Evaluation of Occupational Exposures to Illicit Drugs During an Emergency Medical Services Response

Details

• Personal Author:
  Chiu, Sophia ; Dowell, Chad H. ; Hornsby-Myers, Jennifer ; Trout, Douglas B.
• Corporate Authors:
  National Institute for Occupational Safety and Health
• Description:
  The Health Hazard Evaluation (HHE) Program received a request from a city fire department concerning unintentional exposure to illicit drugs (including fentanyl and analogues) during a response to a drug overdose. One firefighter-emergency medical services (EMS) provider (Responder A) developed adverse health effects during the incident. We visited the fire department over a two-day period right after the incident. During the visit, we conducted voluntary, confidential interviews. We spoke with police officers and firefighter-EMS responders who provided direct care to the overdose victim. During the interviews, we discussed the incident, work history and practices, training, and personal protective equipment (PPE) use. In addition, we spoke with the emergency department (ED) physician and members of the nursing staff who treated the victim and Responder A at the hospital during the incident. We reviewed video footage of the incident from the body camera of an attending police officer, the police department's incident/investigation report, medical records related to the incident for Responder A and the overdose victim, and toured the ED where the victim and Responder A underwent medical evaluation and treatment. We found that the cause of Responder A's health effects and the potential source of exposure could not be definitively identified. Nonetheless, the health effects interfered with Responder A's ability to carry out essential job duties. During the initial response to the drug overdose responders wore PPE that followed current NIOSH guidance for situations where illicit drugs are suspected to be present but not visible. We recommended (1) continuing to follow guidance available from NIOSH and other public health agencies, developing new or modifying existing policies as needed
  
  (2) providing training on how to prevent occupational exposure to illicit drugs
  
  (3) working with 911 dispatch coordinators to identify possible improvements in information gathering and communication before arriving at scenes where there might be illicit drugs
  
  (4) coordinating with local hospitals to have soap and water available after EMS responses for firefighter-EMS providers' use
  
  (5) developing standard ways to share information about forensic laboratory results among agencies that jointly participate in responses involving illicit drugs
  
  and (6) encouraging officers to report possible exposures to and health effects resulting from exposure to illicit drugs to their supervisors. visors.
  
  
• Subjects:
  Emergency Responders Firefighters Hazardous Substances Law Enforcement Occupational Health Personal Protective Equipment Respiratory Tract Diseases Risk Assessment Risk Factors Safety Staff Development Urine Workplace

  More +
• Keywords:
  Drugs Emergency Medical Services Emergency Medical Services Workers Emergency Responders EMS Fentanyl Firefighter Fire Fighters First Responders Gloves Hazardous Drugs Hazards Health Effects Illicit Drug Opioid OSHA Region 3: Exposure Levels Police Officers Respiratory System Disorders Risk Factors Training Urinalysis Work Environment Workers

  More +
• Source:
  Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HHE 2018-0067-3312, 2020 Sep ; :1-24
• Series:
  Health Hazard Evaluation Reports (HHE)
• DOI:
  https://doi.org/10.26616/NIOSHHHE201800673312
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Genre:
  Field Study
• Place as Subject:
  West Virginia ; OSHA Region 3
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  24 pdf pages
• Contributor:
  Hamilton, Cheryl ; Powers, Aja
• NIOSHTIC Number:
  nn:20061097
• NTIS Accession Number:
  PB2022-100320
• Citation:
  NIOSH [2020]. Evaluation of occupational exposures to illicit drugs during an emergency medical ; services response. By Chiu S, Hornsby-Myers J, Dowell C, Trout D. Cincinnati, OH: U.S. ; Department of Health and Human Services, Centers for Disease Control and Prevention, National ; Institute for Occupational Safety and Health, Health Hazard Evaluation Report 2018-0067-3312,
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Services
• Peer Reviewed:
  False
• NAICS and SIC Codes:
  922160 - Fire Protection - (NAICS)
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4a5d78a55d9ad355f27b32f078f6125f387bfe1eea9a6b42e7cdc01c2c12842edf2bcc1ce0c5f990e9ad164a3a9f3411c398062d84aa004e7ceec7a14ad48063
• Download URL:
  https://stacks.cdc.gov/view/cdc/172324/cdc_172324_DS1.pdf
• File Type:
  [PDF - 351.28 KB ]