A Study of First Moments in Underground
 

Mine Emergency Response∗
 

∗The authors are researchers at the Pittsburgh Research Laboratory, Mining Safety and Health 

Research, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease 

Control and Prevention, U.S. Department of Health and Human Services. 

Kathleen M. Kowalski-Trakofler, Charles Vaught, Michael J. Brnich Jr., and
 

Jacqueline H. Jansky
 

Abstract

Researchers at the National Institute for Occupational Safety and Health (NIOSH) conducted 

seven focus groups and 10 individual interviews to gather data on what happens in the first crucial moments of a mine emergency. The goal of the project was to learn about responses on-site 

during the initial phases of a mine emergency to further improve response. The subjects represented underground coal and salt mines in the southern, western, mid-western, and eastern parts 

of the United States. They included on-site responders, mine rescue team members, and experts 

in mine emergency response with extensive experience in managing mine disasters. The types of 

disasters the subjects experienced were diverse, including explosions, fires, and inundations (sudden floods of water or inrushes of dangerous gases). This study was unique in its focus on the 

first moments in an emergency response, in studying underground coal mine emergencies and in 

utilizing a focus group methodology. Results indicated that there were common themes in initial 

response, which included the importance of mine emergency planning and training, quantity and 

The authors acknowledge the dedicated miners, mine rescue teams and their trainers, medical 

mine rescue teams, mine safety training professionals, and mine management across the country. 

Thanks to Melissa Silva, HUCAU Student Intern, Pittsburgh Research Laboratory and Michael 

Meighen, former NIOSH employee. 
quality of communication providing information for decision-making, leadership and trust, plus 

individual personal issues. Previous relevant studies are presented and the researchers discuss the 

data providing specific examples. The article concludes with recommendations to enhance initial 

response in the first critical moments of an emergency. 
1. Introduction 

An underground mine is an inherently dangerous workplace. The safety of 

workers depends upon many interrelated factors, including knowledge of the 

dynamic, ever-changing environment, the ability to recognize and respond to 

hazards, training, experience, and communication. During an emergency, these 

factors can be crucial to response. When something goes awry in an underground 

mine, seconds count and the initial response can be critical to the outcome. 

Understanding the behaviors and issues present in the initial moments of a 

response to a mine emergency may enhance escape, facilitate rescue, and be 

helpful for training miners and decision-makers. The authors define initial 

response as what happens between the time an incident is determined to be an 

emergency (the decisions and actions undertaken by the underground miners, 

surface personnel, and gathering incident command personnel) and the time the 

rescue or escape is well underway (the command center and response personnel 

are in place, rescue teams functional, and plans developing). 

In the United States, mine operators, federal and state mine safety 

agencies, and researchers have looked at numerous aspects of mine emergency 

response. The most intense efforts in this area have occurred following major 

mine emergencies. Some of the better-known events, most of which involved 

multiple fatalities, have included the Farmington No. 9 mine explosion in 1968, 

the Scotia mine explosions in 1976, the Wilberg mine fire in 1984, the Jim Walter 

Resources No. 5 mine explosions in 2001, and the non-fatal Quecreek water 

inundation in 2002. In 2006, several major incidents occurred in underground coal 

mines, resulting in 19 worker fatalities within a five month period. These events 

included two in West Virginia -- an explosion at the Wolf Run Mining Company's 

Sago Mine, and a fire at the Aracoma Coal Company Inc. Alma No. 1 Mine -- and 

an incident in Kentucky, an explosion at the Kentucky Darby Coal Company 

Darby No. 1 Mine. In 2007, a massive ground failure at Crandall Canyon mine in 

Utah resulted in nine deaths. 

These more recent incidents have raised a number of new and re-occurring 

issues about mine emergency preparedness and response. In the months before 

the 2006 incidents, researchers at NIOSH conducted a series of focus groups and 

individual interviews with experienced mine emergency responders. The goal of 

the research was to determine the behaviors and learn about the issues present in 

an initial mine emergency response. After the events of 2006, several of the 

subjects interviewed individually and several subjects in the focus groups were 

randomly contacted to determine if these events altered their perceptions of the 

first critical moments of a mine emergency. These experienced responders 

indicated the more recent events did not change their views. 
Focus group subjects had experienced a mine emergency on-site at their 

mines or were members of a mine rescue team responding to an emergency. 

Individual interview subjects had expertise in managing mine emergencies. The 

types of emergencies the subjects experienced were diverse, and included 

explosions, fires, and inundations. The locations and commodities also varied and 

included underground coal and salt mines located in the eastern, central, southern 

and western United States. 

2. Framework of Key Issues 

The focus group interviews yielded a myriad of data that, in and of itself, would 

be an amorphous mass of unstructured information. If such data are to be useful, 

they must be organized into a coherent and sense-making whole. This coherency 

does not occur whole cloth, but emerges during the process of grouping similar 

data and labeling it conceptually. These concepts, or “themes,” can then be 

organized by their relationship to each other and formed into a framework that 

possesses a significant level of explanatory power (Scott, 2004: 113-126). 

There were several key themes that emerged from the focus group data 

which dealt with the first critical moments in a mine emergency response. These 

themes were as follows: 1) Mine emergency planning, which subjects identified 

as something that impacts the first moments of a response. The better planning 

there is in place, the smoother the first moments are likely to unfold. 2) The key 

issues that arise immediately after an event occurs involve communication and 

information gathering. The respondents considered good communication as 

critical to an informed response. 3) Leadership and trust emerged as important 

considerations, as did 4) training. The better trained individuals are, the better 

able they are to cope with exigencies. Finally, there is decision making, which is 

impacted by whether people are at risk and by 5) individual personal issues. The 

decision making process defines the actions that are to be taken, and as there are 

further communication and information gathering, the dynamic process continues. 

Once these themes were identified, it was then necessary to show their 

relationship to each other as the next step in sense-making. To do this, the authors 

developed a framework to illustrate the themes and suggest their relationship to 

each other. (Figure 1) There are three points to be noted about this framework. 

