HEPATITIS C AND POLICE WORK
By Leslie Gibbenhuck
Hepatitis C is an epidemic, affecting over
200 million people worldwide. Why then, is so little known about this
There have been many articles published on
the risks of transmission of hepatitis C. All "emergency workers" are
high risk. Not only do police officers work with the sector of the
population most at risk (prison, drug users, drunks) but they are also
first responders to motor vehicle accidents and domestic disputes.
Police officers have also been known to use
physical force to restrain and/or arrest. It is common to come in to
contact with blood and bodily fluids, either through direct contact with
individuals or through gathering evidence in the course of an
investigation. Blood and other bodily fluids are usually crucial
evidence and are actually sought out by police officers.
Until recently no police officer was
advised to wear gloves (nitrile are best—as viruses may permeate wet
latex gloves), protective eye wear, or to create barriers (masks and
protective clothing) between themselves and their customers.
Transmission may occur with exposure to
blood (100% of the time), saliva (48%), seminal/vaginal fluid (24%) and
urine (7%). If there is any risk of transmission, the employer has a
legal and moral obligation to safeguard its employees by whatever means
reasonably possible. It is far more responsible to err on the side of
caution, than to dismiss the facts.
2. Are police officers told...?
- Unlike HIV, hepatitis C can live outside
the body for 7 days (although it has also been reported to live up to 6
weeks on a hard surface!)
- There is no vaccination for hepatitis C -
you are not immune!
- If you have hepatitis C, you should be
vaccinated for hepatitis A and B.
- To get tested annually for all other
possible work acquired viruses or at least after exposure to any blood
or bodily fluids.
- About the guidelines to officers about
work-acquired illnesses. Are they told to have themselves tested, to
follow-up (daily) exposures to hazardous situations?
Canada Labor Code
The Canada Labor Code provides employees
with three rights
1) the right to know
2) the right to participate, and
3) the right to refuse dangerous work.
This puts police officers in an awkward
position, almost all of their work can be classified as "dangerous."
"Through provisions of the Code, employees have a right to know about
known or foreseeable hazards in the workplace and to be provided with
the information, instruction, training and supervision necessary to
protect their safety and health."
3. Employers' Responsibilities
The onus should not be on the individual
but on the employer to inform police officers of known or foreseeable
hazards—when infection can occur without their specific awareness.
Hepatitis C is a preventable disease. There is no effective
treatment, no vaccination and no cure!
The employer has a duty to protect the
health and monitor the health status of police officers. Have officers
been tested as part of an annual physical?
In the absence of such vigilance (regular
testing) the employer cannot reasonably argue its members should have
been monitoring their status, so as to be able to pinpoint a specific
*When Hepatitis C blood work was added to
the annual physicals of Orange County firefighters, fire officials and
state health experts were alarmed at the high rate of infection.
Dr. Jeremy BROWN
Dr. Jeremy BROWN had a paper published in
the Journal of Clinical Forensic Medicine in 1995 on Risk to
Police Officers from Biohazards Encountered in Police Work. Although he
has little to say about hepatitis C, he does warn of "the virus'
propensity to cause serious conditions including chronic hepatitis,
cirrhosis and hepatocellular carcinoma. The consequences are severe."
He also reports conflicting observations
about the increased risk among health care workers but does add that
hepatitis C can be transmitted through accidental needle stick and the
risk is moderate—between that of HIV (low) and hepatitis B (high).
4. Nevertheless, transmissions by
needlestick and bite are documented. Dr Brown warns of the necessity for
police forces to remain abreast of all developments in research and
awareness. Keep in mind this paper was written in 1995, almost four
years ago, when very little was known about hepatitis C or its
Developing a Protocol—as described by the
CDC, Atlanta, Georgia: Issues that need to be considered when developing
a protocol for the follow up of workers occupationally exposed to
1) Limited data about the occupational risk
2) Limitations of available serologic
testing for detecting infection and determining infectivity
3) Poorly defined risk for transmission by
sexual and other exposures
4) Limited benefit of therapy for chronic
5) Cost of follow up
6) Medical and legal implications
7) Immediate vaccination for hepatitis A &
A national survey of U.S. and Canadian paid
fire departments found that 90% of all firefighters provide some level
of medical care in the community. On average 77% of the fire departments
in U.S. and Canadian cities with populations of 1 million or more
provide first-responder services, 80% basic life support, and 50%
advanced life support. This applies to police officers as well.
