ERHMS

Health Monitoring and Surveillance During Response Operations

Purpose

Response personnel need to be monitored in order to document the condition of their health, injury, and illness status 

during emergency operations in response to disasters and emergent events. 

Monitoring refers to the ongoing and systematic collection, analysis, interpretation, and dissemination of data related to 

an individual incident responder. 

Surveillance refers to the ongoing and systematic collection, analysis, interpretation, and dissemination of illness and 

injury data related to an event’s emergency responder population as a whole.

Health (Injury and Illness) Monitoring

• Allows for prompt recognition of risks that may be 

amenable to intervention.

• Gathers information that can be used for 

understanding the health effects of ongoing or 

new exposures occurring during emergent events. 

• Provides valuable information:

 For setting up medical surveillance post-deployment. 

 For follow-up of adverse health consequences 

related to work at an incident. 

 On up-to-date protection against illnesses and 

injuries. 

 On unsafe conditions or practices possibly 

indicating a lack of adequate training. 

Who to Monitor 

• Incident personnel who are deployed to specific 

areas suspected to be hazardous.

• Personnel who are experiencing similar symptoms.

• Workers in certain occupations or with certain 

exposures.

Health (Injury and Illness) Surveillance

• Involves the collection of different types of 

information, including medical, exposure, work 

history and activities, PPE, and training.

• Provides information useful for measuring the 

health impact at the population level, determining 

scope of injury and illness, and planning for the 

next event.

Who to Include in Surveillance 

• Incident personnel identified should be based 

on the type of work being performed, including 

duration of the task, materials being used, and 

potential for exposure.

Monitoring and surveillance helps to document and track incident 

personnel health status during and after an incident
ERHMS

Health Monitoring and Surveillance Data Q&A

Emergency Responder Health Monitoring and Surveillance

The Emergency Responder Health Monitoring and Surveillance (ERHMS) system is a health monitoring and surveillance 

framework that includes recommendations and tools specific to protect emergency responders during the pre-deployment, deployment, and post-deployment phases of a disaster. The intent of ERHMS is to identify exposures and/or signs 

and symptoms early in the course of an emergency response in order to prevent or mitigate adverse physical and psychological outcomes and ensure workers maintain their ability to respond effectively and are not harmed in the course of this 

response work. Data will also help to identify during the post-deployment phase which responders would benefit from 

medical referral and possible enrollment in a long-term health surveillance program. Please refer to Chapter 6 and section 

6T for more information on Health Monitoring and Surveillance During Response Operations.

National Institute for Occupational Safety and Health (NIOSH) ERHMS Contact:

! CDR Renée Funk, Coordinator, ERHMS at rfunk@cdc.gov or 404-498-1376

For more information on ERHMS, please visit: 

erhms.nrt.org & www.cdc.gov/niosh/topics/erhms

Utilizing collected data to prevent or mitigate adverse 

health outcomes while ensuring responder safety

• What Are Potential Sources for Data?

 Monitoring: Exposure monitoring records, purchasing and 

production records, training records, health and safety-related 

policies, and operating procedures.

 Surveillance: Occupational Safety and Health Administration 

(OSHA) logs, healthcare facilities.

• How is Data Acquired?

 Electronic transfer systems, records review, surveys.

• What Type of Worker-Related Data Should Be Obtained?

 Monitoring: Personal information, response-related information, medical information, biological monitoring.

 Surveillance: Denominator, demographics, category of worker, 

level of training, injury or illness.

• What Should be Done with Data after Collection?

Evaluate for quality; code, analyze, and interpret; disseminate in 

concise and easily understood reports; and communicate to stakeholders as close to real-time as possible.