EMERGENCY RESPONSE RESOURCES

Tornado Cleanup and Response

Tornados are columns of air that extend from the sky to the ground rotating with great speed and power. These extreme winds create different physical hazards during and after the event. Clean up activities might present a major challenge for responders who might be in risk of injury due to the alterations the tornado may have left. Injuries and illnesses in the line of duty are preventable. Workers and volunteers involved with tornado cleanup should be aware of the potential dangers involved, and the proper safety precautions. Work-related hazards that could be encountered include: electrical hazards, carbon monoxide exposures, musculoskeletal hazards, heat stress, motor vehicle and large machinery accidents, hazardous materials, fire, confined spaces and falls. Emergency-response directors and supervisors should be aware of the potential dangers involved, and should establish and enforce proper safety programs.

This page informs responders and employers on the hazards they may face during and after a tornado and provides advice on how to prevent injury and protect themselves from potential hazards. The topics include air quality, clean up hazards, confined spaces, electrical hazards, fire, hazardous materials, musculoskeletal hazards, stress and fatigue and use of personal protective equipment.

Disaster Management

Management of activities before, during and after an emergency is a difficult task. Different components must be considered to account for all the potential hazards that can be faced. The preparation of a comprehensive plan is vital to ensure the correct management of resources, consecution of activities and protection of responders. During the elaboration of a disaster management plan, potential hazards can be identified which helps to establish the necessary measures to prevent, control and mitigate those hazards. Such measures can include but are not limited to the establishment of a system to manage personnel during an emergency, provide training to face a particular hazard, define the use of personal protective equipment, and install guidelines and mechanisms to be used in case of an emergency, among others.

The following link redirects to the disaster site management topic page which includes general information on Disaster Site Management. The site provides a series of reports on emergency responders’ safety management in disaster and terrorism response. The different reports cover topics such as rubble and debris, dust and smoke, heat, anthrax, stress, types and use of protective equipment, hazard assessment, risk communications, site management, structural collapse, fire, and explosions. The disaster management page also offers information on other hazards such as asbestos, carbon monoxide, confined spaces chemical and structural hazards and provides guidance on identifying and handling human remains. Other possible hazardous substances and situations such as chemical and structural hazards are also included in the website to ensure the health and safety of workers.

NIOSH Emergency Response Disaster Site Management Page

Hazards

Tornadoes are associated to multiple hazards that represent a risk for emergency responders and recovery workers. During cleanup activities physical, chemical and biological hazards may be present. Challenges faced by emergency response and recovery workers include electrocution, falls, chemical hazards, fire, and physical hazards associated to injury from falling or flying debris, among others.

The following resources besides offering information provides tools to create awareness and offer recommendations to employers and workers to protect themselves from multiple hazards during tornadoes.

Air quality provides reference to the degree in which the air is free of pollutants. Pollutants in the ambient air can be harmful to human health and are emitted from both natural and anthropogenic sources. Emissions from mobile and stationary sources contribute to indoor and outdoor air pollution. To measure air contamination pollutants are monitored and data is collected to provide an air quality index that indicates the air quality type in a particular area which ranges from good to hazardous.

Outdoor air quality focuses on the pollutants present in outside ambient air. Criteria pollutants are substances common in outdoor air and are associated to adverse health effects, this pollutants include particulate matter, carbon monoxide, lead, nitrogen dioxide and ozone. We can be exposed to these pollutants in multiple ways while performing outdoor activities.

During and after tornadoes the air quality can be affected as a result of particles aerosolization and contaminant dispersion. It is important to take appropriate measures to prevent exposures to air pollutants.

Indoor air quality refers to the quality of the air in an office or other building environments. Low quality indoor air may lead to health problems such as allergic reactions, headaches, eye irritation and aggravate other conditions such as asthma. Problem indicators such as odors, mold, and excessive dust can be present when indoor quality is deficient. More information regarding indoor air quality is available in the following website.
NIOSH Indoor Environmental Quality Topic Page

Carbon monoxide (CO) is a gas produced as the result of incomplete combustion processes and is characterized by being odorless and colorless. Carbon Monoxide has the ability to combine to hemoglobin forming carboxyhemoglobin. This process inhibits the ability of hemoglobin to transport oxygen, leading to an oxygen deficiency that may result in permanent heart and brain damage or even death. CO properties make it especially difficult to detect, which increases the risk of injury or death by the inhalation of the gas.

