METHODS: Seven focus groups (n=60) were conducted: three EMS focus groups (n=27), three tree-care focus groups (n=30), and one organized disaster response volunteer group (n=3). During the focus groups, participants were asked to describe similarities and differences between “regular” job/volunteer duties compared to Hurricane Sandy-related job/volunteer duties, describe exposures to contaminants, the use of PPEs and other safety equipment, and to characterize their physical and mental health outcomes.
RESULTS: Focus group results suggest that EMS workers, tree care workers and organized disaster response volunteers take calculated risks to complete their job assignments. Although the employees were aware that some of these risks may lead to adverse health outcomes, they still completed the job tasks and hoped no injuries or other adverse events would occur. The focus group participants described exposure to unusual conditions, such as floodwater, contaminated sand, downed power lines, animals, feces, mold, hostile residents, working 16+ hour days and downed trees, which presented especially dangerous working conditions. The EMS focus group participants noted PPE was not always used. Among the tree care participants, there appeared to be a disparity between those employed by large companies versus day laborers. Larger and more expert companies had more training and higher use of protective equipment than smaller companies. Spanish-speaking laborers reported little formal training and minimal use of PPE.
CONCLUSIONS: Conducting disaster- and worker group-specific focus groups is an effective strategy to uncover health and work-related challenges and risks that may be missed when analyzing major datasets. Information from the focus groups helped identify the presence of hazardous conditions that might lead to injuries and illnesses identified in the datasets, which can be used to create prevention strategies for future disasters. There is some evidence to support the need for tree care companies to provide culturally-appropriate training or PPE to their employees, particularly Spanish-speaking laborers. Finally, enrolling at-risk workers, such as Spanish-speaking day laborers, is challenging, collaborating with worker centers and building upon the existing relationship between NJDOH and the tree industry was critical.