Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 9, Núm. 18 (Ed. Jul – Dic  
026) ISSN: 2737-6273  
2
Occupational protection of search and rescue personnel during earthquake response: an urgent call for  
integrated respiratory health surveillance.  
DOI: https://doi.org/10.46296/gt.v9i18.0385  
OCCUPATIONAL PROTECTION OF SEARCH AND RESCUE PERSONNEL  
DURING EARTHQUAKE RESPONSE: AN URGENT CALL FOR  
INTEGRATED RESPIRATORY HEALTH SURVEILLANCE  
PROTECCIÓN LABORAL DEL PERSONAL DE BÚSQUEDA Y RESCATE  
DURANTE LA RESPUESTA A TERREMOTOS: UN LLAMAMIENTO  
URGENTE A LA VIGILANCIA INTEGRADA DE LA SALUD RESPIRATORIA  
Delgado-García Diemen 1  
1
Editor-in-Chief, Journal Gestar. University of Texas Rio Grande Valley. United States.  
Correo: diemen.delgado@journalgestar.org. ORCID ID: https://orcid.org/0000-0003-2600-8425.  
Resumen  
El personal de búsqueda y rescate (SAR) desplegado en operaciones de respuesta a terremotos  
está expuesto a riesgos aéreos complejos, como sílice cristalina respirable, fibras de amianto,  
partículas derivadas de la combustión y material particulado fino y ultrafino. La evidencia de  
grandes desastres, especialmente el colapso del World Trade Center y los recientes terremotos  
en Asia y Oriente Medio, demuestra tanto efectos respiratorios agudos como enfermedades  
crónicas de las vías respiratorias a largo plazo entre los rescatistas. A pesar de la solidez de esta  
evidencia, las medidas de protección de la salud ocupacional siguen implementándose de forma  
inconsistente en los entornos de respuesta a desastres en todo el mundo. La protección  
respiratoria se retrasa con frecuencia o se aplica de forma inadecuada durante las fases más  
peligrosas del despliegue, cuando la intensidad de la exposición es mayor. Este editorial destaca  
la brecha persistente entre la evidencia científica y la práctica operativa y aboga por la integración  
obligatoria de la protección respiratoria, la vigilancia estructurada de la salud ocupacional y el  
seguimiento a largo plazo del personal expuesto. Se propone un Marco de Protección del  
Rescatista simplificado pero integrado para guiar la prevención en las fases de preparación,  
despliegue y post-despliegue.  
Palabras claves: salud ocupacional, salud respiratoria, rescatistas, prevención.  
Abstract  
Search and rescue (SAR) personnel deployed in earthquake response operations are exposed  
to complex airborne hazards, including respirable crystalline silica, asbestos fibers, combustion-  
derived particles, and fine and ultrafine particulate matter. Evidence from major disasters—most  
notably the World Trade Center collapse and recent earthquakes in Asia and the Middle East—  
demonstrates both acute respiratory effects and long-term chronic airway disease among  
responders. Despite the robustness of this evidence, occupational health protection measures  
remain inconsistently implemented in disaster response settings worldwide. Respiratory  
protection is frequently delayed or inadequately applied during the most hazardous phases of  
deployment, when exposure intensity is highest. This editorial highlights the persistent gap  
between scientific evidence and operational practice and argues for the mandatory integration of  
respiratory protection, structured occupational health surveillance, and long-term follow-up of  
exposed personnel. A simplified but integrated Rescuer Protection Framework is proposed to  
guide prevention across preparedness, deployment, and post-deployment phases.  
Keywords: occupational health, respiratory health, rescuers, prevention.  
Información del manuscrito:  
Fecha de recepción: 14 de abril de 2026.  
Fecha de aceptación: 18 de junio de 2026.  
Fecha de publicación: 10 de julio de 2026.  
2
Delgado-García. (2026)  
understanding of disaster-related  
occupational respiratory disease.  
Long-term cohort studies of exposed  
responders have demonstrated  
persistent respiratory symptoms,  
accelerated decline in lung function,  
and increased prevalence of asthma-  
like disease. Importantly, these  
health effects have persisted for  
decades, underscoring that acute  
disaster exposure may translate into  
chronic, progressive respiratory  
morbidity.  
1
. Introduction  
Earthquake response operations  
represent  
one of  
and  
the most  
hazardous  
demanding  
environments in occupational and  
disaster medicine. Search and  
rescue personnel operate under  
extreme conditions characterized by  
structural collapse, unstable debris  
fields, limited visibility, high physical  
workload, and intense psychological  
stress. Within this context, airborne  
exposure to hazardous particulate  
matter constitutes a major yet still  
insufficiently controlled occupational  
risk.  
Subsequent earthquakes in Japan  
(
2011), Nepal (2015), Taiwan (2016),  
and Türkiye–Syria (2023) have  
reinforced these findings,  
The collapse of buildings generates  
a highly heterogeneous aerosol  
composed of respirable crystalline  
silica, asbestos fibers, cement dust,  
heavy metals, and combustion-  
related by-products, including fine  
and ultrafine particulate matter  
capable of reaching the distal  
airways and alveolar spaces. The  
toxicological complexity of this  
mixture is compounded by the  
absence of environmental control in  
the early phases of disaster  
response.  
consistently reporting increased  
respiratory symptom burden among  
deployed SAR personnel. Although  
study designs vary, the direction of  
evidence is remarkably consistent:  
disaster dust exposure is not a  
transient irritant phenomenon but a  
determinant of long-term respiratory  
health outcomes.  
