City government managers submitted a health hazard evaluation request concerning unintentional occupational exposures to opioids among police staff. City government and police department managers were concerned about possible exposures among police officers who encountered illicit drugs, including opioids, when completing their work duties. At the time of the request, several police officers had reported health effects after possible exposure to suspected opioids at work. For each of the incidents of potential unintentional exposure to opioids reported during 2017-2019, we (1) conducted confidential interviews with the affected police officers about the incidents, work practices and processes, personal protective equipment (PPE) use, and health information

(2) reviewed incident reports, medical records, and forensic laboratory reports

and (3) reviewed body camera footage recorded during incidents, weekly staff notes, training bulletins, and the department procedure manual for information related to preventing unintentional exposure to opioids at work. We found that some police officers developed health effects shortly after law enforcement activities where opioids were suspected or known to be present. The symptoms were severe enough that officers required medical attention and were not able to continue performing their essential job duties. Incidents occurred during law enforcement activities away from police headquarters or during evidence processing. Most incidents involved multiple types of substances whose identities were unknown at the time. None of the officers experienced severe, life-threatening opioid toxicity. These symptoms could be consistent with milder toxicity related to drug exposure or other, unidentified causes. Officers did not have or use PPE appropriate for handling unknown powders in an uncontrolled setting and were insufficiently trained on using PPE. We made recommendations that included (1) following guidance in the NIOSH Topic Page entitled "Preventing Emergency Responders' Exposures to Illicit Drugs," (2) performing job hazard analyses for routine and emergency tasks or work responsibilities and develop controls according to the risks identified, (3) reviewing and updating safety policies and procedures regularly, (4) ensuring officers can access recommended PPE and are trained to use it, and (5) encouraging officers to report when they might have had illicit drug exposure, or a near miss, to their supervisors, including any possible health effects from those potential exposures.