First, the framework deals with a carefully circumscribed set of phenomena – first 

moments in an underground mine emergency. As such, it is simpler than it might 

have been had it incorporated a broader range of issues. Second, the framework 

depicts a dynamic process that unfolds as more information becomes available 

during an event. Third, the framework fits with, and adds to, existing research that 

covers a more general depiction of emergency response. Section 3 explores 

related research that has a bearing on the present problem. 
Figure 1 Framework of First Moments in Mine Emergency Escape 

3. Background and Relevant Previous Studies 

In the aftermath of the mining deaths of 2006 and 2007 in the United States, 

various commissions were convened and reports issued examining mine escape 

and rescue. These included a report by the National Mining Association's Mine 

Safety Technology and Training Commission (MST&TC) released in 2006. In 

addition, new federal (MINER Act, 2006; Title 30 Code of Federal Regulations, 

2007; and the proposed S-MINER Act, 2007) and state legislation, along with 

new mine safety regulations, have passed. These sources and other previous 

studies may provide the reader with some context for the identified themes 

resulting from this study, although none directly addresses the question of what 

happens in the first critical moments of a mine emergency. The documents do 

examine important pre- and post-incident issues that can influence the first 

moments of response. 

There are also studies on the human response to mine emergencies 

conducted by NIOSH researchers over the past twenty years (Cole et al, 1985; 
Cole et al, 1998; Vaught et al, 2000; Vaught et al, 1997; Mallett et al, 1993, 1994, 

1999; Kowalski et al, 2008). 

3.1 Mine Emergency Planning 

Mine emergency plans are mandated in the U.S. mining industry at the federal 

level. All miners should be trained to understand and follow the mine emergency 

plan where they work. Some companies see emergency response planning as 

developing a written response plan that can be pulled from the shelf and used to 

manage an emergency when it occurs. These organizations see having a written 

plan as sufficient. In actuality, a response plan is only one piece of the continual, 

dynamic process of emergency response planning. 

Preparedness suggests a well-rehearsed, comprehensive emergency plan. 

A number of researchers support the notion that planning for an emergency is a 

process and follows a continual, dynamic cycle (Pelfrey, 2005; Perry and Lindell, 

2003). Perry and Lindell illustrate the relationships of three critical components 

of emergency preparedness: planning, the presence of written plans, and training. 

Pelfrey suggests a model of preparedness that contains five broad phases 

including prevention, awareness, response, consequence management, and 

recovery. Pelfrey contends the cycle allows for a dynamic, flexible, and 

continuous process of interaction and integration, and functions as a selforganizing mechanism that improves preparedness for anticipated events and for 

the unimagined events. The research discussed here supports the concept of 

planning as a continual process. 

Orasanu and Connolly (1993) attempted to specify what goes on when 

real-world decisions are made in response to written plans. They arrived at eight 

characteristics of real-world decision making: 1) ill-structured problems; 2) 

uncertain, dynamic environments; 3) shifting, ill-defined, or competing goals; 4) 

multiple event feedback loops; 5) time constraints; 6) high stakes; 7) multiple 

actors; and 8) goals of the organization balanced against the decision maker’s 

personal choice. These characteristics dovetail into the concept of planning as a 

continual process with respect to the dynamic environment, the presence of time 

constraints and the multiple event feedback loops demanding continual 

evaluation. 

An additional factor to consider is that people tend to initially try to 

normalize the situation in an emergency. They tend to interpret events as normal 

as long as possible before defining the situation as out of the norm and needing 

action (McHugh, 1968). Over-planning, or attempting to plan for every possible 

emergency, can be a major pitfall and may in fact result in inadequate planning. 

Good planning should be based on accurate knowledge of known threats. 
Identifying threats and their associated risks will help establish planning 

process priorities. As a first critical step in emergency response planning, a 

thorough hazard analysis and risk assessment should be conducted (Perry and 

Lindell, 2003; Pelfrey, 2005). Pelfrey (2005) also surmises this will help in 

keeping emergency response plans simple and easy to use. 

The Mine Safety Technology & Training Commission report (2006) 

recommends developing a comprehensive emergency response plan that is riskbased and mine specific. A risk-based plan is targeted for the most likely threats 

and assumes that preparing for them also prepares for unrecognized hazards. The 

report suggests that the competencies required for successful escape include: 

technical knowledge, mine specific knowledge, and escape conceptual knowledge. 

Technical knowledge is the understanding and proficiency in the use of 

emergency breathing apparatus (self-contained self-rescuers, or SCSRs), lifelines, 

refuge chambers, etc. Mine specific knowledge refers to knowledge of the mine 

maps, the escapeways, the ventilation system, where the SCSR cache is located, 

the mine emergency response plan, and familiarity with escape capsules. 

Conceptual knowledge refers to the ability to think and adapt to changing 

conditions, to be resilient, to be able to problem solve and make decisions, and to 

understand the dynamic of human behavior in escape, including leadership and 

other psycho-social issues. 

Research conducted by NIOSH, assessing response to underground mine 

fires, reported on the importance of good emergency response planning (Vaught, 

et. al. 2004; Mallett, et al, 1994). The authors found that while there are many 

different kinds of situations, adequate planning and preparation for dealing with 

mine emergencies will ensure an effective response. Effective response, in turn, 

will allow mine operators to deal with the situations, protect both workers and 

others during response events, and return the operation to production as quickly as 

possible. 

3.2 Communication 

Communication, both the process and the content, is important in relaying 

accurate information. Information about the situation affects the initial response 

and defines the first moments of an incident. In addition, both technical and 

interpersonal communication play a central role in the first critical moments of a 

mine emergency response. Previous NIOSH studies indicate that the effectiveness 

of a mine’s communication system is a key factor in the initial response. Research 

has suggested that effective communication will "...reduce confusion, increase 

confidence in decisions, stop rumors and incorrect information, and improve the 

likelihood of success" (Mallett, et al, 1999:3). Kowalski et al, (2003:283) noted 

that “emergency decision makers under stress not only have the effects of their 
own stress response and its resulting consequences but the information they must 

base their judgments on is often unclear, faulty, and incomplete.” NIOSH 

researchers developed the Emergency Communication Triangle which indicates 

three primary and three secondary key pieces of information necessary to 

communicate in the event of an emergency. The primary information is who, 

where, and what; the secondary information is miners (people involved), event 

(what are you facing), and finally response (what is the response so far) (Mallett, 

et al., 1999). 

