Emergency Information for People with Visual Impairments:
Evaluation of Five Accessible Formats
W. Crandall, Ph.D., B. Bentzen, Ph.D., L. Myers, M.Ed., R. Easton, Ph.D.
Smith-Kettlewell Rehabilitation Engineering Research Center
2318 Fillmore Street, San Francisco, CA. 94115
The National Center for Health Statistics estimated that 4.3 million people in the US have difficulty reading the newspaper with their corrected vision -- a functional definition of perceived limitations termed Severe Visual Impairment (Nelson and Dimitrova, 1993). Importantly, an additional 2.3 million people have a disability that involves the loss of intermediate or distant vision. From these statistics, we may conclude that a total of 6.6 million people may be unable to read printed street signs or signage inside buildings at normal viewing distance. Data from the Bureau of the Census put the figure for this same level of impairment at 9.7 million people (McNeil, J., 1993). There is another important way of looking at the demographics of blindness. Estimates of tested acuity classify 1.1 million people as Legally Blind which is defined as corrected acuity of 20/200 or less and a visual field of < 20 degrees (Chiang, Y-P, et. al., 1992).
Many other disabilities prevent persons from reading print. In addition to people who are blind or have low vision and may not be able to see the print, there are many stroke, head-injured, autistic and dyslexic (or even just educationally impaired) persons who may not be able to assimilate printed language even though they can see the page. Many people can accept this information through speech -- having print read aloud to them.
The California State Fire Marshal determined that it was desirable to sponsor a Task Force which would meet to study and propose new rules covering accessible signage in apartment buildings, hotels, motels and lodging houses of all sizes, and office buildings two or more stories in height. The goal of this California State Fire Marshal's Emergency Evacuation Information Task Force For People who are Blind or Visually Impaired (Task Force) is to ensure that fire-related emergency evacuation and procedures information for blind occupants is provided in an accessible format so that blind and visually-impaired individuals have knowledge -- equivalent to that of sighted individuals -- regarding emergencies in buildings.
The problem of providing emergency information to individuals who are visually impaired is complex because emergency procedures vary according to the type of emergency, extent of emergency, size of building (single floor or high-rise), occupancy (i.e., hotel or office building) and type of building construction (i.e., fire and smoke secure guest rooms and/or stairwells). This complexity raises many questions such as:
i. Which format/s provide/s for the most efficient prior familiarization of the greatest proportion of blind users?
ii. Which format/s provide/s for the most efficient emergency egress of blind users?
iii. Which format/s is/are preferred by most blind users?
Current California state fire code requires that hotels, motels and high-rise buildings make available to all persons entering the building emergency procedures and information in the form of a leaflet, brochure, pamphlet or other method (as approved by the authority having jurisdiction) or a floor plan sign (placed at specified locations in the building). Visually impaired persons shall receive instructions of a type they will understand, for example: taping of instructions, instructions in Braille, or other appropriate methods. The emergency procedures information shall include, but not be limited to the following information (see also Appendix A*):
1 . Location of Exits
2 . Location of fire alarm initiating stations
3 . What fire alarm sounds and looks like
4 . Fire department emergency telephone number (911)
5 . Prohibition of elevator use during emergencies
*Most relevant regulations (in context of the committee's charge) are found in Appendix A, California Code of Regulations, Title 19, Section 3.09, Emergency Planning and Information and Section 3.10, Evacuation of Buildings. It is from this regulation that the Task Force is to base its recommendations. Recommendations outside the scope of these regulations will be entertained, but will require separate, legislative action.
Specific activities of the Task Force in order to reach this goal
In order to accomplish this goal, the Task Force is charged with the following responsibilities:
1. To recommend a framework to provide appropriate emergency information to persons who are blind or visually impaired in a format that will allow individual understanding, comprehension and usability which does not conflict with the needs of other disabled people.
2. To determine and make recommendations on methods for informing and educating building and fire officials on the requirements for providing appropriate emergency information to persons who are the blind, visually-impaired, or who have other disabilities.
