Emergency Responder Health Monitoring and Surveillance

Emergency Responder Health Monitoring and Surveillance (ERHMS) is a health monitoring and surveillance framework developed by the National Response Team, an organization of 15 federal departments and agencies responsible for coordinating emergency preparedness and response. The framework includes recommendations, guidelines, tools, and trainings for use in protecting emergency responders during each phase of an emergency response, including pre-deployment, deployment, and post-deployment.

The guidelines and recommendations address the medical clearance, training, and health monitoring of workers from emergency management, fire service, law enforcement, emergency medical services, public health, mental health, disaster relief, and volunteer organizations, as well as construction and other skilled support who may be participating in a broad range of activities including assessment, search and rescue, investigation, recovery, cleanup and restoration. Events in which the framework could be employed include chemical spills, natural disasters such as hurricanes, floods, and earthquakes, and terrorist attacks.

ERHMS was designed to function within the Federal Emergency Management Agency's (FEMA's) National Incident Management System (NIMS), a systematic approach to emergency management. The ERHMS trainings satisfy Public Health Emergency Preparedness capability 14, "Responder Safety and Health." ERHMS has been adopted as the accepted standard organizational focus for emergency response at all levels (local, state and federal) and for all incident sizes and types.

After the health effects among emergency responders to the September 11, 2001 attacks at the World Trade Center became apparent, public health and government officials began to call for improved emergency worker health monitoring and surveillance in the event of future disasters. A 2004 joint report from RAND Corporation and the National Institute for Occupational Safety and Health (NIOSH) entitled “Protecting Emergency Responders, Volume 3” called for enhanced protection of emergency workers in future emergency events and described several areas of improvement. Testimony from RAND in 2007 declared that there had been insufficient protection of 9/11 recovery workers and that future disasters should have an incident safety management structure in place that can make safety decisions and has the equipment, capabilities, and authority needed to implement and enforce them effectively.

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