Two communication issues related to an individual’s tendency to believe a 

warning and take action more quickly have been identified: the credibility of the 

source and the content of the message. The more credible the source, the quicker 

people are likely to respond. The more accurate the content, the better are the 

response decisions (Mallett, 1993). One undesirable effect of inaccurate or 

inadequate information is that it allows individuals to define their circumstances 

as normal, sometimes long after it is time to take action. For example, at a mine 

fire in western Pennsylvania, miners treated the situation as routine until 

presented with overwhelming evidence that the mine was, indeed, on fire. “Lack 

of detailed information ... enabled miners to continue acting ‘as if’ they were not 

in a threatening circumstance long after they should have been responding 

differently." (Mallett et al.,1993:721). 

3.3 Training 

Many experts consider training to be one of the most essential elements in the 

emergency response planning process. Training, in the form of drills, mock 

disasters, and even tabletop simulations, affords the opportunity for planners to 

identify and resolve problems, examine and evaluate the utility of developed 

procedures, refine plans, and train individuals who will be responding to 

emergency events (Perry and Lindell, 2003; Ernst, 2006; Jennings and Lush, 

2004; Smith et al 2001). Training and drills also allow responders to come 

together and develop personal and working relationships with each other (Perry 

and Lindell, 2003). Training for mine emergency preparedness is addressed at 

length in the document produced by the Mine Safety Technology & Training 

Commission. In general, preparedness training focuses on the mine emergency 

plan, self-escape, and aided rescue (mine rescue). Since the present study is 

focused on the immediate, at-the-mine aftermath of an incident, this literature 

review does not address aided rescue. It is significant to note that the MST&T 

Commission’s priority recommendations concluded that regulatory training was 

not sufficient training for preparedness. The Commission stated, regarding the 

training required by 30 CFR Part 48, “training requirements are not sufficient to 

deal with the training gaps that exist in this area” (p. 88). In addition, they noted 
that in the U.S. there is an over-reliance on rote learning and passive training 

methods such as videos. Findings from the Conduct of Simulated Emergency 

Exercises on emergency response capability held at Southern Colliery in 

Queensland, Australia supported the value of simulated exercises and self-rescue 

(Rowan, 1998). The key finding from the conduct of the training simulations was 

to validate self-escape (as opposed to aided rescue or mine rescue) as a robust and 

efficient strategy to enhance the survival of underground personnel. Support of 

self-escape includes ensuring that all underground personnel will have adequate 

oxygen supplies to escape along a designated escapeway. Rescue is provided for 

personnel unable to reach safety on their own. 

The Australian report notes that objective data support what the industry 

has long suspected: that reactive responses through surface management and mine 

rescue teams, which take time to assemble, have limited impact on survival rates 

of underground personnel during the first few hours of an emergency. The report 

notes that a robust, pro-active, integrated, and well-rehearsed self-escape strategy 

is the single best chance for survival for those personnel. Rescue activities rarely 

impact the events in the first critical hours of an incident. Other studies also 

support the conclusion that although there will always be a requirement to have 

rescue teams available to respond to a mine emergency, the greatest impact on 

survivability is the effectiveness of the self-escape response of the workforce in 

the critical minutes after an incident (Brenkly, et al., 1999). 

In general, miners are trained to take time to gather everyone in the first 

moments after a mine emergency is identified. Thus, identifying gathering 

locations in an underground work area is an important part of preparedness 

because it reduces the amount of time needed to gather personnel and begin an 

evacuation. Researchers have noted that the greater the time delay in response, the 

more problematic the response becomes. Mine industry emergency response 

personnel often paraphrase Don Mitchell, a U.S. expert in mine emergency 

response, as saying "In a mine emergency, time is not your friend." 

3.4 Decision-making 

Decision-making directly relates to communications issues. In an emergency, 

decision-making relies on 1) the quality of the information received by everyone 

immediately following the incident and 2) the technical communication system in 

place in the mine. Research has suggested real world decisions made in a mine 

emergency are arrived at in a context characterized by sometimes uncertain 

information that must be acted upon in a short time frame under stressful 

conditions. The process is iterative, meaning that one choice leads to another 

until the incident is resolved. 
Decision-making is also affected by the experience level of the people 

involved. Many events, such as an underground mine emergency, are handled by 

multiple decision makers, not all of whom are experienced in reacting to such a 

situation. In their study of experienced fire ground commanders, Klein and 

Klinger (1991) note that, if the veterans were to take the time to generate a large 

set of options and evaluate them in order to arrive at the optimum choice, the fire 

could get out of control before any decisions are made. These individuals are 

reaching decision points as the event unfolds, and, rather than analyze each 

decision, the commanders rely upon their experience to help them recognize and 

classify each event. Klein (1989) called the strategies the commanders used to 

reach their classification “recognition primed decisions.” The present authors 

suggest that this classification is fit into a sort of template, which allows the 

veterans to quickly arrive at a response that seems appropriate. The fire ground 

commanders will then imagine the option being implemented in order to discover 

potential problems. If the commander foresees problems, he or she might then 

modify the option, or reject it and go to another template. 

Such template-style thinking requires an experienced decision maker (the 

fire ground commander or mine emergency response veteran). In emergency 

situations, there are many instances, especially in the first moments of an incident, 

when a response veteran might not be available and a novice may need to make 

critical choices. The question then becomes one of how he or she functions in a 

situation characterized by a lack of templates to guide decisions. How is the 

novice's decision-making different from a veteran's decision-making? Are his or 

her actions merely random reactions to the event, or do they have meaning and 

purpose? 

Cohen and Freeman (1996), writing about time-stressed decision making, 

argue that any decision maker gives meaning to a novel or unfamiliar situation by 

building a “story” about what is going on. Hunter et al, (2000) note that this story 

building is one way to distinguish between experts and novices. In diagnosing a 

situation, experts are more adept at recognizing when they do not have enough 

information to make an adequate assessment. Novices, by implication, may take 

longer to come to the same recognition. Either way, however, more information 

must be extracted from the situation before a diagnosis can be reached. 

