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1ools Secuon
69
ERHMS
Pre-deployment
11. 8osLerlng and Credenuallng of Lmergency 8esponse and
8ecovery Workers
8osLerlng and credenuallng Lools can range from slmple Lo complex. 1hls dlverslLy can be addressed by
caLegorlzlng Lhe Lools as baslc, enhanced, and comprehenslve. 8aslc rosLerlng and credenuallng Lools
conslsL of prlmarlly self-reporLed lnformauon by Lhe responders. Lnhanced Lools lncorporaLe some sorL of
verlcauon sLep for one or more pleces of lnformauon, such as conducung background checks or verlfylng
a professlonal llcense. Lssenual lnformauon has been ldenued LhaL can be capLured ln a baslc or enhanced
sysLem, and Lhls can be done on paper or by uslng anoLher low-Lech sysLem. Comprehenslve rosLerlng and
credenuallng Lools are mosL llkely elecLronlc daLa sysLems. 8aLher Lhan llsung all posslble rosLerlng and
credenuallng daLa elemenLs ln Lhe comprehenslve secuon, here, brley, are Lhree elecLronlc rosLerlng and
credenuallng sysLems oLhers have used Lo meeL Lhls need for Lhelr organlzauons.
ConLenLs:
1. 8as|c roster|ng and credenna||ng examp|e
2. Lnhanced roster|ng and credenna||ng examp|e
3. Comprehens|ve roster|ng and credenna||ng pr|nc|p|es w|th three examp|es
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ERHMS
8as|c koster|ng and Credent|a||ng Lxamp|e (created by the LknMS Workgroup)
Data 1ype Category Data L|ement
koster|ng Informat|on
name reflx
llrsL name
Mlddle lnlLlal
LasL name
Sufflx
Allas
8esldence Legal 8esldence Llne 1
Legal 8esldence Llne 2
ClLy
SLaLe
Zlp Code
L-mall rlmary L-mall
1elephone rlmary 1elephone number
ersonal ALLrlbuLes 8lrLh uaLe
Cender
PelghL
WelghL
Languages Spoken lluenLly
name of ConLacL who wlll know where
you are ln 6 monLhs reflx
llrsL name
Mlddle lnlLlal
LasL name
Sufflx
Allas
ConLacL's 8esldence Legal 8esldence Llne 1
Legal 8esldence Llne 2
ClLy
SLaLe
Zlp Code
unlque lu number unlque lu number
1ravel uocumenLs assporL number
unlon lnformaLlon unlon name
Local unlon number
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ERHMS
kesponse
Crgan|zat|on CrganlzaLlon ueLalls
Lmployer vs. volunLeer CrganlzaLlon
(lndlcaLe Whlch)
name and Address
ConLacL erson's name and 1elephone
number
Data 1ype Category Data L|ement
Credent|a||ng Informat|on
rofesslonal Llcenses and CerLlflcaLlon
LlsL of llcenses and cerLlflcaLlons wlLh
appllcaLlon Lo emergency response
rofesslonal 1ralnlng
LlsL of successfully compleLed Lralnlng
courses wlLh appllcaLlon Lo emergency
response (may be obLalned from prlor
L8PMS secLlon on Lralnlng)
rofesslonal LducaLlon
LlsL of educaLlonal courses wlLh appllcaLlon
Lo emergency response (may be obLalned
from prlor L8PMS secLlon on Lralnlng)
8elevanL Work Lxperlence lndusLry
CccupaLlon
!ob 1ask
number of ?ears
Ass|gned
Credent|a| Leve| Asslgned CredenLlal Level
1he credenLlal level asslgned by Lhe
admlnlsLraLor afLer verlflcaLlon of Lhe
relevanL lnformaLlon. (Lxample: verlfled
vs. un-verlfled)
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ERHMS
Lnhanced koster|ng and Credent|a||ng Lxamp|e (created by the LknMS Workgroup)
Data 1ype Category Data L|ement
Added L|ements for Lnhanced koster|ng and Credent|a||ng 1oo|
Consent ConsenL Lo use lnformaLlon
uld appllcanL consenL Lo collecLlng,
uslng, and malnLalnlng Lhe appllcanL's
personal lnformaLlon? CpLlons: ?es
| no
CorrecL lnformaLlon ledged
uld appllcanL pledge Lo submlL
only correcL lnformaLlon lnLo Lhe
credenLlallng daLabase? CpLlons: ?es
| no
AppllcanL ConsenL uaLe
uaLe appllcanL pledged Lo provlde
correcL lnformaLlon and consenLed Lo
Lhe collecLlon, use, and malnLenance
of Lhe appllcanL's personal
lnformaLlon.
8ackground Check ConsenL Lo 8ackground Check
uld appllcanL consenL Lo allow Lhe
sLaLe Lo perform background checks?
CpLlons: ?es | no
uaLe ConsenLed Lo 8ackground
Check
uaLe appllcanL consenLed Lo allow
reference and background checks.
CpLlons ?es | no
Dep|oyment references ueploymenL references Ceographlcal ueploymenL reference
1ravel ulsLance
ueploymenL 1lme
lncldenL 1ype
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ERHMS
Comprehens|ve koster|ng and Credent|a||ng r|nc|p|es w|th 1hree Lxamp|es
Soware packages are commerclally avallable LhaL could be used for rosLerlng and credenuallng, buL Lhe
followlng Lhree organlzauons chose Lo develop Lhelr own cusLomlzed elecLronlc sysLem Lo meeL Lhelr needs-
reparedness Workforce ManagemenL SysLem by Lhe CenLers for ulsease ConLrol and revenuon (CuC),
LnCLlnk by Lhe u.S. Army Corps of Lnglneers (uSACL), and Lhe Lmergency SysLem for Advance 8eglsLrauon
of volunLeer PealLh rofesslonals (LSA8-vP), owned and operaLed by each sLaLe and admlnlsLered by Lhe
Cmce of Lhe AsslsLanL SecreLary for reparedness and 8esponse (AS8) aL Lhe u.S. ueparLmenL of PealLh
and Puman Servlces (PPS).
reparedness Workforce Management System (WMS)
1he reparedness Workforce ManagemenL SysLem (WMS) ls currenLly used by Lhe CuC Lmergency
Cperauons CenLer (LCC) Lo manage response eorLs and prepare for fuLure publlc healLh evenLs.
lL ls a powerful Lool LhaL provldes Lhe ablllLy Lo collecL lnformauon on Lhe currenL locauon of all CuC
personnel. CurrenL locauon ls dened Lo lnclude currenL work locauon, home locauon, and Lravel locauon.

Web-based appllcauon provldes CuC emergency response personnel Lhe ablllLy Lo emclenLly and accuraLely
perform Lhese Lasks:
- Manage deploymenLs (personnel senL ln response Lo a publlc healLh emergency/evenL)
- Manage Leams (asslgnmenL Lo lnLernal Leams for evenL response needs)
- LocaLe personnel (ldenufy personnel based on Lravel, asslgnmenL, and work locauons or geographlcal
area)
- ldenufy personnel (based on knowledge, skllls, and ablllues)
- noufy personnel (send Lelephonlc and/or LexL alerLs Lo personnel by Leam or lndlvldual)
1he WMS appllcauon ls Web-based, bullL uslng AS.nL1 and A!Ax, wlLh appllcauon and SCL daLabase
servers hosLed on a redundanL archlLecLure uslng vL8l1AS clusLerlng. Coogle LarLh ls used Lo provlde 2u
mapplng servlces, Mlcroso SCL Server provldes reporung servlces. WMS recelves self-ldenued daLa from
CuC nelghborhood (CuC's lnLernal Web-based phonebook), such as skllls and ablllues, personal conLacL
lnformauon, and paruclpauon preferences.
1he comprehenslve vlew of response eorLs provlded by WMS helps Lo address Lhe lssues of muluple
deploymenL rosLers, over-allocauon of resources, and dupllcauon of coordlnauon eorLs, resulung ln more
emclenL response and operauons. ln addluon, Lhe WMS appllcauon allows users Lo collecL lnformauon on
Lhe degrees, speclalues, subspeclalues, languages, skllls, Lralnlng, professlons, llcenses, employmenL sLaLus,
agency lnformauon, currenL and prevlous work asslgnmenLs, and currenL and prevlous deploymenLs. lL ls
avallable for all CuC personnel.
Lng|neer's L|nk
LnCLlnk ls a robusL, Web-based, Lhree-uer archlLecLure uslng Cracle 10g LnLerprlse (whlch oers enLerprlse-
class performance, scalablllLy, and rellablllLy on clusLered and slngle-server congurauons) as Lhe daLabase
englne, Lhe Cracle Appllcauon Server for Web hosung, and Lhe users' Web browser as Lhe means of enLry.
1he uSACL lnformauon 1echnology (ACL-l1) Cmce manages all of Lhe soware and archlLecLure for LnCLlnk.
LnCLlnk has Lransformed Lhe way uSACL responds Lo emergencles by provldlng Lhe framework for processlng
lnformauon and performlng command and conLrol of uSACL elemenLs. LnCLlnk represenLs ground LruLh"
reporung and allows deployed personnel real-ume access Lo crlucal lnformauon. 1he sysLem represenLs
a slngle daLa enLry polnL LhaL sLandardlzes and lnLegraLes meLhods of collecung, analyzlng, forecasung,
and presenung lnformauon for declslon makers. 1he ueploymenL Module Lracks personnel and mlsslon
requlremenLs from Lhe beglnnlng Lo Lhe end of a uSACL response. Cnce personnel are deployed ln LnCLlnk,
Lhey are Lracked from Lhe beglnnlng Lo Lhe end of Lhelr deploymenL, resulung ln lncreased managemenL
and accounLablllLy of personnel. LnCLlnk reporLs, vlewable by all command elemenLs, allow access Lo
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ERHMS
[usL-ln-ume, crlucal lnformauon. ueploymenL Module reporLs provlde answers Lo sLamng needs, loglsucal
concerns, and Lhe managemenL of personnel.
Safety kepornng |n LNGL|nk: 1he AccldenL 8eporung SysLem (A8S) ls a Lool developed Lo be used for Lhe
lnpuL of accldenL reporL daLa for uSACL personnel, conLracLors, and properLy, as well as non-uSACL personnel
who are on uSACL properLy. 1he sysLem places reporLs meeung speclc crlLerla lnLo an organlzauon's safeLy
log for reporung accldenL lnformauon Lo local uSACL Command and CSPA.
LnCLlnk ls used by uSACL as lLs Lool for MlllLary Conungency and Clvll Lmergency ueploymenLs. lL has
Lhe ablllLy Lo conLaln Lhe followlng lnformauon on every uSACL Leam member: emergency experlence,
cerucauons, languages, lmmunlzauons, medlcal screenlng, emergency phone numbers, Lralnlng, llcenses,
passporL, L lLems, deployed, redeployed, slgned sLaLemenL of undersLandlng for deploymenL, deployed
duLy descrlpuon, home sLauon lnformauon.
Lmergency System for Advance keg|stranon of Vo|unteer nea|th rofess|ona|s (LSAk-Vn)
8efore a publlc healLh emergency or medlcal dlsasLer, advance coordlnauon and communlcauon regardlng
Lhe credenuals and quallcauons of healLhcare personnel ls crlucal. 1he Lmergency SysLem for Advance
8eglsLrauon of volunLeer PealLh rofesslonals (LSA8-vP) addresses Lhls need by developlng a nauonal
neLwork of sLaLe-owned and operaLed sysLems LhaL reglsLer volunLeer healLh professlonals who oer Lo
ll capablllues durlng an emergency. SLaLes verlfy Lhe ldenuLy, credenuals, llcenses, cerucauons, hosplLal
prlvlleges, and relevanL Lralnlng of reglsLered volunLeer healLh professlonals ln advance of an emergency. 1hls
crlucal neLwork faclllLaLes Lhe deploymenL of wllllng, needed, and qualled healLh professlonal volunLeers aL
Lhe nauonal, sLaLe, LerrlLorlal, Lrlbal, and local levels. 1he Cmce of Lhe AsslsLanL SecreLary for reparedness
and 8esponse (AS8) aL Lhe u.S. ueparLmenL of PealLh and Puman Servlces (PPS) admlnlsLers LSA8-vP
and malnLalns Lhls lnLeroperable neLwork of sysLems or verlcauon neLwork.
Lach sLaLe's LSA8-vP sysLem ls bullL Lo a common seL of sLandards deslgned Lo allow swl and slmple
exchange of healLh professlonals wlLh oLher sLaLes. LSA8-vP ensures LhaL sLaLe, local, and Lrlbal healLh
deparLmenLs can access Lhe verlcauon neLwork elecLronlcally and esLabllshes and requlres Lhe appllcauon
of compllance and compllance wlLh measures Lo ensure eecuve securlLy of, lnLegrlLy of, and access Lo Lhe
daLa ln Lhe neLwork.
Cllnlcal prlvlleges are granLed by a requesung enuLy, such as a hosplLal, noL by LSA8-vP. 1he funcuon
of Lhe LSA8-vP sysLem ls Lo provlde accuraLe and rellable credenual and oLher lnformauon Lo faclllLaLe
Lhe granung of prlvlleges on-slLe. Many of Lhe credenuals verlcauon organlzauons consulL wlLh Lhe !olnL
Commlsslon and oLher nauonal accredlung organlzauons. 1he lnformauon malnLalned ln Lhe LSA8-vP
sysLem does noL lnfer healLh professlonal volunLeer compeLency Lo perform healLh servlces. 1he range of
prlvlleges glven and Lhe need for supervlslon remaln under approprlaLe auLhorlLy and conLrol.
1
1 ESAR-VHP Interim Technical and Policy Guidelines, Standards, and Denitions, U.S.
Department of Health and Human Services, June 2005.
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ERHMS
21. re-deploymenL PealLh Screenlng for Lmergency
8esponders
ConLenLs:
1. 8as|c re-dep|oyment Lva|uanon
2. Lnhanced re-dep|oyment Lva|uanon
3. Comprehens|ve re-dep|oyment Lva|uanon r|nc|p|es
4. Lxamp|es of re-dep|oyment Screen|ng 1oo|s used by se|ected Lmergency kesponse un|ts
S. CSnA kesp|rator Med|ca| Lva|uanon uesnonna|re
8aslc re-deploymenL LvaluaLlon (Lo be compleLed by Lhe Lmergency 8esponder) [creaLed by Lhe
L8PMS Workgroup]
uaLe: ___________________________________________________________________
name: __________________________________________________________________
uaLe of 8lrLh: _____________________________________________________________
!ob 1lLle: ________________________________________________________________
Lmployer: _______________________________________________________________
!ob LocaLlon: _____________________________________________________________
lease answer each of Lhe quesLlons Lo Lhe besL of your knowledge:
1. WhaL wlll be your [ob or your responslblllLles whlle deployed? (lf unknown, sLaLe unk.)
__________________________________________________________________________________
2. Whlch of Lhese descrlbes your healLh, ln general?
a. LxcellenL b. very Cood c. Cood d. lalr e. oor

3. uo you have any medlcal or denLal problems or are you currenLly under Lhe care of a physlclan?
?LS / nC
lf ?es, please explaln: ________________________________________________________________
4. uo you have any allergles whlch mlghL lmpalr your ablllLy Lo respond ln an emergency, such as an
envlronmenLal allergy, or an allergy Lo vacclnes, or food or drug allergles?
?LS / nC / uon'L know
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ERHMS
3. uo you have any physlcal llmlLaLlons whlch may affecL your ablllLy Lo respond ln an emergency, may
effecL your ablllLy Lo be LransporLed Lo an emergency, or may lmpalr your ablllLy Lo wear personal proLecLlve
equlpmenL? ?LS / nC
lf ?es, please explaln: ________________________________________________________________
6. Pow would you raLe your currenL physlcal flLness level?
a. LxcellenL b. very Cood c. Cood d. lalr e. oor
7. WhaL ls your currenL:
WelghL (pounds)? _______
PelghL (lnches)? _______
8. (lemales Cnly) Are you pregnanL? ?LS / nC / uon'L know
9. uo you have, or could you easlly obLaln prlor Lo respondlng Lo an emergency, aL leasL a 90-day supply
of your prescrlpLlon medlclne? ?LS / nC
10. lf you requlre prescrlpLlon glasses or conLacL lenses, do you have backup prescrlpLlon glasses or conLacL
lenses easlly avallable?
11. uo you requlre any personal medlcal equlpmenL LhaL may be dlfflculL Lo obLaln or replenlsh durlng a
long-Lerm deploymenL (l.e., greaLer Lhan one week)? ?LS / nC
12. uo you currenLly have any concerns or quesLlons abouL your healLh or ablllLy Lo be deployed on an
emergency? ?LS / nC
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ERHMS
13. Pave you recelved Lhe followlng vacclnaLlons?
Docment Vacc|nat|on Status Date |ast vacc|nat|on rece|ved
(or date of f|na| vacc|nat|on |n
ser|es)
lot oll tespooJets
1eLanus
PepaLlLls 8
lnfluenza
andemlc lnfluenza
lot selecteJ tespooJets
neumococcal vacclne
PepaLlLls A
Measles/Mumps/8ubella
ollo
varlcella
8ables
AnLhrax
Smallpox
Lnhanced re-deploymenL LvaluaLlon (Lo be compleLed by Lhe Lmergency 8esponder) [creaLed
by Lhe L8PMS Workgroup]
uaLe: _____________________________________________________________________________
name: ____________________________________________________________________________
uaLe of 8lrLh: ______________________________________________________________________
!ob 1lLle: __________________________________________________________________________
Lmployer: _________________________________________________________________________
!ob LocaLlon: _______________________________________________________________________
lease answer each of Lhe quesuons Lo Lhe besL of your knowledge:
1. PealLh SLaLus (pre-deploymenL)
a. re-exlsLlng medlcal and menLal healLh condlLlons: ___________________________

____________________________________________________________________
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ERHMS
b. asL surgerles/daLes: ___________________________________________________

____________________________________________________________________
2. Any medlcal and/or flLness concerns LhaL you would llke Lo be addressed:
___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________
3. MedlcaLlons you presenLly Lake:
___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________
4. Allergles (food, medlclne, envlronmenLal):
___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________
3. SubsLances:
e. Alcohol use (AmounL per day): ______________________________________________
f. Smoklng (number of clgareLLes per day): ______________________________________
g. CLher drugs or subsLances (amounL per day): ___________________________________
6. llLness Level:
a. PelghL: ___________ lnches
b. WelghL: __________ pounds
c. 8Ml (Lo be deLermlned by healLh care provlder): ________________
d. CondlLlons LhaL may lmpalr your acLlvlLles of dally llvlng: _________________________

________________________________________________________________________
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ERHMS
e. CondlLlons LhaL may llmlL your ablllLy Lo perform sLrenuous acLlvlLy: _________________

________________________________________________________________________
f. Score on mosL recenL physlcal flLness LesL (lf appllcable):

Score of _______________ ouL of a posslble _____________________
7. !ob-speclflc 8lsk lacLors:
a. uo your emergency response acLlvlLles poLenLlally requlre you Lo wear resplraLory proLecLlon?
?es / no / uon'L know
b. Pave you been flL-LesLed for an n93 resplraLor or oLher resplraLor proLecLlon?
?es / no / uon'L know
c. uo your emergency response responslblllLles lnvolve Lhe poLenLlal of exposure Lo hazardous
subsLances? lf yes, please descrlbe: ___________________________________________

________________________________________________________________________
8. vlslon correcLed ___________________ and uncorrecLed _________________________
9. Pow ls your hearlng? LxcellenL / Cood / lalr / oor
10. uo you have a hlsLory of any of Lhe followlng?
a. ChesL paln ?es / no
b. Syncope ?es / no
c. Abdomlnal paln ?es / no
d. Selzure dlsorder ?es / no
e. PeaL exhausLlon/heaL sLroke ?es / no
f. CLher medlcal / denLal / or psychologlcal condlLlons ?es / no
lf yes, please descrlbe: __________________________________________________

____________________________________________________________________

____________________________________________________________________
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ERHMS
11. Pave you recelved Lhe followlng vacclnaLlons?
Document Vacc|nat|on Status Date |ast vacc|nat|on rece|ved
(or date of f|na| vacc|nat|on |n
ser|es)
lot oll tespooJets
1eLanus
PepaLlLls 8
lnfluenza
andemlc lnfluenza
lot selecteJ tespooJets
neumococcal vacclne
PepaLlLls A
Measles/Mumps/8ubella
ollo
varlcella
8ables
AnLhrax
Smallpox
12. uo you have any llmlLaLlons or concerns abouL deploylng Lo ausLere condlLlons (such as LemperaLure
sLress, no or lnLermlLLenL elecLrlclLy, and few servlces/supplles)?
______________________________________________________________________________
______________________________________________________________________________
13. uescrlbe any funcLlonal and/or access needs LhaL you may have due Lo some form of dlsablllLy.
______________________________________________________________________________
______________________________________________________________________________
1o be compleLed by Agency / CrganlzaLlon / or Lmployer:
14. Lxposure Anuclpauon:
a. AnLlclpaLed deploymenL locaLlon (as speclflc as posslble): _____________________

____________________________________________________________________
b. AnLlclpaLed Lasks Lo be performed (as speclflc as posslble): ____________________

____________________________________________________________________
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ERHMS
c. AnLlclpaLed clrcumsLances under whlch Lasks wlll be performed (l.e., llsL of dlsasLer
Lypes): ______________________________________________________________

____________________________________________________________________
d. CharacLerlsLlcs of expecLed work locaLlons and relaLlonshlp Lo known or suspecLed C88n
(chemlcal, blologlcal, radlologlcal, and nuclear) agenLs or condlLlons: ____________

____________________________________________________________________
13. AnuclpaLed daLe of deploymenL:
16. AnuclpaLed durauon of deploymenL:
17. ConLrol anuclpauon:
g. AnLlclpaLed need for L? ?es / no
h. AnLlclpaLed Lype of L needed: __________________________________________

____________________________________________________________________
l. AdequaLe pre-lncldenL Lralnlng for Lasks? ?es / no
[. AnLlclpaLed shlfL schedules: _____________________________________________

____________________________________________________________________
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Comprehens|ve re-dep|oyment Lva|uat|on r|nc|p|es
1he deslgn of a comprehenslve healLh screenlng Lool for emergency responders ls a challenglng Lask LhaL
requlres a cusLomlzed rlsk assessmenL of Lhe duues and responslblllues of Lhe responder. lL musL Lake lnLo
conslderauon Lhe speclc anuclpaLed work acuvlues, worklng condluons, and work semngs ln whlch a
responder ls expecLed Lo perform. lor Lhls reason, lL ls noL pracucal Lo deslgn a comprehenslve screenlng
Lool LhaL ls approprlaLe for a wlde range of emergency personnel. lnsLead, Lhls documenL provldes a llsL of
Lhe general lssues LhaL should be addressed when deLermlnlng Lhe need for comprehenslve screenlng of
an emergency responder. lL Lhen provldes examples of comprehenslve evaluauon quesuonnalres LhaL are
currenLly used by cerLaln hlgh-rlsk emergency responder groups.
Comprehenslve medlcal screenlng should lnclude a compleLe medlcal hlsLory and revlew of sysLems, a
physlcal examlnauon, and, ln some lnsLances, laboraLory Lesung, as lndlcaLed by cllnlcal [udgmenL and good
occupauonal medlcal pracuce. re-deploymenL blologlcal monlLorlng for exposure Lo hazardous chemlcals
ls noL generally recommended. Such monlLorlng ls noL pracucal for unanuclpaLed exposures Lo hazardous
chemlcals. When exposures Lo speclc chemlcal agenLs are predlcLable, workers should be adequaLely
proLecLed. Powever, Lhere may be some llmlLed lnsLances ln whlch obLalnlng basellne cllnlcal speclmens
before deploymenL for work ln envlronmenLs wlLh predlcLable exposures may be helpful ln subsequenLly
assesslng wheLher Lhe proLecuons used durlng Lhls work are adequaLe and performlng as lnLended.
1he followlng are examples of Lhe Lypes of lssues LhaL should be consldered when deLermlnlng Lhe need
for comprehenslve medlcal screenlng.
1. 8esponse Semngs and Condluons
- AusLere semngs (LemperaLure sLress, no or llmlLed elecLrlclLy and few servlces/supplles)
- ulsasLer zone semngs (physlcal hazards, conLamlnaLed oodwaLers, lnfecuous vecLors)
- Pazardous maLerlals release or uncharacLerlzed and complex exposure zones (lndusLrlal exploslons,
ma[or sLrucLural collapses, commerclal LransporLauon crash)
- 8adlauon or nuclear conLamlnauon semngs
- Long work hours
- lnconslsLenL opporLunlues for resL and nuLrluon
2. 8esponse 1asks
- Peavy lllng or physlcal exeruon
- Pazardous duLy requlrlng use of heavy or cumbersome proLecuve equlpmenL
- 8esplraLory proLecuon requlremenLs
3. ersonal 8lsk lacLors
- Chronlc lllness, degree of medlcal conLrol, and ablllLy Lo malnLaln LhaL conLrol ln Lhe eld semng,
degree of vulnerablllLy or rlsk of exacerbauon glven eld semngs and resources
- urug allergles, parucularly Lo medlcauons used for posL-exposure prophylaxls for blo-Lerror agenLs,
food allergles
- 8ecenL ln[ury and llkellhood of repeaL ln[ury or unexplalned faugue
- Care, malnLenance, and moblllLy requlremenLs for durable medlcal equlpmenL or asslsLance anlmals,
ablllLy Lo evacuaLe
An example of a well-esLabllshed comprehenslve evaluauon can be found ln Lhe uSCC Medlcal Manual
ClM 6000.1C aL: hup://www.uscg.mll/dlrecuves/llsung_clm.asp?ld=6000-6999
83
ERHMS
AnoLher example ls from Lhe nauonal llre roLecuon Assoclauon (nlA): nlA 1382: SLandard on
Comprehenslve Cccupauonal Medlcal rogram for llre ueparLmenLs, 2007, Ldluon hup://www.nfpa.org/
caLalog/producL.asp?pld=138207
Addluonal source of lnformauon regardlng vacclnes: CuC's Lpldemlology and revenuon of vacclne-
revenLable ulseases hup://www.cdc.gov/vacclnes/pubs/plnkbook/defaulL.hLm
Lxamp|es of re-dep|oyment Screen|ng 1oo|s Used by Se|ected Lmergency kesponse Un|ts
8as|c Lva|uanon
lnLerlm Culdance for re-exposure Medlcal Screenlng of Workers ueployed for Purrlcane ulsasLer Work
hup://www.cdc.gov/nlosh/Loplcs/emres/preexposure.hLml
1hls documenL provldes lnLerlm guldance on medlcal screenlng for workers before deploymenL Lo dlsasLer
response acuvlues.
8C1C
hup://college.vfmac.edu/LlnkCllck.aspx?leuckeL=mll8noC3Z3c3d&Labld=180
very baslc seL of quesuons for a 8C1C program.
CenLer for uomesuc reparedness 8esponder Screenlng 1ool
hup://www.emd.wa.gov/Lralnlng/documenLs/Medlcal_Screenlng_lormCu.pdf
1ool ls used for responders under conslderauon for auendance aL Lhe CenLer for uomesuc reparedness,
WMu 1echnlcal Lmergency 8esponse 1ralnlng Course (1L81), WMu PAZMA1 1echnlclan 1ralnlng Course (P1),
WMu Pands-Cn 1ralnlng Course (PC1), WMu Lmergency Medlcal Servlces Course (LMS), WMu Lmergency
8esponder Pazardous MaLerlals 1echnlclan Course (L8 PM), AgrlculLural Lmergency 8esponse 1ralnlng, and
Lhe MCA1l courses (CSM, PLC, 8ASlC, and u).
ueparLmenL of uefense ueploymenL PealLh Cllnlcal CenLer - lorm uu 2793
hup://www.pdhealLh.mll/dcs/pre_deploy.asp
1he Pre-deployment Health Assessment Form (DD 2795) ls a requlred form LhaL allows mlllLary personnel Lo
record lnformauon abouL Lhelr general healLh and share any concerns Lhey have before deploymenL. lL also
helps healLhcare provlders ldenufy lssues and provlde medlcal care before, durlng, and aer deploymenL.
- uu 2793 ls mandaLory for deploylng mlllLary personnel from every servlce, lncludlng reserve
componenL personnel
- uu 2793 ls Lo be compleLed and valldaLed wlLhln Lhe 30 days before deploymenL
Lnhanced Lva|uat|on
coost CootJ Aoxllloty Alt ctew 5cteeoloq lotm
hLLp://forms.cgaux.org/archlve/a7042f.pdf
lL may also be consldered a baslc form, buL lL does go lnLo dlsquallfylng speclflc medlcal condlLlons. lL has
been placed ln Lhls secLlon as an example of an enhanced form.
cuc metqeocy kespoose 1eom MeJlcol cleotooce ColJelloes
(Pard copy ls below)
84
ERHMS
1hls documenL was formulaLed Lo esLabllsh general guldellnes for use ln Lhe medlcal evaluaLlon and Lhe
flLness-for-duLy clearance of appllcanLs who volunLeer Lo parLlclpaLe on Lhe CuC-wlde Lmergency 8esponse
1eam. lL can represenL an enhanced" seL of screenlng crlLerla used for Lhose wlLh responder duLles LhaL
puL Lhem aL moderaLe rlsk of ln[ury and lllness.
CDC kesponder kead|ness Med|ca| C|earance
name: __________________________________uaLe: ____________
Soclal SecurlLy number: ______________________________________
1he lnformaLlon you provlde ln Lhls clearance exam ls prlvaLe and confldenLlal.
ast Med|ca| and Surg|ca| n|story (LlsL any pasL or currenL medlcal concerns, dlseases, sympLoms, surgerles,
procedures or oLher condlLlons)
uaLe CondlLlon CurrenL SLaLus
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Iam||y n|story (LlsL any medlcal condlLlons of blood relaLlves lncludlng hlgh blood pressure, hearL or kldney dlsease,
dlabeLes, cancer, alcohollsm, psychlaLrlc lllness or oLhers)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Soc|a| n|story
uo you use Lobacco ln any form? no ?es
uo you drlnk alcohol ln any form? no ?es
uo you use lllegal drugs or mlsuse oLher drugs? no ?es
Lxplaln any yes" answers. _____________________________________________________________
_________________________________________________________________________________
83
ERHMS
Assessment of hys|ca| Act|v|ty Leve| (uescrlbe Lype, amounL and frequency of physlcal acLlvlLy LhaL you
compleLe on a regular basls.) ____________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Current Med|cat|ons (lnclude prescrlpLlon, over-Lhe-counLer, vlLamlns, supplemenLs, herbals, oLhers)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
A||erg|es (LlsL and descrlbe medlcaLlon, food, lnsecL or oLher allerglc reacLlon or adverse evenL)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
86
ERHMS
Name: _________________________________ Date: _____________
Immun|zat|on n|story (Clve monLh and year when lmmunlzaLlon(s) lasL compleLed lf known)
1eLanus/ulphLherla __________________________________
PepaLlLls A _________________________________________
PepaLlLls 8 _________________________________________
Measles/Mumps/8ubella _____________________________
varlcella (lf unknown, musL LlLer) _________________________________________
AnLhrax ___________________________________________
Smallpox __________________________________________
18 Skln 1esLlng _____________________________________
kev|ew of Symptoms |n Ma[or 8ody Systems PAvL ?Cu LvL8 PAu:
?LS nC ?LS nC
1. lrequenL or severe headaches? 26. kldney or prosLaLe dlsease?
2. ulzzy spells, falnLlng or blackouLs? 27. ulabeLes?
3. Lpllepsy or selzures? 28. 1hyrold dlsease?
4. Lye Lrouble or vlslon problems? 29. CLher endocrlne dlsease?
3. Lar problems or dlfflculLy hearlng? 30. Peavy mensLrual bleedlng?
6. Pay fever or oLher allergles? 31. Anemla/hemaLologlcal dlsorder?
7. uenLal problems? 32. Lasy brulslng or bleedlng?
8. CLher ear, nose or LhroaL problems? 33. 8lood cloLs?
9. Wheezlng or asLhma? 34. ArLhrlLls/[olnL palns/swelllng?
10. ShorLness of breaLh on exerLlon? 33. CLher connecLlve Llssue dlsease?
11. Chronlc cough? 36. !olnL or bone deformlLy/fracLure?
12. Coughlng up blood? 37. 8ack paln, wear a back brace?
13. 1uberculosls or (+) 1b skln LesL? 38. ulfflculLy walklng?
87
ERHMS
?LS nC ?LS nC
14. aln or pressure ln your chesL? 39. Lczema or aLoplc dermaLlLls?
13. alplLaLlons or poundlng hearL? 40. CLher rashes?
16. PearL murmur? 41. Any oLher skln dlseases?
17. CLher hearL problems? 42. Cancer?
18. Plgh or low blood pressure? 43. Any lmmune sysLem dlsorder?
19. lrequenL lndlgesLlon/hearLburn? 44. Chronlc sLerold LreaLmenL?
20. SLomach or lnLesLlnal problems? 43. CLher lmmunosuppresslve drugs?
21. PepaLlLls or llver dlsease? 46. nerve ln[ury or paralysls?
22. 8upLure or hernla? 47. A sleep dlsorder?
23. 8ecLal bleedlng or dlscharge? 48. Lasy faLlgablllLy?
24. lrequenL urlnaLlon? 49. uepresslon or crylng spells?
23. kldney sLones? 30. CLher psychlaLrlc problems?
Clve deLalls of any yes" answers above and commenL on Lhe currenL sLaLus of sympLoms.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
LlsL and descrlbe any oLher medlcal problem, sympLom, or concern noL addressed above. _________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
88
ERHMS
lor women only: Are you currenLly pregnanL? No es uaLe of lasL mensLrual perlod: _____________
Name: ___________________________________ Date:_____________
lease read and slgn Lhe followlng sLaLemenL. lf you feel you need addlLlonal lnformaLlon or have any
quesLlons regardlng Lhe medlcal rlsks of deploymenL or quesLlons regardlng Lhe medlcal clearance
process, please ask Lhe CuC CccupaLlonal PealLh Cllnlc medlcal sLaff.
Dep|oyment on a CDC]A1SDk emergency response team cou|d |nvo|ve phys|ca| and emot|ona|
stressors and hazards, |nc|ud|ng but not ||m|ted to:
- rapld deploymenL Lo any locaLlon upon shorL noLlce
- deploymenL lengLhs lasLlng weeks Lo monLhs
- separaLlon from famlly and frlends
- personal securlLy lssues
- sleep deprlvaLlon, Llme zone changes, and lrregular sleep schedules
- lrregular quallLy, avallablllLy, and varleLy of meals
- exposures Lo exLremes of cllmaLe and alLlLude
- llmlLed avallablllLy of lmmedlaLe medlcal care
- lack of refrlgeraLlon or elecLrlclLy for medlcaLlons, medlcal supplles, or equlpmenL
- lncreased physlcal demands relaLed Lo prolonged sLandlng, walklng, or exerLlon
- rouLlne use of personal proLecLlve equlpmenL such as resplraLors and proLecLlve cloLhlng
- posslble exposure Lo lnfecLlous organlsms, chemlcal, or radlologlc agenLs
- rlsk relaLed Lo allergy, adverse evenLs or slde effecLs from medlcaLlons, vacclnes, or oLher requlred
pharmaceuLlcal lnLervenLlons
- for pregnanL women, posslble rlsk Lo a developlng feLus
l have read Lhe above medlcal quesLlonnalre and sLaLemenLs. l have answered all quesLlons accuraLely
and Lo Lhe besL of my knowledge. l reallze LhaL furLher lnformaLlon or LesLlng may be needed from
my prlvaLe physlclan or oLher sources Lo clarlfy my flLness for Lhls duLy. l know of no condlLlon whlch
would lmpalr my ablllLy Lo funcLlon fully on a CuC emergency response Leam now or for Lhe followlng
Lwo years.
S|gnature________________________________ Date______________________
89
ERHMS
ou may S1C here. 1he c||n|c staff and phys|c|an w||| comp|ete the rema|nder of th|s form.
Name:____________________________________ Date:_____________
1C 8L CCMLL1Lu 8? P?SlClAn:
PelghL_____ WelghL_____ ulse_____ 8________ ulsLanL vlslon:
8 20/___
L 20/___
CorrecLed? ? n
CLlnlCAL
LvALuA1lCn
Check each
lLem as
lndlcaLed.
LnLer
'nL' lf noL
evaluaLed
normal Abnormal noLes or CLher CommenLs
1. Skln
2. Pead and neck (Lhyrold)
3. Lar, nose, and LhroaL
4. Lymph nodes
3. Lyes (lnclude fundoscoplc)
6. Lungs
7. 8reasL
8. PearL
9. Abdomen
10. CenlLalla (lf lndlcaLed)
11. 8ecLal exam (lf lndlcaLed)
12. vascular sysLem
13. LxLremlLles and splne
14. neurologlcal
13. sychlaLrlc (speclfy any slgnlflcanL cognlLlve, mood or behavloral observaLlons)
90
ERHMS
Comprehens|ve Lva|uat|on
NllA 1582 cboptet 6 MeJlcol voloouoos of cooJlJotes
hLLp://www.nfpa.org/abouLLhecodes/llsL_of_codes_and_sLandards.asp?cookle3lLesL=1
hLLp://www.corLlandcounLyflre.org/nlA201382.pdf
1hls documenL provldes a deLalled llsL of Lhe medlcal condlLlons LhaL could lmpacL Lhe ablllLy of a flreflghLer
Lo safely perform essenLlal [ob Lasks. lL ls an example of Lhe Lype of comprehenslve quesLlons LhaL could
be used for a screenlng exam for Lhose responders who face serlous hazards and rlsks when respondlng
Lo emergencles, such as Lhose faced by flreflghLers.
u5cC MeJlcol Mooool clM 6000.1c
hLLp://www.uscg.mll/dlrecLlves/llsLlng_clm.asp?ld=6000-6999
1hls ls a comprehenslve program almed Lo cover all operaLlons of uSCC ersonnel, ranglng from alr crewmen
and marlne vessel lnspecLors Lo polluLlon and emergency responders. 1here ls a baslc form LhaL all personnel
flll ouL, and Lhen, for each speclflc hazard Lo whlch Lhe member may be exposed, Lhere ls a form geared
Lo LhaL hazard (e.g., asbesLos, benzene, nolse).
uepottmeot of uefeose ueploymeot neoltb cllolcol ceotet - lotm uu 2795
hLLp://www.pdhealLh.mll/dcs/pre_deploy.asp
1he Pre-deployment Health Assessment Form (DD 2795) ls a requlred form LhaL allows mlllLary personnel Lo
record lnformauon abouL Lhelr general healLh and share any concerns Lhey have before deploymenL. lL also
helps healLhcare provlders ldenufy lssues and provlde medlcal care before, durlng, and aer deploymenL.
- uu 2793 ls mandaLory for deploylng mlllLary personnel from every Servlce, lncludlng 8eserve
ComponenL personnel
- uu 2793 ls Lo be compleLed and valldaLed wlLhln Lhe 30 days prlor Lo deploymenL
Ametlcoo keJ ctoss
1hese documenLs are used by Lhe Amerlcan 8ed Cross Lo assess Lhelr volunLeers' healLh sLaLus before
deploymenL. (noL avallable onllne, Lhe forms are glven here.)
- nea|th Status kecord: Self assessmenL of physlcal ablllues, medlcal lssues, and medlcauons lled
ouL by Lhe volunLeer and updaLed yearly
- nea|th Status kecord kev|ew Summary Sheet: AdmlnlsLrauve assessmenL compleLed by Lhe 8n or
Mu from Lhe unlL aer revlewlng Lhe PealLh SLaLus 8ecord from Lhe volunLeer
- re-ass|gnment nea|th uest|onna|re: CheckllsL fllled ouL by Lhe unlL deploylng Lhe volunLeer
lncludlng several healLh quesLlons asked Lo Lhe volunLeer lmmedlaLely prlor Lo deploymenL Lo
assess lf Lhere has been a change ln healLh sLaLus slnce Lhe compleLlon of Lhe PealLh SLaLus 8ecord
- hys|ca| Capac|ty Gr|d: MaLrlx LhaL llsLs Lhe poLenLlal dlsasLer deploymenL roles and Lhe physlcal
requlremenLs for each

