I • I • r 
DATE: TO: PUBLIC WORKS PERSONNEL FROM: JIM PIERCE SUBJECT: HEPATITIS VACCINE Please read the attached literature concerning hepatitis. The Public Works Department is offering to all
Department employees the opportunity to receive Hepatitis vaccine shots at no cost to the employee. There is no requirement that you take the shots. It is completely voluntary on your
part. Please complete the information below and return it to your supervisor. NAME D I choose to receive the vaccine for Hepatitis A. D I choose to receive the vaccine for Hepatitis
A and Hepatitis B(combined vaccine) D I will be responsible for scheduling any second doses required. D I choose NOT to receive Hepatitis vaccine. SIGNATURE 
Hepatitis A, B, Cs Hepatitis C has been much in the news. Naomi Judd, Pamela Anderson, and Larry Hagman have announced that they are infected with it; Mickey MantIe died of complications
from it. About 4 million Americans are infected, and the number of deaths, mostly among those infected more than a decade ago, is rising dramatieally every year. The good news is that
the number of new infections has dropped just as dramatically. It's easy to be confused about the various forms of viral hepatitis-A, B, and C (not to mention D and E)-which differ in
important ways. Hepatitis A spreads by different means than B or C. The symptoms are often similar, but they can vary greatly in severity and in when they appear. There are more acute
cases (short-term disease following the initial infection) of hepatitis A and B in this country, bur hepatitis C is the biggest problem because more of those infected remain infected
for life. And while there are vaccines for hepatitis A and B, there is none for C. What is it? Hepatitis means inflammation of the liver. The infectious form is usually caused by one
of five viruses (called A, B, C, D, and E). It impairs the ability of the liver to carry out its normal functions, and may cause mild to severe flu like symptoms as well as jaundice
(yellowish skin and eyes) and, many years later, serious lifethreatening ailments such as cirrhosis and liver cancer. But often there are no symptoms. There are also noninfectious forms
of hepatitis caused by toxic substances-notably alcohol-and by the excessive use of certain medications. These include acetaminophen (brand name Tylenol), especially when taken with
alcohol. Since the hepatitis vIruses spread in different ways, certain groups are at greater risk for each infection. Hepatitis A spreads via contaminated food and water, while B is
now primarily a sexually transmitted infection. Hepatitis C is mostly a worry for those who received transfusions before] 992. There are drugs to treat hepatitis Band C (but notA). These
are not always effective and are expensive; some have bad side effects. Protecting yourself and others ,/Wash your hands_ Always wash with soap and water after using the toilet, after
changing diapers, before handling food, and before eating. This helps stop the spread of many diseases, including hepatitis A. ,/Cook your foods adequately. Hepatitis A can spread via
raw or undercooked food, especially shellfish. ./' Practice safer sex. Condoms significantly reduce your risk of getting hepatitis Band C. This is especially important if you know that
your partner is infected or ifyou have multiple partners. ,/Hepatitis A vaccine. People who travel to Mexico Or Latin America, Africa, Eastern Europe, the countries of the former Soviet
Union, or other areas where hepatitis A is common should be vaccinated. So should those with chronic liver disease (including hepatitis B orC), as well as children living in states Or
communities with a high rate ofhepatitis A. Thevaccine provides protection for at least 10 years if you get a second shot shot after 6 to 12 months. ./' Hepatitis B vaccine. Newborns
are now routinely vaccinated. Children and adolescents (not previously vaccinated) should also get the vaccine_ Other groups include sexually active gay men, heterosexuals with multiple
partners, health-care workers, drug users who share needles, and people who travel frequently to high-risk areas. Ifyour partner is infected, you should be vaccinated. The three-dose
vaccine provides immunity for at least seven years. ./' Consider the new combined vaccine for hepatitis A and B if you are Lraveling 10 countries where these diseases are common, or
if you are a health-care worker Or have chronic liver disease. ,/Talk to your doctor about getting tested for hepatitis C if you had a blood transfusion before July 1992. Methods used
to Screen donated blood were less accurate before then, so the risk of acquiring the virus from a transfusion was greater. Also consider testing if you have ever shared a needle or have
had unsafe sex with multiple partners. There is an FDA-approved home test for hepatitis C, sold in drugstores for about $70 and also available by mail (call 888-888-HEPC). ,/Ifyou are
pregnant, have a hepatitis B test. Ifi!,s positive, a physician can help protect the newborn with a special injection at birth. ./' Unsterilized needles can transmit blood infected with
hepatitis B or C (as well as HIV). Ifyou are getting your body pierced Or tattooed, or are receiving acupuncture, make sure the needles are brand new or have been properly sterilized
in an autoclave. ./' Don't share razors, toothbrushes, manicure tools, or anything else that might transmit blood. What you need to know TYPE CHRONIC HOW TRANSMIITED VACCINE COMMENT
A No Primarily food or water contaminated by feces of an infected person. B About 5% of adult infections C About 85% of cases Blood and other body fluids, usually via unprotected sex
or shared needles (same as HIV). Also mother to fems. Blood, usually via transfusions before 1992 or shared needles. Sexual transmission rare, but risk rises with multiple partners.
D Yes Same as B. Yes, alone Usually causes no symptoms or mild flulike symptoms, nausea, diarrhea, or with B. and jaundice. Most people recover completely. Can cause serious illness
and, in rare cases, death. Confers lifelong immunity. High risk when traveling in developing countries. --------------.------Yes. alone or with A. No. No. Symptoms general1y mild; half
get jaundice. About 1 million Americans have chronic infections, are carriers, and are at risk for cirrhosis and/or liver cancer. Health-care workers are at increased risk. Fewer new
infections in recent years. thanks to vaccine and screening of donated blood. Called non-A, non-B hepatitis until 1988. About 4 million chronic carriers in U.S. Usually no (or mild)
initial symptoms. Symptoms may not appear for 10-20 years; about 20% develop cirrhosis or liver cancer. Risk from transfusions now minuscule. Leading cause for liver transplants in U.S.
Health-care workers a,e at increased risk. .._--_._-------------_.._Rare in U.S. Occun; only in people with hepatitis B. E No Same as A. No. Rare in U.S. Almost exclusively i n developing
countries, especially south Asia. UC Bcrt.-elc!J /f/clhzess Letter, December .2002 5 
􀁈􀁅􀁐􀁾􀁔􀁉􀁔􀁉􀁓􀀠A············ CAN .................. ,. BE ........... PREVENTED! Hepatitis A ... is a disease of the liver ... is spread by feces (stool)-to-mouth contact from:
• unwashed hands • uncooked food (including shellfish) • anal-oral sex ... is commonly spread in: • families .• child-care centers with diapered children • jails • shelters . • other
institutions with diapered persons ... is common in places lacking safe systems for sanitation of water and food ... is no! spread by coughing, 0 sneezing, or other casual 0 . contact
""'"""" '"' d0 􀁯􀁾o Signs and Symptoms • fatigue • mild fever • flu-like illness • nausea and vomiting • stomach ache • loss ofappetite ... Some people have: • no symptoms at all •
yellow eyes and skin fjaundice) • dark urine • light-colored stool treatment • doctor visit • rest • low-fat foods • plenty of liquids • no beerl wine, or liquor • no tlpotf! or other
drugs ... Antibiotics and other medications do not help because hepatitis A is caused by a virus. Prevention ... Wash your hands well after using the bathroom, before touchirig food
or drink, and after changing a baby's diaper. (.. Do not let anyone who has hepatitis A make or serve food for you or your family . ... Ifyou live or have dose contact with someone who
has hepatitis A, ask your local health department or physician ifyou need an immune globulin (IG) shot. ... There is a vaccine (2 doses six months apart) for persons 2years old or older.
Get the vaccine ifyou: • live in or travel often to a country where hepatitis A is common • are a child living in an area where hepatitis A is commOn • use street drugs • are a man who
has sex with other men • have chronic liver disease ora blood-dotting disorder m Texas: Depal'ltnaltofHmUh . TDH 6·11A 8/97 
Jim Pierce From: Bonnie Battersby [bbattersby@waxahachie.com] Sent: WedneSday. October 20. 2004 11 :30 AM To: Jim Pierce Subject: CONSENT FORM ELLIS COUNTY DIAGNOSTIC CLINIC 505 N. HWY,
77, SUITE 200 WAXAHACHIE, TX 75165 HEPATITIS B VACCINE CONSENT/REFUSAL FORM Indicate below by your signature that you WiSH 􀁾􀀹􀀠RECEIVE the Vaccine. By this signature you are confirming
that you received an explanation of the immunization program, that you have granted permission to Ellis County Diagnostic to administer these injections and that you agree to release
Ellis County Diagnostic, its employees and agents from responsibility with regard to adverse reaction from these injections. Date Signature City of Waxahachie : Dates : Vaccinated Vaccine
Type Lot Number Expiration Signature I I Indicate below by your signature that you received an explanation of the vaccine and DO 􀁾􀁏􀁔􀀠􀁾􀁉􀁓􀁈􀀠TO RECEIVE the vaccine at this time.
