Disaster Science Research Initiative Background Paper
The National Institute for Occupational Safety and Health (NIOSH) is the only Federal agency charged by Congress in the Occupational Safety and Health Act of 1970 to conduct worker safety and health research. NIOSH has been a leader in the field of disaster science research especially with regard to finding new ways to ensure responder safety and health before, during, and after a disaster. In partnership with other Federal and state agencies, as well as private sector entities, NIOSH has made responder safety and health research an important part of its research portfolio. Nearly a decade ago, NIOSH established the NIOSH Emergency Preparedness and Response (EPR) Program to advance scientific research in the area of responder safety and health.
In 2002, NIOSH organized its disaster science activities in an Emergency Preparedness and Response Office (EPRO). Today, the EPRO coordinates NIOSH’s preparedness and response activities during man-made and natural disasters as well as coordinates NIOSH’s disaster science research activities. Based on NIOSH’s experience in responding to disasters, the Institute led an interagency work group following Hurricane Katrina to develop the Emergency Responder Health Monitoring and Surveillance (ERHMS) Guidance, which was adopted by the National Response Team in 2012. ERHMS provides guidance and tools to assist public and private sector entities in protecting responders prior, during, and after an emergency response incident.
NIOSH’s experiences in responding to emergencies including the World Trade Center disaster, Hurricane Katrina, and the Deepwater Horizon disaster have also stimulated scientific inquiry among occupational safety and health researchers with regard to the long-term health outcomes from disaster response and the use of biomonitoring in emergency responders. Scientific study can provide better understanding and mitigation of responder health effects from disasters and can lead to improvements in the effectiveness of emergency responses.
Disaster science as it relates to responder safety and health can present unique challenges to occupational safety and health researchers. First, a decision process needs to be in place in advance of a disaster to determine if a responder research study is warranted. Many factors need to be weighed, but it is imperative that a scientific study not interfere with actual response activities. Second, responder safety and health research studies are difficult to design and difficult to implement. Strategic thinking about what study designs and implementation plans are most feasible for responder safety and health studies is important. Third, research can be costly and scientists must assess whether studies are a worthwhile public health investment that will enhance future response efforts. The goal of disaster science research would be to produce useful, reliable results. As emergencies are by definition unpredictable, an accelerated decision-making process is necessary to determine if research should be undertaken.
In January 2014, NIOSH launched the NIOSH Disaster Science Research (DSR) Initiative to Enhance Responder Safety and Health. The DSR Initiative will concentrate on developing an approach to timely, scalable, scientifically sound responder-based research that can feasibly be implemented before, during, and after a large-scale disaster. The DSR Initiative is based on the framework developed in A Decision Process for Determining Whether to Conduct Responder Health Research Following Large Disasters,1 which includes factors to consider for a research study, critical gatekeeper functions, and a process of expert opinion consultation (see Appendix 1).
Some of the potential research questions under consideration by the DSR Initiative to Enhance Responder Safety and Health include:
- Considering the possible types of responses and the responders involved, what are the primary questions needing research? Where are the major gaps in our understanding of exposures and other factors influencing responder health?
- What disaster research is NIOSH uniquely positioned to do?
- What is the role of the academic community in responder safety and health research? What is the role of emergency preparedness and response practitioners and consultants in responder safety and health research?
- What role should biomonitoring play in responder disaster research and how is it best implemented?
- What are the major barriers to disaster science research to enhance responder safety and health?
- How can ERHMS best be used to complement responder disaster research?
- How does disaster research best fit into existing national response policies and systems?
The DSR Initiative will explore the use of an All-Hazards Research Framework adaptable to different disaster scenarios. Special considerations would include the impact of a novel exposure, unexpected or severe health effects, the effectiveness of a proposed intervention, mental health/resilience issues, and disease outcomes with latency periods. Defining “research” in its broadest sense would include etiologic, intervention, applied, comparative effectiveness research, worker-based participatory research, meta-analyses, and survey research.
The NIOSH DSR Initiative is led by the NIOSH Deputy Director for Program and the NIOSH Associate Director for Emergency Preparedness and Response. An internal work group of NIOSH subject matter experts will assist in developing the DSR Initiative. To move the DSR Initiative forward, NIOSH plans to work with the responder community, including the incident command structure, Federal, state and local partners, academic institutions, labor, practitioners and consultants, and industry at an early stage to seek broad and comprehensive input. NIOSH invites partner participation in the DSR Initiative by all those interested in ensuring the safety and health of responders before, during, and after a disaster through research. Please contact CAPT Margaret Kitt at firstname.lastname@example.org or CDR Lisa Delaney at email@example.com if you have any questions about, or are interested in participating in, the NIOSH Disaster Science Initiative to Enhance Responder Safety and Health.
Appendix 1: Tables and Figures extracted from A Decision Process for Determining Whether to Conduct Responder Health Research Following Large Disasters1
|Adverse health event-related factors||
|Public health significance and scientific importance||
|Level of research interest||
Table 2: Critical Gatekeeper Factors
- Decker JA, Kiefer M, Reissman DB, Funk R, Halpin J, Bernard B, Ehrenberg RL, Schuler CR, Whelan, Myers K, Howard J. A Decision Process for Determining Whether to Conduct Responder Health Research Following Large Disasters. American Journal of Disaster Medicine, 2013, 8(1):25-33.
- Decker JA, Debord DG, Bernard B, Dotson GS, Halpin J, Hines CJ, Kiefer M, Myers K, Page Elena, Schulte P, Snawder J. Recommendations for Biomonitoring of Emergency Responders: Focus on Occupational Health Investigations and Occupational Health Research. Military Medicine, 2013, 178(1):68-75