Issues Regarding Sewer Gasses and Long-Term Care

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An article published in the Western Journal of Medicine reports that floor drain pipes can be “the source of ‘sewer gas,’ vile germ-laden air that presumably seeped into the house through faulty, filthy plumbing and sickened and sometimes killed its inhabitants.”  1

Further, the article quotes a New York City public health official saying sewer pipes are “smeared from top to bottom with the foulest organic matter, often putrefying under the worst conditions,” and making it “the worst enemy of those who live [inside].”

And, a New York physician claims that more people are killed each year as a result of sewer gasses entering homes and facilities “than yellow fever in its worst periods of the epidemic.”

You might be wondering, why haven’t I heard these alarming claims from what sound like such credible sources before?  

The reason is very simple: These comments were made about 120 years ago when plumbing was still quite primitive. But at that time, people were getting sick due to sewer gasses escaping in homes and facilities, and there were deaths. The reports led to a sanitary reform movement and the establishment of public health programs specifically to address sewer gases.

Thing of the Past?

Administrators may now feel a sense of relief, believing problems like this are now all a think of the past.  However, that would not be totally accurate.

After the SARS (severe acute respiratory syndrome) broke out in Hong Kong in 2003, researchers looked for explanations as to how this happened, where it started, and how it spread. What they uncovered was that there was a “ground zero” for SARS. Ground zero was an apartment complex called Amoy Gardens in Hong Kong in which 329 residents came down with the disease and 33 died.

As to how it happened, the researchers were also able to find “patient zero,” a man living in the Avery Gardens who was showing one of the key symptoms, a very serious case of diarrhea. Those caring for him soon came down with the disease apparently by touching contaminated surfaces the victim had touched. But as to how it spread, the researchers reported the following:

Environmental factors played an important part in this outbreak. Each block at Amoy Gardens has soil stacks collecting effluent from the floors. The soil stack is connected to the water closets, the basins, the bathtubs and the bathroom floor drains. Each of these sanitary fixtures is fitted with a U-shaped water trap to prevent foul smells [from] getting into the toilets from the soil stack. For this to work, the U-traps must contain water. However…the U-traps connected to most floor drains were probably dry and not functioning properly.”  2

This allowed droplets of the SARS virus to enter the apartments. “[These] virus-contaminated droplets could readily have been deposited on floor mats, towels, toiletries and other bathroom equipment.” When residents touched these items, they came in contact with the contaminated germs which spread the disease.

The Take Away

There are two key takeaways here. One is that disease can spread from floor drains.

The second takeaway is a bit less noticeable. In the SARS report, it was noted that all of the sanitary fixtures were fitted with “a U-shaped water trap,” that were “probably dry and not functioning properly.” This is more common than you might think.

For instance, schools that close for summer vacation often have many floor drains, as well as sink drains, shower drains, or food service area drains, that have dried during the warm summer months. As water in the U traps dry, sewer odors can be released.

To help prevent this, administrators and custodial workers should locate every floor drain your facility. With this information in hand, we have three options to help keep U-traps filled and preventing them from drying out:

Water: Develop a program where two cups of water – no cleaning solutions, bleach, or other chemicals are necessary – are poured into all floor drains at least once per month. In very warm and dry climates, this may need to be performed weekly.

Trap primer: A trap primer is a system, connected to a water supply, that detects when trap water has evaporated and releases small amounts of water into the drain to refill the trap. In most cases, a contractor or plumber will need to be called in to install these devices, which can be costly.

Liquid trap seal primer: Often referred to as “ever prime,” this is an odorless, biodegradable liquid that can be poured down drains. It should keep the drain trap filled for three or more months, possibly longer. This task should be performed about every three to six months.

We certainly are light years away from the plumbing that was installed in facilities in the late 1800s. But advances in plumbing technology has not been able to take care of everything, including making sure water traps are kept filled year round. Fortunately, administrators have options available to handle this task to help prevent sewer odors from entering their facilities and keeping their patients and staff healthy.

A frequent speaker and author on water conservation issues, Klaus Reichardt, is the founder and managing partner of Waterless Co. Inc, Vista, Calif. Reichardt founded the company in 1991 with the goal to establish a new market segment in the plumbing fixture industry with water efficiency in mind. The company’s principal product, the waterless urinal, works entirely without water.

1“The insidious foe”—sewer gas” by James Whorton, Western Journal of Medicine January 2002

2 “The SARS epidemic in Hong Kong: what lessons have we learned?” by Lee Shiu Hong, Journal of the Royal Society of Medicine, August 2003

Note: U-traps are also known as P-traps or J-traps; they all serve the same purpose