Protecting Yourself While Helping Others

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Protecting Yourself While Helping Others

• Safety and Hazard Awareness for Responders
• Janet L. Harreld (plus NIEHS WETP and OSHA)

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Employers workers responsibilities under the
OSH Act

• Occupational Safety Health Act requires that
  employers provide a safe and healthful workplace
  free of recognized hazards AND follow OSHA
  standards. Employers are also supposed to provide
  training, medical exams record keeping
• Workers MUST follow employers safety health
  rules AND wear or use all required gear
  equipment

Post disaster, its difficult to predict and
anticipate all of the physical, chemical
biological hazards
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Incident Command System - ICS

• Compliance with ICS can help ensure as safe a
  work situation as possible given potentially
  hazardous conditions
• Safety is a major component of Command for ICS so
  it is to everyones advantage to work within the
  System

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Injuries and Fatalities

• The majority of disaster related injuries and
  illnesses occur in clean up and reconstruction
• Electrocution from downed power lines
• Falls from heights through openings
• Struck by falling debris
• Exhaustion from working extended shifts in PPE
• Heat stress from overexertion and dehydration
• Chemical and biological hazard exposures
• Struck by/caught between traumas from heavy
  hand held equipment

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Post Disaster Work is Different

• Debris Removal 32
• Roofing 26
• Other 22
• Utilities 10
• Tree trimming 8
• Building repair 2

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Post Disaster Work Conditions

• Standing floodwaters
• Structurally unsound workplaces
• Significant amounts of debris
• Downed power lines
• Contaminated floodwater fuels, oil, raw sewage,
  or chemical biological hazards
• Downed trees, up rooted flora
• Roofs need to be made water tight quickly
• Green black molds
• Possibility of exposed asbestos
• Animals domestic (frightened) and wild
  (equally)
• Traffic transportation issues

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Reconnaissance may be Required!

• Attempt to obtain any and all information
  possible about the area you are taking workers
  into
• Nearest additional potable water source (should
  have own on site)
• Clearly defined work schedule and
  responsibilities (who is the go to person?)
• Emergency route for medical or safety reasons
• Dependable communication system back up and
  contact information

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Just in Case Things

• Insect repellent with DEET or Picaridin
• Appropriate PPE for situation
• Earplugs
• Personal bottled water
• Sun screen
• Rain gear
• Pocket knife

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10 To Dos

• Shower frequently and wash hands well and often
  with clean water
• Avoid contact with stagnant water wash and
  sanitize immediately if exposed
• Use appropriate and durable gloves when handling
  debris
• Use heavy duty footwear (consider steel toe/shank
  books)
• Use hearing protection in noisy environments
  (chainsaws, power tools

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10 To Dos

• Use eye protection all the time (not just for
  debris but for liquids)
• Know your medicines, your allergies, your
  vaccination history (tetanus) your blood type
• Watch where you walk and how you walk due to
  increased risk of slips, trips and falls
• Dont put hands or feet into places (inside walls
  or down drains) that you cant see
• Be careful with and around vehicles (vehicular
  accidents account of almost ½ of all fatalities
  in a flood)

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AND

• If you are going to be involved in direct patient
  care or might have contact with body fluids,
  NIEHS recommends you have the Hep B vaccine
  series
• DONT WORK ALONE and be certain someone at base
  knows where you are

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Emergencies in the Field

• Notify your supervisor or the incident commander
  of any injury sustained at your site
• For minor injuries Apply first aid and seek
  attention at a first aid station or clinic dont
  assume its nothing
• For serious injuries Get help immediately and
  know your exact location

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Hazards Physical Environment

• In flood situations, you may not be able to see
  the ground or know how deep the water is
• Terrain can vary greatly

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Hazards Physical Environment

• Climate (typically April or May through November
  for hurricanes, tornados and flooding)
• Be aware of
• High Humidity
• High Temperatures (combined with high humidity)
• Potential for rapid changes in weather including
  additional storms

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Hazard Traumatic Stress

• Pace yourself and take frequent breaks (make sure
  others do as well)
• Watch out for each other you may see a hazard
  your co-worker does not
• Dont be placed at risk
• Maintain a regular schedule regular eating
  sleeping are crucial
• Drink plenty of water or fluids if you are
  already thirsty you may be dehydrated - Rule 5
  to 7 ounces every 15 to
• 20 minutes

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Hazard Traumatic Stress

• Take breaks away from the work area if possible
• Recognize and accept what you cannot change
  waiting, equipment failures, loss
• Give yourself permission to feel horrible you
  and others are in a difficult situation
• Be aware that you may suffer from traumatic
  stress syndrome or depression

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Hazard Heat Stress - Minor

• Heat Rash - Uncomfortable but common when sweat
  cant evaporate people wearing protective
  clothing may be particularly susceptible Keep
  skin dry clean, wear loose fitting clothing
• Sunburn sunburns prevent your skin from
  functioning as it should Apply sunscreen
  frequently if burned, get out of the sun

