Pilot Study on Risk Perceptions and Knowledge of Fentanyl Exposure Among New York State First Responders

Abstract

Objectives:The present opioid epidemic and abuse of fentanyl in the United States has led to an increased risk of exposure to first responders. Law enforcement, fire, and emergency medical services are receiving misinformation on fentanyl health and safety risks and this has led to miscommunication. Understanding the risk perceptions and knowledge of first responders regarding fentanyl can help identify training gaps.Methods:A 15-item 6-point Likert scale online questionnaire was developed and distributed to firefighters, police officers, and emergency medical technicians, regarding perceptions of fentanyl exposure, and additional questions concerning knowledge. The online questionnaire was sent to 15 associations of national and New York State first responders with 3 associations acknowledging and distributing the survey.Results:Of the 247 participants, 187 served New York State; 92 worked in law enforcement; and the other 95 worked in either fire, emergency medical service, or both. New York State first responders generally agreed with expert risk perceptions and knowledge of fentanyl exposure in the pilot study. Items pertaining to using hand sanitizer, selecting glove type, and dermal exposure to fentanyl had lower agreement with expert beliefs.Conclusions:Risk perceptions and knowledge could be used to evaluate fentanyl response training among first responders.

Occupational Safety and Health and Illicit Opioids: State of the Research on Protecting Against the Threat of Occupational Exposure

“…In the Persaud/Jennings 2019 survey of New York State law enforcement officers, firefighters, and EMS personnel (discussed above), 37% of EMS/firefighters and 24% of law enforcement officers answered that hand sanitizer is safe to use after handling fentanyl. 34 If alcohol-based hand sanitizer increases transdermal absorption, then the approximately one-third of first responders who believe hand sanitizer is safe to use may be at increased risk of harm. No other studies examining knowledge or utilization of decontamination methods were identified.…”

“…[31][32][33] The second study was a 2019 survey of 187 New York state law enforcement officers, firefighters, and emergency medical technicians regarding knowledge of fentanyl exposure and PPE. 34 The study found that responders generally agreed with expert risk perceptions of fentanyl but had lower agreement with expert recommendations on PPE. Most respondents understood the need to protect their eyes, nose, and mouth when working with fentanyl and to not disturb fentanyl without PPE.…”

“…In fact, the authors of the 2019 survey conducted in New York State noted that their study is the first of its kind to explore the risk perceptions and knowledge of first responders with respect to fentanyl exposure. 34 Although other studies were identified that examine barriers to PPE usage more generally, these studies focus only on firefighters and so similar factors may or may not affect PPE-related decision-making among other occupations. Whether the motivations behind PPE use or misuse in other situations apply equally to illicit opioid exposure, and if greater knowledge of the risks posed by opioids can overcome the barriers to use and change patterns of PPE utilization remains unclear.…”

“…Overall, there is a clear gap in knowledge regarding the proper use of PPE across occupations including employer practices to support proper PPE utilization. Research suggests there may be evidence of nonutilization or improper utilization of PPE among potentially exposed first responder populations, [30][31][32][33][34] and NIOSH is working with fire departments to identify various practices related to PPE. 38 Additional future studies may identify opportunities at the employer and worker level for behavior change methods, including new or modified trainings, to improve occupational safety.…”

Can touch this: training to correct police officer beliefs about overdose from incidental contact with fentanyl

“…Despite a consistent stream of media accounts of overdose from fentanyl exposure, few studies have reported on officer perceptions of this misinformation. A survey of first responders in New York found that 80% believed "briefly touching fentanyl could be deadly" (Persaud & Jennings, 2020). To our knowledge, only one study has reported on the effects of correcting this perception.…”