Environmental Safety and Health Assessment Template

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					                                                            +++ Northwoods Consortium Template v. 1.1 +++

                                                                  XX Health Department/Tribal Health Center
                                                            Environmental Health Assessment & Response Protocol



Introduction
The purpose of this document is to provide initial guidance and additional resources to address environmental health threats and emergencies at the local level. The document is based on
Objectives and Activities developed by the St. Louis University School of Public Health. The protocol covers the following areas:
   • Containment and Isolation                                                                         • Shelter Management
   • Decontamination                                                                                   • Vector Control
   • Epidemiology                                                                                      • Waste - Liquid/Sewage
   • Food                                                                                              • Waste - Medical
   • Hazardous Materials                                                                               • Waste - Solid Waste Disposal
   • Human Health Hazards                                                                              • Water - Drinking
   • Information                                                                                       • Water - Recreational

While the protocol includes references and resources for each situation, many environmental health resources cut across these categories. They include:
   • Wisconsin Division of Public Health emergency number: 608-258-0099
   • Wisconsin Division of Public Health Environmental Health website: http://dhfs.wisconsin.gov/eh/
   • Fact Sheets:
        Communicable: http://dhfs.wisconsin.gov/communicable/communicable/factsheets/index.htm
        Communicable: www.cdc.gov/node.do/id/0900f3ec8000e035
        Chemical: www.cdc.gov/niosh
        Chemical: www.atsdr.cdc.gov
   • ATSDR toll free number: 1-888-422-8737 (Agency for Toxic Substances and Disease Registry)
   • Wisconsin Poison Control: 1-800-815-8855
   • Wisconsin DNR: www.dnr.state.wi.us
   • Wisconsin Public Health Emergency Plan (PHEP) www.han.wisc.edu
   • State Statutes: http://www.legis.state.wi.us/rsb/stats.html
   • (Local Plans/Procedures)
   • Local Partners/Contact Information




                                                                                               1
                       Objectives                                 Activities                                        Resources/References                             Other Considerations

                  1. Assist in the           1.   Provide consultation on:                      •       Mortuary section of local EOP
                     implementation of a          a. Risk of disease.                           •       Local Coroner
                     quarantine to                b. Limiting movement of people and            •       Sample mortuary section on Northwoods Website
Containment &




                     prevent the spread               materials.                                        http://www.co.marathon.wi.us/infosubcon.asp?dep=20&sid
  Isolation




                     of illness or injury         c. Corpse management and death registry               =223
                  2. Assist in necessary                                                        •       Local Register of Deeds
                     quarantine              2.   Advise and/or direct:
                     activities.                  a. Containment strategy for individuals and
                                                     groups.
                                                  b. Embargo strategies for materials as
                                                     necessary.

                  Assure protection of the   1. Identify decontamination resources.             • CEAT (Chemical Exposure Assessment Teams)                      CEAT (Chemical Exposure
                  public health and          2. Secure individual and/or site until             https://www.han.wisc.edu/mod_news/news_view.jsp?id=13221         Assessment Teams):
                  environment through           decontamination can be conducted.               • Haz Mat                                                        •   Are DPH Staff which can include
Decontamination




                                                                                                                                                                     toxicologists, environmental health
                  decontamination            3. Assure proper decontamination is conducted.     • Hospitals (all now have decontamination tents)                     scientists, radiological specialists,
                  activities                 4. Provide consultation as appropriate.                                                                                 health educators, epidemiologists
                                                                                                                                                                 •   Are accessed via the DPH
                                                                                                                                                                     emergency telephone number
                                                                                                                                                                 •   Assist in the event of chemical or
                                                                                                                                                                     radiological contamination
                                                                                                                                                                 •   Can provide toxicological and
                                                                                                                                                                     technical support, environmental
                                                                                                                                                                     sampling, assessment of human
                                                                                                                                                                     exposure risk, prevention/ mitigation
                                                                                                                                                                     recommendations.




