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Norman C, Marland V, McKenzie C, Ménard H, Nic Daéid N. Evaluation of fentanyl immunoassay test strips for rapid in-situ detection of fentanyl and fentanyl analogs in seized samples and alternative matrices. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104102. [PMID: 37343365 DOI: 10.1016/j.drugpo.2023.104102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/23/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Ion mobility spectrometry is used for the rapid detection of drugs at points of security but are unable to differentiate some drugs leading to the instrument alarming for a drug not present in the sample. This can be particularly problematic for samples that alarm for fentanyl. In this study, fentanyl immunoassay strips were evaluated for use as a secondary test for fentanyl, including for the testing of alternative matrices, such as powders, e-liquids, and infused papers and textiles. METHODS The limit of detection of fentanyl immunoassay strips was examined along with their selectivity to 18 fentanyl analogsand 72 other drugs and cutting agents. The effectiveness of the test strips at the detection of fentanyl in the presence of other drugs was examined by testing a series of concentrations of fentanyl in solution in combination with other drugs. The testing of alternative matrices was explored with laboratory prepared samples through sampling with cotton buds and extraction in water. RESULTS The fentanyl immunoassay strips detected fentanyl at concentrations of 45 ng/mL and reacted with 16 of 18 tested fentanyl analogs with carfentanil and norfentanyl being the only analogs to not react. There was no reactivity with other drugs or cutting agents. The effectiveness of the fentanyl test strips was not reduced when fentanyl was mixed with other drugs. Fentanyl was successfully detected with high sensitivity in all alternative matrices. CONCLUSION The fentanyl immunoassay strips were found to be an effective secondary test for fentanyl and at least 16 fentanyl analogs in seized drug samples, including when mixed with other drugs. The effectiveness of the sampling methods for alternative matrices should be further evaluated using fentanyl and fentanyl analog casework samples. The use of this method by law enforcement and other agencies should be examined to assess its effectiveness and ease of use in operational settings.
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Affiliation(s)
- Caitlyn Norman
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK.
| | - Victoria Marland
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Craig McKenzie
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK; Chiron AS, Stiklestadveien 1, 7041 Trondheim, Norway
| | - Hervé Ménard
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Niamh Nic Daéid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
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Affiliation(s)
- David Love
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
| | - Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA
- 70113 Street, N.W., Suite 750, Washington, DC, 20005-3967, USA
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Chiu SK, Hornsby-Myers J, Iverson C, Trout D. A Cluster of Health Symptoms After a Law Enforcement Operation: A Case Study. Saf Health Work 2022; 13:507-511. [PMID: 36579004 PMCID: PMC9772466 DOI: 10.1016/j.shaw.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/07/2022] [Accepted: 08/15/2022] [Indexed: 12/31/2022] Open
Abstract
Law enforcement officers (LEOs) often encounter rapidly changing and uncontrolled situations that expose them to various hazards. A law enforcement agency requested an evaluation by the National Institute for Occupational Safety and Health (NIOSH) when multiple LEOs reported illness after executing a search warrant and taking a suspect into custody. NIOSH investigators interviewed LEOs and reviewed medical records, forensic laboratory results for collected evidence, and environmental testing results of samples taken after the operation. Two-thirds (25 of 38) of LEOs who participated in the operation reported ≥1 symptom. Eleven LEOs met a case definition for influenza-like illness (ILI). Members of one unit were more likely to have ILI than non-members (prevalence ratio (PR), 4.1; 95% confidence interval (CI): 1.3-13.0; p = 0.01). Influenza vaccination was associated with a lower prevalence of ILI (PR, 0.2; 95% CI, 0.1-0.9; p = 0.02). Preventing employees from working while ill and annual influenza vaccination might prevent similar occurrences.
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Affiliation(s)
- Sophia K. Chiu
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
- Corresponding author. National Institute for Occupational Safety and Health, 1090 Tusculum Ave, Mailstop R-9, Cincinnati, OH 45226-1938, USA.
| | - Jennifer Hornsby-Myers
- Emergency Preparedness and Response Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Christopher Iverson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
- Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Douglas Trout
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
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Cerles AA, Dinh NNL, MacMillan L, Kemp DC, Rush MA. Development of Novel Video-Based First Responder Opioid Hazard Refresher Training. New Solut 2021; 31:298-306. [PMID: 34382476 DOI: 10.1177/10482911211038336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
First responders encounter many hazards in the execution of their duties, and exposure to hazardous materials such as opioids is a primary safety concern. The ongoing opioid crisis in the United States continues to be a major public health issue, with overdose deaths from opioids reaching epidemic levels. Although responders frequently encounter opioids, available data on safety and risk are not always well-communicated, and we identified a need for refresher and just-in-time training products on this topic. In response, we created a training video series that is informative, concise, and visually appealing. The video series, available on YouTube, was tested with a small initial population, with findings suggesting key questions for a larger study focused on integration of the refresher training with existing programs to optimize retention and adoption of safety practices.
