Abstract
Abstract
Hurricane Sandy damaged or destroyed 76,000 buildings with over 300,000 housing units; nine percent of the total housing in New York City. Sandy also damaged 405 New York City Housing Authority (NYCHA) buildings, affecting 35,000 units. Affected residents were forced to move in with family, temporary housing, or endured long periods without heat or electricity, as most building systems were located in flooded basements. Additionally, workers, volunteers, and residents who engaged in cleanup were potentially exposed to raw sewage, mold, asbestos, lead, dust, carbon monoxide, as well as electrocution; slips, trips, and falls; and construction-related safety hazards. Stress and trauma were also significant. These exposures may cause death, disease, and injury. The need to provide protection programs and effective training crosses a number of populations including day laborers, volunteer groups, and residents who are involved in cleanup and rebuilding. The National Institute of Environmental Health Sciences (NIEHS) Worker Training Program (WTP) has provided funding to more than 20 grantees including universities, labor unions, and other organizations to provide effective worker health and safety and disaster preparedness and response training for more than 20 years. This has built a critical infrastructure in the targeted industrial sectors and unions. WTP has also been active in disasters including September 11, Katrina, the Gulf oil spill, and Sandy. Preventing injury and disease in all the groups that are involved in disaster response, cleanup, and rebuilding warrants extending the NIEHS health and safety programs to volunteers, residents, and worker populations who previously have not had access to hazardous materials and related training programs. This can be accomplished by adapting health and safety programs and just-in-time training to the needs and cultures of these groups. These efforts should also further ongoing approaches to empower grantees and end-users so that they can independently build dynamic health and safety and training programs into their disaster preparedness and response work.
Introduction
H
Environmental Justice Impact
Among those most affected were individuals with the greatest socioeconomic, health, and pre-existing environmental disparities. One particularly impacted population was residents of nearly 400 NYCHA buildings. It was estimated that nearly 80,000 NYCHA residents were impacted by Sandy and many buildings lost electricity, power, heat, and water following the storm. 4 A survey of NYCHA residents conducted by the Urban Justice Center and community organizations found that “the impact of Hurricane Sandy on minority and low-wage communities was intensified by inadequate preparedness and response.” 4 Another key finding was that the health impacts of mold, which was identified as a major problem in NYCHA housing even before the storm, reportedly increased following Sandy. Concerns regarding the health impacts of mold are further underscored by high levels of pre-existing medical conditions in these communities, such as asthma, which likely increases an individual's sensitivity to exposure. 5
A New York University Furman Center report 4 highlights Hurricane Sandy's impact on NYCHA housing and its residents. The report notes that a higher share of low-income households, both renters and owners, filed for Federal Emergency Management Agency (FEMA) assistance than high-income households. Renters who filed for FEMA assistance were more likely to report an income of less than $30,000 than owners (2/3 of renters, 1/3 of owners). The median income reported by owners filing with FEMA was more than three times that of renters.
Sandy's disproportional impact on housing was not just on low-income populations. The percentage of households with seniors living in a flood zone, and of seniors who lived alone in a flood zone, putting them at greater risk for harm, were higher than the greater NYC area.
In addition to the disproportionate impact of the storm on low-wage and minority communities, the National Institute of Environmental Health Sciences (NIEHS) Worker Training Program (WTP) found that residents often had the dual impact of not only being displaced by the storm, but also working as disaster workers or volunteers.
Background on the Niehs Worker Training Program Sandy Response
As part of the Hurricane Sandy response, the NIEHS WTP has provided funding to more than 20 grantee consortia including universities, labor unions, and other organizations to provide innovative worker health and safety and disaster preparedness and response training for more than 20 years. The WTP has built critical infrastructure in targeted industrial sectors and has mobilized significant health and safety training resources and gained invaluable experience in prior disasters including the September 11 attack on the World Trade Center, Hurricane Katrina, and the Gulf oil spill.
Following Superstorm Sandy, FEMA provided a mission assignment to the NIEHS WTP to participate in a mold task force and to provide support and safety training to recovery workers who were engaged in hazardous waste removal and handling. Support and assistance was also provided in the development and delivery of site-specific health and safety training as well as assistance with respirator fit-testing and training for the proper use of personal protective equipment (PPE). Additionally, in the summer of 2013, two years of supplemental funding was provided through the Disaster Relief Act. This additional funding allowed NIEHS WTP grantees 6 to provide worker safety awareness training, through existing programs in the New York and New Jersey communities. WTP grantees provided training on disaster response, incident command systems, lead, asbestos, mold remediation, confined space, and numerous other topics. Part of these efforts included connecting with a number of the long-term recovery groups and scheduling training through construction and health and safety subcommittees and constituent volunteer groups. The training included mucking and gutting, mold remediation, and OSHA 10-hour construction classes.
