85 - Chemical, Biological, Radiological, and Nuclear Quarantine

Quarantine is a public health measure used to control the spread of contagious disease or environmental toxins within a population. Quarantine can be a helpful tactic in the setting of chemical, biological, radiological, or nuclear disasters. The success of quarantine demands tailoring preventative measures to the specific features of a given exposure. The criteria for initiating quarantine is clearly delineated in federal, state, and local laws, regulations, and policies. Successful quarantine and mitigation of risk depends on a complex interplay between first responders, affected individuals, and local, state, and federal services and authorities. As was seen in the current COVID-19 pandemic, there are many potential pitfalls that can be encountered during initiation and sustaining a quarantine effort.

FASTER Project Technologies: A Reality of the Future

FASTER is an H2020 research project, within the European framework, in which Urban Search and Rescue (USAR) teams, in addition to other first responders, conduct an on-theground assessment of latest support technologies. These technologies are to be used in victim rescue response situations well as for coordination and safety procedures between disaster responders in diverse types of catastrophe scenarios. The tools have been developed by technical partners of the FASTER project committee and, with the aim of assessing the tools, two pilot exercises were conducted in collapsed buildings in Spain, simulating the impact of two earthquakes. The objective is to integrate and adapt the FASTER tools in initial interventions during the search for and rescue of victims. The focus is placed on information gathering in the disaster area, among other aspects. Simulation exercises were conducted in real locations involving collapsed buildings using drones, unmanned vehicles, canine wearables, a mobile command centre, a weather station and social network analysis, with real people acting the part of victims together with human dummy figures. Through these exercises, an assessment was carried out of the acceptability, ease of use, applicability, efficiency, and effectiveness of FASTER technology. The outbreak of the COVID-19 pandemic during the implementation of various pilot exercises was a setback that led us to introduce a USAR Camp deployment procedure involving preventive anti-COVID-19 measures, in accordance with the recommendations of official organisations such as INSARAG and the WHO. © 2023 by Nova Science Publishers, Inc. All rights reserved.

Merely mortal: A quantitative examination of the dehumanization of first responders

Background: While understaffing and work-related stress are not unusual within first responder professions, the past few years have added additional strain. COVID-19, political and civil unrest, and economic downturn have stretched the first responder workforce thinner than ever, contributing to a reduction in the workforce through death, early retirement, attrition, or decreased vocational effectiveness. Unfortunately, public stereotypes coupled with the tenets of first responder culture have done little to support those who serve. Public perception often involves polarized stereotypes about first responders (e.g., good guys or bad guys, heroes or villains), and first responder culture encourages a machine-like demeanor. The imagery of heroes, villains, and machines is indicative of dehumanization, or denial of some aspect(s) of humanity. The purpose of this study was to examine how first responders' perceptions of dehumanization (meta-dehumanization) relate to workforce threats including suicidality, burnout, and decreased self-efficacy. Methodology: A total of 211 first responders from the US and Canada participated in this study by completing two measures of meta-dehumanization, the Suicide Behaviors Questionnaire-Revised, the Burnout subscale of the Professional Quality of Life Scale, and the General Self-Efficacy Scale. Analyses included Pearson product-moment correlation, ANOVAs, and hierarchical regression analyses. Results: Statistically significant relationships were found between meta-dehumanization for each of the three workforce threats when controlling for time in the profession. Results from ancillary analyses indicated that these relationships continued to be statistically significant even after controlling for country of residence (US or Canada). (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Mental health impacts on other essential workers

The stressors, and subsequent mental health sequelae, associated with being a part of the frontline, patient-facing healthcare response to the COVID-19 pandemic have been clear from the very start of the pandemic. However, a broader group of workers, perhaps typically not considered to be part of the frontlines of a public health emergency response, have also been deemed essential to the response to the COVID-19 pandemic. Protective service workers, including law enforcement and emergency services, those working in food production, processing, and dietetics, maintenance and environmental service workers, and laboratory workers are among those unable to work from home, yet potentially unaccustomed to the stressors of being an essential workers during a public health emergency. Changes to many systems-including health insurance and other benefits, provision of personal protective equipment, and prioritizations for vaccinations and other pharmaceutical and nonpharmaceutical interventions-are needed going forward to retain and protect essential workers during future public health emergencies. © 2023 The authors.

PTSD and Partial PTSD among First Responders One and Five Years after the Paris Terror Attacks in November 2015.