3. To evaluate the need for a certification process for emergency evacuation systems manufacturers and/or products.
4. To determine and make recommendations on effective enforcement mechanisms.
What the Task Force concluded thus far
There appears to be good agreement among the three Orientation & Mobility (O&M) Specialists who are members of the Task Force that within this context, some mixture of audible and tactile format is best for reaching the largest number of visually impaired individuals. Meeting minutes reflect the opinion that familiarity with the building before the emergency is important, that audible information could be most easily used by a majority of occupants and that messages should be very short. During an actual emergency however, the very high decibel audible alarms in many buildings are potentially in conflict with any audible sign system for emergency information -- not only for blind people, but also for people whose hearing is impaired. That is, when these loud alarms are activated then nothing else can be heard. These loud alarms pose a special challenge to blind people as their primary communication channel (hearing) is thereby blocked in emergency situations.
Because waiting until the actual emergency event to occur before seeking emergency procedures information puts one at a distinct disadvantage in situations where a rapid response is critical, early knowledge of emergency procedures (including the route to the nearest exit) for each building seem to be the best insurance against harm. Because evacuating every building in every fire emergency is not always desirable, the committee has placed emphasis upon establishing ways of providing comprehensive emergency information in that it be comparable to that offered to sighted people. The Committee discussed options for providing pre-emergency preparedness information, such as handouts in the form of tactile maps, Braille, raised and large print or devices such as portable recorders, auditory push-button devices and infrared signs built into all "EXIT" route signs as potentially being appropriate mechanisms of preparing occupants for emergencies.
Community meeting to establish priorities
Against the background of work already accomplished in prior Task Force meetings, the Task Force called a meeting at the San Francisco Rose Resnick Lighthouse for the Blind with a group of approximately 35 interested parties composed of O&M Specialists, leaders from many blind service organizations from the San Francisco Bay Area, interested blind individuals, several San Francisco City fire fighters and several manufacturers of equipment. Here, the Task Force received community input as to what mechanisms and/or formats should be used to provide the emergency evacuation information to blind and visually impaired individuals. All present agreed that equivalency is at best extremely difficult to define and at worst impossible to implement; to try may not be in the best interest of blind individuals. Instead, providing personal life safety information was considered primary. Ensuring familiarity with the building and familiarity with the emergency procedures before the actual emergency was considered key to the effective response to an emergency -- whatever response is most appropriate: staying in a room or office; proceeding to the safe area of refuge (such as the stairwell); or exiting the building.
Three recommendations came from this community group meeting:
1. All exits signs shall be in Braille, raised print and large print in high contrast.
2. Exit route signs shall be accessible through an infrared system using a receiver, and shall have an emergency power back up system. During an emergency an audible indicator (sound or word) shall be provided at the point of the exit. This would be considered an approximation of equivalency.
3. Emergency procedures information shall be available, upon request by consumer option, in the following formats: large print, Braille, and an audible form. The audible form can include but shall not be limited to a personal tour. A personal tour alone with an alternate, audible format would fulfill this requirement.
The next step was to attempt a consensus regarding these recommendations by submitting a survey to a broader group of O&M and blind persons for vote and comment. Of the 15 respondents, on recommendation #1, 14 agreed and 1 disagreed; on #2, 10 agreed and 3 disagreed; and on #3, 12 agreed and 2 disagreed. The survey, along with an analysis of the responses and extensive comments of participants can be found in Appendix B.
Need for research
During the course of the past years Task Force efforts, it has become apparent that there is little research which compares the use by persons with visual impairments of different formats for obtaining wayfinding information; especially in the context of emergency situations. Very little attention has been directed toward solving the life safety issue of providing emergency information to blind occupants of buildings in accessible formats. Indeed, the California State Fire Marshal recently conducted a nationwide survey in 1998 to determine how other states had approached this problem and found that no state had promulgated laws or rules in this area.
Members of the Task Force felt that if research was done there would be objective and subjective data upon which to base their recommendations.
In order to model the effectiveness of communicating emergency information in a number of accessible formats, a paradigm was established where subjects read or listened to instructions for executing a travel task and then were asked to execute this task. Specifically, communication effectiveness was determined by objective and subjective measures for each of the following five accessible formats: Braille, raised print, tactile maps, push button audible signs (as exemplified by TouchearR Signs) and remote infrared audible signage (exemplified by Talking SignsR) by providing subjects with route information to a designated exit stairway. Travel to the emergency exit stairway was not meant to simulate an emergency situation. The study components were: