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Danger comes expectedly with some work, such as crop dusting, America's single most dangerous job. The worker in a 24-hour urban convenience store, living with the risk of a deadly robbery, has the job ranked second most dangerous. Even "safe" jobs such as news reporting, electrical repair and claims adjusting are open to psychological, if not physical harm as well.

Ronald Thompson is a 35-year-old maintenance worker living in College Station, Texas, with his wife and children. In 2003 and 2004, he spent some months driving for KBR in Iraq and Kuwait. He has been trying to locate the widow of a friend of his who died when his truck collided with an Iraqi construction vehicle. Ronald worked there upward of 15 hours a day, seven days a week. His employer trained him and monitored his stress-coping skills about as well as they oriented him to the trucks: "They drove with me once around the block."

Public safety and medical workers know the occupational package they buy into, or should know. They are trained in crisis response, and society recognizes their labors.

However, when a member of the World Trade Center cleanup crew helped a buddy through the shock of what was found in the rubble, it didn't count, as if it were a phantom task. These workers had to deal with being unprepared and isolated.

An article about the experiences of the WTC cleanup crew was published this past summer in the "Journal of Occupational and Environmental Medicine." Hundreds of former cleanup crew workers responded to a survey to describe their adjustment to the cleanup work. Rates of self-reported mental distress were significantly higher than for the average American population.

I asked Sara Johnson, a co-author of the article, about lessons to be drawn.

"Employers should recognize that their employees may be nontraditional first responders," she told me. They may be constrained by the high turnover of employees, for instance in construction. However, Johnson says that employers can take a few specific steps. Make sure of stocking personal protection supplies and equipment appropriate for first-responder work, such as face masks. Make sure also of providing counseling services.

According to Johnson, many workers will develop a problem--be it respiratory, emotional, or otherwise--and not recognize it. Employers must monitor for these risks.

Tom Lynch of www.workerscompinsider.com has been working with employers on workers' comp issues since the mid-1980s. He developed the injury-response programs that have become the standard among employers today. I asked him how a 10- to 100-employee building maintenance firm might deal with the challenge of nontraditional response.

He told me, "Be not afraid of danger," as Shakespeare might have written. "Some are born to cope with it; others have danger thrust upon them, and others learn to master it."

PETER ROUSMANIERE, a Vermont-based consultant and writer, is the workers' comp columnist for Risk & Insurance®.

November 1, 2005

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