"I just point and grunt," says one veteran homicide detective when asked about protecting himself at crime scenes. "I don't touch bodies if! don't have to." Protection to this officer runs more along the lines of a 12-gauge shotgun named Bertha and at least two pistols. He does, of course, keep a leather pouch stuffed with latex gloves in his car. But his most important weapon, the one that provides the greatest protection, is his common sense.

He does not believe that he is immune to contracting an infectious disease, so he is exceedingly cautious about his actions at the scene of a crime. He follows the simple guidelines that Joseph Warren, a forensic biologist for the Tarrant County Medical Examiner's office in Fort worth, Texas, believes should apply to all officers. "Don't drink, smoke, eat or chew gum at a crime scene. If you're drinking a Coke or coffee and you put it down, what is going to be on it when you pick it up? Don't use the telephone at the crime scene because it might have blood in or on it, and you might breathe in some of the contamination. Wear gloves to protect yourself and the evidence."

These are just a few of the guidelines suggested by Warren and a host of other experts who believe a calm, rational view of infection control is the only one to take.

Statistically Speaking ...

The statistics are like a double-edged sword. They do not paint law enforcement officers as impervious to disease, but they do indicate that an officer's chances of contracting one are slim, especially with regard to the AIDS Virus.

Surprisingly, the Centers for Disease Control (CDC) do not keep statistics on the incidence of law enforcement officers contracting the HIV virus through their work. According to Tom Skinner in the CDC's press office, the Centers keep statistics only on health-care workers. But an FBI study conducted from 1981 to 1991 reports that fewer than 10 officers contracted the disease on the job. In most cases, the virus was transmitted through the absorption of contaminated blood through cracks in the skin or open sores, or through accidental or intentional needle sticks.

The FBI gathered its information by surveying law enforcement agencies and asking each of them to report any incident of an officer's contracting an infectious disease. The FBI admits its study is not scientifically valid in all cases, and when the CDC studied the evidence, they disagreed that all of the cases represented job related infections. Still, the FBI has enough faith in the thoroughness of its study to conclude that an officer's chances of contracting any disease on the job-including hepatitis B and AIDS-are extremely small. "Law enforcement officers have a greater chance of being killed by a criminal in the line of duty, or even in an automobile accident, than of dying from an infectious human disease contracted on the job," the agency reported.

Although that is good news for police officers, it does not remove the threat, nor does it mean officers can be cavalier about protection. The occupational Safety and Health Administration (OSHA) requires that each officer be supplied with latex gloves, sharps containers for hypodermic needles, razors or other sharp objects; masks, eye protection to protect the mucous membranes from airborne pathogens, and CPR masks, even though transmission of AIDS by mouth is rare due to the virus' inability to survive stomach acid.

It is the AIDS virus that sparks the deepest fear, since there is no cure, and those who develop AIDS are usually dead within a few years. Fortunately, the chances are less than 1 percent that an officer will contract the virus on the job. The greater danger lies with tuberculosis (TB), hepatitis and meningitis.

Tuberculosis. This disease is transmitted through the air by suspects who are coughing, hacking and wheezing in the back of the patrol car or in the jail cell. The modem strain of TB is drug-resistant, and even those who test positive for it may not show symptoms. This is because TB generally affects people whose immune systems are already weak, which may explain why prisons have a high rate of TB-infected inmates.

Hepatitis B. Known today as HBV, this is a bloodborne pathogen that can live outside the body longer than the HIV virus. One study found that the HIV virus in a dead body dies after 21 hours, but that HBV not only lives longer but is found in greater concentrations in the blood. HBV can cause liver cancer, cirrhosis, and acute and chronic active hepatitis. A safe and effective vaccine to prevent HBV is available and provides at least 90 percent protection for up to seven years.

Meningitis. Also spread by airborne transmission, this disease causes inflammation of the membranes that surround the brain. Although it is not fatal, its three forms-viral, tuberculosis and bacterial meningitis-can result in headaches, fever, vomiting, stiff neck and light sensitivity.

Protecting officers does not have to be a difficult \ or expensive proposition. Yet when the FBI informally surveyed 70 agencies, it found that 43 (61 %) did not have a policy regarding bloodborne diseases, 42 (60%) did not provide training on bloodborne diseases and 50 (71 %) did not know that OSHA requires agencies to provide protective equipment and free HBV vaccines. (Employees are not required to take the vaccine, but must sign a declination form if they refuse.)

OSHA's "universal precautions" are based on the premise that all human blood and bodily fluids are potentially infectious for HIV, HBV and other bloodborne pathogens. Implemented in 1992, they also require interactive training, which calls for something more than a video during roll call. A trained officer must be present to answer questions. Other OSHA requirements include the following:

• Employers are required to identify, in writing, the people who could reasonably be exposed to infectious substances. They must also have a written exposure-control program that details how the OSHA requirements will be implemented, as well as the procedures that will be used to evaluate the circumstances surrounding exposure incidents.

• For those who have been exposed, OSHA requires testing to show whether there has been any transmission of infection, follow-up treatment to prevent illness and counseling to modify the officer's behavior to prevent infecting others. All diagnoses must remain confidential.

• Medical records for employees with occupational exposure must be kept in confidential status for the duration of employment plus 30 years.

• The department must also maintain training records for three years, including dates, contents of the program, the trainer's name and qualification, and the names and job titles of everyone attending the sessions.

