. For general information on protecting yourself, read this Web site’s fact sheets on evacuation, sheltering in place, and personal cleaning and disposal of contaminated clothing.

Basic information on chemical emergencies

Basic chemical emergency information designed for the public can be found in the general and chemical-specific fact sheets and in the toxicology FAQs on this Web site.

In-depth information on chemical emergencies

Chemical emergency information designed for groups such as first responders, clinicians, laboratorians, and public health practitioners can be found in the case definitions, toxic syndrome descriptions, toxicological profiles, medical management guidelines, emergency response cards, First Responders page, and Laboratory Information page.

For more information…

For more information about chemical emergencies, you can visit the following websites:

Guide For Crime Scene Biological And Infectious Hazard Clean Up

biohazard-clean-up-remediationProfessional cleaners that deal with trauma clean-up can better market their services by advertising their full compliance with guidelines laid out in the Reference Guide for Trauma and Crime Scene Biological and Infectious Hazard Clean Up. This standard, which can be purchased from the IICRC website, outlines procedures for removing any disease-causing agents that escape into the environment when an individual dies or suffers severe injury.  It also enumerates the many health effects caused by biohazards, necessary equipment professionals require, and the safe transport and disposal of waste materials.


One of the more important points of focus addressed by the standard is that of material and building science
.  Any tissue or bodily fluid is classified as a biohazard per Federal regulations.  Whenever a violent crime occurs within a building, or when a body begins to decompose within its interior, the surrounding building materials become contaminated with a variety of toxic agents.  The Reference Guide for Trauma and Crime Scene Biological and Infectious Hazard Clean Up provides a number of detailed items that cover the removal of these toxins from building materials.  For example, blood stains on the carpet typically soak through the carpet and seep into the flooring beneath.  Effective environmental cleaning not only removes the biohazard from the carpet, but also from its supporting understructure.

Certain tools are required for biohazard removal.  Special equipment, such as protective gear, must also be worn by the removal personnel in order to protect them from the hazardous materials they are using.  It benefits any organization specializing in this type of work to follow the recommended equipment list found in the standard.  Tools that can be reused, along with equipment that is by nature disposable, is clearly defined.  Containers for various types of waste, along with chemicals that help sanitize the environment after cleaning is complete, are also covered in the standard.

The Reference Guide for Trauma and Crime Scene Biological and Infectious Hazard Clean Up also talks about the various health effects associated with different types of incidents.  Diseases such as the Flu, including Type A and H1N1, HIV/AIDS, Type A and B Hepatitis, TB, Cholera, and Salmonella are all diseases that can be transmitted from bodily fluids.  These fluids escape into the environment any time a body decomposes, whether a person commits suicide, is murdered, or suffers some type of tragic, accidental death.

Other aspects of the biohazard removal industry are also covered in the Reference Guide for Trauma and Crime Scene Biological and Infectious Hazard Clean Up.  General safety and health precautions are addressed in the standard.  Administrative procedures that pertain to the execution of various cleanup jobs are also enumerated.  Guidelines for inspection are covered, along with information on when and how to demolish structures that are simply too hazardous to remain standing.  Content removal, transportation, and disposal of contaminants are also covered in the material.

Professionals interested in purchasing the Reference Guide for Trauma and Crime Scene Biological and Infectious Hazard Clean Up can do so online at the IICRC website.  This site also contains information on continuing education, professional certification, and marketing materials that registrants and certified firms can use to solicit their services to their respective communities.

 

Written By: The Institute of Inspection, Cleaning and Restoration Certification (IICRC)

Back to main topic: Certifications & Brochures

Suicide survivors face grief, questions, challenges

Harvard Women's Health Watch

POSTED AUGUST 12, 2014, 1:21 PM , UPDATED OCTOBER 29, 2015, 8:26 PM – Harvard Women’s Health Watch

The death of Robin Williams, reportedly from depression-related suicide, can seem paradoxical. How can such a funny, lively, and successful person be depressed enough to end his life? Crushing sadness can hide behind humor.

