During the World Trade Center attack on September 11, 2001, hundreds of thousands of people were exposed to environmental contaminants and traumatic injuries, and nearly 3,000 people lost their lives (Lucchini et al., 2017). As workers from every U.S. state rushed in to help those affected, there was minimal health tracking of workers and records of what they were exposed to or what type of personal protective equipment they may have been wearing early in the response. As a result, 450 workers died and hundreds more were seriously injured (Jackson et al., 2002).
In order to ensure workers can respond safely and effectively to future emergencies, the National Institute for Occupational Safety and Health (NIOSH) collaborated with federal agencies, state health departments, and unions to create the Emergency Responder Health Monitoring and Surveillance (ERHMS) System. ERHMS is a framework that allows an organization to monitor the health and safety of emergency responders throughout the predeployment, deployment, and post-deployment phases of a response. The goal of ERHMS is to prevent short- and long-term illness and injury in emergency responders. Traditional groups of workers that typically respond to emergencies include police, fire, emergency medical personnel, and construction and utility workers, but can also include environmental health specialists, industrial hygienists, mental health professionals, and other public health personnel and volunteers.
There are well documented gaps and deficiencies in the health monitoring and surveillance of emergency response workers in reports following the 9/11 terrorist attacks (Jackson, Baker, Ridgeley, Bartis, & Linn, 2004), but unfortunately, these trends have continued during the responses to Hurricanes Katrina and Rita (Bergan, Thomas, Schwartz, McKibbon, & Rusiecki, 2015; Rusiecki et al., 2014) and Deepwater Horizon (Kitt et al., 2011; National Institute for Occupational Safety and Health, 2011).
ERHMS aims to ensure specific activities to protect the health and safety of emergency response and recovery workers are conducted during each of the three phases of a response (Figure 1). During the predeployment phase, organizations should ensure workers are properly rostered, credentialed and trained; fit for duty; and can store this information in a secure manner. During the deployment phase, health monitoring and surveillance should be conducted while workers perform their job tasks to ensure...