With the number of opioid-related deaths rising, first responders are becoming increasingly worried about accidental occupational opioid exposure, leading to a number of publications on, and awareness of, proper fentanyl hazmat preparation.
Opioid-related incidents killed more people than those involved in major car accidents in 2015, putting first responders at risk for exposure to fentanyl, both alone and mixed with heroin, and carfentanil, known as “elephant tranquilizer.” Recent reports of emergency medical personnel experiencing symptoms of opioid exposure have raised concerns about the amount of personal protective equipment that should be required to answer overdose calls in the field.
In a survey of 235 firefighters, 35 percent say fentanyl hazmat preparation is one of their biggest concerns.
Transdermal and Respiratory Opioid Exposure
Standard grade nitrile gloves are sufficient to guard against transdermal, or skin exposure to opioids, according to the National Institute of Occupational Safety and Health and the InterAgency Board for Equipment Standardization and Interoperability.
The bigger threat comes with the exposure to respiratory opioids, often encountered on a scene where drugs are being manufactured or sold in large quantities. NIOSH recommends a P100 HEPA mask for first responders in this situation, and for other opioid exposure concerns, they recommend calling a hazmat team to assess the risk.
Adequate Protection Calls for Constant Reassessment
A recent publication released by the Interagency Board on the selection and use of PPE when encountering synthetic opioids focuses on assessing the potential for opioid exposure. In a warning, it acknowledged that "[PPE] alone is not sufficient to ensure protection from synthetic opioids.”
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To best protect first responders, the report encourages all organizations to define minimum standards of required PPE equipment, which can then be added at personal and organizational discretion through risk assessment, which includes:
- Amount and reliability of available information regarding the potential presence of synthetic opioids
- First responder proximity to bulk materials
- Duration of first responder proximity to materials
As more information about the situation becomes available, or as first responders work their way through the scene, more fentanyl hazmat preparation may be necessary. Constantly reassessing the need for PPE is vital to protecting first responders from accidental occupational opioid exposure.
