Fentanyl: Preventing Occupational Exposure to Emergency Responders

Resources

CDC Resources

• CDC National Center for Injury Prevention and Control: Fentanyl
• CDC Health Alert Network Health Update 395: Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities
• CDC Health Alert Network Health Update 384: Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities

Other Key Resources

• National Institutes of Health Fentanyl
• National Highway Traffic Safety Administration (NHTSA) Office of Emergency Medical Services (EMS): Video: How EMS can reduce opioid exposures

NIOSH Resources

• Evaluation of Law Enforcement Agents’ Potential Exposures during a Raid of a Clandestine “Spice” Lab
• Evaluation of Employee Exposure to Lead and Other Chemicals at a Police Department
• Evaluation of Potential Employee Exposures During Crime and Death Investigations at a County Coroner’s Office
• Evaluation of Police Officers’ Exposures to Chemicals While Working Inside a Drug Vault – Kentucky
• U.S. Customs and Border Protection Canine Enforcement Training Center Front Royal, Virginia
• State of Iowa Division of Narcotics Enforcement
• NIOSH For Respirator Users
• NIOSH Certified Equipment List
• NIOSH Emergency Response Card for Fentanyl

Other Resources

• The Interagency Board Recommendations on Selection and Use of Personal Protective Equipment and Decontamination Products for First Responders Against Exposure Hazards to Synthetic Opioids, Including Fentanyl and Fentanyl Analogues
• ACMT and AACT Position Statement: Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders
• Justice Institute of British Columbia Fentanyl Safety for First Responders
• OSHA Respiratory Protection
• OSHA Respirator Fit Testing
• NCIPC maps of Law Enforcement Encounters with Fentanyl
• NCIPC maps of Synthetic Opioid Overdose death rates
• Training Video on Reversing Opioid Overdose in Dogs – Illinois Vet Med Educational tool for licensed veterinarians created by University of Illinois College of Veterinary Medicine in collaboration with the American Veterinary Medical Association, Illinois State Veterinary Medical Association, and University of Illinois Police Training Institute

References

• ASHP (2004). ASHP Guidelines on Handling Hazardous Drugs. Retrieved October 6, 2016, from https://www.ashp.org/DocLibrary/BestPractices/PrepGdlHazDrugs.aspx
• Centers for Disease Control and Prevention.  How to Remove Gloves. Retrieved October 6, 2016, from https://www.cdc.gov/vhf/ebola/pdf/poster-how-to-remove-gloves.pdf
• Connor, T. (1999). Permeability of nitrile rubber, latex, polyurethane, and neoprene gloves to 18 antineoplastic drugs. Am J Health Syst Pharm, 56(23), 2450-2453. Retrieved October 6, 2016
• Drug Enforcement Agency. Drug Fact Sheet: Fentanyl. Retrieved, October 6, 2016, from https://www.dea.gov/druginfo/concern_fentanyl.shtml
• Gladden RM, Martinez P, Seth P (2016). Fentanyl Law Enforcement Submissions and Increases in Synthetic Opioid–Involved Overdose Deaths — 27 States, 2013–2014. MMWR Morb Mortal Wkly Rep 65:837–843. DOI: https://www.cdc.gov/mmwr/volumes/65/wr/mm6533a2.htm
• National Institute for Occupational Safety and Health (NIOSH) (2008). Personal Protective Equipment for Health Care Workers Who Work with Hazardous Drugs. Retrieved October 6, 2016, from Workplace Solutions: https://www.cdc.gov/niosh/docs/wp-solutions/2009-106/pdfs/2009-106.pdf
• NIOSH (2004). NIOSH Alert: preventing occupational exposures to antineoplastic and other hazardous drugs in healthcare settings. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Retrieved October 6, 2016, from https://www.cdc.gov/niosh/docs/wp-solutions/2009-106/pdfs/2009-106.pdf
• National Institute on Drug Abuse. DrugFacts—Fentanyl. Retrieved October 6, 2016, from https://www.drugabuse.gov/drugs-abuse/fentanyl
• National Institute on Drug Abuse. Overdose Death Rates. Retrieved October 24, 2016, from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
• Occupational Safety and Health Administration (OSHA) (2011). Respiratory Protection. Retrieved October 6, 2016, from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=12716
• OSHA (2002). Respiratory Protection OSHA 3079. Retrieved October 13, 2016, from https://www.osha.gov/Publications/osha3079.pdf
• OSHA (n.d.). Respirator Fit Testing. Retrieved October 13, 2016, from https://www.osha.gov/video/respiratory_protection/fittesting_transcript.html
• Taylor, Donald R., MD (2005). The pharmacology of fentanyl and its impact on pain management: routes of treatment for fentanyl administration and implications for pain management. Medscape Neurology, 7(2).
• Van Nimmen, N.F.J., Poels, K.L.C, & Veulmans, H.A.F. (2006). Identification of exposure pathways for opioid narcotic analgesics in pharmaceutical production workers. Ann Occ Hyg, 50(7), 666.
• Varvel J.R., Shafer S.L., Hwang S.S., Coen P.A., & Stanski D.R. (1989). Absorption characteristics of transdermally administered fentanyl. Anesthesiology. 70, 928-934.
• Wallemacq, P., Capron, A., Vanbinst, R., Boeckmans, E.J.G., & Favier, B. (2006). Permeability of 13 different gloves to 13 cytotoxic agents under controlled dynamic conditions. Am J Health-Syst Pharm, 63, 547-556. Retrieved October 8, 2016