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Environmental Health Training in Emergency Response (EHTER) - Awareness Level

Read about how EHTER prepares environmental health workers for emergency response. Find out how EHTER graduates apply what they learned in the course to tornado responses in Birmingham and Tuscaloosa, Alabama, and Joplin, Missouri. Learn how EH responders in Alaska, Tunisia, and the Caribbean also received the training.

See video from the Federal Emergency Management Agency (FEMA) Center for Domestic Preparedness (CDP) on the environmental health response to Alabama tornadoes: six months later.

Photo: Flooded houses.

EHTER provides an overview of environmental health topics, issues, and challenges faced during emergency response and recovery. The purpose of the course is to increase the level of emergency preparedness of environmental health practitioners and other emergency response personnel by providing them with the necessary knowledge, skills, and resources to address the environmental health impacts of emergencies and disasters.


Several assessments have demonstrated the need for emergency preparedness and response education and training for environmental health practitioners. However, there is currently no national, comprehensive, standardized education and training program in this area.

To address this need, CDC’s Environmental Health Services Branch (EHSB) collaborated with federal, state, and local public health and environmental health partners to develop a comprehensive training. EHTER's 10 modules focus on key environmental health issues and challenges for emergency response and recovery, such as food safety, water quality and quantity, wastewater disposal, shelter assessment/sanitation, vector control/pest management, responder safety and health, building assessment, solid waste and debris, radiation and environmental health response, and disaster management.

CDC strives to make EHTER available to the environmental health workforce at the state, local, tribal, and territorial levels. To help ensure that this critical component of the public health workforce has the training they need, the EHTER Awareness Level course is available for free through the National Environmental Health Association (registration is required).

Environmental health practitioners perform many critical functions during emergency response and recovery, such as conducting shelter assessments, testing drinking water supplies, conducting food safety inspections, and controlling disease-causing vectors. EHTER will better prepare federal, state, local, and tribal environmental health practitioners (e.g., sanitarians, environmental health specialists) by providing them with the basic knowledge, skills, and resources to address the environmental health concerns that result from emergencies and disasters.

Thousands of environmental health practitioners from the United States and around the world have successfully completed EHTER. Post-training test scores have consistently shown marked improvement of preparedness knowledge over pre-training test scores. Participant feedback has been very positive and has led to continuous improvements in the training. Participants have also demonstrated real-world application of the concepts and information learned, improving response and recovery capacities during actual emergencies and disasters such as power outages, a train derailment with release of hazardous materials, tornadoes, and wildfires.

Several states, including Florida, Arizona, California, Louisiana, and West Virginia, have adopted the EHTER curricula and delivered courses for their environmental health practitioners.

Next Steps

CDC experts are working closely with FEMA/CDP in Anniston, Alabama, to develop an EHTER blended learning approach that includes

  • An independent-study, online awareness level course on FEMA’s Independent Study Program website.
  • An instructor-led operations level course.
  • An instructor-led planning and management level course.

Transportation, lodging, and meals are provided by FEMA/CDP to students from state, local, and tribal jurisdictions at no cost to their agencies. For more details about EHTER courses being offered at CDP, please visit ops.

CDC experts are also working closely with the International Federation of Environmental Health to develop and deliver EHTER-based courses and workshops internationally. For more information, please visit


“Excellent course, I attended in August and two other staff from our Environmental Health Division have attended as well and agree it was a valuable and interesting course.”
John Alden, R.S. Public Health Emergency Preparedness Program Manager, Yuma County Public Health Services District

“I feel very fortunate to have attended the EHTER course when I did. … the CSX train derailment in Madison County on March 12, 2007, served as a prime example of why we need to be prepared for such emergencies. … The concepts covered during the EHTER course were very helpful during the emergency and our subsequent response activities…we hope to secure the same training for all county environmental health staff as well as other public health staff and emergency responders.”
Geoffrey Snyder, Environmental Health Director in Madison County, New York

Additional Information

Download the EHTER fact sheet [PDF - 372 KB].

For more information on EHTER, contact

For more information and resources related to environmental health emergency response, visit the CDC Emergency and Terrorism Preparedness for Environmental Health Practitioners Web site at

For more information and resources related to Environmental Health Services (EHS), visit the CDC EHS Web site at

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