During an emergency, usually electrical power deficiencies increase the use of gas powered generators generating CO and some workers may place generators in enclosed spaces which can lead to the accumulation of the gas resulting in CO poisoning.

Small gasoline-powered tools can pose a serious health hazard following natural disasters. Examples of these tools include pumps, compressors, and generators. They produce high concentrations of CO–a poisonous gas that can cause illness, permanent neurological damage, and death. This web page provides recommendations for employers, equipment users, tool rental agencies, and tool manufacturers for preventing CO poisoning. NIOSH makes available publications on how to prevent carbon monoxide poisoning from small gasoline powered engines, tools, and reports on fatality assessment and control evaluations.
NIOSH Carbon Monoxide Hazards from Small Gasoline Powered Engines Topic Page

The CDC carbon monoxide topic page contains reports detailing the problems associated with carbon monoxide from portable generators, motorboats, fires, and other emission sources. Workers can find educational materials, prevention toolkits, factsheets and general safety recommendations to protect themselves. Other materials available include recent publications modelling the effects of the use of gasoline powered generators on indoor CO exposures, clinical guidance for CO poisoning, and disaster surveillance information and resources.
CDC Carbon Monoxide Poisoning Topic Page

After a tornado, emergency response and recovery workers may encounter massively affected zones which implies the presence of multiple hazards. This hazards may include electrical hazards, carbon monoxide, musculoskeletal hazards, thermal stress, structural instability, hazardous materials, and fire. Therefore the implementation of safety measures in advance to this events is vital. While performing cleanup activities all the previously installed measures and control should be in use. One of the most important parts during emergencies is the use of Personal protective equipment to prevent potential hazards that are not evident. The following recommended pages list potential hazards and provide information and recommendations to prevent, mitigate and control potential exposures during cleanup activities after different types of disasters. The CDC tornado webpage offers general advice on preparedness before a tornado event.

After a flooding event, storm or hurricane hazards associated to cleaning up may rise. Hazards include injury, electrocution, carbon monoxide poisoning and waterborne diseases among others.

The Centers for Disease Control and Prevention provides a resource for Hurricane recovery and preparedness. This document includes key facts to prepare for a hurricane or severe flooding and provides advice on how to prevent illness, injury and hazards, before, during and after a disaster.
NIOSH Emergency Response Resources – Natural Disasters

The following webpage provides general recommendations for preparing for a tornado. General advice includes what to do during a tornado and how to proceed and be safe after the tornado has passed. Other included advice provides recommendations in case there is flooding after the tornado and how to cleanup flood water. The CDC offers some materials such as infographics for preparedness and factsheets.
CDC Tornados – Health and Safety

Electrical work poses a hazard for emergency response and recovery workers where burns, falls, and electric shocks can cause injury or death if proper measures are not in place. During emergencies electrical services and equipment might present malfunctions and in some other cases the service might be out. During the installation service hazardous energy might be a source of injury or death. Elements such as overhead lines, circuits, and cables present a hazard for electric shocks and electrocution. Other electricity conducting elements such as ladders and other metal objects present an electrocution hazard. Safe work environments isolating energized components and safety procedures are a main part of safe work.

NIOSH provides different resources on electrical safety and electrocution. These resources include publications and fatality investigations. The electrical safety student manual provides general information on electrical hazards, explaining different types of hazards and types of electricity burns. The manual also provides an overview of a safety model, and how to recognize, evaluate and control electric hazards. Other NIOSH publications evaluate accidental contact with power lines as a cause of electrocution and document their operations to take preventive measures and avoid accidental injury or death. NIOSH publications also provide case studies and investigations that provide examples on how to install safety control measures. NIOSH Fatality Investigation reports and additional resources are also available for consultation.
NIOSH Traumatic Injury: Electrical Safety Topic Page

This NIOSH publication includes recommendations that can be used to help save the lives of workers who have contact with electrical energy. Previous incidents have shown that immediate resuscitation could help save the lives of electrocution victims. This document provides access to previous case reports and provides recommendations to prevent electrocution, install safe practices, and advises on the use of cardiopulmonary resuscitation and advance cardiac life support.
NIOSH Alert: Request for Assistance in Preventing Fatalities of Workers Who Contact Electrical Energy

The OSHA electrical topic page provides access to the industry specific applicable OSHA standards. Construction specific information is available to protect employees from electrical hazards. Hazard recognition in working environments is supported by explaining the hazards of contact with power lines, misused equipment, lack of the use of protective equipment and improper use of cords and elements conductive electricity. OSHA provides possible solutions to address these hazards and diminishes the risk of injury or death by electrical hazards. OSHA offers additional training to anticipate hazards and avoid injury.
OSHA Electrical Topic PageExternal

During and after emergencies work activities may include the use of ladders, walking on unstable surfaces, climbing to above the ground heights, wading through surfaces with holes, among others. Emergency and recovery workers may be in potential risks to fall from ladders and roofs or suffer related accidents. This hazard is common and may lead to injury or even death. Identifying fall hazards, planning, and creating applicable strategies to reduce and eliminate fall hazards should be part of the measures applied before doing the work.