ERHMS
Page 1 January 15, 2008
Health Status Record
CONFIDENTIAL
To be completed and signed by the individual. Please print all information
New Annual Update Change in Health Status
If this is an Annual Update, is there a change in:
Health Status Address Phone No. E-mail Address Contact Information
Name: DSHR #
Last First MI
Address:
Street City State ZIP
Phone:
Home Cell Work
E-mail Address:
Emergency Contact:
Name Phone Relationship
Unit of Affiliation:
Chapter Name Phone Chapter Code
Group/Activity/Position:
First Second Third
Mark Yes if you are able and No if not able and explain any limitations under Limitation Explanations
below (all accommodations must be requested in writing with supporting medical documentation):
yes no Lift and carry 20 lbs multiple times per shift yes no Speak clearly on phone and in person
yes no Lift and carry 50 lbs multiple times per shift yes no Read small print for extended periods
yes no Stand for two-hour periods yes no Work for long periods on a computer
yes no Sit for two-hour periods yes no Climb two or more flights of stairs
yes no Walk on uneven terrain yes no Drive in daytime and at night
yes no Walk two miles during a shift yes no Work/live in areas with mold/mildew
yes no Bend or stoop multiple times during a shift yes no Work/live in areas with smoke/poor air
yes no Crawl on floor or ground yes no Work/live with little or no privacy
yes no Work outdoors in inclement weather yes no Sleep on the floor or a cot
yes no Work in extreme heat and/or humidity yes no Travel by any type of transportation
yes no Work in extreme cold yes no Work 12 hr shifts/nights/weekends
yes no Able to step up/down 18 inches yes no Work productively during change/stress
yes no Spend hours writing
Mark Below Yes if Required or No if Not Required
yes no Electricity for medical devices/meds yes no Assistance with health monitoring
yes no Special food or timing of meals yes no Air conditioning for health reasons
yes no Access to specialized medical care
Limitation(s) Explanations:
Date of last Tetanus shot (Within 10 years is considered up to date):



Height: Weight: DOB:
Allergies (food, medication, insect, dust, latex, etc.) What happens? What do you do?
Explanations:

ERHMS
Page 2 January 15, 2008
In the last 12 months, have you been diagnosed with/continued treatment for any of the following?
yes no Heart attack/heart disease yes no Bleeding disorders/anticoagulation therapy
yes no High blood pressure yes no Stroke/CVA/TIA
yes no Migraines/frequent headaches yes no Mental Health (Anxiety/PTSD/Bipolar)
yes no Skin problems/breaks in skin/lesions yes no Seizures/nervous system/neurological
yes no Stomach/intestine/hernia yes no Sleep apnea/sleep disorders
yes no Urinary problems yes no Problems walking, moving
yes no Asthma/COPD/emphysema yes no Back/joint/bone problems
yes no Vision problems (Not corrected) yes no Immune system problems
yes no Hearing problems/hearing aids yes no Infectious disease
yes no Diabetes Other:
Explain yes items above:
Any ER visits, hospitalizations, surgeries or ongoing therapy during the last 12 months? yes no
If yes, explain and include dates:
Please list all prescription and over-the-counter medications, and reason for taking:
MEDICATIONS HOW OFTEN REASON FOR TAKING
List all medical equipment or assistive devices used (crutches, canes, nebulizer, CPAP, oxygen,
braces (arm/leg), wheelchair, service animals, etc.):
I have reviewed the physical requirements for my group and activity in Connection 2006-028, Deploying a Healthy
Workforce and the DSHR System Handbook (with addendums) with my unit of affiliation. I understand the
physical requirements for being a disaster worker and hereby state that I am able to fulfill those requirements. I
understand that if my health status changes, I am responsible for updating this form immediately and submitting to
my unit of affiliation.
I understand that while health insurance is NOT required, I will be financially responsible for my health care
expenses.
In signing below, I give permission for the Red Cross Staff Health Reviewer to contact my health care provider for
information concerning my current health status. I will be notified before contact with my health care provider is
made. I understand that refusal to sign may limit deployment.
My typed signature/date is verification that information on this form is correct. Please sign form if faxing.
Signature of DSHR Member: Date:
Signature of Health Reviewer: Date:
Page 3 January 15, 2008
Codes-Hardship/Restriction:

ERHMS
disaster_health_status_record_summary.doc (6-06)
HSR Review Summary Sheet ARC Use Only
Place in the following DSHR Members personnel health file
Name:
DSHR Number:
Date HSR Completed:
{Must be completed yearly}
Reviewed By:
Title:
Date Reviewed:
ARC Hardship Codes; Check all that apply:
None C7 Working Conditions
C1 Water Disruption C8 Limited Health Care
C2 Power Outage C9 Extreme Emotional Stress
C3 Limited Food Availability C10 Travel Conditions
C4 Extreme Heat and/or Humidity
Limitation
C11 Transportation
C5 Extreme Cold C12 Air Quality
C6 Housing Shortages C13 Lifting Limitation
Place the Hardship Code information in the DSHR System database under Restriction Information.
RH Restricted Hardship, note codes checked above
RM Restricted Medical
TI Temporarily Inactive
Comments:

ERHMS
Pre-Assignment Health Questionnaire
This form is to be filled out by the person at the unit of affiliation that is responsible for DSHR
deployment or their designee. If the unit should not have deployed the member based on their DSHR
record, they may be charged for the members travel.
Member Name _______________________________DSHR# ______________ Requested for DR# ______
1 Does the member have a current Health Status Record on file? Yes_____ No_____ If no, have
member complete Health Status Record before continuing.
2 Does the member have a medical restriction (RM) on their DSHR profile? Yes_____ No____ If
yes, do not recruit. The RM needs to be resolved first.
3 Verify any hardship codes associated with the relief operation. Does the members DSHR
record include any of the hardship codes associated with this relief operation? Yes___ No___ If
yes, do not recruit without clearance from the Chapter Health Reviewer. If the chapter
does not have a Health Reviewer, the Division Health Consultant must be notified to
review the information prior to assignment and deployment.
Read the following statements to the member: Do not give me any health information. Give
me yes or no answers. If you fail to give accurate information and are not able to serve as
recruited on the relief operation for health reasons, the Red Cross may request reimbursement
for your travel.
1 Are there any requirements for your group/activity/position on the Physical Capacity Grid that
you cannot meet? (Chapter recruiters may need to read the requirements to the member).
Yes____ No____
2 Do you currently have any stitches or areas of broken skin? Yes___ No____
3 Do you currently have a cast, brace or other device that restricts movement? Yes__ No___
4 Do you currently use a cane or other device to assist you? Yes___ No____
5 Have you been hospitalized or seen in the ER in the past six months? Yes__ No___
6 In the past three days, have you had any symptoms of illness such as fever >100 degrees,
cough, sore throat, diarrhea, headache, flu like symptoms etc.? Yes___ No____
7 Has anyone in your immediate family had the flu or flu like symptoms (fever >100 degrees,
cough, sore throat, diarrhea, headache within the past 7 days?
Yes ____ No ___
8 Have you been around anyone with the flu or flu like symptoms (fever >100 degrees, cough,
sore throat, diarrhea, headache in the past 7 days?
Yes ___ No ___
9 Have you traveled outside of your normal commuting area in the past 10 days? Yes ___ Where?
_________ No ___
10 Do you have any medical/laboratory tests scheduled within the next month? Yes___ No___
11 Have you started, changed or stopped any medications in the past 14 days? Yes___ No___
12 Will you need to refill any prescriptions during your assignment? Yes___ No___
If there are any Yes answers to these questions, the member must be approved by the Health
Reviewer before deployment.
Name of person obtaining information ____________________________________Date _____________
Name of Health Reviewer given the yes information above: __________________________
Retain this form in the members DSHR file in case it is requested by Staff Health at national
headquarters, the Division Staff Health Consultant or Staff Health on the relief operation.
Rev 4/09

ERHMS
D
8
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P
h
y
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a
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C
a
p
a
c
i
t
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G
r
i
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Lift / carry 20 lb Muliple
times/shift
Lift / carry 50 lb Muliple
times/shift
Stand for two-hour periods
Sit for 2 hours periods
Walk on uneven terrain
Walk for two miles during
a shift
Bend or stoop multiple time
a shift
Crawl on the floor or ground
Work outdoors in inclement
weather
Work in extreme heat and/or
humidity
Work in extreme cold
Able to step up/down
18 inches
Spend hours writing
Speak clearly on phone and
in person
Read small print for
extended periods
Work for long periods on
computer
Climb two or more flights
of stairs
Drive in day time and
at night
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96
ERHMS
CSnA kesp|rator Med|ca| Lva|uanon uesnonna|re
1he followlng llnk ls where one can nd Lhe CSPA 8esplraLor Medlcal Lvaluauon Cuesuonnalre, whlch ls
conLalned ln Appendlx C of CSPA sLandard 1910.134 ersonal roLecuve LqulpmenL: hup://www.osha.
gov/pls/oshaweb/owadlsp.show_documenL?p_Lable=S1AnuA8uS&p_ld=9783
97
ERHMS
31. PealLh and SafeLy 1ralnlng 1ool
1able used Lo record Lhe Lralnlng a responder has recelved (creaLed by L8PMS workgroup).
kesponder 1ra|n|ng Documentat|on form
Category 1op|c 1ra|n|ng kece|ved
SAIL1 AWAkLNLSS
urlvlng Pazard Awareness
LnvlronmenLal CondlLlons
ersonal roLecLlve LqulpmenL
ulsasLer Zone SafeLy
CCMMUNICA1ICNS
Pazard CommunlcaLlons
lncldenL AcLlon lan
PealLh and SafeLy lan
SLandard CperaLlng Culde/rocedure
SlLuaLlon 8eporLs
Moblle CommunlcaLlons
SLLI CAkL]8UDD CAkL
hyslcal
LmoLlonal
Medlcal
Work schedule
CkGANI2A1ICN
lncldenL Command SysLem
naLlonal lncldenL ManagemenL SysLem
DLCCN1AMINA1ICN
Chemlcal/8lologlcal deconLamlnaLlon
Cross deconLamlnaLlon
LqulpmenL deconLamlnaLlon
SI1L CLkA1ICNS
SlLe ConLrol
CredenLlallng
AccounLablllLy
DISAS1Lk
CnAkAC1LkI2A1ICN
Speclflc ulsasLer 1ypes
98
ERHMS
41. uaLa ManagemenL and lnformauon SecurlLy
Data Management Check||st (created by LknMS workgroup)
1ype of Data
Database Ava||ab|e
Source]Locat|on
?es no
koster and Credenna||ng
8osLer
Credenuals
8adges
re-deploymenL PealLh Screenlng
PealLh Screenlng 8esulLs
lmmunlzauons
1ralnlng
1ralnlng uaLa
Cn-slLe ln-processlng
Cn-slLe 8osLer
SlLe-speclc 1ralnlng
L uocumenLauon
PealLh MonlLorlng and Survelllance
ln[ury and lllness (lndlvldual)
ln[ury and lllness (opulauon)
8lomonlLorlng uaLa
AcuvlLy uocumenLauon and Lxposure AssessmenL
LnvlronmenLal uaLa
Lxposure uaLa
!ob 1ask uaLa
CuL-processlng AssessmenL
CuL-processlng Survey
osL-evenL 1racklng
Medlcal Screenlng Lxams
osL-evenL MonlLorlng or Survelllance
99
ueploymenL hase
100
ERHMS
S1. Cn-s|te kesponder In-process|ng
Contents:
1. In-process|ng (samp|e badges)
2. S|te-spec|hc 1ra|n|ng (samp|e badges)
3. Cut-process|ng (samp|e demob|||zat|on card)
4. NICSn Deepwater nor|zon koster form
In-process|ng (ersonne| Accountab|||ty)
8esponder lu 8adge
101
ERHMS
8esponder SlLe LnLry 8adge
Command Area LnLry 8adge
102
ERHMS
S|te-Spec|f|c 1ra|n|ng 8adge
Cut-process|ng
uemoblllzaLlon Card

ERHMS
NICSn Deepwater nor|zon koster Iorm
104
ERHMS
61. PealLh MonlLorlng and Survelllance durlng 8esponse
CperaLlons
Deepwater nor|zon nea|th nazard Lva|uat|on Survey
1.
Form Approved
OMB No. 0920-0260
Expires January 31, 2012
Date _____________ NIOSH Health Hazard Evaluation on the Oil Spill
Name
Age
Male
Female
Race/Ethnicity
White Black Asian
Hispanic Other
Are you a:
BP employee Contractor employee
Coast Guard Other____________________
Name of Current Employer during this Oil Spill Event
List your Usual
Job before
this one.
Have you had exposure to:
Not at All A Few Days Almost Every Day Daily
Oil
Dispersant
Cleaners
Dust
Number of days working on the Oil
Spill Activities:
Do you have any of the following symptoms? (Please put a checkmark next to all that apply)
Scrapes or cuts
Burns by fire
Chemical burns
Bad sunburn
Headaches
Dizziness
Feeling faint
Fatigue/exhaustion
Weakness
Itchy eyes
Red or irritated eyes
Nose irritation
Nose bleed
Sinus problems
Sore throat
Metallic taste
Any Other symptoms:
Cough
Trouble breathing
Short of breath
Chest tightness
Wheezing
Fast heart beat
Chest pressure
Nausea
Vomiting
Stomach cramps
Diarrhea
Itchy skin
Red skin
Rash
Hot and dry skin
Do you smoke cigarettes?
Yes
No
Do you have any health
problems ?
Allergies
Lung Problems
High blood pressure
Diabetes
Dermatitis or skin rash
Neck pain
Shoulder pain
Hand pain
Back pain
Feeling
worried/stressed
Feeling pressured
Feeling depressed /
hopeless
Feeling short
tempered
Frequent changes in
mood
Have you:
Had skin contact with the oil
Experienced disturbing odors
Check any training you have had
for this event:
No training yet
45 minutes of training
4 hours of training
Haz-MatTraining
Other
103
ERHMS
71. lnLegrauon of Lxposure AssessmenL, 8esponder AcuvlLy
uocumenLauon, and ConLrols lnLo L8PMS
Contents:
1. CSnA Deepwater nor|zon ersona| rotecnve Lqu|pment (L) Matr|x
2. Inc|dent Safety and nea|th Management nandbook
3. Nk1 Iat|gue Management k|sk Assessment 1oo|
4. NICSn Deepwater nor|zon Stag|ng Area Safety Informanon Check||st
S. NICSn nea|th nazard Lva|uanon rogram Worker Cbservanon Iorm (Lxposure Assessment Data
Co||ect|on 1emp|ate)
6. NICSn Deepwater nor|zon Cn Shore Lxposure Assessment Data Co||ecnon Iorm
CSnA Deepwater nor|zon ersona| rotect|ve Lqu|pment Matr|x
hLLp://www.osha.gov/ollspllls/gulf-operaLlons-ppe-maLrlx.pdf
MaLrlx creaLed for Lhe ueepwaLer Porlzon 8esponse Lo qulckly ldenufy mlnlmum L requlremenLs and
addluonal conslderauons for selecLed Lasks boLh on- and o-shore.
AInA Inc|dent Safety and nea|th Management nandbook
hLLps://webporLal.alha.org/urchase/roducLueLall.aspx?roducL_code=2d99f67d-4778-de11-96b0-
0030368361fd
1hls Pandbook ls avallable from Lhe Amerlcan lndusLrlal Pyglene Assoclauon (AlPA) webslLe. lL provldes
Lhe followlng:
1. An lmmedlaLe and fleld-expedlenL gulde Lo lncldenL SafeLy Cfflcers or Lhelr sLaffs
2. A sLrucLured safeLy and healLh plannlng and execuLlon process ln order Lo lnLegraLe safeLy funcLlons
lnLo an esLabllshed lncldenL command sLrucLure
3. ShorL Lechnlcal reference lnformaLlon for lncldenL SafeLy Cfflcers or Lhelr sLaff on lssues such as
alr monlLorlng, resplraLory proLecLlon, and personal proLecLlve equlpmenL selecLlon, ln order Lo
develop good plans and acLlons
Nk1 Iangue Management k|sk Assessment 1oo|
hLLp://nrL.org/producLlon/n81/n81Web.nsf/AllALLachmenLs8y1lLle/SA-10491Aullnal/$llle/1Auflnal.
pdf?CpenLlemenL
1hls Lool ls avallable from Lhe naLlonal 8esponse 1eam webslLe and ls Appendlx A of Lhe ColJooce fot
Moooqloq wotket lotlqoe Jotloq ulsostet Opetotloos. 1hls Lool for evaluaLlng rlsk facLors and quanLlfylng rlsk
can be used Lo asslsL ln developlng Lhe plans and procedures and ldenLlfylng Lhe resources each organlzaLlon
should have ln place ln anLlclpaLlon of a ma[or emergency response. As noLed prevlously, Lhls documenL
and Lool are prlmarlly for use durlng Lhe posL-rescue phase of a long-Lerm emergency response operaLlon.
1he Lool ldenues rlsk facLors" and sLressors" wlLhln each rlsk facLor" uslng Lhe concepL of Cperauonal
8lsk ManagemenL and aspecLs of rlsk assessmenL Lools used by ueparLmenL of uefense (uCu) agencles and
Lhe unlLed SLaLes CoasL Cuard (uSCC). 1he laugue ManagemenL 8lsk AssessmenL 1ool ls loosely based on
Lhe uSCC Creen-Amber-8ed (CA8) AssessmenL Model. lnsLead of Lhe sLandard elemenLs of CA8, faugue
106
ERHMS
rlsk facLors or sLressors have been ldenued. 1hese ve (3) ma[or facLors LhaL conLrlbuLe Lo or are aecLed
by faugue and Lhelr assoclaLed sub-facLors, or sLressors," are ldenued ln Lhe research on faugue and
exLended work hours.
1he rlsk facLors or sLressors lnclude:
Ma[or lacLor A - 1lme - Sub-facLors: long hours (more Lhan 8 hours/day), exLended hours per week (greaLer
Lhan 40 hours per week), and exLended weeks (more Lhan Lwo weeks)
Ma[or lacLor 8 - Llvlng Condluons - Sub-facLors: quarLers, food, sanlLauon, and recreauon/lelsure
opporLunlues
Ma[or lacLor C- naLure of Work - Sub-facLors: phase (rescue, response, or demoblllzauon), acuvlLy, level of
L, shl work, securlLy, famlllarlLy wlLh area, and famlllarlLy wlLh emergency and dlsasLer work
Ma[or lacLor u - SlLe Condluons - Sub-facLors: chemlcal hazards, mulu-chemlcal hazards, lonlzlng radlauon,
and oLher WMu
Ma[or lacLor L - Lmouonal SLress - Sub-facLors: poLenual for encounLerlng casualues (wounded or deceased)
and people who have losL relauves, frlends, properLy, peLs, eLc.

ERHMS
NICSn Deepwater nor|zon Stag|ng Area Safety Informat|on Check||st
Staging Area Information Check List

1

Staging Location:
(Insert County/Parish,
State)

Date:


NIOSH Personnel:


Number of Workers:


Type of Workers:
VOO, On-shore, Off-shore

Number of collected
surveys:

Describe Work Tasks:




Workshift time/duration:




Module Training required


Personal Protective
Equipment Required





Safety Concerns observed:


Top Safety Concerns
observed by Safety Officer

(Identify Safety Officers)




Decon in Use


Describe Medical Support

Heat Stress Coordinator

ERHMS
Staging Area Information Check List

2

Heat Stress Program
Details

(Shade provided, time
on/off)




Hot Zones


Hot Zone Markings



Safety Briefings ( yes/no
when





Specific Messages during
briefing





Hygiene Logistics
(hand washing stations,
etc)





Consumables provided to
workforce at staging
area?
(food, water, Gatorade,
etc.)



Workforce Organization
(buddy system, etc.)




Pre-employee medical
screening




109
ERHMS
Staging Area Information Check List

3







Description of Site



















Issues Observed: vlslL 1exL:

ERHMS
NICSn nea|th nazard Lva|uat|on rogram Worker Cbservat|on Iorm (Lxposure Assessment
Data Co||ect|on 1emp|ate)
GENERAL NFORMATON
Name: Job title:
Process description: Length of process:
Dept: Line: Location:
3peoito tasks:
Potential exposures:
Sampling conducted: . Air . Noise . Heat stress . Dermal/surface . Other:
W
O
R
K
E
R


O
B
S
E
R
V
A
T
I
O
N


F
O
R
M
HETA #
Date:
Sequence #
P
a
g
e

1


(
S
e
e

B
a
c
k
)
RESPRATORY PROTECTON
1ype (half-mask, eto.): Mnf: Model:
1ype of oartridge or tlter:
Respirator use:
. Mandatory . Voluntary
Is employee in a written respiratory protection program?
. Yes . No . Uon't know
Correct type of respirator for
exposures?
. Yes . No Worn correctly? . Yes . No
Respirator condition
(valves, seal, oleanliness, eto.):
Frequency of use: Changeout frequency
(for respirator or oartridge):
Employees judgment of
effectiveness:

Company name:
Completed by:
Air SAmpling informAtion
(Uraw arrows to link samples for 1wA oaloulation. 0ray is required)
Sample #
Sampling media
Pump #
Type . PBL . Area . PBL . Area . PBL . Area . PBL . Area
Agent(s)
1ask (if task
based)
Start time
(military)
Stop time
(military)
Pump time (min)
Avg. tow (LPM)
Cono.
Averaging time
(8hr, 15min, eto.)

