Figure 5.1 Making Decisions and Assessing Options
	• Performing hazard assessment • Making risk management decisions • Selecting appropriate protective measures
RAND MG170-5.1

Assessing Hazards: Judging the Level of Risk Faced by Responders

Once hazard information is available to a safety manager, the data must be assessed to evaluate the danger posed to responders. In the earliest stages of response operations, this assessment will be based on information that is immediately available to the first responders at the scene. Although this initial “size up” will guide safety management efforts during the early stages of operations, the characteristics of disaster situations pose significant challenges to the continuation of effective hazard assessment.

Large Geographic Scale. The scale of major disasters, and the resulting magnitude of the safety concerns, can prevent safety managers from effectively assessing hazards. Because of the demands of the disaster, a single safety manager may be forced to address more safety issues than he or she can reasonably manage.

Large Numbers of People Affected, Injured, or Killed. The need to take immediate action when lives are at risk limits the time responders have available to make decisions. Such time constraints make it difficult for safety managers to effectively assess hazards and the risks posed to responders.² In the most intense situations, safety managers may even be “pulled away” into operational activities, thus compromising efforts to consistently assess safety hazards [Study Interviews].

Multiple, Highly Varied Hazards. The unusual hazards in some post-disaster environments can make it difficult to translate monitoring information into practical and actionable hazard assessments. During day-to-day response activities, responders build considerable experience with the hazards they routinely face. In disasters, most responders face hazards that are unfamiliar and are more difficult to assess. For some hazards—such as environmental pollutants, unusual hazardous materials, or biological threats—hazard assessment information may be highly technical in nature. In some cases, there is no consensus on guidelines or regulatory requirements to define what constitutes a dangerous level for particular hazards [EPA 2002].

Wide Range of Needed Capabilities. The involvement of many responder organizations in large-scale responses can also complicate hazard assessment. If different organizations use different criteria to judge whether the area is dangerous, serious confusion can arise. At the World Trade Center site, for example, disparities in the hazard assessment efforts of different agencies occurred because differing standards were being applied [Lioy and Gochfeld 2002]. Different standards were used by various organizations measuring asbestos, for example, leading to confusion about the results [Lippy 2002].³ Data sharing problems among separate agencies can also complicate hazard assessment efforts.

Recommendation 5.1—Identify and Connect with Experts in Hazard Assessment During Preparedness Planning

The nature of some hazards involved in disasters requires that technical and safety experts from outside “traditional” response organizations become involved in safety management decision making. Hazard assessment is a process of identifying the hazards present at the scene and determining their potential impact on responder health and safety. While knowing the level of a hazard is a first step, a safety manager also needs to understand how responders’ exposures are affected by their activities. All relevant variables must be weighed in the context of the response situation to enable sound decisions on how the hazards can be effectively managed. Because disaster response operations are inherently time-limited environments, these assessment decisions must be made rapidly.

Making these assessments for many hazards requires technical input beyond simply providing information on the presence or level of a hazard at the disaster scene. As a result, technical experts and responders from safety-related organizations participating in safety management need to provide safety managers with the context and follow-up required for hazard information to be useful. In the case of complex respiratory hazards, for example, hazard assessment requires information beyond simply measuring the level of a contaminant in the environment.⁴ Such information includes the likely health effects of particular hazards, the applicability of different protective options to reduce hazard exposures, and the consequences on response operations and for responders from potential safety actions. Such assessment is straightforward for some hazards, such as the physical risks posed to responders by debris at some disaster scenes. For others, however, where the biological effects of particular materials are not fully understood or there is no consensus on appropriate protective options, significant expert input may be required for decision making.

To ensure that appropriate expertise is available after a disaster occurs, relevant technical experts and organizations must be identified as a component of preparedness activities. Response safety managers must understand any procedural or legal requirements to call required experts in after a disaster and how rapidly they can respond to an evolving event. These experts could be drawn from federal, state, or local regulatory or technical agencies, universities, nongovernmental organizations, or the private sector. Depending on the nature of the disaster, individuals with knowledge relevant to safety management could range from military experts on unconventional weapons and infectious disease epidemiologists to industrial hygienists or occupational physicians. Integrating such assistance into decision making also requires significant interagency coordination to foster the needed exchange between operational responders and outside hazard experts.⁵ When there is no mechanism for this interaction to occur or barriers between organizations get in the way of effective cooperation, critical technical information for protecting responder safety may not be effectively linked to safety and operational decisions.

