Synthetic opioids can be absorbed into the body via inhalation, skin contact, or ingestion. The high potency of these drugs combined with the many possibilities of exposure increases the risks to this hazard.
The potency of synthetic fentanyl, for example, is so strong that even the smallest trace amounts pose environmental hazards. In some cases, synthetic opioid use could arguably pose an even greater environmental risk because of the increased difficultly for visual detection of the hazard.
Fentanyl is around 20 to 40 times more toxic than heroin and 50 to 100 times more toxic than morphine, which makes the risk of accidental overdose higher.
Train all employees to recognize the signs of illicit drug use, production, and associated paraphernalia. Employees should never attempt to confront a guest or investigate a potentially contaminated room. If illicit drug use or operations are suspected, staff should immediately report the situation to their supervisor and/or to the police.
Overview
Fentanyl
can be highly dangerous and a small amount touching the skin or inhaled can
cause serious
harm. Primary
routes of exposure include inhaling powders or aerosols, making contact with
mucous membranes, and ingestion. Secondary exposure includes items that break
the skin, such as needlesticks.
– Any
primary exposure can potentially result in a variety of symptoms that can
include the
rapid onset of life-threatening respiratory depression. Brief
skin contact, however, is not likely to trigger an overdose and can be treated
with prompt
decontamination.
– Wearing
gloves and masks can help prevent exposure.
– Educating
staff to look out for the possible symptoms and side effects of fentanyl
contact could help
save a life.
– Train
all employees to recognize the signs of illicit drug use, production, and
associated paraphernalia.
– Employees
should never attempt to confront a guest or investigate a potentially
contaminated room.
If illicit drug use is suspected, staff should immediately report the situation
to the local authorities.
In situations where employees are not trained to handle
suspected illicit fentanyl, report the exposure immediately and wait for
emergency response. Never handle illicit fentanyl without using the
appropriate personal protection equipment.
Other safety measures to follow if exposure is suspected
– Do not eat, drink, smoke,
or use the bathroom.
– Do not touch the eyes,
mouth, or nose after touching any surface potentially contaminated
– Wash hands (or other
unprotected skin) with soap and water immediately after a potential
exposure and after leaving an area where illicit fentanyl is known or
suspected to be present to avoid potential exposure and cross
contamination.
– Do
not use alcohol-based hand rubs to clean contaminated skin in situations where
exposure to illicit fentanyl is suspected. Use of such hand rubs could increase
absorption through the skin.
– Avoid performing tasks
(such as shaking potentially contaminated clothing or bedding) that might
aerosolize illicit fentanyl that is present because it might increase risk
of exposure to employees.
– If powder or dust is
identified on clothing, a wet wipe should be used while wearing the PPE as
recommended below to remove it. The materials should be carefully placed
in labeled durable 6 mil polyethylene bags and segregated from other
laundry until they are laundered.
Decontamination
– Employees who come into contact with illicit fentanyl should immediately remove clothing and use soap and water to thoroughly wash and rinse potentially contaminated skin.
– Avoid breaking the skin during the decontamination process and they should cover all open wounds.
– Do not use alcohol-based hand rubs or bleach solutions to clean contaminated skin.
– All contaminated clothing should be removed, segregated from other laundry, and laundered at the facility when possible, being careful not to disturb any areas of contamination.
– Decontamination of reusable PPE and equipment should be done according to the manufacturer’s recommendations. Contaminated single use PPE should be placed in labeled durable 6 mil polyethylene bags and disposed of appropriately.
– Surfaces suspected or know to be contaminated with illicit fentanyl that are able to be cleaned (such as hard, non-porous surfaces) should first be washed with soap and water before using a disinfectant (such as bleach).
– Any activity which could result in making an unknown contaminant airborne (such as dry sweeping or vacuuming with a standard vacuum) should not be performed.
– A high-efficiency particulate air (HEPA) filter vacuum should be used when sweeping or vacuuming is required.
Laundry
– Launder clothes worn by employees that has been exposed to illicit fentanyl at the in-house laundry facilities if available.
– Clothing should be carefully placed in labeled durable 6 mil polyethylene bags and segregated from other laundry until they are laundered.
– If the facility does not have in-house laundry facilities, the potentially contaminated linens or uniforms should be segregated and identified when sent for laundering.
– Laundering
should be done in a manner that minimizes disturbance of any areas of
contamination
Disclaimer: The provided information is for informational purposes only. Organization-specific policies and procedures must be developed to address the risk of all hazardous tasks, including the potential exposure to illicit substances.
Resources:
https://www.cdc.gov/niosh/topics/fentanyl/healthcareprevention.html
http://www.safetyandhealthmagazine.com/articles/17057-niosh-issues-fentanyl-safety-
Recommendations-for-health-care-workers. https://oklahomahotels.org/news_manager.php?page=18662
http://forensicanalytical.com/blog/hospitality-exposure-synthetic-opioid-production-and-use/
— Reprinted courtesy of Saskatchewan Hotel & Hospitality Association.