1 barriers to evacuation from the wtc on september 11, 2001 national disaster medical system...
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Barriers to Evacuation from the WTC on September 11, 2001
National Disaster Medical SystemDisaster Response Conference
April 20, 2004
Robyn R.M. Gershon, MHS, DrPHPrincipal Investigator
NCDPNational Center for
Disaster PreparednessColumbia University
CPHPCenter for Public
Health PreparednessColumbia University
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Dr. Kristine QureshiDr. Stephen MorseDr. Elizabeth SmailesDr. Tracy DurrahDr. Victoria RaveisMs. Erin Hogan
Dr. Alan Fleischman (NYAM)Dr. Fred Matzner (Our Lady of Mercy Medical Center)Mr. Glenn Corbett (John Jay)Dr. Charles Jennings (John Jay) Dr. Mark Franklin Peyrot (Loyola)Dr. Martin Sherman (Loyola)Dr. Rae Zimmerman (NYU)
Mailman School of Public Health:
Research TeamP.I. - Dr. Robyn Gershon
Other Institutions:
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• Study goals
• Background information on the WTC attacks
• Evacuation behaviors- what is known/does it apply to high rise buildings
• Qualitative data findings
• Preliminary policy implications
Lecture Outline
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1. To identify the individual, organizational, and structural factors that affected evacuation from the WTC on 9/11/01
2. To inform policy and practice in order to improve the safe evacuation of high rise structures
Goals
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Logistical Considerations:
• Funding timeliness
• Access to survivors
• Cooperation across studies
Logistical Challenges to Disaster Research
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Ethical Considerations:• Decision-making ability of survivors and
assessment of ability• How to assess impact of the research on the
survivors• How to assure confidentiality of data, litigation
issues• Access to survivors• Weighing societal benefits vs. costs to
participants, especially when individual benefits may be lacking
Ethical Considerations of Disaster Research
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• Building Facts
• Timeline
• 9/11 Attacks
• Evacuation
• Morbidity and Mortality
Background Information
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South
North
WTC Complex
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Timeline of Events
Announcement heard in WTC 2 (South)
WTC 1 (North) hit
WTC 2 (South) hit
WTC 2 (South) collapses
WTC 1 (North) collapses
8:46 8:55 9:02 9:59 10:28
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September 11, 2001
North Tower Impact
• Impact: 8:46 am- American Airlines Flight 11
• Collapsed 1 hour and 42 min after impact
South Tower Impact
• Impact: 9:02 am- United Airlines Flight 175
• Collapsed 57 minutes after impact
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• In the span of 102 minutes, approximately 18,000 people evacuated the North and South Towers
• High percentage of people below the impact site survived from both towers
• 16-18 survivors above impact site in South Tower
• 0 survivors above impact site in North Tower
• Approximately 200 people jumped or fell from floors above impact
• Fatalities below impact line linked to proximity
WTC Evacuation
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• 1103 injuries or illnesses related to attack
−73% treated and released from EDs
−16% hospitalized
−0.4% died during emergency care
• 790 physical injuries
• 152 non-injury conditions
InhalationBurnsFracturesOcularHead Injuries
RespiratoryCardiacNeuro/psych
Morbidity and Mortality: Injuries/Illness
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• 479 rescue workers• 157 jetliner crew and passengers• 2190 civilian deaths
- 1434 in North Tower - 599 in South Tower - 147 location unknown - 10 bystanders (on the ground)
• 70% worked on upper floors• Approximately 800 people in North Tower and
300 people in South Tower were trapped above impact zone
Morbidity and Mortality: Fatalities
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Study Overview
QuestionnaireDevelopment
& Administration
Data Analysis
Participatory Action Teams
Identification of Risk
Reduction Strategies& Recommendations
Feedback to Participants &Stakeholders
Preparation of
Reports
Qualitative Processes & Analyses
Sample Frame Identificationand Strategy
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What is Known:
• Will not go towards smoke
• Seek out groups, group size is important
• Individual and group panic dependent on several key factors
• Information serves as motivator
• Familiarity adaptive and pro-social behaviors
Human Behaviors in Fire Emergencies
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What is Known:
• Social contact neutralizes threat
