In the wake of the September 11, 2001, terrorist attacks, the risk of terrorism and the demands of homeland security are a central component of any discussion of protecting emergency responders. In addition, the nation faces the risk of hurricanes, earthquakes, large industrial incidents, and other natural disasters. During and after such events, responders face the risk of physical injury, traumatic stress, and hazardous exposures. Effectively addressing such risks requires bringing together the capabilities of a range of response organizations from all levels of government, nongovernmental organizations, and the private sector. This study provides recommendations for preparing for response to such disasters and other large-scale incidents. It uses literature review, study interviews with members of the response community, and information gathered at the RAND Corporation-National Institute for Occupational Safety and Health workshop Protecting Emergency Responders: Safety Management in Major Disaster and Terrorism Response in Arlington, Va., on February 27, 2003. From the examples of several large-scale response operations (the September 11 terrorist attacks, Hurricane Andrew, and the Northridge Earthquake), the authors were led to the conclusion that the emergency response community should put in place structures and preparedness efforts that will formalize an integrated, incident-wide approach to safety management at major disaster response operations. Related documents: Brian A. Jackson, D. J. Peterson, James T. Bartis, Tom LaTourrette, Irene Brahmakulam, Ari Houser, and Jerry Sollinger, Protecting Emergency Responders: Lessons Learned from Terrorist Attacks, RAND Corporation, CF-176-OSTP, 2002; Tom LaTourrette, D. J. Peterson, James T. Bartis, Brian A. Jackson, and Ari Houser, Protecting Emergency Responders, Volume 2: Community Views of Safety and Health Risks and Personal Protection Needs, RAND Corporation, MR-1646-NIOSH, 2003.