Emergency Responders

Emergency response and recovery workers need to be aware of all the potential hazards they might face while supporting different types of responses. It is essential for emergency responders to have access to training and information that provides basic and advanced knowledge associated to the events they will be working on. Preparation should be provided through all emergency stages, pre-event, during the event and post-event. Pre-event preparedness activities should include training, access to readily available information, field assessments, and equipment availability. Safety management information should be provided to minimize potential deaths, injuries, and illnesses in preparation to the event, although guidance should be given throughout the whole response. During the event and on the post-event phase, it is important for emergency response and recovery workers to attend and clean up the hazards in a timely and secure manner, protecting their health in first place, in this phase the correct use of PPE and the recognition of hazardous environments plays an important role. Given the importance of this information for emergency response and recovery workers, this topic page provides information on safety management, the Ryan White act, bloodborne infectious diseases, use of personal protective equipment and resources for traumatic incident stress.

A main component of disaster management is safety. Safety management makes reference to all the possible strategies that can be implemented to assure the safety of workers while performing their jobs. The purpose of safety management is to prevent hazards and reduce potential harmful incidents that can occur in the workplace. The strategies implemented can include safety prevention measures such as the use of personal protective equipment or the establishment of health and safety policies.

NIOSH and RAND produced four reports in a series detailing previous emergency responses associated to terrorist attacks.

The first three reports provide recommendations and the need for research, training and other strategic approaches to help protect emergency responders in terrorist attacks. These reports describe the lessons learned from previous terrorist attacks, while making an emphasis in preparedness, suggesting the implementation of training and the use of personal protective equipment (PPE).

The fourth report is a technical source for emergency response following large structural collapse events. From the experience with collapsed buildings, the report provides examples of documented health effects, varying from evidence of respiratory and biological hazards to chemical and physical hazards. The report explains the need of establishing PPE guidelines and offers advice for its use and compatibility, and provides guidance on how to set safe exposure limits.

Each individual report can be accessed using the following links:

Protecting Emergency Responders Safety Management in Disaster and Terrorism Response

Each individual report can be accessed using the following links:

NIOSH conducts independent investigations of firefighter line of duty deaths. The program was implemented after constant work-related firefighter deaths. The objective of the program is to conduct investigation on firefighter fatality and recommend strategies to prevent death and injury among firefighters. The program investigates medical deaths and traumatic injury deaths assessing personal and workplace factors. Other factors are also investigated, examples of this are estimations of physical demands, exposure to chemicals, presence of coronary artery disease and fitness and wellness programs implemented in the fire departments. Circumstances investigated include burns, falls, structural collapse, electrocution, motor vehicle incidents, and diving incidents.

This web page provides access to complete lists of NIOSH investigation reports and other fire fighter safety publications and resources. The reports describe different cases and provide recommendations for preventing the development of rhabdomyolysis and injuries, and prevent exposures to diesel exhausts, heat stress, dermal exposure to polycyclic aromatic hydrocarbons, and traffic hazards, among others.
NIOSH Fire Fighter Fatality Investigation and Prevention Program

The National Clearinghouse is the primary source for hazardous waste worker curricula, technical reports, and weekly news involving hazardous materials and waste. NIEHS provides training on topics such as hurricane hazard awareness, violence in the workplace, asbestos and lead awareness, mold hazards awareness, and respirator protection training. The clearinghouse webpage, besides training, offers other materials such as an app in disaster preparedness, education apps on Ebola, podcasts covering avian flu and hurricane safety, booklets and videos covering different natural disasters and providing health and safety recommendations.
NIEHS National ClearinghouseExternal

Environmental emergencies involving the release, or threatened release, of oil, radioactive materials or hazardous chemicals may potentially affect communities and the surrounding environment. EPA’s web site provides information about these activities, links to the key groups involved in contingency planning and response, and provides information on how to report hazardous substance and oil spills. The topic page offers access to other webpages focused on emergency management, tribal emergency preparedness and response coordination, community involvement, the national response framework, and emergency response resources in case of affectation to water or wastewater utilities. All of this resources might be useful for emergency response and recovery workers.
EPA Emergencies Topic PageExternal

