It seems like every time you turn on the news or check out a paper there’s another tragic story about an opioid overdose. Since doctors recently cracked down on prescribing oxytocin and other easily-abused opioids like Percocet and Vicodin, another drug has quickly made its way onto the scene as an even deadlier replacement: fentanyl.
Fentanyl is known to be 50 times stronger than heroin. A speck the size of a grain of salt can actually kill you. That’s a pretty terrifying fact. Even scarier? Fentanyl can be absorbed through the skin or eyes, or inhaled if it becomes airborne, putting emergency responders – and even police dogs – in extreme danger if exposed. And now, many drug dealers are adding fentanyl (along with additional fillers like baking soda) to other drugs in an effort to increase potency for less cost.
So it’s clear: the drug world is changing. When a police officer sees white powder, they can no longer assume it’s something as recognizable as cocaine. Synthetic drugs are on the rise, and law enforcement and EMS are at particular risk for exposure to these highly-concentrated formulas. It’s more important than ever for first responders to protect themselves against the risk of accidental fentanyl exposure.
Let’s talk about a few ways you can take the right precautions.
Unfortunately NIOSH doesn’t currently have any occupational exposure data on Fentanyl among emergency workers, but they have provided some interim guidance regarding respiratory hazards.
NIOSH suggests that while handling and processing fentanyl and its analogs, first responders (like law enforcement personnel, emergency medical services [EMS], and firefighters) should wear:
- NIOSH-approved half-mask filtering facepiece respirator rated P100 or a tight-fitting full facepiece air-purifying respirator with multi-purpose P100 cartridges/canisters. If an elastomeric half mask respirator is used instead of a respirator with a full facepiece, safety goggles/glasses should also be worn for ocular protection.
- Chemical, biological, radiological, and nuclear (CBRN) canisters with full face respirators provide P100 protection as well.
- Powered air-purifying respirators (PAPRs) with high-efficiency particulate air (HEPA) filters may also be used.
Ideally, a full-facepiece respirator is used to provide respiratory and eye protection, but in the absence of a full-facepiece:
- Use indirect vented goggles if using a half face respirator; the purpose of the indirect venting is to limit or prevent the passage of liquid splash and dust into the goggle.
First responders who are performing any task that would potentially aerosolize fentanyl, such as sweeping or “burping” bags to remove air, should wear dermal protection that covers their arms and legs:
- Coveralls or chemical-resistant and disposable protective sleeves that are impermeable, coated, and film-based.
- Chemical-resistant/disposable boot covers are also recommended to reduce spread of contamination.
- Since Fentanyl be dissolved and/or the powder could move through seams, it may be prudent to use a garment with sealed seams.
- Flame resistant coveralls are recommended for work in clandestine labs in the event that Bunsen burners or other gas operated, open flame heat sources are present.
Hand protection is absolutely essential for first responders who may be handling fentanyl:
- Choose a non-latex glove that is greater than or equal to 5 mil +/- 2 mils (0.127mm/-0.051mm) thick.
- Choose the correct sized gloves, since gloves that are too small may be uncomfortable and tear, and overly large gloves can interfere with dexterity.
- Replace gloves after 30 – 60 minutes of use. If gloves are torn or punctured, replace immediately!
- Double gloving is suggested. If sleeve cuffs are present, the inner gloves should be worn under the sleeves, while the outer gloves should be placed over the sleeve cuff. After handling the drugs, the outer gloves should be removed and properly disposed of while the inner gloves can be used to label evidence.
- Always treat gloves as if they have been exposed and perform proper donning and doffing technique. Wash hands as soon as possible with soap and water to remove any possible contamination.
- Though glove color is a personal preference, a dark color glove may better assist with identifying and/or visualizing drug powder residue.
- Pay attention to the AQL (Acceptable Quality Level), which is a statistical measurement of the number of defects possible in a production run. The lower the number, the better. Ideally you want at least a 0.65 or less (6 in 1000 potentially have a defect).
It’s important to recognize that the exposure level you initially selected can change and your PPE should be adjusted accordingly. Higher levels of PPE may also be necessary to protect responders from exposure to other chemicals that could also be present in addition to fentanyl.
Stay tuned for next week’s blog where we’ll be taking an in-depth look at the innovative tools police and EMS are using to identify fentanyl. In the meantime, if you need help selecting the right PPE for your first responders, get in touch with us today.