1. PROTECTING EMERGENCY RESPONDERS Tom LaTourrette D.J. Peterson Brian A. Jackson James T. Bartis Ari N. Houser Community Views Of Safety And Health Risks And Personal Protection Needs

2. 2 Presentation Overview About the project Service-specific issues Terrorism response Cross-cutting issues Concluding observations

3. 3 Responder Community Input is Essential to Improving Protection Structured discussions with responder community members Sought to obtain emergency responder community views about –Current and evolving activities –Hazards of greatest concern –Critical protection needs –Factors limiting progress in reducing injuries Intended to complement surveillance data to gain insight into responder perspective Provide input to the national effort for improving personal protection of emergency responders

4. 4 Project History 2001: NIOSH opens National Personal Protective Technologies Lab –August 2001 RAND on-board 9/11: Priorities reordered –RAND & NIOSH agree to focus on lessons learned from terrorist attacks 2002: RAND returns to task in a community that has fundamentally changed

5. 5 Fire Service Priorities: Fireground Protection Thermal protection adequate, but critical problems remain Stress: Physical and thermal Isolation/threat awareness Communications Personnel accountability/location Equipment status/service life

6. 6 Emergency Medical Service Priorities: Assaults & Infectious Diseases Assault protection (vests and training) is very uneven Basic medical protection (gloves, goggles, gowns) not appropriate for field use ("find us a glove that works...") Multiple delivery systems detract from coordination and focus –E.g., difficult to find basic fatality and injury data

7. 7 Law Enforcement Priorities: Assaults and Vehicular Accidents Formidable hurdles to ensuring protection –Typically first on scene ("blue canaries") –Protective gear must not interfere with tasks or community interactions –Protection must be immediately accessible Armored garment shortfalls –Tradeoffs between protection and acceptance Vehicle injuries –Safe design & behavior

8. 8 Equipment worked as designed but fell short in multi-threat, extended campaigns Equipment not always available or maintainable Inconsistent risk assessment and communication Terrorism response fraught with uncertainty –What is the threat; what are hazards? –What response procedures will be used? –What protection is appropriate? Sense of urgency initially fueled poorly-informed acquisitions Terrorism Response is a Major Concern

9. 9 Protection Problems Exist at the Systems-Level Need interoperable communications –High-traffic capability –Many agencies maintain multiple systems Improved hazard assessment capabilities Human factors influence protection –Operational framework not always well-defined –Knowledge and risk management difficult –Responder wellness and physical fitness

10. 10 Procurement and Logistics Are Increasing Concerns Acquisitions are often poorly informed Standards & certification are essential Space for new protective gear is very limited, in stations, in vehicles, on personnel Maintenance is an increasing concern Interoperability highly beneficial for large incidents, but impediments are high

11. 11 Concluding Observations Routine emergencies pose significant threats to responder safety Terrorism response adds new & unfamiliar threats— CBRN & massive damage Many findings regarding protecting responders in terrorism apply to disasters in general Continued technical advances are critical But so are training and education