Emergency Responder Health Monitoring and Surveillance

Note: The final version of this docket along with all submitted comments can be found on the docket archive page.

The National Institute for Occupational Safety and Health (NIOSH) requests comments on the draft guidance document, Emergency Responder Health Monitoring and Surveillance, NIOSH Docket Number: NIOSH 223.

The draft guidelines contained in this report are the product of a consortium of federal agencies, state health departments, and volunteer organizations whose common goal was to create a more comprehensive and systematic approach to ensuring the safety and health of emergency responders. While the workgroup was convened and led by the National Institute for Occupational Safety and Health (NIOSH), this draft manuscript is intended as a future submission to the National Response Team (NRT), Worker Safety and Health sub-committee review board for consideration as an interagency resource document. As a consequence, the final version of this document will not be an official NIOSH document. NIOSH is presenting this draft document to the public to receive input prior to submission for NRT approval.

The information contained in this draft document has not been formally disseminated by the National Institute for Occupational Safety and Health or any of the agencies that contributed to the document. It does not represent and should not be construed to represent any Agency determination or policy.

Following the World Trade Center attacks in 2001, concerns were raised regarding the ability of the emergency response community to ensure the safety and health of all workers involved in a large scale, complex emergency response. More recent disasters, such as Hurricane Katrina and the Deepwater Horizon Oil Spill, continue to reveal the gaps which exist in the safety and health programs utilized during large scale emergency events.

This draft document proposes a new framework for ensuring responder safety and health by monitoring and conducting surveillance of their health and safety during the entire cycle of emergency response, including the pre-deployment, deployment, and post-deployment phases of a response. The proposed system is referred to as the “Emergency Responder Health Monitoring and Surveillance (ERHMS)” system, and includes a guidance section describing the principles involved in ensuring optimal responder safety and health, as well as tools which can be utilized to help facilitate the execution of these principles during an actual response.

The goals of the ERHMS system are to ensure that only properly trained and properly fit responders are deployed to a response, that the health and safety of all responders are appropriately monitored during a response, and that a systematic and comprehensive evaluation be conducted to determine the potential need for long term surveillance of responders’ health after their deployment has been completed. This system will help to ensure that hazardous occupational exposures and/or signs and symptoms observed during the course of an emergency response are utilized in an effort to mitigate adverse physical and psychological outcomes and determine whether protective measures are sufficient to prevent or reduce harmful exposures to workers. The system should also help to identify which responders would benefit from medical referral and possible enrollment in a long-term health surveillance program.

The ERHMS system proposes a coherent, comprehensive approach to protecting these groups of workers and a need for detailed, practical guidance on how to implement such an approach. Any effort to meet this need must incorporate a variety of measures, including the following: (1) medical screening that focuses on assessment of fitness and ability to safely and effectively deploy to a response, (2) training regarding hazards to be anticipated and protective measures to mitigate them, (3) approaches to centralized tracking or rostering of responders, (4) surveillance and monitoring for exposures and adverse health effects, including supporting efforts in environmental monitoring and assessment, (5) out-processing assessments on completion of response duties and deployments, and (6) follow-up or long-term surveillance or monitoring for potential delayed or long-term adverse effects of the deployment experience. Similarly, such a system must include activities to be performed at all stages in the response spectrum−prior to, during, and following deployment. Finally, any guidelines or recommendations for procedures to implement these protections must be fully compatible with and function within the National Incident Management System (NIMS) structure, which have been adopted as the accepted standard organizational focuses for emergency response at all levels.

Draft Preliminary Public Comment Version:

Guidance Document: Emergency Responder Health Monitoring and Surveillance [PDF - 10,129 KB]

Public Comment Period

Written comments on the document will be accepted through April 5, 2011 in accordance with the instructions below. All material submitted to NIOSH should reference Docket Number NIOSH-223. All electronic comments should be formatted as Microsoft Word and make reference to docket number NIOSH-223.

Comments will be accepted until 5:00 p.m. EDT on April 5, 2011

To submit comments, please use one of these options:

Send NIOSH comments using this online form
Send comments by email.
Fax comments to the NIOSH Docket Office: 513-533-8285
Send by Mail to:
NIOSH Mailstop: C-34
Robert A. Taft Lab.
4676 Columbia Parkway
Cincinnati, Ohio 45226

All information received in response to this notice will be available for public examination and copying at the ...
NIOSH Docket Office
4676 Columbia Parkway, Room 111
Cincinnati, Ohio 45226.

A complete electronic docket containing all comments submitted will be available on the NIOSH docket home page, and comments will be available in writing by request. NIOSH includes all comments received without change in the docket, including any personal information provided.