141st APHA Annual Meeting

In This section

286688
Splash and non-intact skin bloodborne pathogen exposure risk factors in the Philadelphia fire department

Tuesday, November 5, 2013 : 4:30 PM - 4:45 PM

Christine Fung, MPH , Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA
Curtis E. Cummings, MD, MPH , Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA
Nancy Belsky, Capt. FSP ECO , Infection Control Office, Philadelphia Fire Department, Philadelphia, PA
Background: Few data are available regarding risk factors for non-intact skin and mucous membrane exposures (e.g., splashes of blood/ body fluids) among first responders. Also, few studies evaluate detailed health databases of fire department populations. Bloodborne pathogen (BBP) infections hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) are preventable. We investigated BBP and other potentially infectious materials (OPIM) exposures in Philadelphia Fire Department (PFD) paramedics. Methods: 52 mucous membrane and 38 non-intact skin exposures to BBP and OPIM recorded by the PFD from 2001 to 2011 were analyzed. Demographics, clinical factors, outcomes, and exposure factors were studied. Rates of exposures were calculated using call volume. Results: There were no seroconversions to HIV, HBV, or HBC. Mucous membrane exposure rate was 194/1,000,000 calls; non-intact skin exposure rate was 156/1,000,000 calls; these rates were at least 6.25 times lower than reported elsewhere. Exposures occurred most often on Mondays, Wednesdays and Fridays. Patient actions causing multiple exposures included: spitting in eyes, biting, scratching, other assault and removing members' mask; other frequent events were breached gloves and fluid splash from endotracheal tubes. Conclusions: To our knowledge this is the first such detailed study of paramedic non-intact skin and mucous membrane exposures. While no BBP seroconversions occurred, exposure remains a threat to first-responder health. For prevention, a Standard Operating Procedure has been written for the PFD. Members should complete HBV vaccine series and use personal protective equipment and work practices that minimize risk of exposure.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Discuss the risks of splash and non-intact skin exposures to blood-borne pathogens in Philadelphia Fire Department paramedics Describe factors related to splash and non-intact skin exposures to blood-borne pathogens in Philadelphia Fire Department paramedics

Keywords: EMS/Trauma, Injury Risk

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator, have previously presented related information and other papers at APHA meetings, have published papers in Occupational Health and have worked in Occupational Health since 1980.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4402.0: Occupational injuries