and air is measured consistently and that the information is readily available to everyone who is looking for the data.

Lioy highlighted the following areas in which further research and discussion need to occur in order to address large-scale disasters:

  • While the country is beginning to learn to address acute events effectively, first responders, policy makers, and researchers need to continue to learn from large-scale, complex disasters how to develop effective strategies to respond to acute events.

  • Strategies need to be put in place to obtain accurate exposure data as an event is unfolding. This is particularly challenging when the disaster is unexpected, such as 9/11, and there is a lack of trained personnel to perform monitoring. Nonetheless, scientists need to begin these discussions and plan for monitoring while a disaster is not occurring, not as the event is happening.

  • Although exposure guidelines are available, there are no guidelines that effectively address acute exposure levels or routes of exposures that are experienced during a disaster.

  • First responders and recovery personnel—those in charge of cleanup—need to be trained to use respirators correctly.

  • Before allowing people to return to their homes and workplaces, researchers and policy makers need to consider the variety of toxins and their potential to act synergistically in order to provide guidance so that individuals can protect themselves.

Many issues still exist with exposure standards, said Lioy. There are no acute exposure guidelines that effectively address different disasters. One of the main questions is still how safe is safe and how bad is bad. There isn’t reliable information for acute exposure responses because standards appropriate for reentry and for approving the safety of living in a post-disaster community have not yet been developed. EPA has started developing the standards, which are called Acute Exposure Guidelines. However, biological agents and more chemicals need to be added to the guidelines to ensure the most effective approach in short-, medium-, and long-term risk assessments. It is imperative that this is done and done well, noted Lioy.

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