Applying Infection Control to Risk Management

Editor's Note: This article was written before the Ebola Virus hit the U.S. Find the latest on Ebola on the WHO website and CDC website.

Fire departments are in the business of risk management. Risk management is the identification and forecasting of dangers or threats and the implementation of potential actions that either mitigate or prevent damage from those dangers or threats. We often do this by training, creating and revising fire pre-plans and making a post-incident analysis. We tend to focus a lot of our time on these items to reduce damage to life and property.

Departments need to make sure that we do not limit our risk management to the service of others. We must ensure that we are also minimizing risk for our members. There are many ways to do this, but one avenue that is even more important today than ever concerns infection control.

What Is Infection Control?

To understand fully infection control we must consider what infectious diseases are. The Mayo Clinic explains that "infectious diseases are disorders caused by organisms-such as bacteria, viruses, fungi, or parasites." These disorders can be transmitted from person to person through a variety of pathways. Pathways include, but are not limited to, transmission through blood or other bodily fluids, contaminated and mishandled food, and contact with infected animals.

Thus, by discussing infection control we are focusing on methods in which we can prevent the contracting of infectious diseases. Some of these steps we can take are extremely simple such as properly washing your hands, whereas, others are more complex such as vaccination programs. In most, if not all, cases these steps are worth the cost. Failure to implement these steps can increase risk for our staff to become infected generating potentially expensive medical costs, time-consuming worker’s compensation claims, unnecessary overtime costs, and time away from work.

Resources

There are many agencies that have involvement with, or can provide resources for, your department concerning infectious diseases. Some of these create requirements for agencies such as fire departments where others simply can provide resources. It is impossible to discuss all of these here (and some vary based on the state you reside in), but we will discuss a few examples.

First, NFPA 1581 sets forth the minimum requirements for infection control in fire departments. The requirements include items such as having a written policy, an educated person to serve as infection control officer, and provision of training for staff. This guidance should help you make sure that you either have everything in place or know where to start if you do not.

Another agency involved is the Occupational Safety and Health Administration (OSHA). Many look at OSHA as an agency that is punitive and the organization can be where necessary. However, it can also be of benefit. OSHA does a good job of providing information concerning scientific actions to take to alleviate risks or hazards. An example would be what types of hand sanitizer work against potential exposures in different types of tasks. OSHA also can be a clearinghouse for guidance from other agencies.

Two other agencies that deal with infectious diseases to some extent are the Centers for Disease Control and Prevention and the World Health Organization. The CDC and WHO do a great job of staying on top of novel or emerging diseases and forwarding the information out to others.

A current example is Chikungunya (don't laugh…it is an actual disease). Chikungunya is a viral infection that is transmitted via the bite of a mosquito. As of the writing of this article, there have not been any infections occurring in the United States even though there are cases where citizens were infected on trips to other countries. This may not sound important, but staying on top of these emerging diseases and getting the guidance on protection can help prevent infections. You may not see the link here, but when fighting brush and trash fires there are chances of getting bitten by such mosquitoes.

Parts Of An Infection Control Program

As stated earlier NFPA 1581 details minimal parts of an infection control program. Some of these are:

• Assessing the risk: We must know what the threats we face are prior to starting or revising a program.
• Policy: The policy is there to define threats, provide methods to protect staff, explain how to report exposures, etc. It is the foundation of the program.
• Training: OSHA requires regular training of the policy, emergent threats, and reminders about the steps for reporting exposures.
• Officer: Your department should have a trained staff member to be the infectious control officer. They need to be trained on your policy, but also on the requirements of NFPA and OSHA.
• Vaccination program: Many infectious diseases can be prevented by vaccinations. Such illnesses include Hepatitis B, influenza, and Measles.

Other Items of Note

With those carcinogens there is also the potential for those viruses or bacteria to be living on your gear as well. Clean gear is good gear. Wash it regularly. Wash your hands, wash your hands, wash your hands! Many of the diseases that can be communicable can be prevented with simple hand washing. Make sure you are washing your hands regularly and don't take it for granted. Use soap; lather it up, do it right. Protect yourself!

Conclusion

Managing risk for ourselves is important. Infection control programs can aid in protecting us. We must keep in mind that by protecting ourselves we are also protecting the citizens we pledged to protect and just as important we are protecting our families by not taking these diseases home. Even though the training can sometimes be boring, and even though we may joke around about diseases, the benefit is worth every bit of the cost.

DAVID HESSELMEYER is a 17-year veteran of emergency services. He holds certifications as a firefighter, rescue technician, paramedic, instructor and Executive Emergency Manager. In addition, he earned a Masters of Public Administration from East Carolina University. Hesselmeyer is the owner of On Target Preparedness, LLC (OTP), which contracts with various agencies to assist in risk assessments, disaster plan writing, plan revision, exercise development, grant writing, etc. He currently serves with Buies Creek Fire Rescue and Harnett County EMS. He can be contacted at [email protected] or visit his website at www.ontargetprep.com.