Source: Suicide survivors face grief, questions, challenges

In the United States alone, nearly 40,000 people a year die by suicide. Each of these leaves behind an estimated six or more “suicide survivors” — people who’ve lost someone they care about deeply and are left grieving and struggling to understand.

The grief process is always difficult. But a loss through suicide is like no other, and grieving can be especially complex and traumatic. People coping with this kind of loss often need more support than others, but may get less. Why? Survivors may be reluctant to confide that the death was self-inflicted. And when others know the circumstances of the death, they may feel uncertain about how to offer help.

What makes suicide different

The death of a loved one is never easy to experience, whether it comes without warning or after a long struggle with illness. But several circumstances set death by suicide apart and make the process of bereavement more challenging. For example:

A traumatic aftermath. Death by suicide is sudden, sometimes violent, and usually unexpected. Depending on the situation, survivors may need to deal with the police or handle press inquiries. While still in shock, they may be asked if they want to visit the death scene. Sometimes officials discourage the visit as too upsetting; other times they encourage it. “Either may be the right decision for an individual. But it can add to the trauma if people feel that they don’t have a choice,” says Jack Jordan, Ph.D., clinical psychologist in Wellesley, MA and co-author of After Suicide Loss: Coping with Your Grief.

Recurring thoughts. A suicide survivor may have recurring thoughts of the death and its circumstances, replaying over and over the loved one’s final moments or their last encounter in an effort to understand — or simply because the thoughts won’t stop coming. Some suicide survivors develop post-traumatic stress disorder (PTSD), an anxiety disorder that can become chronic if not treated. In PTSD, the trauma is involuntarily re-lived in intrusive images that can create anxiety and a tendency to avoid anything that might trigger the memory.

Stigma, shame, and isolation. There’s a powerful stigma attached to mental illness (a factor in most suicides). Many religions specifically condemn the act as a sin, so survivors may understandably be reluctant to acknowledge or disclose the circumstances of such a death. Family differences over how to publicly discuss the death can make it difficult even for survivors who want to speak openly to feel comfortable doing so. The decision to keep the suicide a secret from outsiders, children, or selected relatives can lead to isolation, confusion, and shame that may last for years or even generations. In addition, if relatives blame one another — thinking perhaps that particular actions or a failure to act may have contributed to events — that can greatly undermine a family’s ability to provide mutual support.

Mixed emotions. After a homicide, survivors can direct their anger at the perpetrator. In a suicide, the victim is the perpetrator, so there is a bewildering clash of emotions. On one hand, a person who dies by suicide may appear to be a victim of mental illness or intolerable circumstances. On the other hand, the act may seem like an assault on, or rejection of, those left behind. So the feelings of anger, rejection, and abandonment that occur after many deaths are especially intense and difficult to sort out after a suicide.

Need for reason. “What if” questions can arise after any death. What if we’d gone to a doctor sooner? What if we hadn’t let her drive to the basketball game? After a suicide, these questions may be extreme and self-punishing — unrealistically condemning the survivor for failing to predict the death or to successfully intervene. In such circumstances, survivors tend to greatly overestimate their own contributing role — and their ability to affect the outcome.

“Suicide can shatter the things you take for granted about yourself, your relationships, and your world,” says Dr. Jordan. Some survivors conduct a psychological “autopsy,” finding out as much as they can about the circumstances and factors leading to the suicide. This can help develop a narrative that makes sense.

Sometimes a person with a disabling or terminal disease chooses suicide as a way of gaining control or hastening the end. When a suicide can be understood that way, survivors may feel relieved of much of their what-if guilt. “It doesn’t mean someone didn’t love their life,” says Holly Prigerson, Ph.D., professor of psychiatry at Harvard Medical School and Director of Psycho-Oncology Research, Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute.

