CHAPTER 3

Personal & Public

Health Considerations

RESPONSIBILITY

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he embalmer is responsible for:• public health safety and• personal health safety

D

on’t forget to protect YOURSELF!!!!

OCCUPATIONAL RISKS

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he CDC has concluded that funeral directors have an

increased risk of contracting tuberculosis as a result

of direct contact with the deceased.

OCCUPATIONAL RISK

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he most frequently reported diseases include:• hepatitis• staphylococcal and other skin infection• pulmonary and skin tuberculosis.

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xpose occurs most often by• direct contact with blood• needle sticks

OCCUPATIONAL RISK

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he longer you’re an embalmer the higher the risk

factor of contracting an HBV infection.

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o Please, Please, Please BE CAREFUL!!!

EXPOSURE TO CHEMICALS

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xposure to formaldehyde is probably the most significant

chemical exposure an embalmer has to face.

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he most common health problems in the prep room

include chemical contact with the skin, eye and nose

irritation, and upper respiratory irritation.

NON-CHEMICAL HAZARDS

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on-Chemical Hazards Include• Heat• Ionizing Radiation• Non-Ionizing Radiation

HEAT

W

ith all of the Personal Protective Equipment an embalmer

is required to wear it is no wonder why they can get so hot.

B

reathing in chemicals while you’re sweating is not good.

If the ventilation system in the funeral home is not enough,

an additional fan on the embalmer may be necessary.

HEAT

• Just make sure that the fan is placed in a position that works with the ventilation system and not against it.

• This is a very simple and silly suggestion, but you would be surprised what some facilities do to cut operating costs.

• Be aware of your surroundings and know when you are enduring unhealthy exposure.

IONIZING RADIATION

I

f the deceased has undergone radiation treatment the

facility should not call the funeral home until the levels

no longer pose a threat. The embalmer would have no

way of knowing if a body had recently undergone

radiation, we have to rely on the medical community in

this matter. • (This is the radiation officer question I had on my NBE - I know I missed

it.)

NON-IONIZING RADIATION

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his is very rare. It is in the case of microwave ovens

or computer monitors. But employees still have a

right to know that they are being potentially

exposed.

EXPOSURE CONTROL PLAN

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very funeral home should have an Exposure

Control Plan that includes:• exposure determination• methods of compliance• hepatitis B vaccination• hazard communication• record keeping

EXPOSURE DETERMINATION

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n a funeral home exposure most often includes:• embalmers• transfer personnel• hairdressers• funeral directors• housekeepers (laundry workers)

EXPOSURE DETERMINATION

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any funeral home managers are only letting essential

employees into the exposed areas. That means many

receptionists and drivers can no longer go into the

preparation room.

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hat can you do to prevent “unauthorized” individuals

from entering the preparation areas or room?

METHODS OF COMPLIANCE

C

ompliance with the Blood-borne Pathogens

Rule is accomplished by:• universal precautions engineering

controls• work practice controls

UNIVERSAL PRECAUTIONS

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niversal Precautions is the act of treating every deceased as

if they have a potential communicable disease.

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any embalmers never see a death certificate or cause of

death which makes Universal Precautions very important.

G

eneral Washington Pancake

PRACTICING UNIVERSAL PRECAUTIONS

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racticing Universal Precautions includes:• using personal protective equipment• properly decontaminating infected surfaces;

like an embalming table for example• What other areas need to be decontaminated?• properly handling and disposal of infectious

waste

PRACTICING UNIVERSAL PRECAUTIONS

• Applying appropriate measures to control leaks, drips, and spills of infectious materials.

• Applying proper work practice skills.• Properly handle contaminated laundry.

ENGINEERING CONTROLS

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ngineering controls are parts of the design of

the building and include:• Adequate Ventilation• Proper Plumbing

ADEQUATE VENTILATION

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he purpose of the ventilation system is to remove the

airborne contaminates which include embalming

fluid vapors and replace them with fresh air.

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he number of exchanges per hour vary but the average

for a room with 1 table is 12 to 20 air exchanges.

