Hurricane Response Guide for Environmental Public Health Professionals, 2024. National Environmental Health Association (www.neha.org).
Hurricane Response Guide for Environmental Public Health Professionals 2024
Hurricane Response Guide for Environmental Public Health Professionals
This National Environmental Health Association (NEHA) Hurricane Response Guide (Response Guide) serves as operational guidance for experienced environmental public health (EPH) professionals at the state, tribal, local, and territorial level (STLT) in hurricane-prone regions. Designed for public sector use, this Response Guide aligns with and complements existing frameworks, such as the National Response Framework (NRF), the National Disaster Recovery Framework (NDRF), and the National Incident Management System (NIMS). It aims to bolster preparedness, response, and recovery efforts before, during, and after a hurricane strikes.
Key features of this Response Guide include:
1. Operational Guidance: Detailed task checklists centered around the 15 functional areas of the NEHA Environmental Public Health Emergency Preparedness and Response (EPHEPR) Capability Framework. 2. Pro Tips: An overview of essential concepts and best practices by functional area to increase environmental public health professionals’ knowledge base. 3. National Guidance, Standards, and Forms: A selection of key resources by functional area to provide additional guidance and support. This Response Guide provides information about the various consequences of hurricanes, including flooding, power outages, chemical hazards, food contamination, and increased vector-borne disease transmission. By outlining these potential impacts, this Response Guide equips EPH professionals with evidence-based considerations for formulating effective mitigation strategies and actionable responses, adaptable to various levels of emergency response. Funding and Liability Statement Funding for this project was 100% supported by the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Diseases Registry (ATSDR) under Grant # NU38OT000300-05-04 (Cooperative Agreement # CDC-RFA-OT18-1802). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services (HHS). This Response Guide is not intended to provide legal advice with regards to emergency response, life-safety, or life-saving efforts, actions, decisions, or activities. All content herein is solely for informational purposes only and does not replace practitioner, professional, organizational, agency, or departmental decisions making, incident action planning, or other emergency response actions. Acknowledgments Publication of this Response Guide would not have been possible without the collective efforts and contributions from the following people: • Veronica Bryant Emergency Preparedness and Outbreak Response Coordinator, North Carolina Public Health
• Tim Hatch District Administrator, Alabama Department of Public Health • John Kolman District Health Officer, Hawaii Department of Health • Tracy Wade Assistant Bureau Chief, Florida Health
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Key Contents Click on a colored tile to jump straight to the section.
Introduction
EPHEPR Response
Part 1: Pre-Incident
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Acronym List
Part 3: Back from the Field
Part 2: In the Field
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Appendix 1-C: Important Reference Documents
Appendix 1-B: Mutual Aid
Appendix 1-A: Disaster Management Overview
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Full Table of Contents Funding and Liability Statement ............................................................................................................................................ Acknowledgments ...................................................................................................................................................................... Introduction ................................................................................................................................................................................... Environmental Public Health and Hurricane Response .................................................................................................. Part 1: Pre-Incident .................................................................................................................................................................... Role of Environmental Public Health .............................................................................................................................. Before a Hurricane ......................................................................................................................................................... During a Hurricane ........................................................................................................................................................ After a Hurricane ............................................................................................................................................................ Preparing for Hurricane Season ....................................................................................................................................... Readiness Actions ................................................................................................................................................................ Prepping for the Field .......................................................................................................................................................... Part 2: In the Field ....................................................................................................................................................................... Identify Environmental Public Health Risks for the Affected Population ............................................................ Coordinate Environmental Public Health Response and Resources .................................................................... Assure the Safety and Integrity of Water Systems .................................................................................................... Assure the Safety and Integrity of Solid Waste/Debris Management Systems ............................................... Assure the Safety and Integrity of Wastewater Systems ........................................................................................ Assure the Safety of Emergency Shelters ..................................................................................................................... Assure the Integrity of Food Supply and Delivery Systems ..................................................................................... Assure the Safety and Integrity of Buildings ............................................................................................................... Assure the Safety of Indoor/Outdoor Air Quality ........................................................................................................ Provide Vector Surveillance and Control ....................................................................................................................... Provide Environmental Public Health Support to Hazardous Material (HAZMAT) Management ............... Provide Environmental Public Health Support to Radiological Management ................................................... Assure the Safety of Recreational Water ...................................................................................................................... Conduct Open Water Monitoring .................................................................................................................................... Assure Effective Environmental Sampling .................................................................................................................... Part 3: Back From the Field ...................................................................................................................................................... Notes ............................................................................................................................................................................................... Acronym List ................................................................................................................................................................................. Appendix 1-A: Disaster Management Overview .............................................................................................................. Appendix 1-B: Mutual Aid ........................................................................................................................................................ Appendix 1-C: Important Reference Documents .............................................................................................................. Attachment 1: Environmental Public Health Preparedness and Response Capability Framework ................... Attachment 2: Go-Bag Checklist ............................................................................................................................................