ERHMS
NICSn nea|th nazard Lva|uat|on rogram Worker Cbservat|on Iorm (Lxposure Assessment
Data Co||ect|on 1emp|ate)
protective clothing / gloveS
Type (gloves,
coveralls, etc)
Mnf
Model
Material
Available but not
worn
. . .
Changeout freq.
Condition . Good . Fair . Poor . Good . Fair . Poor . Good . Fair . Poor
Description
Other PPE . 0lasses . ard hat . 3teel 1oe Boots . 0ther:

Uncovered skin
(Check all that
apply)
. Arms . Hands . Wrist . Neck
. Face . Legs . Other:

notes



P
a
g
e

2
W
O
R
K
E
R


O
B
S
E
R
V
A
T
I
O
N


F
O
R
M
enGIneerInG controls
Task/Process
Type (LEV,
enclosure,
etc)
Mnf
Model
Description
Judgment of
effectiveness
. Effective . Ineffective . Effective . Ineffective . Effective . Ineffective
If ineffective,
why?
Further
evaluation
needed?
. Yes . No . Yes . No . Yes . No
HearInG protectIon
Type: . Plugs . Muffs . Both . Available but not worn
Mnf: Model: NRR:
Use: . Mandatory . Voluntary Worn correctly? . Yes . No
Is employee in a written hearing conservation program? . Yes . No . Dont know

ERHMS
NICSn Deepwater nor|zon Cn Shore Lxposure Assessment Data Co||ect|on Iorm




IH observer Date (mm/dd/yy)
Worksite information Time
St ate County Division

Command Center (Division Name)

Site Location

Nature of operation (check one)
shoreline/marsh cleanup equipment decon wildlife decon waste mgmt
other, specify
Date operation began (mm/dd/yy) No. workers

Day or night operation? Day Night

Oil Contamination: Heavy Moderate light None Temp F RH %
Job/task information
Describe
Does the task involve any of the following? Check all t hat apply
heavy lift ing high pressure water/cleaner power hand t ools
awkward postures repetitive motions diesel-powered equipment
Chemical hazards
Is there evidence of oil or chemicals on employees' work clothes? No Yes
Is there evidence of unprotect ed skin contact with chemicals or oil? No Yes
Is there evidence of unpleasant odors? No Yes
Chemical form
solid
liquid/ pour
liquid/ spray
Ot her
inhalation
potential
hi
med
low
Dermal
Pot ential
hi
Med
lo
duration
(hrs/ day)
if indoors,
ventilat ion:
none
general
local exhaust
Comments
Oil


Dispersant


Cleaner


other
(Specify)

ERHMS








Personal protective equipment observed in use

Other
PPE Type In use? Replacement
Frequency
Type Ot her Info Provided by Use is

Safety
glasses
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Goggles
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Gloves
No
Yes
As nec Daily
Task Other

Short Long Employer
Employee
Required
Voluntary
Respirator
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Safety
shoes
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Hard hat
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Hearing
Protection
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Face
Shield
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Tyvek or
Tychem
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Rubber
Boot s
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Slicker
Suit (rain)
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Ot her
No
Yes
As nec Daily
Task Other
Employer
Employee
Required
Voluntary
Clothing No Yes Type
Shirt
No Yes Long sleeve Short sleeve
Pant s
No Yes Long Short
Head covering
No Yes

Protective sleeves
No Yes

Apron
No Yes

Waders
No Yes

ERHMS




Other preventive measures
It em No Yes Comments
Shower facilities on site

Handwash facilities onsite

Emergency eyewash onsite

Adequate sanit ary facilit ies

Access t o air condition area for breaks

Shaded work area

Shaded break area

Do workers eat , drink, or smoke in work area?

Adequate wat er provided?

MSDS readily available
non-English, as needed

Unlabelled chemical cont ainers?

Facilities for first aid?

Procedures for medical emergencies?

Decon of clothing

Decon of t ools?

Other
What is t he average number of hours worked per day?
What is t he maximum number of hours worked per day?
Is there a work/rest regimen? No Yes minutes on minutes off

Check if any evidence of the following.
snakes wild animals mosquit oes ticks alligators
Comments
113
ERHMS
lCS lorm 214 AcLlvlLy Log
1. Incident Name 2. Date Prepared 3. Time Prepared
4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period (Date/Time)
7. Personnel Roster Assigned
NAME ICS POSITION HOME BASE
8. ACTIVITY LOG (CONTINUE ON REVERSE)
TIME MAJOR EVENTS
9. Prepared By:
116
ERHMS
lCS lorm 204 AsslgnmenL LlsLs
ICS 204 8/96
3. Incident Name 4. Operational Period (Date/Time)
1. Branch 2. Division/Group
5. Operations Personnel
6. Resources Assigned This Period
Strike Team/Task Force/Resource
Identifier
Leader Phone
# of
Pers.

Drop Off
Point/Time
Pick Up
Point/Time
7. Assignments
8. Special Instructions/Safety Message
11. Approved By: (Planning Section Chief) Date/Time Approved Prepared By
Div./Group/Unit
Tactical
Command
Local
Repeat
Function Freq. System Chan.
Support
Local
Repeat
Function Freq. System Chan.
Ground-To-Air
117
ERHMS
lCS lorm 208 SlLe SafeLy and ConLrol lan
ICS 208 HM Page 1 3/98
SITE SAFETY AND
CONTROL PLAN
ICS 208 HM
1. Incident Name:
2. Date Prepared:
3. Operational Period:
Time:
Section I. Site Information
4. Incident Location:
Section II. Organization
5. Incident Commander: 6. HM Group Supervisor: 7. Tech. Specialist - HM Reference:
8. Safety Officer: 9. Entry Leader: 10. Site Access Control Leader:
11. Asst. Safety Officer - HM: 12. Decontamination Leader: 13. Safe Refuge Area Mgr:
14. Environmental Health: 15. 16.
17. Entry Team: (Buddy System)
Name: PPE Level
18. Decontamination Element:
Name: PPE Level
Entry 1 Decon 1
Entry 2 Decon 2
Entry 3 Decon 3
Entry 4 Decon 4
Section III. Hazard/Risk Analysis
19. Material: Container
type
Qty. Phys.
State
pH IDLH F.P. I.T. V.P. V.D. S.G. LEL UEL
Comment:
Section IV. Hazard Monitoring
20. LEL Instrument(s): 21. O
2
Instrument(s):
22. Toxicity/PPM Instrument(s): 23. Radiological Instrument(s):
Comment:
Section V. Decontamination Procedures
24. Standard Decontamination Procedures: YES: NO:
Comment:
Section VI. Site Communications
25. Command Frequency: 26. Tactical Frequency: 27. Entry Frequency:
Section VII. Medical Assistance
28. Medical Monitoring: YES: NO: 29. Medical Treatment and Transport In-place: YES: NO:
Comment:
118
ERHMS
81. Communlcauons of Lxposure and PealLh MonlLorlng and
Survelllance uaLa uurlng an Lmergency 8esponse
Contents:
Iorms Lxp|a|n|ng Data Use and D|sc|osure and r|vacy Act Statement
Clven Lo responders before Lhey have lnformaLlon collecLed, so Lhey are aware how Lhelr lnformaLlon wlll
be handled and proLecLed.
- nlCSP lorm used uurlng ueepwaLer Porlzon 8esponse
- ueparLmenL of Pomeland SecurlLy (uPS) lorm

ERHMS
NICSn Iorm Used Dur|ng Deepwater nor|zon kesponse



NIOSH is part of the Centers for Disease Control and Prevention (CDC)
in the Department of Health and Human Services. CDC/NIOSH is the federal agency that evaluates and makes recommendations for
the prevention of work-related injury and illness.
DATA USE AND DISCLOSURE
Why is NIOSH here at the site of the Gulf Oil Spill?
We would like to monitor potential health eIIects workers involved in cleanup oI an oil spill may experience so
we can help protect them in the Iuture.
We have experts who routinely conduct these surveys oI employees and employers.
Why is this evaluation being done?
We know that workers may be potentially exposed to things in an oil spill cleanup: such as oils, volatile organic
compounds, polyaromatic hydrocarbons, diesel Iumes, heat, noise, and heavy liIting.
We know that training will help provide inIormation to workers about these exposures, and we are interested in
what training workers receive.
We want to gather inIormation Irom workers involved in cleanup, so that aIter cleanup is over, we can see iI
workers experienced any symptoms related to the oil spill work. Oil spill exposures may cause some workers to
experience symptoms like skin rash, throat irritation and cough, and back pain. We do not know iI these symptoms
will occur or iI they do, what will be the extent oI these symptoms. We want to learn as much as we can in order to
reduce symptoms now and in the Iuture.
Documenting symptoms in this incident may provide inIormation that NIOSH can use to protect the health oI
workers in this clean up and in Iuture clean-up eIIorts.
Which employees does NIOSH want to evaluate?
NIOSH would like to evaluate ALL oI the clean-up workers so that we can record any illness, injury, or stress
that is occurring.
Will your answers be private?
Although the questionnaires will ask Ior personal inIormation, it will only be used so that we can Iollow up with you,
but ONLY group data will be reported.
Participation in this survey is voluntary. You will decide whether you want to provide us with this inIormation. You are
Iree to choose not to answer these questionnaires. It is up to you.
With your permission, NIOSH is allowed to collect and keep inIormation about you, including your results Irom this
questionnaire, because oI two laws passed by Congress. These laws are:
1. The Public Health Service Act (42 U.S.C 241)
2. The Occupational SaIety and Health Act (29 U.S.C. 669)
II the inIormation we are collecting is maintained and retrieved by personal identiIiers, such as your name, it will
become part oI the CDC record system, maintained under the Iederal Privacy Act, and we will protect it to the extent
allowed by law. We are requesting the last Iour digits oI your Social Security Number so we can make sure to
diIIerentiate you Irom others with similar names. Again you are Iree to choose not to provide this inIormation.
You should know, however, that there are limited conditions under the Privacy Act when we could be authorized to
release this inIormation to outside sources. These conditions under which we might release this inIormation are listed on
Page 2 (the Privacy Act).
What will be the result of this evaluation?
NIOSH will provide a Iinal written report through CDC to BP, its contractors, the workers, and Iederal and state
government agencies. This report will not contain individual inIormation and will be available to the public.
Contact: NIOSH, 404-498-GULF (4853), CDCNIOSHGULFWORKERCDC.GOV

ERHMS

Privacy Act

The Information you provide will become part of the CDC Privacy Act System, 09-20-0147, Occupational
Health Epidemiological Studies and EEOICPA Program Records and may be disclosed to

Appropriate state or local health departments to report communicable diseases;

A State Cancer Registry to report cases of cancer where the state has a legal reporting program providing
for confidentiality;

Private contractors assisting NIOSH;

Collaborating researchers under certain circumstances to conduct further investigations;

One or more potential sources of vital statistics to make determinations of death, health status or to find
last known address;

The Department of Justice or the Department of Labor in the event of litigation;

Congressional offices assisting an individual in locating his or her records;

You may request an accounting of the disclosures made by NIOSH.

Except for these and other permissible disclosures authorized by the Privacy Act, or in limited circumstances
required by the Freedom of Information Act, no other disclosures may be made without your prior written
consent.

121
ERHMS
Department of nome|and Secur|ty (DnS) Iorm
r|vacy Act Statement: DnS's Use of our Informat|on
r|nc|pa| urposes:
Cfflce of PealLh Affalrs (CPA) has developed Lhe osL-deploymenL CccupaLlonal PealLh and Lxposure
Survey Lo provlde uPS componenLs and offlces wlLh a sLandardlzed Lool Lo collecL occupaLlonal healLh and
exposure daLa from employees reLurnlng from duLy ln hazardous locaLlons. Lmployees' parLlclpaLlon ln Lhls
survey ls sLrlcLly volunLary (employees may opL Lo provlde all, some, or none of Lhe lnformaLlon requesLed).
lnformaLlon collecLed uslng Lhls survey wlll enable uPS Lo address occupaLlonal healLh concerns resulLlng
from deploymenL of lLs employees Lo hazardous locaLlons and wlll promoLe Lhe healLh of lLs workforce by
lmprovlng lLs occupaLlonal healLh servlces.
kout|ne Uses and Shar|ng:
ln general, a componenL/offlce safeLy and healLh offlclal wlll noL use Lhls lnformaLlon for any purpose
oLher Lhan Lhe rlnclpal urposes, and wlll noL share Lhls lnformaLlon wlLhln or ouLslde Lhelr componenL.
Cnly sLaLlsLlcal (aggregaLed) daLa exLracLed from survey resulLs may be shared wlLh oLher enLlLles wlLhln
Lhe ueparLmenL or ouLslde of Lhe ueparLmenL. ln addlLlon, ln cerLaln clrcumsLances uPS may share Lhls
lnformaLlon on a case-by-case basls as requlred by law or necessary for a speclflc purpose, as descrlbed ln
Lhe CM/CCv1-10 Lmployee Medlcal llle SysLem of 8ecords noLlce (71 l8 3336).
DnS Author|ty to Co||ect th|s Informat|on:
uPS requesLs LhaL personnel reLurnlng from deploymenL volunLarlly submlL Lhls lnformaLlon under lLs
followlng auLhorlLles: SubparL L of 1lLle 3 of Lhe Code of lederal 8egulaLlons, Lmployee Medlcal llle SysLem
8ecords (2009).
Access|ng and Correct|ng Informat|on:
lf for any reason you wlsh Lo access or correcL Lhe lnformaLlon provlded ln Lhe posL-deploymenL survey,
you may go Lo your componenL or offlce's prlnclpal safeLy and healLh offlcer Lo requesL access Lo your
Lmployee Medlcal llle. lf you are unable Lo access Lhe lnformaLlon from Lhe componenL or offlce prlnclpal
safeLy and healLh offlcer, Lhen you may dlrecL your requesL ln wrlLlng Lo Lhe approprlaLe lClA Cfflcer, whose
conLacL lnformaLlon can be found aL hLLp://www.dhs.gov/fola under conLacLs." AddlLlonal lnsLrucLlons are
avallable aL LhaL webslLe and ln Lhe CM/CCv1-10 SysLem of 8ecords noLlce, referenced above.
122
osL-ueploymenL hase
123
ERHMS
91. 8esponders CuL-processlng AssessmenL
Contents:
1. We|come nome Letter (samp|e)
2. Suggested Informanon to Gather Dur|ng Cut-rocess|ng Assessment
3. Department of nome|and Secur|ty ost-Dep|oyment Assessment Iorms
4. NICSn Deepwater nor|zon ost-Dep|oyment Survey
S. keference Used to Create kesponders Cut-rocess|ng Assessment Secnon (hard copy)
6. ICS Iorm 221 Demob|||zanon Check||st (pdf f||e)
We|come nome Letter to be D|str|buted Dur|ng Demob|||zat|on or Cut-process|ng (created by
the LknMS workgroup)
(|ace of Dep|oyment) ost-Dep|oyment nea|th Informat|on for kesponders
Welcome back and Lhank you for a [ob well done durlng your deploymenL! lease read Lhe followlng
documenL Lo famlllarlze yourself wlLh lllnesses LhaL may be more common ln lndlvlduals LhaL have been
Lo/lnvolved ln (lace of ueploymenL). lnformaLlon ln Lhls maLerlal wlll help alerL you Lo healLh concerns
(ln[ury, lllness, and menLal healLh) LhaL may need furLher evaluaLlon.
1h|ngs to te|| your doctor:
- lf you are experlenclng sympLoms such as fever, u-llke lllness, chllls, headache, [olnL/muscle aches
- lf you were ln[ured or have wounds LhaL are noL heallng well whlle ln/lnvolved ln (lace of
ueploymenL)
- lf you feel depressed, confused, have Lrouble sleeplng, or have a hard ume ad[usung back lnLo your
home envlronmenL
- lf you were bluen or scraLched by an anlmal whlle ln (lace of ueploymenL)
- lf you belleve you were exposed Lo hazards such as dusL, paLhogens, or chemlcals and conunue Lo
have perslsLenL healLh problems
What to watch for |n the next few weeks:
lf you experlence sympLoms or condlLlons dlscussed ln Lhls documenL or have oLher concernlng sympLoms
noL llsLed, please see your docLor as soon as posslble.
[LlsL of Lhe sympLoms you would mosL llkely see wlLh Lhe dlseases of concern for Lhe locaLlon or lncldenL
personnel were lnvolved ln]
LxAMLL
- lncreased sLress, dlfflculLy ad[usLlng Lo rouLlne, sleeplessness, perslsLenL sadness, depresslon
I||nesses More Common |n Ind|v|dua|s Who nave 8een to]Invo|ved |n (|ace of Dep|oyment)
[LlsL poLenLlal exposures, lllnesses, ln[urles, or menLal healLh lssues common Lo Lhe locale or lncldenL
(examples: 18, !apanese encephallLls, dusL/asbesLos, menLal healLh.). Pere go lnLo more deLall abouL
causes, laLency perlods, sympLoms.]

124
ERHMS
LxAMLL
sycho|og|ca|]Lmot|ona| D|ff|cu|t|es: As a responder or rellef worker, you may have encounLered exLremely
sLressful slLuaLlons, such as wlLnesslng loss of llfe, ln[urles, separaLed famllles, and desLrucLlon. 1hese
experlences may cause psychologlcal or emoLlonal dlfflculLles. up Lo one-Lhlrd of workers wlll experlence
depresslon shorLly afLer reLurnlng home. A menLal healLh professlonal can help you wlLh psychologlcal or
emoLlonal dlfflculLles. [LlsL conLacL lnfo.]
Suggested Informat|on to Gather Dur|ng Cut-process|ng Assessment
Ver|fy persona| |nformat|on
verlfy ldenLlfylng and conLacL lnformaLlon
- name
- Address
- hone number(s) (work, home, cell)
- L-mall address(es) (work, personal)
- Age, daLe of blrLh
- Sex
- Soclal SecurlLy number (lasL four dlglLs) or unlque ldenLlflcaLlon number
- ConLacL lnformaLlon for someone who wlll know where Lhe worker ls 6 monLhs afLer demoblllzaLlon
- 8esponse organlzaLlon
lndlcaLe employer or volunLeer organlzaLlon
name and address
ConLacL person's name, phone, and emall
verlfy usual work
- lndusLry
- CccupaLlon
- !ob Lasks
- number of years
verlfy luncLlonal and Access needs
- rlmary language
kesponse-re|ated |nformat|on
8esponse/recovery work
- 1ype of response/recovery work performed
- ClrcumsLances under whlch work was performed
Ceographlc locaLlon
uaLes and Llmes (aL leasL shlfLs worked) work was performed
known hazardous exposures or condlLlons
- 1ype of exposure or condlLlons (lf known)
- Work pracLlces
123
ERHMS
- roLecLlve measures used by responders Lo proLecL Lhemselves from dangers of any klnd (e.g.,
personal proLecLlve equlpmenL llsLed so lL can be checked off by Lhe person belng assessed)
CuallLaLlve quesLlons
- uld you have adequaLe Lralnlng on safeLy and healLh lssues relaLlng Lo your work?
- WhaL were Lhe mosL poslLlve aspecLs of Lhls deploymenL for you?
- WhaL were Lhe mosL dlfflculL aspecLs of Lhls deploymenL for you?
- uo you have any suggesLlons for Lhlngs your organlzaLlon could do dlfferenLly for fuLure deploymenLs?
- uo you have any concerns abouL your own well-belng as you leave?
ln[urles susLalned or lllness sympLoms experlenced durlng response/recovery work
* Coal: use Lhe correcL number and Lype of quesLlons Lo ralse cllnlcal susplclon for referral raLher
Lhan render an accuraLe dlagnosls
- ln[urles
uescrlpLlon of ln[ury
CompleLe resoluLlon vs. sLlll presenL
- PealLh concerns
CurrenL healLh concerns
- use sLandardlzed llsL by general body sysLem, lncludlng emoLlonal and behavloral healLh (anxleLy,
mood, alLered behavlor, sleep problems, subsLance abuse, 1Su, and depresslon)
- use only as Lrlgger quesLlons for follow-up
- lnclude query abouL urgency Lo evaluaLe Lhe need for more lmmedlaLe healLh evaluaLlon referral
- oLenLlal sources of quesLlons: ueepwaLer Porlzon 8esponse Survey, Army's osL-deploymenL
PealLh AssessmenL (see Loolbox)
new vs. exacerbaLlon of preexlsLlng condlLlon

ERHMS
Department of nome|and Secur|ty Documents Used to Conduct ost-dep|oyment Assessment
DEPARTMENT OF HOMELAND SECURITY
OFFICE OF HEALTH AFFAIRS
POST-DEPLOYMENT ASSESSMENT QUESTIONNAIRE DECLINATION
Print: First Name:
As a DHS Mission Critical and/or Emergency Essential employee returning from designated deployment
assignment, and may have been exposed to biological or environmental hazards, you are eligible to
participate in the DHS Post Deployment Medical Assessment. Every work experience is unique and may
reflect individual differences regarding exposures. Completion of this document is voluntary. If you do not
wish to participate, you are required to complete this Declination form.
DECLINATION: (General): I understand that due to my deployment work assignment and
possible exposure to potential biological or environmental hazards, I may be at risk for illness. I have
been given the opportunity to be evaluated; however, I decline the evaluation at this time. I understand
that by declining this assessment, I could be at risk for illness secondary to possible exposures.
Signature:
DHS Form 5202 (3/10)
Date:
MI: Last Name:

ERHMS
1

DEPARTMENT OF HOMELAND SECURITY
DHS Post Deployment Health Screening Questionnaire

INSTRUCTIONS: This document addresses deployment related exposures that you may have come in-contact with during
your tour of duty. Every work experience is unique and may reflect individual differences regarding exposures. Completion of
this document is voluntary. If you do not wish to participate, you are required to complete the attached Declination Form.
1. Complete each item based on your personal experience during your deployment and your best judgment of actual or
suspected exposures. Additional hazards may be noted and commented upon in the spaces provided.
2. Sign the Authorization for Release of Information and return it along with this survey to your component medical reviewing
physician or agency equivalent.
Todays Date
LAST NAME FIRST (No nicknames) MIDDLE
Sex: Male Female
Component
Deployment Dates:
What were your duties during deployment? (Please check that apply applies)
Search, Rescue Law Enforcement/Security
Safety/Health Recovery
Immigration Enforcement duties
Operations Other
Peer Support/Critical Incident Stress Management Medical/Health Care
Worksite (Please check each check boxes that applies):
Deployment sites:
hrs/day days/week weeks/month
Shift Work: (check one):
Total Hours per week (worked):
Rest Periods:
Average hours sleep per day/night:
Was sleep/rest period uninterrupted?
Age: Job Title:
DISTRICT/DIVISION ADDRESSES YOUR WORK TELEPHONE NO.
Daily travel time to work site (if applicable):
total months
8 hours 12 hours 16 hours other(explain):
From: To:

ERHMS
2
Housing
How were you housed while deployed?
Fixed Shelter Tents Mobile Unit Open Air/On the Ground
Other:
Did your temporary house include (Check all that apply)? Heating Ventilation Adequate lighting Toilet facilities
Shower facilities
Food/Nutrition:
Did you have adequate supplies of (potable) drinking water? Yes No
Were food storage containers clearly marked and segregated to the extent possible to prevent contamination?
Yes No. If No, please explain:
If applicable, were food preparation surfaces cleaned and disinfected regularly? Yes No Not Applicable
Personal Protective Equipment (PPE) Used at Recovery Site (Please check each checkboxes that applies):
Respirator (please print type e.g., disposable mask, half face reusable, full face, PAPR, SCBA).
Gloves Coveralls (Cloth and/or disposable) Insect repellent Steel toed construction shoes
Goggles / Glasses Hearing Protection Hard hat
Other
If you were required to wear a respirator, did you receive a medical evaluation prior to wearing the respirator? Yes No
If you were required to wear a respirator, were you fit-tested on same type of respirator?
5. Did you experience any type of injury or trauma to your head, neck, torso or limbs?
Exposures: The following questions pertain only to your deployment
1. Did you require medical attention during your deployment? Yes No
2. Did you work in close proximity to flood waters? Yes No
3. Did you sustain any skin wounds? Yes No
4. Did you experience any bites (Insects, snakes, dogs, other) Yes
(check: Muffs Ear Plugs / )
Yes No
If Yes, please explain
If Yes, How many hours (average)
and how many days?
If Yes, please describe:
If Yes, please describe: No
Yes If Yes, please describe: No

ERHMS
3
6. Did you handle or manipulate deceased persons? Yes
If yes, what type of personal protective equipment (PPE) did you wear?
7. Do you have concerns about possible exposures or events during this deployment that you feel may affect your health?
EXPOSURE TABLE - The potential exposures listed below refer to your deployment.
EXPOSURE TYPE LENGTH OF EXPOSURE
PROTECTION USED
WITH EXPOSURE
Comments
INSTRUCTIONS

Check chemicals or work
conditions that apply to you
INSTRUCTIONS

Number of days
INSTRUCTIONS

% Time you wore protective
equipment with this exposure
(I.e., 10%, 25%, 50%, etc.)
Please include any additional
comments you may wish to add.
(Write legibly)
Dust
Fumes
Gases
Carbon Monoxide
Cement Dust
Other Dust
Chemicals/Solvents
(Specify if known)
Blood/Body Fluids
Sewage (Untreated)
Smoke/Fire
Other Exposure (list)
Other Exposure (list)
Work Force Health Protection Measures; please indicate which of the following items you used during this
deployment.
DEET insect repellent applied to skin
Pesticide-treated uniforms/clothes
Eye Protection (Not commercial sunglasses or prescription glasses)
Hearing Protection: (List protection used):
Respiratory Protection (N95 or other respirator):
No
No Yes If Yes, please explain:

ERHMS
4
Since your deployment, please check any of the following medical complaints that apply to you.
Symptom
Check all that apply to you
FREQUENCY**
How often you
experience the
complaint - Often,
Sometimes,
Rare, Seasonally
Severity
On a scale of 1-10
(1=very mild,
10=severe health
problem) rate each
problem you check
Fever
Cough lasting more
than 3 weeks
Trouble breathing
Bad Headaches
Generally
feeling weak
Muscle aches
Swollen, stiff or painful
joints
Numbness or
tingling in hands or
feet
Trouble hearing
Ringing in the ears
Watery, red eyes
Dimming of vision,
like the lights were
going out
Chest pain or pressure
Dizzy, light headed,
passed out
Diarrhea
Vomiting
Frequent
indigestion/
heartburn
Trouble sleeping or
still feeling tired after
sleeping
Trouble concentrating,
easily
distracted
Forgetful or trouble
remembering things
Increased irritability
New or Old
If this complaint is NEW, place
the letter "N" in this column.
If this condition is a
Worsening of a
previous/existing condition,
place the letter "O" in this
column.
Treatment
If you have seen a
medical professional
for this complaint,
please list the
Diagnosis and
Medication you are
taking.
Do you think this
Symptom could be
related to exposures
at the Recovery Site?

Print YES or NO in this
column for each symptom
you have checked.
Skin diseases or
rashes

ERHMS
5
Fatigue/Discomfort
or multisystem
complaints
Other: (Please list)
Other: (Please list)
** Often = Almost daily Rare = less than monthly Sometimes = 1-3 times a month
Seasonally = concentrated exposure during a predictable time period
IMMUNIZATION STATUS
1. Have you had a skin test for tuberculosis (PPD) within the last year? Yes No
a. Date of last PPD Skin Test:
Result: Positive Negative
2. Date of last Tetanus shot:
3. At any time during your deployment, were you exposed to human body fluids, tissue or organ material from a human (living or dead)?
Yes No, if yes, please explain:
List personal protective equipment worn (if applicable):
4. Have you received the hepatitis B vaccine (HBV)? Yes No
#1:
#2:
#3:
Did you receive vaccinations prior to your deployment?
If yes, please indicate the following vaccinations:
H1N1 Influenza
Seasonal Influenza
Typhoid
Meningococcal
Yellow Fever
Tetanus (Tdap)
Polio
MMR (Measles, Mumps and Rubella)
Hepatitis A (HAV)
Rabies
If Yes, please list dates of immunization:
5. Yes No