The following page provides fast facts to inform workers about the most common types of fall hazards at the workplace and the impact they have in different workplaces. The website provides some examples of controls that can be applied to prevent work related falls. NIOSH features the use of an app designed to use ladders safely. The app provides indications according to the position of the ladder, infographics, and additional information are also available for employers and emergency response and recovery workers.
Falls from Elevations Topic Page

During and after fires, emergency response and recovery workers are in risk of exposure to hazards such as smoke inhalation, extreme heat, falls, burns, injury, irritation, and death. This topic page contains publications and reports, that are part of the fire fighter fatality investigation and prevention program (FFFIPP), addressing common adverse health consequences for workers during and after fires, including rhabdomyolysis, hyperthermia, sudden cardiac death, and injuries. The page also provides advice on related topics such as carbon monoxide, heat stress, and respirators.

The large amounts of debris caused by tornadoes can lead to an extended clean-up involving many methods of debris disposal. Clean-up workers who may be less familiar with fire safety than are firefighters may use burning as a method of debris disposal. This document contains guidelines for preventing injury and illness during burning activities.
NIOSH Interim Guidance on Health and Safety Issues Among Clean-Up Workers Involved with Burning of Hurricane Debris

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

Substances that have the ability to create a physical or health hazard are considered hazardous.  During and after emergencies there is risk of exposure to hazardous substances of different origins but mainly to chemical hazards. Due to their properties chemical hazardous substances may be, but are not limited to being toxic, explosive, flammable, self-reactive, oxidizing, or corrosive. Exposure to these substances by different routes including inhalation, dermal absorption, or ingestion can lead to adverse health effects, enhancing the need to know about the hazards associated to these substances beforehand.

Chemical agent information is needed for emergency response and recovery workers to appropriately plan for risks resulting from possible chemical incidents. Several organizations have developed information databases, including short-term and long-term criteria, each with specific purposes, exposure scenarios, and severity of adverse health effects considered in their development.

Databases offer their users the possibility to consult by name, the properties, physical descriptions, exposure routes, target organs, associated symptoms in case of exposure, personal protection recommendations, standards, and first aid for a particular chemical.

The NIOSH chemical hazards webpage has available resources that offer detailed information about particular chemical agents. An example of this is the chemical hazards emergency medical management website, where there is information for first responders for how to prepare to respond, how to conduct themselves arriving in the scene, and how to conduct casualty triage, assessment, treatment and transport, and train and plan. Some substances included are ammonia, chlorine, hydrogen cyanide, mustard agents, nerve agents, phosgene and other hazardous chemicals. Other resources that offer similar information including PPE recommendations are the Emergency Response Safety and Health database and the NIOSH pocket Guide to Chemical Hazards. The last resource, has a printer version available and also provides an app that allows users to look for the chemical structures, exposure limits, chemical and physical properties, emergency treatment, respirators selection, and signs and symptoms of exposures.
NIOSH Emergency Response Chemical Hazards Page

Musculoskeletal hazards are common across all work settings. Depending on the type of activity, different ergonomic controls must be in place to prevent injury. Activities that involve the use of heavy elements, vibration, repeat movements, and stay in a particular position and sustain an awkward posture can lead to musculoskeletal adverse effects. Emergency response and recovery workers are in risk of exposure to musculoskeletal hazards after working during long hours in extreme conditions that can imply difficult and repetitive motions. Musculoskeletal hazards may lead to the development of chronic pain in extremities, muscles, illness, injury, disorders and pain. This hazard may be present across multiple activities and industries including agriculture, construction, healthcare, manufacturing, mining, and transportation among others.

