NFPA 1581

The fire department infection control program must have a written policy statement. Such a policy statement should clearly define the department’s mission in limiting the exposure of members to infectious diseases during the performance of their assigned duties and while in the fire station living environment. Examples of generic policy statements are found in the appendix of NFPA 1581.

Training and education of fire service and emergency personnel is an important component of any fire department infection control program. Section 4.3.3 states "The training program shall include proper use of personal protective equipment, standard operating procedures for safe work practices in infection control, proper methods of disposal of contaminated articles and medical waste, cleaning and decontamination, exposure management, and medical follow-up." In addition, section 4.3.3 states "The education program shall provide information on epidemiology, modes of transmission, and prevention of diseases." Fire fighters and emergency responders should be educated on the diseases that have the potential for occupational exposure. These diseases are discussed in the beginning of this manual.

The infection control program should have an experienced individual within the department designated as the infection control officer. The officer has the responsibility to maintain communication between the fire department and all community health care professionals. The infection control officer also has the responsibility to examine compliance procedures and engineering controls, investigate exposure incidents, notify members of exposure, properly document the exposure, and ensure medical follow-up is received by the individual following an exposure.

Exposure to an infectious or contagious disease requires prompt action, particularly if the individual does not have adequate immunity to the disease. The standard requires that the fire department have established procedures for reporting an exposure incident and provides instructions for the treatment of an exposure. The exposed area should be washed immediately, reported to the infection control officer after the exposure incident, and treated by the fire department physician as soon as practical. All exposures of an individual to an infectious or contagious disease, while on or off the job, should become a part of that person’s confidential health file. In addition, the information from the duty related exposure should be made anonymous and added to the department’s health database.

The standard outlines the recommended facilities for infection control within the department. These recommendations also comply with CDC and OSHA regulations. The fire department should be equipped with facilities for disinfection, cleaning, and storage. NFPA 1581 provides recommendations for fire department apparatus that are used to transport patients. Consideration of infection control measures should be applied to bathrooms, kitchens, sleeping areas, laundry facilities, equipment storage areas, cleaning areas, disinfection facilities, and disposal areas. These can also be used in the design of new fire stations.

The standard details the protection of the fire fighter and other emergency responders while performing emergency medical operations. Personnel physical condition, protective clothing and equipment, and operational techniques are provided minimum standards for infection control.

The infection control program outlined within the standard also addresses skin washing practices, disinfectant handling and use, cleaning of contaminated emergency medical equipment, disposal of infectious materials, and the laundering of linens. As an important factor in infection control, section 8.1.1 of the standard addresses hand washing with, "Hands shall be washed as follows: (1) After each emergency medical incident; (2) Immediately or as soon as possible after removal of gloves or other personal protective equipment; (3) After cleaning and disinfecting emergency medical equipment; (4) After cleaning personal protective equipment; (5) After any cleaning function; (6) After using the bathroom; (7) Before and after handling food or cooking and food utensils." As another important factor in infection control, cleaning and disinfection of equipment and clothing should be performed in the proper area and on a regular basis and/or immediately following an exposure incident. Under no circumstances should contaminated equipment or clothing be taken home for cleaning.

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