Recommendation 5.2—Develop a Better Understanding of Relevant Exposure Thresholds and Guidelines for Disaster Response Conditions

In project interviews and workshop discussions, responders indicated that there are significant problems in defining the appropriate regulatory guidelines and exposure thresholds to interpret hazard data during emergency response.

Questions were raised about the appropriateness of existing occupational exposure guidelines for shorter-term, potentially very intense exposures during emergency response operations [Study Workshop; Lioy and Gochfeld 2002].⁶ Differences must also be resolved between exposure thresholds defined for occupational environments versus those for overall exposure of the public at large [Study Workshop].

From the diversity of views observed, it is clear that there is no current consensus on appropriate thresholds and standards for interpreting monitoring data during disaster response conditions. To improve overall understanding of hazard exposures, there is a need for further scientific research and data collection to better understand intense short-term hazards exposures, simultaneous exposure to many hazards, and the potential long-term health effects that can result. Because of the complexity of these areas, such a research effort represents a long-term investment to improve understanding in these areas.

In the short term, guidelines are needed to assist Incident Commanders in making decisions as part of the overall risk-benefit analysis of response operations. Development of these guidelines must involve the full range of response organizations so technical disagreements about hazard data can be addressed and, to the extent possible, resolved as part of preparedness efforts. It is clear that such technical disagreement cannot be successfully resolved during the time-limited and high pressure conditions of an ongoing disaster response.

Managing Risk: Balancing Risks and Benefits in Response

Hazard information provides the basis for risk assessment—weighing the need for decisive operational action against the risks involved in doing so. Safety managers provide critical input on risks and safety options that Incident Commanders consider in the context of the practical needs of the response. Effective safety management therefore requires a clear judgment on whether disaster victims can still be rescued or whether response activities are in a recovery, or cleanup, mode [Worker Education and Training Program 2002]. The nature of disaster situations makes drawing this distinction particularly difficult, however.

Large Numbers of People Affected, Injured, or Killed. Because of the large number of individuals affected by a disaster, it is often difficult to determine the potential benefit from continued rescue operations. Although distinguishing between the rescue and recovery phases of a response seems clear in principle, making the distinction during particular responses is often problematic [Neal 1995]. Identifying extreme cases is straightforward. At the site of the September 11, 2001, crash of Flight 93 in Shanksville, it could be quickly established that there were no survivors and a decision could be made to adjust response tactics [Grant and Hoover 2002]. Response activities at the World Trade Center site are an example of a much more difficult case because circumstances prevented local authorities from making a clear distinction between the rescue and recovery phases.⁷

Wide Range of Needed Response Capabilities. The involvement of multiple organizations in major disaster response can also create other complications for safety decision making Organizations from different response disciplines can have very different approaches to risk management [Jackson et al. 2002]. Such differences in approach can derive from the nature of their activities—e.g., law enforcement responders have different practical concerns about some risks compared with the concerns of emergency medical responders. Such differences can result in organizations coming to different judgments about appropriate risk levels.

Recommendation 5.3—Address the Transition Between the Rescue and Recovery Phases of Disaster Response Operations in Preparedness Planning

After a major event, making the decision that the diminishing chances of rescuing anyone alive no longer justify putting responders at an elevated risk is difficult. Views clearly differ on the right approach to this issue. Some responders indicated that, since victim survivability is so difficult to predict, it is important to maintain rescue operations as long as any possibility exists. Others voiced caution at that strategy, emphasizing the added risks involved in the faster pace of rescue operations.