OSHA and its State Plan partners help set and implement national safety and health standards for emergency responders. OSHA’s topic page offers multiple resources for emergency response and recovery workers, which include, general guidance on preparedness and response activities explaining OSHA’s role in emergency response and highlighting the types of personal protective equipment available and recommended for each case. OSHA provides information on natural disasters and weather, oil, chemical, biological, radiological, nuclear and explosive incidents and disease agents and toxins. The available resources include eTools, guidance documents, Fact sheets, Quickcards, and brochures.
OSHA Emergency Preparedness and Response Topic PageExternal

During the release of a hazardous substance, emergency response and recovery workers are in high risk of exposure. OSHA created a best practices manual designed to guide hospital employees or healthcare workers working as first receivers in case of a release of a hazardous substance. This manual introduces the potential hazards emergency response and recovery workers might face, discusses the types of PPE appropriate for each situation, provides the applicable OSHA standards according to the hazard and offers tables designed to assist employers and workers in the selection of PPE and adequate safety control measures. The best practices document includes experiences with contaminated victims, and offers specific recommendation in the use of respirators, gloves, boots, protective garments, training, emergency management plans, safety procedures, and waste management.
OSHA Best Practices for Hospital-based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous SubstancesExternal

During emergencies exposure to blood and other body fluids are common. Emergency response and recovery workers are at risks of exposure to blood borne infectious diseases through contact with sharp objects and the potential contamination of open wounds. Concerns include the transmission of human immunodeficiency virus (HIV) and hepatitis. Therefore it is important to establish safety practices to prevent and control the exposure to blood and body fluids. Safety controls can include engineering controls, use of personal protective equipment but more importantly training for the safe handle of needles and sharps and guidelines for the management and treatment of incidents.

This topic page provides guidance to employers and employees on how to create an exposure control plan to prevent exposure to bloodborne pathogens. It also informs emergency response and recovery workers about their rights as workers such as the right to know when they have been potentially exposed to life-threatening diseases, known as the Ryan White treatment Extension Act of 2009. Other materials such as factsheets that offer practical advice on the disinfection and treatment of sharps and contaminated waste are also offered.  OSHA has recommendations and standards associated to the protection of workers from bloodborne infectious diseases, provided in this page.

Describes the Ryan White HIV/AIDS treatment Extension Act of 2009, which pertains the notification of emergency response employees who may have been exposed by victims of emergencies to potentially life-threatening infectious diseases, so exposed emergency response and recovery workers can take informed decisions regarding their health and safety. The following topic page provides a description of the Ryan White Act of 2009 and makes available a series of flow charts explaining the procedures for notification of possible exposure to infectious diseases.
Ryan White Act of 2009

This page has resources and guidelines including engineering controls and work practices to help workers prevent exposure to blood and other body fluids. This webpage offers recommendations to establish work practices that prevent exposure to body fluids. Other resources offered include information on bloodborne pathogens, recommendations to prevent needle-sticks and sharps injuries, engineering controls, Personal protective equipment, and management and treatment guidelines.
NIOSH Bloodborne Infectious Diseases Topic Page

This NIOSH publication provides guidance to develop a comprehensive bloodborne pathogens exposure prevention program that will help protect emergency response and recovery workers. The publication recommends the establishment of a written exposure control plan that workers can easily access. Through this plan it recommends to do an employee exposure determination and provide safety devices to prevent injuries. This guidance explains the basic elements of an exposure control plan and provides suggestions for further implementation.
First Responders: Protect Your Employees with an Exposure Control Plan

OSHA provides access to a series of one page fact sheets on subjects such as using protection when handling sharps, personal protective equipment cut risks, reporting exposure incidents, Hepatitis B vaccination, and decontamination to protect workers from different exposures.
Bloodborne Fact SheetsExternal