Following the Paris terror attacks in November 2015, a large number of first responders (FR) were mobilized and consequently were at risk of developing posttraumatic stress disorder (PTSD). Based on the ESPA 13 November survey, the objectives of this study were to 1) describe the prevalence of PTSD and partial PTSD in FR five years after the attacks, 2) describe the changes in PTSD and partial PTSD from one to five years after the attacks, and 3) examine factors associated with PTSD and partial PTSD five years after the attacks. Data were collected using an online questionnaire. PTSD and partial PTSD were measured using the Post-Traumatic Stress Disorder Checklist based on the DSM-5 (PCL-5). Gender, age, responder category, education level, exposure, mental health history, history of traumatic events, training, social support, concern about the COVID-19 epidemic, and somatic problems present after the attacks were all analyzed as potential factors associated with PTSD and partial PTSD using multinomial logistic regression. A total of 428 FR were included 5 years after the attacks, of which 258 had participated also 1 year after the attacks. Five years after the attacks, the prevalence of PTSD and partial PTSD were 8.6% and 22%, respectively. Presence of somatic problems after the attacks were associated with PTSD. Involvement in dangerous crime scenes was associated with a higher risk of partial PTSD. No awareness of psychological risks in the context of professional activity through specific training was associated with partial PTSD, in particular among participants aged 45 years or more. To mitigate PTSD for FR, monitoring mental health symptoms, providing mental health education, and providing treatment may be needed for several years after the attacks.

The impact of COVID-19 on first responders in the United States of America

Purpose: This project specifically aims to examine (1) the individual impact of coronavirus disease 2019 (COVID-19) on first responders, (2) the organizational impact of COVID-19 on first response agencies and (3) policy and organizational response and support efforts to mitigate potentially harmful effects of the pandemic. Design/methodology/approach: The authors' conducted a mixed-methods analysis, including a review of secondary sources (e.g. government documents, organizational policies and news pieces), state-level policies, encompassing surveys, in-depth semi-structured interviews and PhotoVoice focus groups. Findings: COVID-19 compounded many of the inherent risks facing first responders and added new stressors. First responders assumed added responsibilities during the pandemic which increased workloads, job-related stress, burnout, distance from the community and first responders' feelings of frustration. Even with personal protective equipment (PPE), first responders faced greater exposure to individuals with COVID-19 and were primarily concerned with transmitting the virus to family members, or other members of the first responders' support networks. State-level COVID-19 policies that were geared toward first responders aimed to improve the first responders' personal lives outside of work and mitigate burnout within the profession. First response agencies adapted to the pandemic by implementing a wide range of measures. Practical implications: First responders also identified several weaknesses in the first responders' agencies' approach to the pandemic. To prepare for the next public health emergency, first response agencies should proactively train employees, build up the first responders' supplies of equipment and PPE, implement policies to strengthen their workforce (e.g. increase hiring for understaffed positions, reduce turnover and mitigate role abandonment), allow for greater employee autonomy, improve communication between leaders and employees and prioritize employees' mental health, as well as other factors relating to departments' informal culture. Originality/value: This is one of the largest studies conducted on three types of first responders (police officers, fire firefighters, emergency medical technicians (EMTs) and paramedics) across the United States of America during a public health crisis. © 2023, Emerald Publishing Limited.

Interplay between Safety Climate and Emotional Exhaustion: Effects on First Responders' Safety Behavior and Wellbeing Over Time.

Various job demands continuously threaten Emergency Medical Service (EMS) first responders' safety and wellbeing. Drawing on Job Demands-Resources Theory, the present study examines the effects of the organizational context-safety climate-and the psychological context-emotional exhaustion-on safety behaviors and wellbeing over time. We tested our hypotheses in a longitudinal study of 208 EMS first responders nested within 45 stations from three fire departments in US metropolitan areas over 6 months during the beginning of the COVID-19 pandemic. Multilevel modeling showed that the relationship between safety climate and safety compliance behaviors can be attenuated when EMS first responders experience high emotional exhaustion. Emotional exhaustion was also negatively associated with morale while safety climate was positively associated with morale. Additionally, EMS first responders experienced increased depression when their emotional exhaustion levels were high. Higher safety climate was associated with decreased depression when emotional exhaustion was within a low-to-medium range. Higher safety climate was also associated with lower absolute levels of depression across the entire range of emotional exhaustion. These findings suggest that promoting safety climate and mitigating emotional exhaustion can augment EMS first responders' safety behaviors and wellbeing.].

No fear: Willingness of smartphone activated first responders to assist with cardiac arrest during the COVID-19 pandemic.

