Emergency Preparedness and Response: Burden, Need and Impact

Burden, Need and Impact

The Emergency Preparedness and Response (EPR) program serves to improve the health and safety of all response workers, and to narrow existing gaps in protecting response workers. The NIOSH Preparedness and Response Office (EPRO) provides overall pre-event preparedness planning and coordination of NIOSH technical expertise, and on-site support during responses and encourages disaster science research.

Emergency response to disasters can entail a wide variety of activities carried out by emergency management, fire service, emergency medical service, law enforcement, the public health and health care sectors, as well as construction and other skilled support, disaster relief, and volunteer organizations. Emergency responders and front-line health care workers play a pivotal role in planning and responding to disasters.  However, through the course of their work, they may be exposed to potential dangerous working conditions that places them at high risk for occupational injury, illness, or death. It is imperative to minimize the hazards faced by responders as they carry out their important work.

While little data is available describing the hazards and related health outcomes of workers who respond to emergencies, examples can illustrate the impact of not adequately assessing hazards that exist during responses. In the aftermath of Hurricane Sandy making landfall, OSHA inspectors found more than 3100 instances of dangerous work conditions during clean-up operations. Twelve workers died in the weeks after the storm from various hazards including: falls, chemical asphyxiation, and electrocution.1 A survey of 93 emergency responders who responded to a 2012 vinyl chloride release from a train derailment found that 26% of respondents experienced headache and upper respiratory symptoms during the response. Exposure monitoring was unavailable and the majority of respondents did not use respiratory protection.2 Perritt et al reported work-related injuries and illnesses among World Trade Center responders.  A total of 4768 injuries and illnesses requiring medical treatment were reported by responders resulting in a rate of 16 injuries/illnesses requiring medical treatment per 100 responders.3

Workers are a common denominator at any disaster or novel emergency event. Protecting the health and safety of these workers by preventing diseases, injuries, and fatalities is a NIOSH Emergency Preparedness and Response Program priority. This can be accomplished by ensuring that responder safety and health is addressed systemically during all phases (pre-, during-, and post-deployment) to make certain only qualified, trained, and properly equipped personnel are deployed. While little data is available describing the hazards and related health outcomes of workers who respond to emergencies, better knowledge and characterization of the hazards that exist in the response environment are needed to provide immediate actionable information to improve the health and safety of responders. In addition, information gained from one response can be applied to future response plans by incorporating lessons learned from past emergencies into response protocols.

EPRO has developed recommendations to protect the health and safety of emergency response and recovery workers, often collaborating with other agencies like the Occupational Safety and Health Administration and the Environmental Protection Agency. EPRO also works to ensure federal response plans and preparedness efforts incorporate occupational safety and health actions to protect workers.. EPRO has also developed practical tools. EPRO developed the Emergency Responder Health Monitoring and Surveillance (ERHMSTM) system in collaboration with the U.S. National Response Team (NRT), and a number of federal agencies, state health departments, labor unions, and volunteer emergency responder groups. ERHMSTM is a health monitoring and surveillance framework that includes recommendations and tools specific to protect emergency responders during all phases of a response, including pre-deployment, deployment, and post-deployment phases. It has been used by several organizations, including the Georgia Department of Health during the response to Hurricanes Matthew and Irma.

1 New York Daily News [2013]. Sandy work toll 16 in NY and NJ were killed on the job. Available at http://www.nydailynews.com/new-york/hurricane-sandy-claimed-16-workers-2-nyc-article-1.1331744.
2Brinker, K. et al [2015]. Assessment of emergency responders after a vinyl chloride release from a train derailment- New Jersey, 2012. MMWR 63(53): 1233-1237.
3Perritt, et al [2012]. Work-related injuries and illnesses reported by World Trade Center Response Workers and Volunteers. Prehosp Dis Med. 26(6):401-407.
Page last reviewed: October 2, 2019