• Evacuation behaviors related to prior experience and practice- “auto-pilot”
• Lack of leader, ambiguity leads to milling behaviors
• Move towards and stay with group even if it is not the best option
Human Behaviors in Fire Emergencies
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• Key Informant Interviews
• In-depth Interviews
• Focus Groups
Qualitative Data
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Individual Barriers:• Disabilities and poor physical
condition
• Last minute work-related tasks
• Taking personal items, making calls
• Footwear
• Waiting for instructions/direction
• Poor familiarity with WTC building
• Fear of negative impact on job
Individual Facilitators:• Direct evidence of
magnitude
• Intuition
• Prior experience
Factors Associated with Evacuation
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Organizational Barriers:• Lack of internal communication• Confusion re: fire safety responsibility
• Lack of preplanning for disabled
• Variability in training
• Poor commitment to safety climate
• Lack of orientation to building
• Lack of visitor planning
• Lack of direction on street
• Subway level mismanagement
• Breakdown in Fire Safety procedures
• Lack of info on building egress point limits
Factors Associated with Evacuation
Organizational Facilitators:• Fire drill participation• Support from senior
management• Fire safety procedures in
addition to PANYNJ
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Structural Barriers:• Poor visibility of exit signs
• Lack of back-up communication systems
• Elevator communication
• Locked egress (re-entry points)
• Stairwell width
• Stairwell design (e.g., switching)
• Debris/water/smoke
Factors Associated with Evacuation
Structural Facilitators:• Well lit stairwells
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Individual:
– Degree of personal responsibility
– Familiarity with building, especially exit points
– Determine time to descend
– Disability preparations
– Comfortable footwear
– Start evacuation immediately
Preliminary Recommendations
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Organizational:
– Delineation of responsibilities
– Written plans, policies that target full evacuation if necessary
– Training, mandatory, new, annual, and orientation
– Drills to include stairwells, 3 flight minimum
– Leaders chosen with experience
– Responsibilities of building owners, lease holders, employers and employees
– Coordination/pre-planning with local agencies
Preliminary Recommendations
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Structural:
– Redundancy of communication systems
– Communication in elevators
– Signage
– Lighting
– Egress
Preliminary Recommendations
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Phase III: Questionnaire Development & Administration
• Security badge list from Port Authority of NY/NJ in December 2003
• ~100,000 employees in WTC 1, 2, 7• Current as of April 2001• Excel spreadsheet file
– Names– Employer Names– Tower– Floor– WTC phone #– Badge type (permanent employee, contractor, PANYNJ
employee)
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• Sample underwent “cleaning”– WTC 7 employees removed– Names of deceased removed (checked 3x)– Duplicate entries removed
• 30,000 sampling frame (randomly selected)– 20,000 randomly selected from sample to
receive recruitment letter
Questionnaire cont.
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Questionnaire: Process
• Hard copy, web-based, and email versions• Recruitment letter w/ return post card
– Accept/decline– In WTC 1 or 2 on 9/11– Bar code – Web based or paper version option (mailed or emailed)– Code # serves as web based user ID
• After 2 weeks, no card or web completion first reminder card
• Two month data collection phase
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Preliminary Recommendations
• High rise occupancies High risk occupancies
• Inform: – Building owners, leaseholders, employees
– Code development
– Building design
– Regulatory compliance
– Emergency planners
• Next Steps:
– Develop and evaluate model evacuation plan
– Meet with OSHA, WTC builders
– Widespread dissemination to reach all stakeholders
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OSHA 1910: Occupational Safety & Health Standards
Subpart E– Means of Egress:1910.37 Means of Egress1910.38 Employee Emergency PlansAppendix to Subpart E--Means of Egress
Subpart K– Medical and First Aid:1910.151 Medical Services and First Aid
Subpart L– Fire Protection:1910.155 through 1910.165
Subpart Z– Toxic and Hazardous Substances:1910.1200 Hazardous Communications
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http://cpmcnet.columbia.edu/dept/sph/CPHP/wtc.html
Thank youWorld Trade Center Evacuation Study