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In the world of emergency response,
managing safety is fundamentally a question of managing risk.
Because dangers are inevitable, decisionmakers must weigh
the potential benefits of response activities against the
risks involved. The ability to perform such risk-benefit analysis
effectively depends on ready access to accurate and comprehensive
information. Incident Commanders need to be able to base their
assessments and decisions about responder safety on the right
balance of relevant knowledge: “Too little information
results in poor risk assessment by the decision maker and
results in error, injury, and death. Too much information
overloads the decision maker and makes it difficult to make
effective decisions” [IAFC 2002, 5].
This first vital step of risk management, gathering information,
initiates the safety management cycle. Managers depend on
three types of information (see Figure 4.1):
- Hazard Information. Timely and accurate facts
on the range of potential hazards present and expected at
a disaster scene.
- Information on the Responder Workforce. Knowledge
of the responders involved at an incident scene, coupled
with information on their capabilities, equipment, and training.
- Information on Responders’ Health and Injuries.
Information on injuries and illness suffered by responders,
hazardous exposures encountered by responders, and other
data related to responders’ health status.
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Figure 4.1
Gathering Information |
- Understanding the hazard environment
- Maintaining responder and unit accountability information
- Collecting injury, exposure, and health status data
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RAND MG170-4.1 |
While gathering these types of information may be fairly straightforward
within the limited scope of a small-scale emergency, a major disaster
is a very different story. When multiple hazards and a multiagency
responder workforce increase the complexity of a response operation,
the difficulty of collecting and managing any information balloons.
However, the risks posed to responders by disaster situations make
doing so increasingly critical.
Hazard Information: Understanding
the Disaster Environment
To protect responders during a response operation, safety managers
must have information on the hazards at the disaster scene. They
need a reliable and comprehensive understanding of the situation—what
hazards are present and what others could arise. This information
is equally critical as response managers plan operational actions
and responders begin to treat victims. However, several key characteristics
of major disasters prevent responders from gaining sufficient information
on the hazard environment.
Large Geographic Scale. When a disaster scene
covers a large geographic area, collecting and managing hazard information
becomes problematic because of the difficulty of getting an overview
of the scene. For example, responders to the World Trade Center
reported individuals near the base of the buildings had problems
even seeing what was going on, much less systematically collecting
information on the hazard environment [Study Interviews]. Similar
problems exist in hurricane and earthquake response operations where
it is difficult to amass needed information for the entire affected
area.
Large Numbers of People Affected, Injured, or Killed.
Efforts of local organizations to gather hazard data can be further
hindered by operational demands, such as the need to devote responder
resources to aiding substantial numbers of victims. This was a real
issue during Hurricane Andrew, when response units tasked with assessing
hazards could not complete their tasks because so many victims in
the areas these units were surveying urgently needed immediate assistance
[Paulison et al. 1993, 72].1
Multiple, Highly Varied Hazards. Because the numerous
hazards at the site of a major disaster are so diverse, they will
inevitably go well beyond the experience of single response agencies.
This makes it very difficult for individual organizations to characterize
threats. At the World Trade Center site, responders faced ongoing
fires, two collapsed skyscrapers, significant airborne hazards,
large numbers of casualties, and the possibility of additional terrorist
attack. The Northridge earthquake involved collapsed and weakened
structures, hazardous materials, electrical hazards, and fires [FEMA
1994a]. The threat of violence to responders during some disasters,
such as major civil unrest or terrorist events, is particularly
problematic since many responders do not encounter it during their
day-to-day operations and, as a result, cannot readily assess it
[FEMA 1994c].2 In addition,
the traumatic nature of many post disaster environments also presents
critical incident stress issues that are poorly understood by some
responding organizations and are very difficult to assess.
Furthermore, the hazard environment itself at disaster sites can
inhibit attempts to collect needed information. The loss of electric
power in many natural disasters hinders hazard assessment and monitoring.
At the World Trade Center, the large amounts of particulate matter
in the air interfered with environmental monitoring equipment that
had not been designed to operate in disaster situations [Lioy and
Gochfeld 2002, 77].
Wide Range of Needed Response Capabilities. The
involvement of many independent response organizations in responding
to a major disaster can complicate efforts to amass accurate hazard
data.3 If many agencies independently
carry out hazard monitoring efforts, problems in coordinating either
assessment methods or the guidelines used to interpret results can
produce inconsistencies in the data. If no good method exists to
resolve these differences and determine the source of any apparent
contradictions, hazard monitoring results become much less useful.
