The Occupational Health Sub-council Welcome to the Occupational

The Occupational Health Sub-council Welcome to the Occupational Health Disaster Expert Network (OHDEN) ! Presented by the OH-SC (Occupational Health Sub-council) Click here! OH-SC offers: Emergency Information for non-members CDC Poison Control Centers Public Health Departments . . . Nonmembers can learn all about the OH-SC and about the involvement of DHS and HHS • Disaster-response assistance • Alerts on potential terrorist activity • Current hot topics • Real-time Q&A with experts • Secure means for reporting incidents • Secure discussion forum (web and/or voice) • Emergency preparedness: checklists, plans • Emergency preparedness/response training • Research, reports, and abstracts • Links to secondary sources • FAQs • Best practices Username: Password: Want to be a member? Subscribe

The Occupational Health Sub-council About the OH-SG: Public Health and Healthcare services were designated by President Clinton’s Presidential Decision Directive PDD-63, now superseded in the Bush Administration by Homeland Security Presidential Directive 7 (HSPD-7). This sector is one of several critical infrastructures and key resources identified as needing protection from terrorist attacks. Under the auspices of the DHS and coordinated through Health and Human Services, the Occupational Health Sub-council (OH-SG) was created to develop resources to establish a community and to develop necessary resources. The OH-SC is an advisory group consisting of OH physicians, nurses, industrial hygienists, and other workplace health providers.

The Occupational Health Sub-council About OHDEN • The Occupational Health Disaster Expert Network • OHDEN is how OH-SC will achieve its mandate. • OHDEN is a community that provides communication for OH professionals. • OHDEN is a web-based resource and a community of occupational-health professionals. • Odin is the Norse god of death, poetry, and wisdom.

The Occupational Health Sub-council

The Occupational Health Sub-council The OHDEN Entry Point http: //www. ohden. org http: //www. ohden. net

The Occupational Health Sub-council

The Occupational Health Sub-council For Members Welcome, Dr. Doe! Modify your personal profile Two types of data: Category 1: Emergency data, which is interactive Category 2: Reference information Category 1 Category 2 Urgent or Life-threatening If immediate assistance or information is needed Emergency Preparedness and Response Reference Information

The Occupational Health Sub-council Category 1 If you need to speak to an expert right now: Click here If you need to report an incident right now: Click here Emergency links and numbers. Enter zip code: 27708 Dirty bomb threats Ricin Conferencing Entering a zip code will provide access to emergency links and phone numbers in that area. Review schedule of emergency conferences (e-mail or phone) Review archive of conferences Send Alerts Receive Alerts Send alert to all members Send alert to selected members Read latest CDC Alerts Read latest HC-ISAC alerts Read latest OH-CG web alerts Read latest DHS alerts

The Occupational Health Sub-council Category 1 Emergency contacts for zip code: 27708 Phone Mandatory numbers to call can be so indicated. E-mail Internet Emergency number for your area…………………. 911 Local health department…………………. . . . . (555) 123 -4567; Fire department……………………. . (555) 123 -4567; Police department………………. . . . ………. . (555) 123 -4567; Ambulance…………………. . . (555) 123 -4567; Poison control center…………………. . . . . ……. (555) 123 -4567; Local emergency management office……. . . . . (555) 123 -4567; tttt@uuu. vvv; http: //. . . Local hospital facilities…………………. . . (555) 123 -4567; Local American Red Cross chapter………. . . . . (555) 123 -4567; State or regional emergency management offices…. . (555) 123 -4567; State or regional FEMA offices………………(555) 123 -4567; State or regional public-health offices…………………(555) 123 -4567; tttt@uuu. vvv; http: //. . . [Regional OSHA (or state OSH) offices…………………(555) 123 -4567; tttt@uuu. vvv; http: //. . . ] [Local occupational-health resources……………. (555) 123 -4567; tttt@uuu. vvv; http: //. . . ] Workplace-specific emergency resources [Other pertinent local offices, agencies, or groups…. . (555) 123 -4567; tttt@uuu. vvv; http: //. . . ] Link to emergency-assistance sites on the Internet (e. g. , DHS, HHS, FEMA, OSHA, EPA, others)…………………. http: //. . . Other (e. g. , IM, radio)

The Occupational Health Sub-council For Members Welcome, Dr. Doe! Modify your personal profile Two types of data: Category 1: Emergency data, which is interactive Category 2: Reference information Category 1 Category 2 Urgent or Life-threatening If immediate assistance or information is needed Emergency Preparedness and Response Reference Information

The Occupational Health Sub-council Category 2 Learn all about: Disaster Prevention and Preparedness Disaster Response: Acute Phase Disaster Recovery and Mitigation Would you like to learn at your own pace about disaster preparation? Search on a topic (Enter keyword(s) and click link below): View articles contributed by OH-CG members View information from other selected websites Members can search for OH-CG-reviewed websites and OH-CG-authored articles.