--""--Date Signature 10/2112004 
817551:>88a31e/18/2ae4 91:4e i I OalQ h" OlPost-It' Fax Nole 7671 pag.... fro", 􀁾􀀺􀁜􀀬􀀠(-1..",.....1 \ Ta 􀁾􀁜􀁾\(ie. f" <--e..J CO,IO&pL Co, c,.\ ..\a ........... i -I Phone It Phone_
􀁾􀀨􀀿-I a. Vs-0"1("" Fa:r'F... 97Z-yS'"O '7-"lS'S 71 I I 1 I I i BEPATITIS VACCINATION CONS,ll;NTID,ll;CLINATION FORM I I understlUld that due to my occupational exposure to potentially
infectious materials, I may be at:1 risk of acquiri1l,!l the Hepatitis A and B vinls, I have been given the opportunity to be vaccinated 1 with the Hepatitis A and .B vaccines at no
charge to myself. I :1I Please check one; o Yes, I would like to receive the Hepatitis A Vaccination 2.!l!J1,;,1; -• :1 o Yes, I would like to receive Ihe Hepatitis B Vaccination only.
i :1 o Yeli, I would like to receive both Hepatitis A and Hepatitis B vaccines, I o INo, I decline both the Hepatitis A and Hepatitis B vaccines at this time. 'understand, by declining
both vaccines that I continue to be at risk: of acquiring1 Hepatitis A andlor Hepatitis B, which aie both serious diseases. I understand that 1 in the future, ifI desire to be vaccinated
with either Or both vaccines, I can receive j the vaccines at no charge to me. I,I Employee Signature Date Employee Printed Name lob TideiDepartment ,\ ,1,I 'I;' 1 
HEPATITIS 8 I""UNIZATION AUTHORIZATION/REFUSAL EMPLOVEE NAME: MTE: ________________ PROJECT: OEPT: ________ AUTHORIZATION: 1, • do hereby authoriZe tbe admi ni strati on of l{ecoRibivax/RecOIIIblVax
booster. ( understand tbe occupatlonal risks of contracting Hepatitis B, the i_unity provided by Recombivilx, the contrainditations and the effectiveness of tbe vaccine. Although the
duration for protection is unknown at present, available data suggests immunity will last about five Years. I also understand the Recombivax will not prevent other typesof Hepatltis
(for example, Hepatitis A and Hepatitis C). Because of the longinCUbation period for Hepatitis B, it is possible for unrecognized infection to b" present at the time RecOI1Ibfvax is
given. The vatelne may not preventHepatitis in such persons. I understand I should NOT take this injection if I am allergic to yeast or yeast products. If I have a history of some type
of liver disease I will consult 􀁾􀀠physician before I take the injection. Signature: ______________ Witness: REFUSAL: I understand that due to 􀁾􀀠occupational exposure to blood or
other potentially infectious materials I lIlY be at risk of acquiring hepatitis B virus (HeV)infection. I have been given the opportunity to be vaccinated wlth hepatitis B vaccine, at
no charge to 􀁾􀁳􀁥􀁬􀁦􀀮􀀠However, I decline hepatitis Bvaccination at this time. I understand that by declining this vaccine, I continue to be at riSK of acqUiring bepatitis 8, a serious
disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive
the vaccination series at no charge to me. Signature: ____________ Witness: ____:....-_______ IMMUNIZATION RECORD; PrevlOIlS imunization _______ NO _____ YES OATES: H8SAB __􀁾NO ___
YES RESULTS ___--'-_____-'--___ VACCINATION RECORD; DATE SITE ADMINISTERED BV LOT # I/l9 39I1d 
HEPATITIS A SHOTS OFFERSHEPA ENTITY BUT NOT REOUIRED Ft. Worth x Waxahachie x (Cleburne X (A&B) REQUIRED Azle X (Offers A&B, Tetanus, Chicken Pox, TB, MMR) Trinity River Authority x
" Flower Mound x Garland x **Denton * Flower Mound only recently decided to provide the vaccinations. Our Human Resources (HR) group is administrating the program and has been researching
the issue as well. My understanding from HR is that the CDC doesn't recommend the A, since they haven't seen a "significant" occurrence of Hep A in workers coming in eontact with sewage.
HR still plans to offer the Hep A vaccine because the "significant occurrence" langnage suggests that it's still a possibility. ** Denton does not vaccinate for Hepatitis A. They do
vaccinate for Hep B for those workers with potential exposure. According to CDC, "Sewerage workers" do not typicaDy receive Hep A bccause there are no widespread, work related outbreaks.
CDC recommends simply appropriate and thorough hand washing and otherwise good hygiene. 
Central Regional Wastewater System 6500 W. Singleton elvd. Dallas. Texas 7521Z Phone; 972.263.2251, ext. 308 Fa>: 97Z.331,4412 To: Jim Pierce Compatly City of Addison Fax: 972-450-2837
Date; October 20. 2004 Fn>m: Shelley Fialho Title: Manager, Administrative Services Re; Hepatitis B FOrm Pages: 2 (including cover page) Jim. As yOll requested, I am folWarding !he Hepatitis
B ImmuniZation AuthoriZation/Refusal fonn used by us. 􀁚􀁬􀁾􀁾􀀭􀀱􀀺􀁅􀁅􀀭􀁚􀁌􀀶􀁓􀁾􀀺􀀺􀁊􀀠11111zene 39\1d 
HEPATITIS B IMMUNIZATION AUTHORIZATION/REFUSAL EMPLOYEE NAME: DATE: _____􀁾__ PROJECT: OEPT: ________ AUTHORIZATION: I, • do hereby authori ze the admi oi stnti 011 of t!ecambivax/Rec.ombiva)(
booster. I understand the occupational risks. of contracting Hepatitis e, the immunity provided by Recombivax, the contraindications and the effectiveness of the vaccine. Although the
duration for protection is unknown at present, available data suggests immunity will last about five years. I also understand the Recombivax will not prevent other types of 􀁾􀁥􀁰􀁡􀁴􀁩􀁴􀁩􀁳􀀠(for
example, Hepatitis A and Hepatitis C). Because of the longincubation period for Hepatitis B. it is possible for unrecognized infection to be present at the time Recombivilx is given.
The vacc1ne may not preventHepatitis in such persons. I understand I should NOT take this injection if I am aller9ic to yeast or yeast products. If I have a history of some type of liver
disease I will consult my physician before I take the injection. Signature: ___________ Witness: ___________ REFUSAL; I understand that due to my 􀁯􀁣􀁣􀁵􀁰􀁡􀁴􀁩􀁯􀁮􀁾􀁬􀀠exposure to
blood or other potentially infectious 􀁬􀁮􀁾􀁴􀁥􀁲􀁩􀁡􀁨􀀠I may be at risk of acquiring hepatith 8 Virus (HBV)infection. I have been given the opportunity to be vaccinated with hepatitis
B vaccine, at no charge to myself. However. I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis
8. a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and r want to be vaccinated with hepatitis B vaccine,
I can receive the vac.cination series at no charge to me. Signature: ___________ Wi tness: ___.--;_______ IMNUNIZATION RECORD: Previous immunization _____ NO _____ YES OATES: HBSA8 ___
NO ___ YES RESULTS ___--'"_ VACCINATION RECORD: DATE sITE ADMINISTERED BV LOT fI ltl>l1-tE:e-LL6SMClO 11,,1􀀻􀀺􀀻􀀱􀁩􀁬􀀯􀁾􀀰􀀠3911d 
SAFETY REVIEW BOARD AGENDA Date: November 16,2004 To: Safety Board Members From: Val Benavides, Safety Review Board Secretary Subject: Agenda for Meeting Wednesday, December 1,2004 Finance
Conference Room, 8:30 a.m. 1. Approval ofminutes -October 13 meeting 2. Property Damage a. Damacio Rodriguez (PD) -9/24/04 -Officer was backing out ofPD parking lot when the bumper ofhis
vehicle came in contact with the bumper ofanother police vehicle. One prior accident, preventable & chargeable with verbal counseling (12102). b. B. D. Tilton (PD) -10/12104 -While backing
his squad car, trailer hitch struck brick mailbox. No prior accidents. c. Troy Patterson (Fire) 9/12104 -At Station One, fire vehicle was being backed into bay & accidentally damaged
driver's side mirror. No prior accidents. d. Mark Metdker (Fire) 10112104 -Town vehicle was parked in the service vehicle parking space ofthe Colonnade when another vehicle struck it
while pulling into a space next to it One prior accident, preventable & chargeable (1985) . . . 3. Personal Injuries a. Ryan Haley (Fire) 9118/04 -During a training exercise, employee
was crawling on some sheetrock that broke & his knee hit a piece ofaluminum wall stud causing trauma to his knee. No lost time. b. Bill Bonny (Fire) 10/22104 -Shoulder strain while pulling
hose from engine. No lost time. c. Monica Hemandez (Fire) 10129/04 -Insect bite on arm while pruning office plants. No lost time. d. Darin Jones (Fire) 10/13/04 -Insect bites to forearm
while loading fire hose.at training facility. No lost time. e. Charlie Foster (PD) 9/23/04 -Officer strsined his right shoulder/elbow when reaching for a briefcase in his vehicle. 3.5
hours lost time. 
SAFETY REVIEW BOARD AGENDA (contd.) Page 2 f. Michael Gillen (PD) 9129/04 Officer experienced a sore knee after jumping over a chain to assist in an arrest. No lost time. g. Billy Clay
(PD) 10115/04 Officer was struggling to make an arrest ofa resisting subject & fell to the ground spraining his knee. No lost time. h. David Bennett (PD) 10116/04 -Dog bite to both hands
from police K-9 while dog was in a dog fight. No lost time. 1. Jeremy Hotchkiss (PD) 10121104 While handcuffmg a burglary suspect, officer came in contact with suspect's blood. No lost
time. j. Toni Brown (PD) 10/21104 -Employee fell outside ofpolice building on concrete sidewalk. k. Joel Cruz (Utilities) 9/29/04 -While cleaning a meter vault, employee received a puncture
wound when a piece ofwood slipped from his hands. 23.25 hours lost time. 
AMENDED SAFETY REVIEW BOARD MINUTES Date: August 25, 2004 To: Safety Board Members From: Val Benavides, Safety Review Board Secretary Subject: Minutes ofMeeting -Wednesday, August 25,
2004 Finance Building, 8:30 a.m. Members in attendance: Randy Moravec, Judy Stafford, Asst. Fire Chief Chris Kellen, Capt. Greg Layman, Ricky Smith, Jim Pierce, Tom Hess, Tim Hastings,
& Mario Canizares. Staff present: Val Benavides 1. Judymade a motion to approve the minutes ofJuly 21 & Capt. Layman seconded. Motion carried unanimously. 2. Property Damage a. Carolyn
Burgett (Finance) 6114/04 -Carolyn appeared before the Board to explain that while out oftowo on Town business, she was pulling into a parking space with a rental car & misjudged the
distance to the car in the next space. Her right front bnmper carne in contact with a parked van. Jim made a motion to accept the department's recommendation of preventable, chargeable,
with an oral reprimand. Chief Kellen seconded & the motion passed unanimously. b. Shawn Ainsworth (Fire) 6127/04 -Shawn appeared to explain that he had been assigued to Station 1 for
about a month & was not that familiar with the fire apparatus. He was trying to move Engine 101 to clean up some foam which had spilled underneath. When he moved forward he heard a loud
noise & stopped. It was then he noticed the hydraulic ladder bracket was half-way down & it had come in contact with the bay door. Mario made a motion to accept the department's recommendation
ofpreventable, chargeable with a verbal reprimand. Chief Kellen seconded & the vote was unanimous. c. Charlie Foster (police) 7/22104 -Officer Foster appeared to explain how he was stopped
at the intersection ofInwoodlAddison Rd. behind another vehicle. As the car in front ofhim started to move forward, Foster diverted his attention to a different vehicle & his front push
bar carne in contact with the car in front ofhim. Ricky made a motion to accept the department's recommendation ofpreventable, chargeable with a vemal reprimand. Chief Kellen seconded
& & the vote was unanimous. 3. Personal Injuries a. Daony Saenz (Fire) 7/10/04 -Blood may have entered eye while intubating a CPR patient. Chief Kellen explained that the officer violated
department policy by not wearing protective eyewear. Jim made a motion to accept the department's recommendation ofavoidable. Judy seconded & the vote was unanimous. Capt. Layman made
a motion of chargeable with verbal reprimand. Jim seconded & the vote was unanimous. 