This was a particular problem at the World Trade Center, where federal,
state, local, nongovernmental, and private-sector organizations
all conducted hazard assessment [Lioy and Gochfeld 2002]. By one
estimate, no fewer than nine agencies had significant roles in environmental
monitoring at the site [Nordgrén et al. 2002]. Similar problems
were cited at the Pentagon [see Jackson et al. 2002].
Damage to Infrastructures. Difficulties in collecting
needed information are exacerbated by damage to or disruption of
critical infrastructures. In many disaster situations, communications
systems are damaged or overloaded with traffic, preventing responders
from collecting and sharing information [Arlington County 2002,
A-36; Weber et al. 2002; Auf der Heide 1989].
Direct Effects on Responder Organizations. Disasters
can similarly damage response organization assets needed to gather
information after an incident occurs. Response planning by the Miami-Dade
Fire and Rescue Department called for aerial assessment of the damage
and hazards after a hurricane by members of its air rescue division.
However, during Hurricane Andrew, both of the department’s
only two helicopters were damaged [Paulison et al. 1993].
Recommendation 4.1—As Part of Preparedness Efforts, Put in
Place a Coordinated, Multiagency Plan for Monitoring Hazards
Although gathering information on some hazards after a disaster
is straightforward —for example, determining the locations
of collapsed buildings after a tornado —other hazards, such
as airborne contamination or the presence of particular pathogens,
are much more difficult to identify and measure. Currently there
are no technological solutions able to “simply measure all
possible disaster hazards simultaneously” [Study Interview].
Consequently, to acquire information on the full range of foreseeable
hazards that might be present during or after a disaster, safety
managers must have, or be able to access, the assessment capabilities,
supplies, and expertise needed to identify, understand, and monitor
those potential hazards.
To make this possible, hazard monitoring must be a critical element
of preparedness activities. Response organizations must put plans
in place to carry out hazard assessment in disaster situations.
The preparedness effort must include the following:
- Define the types of hazards that major disasters may present
and determine the timeframes over which safety managers will need
information about each hazard.
- Put capabilities in place at the local level to enable safety
managers to gather the information they will need immediately.
- For capabilities that will not be available at the local level,
establish ways for individual agencies to access hazard assessment
resources from other response organizations.
Define Hazard Types and Information Needs. Because
not all hazards can be measured simultaneously, choices must be
made about what hazards are examined first at particular events.
By defining how rapidly hazard information will be needed, local
planners can determine which assessment capabilities will be needed
immediately and therefore must be provided locally. Other assessment
capabilities, perhaps less critical or not needed immediately, could
be provided by reinforcing organizations coming from beyond the
local area. Responders identified the immediate need to monitor
the environment for chemical agents, biological agents, radiation,
flammable gases, and oxygen deficiency as key [Study Interviews].
Such a list provides a clear strategy for what hazards should be
examined as assessment resources arrive at a scene.
Develop Local Hazard Monitoring Capabilities.
When a major crisis hits, safety managers will need certain hazard
data immediately. Capabilities must be in place at the local level
to gather that information. Data on facilities and locations that
could present safety and health risks for responders is one key
example of this kind of information [Study Interviews]. Such data
can be acquired through facility inspections, regulatory filings,
or other data collection.4 Because
such information is only useful if it is immediately available and
up to date, the importance of keeping this type of information current
and readily accessible to responders cannot be overemphasized [Study
Interviews].
Local response organizations also need capabilities for collecting
information about hazardous or infectious materials in the air,
water, ground, or debris following a disaster—for example,
direct-reading instruments, field tests, and laboratory assay methods.
Certain response units will routinely have some hazard assessment
technologies used for these purposes—e.g., gas monitors used
by firefighters. Local hazardous materials responders and other
specialized response teams may have access to more sophisticated
devices to measure the presence of chemicals, weapons of mass destruction,
and other hazards.5 Other hazard
assessment capabilities are based on individual responder training;
for example, the capability of responders to assess the risks posed
by moving water in a flood situation [FEMA 1994b]. But where local
organizations do not have the capabilities needed to gather necessary
information, the resources must be put in place.
Finally, major disasters require responders to have access to “big
picture” hazard information. To handle this issue, systems
can be put in place to ensure rapid access to overhead imagery [Study
Interviews]. For example, response organizations could maintain
access to public or private helicopters to provide Incident Commanders
with a quick overhead perspective of a disaster scene.6
Access to Needed Hazard Assessment Resources in Other Organizations.
