The drugs don’t work


garment. In operations where there is minimal, if any, potential for contact with opioids or the dust, standard duty uniforms will provide the necessary protection. The table below highlights PPE to consider in various operational situations. When choosing nitrile gloves, it is


recommended that they are tested for liquid penetration in accordance with ASTM F1671/F1671M9


. This


requirement incorporates suspended particulate matter and is more stringent than the ASTM D5151 water leakage test used for a lot of examination gloves. Any nitrile gloves certified against NFPA 199910


use examination gloves are appropriate for use with fentanyl. NIOSH also recommends that the nitrile gloves have a minimum thickness of 5mm. When choosing a particle tight


ensemble for moderate to high exposure risks, it is recommended that the entire ensemble, as worn, is tested in accordance with the particle inward leakage test referenced in section 8.5 in NFPA 1994.11


This test, modified from the US Department of 1. Janssen, P (1961) Lower Alkyl Esters of 1-(2-Bezoylethyl)-


3-Methyl-4-Phenylpiperidine-4-Carboxylic Acid and 1-(3- Hydroxy-3-Phenylpropyl)-3-Methyl-4-Phenylpiperidine-4- Carboxylic Acid, United States Patent Office Patent


3,004,977. Patented on 17 Oct 1961. 2.


DeLuca, R (2004) Monograph and Occupational Exposure Limit for Fentanyl, Fentanyl Citrate, and Fentanyl


Hydrochloride. Corporate Johnson & Johnson documents. 3.


Mallinckrodt (2011) Fentanyl Transdermal Therapeutic System, Material Safety Data Sheet, Version 02, Revision


Date 04-08-2011. 4.


Van Nimmen, N, Poels, K, and Veulemans, H (2006)


Identification of Exposure Pathways for Opioid Narcotic Analgesics in Pharmaceutical Production Workers, Ann


Occup Hyg, 50(7): 665-677. 5.


International Organization for Standardization. (2015)


Respiratory Protective Devices – Human Factors – Part 1: Metabolic Work Rates and Respiratory Flow Rates, ISO/TS


16976-1:2015. 6.


IAB (2017) Recommended Best Practices to Minimize


Emergency Responders Exposures to Synthetic Opioids, Including Fentanyl and Fentanyl Analogues, released October 2017. (https://interagencyboard.org/sites/default/files/ publications/IAB%20Recommended%20Best%20Practices%


20for%20Opioid%20Response%20October%202017.pdf) 7.


NIOSH (2017), Fentanyl: Preventing Occupational


Exposure to Emergency Responders, last updated 30 August Roy, S and Flynn, G (1990) Transdermal Delivery of


2017. (https://www.cdc.gov/niosh/topics/fentanyl/risk.html) 8.


Narcotic Analgesics; pH, Anatomical, and Subject Influences on Cutaneous Permeability of Fentanyl and Sufentanil,


Pharmaceutical Research, 7(8): 842-847. 9.


ASTM F1671/1671M. (2013) Standard Test Method for


Resistance of Materials Used in Protective Clothing to Penetration by Blood-Borne Pathogens Using Phi-X174


Bacteriophage Penetration as a Test System. 10.


Ensembles for Emergency Medical Operations. 11.


CBRN Terrorism Incidents. 12.


NFPA 1999 (2018) Standard on Protective Clothing and NFPA 1994 (2018) Standard on Protective Ensembles for


First Responders to Hazardous Materials Emergencies and DoD (2013) Test Operating Procedure (TOP) 10-2-022A


Chemical Vapor and Aerosol System-Level Testing of NFPA 1991 (2016) Standard on Vapor-Protective


Chemical/Biological Protective Suits. 13.


Ensembles for Hazardous Materials Emergencies and CBRN Terrorism Incidents.


CBRNe Convergence, Orlando, USA, 6-8 November 2018 www.cbrneworld.com/convergence2018 38 CBRNe WORLD February 2018 www.cbrneworld.com Defense aerosol system test12 ,


challenges ensembles with 2.75μm particles which are similar in size to fentanyl particles. Any ensembles certified against NFPA 1994 Class 4 are appropriate for use with high hazard fentanyl milling laboratories. In addition, ensembles that are challenged with the man-in-simulant tests used in NFPA 199113


and NFPA


199411 are also suitable and provide the extra benefit of chemical vapour protection to varying levels.


as single In summary, the protective


clothing and accessories should meet suitable standards and should be selected taking into account the task, task duration, location, situation, hazard, and potential for contact. The tables above provide a basis to support your PPE selection. Each country has its own sets of standards and test methods that should be applied in your site-specific risk assessment in place of the US standards mentioned above.


CBRNeWORLD


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