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SUPPLEMENTARY Alternates

Report of the Committee on

Fire Service Occupational Safety and Health

Alan V. Brunacini, Chairman City of Phoenix Fire Dept., AZ

Don R. Forrest, Vice Chairman United Firefighters of LA City, CA

Murrey E. Loflin, Secretary Virginia Beach Fire Dept., VA

Donald Aldridge, Lion Apparel Inc. Joseph A. Bigler, Mine Safety Appliances Co

Rep. Industrial Safety Equipment Assn. Vincent J . Bollon, Int ' l Assn. of Fxre Fighters

Rep. Int ' l Assn. of Fire Fighters Edward Carter, Oceanside Fire District, NY William J. Cesareo, Wilton Fire Dept., CT Boyd F. Cole, Underwriters Laboratories Inc. A. W. Conners, Grand Rapids Fire Dept., MI

Rep. Int'l Assn. of Fire Chiefs James M. ConnoUy, M&M Protection Consultants John B. Deitz, Brookhaven Nat'l Laboratory

Rep. NFPA Industrial Fire Protection Section Richard M. Duffy, Int 'l Assn. of Fire Fighters T /C FSPE/IAFF Stephen N. Foley, Longmeadow Fire Dept., MA

Rep. Massachusetts Firefighting Academy Jerry R. Hall, CA State Firemens Assn. JoAnne Fish Hildebrand, Port Republic, MD Scott D. Kerwood, Tulsa Fire Dept., OK Jonathan D. Kipp, Compensation Funds of New Hampshire Eric S. Lamar, Washington, DC

Rep. Int'l Assn. of Fire Fighters Bruce H. Lancaster, Howard County Fire Dept., MD

Rep. NFPA Fire Service Section Darl R. McBride, Silver Spring, MD

Rep. Int'l Society of Fire Service Instructors Robert T. McCarthy, US Fire Administation Robert W. Meyer, Johnson & Higgins Robert D. Neamy, Los Angeles City Fire Dept., CA Neil Rossman, Rossman, Rossman & Eschelbacher John A. Sharry, Lawrence Livermore Nat'l Laboratory Arthur C. Smith, NYBoard of Fire Underwriters

Rep. American Insurance Services Group, Inc. Philip C. Stittleburg, Jenkins & Stittleburg

Rep. Nat'l Volunteer Fire Council Harry IL Tompkins, Pierce Mfg Inc. Michael V. Vance, Southwest Toxicology Services, Inc.

Robert K. Andrews, M&M Protection Consultants (Alt. toJ. M. Connolly)

Angelo M. Catalano, North Bellmore Fire District, NY (Alt. to E. Carter)

Iby George, Virginia Beach Fire Dept., VA (Alt. to M. E. Loflin)

Thomas Healy, Phoenix Fire Dept., AZ (Alt. to A. V. Brunacini)

Timothy V. Manning, Los Angeles City Fire Dept., CA (Alt. to IL D. Neamy)

Gordon M. Sachs, US Fire Administration (Alt. to R. T. McCarthy)

BradleyJ. Schmldt, Underwriters Laboratories Inc. (Alt. to B. Cole)

Staff Liaison: Bruce W. Teele

This list represents the membership at the time the Com- mittee was balloted on the text of this edition. Since that time changes in the membership may have occurred.

The Supplementary Report of the Committee on Fire Service Occupational Safety and Health is presented for adoption.

This Supplementary Report was prepared by the Technical Committee on Fire Service Occupational Safety and Health and proposes for adoption a Supplementary Report which documents its

cfion on the public comments received on new NFPA 1581, Stan- dard on Fire Department Infection Control Program, published in the Technical Committee Reports for the 1991 AnnualMeeting.

This Supplementary Report has been submitted to letter bal- lot of the Technical Committee on Fire Service Occupational Safety and Health which consists of 29 voting members; of whom 25 voted affirmatively, 1 negatively (Mr. Dietz), 1 abstained (Mr. Meyer), and 2 ballots were not returned (Messrs. Connors and McBride).

Mr. Dietz voted negatively as he does not concur in the response to 1581-1 through 1581-7. Industrial fire brigades and fire departments should be excluded from the scope of thxs standard since OSHA instruction CP:2-2.44 pro~4des adequate controls.

Mr. Meyer abstained as he was just appointed to the Com- mittee and was not a member when this document was developed.

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(Log # 47) 1581- 1 - (1-1.2): Acceptin Part. SUBMITTER" Greg Pc,well, Industrial Fire Protection Section COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Revise 1-1.2 by deleting the words "and fire brigades". SUBSTANTIATION: Infection control procedures for industrial fire departments and industrial fire brigades are adequately covered by OSHA Instruction CP: 2-2.44. Additional requirements for industrial fire departments and brigades would cause inconsistent implementation and enforcement. The committee has not demonstrated that the existing OSHA requirements are inadequate for industrial fire departments and fire brigades. COMMITTEE ACTION: Accept in Part. The committee agrees to remove "fire brigades" from the scope but has substituted "indust0:ial fire departments.

Revise 1-1.2 to read: "These requirements are applicable to organizations providing fire

suppression; rescue, and other emergency services including public, military, private, and irLdustrial fire departments"

Add new definition to 1-3 to read: "Industrial Fire Department, An organization similar to municipal

fire departments provicling fire suppression, rescue, and related activities, but that is intended for service at a single profit, non- profit, or governmental facility including such occupancies as industrial, commerical, mercantile, warehouse, and institutional. The industrial fire department is generally trained and equipped for spe- cialized operations based on site specific hazards present at the facility." COMMITTEE STATEAVlENT: The committee agrees that the OSI/A requirement most likely will be sufficient where fire brigades also deliver emergency medical services (EMS). The committee does not agree that industrial fire departments should not be included in NFPA 1581 as Sections 2-i, 2-3, 2-4, 2-5, 3-2, and 5-4; and paragraphs 3-3.2, 5-1.2, and 5-1.3 apply to any fire department whether or not they deliver EMS. See also action taken on Public Comment 007.

(Log # 29) 1581- 2 - (1-1.2): Accept SUBMITTER: Gerald M. Brown, General Motors COMMENT ON PROPOSAL NO," 1581-1 RECOMMENDATION: Delete "fire brigades" from the scope (1- 1.2). SUBSTANTIATION. NFPA 600 and the Technical Committee on Loss Prevention Practices and Procedures have "fire brigades" under its scope. Fire brigades are out of the scope of NFPA 1581. COMMITTEE ACTION: Accept. COMMITTEE STATEMENT: See also Public Comment 1581-1.

(Log # 15) 1581- 3 - (1-1.2): Accept SUBMITTER: J. William Sheppard, General Motors COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Delete text.

Delete "and fire brigades." SUBSTANTIATION: Fire brigades are outside the scope of this document as they are covered under NFPA 600. COMMITrEE ACTION: Accept. COMMITTEE STATEMENT: See also Public Comment 1581-1.

(Log # 49) 1581- 4 - (1-1.2): Accept in Principle SUBMITTER: Michael S. Kaminski, Wisconsin Electric Power Co. COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Delete text.

Delete "private fire brigades". SUBSTANTIATION: This document is written for professional fire service personnel regularly performing medical response activities to unknown victims at any location within their jurisdiction. Private fire brigades are organized to perform fire response for local incidents within their own facilities where they are familiar with the facility, hazards and personnel. Private fire brigades typically perform minimal first aid functions for fellow employees. The safety pro-

gram at the private facility can contemplate what level of equipment and training is appropriate. Private fire brigades should be excluded from the document scope. COMMITTEE ACTION: Accept in Principle. COMM/TTEE STATEMENT: Term "private fire brigades" did not exist in 1-1.2. "Fire brigades" was deleted. See also Public Comment 1581-1.

(Log # 63) 1581- 5 - (1-1.2): Accept in Principle SUBMITFER: Richard Wickman, Baltimore Gas and Electric Com- Pcany

OMMENT ON PROPOSAL NO.: 1581-I RECOMMENDATION: Delete text.