The diversity of hazards that can exist after a major disaster means
that individual response organizations must often rely on external
organizations to provide supplemental hazard assessment capabilities
and expertise.7 For example,
external organizations possess technology and expertise to measure
hazards such as airborne pollutants, heavy metals, asbestos, particulates,
and others. In addition, external organizations can also provide
access to technical assets that local response organizations could
never support on their own. Beyond the helicopters discussed above,
a range of other sophisticated overhead monitoring platforms can
also contribute to management of responder safety. Depending on
the disaster type, information from weather and imaging satellites,
airborne infrared sensors, thermal sensors, LIDAR (light detection
and ranging) instruments, or other monitoring systems can provide
useful overhead viewpoints.8
Consequently, agreements—such as memoranda of understanding,
formal plans, or mutual aid agreements—must be put in place
before a major disaster occurs to enable local response agencies
to coordinate efforts to assess hazards and access resources from
other agencies.9 Agreements
must also be in place to ensure that information produced by these
varied sources can be effectively shared and used among response
organizations.10
Safety managers at a major disaster need points of contact in key
organizations at the local, state, and federal agency levels, as
well as relevant nongovernmental organizations. With these contacts
in place, they will have resources to call on when they face a specialized
hazard assessment need. This requires developing contact lists and
information about the assessment capabilities of relevant organizations,
as well as building the inter organizational relationships needed
to make such coordinated hazard monitoring function effectively.11
Recommendation 4.2—Develop Assessment Methods, Checklists,
Guidelines, and Standards to Assist in Hazard Monitoring Efforts
Among Multiple Agencies
Following a disaster, responders may not know all the potential
health and safety risks that should be examined or where to obtain
monitoring capabilities for unfamiliar hazards. As a result, tools
and resources to provide responders with guidance on hazard monitoring
needs and facilitate access to outside resources are needed. As
described above, development of lists of potential hazards is a
critical element of disaster response planning. Beyond their utility
in preparedness efforts, such lists can also provide first responders
at a disaster scene with information on potential hazards that require
assessment. Study discussion participants indicated that such lists—by
alerting responders to the types of questions they should be asking
after particular disasters—are needed to better define safety
efforts, especially in the early phases of disaster operations.
In addition, such common lists can also help ensure that responders
from different organizations have a uniform understanding of hazard
monitoring needs. To ensure that such assessment tools are readily
at hand when a disaster occurs, ideally they should be tailored
to be relevant to routine response operations as well.
Assessment methods are also needed to manage and assure that hazard
information produced in large-scale assessment operations is uniform
and comparable enough to be useful for safety management. Direct
observation of the disaster aftermath is always a major source of
hazard information for safety management. Although a few responders
may be able to collect the necessary information at a small incident,
directly assessing a hurricane or earthquake impact zone could require
hundreds of individuals. To perform such an assessment effectively,
many individuals must be coordinated in information gathering efforts.
This need also applies to assessments performed by technical experts;
for example, there were issues with consistency of the building
stability assessments performed by structural engineers drawn from
many organizations after the Northridge earthquake [Collins 1999].
Interviewees reported use of standardized “score cards”
or templates for damage assessment by response units to ensure consistency
among the efforts of many individual responders.12
Monitoring guidelines and standards can also contribute to ensuring
that technical hazard assessment efforts—in areas such as
air quality, water contamination, or other environmental threats—of
different organizations can effectively contribute to safety management.
Problems with different organizations using incompatible analytical
methods or producing data that are not comparable can significantly
undermine hazard assessment efforts. Responders indicated that efforts
to standardize analytical methods and protocols to the extent possible
should therefore be an important part of preparedness [Study Workshop].
Recommendation 4.3—Develop Information Management Systems
and Processes So That Response Organizations Can Use Hazard Data
More Effectively
The scale and multiagency nature of disaster response operations
result in a requirement for information management tools to focus
and integrate safety management. To make it possible to use information
from different response organizations’ monitoring efforts,
hazard data must be produced and presented so it can be easily compared
and utilized by safety managers. In presenting the results of assessments,
standard forms and formats would make it easier for Incident Commanders
to readily absorb needed information [Study Workshop].13
When different hazard assessment organizations present their results
in markedly different ways, it is more difficult for safety managers
to use the information under time-limited conditions.14
If data are presented in a uniform manner, recognizing and resolving
any disagreement among different data sources are also more straightforward.
Addressing such issues is particularly important when the hazard
situation at an incident scene is uncertain enough that appropriate
monitoring and assessment strategies are not clear.