SAFETY REVIEW BOARD MINUTES Page 2 b. Jared Scbreher (Fire) 7/25/04 Pulled muscle in back when fighting a car fire. Chief Kellen stated the officer did not perform any unsafe acts &
is in top physical condition. Tim made a motion that the injury was unavoidable, Judy seconded & the vote was unanimous. c. Carolyn Flanagan (police) 6126/04 Bruise to shin & forearm
when moving a jail inmate from one cell to another. Capt. Layman explained that the prisoner was not combative until the employee tried to move Irim. The Police Department has instituted
a new policy stating a second employee should be present when moving a disruptive prisoner. Tom made a motion that the injury was unavoidable. Chief Kellen seconded & the vote was unanimous.
d Charlie Foster (police) 7/13/04 Bruise to left shoulder when resisting prisoner kicked police officer. Capt. Layman explained that the officer was removing an intoxicated prisoner
from the squad car when he became violent & started kicking. Judy made a motion ofunavoidable, Chief Kellen seconded & the vote was unanimous. e. Raul Rivera (parks) 7/21104 -Pulled
muscle in back when throwing limbslbrush on bed of truck. Ricky explained that a parks crew was trimming trees in the Les Lacs area & employee was using all safety precautions. The next
day employee complained ofback hurting. He saw a doctor who said he had a pulled muscle. He was placed on light duty at the recreation center for several days & returned to full duty.
Ricky made a motion ofunavoidable, Capt. Layman seconded & the vote was unanimous. 4. Other Business The Board continued its discussion of a Town inununization policy regarding Hepatitis.
Jim feels it is important for Public Works employees, who are exposed to waste water, be immunized against Hepatitis A. This would apply to about eight employees. He would like to see
us offer the shot to the employees & ifthey decline it to sign a waiver. Judy was of the opinion that their exposure is low according to Texas Health Department guidelines. Randy asked
that we find out what the policy is at some other area cities & then further discuss at next month's meeting. The meeting adjourned at 9:40 a.m. 
SAFETY REVIEW BOARD MINUTES Date; Octeber 27, 2004 Te: Safety Beard Members From: Val Benavides, Safety Review Beard Secretary Subject: Minutes .ofMeeting -Wednesday, October 13, 2004
Finance Building, 8:30 a.m. Members in attendance: Randy Moravec, Judy Stafford, Capt. Greg Layman, Tom Hess, Mario Canizares, Neil Gayden (for Tim Hastings), Ron Lee (fer Ricky Smitb),
& Jim Pierce. Absent: Asst. Chief Chris Kellen, Tim Hastings & Ricky Smitb. Staff present: Val Benavides I. Judy made amotion to approve tbe minutes oftbe last meeting .of August 25.
Randy asked tbat tbe minutes be amended to include tbe Board's disciplinary action ofverbal reprimand for Danny Saenz. Mario seconded & the vote was unanimous. 2. Property Damage a.
Jeff Rose (PO) 8120/04 -Officer's vehicle was struck as he was exiting a parking lot onto Spring Valley. Officer Rose appeared before tbe Board to explain how he was trying to exit tbe
parking lot & drive east on Spring Valley, cressing twe lanes of backed-up traffic headed west during rush heur. One lane oftraffic stepped to let him threugh & when he pulled inte tbe
next lane, a car he did not see coming strnck him. Judy made a motion to concur witb tbe department's recommendatien of preventable & chargeable with a written reprimand & defensive
driver's course. Tom seconded & tbe vote was uuanimous. Capt. Layman said tbe department recommends that Officer Rose attend a TML defensive driving course. b. Jack Burns (pelice) 8/21104
-Officer pulled out .ofdriveway onte Marsh Lane te pursue a speeder when his vehicle came in contact witb another. Officer Burns appeared before tbe Beard te explain how he was parked
in the driveway oftbe Waterford Townhemes clocking tbe speed of traffic. A speeding car drove past & as the Officer was pulling out te tbe right onto Marsh, anotber car was exiting tbe
driveway to go left & tbe twe cars cellided. Jim made a metion .of preventable, Ron seconded & tbe vote was unanimous. Mario made a motion to accept tbe department's recommendation of
chargeable witb a a verbal reprimand & defensive driving course. Jim seconded & the vete was unanimous. 3. Personal Injuries a. JeffRose (PO) 8120/04 -Officer sustained a stiff back
from vehicle accident described above. Judy made a motion ofavoidable, Tom seconded & tbe vote was unanimous. b. Julia Wheeler (PO) 9/3/04 -Julia is a police cadet who fell frem a 6
foot .obstacle Gourse & sprained her wrist. Tom made a motion ofunavoidable. Ron seconded & tbe vote was unanimous. c. Troman Akins (PO) 917104 -While investigating a residential burglary,
Officer Akins chased a fleeing suspect, jumped over a fence & strained tbe muscles behind his right knee. Judy made a metien .of unaveidable. Ron seconded & tbe vete was unanimous. 
SAFETY REVIEW BOARD MINUTES (continued) Page 2 d. Tony Bagley (PD) 9/9/04 -An identity theft suspect was found at the Addison Athletic Club. Officer Bagley was one of three officers
who tried to apprehend him & chased him through the neighborhood. Officer Bagley fell from a wall during the chase & sprained his left shoulder. He lost 18 hours ofwork & is in rehab
now. Mario made a motion pfunavoidable. Jim seconded & the vote was unanimous. e. Jeff Rose (PD) 9/9/04 -Officer Rose sustained a broken bone in his right middle finger while attempting
arrest of the suspect described in above altercation. He lost 21 hours of work. Mario made a motion ofunavoidable. Jim seconded & the vote was unanimous. f. Bryan Ball (PD) 9/904 -Officer
Ball sustained a sprain to the left knee when he fell twice to the ground "as he was assisting in the arrest described above. He lost 12 hours ofwork. Mario made a motion of unavoidable.
Jim seconded & the vote was unanimous. g. Andrew Cerminara (PD) 911 4/04 -Officer & arrested person fell to the ground during a struggle to place handcuffs on him. They both landed on
the Officer's elbow & caused a sprain. Jim made a motion ofunavoidable, Ron seconded & the vote was unanimous. 4. Health Immunization Policy Jim shared information with the Board regarding
a poll ofarea cities concerning Hepatitis A immunization of municipal employees. Results ofthe poll were distributed to Board members. He cited the highest rate of workers comp injuries
to be from streets, motorcYcle & utilities accidents. Jim made a motion that Addison adopt a health policy in Utilities to offer the Hepatitis A immunization on a volunteer basis, the
cost of which the Town would pay. Ifan employee declines, they would need to sign a waiver. Tom "seconded & the motion passed unanimously. Randy also recommended training to educate
employees on the availability ofthe immunization. The meeting adjourned at 9:35 a.m. 
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HEPATITIS A SHOTS OFFERSHEPA ENTITY BUT NOT REQUIRED REQIDRED Ft. Worth x Waxahachiex ; Cleburne x (A&B) Azle· X (Offers A&B, Tetanus, Chicken Pox, TB, MMR) Trinity River Authority x .. Flower Mound x Garland x "*Denton .. Flower Mound only recently decided to provide
the vaccinations. Our Human Resources (DR) group is administrating the program and has been researching the issue as welL My understanding from HR is that the CDC doesn't recommend the
A, since they haven't seen a "significant" occurrence ofHep A in workers coming in contact with sewage. HR stiU plans to offer the Hep A vaccine beeause the "significant occurrence"
language suggests that it's still a possibility. "* Denton does not vaccinate for Hepatitis A. They do vaccinate for Rep B for those workers with potential exposure. According to CDC,
"Sewerage workers" do not typicaUy receive Hep A because there are no widespread, work related outbreaks. CDC recommends simply appropriate and thorough hand washing and otherwise good
hygiene. 
HEPATITIS A SHOTS OFFERSHEPA ENTITY BUT NOT REOUIRED REOUIRED Ft. Worth x Waxahachie x , Cleburne X (A&B) Azle X (Offers A&B, Tetanus, Chicken Pox, TB, MMR) Trinity River Authority x
* Flower Mound x Garland x "*Denton * Flower Mound only recently decided to provide the vaccinations. Our Human Resources (HR) group is administrating the program and has been researching
the issue as well. My understanding from HR is that the CDC doesn't recommend the A, since they haven't seen a "significant" occurrence of Hep A in workers coming in contact with sewage.
HR still plans to offer the Hep A vaccine becanse the "significant occurrence" language suggests that it's still a possibility. ** Denton does not vaccinate for Hepatitis A. They do
vaccinate for Hep B for those workers with potential exposure. According to CDC, "Sewerage workers" do not typically receive Rep A because there are no widespread, work related outbreaks.
CDC recommends simply appropriate and thorough hand washing and otherwise good hygiene. 
HEPATITIS A SHOTS OFFERSHEPA ENTITY BUT NOT REOUIRED REOUIRED Ft. Worth x Waxahachie X ! Cleburne X (A&B) AzIe X (Offers A&B, Tetanus, Chicken Pox, TB, MMR) Trinity River Authority x
* Flower Mound x Garland x *"Denton * Flower Mound only recently decided to provide the vaccinations. Our Human Resources (HR) group is administrating the program and has been researching
the issue as well My understanding from BR is that the CDC doesn't recommend the A, since they haven't seen a "significant" occurrence of Hep A in workers coming in contact with sewage.
BR still plans to offer the Hep A vaccine because the "significant occurrence" language suggests that it's still a possibility. ** Denton does not vaccinate for Hepatitis A. They do
vaccinate for Hep B for those workers with potential exposure. According to CDC, "Sewerage workers" do not typically receive Hep A because there are no widespread, work related outbreaks.
CDC recommends simply appropriate and thorough hand washing and otherwise good hygiene. 
BEPATmS A SHOTS OFFERSBEPA ENTITY BUT NOT REOUIRED REOUIRED Ft. Worth x Waxahachie X ! Cleburne X (A&B) Azle X (Offers A&B, Tetanus, Chicken Pox, TB, MMR) Trinity River Authority x *
Flower Mound x Garland x **Denton * Flower Mound only recently decided to provide the vaccinations. Our Human Resources (HR) group is administrating the program and has been researehing
the issue as well. My understanding from HR is that the CDC doesn't reeommend the A, since they haven't seen a "significant" occurrence ofHep A in workers coming in contact with sewage.
