Evaluation of Potential Occupational Exposures to Opioid Drugs During a Law Enforcement and Emergency Medical Services Response (Interim Report)

Details

• Personal Author:
  Chiu, Sophia ; Hornsby-Myers, Jennifer ; Trout, Douglas B.
• Corporate Authors:
  National Institute for Occupational Safety and Health
• Description:
  Introduction: The NIOSH Health Hazard Evaluation program received requests for an evaluation from a county-s Fire Chief and Sheriff. The requests concerned possible work-related exposure to opioid drugs (including fentanyl or its analogues) among responders during the course of a law enforcement and fire and rescue response. On March 1-2, 2018, Deputy Sheriffs and fire fighter-emergency medical service (EMS) providers responded to a private residence where a drug overdose had taken place. Deputy Sheriffs and fire fighter-EMS providers developed symptoms during the response. A total of nine responders were evaluated at a local hospital. We visited the Fire and Rescue Department, Sheriff-s Office, and hospital on March 13-14, 2018. On March 16, 2018, we sent an interim letter to the requestors and employee representatives briefly summarizing our activities and preliminary findings. This interim report summarizes current findings and recommendations for this evaluation. At the time of the evaluation, the Fire and Rescue Department had 131 full-time career fire fighter-EMS providers operating from 13 stations. The department also included approximately 200 active volunteer fire fighter-EMS providers operating via 14 volunteer fire/rescue or EMS squads. Daily staffing for the department included six paramedic transport units (ambulances) and four fire suppression units (engines), along with various other support equipment. Fire fighter-EMS providers worked in 24-hour shifts on days 1, 3, and 5 of a 9 day-day cycle and were off on days 2, 4, and 6-9 of the cycle. The Sheriff's Office included a Field Operations Division with 114 assigned deputies. Deputies were assigned to one of three overlapping 11.5-hour shifts (day, evening, or midnight). In the recent past, both the Fire and Rescue Department and Sheriff's Office had received an increased volume of calls related to drug overdoses. This trend is consistent with the increased number of overdose fatalities related to fentanyl, fentanyl analogues, and other illicit drugs nationally [CDC 2018]. The Fire and Rescue Department responded to over 170 calls related to opioid use in 2017. Among those responses, over 120 different victims received naloxone as part of the response. Conclusions: During a response in March 2018, Deputy Sheriffs and fire fighter-EMS providers developed health effects shortly after treating or transporting a victim with suspected opioid overdose. The etiology of symptoms and potential source(s) of exposure for the workers could not be definitively identified. None of the responders' health effects involved classic, life-threatening opioid toxicity. A mild degree of opioid toxicity can cause symptoms similar to some of the non-specific symptoms reported by responders in this response. Recommendations are provided below. Training and education to improve understanding of the routes of exposure to opioid and other drugs likely to cause symptoms and measures to protect against work-related exposure to opioids and other drugs can help prevent exposures and prevent health effects among Sheriff's Office and Fire and Rescue Department employees. Further evaluations and research are needed to improve understanding of the routes of exposure and potential health effects among first responders potentially exposed to opioid drugs (including fentanyl and fentanyl analogues) in the course of their work.
• Subjects:
  Emergency Responders Firefighters Law Enforcement Occupational Health Personal Protective Equipment Protective Clothing Safety
• Keywords:
  Drugs Emergency Medical Services Workers Emergency Medical Technician Emergency Responders EMS EMT Fire Fighters Gloves Heroin Law Enforcement Officer LEO Police Officers PPE Protective Clothing

  More +
• Source:
  Atlanta, GA: 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 2018-0083, 2018 Apr ; :1-13
• Series:
  Health Hazard Evaluation Reports (HHE)
• DOI:
  https://doi.org/10.26616/NIOSHHHE20180083
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Genre:
  Field Study
• Place as Subject:
  Georgia ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  EPRO - Emergency Preparedness and Response Office ; DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  13 pdf pages
• NIOSHTIC Number:
  nn:20051370
• Federal Fiscal Year:
  2018
• NORA Priority Area:
  Services
• Peer Reviewed:
  False
• NAICS and SIC Codes:
  92 - Public Administration - (NAICS)
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3a9794d6f6b9d78f96a3fe73a637e16620856044047fdfea44d23dae5560b01b407a18e1ba928783d11fe2d1b20152f17b446af17b5d7602dfcffd6a108605cd
• Download URL:
  https://stacks.cdc.gov/view/cdc/172367/cdc_172367_DS1.pdf
• File Type:
  [PDF - 158.36 KB ]