For multiagency hazard monitoring efforts, rapidly examining and
assessing hazard data produced by a range of different response
organizations can be difficult. Examination and assessment under
high-pressure disaster situations require databases to collate data
and rapidly deliver needed hazard information.15
Appropriate data-bases would make it possible for safety managers
to quickly examine data produced by different response organizations
to identify discrepancies, track the evolution of the hazard environment
over time, and flag potential problems that require follow-up examination.16
Because disaster response operations frequently take place over
large areas that involve significant differences in hazard environments,
management tools that allow responders to track data spatially can
also contribute to safety management. To both deliver assistance
and protect responders after a major incident, it is critically
important to understand differences in the hazard environment across
the entire site. Depending on details of an incident, some areas
might be very hazardous to responders while others pose no major
safety concerns. Because of the potential for destruction of landmarks
and other location indicators after a major event, strategies based
on the global positioning system (GPS) to assist in locating and
defining hazard areas would be valuable.17
Geographic information systems (GIS) can provide a useful tool to
organize hazard information for an entire incident scene and make
it readily accessible to safety managers [Greene 2002]. By building
a framework to consistently present data, such technologies can
make available the “panoramic view” of an incident that
responders indicated can be elusive at major incidents.18
Recommendation 4.4—Undertake Joint Exercises that Include
Multiagency Hazard Monitoring Efforts
To put multiagency monitoring capabilities in place rapidly after
a major disaster, hazard assessment activities must be practiced
and relationships built among cooperating organizations. As a result,
disaster exercises should include hazard assessment components that
test the adequacy of assessment plans and exercise multiagency coordination
processes. All relevant organizations should be involved as a way
of building relationships and experience in joint operations that
pose realistic, safety related issues for responders.
Information on the Responder Workforce:
Maintaining Accountability Data on Responders and Units
Along with an accurate sense of the types of hazards present, Incident
Commanders need reliable and timely information on the responders
operating at the disaster scene. This accountability information
on both individual responders and their units is integral to effective
safety management. The study recommends several ways of overcoming
existing shortfalls in responder accountability during response
operations. A combination of standard operating procedures, identification
systems, and emerging technologies can strengthen the capability
of Incident Commanders to know which responding entities are at
the disaster scene, what functions they are performing, and where
their personnel are located.
The nature of disaster response operations presents significant
barriers to obtaining and maintaining sufficient information on
the response workforce.
Large Geographic Scale. Large and complex disaster
scenes undermine efforts of response managers to maintain accountability
information for response units and effectively track response resources.
Responding to incidents over large areas requires more responders,
increasing the challenges in maintaining an awareness of individuals’
locations and activities. Complex and widespread disaster scenes
also make establishing scene perimeters difficult, thereby reducing
the opportunity to collect accountability information as workers
enter and leave the scene.
Prolonged Duration. Because major disaster response
operations often require action over days, weeks, or even months,
responding organizations must manage responder shift changes and
work-to-rest rotations. The evolution of responders operating at
the scene over time further complicates obtaining and maintaining
accurate accountability information.
Wide Range of Needed Capabilities. The involvement
of responders from many organizations also makes it difficult to
collect information on the capabilities, activities, training, and
equipment of responders at the incident. For example, after Hurricane
Andrew, the Miami-Dade Fire Department alone estimated that it received
mutual aid from 100 Florida departments and 25 out-of-state departments
[Paulison et al. 1993, 68]. Over 100 organizations participated
in the response to the attack on the Pentagon [Institute for Crisis
Disaster and Risk Management 2002] and the number of organizations
involved in the World Trade Center response has been estimated to
exceed 400 [Harrald 2002].19
Although individual organizations will be familiar with the capabilities
of their members and have mechanisms to monitor re-ponder accountability,
few mechanisms exist to provide that information effectively to
Incident Commanders.20
Influx of Convergent Volunteers and Supplies.
Accounting for volunteers— many of whom are not connected
to any organization—is even more problematic. Since they are
generally not organized in a way that would allow response managers
to collect and manage information on individual volunteers’
capabilities, training, and activities, it is particularly difficult
to integrate convergent volunteers into safety management efforts.21
Recommendation 4.5—Bolster the Role of
Response Units in Accounting for Personnel
For responders who are organized into defined response units, connection
to the incident command structure at the unit level is a promising
means for ensuring personnel accountability. Information on personnel
accountability can be collected and utilized through mechanisms
to link responding units to the incident command structure. Having
units “report in” upon arrival at the scene is the first
step. Then the Incident Commander is aware of their presence at
the site and can coordinate their activities.22
Once assigned a response activity and operating location, responding
units periodically report their location and activities, thus maintaining
accountability. These reports ensure that the Incident Commander
remains aware of their presence when he or she makes choices on
how to deal with hazardous conditions at the disaster scene. Such
“unit level” accountability systems work best for response
organizations that have defined and stable units.23
In other disaster response organizations, many of which are organized
very differently, applying unit-based approaches may require forming
responders into appropriate groups specifically for disaster response
purposes. Such a strategy must be planned, exercised, and evaluated
before an event occurs if it is to be successful in post-disaster
conditions.
