Preparedness as a Means for Survival and Solidarity Raymond Richard Neutra MD Dr.PH Chief, Division of Environmental and Occupational Disease Control California Department of Health

Goals of Preparedness for the Crisis and Recovery Phases Minimize mortality and morbidity Minimize post traumatic stress syndrome Minimize conflict of stakeholders with different interests and ideologies in crisis and recovery phases Maximize group solidarity between, during and after disasters.

Division of Environmental and Occupational Disease Control Occupational Health Branch Environmental Investigations Branch Environmental Health Lab Childhood Lead Poisoning Prevention Birth Defects Monitoring

Occupational Health Branch Capabilities Non-regulatory, public health program to reduce work- related injury & illness Technical consultation & workplace hazard helpline –Industrial Hygiene –Medical –Toxicological Tracking data on work force to assess exposure risk factors or health status Collaboration with employers, labor, Cal/OSHA 850 Marina Bay Parkway, Building P 3 rd Floor, Richmond, CA

Occupational Health Branch Preparedness Accomplishments Determined staff roles in disaster response & conducted drills to train staff Initiated interagency contacts re: preparedness planning (NIOSH, Cal/OSHA, Fed OSHA) Provided occupational health input into plans US Postal Service anthrax detection program State Pandemic Influenza Plan Gave talks on disaster preparedness Avian Flu—poultry industry, planners Pandemic Influenza—health care workers Adapted epidemiologic survey instruments for worker follow-up to an event

Our Next Challenge Helping management and labor in vulnerable workplaces prepare for the challenges of the recovery phase

Uncertain Science and Recovery Phase Stakeholder Negotiations How clean is clean ( Senate vs Post Office) Who decides? What process will be used? Love Canal, MedFly Spraying, Anthrax in SFO Airport.

Chaordic Coordiantion Dee Hock the Chaordic Age Bottom up systemic linkages vs: –A) Soviet hierarchy –B) Government admonitions with hopes of uncoordinated nuclear family preparedness –C) Small teams of volunteers insufficient for Katrina, Earthquake or Pandemic Flu WWII Air Raid Warden system: block captains, Zones, Mayor, States, Fiorella La Guardia

Sustainable Dual Use Preparedness Structures Disasters are rare, preparedness has opportunity costs. Disasters evoke psychological denial Vulnerable workplaces should plan for crisis and contaminated recovery. Challenge to make preparedness activities and organizations sustainable and supportive of non disaster functionality. Prepare for moderate and overwhelming disasters