IN NOVEMBER, THE NEW YORK TIMES brought readers behind the scenes at the city’s Ebola monitoring center, run by the New York City health department. Dozens of staffers monitored traveler databases, looking for people who entered the city after trips to West Africa. More than 250 people—a third of whom were being tracked following contact with the city’s first Ebola patient, Dr. Craig Spencer—received daily phone calls inquiring about their body temperature and overall health. The medical staffers who cared for Spencer, including members of the Fire Department of New York (FDNY) who transported him to Bellevue Hospital, were part of this select group being monitored.
Over the past few months, each time an Ebola patient required transport to a hospital, first responders around the country were actively engaged in packaging patients and transporting them to hospitals. Few communities have the resources of New York City, which raises an important question: How can response agencies across the U.S., including police, fire, and emergency medical services, prepare for encountering infectious, high-risk patients?
NFPA 1581, Fire Department Infection Control Program, provides minimum criteria for infection control at any incident or work station where fire department members are involved in routine or emergency operations. It addresses personal protective equipment, hazard communication, and decontamination of apparatus, individuals, and equipment. The foundation of the standard is for each agency to have an infection control program. The program is defined as the department’s formal policy and implementation of procedures for the control of infectious and communicable disease hazards where employees, patients, or the general public risk exposure to blood, body fluids, or other potentially infectious materials in the work environment.
In the 1980s, the world was introduced to a teenager named Ryan White, who had contracted HIV while receiving blood transfusions for hemophilia. Despite having no symptoms, White was barred from attending public schools. His mother launched a campaign to raise awareness that HIV affected all segments of the population, and that by exercising proper precautions, daily interaction with people who were HIV-positive—or who had developed AIDS as a result of HIV infection—posed little risk of exposure. This was when latex gloves were introduced to first responders, who had previously taken few precautions to protect themselves against blood or bodily-fluid exposure. In the case of HIV/AIDS, simple personal protection, understanding the disease and means of transmission, and proper decontamination after a possible exposure provided a high degree of protection for responders, and the knowledge gained through that experience can be found within NFPA 1581.
NFPA 1581 has been shaped by other infectious threats, including hepatitis C, the N151 flu virus, the methicillin-resistant Staphylococcus aureus bacterium, and bioterrorism agents. These and more have been considered by the Technical Committee, and the standard has been repeatedly updated so that its requirements reflect the latest and best approaches to establishing an effective fire department infection control program.
Even if you are a member of a responder agency that doesn’t have New York City’s health department working on your behalf to monitor and track your exposure to any potentially infectious disease, you can still develop an effective infection control program to help you work safely. NFPA 1581 is the right tool for the job.
KEN WILLETTE is division manager for Public Fire Protection at NFPA.