When unit-based approaches are used to support accountability,
it should be noted that unit or crew integrity is essential.24
As units deploy to the disaster scene, they must account for all
individual responders who are members of their unit. Requiring that
units enter and depart the disaster scene together, and that they
operate as coherent units, ensures that individual or small groups
of responders are not placed in life-threatening situations without
the knowledge of their commanders.
Recommendation 4.6—Develop Personnel Identification and Credentialing
Systems Better Suited to Major Disaster Response Operations
If responder identification and accountability functions cannot
be provided at the unit level (Recommendation 4.5),
mechanisms must be put in place to provide safety managers with
this information for individual responders. Different types of identification
methods exist for identifying responders in major emergency responses.
Some responding units make use of high-visibility vests to identify
key personnel and color coded armbands to identify types of responder
personnel. Issuing “event badges” to responders is another
way of identifying personnel at the disaster scene and indicating
their authorized activities. In addition to including individual
and unit identification, badges can be color-coded by day or can
indicate the areas at the disaster site where the responder is allowed
access. Although such identification systems can provide some capabilities
to visually identify responders, they cannot provide the accountability
information safety managers need to adequately protect responders
at disaster response operations. In addition, they do not provide
necessary safety-related information about responders (e.g., expertise,
training, and personal protective equipment levels) for effective
safety management. As a result, it is clear that more robust identification
and credentialing systems are needed to protect the safety and health
of responders during major disaster responses. Incident Commanders
must be able to identify authorized responders at a disaster scene,
track their location and activity if needed, and have access to
information on whether they possess the right qualifications for
working in a specific environment.
Because of the practical difficulties in implementing identification
systems after a disaster,25
providing these capabilities must be included in preparedness efforts.
Systems must be designed not only to prevent unauthorized individuals
from gaining access, e.g., by duplicating badges, but also to ensure
that responders with legitimate needs to participate are not excluded.
Any identification system should also provide information on responder
credentials: their certifications, training levels, and other information
on their general skills relevant to operating in a hazardous environment.
26 It was also suggested that
including information on any cross-training experience that individuals
possess, as well as some medical information (e.g., vaccination
history and possible antibiotic sensitivities), could be important
for protecting safety in specific disaster situations.27
Responders cited a range of technological approaches that could
make responder identification, credentialing, and accountability
information much more readily available to safety managers. Key
technology options cited include “smart cards” that
could be rapidly scanned at a staging area or entry point at the
disaster scene to authenticate the identity and qualifications of
individual responders.28 Other
options include the use of radio frequency tags that transmit the
location and status of individual responders, or bar code identifiers
or biometric systems suitable for tracking the movement of responders
through entry/exit points. Responders emphasized that any new technological
approaches should be subjected to pilot tests with operational units
to ensure that such equipment will work well in actual disaster
circumstances.
Recommendation 4.7—Utilize Scene Control to Improve Cross-Agency
Accountability
Although technological solutions can contribute to improving personnel
accountability, lower technology options can make a significant
contribution as well. For events where a hard perimeter can be established
around the incident scene, even recording units’ response
assignments and activities as they enter and leave the scene could
improve accountability.29
Effective scene control has the benefit that it represents a critical
means for ensuring multiagency accountability. Since all responders
must cross the perimeter to participate in response activities,
information can be collected from them independent of their “home
organization.” Taking advantage of this strategy requires
that establishing clear scene perimeters, supported by personnel
monitoring those who enter and leave the scene, is a priority in
response operations. Means to do so must be included in preparedness
plans to ensure that scene control can be established as early as
possible in a response.
Recommendation 4.8—Develop Minimum Standards for Safety and
Health Training for All Responders Involved in Disaster Response
Operations
The need for safety managers to gather information on worker capabilities
and training is created by the significant differences that exist
among responding organizations. If safety managers could assume
a common, base level of training for all responders involved at
an incident, the need to gather such information would be significantly
reduced. In addition to contributing directly to better safety management,
not having to devote effort to gathering information on responder
capabilities would allow safety managers to give more attention
to other concerns. Study discussions indicated that the curriculum
should include a basic familiarity with the following:
- the ICS approach to disaster response
- common terminology for safety and health issues
- an “all-hazards” perspective on the range of hazards
that could be encountered during disaster response activities
- relevant protective equipment, and when and how to use it
- decontamination and rehabilitation processes
- an overview of the diverse organizations that are likely to
become involved in major disaster response.
