NFPA 1582

Chapter 7 of the standard provides the standards for medical screening of fire fighters. Each medical evaluation shall include a medical history (including exposure history), physical examination, blood tests, urinalysis, vision tests, audiograms, spirometry, chest x-ray (as indicated), electrocardiogram, cancer screening (as indicated), and immunizations and infectious disease screening (as indicated).

The standard requires the following infectious disease immunizations or infectious disease screenings be provided, as indicated:

  1. Tuberculosis screen (PPD) — annually or more frequently according to CDC guidelines unless member has a history of positive PPD, in which case CDC guidelines for management and subsequent chest radiographic surveillance shall be followed
  2. Hepatitis C virus screen — baseline and following occupational exposure
  3. Hepatitis B virus vaccinations and titers — as specified in CDC guidelines
  4. Tetanus/diphtheria vaccine — booster every 10 years
  5. Measles, mumps, rubella vaccine (MMR) — one dose of MMR vaccine to members born after 1957 without prior immunization and/or evidence of immunity as outlined in Morbidity and Mortality Weekly Report 47(1998):1–57
  6. Polio vaccine — A single booster of IPV for members traveling to endemic areas in the line of duty, or as outlined in Morbidity and Mortality Weekly Report 49(2000):1–22
  7. Hepatitis A vaccine — offered to high-risk (HazMat, USAR, and SCUBA team members) and other personnel with frequent or expected exposures to contaminated water
  8. Varicella vaccine — offered to all non-immune personnel
  9. Influenza vaccine — offered to all personnel annually
  10. HIV screening — available to all personnel

Chapter 7 also requires that pre-screening and immunization against biological threat agents shall be made available to members following CDC guidelines or recommendations. All members shall be immunized against infectious diseases as required by the authority having jurisdiction and by 29 CFR 1910.1030. The fire department physician shall ensure that all members are offered currently recommended immunizations.

In regards to post-exposure bloodborne pathogen testing, physicians who care for members shall follow current CDC recommendations for post-exposure prophylaxis (PEP) for bloodborne pathogen (BBP) exposures. There shall be a written protocol for members who present with BBP exposures. HIV testing shall be offered on a confidential basis as part of post-exposure protocols and as requested by the fire department physician or member. All results from HIV tests shall be provided directly to the member and shall be maintained by the physician as confidential documents. Results from HIV tests shall not be forwarded to any local, state, provincial, national, or international authorities or databases unless mandated by public health statutes.

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