By: Mary Jane Dittmar
Fire Engineering, and FireEngineering.com
What are some of the things your department should be doing to protect you from infectious diseases? Obviously, it should have a well-defined infection-control policy in place, and the policy should be enforced. “An infection-control program is an excellent risk management tool for protecting members’ safety, health, and welfare,” notes Murray Loflin, health/safety and infection control officer for the Virginia Beach (VA) Fire Department. An infectious disease can end your career and threaten your life, Loflin stresses; “The fire service must ensure that we take care of our own,” he adds.
The policy should establish the procedures for reporting actual and possible exposures to blood and other body fluids (airborne or bloodborne), specify the individual(s) to whom the exposures should be reported, describe the medical/testing and follow-up schedule for a base test and designated follow-up tests to ensure that employees receive appropriate treatment as soon as a disease is detected, a description of the confidentiality aspect of the program, and-ideally-a “benefits” section that covers sick leave, workmen’s compensation, medical coverage, temporary and permanent disability, and other major employment policy issues that affect the welfare of the employees and their families. (If you are a member of a union, it is a good idea to consult with your union local also concerning health and financial benefits and support you can expect.).
Your department should also offer educational programs that alert you to the health hazards you face daily on your job and the absolute importance of reporting all airborne and bloodborne exposures, including those you may be unsure about.
Accurate testing for hepatitis C became available in 1992, cautions Andi Thomas of Hep-C ALERT, a Florida-based patient advocacy organization. If you were tested for an exposure to blood before then, you should be retested, she advises. (1) Also, if you were on the job before the advent of universal precautions for infectious disease and were never tested, you should be tested. Les Yost of Philadelphia Fire Fighters Local 22 points out that the majority of responders in the Philadelphia Fire Department who have contracted hepatitis C are 15- to 20-year veterans. (1) If you fall into either of these categories, ask your department about providing the tests.
Remember (it can’t be said too many times): You will not know at the time you are responding to a medical call or an auto extrication or some other accident whether the patient/victim has an infectious disease. Nor may you know for years that you have hepatitis C. You can have it and not become aware of it for years-when it may be too late to do anything about it. So always take the proper precautions, and be sure to report any real or perceived exposure to your employer in writing. To protect your health and your welfare and that of your family, establish a paper trail of actual and potential exposures, and keep a copy of each document for your records.
Depending on your location and the position of your department/municipality, you may or may not have to wage a fight to better protect your health and welfare. You can see from the following the vast differences in attitude that exist from jurisdiction to jurisdiction.
Thanks to Steve Hess of the Philadelphia Fire Department for alerting me to the fact the Ohio Department of Health is sponsoring a Hepatitis C awareness campaign during the month of May, which has been designated “Hepatitis C Awareness Month.” The campaign will include radio, television, and outdoor campaigns. In the literature describing the campaign, emergency medical professionals, firefighters, and police officers were among the populations listed as being at “a higher risk” for contracting this disease.
Hess sees this as positive “because we had to fight like hell here in Philadelphia just to get them to admit that firefighters and paramedics had an elevated risk,” he explains. “The state of Ohio is very upfront with that fact,” he points out.
At the other end of the spectrum, Hess points to the city of Orlando, Florida, where he says firefighters “are having a hard time with their municipal government over this issue.” According to an Orlando Sentinel April 3 article written by Mark Schlueb (OrlandoSentinel.com), audiotapes recorded during labor/union negotiations in 1996 show that the firefighters had asked to be tested but were refused. Since then, several firefighters have been diagnosed with hepatitis C.
Size up your situation, and act accordingly. As Philadelphia Fire Department Paramedic Mary Kohler (February HealthBeat column) observed during her battles with the City of Philadelphia, and reported while on a hepatitis C panel at FDIC 2001, “Hepatitis C is an issue of people with feelings who are in pain and in fear of dying … An issue of human life and dedication and service has been reduced to one of politics, finances, and impersonality.”
Next time, a look at some specific fire department programs.
1.Dittmar, Mary Jane, “Hepatitis C and the Fire Service, Part 2: Mounting an Offensive,” Fire Engineering, January 2001.Comments or ideas? Have experiences to share? Suggestions to offer? E-mail Mary Jane Dittmar at firstname.lastname@example.org.