HR still plans to offer the Hep A vaccine because the "significant occurrence" langnage suggests that it's still a possibility. ** Denton does not vaccinate for Hepatitis A. They do
vaccinate for Hep B for those workers with potential exposure. According to CDC, "Sewerage workers" do not typically reeeive Hep A because there are no widespread, work related outbreaks.
CDC recommends simply appropriate and thorough hand washing and otherwise good hygiene. 
Jim Pierce From: Todd Holtz [Todd.Holtz@Cityofdenton.com] Sent: Friday, September 24, 2004 3:38 PM To: bjordan@apaienv.com; Jim Pierce Cc: John Hudson; Scott Payne Subject: Re: Hepatitis
Shots I was asked by John Hudson to respond to your e-mail if I could add anything...The City of Denton does not vaccinate any employees, including "sewer workers", for Hep. A. We do
vaccinate for Hep. B for those workers whom we have deemed as having potential exposure. According to the CDC, "sewerage workers" do not typically receive the Hep. A vaccination because
there are no reports of wide-spread, work-related outbreaks. The CDC recommends simply, appropriate and thorough hand-washing and otherwise good hygiene. Todd Holtz City of Denton Risk
Management Dept. Safety & Wellness Administrator (940) 349-7891 Have a Safe Day! »> "Jim Pierce" <jpierce@ci.addison.tx.us> 9/23/2004 5:08:16 PM »> Betty: I am trying to build a case
to provide Hepatitis A shots for our utility workers. Could you poll the membership and ask if any any cities or towns in the area are offering, or requiring, their utility (sewer) workers
to be vaccinated? If so I would like some details of their program. They can contact me as per below. Thanks, Jim Pierce, P.E. Assistant Public Works Director P.O. Box 9010 Addison,
TX 75001-9010 972-450-2879 jpierce@ci.addison.tx.us This e-mail and any files or attachments transmitted with it contains Information that is confidential and privileged. This document
may contain Protected Health Information (PHI) or other information that is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended
recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly
prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please delete it and notify Hamid Khaleghipour at 972-450-2868
immediately. Thank you. 1 
Jim Pierce From: Randy Williams [randy.williams@f1ower-mound.com] Sent: Friday, September 24,2004 9:47 AM To: Jim Pierce Cc: Betty Jordan (E-mail) Subject: RE: Hepalitis Shots Jim, Flower
Mound only recently decided to provide the vaccinations. Our Human Resources (HR) group is administrating the program and has been researching the issue as well. My understanding from
HR is that the CDC doesn't recommend the A, since they haven't seen a "significant" occurrence of Hep A in workers coming in contact with sewage. HR still plans to offer the Hep A vaccine
because the "significant occurrence" language suggests that itfs still a possibility. The Flower Mound program will be voluntary. There will be forms that the employee will sign indicating
that they understand the program is voluntary and that there are risks involved. Also, Flower Mound will pay for a completed series one time. If the employee misses one of the follow-up
vaccines, the Town will not pay for another series. Hope this helps. Randy -----Original Message----From: Jim Pierce [mailto:jpierce@ci.addison.tx.us] Sent: Thursday, September 23, 2004
5:08 PM To: Betty Jordan (E-mail) Subject: Hepatitis Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility workers. Could you poll the membership and
ask if any cities or towns in the area are offering, or requiring, their utility (sewer) workers to be vaccinated? If so I would like some details of their program. They can contact
me as per below. Thanks, Jim Pierce, 􀁐􀀮􀁅􀁾􀀠Assistant Public Works Director P.O. Box 9010 Addison, TX 75001-9010 972-450-2879 jpierce@ci.addison.tx.us This e-mail and any files or
attachments transmitted with it contains Information that is confidential and privileged. This document may contain Protected Health Information (PHI) or other information that is intended
only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If
you are not the intended recipientI any disclosure, copying, printingl or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations.
If you have received this information in error, please delete it and notify Hamid Khaleghipour at 972-450-2868 immediately. Thank you. 1 
Jim Pierce From: Todd Reck [TReck@cUrving.tx.us) Sent: Friday, September 24, 2004 4:55 PM To: Jim Pierce Subject: RE: Hepatitis Shots I don't remember the details and can't find the
old e-mails. I do remember that there was a city that used to pay for shots and quit the program. Some of the cities paid for Hepatitis C shots and some paid for Hepatitis A shots. We
couldn't find any consistency from the cities we called that we could use to build a case. Please let me know if you find anything differently. Todd -----Original Message----From: Jim
Pierce [mailto:jpierce@ci.addison.tx.us] Sent: Friday, September 24. 2004 1:33 PM To: Todd Reck Subject: RE: Hepatitis Shots Todd: Thanks for your reply. Can you elaborate on "the results
were inconsistent"? Jim Pierce, P.E. Assistant Public Works Director P.O. Box 9010 Addison. TX 75001-9010 972-450-2879 -----Original Message----From: Todd Reck (mailto:TReck@ci.irving.tx.us]
Sent: Friday. September 24, 2004 8:01 AM To: Jim Pierce Subject: RE: Hepatitis Shots Jim, We looked into this a year or so ago and decided we would not provide the shots for now. I think
we found a few who provided shots. but the results were inconsistent. Todd Reck City of Irving -----Original Message----From: Jim Pierce (mailto:jpierce@ci.addison.tx.us] Sent: Thursday.
September 23. 2004 5:08 PM To: Betty Jordan (E-mail) Subject: Hepatitis Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility workers. Could you poll
the membership and ask if any cities or towns in the area are offering, or requiring, their utility (sewer) workers to be vaccinated? If so I would like some details of their program.
They can contact me as per below. Thanks, Jim Pierce. P.E. Assistant Public Works Director P.O. Box 9010 1 
Addison. TX 75001-9010 972-450-2879 jpierce@ci.addison.tx.us This a-mail and any files or attachments transmitted with it contains Information that is confidential and privileged. This
document may contain Protected Health Information (PHI) or other information that is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are
the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information
is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please delete it and notify Hamid Khaleghipour
at 972-450-2868 immediately. Thank you. 2 
Jim Pierce From: ShialrChen lee [SClEE@Cpyi.comj sent: Friday, September 24, 2004 8:51 AM To: Jim Pierce Subject: FWd: Hepatitis Shots for Utility Workers Fwd: Hepatitis Shots for Utlli
... Jim, DCHHS does provide the vaccine shot for the citizens of Dallas County who has risk of Hepatitis, they might be able to do the same for your worker or offer more related information
for your need. Here is there website for your use, http://www.dallascounty.org/html/citizen-serv/hh-services/index.html Or you can contact the nurse who seems in charge of Hepatitis
shot, her direct number is 214-819-2011 and her name is Sally Coldwell Hope this can help and good luck to you! Shiao-Chen Lee Chiang, Patel & Yerby, Inc. 1820 Regal Row, Suite 200 Dallas,
Texas 75235 Tel: 214-589-6910 Fax: 214-638-3723 E-mail: sc1ee@cpyi.com 1 
Jim Pierce From: Bonnie Battersby (bbattersby@waxahachie.com] Sent: Monday, September 27,20041:49 PM To: Jim Pierce Subject: [Maybe SPAM] Hep B Shot The City of Waxahachie offers out
the Hep B shot to all Utility employees, except at the water Treatment Plant We give out a flyer during orientation and ask them if they want to participate. This is strictly voluntary
and they have to sign off to consent or to refuse participation. The City pays for the shot, and tracks the dates until the series is completed. If we have someone in the WTP who will
be putting time in at the WWTP, we would offer them the shot as well. Hope that helps a bil. 9/27/2004 
Jim Pierce From: Shelley Fialho [FialhoS@lrinilyra.orgJ Sent: Monday, September 27, 2004 1 :03 PM To: Jim Pierce Subject: RE: Hepatitis Shots Mr. Pierce, I am the Manager of Administrative
Services at the Central Regional Wastewater System ofthe Trinity River Authority, \I is not mandatory for our employees to have a Hepatitis B vaccination. However, it is strongly recommended,
We contract with a private RN who administers the vaccination. Our General Services department purchases the vaccine for however many employees throughout the Northern Region projects
and she schedules times and date with each project. I do not know what procedures our Southern Region has regarding Hepatitis B. Ifyou have forther questions, please feel free to contact
me. Shelley M. Piallio, PHR Manager, Administrative Services fialhos@trinityraorg direct: 972-331-4308 fax: 972-331-4412 ----Original Message---From: Jim Pierce 􀁛􀁭􀀱􀀡􀁩􀁉􀁜􀁑􀁊􀁰􀁬􀁾􀁾􀁩􀀮􀁡􀁤􀁤􀁩
􀁳􀀹􀁮􀀮􀁴􀁸􀀬􀁵􀁳􀁬􀀠Sent: Thursday, September 23,20045:08 PM fo: Belly Jordan (B-mail) Subject: Hepatitis Shots Belly: I am trying to build a case to provide Hepatitis A shots for
our utility workers. Could you poll the membership and ask ifany cities or :owns in the area are offering, or requiring, their utility (sewer) workers to be vaccinated? Ifse I would
like some details of their program. They can contact me as per below. Thanks, Jim Pierce, P.E. .. ssistant Public Works Director '.0. Box 9010 "ddison, TX 75001-9010 172-450-2879 pierce@ci.addison.tx
,us fbis e-mail and any files or attachments transmitted with it contains Information that is confidential and privileged. This document may :ontain Protected Health Information (PHI)
or other information that is intended onty for the use ofthe individual(s) and entity(ies) to whom it s addressed. tfyou are the intended recipient, further disclosures are prohibited
without proper authorization. Ifyou are not the intended ecipienl, any disclosure, copying, printing, or use ofthis information is strictly prohibited and possibly possibly a violation
offederal or state law and egulations. Ifyou have received this information in error, please delete it and notiJY Hamid Kba\egrupour at 972-450-2868 immediately. [bank you. 􀁾􀀯􀀲􀀷􀀱􀀲􀀰􀀰􀀴􀀠
Jim Pierce From: Lai, An [ALai@ci.garland.tx.us] Sent: Saturday, September 25, 20046:49 AM To: Jim Pierce Subject: RE: Hepatitis Shots City ofGarland requires Hepatitis A shots for WfWW
workers. ----Original Message---From: Jim Pierce 􀁛􀀱􀀩􀀱􀁾􀀮􀁩􀁬􀀡􀁯􀀺􀁪􀁰􀁩􀁥􀁲􀁣􀁥􀁀􀁣􀁩􀀮􀁡􀀼􀁬􀁊􀀡􀁩􀁳􀀹􀁮􀀮􀁴􀁸􀀬􀁵􀁾􀀠Sent: Thursday, September 23, 2004 5:08 PM To: Betty Jordan
