The 2017 Atlantic hurricane season will be remembered as one of the deadliest, most destructive, and costliest seasons on record. September 2017 was exceptionally intense, as multiple major hurricanes ravaged the Caribbean and the Gulf Coast. On September 7, Hurricane Irma, a Category 5 storm, skirted north of the U.S. commonwealth of Puerto Rico, straining the island’s aging infrastructure and leaving approximately 60,000 people without power. Puerto Rico was barely recovering from Irma when the Category 4 Hurricane Maria ripped through the middle of the island on September 20. Torrential rains, furious winds, and storm surge caused catastrophic damage to homes, businesses, and infrastructure. Maria disabled the island’s electrical grid, leaving 95 percent of the 3.4 million inhabitants without power.  The devastation triggered a humanitarian crisis of epic proportions. To this day, Puerto Rico is still reeling from the storms’ impact. Remaining hard-pressed storm survivors are left to deal with the crippling effects of the hurricane, including limited access to adequate food, clean water, medicine, fuel, phone service, and electricity.  CHALLENGES AND LIMITATIONS The severity of the storm prompted responses from various contracting and government agencies, including the Federal Emergency Management Agency and the U.S. Army Corps of Engineers. My employer at the time was recruiting personnel to help provide temporary electrical power in Puerto Rico and the U.S. Virgin Islands. Initially, I volunteered to deploy to Puerto Rico for 14 days, only to extend my deployment to 53 days. Before deploying, I was thoroughly briefed on the challenges and limitations that plagued disaster relief efforts on the island, such as the mangled infrastructure, spotty communication, and inadequate size of the work force. 
I became particularly versed about the Jones Act, a century-old regulation that requires goods shipped within the United States to be carried on vessels owned, built, and operated by Americans. The outdated law was said to have impeded hurricane relief efforts by limiting the shipment of critical supplies and by driving up the cost of basic goods on the island, which are higher, on average, compared with those of the mainland. Bipartisan pressure from congressional leaders resulted in the Trump administration issuing a 10-day waiver that allowed foreign ships to deliver aid to the island; unfortunately, securing experienced drivers and transportation to unload shipped containers from the island’s ports proved to be an additional challenge. Fuel shortages, damaged roads, and debris prevented the delivery of critical supplies to areas heavily affected by the hurricane—including the island’s mountainous and rural regions.  Site condition assessments were conducted by quality assurance teams, whose findings were reported to the chain of command. The information gathered from site condition assessments assisted with the safe passage and installation of temporary diesel generators to areas affected by power shortages. Damage to cellphone towers and underground phone and internet cables limited communication among relief workers and caused distress among Puerto Ricans who were desperate to contact family members. My initial concerns with mobile phone service were minimized once I learned that a few of the major phone carriers had mobile phone connectivity available on parts of the island.  MISSION OPERATIONS Despite the pre-deployment briefings, upon arriving on the island, I felt ill prepared to address the magnitude of the disaster, especially since it was my first time working on a disaster project. My first day at the incident command center was an eye-opening experience. My initial scope of work centered on documenting mission assets and personnel costs. As mission operations expanded across the island, so too did personnel and equipment numbers. I was tasked with accurately tracking and inputting mission assets into an asset management database. For several weeks I navigated through chaotic situations, including cell service and GPS disruptions, last-minute directives, shipment delays, and communication breakdowns. Eventually, I found my footing in all the confusion and focused my energies on streamlining the asset management tracking process for transportation equipment (that is, trucks, tractors, trailers, and heavy lifting equipment) and other equipment vital to the mission.  As a cost documentation leader, I established great working relationships with the subcontractors, who were responsible for the hauling and installation of temporary diesel-powered generators to critical public facilities such as water pump stations, wastewater treatment plants, schools, and hospitals. Mission operations ran 24/7, including holidays. Establishing and maintaining a strong and positive safety culture was paramount to mission operations. This message was reiterated at the daily safety meetings, which included workers from the mainland United States and Puerto Rico. Line supervisors expressed genuine concerns for the health and safety of their workers, which translated into a safer workplace. Corporate management conducted frequent visits to observe operations and recognize team accomplishments, including restoration of power at a secondary school in San Juan. The sight of schoolchildren dancing, celebrating, and crying tears of joy once the power was restored boosted employee morale. Such successes reaffirmed the importance of our contributions to the mission, the island, and its people. A BLENDED WORK FORCE Throughout my deployment, safety personnel identified and corrected weaknesses in their training programs by retraining workers and implementing incentives to promote a safe workplace, and local bilingual translators assisted subcontractors with language and cultural barriers. Still, cultural differences in this blended work force presented minor complications with safety communication and compliance.
Utility trucks help workers restore electrical power near Palmer, Puerto Rico, in February 2018. Photo credit: Pamela Brick /
The sight of schoolchildren dancing, celebrating, and crying tears of joy once the power was restored boosted employee morale. Such successes reaffirmed the importance of our contributions to the mission.
