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National Crisis Support Hotlines and Directories: For Healthcare Workers Experiencing COVID-19-Related Stress and Burnout
This document provides the following resource information for healthcare workers: "Physician Support Line"; "Disaster Distress Helpline"; "National Suicide Prevention Lifeline"; "Crisis Text Line"; "SAMHSA's [Substance Abuse and Mental Health Services Administration] National Helpline"; "Emotional PPE [personal protective equipment] Project"; "Behavioral Health Treatment Services Locator (SAMHSA)"; "Find A Psychiatrist"; and "Psychologist Locator."
United States. Department of Health and Human Services; United States. Federal Emergency Management Agency
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Beyond the Response: Addressing Compassion Fatigue and Behavioral Health Needs for Healthcare Providers [presentation]
This presentation provides an overview of efforts and measures taken by the Assistant Secretary for Preparedness and Response (ASPR) to address cognitive fatigue and behavioral health needs for healthcare workers. The presentation outlines the ASPR goals, risk factors, and resources that professionals can use to improve the health and resilience of healthcare providers.
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
Brannman, Shayne; Naturale, April
2019-11-05
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Preparing for the Flu (Including 2009 H1N1 Flu): A Communication Toolkit for Child Care and Early Childhood Programs
"The purpose of 'Preparing for the Flu: A Communication Toolkit for Child Care and Early Childhood Programs' is to provide information and communication resources to help center-based and home-based child care programs, Head Start programs, and other early childhood programs implement recommendations from CDC's Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009-2010 Influenza Season."
United States. Department of Health and Human Services; Centers for Disease Control and Prevention (U.S.)
2009
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H1N1 Flu: A Guide for Community and Faith-Based Organizations
The U.S. Department of Health and Human Services and the Centers for Disease Control have published this guide as a resource for H1N1 flu preparedness for community and faith-based organizations in the United States. "To help keep communities healthy during the upcoming flu season, it will take all of us-community and faith-based organizations, government, businesses, and schools-working together. The federal government alone cannot prepare for or respond to the challenge of the 2009-2010 flu season. Leaders and members of community and faith-based organizations (CFBOs), people like you, know their communities well. As trusted leaders, you can communicate important health information in an effective and motivating manner. You know the people in your community who are most vulnerable and hard-to-reach. Organizations like yours are uniquely positioned to help keep people healthy during the 2009-2010 flu season. […] Since there is a great deal of variation among CFBOs, different parts of this document will be more relevant to your organization than others. Use this guide to help inform your response to both 2009-2010 seasonal and 2009 H1N1 flu. Remember to be creative as you design a response plan that is relevant and useful to the people you serve."
United States. Department of Health and Human Services; Centers for Disease Control and Prevention (U.S.)
2009
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At-Risk Individuals
"The US Department of Health and Human Services (HHS) has developed the following definition of at-risk individuals: Before, during, and after an incident, members of at-risk populations may have additional needs in one or more of the following functional areas: communication, medical care, maintaining independence, supervision, and transportation. In addition to those individuals specifically recognized as at-risk in the Pandemic and All-Hazards Preparedness Act (i.e., children, senior citizens, and pregnant women), individuals who may need additional response assistance include those who have disabilities, live in institutionalized settings, are from diverse cultures, have limited English proficiency or are non-English speaking, are transportation disadvantaged, have chronic medical disorders, and have pharmacological dependency. This HHS definition of at-risk individuals is designed to be compatible with the National Response Framework (NRF) definition of special needs populations. The difference between the illustrative list of at-risk individuals in the HHS definition and the NRF definition of special needs is that the NRF definition does not include pregnant women, those who have chronic medical disorders, or those who have pharmacological dependency. The HHS definition includes these three other groups because pregnant women are specifically designated as at-risk in the Pandemic and All-Hazards Preparedness Act and those who have chronic medical disorders or pharmacological dependency are two other populations that HHS has a specific mandate to serve."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2010
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Disaster Behavioral Health
"Following an emergency event it is common for individuals and families in and around the affected region to experience distress and anxiety about safety, health, and recovery. Previous exposure to large scale events, such as a severe hurricane or flood, may place residents and responders who experience a new disaster at greater risk for adverse stress reactions. People may display symptoms and reactions such as: 1) Emotional symptoms such as irritability or excessive sadness. 2) Cognitive dysfunction such as difficulty making decisions or following directions. 3) Physical symptoms such as headache, stomach pain, or difficulty breathing. 4) Behavioral reactions such as consuming more alcohol or interpersonal conflict. 5) Failure to adhere to needed physical or psychiatric medication needs."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2010
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State & Local Planners Playbook for Medical Response to a Nuclear Detonation
"This State and Local planners Playbook is a resource developed by non-government and government subject matter experts from the Nuclear Detonation Scarce Resources Working Group. It is not a 'must follow' structured road-map. It is offered as a guide to assist State, regional, local, tribal, and territorial medical and public health planners and other subject matter experts preparing their venues for a nuclear detonation. [...] This is a living document that will be updated periodically on this website. Users are encouraged to submit comments through the website and to join the REMM ListServ to receive notice of important changes to the Playbook and the REMM website." The site provides background information, action steps, additional information sources, a manuscript list, and an acronym list.