Remove "fire brigades" from the scope. SUBSTANTIATION: The committee representation does not include "end users" of the document from the commercial and industrial areas. The document should be returned to committee. COMMITTEE ACTION: Accept in Principle. COMMITTEE STATEMENT: 'Fire brigades" is being deleted from 1-1.2. See also action taken on Public Comment 1581-1.

(Log # 47a) 1581- 6 - (1-1.3 (New)): Accept in Principle SUBMrrrER: Greg Powell, Industrial Fire Protection Section COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add a new 1-1.3 as follows:

'q'hese requirements are not applicable to industrial fire departments and industrial fire brigades." SUBSTANTIATION: Infection control procedures for industrial fire departments and industrial fire brigades are adequately covered by OSHA Instruction CP: 2-2.44. Additional requirernents for industrial fire departments and brigades would cause inconsistent implementation and enforcement. The committee has not demonstrated that the existing OSHA requirements are inadequate for industrial fire departments and fire brigades. COMMITTEE ACTION: Accept in Principle. Add a new 1-1.3 to read: "1-1.3: This standard does not apply to industrial fire brigades that

also may be known as emergency brigades, emergency response teams, fire teams, or plant emergency organizations."

Reject exclusion of industrial fire departments. COMMITTEE STATEMENT: The committe has deleted fire brigades but does not agree that industrial fire departments should be excluded from NFPA 1581. See also action taken on Public Com- ment 1581-1.

(Log # 29a) 1581- 7 - (1-3): Accept SUBMITrER: Gerald M. Brown, General Motors COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Delete text.

Delete "fire brigades" from the definition (1-3). SUBSTANTIATION: NFPA 600 and the Technical Committee on Loss Prevention Practices and Procedures have "fire brigades" under its scope. Fire brigades are out of the scope of NFPA 1581. COMMITTEE ACTION: Accept. COMMITTEE STATEMENT:

(Log # 48) 1581- 8 - (1-3): Accept in Part in Principle SUBMITrER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

In the definition section you need a definition for "cleaning" and for "high-level disinfection." SUBSTANTIATION; None. COMMITTEE ACTION: Accept in Part in Principle. Add new definition of cleaning to read:

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1-3 Cleaning- The physical removal of dirt and debris. This is generally accomplished with soap and water and physical scrubbing,

Reject new definition on "high level disinfection." COMMITTEE STATEMENT: The committee agrees and has added a new definition for "cleaning."

However, the committee will not add a definition of"h igh level disinfection" as the discussion that explains this is con ta ined in the appendix in A-5-3.8.

(Log # 48a) 1581-9- (1-3): Reject SUBMITTER: Katherine West, USFA/NEA COMMENT O N PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

I would suggest expanding the definition of immunization to include active and passive for clarification. SUBSTANTIATION: None. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee will not add the definitions as they are not applicable to this standard and the terms are not used.

(Log # 36) 1581- 10- (1-3): Accept in Principle SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Delete text.

Body Fluids: The statement "and concentrated HIV or HBV viruses" should be deleted. SUBSTANTIATION: HIV or HBV are viruses found in body fluids. They are not classified as body fluids as indicated by the statement. COMMITTEE ACTION: Accept in Principle.

Revise definition of "body fluids" to delete last phrase " and concentrated HIV or HBV viruses", and replace with: "... and fluids that might contain concentra ted HIV or HBV viruses." COMMITTEE STATEMENT: The committee agreed and has modified the submitters wording to reflect the change in the definition.

(Log # 35) 1581- 11 - (1-3): Reject SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Depar tment COMMENT O N PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Contaminated - T h e process by which a disease germs or infectious material is introduced into or on a normally sterile object. SUBSTANTIATION: The listed definition of contaminated is not complete. Contamination is not limited to contact with body fluids. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Existing definition is appropriate for this document .

(Log # 3) 1581- 12 - (1-3): Accept in Part. SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO." 1581-1 RECOMMENDATION: New text.

Replace the definition of Emergency Patient Care with the following:

Emergency Medical Care: The management of illness, accident, or certain physiological problems on an urgent basis until definite medical care is available. SUBSTANTIATION: This phase and definition clarifies the intent and more completely describes the topic being defined. It was taken from NFPA 1004, Fire Fighter Medical Technician Professional Qualifications. COMMITTEE ACTION: Accept in Part.

Change 1-3 Emergency Patient Care to read:

1-3 Emergency Medical care. Reject change in the definition of the term.

COMMITTEE STATEMENT: The committee agrees that the term "emergency medical care" is more appropriate, but that the definition as printed in the TCR for "emergency patient care" is more appropriate.

(Log # 67) 1581- 13 - (1-3): Accept in Part. SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.


Emergency Medical Care: The management of illness, accident, or certain physiological problems on an urgent basis until definite medical care is available. SUBSTANTIATION: This phase and definition clarifies the intent and more completely describes the topic being defined. It was taken from NFPA 1004, Fire Fighter Medical Technician Professional Qualifications. COMMITTEE ACTION: Accept in Part. COMMITTEE STATEMENT: See action taken on Public Comment 1581-12.

(Log # 23) 1581- 14 - (1-3): Accept in Part. SUBMITrER: David J. Barillo, MD, Newark Fire Depar tment COMMENT O N PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.


Emergency Medical Care: The management of illness, accident, or certain physiological problems on an urgent basis until definite medical care is available. SUBSTANTIATION: This phase and definition clarifies the intent and more completely describes the topic being defined. It was taken from NFPA 1004, Fire Fighter Medical Technician Professional Qualifications. COMMrlTEE ACTION: Accept in Part. COMMITTEE STATEMENT: See action taken on Public Comment 1581-12.

(Log # 34) 1581-15 - (1-3): Reject SUBMITTER: Sherri-Lynne Almeida R_N, MSN, M. Ed, Houston Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revised text.

Exposure - Contact with an infected person or agent which involves a mode of transmission specific for a particular disease and a vehicle of transmission particular for a disease. SUBSTANTIATION: Definition listed in document is too specific and not complete. There are other methods of transmitting a disease than those ment ioned. If you wish to be specific then you need to list all methods of transmission. COMMITrEE ACTION: Reject. COMMITTEE STATEMENT: The defiition presented in the TCR is more suitable for this document and it is also the same definition as used by the U.S. Centers of Disease Control.

1581- 16 - (1-3): Reject (Log # 39) SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Depar tment COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Revise text.

Fluid Resistant Clothing - Protective clothing that provides a barrier against splashing or spraying of body fluids or other potentially infectious material and is impervious to these fluids or materials.

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SUBSTANTIATION: Current CDC standards suggest that protective clothing be impervious to fluids or infectious materials. The listed definition makes no mention of this. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The definition printed in the TCR is more suitable for this document and it is also the same definition used by the U.S. Centers for Disease Control. The concept of fluid resistance is appropriate for the fire service.

1581- 17 - (1-3): Reject (Log # 38) SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Infection Control Liason. person or persons within the fire department who are responsible for coordinating efforts surrounding the investigation of an exposure; coordinating immunization schedules; manage pre and post exposure follow-up; coordinate screening and testing of members; provide counseling and continuing education for members. SUBSTANTIATION: This is the job description for the infection control liason for the Houston Fire Department. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The definition as printed in the TCR is more suitable for this document and for the broad spectrum of fire departments that will be users of this document.

1581- 18- (1-3): Reject (Log # 4) SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

Add the following definition: Infection Control Program: A written policy and implementation

of procedures relating to the control of infectious disease hazards where employees may be exposed to direct contact with body fluids, airborne pathogens, or other modes of transmission of communicable diseases. SUBSTANTIATION: An infection control program is discussed in Chapter 8 of the Standard, and is the topic of NFPA 1581 (pro-

osed), Standard on Fire Department Infection Control Program. o be complete, this definition needs to be added. It is based on

the definition of Infection Control Program found in OSHA Com- pliance Directive CPL2-2A4B (February 22, 1990). COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The entire document defines the infection control program.