The Occupational Health Sub-council

The Occupational Health Sub-council Three main categories are available to assist members in learning.

The Occupational Health Sub-council

The Occupational Health Sub-council Disaster Prevention and Preparedness A. What is a disaster? (definitions, scope, applicability) B. How are disasters managed in the U. S. and abroad? C. Risk assessment for my workplace D. Risk communication for the public and the media (before the disaster) E. Risk communication for workforce and family members (before the disaster) F. Establishing communications channels before a disaster G. Planning for immediate medical response to a disaster H. Planning for data collection (clinical and epidemiological medical surveillance) I. Planning for security J. Legal and ethical issues K. Training and education (before the disaster)

The Occupational Health Sub-council Disaster Prevention and Preparedness B. How are disasters managed in the U. S. and abroad? 1. Local, state, regional, and national (federal) response plans in effect in the U. S. a. Phases of response (planning, crisis management, consequence management, recovery, etc. ) b. Our own explanation and summary of these plans c. Hyperlinks to the appropriate information sources 2. 3. 4. 5. Response plans applicable to U. S. workers abroad How do these systems interface with my workplace? Why (and in what specific ways) should my workplace prepare? Establishing a workplace-specific disaster-response plan: Critical steps, including setting up an organization, funding, wiring diagrams, communication pathways, accountability, personnel, equipment, immediate medical care, agreements with local or regional medical facilities, antidote distribution, evacuation, etc. ) C. Risk assessment for my workplace 1. Hazard identification (including worker populations affected) a. How will I know that there’s a disaster? b. Specific hazards that I should look for 2. Dose-response assessment 3. Exposure assessment 4. Risk characterization E. Risk communication for workforce and family members 1. 2. 3. 4. To workers To management To worker families To relevant local, state, and federal agencies

The Occupational Health Sub-council Disaster Prevention and Preparedness F. Establishing communications channels before a disaster 1. Whom to call a. For information / consultation / help b. For reporting / data collection 2. When to call (under what circumstances) 3. What to communicate 4. Security /confidentiality of data being communicated 5. How to organize communications channels in the planning stage G. Planning for immediate medical response to a disaster 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The roles of medical personnel in the workplace (and their relationship to management and workers) Medical resources (personnel, equipment, antidotes, transport) available in the workplace Self-aid and buddy aid (and training for self-aid and buddy aid) Emergency-medical-treatment resources in the workplace Agent detection, identification, confirmation, and risk assessment Decontamination a. Personnel b. Equipment c. Buildings and worksites d. Environment First-responder issues Transport off site Medical treatment off site The role of medical resources

The Occupational Health Sub-council Disaster Prevention and Preparedness H. Planning for data collection (medical surveillance) 1. Data collection and preservation from individual workers for individual diagnosis and medical management 2. Epidemiological medical surveillance (from living workers and from dead victims) a. Exposure monitoring (IH), with protocols for collection of environmental specimens b. Biological monitoring, including protocols for collection of medical specimens c. Health-effects monitoring (medical monitoring) 3. Confidentiality of data (e. g. , HIPAA considerations, IRB protocols, etc. ) 4. Specific sampling protocols (lists, where to find them, how to develop them, etc. ) I. Planning for Security 1. Worker security (protection, evacuation plans and assembly points) 2. Physical security 3. Information security K. Training and Education (before the disaster) 1. 2. 3. 4. 5. What’s available? (and from whom, for whom? ) What’s needed for your particular workplace (and how do you find out)? Contact and application procedures? CME modules available addressing disaster readiness CME module: OH ISAC website for on-line training sponsored by ACOEM

The Occupational Health Sub-council Category 2 Learn all about: Disaster Prevention and Preparedness Disaster Response: Acute Phase Disaster Recovery and Mitigation Would you like to learn at your own pace about disaster preparation? Search on a topic (Enter keyword(s) and click link below): View articles contributed by OH-CG members View information from other selected websites Members can search for OH-CG-reviewed websites and OH-CG-authored articles.

The Occupational Health Sub-council Disaster Prevention and Preparedness Search (type in keyword): +disaster +“mental health” Do you need online assistance?