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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Healthcare Organization and Hospital Discussion Guide for Cybersecurity
From the Document: "The 'Cybersecurity Discussion Guide' is intended to help participants identify issues, strengths, and weaknesses associated with response capabilities, communication and information sharing for their healthcare organization or hospital when responding to a cybersecurity incident, and prevention planning. Moreover, the 'Cybersecurity Discussion Guide' provides insight into the healthcare organization's or hospital's response to a public health emergency, including communicating and coordinating with other agencies, departments, or organizations. It also provides a catalyst for developing strategies to address the issues and weaknesses identified during the discussion-based exercise."
Centers for Disease Control and Prevention (U.S.); United States. Department of Health and Human Services
2016-08
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Engaging Healthcare Partners in the Disaster Healthcare Delivery System
From the Introduction: "The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR)'s Hospital Preparedness Program supports the development of regional healthcare coalitions (HCCs). The core members of HCCs are hospitals, public health departments, emergency management organizations, and emergency medical services."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
Brannman, Shayne; Nieratko, Jennifer; Patnosh, Jason . . .
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The Exchange, Issue 9, 2019
From the Document: "In this issue of 'The Exchange,' we discuss planning, response, and lessons learned specific to chemical incidents. ASPR [Assistant Secretary for Preparedness and Response] TRACIE [Technical Resources, Assistance Center, and Information Exchange] interviewed subject matter experts from the federal government, a healthcare provider, and a fire chief to learn more about emerging threats and past and current challenges in chemical incident response."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2019
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Planning for Psychiatric Patient Movement During Emergencies and Disasters
From the Document: "This document identifies basic considerations to assist public health and medical planners to prepare for the movement of psychiatric patients in the event of a disaster and to guide responders and care providers during psychiatric patient movement. Differences in State and local laws, regulations, and requirements will need to be considered when conducting planning for movement or evacuation of psychiatric patients. Please note that this document addresses patients of psychiatric facilities or units (rather than residents of community programs)."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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Helping Children and Adolescents Cope with Disasters and Other Traumatic Events: What Parents, Rescue Workers, and the Community Can Do
From the Document: "When people think of trauma, they often focus on physical injuries. However, people also can experience psychological trauma after witnessing or experiencing distressing events. Trauma can be caused by natural disasters such as hurricanes, earthquakes, and floods. It also can be caused by acts of violence--such as terrorist attacks and mass shootings--as well as motor vehicle and other accidents. Reactions to trauma can be immediate or delayed. Responses may differ in severity and can include a wide range of behaviors and responses, sometimes influenced by culture."
