Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-17T18:14:45.593Z Has data issue: false hasContentIssue false
  • English
  • Français

Accidental Occupational Exposure to a Large Volume of Liquid Fentanyl on a Compromised Skin Barrier with No Resultant Effect

Published online by Cambridge University Press:  20 June 2022

Ryan Feldman Open the ORCID record for Ryan Feldman [Opens in a new window]  and
Benjamin W. Weston Open the ORCID record for Benjamin W. Weston [Opens in a new window]
Ryan Feldman*
Affiliation:
Froedtert and the Medical College of Wisconsin, Department of Pharmacy, Milwaukee, WisconsinUSA Medical College of Wisconsin, School of Pharmacy, Milwaukee, WisconsinUSA Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, WisconsinUSA
Benjamin W. Weston
Affiliation:
Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, WisconsinUSA
*
Correspondence: Ryan Feldman, PharmD, BCPS, DABAT Froedtert and the Medical College of Wisconsin Froedtert Hospital – Pharmacy Milwaukee, Wisconsin53226-3596USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The high prevalence of fentanyl in the illicit drug supply has generated concern among first responders regarding occupational exposure. Social media sharing of unconfirmed first responder overdoses after brief exposure to fentanyl may be contributing to an inappropriate risk perception of brief dermal fentanyl exposure. This case details a dermal exposure to a large dose of analytically confirmed pharmaceutical fentanyl (fentanyl citrate, 10 microgram fentanyl base per ml), over a large skin surface area. Additionally, the exposure occurred at a site with some skin barrier compromise, a factor that can increase fentanyl absorption. The patient underwent appropriate decontamination and underwent a brief medical assessment with no clinical effects of opioid exposure observed. This information is of value to first responders and other health care workers who are at risk of occupational fentanyl exposure. Findings are consistent with in vitro and ex vivo data supporting low risk of rapid absorption after brief dermal fentanyl exposure.

Keywords

dermal absorptionfentanyloccupational exposureopioid
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 4 , August 2022 , pp. 550 - 552
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rhodes, CJ, Phillips, CM. The surface area of the hand and the palm for estimating percentage of total body surface area: results of a meta-analysis. Br J Dermatol. 2013;169(1):76–84.CrossRefGoogle ScholarPubMed
Del Pozo, B, Sightes, E, Kang, S, Goulka, J, Ray, B, Beletsky, LA. Can touch this: training to correct police officer beliefs about overdose from incidental contact with fentanyl. Health Justice. 2021;9(1):34.CrossRefGoogle ScholarPubMed
Persaud, E, Jennings, CR. Pilot study on risk perceptions and knowledge of fentanyl exposure among New York state first responders. Disaster Med Public Health Prep. 2020;14(4):437–441.CrossRefGoogle ScholarPubMed
Winograd, RP, Phillips, S, Wood, CA, et al. Training to reduce emergency responders’ perceived overdose risk from contact with fentanyl: early evidence of success. Harm Reduct J. 2020;17(1):58.CrossRefGoogle Scholar
Beletsky, L, Seymour, S, Kang, S, et al. Fentanyl panic goes viral: the spread of misinformation about overdose risk from casual contact with fentanyl in mainstream and social media. Int J Drug Policy. 2020;86:102951.CrossRefGoogle ScholarPubMed
Larsen, RH, Nielsen, F, Sørensen, JA, Nielsen, JB. Dermal penetration of fentanyl: inter- and intraindividual variations. Pharmacol Toxicol. 2003;93(5):244–248.CrossRefGoogle ScholarPubMed
Roy, SD, Flynn, GL. Transdermal delivery of narcotic analgesics: pH, anatomical, and subject influences on cutaneous permeability of fentanyl and sufentanil. Pharm Res. 1990;7(8):842–847.CrossRefGoogle ScholarPubMed
Moss, MJ, Warrick, BJ, Nelson, LS, et al. ACMT and AACT position statement: preventing occupational fentanyl and fentanyl analog exposure to emergency responders. Clin Toxicol (Phila). 2018;56(4):297–300.CrossRefGoogle ScholarPubMed
Product Information: Duragesic (fentanyl transdermal system) for transdermal administration. Janssen Pharmaceuticals. 2016. https://www.janssenmd.com/pdf/duragesic/duragesic_pi.pdf. Accessed February 1, 2022.Google Scholar
Lent, EM, Maistros, KJ, Oyler, JM. In vitro dermal absorption of carfentanil. Toxicol In Vitro. 2020;62:104696.CrossRefGoogle ScholarPubMed