Health Risks Shadow EMTs

TAMPA - The face and hand protections are as much a part of a county ambulance's equipment as oxygen and a backboard. Breathing masks guard against coughed-up blood and saliva; eye goggles and face masks do the same. Disposable rubber gloves are almost a part of the uniform.

Older paramedics remember a time when those safeguards weren't there, when they dove in at traumatic scenes bare-handed and inhaled particles from infected lungs without worrying about the tiny pathogens in the blood of the people they treated.

Slowly, a small part of the old guard is dying because of it. A small percentage, to be sure, but enough to warrant concern.

Two Hillsborough County paramedics and one firefighter died last year because of complications of hepatitis C, a dangerous contagion contracted through their work more than a decade ago, before face masks and gloves were standard wear.

"Hepatitis C is a big iceberg out there," said Hillsborough Fire Rescue Capt. Glenn Thompson, who supervises a crew in Dover. "There is a surprisingly high number of hepatitis C-positive people here."

Active paramedics and emergency medical technicians don't often die from work-related injuries or illnesses, he said. Three dying in one year - from an identical cause - has prompted concern.

Thompson said he wonders whether more are about to die.

"Hepatitis C is a real threat," Thompson said. "It's a heartier beast than initially envisioned."

In the past several months, he has attended funerals of two co-workers - they were also friends - who died of hepatitis C, and there are rumors of more cases. When a police officer, firefighter or paramedic dies in the line of duty, much is made of it, Thompson said. When a paramedic with decades of service dies a slow, agonizing death from hepatitis C, there is little notice.

That's not right, Thompson thought at a funeral for a good friend who died on Christmas Eve. He was 50 years old and had battled hepatitis C since 1999, Thompson said.

"He went through hell," Thompson said. The victim, whose name is not being published because of privacy concerns, was exposed when he was stuck with a hypodermic needle in the late 1990s.

Federal health privacy protections mean that paramedics and firefighters do not have to publicly disclose whether they have contracted hepatitis C. Some do. Others don't. Some die and the cause is never made public. Health officials estimate 3 percent to 5 percent of the county's 900 firefighters and paramedics have the disease.

The virus is passed through contact with contaminated blood. Years - even decades - can go by before symptoms emerge. Health experts estimate that almost 4 million Americans are infected, and most don't know it.

By the time patients become jaundiced and show other symptoms, the disease is often well-advanced. Long-term therapy may include Interferon, which requires frequent and painful shots, and strength-sapping medication.

One Stick Does It

"I had a needle stick in 1996 on a call we went out on," said firefighter and paramedic Gus Garcia, who knows that a needle stick infected him with hepatitis C. "It was a stick that was documented, and someone else on that same call now has hepatitis C, too."

Garcia said he never had symptoms.

About a year after the call, he was tested, along with about 300 other paramedics and firefighters.

"Two weeks later, they notified me to come back," he said. "They said, 'You got this thing going on.'"

Initially, he denied it, then admitted his infection and went on a hepatitis C fact-finding binge.

"I bogged myself down with information," he said. So much so that he is now chairman of a hepatitis C support group in Tampa.

But back then, it took a year before he began treatment. "That was three injections and four pills a day," he said. It lasted one year and at the end the treatment had failed to defeat the virus.