ERHMS

Purpose

IntegrationofExposureAssessment,ResponderActivity 

Documentation,andControlsintoERHMS

If hazardous exposures are identified or anticipated, exposure assessment plans must be established. This exposure assessment must be performed early in an incident response and sustained throughout the incident response and recovery 

phases. This assessment is necessary to establish links for the purposes of medical and public health intervention, compliance, or liability actions.

Principles of Sampling Strategies

Important parameters of the sampling strategy include the scope; comprehensiveness; number, timing, and frequency; 

and the methods used for sampling:

The following factors must be assessed:

• Jobrequirementsandtasks.

• Existingengineeringandadministrativecontrols.

• Personal protective equipment (PPE) requirements, 

standard operating procedures, and worker training.

• Potential hazardsinvolved in collecting and 

shipping thesamples.

The following factors must also be considered:

• Additive/synergistic effects from simultaneous 

exposure to mixtures of substances.

• Appropriate adjustments for nontraditional work 

shifts.

• AppropriateReferenceValuesandOccupational 

ExposureLimits(OELs).

• Reported health problems and concerns of workers.

• Other stressors (e.g., heat, fatigue, noise, ionizing 

radiation) that may be present.

• All routes of exposure (e.g., dermal, inhalation).

• Obtainingrepresentativesamplesusingappropriate 

sample strategy approaches.

Don’t forget:

• Multiple sampling strategies are often necessary.

• It is critical to understand the advantages, 

disadvantages, and limitations of the sampling 

methodology used.

• Skin contact can be a significantroute of exposure 

thatshould not beoverlooked.

Operating monitoring equipment to detect 

hazardous exposures
ERHMS

Types of Exposure Assessment Determinations

There are three decisions that public health professionals ascertain from the assessment:

(1) Acceptable:A job ortask has exposures below a pre-determinedOEL.

(2) Unacceptable: Exposures exceed orwill exceed predeterminedOELs, and imply an added health risk to the affected 

responders.

(3) Uncertain:Complex,unknownormixedexposures;requiresfurtherinformationgathering.

Documenting Responder Activities

Examples of information to be collected, documented, and included in investigative reports:

• Date, time, location, photos, and contact information of individual collecting the sample.

• Background readings, locations, and number of samples taken.

• The activity/task being evaluated, and number of workers exposed.

• Chemicals monitored, volumes/concentrations in use, other hazards present.

Measures to Control Exposure, Including PPE

• Verify that the PPE recommended is consistently and correctly worn by responders.

• Ensure that change schedules for recommended PPE are clear and appropriate.

Use of controlsshould be monitored, new controls being implemented should be noted, and use of controlsthrough 

direct observation in the field should be verified.

Emergency Responder Health Monitoring and Surveillance

The Emergency ResponderHealth Monitoring and Surveillance (ERHMS)systemis a healthmonitoring and surveillance 

framework thatincludesrecommendations and toolsspecific to protect emergency responders during the pre-deployment, deployment, and post-deployment phases of adisaster.The intent of ERHMS isto identify exposures and/orsigns 

and symptoms early in the course of an emergency response in orderto prevent ormitigate adverse physical and psychological outcomes and ensure workersmaintain their ability to respond effectively and are not harmed in the course ofthis 

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

medicalreferral andpossible enrollmentina long-termhealthsurveillanceprogram.Please refertoChapter7,section7T, 

andAppendix B formore information on Integration of Exposure Assessment, Responder ActivityDocumentation, and 

Controls into ERHMS.

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

 erhmsonline@cdc.gov

For more information on ERHMS, please visit: 

www.cdc.gov/niosh/erhms