1. 17 Nov 20061 EXPOSURE ASSESSMENT OF AIRBORNE COCAINE GENERATED DURING THE MANUFACTURE OF DRUG DOG TRAINING AIDS S. Smallets Jr., MS, CIH NAVMEDCEN Portsmouth

2. 17 Nov 20062 Military Working Dog Program Part of DoD war against drugs Established at Lackland AF Base, Texas in 1990 Provides training for drug detection dogs

3. 17 Nov 20063 Military Working Dog Program Training for dogs and handlers requires training aids Training aids are ventilated canisters containing one of the common street drugs Prepared exclusively by NCIS Regional Forensic Laboratory (NCIS RFL)

4. 17 Nov 20064 Personnel Exposure to Drugs Several researchers have looked at passive cocaine exposures in occupational settings Dermal absorption during application as local anesthetic. L.S. Fitzmaurice et al. TAC use and absorption of cocaine in a pediatric emergency department. Ann. Emergency Med. 19:515-518 (1990) Handling contaminated money. M. A. ElSohly. Urinalysis and casual handling of marijuana and cocaine. J. Anal. Toxicol. 15:46 (1991) Handling large quantities of cocaine. S. D. Le et. al. Occupational exposure to cocaine involving crime laboratory personnel. J. Forensic Sci 37:959-968 (1992) Laboratory personnel preparing cocaine training aids for a military working dog program. J. M. Gelhausen et al Urine Analysis of laboratory personnel preparing cocaine training aids for a military working dog program. J. Anal. Toxicol. 25:637-640 (2001)

5. 17 Nov 20065 Personnel Exposure to Drugs Drug screening (urinalysis) of NCIS RFL personnel by Navy Drug Screening Laboratory (NDSL) between December 1999 and January 2001 28 of 233 urine samples had detectable levels of benzoylecgonine (BZE) The possibility of a positive drug test due to on-the-job exposure can be a concern

6. 17 Nov 20066 Personnel Exposure to Drugs Issues Legal consequences could arise for laboratory employees participating in a DoD civilian drug testing program Uncertainty of health effects of long term low level exposure to various street drugs is also of concern Navy Drug Screening Lab (NDSL) and NCIS RFL requested an IH evaluation of cocaine exposure resulting from manufacture of training aids

7. 17 Nov 20067 IH Exposure Assessment Quantify levels of cocaine in the air-Baseline Personnel preparing training aids Other lab and administrative personnel Evaluate use of PPE and housekeeping Determine urine BZE as a marker for cocaine exposure Implement procedural changes to minimize occupational exposure Determine effectiveness of changes-Followup

8. 17 Nov 20068 IH Exposure Assessment -Air Sampling No NIOSH/OSHA method for sampling cocaine in air “Occupational Exposure to Cocaine Involving Crime Lab Personnel”, Journal of Forensic Sciences, JFSCA, Vol. 37, No 4, July 1992 pp.059-968 Impingers – 15 ml water with 30 mg ascorbic acid; sample at 1 l/m Analysis done by GC-MS by NDSL Jacksonville, FL

9. 17 Nov 20069 Sampling Train

10. 17 Nov 200610 Impingers with trap

11. 17 Nov 200611 No OSHA or ACGIH OEL Personal Breathing Zone air sampling 4 chemists engaged in training aid manufacture General Area air sampling 3 locations Urinalysis-BZE Chemists, other lab workers, administrative personnel Surface sampling (cobalt thiocyanate) and observation Work surfaces Respirators Ventilation-Lab Hoods IH Exposure Assessment-Method

12. 17 Nov 200612 Reception* Laboratory* Lab Hood Work Bench (Sealing) Lab Bench (Weighing and Stuffing Trial 1) Latents Office* NCIS Forensic Lab Layout Latents Lab Instrument Room Lab Director Senior Chemist * GA Sample location

13. 17 Nov 200613 NCIS RF Laboratory

14. 17 Nov 200614 Manufacture Process 2 steps Preparation (1 chemist) Un-package seized cocaine Weigh and grind in mortar and pestle Fabrication (3 chemists) 5, 3, 2, 1 g quantities are weighed using plastic tray and scale (Weighing) Material is put into bindles (Stuffing) Bindles are placed in metal container (Sealing) 400 – 500 grams of cocaine processed

15. 17 Nov 200615 Characterize Exposure- Tasks - Preparation Confiscated Material Unpacking

16. 17 Nov 200616 Characterize Exposure- Tasks - Preparation

17. 17 Nov 200617 Characterize Exposure- Tasks - Preparation WeighingGrinding

18. 17 Nov 200618 Exposure Assessment Respirators, Skin contact

19. 17 Nov 200619 IH Exposure Assessment -Housekeeping

20. 17 Nov 200620 Characterize Exposure- Tasks Fabrication Weighing Setup Stuffing Setup Lab bench covered with brown paper

21. 17 Nov 200621 Characterize Exposure- Tasks Fabrication Weighing Scale Plastic tray 5, 3, 2, or 1 gram quantities

22. 17 Nov 200622 Characterize Exposure- Tasks Fabrication Stuffing Bindles are constructed from pre- folded filter paper (Whatman #4) Material is poured into bindles using a funnel Stapled

23. 17 Nov 200623 Characterize Exposure- Tasks Fabrication Sealing Bindles are placed in 3 oz tin seamless slipcover cans. Cans have 7 pre-punched holes for ventilation of substance odor Can is secured with lead disc seals

24. 17 Nov 200624 Characterize Exposure- Tasks Fabrication Metal containers then placed in mailing envelopes