(Log # 65) 1581- 19 - (1-3): Reject SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

Add the following definition: Infection Control Program: A written policy and implementation

of procedures relating to the control of infectious disease hazards where employees may be exposed to direct contact with body fluids, airborne pathogens, or other modes of transmission of communicable diseases. SUBSTANTIATION: An infection control program is discussed in Chapter 8 of the Standard, and is the topic of NFPA 1581 (proposed), Standard on Fire Department Infection Control Program. To be complete, this definition needs to be added. It is based on the definition of Infection Control Program found in OSHA Com- pliance Directive CPL2-2.44B (February 22, 1990). COMMITTEE ACTION: Reject, COMMITTEE STATt~IF_,NT: The entire document defines the infection control program.

1581- 20 - (1-3): Reject (Log # 24) SUBMITFER: DavidJ. Barillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text. Add the following definition: Infection Control Program: A written policy and implementation

of procedures relating to the control oflnfectious disease hazards where employees may be exposed to direct contact with body fluids, airborne pathogens, or other modes of transmission of communicable diseases. SUBSTANTIATION: An infection control program is discussed in Chapter 8 oft_he Standard, and is the topic of NFPA 1581 (pro-

~ osed), Standard on Fire Department Infection Control Program. o be complete, this definition needs to be added. It is based on

the definiuon of Infection Control Program found in OSHA Com- pliance Directive CPL2-2.44B (February 22, 1990), COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The entire document defines the infection control program.

1581- 21 - (1-3): Reject (Log # 51) SUBMITTER: Murrey E. Loflin, Virginia Beach Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text. Add the definition - Infectious Exposure Form to read as: A written record documenting a member's exposure to an

infectious disease which provides vital data in the event follow-up treatment is necessary. SUBSTANTIATION; Provides written documentation of information needed when a member is exposed to an infectious disease. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that the existing language in 2-5.4 adequately covers the subject. The term "infectious exposure form" is not used in the text of the document and therefore does not need to be defined.

(Log # 37) 1581- 22 - (1-3): Accept SUBMrVIT, R: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Medical Waste - Items to be disposed of that have been contaminated with human waste, blood, or body fluids; or human waste, human tissue, blood or body fluids for which special handling

~ recaution are necessary. UBSTANTIATION: Medical waste consists of articles which have

been contaminated with infective agents or materials. The listed definition is very confusing. COMMITTEE ACTION: Accept.

1581- 23 - (1-3): Reject (Log # 33) SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Mucous Membrane - Membrane lining passages and cavities com- municating with the air. SUBSTANTIATION: NFPA statement is to specific. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The definition printed in the TCR is more complete and more appropriate as it is a recognized medical definition

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(Log # 32) 1581- 24- (1-3): Reject SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Needle - A pointed ins t rument for stitching, ligaturing, or punctur- ing. SUBSTANTIATION: Above definition more concise with current medical terminology. COMMITTEE AGTION: Reject. COMMITrEE STATEMENT: The definition pr inted in the TCR is more appropriate for this document .

1581- 28 - (1-3): Reject (Log # 52) SUBMITTER: Murrey E. Loflin, Virginia Beach Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add definition "Universal Precaution" as follows:

Methods designed to safeguard the member from exposure to potentially infectious agents through the use of protection such as gloves, gowns, masks, and protective eyewear. SUBSTANTIATION: Guidelines for members to follow to prevent potential exposures to infectious diseases in all situations. COMMITTEE ACTION: Reject. COMMITPF..E STATEMENT: This term is not used in the text.

(Log # 2) 1581- 25 - (1-3): Accept SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Change term and definition of Respiratory Assist Devices as follows: Resuscitation Equipment: respiratory assist devices such as bag-

valve masks, oxygen demand valve resuscitators, pocket masks, and other ventilation devices that are designed to provide artificial respiration or assist with venriladon of a patient. SUBSTANTIATION: The current definition was not consistent in terminology with CDC guidelines or OSHA regulations, nor was it clear as to the scope of the definition. In reviewing the terms/defini t ions in these other documents, it was found that "resuscitation equipment" is the term commonly used and that the definitions include the devices listed. This new definition more completely describes that term as it is used in the standard. COMMITTEE ACTION: Accept.

(Log # 66) 1581- 26- (1-3): Accept SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Revise text.


vah'e masks, oxygen demand valve resuscitators, pocket masks, and other ventilation devices that are designed to provide artificial respiration or assist with ventilation of a patient. SUBSTANTIATION: The current defimtion was not consistent in terminology with CDC guidelines or OSHA regulations, nor was it clear as to the scope of the definition. In reviewing the terms/defini t ions in these o ther documents, it was found that "resuscitation equipment" is the term commonly used and that the definitions include the devices listed. This new definition more completely describes that term as it is used in the standard. COMMITTEE ACTION: Accept.

(Log # 22) 1581- 27- (1-3): Accept SUBMITTER: DavidJ. Barillo, MD, Newark Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.


valve masks, oxygen demand valve resuscitators, pocket masks, and other ventilation devices that are designed to provide artificial respiration or assist with ventilation of a patient. SUBSTANTIATION: The current definttion was no t consistent in terminology with CDC guidelines or OSHA regulations, nor was it clear as to the scope of the definition. In reviewing the terms/defini t ions in these o ther documents, it was found that "resuscitation equipment" is the term commonly used and that the definitions include the devices listed. This new definition more completely describes that term as it is used in the standard. COMMITTEE ACTION: Accept.

(Log # 50) 1581-29- (Chapter 2, 2-1.1): Accept in Principle SUBMITTER: Michael S. Kaminski, Wisconsin Electric Power Co. COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Add wording to paragraph 2-1.1 stating: "For private fire brigades and private facilities the company safety

program is sufficient to handle requirements of this section. It is recognized that local conditions vary atprivate facilities and program requirements need only be those deemed necessary for the local conditions." SUBSTANTIATION: Private facilities may perform only minimal first aid response and to known areas and personnel. Local conditions may not warrant the extensive requirements proposed for public fire depar tments which must respond to all calls and encounter unknown conditions each time. COMMITTEE ACTION: Accept in Principle. Add to the end of A-2-1.1: "It is possible that an existing program or policy may satisfy the

requirements of this standard; if so, they may be adopted in whole or in part, in order to comply with this standard. An example of such an existing policy or program may be a corporate infectmn control program or an employee immunization program. COMMITTEE STATEMENT: The committee agrees that any inplace program that meets the requirements of the standard can be used and nothing in any NFPA document prohibits implace, com- pliant programs, systems or procedures from being cont inued to be used. However the committee will add material to the appendix to reinforce these thoughts.

(Log # 1) 1581- 30 - (2-1.6): Accept SUBMITTER: Arthur C. Smith, AISG COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Delete paragraph 2-1.6 SUBSTANTIATION: Medical personnel i.e., doctors, nurses, dentists etc. have little if any control over type, frequency or severity of infectious exposure yet are not forced to discontinue their services when pregnant. Also, in view of recent Supreme Court ruling prohibit ing General Motors from d iscont inu ingpregnant employees from working in potentially hazardous activities, we should not knowingly place the fire service in a situation which would result in legal action against them. COMMITrEE ACTION: Accept.

(Log # 48b) 1581- 31 - (2-1.6): Reject SUBMIT'I'ER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

2-1.6 Upon what study data are you basing this recommendation? In the medical environment this is an administrative decision as universal precautions reduces risks. SUBSTANTIATION: None. COMMITTEE ACTION: Reject.

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COMMITTEE STATEMENT: Submitter did not provide an}, action she wished the Committee to consider nor any proposed revasion to the TCR text. See also action taken on Public Comment 30

(Log # la) 1581- 32 - (2-2): Accept SUBMITrER: Arthur C. Smith, AISG COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new paragraph to 2-2.