Models could be developed from existing safety standards and training
programs, such as those related to satisfying OSHA requirements
for emergency response workers or skilled support personnel at sites
where hazardous materials are present.30
Beyond such minimum requirements, different response disciplines31
might add additional training requirements for their members.32
Information on Responders’
Health and Injuries: Collecting Injury, Exposure, and Health Status
Data
Information on responder injuries and health status is critically
needed to allow safety managers to address safety problems and intervene
to improve responder protection. The extent to which information
on responder injuries and health status is available to Incident
Commanders reportedly varies. For example, some study workshop participants
indicated that current systems in many areas could provide this
information; others, including responders involved in recent disaster
response operations, contradicted that view. Project interviews
indicated that the characteristics of disaster situations can make
it particularly difficult to collect this information and provide
it to safety managers.
Large Number of People Affected, Injured, or Killed.
During project discussions, responders reported that the focus in
disaster situations is on meeting the medical needs of victims,
rather than on the needs of the responders serving them. The intense
operational pressures compete with efforts to collect information
on the health status of the responder workforce.
Large Geographic Scale. Just as the scale of disaster
scenes hinders efforts to collect hazard information and maintain
responder accountability, it also gets in the way of collecting
needed health information on responders. Because responders are
often treated at multiple locations (or individually by their peers),
mechanisms are not routinely in place for injury or exposure information
to feed back to safety management [Study Interviews].33
This was a particular issue at Hurricane Andrew where both responders
and victims were treated at broadly dispersed medical facilities
[Study Interviews].
Wide Range of Needed Capabilities. The involvement
of many different responding organizations also makes it difficult
to collect needed health status information. Although some individual
responder organizations may have mechanisms to collect information
on injuries or exposures suffered by their own members, those mechanisms
may not be effective in post-disaster conditions, and routes are
often not in place to share such information to apprise safety management
more broadly.
Influx of Convergent Volunteers and Supplies.
Because convergent volunteers are generally not effectively organized
or connected to the Incident Command System, no mechanism exists
for managers to become aware of injuries or exposures that occur
during such volunteer activities.
Recommendation 4.9—Develop Systems to Provide Timely Information
on Responder Injuries and Exposures
Currently, self-reporting by responders is the primary method used
to document injuries during response operations. However, the significant
operational pressures that exist in the early phases of a response
may result in responders failing to report injuries.34
Getting a complete view of responder health status and potential
risks is also impeded by underreporting of less serious injuries
that, while not immediately disabling or life threatening, could
be indicative of more serious problems [Study Interviews].35
Without timely feedback on responder injuries, disaster safety managers
will not have accurate information on the scope and extent of non
critical injuries, as well as the specific areas of the site where
particular injuries are occurring [Study Interviews].
To ensure that necessary medical information is available, the
types of injury and exposure information needed should be defined—depending
on the nature of the incident and hazards present—as an element
of preparedness planning. Formal systems must be put in place to
track injuries to emergency responders at major events.36
In light of the multiagency nature of disaster operations, these
systems must provide mechanisms to collect such data across different
responding organizations. In addition, to be most useful for injury
prevention, these systems must be able to track injuries in as close
to real time as possible under the circumstances. How such systems
would be implemented would clearly differ depending on the specifics
of a local community. If responder injuries are all treated at the
disaster scene in a centralized manner, collecting it may only require
consistent reporting to incident safety managers. If responders
are treated at local hospitals or at other locations away from the
disaster scene, data collection and coordination mechanisms would
be required to gather the needed information.37
Whatever procedure is used, data collection must be systematic,
using a defined set of terms and reported in a consistent manner.38
Summary
Major disasters present numerous barriers for gathering key types
of information required for effective safety management. The nature
of major disasters, particularly in terms of a multitude of potential
hazards and the diverse responder workforce, makes the gathering
of safety-related information critical for protecting emergency
responders. Safety managers need timely and accurate information
on the range of potential hazards present (or expected) at a disaster
scene. Better personnel accountability systems, including credentialing
mechanisms to provide information on responder capabilities, are
needed to protect responders during incident operations. Finally,
innovative means are needed to provide timely feedback on the injuries
and health exposures responders suffer while carrying out disaster
response assignments.