25. 17 Nov 200625 Worker IDTask/ Sample Date Sample Time (Minutes) Result (mg/m 3 ) 8 hr-TWA (mg/m 3 ) WWeighing Sealing Stuffing Weighing 10/23/01 76 61 52 50 239 0.0644 0.0098 0.2417 0.3102 0.06994 HStuffing Weighing Sealing Stuffing 10/23/01 79 59 53 46 237 0.1820 0.0526 0.0147 0.0651 0.04428 ASealing Stuffing Weighing Sealing 10/23/01 81 55 51 48 235 0.0054 0.1454 0.0762 0.0125 0.02692 GGrinding 10/22/01 350.4004 0.0292 PBZ Results Trial 1

26. 17 Nov 200626 PBZ Results Trial 1 by Task Weighing (mg/m3) Stuffing (mg/m3) Sealing (mg/m3) Preparation (mg/m3) 0.06440.24170.00980.4004 0.31020.1820.0147---------- 0.05260.14540.0054---------- 0.07620.06510.0125---------- 0.12580.15850.01060.4004 Average

27. 17 Nov 200627 8 Hr TWA’s and Urine BZE Trial 1 Worker ID 8 Hr TWA (mg/m3) Highest BZE (ng/ml) W0.069936 H0.044323 A0.0269ND G0.029247 9 others tested for BZE, 2 < 12 ng/ml and 7 ND

28. 17 Nov 200628 Trial 1 General Area Samples Sample Date TaskLocationSample Time (minutes) Result (mg/m 3 ) 10/22/01BackgroundLatents32<0.0022 10/22/01BackgroundReception31<0.0022 10/22/01BackgroundLaboratory32<0.0022 10/22/01GrindingLatents490.0019 10/22/01GrindingReception45<0.0016 10/22/01GrindingLaboratory450.0062 10/23/01Make Trg AidLatents1050.0033 10/23/01Make Trg AidReception105<0.0007 10/23/01Make Trg AidLaboratory1040.0031 General Ventilation not operating

29. 17 Nov 200629 Recommendations Reduce amount of dust in breathing zone Dust not well controlled, observation showed dust on surfaces Perform preparation and manufacturing tasks in the available lab hoods instead of lab bench Prevent inhalation of dust that reaches breathing zone Inside of respirators tested positive using cobalt thiocyanate, variety of respirators, no training, no fit testing Obtain NIOSH approved respirators, training and fit testing Prevent absorption of cocaine by skin contact Observation showed opportunity for skin contact Avoid skin contact, don’t roll up lab coat sleeves

30. 17 Nov 200630 Modified Preparation Set up Average face velocity 80 fpm

31. 17 Nov 200631 Modified Preparation

32. 17 Nov 200632 Modified Weighing and Stuffing 70-80 fpm Hood interfered with balance, ventilation used intermittently

33. 17 Nov 200633 Sealing

34. 17 Nov 200634 PBZ Results Trial 2 by Task Weighing (mg/m3) Stuffing (mg/m3) Sealing (mg/m3) Preparation (mg/m3) 0.03730.02010.02020.2215 0.03370.01060.0117 ---------- 0.02870.06790.0110 ---------- 0.00450.01810.0159 ---------- 0.02510.02910.01470.2215 Average

35. 17 Nov 200635 8 Hr TWA’s and Urine BZE Trial 2 Worker ID 8 Hr TWA (mg/m3) Highest BZE (ng/ml) W0.0116ND H0.0181<12 A0.011213 G0.017517

36. 17 Nov 200636 Worker IDTask/ Sample Date Sample Time (Minutes) Result (mg/m 3 ) 8 hr-TWA (mg/m 3 ) WSealing Stuffing Weighing Sealing 02/14/02 77 63 84 60 284 0.0202 0.0106 0.0287 0.0159 0.0116 HWeighing Sealing Stuffing Weighing 02/14/02 75 61 71 78 285 0.0373 0.0117 0.0679 0.0045 0.0181 AStuffing Weighing Sealing Stuffing 02/14/02 78 55 71 64 268 0.0201 0.0337 0.0110 0.0181 0.0112 GGrinding 02/14/02 380.2215 0.0175 PBZ Results Trial 2

37. 17 Nov 200637 WeighingStuffingSealingGrinding Trial 10.12580.15850.01060.0292 Trial 20.02510.02910.01470.0175 Difference80%82%38%40%

38. 17 Nov 200638 Task Air Sample Average Concentration Comparison

39. 17 Nov 200639 Chemist 8 Hr TWA Comparison

40. 17 Nov 200640 Urine BZE Comparison All values =1 were ND 12 LOD

41. 17 Nov 200641 General Area Sample Comparison Airborne Cocaine (mg/m3) BaselineFollow-up AreaBackgroundGrindingMk Trg AidBackgroundGrindingMk Trg Aid Reception<0.0022<0.0016<0.00070.02100.00040.0011 Latents<0.00220.00190.00330.00450.00550.0082 Lab<0.00220.00620.0144<0.00220.0100.0043 Baseline- HVAC inoperable Follow-up- HVAC operating

42. 17 Nov 200642 8-hr TWA vs Urinalysis Worker ID 8 Hr TWA (mg/m3) Trial 1 8 Hr TWA (mg/m3) Trial 2 BZE (ng/ml) Trial 1 BZE (ng/ml) Trial 2 W0.070.0136ND H0.040.0223<12 A0.030.01ND13 G0.030.024717

43. 17 Nov 200643 Conclusions-Thoughts Consistent with previous reports i.e. occupational exposure to cocaine can lead to positive BZE Noted reductions in BZE suggest that improved use of PPE particularly respirators and the increased use of ventilation can be effective in mitigating occupational exposure

44. 17 Nov 200644 Acknowledgements H. R. Hayes, CIH (NMCP) D. C. Brunick (NEHC) D. L. Deary (NMCP) LT. J. Gehlhausen (NDSL) J. A. Given (NCISRFL)