Understanding The Hazards and Training Needs
In order to develop the most appropriate health and safety training for the Sandy response, NIEHS WTP reviewed available information from federal and state agencies as well as information from NIEHS field managers and response workers. For example, OSHA and the Centers for Disease Control and Prevention (CDC) identified significant exposures and deaths from carbon monoxide associated with the use of generators and heaters. 7 OSHA also reported significant levels of noise associated with a wide variety of cleanup and recovery activities, posted on its website from its Sandy Health Response Team testing results.
The environmental sampling conducted by OSHA and the New York City (NYC) Department of Environmental Conservation did not include personal sampling during mucking and gutting and mold remediation of Sandy-impacted homes. Such exposures may pose additional risks to workers, volunteers, and homeowners and general precautions for dust, asbestos, lead, and silica should have been taken during the cleanup of storm damaged building materials.
Additionally, field surveys conducted by NIEHS awardees revealed that most homeowners and volunteer groups involved in mucking and gutting Sandy damaged homes had limited or no knowledge on how to identify a variety of hazardous materials, such as asbestos and lead, commonly found in residential and commercial structures built before 1975. Additionally, health and safety training in hazard identification and control is not generally available to these populations and when it is offered, often excludes information on important hazards such as mold and exposure to raw sewage.
Lastly, involvement in responses to hurricanes or other disasters may increase existing mental health conditions or contribute to new mental health problems. 8 Increases in levels of post-traumatic stress disorder (PTSD) and other mental health problems have been observed, especially in the months immediately following a natural
disaster. Some of the highest rates of PTSD 9 and mental health problems were found in disaster volunteers and those not traditionally thought of as “responders” or “disaster professionals.” A study 10 in 2004 found that general volunteers who responded to a natural disaster had rates of PTSD almost twice that of professionals (30% versus 18%).
Understanding Training Needs for Special Populations
Volunteers
In addition to training for homeowners and workers on the various hazards and exposures common to disaster, additional attention needs to be paid to untrained groups of volunteers that spontaneously respond to disasters. Countless volunteer groups, often from areas not impacted by the storm, were instrumental in providing support and assistance with cleanup activities throughout the Sandy response. The use of spontaneous volunteers (SV), volunteers who are not connected to a pre-disaster network or response agency, is common after a disaster. While the support provided by SVs is important, volunteers limited training and often-limited experience in disaster environments can lead to unsafe work practices and exposures, therefore increasing the risk to volunteers and the organizations they work with.
In a survey 11 of 24 National Voluntary Organizations Active in Disasters (VOAD), researchers found that volunteers in recent disasters were rarely credentialed, only 53% of organizations provided training, and only 21% provided health or workers compensation, despite 79% of surveyed organizations reporting that they “regularly” use SVs in disaster response. These findings highlight that while volunteers are important in supporting recovery, organizations are not properly training or organizing responses to ensure adequate health and safety efforts are being undertaken to reduce risks to both those responding and to the organization itself.
Day laborers
Day laborers were another important source of post-Sandy support for homeowners and communities during mucking and gutting, cleanup, and recovery. NIEHS identified the lack of health and safety training as an important need following Sandy. Day laborers have played a pivotal role in disaster relief efforts and it is logical to expect that they will continue that role in future disasters. 12 Day laborers are also a labor sector that is often at risk of injuries and exposure to hazardous materials, particularly in post-disaster environments. At least 4,000 day laborers worked on Sandy recovery in the New York metro area, according to an estimate provided by Baruch College sociologist Héctor Cordero-Guzmán and the National Day Laborer Organizing Network. 13
A study of day laborer experience in Sandy conducted by Baruch College 13 featured structured interviews and a survey of leaders of 11 day laborer workers centers in New York and New Jersey. The researchers also attended three meetings of day laborers including 23 workers who were involved in Sandy cleanup work. The study concluded that “the biggest challenge faced by day laborers during their participation in Sandy reconstruction and recovery efforts was the exposure to hazardous material and unsafe working conditions. This was exacerbated by lack of immediate access to proper training, information on potential hazards or adequate equipment.” Additional results from the survey are in Table 1.
During the Sandy response, unsafe working conditions for day laborers and volunteers, many of which may have been present in previous disasters, were exposed. The Baruch survey found that many day laborers were employed directly by homeowners who may have been unfamiliar with requirements to provide safety equipment, or unable to obtain the equipment. Many contractors were also found to not have provided protection or training to workers and day laborers. Day laborers were at risk for wage theft, underpayment, lack of food or rest breaks, and exposure to hazardous materials.