Of special concern are the forensic scientists who routinely handle crime scene evidence. They work in the crime labs that are typically tacked onto the building as an afterthought, or are located in a dark, dank comer of the basement. In a survey of some of the largest labs in the country, done by the architectural firm of McClaren & Wilson, Inc., mechanical systems did not work, safety functions were substandard, space was severely limited and air handling units and fume hoods did not test properly. Jim McClaren, principal architect at McClaren Wilson, Inc., notes that although "the New York state lab only had one fume hood, and they had to make do for years and years, [t]hey still did incredible work and maintained the respect of the judiciary."

McClaren's firm has designed crime labs throughout the United States and Canada, which is a difficult and exacting process. "There are a lot of lab planners who do pharmaceutical labs, animal testing labs, labs for research at universities. But none of those take[s] firearms apart or do[es] an acid wash looking for serial numbers. None has the chain of evidence requirement imposed on them, or the necessary level of security because of the drugs and valuables in the lab. They had the lab experience, but none of them had the experience to deal with this kind of specialty. So we took on an area that nobody else seems to want," McClaren explains.

The need for universal precautions is vital in the lab, where most of the items come from drug users and other high-risk groups. Although the AIDS virus cannot survive long outside the body, HBV can live at east a week on surfaces where it has dried at room temperature. In addition, particles of dried blood can become airborne and be inhaled by workers, or recirculated throughout the rest of the building via the HVAC system.

McClaren recommends that departments building a new lab or remodeling an existing facility give careful consideration to incorporating infectious disease controls. Officers should have a place to dry and package wet evidence, without first dragging it through the rest of the building. He suggests a single-pass air conditioning and heating system that is entirely separate from the rest of the building, with air exhausted above the roof and away from the building's other air intakes or filtered through HEPA filters. A negative-air, or biohazard, vestibule will allow workers to don gloves, gowns, eye protection and face shields prior to entering the lab, and to clean up at a "clean sink" as they leave. Because the air in the vestibule is under negative pressure, none of it can escape into the hallway to contaminate the rest of the building.

Criminalist report workstations should be located outside the lab itself. Sinks should have paddle arms, like those in a hospital, or an infrared beam to turn them on and off. Installation of "talkback" telephones will prevent contaminated hands from picking up the receiver.

Facilities vary throughout the United States, as do the attitudes about safety precautions, McClaren says. "In Maryland's state lab, the safety officer had a huge binder of safety precautions. But some of these agencies I go into, I just shudder. In the visitors' vestibule of one, the smell of rotting marijuana almost took the top of my head off.

"The decision to build a new lab is almost always crisis-driven. Most administrators know the conditions are bad, but they get along for years without addressing [them]. The smaller labs seem to be better about taking a proactive role, as are the midsize agencies. But with the big ones, it's like kicking the rudder on a supertanker." McClaren says. "What typically happens is they wait for the crisis and then blame everyone who has been responsible for perpetuating the problem.

"A lot of police departments are bad about not wanting the public to know how bad things are.
They keep their boots shined and their cars cleaned, but they won't tell the public that the environment they work in is unhealthy or unsafe."

Barry Fisher, director of the Los Angeles County, California, Crime Lab, literally wrote the book on crime scene investigation. As author of Techniques of Crime Scene Investigation, Fisher has closely studied the problems in handling biological evidence. Workers under his direction wear gloves, safety glasses, lab coats and sleeve protectors and safety shields, as required.

"We need to be concerned, and we need to be educated," Fisher says. "The department has an obligation to follow the OSHA regulations and the state rules and regulations, but beyond that there are liability issues. This is basically risk management to safeguard your employees. You're not going to send a police officer out on patrol without a vest, for example. By the same token, there are things that are just required of modem-day policing. My belief is that if people are properly trained and knowledgeable about what the potential risks are, then the fear factor is not a real issue.

Neither Fisher nor Warren could cite a single case of a lab worker contracting an infectious disease on the job. And while they agree that the risks are probably lower than people believe, they also urge workers to use caution and good judgment, and to avoid becoming complacent. "It's a question of familiarity breeding contempt. You're not on your guard," Fisher says.

In the Los Angeles lab, all workers are supplied with the required personal protective equipment, as well as gennicidal soap with which to clean up. They are not allowed to wear their lab coats in the lunch room.

Workers in the Tarrant County lab wear lab coats and two pairs of gloves, as well as eye covering, face shields or a safety hood that has a negative air flow to prevent contamination from dried blood dust. Next to every worker are alcohol swabs and a 10 percent bleach solution to clean surfaces.

To make sure all bases are covered, the following precautions should be taken:

• Employees should wash with soap and water immediately after removing gloves or other protective equipment, and flush mucous membranes following contact with any potentially infectious materials.

• Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses should be prohibited in work areas.

• Food and drinks should not be kept in refrigerators, freezers, shelves, cabinets or on countertops or work benches where potentially infectious materials are present.

• Mouth pipetting/suctioning of blood or other potentially infectious materials should be prohibited.

• Broken and contaminated glassware should not be retrieved by hand but by other mechanical means. Likewise, contaminated reusable sharp instruments should not be stored or processed in a manner that requires employees to retrieve them manually.

• Contaminated laundry should be handled as little as possible, and bagged or "containerized" at the location where it is used, but not sorted or rinsed there. Containers should be properly labeled or color coded, and contained to prevent leaking. Employees handling laundry should wear gloves and other appropriate protective equipment.

• Training should be ongoing and documented. To prevent prejudicial treatment, officers should be taught to look at the disease and how it is transmitted, not who has it. Instead of focusing on high risk groups, one expert emphasizes, focus on high-risk behavior.