Pregnant members that engage in emergency medical operations shallbe educated in the potential health risks to the individual as well as the fetus. SUBSTANTIATION: Medical personnel i.e., doctors, nurses, dentists etc. have little if any control over typ.e, frequency, or. severity of infectious exposure yet are not forced to dlsconunue their services when pregnant. Also, in view of recent Supreme Court ruling prohibiting General Motors from discontinuing pregnant employees from working in potentially hazardous activities, we should not knowingly place the fire service in a situation which would result in legal action against them. COMMITTEE ACTIO N: Accept. Add new 2-2.4 to read: "Members that engage in emergency medical operations shall be

educated in thepotential reproductive health risks to the individual as well as to the fetus." COMMITTEE STATEMENT: The committee agrees but has modified the proposed language to include both male and female members.

(Log # 48c) 1581- 33- (2-2.2): Accept SUBMITTER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text. Add "and exposure management and medical follow up" for com-

pleteness. SUBSTANTIATION: COMMITTEE ACTION: Accept. Add proposed text to end of 2-2.2.

(Log # 53) 1581- 34- (2-2.3): Reject SUBMITI'ER: Murrey E. Loflin, Virginia Beach Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text. Add the words "venereal diseases" to the list of infectious diseases.

SUBSTANTIATION: Information and educational materials regarding venereal diseases needs to be provided due to the potential risk factors to members. COMMITTEE ACTION: Reject. COMMITTEE STAT~XMENT: The list contained in 2-2.3 is not intended to be all inclusive.

(Log # 41 ) 1581- 36 - (2-3): Reject SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

The infection control liason shall be responsible for maintaining records of exposures, immunizations, andmedical follow-up post exposure. SUBSTANTIATION: Record keeping is mandated by OSHA, therefore, an individual should be assignedthe responsibility of record keeping. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that this issue is adequately covered in 2-5, and that it is an administrative matter as to who performs the task.

(Log # 62) 1581- 37- (2-3.1): Accept in Principle SUBM/TTER: Richard Wickman, Baltimore Gas and Electric Com- p l y an COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

The emergency organization shall assign one or more members as the infection control liason. Where commercial and industrial operations provide medical personnel, they may serve in this function, SUBSTANTIATION: In the commercial and industrial setting this allows the most qualified on site people to assume the role of the infection control liason, COMMITTEE ACTION: Accept in Principle.

Revise 2-3.1 to read: "The fire department shall designate one or more members or

other qualified persons as the infection control liaison." COMMITFF_,,E STATEMENT: The committee agrees with the submitter and has modified the submitters proposed text and revised 2-3.1 to meet the submitters intent.

(Log # 8) 1581- 38- (2-3.3): Reject SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text. Add the phrase "or suspected exposure" after the word "exposure"

in the first line. SUBSTANTIATION: The investigation that is addressed in this paragraph is intended to determine, whether or not. an exp.osure actually occurred. Occasxonally, the member revolved wall suspect that an exposure did occur, but will not be certain. The added phrase willmore clearly address this case. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that the pro- ~.osed phrase is not necessary due to the definition of the term 'exposure'.

(Log # 40) 1581- 35 - (2-3): Reject SUBMITrER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text. The infection control liason shall ensure that all members be

offered the Hepatitis B vaccine. SUBSTANTIATION: This should be part of the liason's responsibilities. COMMrlq'EE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that this issue is covered sufficiently in 2-4.1, and it may not be the sole responsibility of the infection control liaison.

(Log # 17) 1581- 39 - (2-3.3): Reject SUBMITTERx DavidJ. Barillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

Add the phrase "or suspected exposure" after the word "exposure" in the first line. SUBSTANTIATION: The investigation that is addressed in this paragraph is intended to determine whether or not an exposure actually occurred. Occasionally, the member involved will suspect that an exposure did occur, but will not be certain. The added phrase willmore clearly address this case. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that the pro- ~eOSed phrase is not necessary due to the definition of the term

xposure". See also Public Comment 1581-38.

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(Log # 69) 1581- 40 - (2-3.3): Reject SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text:

Add the phrase "or suspected exposure" after the word "exposure" in the first line. SUBSTANTIATION: The investigation that is addressed in this paragraph is in tended to determine whether or not an exposure actually occurred. Occasionally, the member involved will suspect that an exposure did occur, but will no t be certain. The added phrase wi l lmore clearly address this case. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The commit tee feels that the pro- ,posed phrase is not necessary due to the definition of the term 'exposure". See also Public Comment 1581-38.

(Log # 54) 1581- 41 - (2-3.3): Accept SUBMITTER: Murrey E. Loflin, Virginia Beach Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

l Add additional sentence to read: "The infection control liaison shall also ensure proper documenta-

tion of the exposure is recorded as specified in Section 2-5 of this standard". SUBSTANTIATION: Written documenta t ion of an exposure is very important and significant part of this process. The infection control liaison must ensure the documentat ion is completed. COMMITTEE ACTION: Accept.

(Log # 48d) 1581- 42 - (2-4.2): Accept in Principle SUBMITTER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

We are in the middle of a national TB epidemic TB skin testing via PPD method needs to be added to this listing. SUBSTANTIATION: None. COMMITTEE ACTION: Accept in Principle.

Revise 2-4 to read: "2-4 Immunization and Testing" Add new 2-4.3 to read: "2-4.3 The fire depar tment shall make available or ensure that

members have access to tuberculosis screening at least annually." COMMITTEE STATEMENT: The committee agrees with the submitter and added new text to cover this issue.

(Log # 42) 1581- 43 - (2-4.2): Reject SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revised text.

The fire depar tment shall ensure that all members have adequate immunity, as de termined through consultation with a physician or advanced nurse practitioner, to temus, diptheria, rubella, measles, polio, and influenza. SUBSTANTIATION: The addit ion of advanced nurse practitioner may be of value to many departments . This individual can work independent ly under the guidelines established by a medical director. This would free up the medical director. It is also more cost effective to use an advance practitioner than a physician. COMMITTEE ACTION: Reject. COMMITTEE STATEMF_2qT: The committee feels that the existing text allows the delegation of the responsibility by a physician.

(Log # 61) 1581-44- (2-4.2): Accept in Part. SUBMITTER: Murrey E. Loflin, Virginia Beach Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

Add "mumps" and hepatitis B" to list of diseases the physician must determine immunity against. SUBSTANTIATION: Due to the potential risk factors of the mumps and hepatitis B, they must be added to the list o f infectious diseases the physician needs to determine immunity. COMMITTEE ACTION: Accept in Part. Add "mumps" to the items in series in 2-4.2. Hepatitis B. will not be added

COMMITTEE STATEMENT: The committee agrees and has added mumps, but will not add Hepatitis B as it is covered by 2-4.1.

(Log # 43) 1581- 45 - (2-5.2): Reject SUBM1TI'ER: Sherri-Lynne Almeida RN, MSN, M. Ed, t touston Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revised text.

The fire depar tment shall have an established procedure for members to immediately report an exposure and have protocols established to govern exposures which may need immediate medical follow-up. SUBSTANTIATION: Notification of the infection control liason within three hours of the exposure is unreasonable and not medically necessary. The majority of the exposures which occur in the pre-hospital care setting are of the nature that follow-up can be h a n d l e d t h e next morning during normal office hours. The NFPA statement may have grave financial implications for departments. This would require that they have someone available 24 hours per day requ i r ingOT or call pay. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The protocols for exposures are covered in 2-5.3. The requirements of 2-5.2 are for an m-house report- ing of potential exposures.

(Log # 60) 1581- 46- (2-5.2): Reject SUBMITTER" Murrey E. Loflin, Virginia Beach Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revised text.

Change "within 3 hours" to "as soon as possible". SUBSTANTIATION: It is imperative that members notify the infection control liaison of an exposure. If there are factors which cause a delay, this wording allows the member to make the notification and not be restrained by an actual time frame. COMMITTEE ACTION: Reject. COMMITI'EE STATEMENT: The committee feels that 3 hours is a reasonable time. A shorter notification time can be established by individual fire depar tment policy.

(Log # 59) 1581- 47 - (2-5.8): Accept SUBMITYER. Murrey E. Loflin, Virginia Beach Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: New text.