Aim: To understand the fear and willingness to respond of smartphone activated first responders during the COVID-19 pandemic. Methods: We invited smartphone activated first responders registered with the GoodSAM application in Victoria, Australia to take part in an online survey in November 2020. We assessed willingness to respond to an alert and provide CPR during the pandemic and administered the Fear of COVID-19 Scale questionnaire. Regression analysis was conducted to investigate associations between occupation, clinical training, and years of clinical experience with willingness to respond and fear of COVID-19. Results: The survey response rate was 5.1%. Responders (n = 348) had a median age (interquartile range) of 46 years (33-55). Most (67%) were aged 30-59 years and 43% were female. Responders spanned several occupations including paramedics (12.6%), registered nurses (14.7%), and non-clinical individuals (21.8%). Most (92%) reported they would feel comfortable responding to a GoodSAM alert during the pandemic. Almost all (>95%) reported they would provide CPR. About 20% reported being afraid of COVID-19 but only 3.2% reported they had a high-level of fear of COVID-19. The odds of paramedics being willing to respond to an alert was reduced by 73% during the pandemic (OR 0.27, 95% CI 0.11 to 0.69). No other associations were found with willingness or fear of COVID-19. Conclusion: Although willingness was high and fear of COVID-19 was low, some smartphone activated first responders were less willing to respond to an alert during the pandemic. These findings may inform future pandemic planning and decision-making around pausing first-responder programs.

Reinfection With Severe Acute Respiratory Syndrome Coronavirus 2 Among Previously Infected Healthcare Personnel and First Responders.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus testing among first responders and healthcare personnel who participated in a May 2020-August 2020 serosurvey that assessed spike protein antibodies provided an opportunity to assess reinfection. METHODS: Serology survey data were merged with virus testing results from Rhode Island (1 March 2020-17 February 2021) and New York City (10 March 2020-14 December 2020). Participants with a positive virus test ≥14 days before their serology test were included. Reinfection was defined as a second positive SARS-CoV-2 test ≥90 days after the first positive test. The association between serostatus and reinfection was assessed with a proportional hazards model. RESULTS: Among 1572 previously infected persons, 40 (2.5%) were reinfected. Reinfection differed by serostatus: 8.4% among seronegative vs 1.9% among seropositive participants (P < .0001). Most reinfections occurred among Rhode Island nursing home and corrections personnel (n = 30) who were most frequently tested (mean 30.3 tests vs 4.6 for other Rhode Island and 2.3 for New York City participants). The adjusted hazard ratio (aHR) for reinfection in seropositive vs seronegative persons was 0.41 (95% confidence interval [CI], .20-.81). Exposure to a household member with coronavirus disease 2019 (COVID-19) before the serosurvey was also protective (aHR, 0.34; 95% CI, .13-.89). CONCLUSIONS: Reinfections were uncommon among previously infected persons over a 9-month period that preceded widespread variant circulation. Seropositivity decreased reinfection risk. Lower reinfection risk associated with exposure to a household member with COVID-19 may reflect subsequently reduced household transmission.

Trauma mitigation for the workforce: A conceptual framework applied in COVID-19 pandemic conditions

The sudden and protracted emergency stemming from the coronavirus disease-2019 (COVID-19) pandemic presents potential exposures, or exacerbations, of psychological trauma to workforces. Organizationally significant traumatic stress warrants the trauma-informed attention of emergency managers wishing to protect the well-being of responders and prevent performance breakdowns. This study focuses on interventions that can be applied at the organizational level without the need for specially trained clinicians. We first provide a rapid review of design principles intended to provide safe, ethical, and efficacious interventions that utilize informational and social learning principles. Next, we present a conceptual framework, drawing from the disaster management and clinical trauma evidence base, targeted to build proactive workplace programs for trauma mitigation. Duty of care and shared responsibility are discussed as a way to balance obligations and burdens of operating in milieus characterized by psychological trauma. Assuming that clinically significant trauma is handled by established systems of mental healthcare, the five case studies in this study demonstrate how empirical findings support program elements to address subclinical trauma in emergency managers and responders across sectors. © 2022 Weston Medical Publishing. All rights reserved.

Public health emergencies: Case studies, competencies, and essential services of public health