The Occupational Health Sub-council Disaster Prevention and Preparedness Search (type in keyword): +disaster +”mental health” Do you need online assistance? URL: http: //www. psych. org/disasterpsych/links/11 sept 02 guide. cfm Title: American Psychiatric Association Disaster Psychiatry: Plan of Action Abstract: This web page is sponsored by the American Psychiatry Association (APA). This particular page is a news release dated 20 August, 2002. It concerns a brochure released by the National Partnership for Workplace Mental Health to enable employers, employees, and families of employees deal the mental-health impact of terrorism and other disasters. The title of the brochure is, “When Disaster Strikes: Managing Mental Health in the Workplace. ” The brochure exists as a PDF file accessible from a link on this page. The brochure is nontechnical and in color and can be viewed and printed as a foldable brochure from any system that has Adobe Acrobat Reader. It would be useful before, during, and after a disaster and would be useful to distribute to employees—or to make available for them at employee health clinics—well before the disaster occurs. It is not copyrighted, and the APA approves and encourages its wide dissemination in the workplace. Relevance and usefulness to workplace disaster prevention and preparedness: High; recommended This review last updated 30 April, 2004 by OH AC (James M. Madsen, MD, MPH) Click on the URL to go directly to the site.

The Occupational Health Sub-council Disaster Prevention and Preparedness

The Occupational Health Sub-council Capabilities for Secure Intranet Searches OHDEN Intranet Experts Web Emergency OHDEN • Intranet Search Capability for OHDEN • Licensed search product • Internal (firewall-protected) or global options • Criteria-based searching • Based on underlying specific taxonomy (keyword / MESH concept) • Searchable with Boolean logic • Category-specific resources

The Occupational Health Sub-council OHDEN Taxonomic Categories

The Occupational Health Sub-council OHDEN Taxonomy: Comprehensive Subsets

The Occupational Health Sub-council

The Occupational Health Sub-council Tagged Keywords for Unstructured Searching

The Occupational Health Sub-council Comprehensive Systematic Taxonomy: Example ○ Resource Type(s) {resource type} – – – – – – – – ○ Biographical (OHDEN member) {biographical} ○ Available for consulting {consultant} ○ U. S. Federal Government: DHS [NOS] {Federal} ○ U. S. Federal Government: DHS: FEMA (disaster response) {FEMA} ○ U. S. Federal Government: HHS and healthcare issues (including ESF #8) [NOS] {HHS} ○ U. S. Federal Government: HHS: CDC [NOS] {CDC} ○ U. S. Federal Government: HHS: CDC: NIOSH {NIOSH} ○ U. S. Federal Government: DOL and labor issues [NOS] {labor} ○ U. S. Federal Government: DOL: OSHA and workplace issues {OSHA} ○ U. S. Federal Government: Other {Federal} ○ Regional Resources {regional} ○ State Resources {state} ○ Local Resources {local} ○ Professional Organizations {professional} ○ Nonprofit Organizations {nonprofit} ○ University Resources [NOS] {university} ○ University Resources: Public {public university} ○ University Resources: Private {private university} ○ Poison-control Centers {poison-control centers} ○ Medical Resources: Medical Search Engines [NOS] {medical search engines} ○ Medical Resources: Occupational-and-environmental-medicine Sources {OEM search engines} ○ Medical Resources: Evidence-based-medicine (EBM) Sources {EBM} ○ Databases: Query-engine-based {search-engine databases} ○ Databases: Other {databases} ○ Military Resources {military} ○ Private Resources: Occupational {occupational} ○ Private Resources: Other {private} So far, ○ Free Resources {free} 264 bottom-level catalog elements ○ Subscription or Fee-based Resources {not free} (not counting headings and subheading) ○ Resources Owned or Produced by OHDEN {OHDEN} ○ Websites (external to OHDEN) {external websites}

The Occupational Health Sub-council Revealed Keywords

The Occupational Health Sub-council Disaster Response: Acute Phase Please fill out the following questions to help refine and expedite searches and then submit: Select proximity to disaster (off site) Type of emergency (multiple selections allowed) 1 - 100 ft Chemical 101 – 500 ft Biological 501 -1, 000 ft Radiation 1, 001 – 5, 279 ft Natural 1 - 5 miles Unknown Greater than 5 miles Origin of disaster? 1) Natural 2) Intentional (informs law enforcements) Volume amount (select one and enter amount): Solid 3) Unknown Liquid Gas Route (multiple selections allowed) N/A Air Soil Water Food Transportation Disaster location Inside facility Off site N/A This is just one example of the type of query information on which searches could be based.

