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Title Operations / Policy A-4
Effective Date 08-19-11
Rescinds 10-30-09
Subject Communicable Diseases
Purpose To establish policy to be followed when a member of this department comes in contact with a communicable disease or human bite.
Scope This directive applies to all personnel.
Reference Texas Worker’s Compensation Commission Rules: 122.3, 122.4 and 110.108
CALEA  
  1. Definitions:
    1. AIDS: Acquired Immune Deficiency Syndrome, a communicable disease caused by Human Immunodeficiency Virus.
    2. ALT: Alanine Aminotransferase, an enzyme found in human blood. ALT is measured to see if the liver is damaged or diseased. Low levels of ALT are normally found in the blood. When the liver is damaged or diseased, it releases ALT into the bloodstream, which makes ALT levels go up. Most increases in ALT levels are caused by liver damage.
    3. Body fluids: Fluids that have been recognized by the Centers for Disease Control and Prevention as directly linked to the transmission of HIV and/or HBV and/or to which Universal Precautions apply: blood, semen, blood products, vaginal secretions, cerebrospinal fluid, synovial fluid, pericardial fluid, amniotic fluid, and concentrated HIV or HBV viruses.
    4. EH&S: Environmental Health & Safety at The University of Texas at Austin. EH&S is responsible for planning, implementing and administering The University's health and safety program, and for providing supportive technical consultation, training, investigation, and inspection to ensure compliance with guidelines set forth by federal, state and local laws and regulations. Its primary functions are to assist the University community in meeting health and safety responsibilities, to prevent or reduce accidents and to identify and eliminate environmental hazards and dangerous conditions.
    5. HAV: Hepatitis A Virus, a viral form of hepatitis normally spread by fecal contamination and generally not a significant risk for emergency care providers.
    6. HBV: Hepatitis B Virus, a viral form of hepatitis spread through blood contact, and also as a sexually transmitted disease. Hepatitis B is a significant risk for emergency care workers. Infection may result in death, chronic hepatitis, liver cancer, or cirrhosis of the liver. A vaccine to prevent spread of hepatitis B is available.
    7. HCV: Hepatitis C Virus, a more recently identified viral form of hepatitis spread via blood contact.
    8. HHSD: Austin/Travis County Health & Human Services Department. HHSD is statutorily responsible for obtaining blood specimens from subjects who have exposed emergency responders to their blood.
    9. HIV: Human Immunodeficiency Virus, the causative agent of AIDS. HIV type 1 (HIV-1) causes most cases of AIDS. A second virus, HIV-2 is a less common cause of the disease.
    10. OHP: Health Point, Occupational Health Program in Human Resource Services at The University of Texas at Austin. OHP offers a variety of occupational health services, including testing, vaccination, and counseling due to stress associated with possible exposure to blood borne and airborne pathogens.
    11. PCR: Polymerase Chain Reaction. A PCR test is very useful to find a very recent infection, determine if HIV infection is present when antibody test results were uncertain, and screen blood or organs for HIV before donation.
    12. Prophylaxis: a defined preventive drug treatment that may stop infection from developing.
    13. Seroconversion: a change in the status of one's serum test. For example, someone initially tests negative for HIV, then tests positive at a later date.
    14. TB: Tuberculosis, a communicable disease caused by the bacteria Mycobacterium tuberculosis, usually affecting the lungs. The incidence of TB as a multi drug resistant infection has increased since the advent of AIDS.
  2. Obligation to Perform Duty:
    1. As a part of police operations, employees may come into contact with persons carrying infectious diseases, including AIDS, hepatitis and tuberculosis. Employees should use caution and follow the guidelines in this policy when dealing with blood or body fluids.
    2. Employees are expected to take every precaution to prevent contracting a communicable disease. Research has shown that when standard precautions are taken, the transmission of disease through the types of contacts experienced by police are unlikely. Employees are reminded that fear of communicable disease does not excuse them from their obligation to perform their duty.
  3. All Body Fluids are Presumed to be Contaminated:
    1. For the purpose of employee safety, all blood and body fluid, or clothing and property soiled with blood or body fluid, are assumed to be contaminated. Saliva and urine may contain only trace amounts of the HIV virus and actually pose little risk of infection. Blood, semen and vaginal discharge are known to carry high concentrations of the HIV virus.
  4. Officer Responsibilities:
    1. Officers will carry protective gloves while on duty.
    2. Officers will ensure that gloves are not torn prior to use. Rings, jewelry or long fingernails may compromise the strength of the gloves. Officers should properly dispose of used gloves. Gloves should not be left at the scene of a call or arrest.
