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Printing Instructions
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| Critical Incident Stress
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The Occupational Safety and Health Act (OSH Act) requires employers to comply with hazard-specific safety and
health standards. In addition, pursuant to Section 5(a)(1) of the OSH Act, employers must provide their employees with a workplace
free from recognized hazards likely to cause death or serious physical harm. Emergency Preparedness Guides do not and cannot enlarge or
diminish an employer's obligations under the OSH Act.
Emergency Preparedness Guides are based on presently available information, as well as current occupational safety and health provisions
and standards. The procedures and practices discussed in Emergency Preparedness Guides may need to be modified when additional, relevant
information becomes available or when OSH Act standards are promulgated or modified. |
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General Information
Does any OSHA standard apply to critical incident stress?
OSHA has no standards that apply to the hazards associated with critical incident
stress. However, in the interest of the health and safety of the
emergency responders and workers, the agency recommends that the following information
be shared to help reduce the risks associated with critical
incident stress.
What is critical incident stress?
Workers responding to emergency events and or disasters
will see and experience events that will strain their ability to function.
These events, which include having to witness or experience tragedy, death,
serious injuries and threatening situations are called "Critical
Incidents." The physical and psychological well-being of those experiencing this stress, as well as their future ability to
function through a prolonged response, will depend upon how they manage this
stress. Post Traumatic Stress Disorder differs from critical incident stress by
lasting longer than four weeks after the event triggering the emotional, mental or
physical response. Most instances of critical incident stress last between two
days and four weeks.
What are some signs of critical incident stress?
The signs and symptoms of critical incident stress can be physical, emotional, cognitive,
or behavioral. Individuals express stress in different ways and
therefore manifest different reactions. The list below is not exhaustive
but will help supervisors to identify workers who are exhibiting stress reactions.
| PHYSICAL |
COGNITIVE |
EMOTIONAL |
BEHAVIORAL |
Fatigue
Chills
Unusual thirst
Chest pain
Headaches
Dizziness |
Uncertainty
Confusion
Nightmares
Poor attention/
decision making ability
Poor concentration, memory
Poor problem solving ability |
Grief
Fear
Guilt
Intense anger
Apprehension and depression
Irritability
Chronic anxiety
|
Inability to
rest
Withdrawal
Antisocial behavior
Increased alcohol consumption
Change in communications
Loss/increase in appetite |
What can be done immediately?
During the emergency phase of the response, monitoring
of employees by simple conversation and observation may help to identify
early signs for some responders. The following steps can help to reduce
significant stress detected early in the response:
- Limit exposure to noise and odors.
- Dictate an immediate 15 minute rest break.
- Provide non-caffeinated fluids to drink.
- Provide low sugar and low fat food.
- Get the person to talk about his or her feelings.
- Do not rush the person back to work.
What is Critical Incident Stress Management?
Critical Incident Stress Management is system of education,
prevention and mitigation of the effects from exposure to highly stressful
critical incidents. It is handled most effectively by specially trained
individuals, such as crisis intervention specialists.
What is Critical Incident Stress Debriefing?
Critical Incident Stress Debriefing (CISD) is a facilitator-led group process
conducted soon after a traumatic event with individuals considered to be under
stress from trauma exposure. When structured, the process usually (but not
always) consists of seven steps: Introduction; Fact Phase; Thought Phase;
Reaction Phase; Symptom Phase; Teaching Phase; and Re-entry Phase. During the
group process, participants are encouraged to describe their experience of the
incident and its aftermath, followed by a presentation on common stress
reactions and stress management. This early intervention process supports
recovery by providing group support and linking employees to further counseling
and treatment services if they become necessary.
References
King County, Washington CIS Management website
US Dept. of HHS Substance Abuse and Mental Health Services Agency (SAMHSA), Emergency Mental Health and Traumatic Stress website
SAMHSA Training Manual for Mental Health and Human Service Workers in Major Disasters
International Critical Incident Stress Foundation
Primer on CIS Management
NIOSH Publication No. 2004-144: Protecting Emergency Responders, Volume 3
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Last Updated: 01 March 2005
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