National Institute of Mental Health (U.S.); United States. Department of Health and Human Services
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Disaster Behavioral Health Capacity Assessment Tool
From the Document: "Disaster behavioral health is the provision of mental health, substance abuse, and stress management services to disaster survivors and responders. Following an emergency event it is common for individuals and families, as well as disaster responders, to experience distress and anxiety about safety, health, and recovery. Disaster behavioral health is an integral part of the overall public health and medical preparedness, response, and recovery system. It includes the interconnected psychological, emotional, cognitive, developmental, and social influences on behavior, mental health, and substance abuse, and the effect of these influences on preparedness, response, and recovery from disasters or traumatic events. Unlike traditional mental health services, disaster behavioral health interventions can be provided by non-clinicians as well as other professionals as long as they are properly trained in disaster behavioral health concepts and evidence-based interventions."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2014-07-23
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Disaster Behavioral Health Coalition Guidance
From the Document: "During disaster response and recovery, there may be challenges coordinating behavioral health services. Behavioral health services are often provided by a variety of agencies and organizations, such as state and local government, mental health departments, substance abuse programs, hospital-based and outpatient services, private clinicians, and volunteer groups. In an emergency event, it is important for communities to determine what supportive services and treatment options are available, who are the providers, and whether gaps or duplication of services exist. Establishing a disaster behavioral health coalition can facilitate communication across provider groups, coordinate behavioral health care efforts, and help identify existing and emergent needs."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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Concept Plan: For the Implementation of the National Biosurveillance Strategy for Human Health
"This Concept Plan for Implementation of the National Biosurveillance Strategy for Human Health (Concept Plan) responds to Homeland Security Presidential Directive 21 (HSPD-21), which was issued in recognition of significant health-related threats to the residents of our nation. Included in HSPD-21, as a critical component of public health and medical preparedness, is the development of a 'nationwide, robust, and integrated biosurveillance capability.' The U.S. Department of Health and Human Services (HHS) charged the Centers for Disease Control and Prevention (CDC) with leading the implementation of this component of HSPD-21. In 2008, CDC's Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER) established the Biosurveillance Coordination Unit (BCU) to respond to the biosurveillance mandate of HSPD-21. The basis for the efforts under HSPD-21 can be found in several prior executive and legislative actions. HSPD-9 and HSPD-10 created a new biological threat awareness capacity and established an integrated warning system. The Pandemic and All-Hazards Preparedness Act of 2006 (PAHPA), among other recommendations, proposes new national surveillance methods. And finally, PL 110-53, which implemented the recommendations of the 9/11 Commission, mandates the federal government identify and track biological events of national concern by integrating and analyzing data. Each of these actions provided the building blocks for the foundation of biosurveillance."
United States. Department of Health and Human Services; Centers for Disease Control and Prevention (U.S.)
2010-01
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Coalition Surge Test: An Exercise for Assessing and Improving Health Care Coalition Readiness
From the Preface: "The Coalition Surge Test (CST) includes a user-friendly peer assessment low/no-notice exercise that helps health care coalitions identify gaps in their surge planning. Low/no-notice exercising is important in assuring that health care coalitions can transition quickly and efficiently into 'disaster mode' and provide a more realistic picture of readiness than preannounced exercises. The exercise is designed to be challenging and is intended to support continuous improvement."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2017-01
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Provider Survey and Certification Frequently Asked Questions: Declared Public Health Emergencies -- All Hazards Health Standards and Quality Issues
From the Document: "The waivers and modifications apply only to providers located in the declared 'emergency area' (as defined in section 1135(g)(1) of the SSA) in which the Secretary has declared a public health emergency, and only to the extent that the provider in question has been affected by the disaster, or is treating evacuees. The CMS [Centers for Medicare & Medicaid Services] Regional Office(s) will review the provider's request and make decisions on a case-by-case basis. The waivers do not apply to care that is delivered to an evacuee by a provider that is not located in one of the designated areas. Providers outside of the affected areas should operate under normal rules and regulations unless specifically notified otherwise."
United States. Department of Health and Human Services; Centers for Medicare & Medicaid Services (U.S.)