    3. Officers will exercise caution and use gloves when doing any of the following:
      1. Searching arrested persons.
      2. While searching vehicles, officers should be wary of placing their hands in blind spots where they might be stuck with a hypodermic needle.
      3. Handling, packaging or transporting any items which may contain blood or body fluid.
      4. Administering first aid to injured persons when officers risk exposure to body fluid or blood.
      5. Cleaning areas contaminated by blood spills or body fluid.
    4. Officers will wash their hands after using gloves. Gloves are not to be re-used.
    5. Officers will dispose of “sharps” in the OEHS approved storage container kept in the CIU photograph room or the trunk of the patrol car.
    6. Transporting procedures.
      1. When transporting any person with blood or body fluid on their person, they should be transported alone.
      2. If arrested is uninjured, but contaminated, they will be transported directly to central booking or UPB as applicable. If taken to the UPB, they will be placed immediately in detention and the shift commander notified. Injured arrestees will be treated at Brackenridge Hospital.
      3. After transporting, officers will inspect the vehicle to determine if it is contaminated by blood or body fluid. Should either substance be found, officers will notify their supervisor who will supervise clean up. Arresting or transporting officers are responsible for cleaning vehicles or detention areas. The effected area should be washed with a solution of one part bleach to nine parts water.
      4. Special precautions are required when transporting and arresting persons suspected of carrying tuberculosis (TB). Persons having TB can cough up disease carrying droplets. If another person inhales these droplets, they can become infected. The most notable symptom of TB is a persistent cough in which the person is coughing up phlegm. Police officers are most likely to encounter infected persons when dealing with transients, aliens and IV drug users. Officers can best safeguard against exposure by insuring adequate ventilation when interviewing or transporting suspected carriers of TB.
    7. First Aid
      1. All persons must have equal access to first aid.
      2. If an officer begins first aid, they may not stop unless: Administration of treatment is complete and the recipient is no longer in an acute emergency situation; EMS/AFD has arrived and assumed responsibility of providing first aid; or the officer becomes physically exhausted and is unable to continue care.
      3. Officers will not use CPR barrier equipment unless they have been trained in its use.
      4. Should an arrested person, or former arrested person, claim that they were exposed to a reportable disease while in the custody of UTPD, the claimant may: Request that the person who exposed them to the disease submit to testing and be entitled to diagnostic testing.
    8. Crime scenes — evidence
      1. Only those who need access will enter a crime scene.
      2. Officers will not smoke, eat, drink, or chew gum at a crime of accident scene.
      3. All blood spills will be considered contaminated.
      4. Evidence that is stained with body fluid or blood will be transported to the UPB in a plastic bag. If wet, it will be allowed to air dry. Special precaution will be taken with sharp objects.
      5. Gloves will be worn during handling of contaminated evidence.
      6. Officers will wash hands upon leaving crime scenes.
      7. Officers are not responsible for cleaning spills of blood or body fluid at the scene of a crime or accident. However, officers should insure that the scene is secured until clean, or otherwise insure that no risk to public health results from exposure to the crime scene.
  5. Equipment and Supplies:
    1. Each patrol vehicle will contain an Emergency Response Kit. Items that are to be kept in the kit will be listed in SOP 30.
  6. Confidentiality:
    1. All medical information, including information about HIV/AIDS, will be treated confidentially.
  7. Occupational Exposure to reportable diseases:
    1. When an officer has been involved in a line of duty incident resulting in a blood or body fluids exposure, the following will occur:
      1. An exposed officer will seek immediate medical treatment. Injuries may be treated on scene by Austin/Travis County Emergency Medical Services or at the nearest available hospital.
      2. Treatment for initial occupational health services will be conducted at a St David’s facility, which will include negative baseline testing for HIV, HBV, and HCV and the start of prophylaxis regimens used to thwart infection of these pathogens.
        1. Monday through Friday, between 8am and 4:30pm, officers will seek treatment at
          St David’s Occupational Health Services, 918 E 32nd St, Austin, TX 78705 (512-544-8195)
          .
        2. At all other times, officers will seek treatment at
          St David’s Medical Center Emergency Room, 919 E 32nd St, Austin, TX 78705 (512-476-7111)
          .
      3. Exposed officer will immediately notify their supervisor, who will prepare a first report of injury and ensure that the exposure is documented in an incident or offense report.