PROPER PLUMBING

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xamples of controls that could reduce the

possibility of water contaminates include:• vacuum breakers on the main water line

leading into the building• vacuum breakers on the hydroaspirator• discharge basins/flush sinks

• having a suitable water source for the embalming table

• having an eyewash station• having a proper drench shower• having a proper hand washing station• having proper shower room facilities for

the embalmer to use after the embalming

PROPER PLUMBING

WORK PRACTICE CONTROLS

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ork Practice Controls include:• hand washing• proper handling of disposal of

contaminated waste and sharps• avoiding splashing, spraying, or splattering • use of personal protective equipment• keeping a record of housekeeping

PERSONAL PROTECTIVE EQUIPMENT

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personal note about PPE:• I always kept a pair of old jean, sneakers, and a

shirt (Oingo Boingo Concert Shirt) to wear under my ppe. They were clothing items that if they got blood on them I would just throw them away. I never embalmed in my or suit. I took off my ppe to go direct a funeral. I always embalmed in old clothes.

• Now with the availability of full body suits, I can use a jumpsuit if needed.

HEPATITIS B VACCINATION

O

nce it is determined that a person has an occupation

exposure the vaccination program must be:• offered at no cost to the employee• offered at a reasonable time and place• performed by a health care professional• provided under the U.S. Public Health Service

HEPATITIS B VACCINATION

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n employee has the right to decline the

vaccination but at any point in time, if the

employee changes their minds then the

vaccination must be given.

POST-EXPOSURE EVALUATION

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f there has been an incident the evaluation will include:• a detailed explanation of what occurred including

the events and circumstances of what happened• identification and documentation of the source

individual • collecting and testing the blood for HBV and HIV

POST-EXPOSURE EVALUATION

• Taking steps necessary to assist in the prevention of infection or disease

• offering counseling• conducting an evaluation of any reported

illnesses

HAZARD COMMUNICATION

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abels must used to mark infectious hazards.

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mployees must be provided training on the infectious hazards in

the work place.

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he training program is very extensive and is outlined on

page 40 of your book. You should read this information

carefully.

HAZARD COMMUNICATION

• Perhaps the most important things listed are numbers 10 and 11. You need to know what to do if an emergency occurs including what procedures to follow.

RECORD KEEPING

R

ecord Keeping in this case refers to the

documentation of training with respect to

occupational exposure to blood-borne pathogens.

E

mployers are required to make all records available

to the employees.

TERMS REFERRING TO DISINFECTION & STERILIZATION

A

sepis- freedom from infection and from any form of life;

sterility.

B

actericidal- destructive to bacteria

B

acteriostatic- inhibiting the growth or multiplication of

bacteria (no destruction of viability implied).

C

leaning- removal of infectious agents by scrubbing and

washing, as with hot water, soap, or a suitable detergent.

D

isinfectant- an agent, usually chemical, applied to

inanimate objects/surfaces for the purpose of destroying

disease causing microbial agents, but usually not

bacterial spores.

TERMS REFERRING TO DISINFECTION & STERILIZATION

TERMS REFERRING TO DISINFECTION & STERILIZATION

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ermicide- A germicide is the same thing as a disinfectant

except it can also be applied to living tissue.

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anitizer- An agent, usually chemical, that possesses

disinfecting properties when applied to a pre-cleaned

object/surface.

TERMS REFERRING TO DISINFECTION & STERILIZATION

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terilization- a process that renders a substance

free of all microorganisms.

HAZARD COMMUNICATIONS

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he Hazard Communications Rule requires that

employers must tell their employees about the

dangers that exist in the work place as a result

of hazardous chemicals or materials and they

must train their employees in how to use

these chemicals and materials safely.

FORMALDEHYDE STANDARD

U

nder the Formaldehyde Standard, employers must

monitor employees to determine how much

exposure exists in the workplace.

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he specific point at which exposure is unsafe in called the

action level.

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he permissible exposure limit (PEL)sets the maximum

exposure that is allowed.

FORMALDEHYDE STANDARD

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he two tests are: (This is MAS IMPORTANTE)• the time-weighted average (TWA) done

over an 8 hour time period which must read below 0.5ppm or re-testing must be done, and

• the short-term exposure level (STEL) done over a 15 minute period which must read below 0.2ppm or re-testing must be done.

CONCLUSION

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here are many things that you can be exposed to as an embalmer.

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our best defense is education.

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now how to protect yourself and know your rights.

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bove all, use common sense.