David Pirnat, Second Lieutenant, Fairfax County, Virginia, Police Department aw enforcement officers face a variety of dangers, yet one of the most serious threats to officer health and well-being cannot be stopped by Kevlar, is not affected by OC spray, and cannot be defeated by even those officers most skilled at defensive tactics: pathogenic microorganisms causing infectious disease. Law enforcement officers are at risk for exposure to potentially infectious pathogens by the nature of their job. Be it rendering aid to the injured at a vehicle crash, fighting to control an intoxicated subject, or arresting a sick suspect, there are a multitude of situations where officers may be exposed to the diseases carried by those with whom they interact. Exposure to an infectious disease is an extremely stressful incident for an officer. Even when told by medical professionals that the potential of developing a disease is slim, an exposure event can bring significant anxiety for the officer—not just for their own well-being, but for the possibility of bringing a disease home to their families.
Pathogens that cause infectious diseases may be blood-borne (HIV, hepatitis), airborne (tuberculosis, influenza, meningitis, whooping cough), or acquired by contact (MRSA and others). Regardless of the mode of transmission, proper use of personal protective equipment (PPE) will minimize the chance for exposure. Unfortunately, many officers do not regularly use PPE or even carry it with them.
Emergency Medical Services (EMS) personnel have much more direct contact with injured and sick people than law enforcement officers do and have institutionalized the use of PPE. EMS personnel exit their units already wearing the appropriate PPE for the incident. In contrast, too few law enforcement personnel recognize the need for PPE, even though many calls for service in the profession are likely to be confrontational. How often does an officer respond to a violent incident, where the dispatch information even includes witness statements such as, “there is blood everywhere” or “covered in blood,” without first donning protective gloves or protective glasses? This officer may quickly find he or she is involved in a physical confrontation or foot chase with a bleeding subject and has missed the opportunity to don PPE before going hands on with the subject.
Respiratory protection is also an important component of PPE. A properly fitted National Institute of Occupational Safety and Health (NIOSH)—approved disposable N95 mask will reduce the wearer’s risk of inhaling airborne particles, thereby protecting the wearer from whooping cough, influenza, tuberculosis, and other airborne pathogens. Officers do not need to diagnose a person’s ailment; they need to recognize the symptoms of a respiratory illness with potential for transmission through coughing, sneezing, or wheezing and don the mask. This is especially true if they will have prolonged close contact, such as transporting the person in a vehicle. The N95 mask is also highly effective when officers must enter locations with high concentrations of airborne particles or mold spores, a condition found in many hoarding houses.Personal protective equipment will not protect an officer if it is not used, and it must be provided and made easily accessible. Law enforcement departments need to promote the use of PPE and ensure they are providing the best equipment possible. This includes provision of high-risk infection control gloves that will not easily tear during law enforcement activities, NIOSH-approved N95 particulate-filtering face piece respirators, eye protection from body fluid splashes, and a waterless hand sanitizer for officers who do not have access to hand-washing facilities (i.e., officers on patrol).
Even with the most proactive procedures in place, pathogen exposures are inevitable. Departments must have an effective exposure control plan in place to assist officers. The Occupational Safety and Health Administration (OSHA) outlines protection standards for all occupations in which workers could be exposed to body fluids in their Bloodborne Pathogens Standard: Title 29 of the Code of Federal Regulations at 29 CFR 1910.1030. Adherence to the standards for prescribed protection provides the foundation for the development of both work environment and administrative policies that reflect the scope of infectious disease exposure, whether blood-borne, airborne, or transmitted by contact and elicits an understanding of their management.
The critical functional components of an exposure control plan are the need for immediate post-exposure reporting, source blood testing, consultation with infectious disease specialists, and provisions for the counseling and treatment of exposed officers. Time is not always on the side of the exposed officer. Post-exposure prophylaxis treatment following an occupational exposure to HIV has a very short effective timeframe. Departments cannot wait until after an exposure has occurred to try and figure out the legal, procedural, and medical requirements for drawing a source subject’s blood, testing it, and following up with the necessary treatment for the exposed officer. Most fire and rescue services already have safety officers with knowledge of exposure management, and they serve as an invaluable resource.
The Fairfax County Police Department in Virginia has a Second Lieutenant assigned as a full-time safety officer, assisted by a team of 10 supplemental safety officers. The safety officer works closely with all entities at the department to ensure safe working conditions at incident scenes, training venues, and any other sites where officers are deployed. Additionally, the safety officer works closely with County Risk Management to identify injury trends or safety concerns, and identifies training needs and changes to policy or procedures related to safety. The safety officer is responsible for the department’s exposure control plan, and a safety officer will respond out to assist with risk exposures to officers. This has been found to be an effective way of handling risk exposures. Frequently, an incident with a risk exposure to an officer will involve the use of force, possibly an otherwise injured officer or prisoner, or other component requiring a supervisor’s attention. Having a safety officer, who is familiar with risk exposure procedures and responds and takes care of the risk exposure aspect of the incident, frees up the supervisor to handle the other required duties and ensures all the proper procedures are followed and the exposed officer is properly cared for.
Benjamin Franklin’s well known idiom, “An ounce of prevention is worth a pound of cure,” is especially appropriate for infectious disease exposure control. With the proper equipment, training, and procedures in place all can be better protected against this serious threat to officer safety.♦
Please cite as:
David Pirnat, “Protecting Officers against Pathogens,” Officer Safety Corner, The Police Chief 81 (May 2014): 12–13.