2 2 5 6 7 7 7 7 8 9
10 10 11 13 16 21 34 41 46 51 59 63 67 73 76 80 86 89 93 94 97
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Introduction At the National Environmental Health Association (NEHA), our mission is to build, sustain, and empower an effective environmental public health workforce. Since 1937, NEHA has been training and educating environmental public health (EPH) professionals. To continue our support, we have developed this Hurricane Response Guide (Response Guide) to assist professionals and help inform their decision-making processes across preparedness, response, and recovery efforts in hurricane-prone areas. What is the Hurricane Response Guide? The Response Guide is a comprehensive resource that compiles federal guidance, best practices, feedback from subject-matter experts, and national resources. It is organized around NEHA’s Environmental Public Health Emergency Preparedness and Response (EPHEPR) Capability Framework (see Attachment 1) to provide a centralized reference for professionals. Who is this Response Guide For? This Response Guide was designed for state, tribal, local, and territorial (STLT) EPH professionals working in hurricane-prone regions or deployed to an area impacted by a hurricane. It is a valuable resource for individuals responsible for addressing EPH concerns during hurricane-related emergencies. Why Should I Use This Response Guide? Responding to disasters can be overwhelming. This Response Guide is designed to help professionals in the field understand the activities and considerations they should address when dealing with various EPH concerns during hurricane response. It provides a structured approach to navigating the complexities of hurricane response and recovery efforts, even in multi-tasking and high-stress environments. When Should I Use This Response Guide? The Response Guide should be reviewed before hurricane season as a preparedness measure. It can also be used during active response and recovery following a hurricane. This Response Guide was designed to be a versatile tool that supports EPH professionals at different stages of hurricane-related emergencies. Where Can I Find Additional Resources? In addition to this Response Guide, NEHA has several other resources that may be helpful. These are available at www.neha.org/practice .
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Environmental Public Health and Hurricane Response EPH professionals play a critical role in supporting the response to hurricanes by addressing the various EPH concerns that could arise during or after a hurricane. They bring a unique perspective and level of expertise to mitigating many of the risks hurricanes pose to public health and safety. In the aftermath of a hurricane, state, tribal, local, and territorial (STLT) EPH professionals perform a wide range of tasks to protect the public’s health and safety. For example, they ensure drinking water safety by conducting water quality tests and implementing water treatment measures, as floodwaters can contaminate drinking water sources with raw sewage, toxic chemicals, and debris. Additionally, they provide guidance on proper food storage and disposal of spoiled or contaminated food from homes and businesses. They ensure that those providing mass feeding for victims and emergency responders adhere to safe food handling practices to prevent foodborne illnesses. EPH professionals also coordinate with agencies to restore and monitor sanitation services, manage debris removal, and prevent the spread of vectors and other pests that can contribute to the spread of disease. Furthermore, EPH professionals perform many other duties, including assessing the safety and cleanliness of emergency shelters, collaborating with hazardous materials (HAZMAT) teams to manage HAZMAT released from damaged facilities, and providing the public with information about health risks, protective measures, and available resources during and after hurricanes. By addressing these EPH concerns, EPH professionals help protect the health and safety of communities affected by hurricanes. These measures prevent the spread of disease and support the overall disaster response and recovery efforts.
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Part 1: Pre-Incident To prepare for hurricane season, it is crucial to familiarize yourself with the role of EPH professionals and challenges they typically face during hurricanes. The typical EPH challenges that can arise during hurricanes and take proactive steps to prepare. This section of the Response Guide provides an overview of the role of EPH professionals and pre-incident actions they can take to enhance readiness for the upcoming hurricane season. Reviewing this Response Guide throughout hurricane season will build muscle memory, confidence, and familiarity with the content. Role of Environmental Public Health The EPH hurricane response role is crucial in protecting community health and safety before, during, and after the event. EPH professionals are key players in mitigating the wide-ranging environmental hazards that hurricanes can create or exacerbate, affecting human health. Before a Hurricane EPH professionals assist in preparedness efforts by assessing potential environmental risks, developing response plans, and educating the public on safety measures. This includes identifying vulnerable infrastructure, such as water treatment facilities or hazardous waste sites, that could pose significant risks if compromised. EPH professionals also develop relationships with key partners prior to the storm and identify opportunities for Memoranda of Understanding (MOUs) with these partners. During a Hurricane EPH professionals play a critical role in hurricane response, but their effectiveness is greatly influenced by the complex relationship between national and state, tribal, local, and territorial (STLT) response systems in the United States. While most agencies follow the National Response Framework (NRF), there is a significant variation in how STLT systems operate, particularly in terms of activation triggers, authority, and autonomy. This variability directly impacts EPH responses to hurricanes. While active response during the storm is limited, EPH professionals often work from Emergency Operations Centers (EOCs) to monitor developing environmental threats and coordinate with other emergency responders, often as a part of Emergency Support Function (ESF) #8. 1 EPH professionals working in hurricane-affected areas should take the following steps: 1. Determine whether the STLT EOC has been activated and identify the appropriate points of contact. 2. Clearly define their roles, reporting requirements, and operating authorities within the national and STLT response structures. 3. Establish communication protocols within the response structure. 4. Understand the decision-making authority for data collection, custody, and release. 5. Familiarize themselves with the STLT procedures for developing and approving public information messages, which is crucial for effective risk communication during hurricane response. 6. Identify the need for establishing or activating MOUs . 7. Be prepared to adapt their approach based on the level of autonomy and the specific incident management structure of the STLT government. 8. Adapt to the challenging and harsh conditions while performing the critical EPH duties to ensure the health and safety of food, water, air, and the environment.
