Perceptions of opioid and other illicit drug exposure reported among first responders in the southeast, 2017 to 2018

Background: Opioid use has risen dramatically in recent years, and its illegal use puts first responders at risk when intervening in overdoses. Synthetic opioids, like fentanyl with a potency 50 to 100 times greater than morphine, pose a great risk and accidental exposure via ingestion, inhalation, mucosal, or percutaneous routes, can potentially lead to fatal outcomes. Anecdotal media accounts in early 2017 of accidental occupational opioid exposure among first responders generated a national concern. Methods: To identify first responders' recollections, beliefs, and concerns about possible occupational exposure to opioids and other drugs, researchers in Kentucky, Virginia, Mississippi, and Georgia administered an emailed, anonymous convenience sample survey. Results: A total of 5955 surveys were analyzed with 15% of respondents reporting they believed they had been exposed to opioids, and of those, less than 1% reported experiencing health effects from perceived exposure. Over half (51%) of respondents reported being “very or somewhat concerned” about developing health effects from exposure to opioids. Half of respondents reported being unaware of Centers for Disease Control and Prevention (CDC)/National Institutes for Occupational Safety and Health (NIOSH) guidelines for preventing occupational-related opioid exposures. Conclusions: Only a small fraction of first responders believed they had experienced symptoms related to opioid exposure in overdose response calls, but half were concerned about potential exposures and half were unaware of the educational guidance on prevention available. The high level of concern regarding potential exposure warrants the need for the development and or enhancement of targeted educational training interventions and further dissemination of pre-existing training interventions to ensure first responders have the knowledge and understanding of occupational opioid exposures and minimize stress associated with the potential rare exposures.