Due to the hazardous nature of some communicable diseases, members shall be required to report to the infection control liaison when the member has received a confirmed exposure that has occurred off-duty or is being medically treated or tested due to presenting signs or symptoms. Verbal notification shall be followed up with a note or letter from the member ' s physician describing the disease exposed to, t reatment required, and fitness for regular fire depar tment duties relative to communicability hazard to fellow workers and civilians at emergency incidents. SUBSTANTIATION: This provides procedures for notification in the event of an exposure to an infectious disease while off-duty. COMMITTEE ACTION: Accept.

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(Log # 48e) 1581- 48 - (3-1.2): Reject SUBMITTER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION.... Revise text. Need to have the word cleaned added before the word disinfecting.

Cleaning is the first step-always. SUBSTANTIATION: None. COMMITTEE ACTION, Reject. COMMITTEE STATEMENT: The committee believes that this issue is adequately covered in Section 3-2. The submitter appears to be addressing a procedure, however 3-1.2 applies to a facility.

(Log # 48f) 1581- 49 - (3-1.3): Reject SUBMITTER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION. Revise text.

Need to have the word cleaned added before the word disinfecting. Cleaning is the first ste~always. SUBSTANTIATION: None. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT. The committee believes that this issue is adequately covered in Section 3-2. The submitter appears to be addressing a procedure, however 3-1.3 applies to a facility.

(Log # 44) 1581- 50 - (4-1.2): Accept in Part. ] SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston ] Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION': Revise text.

Any member who has skin contact with body fluids shall thoroughly wash the exposed area immediately using water or saline on mucosal surfaces anda germicidal agent and water on skin surfaces. If water is not available skin cleaning agents that do not require water should be utilized. SUBSTANTIATION: ,Ordinary soap does not adequately clean skin surfaces contaminated with bacterium, virus, etc. Saline is a preferred flushing agent for mucosal surfaces (i.e. eyes). [ COMMITTEE ACTION: Accept in Part.

I Add words "or saline" after the word "water" in first sentence of 4- 1.2 Also add new A-4-1.2 to read: "A-4-1.2 If germicidal agents are readily available they can be used

in lieu of soap when washing skin surfaces." Reject any other word changes.

COMMITTEE STATEMENT: The committee agrees and has added saline as an alternative to water for immediate washing, and the appendix item on germicidal agents. The committee, . . . . does not agree with the other proposed changes as the term should ns not appropriate for the text of a standard and the TCR text more adequately emphasises the importance of washing.

(Log # 48g) 1581- 51 - (4-2.3): Accept in Principle SUBMITrER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Revise text.

Handwashing is required following glove removal this statement should be added. SUBSTANTIATION: None. COMMITTEE ACTION: Accept in Principle. Add as second sentence to 4-2.3: "Hands shall be washed as specified in 5-1.3 of this standard follow-

ing removal of medical gloves." COMMITTEE STATEMENT: The committee agrees and has added appropriate text.

1581- 52 - (4-2.5): Reject (Log # 58) SUBMITrER: Murrey E. Loflin, Virginia Beach Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Change the word "victim" to vehicle". SUBSTANTIATION: Specifies a particular type of extrication commonly known throughout the emergency servaces community. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The term "victim" is the correct term.

(Log # 48h) 1581- 53 - (4-2.7): Reject SUBMITI'ER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Revise text.

Mention reference to the material safety data sheet information. SUBSTANTIATION: None. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that this issue is adequately covered in 5-2.2.

(Log # 57) 1581- 54 - (4-2.8): Accept SUBMITrER: Murrey E. Loflin, Virginia Beach Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION. Revise to read:

"Members shall not eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses while wearing gloves." SUBSTANTIATION: Additional precautions members need to take to prevent an infectious disease exposure. COMMITTEE ACTION: Accept.

(Log # 12) 1581- 55 - (4-2.10): Accept SUBMITrER. Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION-. Change first sentence of 4-2.10 to begin as follows:

4-2.10 Resuscitation equipment, including pocket masks, shall be available... SUBSTANTIATION: This more clearly delineates the intent of the paragraph, and makes it consistent with the definitions in Section 1- 3 of the Standard. COMMITTEE ACTION: Accept.

(Log # 18) 1581- 56 - (4-2.10): Accept SUBMITTER: DavidJ. Barillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Change first sentence of 4-2.10 to begin as follows:

4-2.10 Resuscitation equipment, including pocket masks, shall be available... SUBSTANTIATION. This more clearly delineates the intent of the

~ aragraph, and makes it consistent with the definitions in Section 1- of the Standard.

COMMrrTEE ACTION: Accept.

(Log # 75) 1581-57- (4-2.10): Accept SUBMITrER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Change first sentence of 4-2.10 to begin as follows:

4-2.10 Resuscitation equipment, including pocket masks, shall be available...

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SUBSTANTIATION: This more clearly delineates the intent of the paragraph, and makes it consistent with the definitions in Section 1-3 of the Standard. COMMrI'FEE ACTION: Accept.

(Log # 45) 1581- 58 - (4-3.3): Accept in Part. SUBMITTER: Sherri-Lynne Almeida RN, MSN, M. Ed, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

Needles shall not be recapped, bent, or broken. Following use, all sharp objects shall be immediately placed in sharps containers. These sharp containers shall be in all Emergency Medical Response vehicles and readily available. SUBSTANTIATION: The addition of "bent or broken" is consistent with the wording provided by the Center for Disease Control.

Sha containers should be available in all vehicles that make emer- r p , . .

gency medical responses, not just transport vehtcles. Many systems utilize first responders and send an engine company as the first line response. These engines would be eliminated by the current NFPA statement since they do not provide patient transportation. COMMITTEE ACTION: Accept in Part.

Revise first sentence of 4-3.3 to read: "Needles shall not be recapped, bent, or broken." Reject all other proposed text changes.

COMMITTEE STATEMENT: The committee agrees and has revised the first sentence of 4-3.3 to cover bent and broken needles. The committee does not accept the wording about sharp con-

tainers and feels the existing text of 4-3.3 adequately covers the availability of such containers,

(Log # 48i) 1581- 59 - (5-1.3): Reject SUBMITTER: Katherine West, USFA/NA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: 5-1.3 Handwashing is for at least 1...55 seconds - please correct. SUBSTANTIATION: None. COMMITI'EE ACTION: Reject. COMMITTEE STATEMENT: The 10 second criteria is taken from the Guidline on Handwashing from the U.S. Centers for Disease Control.

(Log # 56) 1581- 60 - (5-1.3): Accept SUBMITrER: Murrey E. Loflin, Virginia Beach Fire Department COMMENT ON PROPOSAL NO.-" 1581-1 RECOMMENDATION; Revised text:

Hands, and contaminated skin surfaces shall be washed with soap and water ..... SUBSTANTIATION: Only those areas of the body that are contaminated need to be cleaned rather than washing parts of the body that are onlyexposed not contaminated. COMMITTEE ACTION: Accept.

(Log # 46) 1581- 61 - (5-1.3): Reject SUBMITTER: Sherri-Lynne Mmelda, Houston Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revised text:

Hands and other exposed skin surfaces shall be washed with a germicidal agent and water by scrubbing all surfaces for at least 10 seconds, followed by thorough rinsing under running water. SUBSTANTIATION: Scrubbing is know to be a more effective means of clean a surface. Again a germicidal will be more effective than soap in cleaning. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that the existing text is adequate and is based on the current guidelines from the U.S. Centers for Disease Control.

(Log # 48j) 1581- 62 - (5-3.6): Reject SUBMITrER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: 5-3.6 Add check local regulations to verify which agents can be poured into the sewer system. SUBSTANTIATION'- None. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The agents and quantities used for handwashing can be emptied into sewer systems.

(Log # 48k) 1581- 63 - (5-4.2): Reject SUBMITTER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revised text

5-4.2 I still take issue with this statement as written. Statements should be based on scientific data for a rationale. This needs to be

~ ualified. UBSTANTIATION: None.

COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The submitter did not provide any suggested text for the committee to consider.