1 Emergency Support Functions vary by jurisdiction. The National ESF #8 is Public Health and Medical Services.
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After a Hurricane EPH professionals are most active after a hurricane. Their roles include the following actions: 1. Conducting rapid EPH assessments to identify immediate risks. 2. Ensuring safe drinking water by testing water sources, implementing boil water advisories (BWA) when necessary, and working to restore safe water systems. 3. Monitoring food safety , especially in areas affected by power outages, and providing guidance on safe food handling and storage. 4. Assessing and mitigating risks from sewage overflows and wastewater treatment system failures . 5. Identifying and addressing hazardous materials (HAZMAT) releases from damaged industrial facilities or flooded households. 6. Implementing vector control measures to prevent outbreaks of mosquito-borne diseases in areas with standing water. 7. Providing guidance on safe cleanup of mold and other biological contaminants in flood-damaged buildings. 8. Monitoring air quality , particularly in areas affected by burning debris or increased generator use. 9. Ensuring proper management and disposal of disaster debris to prevent environmental contamination. 10. Conducting health and safety assessments of emergency shelters and temporary housing . 11. Providing public education on EPH risks and protective measures . 12. Collaborating with other agencies and jurisdictions to coordinate EPH response efforts. 13. Participating in mutual aid agreements , such as the Emergency Management Assistance Compact (EMAC), to share resources, expertise, and personnel across STLT lines when local capabilities are overwhelmed. 14. Ensuring proper credentialing under the National Incident Management System (NIMS) to validate qualifications and authorize specific functions, especially when crossing state lines. 15. Operating within various coordination facilities , such as the Incident Command Post (ICP), EOC, or Joint Information Center (JIC), depending on the scale and phase of the response. Throughout all phases, EPH professionals play a critical role in risk communication by helping to translate complex EPH information into actionable guidance for the public and policymakers. They also contribute to long-term recovery efforts, which assist in building community resilience against future hurricane impacts. The effectiveness of EPH professionals in these roles often depends on their ability to navigate the complex interactions between national and STLT response systems by adapting their approach to the specific governance and incident management structures of the affected area. This includes understanding and utilizing various mutual aid agreements, from international to local levels, and being familiar with the NIMS resource typing system, which categorizes EPH professionals as EPH generalists, specialists, or team leaders. EPH professionals may also be part of specialized EPH Strike Teams, which can be deployed before or after a hurricane through mutual aid agreements like EMAC. These teams provide crucial support to affected jurisdictions, bringing additional expertise and resources to enhance the overall hurricane response and recovery efforts.
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Preparing for Hurricane Season Hurricane season normally runs from June 1st to November 30th in the Atlantic and May 15th to November 30th in the eastern Pacific, but due to climate change, we are seeing hurricane activity outside of this time frame. To prepare for hurricane season, EPH professionals can work proactively with other disaster readiness and response partners to enhance their ability to respond effectively to hurricanes and protect the health and safety of the communities they serve.
What is a hurricane?
