DO NOT EXPOSE SKIN

We work in a water world and its rift with hazards and dangers. Many of these are obvious, from predators to inclement weather and dangerous water conditions. We cannot protect ourselves from everything that is possible or probable, otherwise nobody would ever enter the water, yet we go to help others and assume that risk.

Our skin becomes soft and easy to chafe from friction on the seat or re-boarding, with the physical load of being a Rescue Water Craft Coxswain or crew member we require full protection for personal safety. It's really a 'no brainer'. Cover up so you can reduce the risk of abrasion or lacerations.

We need to know what we are dealing with and understand the things we can do to mitigate the risk measures that are in our control. Take care of your personal protective equipment!

K38 requires that students come to class prepared with their Personal Protective Equipment (PPE). This means full coverage to protect their body from scrapes and cuts. We do not allow board shorts, or students who are barefoot.

We know waterways are contaminated after rainfall when counties issue health alerts. These alerts are directed to microorganisms called pathogens.

Exposure to sewage-polluted water is the most common source of illness in recreational water users, even swallowing a small amount may induce sickness. Sewage makes its way to waterways most commonly through sewage overflows, polluted storm water urban runoff, malfunctions in treatment plants, boating waste, and septic systems malfunctions.

This is why we hear the recommendation to avoid contact with waterways for 72 hours after a rain event, especially near a storm water drain. Seventy-two hours is used as a general rule because natural processes help return bacteria levels to normal during this time period.

Ocean currents play an important role by diluting and dispersing stormwater runoff, which is why elevated bacteria levels can remain persistent at enclosed beaches with little circulation.

However, as RWC first responders we do not always have a choice when the call comes to deploy for a mission. We are boat based, but we can be splashed by water and maintain water contact. But we do have a choice in maintaining our personal protective equipment and ensuring it is ready to go.

ILLNESSES
We have all had one or several of these throughout our career. None of us have come out of the water without some kind of impact. It could be as simple as not cleaning your PPE and allowing an environmental for bacteria to breed.

They are a wide range of non-enteric and enteric illnesses. The most common is gastrointestinal illness (AGI).

These symptoms include vomiting, diarrhea, nausea, fever and stomachache. Different types of polluted water pathogens such as viruses, protozoa and bacteria can cause serious infectious disease of AGI
Non-enteric illnesses include ear, eyes, nose, and throat infections

Some of the most common bacteria causing soft tissue infection after water exposure include Aeromonas species, Edwardsiella tarda, Erysipelothrix spp., Vibrio vulnificus and Mycobacterium marinum. But that is not all, we have unknown or unseen pollution to contend with.

A Streptococcus (GAS) bacteria
Group A streptococcus (GAS) is a bacterium that is often found in the throat and on the skin of people. GAS is most often associated with “strep throat” and impetigo (blisters on the skin). On rare occasions, GAS can cause severe, life-threatening illness like toxic shock syndrome and necrotizing fasciitis (flesh eating disease).

Sometimes described as "the flesh-eating bacteria"

Staphylococcus (or "staph") Bacteria
Staph is resident flora of the human skin, meaning that it normally resides on the skin but does not cause disease. Staph is a gram-positive bacterium that can enter the body through cuts, abrasions, or by coming in contact with the mucous membranes of the nose, eyes, and nostrils causing disease and infection.

The infection often begins with a little cut, which gets infected with bacteria. This can look like honey-yellow crusting on the skin.

These staph infections range from a simple boil to antibiotic-resistant infections to flesh-eating infections.

The difference between all these is the strength of the infection, how deep it goes, how fast it spreads, and how treatable it is with antibiotics. The antibiotic-resistant infections are more common in North America, because of our overuse of antibiotics.

The deadly bacteria species, legionella, thrives in the mist of warm freshwaters and enters the lungs when tiny legionella-containing water droplets are inhaled. It is most often found in public spas, hot springs, rivers, and lakes, but outbreaks have occurred at beach shower facilities.

Cellulitis
One type of staph infection that involves skin is called cellulitis and affects the skin's deeper layers. It is treatable with antibiotics.

The signs of cellulitis are those of any inflammation -- redness, warmth, swelling, and pain. Any skin sore or ulcer that has these signs may be developing cellulitis. If the staph infection spreads, the person may develop a fever, sometimes with chills and sweats, as well as swelling in the area.

Infection-producing germs that can lurk in water include Pseudomonas aeruginosa, which causes swimmer's ear (an infection of the outer ear canal, known medically as otitis externa) and skin rash (dermatitis). Others include cryptosporidium, Giardia lamblia, shigella, and E. coli, which can cause diarrhea.

Diarrhea may occur when contaminated water is swallowed and driven into the mouth or nose. (do not swallow water)

What is Vibrio vulnificus?