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Hazard Heat Stress - Major

• Heat Cramps severe muscle cramps either while
  working or later when relaxing Move into
  shade drink lightly salted water check in
  with medical personnel
• Heat Exhaustion headache and nausea and
  possibly cramping body is on the verge of shut
  down and requires medical attention
  immediately Symptoms clammy, cool, moist
  pale skin fatigue weakness heavy
  perspiration intense thirst low blood pressure
  (due to lack of blood volume) anxiety or
  agitation impaired judgment fainting loss of
  coordination vomiting rapid breathing

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Treatment
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Hazard Heat Stroke

• Heat Stroke is life threatening and requires
  immediate medical attention
• Early symptoms include
• Body temp of 105 or above
• No perspiration
• Hot, red, flushed skin
• Rapid pulse
• Difficulty breathing
• Constricted pupils
• High blood pressure
• Headache or dizziness
• Confusion or disorientation
• Weakness
• Nausea or vomiting

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Heat Stroke

• Advanced symptoms include
• Seizure or convulsions
• Collapse
• Loss of consciousness
• Deep coma
• No detectable pulse
• Body temp over 108
• Be aware that heat stroke can appear to be
  something else such as a heart attack or head
  injury

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Hazard Eye Injuries

• Eye injuries can be caused by dust, flying
  debris, contaminated liquids and welding flash.
• Use safety glasses at all time preferably ones
  with side shields marked with ANSI Z87
• If you have prescription eyewear or will be
  exposed to fine particle dust, use goggles
• If welding or are working near by, be certain to
  use the correct eye wear for light burn
  protection

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Hazard Noise

• Gas powered anything creates noise at a level
  that may be damaging to hearing
• Heavy equipment
• Chainsaws
• Pay extra attention when working in disaster
  sites with hearing protection as you may not hear
  cries for help, moans or other sounds of buried
  victims or you may not be ware of another hazard
  due to impeded hearing

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Hazard Potentially hazardous dust

• Dust and airborne particulate matter may have
  hazardous substance such as asbestos and silica
• Use a respirator or ask about whether you should
• N-95 is acceptable for most activities including
  silica and Portland cement
• If asbestos is present, use half mask
  elastometric with N, R or P-100 series filters
• If contaminates are causing eye irritation, use a
  full face with P-100 organic vapor/acid gas filter

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Respirator use

• Be fit tested for your respirator. It wont
  protect you if it doesnt fit
• Do a positive and negative seal check each time
  and wash your respirator daily
• Men cannot wear full beards and get a good fit
  think about whats important hair grows back
• Surgical masks arent meant to prevent
  particulates from coming in they are meant
  to protect stuff from getting out

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Hazard Unstable work surfaces

• Dont walk on any questionable surface
• Use bucket lifts when possible
• Erect scaffolding on stable surfaces anchor
  only to stable structures
• Wear protective gear including slip resistant
  shoes or boots
• Use fall protection with lifelines tied off

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Hazard Standing or Flood Water

• Be aware that water may be carrying raw sewage
  and high levels of other contaminants
• Keep contact with water to a minimum
• Wear waders and water proof gloves
• Separately wash clothes that come in contact with
  contaminated water
• Keep open cuts or sores as clean as possible
  with soap and water and apply an antibiotic
  ointment
• Be certain flood water doesnt enter your mouth
• Stay alert for rushing water

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Hazard Chemical Release following Disasters

• Orphaned chemical fuel tanks (chlorine tank
  found in downtown Gulfport, MS after Katrina)
• Diesel, gasoline (both leaking up from below
  grade tanks), motor oil (from waste oil stored
  properly), chlorine, liquid oxygen, medical
  waste, corrosives
• Industrial and household products (including
  paint and cleaners)
• Leaking below and above ground tanks

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Hazard Chemical Exposure

• Entry into unknown situation, use Self Contained
  Breathing Apparatus (SCBA)
• Symptoms of exposure include irritation in eye,
  nose, throat and upper respiratory tract contact
  irritation flu like issues difficulty
  breathing fatigue loss of coordination memory
  problems, sleeplessness, mental confusion.

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Hazard Electrical, Overhead Power Lines, Downed
Electrical, Cable

• Assume all power lines are live ALWAYS
• Verifying that a line is not energized may not
  ensure your safety. Lines on both the load and
  supply side of the work area must be grounded.
• Use GFCIs whenever possible

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Hazard Carbon Monoxide

• Carbon Monoxide is a colorless, odorless gas it
  has no warning properties
• Use CO warning sensors when using or working
  around combustion sources
• Shut off any engine immediately if symptoms
  develop and get fresh air at once
• Do not use gasoline generators or portable fuel
  driven tools in confined spaces or in poor
  ventilation
• Do not work in areas near exhaust as CO poisoning
  can occur even outdoors in high concentrations

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Hazard Ladders

• Check all ladders for condition if not good,
  dont use! Think about whats important
• Be very careful where ladders are placed watch
  for electrical lines, cables clotheslines
• Position ladder at 75 degree angle to extend at
  least 3 feet above the landing surface
• Dont place ladders on uneven or unstable (water
  logged) terrain
• Dont apply more weight on the ladder than it was
  designed to support

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• Is there a problem here?