Pennington and Hastie (1993), in their study of jury members, argue that jurors 

extract information in bits and pieces from various sources and impose a story 

type structure on the process. This story construction is a strategy for 

understanding human action, but, as Cole (1997:331) notes, these constructed 

stories usually must fill in gaps by integrating facts, perceptions, intentions, 

actions and their consequences into coherent meaning. In the same vein, the 

respondents in this study used stories to make sense of their past involvement in 

emergencies. 
3.5 Leadership/Trust 

Kowalski, et al (1994) examined miners’ responses during their escapes and 

found miners tend to respond as a group and the quality of leadership affects the 

group’s behavior. In addition, the authors found that leadership emerges during an 

escape such that the boss is not always the escape leader. In the study, which 

evaluated eight separate groups escaping from three separate underground coal 

mine fires, six characteristics of a leader in escape from an underground fire were 

determined. These included: 1) incidental learning, being attentive to the 

environment; 2) leadership developed naturally, not coerced; 3) leaders were 

flexible, yet decisive; 4) leaders were open to input from others; 5) leaders 

provided a reassuring, calming effect for the escaping miners; and 6) leaders used 

a logical decision-making process. 

3.6 Personal Issues 

Personal issues affecting response include medical conditions, emotional state, 

fatigue, social support, and trust in leadership. The RAND Report, “Protecting 

Emergency Responders Lessons Learned from Terrorist Attacks” (Jackson et. al., 

2002) found that the personal and professional bonds of the responders led to 

greater risk-taking during the response. This conclusion is relevant in the small 

mining community where everyone knows everyone. A further RAND report 

(Willis, 2006) found that “some PPE equipment, such as helmets and fireprotective clothing can be very heavy. Some boots and respirators may cause 

discomfort or increased risk of heat stress because of prolonged use. These issues 

can lead to rapid fatigue or distractions, placing responders at greater risk in an 

already hazardous work environment. “(p.9) Mine rescue team equipment fits this 

description. 

The duration of an emergency response may create the need for additional 

safety activities. Responders often work extended work shifts. This can result in 

fatigue and affect decision-making. It was reported that responders and managers 

worked unsustainably long work shifts at Hurricane Andrew, the World Trade 

Center response, and the anthrax attacks. Command personnel and mine rescue 

team members have reported similar long hours over many days in response to 

mine disasters. (Jackson, 2004). 

The traumatic nature of a major disaster can have significant effects on 

individuals and organizations responding to the event. The 2004 RAND study 

indicated that focus groups discussed a culture shift in so far as the understanding 

and need for traumatic incident stress information and training. Researcher also 

showed that support provided for families of responders could be an important 

component in meeting the emotional needs of responders. 
 

4. Method 

The research questions for this study were: 1) What happens in the first critical 

moments of an emergency response? What are the first reactions and decisions? 

2) What are the key issues of importance in the first moments of the response? 

What is the role of communication? 3) What should be happening – what are the 

lessons learned? How can we improve initial mine emergency response? 

Qualitative data were gathered through focus groups and individual 

interviews. To allow participants greater freedom of expression, the individuals 

and organizations represented are not identified. Three different experienced 

researchers served as scribes and the sessions were mechanically recorded. The 

focus groups were all facilitated by the same research psychologist, in order to 

provide consistency in the data collection method. Researchers developed a preplanned discussion guide, which provided further consistency. Once the sessions 

were transcribed, the data were analyzed for specific patterns, key concepts, and 

trends. 

Each focus group included different participants and was two to three 

hours in duration. There were seven focus groups composed of individuals who 

were knowledgeable in mine escape, experienced in mine escape, and/or who had 

expertise in the area. Three focus groups contained members of a mine rescue 

team, while four groups were comprised of on-site responders. Participants, 

including individual interview subjects, comprised supervisors, rank-and-file 

miners, industry representatives, mine rescue trainers, as well as state and federal 

mining agency personnel. 

NIOSH researchers developed a discussion guide (Appendix A) to be used 

with the focus groups. The questions were open-ended in order to encourage 

discussion. The discussion guide was designed to target the three key areas and 

generate discussion and interaction among the participants, while answering the 

research questions. The guide consisted of these questions to provoke discussion 

and answer the three research questions. 

1) What happens in the first critical moments of an emergency response? What 

are the first reactions and decisions? A) What were your first reactions after 

understanding that there was a real emergency? B. What were the first decisions 

made? 

2) What are the key issues of importance in the first moments of the response? 

What is the role of communication? What role did information play in the 

emergency (i.e. communication)? 

3) What recommendations would you suggest to improve mine emergency 

response? What should be happening – what are the lessons learned? How can we 

improve initial mine emergency response? 
In addition, there was opportunity during the focus group sessions and the 

individual interviews to discuss other issues pertinent to the topic and the 

participants. 

Researchers performed a multi-stage qualitative data analysis. Preliminary 

analysis allowed the researchers to identify major patterns and topic areas. Each 

topic area was targeted in a second analysis for validation and more in-depth 

understanding. A third analysis targeted specific examples of each topic and the 

inter-relatedness of topics. Finally, a framework was developed to illustrate the 

relationship between the topic areas (Figure 1). Key concepts were identified 

within topic areas. 

Lessons learned and recommendations were the objective of the final data 

analysis. 

It was determined that the data from the three mine rescue team focus 

groups provided additional and some different information than those focus 

groups comprised of on-site responders. Mine rescue teams respond within the 

first or second day of an incident as opposed to within the first critical moments. 

These subjects provided an important contribution to the study because of the 

teams’ insights into the consequences of initial on-site decisions. Often, the mine 

rescue teams have to “live” the consequences of the initial on-site response. The 

topic areas that impact the initial moments of a mine emergency response, as 

identified by the focus groups and subject interviews included: 

preparedness/planning, communication/ information, training, leadership/trust, 

decision-making, and personal issues. The authors utilized these key topic areas 

to organize the selected literature review and to organize the data for the reader. 

As noted, these data were collected shortly before the events of 2006, but they 

include informal follow-up discussions with targeted subjects after the events of 

2006 and 2007. These subjects were a sample of convenience available to 

researchers during the year after the events. These follow-up discussions further 

confirmed the results of this study. 

5. Results and Observations 

5.1 Planning 

Every focus group or individual interviewed talked about emergency response 

planning and its importance in managing the initial aspects of mine emergencies 

and the on-going incident. The list below depicts key points made by focus groups 

and individuals, related to aspects of emergency response planning. 

• Having a plan helped or will help in managing the emergency. 

• Know your plan thoroughly. 

• Every person should have a job under the plan. 
•	 Everyone must be trained on the response plan. 

•	 Revisit the plan constantly as the situation changes. Flexibility is 

important in real life emergencies. 

•	 You must be prepared for emergencies - no matter what. It must be a 

priority. 