Support from other survivors

Suicide survivors often find individual counseling (see “Getting professional help”) and suicide support groups to be particularly helpful. There are many general grief support groups, but those focused on suicide appear to be much more valuable.

“Some people also find it helpful to be in a group with a similar kinship relationship, so parents are talking to other parents. On the other hand, it can be helpful for parents to be in a group where they hear from people who have lost a sibling — they may learn more about what it’s like for their other children,” says Dr. Jordan.

Some support groups are facilitated by mental health professionals; others by laypersons. “If you go and feel comfortable and safe — [feel] that you can open up and won’t be judged — that’s more important than whether the group is led by a professional or a layperson,” says Dr. Prigerson. Lay leaders of support groups are often themselves suicide survivors; many are trained by the American Foundation for Suicide Prevention.

For those who don’t have access to a group or feel uncomfortable meeting in person, Internet support groups are a growing resource. In a study comparing parents who made use of the Internet and those who used in-person groups, the Web users liked the unlimited time and 24-hour availability of Internet support. Survivors who were depressed or felt stigmatized by the suicide were more likely to gain help from Internet support services.

You can join a support group at any time: soon after the death, when you feel ready to be social, or even long after the suicide if you feel you could use support, perhaps around a holiday or an anniversary of the death.

Getting professional help

Suicide survivors are more likely than other bereaved people to seek the help of a mental health professional. Look for a skilled therapist who is experienced in working with grief after suicide. The therapist can support you in many ways, including these:

  • helping you make sense of the death and better understand any psychiatric problems the deceased may have had
  • treating you, if you’re experiencing PTSD
  • exploring unfinished issues in your relationship with the deceased
  • aiding you in coping with divergent reactions among family members
  • offering support and understanding as you go through your unique grieving process.

A friend in need

Knowing what to say or how to help someone after a death is always difficult, but don’t let fear of saying or doing the wrong thing keep you from reaching out to a suicide survivor. Just as you might after any other death, express your concern, pitch in with practical tasks, and listen to whatever the person wants to tell you. Here are some special considerations:

Stay close. Families often feel stigmatized and cut off after a suicide. If you avoid contact because you don’t know what to say or do, family members may feel blamed and isolated. Ignore your doubts and make contact. Survivors learn to forgive awkward behaviors or clumsy statements, as long as your support and compassion are evident.

Avoid hollow reassurance. It’s not comforting to hear well-meant assurances that “things will get better” or “at least he’s no longer suffering.” Instead, the bereaved may feel that you don’t want to acknowledge or hear them express their pain and grief.

Don’t ask for an explanation. Survivors often feel as though they’re being grilled: Was there a note? Did you suspect anything? The survivor may be searching for answers, but your role for the foreseeable future is simply to be supportive and listen to what they have to say about the person, the death, and their feelings.

Remember his or her life. Suicide isn’t the most important thing about the person who died. Share memories and stories; use the person’s name (“Remember when Brian taught my daughter how to ride a two-wheeler?”). If suicide has come at the end of a long struggle with mental or physical illness, be aware that the family may want to recognize the ongoing illness as the true cause of death.

Acknowledge uncertainty. Survivors are not all alike. Even if you are a suicide survivor yourself, don’t assume that another person’s feelings and needs will be the same as yours. It’s fine to say you can’t imagine what this is like or how to help. Follow the survivor’s lead when broaching sensitive topics: “Would you like to talk about what happened?” (Ask only if you’re willing to listen to the details.) Even a survivor who doesn’t want to talk will appreciate that you asked.

Help with the practical things. Offer to run errands, provide rides to appointments, or watch over children. Ask if you can help with chores such as watering the garden, walking the dog, or putting away groceries. The survivor may want you to sit quietly, or perhaps pray, with him or her. Ask directly, “What can I do to help?”