(Log # 13) 1581- 64 - (5-5.2.1): Accept SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new Section 5-5.2.1 as follows:

5-5.2.1 If the exterior of the leak-proof bag is contaminated, another bag shall be added. SUBSTANTIATION: This verbage is consistent with CDC Guidelines and OSHA compliance regulations. It will help ensure a reduced chance of exposure to body fluids shoudl the integrity of the original bag be breeched, yet is only required if this failure is deemed "likely" by the emergency response personnel. This new section expands on the minimum level of safety that is addressed by other documents in the infection control area. COMMITTEE ACTION: Accept.

(Log # 19) 1581- 65 - (5-5.2.1): Accept in Principle SUBMITrER: DavidJ. Barillo, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new Section 5-5.2.1 as follows:

5-5.2.1 If outside contaminationof the leak-proof bag used for dis-

~ osal is likely, a second bag shall be added. UBSTANTIATION: This verbage is consistent with CDC

Guidelines and OSHA compliance regulations. It will help ensure a reduced change of exposure to body fluids should the integrity of the original bag be breeched, yet is only required if this failure is deemed "likely" by the emergency response personnel. This new secdon expands on the minimum level of safety that is addressed by other documents in the infection control area. COMMITI'EEACTION: Accept in Principle. COMMITTEE STATEMENT: See action taken on Public Comment 1581-64.

(Log # 76) 1581-66- (5-5.2.1): Accept in Principle SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new Section 5-5.2.1 as follows:

5-5.2.1 If outside contamination of the leak-proof bag used for disposal is likely, a second shall be added. SUBSTANTIATION: This verbage is consistent with CDC Guidlines and OSHA compliance regulations. It will help ensure a reduced chance of exposure to body fluids should the integrity of the original bag be breeched, yet is only required if this failure is

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deemed. "likely" by the emer...g ency resp onse.'p(ersonnel.. This new secuon expands on the minimum level of salety that is addressed by other documents in the infection control area. COMMrrTEE ACTION: Accept in Principle. COMMITTEE STATEMENT: See action taken on Public Comment 1581-64.

developers of the USFA Guide are members of the NFPA FSOSH Subcommittee on Infection Control Programs. COMMITrEE ACTION: Reject. COMMITTEE STATEMENT: The referenced document is not available at this time.

(Log # 14) 1581- 67 - (5-6): Accept. SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT O N PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new secdon 5-6 as follows:

5-6 Linen 5-6.1 Contaminated linen shall be placed in a leak proof bag and

sealed at the location where it was used, and shall be transported for proper cleaning or disposal. SUBSTANTIATION: A procedure for dealing specifically with contaminated linen is an OSHA requirement (CPL2-2.44B), and thus should beplaced in this standard. It corresponds completely with 5- 4.5.2 and 5-5.2, which deals with contaminated clothing and contaminated disposable medical supplies, respectively. COMMITrEEACTION: Accept.

(Log # 20) 1581- 68 - (5-6): Accept SUBMITTER: DavidJ. Sarillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new section 5-6 as follows:


sealed at the llocation where it was used, and shall be transported for

g roper cleanig or disposal. UBSTANTIATION: A procedure for dealingspecifically with con-

taminated linen is an OSHA requirement (CPL2-2.44B), and thus should beplaced in this standard. It corresponds completely with 5- 4.4.2 and ~-5.2, which ,deals with contaminated clothing and contaminated disposable medical supplies, respectively. COMMITPEEACTION: Accept.

(Log # 77) 1581- 69 - (5-6): Accept SUBMITrER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new secdon 5-6 as follows:


sealed at the location where it was used, and shall be transported for

g roper cleaning or disposal. UBSTANTIATION: A procedure for dealing specifically with con-

taminated linen is an OSHA requirement (CPL2-2.44B), and thus should be placed in this standard. It corresponds completely with 5- 4.5.2 and 5-5.2, which deals with contaminated clothing and contaminated disposal medical supplies, respectively. COMMITI'EEACTION: Accept.

(Log # 6) 1581- 70 - (A-2-1.2): Peject SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new appendix secdon as follows:

A-2-1.2 For appropriate guidelines on developing, implementing, managing, andevaluadng and infection control program, consult: The U.S. Fire Administration Model Infection Control Program Guide, 1990. SUBSTANTIATION: The USFA Model Infection Control Program Guide is designed to assist fire departments in developing, implementing, managing, and evaluating an infection control program, based on CDC guidelines OSHA compliance directives and proposed regulations, and this proposed NFPA standard. Two of the

(Log # 25) 1581- 71 - (A-2-1.2): Reject SUBMITI'ER" DavidJ. Barillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new appendix section as follows:

A-2-1.2 For appropriate guidelines on developing, implementing, managing, and evaluating and infection control program, consult: The U.S. Fire Administration Model Infection Control Program Guide, 1990. SUBSTANTIATION: The USFA Model Infection Control Program Guide is designed to assist fire departments in developing, implementing, managing, and evaluating an infection control program, based on CDC guidelines OSHA compliance directives and proposed regulations, and this proposed NFPA standard. Two of the developers of the USFA Guide are members of the NFPA FSOSH Subcommittee on Infection Control Programs. COM.MYVI'EE ACTION. Reject. COMMITTEE STATEMENT: The re ferenced document is not available at this time. Also see Public Comment 1581-70.

(Log # 70) 1581- 72 - (A-2-1.2): Reject SUBMITTER: EugeneV. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new appendix section as follows:

A-2-1.2 For appropriate guidelines on developing, implementing, managing, and evaluating and infection control program, consult: The U.S,Fire Administration Model Infection Control Program Guide, 1990. SUBSTANTIATION" The USFA Model Infection Control Program Guide is designed to assist fire departments in developing, implementing, managing, and evaluating an infection control program, based on CDC guidelines OSHA compliance directives and proposed regulations, and this proposed NFPA standard. Two of the developers of the USFA Guide are members of the NFPA FSOSH Subcommittee on Infection Control Programs. COMMITTEE ACTION. Reject. COMM1TrE, E STATEMENT: The referenced document is not available at this time. Also see Public Comment 1581-70.

(Log # 7) 1581- 73 - (A-2-2.1): Reject SUBMITI'ER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add second paragraph to A-2-2.1 to read:

Delivery of a Field Training Course entitled 'Infection Control for Emergency Response Personnel: The Supervisors Role and Respon- sibility" is available through the National Fire Academy. The course is based on the CDC Curriculum Guide for Public Safety and Emer- gency Response Workers, OSHA Compliance Directives and regulations, and NFPA Standards. It is designed to instruct emergency response supervisors about infection control issues, and enable these supervisors to then train their personnel. For additional information, contact the National Fire Academy, Extension Services Branch, 16825 S. Seton Avenue, Emmitsburg, MD 21727. SUBSTANTIATION: This course is an important reference in this document for the reasons cited in the proposal. Emergency Service personnel need to know that this training/education is readily available at l i tde/no cost. The course was developed to comply with Pro- posed NFPA 1581 as well; two of the developers of the course are members of the NFPA FSOSH Subcommittee on infection control programs.

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COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The referenced document is not available at this time.

(Log # 26) 1581- 74 - (A-2-2.1): Reject SUBMITTER: DavidJ. Barillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add second paragra~,h to A-2-2.1 to read:

Delivery of a Field Training Course entitled 'Infection Control for Emergency Response Personnel: The Supervisors Role and Respon- sibility" is available through the National Fire Academy. The course is based on the CDC Curriculum Guide for Public Safety and Emer- gency Response Workers, OSHA Compliance Directives and regulations, and NFPA Standards. It is designed to instruct emergency response supervisors about infection control issues, and enable these supervisors to then train their personnel. For additional informa- tit-n, contact the National Fire Academy, Extension Services Branch, 16825 S. Seton Avenue, Emmitsbur.g, MD 21727, SUBSTANTIATION: This course is an important reference in this document for the reasons cited in the proposal. Emergency Service personnel need to know that this training/education is readily available at little/no cost. The course was developed to comply with Pro- posed NFPA 1581 as well; two of the developers of the course are members of the NFPA FSOSH Subcommittee on infection control programs. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The referenced document is not available at this time. Also see Public Comment 1581-73.