Many groups and individuals emphasized that it is necessary to develop a 

comprehensive plan for mine emergencies. As one group noted, “It’s important to 

be prepared before any emergency. Good structure and good procedures need to 

be in place.” Another group acknowledged that a mine can prepare for an event 

but not necessarily what transpires during the event. That group felt that having a 

good response plan will help responders adapt to the situation. Knowing the plan 

thoroughly was deemed as important as having it in the first place. Knowledge of 

the plan can help provide an appropriate response in those first moments after a 

mine emergency is determined. One group said “You have to know your plan so it 

can be activated effectively.” Another said that it is essential for people at the 

mine to be knowledgeable in the response plan for their operation. They 

suggested that the way to be knowledgeable about the plan was through training 

and practice. 

Both focus groups and interviewees stressed the importance of training 

people on the mine’s emergency response plan. One focus group held that people 

who will be responding to mine emergencies must be trained on the mine’s 

emergency response plan with hands-on training. Another group felt that every 

person at the mine should be trained on the response plan. This would ensure that 

all players know the plan, should they be called upon to undertake a role in 

dealing with the emergency. Finally, two groups discussed the importance of 

ensuring every person has a job under the emergency response plan. They stressed 

this would help workers become familiar with both the plan and the roles they 

will assume, should an event occur. 

Subjects discussed the importance of cross-training, as it is rare for all 

personnel to be available or present at the time of an emergency. Cross-training 

provides backup for filling crucial roles and an understanding of other jobs which 

can improve teamwork. Four focus group participants felt that having an 

emergency response plan either helped in managing a past emergency or would 

help in dealing with a future event. As one individual said, “The rescue went well 

due to [the mine] having a good response plan in place.” In another instance, 

participants noted their mine had a good response plan and had adequately trained 

employees on the plan. The group felt this helped mine personnel focus on the 

need to be prepared for emergencies. 

Finally, two groups talked about the importance of revisiting the 

emergency response plan. The first group suggested that a mine use their response 
plan repeatedly. If decisions are made based on the plan and the situation changes, 

responders can go back to the plan and make a new decision to fit encountered 

changes. The second group advised that operators “reiterate the response plan” as 

the emergency unfolds, consulting and restudying the plan as the event continues 

to develop. 

The overarching theme identified from study participants was that mine 

operators must have an emergency response plan to successfully manage 

emergencies that will arise and on which workers must be trained, and practice 

the plan before an event occurs. 

Training and practice of the mine emergency plan impacts what happens 

in the first critical moments of a mine emergency. 

5.2 Communication/Information 

In general, subjects agreed that “most of the problems (in emergency response) 

come from communication breakdown”. Information is an important part of the 

first reaction to an event and most focus groups and individuals began with a 

discussion of information. Several focus groups and individuals argued that an 

initial response is only as good as the information received. Critical information 

must be conveyed; the information must be accurate, precise, and from a trusted 

source; and if possible, should come directly from the source rather than through 

middlemen or an information chain. Mallett, et al, (1999) identify crucial 

information that must be conveyed in a mine emergency. 

• Who are you? (Identify yourself) 

• Where is the problem? 

• What happened? 

Subjects in the present study identified these same topics. Besides these three 

pieces of information, other important information is needed to make informed 

decisions. One must find out details of 1) the event (how large is the fire or how 

much water has come in); 2) miners involved (is everyone accounted for or are 

any miners missing or injured); and finally 3) the response (is the fire being 

fought, etc.). 

Many of the focus groups and individual subjects told the interviewer that 

their first question is generally "What is the nature of the emergency?" quickly 

followed by "Are there people involved?" Next, they need information to assess 

the safety of the scene: "Could this happen again?" In other words, could there 

be another explosion, inundation, or belt fire. In order to answer these questions, 

one interviewee said, “The first thing I do is gather accurate information.” 

Subjects reported that accurate information is critical in any emergency. One 

decision-maker said that he told his people he did not want to hear any 

information unless it was accurate. He did not want to hear “I think” or “it would 
appear” or “it seems”. He wanted only correct information of which they were 

certain. 

The source of the information is often a key consideration in the 

credibility of that information and can increase or decrease confidence in that 

information. Every focus group and interview discussed evaluating the source of 

information. “Who is giving you the information? Is this a trusted individual? 

What is your personal experience with the person? Are they a credible source? 

You evaluate the source based on your own experience with the individual.” One 

respondent posed the question, “How do you sort out and distill the information? 

There are rumors and confusion and you must find the most valuable person to 

convey what’s going on.” For example, more weight is afforded a 25-year veteran 

miner reporting fire and smoke than a new miner with four months' experience 

excitedly reporting “Fire! Smoke!” 

Particularly in the early stages of an emergency, denial and chaos can 

increase confusion. Decision-makers indicated that they rely on trust. One 

decision-maker said "It becomes a matter of trust. Who do you trust? Who can 

you trust?" Trust was the common thread in evaluating information, and trust of 

the source of information was closely linked with decision-making. Those in 

charge of emergencies rely on the knowledge and experience of the people 

providing information, whether on the nature of the emergency or resources 

available. 

There are, then, certain questions those in charge ask about the 

information itself: “Is the information reliable? Is it first or second-hand? Does 

the information make sense based on my own perceptions and knowledge of the 

environment?” Subjects agreed that the responder needs to be able to 

communicate with the information giver and ask the right questions to ferret out 

as much information as possible. Subjects felt that direct communication was 

important and that it is advisable to “cut out as many middlemen between the 

recipient and provider as possible. Information is changed as it is passed along. 

Bits and pieces get lost.” 

Interviewees were unanimous in the observation that accurate, detailed 

information is basic to good decision-making, while too much information or 

conflicting information is a serious problem. Other information factors affecting 

the response included the context of the information, the detail or precision of 

information, time factors, and information about the involvement of people. 

Subjects reported that it was important for leaders to determine the context of 

information they received, and that after accuracy of information, detailed or 

precise information became important. The need for more precise information 

increases as the event progresses 

Subjects indicated that the involvement of people changed the nature of 

the response, which became more intense if people were trapped or hurt. 
Interviewees told researchers that miners and mine rescuers take more risks when 

people are involved. Information about injured or trapped people is, therefore, 

important. 

Time factors are a consideration. Although quick responses are essential, 

acting on incorrect initial information can cause problems. One decision-maker 

indicated that “there is a thin slice of truth in initial information". This is 

especially relevant in an underground mine where, once committed to a plan of 

action, reversing that plan is not an easy task logistically due to the environment. 

