General Recommendations: Knowledge and Skill Recommendations for All Workers

During the second day of the conference, breakout sessions were held to develop recommendations around the following two questions:

1. What are the common knowledge and skills that workers in different workforce sectors need, in order to safely respond to an event involving CBRNE hazards?
   
   
2. What are the specific knowledge and skills that workers in different workforce sectors need, in order to safely respond to an event involving CBRNE hazards?

The breakout sessions involved workers from six different sectors.

• Transportation
  
  
• Manufacturing
  
  
• Emergency response
  
  
• Health care
  
  
• Skilled support
  
  
• Remediation/decontamination.

Participants were asked to consider training needs during the pre-event, event, and post-event periods. They were also asked to assume that workers were skilled and trained in their individual jobs.

There was a high degree of consensus from the participants that all workers, regardless of job title or industry, should know and be able to do the following (figure 1, table 1).

Essential knowledge identified by conference participants includes:

• A basic understanding of the hazards involved, including concepts of contamination and decontamination.
  
  
• An understanding of each employee’s specific role in an emergency, the roles of other potential participants and responders, and the limitations of individual roles (what each worker should and should not do).
  
  
• An understanding of the ICS and the role it plays.
  
  
• Knowledge of how communications systems work in the response to an emergency.

Essential skills that all workers should have (in addition to their specific occupational skills) include:

• The ability to recognize a threat or an abnormal condition.
  
  
• The ability to access the emergency notification system.
  
  
• The ability to use PPE safely and appropriately.
  
  
• The ability to use specific information resources and tools.
  
  
• The ability to evacuate the workplace safely.

These generic training components were identified by all of the groups as knowledge and skills that all workers should have when confronting CBRNE threats regardless of the workforce sector involved. The participants also recommended specific knowledge and skills for different types of workers, but there was general recognition that work remained to develop these worker-specific competencies more completely.

Based on the groups’ recommendations, a framework of recommendations for new generic training components has been constructed. Figure 1 illustrates how these generic training components would fit into the current training scheme. All workers should receive basic training to be able to recognize hazards and threats. All workers should know whom to notify and how to activate the notification system in the event of an emergency or threat. They should all understand how the ICS works, and should understand what their role is in the event of an emergency. Additionally, all workers should understand the role of other personnel, and should know the limitations of their own functional roles (it is as important to know what one should not be doing as it is to know what one should be doing, in an emergency). It should be stressed that the skills component of these suggested requirements (activation of the emergency notification system, use of personal protective equipment, and evacuation) must be practiced in “real-world” simulations. Another point emphasized by every group was the importance of including all workers in training, not just those who were deemed likely to be “at risk.” The conference participants stressed that workers involved in communications (dispatchers) were an especially important group to train because of their central role in recognizing and responding appropriately to an emergency situation.

Table 1 shows the recommended generic training components, side by side with current training requirements for workers covered under HAZWOPER. Two points should be emphasized here. First, it should be noted that these generic training requirements would be supplemented by trade-specific knowledge and skills recommendations. In a number of cases, such as emergency responders and health care workers, these competencies have been defined in some detail. In other cases (for example, for transportation workers) there have been some efforts to define specific skills and knowledge requirements, while some still need a great deal of development in this area in order to define the correct knowledge and skill sets. Secondly, the pool of workers eligible for pre-event HAZWOPER training may be larger than it is currently being conceived, because they are likely to be involved in any emergency response or post-emergency response clean-up operations.

Table 1. Side-by-side comparison of current training requirements and proposed new generic training recommendations for workers at risk of CBRNE exposure.

Recommendations for Development and Implementation of New Training Components

In addition to recommending the components described above, participants discussed how the training should be implemented and integrated into the existing health and safety training. Their recommendations can be summarized as follows:

1. Training plans should recognize the significant differences among different workforce sectors, in the degree to which they are prepared to respond to the threat of CBRNE attacks. Some workers, particularly emergency responders, may receive considerable training, while many others receive little or no applicable training. For example, workers who, in their daily work activities, are further removed from emergency response activities (manufacturing workers, service sector employees not involved in emergency response, food and agricultural workers) receive little or no applicable training.
   
   
2. Training for new CBRNE threats should be integrated into basic safety and health training, in a unified training plan that builds on and supplements other current training requirements. Many speakers and participants emphasized the notion that training for different types of hazards should be based on a single emergency response plan. First, it simplifies training and increases the likelihood of successful implementation. Second, it will not always be clear exactly what the threat is, or whether there is only one threat. A single emergency response plan would not rely solely on the nature of the threat.
   
   
3. The many Federal agencies involved in regulating or guiding activities of certain industries must coordinate their guidance and regulations regarding worker training. Because there are many agencies involved in the regulation of different occupational sectors, there are a number of different and often-conflicting regulations that need to be reconciled regarding different aspects of worker training. Chemical manufacture and transportation, for example, involves DOT, OSHA, and the U.S. Environmental Protection Agency (EPA), to name just three. One speaker pointed out that the placarding of chemical transport vehicles might be discouraged by one agency, while it was being required by another. Creating uniform requirements will facilitate the development and adoption of training programs across multiple agencies.
   
   
4. At a minimum, the Federal government should issue recommendations on worker safety training for new threats, including chemical, biological, radiological, nuclear, and explosive weapons. While participants were divided on whether there should be only guidelines for training as opposed to standards, there was agreement that guidance on training from the Federal government is needed. Many participants felt that some workers do not receive even basic safety and health training now, so to expect any increase in training in the absence of a strong Federal initiative or requirement was unlikely. In addition, some participants raised questions about liability, which they felt would be an additional deterrent to training unless the issue is specifically addressed by the government.
   
   
5. At all levels of response, training should reflect a high degree of coordination between the emergency response and public health communities. Conference participants heard repeatedly that the key to effective emergency response is coordination between the emergency response community, public health agencies, and the employer and employees. Communication between the public health and emergency response organizations is especially critical. In some cases, these links are well developed and smooth. However, many public health organizations are not accustomed to the top-down incident command structure widely used by emergency responders. The greater the coordination between these entities in the pre-event phase, the better the response will be in the event of an actual attack.
   
   
6. Regardless of which training plan is involved, an essential element must be frequent and regular “real-life” rehearsals. Conference participants unanimously agreed on this point. Participants stressed that this would require a commitment of resources on the part of employers, employees, and the government. This is essential if the training is going to accomplish its goal of preparing workers to respond effectively in the event of any future events.