2013-05-21
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Federal Recovery Programs for Healthcare Organizations
From the Document: "Each year healthcare facilities are directly impacted by disasters. Pre-disaster planning is critical to ensure effective post-disaster recovery. An underemphasized but key component of any disaster plan are the organization's financial and administrative preparedness capabilities. The federal government can provide relief to organizations (including healthcare organizations) via direct reimbursement for expenses and damages and disaster-related loans. This tip sheet provides an overview of eligibility factors, program/grant requirements, and pre- and post-disaster federal financial opportunities for healthcare facilities."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2019-07
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Guide to Privacy and Security of Electronic Health Information
From the Introduction and Purpose: "Everyone has a role to play in the privacy and security of electronic health information -- it is truly a shared responsibility. The Office of the National Coordinator for Health Information Technology (ONC) provides resources to help you succeed in your privacy and security responsibilities. This Guide to Privacy and Security of Electronic Health Information (referred to as 'Guide') is an example of just such a tool. The intent of the Guide is to help health care providers ― especially Health Insurance Portability and Accountability Act (HIPAA) Covered Entities (CEs) and Medicare Eligible Professionals (EPs) from smaller organizations ― better understand how to integrate federal health information privacy and security requirements into their practices. This new version of the Guide provides updated information about compliance with the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs' privacy and security requirements as well as the HIPAA Privacy, Security, and Breach Notification Rules."
United States. Department of Health and Human Services. Office of the National Coordinator for Health Information Technology
2015-04
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Mass Casualty Trauma Triage: Paradigms and Pitfalls
From the Intended Scope and Action: "The focus of this paper is specifically designed to educate emergency planners on the key distinctions of no-notice, dynamic incident scenes with exceedingly large numbers of patients. This will require review of current plans and making necessary modifications to those plans and corresponding training and exercises to ensure preparedness for these types of events. Each community has a unique set of resources and needs and may therefore require different solutions than other jurisdictions. It is important to note that this is a discussion document, and not a consensus document. Therefore, the authors have tried to represent the diversity of opinions where they were significant. This document is also focused on triage and does not account for the broad range of supporting disaster planning required for successful response."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2019-07
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2010 Hurricane Playbook
This U.S. Department of Health and Human Services, 2010 Hurricane playbook provides guidance for decision makers in the event of a hurricane. It outlines key measures and options essential to effective decision making and directing in response to a hurricane.
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2010-07-09
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Report of the Expert Panel Workshop on the Psychological Responses to Hazardous Substances
"Although much has been written about the physical health effects of toxic substances and much research is underway today, there has not been a compilation of the social and psychological effects that exposure to toxic substances can engender. In September 1995, ATSDR cosponsored with Emory University and the Connecticut Department of Health, an expert panel workshop on the Psychological Responses to Hazardous Substances. The purpose of this workshop was to thoroughly explore and examine all that is known about how communities and individuals respond socially and psychologically to hazardous substances and the possible effects of those responses on their health. To present a broad view of this complex and intertwined subject, many different perspectives and viewpoints are presented. Both community members and scientists from different disciplines, including social, psychological, and neurological, were invited to interact and present their opinions. What emerged from the panels is an initial attempt to define and discuss a newly emerging public health issue"how to respond to the psychosocial distress in communities affected by exposures to hazardous substances."
United States. Department of Health and Human Services; United States. Agency for Toxic Substances and Disease Registry
Tucker, Pamela
1995
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Report to the President on Issues Raised by the Virginia Tech Tragedy
"On April 21, 2007, in response to the tragic shootings at Virginia Tech, President George W. Bush directed Secretaries Michael Leavitt and Margaret Spellings and Attorney General Alberto Gonzales to travel to communities across our nation and to meet with educators, mental health experts, law enforcement and state and local officials to discuss the broader issues raised by this tragedy. The President instructed Secretary Leavitt to summarize what they learned from these meetings and report back with recommendations about how the federal government can help avoid such tragedies in the future. […] This report does not seek to investigate the specifics of the Virginia Tech tragedy itself. That work is currently being done by the Virginia Tech Review Panel appointed by Governor Kaine. Instead, this report summarizes the major recurring themes we heard in our visits across the country. It includes critical steps state and local leaders identified to address school violence and mental illness at the community level. The report includes recommended actions the federal government can take to support state and local communities and ensure that the federal government and federal law are not obstacles to achieving these goals. The recommended action items are not, individually or together, a panacea for the many complex issues our society confronts in trying to prevent another tragedy. Rather, they are an attempt to frame the issues and identify tangible steps we can take over time to help prevent events like the Virginia Tech tragedy."
