Abstract
Firefighters and emergency medical services (EMS) personnel have the potential for occupational exposures to blood, which increases their risk for occupational blood-borne infection. To address this concern, the authors conducted a literature review of occupational blood exposures, the seroprevalence of blood-borne pathogens among these workers, and the seroprevalence of blood-borne pathogens among the patients they serve. A MEDLINE search was conducted, and all identified articles that described surveys of exposures to blood or surveillance of blood-borne infections among firefighters and/or emergency medical technicians (EMTs) in the United States were reviewed. For hepatitis B, only seroprevalence surveys conducted after the 1992 requirement by the Bloodborne Pathogens Standard to offer vaccination to potentially exposed employees were included. From these data, the expected number of annual occupational hapatitis C virus seroconversions was estimated to be between 5.8 and 118.9 per 100,000 employee-years for EMT-paramedics, between 3.4 and 33.7 per 100,000 for firefighter-EMTs, and up to 3.6 per 100,000 for firefighters (non-EMT). This review suggests there are a limited number of studies addressing this issue, and these studies have numerous limitations. Despite the expected occupational seroconversions and recognizing the limitations in drawing conclusions from these studies, it appears that firefighters and EMS personnel do not have an elevated seroprevalence of hepatitis C virus compared with the general population. Improved exposure surveillance programs would clarify exposure risks and identify potential interventions for firefighters and EMS personnel.