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Infectious diseases: It's a war!

January 3, 2001
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Dan Markiewicz
Most employers have emergency action plans to address a tornado. But with the exception of health care facilities, very few employers have addressed potential infectious disease outbreaks in their emergency plans. This is a mistake. Infectious disease in workplaces today is a greater risk than a tornado.

Infection rates among Americans are soaring. Mortality from infectious diseases in the U.S. has doubled in recent years. More than 30 new infectious diseases have been discovered within the past two decades. And the U.S. Surgeon General has warned Congress that infectious diseases threaten U.S. national security.

Here are four factors behind these troubling developments:

1. Resilient enemy

We now know that many infectious microbes are very resilient. A key survival mechanism for some microbes involves a rapid genetic mutation, with the mutated form more adaptable to various attacks.

We’ve unwittingly contributed to the creation of drug-resistant forms of infectious disease by the misappropriate use of disinfectants and antibiotics. An example is the drug-resistant strain of tuberculosis that is becoming more prevalent in the U.S.

Antibiotics, most likely coming from feedlot runoff or other agricultural activities, are now found in surface waters. Scientists are alarmed that the brewing of antibiotics and other pollution in some back stream may help create a “super-microbe” that could invade and quickly decimate an unprotected population.

2. Pollution

Global warming may also be aiding infectious microbes. An unusually long period of warm weather in 1345-46 made conditions favorable for the spread of the plague, or “Black Death,” that killed more than a third of Europe’s population. A similar development, though less dramatic, occurred in 1993 when a drought in the western U.S. brought disease-carrying rodents into closer contact with people. A new disease, hanta virus pulmonary syndrome, emerged. More than two-thirds of the people who became infected with the disease died.

3. Globalization

The battle against infectious diseases on the global front is much worse than in the U.S. In some developing countries infectious diseases account for one in every two deaths. With millions of people and products crisscrossing the globe regularly, the Ebola virus could hitch a ride from a person in Africa and land in Alabama the same day.

This is one reason why the Surgeon General, along with the CIA’s National Intelligence Council, recently warned Congress that infectious diseases threaten U.S. national security.

4. Lax attitudes

Many of us are nonchalant about proper hand washing — the simplest and most effective means of limiting the spread of many infectious diseases. In a recent survey, the Centers for Disease Control asked people if they washed their hands after using a public toilet. Ninety-seven percent said they did — but observation found the number to be about 75 percent. And most people just quickly rinsed their hands in water and dried them with a paper towel. Germs readily survive unless you use soap and wash beneath the tips of fingernails.

Lax attitudes also exist in workplaces. Although prevention methods were widely understood and available, more than 12,000 hepatitis B infections occurred among health care workers in 1986. Voluntary adherence to the CDC’s 1986 “Universal Precautions” for bloodborne pathogens helped reduce HBV infections among health care workers to less than 6,000 by 1992. One year after OSHA issued and enforced its bloodborne pathogens standard, HBV infections among health care workers dropped to about 1,000, and the number continues to fall. A law should not have been necessary to do what was right.

Employers are also not taking full advantage of the law’s potential benefits. Many afford protections only to employees “with a duty” to come into contact with blood or other potentially infectious materials at work. And training is generally limited to workplace risks, ignoring disease transmission by sex practices, for example.

Expanding bloodborne pathogens training to more employees makes economic sense. An infection that leads to a chronic disease such as AIDS among a worker or his/her family members may require more than $400,000 of lifetime drug and medical direct costs. A good portion of these costs will be borne by the employer through increased insurance premiums, regardless if the disease was contracted at work or elsewhere.

ISHN’s 17th Annual White Paper Survey found only 14 percent of readers are concerned about infectious diseases, and bloodborne pathogens are near the bottom of their safety and health priorities for 2001. I encourage you to read Pulitzer Prize-winning author Laurie Garrett’s book, “Betrayal of Trust: The Collapse of Global Public Health,” which meticulously explains how lax attitudes on global public health are threatening hard-won gains in health and life expectancy.

Also, review infectious disease information via the CDC’s “Emerging Infectious Disease” online journal at www.cdc.gov/ncidod/eid/. This site will also link you to the CDC’s National Center for Infectious Disease Web site.

Hopefully, learning more about infectious diseases will raise the level of concern and attention due this important topic. And remember, we are at war with microbes and other agents that cause infectious disease. You should be a soldier in this war.

Sidebar: What you can do

  • Every employer should have a policy and procedures for dealing with infectious diseases.

  • Find and eliminate hiding places for infectious microbes.

  • Ensure sound sanitary and hygienic practices among your workers and visitors.

  • Be alert to the type of infectious diseases that are possible among workers or citizens in your community — and how to control them.

  • Encourage proper vaccinations among employees and their family members.

  • Employees who travel, particularly overseas travel, should be given special attention.

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