One seasoned emergency decision-maker, who had led numerous emergency 

responses, said he would advise one critical initial action: “STOP”. At a time 

when everyone is scurrying, his advice to stop is meant to gather accurate 

information. He had witnessed numerous incidents where decisions were made 

on initial and, oftentimes, incorrect information. Because of the logistical 

difficulty of correcting incorrect action deep within an underground coal mine and 

the further issue of possible disrupted communication, pausing the initial response 

to re-evaluate the emergency makes sense. Whereas, telling the local fire 

department to stop while managing a community emergency is not necessarily 

appropriate because the fire fighters and their command have more flexibility in 

the ability to manage and quickly adjust decisions and actions. . The rule of thumb 

from some of the mining experts seems to be to “make haste slowly”. An 

underground coal mine fire is very different than a structural blaze. Workers’ 

escape paths in a low coal seam may be such that workers cannot walk upright; 

workers may have miles to travel to safety; the coal itself is a fuel. Underground 

salt mines pose problems with inundations since the water dissolves the salt. 

Initial decisions in these environments are crucial. 

5.3 Leadership 

Leadership is a key issue in mine emergencies, for both the escaping miners and 

the rescue command center. The leader’s first responsibility is the safety of the 

miners during escape or working at the site. Leadership characteristics applicable 

to the initial response mentioned by subjects, included the appearance of 

confidence and calmness, and being able and willing to make tough decisions. In 

addition, flexibility in leadership is important and trust in the leader impacts 

followers in the initial phases of an emergency. 

Subjects were near unanimous in saying that a disaster cannot be managed 

if the primary concern is for political or economic consequences. Ideally, 

decisions will be made quickly, based on the leader's knowledge and on accurate 

information, and these can be implemented promptly. Flexibility is difficult to 

maintain if the command center or designated leadership is away from the scene. 

Subjects emphasized that operations and rescue operations should be led from on-
site and not from a headquarters located far away from the scene. Leaders need to 

be present and able to focus on the here and now. Subjects noted that such focus 

is critical for both underground and on the surface managing a disaster. Subjects 

noted that such focus is critical for both those underground and for those on the 

surface, managing a disaster. 

Finally, trust and an underlying belief in the leader are critical on the 

surface as well as underground. Escaping miners or members of the command 

center team must trust that the leader can do what is necessary in response to the 

situation. 

5.4 Training 

Five focus groups and a number of individual interviewees mentioned training as 

affecting decision-making and every other aspect of emergency response. In 

general, subjects agreed that there should be training in decision-making, as well 

as universal training in emergency response. One subject said “Emergency 

response training is necessary for individual miners and additional response 

training is necessary for those in charge, foremen, etc.” More hands-on training 

should include the “why we do this” and how it will help in an emergency. 

Subjects suggested that the same basics exist in all kinds of emergencies, 

surface and underground, and, therefore, basic, general emergency training could 

be valuable. One said: “It’s important to study what really happens each time. 

Everyone must be trained and cross-trained. People can find themselves in an 

unfamiliar situation, like a foreman working on a particular section for only one 

day. Regardless, everyone must be trained to know, in general, what to do in an 

emergency.” One group said “[We] need more training on things a miner needs 

to know and be responsible for – knowing where escapeways are and how they 

are marked, fire extinguisher locations and how to use them, where you are in the 

mine, and how to find your way out of the mine.” Hands-on training in realistic 

situations is the best way for miners to become prepared and confident. Working 

and training together enables members to get to know and trust each other. 

“Better and more training make the proper reactions instinctive and people are 

less likely to panic or mess up.” 

5.5 Decision-Making 

Decision-making is a critical outcome of the activities that take place in an 

emergency’s first moments. Many of the issues impacting decision-making have 

been discussed in the preceding text and depicted by the framework in Figure 1. 

Subjects provided a plethora of information on decision-making, and the authors 
conducted a content analysis of the data from all focus groups and all individuals. 

Responses were categorized and tabulated. 

The subjects discussed twelve identifiable factors that had an impact on 

decision-making. These factors were organized into five categories ranging from 

circumstances outside the individual (situational and organizational), to thinking 

(cognitive), and automatic reactions, both mental and physical (autonomic and 

physiological). The factors and the number of groups or individuals discussing 

each factor are presented here. 

Factors Affecting Decision Making and Frequency of Responses 

Factors 

Situational 

•	 Circumstances – The type of problem, its severity and whether 

there are people involved, influences decisions. 

Organizational 

•	 Roles – Whether one plays one’s role calmly and with confidence 

influences decisions. 

•	 Objectives – Conflicting agendas affect decision making. 

Cognitive 

•	 Information – The source, the relative certainty, the relative 

accuracy and the flow. 

•	 Communication – The source is most important. 

•	 Knowledge – Whether knowledge is gained directly or 

Indirectly, and whether it is adequate or inadequate. 

Autonomic 

•	 Training – Good training leads to good decisions. Makes 

decisions “instinctual.” 

•	 Instinct – When one is well-trained, “instinct” kicks in. This 

reduces the number of decisions that have to be made. 

Psychological 

• Stress – Stress leads to bad decisions. 

• Fatigue – One cannot make good decisions when fatigued. 

 Frequency 

 8 

 6 

 3 

 9 

 3 

 3 

 5 

 4 

 4 

 2 
• Adrenalin – Too much adrenalin can lead to bad decisions. 2 

• Fear 1 

Examples of representative responses that touch on these issues follows. 

The circumstances discussed by the subjects ranged from chaotic to 

straightforward. In one chaotic instance, where there was a massive roof fall and 

inundation in an underground salt mine, there were people involved but the 

response was characterized by several key failures. First, upper management 

seemed overwhelmed and made little effort to coordinate the response. Second, 

the chain of command broke down and people were reacting by “shooting from 

the hip”. One subject noted the situation needed someone who was willing to 

make decisions because the event involved such life-or-death choices as saving 

the mine versus saving people. Several subjects, discussing two separate incidents 

(one relating to a loss of life and the other to the loss of the mine), concluded that 

good decisions cannot guarantee good outcomes and vice versa. 

