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BACKGROUND: Each day, more than 11,500 private sector workers in the U.S. suffer work-related injuries or illnesses. The American Red Cross (ARC), an organization with a network of paid staff and volunteers (hereafter referred to as responders), works to prevent and alleviate human suffering in the face of emergencies. In recent years, the ARC has noted health concerns among responders and has since developed a program to focus on wellness. However, occupational injury and illness rates for responders have not been well documented and are difficult to compare with those for full-time workers. Such work-related injuries and illnesses are preventable and should be a focus of responder organizations.
METHODS: We retrospectively reviewed disaster data collected by ARC national headquarters to identify factors associated with responder injuries and illnesses. We focused on several characteristics, including disaster type, region, and year. An additional characteristic, disaster relief operation (DRO) level, is an indicator of operational costs. DRO levels ranged from 3 (lower cost) to 5+ (higher cost). Median rates were calculated for each characteristic by dividing the number of injuries or illnesses by the total number of responders. Rate ratios (RRs) with 95% confidence intervals (CIs) were estimated using negative binomial regression.
RESULTS: We analyzed a total of 113 disasters. Hurricanes had the highest rates of injuries (14 per thousand responders) and illnesses (18 per thousand responders). Rates by seven regions of the U.S. varied widely, and the year 2009 had greater rates (29 per thousand responders for both injuries and illnesses) when compared with other years. DRO level 5+ had the highest median rates of injuries (18 per thousand responders) and illnesses (36 per thousand responders). In the adjusted model for injuries, RRs were higher for DRO levels 4 (3.6 [CI, 2.0–6.7]) and 5+ (4.9 [CI, 2.2–11.0]) than for level 3. In the adjusted model for illnesses, RRs also were higher for DRO levels 4 (4.4 [CI, 2.6–7.3]) and 5+ (8.6 [CI, 4.1–17.7]) than for level 3.
CONCLUSIONS: Higher DRO levels were a significant predictor of greater rates of occupational injuries and illnesses. DRO level may be a proxy for other factors such as multiple or longer deployments, larger numbers of responders, and austerity of conditions. Careful selection of responders is warranted for deployments to such disasters, and future analyses should focus on similar characteristics to evaluate responder injuries and illnesses.