United States. Department of Justice; United States. Department of Health and Human Services; United States. Department of Education
Leavitt, Michael O.; Gonzales, Alberto R.; Spellings, Margaret, 1957-
2007-06-13
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Odors from the BP Oil Spill
"Residents of the Gulf Coast are concerned about odors from the BP oil spill and whether they are harmful to breathe. Some residents along the coast report smelling odors, and experiencing eye, nose, or throat irritation, nausea, or headaches. The Environmental Protection Agency (EPA) and the Centers for Disease Control (CDC) are concerned about the odors and any health effects from the pollutants causing the odors. We have been particularly concerned about pollutants that could reach shore from the burning of oil and pollutants that may evaporate from the spill as it spreads closer to shore, potentially affecting residents along the shoreline. ! Since late April, EPA has been monitoring the air at multiple sites along the Gulf Coast for certain pollutants that are associated with petroleum products and from the burning oil out at sea. EPA's air monitoring to date, has found that air quality levels for ozone and particulates are normal on the Gulf coastline for this time of year and odor-causing pollutants associated with petroleum products are being found at low levels. This report summarizes the information that is available at this time. We are continuing to work to increase our information base."
United States. Department of Health and Human Services; Centers for Disease Control and Prevention (U.S.)
2010
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Pandemic and All-Hazards Preparedness Act (Public Law 109-417): Progress Report on the Implementation of Provisions Addressing At-Risk Individuals [August 2008]
"This report [published in August 2008] describes the activities undertaken since the passage of [the Pandemic and All-Hazards Preparedness Act] PAHPA to address the needs of at-risk individuals. It also provides a look ahead at some of the activities planned as HHS continues its implementation of the new law. The report also serves to inform members of Congress how this Department, working with Federal partners, will continue to improve the Nation's preparedness for at-risk individuals in public health and medical emergencies. Many of the actions called for in PAHPA build upon work the Department has already begun. Other actions require establishing new processes and strategies."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2008-08
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Strategic Improvements to the National Disaster Medical System (NDMS): Report from the Disaster Medicine Working Group NDMS Assessment Panel
"The National Biodefense Science Board (NBSB) was asked to provide feedback to the U.S. Department of Health and Human Services on the review of the National Disaster Medical System (NDMS) and national medical surge capacity as required by the Pandemic and All-Hazards Preparedness Act (PAHPA) and as specified by Paragraph 28 of Homeland Security Presidential Directive (HSPD)-21. To accomplish this task, the request for review was forwarded to the NBSB, Disaster Medicine Working Group. The Disaster Medicine Working Group of the NBSB, in conjunction with support staff, established the NDMS Assessment Panel to provide input for this task. This NDMS Assessment Panel was comprised of a wide range of government, public, and private sector subject matter experts in NDMS and surge capacity (Appendix A). Multiple documents were considered by the Panel (Appendix B), including the 'Joint Review of National Disaster Medical System, Consolidated Report of Recommendations, Stakeholder Review Draft, Version 3.0' by the MITRE Corporation ('the MITRE report'). In preparation for making the recommendations, the panel met multiple times via teleconference over several months and attended one face-to-face meeting held on June 19, 2008 in Arlington, VA. The agenda of the NDMS Assessment Panel meeting is provided in Appendix C."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2008-09
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Preparing for the Flu (Including 2009 H1N1 Flu): A Communication Toolkit for Institutions of Higher Education
"This new guidance applies to any flu virus circulating during the 2009-2010 academic year, not only 2009 H1N1 flu. It recognizes the need to balance risks of illness among faculty, students, and staff with the benefits of keeping students in classes. It offers strategies and guidance for current flu conditions and for more severe flu conditions. This guidance recommends that, based on current flu conditions, faculty, students, and staff with flu-like illness should stay in their home, dormitory, or residence hall until at least 24 hours after they no longer have a fever (100 degrees Fahrenheit or 38 degrees Celsius) or signs of a fever (have chills, feel very warm, have a flushed appearance, or are sweating). This should be determined without the use of fever reducing medications (any medicine that contains ibuprofen or acetaminophen). This is a shorter time period than outlined in previous CDC [Centers for Disease Control and Prevention] guidance, which recommended that sick faculty, students, and staff remain at home 7 days after symptoms begin. The recommendation to stay away from classes and from work for 7 days will be made only under more severe flu conditions. Under more severe conditions, a longer period will be recommended for healthcare settings and anywhere a high number of people at higher risk for complications from flu may be exposed."
