As industrial hygienists and environmental health and safety professionals, we are likely expected to serve on an Emergency Management Committee and to provide expertise on protecting the work force before and during a crisis. To fulfill this role, we should have a strategic- level understanding of how emergency management plans are developed. Gaining sufficient competency in this area helps integrate work force health, safety, and environmental management with incident response operations. Drawing from guidance published by the United States Federal Emergency Management Agency, this article describes key areas where our profession can support the emergency management community.
When developing or updating emergency operations plans, several principles apply:
Use a “whole-of-community” approach. This principle requires that organizational leadership understand the work force and the nearby population that would be affected by a crisis. Examples include identifying the number of workers, their location on a facility, and the critical functions they perform; identifying at-risk individuals (such as persons with functional needs) who may require additional assistance; identifying residences or public facilities such as schools within a designated impacted area; and possibly identifying nearby critical infrastructures (such as hospitals) that would be affected by hazards occurring at a facility. This principle also requires wide stakeholder engagement to achieve sufficient input into planning considerations and response actions to support the entire community in a crisis.

Use a logical and analytical process. This principle validates the rationale for performing critical emergency response tasks. Representatives of the various stakeholders participate in a sequential process of gathering and analyzing information, clarifying objectives, and finding different approaches to achieving objectives. This process identifies resources to achieve key tasks and describes performance criteria indicating that objectives have been accomplished. This process requires extensive work over weeks to months, depending upon the organization’s size, functions, and impacted populations.
Avoid starting from scratch. Except in newly created organizations, emergency management planning should be founded on existing plans, agreements, and frameworks. Planners from the stakeholder groups should research existing emergency management plans or existing agreements with local authorities, contractors, and parent organizations. These arrangements should serve as a reference base as organizations update their emergency management plan or build a new one. Using the analytical and logical process described earlier, planners should determine whether these existing agreements require adjustment to meet the stakeholder communities’ requirements to mitigate against or respond effectively to a hazard.
Consider all hazards. Based on required capabilities to respond to certain hazards, stakeholders should identify common capabilities applicable to all hazards. For example, operational communication during an incident could apply to a hurricane, an act of terrorism, or an earthquake. While approaches to operational communication may differ according to incident and circumstance (for example, due to loss of power or cell phone coverage), the organization should recognize that this capability requires specificity in emergency management planning. Table 1 below lists thirty-two capabilities that may apply to organizations when developing emergency plans.
Identify tasks, allocate resources, and establish accountability. The overall evaluation of a plan is based on this principle. Tasks are actions critical to accomplishing the plan’s objectives and are specific to one of the capabilities shown in Table 1. These tasks do not stand alone; they should be integrated with other tasks of other capabilities. For example, deploying PPE to a segment of the work force may depend on communication tasks, logistics and resupply tasks, and situational assessment tasks.
Senior health and safety managers should engage early with emergency management planners.
Table 1. Capabilities by Mission Area
Tap on the table to open a larger version in your browser.
THE PLANNING PROCESS Figure 1 below depicts the six-step process for developing emergency management plans. Step 1: Form a Collaborative Planning Team This step formalizes a whole-of-community approach to developing or updating plans in response to a crisis. Forming this team involves clarifying the organizational leadership’s intent for such plans. Leaders may scope emergency management plans to support the organization’s mission, goals, values, and strategic-level risks—for example, by ensuring that the plans are sustainable over time. Many organizations may not have the assets or qualified personnel in-house to sustain operations past a 24- to 72-hour period. The plan must reflect this temporal limit and ultimately specify a transition or shutdown phase as well as required recovery tasks to regain “normal operations.”
Obtaining leadership “buy-in” early in the planning process is critical to the plan’s acceptance. Engaging with senior leadership shows the team’s interest in their leaders and allows leaders to recognize the importance of preparing their organizations for a crisis. Together, both senior leaders and the Collaborative Planning Team can forge a comprehensive plan agreeable to stakeholders and manageable within the organization’s leadership hierarchy.
To ensure health and safety principles are integrated into the planning process, senior health and safety managers should engage early with emergency management planners. Too often, the health, safety, and environmental management community is integrated with emergency management plans after those plans are developed. In these cases, complying with worker health and environmental regulations and safeguarding the population are more challenging. Early engagement is necessary through active participation within a Collaborative Planning Team.

