November 16, 2001

Among the images seared onto Americans’ minds after the September 11th terrorist attacks were those of airplanes flying into buildings and firefighters rushing to the scene, only to be crushed by collapsing debris. With these losses fresh in their minds, representatives of the airline industry and firefighters spoke at a recent seminar at HSPH called, "How Has Occupational Safety and Health Changed Since September 11th, 2001?" sponsored by the Harvard Education and Research Center of the school’s Occupational Health Program.

"Here we have two occupations that have been under enormous stress, which has taken an extraordinary toll," said Eileen McNeely, instructor in occupational health in the Department of Environmental Health, who helped organize the seminar.

What quickly became evident in the discussion was that, like the rest of the country, no one in the firefighting or airline fields had been prepared for the nature of the attacks or breadth of the losses. Both fields have been affected dramatically, but changes to how workers will operate from now on remain unclear.

"I don’t really know how this will affect the job," said District Fire Chief Paul Burke of Boston. "It’s tough right now. We’ll still go into burning buildings and do what we have to do, but I’m sure we’ll look at things differently."

Firefighting officials have shifted their focus to emergency planning, said Burke, who visits offices and reviews their evacuation plans. A common problem he spots is that employees with little authority in the office are often designated as the ones in charge of telling people when to leave in emergencies. He described a situation at a large law firm where a low-paid clerk was supposed to tell the president of the company to evacuate.

"It doesn’t work that way," said Burke. "The president needs to take responsibility, and he’s the one that needs to say ‘go.’ That’s what we’re trying to stress, emergency planning."

He added that doctors and scientists are particularly bad about evacuating buildings, for fear of leaving experiments.

In addition to the new emphasis on emergency planning, firefighters are now coping with an exacting emotional toll. On one Saturday alone, Burke had been invited to 24 funerals or memorial services. He attended two that day. Buses carrying firefighters from Boston to New York to attend such services were running several times each week, said Burke.

"Firefighters are used to people dying in the line of duty, but the scope of the deaths never happened this quickly or under these kinds of conditions before," he said.

Attending funeral and memorial services in uniform is important, said Burke, because it shows respect, unity and support. But the services also serve as an emotional outlet to a group known for its stoicism in the face of imminent danger.

"Going to the funerals give people a way to help out," said Burke. "They don’t feel helpless."

He added that everyone he knew had somebody directly affected by the attacks. A Boston firefighter in Burke’s firehouse saw the attacks on the World Trade Center on television and knew his brother, another firefighter, had responded. The man watched the buildings disintegrate, suspecting his brother was probably inside. His fears were later confirmed.

"We will learn from and study the events of September 11th," said Burke. "You just have to feel comfortable that the training, equipment and knowledge that you have will give you a better chance than average to do your job and go on."

To provide perspectives from the airline industry, Karen Scopa, vice president of the Association of Flight Attendants and chairperson of Occupational Health and Safety, United Airlines, and Tracy Burpee, representative of the Employee Assistance Program, spoke.

Scopa said that prior to September 11th, she never had worked with Burpee because there was no need. Occupational health and employee assistance issues rarely intertwined. Now, the pair sees each other every day, said Scopa.

To understand how the industry changed, one needs to understand what it used to be like, said Scopa. Prior to September 11th, the occupational health issues of flight attendants revolved around crazy hours, lack of sleep and injuries from working in small spaces.

"I never had anyone call and say they were suffering from post-traumatic stress disorder," said Scopa. "Now, that’s the main focus of my job."

It’s also controversial. The airline industry is not accepting post-traumatic stress disorder as an occupational health issue, she said. And the emotional aid the employees once had is diminishing. There were five employees who worked for the Employee Assistance Program at United Airlines. Now, the program has been slated for a cutback, leaving the employees’ unions to handle employee assistance programs, said Scopa.

Training of flight attendants in the post-September 11th era will change dramatically, said Scopa. Hired for their emotional intelligence and ability to make people feel comfortable, flight attendants now are asked to serve as the front lines of defense on airplanes, needing to protect themselves, the passengers and the pilots. They used to do routine safety checks, making sure fire extinguishers were full. Now they have to look for knives and guns.

A spokesperson at United Airlines Media Relations in Elk Grove Village, IL declined to comment on the remarks made at the seminar.

Fariba Piroozmandi, counselor for the Employee Assistance Program at Mt. Auburn Hospital, also spoke. Her program assists more than 50 companies. She said on September 11th, they had to react quickly, contacting each company to ascertain its needs. They sent out stacks of brochures about counseling and other issues and remain in frequent contact with the companies, she said

Melissa Perry, instructor in occupational health in the Department of Environmental Health, observed that the events of September 11th have rippled through the occupational health field. In less than two hours, more people died or were injured on the job in the US than usually happens in one year.

"For the first time, we saw workplaces as targets and therefore dangerous, where you could fall victim to a terrorist attack," said Perry. She added that since September 11th, other workplaces have become arenas where employees are becoming victims of terrorists, by opening or processing envelopes tainted with anthrax.

The parallels made between the September 11th and Pearl Harbor attacks were not applicable, Perry said, because unlike at Pearl Harbor, the people in the World Trade Center and civilians at the Pentagon were not in the military. They were engaged in the regular tasks of their work day, participating in conference calls, returning voice mails, checking e-mail accounts.

The Bureau of Labor Statistics is now grappling with how to code the deaths and injuries of so many people at work. The bureau is expected to create a new category to account for the deaths and injuries on September 11th so that normal data trends do not spike from an aberration.

"One theme that I took away from the seminar is that we are just beginning to process our thoughts and decision-making about training and other occupational health issues in response to September 11th," said Perry.

The seminar was partially funded by the National Institute for Occupational Safety and Health.