1 This problem has also been observed in earthquake
response operations [Collins 1999].
2 For example, in the Los Angeles riots in 1992, ten
firefighters were injured by violence, including two who were shot
[Taylor and Sanchez 1992]. The risk of violence is particularly
pronounced during some terrorism incidents where follow-on attacks
may target responders. This has occurred in attacks in Russia, Israel,
Northern Ireland, and in bombings at both an abortion clinic and
a nightclub in Atlanta, Ga. [RAND and Oklahoma City National Memorial
Institute for the Prevention of Terrorism (MIPT) 2003; Thomas 1997].
3 Multiple agencies may gather hazard information to
inform their own safety management efforts or they may have statutory
or other responsibilities to collect and disseminate the information.
4 For example, during Hurricane Andrew there were problems
with responders not being fully aware of hazardous materials at
hurricane-damaged sites [Lewis 1993, 72; Study Interviews]. In light
of what they learned during the aftermath of the hurricane, local
responders indicated that the availability of regulatory information
on such materials would make it much easier to assess potential
hazards. Other responders cited the usefulness of inspection information
on construction and building contents for hazard assessment [Study
Interviews].
5 Although significant technology is available, assessment
methods to provide first responders with needed information do not
exist for all hazards or may not be broadly accessible to response
organizations because of technical, resource, or other limitations.
As a result, beyond the management issues, significant technical
issues exist in this area as well. Improvements to the capabilities
of current monitoring technologies, broader diffusion of the equipment
in the response community, or the development of new strategies
or technologies could contribute to providing responders with more
rapid and accurate information on post-disaster operating environments.
6 In planning for airborne assessment, it is important
to include backup options if adverse weather, flight restrictions,
or disaster damage hinder the use of aerial assets.
7 This need to rely on capabilities maintained by a
range of other organizations was a key driver for recommending the
integrated, incident-wide approach described in Chapter Seven.
8 Immediately following the September 11 attacks, satellite
imaging and aerial over flights of the World Trade Center and Pentagon
sites were undertaken for damage assessment and hazard monitoring
purposes [Williamson and Baker 2002, 870 873].
9 To ensure that critical monitoring tasks are performed,
planning must include the requirements for activating agreements
or calling on outside resources. Because not all contingencies can
be predicted during planning, backup sources for critical monitoring
capabilities should be identified where possible.
10 Failure in sharing information among response organizations
can pose significant safety issues. In the California wildfires
of 1993, breakdowns in communications between response services
meant that some responders were not sufficiently aware of the speed
and direction of movement of the wildfires [California Office of
Emergency Services 1993].
11 Such contact lists could be developed at the local
level as individual response organizations identify hazard assessment
resources they need; alternatively, for national level assets in
particular, such contact lists could be developed at the federal
level as part of national preparedness efforts.
12 Such tools and training are particularly important
if volunteers or other nontraditional responders participate in
the hazard assessment process [Lewis 1993, 71].
13 Such standardized hazard assessment tools could
be beneficial in routine emergency response as well as major disaster
operations. In addition, use during routine events would increase
familiarity with the tools and help ensure that they could be used
effectively during large-scale response operations.
14 In general, safety managers must filter out needed
safety-related information from the larger body of available information.
The challenge is converting the quantity of information inherently
involved in large-scale incidents to the quality information needed
to manage responder safety.
15 During the World Trade Center response, for example,
the Environmental Protection Agency developed a “Multi-Agency
Data Management System” in an attempt to rationalize different
organizations’ monitoring efforts [EPA 2002].
16 The common data presentation methods described above
could significantly facilitate any effort to produce such hazard
information databases by providing a common input format for all
organizations’ monitoring information.
17 For example, Hurricane Andrew stripped road signs
from a significant fraction of the roads making it difficult for
even local responders to navigate the response area [Lewis 1993,
19].
18 Because specialized database or mapping systems
may not be sufficiently applicable to response organizations’
day-to-day operations, these assets might be better built within
states, regionally, or nationally and deployed rapidly to large-scale
incident scenes.
19 The response to the September 11, 2001, plane crash
in Shanksville, Pa., involved over 74 organizations [Grant and Hoover
2002].
20 In Hurricane Andrew, problems tracking what federal
responders were on site led to confusion about who was deployed
where and resulted in duplicative staff requests [FEMA 1993, 157].