Hurricanes (referred to as tropical cyclones or typhoons in other parts of the world) are low- pressure weather systems that rotate. They are characterized by organized thunderstorms and the absence of fronts, which are boundaries separating air masses of various densities. These cyclones are classified based on their maximum sustained surface winds. Those with winds below 39 miles per hour (mph) are called tropical depressions, while those with winds of 39 mph or higher are categorized as tropical storms. Once a storm’s maximum sustained winds reach 74 mph, it is classified as a hurricane. Hurricanes are categorized using the Saffir-Simpson Hurricane Wind Scale , which rates the storms from 1 to 5, based on their maximum sustained winds. A higher category indicates a more significant potential for property damage. Hurricanes typically form in the Atlantic basin, encompassing the Atlantic Ocean, Caribbean Sea, Gulf of Mexico, and eastern North Pacific Ocean. Less frequently, they can also originate in the central North Pacific Ocean. 2
2 What is a hurricane? National Ocean Service, National Oceanic and Atmospheric Administration
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Readiness Actions The following are readiness considerations to review before hurricane season (June 1st): Understand the National Incident Management System (NIMS)/Incident Command System (ICS) as learned in entry-level ICS courses (see Appendix 1-A ). Review national guidelines to ensure understanding of national best practices in hurricane preparedness, response, and recovery. Assess potential EPH risks and identify new community vulnerabilities and threats , such as areas prone to flooding and new facilities or industries that may store or produce hazardous materials (HAZMAT). Gather an adequate supply of resources prior to hurricane season. This includes sampling equipment, communications, and radios. Understand your role in your jurisdiction’s ICS and communicate how you can provide support before, during, and after a hurricane. Coordinate with other local responders to establish a working relationship before hurricane season begins. Develop, update, print, and disseminate educational materials on EPH and risk communication strategies to inform the public about hazards, protective measures, and emergency procedures. Ensure proper functioning and maintenance of environmental monitoring and surveillance systems . Support the assessment of critical facilities and infrastructure to identify vulnerabilities and recommend necessary upgrades or mitigation measures. Identify and assess facilities with HAZMAT , ensuring proper safety and containment plans and measures are in place. Collaborate with emergency management and the lead disaster shelter organizations to list and assess potential shelter locations and temporary housing sites to ensure facilities meet EPH and safety standards. Develop, update, and gain approval for press releases or social media templates addressing common EPH issues and provide these templates to public information officers. Communicate with elected officials and boards of health to determine where risk exposures exist and assess the magnitude of those anticipated risks. Participate in training and exercises to test and refine emergency response plans, protocols, and decision-making processes . Prepping for the Field Before working in the field to respond to a hurricane, whether locally or in collaboration with another jurisdiction, it is crucial to take proactive measures to enhance the safety, effectiveness, and readiness of responding personnel. These initial steps will prepare you to carry out your duties safely and effectively in the hurricane-affected area. 1. Attend briefings about the incident to understand the specific mission objectives, potential hazards, and overall situation on the ground. This information may be available through the Incident Action Plan (IAP) of your state, tribal, local, or territorial (STLT) Emergency Operations Center (EOC). 2. Gather all necessary personal protective equipment (PPE) (e.g., hard hats, safety glasses, hearing protection, gloves, gowns, high-visibility vests). Ensure that the PPE is in good condition and fits properly . Check all expiration dates on equipment and restock as needed. Specific guidance may be found in your Health and Safety Plan . 3. If you are eligible, enroll your cell phone into FirstNet . 4. Identify, print, or prepare existing health communication materials that can be quickly distributed after a storm. 5. Assemble a go-bag (see Attachment 2 ).
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Part 2: In the Field EPH professionals play a critical role in assessing and mitigating potential health risks in the aftermath of a hurricane. Part 2 of this Response Guide is designed to support professionals navigating the unique challenges of post-hurricane EPH. By referencing this section, EPH professionals can ensure they have covered all the necessary bases, from assessing water quality and food safety to monitoring and managing vector-borne diseases. Part 2 provides a step-by-step introduction to the functions outlined in the Environmental Public Health Emergency Preparedness and Response (EPHEPR) framework (see Attachment 1). It also includes a checklist of common tasks and “pro tips” from experienced professionals who have dealt with environmental impacts from hurricanes in the past. The “pro tips” are organized into 3 sections representing essential items, best practices, and national guidelines, standards, and forms resources. Using the “In the Field” section increases EPH professionals’ confidence by giving them the tools and knowledge they need to address complex environmental challenges and protect the health and well-being of disaster survivors in affected communities. This section is designed for use in the field. To make the most of this resource, print the individual issue pages and laminate them for durability. Use them to fill out important information and take notes while responding.
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Functional Areas Click on a colored tile to jump straight to a functional area.