Public Health Emergencies provides a current overview of public health emergency preparedness and response principles with case studies highlighting lessons learned from recent natural and man-made disasters and emergencies. Designed for graduate and advanced undergraduate public health students, this book utilizes the 10 essential services of public health as performance standards and foundational competencies from the Council on Education for Public Health to assess public health systems. It emphasizes the roles and responsibilities of public health careers in state and local health departments as well as other institutions and clarifies their importance during health-related emergencies in the community. Written by prominent experts, including health professionals and leaders on the frontlines, this textbook provides the framework and lessons for understanding the public health implications of disasters, emergencies, and other catastrophic events, stressing applied understanding for students interested in pursuing public health preparedness roles. Practical in its approach, Part One begins with an introduction to the fundamentals of public health emergency preparedness with chapters on community readiness, all-hazards preparedness design, disaster risk assessments, and emergency operation plans. Part Two covers a range of public health emergency events, including hurricanes, tornadoes, earthquakes, disease outbreaks and pandemics, accidents and chemical contamination, nuclear and radiological hazards, extreme heat events, and water supply hazards. The final part addresses special considerations, such as how the law serves as a foundation to public health actions;preparedness considerations for persons with disabilities, access, and functional needs;children and disasters;and a chapter evaluating emerging and evolving threats. Throughout, chapters convey the roles of front-line, supervisory, and leadership personnel of the many stakeholders involved in preparedness, response, and recovery efforts to demonstrate decision-making in action. © 2022 Springer Publishing Company, LLC.

A heuristic investigation of private ambulance paramedics and EMTs

This study was a qualitative study that used the heuristic model to investigate the life experiences of private ambulance paramedics and EMT personnel. The study has clinical relevance to mental health practitioners who may treat individuals from this profession, programmatic relevance to managers and supervisors of private ambulance companies, as well as the ability to increase awareness and sensitivity of this group among the general public. Little information was present in the professional literature about the experience of private ambulance paramedics and EMTs, pointing to the need for this study. This study reviewed the limited literature that pertained to this group. Specifically, it addressed the long history of paramedics and EMTs;the inherent role of stress, anxiety, and PTSD associated with the job;and the role of adaptive and maladaptive coping in job stress. It outlined the differences between the term first responder (typically defined as police and firefighters) and paramedics/EMT personnel. This study explored the lived experience of 12 paramedic/EMT personnel using a modified heuristic model in order to identify major themes that cut across the co-researchers. The major themes identified were: Altruism, Coping, Psychological Distress, COVID-19/SARS-CoV-2, Camaraderie, and Preparation. These themes were derived from thematic analysis and displayed in quotes from co-researchers as examples. Included are three exemplary portraits, a composite description of all themes, all co-researchers, and a creative synthesis. The study continued with a discussion of the implications of the findings to members of this group, clinicians who may have come in professional contact with these individuals, and recommendations to managers and supervisors of ambulance companies. Limitations and direction for future research are also described. The study concludes with personal reflections of the research and process. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Mental Disorder Symptoms and the Relationship with Resilience among Paramedics in a Single Canadian Site.

There is growing recognition in research and policy of a mental health crisis among Canada's paramedics; however, despite this, epidemiological surveillance of the problem is in its infancy. Just weeks before the emergence of the COVID-19 pandemic, we surveyed paramedics from a single, large, urban paramedic service in Ontario, Canada to assess for symptom clusters consistent with post-traumatic stress disorder (PTSD), major depressive disorder, and generalized anxiety disorder and to identify potential risk factors for each. In total, we received 589 completed surveys (97% completion rate) and found that 11% screened positive for PTSD, 15% screened positive for major depressive disorder, and 15% screened positive for generalized anxiety disorder, with one in four active-duty paramedics screening positive for any of the three as recently as February 2020. In adjusted analyses, the risk of a positive screen varied as a function of employment classification, gender, self-reported resilience, and previous experience as a member of the service's peer support team. Our findings support the position that paramedics screen positive for mental disorders at high rates-a problem likely to have worsened since the onset of the COVID-19 pandemic. We echo the calls of researchers and policymakers for urgent action to support paramedic mental health in Canada.

Specialized Training on Sulphur Fire Fighting - Competency Enhancement

Multiple incidents in the Sulphur Handling facility in the past and significant findings from the investigations revealed the need for competency enhancement of employees and Central Fire Brigade team in terms of firefighting with specific reference to Sulphur fires. With immense support and leadership commitment, we focused to enhance the competency level of employees and Contractors those who are identified as first responders. We have undergone multilevel search to provide Sulphur firefighting techniques and concluded with a specialized third party training with an intensive core idea to conduct the training utilizing the firefighting equipment's and facilities available within the plant to make it lively and specific to the work environment. - 1st Time Specialized Sulphur Fire Fighting Training in ADNOC Group of Companies. - Utilizing Plant Assets and Real Time Scenarios - Switch from Conventional methods to Modern techniques. - Theory & Practical - COVID 19 compliance - Knowledge sharing with other Operating Companies. © Copyright 2021, Society of Petroleum Engineers

Pandemic Experience of First Responders: Fear, Frustration, and Stress.