      4. Supervisor will immediately contact EH&S and advise them that an officer has been exposed to body fluids. EH&S will coordinate with OHP to begin the occupational health case management process for the exposed officer. The supervisor will notify the chain of command that an exposure has occurred.
        1. EH&S can be contacted at
          Service Building, 304 E 24th St, Austin, TX 78705
          , through the 24 hour hotline (512-471-3511), or through the emergency response pager (512-875-0911).
        2. OHP can be contacted at
          North Office Building A 3.214, 101 E 27th St, Austin, TX 78712
          or via phone (512-471-4647).
      5. Exposed officer may request HHSD to order the testing of the person who exposed the officer.
        1. For this to occur, the exposed officer must immediately complete the HHSD Blood Draw Affidavit Aug '11 (PDF) and Blood Draw Addendum Peace Officer Notary (PDF) but no later than 72 hours after the time of the exposure.
        2. The affidavit must be notarized (a peace officer’s signature is not valid) and must be hand delivered or faxed to HHSD.
        3. HHSD can be contacted at
          15 Waller St, Austin, TX 78702
          , via phone (512-972-5803 or 512-972-5555), or via fax (512-972-5772).
        4. When HHSD receives a completed Sworn Affidavit Requesting Testing Following An Exposure, HHSD personnel will obtain blood specimens from the source of the exposure at their present location (hospital, jail, home, etc.) HHSD will manage issues related to consent or refusal by the source in accordance with HHSD’s Transport Exposure Policy. HHSD has an escalation process in place to obtain court orders for subjects who refuse to consent to providing a blood specimen when the basis for obtaining the specimen is related to a high risk exposure.
        5. Upon collection of the blood specimen, HHSD will submit the specimen to a laboratory of OHP’s choosing. OHP will provide HHSD laboratory test slips to ensure proper billing of the laboratory charges to OHP and proper transmission of test results to OHP staff
      6. OHP will review the officer’s negative baseline test results for HIV, HBV, and HCV as well as any test results related to blood samples obtained by HHSD. OHP will utilize these results as part of their occupational health case management with the exposed officer. OHP services include counseling due to stress associated with possible exposure, coordination with UTPD and worker’s compensation, and the following post-exposure testing protocols:
        1. 6 weeks after exposure – PCR, HIV, HBV, and HCV antibody testing
        2. 3 months after exposure – HIV testing
        3. 6 months after exposure – HBV and HCV antibody and ALT testing
        4. 1 year after exposure – HIV testing
    2. When an officer claims occupational exposure to a reportable disease, including HIV/AIDS, the claimant may request testing and counseling. The state must assume the expenses for testing and counseling. The payment will be from funds appropriated for payments of worker’s compensation benefits. Payment is to be based on rules established by the Attorney General’s Office.
    3. The Texas Worker’s Compensation Commission has passed rules regarding exposure to certain communicable diseases and human immunodeficiency virus (HIV). These rules require that in order to be eligible for worker’s compensation benefits, an employee must have a negative baseline test within ten days of the exposure and provide documentation of the test and the circumstances of the exposure to the employer. The cost of the testing is to be paid by the employee’s worker’s compensation carrier.
      1. Rule 122.3 applies to law enforcement workers, fire fighters, emergency service workers, paramedics, and correctional officers who are exposed to a reportable disease. Reportable diseases are those communicable diseases required to be reported to the Texas Department of Health. A sworn affidavit is required to be filed with the employer.
      2. Rule 122.4 applies to all state employees who claim a possible work-related exposure to HIV. A written statement is required to be filed with the employer.
      3. Rule 110.108 requires employers to notify employees of these requirements by posting a notice in personnel offices and where employees are likely to read the notice on a regular basis.
      4. These rules apply only to the baseline test and do not include any benefit for follow-up testing or prophylactic treatment. In the past, these costs, including the cost for the baseline test, have been absorbed by the components in accordance with recommendations of the Occupational Exposure Work Group (OEWG). Nothing in these rules or the Worker’s Compensation Act prohibits handling exposures in the current manner providing the proper protocols are followed for documentation and the employee is not required to pay.
  8. Hand Sanitation Stations
    1. One of the easiest ways to combat communicable diseases is to frequently wash hands. Hand sanitation stations have been mounted throughout the department to assist with keeping hands germ free. Employees are encouraged to use the sanitizing gel after touching commonly used surfaces like door knobs or community computers or having personal contact with another person.