5. Although no case studies have been done
to support the allegation that there is a higher rate of infection among
police officers, there has not been mandatory testing to deny this claim
How does one know how long they have been
infected with hepatitis C? There is no definitive test to determine the
moment of infection. The onset of chronic illness varies from person to
person. Transmission and symptoms are two of the many puzzling features
of hepatitis C.
Most people infected with hepatitis C do
not know about their infection because there has been little effort made
to notify or educate them or to advise them of treatment possibilities
and lifestyle changes.
Precedents Being Set:—James Edward
Petrowitz versus City of La Crosse Fire Department
Hepatitis C is contained in the blood of
the person who is the carrier. It is possible to have the virus without
symptoms. Evidence shows it is very common for a firefighter to be
exposed to blood of various people. They will often arrive at the scene
of accidents, shootings, child births and other incidents before the
The word "firefighter" could be
interchanged with "police officer." But police officers have many other
exposures as well—add digging through dumpsters and crime scenes,
patting down prisoners, attending fights and disputes, arresting and
subduing criminals, being spat at, and contact with the prison
population (reported infection rate of 78% in recent random Texas
It was found in the case of Petrowitz that
hepatitis C infection was work-related and that he was entitled to
benefits. While in performance of his duty he contracted the disease,
which is permanent and which caused him to retire from his job,
6. It has been established that prisoners
who throw blood or bodily waste on guards can expect extended prison
terms. If they are infected with HIV, hepatitis or TB the penalty can be
increased by 5 extra years.
New York correction officers who acquire
HIV, hepatitis or TB will be getting a big pension hike under a Governor
Pataki bill. This entitles correction officers to tax-free disability
pay worth 3/4 of their final salary but more importantly it presumes the
disease was acquired on the job!
In November 1998, Senators Snowe and Snyder
proposed legislation that would create a presumption that certain
veterans contracted hepatitis C during their service. The legislation is
to include veterans who, during their service, received tattoos, body
piercings, or acupuncture. Depending what center you study the results
from between 10 and 20% of veterans randomly tested - tested positive
for hepatitis C.
In 1989, the hepatitis C virus was isolated
and cloned. Yet, 10 years later most police departments have no protocol
on how to deal with it and have offered no instruction to the officers
on its prevention. In all known cases where it is believed police
officers were infected on the job, they have been denied a disability
pension. Employers are demanding proof that they were infected on the
If an officer chooses to disclose they are
infected with hepatitis C, they are met with mixed response. Most
co-workers choose to keep their distance—not clearly understanding
routes of transmission.
Most officers choose to keep their
infection to themselves—not telling anyone. They fear questions,
ridicule, and a sense of guilt that remains unexplainable. It is as if
somehow they allowed this nasty infection to invade their bodies.
7. Had the officer been shot or stabbed she
would have received a hero's welcome back. Sadly, most are unaware of
the moment of infection. Blood spat at an officer is innocently wiped
away. Employers immediately have one answering questions, which
sometimes have no answers. As with time, all memories seem to fade. Your
employer starts asking personal questions, about your lifestyle.
They doubt you and your words.
Even your doctor has more questions than
answers. Doctors are undereducated and have difficulty coping with this
What are employers and doctors afraid of?
Their own ignorance has caused this problem to mushroom among police
officers and the effects will become clearly evident over the next 10
years as officers realize their infection and come to terms with chronic
illness. What are employers doing to prevent the further spread of
If you learn you are infected please:
1) get educated and help educate others
2) tell your co-workers—if you are injured
on the job they will not think twice about helping out a downed officer.
3) wear a medic alert bracelet—you must be
responsible for not spreading this disease to anyone.
4) use universal precautions everyday.
5) practice safe sex.
6) make yourself available to help fellow
officers when they learn of their infection (peer counseling)
7) understand there are normal stages one
passes through when their life flashes before them. Just because you
have hepatitis C doesn't mean you will die. But you must understand
there are steps you can take to remain healthy and possibly live longer.
The sooner you are diagnosed the sooner you can change your lifestyle.
8) Stop drinking alcohol—it accelerates
liver damage. Diet plays an important role in liver wellness. Learn
about your liver and how to keep it in great shape.
Stages of Hepatitis C
1) Diagnosis - disbelief, shock, denial
2) Impact (Attitudes and Expectations) -
learning to function with a chronic disease
3) Reorganization - dealing with the facts
/ lifestyle changes
One surefire way to reduce the emotional
dilemma faced when an officer encounters a significant exposure is
factual, up-to-date information. This is not simply an issue for the
police officer but for the entire family.
It has been said the "C" stands for
confusion, and so this tragedy continues.....
Leslie Gibbenhuck, President - B.C.
P.O. Box 21058,
Penticton, B.C. V2A 8K8