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Fentanyl: preventing occupational exposure to emergency responders: protecting workers at risk
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August 30, 2017
[PDF-202.65 KB]
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Description:Fentanyl and its analogues pose a potential hazard to a variety of responders who could come into contact with these drugs in the course of their work. Possible exposure routes to fentanyl and its analogues can vary based on the source and form of the drug. Responders are most likely to encounter illicitly manufactured fentanyl and its analogues in powder, tablet, and liquid form. Potential exposure routes of greatest concern include inhalation, mucous membrane contact, ingestion, and percutaneous exposure (e.g., needlestick). Any of these exposure routes can potentially result in a variety of symptoms that can include the rapid onset of life-threatening respiratory depression. Skin contact is also a potential exposure route, but is not likely to lead to overdose unless large volumes of highly concentrated powder are encountered over an extended period of time. Brief skin contact with fentanyl or its analogues is not expected to lead to toxic effects if any visible contamination is promptly removed. There are no established federal or consensus occupational exposure limits for fentanyl or its analogues.
NIOSH has identified the following job categories as positions where responders might come into contact with fentanyl or its analogues.
• Pre-Hospital Patient Care: Emergency medical services (EMS) providers, including first responders, fire department and private companies who attend to individuals with suspected fentanyl overdose. Responders may encounter drugs or drug paraphernalia on or near the patient.
• Law Enforcement: Law enforcement officers who perform day-to-day law enforcement duties. Law enforcement officers may come into contact with fentanyl during the course of their daily activities such as traffic stops, apprehending and searching subjects, and responding to fentanyl overdose calls.
• Investigation and Evidence Handling: Law enforcement personnel who conduct investigations related to fentanyl. Activities may include executing search warrants and collecting, transporting, and storing evidence. Evidence collection activities in the field have the potential to aerosolize powders. Also, law enforcement personnel who handle evidence in the chain of custody have the potential to come into contact with fentanyl unless controls are in place to prevent exposures.
• Special Operations and Decontamination: Workers who conduct special operations where exposure to large amounts of fentanyl are expected. Examples include hazardous material incident response teams responding to a release or spill, and law enforcement officers executing search warrants on opioid processing or distribution sites, or participating in other tactical operations. These activities may aerosolize powders.
NIOSH has no occupational exposure data on fentanyl or its analogues for emergency responders. These recommendations are based on the reported toxicity and the chemical and physical properties of fentanyl and its analogues; NIOSH guidance for other similar chemicals (or in the same family); recommendations from previous NIOSH health hazard evaluation reports about law enforcement personnel exposures to other drugs and chemicals; and the basic principles of industrial hygiene. As new research becomes available, these recommendations will be updated.
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