Figure 1. FEMA's six-step planning process.
Tap on the figure to open a larger version in your browser.
Step 2: Understand the Situation
This step involves research to identify hazards and threats. The planning team determines the physical effects and operational impacts to the organization, the susceptible work force, and the public.
Research is required in several areas. First, the team must clarify the intent of the plan (based on input from stakeholders and leadership). Threats and hazards, as well as their physical effects, are specified for various scenarios. For example, if a hurricane scenario is used, the physical effects include the hurricane category and sustained wind conditions. From these physical effects, operational impacts are determined, such as damage to facilities, power outages, disruption of the water system, and housing issues for the affected work force. The team should categorize these physical and operational impacts according to the organization’s capability to respond.
This analysis should identify facts. In the absence of facts, the analysis should identify valid assumptions that are necessary for the plan to be effective. For example, during an influenza pandemic, it is a fact that the disease will cause severe illness and, in some cases, death among the work force. An assumption may be that significant numbers of workers may not show up to work due to illness, death, or fear of becoming infected. Another assumption with this scenario is the likely shortage of PPE, specifically N95 respirators or non-latex gloves. Both assumptions are valid based on past pandemics. They are also necessary because the assumptions point to potential shortfalls in personnel and resources.
Next, the team develops “planning factors.” This activity consolidates the physical and operational impacts, facts, and assumptions. Quantitative planning factors may include specific numbers or percentages such as 20 percent work force absenteeism, 500,000 tons of debris (resulting from a tornado or hurricane), or economic loss in dollar value. Qualitative planning factors may also be used if quantitative measures aren’t available.
Planning factors are the basis for making decisions. For example, if 20 percent absenteeism is expected during an influenza pandemic, the organization may opt to cease noncritical functions, hire contractor support, or deploy PPE and implement safe work practices (such as 6-foot social distancing) applicable to remaining personnel to sustain all organizational functions. Another example is PPE shortage where the planning factor specifies a 6-month delay in receiving N95 respirators due to high demand. This planning factor may prompt leaders to begin stockpiling PPE or to consider rearranging work schedules to increase social distancing. Step 3: Determine Goals and Objectives Thorough research and analysis in Step 2 helps the Collaborative Planning Team achieve a good understanding of threats, hazards, required capabilities, and resource shortfalls. In addition, the research and analysis points the team to what the organization must do to survive a major event.
Step 3 entails a description of the end state, which clarifies what the organization will look like after a major crisis and successful implementation of response and recovery actions. In an influenza pandemic outbreak, for example, an end state may be that the organization has maintained its critical functions with modest impacts to its work force.
Next, the team should develop a mission statement for the plan. The statement defines the plan’s purpose and primary operational objectives. A simple description of the “who, what, where, when, and why” of the plan will ensure that the team maintains focus on meeting this mission.
After the mission statement, the team should set goals and objectives. Goals are general statements that indicate the intended solution to problems identified by the planning team. An example of a goal for the influenza pandemic scenario is “to ensure the work force is adequately trained on pandemic influenza awareness before the next outbreak occurs.” From these goals, the team develops objectives—specific, identifiable actions carried out during an operation. One objective in a pandemic is “to direct the Office of Health and Safety to immediately conduct 2-hour pandemic influenza awareness training for all employees over a 5-day work week upon notification of the outbreak by CDC and the state/local health department.” Step 4: Develop the Plan With mission statement, goals, and objectives clarified, the Collaborative Planning Team can begin to develop the plan. This step entails the development and analysis of various courses of action necessary to execute the goals and objectives. Using a scenario as the basis for initiating the planning process, the team develops a timeline. From “zero hour”—the beginning of a crisis—the team should specify the decision points to initiate response actions. Stakeholder input from the community is essential in this step. Without it, decisions and response actions critical to the planning process are likely to be missed.
When identifying the response tasks, the team should ensure that specific information about those tasks is clearly stated. For example, what is the action and who is responsible for it? When should the action take place? How long should the action take and how much time is available? What has to happen before the action? What happens after? What resources does the person or entity need to perform the action?

