IAFF Infection Control Policy

The issue of infectious (communicable) disease in the fire service continues to take on an urgent meaning with fire fighter's risks of contracting AIDS, hepatitis, pertussis and MRSA. However, the range of diseases that may affect fire fighters, EMTs, and paramedics goes well beyond this list. The IAFF Death and Injury Survey reports that 1 out of every 50 fire fighters is exposed to a communicable disease annually.

  • 5% exposed to hepatitis B
  • 10.2% exposed to hepatitis C
  • 8.6% exposed to human immunodeficiency virus
  • 0.3% exposed to hepatitis A
  • 29.8% exposed to tuberculosis
  • 10.6% exposed to meningitis
  • 16.1% exposed to blood/bodily fluids
  • 19.4% exposed to some other communicable disease
Disease Exposure Graph

IAFF Policy

Overview

This program is intended to support the provisions of the IAFF Executive Board policy on infectious diseases. Every attempt has been made to substantiate, support, and provide recommendations for our locals to establish similar policies within their departments for the health and welfare of our fellow brothers and sisters.

Officially Designated Physicians

The policy has been updated by the IAFF due to current concern regarding the risk of transmission of HIV, hepatitis C, and other infectious diseases to emergency response personnel. Therefore, the Executive Board developed and adopted the following position statement and recommended guidelines to address this issue:

The IAFF Executive Board supports the Fire Service Joint Labor Management-Wellness Fitness Initiative and NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, as it relates to fire department medical programs (Chapter 10). Specifically, the IAFF supports NFPA 1500, Section 10.6.1, which states:

"The fire department shall have an officially designated physician who shall be responsible for guiding, directing, and advising the members with regard to their health and fitness for various duties."

Limitations on Duty

The IAFF Executive Board believes a policy that specifies limitations on HIV-infected fire fighters, EMTs or paramedics is necessary. If there is clear evidence that such workers pose a significant risk of transmitting infection through an inability to meet basic infection control standards or guidelines, appropriate limitations of duty should be instituted.

Through the Fire Service Joint Labor Management Wellness-Fitness Initiative and NFPA 1500, fire departments are responsible for evaluating the health status of all fire fighters, EMTs, and paramedics and their ability to perform assigned duties.

The fire department must establish procedures for the evaluation of work limitations for employees with an infectious disease who in the course of performing their duties demonstrate evidence of functional impairment or inability to adhere to standard infection control practices or who present an excessive risk of infection to patients or fire department members. The fire department physician must evaluate fire fighter, EMT and paramedic job duties to determine job limitations, if any, in the event of an individual’s contraction of an infectious disease. The evaluation should include an assessment of any factors that may compromise the performance of job duties, as well as a review of scientifically and medically accepted infection control practices. Factors include illness or presence of exudative or weeping lesions that may interfere significantly with the fire fighters’, EMTs’ and paramedics’ ability to perform their jobs and provide quality care. Both physical and mental competencies are also to be considered. Additionally, the fire department physician should review the immunologic status of the fire fighter, EMT and paramedic and susceptibility to infectious diseases.

The fire department physician must assist with developing policies addressing limited duty assignment for non-infectious personnel where there is a greater potential for that individual to contract an infectious disease. Fire fighters, EMTs and paramedics with extensive skin lesions or severe dermatitis on hands, arms, head, face, or neck must be evaluated to determine whether they should engage in direct patient contact, handle patient care equipment, or handle medical waste until such time that they are healed.

Infection Control Programs

The IAFF also demands that all fire departments adopt NFPA 1581, Standard on Fire Department Infection Control Program. The standard requires departments to develop policy guidelines for the prevention of transmission of bloodborne pathogens and other infectious diseases during fire fighter, EMT, and paramedic response activities as well as guidelines for improving infection control practices. The fire department must be responsible for providing barrier protection equipment (gloves, protective garments, etc.), safer needle devices, supplies, proper disinfection facilities, and appropriate training.

Basic Elements of an Exposure Control Plan

  • Written policy for protecting employees from bloodborne pathogens exposures
  • Designated individual responsible for administering the plan
  • Employee exposure determination (a list of job classifications where employees may be exposed)
  • Hepatitis B virus vaccination provisions
  • Employee training (initial and annual training)
  • Methods for control of bloodborne pathogens
    • Universal precautions
    • Engineering controls (for example, safety devices and sharps containers)
    • Work practice controls (for example, sharps handling and disposal, hand washing, cleanup)
    • Personal protective equipment (for example, disposable gloves or face shields)
    • Housekeeping
  • Post-exposure reporting, evaluation, counseling, and follow-up procedures
  • Procedures for evaluating circumstances surrounding an exposure incident
  • Recordkeeping, including sharps injury logs, training records, and annual plan updates
  • Source: http://www.cdc.gov/niosh/docs/2008-115/

Personnel Training

Fire departments must implement annual training for all fire department personnel in universal blood and body fluid precautions, barrier techniques, safer needle devices, and other scientifically accepted infection control policies. Such training also should provide information on infectious disease risk factors and the contagiousness and transmission of infectious disease as well as information on the availability and merits of voluntary, confidential or anonymous counseling and testing as a personal health measure for fire department personnel. Training materials must include information on exposure to infectious diseases and reproductive health.