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 D I R E C T F R O M C D C E N V I R O N M E N T A L H E A L T H S E R V I C E S

I ntroductionEmergency response and recovery work-ers might be exposed to multiple hazard- ous conditions and stressful work environ- ments when responding to a public health emergency. Previous emergency events have demonstrated that significant gaps and defi- ciencies in responder health and safety con- tinue to exist (Michaels & Howard 2012, Newman, 2012). Ensuring the health and

safety of emergency response and recovery workers who might be exposed to hazardous conditions and stressful work environments when responding to a public health emer- gency should remain a top priority (Kitt et al., 2011). The National Response Framework contains a Worker Safety and Health Annex detailing responsibilities for safety and health during major emergencies, including roles for the National Institute for Occupational

Safety and Health (NIOSH) such as exposure assessment and personal protective equip- ment determination.

The NIOSH Emergency Preparedness and Response (EPR) Program was created in 2002 following the events of 9/11, which included attacks on the World Trade Center and Pentagon, and the anthrax letter terrorist attacks. The goal of the NIOSH EPR Program is to coordinate emergency preparedness and response within NIOSH and improve NIOSH’s ability to respond to future emergen- cies and disasters. The NIOSH EPR Program protects the health and safety of emergency response and recovery workers through the advancement of research and collaborations to prevent diseases, injuries, and fatalities in anticipation of and during responses to natu- ral and human-induced disasters and novel emergent events.

The NIOSH EPR Program participates in response planning at the local, state, national, and international levels to ensure the timely identification of health hazards associated with emergency responses and implementa- tion of adequate protection measures; support the Centers for Disease Control and Preven- tion’s (CDC) emergency response efforts; and use the Disaster Science Responder Research Program to identify research needs to protect emergency response and recovery workers while identifying solutions to rapidly support research during emergencies. Training for emergency response and recovery workers is an integral part of the NIOSH EPR Program. This column highlights the NIOSH EPR Pro- gram training opportunities and activities.

E d i t o r ’s N o t e : NEHA strives to provide up-to-date and relevant information on environmental health and to build partnerships in the

profession. In pursuit of these goals, we feature this column on environmental

health services from the Centers for Disease Control and Prevention (CDC)

in every issue of the Journal.

In these columns, authors from CDC’s Water, Food, and Environmental

Health Services Branch, as well as guest authors, will share insights and

information about environmental health programs, trends, issues, and

resources. The conclusions in these columns are those of the author(s) and

do not necessarily represent the official position of CDC.

Kerton Victory is an environmental health specialist and emergency

coordinator with the National Institute for Occupational Safety and

Health’s (NIOSH) Emergency Preparedness and Response Office (EPRO).

Jill Shugart is a senior environmental health specialist and the Emergency

Responder Health Monitoring and Surveillance coordinator with NIOSH

EPRO. Sherry Burrer is a senior epidemiologist and emergency coordinator

with NIOSH EPRO. Chad Dowell is the NIOSH deputy associate director for

emergency preparedness and response. Lisa Delaney is the NIOSH associate

director for emergency preparedness and response.

Insights Into the National Institute for Occupational Safety and Health’s Emergency Preparedness and Response Program

1 figure, 1 table, 1 photo, 1 sidebar, 5 authors

Kerton R. Victory, MSc, PhD, REHS Jill Shugart, MSPH, REHS

Sherry Burrer, MPH-VPH, DVM, DACVPM Chad H. Dowell, MS, CIH Lisa J. Delaney, MS, CIH

National Institute for Occupational Safety and Health

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Training Opportunities and Activities The NIOSH EPR Program has trained over 1,000 public health professionals and emer- gency responders through its Emergency Responder Health Monitoring and Sur- veillance (ERHMS) training courses from 2015−2018 (Table 1). ERHMS is a health monitoring and surveillance framework that includes recommendations and tools specific to protect emergency responders during all phases of a response—prede- ployment, deployment, and postdeploy- ment (Shugart, 2017). The goals of ERHMS are to prevent short- and long-term illness and injury in emergency responders and to ensure workers can respond safely and effectively to future emergencies. ERHMS principles are scalable to both small and large events, including federal-, state-, local-, tribal-, and territorial-level responses (Figure 1).

