By: Mary Jane Dittmar
Fire Engineering

How can you ensure that your health interests are protected? Are you confident that you will be told immediately if you have tested positive for an infectious disease or that you are at risk for a serious health condition? Are you secure in your belief that you will receive the health care you need as quickly as possible to ensure your best chance for recovery?

Many municipalities have conscientiously established comprehensive policies and standards that protect their firefighters in these situations. Others towns and cities may not have clear-cut policies or may try to cut corners because of rising health care, compensation, and insurance costs associated with protracted treatment and long-term disability. It is up to you to find out exactly what your status would be if you were to contract an infectious disease or a major illness. Do you know what your town’s policy is? What your union contract says? To whom you would report an exposure? With whom, and how, to follow up on test results, including those that are part of a routine physical exam?

Do you assume that you will be notified immediately “if anything is wrong”? Even if your department’s policy is to let you know immediately, follow up anyway. Your results might be lost or accidentally filed away. And, there have been allegations from time to time that critical health information was withheld from firefighters who had an infectious disease, such as hepatitis C, or were at high risk for cardiovascular disease. In cases such as these, there generally are charges that the municipality/department withheld that information, denials that this happened, more charges and countercharges, officials’ opinions, and so on. In the meantime, some of the firefighters involved face serious health problems because the firefighters were not treated as soon as signs of the illnesses became evident through test results. Don’t assume. Make sure you know.

As far as infectious diseases are concerned, you have several key responsibilities. Failing to execute them puts you and your fellow firefighters and family members at risk. In addition to becoming familiar with your department’s health policies and standards, review Occupational Safety and Health Administration (OSHA) 1910.1030, Bloodborne Pathogens. Make sure you take all the recommended precautions on every single response that might expose you to blood and other body fluids that could put you at risk for infectious diseases. Properly dispose of sharps and other equipment that can expose your fellow responders.

Are you satisfied that your department’s infection control program is adequate? You can evaluate it against OSHA 1910.1030, which defines the components of such a program and the steps a fire department must take to be compliant. Consult National Fire Protection Association 1581, Standard on Fire Department Infection Control Program. It puts the OSHA requirements within the context of a fire department’s daily operations. It addresses training and education; use of protective clothing and equipment; apparatus, vehicles, and equipment; standard operating procedures for safe work practices in infection control; proper methods for disposing of contaminated articles; cleaning and decontamination; health maintenance; and managing exposures and medical follow-up.

One reminder here: It is critical that you report exposures and anything you think might have been an exposure. You can’t be too careful. Unless you have a report on file, there will be no way to determine that you contracted the disease during the course of your job. And, you may be wasting valuable time in getting treatment that may save you from a chronic, debilitating condition. When you report an exposure (or possible exposure), you will be given a test that can serve as a baseline for the future, and you will be followed up on a regular basis. And, you will be protecting your financial interests and your family’s welfare.

Next time, a look at how some fire departments’ policies.

Little Changes Can Make a Difference Category
Previous columns broached ways to be “proactive” about your health. In this section, we will look at some research related to health problems that have been associated with firefighting and medical response that can lead us in that direction. This information is presented in the spirit of recognizing that good health is a prize to treasure and protect and that there are some things you can do to try to offset some of the negative effects your job and environment may have on your health.

  • Coronary disease. Plant sterol or plant stanol esters may reduce the risk of coronary heart disease by lowering blood cholesterol levels. Therefore, the Federal Drug Administration (FDA) has authorized health claims for the labels of some of these foods. Plant sterols are present in small quantities in many fruits, vegetables, nuts, seeds, cereals, legumes, and other plant sources. Read food labels for the presence of these substances.
  • Cancer. Research has shown that lifestyle changes can play a significant role in preventing cancer. The carcinogens in our environment-and especially during firefighting and overhaul activities (smoke, chemicals, construction and furnishings components, for example)–increase the risk. Anything you can do to strengthen your immune system can help you to better fight illnesses. Such activities include good nutrition, daily exercise, maintaining a desirable weight, and undergoing regular physical checkups. The U.S. Department of Health and Human Services National Institutes of Health passes along the following tips that can help to prevent cancer:
    • Eat a variety of foods each day: vegetables–dark green leafy vegetables; other green vegetables; red, yellow, and orange vegetables; vegetables from the cabbage family (cruciferous): bok choy, broccoli, Brussels sprouts, cabbage cauliflower, collards, kale, kohlrabi, mustard greens, rutabagas, and turnips. All fruits and fruit juices. Whole grain cereals. Lean meats, poultry without skin, and fish. Dry peas and beans. Low-fat dairy products.
    • Avoid excess fat, saturated fat, and cholesterol.
    • Eat foods with adequate starch and fiber. (A high-fiber diet may reduce the risk of colon and rectal cancer.
    • Avoid excess sugar.
    • Avoid excess sodium (may contribute to high blood pressure; untreated high blood pressure can lead to heart attacks, strokes and kidney disease).
    • If you drink alcoholic beverages. Drink moderately.
    • Avoid unnecessary X-rays.
    • Follow the health and safety rules of your workplace.
    • Avoid too much sunlight; wear protective clothing, and use effective sunscreens.
    • Don’t smoke. Tobacco smoke causes about one-third of all cancer deaths. Deaths caused by heart disease and emphysema brought on by smoking kill more people that cancer.

Information presented in this column is not to be construed as medical advice. Always consult with your physician before beginning an exercise program or taking supplements or any other substances, especially if you have been diagnosed with a medical condition or are taking medications.

Comments or ideas? What is your department’s policy concerning infectious disease and other health problems? Has your department changed menus or instituted exercise or other programs to improve members’ health? Let us hear from you. E-mail Mary Jane Dittmar at [email protected].