                                                                                                    2
                    Objectives                                Activities                                             Resources/References                             Other Considerations

               1.  Identify the risk      1. Provide demographic and other essential            •       Consortium epidemiologist
                  factors for disease         community data to response team/partners.         •       Control of Communicable Diseases Manual
                  or injury to occur.     2. Inform/teach of any environmental health and       •       Fact Sheets
               2. Determine                   safety concerns and issues unique to the          •       Council of State and Territorial Epidemiologists
                  prevention or risk          community.
Epidemiology




                                                                                                        Environmental Public Health Indicators: A guide for
                  reduction               3. Provide assistance in information and data                 monitoring the occurrence of environmentally-related
                  conditions                  collection and any other support activities               exposures and diseases, (preliminary document with
                  impacting on                available.                                                indicator results available August 2006),
                  human health            4. Assist in/assure the collection of environmental           http://www.cste.org/
               3. Identify methods to         and clinical samples and specimens.
                  reduce or prevent       5. Provide information and education to the public.
                  those conditions        6. Provide information about the population’s
                  detrimental to the          health status with respect to environmental
                  health of the public.       factors (for example, persons with diabetes or
                                              immunocomprised.)
               1. Provide                 1. Act in consultative capacity to assure             •       “Foodborne & Waterborne Outbreak Investigation Manual -   Non-agent counties may need to
                  consultation and           proper food handling practices.                            Appendix I: Public Health Concerns Following a Natural    access state sanitarians in order
                  assistance to           2. Provide information regarding protection                   Disaster”                                                 to complete this objective.
                  emergency feeding          of perishable foods if necessary, and                       www.han.wisc.edu (Topics> Communicable>
                  centers to assure          advice on sorting and disposal of                           Manual)
                  food safety                contaminated food.                                 •       “Safety in a Power Outage” CDC Fact Sheet
Food




                  handling.               3. Assure appropriate disposal of condemned                   www.bt.cdc.poweroutage
               2. Provide information        food stuffs.                                       •       Template EOP Public and Environmental Health
                  on sorting and          4. Assure assessment of licensed establishments.              Addendum for Agents
                  proper disposal of                                                                    http://www.co.marathon.wi.us/infosubcon.asp?dep=20&sid
                  contaminated food.                                                                    =223 (Northwoods Consortium website)
               3. Conduct field
                  surveys of licensed
                  establishments.




                                                                                                    3
                   Objectives                                Activities                                            Resources/References                             Other Considerations

              Provide information to    1. Assess if there are potential health risks due to   • CEAT (Chemical Exposure Assessment Teams) Manual               Coordinate with Emergency
              reduce the risk of           hazardous materials.                                 https://www.han.wisc.edu/mod_news/news_view.jsp?id=13221        Management
              exposure to individuals   2. In collaboration with partners, determine need      • DHFS "Environmental Assessment Equipment Available for
Hazardous
 Materials


              and the public               for evacuation.                                         Local Health Department Use"                                 CEAT Definition: See
                                        3. Refer the incident to the appropriate response      • DNR Spills Program http://dnr.wi.gov/org/aw/rr/spills/         Decontamination Section above
                                           agency and assure adequate follow up.               • DNR Spill Line: 800-943-0003
                                        4. Provide public information on risks and             • Radioactive Materials Staff Contact List:
                                           appropriate agency for assistance.                      http://dhfs.wisconsin.gov/dph_beh/RadioactiveMat/staff.htm
                                                                                               • (List partners and their capabilities here: haz mat - each
                                                                                                   level, fire, etc)
              Protect the public        1.   Conduct assessment of hazard site.                • Local (county and/or township) ordinance(s)                    Human Health Hazard means a
              from human health         2.   Refer to other agencies as appropriate            • State Statutes re Human Health Hazards                         substance, activity or condition
Hazards




              hazards.                  3.   Order mitigation as appropriate                        http://www.legis.state.wi.us/rsb/stats.html                 that is known to have the potential
Human
 Health




                                        4.   Assure appropriate mitigation is completed.            Chapter 254.59                                              to cause acute or chronic illness
                                                                                               • DHFS "Environmental Assessment Equipment Available for         or death if exposure to the
                                                                                                    Local Health Department Use"                                substance, activity or condition is
                                                                                                                                                                not abated.

