HHE Report
Health Hazard Report: Occupational Exposure to Illicit Drugs among Library Employees (May 2025)
Interim Guidance
According to substance use trends, there has been an increase in the use of methamphetamine, fentanyl and heroin in the last two years here and across the nation. Leaders in our organization and across many jurisdictions are grappling with how to respond quickly and meaningfully to this complex problem. Multnomah County Risk Management and Public Health have reached out to state and federal partners (including Oregon Health Authority, Oregon Occupational Safety and Health (OR-OSHA), the National Institute for Occupational Safety and Health (NIOSH), and other jurisdictions) for support.
We have compiled the following guidance for what to do when staff suspect or assume illicit substances have been used indoors — specifically by smoking. These recommendations are based on the available information and the experience and knowledge of experts (notably from the County’s Health Department, Risk Management and Facilities) to balance employee safety and the mitigation of harm for building occupants.
This guidance should be customized to include site-specific information before it is used and/or shared with staff.
Know the risks
- The “Secondhand Exposure to Fentanyl and Meth” one-pager produced by the Health Department highlights what we know about health risks associated with secondhand exposure to these kinds of illicit drugs.
Know what resources are available
- The "Naloxone Use in County Facilities" resource sheet for managers and supervisors.
- Where Personal Protective Equipment (e.g., litter grabbers, nitrile gloves, masks, etc.) is located at your work site.
- Where an AED, naloxone (or Narcan), and security or other emergency response personnel are located at your work site.
Follow your work site’s Emergency Action Plan in response to an immediate issue
Know the steps to take after the immediate risks to staff and patrons have been cleared
Download a printable checklist.
- Close the restroom or enclosed space where the incident occurred for 30 minutes.
- Post signage that indicates the closure, the time of closure, anticipated time of reopening, and the location of an alternate restroom if available.
- If a switch is required to operate the exhaust fan, manually turn it on (not all locations will have a manual switch).
- For locations with operable windows in the restroom, open the windows.
- Remove debris/paraphernalia only if you have taken bloodborne pathogen training. Otherwise, reach out to your custodial provider or Property Manager for assistance.
- After 30 minutes (and only after the debris/paraphernalia has been removed), discard the signage and reopen the restroom.
We are committed to continuing our research and will refine this guidance when new information is made available. As a next step, Multnomah County Risk Management is working on a review with NIOSH for our Libraries. Our hope is to confirm and build on our current guidance.
Find answers to frequently asked questions about responding to the suspected use of illicit substances in County facilities on the next page.
Frequently Asked Questions
What is the risk to staff and patrons of incidental exposure to drug residue?
At this time, we are unable to find evidence that there is a risk to staff based on incidental exposure to drug residue. This research paper discusses the misinformation within the public safety community about risks of incidental fentanyl exposure. According to the “Secondhand Exposure to Fentanyl and Meth” fact sheet from the Multnomah County Health Department, smelling smoke is not the same as inhaling a drug. Any kind of smoke can irritate the eyes and airways. Clearing the air with ventilation is the best way to avoid breathing it in.
Is 30 minutes enough time for the restroom in my building?
The recommendation from County Facilities, in partnership with Risk Management and the Health Department, to close the bathroom for 30 minutes is based on the range information we have for different ventilation systems. After seeking feedback from Oregon Health Authority and building in extra time as an additional safety measure, these teams determined that 30 minutes is enough time to ventilate smoke and odors out of the restroom regardless of the size or type of HVAC system at County facilities.
Should we do extra cleaning after suspected substance use?
At this time, we did not find evidence that would necessitate additional cleaning beyond routine cleaning. Regular daily cleaning with normally used cleaning products is recommended. Please be mindful that debris/paraphernalia should be removed only by someone who has taken bloodborne pathogen training. Otherwise, a custodial provider or Property Manager can provide assistance.
Should I be using additional PPE when indoors?
The use of masks and respirators was not indicated as something to include in our protocols, but we have them available for staff to use if they would like to. Nitrile gloves and disposable respirators (like N95 masks) are available for staff to use on a voluntary basis. (Please note: Employees who choose to use disposable respirators on a voluntary basis need to review the County’s procedures on voluntary use of respirators and need to notify management of their decision by completing a brief online form.)