Be there for the long haul. Dr. Jordan calls our culture’s standard approach to grief the “flu model”: grief is unpleasant but is relatively short-lived. After a stay at home, the bereaved person will jump back into life. Unfortunately, that means that once survivors are back at work and able to smile or socialize again, they quickly get the message that they shouldn’t talk about their continuing grief. Even if a survivor isn’t bringing up the subject, you can ask how she or he is coping with the death and be ready to listen (or respect a wish not to talk about it). Be patient and willing to hear the same stories or concerns repeatedly. Acknowledging emotional days such as a birthday or anniversary of the death — by calling or sending a card, for example — demonstrates your support and ongoing appreciation of the loss.

Helpful resources for suicide survivors are available at from the American Foundation for Suicide Prevention and the American Association of Suicidology.

(An earlier version of this article appeared in the July 2009 Harvard Women’s Health Watch.)

 

Viral Hepatitis

hepatitis

Young Persons Who Inject Prescription Opioids and Heroin

The recent explosive increase in the misuse of prescription opioids and heroin in this country has sparked growing public recognition and concern. And deservedly so. The hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the numerous health threats facing people who misuse opioids, particularly those who inject these drugs. These blood-borne viral infections have reached epidemic proportions in most states. Persons who become infected with HBV and HCV are at increased risk for other diseases transmitted through contact with blood, such as HIV.

How Viral Hepatitis is Spread Among Persons Who Inject Drugs

The hepatitis B and hepatitis C viruses are very infectious. People who have direct contact with surfaces, equipment, or objects contaminated with infected blood, even in amounts too small to see, can become infected. Hepatitis B can survive outside of the body for at least 1 week, and hepatitis C can survive on equipment and surfaces for up to 3 weeks.

People who inject drugs can get hepatitis B or hepatitis C from:

  • Sharing needles or reusing needles and syringes
  • Sharing drug preparation equipment such as cookers, cottons, water, ties, and alcohol swabs
  • Reusing personal-care items (e.g., razors, nail clippers, and toothbrushes) from someone infected with HBV or HCV
  • Sexual contact (particularly for HBV infection)

Hepatitis C Among Persons Who Inject Drugs (PWID)

Cases of HCV have been increasing for several years among PWID. The Centers for Disease Control and Prevention (CDC) has investigated and reported outbreaks and alarming increases in disease trends in collaboration with state and local health departments.

  • In 2011, the Massachusetts Department of Health and CDC investigated an epidemic of HCV among adolescents and young adults who were primarily injecting prescription opioids and heroin. In this outbreak, HCV was transmitted through sharing of drug-injection equipment. A report was published in the Morbidity and Mortality Weekly Report (MMWR) describing the HCV epidemic.  The investigation of these cases revealed that HCV was spread from sharing equipment to inject drugs, and that HCV infected persons were mostly injecting prescription opioids or heroin.
  • In 2012, an investigation by the Wisconsin Division of Public Health and CDC attributed rising numbers of HCV infections in the state to increasing use of injected prescription opioid drugs and heroin. CDC found that these infections were caused by different strains of the virus, suggesting the patients were infected through separate, unrelated networks of HCV transmission and that additional cases likely remained undetected.
  • In 2014, the national analysis of HCV surveillance data from 2006-2012 revealed an emerging epidemic of HCV infection, primarily among young persons living in small towns and rural areas. Indeed the number of new HCV infections was found to be rising in at least 30 states, with largest increases in nonurban counties east of the Mississippi River, particularly in Appalachian states.
  • In 2014, a CDC analysis of surveillance data revealed that approximately 30,000 new cases of hepatitis C (referred to as “acute” cases) occurred in 2013, representing a nationwide increase of more than 150% from 2010 to 2013; 28 states reported increases.
  • In 2015, HIV spread quickly among PWID in Scott County, Indiana; almost all persons who became infected with HIV had first been infected with HCV. This outbreak was unique, in that networks of HCV transmission within the community were identified using Global Hepatitis Outbreak and Surveillance Technology (GHOST), technology that enables identification of viruses with similar genetic make-up.
  • In 2015, CDC released a report on the increase in new cases of hepatitis C infection in the Appalachian region associated with injection drug use, often among people who first began drug use with prescription opioids. The article, Increases In Hepatitis C Virus Infection Related To Injection Drug Use Among Persons Aged <30 years, reported an estimated 364% increase in new hepatitis C infections during 2006-2012 among persons aged ≤30 years in four Appalachian states (i.e., Kentucky, Tennessee, Virginia, and West Virginia).