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Pennington ML, Dupree J, Coe E, Ostiguy W, Kimbrel NA, Meyer EC, Gulliver SB. Working near a supervised injection facility: A qualitative study of perspectives of firefighter-emergency medical responders. Am J Ind Med 2021; 64:296-300. [PMID: 33522641 DOI: 10.1002/ajim.23224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND While firefighter-emergency medical responders (FF-EMR) are important stakeholders in cities considering the implementation of a supervised injection facility (SIF), there is little information on perspectives of first responders who serve these communities. The aim of the present study was to identify FF-EMR perspectives on working near a SIF. METHODS FF-EMRs from Vancouver Fire and Rescue Services completed an online survey that queried participant perspectives on working near a SIF. RESULTS Four main themes were identified: positive effects, negative effects, duration of assignment, and sense of duty. Similar percentages of first responders reported positive (22.2%) and negative aspects (25.9%) of working near the SIF, while some (18.5%) indicated preference for a short-term assignment to the SIF area. FF-EMRs most commonly described a sense of duty (35.2%). CONCLUSIONS To our knowledge, our study is the first to identify FF-EMR perspectives related to work near a SIF. Perspectives and concerns of first responders should be considered in policy debates about implementation of new SIFs to guarantee an adequately-prepared first responder workforce.
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Affiliation(s)
- Michelle L. Pennington
- Warriors Research Institute Baylor Scott & White Research Institute Waco Texas USA
- Department of Public Health Baylor University Waco Texas USA
| | - Jessica Dupree
- Warriors Research Institute Baylor Scott & White Research Institute Waco Texas USA
| | - Elizabeth Coe
- Warriors Research Institute Baylor Scott & White Research Institute Waco Texas USA
| | | | - Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System Durham North Carolina USA
- VA Mid‐Atlantic Mental Illness Research, Education, and Clinical Center Durham North Carolina USA
- Department of Psychiatry Duke University School of Medicine Durham North Carolina USA
| | - Eric C. Meyer
- Warriors Research Institute Baylor Scott & White Research Institute Waco Texas USA
- College of Medicine Texas A&M University Health Science Center Bryan Texas USA
- Department of Psychology and Neuroscience Baylor University Waco Texas USA
- Department of Rehabilitation Science and Technology University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Suzy B. Gulliver
- Warriors Research Institute Baylor Scott & White Research Institute Waco Texas USA
- College of Medicine Texas A&M University Health Science Center Bryan Texas USA
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Herman PA, Brenner DS, Dandorf S, Kemp S, Kroll B, Trebach J, Hsieh YH, Stolbach AI. Media Reports of Unintentional Opioid Exposure of Public Safety First Responders in North America. J Med Toxicol 2020; 16:112-115. [PMID: 32096007 DOI: 10.1007/s13181-020-00762-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Daniel Saul Brenner
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Stewart Dandorf
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Stephanie Kemp
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Breann Kroll
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Joshua Trebach
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Andrew Ian Stolbach
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA.
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Chiu SK, Li JF, Nolte KB. Evaluating the Potential for Unintentional Occupational Exposure to Fentanyl and Fentanyl Analogues Among Medicolegal Death Investigators and Autopsy Technicians. J Forensic Sci 2020; 65:1324-1327. [PMID: 31986226 DOI: 10.1111/1556-4029.14288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/16/2022]
Abstract
Recent increases in deaths in the United States from synthetic opioids such as fentanyl and fentanyl analogues (fentanyls) have raised concerns about possible occupational exposures to these potent agents. Medicolegal death investigators and autopsy suite staff might perform job tasks involving exposure to fentanyls. The potential for exposure to fentanyls among medicolegal death investigators and autopsy technicians at a state medical examiner's office was evaluated through review of caseload characteristics, injury and illness logs, and procedures and policies and discussions with management and employee representatives. The evaluation showed that this medical examiner's office had low potential for work-related exposure to fentanyls; its standard operating procedures and personal protective equipment requirements should reduce the potential for occupational exposure. Medicolegal death investigation agencies can develop and implement guidance to control exposures and provide workforce education and training to reduce the potential for work-related exposure to fentanyls.
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Affiliation(s)
- Sophia K Chiu
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Mailstop: R-9, Cincinnati, OH, 45226
| | - Jessica F Li
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Mailstop: R-9, Cincinnati, OH, 45226
| | - Kurt B Nolte
- Office of the Medical Investigator, MSC07 4040, 1 University of New Mexico School of Medicine, Albuquerque, NM, 87131
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