Tuesday, January 27, 2015

Protection of the Disaster Volunteers through the Emergency Responder Health Monitoring and Surveillance (ERHMS) system

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Emergency responders, such as police officers, fire fighters, and paramedics, are often on the front lines during a disaster, which makes them particularly vulnerable to work-related injuries and illnesses during a response. The scientific community has some knowledge about occupational injuries and illnesses among these groups from surveillance systems currently in place, notably the Bureau of Labor Statistics’ (BLS) Survey of Occupational Injuries and Illnesses (SOII), but the BLS database does not include volunteers.   What about the courageous responders from volunteer organizations or volunteer fire fighters and paramedics at local and county levels?


In order to learn more about the associated risk factors for injuries and illnesses suffered by volunteer responders in the line of duty, we analyzed disaster data from the American Red Cross collected between the years 2008 and 2012. Our results were recently published in Disaster Medicine and Public Health PreparednessExternal Web Site Icon. We found that hurricanes showed the highest median rates of injuries (14/1000 responders) and illnesses (18/1000 responders). Additionally, disasters with higher operational costs were a significant predictor for higher rates of injuries and illnesses when compared with disasters with lower operational costs.
What do we do with this information? We know that there is a great demand for volunteers when a severe disaster occurs. However, a responder may have pre-existing health conditions, such as asthma or hypertension, which could increase his or her risk of injuries and illnesses in a physically demanding situation. Careful consideration of a volunteer’s medical history and job duties should be reviewed before a field deployment to prevent injuries and illnesses.

Implementing a framework, such as the Emergency Responder Health Monitoring and Surveillance (ERHMS) system, can protect volunteers from work-related injuries and illnesses through systematic training and monitoring before, during, and after an emergency. Prior to a deployment, responders are placed on a roster, their credentials are verified, health screenings are performed, and health and safety trainings are provided. During a deployment, health and exposure monitoring are conducted, and following a deployment, responder health and function are tracked and after-action assessments are completed.
Protecting volunteers also makes sense for the bottom line. Often, volunteer organizations cover the medical expenses for their volunteers. Saving money on medical costs by preventing injuries and illnesses would be a benefit of implementing ERHMS.
This study looked specifically at Red Cross volunteers. Additional research is needed in other volunteer organizations. If your organization would like to collaborate with NIOSH on similar research, please contact us through the blog comment box below or at nioshblog@cdc.gov.

Kimberly Brinker, RN, MSN, MPH is a Nurse Epidemiologist in the NIOSH Office of the Director.