Identify EPH Risks for the Affected Population EPHEPR Function 1
Coordinate EPH Response and Resources EPHEPR Function 2
Assure the Safety and Integrity of Water Systems EPHEPR Function 3
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Assure the Safety and Integrity of Solid Waste/ Debris Management Systems EPHEPR Function 4 Page 34
Assure the Safety of Emergency Shelters EPHEPR Function 6
Assure the Safety and Integrity of Wastewater Systems EPHEPR Function 5
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Assure the Safety and Integrity of Buildings EPHEPR Function 8
Assure the Integrity of Food Supply and Delivery Systems EPHEPR Function 7
Assure the Safety of Indoor/Outdoor Air Quality EPHEPR Function 9
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Provide Vector Surveillance and Control EPHEPR Function 10
Provide EPH Support to Hazardous Material (HAZMAT) Management EPHEPR Function 11
Provide EPH Support to Radiological Management EPHEPR Function 12
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Assure the Safety of Recreational Water EPHEPR Function 13
Conduct Open Water Monitoring EPHEPR Function 14
Assure Effective Environmental Sampling EPHEPR Function 15
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Identify Environmental Public Health Risks for the Affected Population Aligns to EPHEPR Function 1
In the wake of a hurricane, communities face a myriad of EPH threats that can significantly impact human health and well-being. Identifying these EPH risks is crucial for the affected population during and after a hurricane because it allows professionals to develop effective mitigation strategies. Hurricanes can cause widespread disruption to essential infrastructure and environmental systems, which leads to complex and evolving public health challenges. These challenges may include: 1. Contamination of drinking water sources caused by flooding and storm surges 2. Sewage overflows and wastewater treatment system failures 3. Widespread power outages affecting food safety and medical services 4. Accumulation of debris and hazardous materials 5. Increased vector breeding sites in standing water 6. Mold growth in flood-damaged buildings 7. Air quality issues due to damaged industrial facilities or widespread generator usage The tasks within this function are designed to quickly assess these risks, especially for vulnerable populations who may be disproportionately affected. By engaging with the Incident Command System (ICS), EPH professionals contribute vital expertise in forecasting and addressing immediate and future health risks after a hurricane. Effective execution of this function lays the groundwork for all subsequent EPH response activities, ensuring that resources are appropriately allocated and that mitigation efforts are targeted where they are most needed. This proactive approach is essential in protecting public health and supporting community resilience in the face of hurricane-induced environmental challenges. Tasks Conduct a rapid needs assessment to identify immediate EPH risks/needs and match them with existing capabilities. Determine impacts on water systems by implementing a water quality monitoring program to assess the safety of drinking water, recommending regular testing of private water sources, or identifying contaminants and other pollutants in accordance with the Safe Drinking Water Act (SDWA) . Determine the impact to regulated facilities such as retail food establishments, schools, daycares, hospitals, and other institutions, such as jails. Assess historical risks of vector-borne diseases and develop a plan to help control nuisances and pests, often exacerbated by floodwaters, debris, and solid waste. Identify and map potential releases of HAZMAT from sources such as industrial facilities, storage tanks, or transportation accidents in the affected areas. Evaluate the operational condition of key public health infrastructure (drinking water, wastewater, power, etc.). Assess EPH conditions in disaster shelters, with a focus on monitoring medical shelters, shelters for pets, and those accommodating large numbers of individuals with access and functional needs (AFN), chronic health conditions, substance abuse issues, and disabilities. Verify that environmental issues such as sanitation, hygiene, food operations, facility safety, crowding, waste management, and indoor air quality are monitored and documented using tools such as the CDC Shelter Assessment Tool . Identify EPH risks specific to populations with AFN and areas with vulnerable communities. Engage with emergency management and public health officials to forecast potential EPH risks based on changing post-hurricane conditions.
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Coordinate with public health laboratories as appropriate. Develop initial mitigation strategies for identified EPH risks, to be included in the Incident Action Plan (IAP). Design a health monitoring and surveillance program to track potential exposures to HAZMAT among workers and responders. Contribute EPH subject-matter expertise to the Emergency Operations Center (EOC). Coordinate with state, tribal, local, territorial (STLT), and federal agencies and non-governmental organizations (NGOs) to ensure the necessary resources are available for EPH interventions, such as personnel, equipment, supplies, and funding. Continuously monitor and adapt EPH mitigation measures based on emerging risks, changing conditions, and feedback from the affected population.
Pro Tips Must Know Incident Command System (ICS)
Each incident is unique. Environmental public health’s roles within the ICS structure may vary based on the incident’s needs, the jurisdiction, and the specific skill sets of the EPH professionals involved. EPH professionals should be prepared to collaborate across sections and contribute their expertise wherever it is needed in the response effort. Emergency Support Functions (ESFs) vary at the STLT and federal level. In an EOC, EPH may be part of what is federally recognized as ESF #8: Public Health and Medical Services. Often, EPH professionals work within the Operations Section, specifically supporting the Health and Medical Branch. EPH may also contribute to the Planning Section by providing subject- matter expertise for situation reports, 3 developing EPH portions of the IAP, 4 or helping to forecast potential EPH risks. In some cases, an entire EPH Strike Team might be requested and deployed, functioning as a unit within the Operations Section. Vulnerable Population Risks Vulnerable populations may face disproportionate risks during and after hurricanes due to environmental factors and social inequities. EPH professionals should consider preexisting disparities in their communities, cumulative impacts that may arise from hurricane-induced environmental risks, access barriers, and long-term consequences that could potentially worsen existing health disparities.