(Log # 71) 1581- 75 - (A-2-2.1): Reject SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add second paragra~,h to A-2-2.1 to read:

Delivery of a Field Training Course entitled 'Infection Control for Emergency Response Personnel: The Supervisors Role and Respon- sibility" is available through the NationalFire Academy. The course is based on the CDC Curriculum Guide for Public Safety and Emer- gency Response Workers, OSHA Compliance Directives and regulations, and NFPA Standards. It is designed to instruct emergency response supervisors about infection control issues, and enable these supendsors to then train their personnel. For additional information, contact the National Fire Academy, Extension Services Branch, 16825 S. Seton Avenue, Emmitsburg, MD 21727. SUBSTANTIATION: This course is an important reference in this document for the reasons cited in the proposal. Emergency Service personnel need to know that this trainlng/education is readily available at l i tde/no cost. The course was developed to comply with Pro- posed NFPA 1581 as well; two of the developers of the course are members of the NFPA FSOSH Subcommittee on infection control programs. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The referenced document is not available at this time. Also see Public Comment 1581-73.

(Log # 481) 1581-76- (A-2-2.1): Reject SUBMITTER: Katherine West, USFA/NEA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise text.

I would not recommend this as a curriculum. It does not meet the criteria for such. It has not been tested nor has it a mechanism for feedback. SUBSTANTIATION: None. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The committee feels that this referenced guide is a useful resource.

(Log # 9) 1581- 77 - (A-2-4.2): Accept in Principle SUBMITI'ER: Gordon M, Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new appendix section as follows: A-2-4.2 The U.S. Fire Administration (USFA), in the report, "Sec-

ond Forum on Communicable Diseases," recommends that all emergency response personnel be immunized against all racine- preventable diseases, in accordance with the CDC Immunization t'racfices Advisory Committee guidelines. SUBSTANTIATION: The U.S. Fire Administration is looked at as the lead Federal agency in dealing with infection control issues as they relate to Emergency Response Personnel. USFA held 2 "Forums on Communicable Diseases," at which infection control and emergency response experts from across the country made several National recommendations; this is one of those recommendations. The Forum report is available from USFA, and lists the recommendations of both Forums (including this recommendation). COMMITTEE ACTION: Accept in Principle. Add proposed text as A-2-4.1

COMMITTEE STATEMENT: The committee agrees and will add the proposed text, however, it will be added as A-2-4.1 as it is the more appropriate reference.

(Log # 27) 1581- 78 - (A-2-4.2): Accept in Principle SUBMITTER: DavidJ. Barillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Add new appendix section as follows:

A-2-4.2 The U.S. Fire Administration (USFA), in the report, "Sec- ond Forum on Communicable Diseases," recommends that all emergency response personnel be immunized against all racine- preventable diseases, in accordance with the CDC Immunization Practices Advisory Committee guidelines. SUBSTANTIATION: The U.S. Fire Administration is looked at as the lead Federal agency in dealing with infection control issues as they relate to Emergency Response Personnel. USFA held 2 "Forums on Communicable Diseases," at which infection control and emergency response experts from across the country made several National recommendations; this is one of those recommendations. The Forum report is available from USFA, and lists the recommendations of both Forums (including this recommendation). COMMITTEE ACTION: Accept in Principle. COMMITTEE STATEMENT: See action on Public Comment 1581- 77.

(Log # 72) 1581- 79 - (A-2-4.2): Accept in Principle SUBMYffPER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.- 1581-1 RECOMMENDATION: Add new appendix section as follows:

A-2-4.2 The U.S. Fire Administration (USFA), in the report, "Sec- ond Forum on Communicable Diseases," recommends that all emergency response personnel be immunized against all racine- preventable diseases, in accordance with the CDC Immunization Practices Advisory Committee guidelines. SUBSTANTIATION. The U.S. Fire Administration is looked at as the lead Federal agency in dealing with infection control issues as they relate to Emergency Response Personnel. USFA held 2 "Forums on Communicable Diseases," at which infection control and emergency response experts from across the country made several National recommendations; this is one of those recommendations. The Forum report is available from USFA, and lists the recommendations of both Forums (including this recommendation). COMMITTEE ACTION: Accept in Principle. COMMITTEE STATEMENT: See action on Public Comment 1581- 77.

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(Log # 10) 1581- 80 - (A-2-5.3): Reject SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION'.: Revise as follows:

Insert 1st paragraph ol'A-2-5.3: OSHA Instruction CPL 2-2.44B describes the following OSHA

requirements for post-exposure guidelines, based upon CDC Guidelines:

Follow-up Procedures After Possible Exposure to HIV or HBV: a) If a health care worker has a percutaneous (needlestick or

cut) or mucous membrane (splash to eye, nasal mucosa, or mouth) exposure to body fluids or has a cutaneous exposure to blood when the worker's skin is chapped, abraded, or otherwise non-intact, the source patient shall be reformed of the incident and tested for HIV and HBV infections, after consent is obtained.

b) If pat ient consent is refused or if the source patient tests positive, the health care worker shall be evaluated clinically and by HIV antibody testing as soon as possible and advised to report and seek medical evaluation of any acute febrile illness that occurs within 12 weeks after exposure. HIV seronegative workers shall be retested 6 weeks post-exposure and on a periodic basis thereafter (12 weeks and 6 months after exposure).

c) Follow-up procedures shall be taken for health care workers exposed or poLentially exposed to HBV. The types of procedures depends on the immunization status of the worker (i.e., whether HBV vaccination has been received and antibody response is adequate) and the HBV serologic status of the source patient. The CDC Immunization Practices Advisory Committee has published its recommendat ions regarding HBV post-exposure prophylaxis in table format in June 7, 1985 Morbidity and Mortality Weekly Report.

d) If an employee refuses to submit to the procedures in (b) or (c) above when such procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are designed for that benefit o f the exposed employee.

Replace first part of t3rst sentence (up to colon) in existing A-2-5.3 with the following:

Post exposure guidelines can also be found in: SUBSTANTIATION: The post-exposure guidelines in each of the referenced documents is the same; the OSHA documentp resen t s it in regulatory language and thus was selected to be quo tedhe re .

It may be difficult for rural depar tments to obtain the listed documents in a timely manner , and NFPA 1581 may be the only IC document they have. This document will be incomplete without guidelines for post-exposure follow up as a reference in these cases or for depar tments to refer to after receiving questionable advise. The information in 5-3.8 (disinfection methods) and 5-4.3 (cleaning of protective clothing) is spelled out in this manner for the same reason. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Rapidly changing technology is already making the su'~mitters referenced information obsolete.

(Log # 28) 1581- 81 - (A-2-5.3): Reject SUBMITTER: David[. Barillo, MD, Newark Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise as follows:

Insert 1st paragraph ofA-2-5.3: OSHA Instruction CPL 2-2.44B describes the following OSHA


Follow-up Procedures After Possible Exposure to H W or HBV: a) If a health care worker has a percutaneous (needlestick or cut)

or mucous membrane (splash to eye, nasal mucosa, or mouth) exposure to body fluids or has a cutaneous exposure to blood when the worker's skin is chapped, abraded, or otherwise non-intact, the source patient shall be informed of the incident and tested for HIV and HBV infections, ~£ter consent is obtained.

b) If patient consent is refused or if the source patient tests positive, the health care ~orker shall be evaluated clinically and by HIV antibody testing as soon as possible and advised to report and seek medical evaluation of any acute febrile illness that occurs within 12

weeks after exposure. HIV seronegative workers shall be retested 6 weeks post-exposure and on a periodic basis thereafter (12 weeks and 6 months after exposure).

c) Follow-up procedures shall be taken for health care workers exposed or potentially exposed to HBV. The types of procedures depends on the immunization status of the worker (i.e., whether HBV vaccination has been received and antibody response is adequate) and the HBV serologic status of the source patient, The CDC Immunization Practices Advisory Committee has published its recommendat ions regarding HBV post-exposure prophylaxis in table format in June 7,1985 Morbidity and Mortality Weekly Report.

d) If an employee refuses to submit to the procedures in (b) or (c) above when such procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are designed for that benefit o f the exposed employee.