United States. Department of Health and Human Services; Centers for Disease Control and Prevention (U.S.)
2009
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What You Need to Know About Administrative Detention of Food
"The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act) directs the Food and Drug Administration (FDA), as the food regulatory agency of the Department of Health and Human Services, to take additional steps to protect the public from a threatened or actual terrorist attack on the U.S. food supply and other food-related emergencies. The Bioterrorism Act authorizes an officer or qualified employee of FDA to order the detention of any article of food that is found during an inspection, examination, or investigation under the Federal Food, Drug, and Cosmetic Act, if the officer or qualified employee has credible evidence or information indicating that the article of food presents a threat of serious adverse health consequences or death to humans or animals. FDA has now issued its Administrative Detention final rule with procedures for instituting on an expedited basis certain enforcement actions against perishable foods subject to a detention order. This final rule also describes the process for appealing a detention order. The authority in section 303 of the Bioterrorism Act to detain administratively an article of food took effect on June 12, 2002, and immediately upon enactment of the Bioterrorism Act. The procedures specified in the final rule that FDA would use to detain food administratively took effect on July 6, 2004. This booklet was created to inform food manufacturers, processors, packers, transporters, importers, and exporters about a new FDA bioterrorism regulation that is in effect. It contains important information that may affect your firm."
United States. Department of Health and Human Services; United States. Food and Drug Administration
2004-11
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Public Health Concern at Department of Energy Sites: ATSDR's Public Health Response
"ATSDRs activities have helped protect public health for communities near DOE facilities. The agencys activities at DOE sites have identified significant adverse health outcomes, the need for additional health studies, inadequacies in monitoring equipment, and people at risk because of exposure. ATSDRs public health assessments and health consultations have made recommendations to mitigate exposures, conduct health studies, and further categorize environmental releases. In 1993, ATSDR reviewed DOE documents for the Maywood Interim Storage Site and adjacent commercial properties in New Jersey. ATSDR determined that DOE was not monitoring for a main daughter product of thorium-232, a contaminant of concern at the site. ATSDR recommended in a health consultation that DOE monitor for this daughter product, radon-220. In May 1997, DOE notified ATSDR that, as a result of the health consultation, DOE had tested for radon-220 and found elevated levels at some locations. Clean-up efforts have reduced concentrations to levels within DOE limits at some locations. Approximately 500 persons were potentially affected."
United States. Department of Health and Human Services; United States. Agency for Toxic Substances and Disease Registry
1998-10
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Early Detection System for Highly Pathogenic H5N1 Avian Influenza in Wild Migratory Birds: U.S. Interagency Strategic Plan
"The goal of this plan is to describe the essential components of a unified national system for the early detection of HPAI [highly pathogenic avian influenza], specifically highly pathogenic H5N1 avian influenza, in migratory birds. While the immediate concern is a potential introduction of highly pathogenic H5N1 avian influenza into the U.S., the development of a system that is capable of detecting the introduction of all HPAI viruses through migratory birds would significantly improve the biosecurity of the Nation. This document provides guidance to Federal, State, university, and non-governmental organizations for conducting HPAI monitoring and surveillance of migratory birds in the U.S. It is expected that this document will be used by agencies and organizations to develop regional and/or state-specific implementation plans for HPAI surveillance."
United States. Department of Agriculture; United States. Department of Health and Human Services; United States. Department of the Interior
2006-03-14