(E-mail) Subject: Hepatitis Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility workers. Could you poll the membership and ask if any cities or towns
in the area are offering, or requiring, their utility (sewer) workers to be vaccinated? If so I would like some details oflbeir program. They can contact me as per below. Thanks, Jim
Pierce, P.E. Assistant Public Works Director P.O. Box 9010 Addison, TIC 75001-9010 972-450-2879 jpierce@ci.addison.tx,us This e-mail and any files or attachments transmitted with it
contains htformation that is confidential and privileged. This document may contain Protected Health htformation (PHI) or other infonnation that is intended only for the use ofthe individual(s)
and entity(ies) to whom it is addressed. Ifyou are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any
disclosure, copying, printing, or use of this infonnation is strictly prohibited and possibly a violation offederal or state law and regulations, Ifyou have received this information
in error, please delete it and notifY Hamid Khalegbipour at 972-450-2868 immediately. ThankyOu. 9127/2004 
Jim Pierce From: Doug Newport [dougn@wallace-group,comJ Sent: Friday, September 24, 2004 10:26 AM To: Jim Pierce Subject: RE: Hepatitis Shots Jim This is Doug Newport. Good to hear from
you. How have you been? I am home recupperating from prostate cancer surgery. My surgery was about 1 112 weeks ago and I am doing fine. I am working for the Wallace Group out of waco
in their Dallas office. I am have great fun working for them. When I worked for the Ci1;y of Independence Mo. we had an area of town that was on septic tanks and there was a high incident
of hepatitis in that area. I would highly recommend that the City's sewer workers be lIacinated. Doug Newport From: Jim Pierce [mailto:jpien::e@d,addison.tx.us] Sent: Thu 9/23/2004 5:08
PM To: Betty Jordan (E-mail) SUbjed:: Hepatitis Shots Betty: I am tIying to build a case to provide Hepatitis A shots for our utility workers. Could you poll the membership and ask if
any cities or towns in the area are offering, or requiring, their utility (sewer) workers to be be vaccinated? lfso I would like some details oftheir program. They can contact me as
per below. Thanks, Jim Pierce, P.E. Assistant Public Works Director P.O. Boll. 9010 Addison, TX 75001-9010 972-450-2879 jpierce@ci.addison.tl!..us This e-mail and any files or attachments
transmitted with it contains Information that is confidential and privileged. This document may contain Protected Health Information (PID) or other information th.t is intended only
for the use of the individual(s) and entity(les) to whom It is addressed. Ifyou are the intended recipient, further disclosures are prohibited without proper authorization. Ifyou are
not the intended recipient, any disclosure, copying, printing, or use ofthis information is strictly probibited and possibly a violation of federal or state law and regulations. Ifyou
bave received this information in error, please delete it and notifY Hamid KbaJegbipour at 972-450-2868 immediately. Thank you. 9124/2004 
Jim Pierce From: Zabolio, Jody [Jody.Zabolio@fortworthgov.org] Sent: Friday, September 24,2004 10:15 AM To: Jim Pierce Subject: RE: Hepatitis Shots Jim, the City of Fort Worth offers
the Hepatitis A series of vaccinations to anyone who wishes to receive them. It is completely vOluntary although strongly recommended to those who are likely to corne in contact with
sewage in their day-to-day work activities. For those who choose to receive the series, the City covers all the costs. Feel free to contact me if you have any questions. P.S. I am fairly
certain that we also offer the Hepatitis C series as well although the person who administers the program is not at work today to verify. Thanks for your help! Jody Zabolio 817-392-4963
Fax: 817-548-5755 -----Original Message----From: Jim Pierce [mailto:jpierce@ci.addison.tx.us] Sent: Thursday, September 23, 2004 5:08 PM To: Betty Jordan (E-mail) Subject: Hepatitis
Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility workers. Could you poll the membership and ask if any cities or towns in the area are offering,
or requiring, their utility (sewer) workers to be vaccinated? If so I would like some details of their program. They can contact me as per below. Thanks, Jim Pierce, P.E. Assistant Public
Works Director P.O. Box 9010 Addison, TX 75001-9010 972-450-2879 jpierce@ci,addison.tx.us This e-mail and any files or attachments transmitted with it contains Information that is confidential
and privileged. This document may contain Protected Health Information (PHI) or other information that is intended only for the use of the individual(s) and entity (ies) to whom it is
addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing,
or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please delete it and
notify Hamid Khaleghipour at 972-450-2868 immediately. Thank you. 1 
Jim Pierce From: David Wasson [bwsadlw@bwsa.org] Sent: Friday, September 24, 2004 9:39 AM To: Jim Pierce Subject: RE: Hepatitis Shots Jim we offer the shots to any employee wanting to
take it. There'were a few that did not want to take it. David L. Wasson General Manager Benbrook Water « Sewer Authority 1121 Mercedes Street Benbrook, Texas 76126 Phone: 817.249.1250
Fax: 817.249.6965 􀁾􀁾􀁾􀀭􀀭􀁏􀁲􀁩􀁧􀁩􀁮􀁡􀁬􀀠Message----From: Jim Pierce [mailto:jpierce@ci.addison.tx.us] Sent: Thursday, September 23, 2004 5:08 PM To: Betty Jordan (E-mail) Subject:
Hepatitis Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility workers. Could you poll the membership and ask if any cities or towns in the area are
offering, or requiring, their utility (sewer) workers to be vaccinated? If so I would like some details of their program. They can contact me as per below. Thanks, Jim Pierce, P.E. Assistant
Public Works Director P.O. Box 9010 Addison, TX 􀀷􀀵􀀰􀀰􀁬􀁾􀀹􀀰􀁬􀀰􀀠972-450-2879 jpierce@ci.addison.tx.us This e-mail and any files or attachments transmitted with it contains Information
that is confidential and privileged. This document may contain Protected Health Information (PHI) or other information that is intended only for the use of the individual(s) and entity(ies)
to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying,
printing, Or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please delete
it and notify Hamid Khaleghipour at 972-450-2868 immediately. Thank you. 1 
Jim Pierce From: John Bennett [BennettJ@trinityra.org] Sent: Friday, September 24, 2004 9:34 AM To: Jim Pierce Subject: RE: HepaHtis Shots TRA offers the shots on a voluntary bases to
all our employees worldng In the wastewater field. -----Orlginal Message---From: Jim Pierce 􀁛􀀡􀀡􀁌􀁡􀁩􀁬􀁎􀁊􀁰􀁩􀁥􀁲􀁣􀁾􀁀􀁬􀀻􀁌􀁡􀁤􀁤􀁩􀁳􀁑􀁬􀁬􀀮􀁴􀁸􀀮􀁵􀁳􀁬􀀠Sent: Thursday, September
23, 2004 5:08 PM To: Betty Jordan (E-mail) Sul:!iect: Hepatitis Shots Betty: I am trying to build a Case to provide Hepatitis A shots for our utility workers. Could you poll the membership
and ask ifany cities or towns In the area are offering, or requiring, their utility (sewer) workers to be vaccinated? Ifso I would like some details of their program. They can contact
me as per below. Thanks, Jim Pierce, P.E. Assistaot Public Works Director P.O. Box 9010 Addison, TX 75001-9010 972-450-2879 jpierce@ci.addison.tx.us This e-mail and any files or attachments
transmitted with it contains Information that is confidential and privileged. This document may contain Protected Health Information (PHI) or other Infurmation that is intended only
for the use ofthe individual( s) and entity(ies) to whom it is addressed. Jfyou are the Intended recipient, further disclosures are prohibited without proper authorization. If you are
not the Intended recipient, any disclosure, copying, printing, or use ofthis Information is strictly prohibited and possibly a violation offederal or state law and regulations. If you
have received this Information In error, please delete it and notify Hamid Khaleghipour at 972-450-2868 immediately. Thank you. 912412004 
Jim Pierce From: White, Rick [RWhile@CLazleJx.usj Sent: Friday, September 24, 2004 8:54 AM To: Jim Pierce Subject: RE: Hepatitis Shots The City of Azle does require there workers to
be vaccinatedl but we do encourage it and pay for the shots and testing. This program was started in the 2002-2003 budget and all of our Utility Maintenance workers have received there
shots and only 1 plant operator has declined to take the shots. We currently offer the Hepatitis A -B -tetanus -chicken pox TB MMR. The shots are given through the occupational health
at Harris Methodist North West. If you need any further information contact me at the number below. Rick White Utility Manager City of Azle 613 S.E Parkway Azle, Texas 76020 817-444-2541
Ext.258 This e-mail is confidential and intended solely for the use of the individual to whom it is addressed. Any views or opinions presented are solely those of the author and do not
necessarily represent those of The City of Azle or its citizens. If you have received this e-mail message in error, please phone Rick White at 817-444-2541 Ext.258. Please also destroy
and delete the message from your computer. For more information on The City of Azle, visit our web site at: http://azle.govoffice.com -----Original Message----From: Jim Pierce [mailto:jpierce@ci.addi
son.tx.us] Sent: Thursday, September 23, 2004 5:08 PM To: Betty Jordan (E-mail) Subject: Hepatitis Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility
workers. Could you poll the membership and ask if any cities or towns in the area are offering, or requiring, their utility (sewer) workers to be vaccinated? program. They can contact
If so me as I per below. would like some Thanks, details of their Jim Pierce, P.E. Assistant Public Works DirI?O. Box 9010 Addison, TX 75001-9010 972-450-2879 jpierce@ci.addison,tx.us
ector This e-mail and any files or attachments transmitted with it contains Information that is confidential and privileged. This document may contain Protected Health Information (PHI)
PHI) or other information that is intended only for the use of the individua1(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited
without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this 1 
information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please delete it and notify Hamid
Khaleghipour at 972-450-2868 immediately. Thank you. 2 
Jlm Pierce From: Julie Winchell Ul.lliw@jclebl.lme.netj Sent: Friday, September 24, 2004 8:49 AM To: Jim Pierce Subject: Re: Hepatitis Shots Jim, Here in Cleburne we offer the option
to take hepatitis A and B vaccinations to all Sanitation, Water Utilities (distribution, collection, and plant employees -not office only personnel), Police and Fire Department employees.