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Hazard Chain Saw

• Use PPE (hard hat, gloves, safety glasses or
  goggles, cut resistant clothing, boots)
• Match the chain saw to the job dont ask a too
  small machine to do the job
• Cut at waist level or below in order to maintain
  control
• Coworkers should remain at least 150 feet away
  from anyone felling a tree and at least 30 feet
  away from limb removal or cutting up fallen tree

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Hazard Confined Spaces

• A confined space is large enough for someone to
  enter fully and perform assigned work and has a
  limited or restricted means of entry or exit
  (OSHA)
• NEVER enter a confined space alone be certain
  someone else is outside
• Be certain to ventilate the space and monitor for
  hazardous conditions of any sort
• Good, reliable communication

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Hazard Structural Integrity

• Do not enter any structure that has evidence of
  large cracks, shifting or partial collapse
• Enter structures only during the daytime
• Determine if any hazardous substances have been
  anywhere on the property including tanks and
  pipes (propane heating tanks)
• Leave structure immediately if unusual sounds
  (indicative of shifting) or smells (potential
  leak) are noticed

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Hazard Mold

• Avoid breathing dust (fungal spores) generated by
  wet or previously wet building materials
• Use N-95 disposable respirator at minimum
• Wear long, preferably water proof, gloves that
  come to the middle of the forearm.
• Avoid touching mold or moldy items with bare
  hands
• Wear goggles NO holes
• You cannot save moldy dry wall

When in doubt, throw it out!
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Hazard Trench or Immersion Foot

• Feet are wet for long periods of time
• Symptoms tingling and/or itching sensation,
  pain, swelling, cold blotchy skin, numbness
  may become red, dry painful after warming
  blisters may form followed by skin tissue dying
  and falling off
• Seek medical assistance as soon as possible
• To prevent air dry elevate and exchange wet
  for dry

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Hazard Handling Bodies of Victims

• There is no risk of infectious disease from
  simply being near human remains
• If handling, human remains may contain blood
  borne viruses such as HIV and bacteria that cause
  diarrheal diseases
• If may be handling human remains or coming into
  contact with bodily fluids Use gloves Use
  goggles, protective clothing and masks if
  anticipate large quantities or possibility of
  splash Wash hands frequently Use body bags to
  reduce risk of contamination

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Hazard Poisonous Plants

• Know poisonous plants in the area you are
  entering Poison Ivy, Poison Oak, Poison Sumac
• Use gloves wear long sleeves and pants
• Rubbing alcohol, if used immediately, may remove
  the oily residue that causes reaction
• Know if anyone has topical allergies or
  allergies to stings

Any apparel or tool that comes into contact with
poisonous plants should be assumed to be
contaminated
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Hazard Insects

• Mosquitoes West Nile and Dengue Fever very
  prevalent in flooded areas use repellents that
  contain DEET or Picardin (use only as directed)
• Bees, Wasps, Hornets stings can cause severe
  reactions keep food scraps sealed and be
  cautious around open garbage bins
• Spiders know what types of spiders may be
  present in the region if bitten, watch bite
  closely seek medical attention
• Ticks Lyme Use repellent Check body for ticks
  and remove promptly if discovered

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Hazard Animals

• Be aware and wary of live domestic and wild
• Do not touch carcasses without appropriate PPE
• Avoid any direct contact with rodents or rodent
  droppings dead rodents typically have fleas
• If bitten or scratched, even by domestic animal,
  seek medical attention immediately

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Hazard Snakes Reptiles

• Watch for swimming snakes seeking higher ground
• Be careful putting hands or feet into dark,
  protected, and/or hidden areas use tools to move
  or remove debris
• If bitten REMAIN CALM obtain medical attention
  immediately if cannot get immediate medical
  attention, lay or sit person with bite at lower
  level than heart keep as still as possible
  remember color and head shape of snake

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Resources and credits

• NIEHS http//tools.niehs.nih.gov.wetp thanks to
  Chip Hughes and his people at the WETP at NIEHS
• NIOSH Guide Suggested guidance for Supervisors
  at Disaster Rescue Sites www.cdc.gov/niosh/emhaz2.
  html
• NIOSH Traumatic Incident Stress Information for
  Emergency Response Workers http//www.cdc.gov/nios
  h/unp-trinstrs.html
• CDC Emergency and Preparedness Response
  http//www.bt.cdc.gov/disasters/floods/

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NIEHS Hurricane Response Orientation

• WETP at NIEHS created a booklet and a companion
  orientation briefing for disaster responders.
  This was done as part of the Worker Safety and
  Health Support Annex of the National Response
  Plan and the Annex was activated in response to
  Hurricanes Katrina and Rita.
• The booklet was updated in 2007 and is available
  at
• http//tools.niehs.nih.gov/wetp