Police officers, firefighters, and paramedics are on the front lines of crises and emergencies, placing them at high risk of COVID-19 infection. A deeper understanding of the challenges facing first responders during the COVID-19 pandemic is necessary to better support this important workforce. We conducted semi-structured interviews with 21 first responders during the COVID-19 pandemic, asking about the impact of COVID-19. Data collected from our study interviews revealed that, despite large numbers of COVID-19 infections among the staff of police and fire departments, some-but not all-first responders were concerned about COVID-19. A similar divide existed within this group regarding whether or not to receive a COVID-19 vaccination. Many first responders reported frustration over COVID-19 information because of inconsistencies across sources, misinformation on social media, and the impact of politics. In addition, first responders described increased stress due to the COVID-19 pandemic caused by factors such as the fear of COVID exposure during emergency responses, concerns about infecting family members, and frustration surrounding new work policies. Our findings provide insight into the impact of COVID-19 on first responders and highlight the importance of providing resources for education about COVID-19 risks and vaccination, as well as for addressing first responders' mental health and well-being.

The principal as first responder: Principals' perceptions on emergency preparedness training in California public schools

There have been numerous crisis incidents on school campuses throughout the United States, including shootings, natural disasters, domestic terrorist threats, and medical emergencies (FEMA, 2016). In 2020, with the global community at its highest state of alert, and with the consequent effect on millions of educators, students, and their families, emergency preparedness took center stage in the United States and its public schools. In response to COVID-19, the level of urgency prompted a focus on the state of emergency preparedness in the nation's schools. Emergencies are not limited to pandemics. Before COVID-19, school shootings dominated the national debate related to school safety. High profile shootings such as those at Columbine High School (1999), Sandy Hook Elementary (2012), and Marjory Stoneman Douglas High School (2018) continue to inform national debate, including the role of the principal in implementing an adequate response and minimizing injury or loss of life (Marjory Stoneman Douglas High School Public Safety Commission Initial Report, 2019). Natural disasters and political unrest have also contributed to a heightened sense of awareness and demand for schools adequate safety plans. Experience and training, either in an administrative preparation program or through K-12 school districts, play an integral role in administrators' perceptions of their preparedness to handle emergencies adequately. Administrators preparation to handle a crisis must consider research that addresses how they respond in emergencies and must recognize the necessity to identify strengths, weaknesses, and gaps to ensure students physical and emotional safety (Tipler et al., 2017). Preservice programs and school districts must equip school site administrators with the necessary support and training to ensure all stakeholders' safety. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Burnout and Psychological Vulnerability in First Responders: Monitoring Depersonalization and Phobic Anxiety during the COVID-19 Pandemic.

BACKGROUND: It is common knowledge that first responders are among the helping professionals most at risk of burnout and psychological vulnerability. During the COVID-19 pandemic, their mental health has been subjected to various risk factors. METHODS: Data on socio-demographic characteristics, the Maslach Burnout Inventory (MBI) and psychological vulnerability (SCL-90-R) were obtained from 228 subjects (55.3% female; M age = 45.23, SD = 13.14) grouped on the basis of their actual involvement during the emergency phases (82% First Responders and 18% Second Responders). RESULTS: First responders exceeded the MBI clinical cut-off, while SRs did not (χ² ≥ 0.5); specifically, EE = 89.8%, DP = 85.8%, and PA = 82.1%. The FR group showed a higher mean in the global severity index (GSI = 49.37) than did the SRs (=43.95), and the FR group exceeded the clinical cut-off in the SCL-90-R scales of SOM (51.06), ANX (52.40), and PHOB (53.60), while the SF group did so only for the PHOB scale (50.41). The MBI dimensions correlated significantly (p = 0.05) with all investigated clinical scales of the SCL-90-R. CONCLUSIONS: Emergency situations expose first responders to specific risk factors related to work performance and relational aspects, which contribute to increased psychological vulnerability and burnout.

Modular Printed Powered Air Purifying Respirator

At present, the world is undergoing a pandemic spawning from the advent of a new coronavirus outbreak known as COVID-19. As a result, hospital staff, paramedics, first responders, and the general world population have been forced to wear personal protective equipment (PPE) and take special measures to prevent catching the virus. Furthermore, because of this necessity, increasing demand on the PPE supply chain has generated many shortages, especially seen in masks designed to stop the inhalation of COVID-19 particles in the air. This inspired our group to design something that could help make PPE more accessible and affordable for the average person. The proposed is an almost entirely 3D printed design to help keep costs down and make it simplistic, such that anyone with a 3D printer has the potential to duplicate it. We hope that with the design, we can help combat the shortage and keep more people safe from COVID-19. Copyright © 2021 by ASME.