Replace first part of first sentence (up to colon) in existing A-2-5.3 with the following:

Post exposure guidelines can also be found in: SUBSTANTIATION- The post-exposure guidelines in each of the referenced documents is the same; the OSHA document presents it in regulatory language and thus was selected to be quo t edhe re .

It may be difficult for rural depar tments to obtain~he listed documents in a timely manner , and NFPA 1581 may be the only IC document they have. This document will be incomplete without guidelines for post-exposure follow up as a reference in these cases or for depar tments to refer to after receiving questionable adx4se. The information in 5-3.8 (disinfection methods) and 5-4.3 (cleaning of protective clothing) is spelled out in this manner for the same reason. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Rapidly changing technology is already making the submitters referenced information obsolete. Also see Public Comment 1581-80.

(Log # 73) 1581- 82 - (A-2-5.3): Reject SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Depar tment COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Revise as follows:

Insert 1st paragraph ofA-2-5.3: OSHA Instruction CPL 2-2.44B describes the following OSHA


Follow-up Procedures After Possible Exposure to HIV or HBV: a) I fa health care worker has a percutaneous (needlestick or cut)

or mucous membrane (splash to eye, nasal mucosa, or mouth) exposure to body fluids or has a cutaneous exposure to blood when the worker's skin is chapped, abraded, or otherwise non-intact, the source patient shall be informed of the incident and tested for HIV and HBV infections, after consent is obtained. b) If patient consent is refused or if the source patient tests posi-

tive, the health care worker shall be evaluated clinically and by HIV antibody testing as soon as possible and advised to report and seek medical evaluation of any acute febrile illness that occurs within 12 weeks after exposure. HIV seronegative workers shall be retested 6 weeks post-exposure and on a periodic basis thereafter (12 weeks and 6 months after exposure).

c) Follow-up procedures shall be taken for health care workers exposed or potentially exposed to HBV. The types of procedures depends on the immunization status of the worker (i.e., whether HBV vaccination has been received and antibody response is adequate) and the HBV serologic status of die source patient. The CDC Immunization Practices Advisory Committee has published its recommendat ions regarding HBV post-exposure prophylaxis in table format in June 7, 1985 Morbidity and Mortality Weekly Report.

d) If an employee refuses to submit to the procedures in (b) or (c) above when such procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are designed for that benefit of the exposed employee.

Replace first part of first sentence (up to colon) in existing A-2-5.3 with the following:

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N F P A 1581 - T C D

Post exposure guidelines can also be found in: SUBSTANTIATION: The post-exposure guidelines in each of the referenced documents is the same; the OSHA documentpresents it in regulatory language and thus was selected to be quotedhere.

It may be difficult for rural departments to obtain the listed documents in a timely manner, and NFPA 1581 may be the only IC document they have. This document will be incomplete without guidelines for post-exposure follow up as a reference in these cases or for departments to refer to after receiving questionable advise. The information in 5-3.8 (disinfection methods) and 5-4.3 (cleaning of protective clothing) is spelled out in this manner for the same r e a s o n .

COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Rapidly changing technology is already making the submitters referenced information obsolete. Also see Public Comment 1581-80.

(Log # 55) 1581- 83 - (A-5-3,8): Accept in Principle SUBMITTER: Murrey E. Loflin, Virginia Beach Fire Department COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Last paragraph to read:

To ensure the effectiveness of an}, sterilization or disinfection process, equipment and instrumentatmn must first be thoroughly cleaned with soap and water of all visible soil. SUBSTANTIATION: To better define how the method of cleaning equipment and instruments before sterilization or disinfection process. COMMITTEE ACTION: Accept in Principle. COMMITTEE STATEMENT: See action on Public Comment 1581- 8 that added a new definition for "cleaning".

(Log # 30) 1581- 84 - (Appendix B): Reject SUBMITTER: Dennis L. Rubin, Chesterfield, VA COMMENT ON PROPOSAL NO." 1581-1 RECOMMENDATION: Add new section as follows: The National Fire Academy offers a two day field course entided,

"Infection Control for Emergency Response Personnel: The Super- visor's Role." Contact the National Fire Academy in Emmitsburg, Maryland for more information. SUBSTANTIATION" The addition will provide more resource information to the user of the document. COMMITTEE ACTION'Reject. COMMITTEE STATEMENT: The referenced course from the NFA is not available at this time.

(Log # 31) 1581- 85 - (Appendix B): Reject SUBMITTER: Dennis L. Rubin, Chesterfield, VA COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add new section as follows:

The United State Fire Administration is currently developing a "Model Infectio Control Program." Contact the United State~ Fire Administration in Emmitsburg, Maryland for more information. SUBSTANTIATION: This addition will provide more resource information to the use of the document. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The referenced document is not available at this time. See also Public Comment 1581-70.

SUBSTANTIATION: These documents were referenced in several public comments. They indicate that USFA is the lead Federal agency in dealing with infection control issues as they relate to emergency response personnel. COMMITTEE ACTION: Accept.

(Log # 21) 1581- 87 - (Section B-l-5): Accept SUBM/TTER: DavidJ. Sarillo, MD, Newark Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add Section B-l-5 as follows: B-l-5 U.S. Fire Administration Publications.

USFA Publications can be obtained from the Publications Office, U.S. Fire Adminstration 16825 South Seton Avenue, Emmitsburg, MD 21727.

U.S. Fire Administration Second Forum on Communicable Dis- eases, November 1989. SUBSTANTIATION: These documents were referenced in several public comments. They indicate that USFA is the lead Federal agency in dealing with infection control issues as they relate to emer-

ncy response personnel. MMITrEE ACTION: Accept.

(Log # 68) 1581- 88 - (Section B-l-5): Accept SUBMITTER: Eugene V. McCarthy, Los Angeles County Fire Department COMMENT ON PROPOSAL NO.: 1581-1 RECOMMENDATION: Add Section B-l-5 as follows: B-l-5 U.S. Fire Administration Publications. USFA Publications can be obtained from the Publications Office,

U.S. Fire Adminstration 16825 South Seton Avenue, Emmitsburg, MD 21727.

U.S. Fire Administration Second Forum on Communicable Dis- eases, November 1989. SUBSTANTIATION: These documents were referenced in several public comments. They indicate that USFA is the lead Federal agency in dealing with infection control issues as they relate to emer-

ency response personnel. OMMITTEE ACTION: Accept.

(Log # 64) 1581- 89 - (Entire Document): Reject SUBMITTER: Richard Wickman, Baltimore Gas and Electric Com-

Pcany OMMENT ON PROPOSAL NO.: 1581-1

RECOMMENDATION: Wherever in the document the words "Fire Department" appear, change thse to the "emergency organization". Thxs includes the document title. SUBSTANTIATION: The SCOPE of the document has been enlarged to include Fire Brigades, and the use of the term fire department is now misleading. Changing the tide will help those end users looking for documents that apply to them to recognize that this document applies. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The definition of "fire department" adequately addresses what organizations are intended under the term. Also, see action taken on Public Comment 1581-1, 1581-2, 1581-3, 1581-6, and 1581-7, that further impacts industrial fire brigade/fire departments.

(Log # 5) 1581- 86 - (Section B-l-5): Accept SUBMITTER: Gordon M. Sachs, U.S. Fire Administration COMMENT ON PROPOSAL NO,: 1581-1 RECOMMENDATION: Add Section B-l-5 as follows:

USFA Publications can be obtained from the Publications Office, U.S. Fire Adminstration 16825 South Seton Avenue, Emmitsburg, biD 21727.

U.S. Fire Administration Second Forum on Communicable Dis- eases, November 1989.

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