The Occupational Health Sub-council Scenario: Anthrax • A Fortune 500 high-tech employer, Apex Industries, with approximately 3000 workers in a single multistory building shared with another 1500 individuals from another global employer, receives an envelope addressed to one of its employees. The envelope contains a fine powder. • The employee opens the letter in a common area, notices the powder, brushes it off his forearm, reads an enclosed offer for a low mortgage rate, and discards the envelope. • At lunch, he realizes that he should report his having noticed the powder in the envelope; but when he tries to retrieve the envelope, he learns that the trash has been taken out. • There is no envelope or powder to test, but the FBI reports that numerous calls have been received in the past hour about similar envelopes delivered to over three dozen cities in the area. Of 200 identical letters, 152 contained harmless powder but 48 tested positive for spores of Bacillus anthracis.

The Occupational Health Sub-council Scenario: Anthrax • As the medical director for Apex International, you learn (while you are preparing to board a flight early the following morning) that your employees have been potentially exposed to anthrax, as have thousands of others in 14 cities across four states. You dash back to your offices. • By 6 a. m. , supplies from the Strategic National Stockpile are being deployed, and Dr. Gerberding from the CDC is holding a press conference. President Bush has expressed grave concern and outrage. • Your company crisis team is called into action by 6: 15 a. m. • A special Haz. Mat team scours the landfill where the trash from your company had been taken and confirms that the letter delivered to your employee did in fact contain anthrax spores. • You elect to begin prophylactic antibiotic treatment, but many questions are coming to you:

The Occupational Health Sub-council Employee Issues • Should I go to the point of distribution (POD) that I heard of from the news? • Should I come to work? When? Is the building closed? For how long? • Am I being paid for time off? FMLA? Worker’s comp? • Will worker’s comp pay my private doctor to give me antibiotics? • I was in the area where my coworker opened the letter but then took a flight to our plant in Bangalore, India. I don’t want to fly back to the POD. Can the company doctor here just give me the ciprofloxacin that I need? • I’m freaked out and so is my family. I called the EAP, but no one there could help us. • I work in the mail room at the building where the mail was opened. Am I going to get sick? What tests can you do to let me know that I’m okay?

The Occupational Health Sub-council Vendor Issues • Our security personnel who work at Apex (but are actually contractors from a private-security company) were in the area, too. Our contract with Apex doesn’t include anything about this kind of contingency. What is Apex going to do for us? • Do we continue to deliver Fed. Ex packages? Also, one of our delivery persons was on the same floor as the envelope yesterday and needs to talk to you. • A food-service worker (not employed by Apex) in the cafeteria was handed a badge to scan and cash by the exposed Apex employee. Does she need prophylaxis? • Corporate Express, a company that delivers office supplies, calls to report that one of their employees delivered to Apex and is now hospitalized and thought to have anthrax. You are requested to call Corporate Express.

The Occupational Health Sub-council Customer Issues • Will your service contracts be honored? Will delivery be on time? What about customer-service response times? • Do not make any more deliveries to us until we hear from official health experts that you products are safe. • What about the item that we just received from you? Is it safe? • We noticed some powdery residue in the packing material for the training materials that you sent us. Can you test the powder for us? • A group of our employees was training at your site on the day of the incident. They are now back in Hong Kong and want to know what to do.

The Occupational Health Sub-council Safety and Industrial-hygiene Issues • What kind of respirators will we need? What about skin protection? • How should we address the issue of environmental containment? – What about the ventilation system? – What about surfaces? • How do we decontaminate the building and its contents without damaging vital documents and other materiel? • Does exhaust ventilation require special monitoring? • How do we manage waste disposal? • How does the particulate size of the powder affect respirator recommendations?

The Occupational Health Sub-council Management Issues • How long do we close the building? Who decides? How long will it take to clean this problem up and get back to business as usual? • How do we assure our employees, vendors, and other partners that our work environment is safe? Who makes this call? • What do we do if the health department forces us to relocate temporarily? We have a business-continuity plan but will still need to send workers into the building during the transition period. • Are our products safe? How will you know? When will you know? • For consistency of communication, everything that you say will now have to be okayed in advance by the senior vice president of marketing. We want to minimize panic, liability, and loss of market share.