              Provide information       1. Provide consultation to public information          •       Local Risk Communication Plan
              relative to public           personnel on matter relating to public and          •       Chemical Fact Sheets
Information




              health,                      environmental health.                               •       Local Emergency Manager
              environmental             2. Inform and educate the public on preventative       •       Key National Websites:
              health and safety            measures, quarantine, decontamination                       • NIOSH: http://www.cdc.gov/niosh/homepage.html
              issues.                      procedures and other public health issues as                • NEHA: http://www.neha.org/
                                           necessary.                                                  • CDC/Environmental Health:
                                        3. Document all activities.                                       http://www.cdc.gov/node.do/id/0900f3ec8000e044




                                                                                                   4
                          Objectives                               Activities                                              Resources/References                                Other Considerations

                     Ensure safe and          Assure each emergency facility is contacted,            Local EOP (defines the role of public health in shelter situation)   Work in coordination with
                     healthy conditions at    inspected and advised on the following:                                                                                      American Red Cross as
                     emergency and            1. Availability of potable water.                       Management of pets                                                   appropriate.
Shelter Management




                     gathering places.        2. Proper disposal of sewage.                           www.bt.cdc.gov/disasters/animalspubevac.asp
                                              3. Sanitary handling and storage of food.                                                                                    Coordinate with EM and/or
                                              4. General sanitation including housekeeping and                                                                             Humane Society on sheltering of
                                                  decontamination.                                                                                                         pets.
                                              5. Safety/injury prevention
                                              6. Vector control                                                                                                            Consider revising public health
                                              7. Proper emergency disposal of solid, infectious                                                                            portion of local EOP to reflect
                                                  and medical waste.                                                                                                       these activities.
                                              8. Availability of suitable water for decontamination
                                                  and personal hygiene.
                                              9. Appropriate alternative shelter of pets.

                     Provide oversight and    1. Assess vector control capabilities and               •       State Statutes re Human Health Hazards                       Also see Human Health Hazard
                     coordination of vector      operations.                                                  http://www.legis.state.wi.us/rsb/stats.html                  Section above.
                     control measures.        1. Assess presence of vector organisms (flies,                  Chapter 254.59
                                                 mosquitoes, rodents, etc)                            •       Rodent Control www.cdc.gov/rodents/
                                              2. Assess conditions that may promote the               •       Mosquito and Tick Control
Vector Control




                                                 proliferation or incursion of vectors.                       http://dhfs.wisconsin.gov/eh/MosquitoControl
                                              3. Implement preventative measures and activities.      •       Citizens Guide to Pest Control
                                                 For example:                                                 http://www.epa.gov/OPPTpubs/Cit_Guide/citguide.pdf
                                                 • Remove garbage                                     •       Animal Hazards After Disaster
                                                 • Provide/require waste receptacles                          www.bt.cdc.gov/disasters/hurricans/animalhazards.asp
                                                 • Order removal of tires                             •       Animal Health Statutes: www.legis.state.wi.us Chapter 95
                                                 • Etc.                                               •       Local Human Health Hazard ordinance
                                                                                                      •       Add any other local ordinances, policies/ procedures/
                                                                                                              partners (ex: DNR)




                                                                                                          5
                       Objectives                                  Activities                                                Resources/References                                  Other Considerations

                  Ensure proper handling     1. Assure the coordination of emergency waste             •       County EOP
                  and disposal of human         disposal facilities.                                   •       County Emergency Manager
Liquid/Sewage


                  liquid waste in order to   2. Assure the securing of commercial chemical             •       County Planning & Zoning Department
                  prevent disease,              toilets and arranging for servicing.
   Waste -




                  prevent contamination      3. If commercial toilets are not available, provide
                  of domestic water             information on alternative safe disposal
                  supplies and prevent          methods.
                  degradation of surface
                  and groundwater
                  quality.

                  1. Ensure that wastes      Assure the proper disposal of medical waste               •       Human Health Hazard resources (State Statute and any           Consider listing locations where
                     which require strict    including collection, storage, transportation,                    local ordinances/procedures)                                   medical waste is generated prior
                     handling under          treatment and disposal systems:                           •       Medical Waste statutes:                                        to an emergency.
                     normal                  1. Identify locations where medical wastes are                    http://www.legis.state.wi.us/rsb/stats.html (Chapter 299.51)
                     circumstances are           generated.                                            •       Medical Waste Administrative Code:                             Examples include: Coroner, law
                     disposed of safety.     2. Determine storage capacity and assess                          http://www.legis.state.wi.us/rsb/code/codtoc.html (NR526:      enforcement, tattoo parlors,
                  2. Prevent access to           accumulation beyond capacity.                                 Medical Waste Management; NR665: Incinerator                   veterinarians, pharmacies,
                     medical wastes by       3. Identify facilities/companies able to collect, store           Standards)                                                     hospitals, medical providers,
                     vertebrate or               and treat waste.                                                                                                             CBRF, blood banks, funeral
Waste - Medical




                     invertebrate            4. Assure emergency containment, removal and                                                                                     homes, dentists)
                     vectors.                    transport.
                                             5. Assure adequate and appropriate recovery and                                                                                  Coordinate with EM. Check local
                                                 clean-up of dispersed medical waste.                                                                                         EOP regarding lists of waste
                                                                                                                                                                              generators and haulers.

