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THE ARGUMENT

Should Massachusetts require HIV testing of people who might have infected first responders?

YES

Eric Teichert

President, Andover Firefighters Local 1658

The International Association of Fire Fighters Death and Injury Report found that 1 out of every 50 Firefighters is exposed to a communicable disease annually. The National Fire Protection Association’s 2018 United States Firefighter Injury Report estimates that firefighters that year experienced 6,175 exposures to infectious diseases, such as hepatitis, meningitis, and HIV. It said that amounted to .3 exposures per 1,000 emergency medical services run by fire departments.

These statistics highlight how some of the duties inherent to the job place firefighters at an elevated risk of contracting an infectious disease, including responding to emergencies involving injuries or active bleeding; medical treatment such as IV insertion, blood draw, and resuscitation. Additionally, responding firefighters often do not know the individual’s health status or what if any, bloodborne pathogens may be present.

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Currently, when a firefighter is exposed to bloodborne pathogens, the fire department involved can request that the hospital to provide a medical history of the patient or obtain the patient’s consent to conduct blood tests to determine if the individual has an infectious disease.

A proposed bill, HB1980, would require blood tests for infectious diseases including HIV at the request of a public safety department when a first responder has been significantly exposed to blood pathogens and where the patient may be incapacitated or refuses the test. The results of that test would be made known only to the person exposed and is protected under federal medical privacy law.

This legislation was proposed by the Professional Fire Fighters of Massachusetts — to which my local union belongs — and had a legislative hearing this session. The Joint Committee on Public Health has determined the bill needs more study, but we remain committed to seeking its adoption.

The Professional Fire Fighters of Massachusetts believes this legislation is needed to ensure the health and safety of our members in the performance of their firefighting duties. We look forward to working with legislators, public health officials, and public health advocates to make improvements to the bill that would address any concerns, while ensuring it protects the rights and privacy of both the patients and firefighters involved.

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NO

Carl Sciortino

Vice President of Government Relations and Community Affairs for Fenway Health, whose AIDS Action division has an office in Lynn

This bill seeks to solve a problem that does not exist. But if enacted it might result in harming those it purports to help. Since the beginning of the AIDS epidemic in the United States, there have been over 1.5 million cases of HIV transmission. There are only 58 documented cases of health care workers being accidentally exposed to HIV; the most recent was in 2008 when a lab technician working with live cultures of HIV was stuck with a needle.

The US Centers for Disease Control recommends simple precautions for those whose occupations place them at risk of accidental exposure to HIV: always assume that blood and other body fluids may contain HIV and take such protective measures as wearing gloves, washing skin surfaces immediately after contact with body fluids, and disposing syringes in sharps containers.

The CDC recommends workers potentially exposed to HIV report it to their supervisor, immediately visit a doctor, and take anti-HIV medications within 72 hours.

Learning the HIV status of the person who may have exposed a first responder to HIV provides no useful information since it would not alter the recommended steps needed to protect the responder’s health.

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If the person were tested and found to have HIV, the responder would need to undergo a course of post-exposure prophylaxis treatment. If the test was negative, the most prudent course of action in high-risk exposures would still be to consider taking anti-HIV medication.

There is also a worst case scenario where a person who has potentially transmitted HIV tests negative because that individual is in the window of time between initial HIV infection and the development of HIV antibodies. In such a case, a first responder has, in fact, been exposed to HIV but is told otherwise.

Fear of HIV transmission among first responders and health care workers is real. But those who face such risks deserve to work in environments in which practices, procedures, and protocols enhancing safety and well-being are prioritized. They also deserve timely and comprehensive counseling, treatment, and access to anti-HIV medication when accidents happen. The last thing they need are false assurances.

This is not a scientific survey. Please only vote once.


As told to Globe correspondent John Laidler. To suggest a topic, please contact laidler@globe.com.