Hepatitis B Among PWID

  • According to CDC estimates, approximately 20,000 new cases of hepatitis B occurred in 2013, representing the first increase in acute cases of hepatitis B since 1990.
  • In 2016, CDC released a report on the increases in new cases of hepatitis B in the Appalachian region.  The report, Increases in Acute Hepatitis B Virus Infections — Kentucky, Tennessee, and West Virginia, 2006–2013, describes a 114% increase in acute hepatitis B from 2006-2013 in three states — Kentucky, Tennessee, and West Virginia; increases primarily occurred after 2009.

Highlights of CDC’s Response to the Epidemic of Viral Hepatitis Associated with Opioid Injection

CDC’s Division of Viral Hepatitis (DVH) is providing the programmatic foundation and leadership for the prevention and control of HBV and HCV infections among PWID. DVH works to improve hepatitis B and hepatitis C prevention by identifying communities at high risk for these infections and increasing testing and linkage to care among persons who inject drugs. Specifically, DVH

  • funds hepatitis coordinators in 48 states and 4 cities who direct local prevention efforts to best meet the needs  of each community;
  • helps communities assess their risks for HBV and HCV transmission, investigate the spread of infection, and prepare a public health response to stop transmission;
  • improves public health surveillance and other sources of critical information to help communities better detect HBV and HCV infected persons and guide delivery of prevention services;
  • studies patterns of HCV transmission, investigates behaviors that increase risk for HCV, and  identifies prevention services (e.g., testing, care, and treatment) that are most effective in stopping disease transmission;
  • trains state/local public health staff in how to guide the delivery of HCV and HBV prevention services in their communities;
  • collaborates with partners to provide technical assistance to prevention programs to identify practices that are most likely to lead to the detection, care, and treatment of viral hepatitis in PWID; and
  • uses a web-based system known as Global Hepatitis Outbreak and Surveillance Technology (GHOST) to improve investigation of HCV infection at the community level.  GHOST allows investigators to determine whether patients are infected with the same strain of HCV, helping uncover patterns and networks of transmission. CDC plans to apply this modern molecular surveillance tool in a growing number of states through a web-based platform that will facilitate effective collaboration and communication across the public health system.

CDC is Committed to Preventing Viral Hepatitis Among PWID

CDC’s DVH recognizes that only through improved prevention (e.g., vaccination, testing, and linkage to viral hepatitis care and treatment) can liver-related morbidity and mortality be prevented in the United States and that PWID are in urgent need for improved access to these services. Although hepatitis B vaccination is over 90% effective in preventing HBV infection, many adults with risks (including PWID) have not been vaccinated. A combination of syringe services programs and drug treatment can reduce transmission of HCV by more than 80% among PWID. The U.S. Department of Health and Human Services (HHS) has released new guidance[PDF – 22 pages] for state, local, tribal, and territorial health departments that will allow them to request to use federal funds to support syringe services programs. CDC models show that the addition of HCV testing and treatment can increase prevention effectiveness even further.

DVH works closely with CDC colleagues in the Division of HIV/AIDS and the Division of Injury Prevention. Partners outside of CDC include the National Institute on Drug Abuse, state and local health departments, and a variety of non-governmental organizations. Partnerships are essential in marshaling the resources to stop transmission of HBV, HCV, and HIV, and the increases in injection drug use.

Additional CDC Resources:

Stay Informed

  • @cdchep  has the latest information on viral hepatitis.
  • Email updates are available from CDC’s Division of Viral Hepatitis.

