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Writing a standard operating procedure for the Philadelphia Fire Department emergency response employees' mucous membrane and non-intact skin exposures to BBP and OPIM
Thesis

Writing a standard operating procedure for the Philadelphia Fire Department emergency response employees' mucous membrane and non-intact skin exposures to BBP and OPIM

Christine Fung
Master of Public Health (M.P.H.), Drexel University
14 Jun 2012
DOI:
https://doi.org/10.17918/etd-4022
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Fung_Christine_2012339.91 kB
PDF Project Access upon request, Email title, URL, or DOI to archives@drexel.edu
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Fung_Christine_2012_Suppl1377.47 kB
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Abstract

Philadelphia Fire Department Bloodborne Pathogens Infectious Materials Public Health
Background: Emergency Response Employees (EREs) comprise firefighters and paramedics and are at risk for bloodborne infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). EREs increase their risk when they are performing basic and advanced life saving skills. Some EREs might be at increased risk for developing HBV infection if they are not immune when exposed. Other risk factors include splashes of blood or body fluids from patients. Objectives: To evaluate and analyze the Philadelphia Fire Department (PFD) EREs exposure to bloodborne pathogens (BBP) and other potentially infectious materials (OPIM), and to compose a standard operating procedure (SOP) specific to the PFD. Methods: A retrospective study was conducted to analyze the PFD EREs'52 mucous membrane and 38 non-intact skin exposures to BBP and OPIM from 2001 to 2011. The data analysis involved examining the causes and risk factors that affect the occurrence of mucous membrane and non-intact skin exposures such as age, years of experience, paramedic activities, and behavioral and environmental factors. In addition, the rates of mucous membrane and non-intact skin exposures were calculated according to call volume. Results: Our study found PFD paramedics non-intact skin and mucous membrane exposures were 21.1 and 6.25 times (respectively) lower compared to other studies. The mucous membrane exposure rate was 194/1,000,000 calls and the non-intact skin exposure rate was 156/1,000,000 calls. Mucous membrane exposures occurred most often on Mondays, Wednesdays and Fridays. Non-intact skin exposures occurred most often Wednesdays and Fridays. Trends in paramedic activities or environmental factors related to mucous membrane and non-intact skin exposures were exhibited. Combative patients spat in the paramedics' eyes on 24 different occasions, and combative patients scratched, bit or cut paramedics11 times. Fluid splash from endotracheal tubes and nasal intubation into the paramedics' eyes occurred 11 times. Gloves ruptured, torn or removed occurred 11 times. Behavioral factors for mucous membrane and non-intact skin exposures included assault and removal of the paramedics' mask by patients. To date, there has been no seroconversion to HBV, HCV, and HIV among the EREs. Conclusion: Although there have been no seroconversions to HBV, HCV, and HIV via non-intact skin and mucous membrane exposures, these bloodborne pathogens are of serious concern to the PFD. EREs are advised to complete their HBV vaccine series and should use appropriate personal protective equipment and take extra precautions to minimize the risk of a bloodborne pathogen exposure.

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