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Preface

wo years since September 11, 2001, when a terrorist attack leveled the World Trade Center, killing thousands of people, and another hit the Pentagon, killing hundreds more, NEHA is issuing a report to assess what lessons for environmental health can be learned from these disasters—widely regarded as the worst and largest international terrorist events in our nation’s history.

The images of terror are still vivid to most of us but not everyone realized that the nation experienced a new kind of environmental health emergency as well. When the World Trade Center and sections of the Pentagon came crashing down that day, the rubble left for rescuers and cleanup crews was laced with asbestos, heavy metals, diesel fuel, PCBs and dozens of other toxins. New York City was enveloped in a cloud of smoke, soot and toxic ash. Perhaps for the first time, the pivotal role of environmental health in terrorism preparedness was made clear. 

 

“Since we’re all on notice to expect some kind of event, NEHA wants to accumulate a base of knowledge to share with those in all areas of environmental health and public health so that they can be better equipped for the future,” Nelson Fabian, director, says.

 

The broad outlines of the incidents at the World Trade Center and Pentagon are fairly well known. But the inside story on how environmental health professionals worked behind the scenes to try to make a difference that day and in the months that followed, however, is not well known. These tragic events offer important opportunities to understand how people responded under stress, as well as lasting lessons for emergency and environmental response.

 

 

 

 

As is clear to even the least imaginative among us, environmental health professionals are now on the frontlines in defending public safety in this age of terrorism. That is one of the main reasons NEHA took on the task of this report. At one time the worst hazards they confronted were corrosive acids, asbestos and contaminated medical needles, New York’s Environmental Police Unit told The New York Times. (1) Today it’s dirty bombs and more.

 

People working in the environmental health fields are today being joined by a host of other professionals—EMS and health first responders, public health nurses and doctors, epidemiologist, forensic pathologists, police and fire officials, and others.

 

In fact, the events of 9/11 brought to the fore many issues that have long been simmering—the need for first responders to be more mindful of health and safety, the need for all emergency personnel to be better coordinated and able to communicate with one another, and, of course, the specter of responding to a biological or chemical terrorist attack.

 

A month after September 11, testifying before the Senate, Jeffrey P. Koplan, MD, Director, Centers for Disease Control and Prevention, stated that "Prior to the September 11 attack on the United States, CDC was making substantial progress toward defining, developing, and implementing a nationwide public health response network to increase the capacity of public health officials at all levels—federal, state, and local—to prepare for and respond to deliberate attacks on the health of our citizens. The events of September 11 were a defining moment for all of us." (2)

 

“While not an entirely new issue, 9/11 did bring to the forefront the need to examine how health and safety issues are handled by first responders,” says disaster expert Tricia Wachtendorf. (3)

 

At the World Trade Center, 450 emergency responders—fully one-sixth of the victims of that attack—perished while doing their jobs, while environmental and medical officials, as well as volunteers, stood helpless to save them. Hundreds of others were seriously injured.

In the aftermath of the attacks, undoubtedly firefighters now will take greater precautions in rushing into burning buildings and carry in more sophisticated hand-held radios. What should be done when it comes to environmental and occupational health?

The mission of this document is to present the facts of responding to a terrorist event as they apply to environmental health professionals of all kinds--be they hazardous waste specialists or sanitarians, air quality technicians or public health department managers.  Our considerations in this report cover air and water quality, radiological and bioterrorism threats, hazardous substances and wastes, waste removal, carting and disposal and public health interventions of all kinds, including food handling, sanitation and vector control.

NEHA was interested in describing the important role of assuring environmental health and safety -- and hearing the stories of those unsung 'heroes' whose stories haven't come out--people at the frontlines who did their regular jobs under rather trying and extraordinary circumstances. These stories emerge—as well as healthy debate on such issues as the community’s right to know about environmental hazards in their neighborhoods and the need of public officials to balance the need to weigh top down control versus community response.

 

What are some of the major issues in addressing a catastrophic health disaster? What were the critical management lessons from the experience? How do public health and environmental health managers need to be better prepared in the future? What was left out last time? What went right and wrong at crucial decision-making junctures?

 

This document describes: 1) What environmental professionals of all kinds did (and, to some extent, how they might have worked with first responders) and the pressures on them in response from the public and the community; and 2) What they might have done differently—what they learned from the experience.

 

This report is also written to call forth a variety of new perspectives—like, asking the question: How soon should the government be able to respond to protect public health and what kind of prior coordination is needed among different agencies? What did the public expect of its public interest agencies in such dire circumstances?

 

Since the events of 9/11, many state and county health departments have started revamping their emergency response and evacuation plans to prepare for potential acts of terrorism, especially chemical and biological terrorism. And many experts see local public health departments as being central to preparedness efforts, rather than peripheral.

 

“All terrorist incidents start as local events and local incident commanders are key agents for protecting the public, and need to be informed,” says Bruce Lippy, an industrial hygienist and occupational health specialist with the National Union of Operating Engineers.

 

“Before 9/11 none of this wasn’t really being taken seriously,” says Thomas R. Ward, R.S. Environmental Health Director for the Union County Health Department in Monroe, N.C. “Now we’re getting better prepared, with contingency plans and problem solving along the lines of what is already done in anticipation of nuclear plant hazards or incidents.”

 

More money is now flowing for local training programs through the Centers for Disease Control, says Ward. Federal agencies are earmarking grants to health departments and environmental health departments for added preparedness efforts as well as emergency response in such areas as insect and vector control.

 

“All terrorist incidents start as local events and local incident commanders are key agents for protecting the public, and need to be informed.”

 

 

It’s vital that some of the billions of dollars spent on counter terrorism efforts at the federal level flow down to the local level. And much more needs to be done to enhance local and state capacities to better identify, prevent, and respond to a host of threats, by rebuilding and modernizing infrastructure.

 

More important than money, infrastructure and equipment in building preparedness, however, is the value of human resources and knowledge—relationships, institutional history and the lessons of past experience.  This report conveys those hard won lessons.

 

Terrorism by its very nature strikes without warning, as has been said; nevertheless, preparedness is key.

 

 

 Footnotes:

(1)     “At one time, the worst things the New York Sanitation Department's Environmental Police Unit were called to deal with were corrosive acids, toxic asbestos, contaminated needles and medical waste. But in the age of radiation threats from dirty bombs, the 10 men on the team have begun to feel that they are on the front lines in the defense of NewYork.” http://www.nytimes.com/2002/07/23/nyregion/23GARB.html?pagewanted=print&position

(2)     Committee on Appropriations, Subcommittee on Labor, Health, and Human Services, Education and Related Agencies, United States Senate, October 23, 2001, for Department of Health and Human Services..

(3)      Tricia Wachtendorf, , field director at the Disaster Research Center at the Department of Sociology and Criminal Justice, University of Delaware in Newark,DE. Retrieved from the Internet: http://www.udel.edu/DRC/tricia/AEM%20Presentation%20July%202002%20DRC.pdf