Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2011-115, 2010 Oct; :1-2
The Challenge: To protect the safety and health of emergency workers during responses to large-scale disasters, incident commanders and emergency managers must have access to sufficient information, assessment and decision making assets, safety resources, and implementation capability. Most major disaster responses involve multiple, diverse responders and response agencies; include unusual and intense hazard exposures; and occur over large areas and extended time periods. These characteristics complicate the gathering and assessment of information, decision making, safety resource management, and implementation and enforcement of safety and health programs. As a result, an incident manager's ability to manage the safety of responders may be seriously compromised. Approach: Researchers gathered input from workers and managers who responded to the 9/11 terrorist attacks in New York City and Arlington, VA; the Anthrax incidents in Boca Raton, FL and New York City; the Northridge, CA earthquake; and Hurricane Andrew in Central FL. Additional information was obtained from the literature on disaster response, which included the safety and health implications of response to floods, transportation accidents, wildfires, civil disturbances, and chemical-biological threats/attacks. The information obtained enabled the study team to develop preliminary recommendations that could be used to spark discussion and prompt additional comments and feedback from the emergency response community. A workshop was conducted in Arlington, VA on February 7, 2003 to obtain expert comment and opinion on integrating safety management into incident command and incident management, preparing for disaster response through training and multi-organizational planning, assessing and monitoring hazards, providing responder health care, conducting surveillance, and related issues. Results: The principal finding of this research is that in preparation for, and during response to major disasters, the safety resources of the multiple participating organizations must be better integrated and coordinated than in the past. The report recommends that safety be viewed as a multi-agency function within the Incident Command System and makes five recommendations for implementing this approach. These recommendations include developing a group of highly trained safety managers who can lead coordination between agencies, incorporating responder safety and health issues more realistically in joint disaster exercises and training, and preparing in advance the types of expertise and other assets needed to protect responder safety so that safety-related reinforcements will be able to be used quickly and efficiently. Additionally, the study makes 26 specific recommendations regarding 1) gathering hazard information and the status of the workforce, 2) assessing hazards and choosing protective options, and 3) effectively implementing safety decisions. Impact: Study findings have informed the development of the National Incident Management System (NIMS) and the National Response Plan (NRP), and the development of the Worker Safety and Health Annex of the NRP. The NIOSH-RAND report has been widely distributed to managers and policymakers at all levels of government with emergency management, disaster response, and worker safety responsibilities. The recommendations have also been disseminated to academic institutions with emergency and disaster management degree programs, and associations and unions that represent emergency managers and responders. The report has received an overwhelmingly positive response, based on the return of approximately 200 reader response cards. Ninety-two percent plus of those responding indicated that they are using the information and recommendations to inform planning, change programs and curricula, and implement specific recommendations. Most of those who have returned the reader response cards are emergency management directors/administrators at local (county or municipal) levels.