I noticed that several of the locals viewed confrontation as undesirable. Constructive criticism wasn’t always positively received, especially coming from a woman. People sometimes talked over me as I tried to explain a procedure or provide constructive feedback about a job task. A casual attitude regarding safety compliance presented an issue with a small percentage of local workers. For example, one day, I spotted a man trying to locate a leak under his semitrailer truck using a flashlight. The man’s body was perpendicularly situated between two large tires. The truck’s ignition was running, and there were no wheel immobilizers in place to keep the tires from rolling. Another man stood next to him holding a flashlight. I walked over to intervene, but the man dismissed me. A safety officer immediately began speaking to the man in Spanish. The man explained to the safety officer that he had his own mechanic shop. He saw nothing wrong with what he was doing and grew quite defensive about the whole situation.  Differences in attitudes regarding time management presented additional challenges, as mainland U.S. culture stresses punctuality but Puerto Rican culture is more relaxed about timeliness. Management also experienced difficulties with employee retention during the holiday season. Puerto Ricans start celebrating the holidays on Christmas Eve and continue up through Three Kings Day (January 6), and this is one of the most important Puerto Rican religious traditions. Fears of manpower limitations were areas of concern for mission operations. Management adjusted work force scheduling by allotting time off to affected employees.  Field and administrative workers were stressed as they fulfilled project deliverables, and with that pressure came the added responsibility of staying safe on the job. Workers were subjected to a plethora of hazards, including noise from operating diesel generators and heavy machinery; falling debris, which included live (high-voltage) electrical wires; and moving machine parts. Other notable stressors were fatigue, flammable chemicals, heat stress, contaminated media (soil and water), poor air quality, slips and falls in rain-soaked locations, insects and pests, repetitive motions, and whole-body vibration from fleet operations. Administrative workers assigned to temporary workspaces in office trailers were subjected to diesel exhaust and particulate matter from nearby haul-and-install operations. Concerned about workers’ health and safety, I offered to advise the safety officer on industrial hygiene and safety-specific issues (when applicable), and addressed inadequate ventilation, fungal contamination, indoor air quality, nuisance dust, and other stressors. Work site evaluations and job hazard analyses were used to identify and control safety and health hazards. Current exposure controls (that is, personal protective equipment) were re-evaluated, stressors in high-hazard areas were identified, and task-specific monitoring plans were developed to address specific chemical, environmental, and physical hazards as well as ergonomic risk factors. FEMA has since transitioned relief efforts from disaster response to recovery, placing infrastructure development in the hands of the U.S. Army Corps of Engineers. As of early April, an estimated 200,000 families and businesses were still without power; however, this number continues to drop over time. More than 2,000 generators have been installed around the island. Through the combined efforts of FEMA, USACE, the Puerto Rico Electric Power Authority, and other industries, reliable power will soon be restored to the entire island.  AN INDUSTRIAL HYGIENE PERSPECTIVE In 2006, AIHA published the white paper “Industrial Hygienists’ Role and Responsibilities in Emergency Preparedness and Response.” It called for development of a professional credentialing system that merges emergency disaster management and industrial hygiene. Such a system would ensure that workers’ health is promptly addressed and protected in all phases of a response. In the present crisis, the U.S. Virgin Islands and Puerto Rico should be included in disaster response and recovery policy decisions. AIHA could play a more active role by collaborating with other government agencies to develop a document that critiques the effectiveness and the feasibility of existing health and safety requirements from an IH perspective as they relate to Hurricane Maria disaster response and recovery efforts. Summarizing lessons learned from the experience in Puerto Rico could be useful in future disaster planning. My time in Puerto Rico will be forever etched in my memory. Driving with a friend along the coast to the vibrant beach town of Loiza, the area hardest hit by both Irma and Maria, was most memorable. I spoke with locals about their horrific experiences, both during and after the hurricane, their struggles, their heartaches, and their desire to survive. A petite elderly woman with silver hair and ebony skin directed us to grab bread and water from a nearby aid truck. From afar, we watched as people stood in the sun waiting for food, water, and ice. My friend and I declined the woman’s offer and identified ourselves as relief workers for the power mission. She graciously thanked us for our contributions and smiled as she walked toward her destination. Through the chaos and destruction, the people of Puerto Rico continue to smile, laugh, and celebrate, and be generous, welcoming, and kind. The power of resilience and hope keeps Puerto Ricans moving forward through these tough times. As the humanitarian crisis persists in Puerto Rico, we must not forget to include our fellow U.S. citizens in emergency disaster management efforts and policy decisions. By connecting with other EHS professionals in the U.S. Virgin Islands and in Puerto Rico, we can assess the needs of this community and determine how AIHA can assist with recovery efforts.    MONICA NETHERLY, MPH, ASP, is an industrial hygienist with the Navy Bureau of Medicine, Directorate of Public Health, in San Diego, Calif. She can be reached via email. Send feedback to The Synergist.
RESOURCES AIHA: Disaster Response Resource Center (2017). AIHA: Incident Preparedness and Response Working Group. AIHA: “Industrial Hygienists’ Role and Responsibilities in Emergency Preparedness and Response” (PDF, 2006).
Bringing Aid  and Electricity after  Hurricane Maria
A Power Mission in Puerto Rico
Damaged power lines in Humacao, Puerto Rico, on Dec. 2, 2017, six weeks after Hurricane Maria struck the island. Photo credit: Alessandro Pietri /
Although the print version of The Synergist indicated The IAQ Investigator's Guide, 3rd edition, was already published, it isn't quite ready yet. We will be sure to let readers know when the Guide is available for purchase in the AIHA Marketplace.
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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