3 During an incident, Situation Reports (SitReps), provide information on significant events related to the incident, including a description of the current situation, critical issues, emergency management resources, community lifelines, and upcoming planning activities. This information is often shared via an ICS-201 Form - Incident Briefing . The Incident Action Plan (IAP), which is developed during each operational period, is the result of a series of meetings and briefings that follow a specific sequence known as the Operational Period Planning Cycle, or “Planning P.” This cycle is visually represented by a diagram that illustrates the order and connections between the various meetings, work sessions, and briefings that occur throughout the planning process. 4
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Best Practices Responder Resilience Pre-Deployment
Know behavioral health impacts Plan coping and support strategies Practice healthy stress management and self-care daily During Deployment Seek support Take breaks and avoid overworking Exercise regularly and maintain healthy eating and sleep routines Rotate job tasks before stress impacts performance Post-Deployment Know behavioral health impacts Get screened and use support resources Use pre-identified self-care and stress management strategies
Resources National Guidance and Standards
An Introduction to the National Incident Management System Basic Incident Command System for Initial Response, ICS-200 Best Practices and Lessons Learned in Deploying Private Sector and Volunteer Resources Through EMAC CDC All-Hazards Preparedness Guide CDC Preparedness Response Capabilities Community Assessment for Public Health Emergency Response Toolkit (CASPER) Draft Environmental Public Health Emergency Preparedness and Response Capability and Functions | NEHA Emergency Operations Center How-To Quick Reference Guide Environmental Health Training in Emergency Response (EHTER) | Environmental Health FEMA Support Function Annexes Hurricane and Flood Mitigation Handbook for Public Facilities ICS Organizational Structure and Elements
Incident Action Planning Process Incident Action Planning Guide Introduction to the Incident Command System, ICS 100 National Incident Management System National Response Framework National Response Framework, An Introduction Forms Disaster Assessment, Response, and Recovery Checklist Disaster-Specific Memorandum of Understanding ICS Resource Center ICS Forms Descriptions ICS 201 - Incident Briefing
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Coordinate Environmental Public Health Response and Resources Aligns to EPHEPR Function 2
In the aftermath of a hurricane, coordinating the environmental public health response is crucial for protecting a community’s health and safety. This function involves efficiently allocating resources, aligning efforts across agencies, and maintaining clear communication channels to address the complex and evolving environmental public health challenges that arise in hurricane-impacted areas. Key aspects of this function include: 1. Resource Management: Rapidly assessing and deploying environmental public health personnel, equipment, and supplies to areas of greatest need, which may include flood-damaged neighborhoods, compromised water systems, or areas with extensive debris. 2. Interagency Collaboration: Working seamlessly with emergency management, public health departments, utilities, and other relevant sectors to ensure a cohesive environmental public health response to hurricane- related hazards. 3. Risk Assessment and Mitigation: Continuously identifying and addressing environmental public health risks specific to the hurricane’s aftermath, such as water contamination, foodborne illness outbreaks, vector-borne diseases, and mold growth in flooded and flood-damaged structures. 4. Information Sharing: Establishing robust communication networks to share timely, accurate information about environmental public health risks and response activities among all stakeholders, including response personnel and the public. 5. Incident Command System (ICS) Integration: Actively participating in the ICS structure to ensure environmental public health concerns are fully integrated into all phases of hurricane response and recovery planning. 6. Responder Safety: Identifying and mitigating health and safety risks for emergency response personnel working in potentially hazardous post-hurricane environments. Tasks Conduct rapid assessments of EPH needs in hurricane-affected areas. Prioritize and deploy EPH personnel, equipment, and supplies to high-risk areas (e.g., flooded neighborhoods). Maintain an up-to-date inventory of available EPH resources and their locations. Coordinate with logistics teams to ensure timely resupply of essential EPH equipment and materials. Establish and maintain contact with key partners (e.g., emergency management, public health departments, utilities, etc.). Participate in regular interagency briefings and planning sessions. Share EPH findings and concerns with relevant agencies to inform their operations. Coordinate joint field assessments with other agencies when appropriate. Conduct ongoing EPH hazard assessments in affected areas. Regularly update Incident Command and Public Information Officers (PIOs) on EPH risks and activities. Contribute to the development of public health advisories and risk communication messages. Maintain clear documentation of EPH activities, findings, and recommendations.
Participate in compilation and dissemination of daily situation reports. Assign EPH liaisons to relevant ICS sections (e.g., Operations, Planning). Attend and contribute to ICS planning meetings and operational briefings. Ensure EPH objectives are incorporated into Incident Action Plans (IAPs). Provide input on EPH resource needs for short-term and long-term recovery planning. Conduct safety briefings for EPH field personnel before deployment. Ensure all EPH staff have appropriate PPE for field work.
