JENNIFER LIN
Courtesy Philadelphia Inquirer
As the ranks of Philadelphia firefighters with hepatitis C continue to grow, the Centers for Disease Control and Prevention said in a report today that rescue workers are not at greater risk of contracting the blood-borne virus that causes the disease.
The CDC concluded that hepatitis C infection was not a work-related risk for so-called "first responders" - firefighters, paramedics and emergency medical technicians.
In a study of five regions, including Philadelphia, doctors at the CDC found that the rate of hepatitis C infection among rescue workers was in line with the general population's.
Local firefighters criticized the report, while some health professionals questioned its limited scope. So far, 152 Philadelphia firefighters are known to be infected with the hepatitis C virus. Most believe they contracted the virus on the job after coming into contact with tainted blood from rescue victims.
The CDC, meanwhile, maintains that the virus is most often transmitted through contaminated needles shared by intravenous drug users or through high-risk sexual activity. Before 1992, when screening for the virus became available, it was also passed on through blood transfusions.
"I had two more guys just this week come up to me and say they were positive," said George Casey, president of Local 22 of the Philadelphia Firefighters Union. "I'd expect this from the CDC. They don't want to set alarms off."
Indeed, the CDC undertook the recent study after news of the Philadelphia problem aroused concerns among other fire departments and public-health officials. Across the country, fire departments are prodding cities to fund testing for members.
Nationally, an estimated 3.9 million people - or 1.8 percent of the population - are infected with the hepatitis C virus, according to the CDC. If untreated, the hepatitis C virus can lead to cirrhosis, advancing to liver failure or liver cancer.
In the CDC study, the infection rate among rescue workers in three cities - Philadelphia, Pittsburgh and Miami-Dade County - was nearly twice the national rate. But the CDC doctors argued that the first-response workers should not be compared with the overall public.
Instead, the researchers said, the more accurate comparison is to men between the ages of 30 and 59, who are the group at highest risk.
"You can't compare men of a certain age group to everyone," said S. Deblina Datta, a physician with the CDC's National Center for Infectious Diseases. "You have to compare them to men the same age in the general population, and when you do that you see that prevalence is not higher."
Datta said that for the male population between 30 and 59, the infection rate for hepatitis C is 5 percent.
The CDC study estimated that in Philadelphia, the hepatitis C virus is prevalent among 3 percent of all firefighters.
It also found an infection rate of 3.2 percent among paramedics in Pittsburgh; 2.1 percent among firefighters in Atlanta; 2.7 percent among firefighters in Miami-Dade County; and 1.3 percent among first responders of all sorts in Connecticut.
The CDC estimated that the infection rate in Philadelphia was lower than what was reported last year by Home Access Health Corp., a Chicago company. Last November, Home Access volunteered to test firefighters here. It found that 97 firefighters - or 4.5 percent of the 2,146 tested - carried the hepatitis C virus. (An additional 55 firefighters are positive for the hepatitis C virus, but were tested by their private physicians and not Home Access.)
The CDC examined the Home Access data and dismissed one-fifth of the results. "Some of the sample that they reported had been completed without some of the confirmation that we normally require," Datta said.
Rich Duffy, director of occupational health and safety for the International Association of Firefighters, said the CDC study is too limited for drawing universal conclusions about the hepatitis C risk for rescue workers. The CDC study covered 4,423 first-response workers.
"This doesn't end the debate," Duffy said. "We're still going to push for screening of all firefighters for hepatitis C."
In Philadelphia, most of the infected firefighters are veterans of the force. Today, firefighters guard against blood-borne disease by wearing goggles and gloves, but 20 years ago, such precautions were not taken.
Mayor Street has pledged $3 million to meet health-care costs for firefighters stricken with hepatitis C.
On the last day of the Republican National Convention, more than 1,000 firefighters from across the country and Canada plan to march through the city to raise awareness about hepatitis C.
"Whenever you have a large cluster of people with hepatitis C, it calls out for special attention," Alan Brownstein, president of the American Liver Foundation. "You have to go after them; they have to be tested."
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