In addition to ERHMS, the NIOSH EPR Program also created a responder health and safety training module for CDC’s En- vironmental Health Training in Emergency Response and Public Health Readiness Certificate Program courses. These courses are offered to CDC staff, as well as to other federal, state, and local health agencies, and have trained over 450 public health profes- sionals from 2015−2018 (Table 1). The re- sponder safety and health training module highlights the importance of critical per- sonnel, equipment, training, and other re- sources needed to ensure that all workers are protected from all hazards during a pub- lic health emergency. While space is limited to attend these in-person trainings, anyone wishing to attend this course can contact CDC’s School of Preparedness and Emer- gency Response.

The NIOSH EPR Program also developed a number of free courses that are offered on NIOSH’s website. Recognizing that many re- sponse and recovery workers are required to work long hours during responses, NIOSH developed the Interim NIOSH Training for Emergency Responders: Reducing Risks As- sociated With Long Work Hours to describe personal strategies to promote good sleep and other safe work practices during a pub- lic health emergency. Additionally, the NIOSH EPR Program developed the Anthrax: Instruc- tor Training in 2014. The training is a collec-

Overview of the Emergency Responder Health Monitoring and Surveillance Info Manager software tool developed by the National Institute for Occupational Safety and Health’s Emergency Preparedness and Response Program

FIGURE 1

Number of Public Health Professionals Who Completed the ERHMS and Responder Health and Safety Training Modules for EHTER and PHRCP Courses, 2015−2018

Year ERHMS EHTER PHRCP Total

2015 255 19 − 274

2016 255 85 61 401

2017 225 70 83 378

2018 210 72 59 341

Total 945 246 203 1,394

ERHMS = Emergency Responder Health Monitoring and Surveillance; EHTER = Environmental Health Training in Emergency Response; PHRCP = Public Health Readiness Certificate Program.

TABLE 1

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tion of train-the-trainer resources including a slide presentation, videos, and handouts to teach responders how to collect, decontami- nate, and ship samples. Sampling procedures taught in the training follow CDC’s recom- mended gold-standard surface sampling pro- cedures for Bacillus anthracis spores (Photo 1).

Through course feedback and program evaluation, the NIOSH EPR Program con- tinues to refi ne and update its trainings and preparedness activities for the next genera- tion of public health professionals and emer- gency responders. The program also actively works with other federal agencies such as the Federal Emergency Management Agen- cy, as well as state and local health agencies and other stakeholders, to integrate key components of responder health and safety

into new and existing trainings and provide technical assistance to these agencies. More information about the NIOSH EPR Program can be found on its website (see Quick Links).

Corresponding Author: Kerton R. Victory, Environmental Health Specialist, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health, 1600 Clifton Road, MS E-20, Atlanta, GA 30329. E-mail: [email protected].

References Kitt, M.M., Decker, J.A., Delaney, L., Funk,

R., Halpin, J., Tepper, A., . . . Howard, J. (2011). Protecting workers in large-scale emergency responses: NIOSH experience

in the Deepwater Horizon response. Jour- nal of Occupational and Environmental Med- icine, 53(7), 711–715.

Michaels, D., & Howard, J. (2012, July 18). Review of the OSHA-NIOSH response to the Deepwater Horizon oil spill: Protecting the health and safety of cleanup workers. PLOS Currents Disasters, Edition 1.

Newman, D.M. (2012). Protecting disas- ter responder health: Lessons (not yet?) learned. NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, 21(4), 573–590.

Shugart, J.M. (2017). Utilizing the Emer- gency Responder Health Monitoring and Surveillance System to prepare for and respond to emergencies. Journal of Envi- ronmental Health, 80(4), 44–46.

• National Institute for Occupational Safety and Health’s (NIOSH) Emergency Preparedness and Response Program: www.cdc.gov/ niosh/programs/epr/default.html

• Emergency Responder Health Monitoring and Surveillance: www. cdc.gov/niosh/erhms/default.html

• Interim NIOSH Training for Emergency Responders: Reducing Risks Associated With Long Work Hours: www.cdc.gov/niosh/emres/ longhourstraining

• Anthrax: Instructor Training: www. cdc.gov/niosh/topics/anthrax/ training.html

Quick Links

Photo 1. The National Institute for Occupational Safety and Health’s (NIOSH) Emergency Preparedness and Response Program staff demonstrate how to sample for Bacillus anthracis spores. Photo courtesy of NIOSH.

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