Vibrio vulnificus is a bacterium that normally lives in warm seawater and is part of a group of vibrios’ that are called "halophilic" because they require salt.

How do persons get infected with Vibrio vulnificus?

People can get infected with Vibrio vulnificus when they eat raw shellfish, particularly oysters. Occurring naturally in the warm coastal waters, particularly during the summer months, Vibrio vulnificus has the potential to cause serious illness.

Persons who have wounds, cuts or scratches and wade in estuary areas or seawater where the bacteria might be present can become ill. There is no evidence of person-to-person transmission of Vibrio vulnificus.

What type of illness does Vibrio vulnificus cause?

Symptoms of Vibrio vulnificus in wound infections typically include swelling, pain and redness at the wound site. Other symptoms of Vibrio vulnificus infection include; nausea, vomiting, abdominal pain, diarrhea, fever, chills and the formation of blistering skin lesions.

Individuals experiencing these symptoms should contact a physician immediately for diagnosis and treatment.

ERYSIPELAS
Erysipelas is a bacterial infection that occurs in the top two layers of skin. It is also commonly referred to as St. Anthony's Fire because it can be very painful and cause an intense, burning sensation.

Erysipelas is similar to cellulitis but affects different skin layers. Streptococcus is the usual culprit.

With erysipelas, the skin infection is usually very red and swollen, and there will be a sharply defined border between the normal and infected skin tissue.

FOLLICULITIIS
Folliculitis is a relatively common infection of the hair follicles. It may be caused by bacteria and fungus and is characterized by tiny, red bumps that are filled with pus.

BLADDER INFECTION

A bladder infection is a type of urinary tract infection (UTI). This refers to an infection anywhere in the urinary tract, such as the bladder, kidneys, ureters, or urethra.

Most cases of bladder infections are acute, meaning they occur suddenly. Other cases may be chronic, meaning they recur over the long term. Early treatment is key to preventing the spread of the infection.

What causes a bladder infection?
Bacteria that enter through the urethra and move into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination.

Bacteria can sometimes attach to the walls of the bladder and multiply quickly. This overwhelms the body’s ability to destroy them, resulting in a bladder infection.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), most bladder infections are caused by Escherichia coli (E. coli). This type of bacteria is naturally present in the large intestines.

An infection can occur when bacteria from the stool get onto the skin and enter the urethra. In women, the urethra is short and the outside opening is not far from the anus, so bacteria can easily move from one body system to another.

Cuts, Scrapes or lacerations

• Wear a full personal protective equipment that is properly sized, cleaned, fitted and no tears or holes
• Clean lacerations immediately
• Use good hygiene
• Wash you hands with warm water and mild soap and rinse with water after changing a wound bandage
• Use waterproof bandages for cuts and scrapes larger than the damage area, replace as needed
• Avoid touching other people’s wounds
• Don’t share razors, toothbrush or other personal items
• Use clean towels, bedding and clothing.
• Shower after each training session, scrub and clean skin, hair and under fingernails/toenails
• Clean your booties, wetsuits gloves and gear after every use
• Contact your doctor immediately if you have a skin, nasal, eye, ear or respiratory infection
• Be aware of alerts or advisories and monitor the weather in your area of operation.
• Do not train or be in the water with any open wound or scrape

Suggested Cleaning Agents
(please consult with your personal doctor, conduct your own research)

1. Water & soap
2. Vinegar
3. Bleach solution diluted 10:1
4. Isopropyl Alcohol
5. Antibiotic ointment and fresh bandages
6. Hydrogen Peroxide (sometimes not recommended for wound care)
7. Iodine
8. Colloidal Silver
9. Oregano Oil

Investigate the products listed above. See if they apply to you and how you would incorporate them or not. Safety is a behavior and its a huge responsibility. We need to look out for ourselves first.

This is a justification to clean out the bilge and wash down the craft. We cannot fully decontaminate a boat due to the foam and rubber components, but we can maintain a clean vessel and a dry bilge and make sure our PPE is ready for us to wear.

Our personal health and safety matters, so don't delay to conduct your research. Now is the time, don't wait until after the fact.

Reference:
https://www.cdc.gov/healthywater/swimming/swimmers/rwi.html

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Meningitis-and-Encephalitis-Fact-Sheet

https://pubs.usgs.gov/circ/1981/0848d/report.pdf

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Posted: June 30, 2019

Content Creator of Rescue Water Craft and Personal Water Craft boating international education standards: Shawn Alladio is the world’s foremost authority and leading subject matter expert. She cares most about her community and the culture surrounding the safety of event service providers and Rescue Water Craft operators, working hard and dedicated towards protecting their reputation, distributing safety information and continuing to train these amazing individuals to the highest standards of care.

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Use at your own risk. Please take a qualified Rescue Water Craft training course and maintain proper records and respect all the PWC, RWC, PPE, and gear OEM manufacturer warning labels and cautions.