ERHMS
6
6. Were you told to take medicines to prevent malaria? Yes No
a. If YES, please indicate which medicines you took and whether you missed any doses (Mark all that apply):
Chloroquine (Aralen)
Doxycycline (Vibramycin)
Mefloquine
Primaquine
Malarone
Other:
If you have been or are experiencing mental or psychological health symptoms, such as claustrophobia, difficulty sleeping/nightmares,
intense anger or outbursts, persistent thoughts, difficulty concentrating, withdrawal from work, family, friends, and activities, depression,
or an increase in the consumption of alcohol, cigarettes or other substances, please obtain the assistance of a physician or mental health
professional if you are not already seeking treatment. You can also obtain assistance through your components Employee Assistance
Program (EAP).
Did you complete Occupational Workmans Compensation Program (OWCP) forms?
Were these forms submitted to the Employee Medical Programs office or equivalent?
(If not, please submit with this Questionnaire)
Have you filed OWCP forms with DOL to date for medical care or follow-up of any conditions listed on this form?
If Yes, please list the claim, the date claim was filed, and the location where claim was filed.
CLAIM DATE FILED
1.
LOCATION
2.
Additional Comments
Employee Signature
DHS Form 5203 (3/10)
Yes No
Yes No
Yes No
Date signed:
133
ERHMS
NICSn Deepwater nor|zon Worker nea|th Survey
1hls survey was creaLed by nlCSP and approved by Lhe Cmce of ManagemenL and 8udgeL durlng
Lhe ueepwaLer Porlzon 8esponse, and lL represenLs an example of an ouL-processlng assessmenL.
CDC]NICSn DLLWA1Lk nCkI2CN kLSCNSL WCkkLk nLAL1n SUkVL
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC ln18CuuC1lCn.]
lnLro 1
Pello, l'm [NAM] from Lhe CenLers for ulsease ConLrol and revenuon, commonly referred Lo as CuC. ls Lhls
[k5lONuN15 NAM]? We are surveylng responders Lo Lhe 8 Culf Cll Splll Lo ask abouL some exposures
and healLh lssues LhaL may have been experlenced by workers and volunLeers ln respondlng Lo Lhe splll.
1hls sLudy ls sponsored by Lhe nauonal lnsuLuLe for Cccupauonal SafeLy and PealLh whlch ls parL of CuC.
SLudy resulLs wlll be used Lo proLecL fuLure workers. 1he survey Lakes abouL 23 mlnuLes Lo compleLe. ?our
paruclpauon ls volunLary, and all your answers wlll be kepL prlvaLe Lo Lhe exLenL permlued by law. lf you
do noL wlsh Lo paruclpaLe, or do noL wanL Lo answer parucular quesuons, Lhls wlll noL resulL ln any penalLy
or loss of beneLs Lo you and your famlly. ?our Lelephone number was provlded Lhrough a rosLer of people
who responded Lo Lhe oll splll. lf Lhere are any quesuons LhaL you don'L feel you can answer, please leL me
know and we'll move Lo Lhe nexL one. So, lf l have your permlsslon, l'll conunue.
[ll ?LS, CC 1C CuLS1lCn SC8n 1]
[ll nC, 8LAu ln18C 2]
lnLro 2
l assure you LhaL everyLhlng you Lell us wlll be kepL 8lvA1L. 1hls pro[ecL wlll be used Lo ldenufy healLh
problems and pauerns of ln[ury faced by oll splll response workers. ?our cooperauon wlll beneL all oll splll
response workers. Would you please conslder helplng us?
[ll ?LS, CC 1C CuLS1lCn SC8n 1]
[ll nC, 8LAu 1PL lCLLCWlnC]
l'm sorry Lo have boLhered you. 1hank you for your ume.
[Lnu CALL]
134
ERHMS
NLVLk, LVLk, Ck CUkkLN1 WCkkLk SCkLLN
SC8n 1. noL counung days you spenL ln Lralnlng, dld you work aL leasL Lhree days on Lhe oll splll response
ln any capaclLy?
?es ................... 1 8efused ............ 99 [CC 1C CuLS1lCn uLMC 1]
no ................... 2 [CC 1C CuLS1lCn uLMC 1]
SC8n 2. Are you currenLly worklng on Lhe oll splll response?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
nLAL1n SM1CMS
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC 8CM1 CnCL 8LlC8L ASklnC CuLS1lCnS S?M 1 1C S?M 13]
l'm golng Lo ask you some quesuons abouL your healLh uu8lnC 1PL AS1 30 uA?S.
S?M 1. ln Lhe pasL 30 days, how oen dld you have a cough?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 2. ln Lhe pasL 30 days, how oen dld you have wheezlng or whlsLllng ln your chesL?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 3. ln Lhe pasL 30 days, how oen dld you have ughLness ln your chesL?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 4. ln Lhe pasL 30 days, how oen were you shorL of breaLh?
133
ERHMS
All Lhe ume ............. 1 8arely. ............ 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 3. ln Lhe pasL 30 days, how oen dld you have a sLuy, lLchy or runny nose?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 6. ln Lhe pasL 30 days, how oen dld you have waLery or lLchy eyes?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 7. ln Lhe pasL 30 days, how oen dld you have burnlng eyes?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
136
ERHMS
S?M 8. ln Lhe pasL 30 days, how oen dld you have burnlng ln your nose, LhroaL or lungs?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 9. ln Lhe pasL 30 days, dld you have a skln rash LhaL lasLed 2 or more days?
?es ...... 1 uon'L know ...... 88 [CC 1C CuLS1lCn S?M 11]
no ....... 2 [CC 1C CuLS1lCn S?M 11] 8efused ............ 99 [CC 1C CuLS1lCn S?M 11]
S?M 10. uld you geL Lhe rash on a parL of your body LhaL Louched or came lnLo conLacL wlLh any of
Lhese? [ln1L8vlLWL8: 8LAu LlS1 Anu CCuL ALL 1PA1 AL?]
Cll ................................................................. 1 olson lvy or polson oak ............ 3
Chemlcal dlspersanLs ..................................... 2 uon'L know ................................ 88
?our personal proLecuve equlpmenL (e.g.,
booLs, gloves, coaLed 1yvek sulL) ................... 3 8efused ...................................... 99
Sunscreen ...................................................... 4
S?M 11. ln Lhe pasL 30 days, how oen dld you have a severe headache or mlgralne?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 12. ln Lhe pasL 30 days, how oen dld you have dlzzlness or llghLheadedness?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
137
ERHMS
S?M 13. ln Lhe pasL 30 days, how oen dld you have nausea or vomlung?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 14. ln Lhe pasL 30 days, how oen dld you have dlarrhea? [ln1L8vlLWL8: ulA88PLA lS uLllnLu
AS A1 LLAS1 1P8LL LCCSL C8 WA1L8? S1CCLS ln A 24 PCu8 L8lCu.]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 13. ln Lhe pasL 30 days, how oen dld you have blurred or dlsLorLed vlslon?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
S?M 16. ln Lhe pasL 30 days, how oen dld you have lower back paln?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
138
ERHMS
S?M 17. l'm golng Lo read you a llsL of four Lypes of sympLoms. lease Lell me wheLher, whlle worklng ln
hoL condluons durlng Lhe oll splll response, you experlenced 1WC C8 MC8L of Lhese Lypes of sympLoms
aL Lhe same ume ln Lhe pasL 30 days?
1 - Peadaches, dlzzlness, llghLheadedness or falnung.
2 - Weakness and molsL skln.
3 - Mood changes such as lrrlLablllLy or confuslon.
4 - upseL sLomach or vomlung.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
S?M 18. Whlle worklng ln Lhe heaL durlng Lhe oll response, noL counung scheduled work breaks, dld
you ever have Lo sLop worklng because of exhausuon or because you goL Loo hoL?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
S?M 19. lor any sympLom or lllness LhaL began slnce Lhe ume you sLarLed worklng on Lhe oll splll re-
sponse, dld you go for medlcal help? [ln1L8vlLWL8: lnCLuuL An? S?M1CM C8 lLLnLSS, LvLn 1PCSL
nC1 LlS1Lu A8CvL 8u1 uC nC1 lnCLuuL ln!u8lLS]
?es .......................... 1 uon'L know ... 88 [CC 1C CuLS1lCn S?M 23]
no ........................... 2 [CC 1C CuLS1lCn S?M 23]8efused ......... 99 [CC 1C CuLS1lCn S?M 23]
S?M 20. WhaL (was/were) Lhe sympLom(s) or lllness(es) LhaL you wenL for medlcal help for?
uon'L know ............. 88 8efused ............ 99
S?M 21. Where dld you go for medlcal help? [ln1L8vlLWL8: CCuL ALL 1PA1 AL?]
lleld or boaL medlcal sLauon ..... 1 ersonal physlclan .........4
urgenL care cllnlc ....................... 2 CLher .............................3
Lmergency room ....................... 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ................................ 88 8efused ..........................99
139
ERHMS
S?M 22. Were you hosplLallzed for (Lhls/Lhese) sympLom(s) or lllness(es)? [ln1L8vlLWL8: PCSl1ALlZLu
MLAnS AuMl11Lu A1 LLAS1 CvL8nlCP1.]
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
S?M 23. Would you say LhaL ln general your healLh ls. [ln1L8vlLWL8: 8LAu LlS1]
LxcellenL ................. 1 lalr ................... 4
very good ............... 2 oor ................. 3
Cood ....................... 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88
8efused ................... 99
S?M 24. Compared wlLh Lwelve monLhs ago, would you say your healLh ls beuer, worse or abouL Lhe
same?
8euer ...................... 1 uon'L know ...... 88
Worse ..................... 2 8efused ............ 99
AbouL Lhe same ...... 3

ln!8 1. Whlle you were worklng on Lhe oll splll response, were you ever ln[ured on Lhe [ob? 1hls would
be an ln[ury LhaL needed medlcal care beyond rsL ald, or an ln[ury LhaL caused you Lo lose aL leasL 4
hours of work, or an ln[ury LhaL caused you Lo be asslgned Lo dlerenL work duues for aL leasL 4 hours.
?es .......................... 1 uon'L know .. 88 [CC 1C CuLS1lCn LxC 1]
no ........................... 2 [CC 1C CuLS1lCn LxC 1] 8efused ........ 99 [CC 1C CuLS1lCn LxC 1]
140
ERHMS
ln!8 2. now l would llke you Lo descrlbe ln as much deLall as posslble how Lhe ln[ury occurred. lnclude
where dld Lhe ln[ury happen?, whaL were you dolng aL LhaL ume?, whaL equlpmenL or Lools were you
uslng?, whaL maLerlals were you handllng?, whaL klnd of ln[ury was lL - a cuL, a broken bone, someLhlng
else?, whaL parL of your body was ln[ured?, anyLhlng else you Lhlnk mlghL be lmporLanL?
[ln1L8vlLWL8: ll 8LSCnuLn1 PAu MC8L 1PAn CnL ln!u8? MLL1lnC 1PL C8l1L8lA ln l1, ASk CnL?
A8Cu1 1PL MCS1 8LCLn1 CnL.]
lnLervlewer
CheckllsL
LocaLlon

Speclflc AcLlvlLy
LqulpmenL & 1ools

MaLerlals Pandled
1ype of ln[ury
(laceraLlon,
fracLure, eLc.)

8ody arL AffecLed
nlCSP uSL CnL?
CLher lacLors
SCu8CL
LvLn1
2
nu
SCu8CL
L-CCuL
uon'L know ............. 88 8efused ............ 99
ln!8 3. uld Lhls ln[ury requlre medlcal care beyond rsL ald?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 [CC 1C CuLS1lCn LxC 1] 8efused ............ 99
ln!8 4. Were you hosplLallzed for Lhls ln[ury?
[ln1L8vlLWL8: PCSl1ALlZLu MLAnS AuMl11Lu A1 LLAS1 CvL8nlCP1.]
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
141
ERHMS

[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC 8CM1 CnCL 8LlC8L ASklnC CuLS1lCnS LxC 1 1P8CuCP
LxC 6.]
lor Lhe nexL seL of quesuons, please answer: All Lhe ume, MosL of Lhe ume, Someumes, 8arely or never.
LxC 1. Whlle worklng on Lhe oll splll, how oen dld/do you have dlrecL skln conLacL wlLh Lhe spllled
crude oll? [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
LxC 2. Whlle worklng on Lhe oll splll, how oen were/are you exposed dlrecLly Lo smoke from burnlng
crude oll? [ln1L8vlLWL8: 8LAu LlS1]
[ln1L8vlLWL8: ul8LC1 LxCSu8L lnCLuuLS SMLLLlnC, 88LA1PlnC C8 CCMlnC ln1C CCn1AC1 Wl1P
1PL SMCkL.]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
LxC 3. Whlle worklng on Lhe oll splll, how oen dld/do you nouce sLrong chemlcal or oLher unusual
odors? [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
142
ERHMS
LxC 4. Whlle worklng on Lhe oll splll, how oen dld/do you smell or breaLhe ln exhausL fumes from Lhe
englnes of cars, Lrucks, boaLs, generaLors or oLher moLorlzed equlpmenL? [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
LxC 3. Pow oen dld you handle or apply chemlcal dlspersanLs such as CC8Lxl1 9300 or CC8Lxl1
9327? [ln1L8vlLWL8: 8LAu LlS1]
[ln1L8vlLWL8: CPLMlCAL ulSL8SAn1S SuCP AS CC8Lxl1 9300 Anu CC8Lxl1 9327 A8L SCLvLn1S
uSLu 1C 88LAk u ClL SLlCkS 8? AC1lnC AS CPLMlCAL uL1L8CLn1S C8 Su8lAC1An1S. 1PL? A8L uSu-
ALL? S8A?Lu C8 C1PL8WlSL ALlLu Cn Su8lACL ClL SLlCkS, 8u1 PAvL 8LLn ln!LC1Lu ul8LC1L?
ln1C 1PL unuL8WA1L8 S18LAM Cl C8uuL ClL SlLLlnC l8CM 1PL WLLLPLAu.]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
LxC 6. Pow oen dld you work ln or near areas where chemlcal dlspersanLs such as CC8Lxl1 9300 or
CC8Lxl1 9327 were applled? [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
WCkk ASSIGNMLN1, LCCA1ICN, AND AC1IVI1ILS
WC8k 1. When dld you begln worklng on Lhe oll splll response? WhaL was Lhe daLe (approxlmaLely or as
nearly as you can remember)? [ln1L8vlLWL8: CCuL 1PL ll8S1 uA1L 1PL 8LSCnuLn1 8LCAn WC8k-
lnC Cn 1PL SlLL Al1L8 llnlSPlnC 1PL lnl1lAL 18AlnlnC, LvLn ll 1PL8L WL8L MuL1lLL S1A81S Anu
S1CS.]
_____/_____/_____ [CC 1C CuLS1lCn WC8k 3]
uon'L know ............. 88 [CC 1C CuLS1lCn WC8k 2]
8efused ................... 99 [CC 1C CuLS1lCn WC8k 2]
WC8k 2. uo you remember whaL monLh you began worklng on Lhe oll splll response (approxlmaLely or
143
ERHMS
as nearly as you can remember)? [ln1L8vlLWL8: CCuL MCn1P AS !An=01.uLC=12]
uon'L know ............. 88 8efused ............ 99
[ln1L8vlLWL8: 8LAu CuLS1lCn WC8k 3 CnL? ll CuLS1lCn SC8n 2 uCLS nC1=1. ll CuLS1lCn SC8n
2=1, CC 1C CuLS1lCn WC8k 3.]
WC8k 3. When dld you sLop worklng on Lhe oll splll response? WhaL was Lhe daLe (approxlmaLely or as
nearly as you can remember)?
_____/_____/_____ [CC 1C CuLS1lCn WC8k 3]
uon'L know ............. 88 [CC 1C CuLS1lCn WC8k 4]
8efused ................... 99 [CC 1C CuLS1lCn WC8k 4]
WC8k 4. uo you remember whaL monLh you sLopped worklng on Lhe oll splll response (approxlmaLely or
as nearly as you can remember)? [ln1L8vlLWL8: CCuL MCn1P AS !An=01.uLC=12]
uon'L know ............. 88 8efused ............ 99
WC8k 3. uurlng Lhe oll splll response, where (dld/do) you usually reporL for work? lf you reporLed for
work aL more Lhan one place, please Lell me Lhe place you reporLed for work mosL oen or for Lhe lon-
gesL perlod of ume. [ln1L8vlLWL8: 8LAu LlS1]
[ln1L8vlLWL8: ll nLCLSSA8?, LxLAln 1PA1 A llLLu S1AClnC A8LA lS 1PL CLn18ALlZLu LCCA1lCn
l8CM WPlCP SPC8LLlnL CLLAnu Anu C1PL8 AC1lvl1lLS ln A A81lCuLA8 A8LA A8L CCC8ulnA1Lu.
1PL? nC8MALL? lnCLuuL 8LSCnuL8 ulnlnC lAClLl1lLS, LCulMLn1 S1C8ACL Anu 8LA8A1lCn
A8LAS, Anu A8L uSuALL? WPL8L 1PL uAlL? SAlL1? 88lLllnCS A8L ClvLn.]
[ln1L8vlLWL8: ll 8LSCnuLn1 lnl1lALL? AnSWL8S 1PA1 PL C8 SPL 8LC81Lu 1C A 8LACP C8 C1PL8
CLLAnu Sl1L, 8LAu 1PL lCLLCWlnC 8C8L:] uld you rsL reporL Lo a eld sLaglng area? A eld sLag-
lng area ls Lhe cenLrallzed locauon from whlch shorellne and oLher cleanup acuvlues ln a parucular area
are coordlnaLed. 1hey normally lnclude responder dlnlng faclllues, equlpmenL sLorage and preparauon
areas, and are usually where Lhe dally safeLy brlengs are glven.
lleld sLaglng area
(lncludlng beaches, docks and deconLamlnauon areas) ............ 1 [CC 1C CuLS1lCn WC8k 7]
u.S. CoasL Cuard shore faclllLy .................................................. 2 [CC 1C CuLS1lCn WC8k 10]
u.S. CoasL Cuard cuuer ............................................................. 3 [CC 1C CuLS1lCn WC8k 10]
CLher shlp or vessel ................................................................... 4 [CC 1C CuLS1lCn WC8k 10]
Avlauon operauons faclllLy ........................................................ 3 [CC 1C CuLS1lCn WC8k 10]
Warehouslng and dlsLrlbuuon or oLher supplles faclllLy ........... 6 [CC 1C CuLS1lCn WC8k 10]
unled Area Command CenLer, 8oberL, LA ............................... 7 [CC 1C CuLS1lCn WC8k 10]
144
ERHMS
unled Command/lncldenL Command CenLer, Moblle, AL ...... 8 [CC 1C CuLS1lCn WC8k 10]
lncldenL Command CenLer, Pouma, LA ..................................... 9 [CC 1C CuLS1lCn WC8k 10]
CLher governmenL faclllLy or omce ........................................... 10 [CC 1C CuLS1lCn WC8k 10]
CLher 8 faclllLy ......................................................................... 11 [CC 1C CuLS1lCn WC8k 10]
CLher ......................................................................................... 12 [CC 1C CuLS1lCn WC8k 6]
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ................................................................................ 88 [CC 1C CuLS1lCn WC8k 6]
8efused ...................................................................................... 99 [CC 1C CuLS1lCn WC8k 10]
WC8k 6. Could you descrlbe where you usually reporLed for work?
[CC 1C CuLS1lCn WC8k 10]
uon'L know ...... 88 [CC 1C CuLS1lCn WC8k 10] 8efused ..... 99 [CC 1C CuLS1lCn WC8k 10]
WC8k 7. Whlch sLaglng area dld you work ouL of? lf you worked ouL of more Lhan one sLaglng area,
please Lell me Lhe one you worked ouL of for Lhe longesL ume. [ln1L8vlLWL8: 8LAu LlS1 ll nLCLSSA8?]
uauphln lsland, AL ........ 1 Crand lsle, LA ................ 10
Crange 8each, AL ......... 2 Shell 8each, LA .............. 11
1heodore, AL ................ 3 Slldell, LA ...................... 12
anama ClLy, lL ............. 4 SL. Mary, LA ................... 13
ensacola, lL ................ 3 venlce, LA ..................... 14
orL SL. !oe, lL .............. 6 8lloxl, MS ...................... 13
SL. Marks, lL ................. 7 ascagoula, MS ............. 16
Amella, LA ..................... 8 ass Chrlsuan, MS ......... 17
Cocodrle, LA ................. 9 CLher ............................ 18
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ................... 88 [CC 1C CuLS1lCn WC8k 10]
8efused ......................... 99 [CC 1C CuLS1lCn WC8k 10]
WC8k 8. uld you work ouL of any oLher sLaglng area(s)?
?es .......................... 1
143
ERHMS
no ........................... 2 [CC 1C CuLS1lCn WC8k 10]
uon'L know ............. 88 [CC 1C CuLS1lCn WC8k 10]
8efused ................... 99 [CC 1C CuLS1lCn WC8k 10]
WC8k 9. WhaL oLher sLaglng area(s) dld you work ouL of? [ln1L8vlLWL8: 8LAu LlS1 ll nLCLSSA8?. CCuL
ALL 1PA1 AL?.]
uauphln lsland, AL ........ 1 Crand lsle, LA ................ 10
Crange 8each, AL ......... 2 Shell 8each, LA .............. 11
1heodore, AL ................ 3 Slldell, LA ...................... 12
anama ClLy, lL ............. 4 SL. Mary, LA ................... 13
ensacola, lL ................ 3 venlce, LA ..................... 14
orL SL. !oe, lL .............. 6 8lloxl, MS ...................... 13
SL. Marks, lL ................. 7 ascagoula, MS ............. 16
Amella, LA ..................... 8 ass Chrlsuan, MS ......... 17
Cocodrle, LA ................. 9 CLher ............................ 18
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ................... 88
8efused ......................... 99
WC8k 10. lease Lell me whaL klnd of responder you are/were whlle worklng on Lhe oll splll. lf you
worked as more Lhan one klnd of responder, Lell me Lhe klnd you were for Lhe longesL perlod of ume.
(Are/were) you a.[ln1L8vlLWL8: 8LAu LlS1.]
8 employee ......................................................... 1 [CC 1C CuLS1lCn WC8k 12]
ConLracLor ............................................................ 2
Local sLaLe or federal governmenL worker ........... 3
volunLeer .............................................................. 4
Cr someLhlng else ................................................ 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ........................................................... 88
8efused ................................................................. 99 [CC 1C CuLS1lCn WC8k 12]
146
ERHMS
WC8k 11. WhaL was/ls Lhe name of your employer or agency whlle worklng on Lhe oll splll?
[ln1L8vlLWL8: ll 8LSCnuLn1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
8CM1.] uo you remember Lhe name of Lhe company (noL Lhe bank) LhaL (lssued/lssues) your paycheck
when worklng on Lhe oll splll? lor volunLeers, whaL agency or organlzauon dld you volunLeer wlLh?
uon'L know ...... 88
8efused ............ 99
WC8k 12. Whlle worklng on Lhe oll splll response, how many days a week (dld/do) you usually work?
uon'L know ...... 88
8efused ............ 99
WC8k 13. Whlle worklng on Lhe oll splll response, how many days (dld/do) you usually work before geL-
ung a day o?
uon'L know ...... 88
8efused ............ 99
WC8k 14. Whlle worklng on Lhe oll splll response, how many hours per day (dld/do) you usually work?
[ln1L8vlLWL8: uCn'1 8LAu]
varled Loo much Lo say ........ 77 uon'L know.........88
8efused ................................ 99
147
ERHMS
WC8k 13. Whlch of Lhe followlng besL descrlbes your usual work schedule whlle worklng on Lhe oll splll
response? [ln1L8vlLWL8: 8LAu LlS1]
A dayume shl .............................................. 1 An lrregular shl or on-call .............. 6
An evenlng shl ............................................. 2 Some oLher shl ............................... 7
A nlghmme shl ............................................ 3
A roLaung shl, one LhaL changes
perlodlcally from days Lo evenlngs
or nlghLs ........................................................ 4
A spllL shl, one LhaL has Lwo dlsuncL
perlods each day ........................................... 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know .................................................... 88 8efused ............................................ 99
WC8k 16. Whlle worklng on Lhe oll splll response, on average, how many hours of sleep do you geL ln a
24-hour perlod? [ln1L8vlLWL8: 8Cunu PCu8S Cl SLLL 1C nLA8LS1 WPCLL PCu8.]
uon'L know ...... 88
8efused ............ 99
WC8k 17. Whlle worklng on Lhe oll splll response, where (dld/do) you usually sleep when o duLy?
[ln1L8vlLWL8: 8LAu LlS1. PL8L, 1PL 1L8MS 1LMC8A8?" Anu L8MAnLn1" 8LlL8 1C 1PL PCuS-
lnC lAClLl1lLS' S18uC1u8L, nC1 1C 1PL 8LSCnuLn1S' PCuSlnC A88AnCLMLn1. 1PL8LlC8L, lC8
LxAMLL, A L8SCn S1A?lnC 1MlOkAkll ln An AA81MLn1 C8 PCuSL (8ulLulnCS Wl1P lCunuA-
1lCnS) 8Ln1Lu 8? 1PLl8 LMLC?L8 C8 A CCn18AC1C8 lS LlvlnC ln A lkMANN1 PCuSlnC lAClLl1?.]
?our own home or anoLher person's home ...................... 1
PoLel or moLel .................................................................. 2
ermanenL mlllLary or oLher governmenL faclllLy
such as a barracks, dormlLory or CoasL Cuard SLauon ..... 3
1emporary mlllLary or oLher governmenL faclllLy
such as a camp or blvouac ................................................ 4
Aboard shlp ...................................................................... 3
Aboard a quarLers barge" or oaLel" ............................. 6
ermanenL houslng faclllues-LhaL ls, a bulldlng wlLh
a foundauon (lncludlng houses and aparLmenLs)-
provlded by your employer or a conLracLor ..................... 7
148
ERHMS
1emporary houslng faclllues such as a LenL or a Lraller
provlded by your employer or a conLracLor ..................... 8
CLher ................................................................................ 9
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ....................................................................... 88
8efused ............................................................................. 99
WC8k 18. uurlng Lhe oll splll response, dld/do you usually work ........ [ln1L8vlLWL8: 8LAu LlS1]
Cshore, LhaL ls on a shlp, boaL or oLher vessel......................1
Cn shore, lncludlng all land acuvlues ......................................2 [CC 1C CuLS1lCn WC8k 24]
8oLh oshore and onshore ......................................................3
lor avlauon or avlauon supporL servlces ................................4 [CC 1C CuLS1lCn LC 1]
uon'L know .............................................................................. 88 [CC 1C CuLS1lCn LC 1]
8efused .................................................................................... 99 [CC 1C CuLS1lCn LC 1]
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC 8CM1 CnCL 8LlC8L ASklnC CuLS1lCnS WC8k 19 1P8CuCP
WC8k 24] l am golng Lo read you a llsL of dlerenL klnds of work you may have done. lease Lell me
wheLher or noL you (or Lhe vessel you were worklng on) dld Lhls klnd of work for each of Lhese whlle
worklng on Lhe oll splll response. lf you are noL sure wheLher you dld any of Lhese Lypes of work, l can
help by readlng you a brlef descrlpuon of LhaL Lype of work.
WC8k 19. Source conLrol
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
Source conLrol operauons lnclude: conLalnlng and repalrlng Lhe wellhead, drllllng rellef wells, underwa-
Ler ln[ecuon of dlspersanLs, and collecuon of oll from Lhe source.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
WC8k 20. Cshore sklmmlng operauons
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
uurlng oshore sklmmlng operauons, oll sklmmlng equlpmenL Lowed by shlps or oLher vessels ls used Lo
remove oll from Lhe surface of open waLer.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
149
ERHMS
WC8k 21. ConLrolled burnlng of oll
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
uurlng conLrolled burnlng operauons, oll ls burned o Lhe surface of Lhe waLer by lgnlung Lhe upwlnd
end of an oll-conLamlnaLed area of open waLer and allowlng lL Lo burn Lo Lhe down-wlnd end.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
WC8k 22. 8oom deploymenL and recovery
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
8oom deploymenL and recovery operauons lnclude semng ouL hard or sorbenL booms used Lo conLaln or
absorb oll and oll producLs oaung on Lhe surface of Lhe waLer from shlps, boaLs, or oLher vessels, and
pulllng Lhem back onboard aer Lhey are used.
WC8k 23. uld you work on a vessel LhaL was parL of Lhe vessel of CpporLunlLy rogram?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC 8CM1 CnCL 8LlC8L ASklnC CuLS1lCnS WC8k 24 1P8CuCP
WC8k 27] l am golng Lo read you a llsL of dlerenL klnds of work you may have done. lease Lell me
wheLher or noL you dld Lhls klnd of work for each of Lhese whlle worklng on Lhe oll splll response.
WC8k 24. Cleanup of beaches, marshes or oLher areas along Lhe shorellne
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
Cleanup of beaches, marshes, or oLher areas along Lhe shorellne lncludes Lhe removal and cleanlng of
oll, oll producLs, and oll conLamlnaLed maLerlals from beaches, marshes and oLher shorellne areas.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
WC8k 23. Cleanlng oll from Lhe splll o boaLs or equlpmenL uslng pressure sprayers
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
Cleanlng oll and oll producLs from Lhe splll o boaLs or equlpmenL uslng pressure sprayers lncludes Lhe
removal of spllled crude oll from Lhe hull or oLher surfaces of boaLs or from oLher equlpmenL uslng pres-
sure sprayers aer Lhe boaLs or equlpmenL became conLamlnaLed durlng use.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
130
ERHMS
WC8k 26. Wlldllfe rehablllLauon
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
Workers and volunLeers are lnvolved ln cleanlng, carlng for and rehablllLaung oll-conLamlnaLed wlldllfe.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
WC8k 27. WasLe sLream managemenL
[ln1L8vlLWL8: ll Su8!LC1 lnl1lALL? AnSWL8S uCn'1 knCW, 8C8L 8? 8LAulnC 1PL lCLLCWlnC
uLSC8l1lCn]
WasLe sLream managemenL lnvolves Lhe collecuon, LransporL, sLorage and recycllng or nal dlsposal of
speclal or hazardous solld and llquld wasLes generaLed durlng Lhe oll splll response.
[ln1L8vlLWL8: WAS1L S18LAM MAnACLMLn1 uCLS nC1 lnCLuuL ML8LL? PAnuLlnC WAS1L A1 1PL
Cln1 WPL8L l1 lS CLnL8A1Lu, SuCP AS 8LACP CLLAn u Sl1LS.]
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
131
ERHMS
LkSCNAL kC1LC1IVL LUIMLN1
LC 1. Pow oen (dld/do) you wear chemlcal reslsLanL gloves and rubber booLs or overbooLs Lo proLecL
your skln from conLacL wlLh spllled crude oll or oll producLs whlle performlng your oll splll response [ob?
All Lhe ume ............. 1 [CC 1C CuLS1lCn LC 3] 8arely ..................... 4
MosL of Lhe ume ..... 2 never ...................... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 [CC 1C CuLS1lCn LC 3]
8efused ................... 99 [CC 1C CuLS1lCn LC 3]
LC 2. WhaL were Lhe reasons you [(dld/do) noL/(dld/do) noL always] wear chemlcal reslsLanL gloves
and rubber booLs or overbooLs? [ln1L8vlLWL8: 8LAu LlS1 Anu CCuL ALL 1PA1 AL?]
lL wasn'L requlred for Lhe work l dld .......................................1
none was avallable .................................................................. 2
1hey dldn'L have my slze .........................................................3
Mlne was damaged and l couldn'L geL a replacemenL ............4
lL goL ln Lhe way of dolng my work ..........................................3
lL was Loo hoL or uncomforLable .............................................6
l dldn'L know how Lo wear lL or use lL .....................................7
l dldn'L Lhlnk l needed lL ..........................................................8
lL goL Loo dlrLy ......................................................................... 9
l forgoL Lo wear lL ..................................................................... 10
l LhoughL wearlng lL made me less safe ...................................11
CLher ....................................................................................... 12
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know .............................................................................. 88
8efused .................................................................................... 99
132
ERHMS
LC 3. Pow oen (dld/do) you wear chemlcal proLecuve cloLhlng, such as a coaLed 1yvek sulL, Lo pro-
LecL your skln from conLacL wlLh spllled crude oll and oll producLs whlle performlng your oll splll response
[ob? [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 [CC 1C CuLS1lCn LC 3] 8arely ..................... 4
MosL of Lhe ume ..... 2 never ...................... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 [CC 1C CuLS1lCn LC 3]
8efused ................... 99 [CC 1C CuLS1lCn LC 3]
LC 4. WhaL (was/were) Lhe reason(s) you [(dld/do) noL/(dld/do) noL always]wear chemlcal proLecuve
cloLhlng? [ln1L8vlLWL8: 8LAu LlS1 Anu CCuL ALL 1PA1 AL?]
lL wasn'L requlred for Lhe work l dld .......................................1
none was avallable .................................................................. 2
1hey dldn'L have my slze .........................................................3
Mlne was damaged and l couldn'L geL a replacemenL ............4
lL goL ln Lhe way of dolng my work ..........................................3
lL was Loo hoL or uncomforLable .............................................6
l dldn'L know how Lo wear lL or use lL .....................................7
l dldn'L Lhlnk l needed lL ..........................................................8
lL goL Loo dlrLy ......................................................................... 9
l forgoL Lo wear lL ..................................................................... 10
l LhoughL wearlng lL made me less safe ...................................11
CLher ....................................................................................... 12
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know .............................................................................. 88
8efused .................................................................................... 99
133
ERHMS
LC 3. Pow oen (dld/do) you wear a resplraLor whlle performlng your oll splll response [ob? Lxamples
of resplraLors lnclude lLerlng facepleces such as a 100 and alr purlfylng resplraLors LhaL have chemlcal
carLrldges. uusL or surglcal-Lype masks are noL resplraLors. [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 [CC 1C CuLS1lCn MuPx 1] 8arely ..................... 4
MosL of Lhe ume ..... 2 never ...................... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 [CC 1C CuLS1lCn MuPx 1]
8efused ................... 99 [CC 1C CuLS1lCn MuPx 1]
LC 6. uld you go Lhrough L Lesung" Lo make sure your resplraLor L correcLly? ?ou mlghL have Lrled
on dlerenL slzes or dlerenL resplraLors.
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
LC 7. uld you recelve Lralnlng abouL how and when Lo properly use Lhe resplraLor you (wore/wear)?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
[ln1L8vlLWL8: 8LAu CuLS1lCn LC 8 CnL? ll CuLS1lCn LC 3 lS nC1=1. ll CuLS1lCn LC 3=1,
CC 1C CuLS1lCn MuPx 1.]
134
ERHMS
LC 8. WhaL (was/were) Lhe reason(s) you [(dld/do) noL/(dld/do) noL always] wear a resplraLor? [ln-
1L8vlLWL8: 8LAu LlS1 Anu CCuL ALL 1PA1 AL?]
lL wasn'L requlred for Lhe work l dld ....................................................1
none was avallable .................................................................. 2
1hey dldn'L have my slze .........................................................3
Mlne was damaged and l couldn'L geL a replacemenL ............4
lL goL ln Lhe way of dolng my work ..........................................3
lL was Loo hoL or uncomforLable .............................................6
l dldn'L know how Lo wear lL or use lL .....................................7
l dldn'L Lhlnk l needed lL ..........................................................8
lL goL Loo dlrLy ......................................................................... 9
l forgoL Lo wear lL ..................................................................... 10
l LhoughL wearlng lL made me less safe ...................................11
CLher ....................................................................................... 12
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know .............................................................................. 88
8efused .................................................................................... 99
133
ERHMS
MLDICAL nIS1Ck
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC 8CM1 CnCL 8LlC8L ASklnC CuLS1lCnS MuPx 1 1P8CuCP
MuPx 13]
8efore you began worklng on Lhe oll splll response, dld a docLor ever Lell you LhaL you had any of Lhe fol-
lowlng:
MuPx 1. AsLhma
?es .......................... 1 uon'L know ... 88 [CC 1C CuLS1lCn MuPx 3]
no ........................... 2 [CC 1C CuLS1lCn MuPx 3] 8efused ........ 99 [CC 1C CuLS1lCn MuPx 3]
MuPx 2. uo you sull have asLhma?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 3. Lmphysema or chronlc bronchlus (CCu)
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 4. Plgh blood pressure (hlgh blood - Lo some)
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 3. PearL dlsease
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 6. ulabeLes (hlgh sugar, sugar, or sugar dlabeLes Lo some)
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 7. AnxleLy
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 8. uepresslon
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
136
ERHMS
MuPx 9. Alcohol abuse problem
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 10. Sleep problems (e.g., sleep apnea, lnsomnla, resLless leg syndrome)
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 11. Allergles
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 12. 8ack problems
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 13. Mlgralne or clusLer headaches
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 14. Pow Lall are you ln feeL and lnches when noL wearlng shoes?
|___| feeL |___|___| lnches
uon'L know ............. 88 8efused ............ 99
MuPx 13. WhaL ls your currenL welghL ln pounds when noL wearlng shoes?
|___|___|___| lbs.
uon'L know ............. 88 8efused ............ 99
MuPx 16. Pave you smoked aL leasL 100 clgareues ln your enure llfe? [ln1L8vlLWL8: 100 ClCA8L11LS=3
ACkS]
?es .......................... 1 uon'L know .... 88
no ........................... 2 [CC 1C CuLS1lCn MuPx 18] 8efused........... 99
137
ERHMS
MuPx 17. uo you now smoke clgareues. [ln1L8vlLWL8: 8LAu LlS1]
Lvery day ................ 1 noL aL all .......... 3
Some days .............. 2
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MuPx 18. uo you now SMCkL Lobacco ln any oLher form such as a plpe or clgars?
[ln1L8vlLWL8: uC nC1 lnCLuuL SMCkLLLSS 1C8ACCC 8CuuC1S SuCP AS CPLWlnC 1C8ACCC C8
Snull.]
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MuPx 19. uo you currenLly use chewlng Lobacco, snu, or snus every day, some days, or noL aL all? [ln-
1L8vlLWL8: SnuS 8P?MLS Wl1P CCCSL. SnuS (SWLLulSP lC8 Snull) lS A MClS1 SMCkLLLSS 1C8AC-
CC, uSuALL? SCLu ln SMALL CuCPLS 1PA1 A8L LACLu unuL8 1PL Ll ACAlnS1 1PL CuM.]
Lvery day ................ 1 noL aL all .......... 3
Some days .............. 2
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MuPx 20. [ln1L8vlLWL8: ASk CnL? ll 8LSCnuLn1 lnulCA1Lu 1PA1 1PL? uSLu SCML lC8M Cl
1C8ACCC ln CuLS1lCn MuPx 17 C8 MuPx 18 C8 MuPx 19. C1PL8WlSL, CC 1C CuLS1lCn MuPx 21.]
Are you currenLly uslng Lhe same amounL of Lobacco (smoklng, chewlng or snu) as before your work on
Lhe oll splll?
More ....................... 1 uon'L know ...... 88
Less ......................... 2 8efused ............ 99
AbouL Lhe same ...... 3
MuPx 20. uurlng Lhe pasL 30 days, how many days per week or per monLh dld you have aL leasL one
drlnk of any alcohollc beverage?
uays per week uon'L know ...... 88
uays per week 8efused ............ 99
no drlnks ln Lhe pasL 30 days ........... 77
138
ERHMS

