Hurricane Florence could trigger a major public health emergency in North Carolina if flooding causes toxic materials from hog manure pits, coal ash dumps and other industrial sites to be washed into the state’s drinking supply water, the Associated Press reports.

North Carolina is home to about 2,300 pork farms with 9 million hogs. There are also dozens of coal ash dumps. If the pits of waste from hogs and the coal ash were to overflow from flooding, toxic lagoons could be created.

Exposure fecal matter could trigger kidney issues, muscle twitching, fatigue, vomiting, diarrhea, and stomach pains, among others. If the pits of coal ash filled with dangerous levels of mercury, arsenic and lead were to mix with food and water sources, it could trigger stomach problems, skin infections, and other health risks.

“This one is pretty scary,” Jamie Kruse, director of the Center for Natural Hazards Research at East Carolina University told the AP. “The environmental impacts will be from concentrated animal feeding operations and coal ash pits. Until the system gets flushed out, there’s going to be a lot of junk in the water.”

Hurricane Florence, currently a category 4 storm, is predicted to bring roughly e feet of rain to eastern North Carolina. After a record-wet summer in along parts of the East Coast, according to the latest report from NOAA, and the remnants of Gordon’s rainfall still fresh, soil moisture is running high, which could lead to faster, more severe flooding. Repeated rounds of heavy rain have caused flooding in some areas since mid-July.

Some forecast guidance suggests that Florence could slow down or stall for several days, much like Hurricane Harvey did over Houston last year. If that were the case, this could further exacerbate the toxic flood risks. A tropical cyclone’s rain potential is largely dependent on its forward speed. The slower it moves, the heavier the rain totals.

North Carolina is a major producer of poultry and hogs. The state’s 9 million hogs are traditionally kept in metal or wooden sheds with grated floors. To contain the massive amounts of manure that accompanies the hogs, the sheds are intentionally designed to facilitate the animal waste to fall out of the sheds and flow into what are referred to as manure pits or lagoons, which contain millions of gallons of untreated sewage, according to the AP.

With floods, these lagoons run the risk of overflowing into crop fields and nearby waterways.

The North Carolina Pork Council said its members have pumped down their lagoon to levels that would allow them to absorb at least two feet of rain. Low-lying farms have been moving their hogs to higher ground, too, as a way to save them and the farmers’ livelihoods.

“Our farmers and others in the pork industry are working together to take precautions that will protect our farms, our animals and our environment,” said Brandon Warren, the pork council’s president and a hog farmer. “The preparations for a hurricane began long before the past few hours or days. Our farmers take hurricane threats extremely seriously.”

The state’s coal ash dumps pose an equally toxic threat. Two years ago, Duke Energy Corp. was ordered to clean up coal-ash ponds around North Carolina that posed serious environmental and public health risks, Bloomberg reported.

“The company won’t be done in time for the storm,” Bloomberg noted, “leaving the sites vulnerable to spills that can unleash the waste.” Duke Energy Corp., the state’s primary electricity provider, operates more than two dozen coal ash pits, which hold the remains of the coal that is burned in their plants. While they are making progress on their cleanup, the remnants in the pits contain hazardous levels of mercury, arsenic and lead, which, if washed into waterways, could be lethal.

The Environmental Protection Agency said Tuesday that it would be monitoring nine toxic waste cleanup sites near the Carolinas coast for potential flooding. More than a dozen such Superfund sites in and around Houston flooded last year in the aftermath of Hurricane Harvey, with spills of potentially hazardous materials reported at two.

Florence continues to grow in size and strength and will be the strongest hurricane to hit the Carolinas in almost three decades.

“This will likely be the storm of a lifetime for portions of the Carolina coast,” the National Weather Service in Wilmington, North Carolina, wrote in its Tuesday evening area forecast discussion.