| Abstract |
The collapse of the World Trade Center and the subsequent persistent and complex health problems experienced by the emergency responders illustrated the need for improved health monitoring and surveillance of emergency responders. As a result, a multi-agency task force was created to address the problem. This task force worked with the U.S. National Response Team (NRT) to develop the Emergency Responder Health Monitoring and Surveillance(TM) (ERHMS(TM)) Technical Assistance Document (TAD). The TAD details best practices and contains tools, examples, and forms that have been used by various agencies when responding to incidents. The TAD is available at https://www.cdc.gov/niosh/topics/erhms/ under Additional Resources, ERHMS Documents. ERHMS(TM) is a framework designed to help protect emergency responders throughout the pre-deployment, deployment, and post-deployment phases of a response as depicted in this diagram. The intent of medical monitoring and surveillance of emergency response and recovery workers is to identify exposures, signs, and symptoms of health outcomes early in the course of an emergency. Early identification will prevent or mitigate adverse outcomes as well as ensure that workers maintain their ability to respond effectively and are not harmed in the course of their work. Monitoring and ongoing assessment can help determine whether protective measures are adequately being provided to the workforce and are sufficient to prevent or reduce harmful exposures to workers. Data collected during the pre-, during-, and post-deployment phases will also help to identify which responders would benefit from medical referral and possible enrollment in a long-term health surveillance program. Key concepts identified within the ERHMS(TM) framework include: Pre-deployment Phase: Rostering and credentialing of emergency response and recovery workers, health screening for emergency responders, health and safety training, data management, and information security; Deployment Phase: On-site responder in-processing, health monitoring and surveillance during response operations, integration of exposure assessment, responder activity documentation and controls, and communications of exposure, health monitoring, and surveillance data during an emergency response; Post-Deployment Phase: Responder out-processing assessment, post-event tracking of emergency responder health and function, lessons-learned, and after-action assessments. This framework builds on systems and practices currently in use and can be used in both small and large scale incidents depending on the needs of the organization and event. ERHMS Info Manager(TM) is a free software platform to track and monitor emergency response and recovery worker activities before, during, and after their deployment to an incident site. ERHMS Info Manager(TM) enables organizations to implement the ERHMS(TM) framework. For more information on how to implement the ERHMS(TM) framework, install ERHMS Info Manager(TM), online training courses, and additional resources, visit the ERHMS(TM) website at https://www.cdc.gov/niosh/erhms/. |