OSHA has established general guidance on bloodborne pathogens and needlestick prevention available in this website. Some of the diseases this prevention focuses on are hepatitis B and C and human immunodeficiency virus. OSHA suggest the establishment of an exposure control plan detailing the protection measures available for workers. This controls should include descriptions of engineering and practice controls, equipment, training, surveillance and use of personal protective equipment. The following link provides OSHA Standards and regulations on bloodborne pathogens and needle stick prevention. Recommendations such as the use of shielded needle devices, needleless devices are examples of controls and are encouraged. The page covers general guidance, enforcement, hazard recognition, evaluation of exposure and control, and standards all associated to bloodborne pathogens and needlestick prevention.
Safety and Health Topics Bloodborne Pathogens and Needle stick PreventionExternal

Personal protective equipment (PPE) is a main source of protection for emergency and recovery workers.  Depending on the type of emergency which may include flooding, hurricanes, fire, electricity, structural collapse, falls, terrorism, earthquakes, tornadoes, extreme temperatures, diseases, among others. It is necessary to protect emergency response and recovery workers from physical, chemical and biological hazards. Routes of exposure include inhalation, dermal contact, ingestion or contact through mucous membranes. Therefore, main protective equipment includes respirators, eye protection, hearing protection and protective clothing. Depending on the hazard, the recommendations on the use of PPE change. Some examples of PPE may include Gas masks, gloves, overalls, boots, and googles.

The following page provides information concerning the proper use of respirators.  Publications referring to respirator approval for chemical warfare, protective equipment for structural collapse events, and selection of PPE are provided. The NIOSH Personal protective equipment page provides informational materials regarding the proper use of PPE under different conditions and situations. The materials cover previous experiences with respirators and their selection, use of protective clothing to protect against biological agents, PPE for flood responders, infection control and hearing protection.
Emergency Response Personal Protective Equipment Page

The variety of situations emergency response and recovery workers face may lead to the development of traumatic incident stress. The manifestation of traumatic incident stress involve physical, emotional, behavioral and cognitive stress. Some of this symptoms might be difficult to identify since long hours of work may produce similar symptoms such as fatigue, thirst, and mental confusion. Nevertheless there are specific emotional, physical, cognitive and behavioral symptoms of traumatic incident stress that can facilitate the identification of this condition. This symptoms can include, but are not limited to, confusion, nightmares, disorientation, memory problems, fatigue, headaches, pains, anxiety, guilt, denial, emotional outburst, and behavioral changes. Some workers present strong reactions while performing their activities on site, while others present them later and it can last from some days to weeks.

The following topic page provides NIOSH recommendations for workers to reduce the risk of experiencing stress during and after a traumatic event. The site also describes symptoms to recognize the presence of traumatic incident stress, and offers access to multiple publications associated to the topic such as reports on previous documented cases of traumatic incident stress in the mining industry and firefighting. Other publications offer recommendations for emergency managers on how to make decisions during these events. Additional resources provide access to coping tools and materials.
Traumatic Incident Stress Topic Page

This publication provides basic information for emergency response workers to prevent, identify, and control symptoms of traumatic incident stress. This document offers a chart listing physical, cognitive, emotional and behavioral symptoms that can be developed after a traumatic incident. The publication describes the dangers of traumatic incident stress and offers recommendations on what to do on-site and at home if traumatic incident stress presents. Finally, it includes resources for coping and additional tools for informing themselves.
Traumatic Incident Stress: Information for Emergency Response Workers
En Español

This web page provides general information for individuals, parents, and families for coping during and after a disaster or traumatic event. The webpage offers different resources for responders including preparation steps before the response in order to learn as much as possible about the role the responder will be performing, steps to take during the response to understand and identify fatigue symptoms, burnout and secondary traumatic stress, and recommendations for adjusting to life and returning to work daily activities after a response.
CDC Emergency Preparedness and Response: Coping with a Disaster or Traumatic Event

Page last reviewed: November 30, 2018