NIOSH offers a bibliographic database of occupational safety and health publications, interventions across industrial sectors, ergonomic recommendations, studies, and other resources to workers and employers to reduce and prevent ergonomics hazards. An example of these resources is the NIOSHTIC-2 website, which offers more than a thousand bibliographic entries covering specifically musculoskeletal or ergonomic hazards in different occupations and industries. Materials offering solutions and controls to prevent ergonomic and musculoskeletal hazards in the workplace, according to the activity performed, are offered by NIOSH. The website includes different recommendations covering the use of ergonomic programs in the workplace with a respective evaluation of the potential hazards of each activity, some manuals, apps and guidelines and recommendations regarding posture, and the use of tools.
NIOSH Ergonomics and Musculoskeletal Disorders Topic 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.
NIOSH 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

Other Stress and Fatigue Resources 

The National Child Traumatic Stress Network is an organization that provides access to services for traumatized children, their take givers, families and communities.  Their website covers topics on the readiness, response, and recovery after various traumatic episodes from bullying and community violence to natural disasters. Some covered topics are earthquake, extreme heat, flood, hurricane, landslide, tornado, tsunami, and winter storms. Some of these resources include factsheets, infographics, mobile apps, and training.

The National Child Traumatic Stress Network (NCTSN) provides materials with educational purposes addressed for different populations. These materials can be used by emergency response and recovery workers to protect themselves against fatigue and stress. The learning center offers a variety of resources for psychological recovery. One of these courses is the psychological first aid online course which puts the participant in a role of a provider in a post-disaster setting. The training offers videos, activities and guidance from experts in this field and can be accessed in the following link.
Interactive Online Course for Psychological First Aid TrainingExternal

Three removal can be a common activity for emergency response and recovery workers during and after an emergency. The operation of chainsaws for these activities may lead to injury. Safeguards against injury while using a chain saw are necessary to protect the health and safety of emergency response and recovery workers. Besides operation of chainsaws that may lead to injury, other common hazards associated to tree removal are electrocutions and falls. Although OSHA has established regulations relevant to tree trimming operations including the recognition and avoidance of unsafe conditions, and establishment and maintenance of working distances from energized conductors, incidents can still happen. Some controls may include proper maintenance of equipment, use of appropriate protective equipment and training.

Chain saws are widely used to remove fallen trees and tree branches after natural disasters. The following webpage provides information on chain saw safety and tips on avoiding injury from the release of bent trees or branches.
Preventing Chain Saw Injuries During Tree Removal After a Disaster 

Many tree trimmers and their employers may lack training and knowledge of OSHA standards and/or may be unaware of the risk posed by inadequate or improper safety procedures and equipment. This Alert describes eight incidents involving five electrocutions and three fatal falls of tree trimmers. Based on previous experience the alert can provide guidance on how to prevent incidents associated to tree trimming.
Preventing Falls and Electrocutions During Tree Trimming

During emergencies domestic animals might be displaced creating potential health and safety hazards for responders. This document provides information on preventing injury and illness that may be caused by bites, scratches, rabies among others, which constitute safety hazards for workers that may be in contact with displaced domestic animals.

Interim Guidance on Health and Safety Hazards When Working with Displaced Domestic Animals
West Nile virus is a mosquito-borne disease. Its transmission happens when an infected mosquito transmits the virus to human hosts by biting them. Infected people may not develop symptoms, in other cases symptoms may include high fever, headache, neck stiffness, disorientation, muscle weakness, and paralysis. Although less than one percent of infected people develop serious illness, some cases may have severe complications with direct affectation to the central nervous system.  Emergency response and recovery workers are at risks of developing a mosquito-borne disease when they work for prolonged hours outdoors.  The NIOSH West Nile Virus (WNV) topic page provides detailed information and frequent asked questions about West Nile Virus and the potential occupational hazards and risks of WNV exposure and infection. Some of the resources available for workers and employers are insect repellent use and safety guidelines, fast facts to protect workers from mosquitoes and ticks, brochures with recommendations for protecting outdoor workers from West Nile virus exposure, OSHA West Nile virus factsheet, and steps to reduce the risk of being bitten for mosquitoes.

NIOSH West Nile Virus Topic Page

This brochure contains answers to questions relevant to outdoor workers regarding West Nile Virus, as well as recommendations for the prevention of exposure to West Nile Virus by outdoor workers. Some of the relevant information covers who is at risk of infection, when are workers at risk of WNV exposure, where are mosquitoes commonly found, how to handle dead animals, recommendations for employers of outdoor workers, and recommendations for workers.

NIOSH Recommendations for Protecting Outdoor Workers from West Nile Virus Exposure
En Español

Personal Protective Equipment

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 goggles.

