When first responders arrive at a scene where illicit drugs may be present, they could be at risk of dangerous exposure. They might inhale drugs; they can have contact through mucous membranes or through needlesticks.
A major concern is exposure to fentanyl or its analogues, which can lead to symptoms, including rapid onset of life-threatening respiratory depression. The exception is skin contact, which is not expected to have toxic effects if the visible contamination is removed promptly.
To help EMS providers and other responders protect themselves, the National Institute for Occupational Safety and Health (NIOSH) has released a new virtual toolkit with videos, infographics, and postcards based on NIOSH safety recommendations.
The resources highlight how best to assess the scene for hazards that may indicate the presence of illicit drugs and what to do—for example, use soap and water, not hand sanitizer (it doesn’t remove illicit drugs and may increase exposure), and don’t eat, drink, smoke, or use the bathroom in the affected area. The infographics also show how to decontaminate and prevent “take-home exposure” to protect responders’ families. The guidelines extend to procedures for protecting working dogs exposed to the drugs.
NIOSH notes that it has no occupational exposure data on fentanyl or its analogues for emergency responders. The recommendations are based on the reported toxicity and the chemical and physical properties of fentanyl and its analogues, NIOSH guidance for similar chemicals, recommendations from previous NIOSH health hazard evaluation reports, and “the basic principles of industrial hygiene.” As new research becomes available, NIOSH says, the recommendations will be updated.
The toolkit resources are shareable and available for disseminating via print, social media, text, and more. The kit is accessible at https://www.cdc.gov/niosh/topics/fentanyl/toolkit.html.