Shortly after 9/11 and the loss of so many firefighters and police in the collapse of the World Trade Center, Washington think tank Rand Corp. teamed with the National Institute for Occupational Safety and Health (NIOSH) to undertake a series of reports on how to protect first responders at terrorist incidents.
Rand invited a broad range of responders, planners and experts to a December 2001 working conference on the WTC and Pentagon attacks, anthrax mailings and Oklahoma City bombing. While Rand expected the initial report to deal with equipment issues, responders convinced it to expanded its scope to include safety management.
A second report soon followed. It dealt with equipment needs for both large-scale and daytoday response. The recently released third report seeks to improve responder understanding of safety management demands at very large incidents.
Brian Jackson was a project team member on all three reports and co-lead investigator on the most recent. He joined Rand 4 years ago, after graduating with Ph.D. from California Institute of Technology and doing postdoctoral work at George Washington University. At Rand, he initially focused on terrorist threats. After 9/11, his focus changed to include responder safety issues. HOMELAND RESPONSE asks him about his most recent report, and why he views both terrorist and large-scale incidents through the same lens.
Homeland Response: You're obviously not a first responder yourself. What gives this report credibility?
Brian Jackson: We relied very heavily on expertise from responder community. We reviewed over 800 published documents and chose to focus on the 9/11 attacks, the Northridge earthquake, and Hurricane Andrew. Then we interviewed people from responder and other organizations who were at those incidents. We then developed draft findings and invited more than 100 responders and federal, state and local officials to review our draft and fill in the blanks. The final report was then reviewed by responder organizations and selected peer reviewers. We really relied on their expertise and participation.
HR: This report is unusual in that it groups terrorism with other types of large-scale events. Why?
Jackson: One of the things we learned from responders is that we don't want to build systems for only one type of event. When that event finally does happen, they would not be practiced enough and the procedures would be unfamiliar. Instead, we want to apply safety management concepts to a broader range of incidents so they are part of daily practice and operations.
HR: So your recommendations cover potential terrorist attacks and large-scale disasters. What do these events have in common?
Jackson: After looking at after-action and lessons-learned reports, we found that largescale events have a lot common that makes it difficult to manage responder safety. First, they are simply much larger than the usual events responders face in day-to-day operations. They may involve integrating hundreds or thousands of responders from outside the area.
Second, they may last for weeks and months, rather than the minutes or hours common in most ordinary events. This changes how incident commanders manage shifts and resources.
Third, there's the unusual nature of hazards that are not faced every day. Responders may not always know how to respond. Take for example the airborne environment after the WTC collapse. None of the organizations were familiar with how to deal with such high levels of airborne particulates, and the safety equipment they needed was not something folks immediately bring to every response.
Finally, major disasters require a multiagency response that can create new safety problems. At WTC, we had firefighters dealing with smoldering fires while construction workers removed debris as part of the excavation. The construction workers were not used to working near firefighters, and the firefighters were not used to working around heavy construction equipment. Firefighters needed to understand the practices construction workers used around heavy equipment and vice versa.
HR: What does this mean to people in the field?
Jackson: One of our main conclusions is the need to coordinate safety activities among all organizations. We need better ways to deal with situations where joint operations create new hazards. Also, we need to take advantage of the safety capabilities each organization brings to the field.
For example, if the environmental agency that monitors water contaminants after a flood is plugged in, responders can use that information to outfit and protect their members. The same is true about organizations that bring stocks of protective equipment to the scene. Firefighters might be used to operating with SCBAs, but law enforcement and construction workers are not. When safety operations are coordinated, everyone benefits from all the expertise and materiel at the scene.
HR: Aside from the need for improved coordination, what other lessons have you learned from large-scale events?
Jackson: Most of the report's recommendations involve preparedness and fall into three broad categories: gathering information about the hazard scene, assessing the information and implementing decisions.
HR: Let's start with gathering information. What do you suggest?
Jackson: Our recommendations focus on coordinating planning among organizations to do hazard assessment. That involves building linkages and developing checklists, guidelines and standards so that individual organizations know what might pose a risk.
Agencies should coordinate to provide actionable information. It's good to know the contaminants at a site in parts per million, but that may not be as useful as understanding that levels are high enough to pose risks. It is important to present information so it can be absorbed quickly, because these are high-pressure situations where time is of the essence.
We need better information on the responders who arrive at a major incident. We have to know they are there and what their skills are. That could be done by credentials and ID information. We also need a firm perimeter so the incident commander can control what units are coming in so they can be included in safety decisions.
