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Convention workshops cover opioid exposure risks in the workplace

BY KATE MOSTACCIO

The opioid epidemic sweeping through New York communities has increased the risk for PEF members in a variety of titles, from law enforcement to health care settings to parks employees.

“As treatments for opioid overdoses increase in hospital and clinical settings, and community use continues to spiral, health care workers and other public sector workers may be exposed to dangerous and in some cases potentially fatal concentrations of these chemical compounds,” said Geraldine Stella, an OSH Specialist with PEF’s Health and Safety Department. “It is important for PEF members to be able to evaluate just how much risk there actually is, and what to do if they are exposed to opioids in the workplace.”

Stella conducted workshops on workplace opioid exposure at the 41st Annual PEF Convention in Albany.

opioidOpioids are a group of drugs including morphine, oxycodone, methadone, heroin, fentanyl, and fentanyl analogues, such as carfentanyl (used by veterinarians). Opioids are often used for pain management and can cause euphoria, a feeling of being high, which increases the potential for the drugs to be used improperly.

Opioids can be in tablet, capsule, injectable, powder, liquid, suppository, nasal spray, skin patch, and edible form, Stella said.

Some of them are far more powerful than others. Fentanyl can sometimes be 50 to 100 times more potent than morphine and carfentanyl as much as 10,000 times more powerful.

“Workers are at risk of exposure to opioids in various forms, either as a part of their job in health care, pain management, and laboratory testing, or accidentally, such as incidences of illegal use by visitors or coworkers, illegal manufacturing labs, pat downs or home and vehicle searches, or discarded paraphernalia,” said Statewide Article 18 Co-Chair Mike Blue. “We want PEF members to be aware of what to do in the event of an exposure.”

Environmental inspectors, forensic lab workers, parole officers, parks and highway workers, emergency responders, social services workers, Corrections and Community Supervision employees — all may be at risk for opioid exposure and need to recognize the forms they come in, symptoms of exposure, and common situations where exposure may occur.

“Signs of exposure include respiratory distress, depression or arrest; nervous system depression; drowsiness; reduced level or loss of consciousness; dizziness, nausea or vomiting; and a limp body,” said Statewide Article 18 Committee Co-Chair and PEF Contract Chair Darlene Williams. “Knowing the signs of an opioid overdose can help PEF members protect themselves in case of exposure.”

Exposures vary from title to title and agency to agency.

For law enforcement, their day-to-day jobs may lead to exposure.

Parole Officers and Corrections employees responding to opioid overdose calls, apprehending and searching subjects, home visits, cell or inmate searches, said Statewide Labor Management Chair Steven Drake, a Mohawk Correctional Facility employee, are all examples of routine duties where exposure is possible.

“Occupational exposure can also occur during investigation and evidence handling; when executing search warrants; or during evidence collection activities in the field, which have the potential to aerosolize powders,” he said.

In the pre-hospital setting, first responders have an increased risk of exposure.

“First responders, fire department and private companies who attend to individuals with suspected fentanyl overdose are at risk,” Williams said. “Responders may also encounter drugs or drug paraphernalia on or near a patient. Those patients may then be transported to health care settings where PEF members work, potentially putting them at risk as well.”

In addition to exposure by direct contact with a patient, workers can be exposed to opioids on surfaces in public restrooms, on the roadside when bags or delivery mechanisms are discarded, and on hospital surfaces.

What should a member do if they are exposed to opioids in the workplace?

“Do not eat, drink, smoke or use the bathroom while working in an area with known or suspected fentanyl or other opioids,” Williams said. “Do not touch the eyes, mouth, and nose after touching any potentially contaminated surface.”

“Routine cleaning of work surfaces and rooms in health care facilities should be done in accordance with the CDC guidelines,” Stella said. “Surfaces that are suspected or known to be contaminated should be washed with soap and water before using a disinfectant, such as bleach.”

She said to avoid activities that might aerosolize a powdered opioid, such as sweeping or using a regular vacuum when cleaning the area. She also stressed washing hands with soap and water immediately. “Do not use hand sanitizers or bleach solutions to clean contaminated skin,” she said.

Stella also stressed using the appropriate personal protective equipment (PPE) whenever decontaminating.

Workplace training

To improve safety, all places of employment where opioid exposure is a real risk should conduct trainings.

“Training needs include how to conduct an on-scene risk assessment, how to recognize the form and determine the quantity of suspected opioids, what the potential exposure routes are for the workplace, how to recognize the signs and symptoms of exposure, and when and how to seek medical help,” said Department of Corrections and Community Supervision (DOCCS) PEF Statewide Health and Safety Chair Lindsay Bonanza.

Education should also include when to use PPE, what type is necessary, proper use and disposal, and the limitations of PPE, she said.

Routes of exposure include skin contact, inhalation, mucous membrane contact, ingestion, and percutaneous exposure or “needlesticks.”

“Activities that aerosolize fentanyl require higher levels of PPE and should be conducted by appropriately trained personnel,” Bonanza said. “Never handle fentanyl or its analogues without the appropriate PPE.”

At a meeting of DOCCS members held at convention, a number of attendees raised concerns about potential exposure to opioids in state correctional facilities.

In particular, members wanted to look at putting in safeguards at methadone clinics and conducting risk assessments at medical facilities, said Drake. “DOCCS SW H&S Committee members recently visited the methadone treatment center at Elmira Correctional Facility to talk to PEF members and other employees there. We want to be sure that important safeguards are consistently in place.”

PEF members who feel opioid exposure is a concern at their workplace, should have the issue put on the Health and Safety and/or Labor Management agenda and raise the issue at their next membership meeting, said Stella.


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