Universal Precautions: Crime Scene Investigations During Pandemics
*Originally published in Forensic Magazine
By: Zack Kowalske and David Snivley
How often do you don the correct personal protective equipment (PPE) or properly practice universal precautions? Universal precautions within a crime scene environment serves two critical functions. First, it minimizes the potential contamination of evidence. In fact, basic crime scene processing protocols reinforce glove use and, depending on the incident type, often call for other PPE gear to prevent cross-contamination of scenes and evidence. Second, and even more importantly, properly utilizing universal precautions reduces threats to the health and safety of crime scene investigators.
There is little need among professional investigators to stress the importance of reducing contamination risk to evidence at a crime scene. But as deliberate as we typically are when approaching crime scenes, investigators frequently fail to diligently ensure their own safety. We cannot stress the importance of changing that habit and properly protecting yourself in hazardous environments of all types.
The Department of Labor’s Occupational Safety and Health Administration (OSHA) defines universal precautions as, “an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens” (OSHA, n.d.). We can expand on this definition to consider all threats, from chemical nerve agents to transdermal drugs, and yes, even global viral pandemics. All of these are real and present risks to modern investigators, and proper PPE use deserves our full consideration.
Personal protective use varies by situation and even among investigative units. In our experience we’ve observed that most investigators understand that “blood is bad,” and typically wear nitrile gloves. However, this tends to be the extent of their personal protection efforts. More commonly, first responders, law enforcement officers, and crime scene investigators are complacent in environments that don’t visually pose a threat, aren’t covered in blood, and seem otherwise monotonous. Sure, gloves are an important first step, but they are not the only one to consider. Is there a minimum PPE level that every scene should require? In current events, law enforcement and public safety face the viral threat of the COVID-19 pandemic and the chemical agent threat of Fentanyl and other derivatives as a result of the opioid epidemic, we suggest that there are.
As it relates to the Covid-19 virus, factual data of the pathogen’s mode of transmission evolves on a daily basis, as does the literal spread of cases. What is known at the time of this article is that the virus is like many respiratory pathogens. It is certainly communicated through direct person-to-person contact and droplet dispersal; and can survive on surfaces for days, allowing for indirect transfer. This provides multiple potential portals of entry into the body. The Center for Disease Control and Prevention (CDC) has provided specific recommendations to first responders for response to and handling incidents when Covid-19 is a pandemic threat. These recommendations include: use distance barriers if possible, from known or believed Coronavirus patients; practice good hand washing hygiene; and employ alcohol-based hand sanitizers. The minimum personal protective equipment recommendations are: a single pair of nitrile gloves, a disposable isolation gown or single-use coveralls, any NIOSH-approved respirator of an N-95 level or higher, and eye protection. It is noted that if a gown or coveralls are not available then the first responder should be sure to disinfect their uniform, duty belt, or/and gear (CDC, 2020).
The question for crime scene investigators then becomes, when are these precautions necessary to employ? Consider this: every scene that we enter is a foreign environment. We are going into the homes, businesses, and spaces of others whose sanitary practices are unknown to us. The simplest answer, albeit cumbersome, is to treat each scene as if it were a known “hot zone. Even otherwise un-suspicious death investigations now bring with them a question of whether Covid-19 is within the etiology of death. That burglary scene now poses the risk of contracting a virus from interacting with the victim, or a surface that the Coronavirus positive offender deposited the pathogen upon.
It is also well worth observing that these precautions extend beyond the threat of a pandemic and into the realm of our daily reality as we negotiate scenes with visible and latent amounts of transdermal drugs. Not unlike a virus transmitted through skin absorption, respiratory inhalation, or mucous membranes, Fentanyl and the opioid epidemic are similarly introduced to unsuspecting investigators. However, where the virus has a relatively low mortality rate, exposure to Fentanyl or a derivative can quickly become nearly instantly fatal. The Department of Health and Human Services cites from a 2019 national survey on drug use and mortality more than 47,000 overdose deaths in 2018 (DHHS, 2019). In a recent news story, an Oklahoma Police Officer is seen collapsing on department surveillance footage after being exposed to Fentanyl mixed with methamphetamines he seized. Despite wearing gloves while packaging the drug evidence, the officer was still exposed and effected. Thankfully, his fellow officers were quick to action and were able to treat him with immediate does of naloxone. So: what is the best recommended PPE protocol for handling evidence that may possible include the fatal chemical agent? The CDC offers guidance there, too; and we’re wise to occasionally review it. The precautions are tiered by the level of response, and crime scene investigators are among the most at risk. For investigators actively collecting suspected drug materials the CDC recommends, at minimum: an elastomeric air purifying respirator, safety goggles, thick or doubled nitrile gloves, and a class 4 ensemble or a full body Tyvek style suit. Again, this is the minimum recommended level; we cannot stress enough that these recommendations be utilized across various investigative units (CSI, Narcotics, and others) tasked with any responsibility to collect drug materials. It should also be noted that unlike the personal hygiene response to a viral threat, the use of alcohol based hand sanitizer should not be implemented when encountering potential Fentanyl.
As in so many areas of law enforcement, complacency kills. As experts in our field we owe it to ourselves, our peers, and our colleagues, to model appropriate behaviors that amount to lifesaving precautions. Whether in anticipation of a viral pandemic or a drug search-warrant, the dangers facing investigators are similar – and therefore similarly averted. Stay safe.
Casiano, L. (2020, March 11). Oklahoma police officer collapses, given overdose-reversal drug Narcan after fentanyl exposure. Retrieved from https://www.foxnews.com/health/oklahoma-police-collapses-given-overdose-reversal-drug-narcan-after-fentanyl-exposure
Center for Disease Control and Prevention. (2020, March 14). What Law Enforcement Personnel Need to Know about Coronavirus Disease 2019 (COVID-19). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-law-enforcement.html
Department of Health and Human Services. (n.d.). What is the U.S. Opioid Epidemic? Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.html
Occupational Health and Safety Administration . (n.d.). Healthcare Wide Hazards (Lack of) Universal Precautions. Retrieved from https://www.osha.gov/SLTC/etools/hospital/hazards/univprec/univ.html