It is voluntary to take the shots and Human Resources has a form that they provide to the employees explaining the program with a place for them to check off and sign whether they want
the shots or not. We started the program a few years ago with all the existing employees given the option at that time. Now 􀁮􀁾􀁷􀀠hires get the form with their new employee orientation
and arrangements for the shots are handled by the Human Resources Risk Manager. The shots are paid for by the City and are given by EMTs from the Fire Department. Records are made and
appointments for the shots and follow up blood work are maintained by the Risk Manager. I feel more confident in my field work because I have had the shot series. For me it is as important
as keeping up my Tetanus shots since my work does require my sampling and working with wastewater effluent. If you have any additional questions about our program please contact Bill
Pannell, the City of Cleburne Risk Manager at (817) 645-0916. Julie Winchell, Environmental Coordinator City of Cleburne (817) 645-0961 -----Original Message From! "Jim Pierce" <jpierce@ci.
􀁡􀁤􀁤􀁩􀁳􀁯􀁮􀁾t:cus> To: "Betty Jordan (E-mail)" <bjordan@apaienv.com> Sent: Thursday, September 23, 2004 5:08 PM Subject: Hepatitis Shots Betty: I am trying to build a case to provide
Hepatitis A shots for our utility workers. Could you poll the membership and ask if any cities or towns in the area are offering, or requiring, their utility (sewer) workers to be vaccinated?
If so I would like some details of their program. They can contact me as per 􀁢􀁥􀁬􀁯􀁷􀁾􀀠Thanksr Jim Pierce, P.E. Assistant Public Works Director P.O. Box 9010 Addison, TX 75001-9010
972-450-2879 jpierce@ci.addison.tx.us This e-mail and any files or attachments transmitted with it contains Information that is confidential and privileged. This document may contain
Protected Health Information (PHI) or other information that is intended only for the use of the individual(s) and entity(ies)to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosureJ copying,
printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please delete
it and notify Hamid Khaleghipour at 972-450-2868 immediately. Thank you. 1 
Jim Pierce From: Joel Otts fjoel@azmail.netl Sent: Thursday, September 23,20049:50 PM To: Jim Pierce Subject: Hepatitis Shots Jim. The City of Waxahachie offers Hepatitis shots for every
utility worker. We do not require these shots but encourage new employees to get them even to the point of paying overthne for the time that they take ifthey are on evening or night
shift. 9/24/2004 
Jim Pierce From: Rafalko, Madelene [Madelene.Rafalko@FortWorthGov.org) Sent: Thursday, September 23, 2004 5:28 PM To: Jim Pierce; Betty Jordan (E-mail) Cc: Shewmaker, Tom Subject: RE:
Hepatitis Shots Betty & Jim: City of Fort Worth offers Hep A vaccinations to staff, but they are not required. You may wish to contact Tom Shewmaker, the Village Creek WWTP Safety Coordinator
for more information. Madelene 't11 -􀀳􀀱􀁾􀁾􀀠¥fttJ -----Original Message----From: Jim Pierce [mailto:jpierce@ci.addison.tx.us] Sent: Thursday, September 23, 2004 5:08 PM 􀁽􀀮􀁊􀁦􀁊􀁨􀀯􀁾􀀠􀁾􀀠TO:
Betty Jordan (E-mail) Subject: Hepatitis Shots Betty: I am trying to build a case to provide Hepatitis A shots for our utility workers. Could you poll the membership and ask if any cities
or towns in the area are offering, or requiring, their utility (sewer) workers to be vaccinated? If so I would like some details of their program. They can contact me as per below. Thanks,
Jim Pierce, P.E. Assistant Public Works Director P.O. Box 9010 Addison, Addison, TX 75001-9010 972-450-2879 jpierce@ci.addison.tx.us This e-mail and any files or attachments transmitted
with it contains Information that is confidential and privileged. This document may contain Protected Health Information (PHI) or other information that is intended only for the use
of the individual(s) and entity (ies) to whom it is addressed. If you are the intended reCipient, further disclosures are prohibited without proper authorization. If you are not the
intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have
received this information in error, please delete it and notify Hamid Khaleghipour at 972-450-2868 immediately. Thank you. 1 
JIM PIERCE, P.E. Assistant Public Works Director (972) 450-2879 (972) 450-2837 FAX jpierce@d.addlson.tx.us Town of Addison 16801 Westgrove Dr. P.O. Box 90l{), Addison, Texas 75001·9010
1-2./-0 ¥􀁾􀁾􀀠 lfrvHh s a 􀁖􀁁􀁃􀁃􀁬􀁲􀁊􀁾􀁾􀀯􀀢􀀠J 􀁾.. 􀁾􀁉􀀠􀀹􀀭􀁾􀁴􀁐􀁕􀂭􀁾􀁴􀁊􀁁􀁉􀁷􀁾􀁛􀁾􀁾􀀠 􀁖􀁴􀁬􀁾􀁲􀀱􀁲􀁾Jlralzh5 􀁾􀀼􀀠􀁾􀁓􀀭􀁥􀀭􀀼􀀭􀁾􀀠 􀁾􀁬􀀠 
Memorandum To: Judy Stafford, Director ofHuman Resources Randy Moravec, Chairman, Safety Review Board Cc: Valerie Benavides, Monica Hernandez From: Chris Kellen, EMSiTraining Chief Date:
July 16, 2004 Re: Hepatitis B Vaccinations It appears that under the Texas Department ofHealth Government Code 607.004 concerning Preventative Immunizations and Vaccinations that police
officers fall under the other g<lVernmentai employee may be exposed in peiforming official duties and for which immunization is possible. It is my recommendation concerning Hepatitis
B immunizations that: 1) The Town adopts a policy for our police officers similar to the fire department and/or the Arlington Police Department's. 2) We also discussed the possibility
of offering preventive immunizations to personnel from public works however I do not believe this is necessary since the primary means of contracting Hepatitis B is through direct contact
ofblood, which unless I am mistaken would not occur very often ifat all. Texas Department of Health Government Code § 607.004. PREVENTATIVE IMMUNIZATIONS AND VACCINATIONS. (a) A certified
fire fighter or other govel1l!lleI1tal employee who operates an ambulance or who responds to emergency medical calls is entitled to preventative immunization for any disease to which
the fire fighter or other governmental employee may be exposed in performing official duties and for which immunization is possible. 
February 1998 .",,:·:,. ,.. "" . 'e California MOrbidityDepartmenl of Health Services State of California S. Kimberly 􀁂􀁥􀁬􀁳􀁨􀁥􀁾􀀠Director Pete Wilson, Governor RECOMMENDED IMMUNIZATION
FOR SEWAGE WORKERS The Division of Communicable Disease Control previously published recommendations for preventing illness in sewage workers (California Morbidity #35/36, September
4, 1992). Questions continue to be received, not only for !he diseases discussed last time but also because of concerns about HlY and hepatitis A and B, It should be emphasized !hat
!here are NO state immunization requirements mandated for sewage workers. Any requirements !hat exist are made at the local level by employers. According to CaVOSHA officials, sewage
workers are not covered by !he "CaVOSHA Bloodborne Pathogens Standard" unless they regularly work directly on sewerage lines within health care facilities or before those lines join
other (e.g., municipal) sewerage lines. This is a difficult area, where the very small risk of disease ((from pooled human sewage) must be balanced against the vcry small risk of adverse
effects (and COS!) of immunization. Though published data do not exist for all of the diseasespecific recommendations outlined below, California Department of Health Services recommendations,
which incorporate the USPHS Advisory Committee on Immunization Practices (ACIP) recommendations where available, are as follows: I. Frequent, routine handwashing is the most important
safeguard in preventing infection by agents present in sewage. 2. Protective clothing (ie., work clothes, coveralls, boots, and..when appropriate, gloves and plastic face shields) is
recommended. Such work clothes should not be worn home or outside !he immediate work envirorunenl 3, Immunization recommendations can be categorized as follows: a, Recommended ? Tetanus-diphtheria
(Td) .... All adults, and especiallY sewage workers, should be up-to-date on Td immunizatinn. For those who have completed the basic series of three immunizations, a booster should be
be given every ten years. ? No other immunizations are routinely reconunended at the present. b, Not Routinely Recommended ? Poliomyelitis -Sewage workers are at very slight risk of
vaccine potio virus exposure but at virtually no risk of wild polio virus exposure. No cases of occupationallY acquired paraiy1ic poliomyelitis in U.S. sewage workers have been documented
since polio vaccine came into widespread usage, ? Typhoid Fever -The risk of this disease for sewage workers in California is exceedingly small, Only one case has cver been reported
in a California sewage worker and this was in an individual who had received at least one dose of typhoid vaccine nine months previously. ? Immune globulin (IG) and Hepatitis A Vaccine
-Routine hepatitis A immunoprophylaxis is not reconunended due to lack of evidence of sigoificant occupational risk for sewage workers in this country (MMWR 1996; 45 No. RR-15), ? Hepatitis
B Vaccine -While blood and other body fluids (e,g" menstrual discharges, ete.) enter the sewage sewage stream, hepatitis B virus is prescnt only in very dilute concentrations. No cases
of hepatitis B have been linked to sewage exposure in the U.S. Moreover, since hepatitis B is not transmitted by the fecal-oral route, there is little risk from municipal sewage. ? Cholera
-The risk of cholera for sewage workers is extremely remote. Only a few cases of imported cholera are reported each year in California and there has been no secondary transmission. Vibrio
cholerae concentrations in California sewage are so dilute as to probably be non-infectious, (Whereas 102 Shigella are needed to cause disease, as many as 1()6 to 108 V. cholerae are
needed,) Even ifcholera did result, specific treatment is readily available, Finally, a word about HIV and the risk of AIDS from sewage. The remarks made above about hepatitis B, and
its extreme dilution in sewage, apply to HlY as well -except that the level of HlY in sewage would be even several orders of magnitude less than that of hepatitis B, Moreover, like hepatitis
hepatitis B, HlY is not transmitted by the feeal-oral route. Thus, the risk of hepatitis B from sewage is virtually non-existent and the risk of HIY transmission from sewage is even
Jess. Reported by: Immunization Branch, Division a/Communicable Disease Control, California Departmenl a/Health Services. M;mthly Report from Prevention Services, CA Department of Health
Services. 714 P Street, Sacramento, CA 95814 Edited by Division of Communicable Disease Control {51 01540·2566) 
Jim Pierce From: John Stubbart [jstubbart@awwa.org] Sent: Thursday. April 29. 2004 10:10 AM To: Jim Pierce Subject: Immunization Jiml AWWA is primarily on the water side, so immunization
is not as much an issue as the wastewater side. On the wastewater side, immunization for hepatitis A&B were ones we always got our staff as a health policy. John Stubbart AWWA Small
Systems Manager Standards Liaison 303-347-6191 »> <jpierce@ci.addison.tx.us> 4/28/2004 3:47:38 PM »> Does AWWA have any written policies or recommendations regarding immuization of operators
or laborers? Thanks From: Jim Pierce jpierce@ci.addison.tx.us AWWA Member: Yes AWWA Member number: 19350 Phone Number; 972-450-2879 Job Title: Management Business: Public Municipal Utility
American Water Works Association The Authoritative Resource for Safe Drinking Water (SM) One World, One Water, One event not to be missed. Coming June 13-17, 2004 in Orlando, FL, ACE
has everything you are looking for in one place! Register online www.awwa.org This email has been scanned for all viruses by the MessageLabs SkyScan service. 1 
,/HEPATITIS 8 IMMUNIZATION AUTHORIZATION/REFUSAL EMPLOYEE NAME: DATE: PROJECT: DEPT: ________ AUTHORIZATION: 1, • do hereby authorize the administration of llecam6ivaX/Recombivax boaster.