The World Trade Center disaster in  
2001 marked a pivotal moment in the  
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Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 9, Núm. 18 (Ed. Jul – Dic  
026) ISSN: 2737-6273  
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Occupational protection of search and rescue personnel during earthquake response: an urgent call for  
integrated respiratory health surveillance.  
2. Development  
Clinically, SAR personnel may  
experience acute respiratory  
Respiratory hazards in earthquake  
environments  
irritation, cough, dyspnea, and  
bronchial hyperreactivity during or  
shortly after deployment. More  
concerning, however, is the growing  
body of evidence indicating long-  
term respiratory sequelae, including  
Airborne  
dust  
generated  
in  
earthquake settings is not a single  
pollutant but a complex mixture of  
fibrogenic, carcinogenic, and irritant  
agents. Of particular concern is  
respirable crystalline silica, a well-  
established cause of silicosis,  
persistent  
airway  
inflammation,  
asthma-like syndromes, and fixed  
airflow obstruction.  
chronic  
obstructive  
pulmonary  
Psychological  
burden  
and  
systemic  
disease, and lung cancer. In disaster  
contexts, silica exposure occurs in  
unpredictable, high-intensity bursts,  
often without adequate respiratory  
The occupational burden of disaster  
response extends beyond the  
respiratory system. SAR personnel  
are repeatedly exposed to traumatic  
scenes, including mass casualties,  
severe injuries, and destroyed urban  
environments. This exposure is  
associated with a high prevalence of  
acute stress reactions, anxiety,  
depression, burnout, and post-  
traumatic stress disorder (PTSD).  
protection  
or  
environmental  
monitoring.  
In addition, asbestos fibers may be  
released from older building  
materials during structural collapse,  
adding a carcinogenic component to  
the  
exposure  
profile.  
When  
combined with combustion products,  
metal particulates, and ultrafine  
particles, the resulting inhalational  
Importantly,  
psychological  
and  
exposure  
becomes  
a
physiological stressors are not  
independent. Increasing evidence  
suggests that systemic stress  
responses may amplify inflammatory  
pathways, potentially exacerbating  
multidimensional respiratory hazard  
with both acute and chronic  
implications.  
respiratory  
vulnerability  
and  
4
Delgado-García. (2026)  
contributing to poorer long-term  
outcomes.  
Towards an integrated protection  
model  
The evidence–practice gap  
To address this gap, an integrated  
Rescuer Framework  
Protection  
Despite decades of accumulated  
evidence, occupational protection for  
(RPF) is proposed. This model  
organizes preventive strategies  
across five interdependent domains:  
SAR personnel remains  
inconsistently implemented. In many  
disaster  
responses,  
is either  
respiratory  
delayed,  
1. Environmental control, including  
dust suppression and exposure  
zoning  
protection  
insufficiently fitted, or unavailable  
during the initial and most hazardous  
phases of deployment.  
2. Respiratory protection, with  
mandatory fit-tested N95/FFP2  
or higher respirators  
This disconnect reflects a structural  
issue in disaster preparedness  
systems, where operational urgency  
3
. Occupational  
health  
pre-  
surveillance,  
including  
deployment screening and post-  
deployment monitoring  
often  
supersedes  
occupational  
health considerations. Yet the  
scientific literature clearly indicates  
that the earliest exposure period is  
frequently the most damaging in  
terms of long-term respiratory  
outcomes.  
4
. Psychological  
protection,  
incorporating structured mental  
health support systems  
5
. Long-term follow-up, ensuring  
detection of delayed respiratory  
and psychological outcomes  
The absence of standardized global  
protocols for respiratory protection  
and health surveillance in disaster  
response represents a critical gap in  
international occupational health  
policy.  
This framework aims to reposition  
occupational health as an essential  
structural component of disaster  
response systems rather than an  
ancillary consideration.  
Policy implications  
The available evidence strongly  
supports the need for a paradigm  
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Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 9, Núm. 18 (Ed. Jul – Dic  
026) ISSN: 2737-6273  
2
Occupational protection of search and rescue personnel during earthquake response: an urgent call for  
integrated respiratory health surveillance.  
shift in disaster response policy.  
Respiratory protection for SAR  
personnel should not be considered  
optional or context-dependent, but  
rather a mandatory operational  
standard.  
contexts  
demonstrates  
exposure  
that  
respiratory  
during  
earthquake response operations is  
associated with both acute and long-  
term health consequences.  
Closing the gap between scientific  
evidence and operational practice is  
an urgent priority. Integrating  
respiratory protection, occupational  
surveillance, and long-term follow-up  
into standard disaster response  
protocols is not only a scientific  
necessity but also an ethical  
imperative.  
International agencies, including  
WHO, INSARAG, and national civil  
protection  
systems,  
should  
incorporate  
standardized  
occupational health protocols into  
disaster preparedness and  
deployment frameworks. These  
should include mandatory respiratory  
protection, exposure documentation,  
and longitudinal health surveillance.  
Protecting those who risk their lives  
to save others must become a  
foundational principle of modern  
disaster medicine.  
Without such measures, the global  
disaster response system will  
continue to generate preventable  
occupational disease among those  
who are essential to saving lives in  
the acute phase of emergencies.  
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