steps that can affect the likelihood of experiencing adverse health effects. Linda Rosenstock moderated the panel discussion.

John Howard proposed a framework that used proximity to the oil spill source to define the risks of exposure and anxiety or concern for specific categories of at-risk populations. He stated that different sub-populations may be more likely to encounter specific hazards, which may affect overall risk calculations and public health responses aimed at injury, illness, and disability prevention. By tracking possible links between measured hazards and adverse health outcomes, a surveillance system may be able to predict future exposures, to mitigate the damage from past and ongoing exposures, and to ensure care for those affected.

Scott Barnhart discussed specific occupational hazards and risks to workers and volunteers, noting that certain other physical and psychological hazards may pose greater risk of harm than more distinct chemical exposures, especially if workers and volunteers are trained properly to use personal protective equipment. Paul Lioy described elements of an effective disaster response, including problem identification, strategic planning, and recognition of opportunities to minimize and prevent exposure.

Maureen Lichtveld explored the various characteristics of the populations in the Gulf States that may inform and improve surveillance system design and implementation. She recommended involving local experts and communities in the development of surveillance and communication activities to ensure that these activities are participatory in nature, include a holistic approach to individual and community health, and provide cultural competence and transparency. This chapter summarizes the workshop presentations and discussions on at-risk populations and routes of exposure.


John Howard, National Institute for Occupational Safety and Health

Different subpopulations experience different types and levels of exposure, which affects risk calculations and preparations for public health responses aimed at preventing injury, illness, and disability. By develop-


This section summarizes the panel remarks of John Howard that pertained to at-risk populations. See Chapter 5 for a summary of Howard’s remarks on the federal response to the Gulf oil disaster.

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