The Role of Emergency Incident Type in Identifying First Responders' Health Exposure Risks

Fire-based emergency management service (EMS) personnel are dispatched to various incidents daily, many of which have unique occupational risks. To fully understand the variability of incident types and how to best prepare and respond, an exploration of the U.S. coding system of incident types is necessary. This study uses potential exposure to SARS-CoV-2 as a case example to understand if and how coding categories for incident call types may be updated to improve data standardization and emergency response decision making. Researchers received emergency response incident data generated by three fire department computer-aided dispatch (CAD) systems between March and September 2020. Each incident was labeled EMS, Fire, or Other. Of the 162,766 incidents, approximately 8.1% (n=13,144) noted potential SARS-CoV-2 exposure within their narrative descriptions of which 86.3% were coded as EMS, 9.9% as Fire, and 3.9% as Other. To assess coding variability across incident types, researchers used the original 3-incident type variable and a new 5-incident type variable reassigned by researchers into EMS, Fire, Other, Hazmat, and Motor Vehicle. Logit regressions compared differences in potential exposure using the 3- and 5-incident type variables. When evaluating the 3-incident type variable, those responding to a Fire versus an EMS incident were 84% less likely to be associated with potential exposure to SARS-CoV-2. For the 5-incident type variable, those responding to Fire incidents were 77% less likely to be associated with a potential exposure than those responding to EMS incidents. Changes in potential exposure between the 3- and 5-incident type models show the need to understand how incident types are assigned. This demonstrates the need for data standardization to accurately categorize incident types to improve emergency preparedness and response. Results have implications for incident type coding at fire department municipality and national levels.

Lessons Learned from the Development and Demonstration of a PPE Inventory Monitoring System for US Hospitals.

An international system should be established to support personal protective equipment (PPE) inventory monitoring, particularly within the healthcare industry. In this article, the authors discuss the development and 15-week deployment of a proof-of-concept prototype that included the use of a Healthcare Trust Data Platform to secure and transmit PPE-related data. Seventy-eight hospitals participated, including 66 large hospital systems, 11 medium-sized hospital systems, and a single hospital. Hospitals reported near-daily inventory information for N95 respirators, surgical masks, and face shields, ultimately providing 159 different PPE model numbers. Researchers cross-checked the data to ensure the PPE could be accurately identified. In cases where the model number was inaccurately reported, researchers corrected the numbers whenever possible. Of the PPE model numbers reported, 74.2% were verified-60.5% of N95 respirators, 40.0% of face shields, and 84.0% of surgical masks. The authors discuss the need to standardize how PPE is reported, possible aspects of a PPE data standard, and standards groups who may assist with this effort. Having such PPE data standards would enable better communication across hospital systems and assist in emergency preparedness efforts during pandemics or natural disasters.

Applying the Social Vulnerability Index as a Leading Indicator to Protect Fire-Based Emergency Medical Service Responders' Health.

During emergencies, areas with higher social vulnerability experience an increased risk for negative health outcomes. However, research has not extrapolated this concept to understand how the workers who respond to these areas may be affected. Researchers from the National Institute for Occupational Safety and Health (NIOSH) merged approximately 160,000 emergency response calls received from three fire departments during the COVID-19 pandemic with the CDC's publicly available Social Vulnerability Index (SVI) to examine the utility of SVI as a leading indicator of occupational health and safety risks. Multiple regressions, binomial logit models, and relative weights analyses were used to answer the research questions. Researchers found that higher social vulnerability on household composition, minority/language, and housing/transportation increase the risk of first responders' exposure to SARS-CoV-2. Higher socioeconomic, household, and minority vulnerability were significantly associated with response calls that required emergency treatment and transport in comparison to fire-related or other calls that are also managed by fire departments. These results have implications for more strategic emergency response planning during the COVID-19 pandemic, as well as improving Total Worker Health® and future of work initiatives at the worker and workplace levels within the fire service industry.