Suicide in America

U.S. Department of Health and Human Services
National Institutes of Health – NIH Publication No. TR 14-6389

barn-lonely-suicideSuicide does not discriminate. People of all genders, ages, and ethnicities can be at risk for suicide. But people most at risk tend to share certain characteristics. The main risk factors for suicide are:

  • Depression, other mental disorders, or substance abuse disorder
  • A prior suicide attempt
  • Family history of a mental disorder or substance abuse
  • Family history of suicide
  • Family violence, including physical or sexual abuse
  • Having guns or other firearms in the home
  • Incarceration, being in prison or jail
  • Being exposed to others’ suicidal behavior, such as that of family members, peers, or media figures.

The risk for suicidal behavior is complex. Research suggests that people who attempt suicide differ from others in many aspects of how they think, react to events, and make decisions. There are differences in aspects of memory, attention, planning, and emotion, for example. These differences often occur along with disorders like depression, substance use, anxiety, and psychosis. Sometimes suicidal behavior is triggered by events such as personal loss or violence. In order to be able to detect those at risk and prevent suicide, it is crucial that we understand the role of both long-term factors—such as experiences in childhood—and more immediate factors like mental health and recent life events. Researchers are also looking at how genes can either increase risk or make someone more resilient to loss and hardships.

Many people have some of these risk factors but do not attempt suicide. Suicide is not a normal response to stress. It is, however, a sign of extreme distress, not a harmless bid for attention.

What about gender?

Men are more likely to die by suicide than women, but women are more likely to attempt suicide. Men are more likely to use deadlier methods, such as firearms or suffocation.Women are more likely than men to attempt suicide by poisoning.

What about children?

Children and young people are at risk for suicide. Suicide is the second leading cause of death for young people ages 15 to 34.

What about older adults?

Older adults are at risk for suicide, too.While older adults were the demographic group with the highest suicide rates for decades, suicide rates for middle-aged adults has increased to comparable levels (ages 24–62). Among those age 65+, white males comprise over 80 percent of all late-life suicides.

What about different ethnic groups?

Among ethnicities, American Indians and Alaska Natives (AI/AN) tend to have the highest rate of suicides, followed by non-Hispanic Whites. Hispanics, African Americans, and Asian/Pacific Islanders each have suicide rates that are about half their White and AI/AN counterparts.

How can suicide be prevented?

Effective suicide prevention is based on sound research. Programs that work take into account people’s risk factors and promote interventions that are appropriate to specific groups of people. For example, research has shown that mental and substance abuse disorders are risk factors for suicide. Therefore, many programs focus on treating these disorders in addition to addressing suicide risk specifically.

Psychotherapy, or “talk therapy,” can effectively reduce suicide risk. One type is called cognitive behavioral therapy (CBT). CBT can help people learn new ways of dealing with stressful experiences by training them to consider alternative actions when thoughts of suicide arise.

Another type of psychotherapy called dialectical behavior therapy (DBT) has been shown to reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self- image, and behavior. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.

Medications may also help; promising medications and psychosocial treatments for suicidal people are being tested.

Still other research has found that many older adults and women who die by suicide saw their primary care providers in the year before death. Training doctors to recognize signs that a person may be considering suicide may help prevent even more suicides.

What should I do if someone I know is considering suicide?

If you know someone who is considering suicide, do not leave him or her alone. Try to get your loved one to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Remove any access he or she may have to firearms or other potential tools for suicide, including medications.

If you are in crisis

Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

For more information on Suicide in America

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 6200, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or
1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free
E-mail: nimhinfo@nih.gov
Website: www.nimh.nih.gov

U.S. Department of Health and Human Services
National Institutes of Health
NIH Publication No. TR 14-6389

* For the most up-to-date statistics on suicide, visit the website of the Centers for Disease Control and Prevention, http://www.cdc.gov/