                                                                                                                                                                              Note: there are no licensed
                                                                                                                                                                              incinerators in Wisconsin.

                                                                                                                                                                              Definition of Medical Waste:
                                                                                                                                                                              Containers, packages and materials that
                                                                                                                                                                              contain infectious waste. Infectious
                                                                                                                                                                              Waste: solid waste that contains
                                                                                                                                                                              pathogens with sufficient virulence and in
                                                                                                                                                                              sufficient quantity that exposure of a
                                                                                                                                                                              susceptible human or animal to the solid
                                                                                                                                                                              waste could cause the human or animal to
                                                                                                                                                                              contract an infectious disease.




                                                                                                           6
                        Objectives                                 Activities                                                Resources/References                              Other Considerations

                   Ensure proper storage     1. Contact disposal company and transfer sites to           Add hauler contact information here or cite EOP if it is listed
Waste Disposal

                   and disposal to prevent      assess situation                                         there.
                   nuisances, odors, or      2. Assist in dissemination of public information on
Waste - Solid




                   contamination of the         safe disposal of waste (including hazardous and
                   food or the                  medical waste).
                   environment.              3. Assure safe temporary storage (if necessary)
                                                and safe removal and disposal.
                                             4. Assist and or assure in monitoring for vectors.

                   1. Assure the             1. Contact municipal water utility and/or TNC               •       “Foodborne and Waterborne Disease Outbreak                A Transient Noncommunity
                      availability of safe      (Transient Noncommunity) for status. Check                       Investigation Manual” www.han.wisc.edu (Topics>           Water system:
                      drinking water to         supplies.                                                        Communicable> Manual)                                     •   Serves 25 or more people at least 60
                                                                                                                                                                               days of the year, but does not serve
                      the public.            2. Follow up immediately on any unsafe water                •       “Transient Water System County Contract Program”              the same people more than six
                   2. Prevent waterborne        samples from municipal or TNC sources.                           Manual (DNR)                                                  months of the year.
                                                                                                         •
Water - Drinking




                      disease and            3. Notify lab of potential increase in tests.                       “Responding to a Boil Water Notice: A Public Health       •   Examples are motels, restaurants,
                      contamination          4. Assure alternate water supply.                                   Message” (DPH documents #PPH4589 & 45090) “Safe               parks, campgrounds, taverns, and
                                             5. Provide public information on water needs,                       Drinking Water” brochure (PUB-DG-061 2000)                    gas stations.
                                                testing, rationing, storage and disinfection                     http://dhfs.wisconsin.gov/eh/waer/index.htm
                                                (public and private water supplies)                      •       "Safe Drinking Water" brochure (PUB-DG-061 2000)          A Nontransient Noncommunity
                                                                                                                 http://www.dnr.state.wi.us/org/water/dwg/pubbro.htm       Water System:
                                                                                                         •       “Drinking Water Contamination Emergency Response
                                                                                                                 Guide” www.han.wisc.edu                                   •   Serves at least 25 of the same
                                                                                                                 (Topics>Laboratory>Laboratories)                              people more than six months of the
                                                                                                                                                                               year, but not as a primary residence.
                                                                                                         •       Any local protocols
                                                                                                                                                                           •   Examples are schools, businesses,
                                                                                                                                                                               and day cares.


                   Prevent disease due       1.   Assess health risks                                    •       Recreational Water Outbreak Response:
Recreation




                   exposure to               2.   Order mitigation as appropriate                                http://www.cdc.gov/healthyswimming/outbreak.htm
 Water -




                   contaminated              3.   Assure appropriate mitigation is completed.            •       Pool Contamination the feces/other body fluids:
    al




                   recreational water.       4.   Provide public information on recreational water               http://www.cdc.gov/healthyswimming/fecal_response.htm#
                                                  safety and response.                                           b
                                                                                                         •       Wisconsin Beach Information: www.wibeaches.us

Reference:
“The Role of the Local Health Department Sanitarian in Natural Disaster and Terrorism Incidents,” St. Louis University School of Public Health
http://www.google.com/u/saintlouis?domains=slu.edu&sitesearch=slu.edu&q=role+of+sanitarian




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