MPL1 1. [ln1L8vlLWL8: ASk CnL? ll CuLS1lCn MuPx 20 > 1 Anu nC1=77, 88 C8 99. ll CuLS1lCn
MuPx=0, 77, 88 C8 99, CC 1C CuLS1lCn MPL1 3.] Cne drlnk ls equlvalenL Lo a 12-ounce beer, a
3-ounce glass of wlne, or a drlnk wlLh one shoL of llquor. uurlng Lhe pasL 30 days, on Lhe days when you
drank, abouL how many drlnks dld you drlnk on Lhe average?
[ln1L8vlLWL8: A 40 CunCL 8LL8 WCuLu CCun1 AS 3 u8lnkS, C8 A CCCk1AlL u8lnk Wl1P 1WC
SPC1S WCuLu SCun1 AS 2 u8lnkS.]
uon'L know ............. 88 8efused ............ 99
MPL1 2. [ln1L8vlLWL8: ASk CnL? ll CuLS1lCn MuPx 20 > 1 Anu nC1=77, 88 C8 99. ll CuLS1lCn
MuPx=0, 77, 88 C8 99, CC 1C CuLS1lCn MPL1 3.] Are you currenLly drlnklng MC8L Lhan you drank ln
Lhe 12 monLhs before Lhe oll splll, LLSS, or A8Cu1 1PL SAML as ln Lhe 12 monLhs before Lhe oll splll?
More ....................... 1 uon'L know ...... 88
Less ......................... 2 8efused ............ 99
AbouL Lhe same ...... 3
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC8CM1 8LlC8L ASklnC CuLS1lCnS MPL1 3 1C MPL1 20.]
now l am golng Lo ask you some quesuons abouL some feellngs LhaL you have had ln Lhe pasL 30 days so
LhaL we can undersLand more abouL Lhls Lype of work for Lhe fuLure. lease answer: All Lhe ume, MosL of
Lhe ume, Someumes, 8arely or never.
MPL1 3. ln Lhe pasL 30 days, how oen was your sleep resLless?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 4. uurlng Lhe pasL 30 days, how oen dld you feel fearful?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
139
ERHMS
MPL1 3. uurlng Lhe pasL 30 days, how oen dld you feel hopeful abouL Lhe fuLure?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 6. uurlng Lhe pasL 30 days, how oen dld you feel lonely?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 7. uurlng Lhe pasL 30 days, how oen dld you have Lrouble keeplng your mlnd on whaL you were
dolng?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 8. uurlng Lhe pasL 30 days, how oen dld you feel sad or depressed?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
160
ERHMS
MPL1 9. uurlng Lhe pasL 30 days, how oen dld you feel LhaL everyLhlng you dld was an eorL?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 10. uurlng Lhe pasL 30 days, how oen dld you feel boLhered by Lhlngs LhaL usually don'L boLher
you?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 11. ln Lhe pasL 30 days, how oen have you felL so angry LhaL you elLher losL your Lemper or felL
ouL of conLrol?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MHLT 12. uurlng Lhe pasL 30 days, how oen dld you feel happy?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
161
ERHMS
MHLT 13. uurlng Lhe pasL 30 days how oen dld you feel LhaL you could noL geL golng"?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 14. uurlng Lhe pasL 30 days, how much have you worrled abouL your fuLure physlcal healLh as a
resulL of worklng on Lhe oll splll? [ln1L8vlLWL8: 8LAu LlS1]
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
MPL1 13. ln Lhe lasL 30 days how oen dld your oll splll response [ob lnLerfere wlLh your famlly llfe ln any
way (e.g., ume spenL wlLh famlly, belng dlsLracLed or shorL-Lempered because of work)? Would you say.
[ln1L8vlLWL8: 8LAu LlS1]
never ................................... 1 1-2 days per week .............4
Less Lhan once a monLh ...... 2 3-4 days per week .............3
1-3 days per monLh ........... 3 3 or more days per week .....6
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know .......................... 88 8efused ................................ 99
MPL1 16. eople dler a loL ln Lhelr feellngs abouL professlonal help for menLal healLh problems. lf you
had a SL8lCuS menLal healLh problem, would you uLllnl1LL? go for professlonal help, 8C8A8L? go,
8C8A8L? nC1 go, or uLllnl1LL? nC1 go for professlonal help?
uenlLely go ........... 1 uenlLely noL go ........... 4
robably go............. 2 uon'L know ................... 88
robably noL go ...... 3 8efused ......................... 99
MPL1 17. uo you have access Lo professlonal help for menLal healLh concerns lf deslred?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
162
ERHMS
MPL1 18. Are you able Lo conLacL people you rely on for supporL lf deslred (people such as famlly mem-
ber, frlend, splrlLual leader, or LrusLed coworker)?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
MPL1 19. WhaL concerns do you have abouL Lhe lmpacL of Lhls oll splll ? [ln1L8vlLWL8: CCuL ALL 1PA1
AL?.]
Loss of personal or famlly buslness ............................................... 1
Loss of [ob opporLunlues ............................................................... 2
needlng Lo relocaLe ....................................................................... 3
Loss of usual way of llfe ................................................................. 4
uamage Lo wlldllfe and Lhe naLural envlronmenL ......................... 3
PealLh concerns abouL food sources from local waLers ................ 6
Loss of Lourlsm .............................................................................. 7
ersonal healLh eecLs .................................................................. 8
uon'L know .................................................................................... 88
8efused .......................................................................................... 99
MPL1 20. ln Lhe pasL 30 days, how oen have you had nlghLmares abouL Lhe oll splll or LhoughL abouL lL
when you dld noL wanL Lo?
All Lhe ume ............. 1 8arely ............... 4
MosL of Lhe ume ..... 2 never ............... 3
Someumes .............. 3
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ............ 99
163
ERHMS
SAIL1 CLIMA1L
SAlL 1. (uld/does) your employer on Lhe oll splll response provlde you clean drlnklng waLer every day?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC 8CM1 8LlC8L ASklnC CuLS1lCn SAlL 2 Anu SAlL 3.]
lease Lell me wheLher you sLrongly agree, agree, dlsagree, or sLrongly dlsagree wlLh Lhe followlng Lwo
sLaLemenLs LhaL mlghL or mlghL noL descrlbe your oll splll response [ob.
SAlL 2. 1here (were/are) no slgnlcanL shorLcuLs or compromlses Laken when worker safeLy was/ls aL
sLake.
SLrongly agree ........ 1 ulsagree ........................ 3
Agree ...................... 2 SLrongly dlsagree .......... 4
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ......................... 99
SAlL 3. l (had/have) Lhe Lralnlng l needed/need Lo perform my [ob safely and compeLenLly.
SLrongly agree ........ 1 ulsagree ........................ 3
Agree ...................... 2 SLrongly dlsagree .......... 4
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know ............. 88 8efused ......................... 99
164
ERHMS
DLMCGkAnICS
uLMC 1. [ln1L8vlLWL8: CCuL SLx C8 ASk ll nC1 knCWn] Are you male or female?
Male ....................... 1 8efused ............ 99
lemale .................... 2
uLMC 2. Are you Plspanlc or (Launo/Launa)?
?es .......................... 1 uon'L know ...... 88
no ........................... 2 8efused ............ 99
uLMC 3. l'm golng Lo read a llsL of race caLegorles, please choose one or more caLegorles LhaL besL ln-
dlcaLe Lhe race you conslder yourself Lo be. Are you. [ln1L8vlLWL8: 8LAu ALL CA1LCC8lLS Anu CCuL
ALL 1PA1 AL?]
White ...................................................... 1 nauve Pawallan ...................3
8lack or Afrlcan Amerlcan ...................... 2 CLher aclc lslander...........6
Amerlcan lndlan or Alaska nauve........... 3
Aslan ....................................................... 4
[ln1L8vlLWL8: uCn'1 8LAu]
CLher ...................................................... 7 uon'L know ..........................88
8efused ................................................... 99
uLMC 4. WhaL ls Lhe hlghesL grade or year of school you compleLed? [ln1L8vlLWL8: 8LAu CnL? ll nLC-
LSSA8?]
never auended school or only klndergarLen ................................. 1
Crades 1 Lhrough 8 (elemenLary) .................................................. 2
Crades 9 Lhrough 11 (some hlgh school)....................................... 3
Crade 12 or CLu (Plgh School graduaLe) ...................................... 4
College 1 year Lo 3 years (some college or Lechnlcal school) ........ 3
College 4 years or more (college graduaLe) ................................... 6
[ln1L8vlLWL8: uCn'1 8LAu]
uon'L know .................................................................................... 88
8efused .......................................................................................... 99
163
ERHMS
kLSCNDLN1 IDLN1IIICA1ICN
[ln1L8vlLWL8: ll ll8S1 Anu LAS1 nAML llLLuS A8L AL8LAu? CuLA1Lu, 8LAu CuLS1lCn lun1 1.
C1PL8WlSL, Skl 1C CuLS1lCn lun1 2.]
lun1 1. Cn Lhe rosLer form you compleLed earller, we have your name llsLed as [ln1L8vlLWL8: 8LAu
Anu SLLL 8LSCnuLn1'S nAML]. ls LhaL correcL?
?es ................... 1 [CC 1C CuLS1lCn lun1 3] 8efused ............ 99
no .................... 2
lun1 2. lease spell your lasL name.
8efused ................... 99
lun1 3. lease spell your rsL name.
8efused ................... 99
lun1 4. WhaL ls your mlddle lnlual?
none ....................... 88 8efused ............ 99
[ln1L8vlLWL8: ll uA1L Cl 8l81P llLLu lS AL8LAu? CuLA1Lu, 8LAu CuLS1lCn lun1 3. C1PL8WlSL,
Skl 1C CuLS1lCn lun1 6]
lun1 3. We have your daLe of blrLh llsLed as [ln1L8vlLWL8: 8LAu uA1L Cl 8l81P]. ls LhaL correcL?
?es .......................... 1 [CC 1C CuLS1lCn lun1 8] uon'L know ............. 88
no ........................... 2 8efused .................. 99
lun1 6. WhaL ls your daLe of blrLh?
_____/_____/_____
uon'L know...88 [CC 1C CuLS1lCn lun1 7]
8efused.....99 [CC 1C CuLS1lCn lun1 7]
166
ERHMS
lun1 7. [ln1L8vlLWL8: 8LAu CuLS1lCn lun1 7 CnL? ll CuLS1lCn lun1 6 = 88 C8 99. C1PL8WlSL, Skl
1C CuLS1lCn lun1 8.] Pow old are you?
uon'L know ............. 88 8efused ............ 99
[ln1L8vlLWL8: ll LAS1 lCu8 ulCl1S Cl SSn llLLu lS AL8LAu? CuLA1Lu, 8LAu CuLS1lCn lun1 8.
C1PL8WlSL, Skl 1C CuLS1lCn lun1 9]
lun1 8. We have Lhe lasL four dlglLs of your Soclal SecurlLy number llsLed as [ln1L8vlLWL8: 8LAu LAS1
lC8 ulCl1S Cl 8LSCnuLn1'S SSn]. ls LhaL correcL?
?es .......................... 1 [CC 1C CuLS1lCn lun1 10] 8efused .................. 99
no ........................... 2
lun1 9. WhaL are Lhe lasL four dlglLs of your soclal securlLy number? [ln1L8vlLWL8: ll 8LSCnuLn1 lnl-
1lALL? AnSWL8S uCn'1 knCW C8 8LluSLS, 8LAu 1PL lCLLCWlnC:] 1he reason we are collecung Lhls
lnformauon ls Lo maLch Lhe responses you glve us Loday Lo our response worker rosLer.
uon'L know ............. 88 8efused ............ 99
lun1 10. ls Lhe Lelephone number l reached you aL Loday Lhe besL number Lo reach you aL ln Lhe fuLure?
?es .......................... 1 [CC 1C CuLS1lCn lun1 12] uon'L know ............. 88
no ........................... 2 8efused .................. 99
lun1 11. Could you glve me a phone number, lncludlng Lhe area code, LhaL we could use Lo reach you aL
ln Lhe fuLure?
(___|___|___) |___|___|___|-|___|___|___|___|
none ....................... 88 [CC 1C CuLS1lCn lun1 13] 8efused ...... 99 [CC 1C CuLS1lCn lun1 13]
lun1 12. ls LhaL a landllne home phone, a cell phone, work phone or someLhlng else?
Landllne home phone ... 1 CLher ...................... 4
Cell phone .................... 2 uon'L know ............. 88
Work phone .................. 3 8efused .................. 99
lun1 13. uo you have anoLher phone number we could use ln case we are unable Lo reach you aL Lhe
number you [usL gave me? lor example, a cell phone or a work phone number.
(___|___|___) |___|___|___|-|___|___|___|___|
none ....................... 88 [CC 1C CuLS1lCn lun1 13] 8efused ...... 99 [CC 1C CuLS1lCn lun1 13]
167
ERHMS
lun1 14. ls LhaL a landllne home phone, a cell phone, work phone or someLhlng else?
Landllne home phone ... 1 CLher ...................... 4
Cell phone .................... 2 uon'L know ............. 88
Work phone .................. 3 8efused .................. 99
lun1 13. Could you Lell me Lhe phone number of a famlly member, frlend or oLher person who would
know how Lo conLacL you 6 monLhs from now?
(___|___|___) |___|___|___|-|___|___|___|___|
uon'L know ............. 88 8efused ............ 99
[ln1L8vlLWL8: ll 1PL S18LL1 Auu8LSS, Cl1?, S1A1L, Anu ZlCCuL llLLuS A8L AL8LAu? CuLA1Lu,
8LAu CuLS1lCn lun1 16. C1PL8WlSL, Skl 1C CuLS1lCn lun1 17.]
[ln1L8vlLWL8: lC8 CuLS1CnS lun1 16 1C lun1 20, ll 1PL 8LSCnuLn1 lnl1lALL? AnSWL8S uCn'1
knCW C8 8LluSLS, 8LAu 1PL lCLLCWlnC:] 1he reason we are asklng for your permanenL address ls so
we can share lnformauon wlLh you ln Lhe fuLure.
lun1 16. We have your permanenL address llsLed as [ln1L8vlLWL8: 8LAu 1PL 8LSCnuLn1'S S18LL1
Auu8LSS, Cl1?, S1A1L, Anu ZlCCuL]. ls LhaL correcL?
?es ................... 1 [CC 1C CuLS1lCn lun1 21] uon'L know ...... 88 [CC 1C CuLS1lCn lun1 18]
no .................... 2 8efused ............ 99 [CC 1C CuLS1lCn lun1 18]
lun1 17. WhaL ls Lhe zlp code of your permanenL malllng address?
uon'L know ............. 88 8efused ............ 99
lun1 18. WhaL sLaLe ls LhaL? [ln1L8vlLWL8: ll lun116=88 C8 99, 8LAu 1PL CuLS1lCn AS, ln whaL
sLaLe ls your permanenL resldence?"]
uon'L know ............. 88 8efused ............ 99 [CC 1C CuLS1lCn lun1 21]
lun1 19. WhaL clLy ls LhaL? [ln1L8vlLWL8: ll CuLS1lCn luLn1 16=88 C8 99, 8LAu 1PL CuLS1lCn AS,
ln whaL clLy ls your permanenL resldence?"]
uon'L know ............. 88 [CC 1C CuLS1lCn lun1 21] 8efused ..... 99 [CC 1C CuLS1lCn lun1 21]
168
ERHMS
lun1 20. [ln1L8vlLWL8: ll CuLS1lCn luLn1 16=88 C8 99, 8LAu 1PL CuLS1lCn AS, CC 1C CuLS1lCn
lun1 21.]WhaL ls Lhe sLreeL number and sLreeL name of your permanenL malllng address?
uon'L know ............. 88 8efused ............ 99
[ln1L8vlLWL8: ll L-MAlL Auu8LSS llLLu lS AL8LAu? CuLA1Lu, 8LAu CuLS1lCn A21. C1PL8WlSL,
Skl 1C CuLS1lCn A22.]
lun1 21. We have your emall address llsLed as [ln1L8vlLWL8: 8LAu 8LSCnuLn1'S L-MAlL Auu8LSS]. ls
LhaL correcL?
?es .......................... 1 [CC 1C CuLS1lCn lun1 23] 8efused ........... 99 [CC 1C CuLS1lCn lun1 23]
no ........................... 2
lun1 22. ls Lhere an e-mall address we could use Lo conLacL you ln Lhe fuLure?
uon'L know ............. 88 8efused ............ 99
[ln1L8vlLWL8: 8LAu 1PL lCLLCWlnC.]
1hank you very much for your paruclpauon. ur. 8enee lunk ls Lhe rlnclpal lnvesugaLor for Lhls sLudy.
Would you llke ur. lunk's e-mall address or Lelephone number ln case you wanL Lo conLacL her abouL Lhe
sLudy aL any ume?
[ll ?LS, 8CvluL 1PL lCLLCWlnC.]
cdcnloshgulfworker[cdc.gov (404) 498-4833
ln Lhe fuLure, you may be conLacLed abouL paruclpaung ln longer-Lerm research sLudles on Lhe poLenual
healLh eecLs of Lhe Culf oll splll response eorLs, and you can choose wheLher or noL you wanL Lo par-
uclpaLe ln Lhose sLudles aL LhaL ume.
[Lnu]
169
ERHMS
keference Document Used to Support 1h|s Secnon
S1CkM, ILCCD, AND nUkkICANL kLSCNSL
Culdance for osL-exposure Medlcal Screenlng of Workers Leavlng
Purrlcane ulsasLer 8ecovery Areas
hLLp://www.cdc.gov/nlosh/Loplcs/emres/medScreenWork.hLml
Cverv|ew
Worklng ln physlcally demandlng, unclean, or unsLable work envlronmenLs, such as hurrlcane recovery
areas, ralses Lhe quesuon of wheLher work exposures wlll have adverse healLh consequences. 1he llkellhood
of such adverse healLh ouLcomes wlll depend on facLors such as work load and work durauon, Lype and
severlLy of work exposures, and work organlzauon, as well as Lhe workers' prlor physlcal and menLal healLh
sLaLus, knowledge abouL and experlence wlLh dlsasLer work, and precauuons Laken whlle worklng (e.g.,
work pracuces, personal proLecuve equlpmenL).
8ecause of poLenual healLh rlsks lnherenL ln posLdlsasLer work, screenlng programs should be underLaken
Lo deLermlne Lhe exLenL, lf any, Lo whlch lndlvldual workers have been adversely aecLed by Lhelr work
and Lo ldenufy as early as posslble any aecLed workers needlng prevenuve measures or medlcal care.
1hls documenL ls lnLended for occupauonal healLh professlonals and oLher cllnlclans who are responslble
for physlcal and menLal healLh overslghL of workers who have deployed or worked ln hurrlcane dlsasLer
response (e.g., response and recovery workers). lL provldes guldance on an approprlaLe medlcal screenlng
approach for Lhese workers as Lhey compleLe Lhelr response acuvlues or reLurn home from Lhe aecLed
areas. 1he documenL does noL address lssues relaLed Lo Lhe perlod prlor Lo lnluaung response or recovery
work, such as predeploymenL screenlng, medlcal clearance, or Lralnlng, Lhese are lmporLanL occupauonal
safeLy and healLh conslderauons LhaL are addressed ln a companlon documenL. 1hls documenL wlll be
reassessed perlodlcally and updaLed as approprlaLe.
ln general, Lhe level of screenlng approprlaLe for a glven work acuvlLy depends on muluple facLors. Powever,
because Lhe condluons encounLered by response and recovery workers may lnvolve complex, unconLrolled
envlronmenLs, posslbly lnvolvlng muluple or mlxed chemlcal exposures, hazardous subsLances, mlcroblal
agenLs, LemperaLure exLremes, long work shls, or sLressful experlences, all such workers should recelve
some assessmenL as a precauuon. 1hls may range from compleuon of brlef assessmenL forms Lo more
comprehenslve and focused evaluauons. Plgh prlorlLy worker groups lnclude Lhose mosL llkely Lo have
exposures Lo hazardous agenLs or condluons and Lhose reporung ouLbreaks of slmllar adverse healLh
ouLcomes. ubllc healLh crlLerla, such as frequency of adverse healLh eecLs, Lhelr severlLy, prevenLablllLy,
or communlcablllLy, publlc lnLeresL, and cosL eecuveness, are oen useful for semng screenlng prlorlues.
urpose of screen|ng
1he prlmary purpose of worker screenlng programs ls Lo proLecL worker healLh by early ldenucauon of
work-relaLed condluons ln lndlvldual workers. 1hrough screenlng, adverse eecLs ln lndlvlduals can be
recognlzed ln a umely way Lo provlde lnLervenuon for Lhe lndlvldual, whlle ldenufylng poLenual rlsks Lo
oLhers ln Lhe same populauon of workers or populauons wlLh slmllar exposures. 1he goal of screenlng ls Lo
ldenufy Lhose who need furLher medlcal auenuon, noL necessarlly Lo denluvely dlagnose or LreaL based
only on lnformauon provlded Lhrough Lhe screenlng. 1herefore, screenlng programs collecL and analyze
lndlvldual-speclc daLa relaLed Lo posLexposure physlcal and menLal healLh sLaLus, whlch are used Lo:
170
ERHMS
- ueLecL posslble adverse menLal or physlcal healLh eecLs relaLed Lo work or exposure
- ldenufy Lhose who need furLher medlcal evaluauon and LreaLmenL
- MonlLor developlng Lrends and pauerns of lllness or sequelae Lo ln[ury or exposure among workers
Determ|n|ng a need for screen|ng
When developlng a posLexposure screenlng program, lL ls lmporLanL Lo deLermlne who should be screened
and Lhe reasons for screenlng Lhem. lor each group of workers, work-relaLed rlsk facLors or characLerlsucs
of commonly experlenced occupauonal ln[urles and lllnesses wlll deLermlne Lhe level or exLenL of screenlng
approprlaLe Lo members of Lhe group. 1hese may lnclude emouonal as well as physlcal healLh facLors. 1he
followlng facLors should be consldered:
- Lxposures or oLher rlsk facLors encounLered whlle deployed
1ype of work performed
uaLes of deploymenL
Speclc locauons of work asslgnmenLs
CharacLerlsucs of work locauons and relauonshlp Lo known or suspecLed hazardous agenLs or
condluons
Speclc [ob Lasks and work load aL work locauons
Speclc hlgh-rlsk exposures or condluons aL work locauons (e.g., conLamlnaLed oodwaLers,
moldy lndoor envlronmenLs, oll or oLher Loxlc spllls)
Lxposure Lo Lraumauc evenLs
roLecuve measures used Lo prevenL hazardous exposures (e.g., use of personal proLecuve
equlpmenL)
uaLes sLarLed and nlshed work aL locauons llsLed above
o Shl schedules: hours per day, days per week, roLauon schedules
- 8eporLs of adverse healLh eecLs among parucular groups of workers wlLh slmllar [ob Lasks, work
locauon, exposure characLerlsucs, eLc.
Dec|d|ng who shou|d be screened
Clven Lhe broad range of poLenual hazards and dlmculL worklng condluons encounLered ln hurrlcane
response work, all workers reLurnlng from or compleung hurrlcane response acuvlues should recelve some
baslc screenlng Lo capLure lnformauon abouL Lhelr demographlcs, preexlsung medlcal condluons, work
experlence and poLenual exposures whlle deployed, and any ln[urles or lllness sympLoms experlenced whlle
ln Lhe eld or slnce leavlng Lhe dlsasLer area. As descrlbed below, Lhose meeung cerLaln crlLerla should
recelve more exLenslve screenlng.
Determ|n|ng the type of screen|ng to be done
ln Lhe early phases of response eorLs, lL ls oen noL posslble Lo fully characLerlze Lhe specLrum of hazardous
agenLs and condluons LhaL may have caused lmmedlaLe or may cause fuLure adverse healLh ouLcomes. As ume
elapses followlng hurrlcanes, envlronmenLal condluons, response acuvlues, exposures, and posslble healLh
ouLcomes wlll conunue Lo evolve, and lnformauon abouL some of Lhese facLors may remaln lncompleLe.
lL ls noL posslble Lo speclfy here a slngle dened seL of condluons for whlch workers should be screened.
ueclslons abouL screenlng needs and whlch healLh ouLcomes Lo monlLor should be based on lnformauon
abouL known or suspecLed rlsk facLors (llsLed ln Lhe secuon ueLermlnlng a need for Screenlng"), whlch
171
ERHMS
ls ellclLed Lhrough Lhe baslc screenlng recommended for all workers leavlng Lhe dlsasLer area. Slmllarly,
acuLe physlcal, cognluve, or emouonal sympLoms experlenced durlng response work may be lndlcaLors of
a poLenual fuLure chronlc condluon, so Lhe presence of sympLoms durlng or aer deploymenL may lndlcaLe
a need for more exLenslve screenlng.
ulerenL screenlng approaches wlll be approprlaLe for dlerenL groups. lor example, rescue and recovery
workers wlLh prolonged and repeaLed exposures Lo conLamlnaLed oodwaLer, workers aL an evacuauon
cenLer, Lruck drlvers dellverlng supplles, and workers handllng loglsucs aL a sLaglng faclllLy wlll each requlre
dlerenL screenlng sLraLegles.
WlLhouL speclc lnformauon abouL chemlcal exposures, blologlcal monlLorlng (l.e., measurlng ln body ussues
or ulds [such as blood or urlne] a chemlcal, one or more of lLs meLabollLes, or a blochemlcal marker of lLs
eecLs) wlll noL have greaL predlcuve or dlagnosuc value, nor would lL be expecLed Lo be cosL eecuve. Such
speclc exposure lnformauon ls unllkely Lo be avallable for mosL locauons and clrcumsLances. Addluonally,
blologlcal monlLorlng would be recommended only lf lLs use as a screenlng Lool for a speclc exposure
were well esLabllshed and cerLaln crlLerla were meL, for example, exposure Lo Lhe speclc hazardous agenL,
ablllLy Lo reLrleve Lhe agenL or lLs meLabollLes from Lhe body, exlsLence of esLabllshed reference values for
lnLerpreung LesL resulLs, and relevance and usefulness of resulLs (e.g., lmporLanL for deLermlnlng LreaLmenL
and for predlcung healLh ouLcome, severlLy, chronlclLy, or need for fuLure screenlng or survelllance). Any
oLher use of blologlcal monlLorlng would be consldered lnvesugauve (e.g., Loxlcology research), wlLh
ob[ecuves LhaL are dlerenL from Lhose of screenlng programs.
llnally, ln addluon Lo documenung predlcLable adverse healLh ouLcomes (on Lhe basls of known exposures,
acuvlues, and work condluons), screenlng programs may ldenufy unexpecLed healLh ouLcomes. Should
such a poLenual emerglng problem be ldenued, furLher lnvesugauon uslng an epldemlologlc or ouLbreak
lnvesugauon" model may be necessary Lo characLerlze lL and assess posslble work-relaLedness. lf Lhls
lnvesugauon suggesLs LhaL Lhe unanuclpaLed healLh ouLcome was relaLed Lo response work, Lhe screenlng
program could Lhen be modled Lo lncorporaLe Lhls new lnformauon Lo deLecL reappearance of Lhe problem
aL an early sLage.
When to screen
lmmedlaLe daLa on posLexposure healLh sLaLus should be collecLed aL Lhe ume of compleuon of response
work or deparLure from Lhe aecLed area, or as soon as posslble aerward.
uependlng on whaL ls learned abouL exposures and on Lhe resulLs of Lhe lnlual screenlng, more deLalled
medlcal evaluauon may be lndlcaLed. Long-Lerm daLa on healLh sLaLus may need Lo be collecLed on some
lndlvlduals aer a perlod away from exposure. 1lmlng wlll depend on Lhe naLure of Lhe exposure or healLh
condluon.
M|n|mum screen|ng |nformanon needs
1he followlng lnformauon should be collecLed on all lndlvlduals undergolng screenlng upon compleuon of
or reLurn from response or recovery acuvlues:
ersona| |nformanon
lJeoufyloq ooJ cootoct lofotmouoo
- name, address, approprlaLe Lelephone number(s), e-mall addresses (work, personal)
- Age, daLe of blrLh, blrLhplace, sex, soclal securlLy number
- ConLacL lnformauon for someone who wlll know where Lhe worker ls 6 monLhs aer leavlng response
work
172
ERHMS
- 8esponse organlzauon:
Lmployer vs. volunLeer organlzauon (lndlcaLe whlch)
name and address
ConLacL person's name and Lelephone number
usool wotk
- lndusLry, occupauon, [ob Lasks, number of years
loocuoool ooJ Access NeeJs
- rlmary language
neoltb stotos befote tespoose wotk
- reexlsung medlcal and menLal healLh condluons
- 8elevanL llfesLyle facLors (e.g., smoklng sLaLus)
- CLher speclc rlsk facLors (depend on [ob, e.g., use of personal proLecuve equlpmenL, exposures)
- lmmunlzauon sLaLus: adulL and speclal rlsk (e.g., healLh care worker)
kesponse-re|ated |nformanon
kespoose wotk
- 1ype of work performed as response or recovery worker and clrcumsLances under whlch LhaL work
was performed, wlLh speclal auenuon Lo documenLauon of Lhe geographlc locauon of Lhe work
and when Lhe work was performed. See Lhe secuon uLled ueLermlnlng a need for screenlng."
lot koowo bozotJoos exposotes ot cooJluoos
- 1ype of exposure or condluons, work pracuces, and proLecuve measures (e.g., personal proLecuve
equlpmenL)
lojotles sostoloeJ ot symptoms expetleoce Jotloq tespoose wotk
- ln[urles: descrlpuon of ln[ury and clrcumsLances, LreaLmenL recelved, wheLher ln[ury resolved or
sull presenL
- SympLoms: Lype, new onseL or exacerbauon of preexlsung condluon, LreaLmenL, lf any, sympLom
sull presenL aer reLurn or new sympLoms developed aer reLurn
- lL may be approprlaLe Lo lnclude speclc screenlng for sLress-relaLed or emouonal sympLoms
Add|nona| screen|ng |nformanon needs
Workers leavlng dlsasLer work who reporL repeaLed or prolonged exposures or who reporL ln[urles or
sympLoms should recelve more comprehenslve screenlng, whlch should address Lhe speclc exposures or
adverse healLh eecLs encounLered. Addluonal screenlng may lnclude a more comprehenslve medlcal hlsLory
and revlew of sympLoms, a physlcal examlnauon, or, ln some lnsLances, laboraLory Lesung, as lndlcaLed by
cllnlcal [udgmenL and good occupauonal medlcal pracuce.
Ior reported exposures
lf poLenually slgnlcanL exposures are reporLed, addluonal screenlng should be dlrecLed Lo deLecL poLenual
adverse aecLs commonly assoclaLed wlLh Lhese exposures. 1hus, for example, lf repeaLed or prolonged
exposures Lo dusLy or moldy envlronmenLs are reporLed, screenlng should address posslble resplraLory or
allerglc ouLcomes.
173
ERHMS
Ior reported symptoms
lf lllnesses or sympLoms are reporLed, lnformauon should be obLalned regardlng correspondlng organ
sysLems (e.g., cardlac, resplraLory, gasLrolnLesunal, skln, menLal healLh), sympLoms, wheLher lllnesses or
sympLoms represenL new onseL or exacerbauon of preexlsung condluon, and LreaLmenL, lf any.
Ior reported |n[ur|es
lf ln[ury ls reporLed, lnformauon should be obLalned regardlng locauon and operauon where ln[ury occurred,
naLure of ln[ury, parL of body aecLed, severlLy (e.g., losL work ume), and LreaLmenL. Mlnlmum lnformauon
abouL ln[ury should lnclude lnformauon sumclenL Lo meeL CSPA requlremenLs for recordable ln[urles.
ln[urles caused by acLs of vlolence should be lncluded.
now |nformanon w||| be used
lor Lhe reasons llsLed ln Lhe prevlous secuon uLled urpose of Screenlng," screenlng programs may be seL
up by varlous organlzauons, lncludlng publlc healLh agencles from all levels of governmenL, publlc secLor
response programs (lncludlng regulaLory agencles and conLracLors), medlcal sLa aL prlvaLe companles,
or lndlvldual pracuuoners. 1o malnLaln condenuallLy of workers' medlcal lnformauon, medlcal or publlc
healLh personnel Lyplcally admlnlsLer screenlng programs. CLher lnLeresLed parues, such as publlc healLh
organlzauons, academlclans, medla, labor unlons, and auorneys, may wanL access Lo grouped screenlng
resulLs (wlLh lndlvldual ldenuers removed) for oLher reasons, pollcles for handllng such requesLs should
be developed ln advance.
Cther cons|derat|ons
AJmlolsttotlve
- ueclslons should be based on needs assessmenL before esLabllshmenL of any screenlng program
- rograms should address clearly sLaLed ob[ecuves
- 1hose sLa members wlLh access Lo daLa resulLs should be clearly ldenued
- ollcles, mechanlsms, admlnlsLrauon, and monlLorlng of prlvacy, condenuallLy, and daLa securlLy
concerns should be sLaLed clearly
- AdequaLe funds, personnel, maLerlals, space, umeframe should be avallable
- rovlslons should be made Lo ensure a sysLem ls ln place for prompL and eecuve referral for more
denluve evaluauon and posslble LreaLmenL of workers ldenued wlLh emergenL medlcal problems,
wheLher physlcal or psychologlcal
5toffloq
- rogram admlnlsLraLor
- ueslgnaLed cusLodlan of lnformauon collecLed
- SLa dedlcaLed Lo collecung Lhe lnformauon should be Lralned ln Lhe lmporLance of accuraLe daLa
collecuon, prlvacy, and condenuallLy of sensluve and medlcal lnformauon
- SLa members avallable Lo analyze Lhe daLa and lnLerpreL and reporL Lhe resulLs
loqlstlcs
- uaLa collecuon locauons should be convenlenL Lo workers (e.g., cenLral locauon where workers
reporL)
- rlvaLe space for malnLenance of prlvacy
- Secure space for malnLenance of condenual lnformauon
174
ERHMS
Other
- Screenlng lnsLrumenL should be slmple, conclse, and sLandardlzed when avallable and approprlaLe.
- Screenlng sysLem should be slmple enough for admlnlsLrauon by healLhcare professlonals
- rogram should recognlze poLenual lmpllcauons regardlng worker's compensauon and relaLed lssues

