By HCJ Staff Writer
The perpetual dance between the Gulf of Mexico and The Mighty Mississippi has shifted upstream. The pivot, brought on by drought conditions in the Mississippi Valley and river dredging, has allowed the Gulf and its saltwater to head towards New Orleans and is expected to impact municipal drinking water and industrial water supplies in the next few weeks.
A Federal Emergency was declared September 20 for Jefferson, Orleans, Plaquemines, and St. Bernard Parishes. These parishes are dependent on fresh water from the Mississippi River for potable water; salt water can be unsafe to consume so humans, animals, and plants will be affected as well as mechanical systems that will not operate with saltwater.
Healthcare Journals reached out to the area’s two largest healthcare systems, LCMC and Ochsner. Both systems are preparing for the event, which is expected, according to the Army Corps of Engineers, on the following dates:
-Oct. 13, Belle Chasse
-Oct. 15, Dalcour
-Oct. 19, St. Bernard
-Oct. 22, New Orleans, Algiers
-Oct. 24, Gretna
-Oct. 25, West Jeff
-Oct. 28, New Orleans, Carrolton
-Oct. 29, East Jeff
Jeffrey Kuo, MD, system medical director for Emergency Management and Preparedness at Ochsner Health, said, “When salt concentration is high or beyond what our bodies are accustomed to handling, our kidneys, or our natural filtration system, need to work harder and may result in an imbalance of water and electrolytes in our cells. The health effects of drinking saltwater have been found to exacerbate underlying medical conditions such as heart and kidney disease and be associated with diarrhea and abdominal pain.”
Jeffrey Elder, MD, associate chief medical officer for emergency management with LCMC, stressed, “Individuals at risk for exposure to high levels of sodium and chloride in drinking water should discuss specific concerns with their healthcare provider. Dialysis providers have also been in communication with regional emergency preparedness departments and have plans to continue to provide dialysis services.”
Ochsner’s Emergency Management and Community Affairs teams are coordinating with local, parish, and state officials. They have also initiated daily emergency operations huddles in mid-September. These huddles include representatives from Infection Control, Supply Chain, Emergency Management, Facilities, Emergency Medical Services, Human Resources, Government Relations and Community Outreach, Security, Lab, and Communications.
Supply Chain teams are assessing water needs and ordering/storing stock now. Primary and secondary sources of potable water have been secured. Facilities teams are assessing building needs. All inpatient locations and surgery centers in the Greater New Orleans region will be equipped with reverse osmosis (R/O) filtration systems allowing operations to proceed as normal.
LCMC Health’s major concern is to have a desalinated water source that will allow them to continue patients care. While bottled drinking water can be utilized for patient and food preparation needs, a desalinated supply of water is needed to allow HVAC and sensitive equipment to function. Plans will allow for LCMC hospitals to continue providing uninterrupted emergency medical care to patients during a potential saltwater event.
“LCMC Health has wells onsite at all hospitals with the exception Lakeside Hospital and New Orleans East Hospital. University Medical Center utilizes an offsite well for HVAC facility needs and has the ability to store water onsite,” said Elder. “Depending on the location, they have different processes for emergency water to meet the needs of the facility. We will utilize the domestic water supply to provide water during this incident with filtering and reverse osmosis performed on site at the hospital.”
“Ochsner has water wells at three locations,” said Kuo. “Ochsner Medical Center-New Orleans – well with existing filtration system that will be able to maintain normal operations including patient care and HVAC; Ochsner Medical Center-Baptist – well does not have existing filtration system (water not currently potable). External R/O system has been procured for this well;
Ochsner Medical Center-Kenner - well does not have existing filtration system (water not currently potable). External R/O system has been procured for this well. We will use a combination of well water, water trucks and bottled water if supplemental mitigation efforts are needed and for locations without well systems.
“Over time, elevated salinity levels can affect the performance and accuracy of many medical devices and appliances. We will use a combination of reverse osmosis (R/O) filtration systems, well water, water trucks, and bottled water to ensure our devices are not damaged. Water for lab instruments, steam sterilization, and dialysis already goes through a thorough filtration process, so it will continue as normal.
“Salt is a mineral with some benefits to the human body; however, when consumed in excess there are significant health concerns. Most people will know to stop drinking water simply based on taste. This should happen well before there is a danger to your health or significant impact on your body’s ability to address the increased salt intake. If you do consume a large amount of salt, you may experience symptoms of dehydration such as dry mouth, infrequent urination, dizziness, and fatigue. More severe symptoms include nausea, vomiting, and hallucinations. Most at risk are: people with pre-existing heart conditions or high blood pressure who are likely on a low sodium diet as counseled by their physician; those who suffer from kidney or liver disease; pregnant women (especially in third trimester); infants; dialysis patients. Excessive salt intake can exacerbate pre-existing heart conditions and kidney disease.”
