Kevin Fetter, a firefighter and paramedic for Snohomish County Fire District 1, couldn’t help but wonder: If MRSA, a potentially life-threatening bacterium, is often found in hospitals and among the public, how much of a threat is it to his coworkers?
“We wondered what we were facing,” he said.
It took persistence, but he finally found a microbiologist at the University of Washington who was interested in helping find an answer.
When UW researchers began looking for MRSA at Fire District 1’s Mariner station, they found it nearly everywhere: on the fire and medic trucks, on the bunker gear, inside the living quarters, on computer keyboards and the kitchen tables, said Marilyn Roberts, a professor of environmental and occupational health sciences.
Overall, MRSA was found in 4 percent of more than 1,000 samples collected from equipment and firefighters.
“I had a colleague who didn’t think we’d find it at all,” Roberts said. Although no firefighters have reported having a MRSA infection, “finding it to the level we found it was surprising.”
Methicillin-resistant Staphylococcus aureus, better known by its four-letter label — MRSA — is a staph infection resistant to antibiotics. Some people have it but don’t become sick from it.
Outside hospitals, MRSA most often causes skin infections. But in hospitals, where people are recovering from injury or disease, MRSA can trigger far more dangerous, sometimes fatal infections, spreading to the bloodstream or causing pneumonia or infections in surgical patients.
The two-year study in Fire District 1 was funded by $200,000 from the state Department of Labor and Industries* using an $8 million fund established in 2007 to improve workplace safety. The fire district spent $2,000 for an initial study of the problem. It is thought to be one of the most comprehensive ever conducted among firefighters anywhere in the nation.
It has focused attention on both the risk of exposure to MRSA that firefighters face — perhaps greater than that faced by the general public — as well as ways to help stop its spread.
The fire district, which takes in nearly 46 square miles of Snohomish County from Silver Firs to Woodway, has stepped up germ-fighting measures in a number of ways. These include setting up hand gelling stations in spots where employees enter living quarters, plastic covers on keyboards and other electronic devices so that they can be cleaned more easily, and washing work clothes on site so the bacteria isn’t carried home on their clothes.
But this is a battle against a germ that can be found on nearly anything touched by a lot of people: elevator buttons, ATMs, gym equipment.
Since many MRSA infections are triggered by cuts, “The biggest protection for everybody, especially this time of year, is hand washing,” Roberts said. “Good hand hygiene is the best protection for MRSA or any infection.”
Fetter was at a trade show in 2008 when he saw a $50,000 machine that claimed it could kill MRSA germs. It was similar to a device used in hospital rooms that had been adapted for medic units.
“You wonder what you’re being exposed to,” he said. “It got me thinking about what we face.”
He looked around for studies on the prevalence of MRSA in ambulances and medic units and couldn’t find answers. He contacted laboratories to see if they might send someone out to do tests.
“It’s pretty scientific,” he said. “It not like rubbing a Q-Tip on something like you see on ‘CSI.’ ”
He made a call to the UW and was referred to Roberts. Some initial testing was conducted. A week or so later, Roberts told him: “We need to look at this a little closer.”
“It wasn’t so much that we were surprised to find it in our medic rigs, that was intuitive,” Fetter said. “It was that we found it in the living quarters.”
Of the firefighters who were found to be “carrying” a staph infection, meaning they weren’t infected and weren’t sickened by it, two-thirds had MRSA, Roberts said.
That’s high, but only 40 people were tested, she said. “We don’t know if it’s representative of the entire state of Washington — or nationally,” she said.
Few studies in the United States, perhaps just two, have ever been done on the presence of MRSA around firefighters. The UW study showed that two types of MRSA were present on equipment and in living quarters inside Mariner Station 11, at 12310 Meridian Ave., adjacent to Mariner High School.
The germs were found on the fire trucks, medic trucks and on firefighters — the first time MRSA has ever been documented inside fire stations, Roberts said.
Fetter said he knew just how tough it would be to deal with the bug from the ongoing battle that hospitals have with MRSA.
“We see what the hospitals go through,” he said. “They still have a problem and they have professional people cleaning all the time.”
Although the UW study found MRSA at the Fire District 1 fire station, it doesn’t mean equipment or employees are a danger to patients.
“You have to remember that none of us is sterile,” said Dr. Yuan-Po Tu, a physician at The Everett Clinic who has monitored MRSA for the past decade.
“As we touch things, we plant bacteria on other surfaces,” he said. “It’s a reflection of who’s in that environment, whether it’s firefighters or other patients.”
Patients shouldn’t worry about being treated or transported by medic crews, Roberts said.
Many people only have the bug for a little while, she said. “It comes and goes. Not all MRSA is created equal.”
The point of the study was to document the importance of disinfection procedures and improve them where possible, Fetter said. “You can be a carrier and not even know it.”
Fetter, who works as the department’s wellness coordinator, began a program to get the word out to fellow employees.
In addition to the installation of touchless hand gel and hand towel dispensers, bunker gear is being put through a washer and dryer and kept out of the living quarters. And instead of just wiping down the surfaces with disinfectant, the cleanser is left on for several minutes to kill more germs.
Employees are being reminded to bandage wounds before they come to work, and if they forget, signs with anti-MRSA messages are posted around the station.
With these and other steps, progress is being made against MRSA, he said. But there’s still more to do.
“The medic unit is easier to clean,” Fetter said. But some items in the living quarters, like carpet and furniture, are harder to deeply clean.
“We know what we’re facing now,” he said. “We’ll share it with the whole nation.”
Roberts said she hopes that a larger study involving more firefighters can be funded to see how widespread the problem is.
There’s been scattered reports of firefighters dying from MRSA, she said, and of firefighters getting MRSA infections. “The problem is getting an exact number,” she said.
The study provided some interesting clues to how the bacterium spreads. There are many other professionals who have similar potential for exposure to MRSA, including painters, fishermen, veterinarians, jail and police employees and Coast Guard personnel, she said.
“We know when people pay attention that the levels of MRSA should be reduced,” she said. “I’m now getting all kinds of people saying, ‘We have a problem in this place. Can you help us?’ ”
Sharon Salyer: 425-339-3486; email@example.com.
*Correction, Dec. 3, 2010: An earlier version of this story was unclear about the funding of a study conducted by a University of Washington researcher on MRSA in Fire District 1. The state Department of Labor and Industries provided $200,000 for the study from an $8 million fund established in 2007 to improve workplace safety. The fire district spent $2,000 for an initial study of the problem.