- Workers lnvolved ln hurrlcane response may encounLer hazardous or sLressful worklng envlronmenLs
and may be aL rlsk for work-relaLed adverse healLh consequences.
- All workers reLurnlng from or compleung response and recovery acuvlues should undergo as soon
as feaslble baslc screenlng Lo documenL Lhelr acuvlues and worklng condluons and ldenufy any
recognlzed exposures, lllnesses, or ln[urles.
- Workers who reporL repeaLed or prolonged hazardous exposures, ln[urles, or sympLoms or for
whom speclc rlsk facLors are ldenued ln Lhe baslc screenlng should recelve more comprehenslve
screenlng, whlch should be dlrecLed aL Lhe rlsk facLors, exposures, or adverse healLh eecLs
encounLered.
173
ERHMS
lCS lorm 221 uemoblllzaLlon CheckllsL
DEMOBILIZATION CHECKOUT
1. INCIDENT NAME/NUMBER 2. DATE/TIME 3. DEMOB NO.
4. UNIT/PERSONNEL RELEASED
5. TRANSPORTATION TYPE/NO.
6. ACTUAL RELEASE DATE/TIME
8. DESTINATION
7. MANIFEST YES NO
NUMBER
9. AREA/AGENCY/REGION NOTIFIED
NAME
DATE
10. UNIT LEADER RESPONSIBLE FOR COLLECTING PERFORMANCE RATING
11. UNIT/PERSONNEL YOU AND YOUR RESOURCES HAVE BEEN RELEASED SUBJECT TO SIGNOFF FROM THE FOLLOWING:
(DEMOB. UNIT LEADER CHECK APPROPRIATE BOX)
LOGISTICS SECTION
SUPPLY UNIT
COMMUNICATIONS UNIT
FACILITIES UNIT
GROUND SUPPORT UNIT LEADER
PLANNING SECTION
DOCUMENTATION UNIT
FINANCE/ADMINISTRATION SECTION
TIME UNIT
OTHER
12. REMARKS
ICS-221
221 ICS 1/83
NFES 1353
INSTRUCTIONS ON BACK
176
ERHMS
101. osL-LvenL 1racklng of Lmergency 8esponder PealLh and
luncuon
Contents:
1. D|saster menta| and behav|ora| hea|th |nd|cators and examp|e measures]too|s, |nc|ud|ng NICSn
menta| hea|th quesnons created for a Deepwater nor|zon post-dep|oyment assessment survey and
c|eared by Cmce of Management and 8udget (CM8)
2. Add|nona| examp|es of measures]too|s
3. Iurther kead|ng
4. Add|nona| resources for track|ng
D|saster Menta| and 8ehav|ora| nea|th Ind|cators and Lxamp|e Measures
oLenually lmporLanL menLal and behavloral healLh lndlcaLors (and example measures) LhaL responders
may conslder for survelllance analyses and prlmary daLa collecuon eorLs are llsLed below. lf uslng basellne
screeners for emouonal healLh sLaLus, Lhese measures should be repeaLed Lo evaluaLe changes/Lrends:
- 8rlef SympLom lnvenLory (8Sl)
- kessler quesuonnalre (k10)
- S8ln1-L
- Sheehan ulsablllLy Scale (SuS)
- Medlcal CuLcomes SLudy ShorL lorm-12 (MCS Sl-12): quallLy of llfe lndlces
- auenL PealLh Cuesuonnalre from 8lML-Mu (PC): modules for depresslon, anxleLy
Ind|cators and Lxamp|e Measures]1oo|s
lndlcaLor Lxample Measure/1ool
Serlous sychologlcal ulsLress kessler-6 or 10
Alcohol and drug use/abuse C.A.C.L. -Alu or 88lSS
Change ln healLh-rlsk behavlors ([ob safeLy
compllance, seaLbelLs, speedlng, smoklng, drug
use)
*
1obacco use 88lSS
ercelved sLress ercelved SLress Scale (SS)
Sulcldal/homlcldal ldeaLlon or behavlor *
vlolence *
CapaclLy for self/dependenL care *
llnanclal sLressors/lncome/employmenL sLaLus *
PealLh-relaLed quallLy of llfe/ MenLally healLhy/
unhealLhy days
88lSS
Sleep-loss 88lSS
177
ERHMS
Adherence Lo publlc healLh recommendaLlons
(l.e., lnfecLlon conLrol/resLrlcLed acLlvlLles/
evacuaLlon)
*
uepresslon 88lSS CpLlonal module
AnxleLy 88lSS CpLlonal module
reexlsLlng chronlc condlLlons *
8arrlers Lo MenLal/behavloral healLh care
(bellefs, sLlgma, loglsLlcs/access Lo servlces and
medlcaLlons)
*
sychosomaLlc SympLoms (somaLlzaLlon) PC-13
lamlly uynamlcs & ConfllcL *
Chlld SLress/AnxleLy 8CMAS
Chlld Abuse & neglecL *
* lndicotes no specifc meosure recommended or use o meosure odopted to specifc popu/onon/survey
method
Descr|pnon of Lxamp|e Measures
NlO5n Meotol neoltb Ooestloos
1o vlew Lhe menLal healLh lLems LhaL are parL of Lhe nlCSP ueepwaLer Porlzon Worker PealLh Survey
please see Lhe Mental Health secLlon of Lhe survey. 1hls secLlon assesses depresslve sympLoms,
alcohol and subsLance abuse, soclal supporL, and access Lo menLal healLh professlonal supporL.
1he nlCSP ueepwaLer Porlzon Worker PealLh Survey ls locaLed ln subsecLlon 91. kespooJets Oot-
ltocessloq Assessmeot of Lhe 1ools SecLlon of Lhls documenL.
------------------------------------------
loJlvlJool Meosotes
CAGL
- 1hls slmple four-quesuon self-LesL speclcally focuses on alcohol use, and noL on Lhe use of oLher
drugs.
- 1he CACL Cuesuonnalre was developed by !ohn Lwlng. no permlsslon ls necessary for uslng Lhe quesuonnalre,
unless lL ls used ln a proL-maklng endeavor.
- 1o access Lhe quesuonnalre, see Lwlng !1 [1984]. ueLecung alcohollsm: 1he CACL Cuesuonalre.
!AMA 252(14):1903-1907.
CAGL-AID (CAGL uesnons Adapted to Inc|ude Drugs)
- Screens for alcohol use and has been adapLed Lo lnclude drugs
- An easy-Lo-admlnlsLer lnLervlew conslsung of elghL lLems
- lor more lnformauon on CACL-Alu, see 8rown 8L, 8ounds LA [1993]. Con[olnL screenlng
quesuonnalres for alcohol and drug abuse: crlLerlon valldlLy ln a prlmary care pracuce. Wls Med !
94(3):133-140.
178
ERHMS
kess|er-6 (k-6 or k-10)
- ueslgned Lo be sensluve Lo dlscrlmlnaLe serlous menLal lllness
- A 6-lLem self-reporL or lnLervlew ln less Lhan 2 mlnuLes, preferred ln screenlng for uSM-4 mood
or anxleLy dlsorders
- used ln pasL or currenLly by Lhe nauonal PealLh lnLervlew Survey (nPlS) and nauonal Pousehold
Survey on urug Abuse, kaLrlna
- hup://www.hcp.med.harvard.edu/ncs/k6_scales.php
anent nea|th uesnonna|re (n-1S)
- useful ln screenlng for somauzauon and ln monlLorlng

somauc sympLom severlLy ln cllnlcal pracuce
and research
- 8rlef, self-admlnlsLered quesuonnalre
- 1he scale and furLher lnformauon can be found ln Lhe followlng arucle: kroenke k, SplLzer 8L,
Wllllams !8 [2002]. 1he PC-13: valldlLy of a new measure for evaluaung Lhe severlLy of somauc
sympLoms. sychosom Med (2):238-66.
erce|ved Stress Sca|e (SS)
- Measures degree Lo whlch slLuauons ln one's llfe are appralsed as sLressful (Lhe quesuons ln Lhe
SS ask abouL feellngs and LhoughLs durlng Lhe lasL monLh)
- 1he quesuonnalre ls avallable ln several languages and conslsLs of a 14-lLem self-reporL.
- Avallable for free from ur. Sheldon Cohen: hup://www.psy.cmu.edu/~scohen/
- used ln Purrlcane Pugo
kev|sed Ch||dren's Man|fest Anx|ety Sca|e (kCMAS)
- Assesses Lhe degree and quallLy of anxleLy experlenced by chlldren and adolescenLs.
- 37-lLem lnsLrumenL, can be admlnlsLered lndlvldually or Lo a group.
- used ln response Lo Purrlcane Pugo.
- Can be purchased aL: hup://porLal.wpspubllsh.com/porLal/page?_pageld=33,234661&_
dad=porLal&_schema=C81AL
Add|nona| Lxamp|es of Measures]1oo|s
syS1Ak1-C|| Sp||| Inc|dent Mod|hed Vers|on
- Assesses lmpacL of Lraumauc exposures, loss, posL-evenL adverslues, loss of soclal supporL, and
ln[ury/lllness
- Comprlslng 16 lLems, lL can be admlnlsLered ln less Lhan 1 mlnuLe by non-menLal healLh professlonals
- ConLacL MSchrelber[medneL.ucla.edu
Acute Stress D|sorder Sca|e (ASDS)
- lndexes acuLe sLress dlsorder and predlcLs 1Su, based on uSM-4 crlLerla and assesses Lrauma and
sLress responses
- A 19-lLem self reporL
- used wlLh Purrlcane kaLrlna evacuees
179
ERHMS
- Scale can be found ln AcuLe SLress ulsorder Scale: A Self 8eporL Measure of AcuLe SLress ulsorder,
by 8lchard 8ryanL eL. al., aL: hup://www.psych.on.ca/les/nonmembers/AcuLeSLressulsorderScale_
u8n_March_3_2010.pdf
8r|ef CCL
- useful lnsLrumenL ln healLh-relaLed research LhaL measures coplng
- A 28-lLem quesuonnalre conslsung of 14 scales of 2 lLems each
- used aer SepLember 11
th
auacks, Purrlcane Andrew
- Scale can be found ln Lhe followlng arucle: Carver CS [1997]. lf you wanL Lo measure coplng buL
your proLocol's Loo long, conslder Lhe brlef CCL. lnL ! 8ehav Med 4(1):92-100 [hup://www.ssc.
wlsc.edu/wlsresearch/plloL/01-801_lnfo/aglng_mlnd/Aglng_App818_8rlefCopeScale.pdf].
Iurther kead|ng
8lanchard L8, !ones-Alexander !, 8uckley 1C, lornerls CA [1996]. sychomeLrlc properues of Lhe 1Su
CheckllsL (CL). 8ehav 8es 1her 34(8):669-673.
8urney C, Lalunen LA, erdrlzeL S, Puckauf P, 1auerseld AL, Chlnn S, olsson n, Peeren A, 8rluon
!8, !ones 1 [1989]. valldlLy and repeaLablllLy of Lhe luA1Lu (1984) 8ronchlal SympLoms Cuesuonnalre:
an lnLernauonal comparlson. Lur 8esplr ! 2(10):940-943.
CuC [1996]. nPAnLS lll 8eference Manuals and 8eporLs [Cu-8CM]. Pyausvllle, Mu: CenLers for ulsease
ConLrol and revenuon, nauonal CenLer for PealLh SLausucs, uaLa ulssemlnauon 8ranch, uPPS (nCPS)
ubllcauon no. 6-0178 (1096). Cu-8CM.
LnrlghL L, SklooL C, PerberL 8 [2008]. SLandardlzauon of splromeLry ln assessmenL of responders
followlng man-made dlsasLers: World 1rade CenLer worker and volunLeer medlcal screenlng program.
ML Slnal ! Med 73(2):109-114.
Luropean CommunlLy 8esplraLory PealLh Survey [1994]. Medlclne and PealLh. LC ulrecLoraLe Ceneral
xlll. L-2920. Luxembourg: Cmce for Cmclal ubllcauons.
Lwlng !A [1994]. ueLecung alcohollsm. 1he CACL quesuonnalre. !AMA 232(14):1903-1907.
Coldberg u, Pllller vl [1979]. A scaled verslon of Lhe Ceneral PealLh Cuesuonnalre. sychol Med
9(1):139-143.
kaLz CL, SmlLh 8, SllverLon M, Polmes A, 8ravo C, !ones k, klllman M, Lopez n, Malko L, Marrone k,
neuman A, SLephens 1, 1avarez W, ?arowsky A, Levln S, PerberL 8 [2006]. A menLal healLh program for
ground zero rescue and recovery workers: cases and observauons. sychlaLr Serv 37(9):1333-1338.
Leon AC, Clfson M, orLera L, larber L, Sheehan uv [1997]. Assesslng psychlaLrlc lmpalrmenL ln prlmary
care wlLh Lhe Sheehan ulsablllLy Scale. lnL ! sychlaLry Med 27(2):93-103.
Mollne !M, PerberL 8, Levln S, SLeln u, Lu 8!, udasln lC, Landrlgan ! [2008] W1C Medlcal MonlLorlng
and 1reaLmenL rogram: Comprehenslve healLhcare response ln aermaLh of dlsasLer. ML Slnal ! Med
73(2):67-73.
lcclrlllo !l, MerrlL MC, 8lchards ML [2002]. sychomeLrlc and cllnlmeLrlc valldlLy of Lhe 20-lLem Slno-
nasal CuLcome 1esL (SnC1-20). CLolaryngol Pead neck Surg 126(1):41-47.
SplLzer 8L, kroenke k, Wllllams !8. valldauon and uullLy of a self-reporL verslon of 8lML-Mu: Lhe PC
prlmary care sLudy. rlmary Care Lvaluauon of MenLal ulsorders. auenL PealLh Cuesuonnalre. !AMA
282(18):1737-1744.
180
ERHMS
Add|nona| kesources for ost-event 1rack|ng
Army ost-Dep|oyment Lva|uanon Iorm
hup://www.duc.mll/whs/dlrecuves/lnfomgL/forms/eforms/dd2796.pdf
1hls form ls a posL-deploymenL healLh assessmenL creaLed and used by Lhe Army. 1hls ls an elecLronlc form
lled ouL by Lhe reLurnlng personnel and a physlclan.
NICSn ocket Gu|de to Chem|ca| nazards
hup://www.cdc.gov/nlosh/npg/
locket ColJe presenLs key lnformauon and daLa ln abbrevlaLed Labular form for 677 chemlcals or subsLance
grouplngs. 1he lndusLrlal hyglene lnformauon found ln Lhe locket ColJe should help users recognlze and
conLrol occupauonal chemlcal hazards. 1he locket ColJe conLalns lnformauon on Chemlcal name, SLrucLure/
lormula, CAS number, 81LCS number, uC1 lu and Culde numbers, Synonyms and 1rade names, Converslon
lacLors, Lxposure LlmlLs, lmmedlaLely uangerous Lo Llfe and PealLh (luLP), hyslcal uescrlpuon, Chemlcal
and hyslcal roperues, lncompaublllues and 8eacuvlues, MeasuremenL MeLhods, ersonal roLecuon and
SanlLauon 8ecommendauons, llrsL Ald, 8esplraLor Selecuon 8ecommendauons, Lxposure 8ouLe, SympLoms,
and 1argeL Crgans.
NICSn ub||canon No. 2008-11S: I|rst kesponders: rotect our Lmp|oyees w|th an Lxposure Contro| |an
hup://www.cdc.gov/nlosh/docs/2008-113/
amphleL LhaL glves baslc lnformauon on Lhe componenLs of an exposure conLrol plan
NICSn ub||canon No. 2002-107: 1raumanc Inc|dent Stress: Informanon for Lmergency kesponse Workers
hup://www.cdc.gov/nlosh/docs/2002-107/
1hls Lwo-page handouL educaLes workers abouL Lraumauc lncldenL sLress, lncludlng how Lhey can recognlze
lL and whaL Lhey can do abouL lL.
Screen|ng and Surve|||ance: A Gu|de to CSnA Standards
hup://www.osha.gov/ubllcauons/osha3162.pdf
1hls documenL was creaLed by CSPA as a qulck reference Lo help locaLe and lmplemenL Lhe screenlng
and survelllance requlremenLs of Lhe lederal CSPA sLandards publlshed ln 1lLle 29 of Lhe Code of lederal
8egulauons (29 Cl8) regardlng cerLaln chemlcals, subsLances, and oLher work hazards. 1hls gulde provldes
a general overvlew of CSPA requlremenLs.
181
ERHMS
111. Lessons-Learned and Aer-Acuon AssessmenLs
Contents:
1. Gu|dance
2. Lxamp|e
3. 1emp|ate
Advlce on lnsuLuung and lmplemenung an aer-acuon reporL ls very deLalled, and numerous documenLs
exlsL Lo help organlzauons esLabllsh Lhelr own sysLem. Powever, Lhe mosL essenual and challenglng parL of
uslng Lhls as a Lool for Lhe Lmergency 8esponder PealLh MonlLorlng and Survelllance program ls conrmlng
LhaL Lhese Loplcs are speclcally addressed ln Lhe reporL. Ad[usLmenLs should be made Lo ensure LhaL L8PMS
ls belng properly evaluaLed ln Lhls sysLem durlng all phases and for all modules.
Gu|dance
nome|and Secur|ty Lxerc|se and Lva|uanon rogram, Vo|ume III: Lxerc|se Lva|uanon and Improvement
|ann|ng, kev. Ieb. 2007.
hups://hseep.dhs.gov/supporL/volumelll.pdf
A documenL LhaL oers proven meLhodology for evaluaung and documenung exerclses and lmplemenung
an lmprovemenL lan.
A Leader's Gu|de to Aher Acnon kev|ews, Department of the Army, 1C 2S-20, 1993.
hup://www.au.af.mll/au/awc/awcgaLe/army/Lc_23-20/Lable.hLm
1he Army has developed Lhls gulde ln order Lo use every Lralnlng opporLunlLy Lo lmprove soldler, leader,
and unlL Lask performance. 1o lmprove Lhelr lndlvldual and collecuve-Lask performances Lo meeL or exceed
Lhe Army sLandard, soldlers and leaders musL know and undersLand whaL happened or dld noL happen
durlng every Lralnlng evenL.
Lessons Learned Informanon Shar|ng
www.LLlS.gov
LLlS.gov ls a u.S. ueparLmenL of Pomeland SecurlLy/lederal Lmergency ManagemenL Agency program:
nauonal, onllne neLwork of lessons learned, besL pracuces, and lnnovauve ldeas for Lhe emergency
response and homeland securlLy communlues.
Lxamp|e
ArllngLon CounLy, vlrglnla [2002]. ArllngLon CounLy aer-acuon reporL on Lhe response Lo SepLember 11
LerrorlsL auack on Lhe enLagon.
hup://www.orldadlsasLer.org/publlcauons/Arl_Co_AA8.pdf
An acLual aer-acuon reporL.
182
ERHMS

PSLL AA8 1emplaLe


hups://hseep.dhs.gov/supporL/AA8-l_1emplaLe202007.doc
A well-deslgned LemplaLe for creaung an aer acuon reporL.
183
ERHMS
Appendix A
1he 8ole of Lhe lncldenL Command SysLem (lCS) and Lmergency
8esponder PealLh MonlLorlng and Survelllance (L8PMS)
L8PMS should be lnLegraLed lnLo Lhe lCS as soon as lL ls esLabllshed for a glven lncldenL. 1he lCS ls a
managemenL sysLem deslgned Lo enable eecuve and emclenL domesuc lncldenL managemenL. lCS lnLegraLes
a comblnauon of agencles, faclllues, equlpmenL, personnel, procedures, and communlcauons operaung
wlLhln a common organlzauonal sLrucLure. lL ls deslgned Lo promoLe eecuve and emclenL domesuc lncldenL
managemenL. A baslc premlse of lCS ls LhaL lL ls wldely appllcable and scalable. lL ls used Lo organlze boLh
near-Lerm and long-Lerm eld-level operauons for a broad specLrum of emergencles, from small Lo complex
lncldenLs, boLh naLural and man-made. lCS ls used by all levels of governmenL-federal, sLaLe, local, and
Lrlbal-as well as by many prlvaLe-secLor and nongovernmenLal organlzauons. lCS ls also appllcable across
dlsclpllnes. lL ls normally sLrucLured Lo faclllLaLe acuvlues ln ve ma[or funcuonal domalns: (1) command,
(2) operauons, (3) plannlng, (4) loglsucs, and (3) nance and admlnlsLrauon [lLMA 2008, lLMA 2010,
CSPA 2009b].
1he lncldenL Commander(lC) or Lhe unled Command(uC) ls responslble for all aspecLs of Lhe response,
lncludlng developlng lncldenL ob[ecuves and managlng all lncldenL operauons. 1he lC ls faced wlLh many
responslblllues when he or she arrlves on scene. unless speclcally asslgned Lo anoLher member of Lhe
Command or Ceneral SLas, Lhese responslblllues remaln wlLh Lhe lC.
Some of Lhe more complex responslblllues lnclude Lhe followlng:
- LsLabllsh lmmedlaLe prlorlues, especlally regardlng Lhe safeLy of responders, oLher emergency
workers, bysLanders, and people lnvolved ln Lhe lncldenL
- SLablllze Lhe lncldenL by ensurlng LhaL healLh and safeLy lssues are addressed and LhaL response
resources are used ln an emclenL and cosL-eecuve manner
- ueLermlne lncldenL ob[ecuves and sLraLegy Lo achleve Lhe ob[ecuves
- LsLabllsh and oversee lncldenL organlzauon
184
ERHMS
- Approve Lhe lmplemenLauon of Lhe wrluen or oral lncldenL Acuon lan
- Lnsure adequaLe healLh and safeLy measures are ln place
1he Command SLa ls responslble for publlc aalrs, healLh and safeLy, and llalson acuvlues wlLhln Lhe
lncldenL command sLrucLure. 1he lC/uC remalns responslble for Lhese acuvlues or may asslgn lndlvlduals
Lo carry ouL Lhese responslblllues and reporL dlrecLly Lo Lhe lC/uC.
1he SafeLy Cmcer (SCl8) ls ln a unlque and cenLrallzed posluon Lo oversee and supporL many of Lhe
processes LhaL provlde daLa Lo and perform Lhe funcuons of L8PMS, from preparedness and Lralnlng Lo
monlLorlng responders, healLh, acuvlues, and Lhelr envlronmenL. AlLhough Lhe duues of Lhe SCl8 may noL
dlrecLly conLrlbuLe Lo all of Lhe daLa collecLed, Lhe resulung lnformauon wlll have an lmpacL on Lhe duues
and acuons Lhe SCl8 Lakes, as such, much of Lhe acuvlues descrlbed ln L8PMS are conducLed, overseen,
or accessed by Lhe SCl8 when performlng hls or her duues.
1he SCl8 monlLors lncldenL operauons and advlses Lhe lncldenL Commander (lC) on all mauers relaung
Lo operauonal safeLy, lncludlng Lhe healLh and safeLy of emergency responder personnel. 1he ulumaLe
responslblllLy for Lhe safe conducL of lncldenL managemenL operauons resLs wlLh Lhe lC or unled Command
(uC) and supervlsors aL all levels of Lhe lncldenL managemenL. 1he SCl8 ls, ln Lurn, responslble Lo Lhe lC for
Lhe seL of sysLems and procedures necessary Lo ensure ongolng assessmenLs of hazardous envlronmenLs,
coordlnauon of mulu-agency safeLy eorLs, and lmplemenLauon of measures Lo promoLe emergency
responder safeLy eorLs, as well as Lhe general safeLy of lncldenL operauons. 1he SCl8 has emergency
auLhorlLy Lo sLop and/or prevenL unsafe acLs durlng lncldenL operauons. ln a uC sLrucLure, a slngle SCl8
should be deslgnaLed, ln splLe of Lhe facL LhaL muluple [urlsdlcuons and/or funcuonal agencles may be
lnvolved. AsslsLanLs/consulLanLs may be requlred and may be asslgned from oLher agencles or deparLmenLs,
consuLuung Lhe uC. 1he SCl8, Cperauons Secuon Chlef, and lannlng Secuon chlef musL coordlnaLe closely
regardlng operauonal safeLy and emergency responder healLh and safeLy lssues. 1he SCl8 musL also ensure
coordlnauon of safeLy managemenL funcuons and lssues across [urlsdlcuons, across funcuonal agencles,
and wlLh prlvaLe-secLor and nongovernmenLal organlzauons. 1he agencles, organlzauons, or [urlsdlcuons
LhaL conLrlbuLe Lo [olnL safeLy managemenL eorLs do noL lose Lhelr lndlvldual ldenuues or responslblllues
for Lhelr own programs, pollcles, and personnel. 8aLher, each enuLy conLrlbuLes Lo Lhe overall eorL Lo
proLecL all responder personnel lnvolved ln lncldenL operauons.
varlous L8PMS-relaLed acuvlues are conducLed under Lhe lCS and are ldenued by an asLerlsk (*) ln Lhe
followlng lCS posluon descrlpuons.
Safety Cmcer kespons|b|||nes
1he SCl8 ls responslble for monlLorlng and assesslng safeLy hazards or unsafe slLuauons and developlng
measures for ensurlng personnel safeLy. lL ls Lhe SafeLy Cmcer's role Lo ensure LhaL approprlaLe safeLy
procedures have been ldenued and are belng sLrlcLly followed.
1he SCl8 reporLs dlrecLly Lo Lhe lC. 1he duues relaLed Lo L8PMS lnclude buL are noL llmlLed Lo Lhe followlng:
- keeplng Lhe lC lnformed of operauonal safeLy problems and poLenual hazards Lhrough lllness and
ln[ury reporLs*
- Assesslng local rlsk* and deLermlnlng Lhe need for resources (lncludlng sLa) and programs, focuslng
on Lhe ldenucauon of unsafe condluons and pracuces, and ensurlng LhaL soluuons are developed
Lo correcL Lhe ldenued problems
- Lnsurlng personnel are followlng safeLy procedures
- Lnsurlng LhaL a personnel accounLablllLy sysLem ls esLabllshed on-slLe and ls uullzed
- ldenufylng necessary safeLy and healLh Lralnlng,* developlng, coordlnaung, or provldlng necessary
Lralnlng relaLed Lo Lhe evenL
183
ERHMS
- Pavlng Lhe auLhorlLy Lo correcL unsafe condluons lmmedlaLely, such as removlng all personnel from
areas of lmmedlaLe danger, havlng Lhe auLhorlLy Lo sLop all operauons when, ln hls or her [udgmenL,
an unsafe condluon or pracuce exlsLs LhaL could lead Lo personal ln[ury or deaLh of any personnel
- ueveloplng and lmplemenung an approprlaLe slLe healLh and safeLy plan (PAS) ln coordlnauon
wlLh exlsung healLh and safeLy programs and Lhe on-scene lncldenL Commander's deslgnaLed SafeLy
Cmcer (SCl8), or oLher federal, sLaLe, Lrlbal, or local governmenLal agency ln charge of Lhe lncldenL,
lf a PAS ls noL esLabllshed, Lhe SCl8 wlll ensure LhaL one ls esLabllshed Lo proLecL responder
personnel
- lnluaung and conducung accldenL lnvesugauons for on-slLe respondlng personnel or equlpmenL
and forwardlng reporLs Lo Lhe lC and Lhe responder's employer
- MalnLalnlng a slLe-speclc lncldenL and accldenL log
- MalnLalnlng and submlmng all safeLy-relaLed documenLauon Lo approprlaLe omces boLh on-slLe
and Lo AP! and lncldenL Commander for lncluslon lnLo aer-acuon reporLs
- aruclpaung ln Aer Acuon 8eporL (AA8) processes on-slLe and aL Lhelr agency relaLed Lo Lhe evenL
- MalnLalnlng accounLablllLy for personnel enLerlng slLe*
- 8ecommendlng and enforclng personal proLecuon equlpmenL use*
1he Loglsucs Secuon provldes for all Lhe supporL needs for Lhe lncldenL, such as orderlng resources and
provldlng faclllues, LransporLauon, supplles, equlpmenL malnLenance and fuel, food servlce, communlcauons,
and medlcal servlces for responders.
1he duues of Lhe Loglsucs Secuon lnclude Lhe followlng:
- LsLabllsh Lhe check-ln funcuon* aL lncldenL locauons
- MalnLaln and posL Lhe currenL sLaLus and locauon of all resources*
- MalnLaln masLer rosLer of all resources* checked ln aL Lhe lncldenL
- rovlde lnpuL Lo and revlew Lhe Communlcauons lan, Medlcal lan and 1ramc lan
1he Medlcal unlL ls responslble for Lhe eecuve and emclenL provlslon of medlcal servlces Lo responders*
and reporLs dlrecLly Lo Lhe Loglsucs Secuon Chlef.
1he prlmary responslblllues of Lhe Medlcal unlL lnclude Lhe followlng:
- uevelop procedures for handllng any ma[or medlcal emergency lnvolvlng responders*
- uevelop Lhe lncldenL Medlcal lan (for responders)
- rovlde conunulLy of medlcal care, lncludlng vacclnauons, vecLor conLrol, occupauonal healLh,
prophylaxls, and menLal healLh servlces for responders*
- rovlde LransporLauon for ln[ured or lll responders
- CoordlnaLe and esLabllsh Lhe rouune resL and rehablllLauon of lncldenL responders*
- Lnsure LhaL ln[ured or lll responders are Lracked* as Lhey move from Lhelr orlgln Lo a care faclllLy
and from Lhere Lo nal dlsposluon
- AsslsL ln processlng all paperwork relaLed Lo ln[urles, slgnlcanL lllnesses, or deaLhs of lncldenL-
asslgned personnel*
- CoordlnaLe personnel and morLuary aalrs for responder faLallues
186
ERHMS
Appendix B
1he CSPA SLandard for Pazardous WasLe Cperauons and
Lmergency 8esponse (PAZWCL8) - 29 Cl8 1910.120 (general
lndusLry) and 29 Cl8 1926.63 (consLrucuon)
1he PAZWCL8 sLandard [CSPA updaLed 2008] ls a comprehenslve regulauon. Lmployers and workers
covered under Lhls sLandard should have compleLe famlllarlLy wlLh all of Lhe requlremenLs of Lhe sLandard.

