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Job-related hepatitis C infections are hard to prove
Knight Ridder Newspapers
on Fri, Nov. 14, 2003
KANSAS CITY, Mo.
(KRT) - When hepatitis C ruined Mike Coghlan's liver, the
Department of Veterans Affairs helped him get a new one. Then it paid for
expensive medications to help him recover.
But when the
45-year-old Philadelphia man got too sick to work and asked for disability
benefits, the VA told him no. He couldn't prove he got the disease while he
was in the service, so he was jobless and finally out of luck.
with hepatitis C suffer from a double whammy: They have a potentially deadly
virus, which can simmer undetected for decades - and that makes it hard for
them to prove how they got it.
As a result,
veterans, health-care workers, firefighters and others who think they got
hepatitis C by being exposed to blood on the job can't easily trace it.
been pushing for laws that make disability automatic or "presumptive" for
hepatitis C-positive veterans and high-risk workers.
But so far,
they have had limited success. Only a few states consider hepatitis C a
presumptive illness for public-safety and health-care workers, and Congress
has at least twice in recent years declined to change the law for veterans.
all hepatitis C-positive veterans who seek disability benefits from the
Department of Veterans Affairs are denied. That added up to more than 4,000
claims rejected in a recent 38-month period.
"I don't know
how I got it, and they don't know how I got it," Coghlan said. "I am not a
drug user. I've been married to the same woman for 25 years."
officials require evidence that any illness or injury directly results from
military service before approving disability payments.
It's not that
veterans have a shortage of known risk factors, including exposure to blood
during combat and battlefield transfusions before 1992.
say injector guns once used to vaccinate recruits also may have spread
hepatitis C. The needleless guns pierce the skin with a high-pressure stream
of medication, which they say can contaminate the end of the gun with blood
that then can infect the next recruit in line.
That was the
way Coghlan, who died March 25 of complications from the disease, thought he
government studies have shown the guns probably spread hepatitis B, and many
vets recall seeing blood on the guns and on the arms of other recruits.
officials quit using the guns in 1998 but continue to insist they were safe.
The VA is not
"We need to
look at the air gun," said Anthony Principi, a Vietnam-era veteran who heads
the Department of Veterans Affairs.
Deyton, who directs VA public health programs, said it's possible the
devices could transmit hepatitis C: "I am sure that, with the right degree
of misuse, the devices could become contaminated."
officials would be more inclined to grant disability if there were more
proof that veterans have special risk factors that increase their rate of
studies don't help. Some show veterans are infected at high rates; others
show their infection rate is actually below the general population.
"We don't know
how many there are," said Teresa Wright, who leads a hepatitis research
program at the San Francisco VA Medical Center.
Hepatitis C is
emerging as one of the most common and severe workplace hazards.
a Hawaii hygienist, got it sterilizing dental equipment. Nellie Crane, a
Washington state deck hand, probably contracted it from an infected needle
discarded on a ferryboat she was cleaning.
were initially denied benefits and had to take their cases to court to win
their claims. Tens of thousands of other workers didn't bother, union
of contracting hepatitis C from a single, contaminated needle stick is
small, perhaps 2 percent or lower. But the number of accidental needle
sticks and other skin punctures each year is high - 380,000 to 600,000,
according to the Occupational Safety and Health Administration.
workers have little hope of getting their treatments or doctor visits
covered - much less lost wages when hepatitis C renders them disabled.
The problem: a
patchwork system of state workers' compensation laws that were created to
deal with broken bones, not hepatitis C.
compensation system does not effectively deal with occupational illness,"
said Bill Borwegen, safety director for the Service Employees International
Union. "It needs to be totally reformed."
fire service paramedic Mary Kohler probably got hepatitis C treating
accident victims. Her fight for benefits included a 15-day sit-in outside
the mayor's office in 2000.
have passed laws making hepatitis C a presumptive illness for firefighters,
said Harold Schaitberger, president of the International Association of Fire
Fighters. The union is fighting for presumption in 21 more states.
"Unfortunately, the Centers for Disease Control has not been very helpful at
all," Schaitberger said. He said a "flawed" CDC report found that emergency
workers do not have a higher rate of the disease than the general public.
using the report to deny disability payments to HCV-positive firefighters,
say the study was valid. Emergency workers are indeed exposed to blood, they
say, but no research shows they have a higher rate of contracting the virus.
City, Mo., the union's Local 42 negotiated contract provisions last year
just to deal with hepatitis C.
offered an unusual 60-day amnesty window during which firefighters could be
tested for the virus without fear that the city would demote or fire them.
Ten of the about 850 uniformed members of the fire department were positive.
contract, firefighters who become disabled can get fully paid leave for up
to a year - if they have no previous diagnosis of hepatitis C. The city also
agreed it would not automatically challenge firefighters who claim they got
the virus at work.
"I am glad to
see here in Kansas City that our local and the city have been able to
understand the importance of testing our members," Schaitberger said during
a recent visit.
in other cities have attacked the problem in different ways.
where 87 firefighters and paramedics are thought to have the disease, the
union is pushing for changes in state law. The union has said it also plans
to pay for testing firefighters.
Fla., city officials tested firefighters but never shared the results,
prompting union officials to file lawsuits and grievances. The two sides are
© 2003, The
Kansas City Star.
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