CHARLESTON, W.Va. -- Shane Casdorph held out as long as he could before he finally took a shower Tuesday evening. West Virginia American Water officials told his family they could use the water at their house in Kanawha City on Monday afternoon, but the licorice smell from last week's chemical leak was even stronger after they flushed their pipes longer than recommended. Despite its cool temperature, the water Casdorph used made his skin feel hot after a four- or five-minute shower, he said. "My ears were burning," said Casdorph, 24. "I've got red places on my feet and back and a red rash on my back." Casdorph said he was hesitant to use the water at all because his mother had become sick the day before after she showered in it, although he said that might be because of a stomach virus. "I don't feel sick or anything," he said. "I've eaten. I don't feel bad." Now, Casdorph said, he wishes the water company had waited a while longer before allowing people to use the water again. "I don't think it was handled properly," Casdorph said. "I think it was way too soon. I don't think they had very much information about it." From 7 p.m. Monday -- hours after downtown and East End residents were told they could flush their pipes -- through 7 a.m. Wednesday, 101 people had gone to emergency rooms in the nine-county area with symptoms they attributed to the chemical, according to Dr. Rahul Gupta, chief officer for the Kanawha-Charleston Health Department. Of those, 46 people had come to the ER between 7 p.m. Tuesday and 7 a.m. Wednesday, Gupta said. Their symptoms included skin and eye irritation, upset stomach, vomiting and diarrhea, Gupta said. The odor from the chemical might cause problems in people who have allergies, migraines, asthma and other existing conditions, Gupta said. The emotional toll of the crisis also might be causing some people to have negative reactions, he said. "We are seeing some cases that may be related to water coming back," Gupta said. "People need to understand that smells can trigger [reactions] . . . the water has been noted to be safe, per the water company. Having these symptoms -- reactions -- doesn't necessarily mean it's harmful. This is just something we're seeing. It, too, shall pass." Dr. Richard Clapp, a professor emeritus at the Boston University School of Public Health, said it's not surprising that some people would be more sensitive to chemical exposure than others. "That always happens," Clapp said. "There's always a range, and some people are more likely to have a reaction than others with the same exposure." The water company waited until the chemical levels in the water were at 1 part per million or below. State officials have said the safe level is below 1 part per million, and cited the federal Centers for Disease Control and Prevention for that number. However, CDC officials referred questions about how they arrived at that number to West Virginia American Water. Clapp said he doesn't know if the water company should have waited until the chemical levels were lower in the water than 1 part per million. However, he said, those who have symptoms and have no exposures to other chemicals should stop using the water for now. "If people have gotten symptoms, and that's their only exposure, yeah, I think they should stop drinking it until it goes down lower," Clapp said. "I don't think it means that the safe level should be 0.1 parts per million or lower, but for the people experiencing symptoms . . . they should probably stop drinking the water." The West Virginia Department of Health and Human Resources plans to monitor the patients for future health problems, according to a spokeswoman. "After this crisis, DHHR epidemiologists, with the assistance of CDC epidemiologists, will conduct a population surveillance, including the review of patient charts," the DHHR's Allison Adler said in a prepared statement. "It is important to wait for all patients to be released from the hospital and to have a complete record prior to starting this surveillance so that the most accurate data is available." Adler said no information about specific patients would be released. "The DHHR has significant experience in performing these surveys as it is part of our Public Health mission," she said. By Wednesday, more than 20 lawsuits had been filed in Kanawha Circuit Court. Most were filed by businesses shut down during the state of emergency declared by Gov. Earl Ray Tomblin, but some are from people concerned about their health. Several people have sued over the unknown effects of being exposed to contaminated water and hope to be granted medical monitoring. Others claim they already are experiencing health problems. Melissa Jean Medley said in a lawsuit that she was admitted to Thomas Memorial Hospital on Friday for "chemically induced pneumonitis with tests indicating an abnormal condition to her lung, extreme coughing, and vomiting." On Wednesday, Richard Gravely filed a lawsuit claiming that he's been suffering from headaches, blurry eyes and wheezing since he took a bath around 2 p.m. Jan. 9, the day the do-not-use advisory was issued by WVAW. Cornellisus D. Christian filed a lawsuit Wednesday claiming that he and his 8-year-old daughter fell ill after drinking the water. He said they didn't find out about the do-not-use order until Friday and drank contaminated water after dinner Thursday. Dr. Alan Ducatman, a professor of occupational and environmental health at West Virginia University's School of Public Health, said there's a lot that health officials don't know about exposure to the chemical, "Crude MCHM." Ducatman said there have been a couple reports of worker exposure to Crude MCHM and that, if he remembered correctly, not a lot happened. He added that worker exposure is different than exposure to the public. The workers were likely not drinking it but inhaling the chemical and they might have gotten some of it on their skin, he said. Ducatman said he didn't want to second-guess the levels the CDC have said are OK. No one can say for sure that it will or will not make people sick, he said. "The answers don't come at the same speed as the toxin is put in the water," Ducatman said. "There's a lot we don't know. We do know that's this is not as toxic as the things that scare us the most. But that doesn't mean it's not toxic." Staff writer Kate White contributed to this report. Reach Lori Kersey at firstname.lastname@example.org or 304-348-1240.