This document is the report of the October 26 and 27, 2002 conference held at the Johns Hopkins Education and Research Center for Occupational Health and Safety in Baltimore, Maryland on the topic of worker health and safety training. The goal of the conference was to identify worker health and safety training needs for various industrial sectors related to weapons of mass destruction, including chemical, biological, radiological, and nuclear weapons and explosives (CBRNE).

Contents

Executive Summary

On October 26 and 27, 2002 the Johns Hopkins Education and Research Center for Occupational Health and Safety held a conference on worker health and safety training in Baltimore, Maryland. The goal of the conference was to identify worker health and safety training needs for various industrial sectors related to weapons of mass destruction, including chemical, biological, radiological, and nuclear weapons and explosives (CBRNE). More than 200 attendees, many of them experts in worker training, CBRNE, public policy, or emergency response, participated in the conference.

Speakers and participants were asked to address the following two central questions: (1)What skills and knowledge are common to all workers who might be exposed to terrorist threats from CBRNE? (2)What skills and knowledge are relevant to these threats specific to workers in different sectors? In addition, participants were also asked about the kinds of training methods that would be useful to impart these skills and knowledge. Conference participants identified several elements of training common to a wide range of workers at all organizational levels in different industries that could form the basis of a core curriculum. The following 13 recommended core components address pre-event and post-event training. Pre-event training would be for all workers, whereas post-event training (for both the immediate post-emergency response and clean-up operations) would be for selected personnel, including first responders, skilled support personnel, and other workers involved in these operations.

Recommended Pre-Event Training for All Workers

1. Basic health and safety training (exposure-health relationships, legal, regulatory, and hazard communication).
2. Basic knowledge and recognition of industry-specific hazards and threats.
3. Ability to access emergency notification systems and notify appropriate parties.
4. Knowledge of the Incident Command System (ICS).
5. Knowledge of the worker’s specific functional role in an emergency, the limitations of that role, and the roles of others.
6. Emergency evacuation and egress.
7. Ability to use personal protective equipment (PPE).

Recommended Post-Event Training

8. Site-specific and event-specific hazards and threats
9. Site-specific and event-specific safety and health plan requirements
10. Ability to use PPE
11. Site-specific command and communication
12. Training as outlined in the Hazardous Waste Operations and Emergency Response (HAZWOPER) standard (29 CFR 1910.120 and 1926.65)
13. Critical incident debriefing and stress management

Other findings from the conference can be summarized as follows. First, there are significant differences among different workforce sectors in the degree to which they are prepared to respond to the threat of CBRNE attacks. Some workers, particularly emergency responders, may receive considerable training while many others receive little or no applicable training. Second, training for new CBRNE threats should be integrated into basic safety and health training, in a unified training plan that builds on and supplements other current training requirements. Third, the many Federal agencies involved in regulating or guiding the activities of certain industries must also coordinate their guidance and regulations regarding worker training. This would help in the creation of a core recommended or required training curriculum, which many participants at the conference felt would be very helpful. Fourth, at all levels of response, training should reflect a high degree of coordination between the emergency response and public health communities. Finally, regular “real-life” rehearsals must be an essential element of all training plans. Based on these findings, the recommended next steps are summarized in the following section.

Figure 1. Recommended generic training elements for all workers with a risk of exposure to new CBRNE threats. All workers would receive pre-event training. Asterisk (*) indicates training that applies to specific workers, such as first responders, skilled support personnel and others involved in emergency response, and post-emergency response operations. This framework does not include trade-specific knowledge and skills. HAZWOPER is the hazardous waste operations and emergency response standard (29 CFR 1910.120 and 1926.65).

Worker Training Recommendations

1. Develop specific competencies for pre-event and post-event worker training, based on the general recommendations presented above.
2. Coordinate Federal policy on worker training for CBRNE threats, through a mechanism that includes the many agencies with jurisdiction over worker safety and health.
3. Adopt and promulgate federal guidelines or standards on worker training for new CBRNE threats, based on the competencies and coordinated Federal policy described above.
4. Conduct an inventory of existing training programs that could be used or adapted for new CBRNE threats.
5. Based on specific competencies, develop and validate new modules for pre-event and post-event worker training.

