Operation PPE – Developing Operation PPE – Developing a Safety First Culture for a Safety First Culture for

Iowa Environmental Public Iowa Environmental Public HealthHealth

2007 - 2008 2007 - 2008 Cory Frank, BA, Iowa Department of Cory Frank, BA, Iowa Department of

Public HealthPublic HealthDes Moines, IowaDes Moines, Iowa

February 2007February 2007

BackgroundBackground

Recent emergencies that involved environmental health Recent emergencies that involved environmental health responders or responders effected responders or responders effected

by environmental contaminants- such as the collapse and by environmental contaminants- such as the collapse and cleanup of the World Trade Center Towers in 2001, Hurricane cleanup of the World Trade Center Towers in 2001, Hurricane Katrina, and local public health outbreaks in Iowa involving Katrina, and local public health outbreaks in Iowa involving endemic fungal species and parasitic organisms like endemic fungal species and parasitic organisms like H. H. capsulatumcapsulatum and and CryptosporidiumCryptosporidium..

Flooding events in rural Iowa have created the need for Flooding events in rural Iowa have created the need for environmental assessments by local environmental health environmental assessments by local environmental health specialists to respond to local emergency management specialists to respond to local emergency management requests.requests.

Funding provided to local public health agencies has not Funding provided to local public health agencies has not incorporated environmental health responders into agency incorporated environmental health responders into agency safety programs if even available.safety programs if even available.

Local environmental health agencies have developed Local environmental health agencies have developed emergency response plans.emergency response plans.

The need for this safety first attitude and agency culture has become The need for this safety first attitude and agency culture has become especially evident due to recent events involving environmental especially evident due to recent events involving environmental public health factors, preparedness planning efforts, and local public health factors, preparedness planning efforts, and local funding gaps including:funding gaps including:

Problem StatementProblem Statement

Why with the important role that Why with the important role that environmental health plays in response environmental health plays in response efforts in the post 9/11 and Hurricane efforts in the post 9/11 and Hurricane Katrina era, do local environmental public Katrina era, do local environmental public health practitioners not have adequate health practitioners not have adequate knowledge or levels of personal knowledge or levels of personal protection equipment (PPE) or active protection equipment (PPE) or active occupational safety programs?occupational safety programs?

Behavior Over Time GraphBehavior Over Time Graph

(14)

Time

Quick Fixes

EH Stock of PPE

Risk to EH due to more involvement in Emergency Response

EH Use of PPE by local EH

Preparedness Funding for local Public Health

Contributing FactorsContributing Factors Creation of local environmental public health response Creation of local environmental public health response

plans involves the use of local EH in the response curve. plans involves the use of local EH in the response curve. CDC Preparedness grant funding was created to involve CDC Preparedness grant funding was created to involve local and State EH agencies; incorporating the need and local and State EH agencies; incorporating the need and use of PPE in job action sheets and when responding.use of PPE in job action sheets and when responding.

●● Current grant project surveyed local EH to Current grant project surveyed local EH to determine that they lack essential job related PPE. Local determine that they lack essential job related PPE. Local health departments do not have occupational safety health departments do not have occupational safety programs to prevent injury during regular job duties let programs to prevent injury during regular job duties let alone an environmental public health emergency.alone an environmental public health emergency.

Local public health agencies have purchased PPE Local public health agencies have purchased PPE for some public health responders such as nurses but not for some public health responders such as nurses but not EH. Also, items such as N95 respirators have been EH. Also, items such as N95 respirators have been purchased and distributed without proper fit testing or purchased and distributed without proper fit testing or medical monitoring of users.medical monitoring of users.

Creation of the IDPH EHRT (team) has promoted Creation of the IDPH EHRT (team) has promoted the roles of EH in emergency response.the roles of EH in emergency response.

Limits to SuccessLimits to Success

REAL World emergencies and

tragedy have increased the need for

Safe EH emergency response

Local/State EH NEED TO use PPE performing

daily work and respond to emergencies

R

No enforcement and buy in of local or

State occupational safety programs

B

Lack of Occupational health programming envelopment in EH

education and training

B

We don’t need to use PPE because we don’t

ever respond

I won’t get hurt and won’t take my work home with me SO WHY DO I NEED IT!

Funding to local EH from Grants

EH response training and information including credentialing in Iowa

Little or no data showing risk or actual injury or death from EH workers or responders

I never have used PPE before WHY SHOULD I NOW?

Local EH lacks PPEFix – Money, tools,

templates given to local public health

Unintended Consequences-Local EH when provided funding did not

purchase PPE

B

R

Fixes That Backfire

1. 2.

3.

Increased EH involvement in emergency response activities

Collaboration with Public Health Nursing

Flexibility provided

R

I don’t have a voice and opinion is not validated

We don’t need PPE we never use it

Program GoalProgram GoalTo reduce the risk of disease and injury to To reduce the risk of disease and injury to

local Iowa Environmental health local Iowa Environmental health professionals due to the availability and professionals due to the availability and knowledge of use of PPE (Personal knowledge of use of PPE (Personal Protection Equipment) by creating an Protection Equipment) by creating an occupational safety culture within local occupational safety culture within local and State environmental public health.and State environmental public health.

Process ObjectivesProcess Objectives1.1. By July 30th, 2008 75% Iowa local By July 30th, 2008 75% Iowa local

environmental health departments will environmental health departments will have received awareness materials and have received awareness materials and training regarding the critical value and training regarding the critical value and use of PPE while performing normal job use of PPE while performing normal job functions and response activities.functions and response activities.

National Goals National Goals SupportedSupported10 Essential EH Services10 Essential EH Services

Monitor environmental and health status to identify Monitor environmental and health status to identify community health problems.community health problems.

Diagnose and investigate environmental health Diagnose and investigate environmental health problems and health hazards in the community.problems and health hazards in the community.

Develop policies and plansDevelop policies and plans Enforce laws and regulations that protect health and Enforce laws and regulations that protect health and

ensure safety ensure safety Assure a competent environmental health workforce Assure a competent environmental health workforce

CDC Health Protection goalsCDC Health Protection goals People prepared for emerging health threatsPeople prepared for emerging health threats

CDC National Strategy to Revitalize CDC National Strategy to Revitalize Environmental Public HealthEnvironmental Public Health

Thank You!Thank You!

Cory FrankCory FrankIowa Department of Public Health, EH Services Bureau, Des Iowa Department of Public Health, EH Services Bureau, Des

Moines, Iowa 50319Moines, Iowa 50319cfrank@idph.state.ia.uscfrank@idph.state.ia.us

(515) 281-8561(515) 281-8561