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Monitor and report on environmental conditions that may pose risks to responders (e.g., heat, contaminated floodwaters). Implement a buddy system for EPH field teams working in potentially hazardous areas. Assist in organizing and staffing community information centers or health clinics. Provide on-site guidance to residents on safe cleanup procedures and health protection measures. Collaborate with community leaders to address specific EPH concerns in their areas. Implement a system for collecting and managing EPH field data. Produce regular reports on EPH activities, findings, and recommendations for leadership. Pro Tips Must Know Key Partners in Hurricane Response Environmental public health professionals must be familiar with the following partners and stakeholders typically involved in hurricane response: Emergency Management Agencies: State, tribal, local, territorial (STLT), and federal agencies (e.g., Federal Emergency Management Agency, or FEMA) that coordinate overall disaster response efforts Public Health Departments: STLT health departments that oversee public health measures and disease surveillance Utility Companies: Water, power, and gas providers crucial for infrastructure restoration Healthcare Facilities: Hospitals, clinics, and long-term care facilities that may need support Environmental Protection Agencies: STLT agencies responsible for environmental regulations and hazardous waste management Law Enforcement and Fire Departments: First responders who assist with evacuations and safety measures Transportation Departments: Responsible for road clearance and transportation infrastructure Housing Authorities: Involved in shelter operations and temporary housing solutions Non-governmental Organizations (NGOs): Organizations, such as the American Red Cross, that provide various support services Community Organizations: Local groups that can assist with outreach and support to vulnerable populations Meteorological Services: Provide ongoing weather information crucial for response planning Waste Management Agencies: Essential for debris removal and proper waste disposal Vector Control Districts: Help manage increased pest and vector issues post-hurricane Mental Health Services: Provide psychological support to affected communities and responders Educational Institutions: May serve as shelters or resource centers Foundation of Risk Communication 5 When developing communication strategies and messages in high-stress situations, remember that when people are concerned, stressed, or upset, they: want to know that you care before they care what you know have difficulty hearing, understanding, and remembering information focus most on what they hear first focus more on the negative than on the positive experience wider gaps between risk perceptions and reality
5 Adapted from Dr. Vincent Covello, Director of the Center for Risk Communication
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Crisis and Emergency Risk Communication The CDC’s Crisis and Emergency Risk Communication (CERC) manual is based on psychological and communication sciences, studies in issues management, and practical lessons learned from emergency responses. Key principles of CERC include: Be first Promote action Be right Be credible Show empathy Show respect Involve stakeholders Plan and evaluate Misinformation, Disinformation, and Malinformation Misinformation is the spread of false information without the intent to mislead. Disinformation is false information that is intentionally designed or spread with full knowledge of it being false (i.e., information has been manipulated). It is intended to deceive and cause harm. Malinformation is a term for information based on fact but removed from its original context to mislead, harm, or manipulate. Malinformation is true, but sharing it is meant to cause harm. EPH professionals might struggle to combat false information, address misconceptions, and ensure that accurate information reaches the public to prevent panic and misinformation-driven actions. When distributing information to the public, always try to be a credible source and stay ahead of misinformation, especially during a crisis. Safety Considerations for Field Work in Post-Hurricane Conditions 1. Always wear appropriate personal protective equipment (PPE). 2. When possible, work in pairs or teams. Maintain regular communications with team members. 3. Be alert to hazards (i.e., downed power lines, unstable structures, submerged objects, and displaced wildlife). 4. Avoid wading through floodwaters. 5. Assume all floodwater is contaminated. 6. Practice proper decontamination procedures after fieldwork, including hand hygiene. 7. Prevent heat stress by staying hydrated and taking regular breaks in shaded or cool areas. 8. Ensure immunizations (e.g., tetanus and hepatitis A) are up to date. 9. Use vehicles appropriate for specific conditions. 10. Carry emergency supplies. 11. Carry a fully charged mobile phone and bring backup power sources. 12. Know emergency contact numbers and evacuation routes. 13. Conduct safety briefings at the start of each workday to review hazards and protocols.
14. Adhere to work/rest cycles to prevent fatigue-related accidents. 15. Be aware of the signs of stress and trauma in yourself and colleagues.
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Hurricane Response Guide for Environmental Public Health Professionals
Mental Health Support In the aftermath of a hurricane, staff may face challenging situations involving extensive death and destruction. The impact can extend to their personal lives, affecting their property and loved ones. Organizations must prioritize staff well-being, allowing time off to address personal needs. Staff should be prepared to interact with a grieving community and be aware of available mental health resources for both themselves and community members. The depression and despondency often common in shelters and recovery centers may necessitate the involvement of mental health professionals. Supervisors must be vigilant for signs of overwork among staff, particularly those compensating for personal losses or empathizing with the affected community. Policies should be in place to monitor staff well-being and direct them to appropriate resources. Larger departments should consider offering group or peer counseling sessions, with individual support readily available. Management must take staff feedback seriously and be proactive in addressing requests for assistance. EPH staff should be trained to recognize situations requiring mental health intervention and know how to make appropriate referrals. Neglecting the mental well-being of staff during a disaster response can lead to further complications. It is crucial to plan ahead and establish contacts with relevant agencies to ensure prompt access to help and support when needed. Best Practices Developing Messaging Five Questions to Help Develop Messages 1. Who are your stakeholders? 2. How do they like to receive important information? 3. What do you want to tell your stakeholders? 4. What do they want to know? 5. What is likely to be misunderstood? Message Mapping Message mapping is a simple technique for organizing information into key messages designed and tailored to address stakeholders’ specific issues and concerns. Steps: 1. Identify the stakeholder and their question or concern at the top. 2. Select three key messages to address each stakeholder’s issue or concern. Consider answering these three questions: What happened? What is the health risk? What actions can they take? 3. Add supporting facts (proof) under each key message.