Who |s covered by CSnA's nA2WCLk standard?
PAZWCL8 covers workers lnvolved ln hazardous wasLe slLe cleanup, hazardous wasLe LreaLmenL, sLorage,
and dlsposal operauons, and emergency response who are exposed or poLenually exposed Lo hazardous
subsLances. 1hus, mosL of Lhe workers descrlbed ln L8PMS are covered under PAZWCL8.
What are emp|oyer respons|b|||nes under CSnA's nA2WCLk standard?
1he PAZWCL8 sLandard requlres employers Lo develop and lmplemenL a wrluen healLh and safeLy program
LhaL conLalns Lhe followlng elemenLs:
- Crganlzauonal sLrucLure and comprehenslve workplan
- SlLe-speclc healLh and safeLy plan (PAS) (More Lhan one plan may be needed lf Lhere are muluple
slLes)
- SafeLy and PealLh worker Lralnlng programs
- Medlcal survelllance program
- SLandard operaung procedures for safeLy and healLh
- lnLerface beLween general program and slLe-speclc acuvlues
MonlLorlng for poLenual exposures ls requlred. Cnce Lhe presence and concenLrauons of speclc hazardous
subsLances and healLh hazards have been esLabllshed, Lhe rlsks assoclaLed wlLh Lhese subsLances shall be
ldenued. Lmployees who wlll be worklng on Lhe slLe shall be lnformed of any rlsks LhaL have been ldenued.
under Lhe sLandard, employers are requlred Lo lnsuLuLe englneerlng conLrols and work pracuces Lo reduce
employee exposure. 1he sLandard also requlres LhaL workers be provlded approprlaLe personal proLecuve
equlpmenL for Lhe Lask and deconLamlnauon, lf necessary.
What are the med|ca| surve|||ance requ|rements for emergency responder workers under CSnA's
nA2WCLk standard?
Lmployers musL make avallable medlcal examlnauons, free of charge, for workers covered under PAZWCL8.
A summary of Lhe PAZWCL8 medlcal survelllance requlremenLs are as follows:
- lrequency of examlnauons:
8asellne physlcal exam prlor Lo asslgnmenL
erlodlc exams every 12 monLhs
AL Lermlnauon or reasslgnmenL (lf Lhe perlodlc exam occurred greaLer Lhan slx monLhs earller)
- Lxamlnauons musL also be made avallable ln Lhe evenL of acuLe exposures, lllnesses or sympLoms
of posslble overexposure Lo hazardous subsLances or healLh hazards
187
ERHMS
- Lxamlnauons are Lo be performed by or under Lhe supervlslon of a llcensed physlclan.
- ConLenLs of examlnauons:
Medlcal and work hlsLory, wlLh speclal emphasls on boLh sympLoms relaLed Lo hazardous
exposures and Lness for duLy, lncludlng ablllLy Lo wear any requlred personal proLecuve
equlpmenL under condluons LhaL may be expecLed aL Lhe work slLe
need for physlcal examlnauon Lo be deLermlned by Lhe examlnlng physlclan
CLher medlcal LesLs, such as chesL x-ray, breaLhlng LesL or laboraLory LesLs, as deLermlned by
Lhe examlnlng physlclan
MusL evaluaLe Lhe worker's ablllLy Lo wear a resplraLor
Lmployers musL provlde Lhe physlclan wlLh Lhe followlng lnformauon: a copy of Lhe CSPA PAZWCL8
sLandard, a descrlpuon of Lhe worker's duues, Lhe worker's anuclpaLed or acLual worker exposure levels,
lnformauon on personal proLecuve equlpmenL Lo be used by Lhe worker, and prevlous medlcal survelllance
examlnauons lf Lhe physlclan does noL already have LhaL lnformauon, and lnformauon requlred by Lhe
8esplraLory roLecuon SLandard, 29 Cl8 1910.134. Aer evaluaung a worker, Lhe physlclan musL provlde
a wrluen oplnlon Lo Lhe employer LhaL lncludes Lhe followlng lnformauon:
- WheLher or noL Lhe worker has a medlcal condluon LhaL would place hlm or her aL lncreased healLh
rlsk from hazardous wasLe operauons or emergency response work or from uslng a resplraLor,
- Any recommended llmlLauons, and
- A sLaLemenL LhaL Lhe worker has been lnformed of Lhe medlcal examlnauon and any medlcal
condluons LhaL requlre furLher examlnauon or LreaLmenL.
1be pbyslcloos wtlueo oploloo most not teveol speclfc exomloouoo foJloqs ot Jloqooses ooteloteJ to
occopouoool exposotes.
What other CSnA standards may app|y to emergency response workers?
Medlcal survelllance examlnauon programs are requlred by CSPA for workers exposed Lo speclc hazardous
subsLances under cerLaln CSPA sLandards. Lxamples lnclude workers exposed Lo asbesLos, hexavalenL
chromlum, and lead. A gulde Lo CSPA sLandards requlrlng medlcal survelllance can be found ln Lhe CSPA
bookleL, Screenlng and Survelllance: A Culde Lo CSPA SLandards" [CSPA 2009c]. CSPA's webslLe, www.
osha.gov, should be checked for Lhe mosL up-Lo-daLe requlremenLs.
lor more lnformauon on CSPA's PAZWCL8 sLandards and oLher CSPA sLandards and guldance maLerlals,
see Lhe followlng llnks:
CSPA PAZWCL8 SLandard for general lndusLry (29 Cl8 1910.120): hup://www.osha.gov/pls/oshaweb/
owadlsp.show_documenL?p_Lable=S1AnuA8uS&p_ld=9763
CSPA PAZWCL8 SLandard for consLrucuon (29 Cl8 1926.63):
hup://www.osha.gov/pls/oshaweb/owadlsp.show_documenL?p_Lable=S1AnuA8uS&p_ld=10631
lnspecuon rocedures for 29 Cl8 1910.120 and 1926.63, aragraph (q): Lmergency 8esponse Lo Pazardous
SubsLance 8eleases:
hup://www.osha.gov/pls/oshaweb/owadlsp.show_documenL?p_Lable=ul8LC1lvLS&p_ld=3671
rlnclpal Lmergency 8esponse and reparedness 8equlremenLs and Culdellnes (2004):
hup://www.osha.gov/ubllcauons/osha3122.pdf
CSPA Culdance Manual for Pazardous WasLe SlLe Acuvlues (1983):
hup://www.osha.gov/ubllcauons/compllnks/CSPC-PazWasLe/4agency.hLml
188
ERHMS
CSPA WebslLe: hup://www.osha.gov/
189
ERHMS
Appendix C
Lxposure AssessmenL and SLraLegy ln lncldenL 8esponse
Cperauons
Methodo|ogy
A conslsLenL approach Lo assesslng exposures regardless of Lhe lncldenL slze or complexlLy ls lmporLanL. An
exposure assessmenL model as deplcLed ln llgure 8 provldes a sound framework LhaL can be used when
characLerlzlng healLh and safeLy rlsks aL an lncldenL response. llgure 2 ln ChapLer 7, deplcLs Lhe exposure
assessmenL's cenLrallLy Lo myrlad safeLy and healLh funcuons.
Starnng the Lxposure Assessment rocess
1he deslgnaLed lncldenL SafeLy Cmcer or hls or her AsslsLanL SafeLy Cmcers are responslble for lnluaung
an exposure assessmenL process. 8elow ls a llsL of quesuons Lo begln Lhls process:
- WhaL are Lhe lncldenL goals and ob[ecuves as seL forLh by elLher Lhe lncldenL Commander or unled
Command?

8eassess
lurLher lnfo CaLherlng
ConLrol
AccepLable uncerLaln
unaccepLable
SLarL
8aslc CharacLerlzaLlon
Lxposure
AssessmenL

I|gure 8: Amerlcan lndusLrlal Pyglene AssoclaLlon (AlPA) Lxposure AssessmenL Model

[lgnaclo 2006]
190
ERHMS
- WhaL are Lhe speclc operauons planned or currenLly belng conducLed LhaL supporL Lhe
accompllshmenL of Lhese goals and ob[ecuves?
- Who and whlch organlzauons are performlng Lhese operauons?
- Pow do Lhese [obs or Lasks geL communlcaLed, supporLed, and supervlsed?
- Where are Lhe speclc locauons LhaL Lhese operauons are occurrlng?
- WlLhln Lhose operauons, whaL are Lhe speclc [obs or Lasks belng performed as parL of LhaL
operauon?
- WhaL ls Lhe durauon of Lhese [obs or Lasks? ls lL ongolng 24/7 operauon unul compleLe, or are Lhe
Lasks occurrlng wlLhln only a specled perlod?
- Are Lhere adequaLe food, waLer, shelLer, sanlLauon, securlLy, and resL areas avallable or broughL ln
Lo meeL Lhe needs of Lhe aecLed workforce aL each slLe?
llgure 8 ls a uered, cycllc process [lgnaclo 2006]. 1he lncldenL SafeLy Cmcer (SCl8) or AsslsLanL SafeLy Cmcer
(ASCl8) aualns Lhls lnformauon Lhrough Lhe revlew of lncldenL Acuon lans, and/or dlscusslons wlLh key
command or general sLa members, as well as dlvlslon or group supervlsors. 1hls lnlual assessmenL wlll be
able Lo resolve low or Lrlvlal exposures as belng accepLable, and many of Lhe apparenL gross overexposures
as unaccepLable [lgnaclo 2006]. 8ecause of lnsumclenL daLa, however, a number of exposures cannoL be
resolved ln Lerms of accepLablllLy, and Lherefore, Lhe exposure assessmenL process deplcLed ln llgure 8
becomes conunuous. SubsequenL cycles of Lhe assessmenL process wlll generaLe more exposure lnformauon
or Lhe use of predlcuve maLhemaucal modellng Lo beuer characLerlze Lhese unresolved exposures [lgnaclo
2006].
Lvery lncldenL response ls unlque, noL slmply by Lhe dlerences ln locauon or respondlng organlzauons,
buL also by Lhe meLhod of Lacucal response. asL response experlences are lnvaluable, buL ad[usung Lo
speclc condluons or lssues on Lhe scene ls much more lmporLanL. 8eal-ume evenLs on Lhe ground, as
well as Lravellng, meeung and Lalklng wlLh people, observlng, llsLenlng, and learnlng are key acuvlues
LhaL an SCl8 or ASCl8 should be engaged ln a conunuous basls [8lLchle 2004]. Addluonally, Lhe conducL
of slLe healLh and safeLy audlLs ls crlucal for early ldenucauon and developmenL and lmplemenLauon of
correcuve acuon plans. 1hese correcuve acuon plans should be dlssemlnaLed wldely Lo ensure a conslsLenL
and eecuve mlugauon of ldenued hazards.
8as|c Character|zanon
Cnce orlenLed Lo Lhe overall lncldenL operauon, a SCl8 or ASCl8 should begln Lhe hazard recognluon
process as parL of baslc characLerlzauon. 1here are several areas Lo focus on for Lhls process [CuC 2008]:
(a) Lacucal operauons area(s), (b) lncldenL Command posL, (c) evacuauon cenLers, (d) sLaglng area, (e) base
camp, and (f) hellbase or hellspoL locauons [CuC 2008].
ln each of Lhese locauons, exposure assessmenL lnformauon can be grouped lnLo Lhe followlng four
caLegorles: (1) workplace lnformauon (l.e., envlronmenLal, faclllLy, and general worklng condluons), (2)
workforce lnformauon (l.e., speclc responders lnvolved, Lhelr numbers, approprlaLeness of Lralnlng/
experlence, and personal proLecuve equlpmenL used), (3) command/conLrol sLrucLure (l.e., workload,
pace, exlblllLy, clarlLy and coordlnauon of [ob Lasklng, supervlslon, and reporung), and (4) hazardous
agenL lnformauon (l.e., speclc conLamlnanL(s) released or used, Lhe agenL's physlcal sLaLe, llkellhood of
co-occurrlng psychologlcal Loxlns") [lgnaclo 2006, 8elssman (ln press-a), 8elssman 2010].

1able 1 provldes a general gulde on speclc lnformauon Lo gaLher ln each of Lhese caLegorles.
191
ERHMS
1ab|e 1 - Spec|hc Informanon to Gather at Lach Inc|dent kesponse Locanon [lgnaclo 2006]
Workplace
lnformaLlon [8lLchle
2006, lgnaclo 2006]
- Sources of release (e.g., Lanker, ground leak)
- ulsperslon poLenLlal downrange as a llquld, vapor, eLc.
- LnvlronmenLal condlLlons such as wlnd, amblenL LemperaLures, humldlLy
- Lnglneerlng conLrols
- oLable waLer and food sources
- Access Lo LolleL faclllLles and safe runnlng waLer for hyglene
- 1ypes of responder vehlcles and supporL seL-up
- ueflned dellneaLlon of conLamlnaLed and non-conLamlnaLed areas
- 8esLrlcLed access Lo affecLed or secure areas
- vlsually evldenL healLh and safeLy hazards (e.g., sllp/Lrlp/fall, crushlng,
conflned spaces, dermal, or resplraLory hazards)
- Alr, waLer, or soll monlLorlng already conducLed and Lhe owner of Lhese
resulLs
- resence and condlLlon of corpses
- number of wounded and lf chlldren are lnvolved
- Adequacy of securlLy
Workforce
lnformaLlon [lLMA
2010, Swanson
1996, McCalllsLer
2010]
- 8esponse agencles or flrms lnvolved Lo lnclude any subconLracLors
- number of personnel lnvolved
- valldaLlng whlch workers are performlng a parLlcular response operaLlon
(and approprlaLeness of Lralnlng/experlence/supervlslon)
- ln each response operaLlon, ldenLlfy speclflc and lmplled Lasks belng
performed
- valldaLe Lhe use and Lype of L
- Cbserve safe work pracLlces belng used
- noLe any slgns/sympLoms observed on response personnel or Lhelr verbal
concerns of medlcal, psychologlcal or behavloral problems
- CperaLlons brleflngs belng done, and lf healLh and safeLy lnformaLlon ls
relayed
- Medlcal and psychologlcal supporL on-slLe
- CperaLlonal work shlfLs and resL breaks
- 8easonable shelLer/lodglng slLuaLlons (safe, clean, quleL, easy LransporL
access Lo workslLe)
Command and
ConLrol
SLrucLure [lLMA
2010, McCalllsLer
2010]
- hyslcal and menLal workload
- ace or Lempo of work
- llexlblllLy and conLrol over how Lhe work ls done
- ClarlLy and coordlnaLlon of [ob Lasklng, supervlslon, and reporLlng
(especlally on Lhe fronL llne of Lhe [ob slLe and wlLhln Lhe command cenLer)
192
ERHMS
Pazardous AgenL
lnformaLlon [lLMA
2010, Swanson and
Cuuman 1996, Mc-
CalllsLer 2010, na-
uonal llre roLecuon
Assoclauon 2008,
CSPA 2007]
- Speclflc chemlcal, blologlcal, and/or radlologlcal agenLs released or used by
responders
- Speclflc psychologlcal exposures relaLed Lo worklng aL Lhe slLe (e.g., sensory
reacLlons Lo deaLh or muLllaLlon, especlally of co-workers, chlldren, or ln
mass casualLy scenarlos), mysLerlous LhreaLs (e.g., blologlcal or radlologlcal
hazards), near-mlss evenLs, and oLher unfamlllar challenges Lo workers
(e.g., havlng Lo manage dlsLraughL communlLy members, vls or medla
reporLers/Lechnlclans)
- hyslcal sLaLe(s)
- Chemlcal and Loxlcologlcal properLles
Lxposure Assessment
lollowlng Lhe baslc characLerlzauon of Lhe lncldenL scene, Lhe nexL sLep ln Lhe process ls Lo perform
an exposure assessmenL. 1o do so, Lhe SCl8 and/or ASCl8 should perform Lhe followlng procedures:
esLabllshlng Slmllar Lxposure Croups (SLCs), denlng exposure proles, and comparlng Lhe exposure
proles wlLh esLabllshed Cccupauonal Lxposure LlmlLs (CLLs) [lgnaclo 2008]. As descrlbed by Mulhausen,
uamlano, and ullen [lgnaclo 2006], an exposure prole ls a characLerlzauon of Lhe Lemporal (e.g., day-Lo-
day) varlablllLy of exposure levels for a SLC. 1hls characLerlzauon requlres an esumaLe of Lhe exposure and
lLs varlablllLy ln addluon Lo [udglng how good Lhose esumaLes are [lgnaclo 2006]. ln an lncldenL response,
Lhe exposure proles are llkely Lo be quallLauve ln naLure because alr monlLorlng wlll llkely noL be done ln
Lhe lnlual response phase. AL besL, however, lnlual alr monlLorlng conducLed by hazardous maLerlal Leams
wlll be llmlLed Lo a speclc area where Lhe conLamlnanL(s) were released and noL necessarlly represenLauve
of acLual personal exposure monlLorlng daLa.
CLLs have been esLabllshed by lederal agencles, professlonal organlzauons, sLaLe and local governmenLs,
and oLher enuues. Some CLLs are legally enforceable llmlLs, whlle oLhers are recommendauons. 1he u.S.
ueparLmenL of Labor Cccupauonal SafeLy and PealLh AdmlnlsLrauon (CSPA) ermlsslble Lxposure LlmlLs
(LLs) are legal llmlLs enforceable ln workplaces covered under Lhe Cccupauonal SafeLy and PealLh AcL.
nlCSP 8ecommended Lxposure LlmlLs (8LLs) are recommendauons based on a crlucal revlew of Lhe sclenuc
and Lechnlcal lnformauon avallable on a glven hazard and Lhe adequacy of meLhods Lo ldenufy and conLrol
Lhe hazard. nlCSP 8LLs can be found ln Lhe nlCSP ockeL Culde Lo Chemlcal Pazards [nlCSP 2003]. CLher
CLLs LhaL are commonly used and clLed ln Lhe unlLed SLaLes lnclude Lhe 1hreshold LlmlL values (1Lvs)
recommended by Amerlcan Conference of CovernmenLal lndusLrlal PyglenlsLs (ACClP), a professlonal
organlzauon, and Lhe Workplace LnvlronmenLal Lxposure Levels (WLLLs) recommended by Lhe Amerlcan
lndusLrlal Pyglene Assoclauon, anoLher professlonal organlzauon. CuLslde Lhe unlLed SLaLes, CLLs have
been esLabllshed by varlous agencles and organlzauons and lnclude boLh legal and recommended llmlLs.
Slnce 2006, Lhe 8erufsgenossenschallches lnsuLuL fur ArbelLsschuLz (Cerman lnsuLuLe for Cccupauonal
SafeLy and PealLh) has malnLalned a daLabase of lnLernauonal CLLs from Luropean unlon member sLaLes,
Canada (Cuebec), !apan, SwlLzerland, and Lhe unlLed SLaLes, avallable aL hup://www.dguv.de/bgla/en/
gesus/llmlL_values/lndex.[sp. 1he daLabase conLalns lnLernauonal llmlLs for over 1230 hazardous subsLances
and ls updaLed annually. Lmployers should undersLand LhaL noL all hazardous chemlcals have speclc CSPA
LLs or recommended CLLs.
193
ERHMS
4
6
A
m
e
r
i
c
a
n

I
n
d
u
s
t
r
i
a
l

H
y
g
i
e
n
e

A
s
s
o
c
i
a
t
i
o
n
F
i
g
u
r
e

4
.
2

A
I
H
A

V
e
r
s
i
o
n

o
f

I
C
S
-
2
1
5
A
.
1able 2 provldes an example of an AlPA form for Pazard and 8lsk Analysls, whlch may asslsL ln Lhls process
[lgnaclo 2008].
194
ERHMS
1hls process lnvolves Lhe followlng baslc sLeps:
- uene Lhe speclc work asslgnmenL/Lask LhaL you are assesslng
- LlsL up Lo ve hazards assoclaLed wlLh performlng Lhls asslgnmenL
- lor each hazard, raLe Lhe healLh, exposure, uncerLalnLy, and rlsk level per Lhls chapLer
- LlsL Lhe speclc Lypes of conLrols needed Lo prevenL ln[ury or lllness. use general conLrol caLegorles,
such as L," 8esplraLory roLecuon," Lye roLecuon," Lnglneerlng ConLrols," or AdmlnlsLrauve
ConLrols"
- Asslgn a healLh rlsk raung for each ldenued hazard, uslng Lhe AlPA PealLh LecLs 8aung scheme
1ab|e 3 - nea|th Lect kanng Categor|zanon [lgnaclo 2006]
Category Health Effect
4 Llfe-LhreaLenlng or dlsabllng ln[ury or lllness
3 lrreverslble healLh effecLs of concern
2 Severe, reverslble healLh effecLs of concern
1 8everslble healLh effecLs of concern
0 8everslble effecLs of llLLle concern or no known or suspecLed healLh effecLs
- Asslgn an exposure rlsk raung (L88). 1he L88 ls an esumaLe of Lhe exposure level LhaL response
personnel may be exposed Lo relauve Lo a speclc Cccupauonal Lxposure LlmlL (CLL) [lgnaclo 2008].
lor safeLy hazards, Lhe L88 can be used Lo dene Lhe llkellhood of Lhe hazard acLually causlng
lllness, ln[ury or deaLh [lgnaclo 2008].
A lack of sumclenL quanuLauve analysls of chemlcal, blologlcal or radlologlcal exposures and a subsequenL
comparlson Lo exlsung CLLs hlnders Lhe ablllLy of Lhe SCl8 Lo make a hazard deLermlnauon. Compoundlng
Lhls problem ls LhaL ln many cases Lhe envlronmenL wlll noL have been well characLerlzed. 1he SCl8 can
raLe hls/her level of uncerLalnLy for Lhe assessmenL, whlch can Lhen prompL a hlgher prlorlLy Lo conducL
furLher lnformauon gaLherlng [lgnaclo 2008].
L88 can be raLed accordlng Lo Lhe followlng AlPA Lxposure 8lsk 8aung scheme [CSPA 2010, lgnaclo 2008]:
1ab|e 4 - Lxposure k|sk kanng
Category xposure kotinq coteqoritotion 5ofety notord kotinq coteqory
4 > CLL very Plgh 8lsk
3 30-100 of CLL Plgh 8lsk
2 10-49 of CLL ModeraLe 8lsk
1 <10 of CLL Low 8lsk
- When deLermlnlng L88, revlew Lhe noLes Laken from walk-around surveys and lnLervlews. 1he
raungs should be based on Lhe followlng lnformauon [lgnaclo 2008]:
MonlLorlng daLa: area or personal monlLorlng
SurrogaLe daLa: exposure daLa from pasL response operauons or uslng anoLher envlronmenLal
agenL also presenL ln Lhe envlronmenL
Modellng daLa should be collecLed by a qualled lndusLrlal hyglenlsL or oLher qualled Lechnlcal
speclallsLs and should be based on physlcal and chemlcal properues of Lhe envlronmenLal agenLs
and on response operauons acuvlues
193
ERHMS
ConLrols used by Lhe workers, elLher englneerlng, safe work pracuces, and/or L and Lhelr
observable eecuveness ln conLrolllng exposures
- Asslgn an uncerLalnLy raung (u8). As descrlbed above, Lhe exposure assessmenLs Lo characLerlze
Lhe exposure rlsks Lo response personnel are llkely quallLauve ln naLure. 1he magnlLude of Lhe
uncerLalnLy assoclaLed wlLh exposure assessmenLs ls an lmporLanL conslderauon when [udglng
exposures [lgnaclo 2006]. 1hls knowledge ls lmporLanL Lo deLermlne lf an assessmenL has malnLalned
lLs lnLegrlLy or lf slgnlcanL gaps ln Lhe assessmenL exlsL requlrlng furLher lnformauon gaLherlng
[lgnaclo 2006].
Iudg|ng Lxposures
1he nal sLep ln Lhe exposure assessmenL process deplcLed ln llgure 1 ls Lo asslgn a rlsk level for
each ldenued hazardous exposure. A rlsk level ls calculaLed based on Lhe lnpuL from Lhe L88,
healLh rlsk raung (P88), and uncerLalnLy raung for Lhe parucular hazard, whlch reecLs Lhe rlsk
assoclaLed wlLh a glven seL of responders performlng a slmllar [ob. lrom Lhls process, Lhe SCl8
can deLermlne lf Lhe exposure Lo healLh and safeLy hazards ldenued ls one of Lhe followlng:

