NIOSH Updates Resources for Protecting Workers from Exposure to Fentanyl

Published September 6, 2017

​NIOSH has updated its workplace safety and health topic page that collects resources and information related to protecting emergency responders from occupational exposure to fentanyl. In a new section on protecting workers at risk, the agency identifies four job categories in which emergency responders might come into contact with fentanyl or its analogues: pre-hospital patient care, or responders who attend to individuals with suspected fentanyl overdose; law enforcement officers who perform day-to-day law enforcement activities; investigation and evidence handling, or personnel who conduct investigations related to fentanyl; and special operations and decontamination, or workers who conduct special operations where exposure to large amounts of fentanyl are expected. A new table that provides personal protective equipment (PPE) recommendations for protection against fentanyl and its analogues based on job category and level of risk is now available. NIOSH has also updated its fentanyl resources page.

Fentanyl is a prescription drug typically used to treat patients with severe pain or to manage pain after surgery. The NIOSH topic page describes fentanyl and its analogues as “extremely dangerous when used illicitly,” and the U.S. Drug Enforcement Administration associates fentanyl with an epidemic of opioid-related overdose deaths in the U.S. The drugs pose a potential hazard to emergency responders, who are most likely to encounter illicitly manufactured fentanyl and its analogues in powder, tablet, and liquid form. Potential routes of exposure include inhalation, mucous membrane contact, ingestion, and exposure through the skin such as with needlesticks. According to NIOSH, these exposure routes can result in a variety of symptoms, including the rapid onset of life-threatening respiratory depression.

“Skin contact . . . is not likely to lead to overdose unless large volumes of highly concentrated powder are encountered over an extended period of time,” according to NIOSH. “Brief skin contact with fentanyl or its analogues is not expected to lead to toxic effects if any visible contamination is promptly removed.”

NIOSH does not have occupational exposure data on fentanyl or its analogues for emergency responders, and there are currently no relevant established federal or consensus occupational exposure limits.