Additional vulnerabilities and at risk groups
Special attention should be given to those with preexisting medical conditions, as they are more likely to develop symptoms at lower levels of exposure. However, experiential evidence reveals that most volunteers do not undergo any pre-deployment medical screening and limited, if any, information regarding potential exposures that may be deleterious to health.
WTP also paid attention to the training of non-English speaking groups as training has been shown to be less effective when not in a native language. 14 In collaboration with the United Steelworkers Union over 40 Spanish-speaking health and safety trainers became authorized to teach the OSHA 10-hour construction course. This filled a significant gap for the Latino day laborer community, enhanced safety and health, and also will potentially increase employment opportunities for day laborers who now have 10-hour cards. Subsequently, Make the Road New York (MRNY) provided OSHA 10-hour health and safety training to close to 650 low-wage immigrant workers.
WTP Health and Safety Training in Response to Sandy
NIEHS initially provided a basic four-hour safety and health awareness training program 15 for cleanup and recovery workers based on its hurricane booklet, “Safety Awareness for Responders to Hurricanes: Protecting Yourself While Helping Others.” Fifty-two thousand and sixteen copies of this booklet in multiple languages were distributed as listed in Table 2 between November 2012 and July 2013.
Initially, training provided by grantees covered material in the NIEHS “Protecting Yourself” hurricane and flood booklets. As more specific needs arose, the course most requested was “Hurricane Sandy Recovery, Protecting Yourself While Mucking and Gutting.” Other courses include “New York Hurricane Sandy, Recovery Tools and Training,” and mold remediation and awareness. Safety awareness training was given to NYCHA workers who were doing door-to-door surveys.
Significant requests for training came from AmeriCorps, New York Cares, and World Cares Center. Other organizations making requests included NYCHA, Habitat for Humanity, VOAD, People's Recovery Summit, New Jersey Work Environmental Council (WEC), FEMA, and some unions without internal safety and health training capacity. Many of the labor unions contacted during outreach had already established hazardous materials training programs through the NIEHS WTP and reported their members were already trained and had the capacity to safely respond and conduct cleanup and rebuilding work.
Throughout the response and recovery process, representatives of NIEHS WTP met with local organizations and awardees to help identify needs and plan trainings. Training programs provided varied by target population, and the most commonly provided trainings included:
• Hurricane Sandy site-specific hazard awareness • Mold hazard awareness and mitigation techniques • Respirator protection training • Work zone safety • Asbestos and lead awareness • Defensive driving • HAZWOPER operations and refresher • OSHA 10-hour construction • First aid, including cardiopulmonary resuscitation or automated external defibrillation (CPR/AED) • Violence in the workplace
In December 2012, NIEHS WTP deployed personnel to conduct outreach and field evaluations of the safety and health needs of workers and volunteers. Based on those site evaluations which mainly included observing gutting, mucking, and mold remediation, an NIEHS mold remediation guidance document, pocket booklet, and PowerPoint slide set were produced. Between January 2013 and June 30, 2013, nearly 1,000 people involved in Sandy recovery were trained by NIEHS awardees, with nearly 2,500 contact hours.
While unsafe working conditions were common following Sandy, a number of organizations, including WTP, worked to actively train and educate community members, workers, and employers on the health, safety, and personal protection issues present. Throughout the response, a unique combination of local organizations, unions, and day labor centers worked together to support the specific needs of day laborers. With the support from government and local charitable organizations, free or low-cost personal protective equipment (PPE) and training was made available to day laborers and those who were frequently not provided equipment or training from their employers.
One important organization active in training and supporting Sandy response workers was MRNY, a community organizing association that focuses on the needs of Latino and low-wage immigrant workers. In conjunction with the United Steelworkers, a WTP grantee, MRNY was well equipped to respond to the immediate occupational health and safety needs of low-wage workers in the aftermath of Hurricane Sandy. In October 2012, MRNY trained workers on construction hazards and provided them with PPE.
To address mental health needs of disaster workers and volunteers, NIEHS WTP has developed an innovative Disaster Worker Resiliency Training Program to train disaster workers and volunteers to recognize risk factors and symptoms of exposure to trauma and stress. The program promotes preparedness, resilience, self-care, and organizational interventions and support.