- Acceptab|e: Pazard ldenued has been deLermlned Lo be low enough LhaL rlsks assoclaLed wlLh
Lhe exposure are low. 1hough raLed accepLable, Lhe SCl8 should conunue Lo reassess Lhe par-
ucular hazard Lo verlfy Lhe accepLablllLy [udgmenL [lgnaclo 2006].
- Unacceptab|e: Pazard ldenued has been deLermlned Lo have an average exposure or Lhe upper
exLremes of Lhe exposure (e.g., peak) Lo be slgnlcanLly hlgh exceedlng Lhe esLabllshed CLL. lor
safeLy hazards, Lhese are Lyplcally hazards wlLh a slgnlcanLly hlgh healLh rlsk raung and a hlgh rlsk
of occurrence [lgnaclo 2006].
I|gure 2. n|erarchy of Contro|s referred and Most Used |n kesponse
Most Preferred
Least Used
In Response
Most Used
In Response
Least Preferred
Elimination
Substitution
Administrative
Controls
Engineering
Controls
Personal Protective
Equipment
196
ERHMS
- Uncerta|n: lnsumclenL daLa ln elLher Lhe assoclaLed response Lask or [ob, or lnformauon of Lhe
hazard may warranL an SCl8 Lo deLermlne Lhe hazard as uncerLaln. ln conLrasL, unaccepLable
[udgmenLs assume LhaL Lhe SCl8 knows Lhe speclc hazards lnvolved, and Lherefore, mechanlsms
of eecuve conLrols can be recommended. uncerLaln exposure [udgmenLs warranL a hlgh prlorlLy
for furLher surveys and oLher lnformauon gaLherlng eorLs or reach-back experL consulLauon ln
order Lo make Lhe approprlaLe conLrol recommendauons [lgnaclo 2006].
Cn Lhe forms used by Lhe AlPA, a formula exlsLs whereby Lhe values asslgned ln Lhe P88 and L88 are
muluplled and Lhen added Lo Lhe deLermlned uncerLalnLy raung. 1he hlgher Lhe rlsk level value, Lhe hlgher
Lhe prlorlLy Lo elLher perform addluonal lnformauon gaLherlng meLhods or lmplemenL conLrol meLhods. 1he
prlmary advanLage ln uslng Lhe AlPA verslon of an lCS213A Pazard and 8lsk Analysls WorksheeL ls Lhe llmlLed
raungs avallable Lo Lhe user. 1here are only four raungs Lo choose ln Lhe P88 and L88 and Lhree raungs ln Lhe
u8. ArblLrary fudglng" of Lhe numbers ls mlnlmlzed ln order Lo provlde lncreased quanuLauve" [udgmenL
ln deLermlnlng rlsks. 1here are oLher lCS213A forms LhaL provlde a much wlder composlLe-Lype assessmenL
of rlsk, whlch could poLenually lead Lo very wlde and arblLrary lnLerpreLauons of Lhe severlLy, probablllLy,
and exposure rlsk raungs. Where a lower rlsk level value ls asslgned Lo one raung, Lhe overall rlsk value
asslgned may, Lhen, blas Lowards elLher a hlgher or lower assessmenL of rlsk. ConsequenLly, an under- or
over-esumauon of Lhe rlsk occurs, resulung ln elLher lnadequaLe conLrols Lo proLecL responders or excesslve
wasLe of resources Lo conLrol. noLe LhaL Lhls form avolds Lhe quesuon of deLermlnlng a probablllLy raung
because ln a very dynamlc lncldenL response operauon, quanufylng Lhe probablllLy of a hazard happenlng
or noL happenlng could noL be rellably ascerLalned or subsequenLly predlcLed.
Contro| Strateg|es |n an Inc|dent kesponse
Aer asslgnlng Lhe approprlaLe values and deLermlnlng a rlsk level for each of Lhe hazards ldenued ln a
work asslgnmenL, 8lock 7 allows Lhe user Lo descrlbe speclc conLrol meLhods (e.g., n93 fllLerlng faceplece
resplraLor, deconLamlnauon) ln a shorL narrauve and a slmple, checked box formaL assoclaLed wlLh a speclc
hazard ln whlch Lhls conLrol meLhod would be approprlaLe Lo lmplemenL agalnsL.
Larly ln a response, safeLy hazards and envlronmenLal agenLs wlLh known and lmmedlaLe shorL-Lerm healLh
eecLs should be Lhe prlmary focus [lgnaclo 2006]. 1he reason ls Lhe llmlLed ume avallable for an SCl8
and hls or her sLa Lo perform Lhls hazard and rlsk analysls. ldenufylng and assesslng Lhe slgnlcanL and
largely observable hazards should be focused for lmmedlaLe conLrol [lgnaclo 2008]. uncharacLerlzed work
envlronmenLs lnvolvlng hazardous subsLances ln any physlcal sLaLe requlre Lhe hlghesL level of L LhaL, lf
posslble, are comblned wlLh englneerlng conLrols unul Lhese subsLances are ldenued and quanued Lo
subsLanuaLe lower level of conLrols.
1he conLrol sLraLegy hlerarchy ls ldenucal Lo any general lndusLry or consLrucuon hlerarchy of conLrols.
Powever, because of Lhe naLure of an emergency lncldenL, Lhe predlcLed use ls reversed, as shown ln llgure
2. 1he developmenL and lmplemenLauon of conLrol meLhods, lncludlng subsuLuuon, ellmlnauon, englneerlng
conLrols, admlnlsLrauve conLrols and L, are noL dlscussed ln deLall ln Lhls appendlx. Powever, addluonal
references are provlded for addluonal consulLauons [Anna uP 2006, nlCSP 2004, nlCSP 2008, nlCSP 2009].
Cnce speclc conLrol meLhods are ldenued for proLecung response and supporL personnel from Lhe
ldenued hazards, Lhe rlsk level can be used Lo prlorluze Lhe need for lmmedlaLe lmplemenLauon. ldeally,
lf resources are falrly robusL, all recommended conLrol meLhods should be lmplemenLed, buL ln reallLy,
loglsucal llnes aL a response wlll be Laxed. SCl8 and ASCl8s need Lo work closely wlLh Lhe approprlaLe
command and general sLa wlLh a prlorluzed llsL of conLrol meLhods uslng Lhe analysls descrlbed above.
Assesslng and lnLervenlng for psychologlcal hazards may requlre addluonal sklll seLs, speclal consulLanLs,
and conduclve relauonshlps wlLh key lncldenL leaders (l.e., wlLh auLhorlLy Lo change process or procedure
as needed) [8elssman (ln press-a), 8elssman 2010]. 1here ls greaL varlablllLy ln sLress Lolerance and
coplng schemes among Lhose respondlng and leadlng response acuvlues ln a dlsasLer conLexL. Cruesome
slLuauons, especlally Lhose lnvolvlng coworkers or chlldren, may lgnlLe sLrong emouonal responses. unusual
or mysLerlous exposures, especlally lnfecuous dlseases or radlauon, may lead Lo unreallsuc safeLy or healLh
197
ERHMS
concerns among responders. AdmlnlsLrauve conLrols are llkely Lo be useful ln llmlung exposure Lo Lhe
psychologlcal Loxlns," along wlLh provldlng adequaLe recovery ume and, posslbly, professlonal supporL.
ln addluon, conlcung safeLy lnformauon, muluple llnes of reporung, and/or role confuslon oen lead Lo
lncreased Lenslons aL Lhe workslLe. 1he ablllLy of Lhe SCl8 Lo reduce unnecessary sLress aurlbuLable Lo
command and conLrol sLrucLure or communlcauon sLyle wlll depend on access Lo, and relauonshlp wlLh,
key declslon-makers.
ln Lerms of posL-evenL medlcal survelllance, Lhe hazard and rlsk analysls documenLs, documenLed eld
observauons of healLh and safeLy compllance, alr monlLorlng records, lncldenL Acuon lans for each
operauonal perlod, and slLe safeLy plans should be revlewed and lncluded ln Lhls survelllance Lo deLermlne
anuclpaLed healLh eecLs assoclaLed wlLh known response exposures LhaL may occur among Lhe evenL
responders.
Data ua||ty Management |n an Inc|dent kesponse
When gaLherlng quanuLauve exposure daLa, SafeLy Cmcers wlll face slLuauons where Lhere may be Loo
llule quanuLauve daLa (from eld dlrecL-readlng lnsLrumenLs and/or sampllng and analysls), or Lhere ls Loo
much daLa. ln elLher clrcumsLance, when analyzlng daLa Lo deLermlne accepLablllLy of exposures, Lhe SafeLy
Cmcer or lndusLrlal PyglenlsL needs Lo assess Lhe daLa quallLy. uaLa quallLy managemenL ls a huge Loplc,
whlch requlres furLher ln-depLh dlscusslon speclc Lo chemlcal, blologlcal, or physlcal agenL hazards. 1hls
secuon wlll auempL Lo brley descrlbe a succlncL evaluauve process Lo assesslng daLa quallLy ln order Lo
drlve one's professlonal [udgmenL Lowards deLermlnlng accepLablllLy of exposure or lf addluonal lnformauon
gaLherlng ls requlred.
Lva|uat|ng Source of Data
CuanLlLaLlve exposure daLa, elLher derlved from fleld dlrecL-readlng lnsLrumenLs or sampllng and laboraLory
analysls (alr, dermal, or blologlcal), requlre careful evaluaLlon. ldeally, Lhe monlLorlng resulLs should be
recorded on a company or generlc alr-monlLorlng form LhaL answers Lhe quesLlons below. Chaln-of-cusLody
records should be aLLached Lo Lhe monlLorlng resulLs for sampllng and laboraLory analysls Lo valldaLe
compllance. When evaluaLlng Lhe daLa, here are some quesLlons Lo ask based on Lhe source of Lhe alr
monlLorlng daLa.
- Speclflcally, who and whaL company performed Lhe alr monlLorlng?
- ls Lhere a brlef descrlpLlon of Lhe response [ob or Lask performed when Lhe monlLorlng was
performed? WhaL abouL a brlef descrlpLlon of Lhe englneerlng conLrols, safe work pracLlces and/
or resplraLors/L used by Lhe workers?
- WhaL Lype of deLecLlon Lechnology (e.g., phoLolonlzaLlon, lon moblllLy specLromeLry, gas
chromaLography/mass specLromeLry) was used?
- When dld Lhe manufacLurer and Lhe user callbraLe Lhe dlrecL-readlng lnsLrumenL?
- WhaL were Lhe envlronmenLal condlLlons (e.g., alr LemperaLure, humldlLy levels, preclplLaLlon,
wlnd speed/dlrecLlon) and physlcal locaLlon (e.g., aL sea on-board a vessel or along a beach) when
Lhe alr monlLorlng was performed?
- ln relaLlon Lo Lhe responders belng monlLored, whaL were Lhe dlsLance and approxlmaLe locaLlon
of Lhe alr monlLorlng?
- ls Lhe dlsplay a dlglLal readouL or analog dlals?
- Are Lhe users of Lhe lnsLrumenL adequaLely Lralned and experlenced on uslng Lhe devlces, or was
Lhe Lralnlng done [usL-ln-Llme for Lhe response?
- Could Lhere have been oLher chemlcals ad[acenL Lo Lhe alr monlLorlng acLlvlLy LhaL may have
confounded Lhe alr-monlLorlng resulLs?
198
ERHMS
- When readlngs were Laken, dld flucLuaLlons occur ln Lhe dlsplay, and lf so, how dld Lhe reader Lhen
deLermlne Lhe resulLs? (lor example, was Lhe deLermlnaLlon based on slmply Lhe mlddle reglon of
where Lhe needle flucLuaLed, or when Lhe needle sLablllzed for a few seconds aL a parLlcular value?)
- WhaL are Lhe recognlzed llmlLaLlons of Lhe parLlcular sampllng meLhodology used?
- Were Lhe sampllng pumps callbraLed ln accordance wlLh Lhe sampllng meLhodology used?
- WhaL laboraLory analyzed Lhe resulLs? uld Lhe manufacLurer and Lhe user callbraLe Lhe dlrecL-
readlng lnsLrumenL accredlLed Lo perform Lhls klnd of sampllng analysls?
- Pow were Lhe sampllng medla sLored and LransporLed Lo Lhe laboraLory? Pow compllanL was Lhe
chaln-of-cusLody?
Lva|uat|ng the Data
1hls ls Lhe dlfflculL porLlon of Lhls secLlon, buL lL requlres brlef dlscusslon. Some quesLlons Lo ask when
evaluaLlng Lhe daLa quallLy lnclude Lhe followlng:
- Are Lhere sufflclenL daLa for Lhls operaLlon Lo perform sLaLlsLlcal analysls?
- Are Lhe daLa exceedlng a glven CLL? WhaL CLL ls belng used and why? uo Lhe daLa comply wlLh
regulaLory compllanL CLLs (e.g., CSPA ermlsslble Lxposure LlmlLs), buL exceed recommended
consensus-based CLLs?
- lf Lhe daLa lndlcaLe a cerLaln alr-monlLorlng level for a speclflc chemlcal (e.g., benzene aL 2 parLs
per mllllon), buL Lhe daLa were derlved from a non-speclflc dlrecL-readlng lnsLrumenL (e.g., flame
lonlzaLlon deLecLor or phoLolonlzaLlon deLecLor), how dld Lhe source know whaL he or she was
speclflcally measurlng? Was Lhe correcL compensaLlon facLor applled for Lhe phoLolonlzaLlon
deLecLor (lu)?
- 8ased on Lhe daLa glven, are Lhere Lrends? lor example, are Lhe daLa showlng hlgher levels aL
parLlcular Llmes of Lhe day or when parLlcular operaLlons are occurrlng (malnLenance down Llmes
versus acLual response operaLlons occurrlng)?
- 8ased on Lhe daLa glven, and afLer performlng a sLaLlsLlcal analysls of Lhe sLandard devlaLlon, whaL
daLa polnLs, lf any, represenL ouLllers? uo Lhey represenL daLa errors resulLlng from sampllng,
or laboraLory analysls or lnsLrumenLaLlon malfuncLlon, or acLual splkes/low readlng levels?
When deallng wlLh quanuLauve exposure daLa Laken from consulLanLs or oLher governmenL agencles, Lhese
assessmenL quesuons are lmporLanL for Lhe analysL Lo ask. ldeally, Lhese klnds of daLa quallLy managemenL
expecLauons should be communlcaLed Lo all response organlzauons gaLherlng exposure monlLorlng daLa
so LhaL Lhese performers can documenL compllance wlLh Lhese expecLauons.
Commun|cat|ng Lxposure Assessment
Deta||ed keport
ChapLer 8 CommunlcaLlons (page 43) Lalks abouL communlcaLlng all aspecLs of L8PMS wlLh mulLlple
audlences. 1hls secLlon Lalks more speclflcally abouL communlcaLlng exposure assessmenL daLa. A
well-wrlLLen reporL on exposure assessmenLs should reflecL Lhe followlng areas [8elssman (ln press-a),
8elssman 2010]:
- Summary Lo lnclude Lhe purpose of Lhe assessmenL, general Lypes of observaLlons, concluslons
and recommendaLlons
- LnvlronmenLal agenLs and Lhe CLL(s) used ln Lhe assessmenL
- AssessmenL daLa used and a brlef descrlpLlon of Lhe exposure assessmenL raLlngs descrlbed
- SLaLlsLlcal analysls performed, lf any
199
ERHMS
- ueLalled observaLlons ln Lhe fleld
- Concluslons
- 8ecommendaLlons
1he use of graphlcal Lools, Lables, and plcLures wlll slgnlflcanLly asslsL Lhe reader Lo undersLand Lhe scope
of Lhe assessmenL.
Commun|cat|ng to kesponse Commun|ty
Coples of exposure assessmenL reporLs should be shared wlLh Lhe overall lncldenL command and general
sLa. lf reporLs covered response or supporL conLracLors, Lhese prlvaLe enuues should be provlded Lhe
assessmenL reporL. Any lndlvldual personal monlLorlng daLa should be shared dlrecLly wlLh Lhe worker who
was monlLored, and Lhe daLa should be LreaLed as personally ldenuable lnformauon (ll).
lf daLa analysls clearly shows exposures exceedlng CLL, lmmedlaLe communlcauon wlLh Lhe response
organlzauons and lncldenL command/general sLas should occur any nal reporL wrlung. lmmedlaLe
conLrols should be recommended so LhaL aecLed responders may comply qulckly Lo avold any furLher
exposures Lo harmful agenLs. When exposures laLer ln a response show a decllne below a glven CLL, Lhls
lnformauon should be communlcaLed Lo Lhe same sLakeholders descrlbed and recommendauons Lo move
away from Lhe mandaLed use of englneerlng, safe work pracuce, or, ln parucular, resplraLors/L should also
be communlcaLed. 8esplraLors and L do add a physlcal burden Lo Lhe resplraLory and clrculaLory sysLems
and so avoldlng Lhese klnds of conLrols, lf deLermlned Lo be no longer needed, should be communlcaLed
and lmplemenLed when pracucable.
Commun|cat|ng to the ub||c]Med|a & o||cy Makers
ln very large lncldenL responses, publlc, pollucal, and medla auenuon Lo worker healLh and safeLy are llkely.
All exposure assessmenL reporLs are dlscoverable lLems for fuLure clvll lawsulLs or release as a form of
publlc record. Wrluen assessmenL reporLs, Lherefore, should be accuraLe and succlncL. All reporLs, as wlLh
any publlc releasable documenL, should rsL be evaluaLed Lhrough Lhe lncldenL Command's ubllc Aalrs
Cmcer, or ln larger responses, wlLh Lhe !olnL lnformauon CenLer (!lC) before release. An lncldenL Command's
leglslauve llalson or omclal should be consulLed before anyone speaks wlLh members of a pollucal body aL
Lhe local, sLaLe or federal level. SafeLy Cmcers or members of a medlcal Leam focused on responder healLh
and safeLy SPCuLu nC1 be releaslng any documenLs dlrecLly Lo any member of Lhe publlc or Lhe medla
unless oLherwlse auLhorlzed by Lhe lncldenL or unled Command, Lhrough clearance from one's publlc
aalrs or !lC. 1hls same guldance holds Lrue for releaslng documenLs Lo pollucal enuues.
1he CenLers for ulsease ConLrol and revenuon has Lools avallable LhaL provlde lnsLrucuon ln how Lo
eecuvely plan and dellberaLely dellver Lhls lnformauon verbally Lo Lhe publlc and medla. no one should
communlcaLe rlsks wlLhouL a well-rehearsed and well-wrluen plan on whaL speclc lLems Lo share and
answers Lo anuclpaLed quesuons. Complex exposure assessmenL daLa, concluslons, and recommendauons
should be carefully Lallored down Lo slmplesL Lerms for Lhe lnLended audlence, who are non-publlc healLh
and non-medlcal professlonals. 1echnlcal Lerms such as parLs per mllllon need Lo be avolded. Cuesuons from
Lhe publlc and medla nLLu 1C 8L An1lClA1Lu and answers approprlaLely craed. LngagemenL wlLh publlc
aalrs, leglslauve aalrs, and Lhe !lC ls mandaLory Lo ensure LhaL Lhls communlcauon ls done approprlaLely.
200
ERHMS
Clossary
- Aher Acnon keport (AAk): 8eporLs LhaL summarlze and analyzes performance ln boLh exerclse and
acLual evenLs. 1he reporLs for exerclses may also evaluaLe achlevemenL of Lhe selecLed exerclse
ob[ecuves and demonsLrauon of Lhe overall capablllues belng exerclsed.
- 8r|ef Symptom Inventory: An lnsLrumenL LhaL provldes pauenL-reporLed daLa Lo help supporL cllnlcal
declslon-maklng aL lnLake and durlng Lhe course of LreaLmenL ln muluple semngs.
- C||n|ca| care: Medlcal assessmenL, dlagnosls, and LreaLmenL servlces for an lndlvldual worker's
healLh concerns or lmpalrmenLs, lncludlng concerns relaLed Lo menLal healLh or ln[ury. PealLhcare
servlces are rendered by llcensed healLhcare pracuuoners and sub[ecL Lo local sLandards of care,
medlcal eLhlcs, provlder-pauenL relauonshlp expecLauons, buslness rules, and faclllLy llcensure.
- Command sta: An lncldenL command componenL LhaL conslsLs of a publlc lnformauon omcer,
SafeLy Cmcer, llalson omcer, and oLher posluons as requlred, who reporL dlrecLly Lo Lhe lncldenL
Commander.
- Lmergency: Any lncldenL, wheLher naLural or man-made, LhaL requlres responslve acuon Lo proLecL
llfe or properLy. under Lhe 8oberL 1. SLaord ulsasLer 8ellef and Lmergency AsslsLance AcL, an
emergency means any occaslon or lnsLance for whlch, ln Lhe deLermlnauon of Lhe presldenL, federal
asslsLance ls needed Lo supplemenL sLaLe and local eorLs and capablllues Lo save llves and Lo
proLecL properLy and publlc healLh and safeLy, or Lo lessen or averL Lhe LhreaL of a caLasLrophe ln
any parL of Lhe unlLed SLaLes.
- Lmergency kesponder nea|th Mon|tor|ng and Surve|||ance (LknMS): A framework of acuvlues
deslgned Lo allow for Lhe monlLorlng and survelllance of emergency responder safeLy and healLh
durlng all phases of emergency response: pre-deploymenL, deploymenL, and posL-deploymenL.
- Iuncnona| and Access Needs: 1he baslc needs of all persons, lncludlng baLhlng, cloLhlng, eaung,
groomlng, ambulaung, Lolleung, and emouonal well-belng.
- nea|th and Safety |an (nAS): A procedure LhaL asslgns responslblllues, esLabllshes personnel
proLecuon sLandards, specles safe operauon procedures, and provldes conungencles LhaL may
arlse durlng eld operauons.
- Inc|dent Command: LnuLy responslble for overall managemenL of Lhe lncldenL. ConslsLs of Lhe
lncldenL Commander, elLher slngle or unled command, and any asslgned supporung sLa.
- Inc|dent Commander: 1he lndlvldual responslble for all lncldenL acuvlues, lncludlng Lhe developmenL
of sLraLegles and Lacucs and Lhe orderlng and Lhe release of resources. 1he lncldenL Commander
has overall auLhorlLy and responslblllLy for conducung lncldenL operauons and ls responslble for
Lhe managemenL of all lncldenL operauons aL Lhe lncldenL slLe.
- Inc|dent Command System: A sLandardlzed on-scene emergency managemenL consLrucL speclcally
deslgned Lo provlde an lnLegraLed organlzauonal sLrucLure LhaL reecLs Lhe complexlLy and demands
of slngle or muluple lncldenLs, wlLhouL belng hlndered by [urlsdlcuonal boundarles. lCS ls Lhe
comblnauon of faclllues, equlpmenL, personnel, procuremenLs, and communlcauons operaung
wlLhln a common organlzauonal sLrucLure and deslgned Lo ald ln Lhe managemenL of resources
durlng lncldenLs. lL ls used for all klnds of emergencles and ls appllcable Lo small, as well as large
and complex, lncldenLs. lCS ls used by varlous [urlsdlcuons and funcuonal agencles, boLh publlc
and prlvaLe, Lo organlze eld-level lncldenL managemenL operauons.
- kess|er uesnonna|re (k10): A 10-lLem quesuonnalre lnLended Lo provlde a global measure of
dlsLress based on quesuons abouL anxleLy and depresslve sympLoms LhaL a person has experlenced
ln Lhe mosL recenL 4-week perlod.
201
ERHMS
- L|a|son omcer: A member of Lhe Command SLa responslble for coordlnaung wlLh represenLauves
from cooperaung and asslsung agencles or organlzauons.
- Log|sncs Secnon: (1) ln Lhe lncldenL Command, Lhe secuon responslble for provldlng faclllues,
servlces, and maLerlal supporL for Lhe lncldenL. (2) !olnL lleld Cmce (!lC), Lhe secuon LhaL
coordlnaLes loglsucs supporL Lo lnclude conLrol of and accounLablllLy for lederal supplles and
equlpmenL, resource orderlng, dellvery of equlpmenL, supplles, and servlces Lo Lhe !lC and oLher
eld locauons, faclllLy locauon, seLup, space managemenL, bulldlng servlces, and general faclllLy
operauons, LransporLauon coordlnauon and eeL managemenL servlces, lnformauon and Lechnology
sysLems servlces, admlnlsLrauve servlces, such as mall managemenL and reproducuon, and cusLomer
asslsLance.
- Med|ca| mon|tor|ng: Cngolng cllnlcal assessmenL of physlcal and menLal healLh ln an lndlvldual
worker Lo deLecL emerglng healLh and ln[ury eecLs LhaL may be work-relaLed (e.g., physlologlcal,
psychologlcal), and Lo lnform needs for medlcal LreaLmenL or oLher servlces and/or worker exposure
conLrol(s). Cnce Lhe basellne cllnlcal sLaLus has been esLabllshed, paruclpanLs ln Lhe program are
perlodlcally assessed for changes ln Lhelr cllnlcal sLaLus.
- Med|ca| Cutcomes Study Short Iorm-12 (MCS SI-12): 1he 12-lLem ShorL lorm PealLh Survey
(Sl-12) was developed for Lhe Medlcal CuLcomes SLudy (MCS), a mulu-year sLudy of pauenLs wlLh
chronlc condluons. 1he resulung shorL-form survey lnsLrumenL provldes a soluuon Lo Lhe problem
faced by many lnvesugaLors who musL resLrlcL survey lengLh. 1he lnsLrumenL was deslgned Lo
reduce respondenL burden whlle achlevlng mlnlmum sLandards of preclslon for purposes of group
comparlsons lnvolvlng muluple healLh dlmenslons (8Anu).
- Med|ca| screen|ng: Medlcally assesslng lndlvldual workers for Lhe presence (or absence) of speclc
physlcal or menLal healLh condluons aL a speclc ume, wlLh Lhe express purpose of early dlagnosls
and, lf approprlaLe, LreaLmenL (secondary prevenuon). Medlcal screenlng focuses on assessmenL
of Lness and ablllLy Lo safely and eecuvely deploy on a response and may enLall hlsLory Laklng,
examlnauon, and/or Lesung procedures.
- Med|ca| surve|||ance: SysLemauc and ongolng collecuon and evaluauon of populauon cllnlcal daLa
(e.g., physlcal and menLal healLh, work hlsLorles, medlcal/psychlaLrlc examlnauon, laboraLory and
lmaglng sLudles or oLher cllnlcal Lesung) LhaL ls used Lo ldenufy hazards, Lo ellmlnaLe ongolng
hazardous exposure, and Lo evaluaLe exposure-healLh ouLcome relauonshlps.
- Med|ca| Un|t: luncuonal unlL wlLhln Lhe Servlce 8ranch of Lhe Loglsucs Secuon responslble for Lhe
developmenL of Lhe Medlcal Lmergency lan, and for provldlng emergency medlcal LreaLmenL of
responders.
- Nanona| Inc|dent Management System: A seL of prlnclples LhaL provldes a sysLemauc, proacuve
approach guldlng governmenL agencles aL all levels, nongovernmenLal organlzauons, and Lhe prlvaLe
secLor Lo work seamlessly Lo prevenL, proLecL agalnsL, respond Lo, recover from, and mlugaLe Lhe
eecLs of lncldenLs, regardless of cause, slze, locauon, or complexlLy, ln order Lo reduce Lhe loss of
llfe or properLy and harm Lo Lhe envlronmenL.
- Nanona| kesponse Iramework: Culdes how Lhe nauon conducLs all-hazards response. 1he
lramework documenLs Lhe key response prlnclples, roles, and sLrucLures LhaL organlze nauonal
response. lL descrlbes how communlues, sLaLes, Lhe federal governmenL, and prlvaLe-secLor and
nongovernmenLal parLners apply Lhese prlnclples for a coordlnaLed, eecuve nauonal response.
lL descrlbes speclal clrcumsLances where Lhe federal governmenL exerclses a larger role, lncludlng
lncldenLs where federal lnLeresLs are lnvolved and caLasLrophlc lncldenLs where a sLaLe would
requlre slgnlcanL supporL. lL allows rsL responders, declslon makers, and supporung enuues Lo
provlde a unled nauonal response.
- Nongovernmenta| Crgan|zanon (NGC): An enuLy wlLh an assoclauon LhaL ls based on lnLeresLs
of lLs members, lndlvlduals, or lnsuLuuons. lL ls noL creaLed by a governmenL, buL lL may work
cooperauvely wlLh governmenL. Such organlzauons serve a publlc purpose, noL a prlvaLe beneL.
Lxamples of nCCs lnclude falLh-based charlLy organlzauons and Lhe Amerlcan 8ed Cross. nCCs,
202
ERHMS
lncludlng volunLary and falLh-based groups, provlde rellef servlces Lo susLaln llfe, reduce physlcal
and emouonal dlsLress, and promoLe Lhe recovery of dlsasLer vlcums. Cen Lhese groups provlde
speclallzed servlces LhaL help lndlvlduals wlLh dlsablllues. nCCs and volunLary organlzauons play
a ma[or role ln asslsung emergency managers before, durlng, and aer an emergency.
- Cccupanona| hea|th surve|||ance: 8efers Lo Lhe ongolng and sysLemauc collecuon, analysls,
lnLerpreLauon, and dlssemlnauon of healLh and ln[ury daLa relaLed Lo an evenL's emergency
responder populauon as a whole, Lhe daLa are lnLended Lo lnform publlc healLh pracuce. 1he
analysls and lnLerpreLauon of Lhese daLa should be dlssemlnaLed ln a umely manner Lo Lhose who
need Lo know (such as Lhe lncldenL command personnel, healLh and safeLy represenLauves), whlch
musL lnclude Lhe workers who conLrlbuLed Lhelr healLh lnformauon Lo Lhe sysLem.
- ost-event responder hea|th track|ng: 8efers Lo Lhe collecuve sulLe of opuons wlLhln Lhe L8PMS
sysLem for followlng Lhe healLh and funcuonal sLaLus (lncludes ln[ury) of workers lnvolved ln lncldenL
response and recovery operauons aer Lhelr response work ls compleLed (l.e., aer workers
demoblllze and reLurn Lo Lhelr usual locauons and acuvlues).
- ost-traumanc stress d|sorder: A Lype of anxleLy dlsorder LhaL ls Lrlggered by a Lraumauc evenL. A
posL-Lraumauc sLress dlsorder can develop when an lndlvldual experlences or wlLnesses an evenL
LhaL causes lnLense fear, helplessness, or horror (MayoCllnlc.com).
- ub||c |nformanon omcer: A member of Lhe Command SLa responslble for worklng wlLh Lhe publlc
and medla and/or wlLh oLher agencles Lo provlde requlred lncldenL-relaLed lnformauon.
- kesponders: lncludes pald amllaLed personnel, conLracLors, subconLracLors, and volunLeer workers
lnvolved ln lncldenL operauons. 8esponders lnclude pollce, re, and emergency medlcal personnel,
as well as oLher responder groups such as publlc healLh personnel, cleanup, and repalr/resLorauon
workers.
- kesponse: lmmedlaLe acuons Lo save llves, proLecL properLy and Lhe envlronmenL, and meeL baslc
human needs. 8esponse also lncludes Lhe execuuon of emergency plans and acuons Lo supporL
shorL-Lerm recovery.
- koster: A rosLer ls a llsL of response workers who have been or conunue Lo be paruclpaung ln any
capaclLy durlng a response evenL, or who are avallable and ready Lo respond before an evenL. 1he
purpose of malnLalnlng such a rosLer ls Lo provlde a formal record of all Lhose who have paruclpaLed
ln response and cleanup acuvlues. lL funcuons as a mechanlsm Lo conLacL workers abouL posslble
work-relaLed sympLoms of lllness or ln[ury, as needed, and serves as Lhe basls for deLermlnlng whlch
workers may requlre posL-evenL Lracklng of Lhelr healLh.
- Safety Cmcer: A member of Lhe Command SLa responslble for monlLorlng and assesslng safeLy
hazards or unsafe slLuauons, and for developlng measures for ensurlng personal safeLy. 1he SafeLy
Cmcer may have asslsLanLs.
- Sheehan D|sab|||ty Sca|e: 1he Sheehan ulsablllLy Scale (SuS) was developed Lo assess funcuonal
lmpalrmenL ln Lhree lnLer-relaLed domalns-work/school, soclal, and famlly llfe.
- Spr|nt-L: An 11-quesuon posL-dlsasLer assessmenL and referral Lool LhaL conLalns Lhe ShorL osL
1raumauc SLress ulsorder (1Su) 8aung lnLervlew (S8ln1) and several quesuons regardlng
depresslon and lmpalred funcuonlng.
- Un|hed Command: An lncldenL Command SysLem appllcauon used when more Lhan one agency has
lncldenL [urlsdlcuon or when lncldenLs cross pollucal [urlsdlcuons. Agencles work LogeLher Lhrough
Lhe deslgnaLed members of Lhe uC, oen Lhe senlor persons from agencles and/or dlsclpllnes
paruclpaung ln Lhe uC, Lo esLabllsh a common seL of ob[ecuves and sLraLegles and a slngle lncldenL
Acuon lan.
203
ERHMS
8eferences
ACl [2011]. 8ecommendaLlons and Culdellnes: Advlsory CommlLLee on lmmunlzaLlon racLlces,
[hLLp://www.cdc.gov/vacclnes/recs/aclp/].
Anna uP [2006]. 1he CccupaLlonal LnvlronmenL: lLs LvaluaLlon, ConLrol, and ManagemenL, lndusLrlal
Pyglene ConLrol of Alrborne Chemlcal Pazards, 3rd edlLlon, ClC ress, lnc.
ArllngLon CounLy, vlrglnla [2002]. ArllngLon CounLy afLer-acLlon reporL on Lhe response Lo SepLember
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