At a glance
This page describes the Deployment Phase of the Emergency Responder Health Monitoring and Surveillance (ERHMS) framework. The ERHMS framework provides recommendations for protecting emergency response and recovery workers during small and large emergencies in any setting.
On-site responder in-processing
Response rostering refers to the processes of personnel identification, accountability, and tracking. Use a roster when the level of response is greater than what the first tier of local responders can handle. The roster should log everyone who reports to the disaster site and is engaged in the response or remediation work.
The Logistics function of the Incident Command System (ICS) is responsible for collecting this information into a comprehensive rostering system. But accountability also includes parallel and linkable procedures conducted by the Planning (demobilization) and Command (Safety Officer) functions of the ICS.
Site-specific training is required and must occur before emergency response and recovery workers enter a designated disaster control zone. Strategies to implement site-specific training should be pre-planned to the extent feasible. Consider different training materials necessary to meet expected and unexpected health and safety hazards onsite. For more information, see section 29 of the Code of Federal Regulations, standard number 1910.120.
Emergency response and recovery workers may need a variety of personal protective equipment (PPE). Many workers will receive PPE during training or as they arrive at the response scene and are placed on the roster. This central function or location for distribution is an opportunity to record information about the amount, type, and condition of PPE.
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Health monitoring and surveillance during response operation
Health monitoring and surveillance are different but complementary methods. Both aim to protect emergency response and recovery workers' health and safety during an emergency operation.
Monitoring is the ongoing and systematic collection, analysis, interpretation, and dissemination of data related to an individual's injury or illness status. Monitoring helps to evaluate occurrences and levels of exposures for an individual responder and assess how that exposure is affecting them.
Surveillance is the ongoing and systematic collection, analysis, interpretation, and dissemination of illness and injury data about an events' responder population. Surveillance helps efforts to track emergency responder illness and injury trends within the defined population during response. A mechanism to allow tracking should be an integral part of the response to any event.
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Integrating exposure, activity, and controls information
Emergency response and recovery workers may be exposed to many hazards in the course of their work. Obtaining accurate and valid worker exposure information is crucial to ensure:
- Exposures are correctly characterized
- Risk is communicated appropriately
- Sufficient information is available to make evidence-based decisions on how to protect emergency response and recovery workers' health and safety
The exposures addressed in the ERHMS framework include biological, chemical, and physical hazards. Physiological stressors are also addressed, including sights and smells of death, exposure to the wounded, and risk of becoming a casualty. There are three risk management categories that safety officers, industrial hygienists, and other public health professionals learn from the assessment process:
- Acceptable exposures
- Unacceptable exposures
- Uncertain exposures (this requires further information gathering)
Emergency response and recovery workers' activities and job tasks may change over the course of their deployment. This is why it is important to document them either through ICS 204 forms, job tickets, or whatever is being used. This information is then linked with exposure and health information to implement controls. Any controls that are implemented should be documented in accordance with the ERHMS framework.
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Communicating exposure and health data
Communication is critical throughout an emergency response. The scope of communication in an emergency response has many facets, including:
- Psychology (phase-dependent)
- Messages (e.g., content, timing)
- Audiences
- Spokespersons
Collecting environmental exposure data, individual health and safety monitoring data, and aggregate surveillance data is relevant to protecting all responders. It is common for organizations to track and report data they are collecting within their own operational structures. However, this information must be communicated to workers inside and outside of organizations and the ICS structure. This is key to informing emergency response and recovery workers about steps they can take to protect themselves from hazardous exposures.