Health And Wellness Concerns

III. WELLNESS CONSIDERATIONS (1-3)

• Nutrition
  • Recent studies have linked poor diet to heart disease, cancer, diabetes, high blood pressure, high cholesterol, and other diseases
  • Training can include learning negative effect of certain foods such as those high in unsaturated fats, guidelines for a balanced diet, the results of good nutrition, and effective weight-control diets
  • Information on nutrition issues can be obtained from CDC, state or local health department, or American Heart Association
• Smoking
  • May affect cardiovascular/pulmonary function
  • May cause cancer
• Back Care
  • Back injuries rank just below heart disease as a cause of firefighter injury
  • Training would include learning following
    • Techniques for proper lifting and carrying
    • Types of equipment that require assistance for carrying
    • Methods for dragging hoselines
    • Exercises for strengthening back muscles
• Heart and Lung Diseases
  • Training should include learning
    • Importance of unimpaired lung capacity and unobstructed blood circulation
    • Causes of heart and lung diseases
    • Methods for reducing potential for those diseases
  • Department must implement a policy for use of SCBA in all toxic atmospheres and in suspected or unknown atmospheres
  • Smoking-cessation program should be developed and implemented
• Infection Control
  • Exposure to a communicable disease can occur just as quickly during cleaning and decontamination of equipment as it can during delivery of patient care
  • Common philosophy is that all patients must be treated as though they have a communicable disease
  • Infection control identifies such issues as
    • Personal protective clothing
    • Mechanical resuscitation equipment
    • Pre-exposure vaccinations for personnel
    • Training and education in infection control
    • Development of standard operating procedures
    • Medical requirements
  • OSHA bloodborne pathogens regulation applies to all occupational exposures to blood or other potentially infectious materials
  • Key to ensuring compliance with regulation is the development of exposure control program and training of members about process for preventing and controlling infection exposure
  • Written plan provides necessary guidelines to ensure compliance and to ensure that personnel understand infection control process
  • Process for controlling potential exposures is accomplished by a thorough training and education program
    • Understanding potential exposure hazards
    • Recognizing appropriate level of protection to be worn or used
    • Knowing methods of caring for an exposure victim
    • Reporting exposure incident
  • Training occurs when an individual is hired and then annual thereafter
  • Detailed contents for training are found in 29 CFR 1910.1030
  • Reporting
    • Fire department must maintain complete records of both exposures to members and member training to meet record keeping requirements of 29 CFR 1910.1030
    • Exposure form, completed at time of exposure, must contain
      • Name and social security number of individual
      • Copy of individual's hepatitis B vaccination status
      • Copy of results of all examinations, medical testing, and follow-up procedures
      • Copy of fire department physician's written opinion
      • Description of employee's duties at time of incident
      • Documentation of circumstances of exposure
      • Results of source individual's blood testing
      • All medical records relevant to treatment of employee
    • Training records, which must be retained for 3 years from time of training, include
      • Dates of training sessions
      • Summary of training given
      • Names and qualifications of training personnel involved
      • Names and job titles of all those attending training sessions
    • Follow-Up
      • Department ensures that medical evaluation and follow-up care occurs within 24 hours after presumed exposure to bloodborne pathogens
      • Following tasks shall be performed during evaluation
        • Document route of exposure and circumstances of exposure
        • Identify source individual if known
        • Test source individual's blood as soon as possible
        • Inform exposed employee of results of testing of source individual
        • Collect and test exposed employee's blood for hepatitis viruses and HIV status
        • Supply post-exposure prophylaxis, if needed, to employee
        • Provide counseling/employee assistance to employee
        • Perform fitness-for-duty evaluation