The materials developed and used in response to Superstorm Sandy have been posted to the NIEHS Worker Health and Safety Training Clearinghouse website: <
Conclusion
The risks to workers, homeowners, and volunteers involved in cleaning up and rebuilding storm damaged homes requires urgent attention. The disproportional impacts to low-income homeowners and renters, and the greater health and safety threats posed to nontraditional workers following the storm require concerted action. Pre-event training and preparedness is key to ensuring responders and residents are protected and aware of hazards following an event. Each organization involved in response should have a plan to identify safety and health hazards so that proper control measures, in conformance with OSHA and state laws, are employed and qualified personnel are deployed that have training in identifying and safely cleaning up hazardous materials. Because homeowners, volunteers, and day laborers are likely to continue to be at high risk, there needs to be a special emphasis on developing health and safety programs and training to protect them. Respiratory protection programs for volunteers and day laborers must be established to include medical screening and fit testing in conjunction with training.
While WTP awardees and staff undertook field observations to determine needs and exposures following Sandy, thorough research should be conducted to better characterize post storm related exposures involved in gutting, mucking, mold remediation, and rebuilding activities. The effectiveness of health and safety training interventions should be evaluated to help organizations supporting response to provide the most effective and efficient health and safety training.
Footnotes
Author Disclosure Statement
The authors have no conflicts of interest or financial ties to disclose.
1
Eric S. Blake, et al., Tropical Cyclone Report Hurricane Sandy (AL182012) October 22–29, 2014, (National Hurricane Center, Feb. 12, 2013).
2
Alliance for a Just Rebuilding et al., Weathering the Storm, Building a More Resilient New York City Housing Authority Post-Sandy (2014).
3
U.S. Department of Labor, Occupational Safety and Health Administration (OSHA) Region 2, Fatal Accidents: Two Month Lookback (Dec. 28, 2012).
4
Furman Center for Real Estate and Urban Policy and Moelis Institute for Affordable Housing Policy, Sandy's Effects on Housing in New York City (Mar. 2013), <
5
American Lung Association, State of Lung Disease in Diverse Communities 2010 (2010), <
6
The grantees include the New York-New Jersey Consortium, which includes the Rutgers University of New Jersey; Hunter School of Health Sciences; New York Committee for Occupational Safety and Health; New Jersey State Police; University at Buffalo; New York City District Council of Carpenters Labor Technical College; and the Universidad Metropolitana.
Other awardees include the Partnership for Environmental Technology Education Community College Consortium for Health and Safety Training, whose members include Niagara and Ulster County Community Colleges in New York, and the following union-based training organizations: International Union of Operating Engineers; Laborers' International Union of North America; International Brotherhood of Teamsters; CPWR—the Center for Construction Research and Training; Service Employees International Union; Civil Service Employees Association, Local 1000 in Albany, N.Y.; American Federation of State, County and Municipal Employees; and International Association of Fire Fighters.
Members of the New York-New Jersey Consortium worked with representatives of the U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Administration (OSHA), and state agencies to support responders, who ranged from well-trained public safety employees to municipal workers, volunteers, and subcontractors with little or no formal training.
7
Centers for Disease Control and Prevention (CDC), “Deaths Associated with Hurricane Sandy—October–November 2012, Morbidity and Mortality Weekly Report, 62(20) (May 24, 2013): 393–397.
8
Kathryn Lane et al,. “Health Effects of Coastal Storms and Flooding in Urban Areas: A Review and Vulnerability Assessment,” Journal of Environmental and Public Health 2013 (2013), <
9
NIEHS Worker Education and Training Program (WETP), Literature Summary and Review of Disaster Mental Health (2013), <
10
Guo et al., “Posttraumatic Stress Disorder among Professional and Non-professional Rescuers Involved in an Earthquake in Taiwan,” Psychiatry Research 127 (June 30, 2004).
11
L. Sauer et al., “The Utility of and Risks Associated With the Use of Spontaneous Volunteers in Disaster Response: A Survey,” Disaster Medicine and Public Health Preparedness 8 (Feb.2014): 65–69, DOI: 10.1017/dmp.2014.12.
12
Aoife Naughton and Wes Wallace, “Day Laborers in the Reconstruction of New Orleans,” Callaloo 29 (Aug. 2006): 1372–1388.
13
Hector Cordero-Guzman et al., Day Labor, Worker Centers and Disaster Relief Work in the Aftermath of Hurricane Sandy (Baruch College School of Public Affairs, Oct. 2013).
14
L. Delp, L. Podolsky, and T. Aguilar, “Risk Amid Recovery: Occupational Health and Safety of Latino Day Laborers in the Aftermath of the Gulf Coast Hurricanes,” Organization and Environment 22 (Oct. 7, 2009): 479–490, doi: 10.1177/1086026609347193.
15
NIEHS, NIEHS Hurricane Sandy Response Report (Sept. 2013), <