Subjects felt that "instinct" could affect emergency response and that 

“...situations sometimes dictate that you trust your instincts.” One subject gave 

the following example. “A group of firefighters worked underground in high 

humidity and heat; they felt exhausted. The mine manager felt they suffered heat 

stroke and evacuated them to the outside before they were physically 

compromised. Instincts can be good or bad; the adrenalin rush may tend to lead 

you to pursue bad instincts such as staying in a situation beyond a reasonable time 

with respect to the limits of your breathing devise technology. The more 

experiences you have with emergencies, the better you get at trusting your 

instincts; however, you never know how the situation will turn out.” 

The focus groups and individual interviewees suggested that stress may 

lead to bad decisions, but that is not necessarily so. Subjects noted “Stress comes 

from the lack of information and lack of confidence. At [our mine], we were 

scared. It was a stressful situation with a heightened awareness. The adrenaline 

was flowing and the feeling was of self-preservation for yourself and the group.” 

Another noted “The effect of stress is different on different people and in different 

situations. Are you underground and making the decisions with the disaster in 

your face or the authority initiating decisions from the surface? A characteristic 

of a good leader is the willingness to make decisions. It helps to know your 

reaction to stress so you are able to deal with it.” 

When an incident occurs, organizational objectives change from routine 

production to emergency response activities (saving people, saving the mine, 

saving equipment). In the same vein, workers must shift from the roles they play 

during routine production to non-routine roles; everything from evacuee to 

director of the command center. People will, therefore, be making decisions in 

less familiar circumstances than usual. Good plans, according to one focus group, 
identify who should do what. Because a plan is mine-wide, it defines roles 

according to one’s position in the organization, not to particular persons. For 

example, one subject reported that he was a shift foreman at the time of a fire at 

his mine and was also captain of the mine rescue team. As the shift foreman, he 

was responsible for both evacuation of the mine and firefighting; as the captain of 

the mine rescue team, his role was to coordinate above ground. Initially, this was 

not a conflict, because evacuation of the workers was the primary objective. 

After the evacuation was completed, fighting the fire became the primary 

objective, and the subject faced a decision: the “question of staying in charge 

above ground or leading the team – which role do I take?” He stated that he was 

“very conflicted.” Since all miners were evacuated, he chose to lead the 

firefighting team. At that point, he shifted from the role of directing the command 

center to directing the team in its firefighting efforts and having to deal with the 

command center in that role instead of a directorial role. Subjects reported other 

instances of role conflict as well. 

5.6 Personal Issues 

Subjects discussed the impact of personal issues on their behavior during an 

emergency. Personal issues included fear, not knowing what to expect in certain 

circumstances, physical fitness for escape, and concern for their families. Almost 

every subject noted that there was a time when he experienced paralyzing fear, 

that he might not make it out of the mine, that he would be injured, or that he was 

going to die. This fear interfered with their ability to function in the emergency. 

Many mentioned the importance of expectations training, such as what to expect 

when wearing an SCSR, or needing to understand how people react in an 

emergency situation, including information about traumatic stress. There was 

mention of the generation gaps of the miners mainly in terms of physical fitness 

for escape. Concern for families was universal. 

6. Discussion 

The research questions for this study were: 1) What happens in the first critical 

moments of an emergency response? What are the first reactions and decisions? 

2) What are the key issues of importance in the first moments of the response? 

What is the role of communication? 3) What should be happening? What are the 

lessons learned? How can we improve initial mine emergency response? Results 

indicated that there were common themes in initial response. The key issues in 

the first critical moments were threefold. First, communication and information, 

influenced by accuracy, shaped the response. Second, decision-making based on 

that information and knowledge of this or similar situations influenced actions. 
Finally, leadership and trust played a significant role in the first moments of a 

mine emergency. Background issues included preparedness/planning and training, 

and individual personal issues. This study was limited by the number of subjects 

and the nature of self report and focus groups. Researchers purposefully provided 

anonymity to subjects to allow them greater freedom of expression resulting in 

richer data. 

What happens in the first critical moments of an emergency response? People 

tend to normalize the situation as long as possible until the facts dictate a serious 

problem and action is absolutely necessary. Time is critical. 

What are the key issues of importance in the first moments of the response? 

Previous planning and training come into play immediately. The quality of, and 

experience with, planning and training can make a substantial difference in the 

initial decisions about, responses to, and outcome of a mine emergency. Adequate 

communication and accurate information from individuals and technical 

information from monitoring devices is vital. Leadership, trust in that leadership, 

and the ability to make decisions rapidly comes into play along with any personal 

issues such as fear, stress, and fatigue. Research supports self-escape as opposed 

to rescue as the most likely scenario for reducing fatalities. The data supports the 

MST&T Commission report that three areas of importance in escape include 

technical knowledge, mine specific knowledge, and escape conceptual knowledge. 

What are the lessons learned? How can the mining industry improve initial 

response? Planning is critical and realistic training makes a difference in 

response. Subjects stated that their experiences show that cross-training is 

important. Cross-training allows for personnel substitutions and better 

understanding of team roles. Identifying and developing leaders for emergencies, 

and providing leadership with realistic emergency drills and simulations, are 

valuable for a timely and coordinated response. Realistic emergency escape 

training should be provided for all miners, including some of the training and 

rescue devices presently only given to mine rescue teams. Subjects indicated that 

training should include such topics as traumatic incident stress and SCSR 

expectations training. 

There are three fundamental ways in which this study differs from other 

studies reviewed in this article. First is the subject itself. An underground coal 

mine is many orders of magnitude larger than a surface structure and also much 

more complex and dynamic with its machinery, entryways, crosscuts, air shafts, 

escapeways etc. Second, this study focuses on first moments of an emergency, 

and as nearly as can be done, only on that time frame. This means the authors 

must make sense out of what the respondents report about a time usually 
characterized by chaos and uncertainty. Third is the methodology itself. By the 

use of focus groups the authors have obtained much richer data than is generally 

gotten through such techniques as questionnaires or even one-on-one interviews. 

The rationale behind the use of focus groups is that the combined responses of the 

group working together will yield more insight than will talking to subjects 

individually. With this in mind it is instructive to examine ways in which the 

focus group data, while supporting findings from other studies, adds something 

new to the discussion about behavior in emergencies. 

Some of the more interesting findings were in the areas of communication, 

decision making, and leadership. Regarding communication it was found that 

great weight is placed on identifying the credibility of the source of the 

information being gathered. If the source is considered not to be credible, much 

time can be lost while additional information gathering is conducted. 