Is there a solution? HCJ asked Mark Davis, who is a research professor at Tulane University Law School and director of the Institute on Water Resources Law and Policy at the Law School.
“I would suggest we take a really hard look at how we want to administer our drinking water to people and how we want to provide important process water to industries that don't work with salt water,” Davis said. “It could be as simple as moving freshwater intakes farther upriver and sharing them across parish lines, as opposed to having Jefferson Parish, Orleans, Plaquemines, and Saint Bernard with their own set of intakes. We should start to regionalize water planning and water service. It would be better in the end and a whole lot more affordable than going at it piece meal and this kind of lurching from crisis-to-crisis mode.”
Saltwater has impacted the area before, Stephen Murphy, PhD, director of the Disaster Management MPH Program in the Tulane School of Public Health and Tropical Medicine’s Department of Environmental Health Sciences writes in “5 things to know about the saltwater intrusion of the Mississippi River.” In 1988, the sill was built too late to keep saltwater from moving as far north as Kenner, which led to the Corps adopting rules now in place that triggered construction of the current sill in July.
Murphy’s piece addresses the problems we might we be facing:
Saltwater is projected to impact the New Orleans area in late October. Surface waters will exceed the U.S. Environmental Protection Agency public water supply standard as a secondary level of 250ppm chloride approximately 15 to 25 miles downstream of the saltwater wedge’s front/toe. WHO drinking guidelines suggest that at approximately 200ppm, people will not want to drink it due to taste. Those with no-salts diets should not exceed 20ppm.
The New Orleans water system does not filtrate salt. When saltwater is pumped through a water distribution system it can cause pipes to corrode, potentially leaching heavy metals from the pipes and pipe fittings into drinking water. It is difficult to predict which metals might leach from pipes, as distribution systems are all different and full maps of water systems are not available. A priority of the response will likely include frequent testing of the water that is going through the water systems' distribution network.
Extended saltwater exposure can also lead to pipe failure, which has been the case with burst pipes in lower parish communities already due to exacerbated drought conditions in the soil/ground causing shifts combined with the weakening onset caused by the corrosive saltwater.
Agriculture concerns exist as well, with large acreage irrigated by the lower Missisippi River as well as animal farms. Many farmlands downriver of New Orleans have already been impacted.
Murry then shares what is being done to combat the issue:
The underwater barrier, the sill, will be increased in size. It is believed to be 45 feet high in an area 90 feet deep, and will be increased to 30 feet below surface and extended outward beyond its present 1,500-foot length.
A 625-foot-long notch will be maintained in the sill to a depth of 55 feet below the water surface over the river's navigation channel to allow ocean-going vessels to continue to move up and down river, with special one-way traffic rules. Ocean-going vessels using the river are allowed to have a 50-foot-deep draft, deeper than the new elevated section of the sill if the notch was not built into it.
For the East Bank of New Orleans, a pipeline has been proposed to feed the New Orleans main water treatment facility with fresh water sourced 10-12 miles upriver, beyond the anticipated end point of the saltwater wedge. This fresh water will be sourced from a point upriver of a naturally occurring barrier – a change in the riverbed topography that experts believe will prevent high salt concentrations from advancing further. The best estimates indicate this pipeline would be able to blend with the higher salt concentrations and dilute the city’s water to an acceptable and drinkable level for most.
For the West Bank of Orleans Parish in Algiers, water will be barged in to be mixed with the local water supply to reduce its salt content to healthy levels.
In addition, officials will expand point of use testing to keep better awareness of the situation, while reverse-osmosis equipment will be utilized as part of the treatment process for water at smaller facilities in Plaquemines Parish.
The state is securing pre-made formula for WIC programs to reduce the impacts of potential higher salt content in water for infant formula.
The Louisiana Department of Health will continue--along with the Governor’s Office of Homeland Security and Emergency Preparedness (GOHSEP)--communicating specific concerns to the public and healthcare systems at https://gohsep.la.gov/emergency/Saltwater.
Current location of the saltwater wedge can be tracked on the US Army Corps of Engineers New Orleans District website.
And special thanks to Stephen Murphy, PhD, director of the Disaster Management MPH Program in the Tulane School of Public Health and Tropical Medicine’s Department of Environmental Health Sciences for permission to reproduce parts of: https://sph.tulane.edu/5-things-know-about-saltwater-intrusion-mississippi-river