NIOSH Reports Address Occupational Exposures to Opioids Among First Responders

NIOSH evaluates potential occupational exposures to opioids among police officers and firefighters during first-responder activities in two new health hazard evaluation (HHE) reports dated August 2021. Both evaluations were requested by city officials who were concerned about possible unintentional exposures to opioids among police and fire personnel. NIOSH staff worked to identify exposure opportunities and incidents affecting both departments, and the agency’s reports make recommendations to limit occupational exposures to opioids in these and other emergency response situations.

In the report on exposures in a city fire department (PDF), NIOSH found that most of the firefighters encountered situations in which they may be exposed to illicit drugs. A survey of first responders conducted by agency staff found that of 189 respondents, 62 percent reported that suspected opioids were visible during their work within the past six months, and 19 percent reported one or more potential routes of exposure. Ninety-two percent of first responders reported wearing gloves when suspected opioids were visible, but similarly high proportions of respondents did not report using a respirator or eye protection in these situations. NIOSH’s recommendations include periodic training on practices to prevent occupational exposures to opioids and improved cooperation with 911 dispatchers to identify situations in which illicit drugs may be present. The HHE report also recommends improvements in mental health services for firefighters.

NIOSH’s other report (PDF) focuses on 16 police officers who were potentially exposed to opioids. Twelve of these officers reported a range of mild, brief health effects, including lightheadedness, heart palpitations, nausea, and constricted “pinpoint” pupils, a symptom of opioid toxicity also known as miosis. While none of the officers experienced definitive signs of serious opioid toxicity and the cause of the health effects could not be identified, the symptoms interfered with the officers’ abilities to do their jobs and many of the incidents were associated with potential routes of accidental opioid exposure. NIOSH staff found that the officers did not have, use, or receive proper training for personal protective equipment appropriate for handling unknown powders. The agency’s report recommends that the department assess hazards associated with routine and emergency job tasks and implement controls such as the development of a written respiratory protection program, the provision of PPE, and training in correct PPE use.

More information about controlling occupational exposures to opioids can be found in NIOSH’s recommendations for preventing emergency responders’ exposures to illicit drugs.