Fentanyl, an opioid 50 times stronger than heroin, continues to pose hazards to both its users and emergency responders, with no reduction of use in sight.
The drug typically is mixed with powder heroin, which causes a higher potential for overdose. When emergency responders need to provide assistance to those experiencing an overdose, they too can be exposed to fentanyl through the inhalation of the powder.
Because of this, NIOSH and the CDC have posted an interim guidance which details steps workers can take to reduce occupational exposure to the substance.
The risks associated with fentanyl and its analogs highlight the need for first responders to perform a risk assessment on each crime scene and follow established work practices appropriate for the specific job tasking along with wearing personal protective equipment (PPE) to effectively manage risks that may cause an exposure. Established work practices are written policies and procedures, as well as tactics and techniques, used when fentanyl may be present to minimize the risk of exposure.
Inhalation exposure can cause respiratory depression. So, respiratory protection is essential. Any respiratory protection should follow the requirements of OSHA’s Respiratory Protection standard, according to NIOSH.
The agency recommends responders wear an approved half-mask filtering facepiece respirator rated P100 or a tight-fitting ,full-face air-purifying respirator with multi-purpose P100 cartridges/canisters. The agency says powered air-purifying respirators (PAPRs) with high-efficiency particulate air (HEPA) filters may also be used.
As an alternative, first responders can wear a NIOSH-approved elastomeric half mask air-purifying respirator with multi-purpose P100 cartridges with ocular protection, according to the website.
In addition, responders could be exposed to fentanyl through skin absorption as well. Gloves should be worn, especially where evidence collection is required.
In situations where fentanyl or other opioids are known to be present, law enforcement and other emergency responders should not eat, drink or smoke while performing operations to prevent unintentional digestion, according to NIOSH.
Lastly, the case of a large spill or release, NIOSH recommends that law enforcement leave the area and call a hazardous materials incident response team.