The Occupational Health Sub-council Issues for the OH Professional • How are you going to answer these questions and deal with these issues? • There’s plenty of general information on the news and on the Internet, but much of it is too general to apply to your specific problems at work. Where can you go to get more specific information? • How can you minimize the risks that confidential data about conditions in your business will reach the media or the general public? • You are responsible for the health and safety of employees at all levels of the organization. Who ya gonna call? Where can you go for help?

The Occupational Health Sub-council

The Occupational Health Sub-council (to go directly to the website)

The Occupational Health Sub-council (to go directly to an introduction)

The Occupational Health Sub-council

The Occupational Health Sub-council (to go to the website)

The Occupational Health Sub-council

The Occupational Health Sub-council (go directly to the introduction)

The Occupational Health Sub-council

The Occupational Health Sub-council Anthrax Scenario • How are you going to answer these questions and deal with these issues? • There’s plenty of general information on the news and on the Internet, but much of it is too general to apply to your specific problems at work. Where can you go to get more specific information? • How can you minimize the risks that confidential data about conditions in your business will reach the media or the general public? • You are responsible for the health and safety of employees at all levels of the organization. Who ya gonnna call? Where can you go for help?

The Occupational Health Sub-council Category 2 Learn all about: Disaster Prevention and Preparedness Disaster Response: Acute Phase Disaster Recovery and Mitigation Would you like to learn at your own pace about disaster preparation? Search on a topic (Enter keyword(s) and click link below): View information from other selected websites View articles contributed by OH-CG members Members can search for OH-CG-reviewed websites and OH-CG-authored articles. Would you like to discuss this topic with fellow occupational-medicine healthcare providers? View list of professional experts on content source Other options: Request current information on a CD Collaboration Center News Center Courses, tutorials, and training Members can consult a list of professionals who provide expertise on a specific topic (on a volunteer basis).

The Occupational Health Sub-council Collaboration and News Center News of the week: SARS resurfaces in China New anthrax prophylaxis Click Here for Discussion Forums Other Topics: Read latest news from CDC Read messages from members Find out topics and schedules for conference calls Access archived recordings of conference calls (2 week max) Make request to editor External Links: HAN ACOEM AIHA WHO AAOHN Link to list of other links

The Occupational Health Sub-council Notification Options Alerts E-mail: IM: Office phone: Fax: Home phone: Mobile phone: Pager: No Yes Click here to enter E-mail address No Yes Click here to enter IM user name No Yes Click here to enter phone number(s) No Yes Click here to enter fax number(s) No Yes Click here to enter phone number(s) No Yes Click here to enter E-mail address Preference (1 is highest) for routine notifications: E-mail: 1 2 3 4 5 IM: 12345 Office: 1 2 3 4 5 Fax: 12345 Home: 1 2 3 4 5 Mobile: 1 2 3 4 5 Pager: 1 2 3 4 5 Preference (1 is highest) for emergency notifications: E-mail: 1 2 3 4 5 IM: 12345 Office: 1 2 3 4 5 Fax: 12345 Home: 1 2 3 4 5 Mobile: 1 2 3 4 5 Pager: 1 2 3 4 5

The Occupational Health Sub-council Forum Participation http: //www. ohden. org http: //www. ohden. net E-mail Forum: Delivery Options Click here to learn about delivery options Each message (immediate) Daily summary (delayed) Web mail at OHDEN. org Web archives only E-mail Forum: Content Options Click here to learn about flags Subject flag (OHDEN) Specialty flag (e. g. , health, safety, security, hygiene, administration) Topic flag (e. g. , chemical, biological, psychological, combinations, unknown)

The Occupational Health Sub-council Conferencing Recorded Calls OHDEN Administration 5 April 05 Chemical Hazard Prep. 22 April 05 Drill Planning for Radiological Event 29 April 05 Upcoming Scheduled Calls (Bridge for conference calls: (202) 555 -1234 code 3390) OHDEN Administration 5 May 05 Credentialing for Chemical Hazard Management 9 May 05 Ventilation System Security / Terrorism 15 May 05

The Occupational Health Sub-council

The Occupational Health Sub-council Current Issues • Limits of Share. Point • Desired elements not available in Share. Point – FTP monitoring of web resources – Robust and innovative listserve capability – Active alerting • Potential of HSIN

The Occupational Health Sub-council Occupational Health Disaster Expert Network OHDEN is: • A repository of selected and targeted references • A library of reviewed web content • An active community of credentialed experts • A professional forum for planning, training, and response • A communication network for urgent alerts • An essential resource to enable occupational health to fulfill its potential as a parallel public-health network to preserve the critical infrastructure of the nation’s workforce and productivity