r understand the occupational risks of contracting Hepatitis B, the immunity provided by Recombivax, the contraindications and the effectiveness of the vaccine. Although the duration
for protection is unknown at present, available data suggests immUnity will last about five years. I also understand the Recombivax wi)1 not prevent Qther types of Hepatitis (for example,
Hepatitis A and Hepatitis C), Because C)f the longincubation period for Hepatitis B, it is possible for unrecognized infection to be present at the time Recllrnbivax is given. The vaccine
may not preventHepatitis in such persons. I understand I should NOT take this injection if I am allergic to yeast or yeast products. If r have a history of some type of liver disease
I will consult my 􀁰􀁨􀁹􀀤􀁩􀁾􀁩􀁡􀁮􀀠before I take the injection. Signature: 􀁟􀁾________􀁾􀁟􀀠Witness: REFUSAL: I understand that due to my occupational exposure to blood Ilr other
potentially infectious materials I may be at risk of acquiring hepatitis B virus (HBV)infection. I have been givQn the opportunity to be vaccinated with hepatitis B vaccine, at no charge
to myself. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis 8, a serious disease.
If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitiS B vaccine, I-can receive the vaccination
series at no charge to me. Signature: ___________ Witness: ________􀁾______________ IMMUNIZATION RECORD: Previous immunization ________ NO _______ YES DATES: HBSAB NO ___ YES RESULTS
􀁾__-'-______-'-___ VACCINATION REtORD; DATE SITE ADMINISTERED BY LOT 1/Ili;-.----+-----+-----+---11 
DATE: 8 NOVEMBER 2004 TO: PUBLIC WORKS PERSONNEL FROM: JIM PIERCE SUBJECT: HEP A TlTIS VACCINE Please read the attached literature concerning hepatitis. The Public Works Department is
offering to all Department employees the opportunity to receive Hepatitis vaccine shots at no cost to the employee. There is no requirement that you take the shots. It is completely
voluntary on your part. Please complete the information below and return it to your supervisor. NAME D I choose to receive the vaccine for Hepatitis A. D I choose to receive the vaccine
for Hepatitis A and Hepatitis B(eombined vaccine) D I will be responsible for scheduling any second doses required. D I choose NOT to receive Hepatitis vaccine. 􀀭􀀽􀀭􀀽􀀭􀀺􀀺􀀭􀀽􀀽􀁾􀀭􀀭􀀭􀀭􀀭......
.....􀁾..... SIGNATURE 
Jim Pierce ---------------------.... _-_.-... From: Bonnie Battersby [bbatlersby@waxahachie.comj Sent: Wednesday, October 20, 200411:30 AM To: Jim Pierce Subject: CONSENT FORM ELLIS
COUNTY DIAGNOSTIC CLINIC 505 N. HWY, 77, SUITE 200 WAXAHACHIE, TX 75165 HEPATITIS B VACCINE CONSENT/REFUSAL FORM :ndicate below by your signature that you 􀁾􀁓􀁈􀀠TO RECEIVE the Vaccine.
By this signature you lre confirming that you received an explanation of the immunization programJ that you have lranted permission to Ellis County Diagnostic to administer these injections
and that you agree :0 release Ellis County Diagnostic, its employees and agents from responsibility with regard to idverse reaction from these injections. late City of Waxahachie Dates
Vaccinated Vaccine Type Lot Number Expiration Signature :ndicate below by your signature that you received an explanation of the vaccine and DO NOT iISH TO RECEIVE the vaccine at this
time. late 1012112004 
10/18/2004 I, i I I " I :,:1 -: i I I J I I , , PAGE 01 817556886301:40 I i Post-It' Fax Note 7671 Oalt! 􀁴􀁡􀁧􀁾􀁳􀁬􀁬􀀾f 13 ;::S: t/V'.-V{ 'eo (" {.."'€From '3:l\ 􀀻􀀻􀀬􀁾.....\ \
Co.lOepL Co, 􀀧􀀭􀁜􀁾􀁜􀁯..􀁕􀀧􀁾􀀠I PhOl"lG/t !Phorutf '8'(/"":/, a'i{" IF...'172}IS-o 4.'!H7 IF.,. HEPATITIS VACCINATION CONSENTIDECLINATION FORM I I understand that due to my occupational
exposure to potentially infectious materials, I may be at risk ofacquiring the Hepatitis A and B virus, I have been given the opponuruty to be vaccinated I I with the Hepatitis A and
B vaccines at no charge to myself I Please eheck one:I I I o Yes, I would like to receive the Hepatitis A. 􀁖􀁡􀁣􀁣􀁩􀁮􀁡􀁴􀁩􀁯􀁮􀁾􀀬I • :\ o Yes,1 would like to receive the Hepatitis
B Vaccination only, i'I o Yes, I would like to receive bath Hepatitis A and Hepatitis B vaccines, I I I o No, I decline both the Hepatitis A and Hepatitis B vaccines at this time, I
'understand, by declining both vaccines that I continue to be at risk of acquiring Hepatitis A andlor Hepatitis B, which are both serious diseases, I understand that in the future, ifI
desire to be vaccinated with either or both vaccines, I can receive the vaccines at no charge to me, Employee Signature Date Employee Printed Name Job Title/DeplU"tment :1 I 
􀁲􀀭􀁉􀁅􀁐􀁾􀁔􀁉􀁔􀁉􀁓􀀠A············ CAN . . . . ....... .. . . ... .. BE··········· PREVENTED! .--:1···\···1···········•........ Hepatitis A .". is a disease of the liver ... is spread
by feces (stool)-to-mouth contact from: • unwashed hands • uncooked food (including shellfish) • anal-oral sex ... is commonly spread in: • families • child-care centerS with diapered
children • jails • shelters • other institutions with diapered persons (.. is common in places lacking safe systems for sanitation of water and food ,.-is not spread by coughing, 0 sneezingl
or other casual 0 contact _. _ 0 0 Sips and Symptoms • fangue • mild fever • flu-like illness • nausea and vomiting • stomach ache • loss of appetite ..Some people have: • no symptoms
at all • yellow eyes and skin (jaundice) • dark urine • light-colored stool 'l'reatment • doctor visit • rest • low-fat foods • plenty of liquids • no beer, 􀁷􀁩􀁮􀁥􀁾􀀠or liquor • no
"pot" or other drugs ..Antibiotics and other medications do not help because hepatitis A is caused by a virus. Prelfention ... Wash your hands well after using the bathroom, before touching
food or drink, and after changing a baby's diaper. ... Do not let anyone who has hepatitis A make or serve food for you or your family . ..If you live or have dose contact with someone
who has hepatitis A, ask your local health department or physician if you need an immune globulin (IG) shot. .. There is a vaccine (2 doses six months apart) for persons 2 years old
Or older. Get the vaccine if you: • live in or travel often to a country where hepatitis A is common • are a child living in an area where hepatitis A is COmmon • use street drugs •
are a man who has sex with other men • have chronic liver disease Or a blood-dotting disorder 􀁾Texas Deparlmcni a/HeaHn . TDH 6·12A 8/97 S?;po 
--------Hepatitis A, B, Cs Hepatitis C has been much in the news. Naomi Judd, Pamela Anderson, and Larry Hagman have announced that they are infected with it; Mickey Mantle died of complications
from it. About 4 million Americans are infected, and the number of deaths, mostly among those infected more than a decade ago, is rising dramatically every year, The good news is that
the number of new infections has dropped just as dramatically. It's easy to be confused about the various forms of viral hepatitiS-A, B, and C (not to mention D and E)-which differ in
important ways. Hepatitis A spreads by different means than B or C. The symptoms are often similar, but they can vary greatly in severity and in wben they appear, There are more acute
cases (short-term disease following the initial infection) ofbepatitis A and B in this country, but hepatitis C is the biggest problem because more ofthose infected remain infected for
life. And while there are vaccines for hepatitis A and B, there is none for C. What is it? it? Hepatitis means inflammation of the liver. The infectious form is usually caused by one
of five viruses (called A, B; C, D, and E), Itimpairs the ability of the liver to carry out its nonnal functions, and may cause mild to severe flulike symptoms as well asjaundice (yellowish
skin and eyes) and, many years later, serious lifethreatening aiiments such as cirrhosis and liver cancer. But often there are no symptoms. There are also noninfectious forms of hepatitis
caused by toxic substances-notably a1cohol--and by the excessive use of certain medications. These include acetaminophen (brand name Tylenol), especially when taken with alcohol. Since
the hepatitis viruses spread in different ways, certain groups are at greater risk for each infection. Hepatitis A spreads via contaminated food and water, while B is now primarily a
sexually transmitted infection. Hepatitis C is mostly a worry for those who received tmnsfusions before 1992. There are drugs to treat hepatitis Band C (but not A). These are not always
effective and are expensive; some have bad side effects. Protecting yourself and others ,/Wash your hands. Always wash with soap and water after using the toilet, after changing diapers,
before handling food. and before eating. This helps stop the spread of many diseases, including hepatitis A. ,/Cook your foods adequately. Hepatitis A can spread via raw or undercooked
food, especially sbellflsh, ,/Practice safer sex. Condoms significantly reduce your risk of getting hepatitis B and C. This is especially important if you know that your partner is infected
or ifyou have multiple partners, ,/Hepatitis A vaccine. People who travel to Mexico Or Latin America, Africa, Eastern Europe, the countries of the former Soviet Union, or other areas
where hepatitis A is common should be vaccinated, So should those with chronic liver disease (including hepatitis B orC), as wellaschildrenlivingin statesorcomruunities with a high rate
of hepatitis A. The vaccine provides protection for at least 10 years if you get a second shot after 6 to 12 months, ,/Hepatitis B vaccine. Newborns are now routinely vaccinated, Children
and adolescents (not previously vaccinated) should also get the vaccine. Other groups include sexually active gay men, heterosexuals with multiple partners, hea1th-<:are workers, drug
users who share needles, and people who trnvel frequently to high-risk areas, Ifyour partner is infected, you should be vaccinated, The three-dose vaccine provides immunity for at least
seven years. ,/Consider the new combined vaccine for hepatitis A and B if you are traveling to countries where these diseases are commont or if you are a health-care worker or have chronic
liver disease, ,/Talk to your doctor ahout getting tested for bepatitis C if you had a blood transfusion before July 1992, Methods used to screen donated blood were less accurate before
then, so the risk of acquiring the virus from a transfusion was greater. Also consider testing if you have ever shared a needle or have had unsafe sex with multiple partners. There There
is an FDA-approved home test for hepatitis C, sold in drugstores for about $70 and also available by mail (call 888-888-HEPC). ,/Ifyou are pregnant, have a hepatitis B test, lfit's positive,
a physician can help protect the newborn with a special injection at birth, ,/Unslerilized needles can transmit blood infected with bepatitis B or C (as well as HIV), If you are getting
your body pierced or tattooed, or are receiving acupuncture, make sure the needles are brand new or have been properly sterilized in an autoclave. ,/Don't share razors, toothbrushes,
manicure tools, or anything else that might transmit blood, What you need to know TYPE HOW TRANSMJlTED VAcrlNE COMMENT A No Primarily food or water Yes. alone contaminated by feces of
orwithB. an infected person. B .........􀀭􀁾.... AhoutS% Blood and other body fluids, of adult usually via unprotected sex infections or shared needles (same as mY). Also mother to fetus.
