Redmond EMS Abstracts.indd - IAFF

Infectious Diseases
Captain James S. Spahr, RS, DAAS, CHEM, MPH
Associate Director for Emergency Preparedness
National Institute for Occupational Safety and Health
1600 Clifton Road, Room 4505, MS E-20
Atlanta, Georgia 30333
404-498-6185
jspahr@cdc.gov
Background:
Captain Spahr is a Commissioned Officer in the US Public Health Service currently serving as a
supervisory safety and occupational health specialist at NIOSH in Atlanta, Georgia. Captain Spahr
is the Associate Director of NIOSH’s Office for Emergency Preparedness and Response - where he
coordinates NIOSH’s response to emergency events, promotes response-worker safety policies,
and coordinates emergency preparedness training exercises. He has worked at NIOSH for over 14
years as a researcher and emergency coordinator. He has also served as an environmental health
specialist for the Health Resources and Services Administration and for the Indian Health Service.
He was also a Project HOPE Educator and Peace Corps Volunteer, and has worked in both county
and state public health departments in Ohio before joining the USPHS Commissioned Corps.
Abstract:
The original Ryan White Comprehensive AIDS Resources Emergency Act was first enacted in
1990. Although primarily focusing on other support for HIV/AIDS victims, the Act included
provisions for notifying emergency response employees when they had been occupationally
exposed to potentially life-threatening infectious disease. Notification was originally directed
toward HIV and related bloodborne diseases like hepatitis B, but ultimately it included infectious
pulmonary tuberculosis, meningococcal disease, plague, diphtheria, rabies, and viral hemorrhagic
fevers within the requirement. Responsibility for developing the list of diseases subject to the
notification provisions and associated guidelines fell to US Department of Health and Human
Services (DHHS), and ultimately resided with CDC/NIOSH. Reporting proceeded according to
this policy reasonably well for a number of years. However, the provisions regarding notification
were omitted during the reauthorization of the Act in 2006, but corrected in the Ryan White HIV/
AIDS Treatment Extension Act of 2009. Once again, the Act assigned to DHHS the responsibility
for developing an updated disease list and associated guidelines, with subsequent delegation to
CDC (and thus NIOSH). Starting from the original disease list and guidelines and adhering to
the requirements of the legislative language, NIOSH has developed a public notice containing
proposed updated disease list that has recently been published in the Federal Register to solicit
public comment. Additions to the original list include hepatitis C, Vaccinia, measles, Varicella
disease, avian influenza, mumps, rubella, severe acute respiratory syndrome, and smallpox.
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