It seems clear that we need to track health information as the scene evolves. If responders are getting a lot of eye injuries, then we can get out information to protect people and improve protection during the response. We've had trouble collecting this information from past incidents because the systems were not there.
HR: Doesn't this create a huge administrative overhead?
Jackson: That depends on how it's implemented. For example, if we have standardized work shifts into and out of scene, we could use the changeovers to collect information on exposures and injuries. A lot of this information could be part of the overall safety management system.
HR: What about your second set of recommendations, hazard assessment?
Jackson: Major disasters frequently mean local organizations don't have all the expertise needed to assess risk. The best way to deal with this is by preplanning what they will need to help make safety decisions. They need guidelines for selecting equipment, especially in early stages of response when information is the least certain, and tools to help incident commanders understand what resources other organizations bring to the scene. They need tools for estimating future resources, because requesting too much creates a logistics burden and actually makes it harder to find what you need. And they need to know how they will react to different levels of contaminants.
Most importantly, though, responders need to know how they will manage risk at different stages of the response. Because potential payoffs are highest during rescue, the levels of acceptable risks are higher than during recovery. Still, these are very difficult judgments to make. At our meetings, different responders came to different conclusions. It's a lot easier to discuss this when you're not faced with a disaster scene.
HR: Your third set of recommendations involved implementation. How do you enforce safety measures at a large incident scene with many different responder organizations, each reporting to their own commanders?
Jackson: We need to address this in preplanning, and it starts with scene control. Responders need a good hard perimeter, and only those people with the right safety equipment and the training to use it can cross the perimeter. This is the only way to enforce safety independent of each organization's standards. One responder who was at Oklahoma City told us, 'If you didn't wear protective equipment, we just wouldn't let you.'"
Long-term operations require special measures to protect health and provide for medical needs. Part of this is planning for long-term operations, including how you'll manage shifts and deal with rest and rehabilitation. Responders need to go quickly into long-term mode. People who work too long at these incidents represent a real problem among individual responders and especially at the command level. If someone works 15-16 hour shifts over several days, you have to question whether they can continue to perform their functions and make good decisions.
We also need to develop better ways to get medical care to responders. Especially early on, the focus is on the victims and hurt responders don't want to stop to be treated. Responders told us that we need to have people, such as other responders, on the frontline with training and supplies, to treat their members. We don't want them to leave the site to be treated.
Many of the people we talked to emphasized mental health protection. Critical incident stress is a major issue in lots of response operations, and commanders underscored the need for an effective employee assistance plan.
Another implementation issue is human resource and equipment management. Large incidents draw lots of responders. We can't let everyone we recall respond directly to the scene or it will become chaos. If everyone turns up at once, it makes it harder to organize 24-hour operations. We also need to track these people better. When Hurricane Andrew hit, responders showed up from other states and we had very significant safety issues knowing who or what was at the scene.
Finally, we recommend building mechanisms to deal with volunteers. They can be a great workforce, but we need mechanisms to know where they are, what we're asking them to do, and whether they are well matched to activities they can do safely. In Hurricane Andrew, many volunteers were coordinated through established organizations that could be connected to the incident command management structure.
HR: You also make some other recommendations that fall outside these categories.
Jackson: We have a section on what you need to integrate this approach to safety management into the planning process so you know what management structure you'll plug in when you get to the scene. Incident management at the Pentagon 9/11 attack worked well because everyone knew everyone else and drew on resources effectively. Some organizations are good that way, but in a major incident they're dealing with OSHA, NIOSH and state and public health agencies that are outside the usual first responder community. We need to build bridges among all these organizations.
HR: Do preparedness exercises help build those bridges?
Jackson: The way most exercises are designed, they're very focused on the operational side, the public protection piece. Frequently, responder safety is only included as a footnote. Most of these exercises announce the hazard before hand — 'it's a dirty bomb,' 'it's hazmat.' In the real world, the first test is whether you can get resources to identify the problem. In exercises, announcing the answer before you give the test can lead to excluding organizations that you will need to rely on in the real world because their functions are already assumed. For those things to work in the response, they have to be included in the exercise so we know how to use the available expertise.
For more information
Three Rand studies provide detailed information on responder safety:
- Protecting Emergency Responders: Lessons Learned from Terrorist Attacks (www.rand.org/publications/CF/CF176)
- Protecting Emergency Responders, Volume 2: Community Views of Safety and Health Risks and Personal Protection Needs (www.rand.org/publications/MR/MR1646)
- Protecting Emergency Responders Volume 3: Safety Management in Disaster and Terrorism Response (http://www.rand.org/publications/MG/MG170)