Yes, alone or with A. C About8S% of cases Blood, usually via Iransfusions before 1992 or shared needles. Sexual transmission rare, but risk rises with multiple partners. No. D Yes Same
.. B. No, E No Same as A. No, Usually causes no symptoms or mild Ilulike symptoms, nausea, diarrhea, and jaundice. Most people recover eompletely, Can Cause serious illness and, in rare
cases, death, Confers lifelong immunity. High risk when traveling in developing countries . Symptoms generally mild; half getj.undice. Abcut 1 million Americans have chronic infections,
are carriers, and are at risk for cirrhosis andlor liver cancer. Health-care workers are 􀁾􀁴􀀠increased risk Fewer new infections in recent years, thanks to vaccine and screening of
donated blood, Called non-A, non-B hepatitis until 1988, About 4 million chronic carriers in U,S. Usually no (or mild) initial symptoms. Symptoms may not appear for 10-20 years; about
20% develop cirrhosis or liver cancer, Risk from transfusions now minuscule. Lending cause for liver transplants in U.S. Health-care workers are at increased risk:, Rare in U.S. Occurs
only in people with hepatitis B. Rare in U.S. Almost exclusively indeveloping countries, especially south Asia. UC Berlwlcy Wellnes.r Letter, December 2002 5 
Shoulders in motion Your shoulder is your most flexible joint, with a wide range of motion: you can rotate your arm 360 degrees and put your hand almost anywhere in a "ide arc. You can
catch a fly ball, lift a heavy box that's been left on your doorstep, and swing a small child all around-at least in theory, Tbis enonnous range, and the complex structure it takes to
provide it, is probably wby the shoulder is so easily injured. Anybody-the young, the middleaged, the old-<:an have shoulder problems. Anyone doing heavy chores around the house and
garden can get shoulder pain. Heavy lifting, in particular, can hurt your shoulderl as can anything involving overhead activity, So can tennis, golf, or throwing a ball. Swimming, ordinarily
so easy on the joints, can sometimes injure the shoulder. This doesn't mean, of course, that you should not pursue these activitiesjust that it's worth thinking about preventive measures.
The shoulder joint is a complicated mechanism, consisting of three bones-the collarbone (clavicle), upper arm bone (humerus), and shoulder blade (scapula). Actually, the shoulder bas
at least two joints, one between the shoulder blade and the collarbone, the second a ball-and-socket jointthat holds the upper end of the arm bone. The ball of the arm bone is actually
larger than the rather shallow socket that holds it (more like a ball on a plate than a ball-and-socket joint), which gives itits great range of motion, and thus must be held in place
by an array of muscles, tendons, and ligaments. The rotator cuff, composed of four different muscles and their tendons, gives the shoulder its great mobility and strength, as well as
holding the arm bone in place. Small sacs, called bursae, cushion muscle, bone, and tendon. And, of course, there is cartilage that cushions and stabilizes this complex mechanism. It's
a beautiful piece of biological engineering-like the knee. And as with thatotherjoint, much can go wrong. You can get shoulder pain for many reasons. You can injure yourself in a fall
or otherwise. You may tear the rotator cuff with repeated golf swings, your tennis overhand, or your Australian crawl. Maybe your job requires, or required, heavy lifting-for example,
hoisting small arnot-sa-small children. Women seem to have more shoulder problems than men, perhaps because of the demands of housework and child care. Besides athletes, many others
are at risk: welders, hairdressers, carpenters, and anybody whose activities involve lots of shoulder movement. Sometimes shoulder pain can start with no discernible cause. Some common
problems Bursitis: The bursae (cushioning sacs) can get inflamed. Itstarts as a kind of dull misery. Excessive strain, from athletic activities or work, can bring it on. Sometimes it
is the first sign of arthritis in the shoulder. Often there is nO evident cause. Osteoarthritis: A thinning of the cartilage that frequently comes with overuse Qr increasing age. Pain
and reduced range of movement are usually the first signs. Tendinitis: Tendons anchor muscle to bone in the shoulder shoulder (and elsewhere in the body). Sometimes tendons get inflamed,
usually following an injury, with resulting pain and swelling. Rotator cuffinjury: Sports orheavy lifting can injure tendons in the rotator cuff, which may get thickened and inflamed,
possibly resulting in microscopic or larger tears. Ifthe tendons swell, they may get trapped under the shoulder bone, a condition known as "impingement syndrome." The bursae can get
into the act as well. UC Berkeley Weiin(J.ls Letter, December 2002 Frozen shoulder: Underuse, perhaps following an injury, may cause loss of range of motion and result in a "frozen"
shoulder. Pain and stiffness usually come on slowly, making movement difficult. Dealing with a shoulder injury The first step is to rest, at least for a day or two. And do what you would
do for any muscle ache or pain: .fTake an over-the-counter pain reliever such as aspirin, ibuprofen, or naproxen. Acetaminophen (Tylenol, for example) will help with pain, but not inflammation.
.fTry icing the shoulder the frrst day Or two. Then try heat. Whatever offers relief is the right thing. .f A sling to anchor the shoulder can help if movement is really painful. But
if the injury is that severe, you need to see a doctor. .fIfpain is severe or doesn't get better in a few days with home treatment, see a doctor. You'll need a diagnosis, and many kinds
of tests are available (X-rays mayor may not be needed). Moist heat, ultrasound, and gentle exercise, especially stretching, are usually effective for shoulder pain. In advanced cases
of rotator cuff injury, surgery is sometimes considered. But an exercise program is the thing to try Trrst, and it works in most cases. Your doctor may refer you to a physical therapist.
The exercises below can help prevent shoulder pain, as well as promote healing. Ifyou play golf Or tennis, swim a lot, or do a lot oflifting or overhead activity in your daily routine,
it's not a bad idea to do some shoulder stretching and conditioning before any trouble starts, If you injure your shoulder in a sport, get some advice from an instructor before you resume
playing. Towel stretch. Grasp a towel behind your back, with one arm behind you and the other ann raised over your shoulder, Pull the towel with the upper hand, but not to the point
ofdiscomfort. Hold for to seconds, repeat. then switch anns, Shoulder strengthener. Lie on your side, supporting your head. Holding a light weight, bend your ann al a 90° angle and position
your forearmparallel to the fioor. Keeping your elbow against your side, raise the weight upward, as shown. then lower itfonvard, Repeat 10 limes. Then switch sides. Strengthener II. Lie on a table
or bed, with one ann hanging down, Hold a light weight, and with the hand rotaled oU!H/ard, swing the ann straight back. HoMjor 2 seconds, then iower slowly, and repeat 10 times. Then
switch sides. Variation: rotale the hand inward and lift fhe weight/orward, almost parallel to the fioor,' hold, lower, and repeat. Band strengthener. Anchor elastic exercise band to
fixed object. Stand with elbow at side, bent at 90°, and grip band. Pull arm slowly across body, keeping elbow at side, then return slowly. Repeat. Then pull with other aml from same
position. Then turn around and repeat with each arm. 6 
(b) The employee and any member ofthe employee's immediate family are entitled to vaccination for a contagious disease to which the employee is exposed during the course of employment.
(c) The employing governmental entity may satisfy the requirements ofthis section by; . (I) providing the immunization or vaccination without charge; or (2) reimbursing the employee
for any necessary and reasonable expenses incurred by the employee for the immunization or vaccination. Arlington Police Deparlment requires all new officers to either; 1. Provide documentation
that they have been vaccinated or, 2. Take the vaccine or, 3. Sign a waiver relieving the City ofany liability should they contract the disease. Please let me know if you need additional
information. Points to consider. Police may arrive Before the Fire Department and may be exposed to Blood and or Bodily fluids before Paramedics can cover wounds. Persons in custody
ofPolice may have commuuicable disease. Police officers will have contact when arrestinglbooking these individuals. Police officers may have to subdue or restrain infected persons and
will be at risk for exposure. Hepatitis can be caused by several factors including chemical toxicity, drugs, alcohol, and most notably viral infections. The five common viruses causing
hepatitis are: Viral Hepatitis A: Typically spread by eating food or drinking water contaminated with human feces. Viral Hepatitis B: Typically spread from mother to child at birth,
through sexual contact, blood transfusions, or needles. Viral Hepatitis C: The most common ofviral forms, typically spread through blood transfusions, needles, sexual contact, or working
in a medical environment. Viral Hepatitis D: Spread only in the presence ofhepatitis B and transmitted in the same ways. Viral Hepatitis E: Most commonly found in people who live in
cOllDtries with poor sanitation. Liver inflammation can also be caused by medications, recreational drug use, severe chemical toxicity, and alcohol abllSe.