In the aftermath of a disaster, concluding rescue operations will almost certainly be exceptionally difficult for responders and political leaders alike [Study Interviews]. However, a decision not to address such issues head on could have significant consequences for responder safety, depending on the incident. Although there was no consensus on the correct approach to solving this problem, it is clear that the politically and emotionally charged environment after a disaster is not an appropriate time to resolve such differences. Planning for this transition, including how the decision will be made and who will make it, should be included in pre-disaster preparedness activities.

Choosing Protective Options and Planning for Safety Needs: Supporting Effective Decision making in Responder Protection and Risk Mitigation

A key component of safety management decision making is choosing appropriate protective equipment and/or risk mitigating measures in light of available hazard information. To make good decisions, safety managers need a clear understanding of the equipment options available to them, how to choose among them, and how to project protection and resource needs as response efforts continue. However, the characteristics of major disasters complicate making these protection decisions.

Multiple, Highly Varied Hazards. The potential for unusual hazards in the post disaster environment complicates protection decisions. During the earliest phases of response operations, detailed hazard assessment information is often not available to guide selection among safety equipment options. Furthermore, shortages of supplies may also mean that the best equipment for particular hazards is not immediately available.

Wide Range of Needed Response Capabilities. While many different responder organizations are needed to address the operational needs of disaster response operations, various organizations often come with very different equipment and safety related capabilities. These variations can have a major effect on the range of safety options available to safety managers. In addition, the number and variety of individual responders involved make estimating equipment needs for the response more difficult.

Influx of Convergent Volunteers and Supplies. While different response organizations come to disaster response operations with differing equipment and capabilities, convergent volunteers often come without supplies or training in the use of protective equipment. Donations of safety-related equipment, while potentially important for both responders and volunteers, also challenge decision making This perspective was highlighted as a serious problem after both Hurricane Andrew and the Oklahoma City bombing [Study Interviews; Oklahoma Department of Civil Emergency Management 2000]. If such convergent supplies are not systematically inventoried, managers do not know what are available and cannot integrate them into safety management.

Recommendation 5.4—During Disaster Planning, Address Issues Concerning Safety Equipment and Multi agency Coordination of Safety Logistics

For safety managers to make good decisions among potential protective options, they require accessible and accurate information about the options available at the incident scene or from outside organizations. Safety managers need to know what particular organizations bring to an incident scene and where needed equipment can be obtained when an event occurs. In some cases, other responding organizations may be able to provide supplemental safety equipment. Pre positioned supply caches maintained by federal agencies should also be integrated into planning. In addition, safety managers may have to make arrangements with private firms to provide needed supplies. The high-pressure conditions immediately following a disaster are a difficult time to pursue new supplier relationships or seek out equipment from new sources.⁸

As a component of preparedness planning, responder organizations should maintain up-to-date inventories of their own resources and any external resources available through agreements or standing contracts. These lists should also include information on any requirements to activate mutual aid pacts, invoke interagency agreements, call on federal resources, or purchase supplemental supplies [Lewis 1993; NFPA 2000b]. To the extent possible, resource planning should also seek to address equipment interoperability concerns that can prevent most effective use of safety equipment in Multi agency operations [Jackson et al. 2002]. It is also critical to plan for any training needed for responders to use equipment effectively. If responders are given equipment that is not properly fitted or are not instructed in its proper use, its effectiveness could be reduced or eliminated [Lippy and Murray 2002]. To the extent possible, these analyses should also try to identify if multiple response organizations in an area are relying on equipment support from the same external organizations or vendors. If this is the case, supplemental capabilities may not be available when a large-scale incident occurs.

Because disaster response operations may include organizations from outside the immediate area, groups that are not included in pre-planning activities may become involved in response operations. Methods to address these groups must be included as part of the planning process. Information on their equipment could be integrated into decision making if they provide sufficient information to safety managers when they arrive at the incident scene. Alternatively, the credentialing systems discussed previously could provide safety managers with information on responders’ equipment.

Promoting standardization and interoperability may be an effective strategy to address Multi agency safety equipment coordination concerns at large-scale incidents. If safety equipment is standardized and interoperable, safety managers will no longer need to collect information on different organizations’ resources since compatibility could be assumed. This could significantly reduce the logistical burden involved in providing supplies during an extended response and could free up managers’ time and attention for other safety concerns.