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Hurricane Response Guide for Environmental Public Health Professionals
Stakeholder: Question or Concern Key Message 1
Key Message 2
Key Message 3
Supporting Fact 1.1
Supporting Fact 2.1
Supporting Fact 3.1
Supporting Fact 1.2
Supporting Fact 2.2
Supporting Fact 3.2
Supporting Fact 1.3
Supporting Fact 2.3
Supporting Fact 3.3
Getting Your Message Out Bridging Technique
In a high-pressure situation, such as a TV interview, bridging can be a helpful technique. Bridging is a technique where you first acknowledge the difficult question and then transition to communicating the key message you want to deliver. Some examples include: “That’s an important aspect to consider, and what I want to emphasize is...” “I understand your concern, and what we know right now is…” “These are challenging circumstances, and it comes back to...”
Resources CDC Publications on Demand CERC Engaging the Community with Credibility CERC Template for News Release
Communication Resources | Natural Disasters | CDC Communicating Risk in Public Health Emergencies Crisis Emergency Risk Communication Plan Checklist Crisis Emergency Risk Communication Checklist: Basic tenets of emergency risk communication Heat-Related Illnesses and First Aid Message Development for Communication Natural Disasters and Severe Weather | Natural Disasters | CDC Public Service Announcements (PSAs) for Disasters | Natural Disasters | CDC Sample Message Planning
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Hurricane Response Guide for Environmental Public Health Professionals
Assure the Safety and Integrity of Water Systems Aligns to EPHEPR Function 3
Hurricanes pose significant threats to water systems, potentially compromising the safety and availability of drinking water for affected populations. The powerful winds, storm surge, and flooding associated with hurricanes can damage water infrastructure, contaminate water sources, and disrupt water treatment and distribution systems. Key hurricane-related challenges to water systems include: 1. Physical damage to water treatment plants, distribution pipes, and pumping stations 2. Contamination of water sources with flood waters, sewage, or chemical pollutants 3. Power outages affecting water treatment and distribution 4. Saltwater intrusion into freshwater sources in coastal areas 5. Increased demand for safe water due to disruptions in normal supply chains 6. Disruptions to water at restaurants, retail food establishments, schools, childcare, healthcare facilities and other institutions like jails or correctional facilities Tasks Assess water system infrastructure, including treatment plants, distribution networks, storage tanks, and pump stations, for damage, leaks, or potential contamination sources due to flooding, power outages, or debris. Identify potential resources to conduct water quality testing (e.g., local health department environmental labs, private labs, or state, tribal, local, and territorial (STLT) or federal agencies). Implement a water quality testing program to monitor for contaminants such as bacteria, viruses, chemicals (Maximum Contaminant Levels (MCLs) from the Safe Drinking Water Act (SDWA), and debris in water sources, treatment facilities, and distribution systems. Advise on proper water system disinfection by increasing chlorine levels or using alternative disinfectants as needed. Issue boil water advisories (BWAs) or do not drink/use orders if water quality is not confirmed safe, providing clear instructions to the public (see CDC Drinking Water Advisory Communication Toolkit ). Assess the status of power supplies and backup generators for water treatment plants and pumping stations. Assist in identifying damaged equipment to restore the water system to full operational capacity. Identify key users (e.g., hospitals, pre-planned shelter locations, long-term care facilities, dialysis centers) that may have impacted water systems. Establish communication and coordination with emergency management agencies, public health authorities, and other stakeholders to coordinate a response and ensure accurate public information. Assess risks and coordinate with restaurants, grocery stores, and other retail food facilities that may not be able to operate due to water safety issues. Identify and establish alternative water sources, such as bottled water distribution sites or temporary treatment systems, if necessary. Coordinate the removal of debris or potential contamination sources from water sources, treatment facilities, and distribution systems to prevent further contamination. Assess and address the needs of private well owners, who may face unique challenges after a hurricane. Conduct long-term monitoring of water quality, as some contaminants may not be immediately apparent. Coordinate with local utilities and government agencies for system repairs and restoration. Educate the public on safe water practices during the emergency, including proper storage, treatment, and use of water from alternative sources.
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