Health and safety professionals should review these same response tasks from a different perspective. Based on the scenario, what are the hazards associated with these actions? Are there enough people to carry out the actions, and are they trained in managing the risks of those hazards? What PPE will these individuals require to safely conduct these actions? Does the organization have that PPE on hand, or can access be granted in a convenient and timely manner? Are there engineering controls and safe work practices to perform those actions safely? Do current organizational procedures include the safety and health practices to perform these actions?
Once the response tasks and appropriate courses of action are identified, the team can identify required resources. At first, the team should not question the availability of the resource; it should focus only on need. Afterwards, the team can match these requirements with realistic resource availability. A resource gap exists when needed resources exceed available resources (either before the crisis or during the crisis). Identifying resource gaps can help the team determine if the courses of action or specific response tasks are feasible. For example, the planning team might determine from its influenza pandemic analysis that N95 respirators are needed for all employees to sustain critical functions for 90 working days. After identifying the required resources—the number of N95 respirators per day and per person—the team may determine that procuring or storing this quantity is not feasible. The team may specify alternative paths such as supplying N95 respirators to only 50 percent of the work force while the remaining 50 percent work from home or an alternate site. Step 5: Prepare, Review, and Approve the Plan The Collaborative Planning Team can now draft the basic plan. FEMA’s publication “Developing and Maintaining Emergency Operations Plans: Comprehensive Preparedness Guide 101” provides examples of plan formats that organizations may use. In short, the plan should have the following characteristics:
  • Simple wording written in the appropriate language(s).
  • Checklists and visual aids (for example, maps and flowcharts) to help communicate complex processes and requirements.
  • Active voice and short sentences that avoid qualifiers and vague wording.
  • Sufficient detail (varies by organization and scope of operations).
  • Consideration of solutions and options during a crisis while avoiding discussions of policy and regulations.
  • Limited discussion of procedures. For example, the plan shouldn’t describe how to don respirators or how to perform decontamination.
  • Ease of accessibility.
  • Identification of the scope and concept of planned response tasks and valid, reasonable assumptions.
  • Feasibility based on broad concurrence among the Collaborative Planning Team, management, and the larger organizational community.
Step 6: Implement and Maintain the Plan This step encompasses training the organization; performing exercises; and reviewing, revising, and maintaining the plan.
Training the organization is critical. It’s extremely important to raise awareness of the plan, of each organizational component, and of each individual’s responsibilities during a crisis.
Performing exercises involves a combination of training events, discussion-based or tabletop exercises, and a full-scale operational exercise. After initial awareness training, the organization should create a timeline for building up the organizational members’ competencies related to crisis response. The discussion-based or tabletop exercise represents the opportunity for the various components to discuss how the organization evolves during a large response. The full-scale exercise is the actual “doing” where employees and key external stakeholders (for example, community first responders) can execute the tasks described in the plan.
Based on the lessons learned from the various training and exercises, the planning team can work with leadership to review the plan and identify any shortfalls. If the training and exercise iterations validate the plan, the planning team and leadership can ensure maintenance of the plan through recurring awareness training. EXPERTISE IN A CRISIS Emergency management planning is an extensive and deliberative process. Time and wide stakeholder input is vital to ensuring clarity around critical decisions, tasks, and resources. Health and safety professionals can provide valuable technical expertise in identifying the specific hazards and appropriate controls necessary to protect the work force during a crisis, and should be actively engaged in all six steps of the plan’s development. JOSELITO IGNACIO, MA, MPH, CIH, CSP, REHS, is a captain in the U.S. Public Health Service and a chemical, biological, radiological and nuclear science advisor for the Federal Emergency Management Agency, Department of Homeland Security. He can be reached at (202) 212-5710 or via email.

RESOURCES FEMA: Developing and Maintaining Emergency Operations Plans: Comprehensive Preparedness Guide 101 (2010).
FEMA: FEMA Operational Planning Manual, FEMA P-1017 (2014).
FEMA: Threat and Hazard Identification and Risk Assessment Guide: Comprehensive Preparedness Guide (CPG) 201 (PDF), Second Edition (2013).

A Six-Step Process for Crisis Preparation
BY JOSELITO IGNACIO

Principles of
EMERGENCY MANAGEMENT
Planning
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Disadvantages of being unacclimatized:
  • Readily show signs of heat stress when exposed to hot environments.
  • Difficulty replacing all of the water lost in sweat.
  • Failure to replace the water lost will slow or prevent acclimatization.
Benefits of acclimatization:
  • Increased sweating efficiency (earlier onset of sweating, greater sweat production, and reduced electrolyte loss in sweat).
  • Stabilization of the circulation.
  • Work is performed with lower core temperature and heart rate.
  • Increased skin blood flow at a given core temperature.
Acclimatization plan:
  • Gradually increase exposure time in hot environmental conditions over a period of 7 to 14 days.
  • For new workers, the schedule should be no more than 20% of the usual duration of work in the hot environment on day 1 and a no more than 20% increase on each additional day.
  • For workers who have had previous experience with the job, the acclimatization regimen should be no more than 50% of the usual duration of work in the hot environment on day 1, 60% on day 2, 80% on day 3, and 100% on day 4.
  • The time required for non–physically fit individuals to develop acclimatization is about 50% greater than for the physically fit.
Level of acclimatization:
  • Relative to the initial level of physical fitness and the total heat stress experienced by the individual.
Maintaining acclimatization:
  • Can be maintained for a few days of non-heat exposure.
  • Absence from work in the heat for a week or more results in a significant loss in the beneficial adaptations leading to an increase likelihood of acute dehydration, illness, or fatigue.
  • Can be regained in 2 to 3 days upon return to a hot job.
  • Appears to be better maintained by those who are physically fit.
  • Seasonal shifts in temperatures may result in difficulties.
  • Working in hot, humid environments provides adaptive benefits that also apply in hot, desert environments, and vice versa.
  • Air conditioning will not affect acclimatization.
Acclimatization in Workers