Introduction

On October 26 and 27, 2002, the Johns Hopkins Education and Research Center for Occupational Health and Safety held a conference on worker health and safety training in Baltimore, Maryland. The goal of the conference was to identify worker health and safety training needs for various industrial sectors related to new threats, including chemical, biological, radiological, nuclear, and explosive (CBRNE) weapons. Conference planners wanted to:

1. Review previous findings relevant to worker safety training for new threats;
2. Examine how various private and public sector organizations were incorporating training for new CBRNE threats into existing health and safety training; and
3. Identify the general skills and knowledge that would be required for all workers, versus the specific skills and knowledge that would be required for unique groups of workers in the pre-event, event, and post-event phases of a CBRNE event.

More than 200 attendees, many of them experts in worker training, CBRNE, public policy, or emergency response, participated in the conference.

Background

Following the events of September 11, 2001, and the subsequent use of anthrax in the mail as a weapon, much attention has focused on bolstering the security and preparedness of various public and private systems in the country. This includes public infrastructure, such as the public health system and public safety sectors, and many private sector enterprises, such as the postal and transportation industries. Many of these organizations had already engaged in considerable activity even prior to this time, but these events spurred even greater efforts.

The hazards associated with weapons of mass destruction are already part of the landscape of the American workplace, although they are typically used in a controlled fashion and are not intentionally introduced to cause harm. Workers in many industries work with or are potentially exposed to chemical, biological, radiological, nuclear, and

explosive (CBRNE) hazards on a regular basis. Agents or conditions capable of causing fire and explosions are routinely found in many workplaces (although not

typically on the scale of the attacks on the World Trade Center (WTC) or the Pentagon on September 11, 2001). Highly toxic and reactive chemicals are manufactured, transported, stored, and used every day in large quantities. Nuclear materials are used in the nuclear energy industry, as well as in the defense industry. Radiological agents are used widely in industrial non-destructive testing, medicine, research, and in many other industries.

Because of the hazardous nature of certain types of work, worker training is an essential aspect of occupational safety and health programs. Many U.S. Occupational Safety and Health Administration (OSHA) standards include a component of worker training. One example of a training requirement already in place that applies specifically to potential terrorism incidents is the HAZWOPER standard (29 CFR 1910.120 and 40 CFR 311)¹. This standard requires health and safety training for employees involved in the emergency operations on a site, who are or could be exposed to hazardous substances and health hazards (see Figure 2). It also includes provisions for both emergency response operations (§1910.120(q)) and for post-emergency response operations, such as cleanup or decontamination (§1910.120(e)). Other Federal agencies with worker safety and health standards also require specific training for emergency conditions or operations.

Recognizing that worker training is an essential element of preparedness for terrorist incidents involving CBRNE threats, this conference was convened to identify core knowledge and skill requirements common to workers in many different industries who might be the targets of these types of attacks.

Conference participants included union members, private-sector employers, government agency officials, and members of the academic and professional public health communities. The themes of the conference were: (1) a review of previous lessons learned about how different types of training worked in the recent events involving acts of terrorism and workplace violence; (2) how these lessons are being applied in various occupational sectors; and (3) what conference participants considered the most important general and occupation-specific training objectives for workers who might be exposed to CBRNE events in the future.

This document was a joint effort of the Johns Hopkins Bloomberg School of Public Health and the National Institute for Occupational Safety and Health.

Disclaimer

Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH).

This document is in the public domain and may be freely copied or reprinted.

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Contributions

Editor: Clifford S. Mitchell, MS, MD, MPH
Associate Public Health Professor
Department of Environmental Health Sciences
Johns Hopkins Bloomberg School of Public Health

Conference Planning Committee

Clifford Mitchell (Chair)
Johns Hopkins Bloomberg School of Public Health

Jacqueline Agnew
Johns Hopkins Bloomberg School of Public Health

Brenda Cantrell
George Meany Center for Labor Studies

Richard Duffy
International Association of Fire Fighters

Richard Fairfax
U.S. Department of Labor Occupational Safety and Health Administration

Lynn Goldman
Johns Hopkins Bloomberg School of Public Health

Joseph “Chip” Hughes
National Institute of Environmental Health Sciences

William Kojola
American Federation of Labor-Congress of Industrial Organizations (AFL-CIO)

Marilyn Null
U.S. Army Center for Health Promotion and Preventive Medicine

Henry Payne
U.S. Department of Labor Occupational Safety and Health Administration

Rosemary Sokas
National Institute for Occupational Safety and Health

Corey Thompson
American Postal Workers Union

Abbreviations