Emergency Responder Health Monitoring and Surveillance Program (ERHMS)

What is ERHMS?

When disaster strikes, the nation depends on emergency response workers who are 

prepared and trained to respond effectively. 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 all phases of a response, including pre-deployment, deployment, and 

post-deployment phases.

This framework builds on systems and practices currently in use, and should prove useful 

to persons or organizations involved in all stages of a response. Despite the wide scales 

of events for which responder health monitoring and surveillance is needed, ERHMS 

principles apply to both small- and large-scale events, including local, state, and federal 

level responses. 

Why should we implement ERHMS?

The intent of ERHMS is to

 identify exposures and/or signs and symptoms early in the course of an emergency response

 prevent or mitigate adverse physical and psychological outcomes

 ensure workers maintain their ability to respond effectively and are not harmed during response work

 evaluate protective measures

 identify responders for medical referral and possible enrollment in a long-term health surveillance program

What activities does ERHMS address in each phase of deployment?

Pre-deployment Phase:

 Rostering and Credentialing of Emergency Response and Recovery 

Workers

 Health Screening for Emergency Responders

 Health and Safety Training

 Data Management and Information Security

Deployment Phase:

 On-site Responder In-processing

 Health Monitoring and Surveillance During Response Operations

 Integration of Exposure Assessment, Responder Activity 

Documentation, and Control

 Communications of Exposure and Health Monitoring and 

Surveillance Data during an Emergency Response

Post-deployment Phase:

 Responders Out-Processing Assessment

 Post-event Tracking of Emergency Responder Health and Function

 Lessons-learned and After-action Assessments

ERHMS can help meet Public Health Preparedness Capability 14: Responder Safety and Health

For more information on ERHMS, please visit: erhms.nrt.org & http://www.cdc.gov/niosh/topics/erhms

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

CAPT Renée Funk, rfunk@cdc.gov or 404-498-1376
Emergency Responder Health Monitoring and Surveillance Program (ERHMS)

Pre-deployment Phase

1. Rostering and Credentialing of Emergency Response and Recovery Workers

 Maintains accountability for all emergency responders

 Assesses responders’ education, training, and experience to deploy in their assigned response capacities

2. Health Screening for Emergency Responders

 Establishes a baseline physical and emotional health, and immunization status for each emergency responder

 Determines responders’ fitness for deployment

 Allows for more informed interpretation of possible post-deployment adverse health effects

3. Health and Safety Training

 Enables responders to fulfill certification requirements to perform duty-specific tasks

 Captures what training arriving responders have when reporting to the disaster and documents its effectiveness

4. Data Management and Information Security

 Maintains privacy required by law

 Facilitates efficient communication between agencies

 Enables reliable, comprehensive monitoring and surveillance post-deployment

Deployment Phase

5. On-site Responder In-processing

 Requires the use of a roster to log responders reporting to a disaster

 Requires that site-specific training (SST) be performed prior to responders entering a disaster control zone

 Ensures dispensing of personal protective equipment (PPE) during SST training or check-in and -out each day

6. Health Monitoring and Surveillance during Response Operations

 Documents the condition of responders’ health, injury, and illness status during emergency operations

 Allows for early intervention to stop further injury and illness of workers 

7. Integration of Exposure Assessment, Responder Activity Documentation, and Controls into ERHMS

 Requires the development of exposure assessment plans for identified/anticipated hazardous exposures

 Establishes links for medical and public health intervention, compliance, or liability actions

 Accounts for responder activities by providing a sense of where responders were operating, for how long, and in 

what capacity, over each day of their involvement in the response

 Allows for early intervention and the establishment of controls to maximize the chances for recovery and to stop 

further exposure for workers remaining on-scene

8. Communications of Exposure and Health Monitoring and Surveillance Data during an Emergency Response

 Requires that information about exposure and health data be communicated to workers, intra-organizationally, 

inter-organizationally, and within and outside the ICS structure

Post-deployment Phase

9. Responder Out-Processing Assessment

 Documents responders’ status at the conclusion of their response duties

 Verifies the accuracy of already captured information and collects additional follow-up information

 Detects possible acute/short-term adverse mental or physical health effects, and identifies those who need 

further medical evaluation or treatment when used in conjunction with pre- and during-deployment data

 Identifies health trends and potential risks within the population of workers

10. Post-event Tracking of Emergency Responder Health and Function

 Provides the data necessary to determine whether further responder health tracking is warranted and if so, 

what type of tracking would be most appropriate

11. Lessons-learned and After-action Assessments

 Assesses how ERHMS has been conducted through all phases and identifies ways to improve its activities