Communication also affects decision making. There are two factors involved 

here: First, given the nature of the enterprise, there is a significant amount of 

dependence placed on technology. If the technology isn’t working correctly, there 

can be a breakdown in the information gathering/decision making process. 

Second, the quality of information received has a great bearing on the outcome of 

a response. Also, in reference to decision making, the use of a cognitive 

“template” aids the decision making ability of an experienced responder, while an 

inexperienced person would be slowed down because of the necessity of 

constructing a “story” that will help him or her to integrate bits and pieces of 

information into coherent meaning. Finally, as regards leadership, it was 

suggested that leaders “emerge” and the amount of trust they garner as the 

emergency goes on has much to do with their success. In addition, it was found 

that how effectively and calmly one plays the leadership role has a great bearing 

on the response outcome. All-in-all, the present research yielded many insights 

that contribute to our understanding of what happens at the start of an emergency. 

7. Conclusions and Recommendations 

NIOSH researchers conducted seven focus groups and ten individual interviews to 

gather data on what happens in the first crucial moments of a mine emergency. 

The authors' conclusions and recommendations from the study are focused 

on four key areas. 

1.	 Preparation and Planning are crucial to successful emergency response. 

Good planning is based on risk assessment, and assessment of hazards is 

the first step. Preparations must be a continuous, dynamic cycle. 

Knowledge of the response plan must be required learning for all miners, 

and realistic practice and plan re-evaluation must be a part of preparation. 
Previous researchers (Pelfry 2005, Perry and Lindell, 2003) support the 

dynamic cycle of emergency planning and response. Mine emergency 

plans must be mine specific (supported by MST&TC 2006). 

2.	 Communication and information are critical. Even with a good plan, 

escapees and responders cannot respond adequately without accurate and 

timely information. The authors recommend mine trainers teach the 

NIOSH Communication Triangle (Mallett, et al., 1999), which provides an 

empirically based sequence of information for accurate communication. 

Although this study was not focused on technology, researchers 

recommend investing in and remaining current in communication 

technology. 

3.	 Leadership and Trust are key issues often not taken into consideration in 

planning and training for a mine emergency. Research is available on 

issues of leadership in escape, command center leadership, and on 

building trust. Leadership is most effective when on-the-scene. 

4.	 The authors recommend providing mine management and miners with the 

information in these areas to integrate into planning and training. 

5.	 Training is one of the most essential elements of a coordinated and timely 

mine emergency response, according to our subjects. The authors agree 

and suggest that the industry should 

a.	 Employ realistic training 

b.	 Train everyone, not just rescue teams. Everyone should have a role 

in mine emergency response. 

c.	 Include cross-training to provide better role interface and 

substitution of roles when necessary. 

d.	 Focus on miners in the training for mine emergency, not just on 

technical solutions. 

e.	 Teach decision-making. 

f.	 Standardize communication, both technology and protocols. 

g.	 Teach miners about stress responses in an emergency to help them 

normalize their responses in an emergency situation. 

h.	 Include SCSR expectations training. 

Understanding the factors important in the initial response to a mine 

emergency can provide direction for future mine emergency planning, response, 

and training. Evaluating past outcomes with respect to these key topic areas can 

help improve initial response in areas including planning, communication, 

leadership, training, and decision-making. Miners can develop a better 
understanding of appropriate actions that can translate into quicker response and 

positive outcomes. Mine operators can learn what they need to address in their 

emergency planning to incorporate successful strategies and to improve response 

behaviors and communication. 

Appendix A 

Discussion/Interview Guide 

Mine Emergency Response: Focus on Initial Response and Communication 

Introduction: Thank you for volunteering to participate in this research focus 

group. The information you share with us will be used to understand key issues in 

the first critical moments of a mine emergency. You are the experts in mine 

emergency response and we are looking to learn from your experiences. We are 

not concentrated on one event or doing a case study of one event. We are 

interested in your expertise in mine emergency response. (Focus group leader 

introduces self and the recorder to the group.) We will be taking notes, as what 

you have to say is very important to us. It is important that you understand that 

you will not be identified individually or through any organizational affiliation. 

Your responses are anonymous. This exchange of information is confidential and 

we ask all participants to respect that confidentiality. Do you have any questions? 

Our Research Questions include: 1. What happens in the first critical 

moments of an emergency response? 2. What should be happening? 3. How 

can we improve initial mine emergency response? 

1. First Reaction 

What is the first reaction when an alarm or a warning is given and affirmed to be 

critical? 

How have you reacted after receiving the initial warning of a problem?
 

What factors influenced how you reacted?
 

How have others reacted after the initial warning was received? 

How near were you to the problem? Were you given instructions? By whom?
 

Research on initial response to a disaster indicates that most people do not panic, 

but fall into their normal roles. Has your experience supported this? How?
 

2. First Decisions – What are some of the first decisions that must be made after 

the initial warning is given and how are these decisions made?
 

Do you try to learn more about the event before initially responding?
 

What do you want to know before initially responding?
 

Did you seek information from others in your group, a supervisor?
 
How does stress play into decision-making and initial response?
 

Did you ever trust your own instincts in determining how to respond?
 

What are the first five (?) initial steps taken when responding after the initial 

warning has been received?
 

Do these steps vary by the type of event or are there steps which are common to 

all events? 

What kind of underlying problems i.e. information uncertainty, knowledge of the 

mine, etc. made it difficult for you to make initial decisions? 

What did you observe in people responding under the stress of an emergency? 

What positive behavior/characteristics did you observe? Negative 

behavior/characteristics?
 

3. Information is critical to making good decisions in the initial stages of a mine
 

emergency. 

Do you evaluate the source of information you received?
 

How do you evaluate the source?
 

Is the source a reliable source? 

What kinds of criteria do you use to evaluate the information source?
 

How do you evaluation the content of the information?
 

What kinds of questions do you ask when finding out about the problem? 

How do you sort through all of the initial information and distill it down?
 

What information do you need to make quality decisions in the first moments of a 

mine emergency?
 

4. Recommendations - Improving emergency communications can help ensure a 

successful response. 

What recommendations would you suggest to improve emergency 

communications?
 

What would you teach mine personnel to help them improve emergency 

communications?
 

Would the content of what you teach differ among miners, supervisors, and
 

communications personnel (the person outside)? If so, how would it differ?
 
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