21 In the Oklahoma City bombing in April 1995, a volunteer
nurse, who was not trained or equipped for urban search and rescue
activities, was fatally injured by a piece of falling debris after
arriving at the disaster scene [Irving 1995, 75; Cone et al. 2003].
22 It should be noted that it is also critical to ensure
that incident managers are not overwhelmed with too much accountability
data, resulting in information overload. Determining the right amount
and frequency of accountability information needed to protect responders
and manage operations is a key component of preparedness planning.
23 This unit reporting mechanism has been developed
extensively in the fire service [Brunacini 2002, 273; Coleman 2001,
17 18], for example, where a strong unit structure is maintained
throughout a response.
24 For resource accountability in emergency operations,
the recommended practice of the fire service is to have supervisors
“maintain constant awareness of the position and function
of all personnel assigned to operate under their supervision.”
One role of the ISO is to ensure that the department’s personnel
accountability system is being used. See NFPA, 2002c, pp. 7, 9.
25 In the Pentagon response, the initial computer production
system for creating color-coded identification badges for responders
was quickly overwhelmed, resulting in substantial delays for responder
relief crews [Arlington County 2002, A-69, C-58]. Similar problems
occurred during the Oklahoma City rescue and recovery effort. It
took several days to establish a system and designate a central
issuing agency [Oklahoma City MIPT 2002, 10 11].
26 Examples could include training levels for hazardous
materials response, compliance with training standards such as those
issued by the National Fire Protection Association, or fit testing
or experience in different types or levels of protective equipment.
27 Alternative mechanisms for verifying responder credentials
were also suggested during study discussions. Qualification information
could be collected centrally—such as through a national registry
of responders similar to that used in emergency medical services—providing
incident managers with a quick route to assess the qualifications
of potential responders. Another possibility is pursuing a “certified-organization”
approach to evaluate and certify the training and skill levels of
responder organizations as a whole.
28 Responders cited the lack of nationwide standards
for training and responder certification as a significant obstacle
to developing credentialing systems for major disaster response.
Setting minimum standards for certification and training of responder
personnel would enable the Incident Command to more easily establish
qualifications of responding units and their personnel.
29 At the Pentagon, operations in some areas had tight
perimeter control, while others did not [Arlington County 2002].
Such accountability strategies based on scene control are even more
problematic in wide area disasters, such as Hurricane Andrew or
the Northridge earthquake, where establishing a hard perimeter around
the entire disaster area is not feasible.
30 The OSHA regulation 29 CFR 1910.120 on Hazardous
Waste Operations and Emergency Response (HAZWOPER) sets training
requirements for skilled support personnel involved in the cleanup
operations at sites containing hazardous materials [U.S. Department
of Labor 2003].
31 One example from the fire service is the consensus
standards and recommended practices on fire and safety issues developed
by the NFPA, which are widely used within the fire service.
32 Related to the need for common responder training
standards, study discussions also highlighted the importance of
having means for verifying the quality of the safety and health
training provided to responders. Without such verification mechanisms,
it is difficult to assess the extent and quality of the safety and
health training given to responders.
33 An exception was the World Trade Center response,
where National Disaster Medical System (NDMS) Disaster Medical Assistance
Teams (DMATs) treated many responders on-site, which made it easier
to collect data. Even in that case, however, responders interviewed
during the study indicated that the data did not reach them fast
enough or in a form that could be readily integrated into safety
management [Study Interviews].
34 Because of their desire to continue assisting victims,
responders who sustain injuries often do not report them so that
they can keep working. Responders suggested that more injuries would
be reported if doing so did not necessarily result in an obligation
to stop working [Study Interviews].
35 For example, routine eye injuries can be indicative
of problems in protection that could result in permanent disability
or, in an environment with significant pathogen risks, relatively
minor cuts could develop into serious medical problems if not appropriately
addressed.
36 We were able to find instances of systematic patient
data collection systems in the literature. At Northridge, a single
patient data collection system was used by DMATs and Veterans Administration
clinics (that also mobilized to provide emergency medical care)
to provide up-to-date data [Leonard et al. 1995]. However, this
system was not specific to emergency responders, and it is not clear
that the emergency responder data were available.
37 The privacy requirements of the Health Insurance
Portability and Accountability Act of 1996 could affect the ability
to collect and utilize health information on the emergency response
workforce. The requirements of the act should therefore be addressed
in any preparedness planning aimed at addressing this safety need.
38 Interviewees indicated that counting and data coding
problems undermined data collection efforts at the World Trade Center
response. For example, a visit to a medical team to get safety glasses
was reportedly entered as an eye injury in the counting system [Study
Interviews].
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