Personal protective equipment is very important for any emergency responder. 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.
NIOSH Emergency Response Personal Protective Equipment Page

Additional Information

Spaces which by design have limited openings for entry and exit, unfavorable natural ventilation which could contain or produce dangerous air contaminants, and which are not intended for continuous employee occupancy are considered confined spaces and working in these environments requires special precautions. Emergency response and recovery workers may have to work in confined spaces such as pits, sewers, tunnels, pipelines, degreasers, ventilation and exhaust ducts among others. Air does not flow in a normal way in these spaces and gases and other substances may stay trapped increasing the possibility of explosion. In other cases, oxygen can be depleted and limit the respiratory capacity. When the work is necessary in these spaces the exposure time must be limited and must be conducted with the appropriate precautions, including the use of personal protective equipment.

The NIOSH confined spaces topic page provides publications describing cases in which the incidents lead to the death of workers are presented. A manual with information on the recognition of confined spaces, describing the types of hazards associated with working in confined spaces, recommendations on PPE and safe work practice advice is offered. Other materials such as a report of the fatality assessment and control evaluation (FACE) program which recognizes hazards in the workplace and provides recommendations for addressing them, and a publication that provides information on hazard prevention and control measures and strategies applied to confined spaces.
NIOSH Confined Spaces Topic Page

The following link provides interim guidance for working safely in confined spaces. This document was originally developed for Hurricane Katrina, where flooding and the consequent transportation of materials through the water may lead to its release in confined spaces, or where the restriction of evacuation routes can create confined spaces. This information is applicable for emergency response and recovery workers whose job requires entry in confined spaces. This document provides NIOSH interim guidelines regarding work in confined spaces in response to a hurricane and offers PPE recommendations.
NIOSH Interim Guidance: Working Safely in Confined Spaces

During and after emergencies health care workers may face multiple hazards as a result of a higher influx of patients and alterations in the everyday work conditions. These unusual conditions can include electricity, cuts, flooding, contamination of the water supply, lack of staff, and lack of supplies or equipment, among others. Hazards health care workers could face while working in an emergency may include exposure to infectious agents, needle stick injuries, chemical hazards, physical hazards, traumatic incident stress, violence, and long hours of work.  Emergency responders and workers involved in health care need to be aware about the hazards they face and need to receive the necessary training to know how to act and stay safe during emergencies.

NIOSH provides resources to prevent hazards healthcare workers might be exposed to during emergencies.  Some of these resources include publications, field notes, infographics, factsheets, training tools, and reports. Some examples of emergencies in which health care workers require special safety measures, such as Ebola, are provided in the website aiming to protect the health of workers. Other resources such as health and safety practices for healthcare workers are also provided.
Health Care Workers Topic Page

During emergencies exposure to blood and other body fluids are common. Health care workers are at special risks of exposure to blood borne infectious diseases. Concerns include the transmission of human immunodeficiency virus (HIV) and hepatitis. 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 HIV/AIDS, Hepatitis B Virus, and Hepatitis C Virus Topic Page 

Extreme heat poses a risk for emergency response and recovery workers who may have to endure long hours outdoors. After a long time with heat exposure and without proper control, the body loses its capacity to balance its temperature which could lead to the apparition of adverse health effects. Occupational exposure to heat stress has been associated with heat stroke, exhaustion, rashes, cramps and dehydration. Symptoms to identify heat stress may include confusion, seizures, headaches, nausea, and loss of coordination. There are some protective measures workers can take to prevent heat stress including hydration and control of heat exposure.

In the following link, NIOSH provides different types of materials to inform workers and employers to illnesses and consequences associated with extreme heat. Some of these materials include infographics, publications describing previous cases of heat related death and injury in agricultural workers, recommendations for the construction industry on hydrations and recommendations applicable to all workers to protect themselves from heat illness. NIOSH has other tools such as an app to prevent workers from exposure to extreme heat and a heat stress podcast so workers can learn to identify symptoms and how to prevent and control them.
NIOSH Heat Stress Topic Page

Depending on the magnitude of an emergency, some events might be more destructive than others and have associated more fatalities. It is important to provide the proper identification and care for the bodies, and to protect the health and safety of the emergency responders and recovery workers on the location. Hazards when working with human remains may include a risks of infection with bloodborne pathogens and diarrheal diseases. Therefore the use of controls, protocols and standard protection measures is vital to ensure a dignified treatment of the victims while protecting the health and safety of the workers.

