Fentanyl Soil
TRSA Safety Committee Advisory
Hospitals should notify outsourced laundries regarding the presence of illicit fentanyl on soiled textiles, likely from expulsion from the body from rescue drug use (Narcan, naloxone). Soil should be packaged in clearly identified bags noting such contaminated items are enclosed. This allows the laundry to handle them following a program that isolates this linen and launders it by maintaining separation from other soil.
Possibly contaminated linens should be loaded directly into a washer without sorting prior to wash and can be sorted afterward. Soil sorters’ universal precautions should include personal protective equipment (PPE: barrier gowns, barrier gloves, n-100 mask, or N-95 with face shield or safety glasses, shoe covers) when handling any linen received from hospitals to protect them from incidental contact.
Unlike other contaminants, fentanyl poses a higher skin absorption risk if alcohol-based hand sanitizers are used. Sorters when leaving the soil room must use soap and water to minimize this risk.
Sorters of items from other industries (F&B, hospitality, industrial) are encouraged to use the same PPE as healthcare sorters and follow the same hygiene procedures. Unlike healthcare sorters, they are at greater exposure risk given the lack of item separation procedures. At the very least, all sorters should be aware of the possible presence of white powder that may be illicit fentanyl. Should they encounter such power, they should stop production and notify a supervisor immediately.