Recommendation 5.5—Develop Guidelines for Selecting Protective Equipment to Use in the Early Phase of Response

During the earliest phases of response operations, before technical expertise can be brought to bear or supplemental safety equipment can be located, responders and safety managers need guidelines, checklists, or other decision making tools to assist in developing appropriate protection strategies. Such tools should provide guidance for selecting equipment based on the initial “size up” of the situation and processes to reevaluate protective options as response operations continue and additional information becomes available.⁹

Recommendation 5.6—Develop Guidelines for Estimating the Safety Equipment Requirements for Disaster Response Operations

In addition to determining the type of safety resources needed for a disaster response, safety managers (in coordination with the logistics section of response management, see Figure 3.1) must also estimate the amount of various safety resources that will be needed over the course of the response effort.¹⁰ To the extent that equipment needs can be defined, reasonable projections of required equipment help to avoid oversights in resource requests or, conversely, requests for supplies that are not needed, unnecessarily complicating logistics operations. Because of the complexity of large-scale, Multi agency operations, safety managers need better methods to estimate resource needs to guide safety logistics efforts.

Summary

Safety management decision making faces a series of challenges, exacerbated during the early phase of a major disaster response when time pressures are severe and substantial uncertainty exists. To effectively protect responders, safety managers need better guidelines and technical support to carry out hazard assessment and clearer risk assessment criteria as response operations transition from rescue to recovery phases. To support effective decision making on responder protective equipment issues, preparedness efforts must ensure that safety managers can rapidly determine available equipment options, have guidelines to assist in choosing equipment in the absence of relevant or complete hazard information, and can reasonably estimate safety equipment needs for large-scale and extended response operations.

¹ Other response decisions can affect responder safety. The choice among response strategies can have safety implications, and some operational actions may affect the presence or intensity of hazards, e.g., when extinguishing fires. For the purposes of this discussion, these decisions are considered operational in nature, and although they would likely involve the input of safety managers, they are not categorized as safety management decision making

² Under time-constrained conditions, managers often rely on cues from their earlier experience to allow rapid decision making [Klein 1998]. Most response organizations, however, lack experience in managing disaster-scale operations.

³ Responders indicated that similar problems occurred in the Pentagon response [Study Interviews].

⁴ In project discussions, such data on levels were often criticized for being “non-actionable,” since, on their own, the data did not provide enough information to guide safety decisions. On the other hand, when technical experts sought only to provide the “correct answer,” i.e., what protective equipment should be worn or what policy implemented based on their hazard assessment efforts, the results might not sufficiently consider the operational needs of the response. For example, at the Pentagon response, some safety and health officials “pressed for a strict policy that would guarantee protection under the most severe conditions, including having all responders operate in Tyvek® suits, regardless of their particular assignment”[Arlington County 2002, A-68]. However, because of the heat stress risk involved in having responders wear these suits for extended periods, this strategy was deemed impractical. Instead, comprehensive decontamination and cleaning of responder equipment was substituted as a safety management strategy that struck a better balance between the operational mission and safety needs of responders engaged in rescue operations.

⁵ This need for integration was one component that drove the research team to consider the integrated, incident wide approach described in Chapter Seven.

⁶ During the period that research for this study was being performed, OSHA was also carrying out an evaluation of the applicability of regulations and productive roles for regulatory agencies in post-disaster environments.

⁷ Study Interviews with a number of organizations involved in the World Trade Center operations, and examination of available literature, produced no discernable consensus on when the site transitioned from the rescue to the recovery mode [Study Interviews; NVFC (National Volunteer Fire Council) 2002; Jackson et al. 2002, 47; Lioy and Gochfeld 2002].

⁸ With respect to the private sector, responders reported that close relationships with supplier organizations were critical for supplying the response operations to the September 11, 2001, attacks.

⁹ For example, RAND and NIOSH are involved in an effort to develop guidelines of this type for protective equipment selection for response operations after a major building collapse.

¹⁰ Such estimates must obviously be periodically revisited as response efforts continue, circumstances change, or better information is developed.