This report describes the health concerns associated with the identification of human victims after a tsunami in the Indian Ocean. Identification and proper handling of victims can be a challenge after a massive event. This report describes a previous experience using temporary morgue operations after the 2004 Tsunami. It describes the hazards of accidental injury with sharps and needles and manipulation of solid waste and biohazardous waste. The report provides recommendations for the proper management of waste and the use of personal protective equipment such as surgical masks, respirators, and latex gloves to protect themselves from multiple hazards.
Health Concerns Associated with Disaster Victim Identification after a Tsunami

The following website provides recommendations for individuals who must have direct contact with human remains. Recommendations include proper hygiene practices and the use of personal protective equipment to prevent contact with body fluids, blood or fecal material resulting of handling human bodies. Additionally to the interim guidance, some additional resources from the pan American health organization and the word health organizations are also mentioned.
Interim Health Recommendations for Workers who Handle Human Remains

Emergency response and recovery workers are at risk of exposure to different diseases while completing their activities. Many of these diseases are vaccine preventable. Required immunizations include tetanus and hepatitis B. Some vaccines are not mandatory because there is a low probability of exposure, nevertheless their use is still highly recommended to prevent the spread of any infection.

The following link provides immunization recommendations for emergency response and recovery workers.
Immunization Recommendations for Disaster Responders

The following page aims to provide information to humanitarian aid workers. The content includes pre-travel care information and packing recommendations. Additionally, it provides information on risks and prevention strategies for relief workers to avoid injury in a disaster area. Recommendations include visiting a healthcare professional before departure and complete a vaccination scheme if needed. Other region specific recommendations are also provided.
Health Recommendations for Relief Workers Responding to Disasters

These interim forms were developed by NIOSH as survey tools for occupational safety and health purposes in the response to Hurricane Katrina but may be applicable for other responses. The interim forms are posted here to provide information to occupational safety and health professionals who are interested in NIOSH efforts to prevent injuries and illnesses among hospital, shelter, and health department employees involved in a disaster response, and who may be looking for tools to ensure health and safety in their own operations.

The interim forms are key to critical information for assessing the potential occupational safety and health impacts of disaster response on health care, health department, and shelter employees.

The following links provide access to four different occupational health and safety survey tools. The forms are designed to be used in case a worker became ill, injured or was exposed to chemical or blood hazards; to evaluate medical care facilities, assess regional operation centers, health departments, and shelters. The forms aim to evaluate personal protection measures, supplies, safety and health controls, recordkeeping systems, training, operations, equipment, assistance, and programs in place among others.

Occupational Health and Safety Survey Tool – Evacuation Centers (Employee Injury or Illness Form)Cdc-pdf [PDF – 44 KB]

Occupational Health and Safety Survey Tool – Hospitals and Medical Care FacilitiesCdc-pdf [PDF – 32 KB]

Occupational Health and Safety Survey Tool – ROC/JFO/Health Dept/FieldCdc-pdf [PDF – 31 KB]

Occupational Health and Safety Survey Tool – SheltersCdc-pdf [PDF – 29 KB]

During emergencies the use of motor vehicles and machines can increase to accelerate the pace and efficiency of response and recovery operations. This can increase the risks of suffering accidents associated to the operation of motor vehicles and machines. An example of this situation are emergency medical service workers that have been involved in vehicle crash-related injuries. Operational controls must be in place to mitigate hazards associated to the manipulation of machines that ca lead to amputations, burns and permanent injuries. Hazards such a as fatigue present during emergencies have also been associated to motor vehicle accidents that could lead to injury or permanent death.

NIOSH has a motor vehicle safety at work webpage that offers guidance to prevent incidents related with motor vehicles. The center identifies risk factors for work related crashes, and promotes and communicates evidence-based policies and practices. The webpage offers different resources to employer to stablish safety programs to maintain workers safe on the road. Other resources include animated images to promote safe driving, crash facts, publications, projects, initiatives, and factsheets.
NIOSH Motor Vehicles Topic Page

Machinery-related hazards are present in virtually every industry. Workers are exposed to these hazards daily in construction, farming, and manufacturing. Emergency response and recovery workers are in risk of exposure to physical hazards associated to the manipulation of machines. The following webpage informs employers and employees about potential injuries that can happen as a result of machine manipulation such as amputations, burns or blindness, and provides advice on the use of safeguards to protect workers.
NIOSH Machine Safety Topic Page

Page last reviewed: March 28, 2018, 12:00 AM