Occupational Risks
Biological Hazards:
- Airborne pathogens (funeral directors have a greater risk for tuberculosis)
- Bloodborne pathogens (hepatitis, staph, and other skin infections) most commonly transferred through needle sticks
- Multi drug resistant pathogens
Chemica
OSHA (Occupational Safety and Health Administration)
A Governmental agency with the responsibility for regulation and enforcement of safety and health matters for most US employees.
- Individual state OSHA agency may supersede the US Department of Labor OSHA regulations.
General Duty Clause
Each employer has a general duty to furnish each employee a place of employment free from recognized hazards that cause or are likely to cause death or serious physical harm.
Hazard Communication Standard (HAZCOM)
OSHA standard that requires employers to notify employees when hazardous chemicals are present in the workplace and to train employees to work with them safely.
Material Safety Data Sheet (MSDS)
This must accompany a hazardous product; a requirement of the Department of Labor and OSHA under the Hazard Communication Standard.
- A form required by OSHA that must accompany a hazardous product that contains: 0.1% of a chemical classified as a carcino
HAZMAT
Hazardous Materials Labeling:
- all containers that hold hazardous materials must be labeled properly as marked by the MSDS.
- Cartons of chemicals should contains an MSDS.
HAZCOM Training
Employers must:
- Identify hazards substances
- Identify the exposure levels that trigger restrictions
- Identify routes of entry and acute or chronic effects of exposure
- Explain exposure symptoms
- Other chemical dangers
- Emergency treatments
- Explai
MSDS/SDS
Material Safety Data Sheet/Safety Data Sheet that should contain:
- An identity of the chemical hazard, chemical and common names.
- Physical characteristics of the hazard
- Health hazards, including signs and symptoms of exposure.
- Primary portal of ent
Formaldehyde Rule
OSHA regulation limiting the amount of occupation exposure to formaldehyde gas.
Time Weighted Average (TWA)
An evaluation of exposures that are time-weighted over an established period. It allows the exposure levels to be averaged generally over an 8-hour time period.
Permissible Exposure Limit (PEL)
The maximum legal limits established by OSHA for regulated substances. These are based on employee exposure that is time weighted over an 8 hour work shift. When these limits are exceeded, employers must take proper steps to reduce employee exposure. For
Short Term Exposure Limit (STEL)
Legal limits established by OSHA to which workers can be exposed continuously for a short period of time without damage or injury. Exposures at the STEL should not be for more than 15 minutes and not repeated more than 4 times per work day.
Action Level (AL)
Exposure Limits; these levels are established to ensure adequate protection of employees at exposures below the OSHA limits, but to minimize the compliance burdens for employers whose employees have exposures below the 8 hour permissible exposure limit (P
Limits
Anything below .5ppm = good
Anything above .75 ppm = bad
Health Risks of Formaldehyde
Acute Effects:
- Ingestion: throat irritation, highly poisonous and will cause death.
- Inhalation: irritates upper respiratory system, inflames nose, throat and lungs.
- Skin: dryness, cracking, scaling, and skin sensitivity.
Chronic Effects:
- Carcinoge
Signs of Formaldehyde Exposure
- Irritation of the eyes, nose, and throat
- Swelling of the eyelids
- Respiratory disorders
- Allergic reactions
- Frequent headaches or dizziness
- Jaundice
- Bruising easily
Employee Reporting
- Employees must report to employer with any symptoms or over-exposure
- Employee must be offered a Medical Disease Questionnaire for a physicians review
- These procedures are to be followed even if they are tested below the PEL or STEL.
Medical Removal Protection
- Employees who suffer from adverse effects from formaldehyde exposure must be removed to jobs with less exposure until they feel better.
- Employee benefits can continue up to 6 months or until a physician determines that the employee can never return.
Formaldehyde Rules
Formaldehyde monitoring also applies to:
- formaldehyde gas solutions
- paraformaldehyde
- solids and mixtures containing HCHO
What to do when the Formaldehyde Test is Over Limits
- Employers must use formaldehyde warning signs
- begin medical surveillance
- require employees to wear respirators
- and periodic testing every 6 months for over the AL and 12 months for over the STEL
Engineering Controls in the Building
- eye wash station
- quick drench shower
- hand wash station
-sinks in good working order
- suitable water source on the embalming table
Ways to Minimize Exposure Levels
- Proper exhaust ventilation
- Prevent spills
- Cap empty bottles
- Keep lids on your machines
Ways to Minimize Exposure Levels During Embalming
- Continuous aspiration of autopsied cases
- Clamp vessels in an autopsied body
- Clamo drainage veins once blood has been cleared (this allows for less HCHO to become airborne, better pressure, and minimizes waste chemicals).
- Closed system drainage
- R
PPE (personal protective equipment)
A barrier between a person and pathogens; includes gloves, gowns, masks, goggles, and face shields.
- Get rid of disposable items
- Launder what you can
- Address torn PPE
- Neutralize spills
- Label disposal container
- Red bags for HAZAMT
Why do we as Embalmers Need to be Clean?
- To protect the public
- To protect ourselves
- To create a clean and sanitary body
- To protect the environment
Personal Hygiene After the Prep Room
- Wash hands
- Clean fingernails
- Brush teeth
- Clean nose
- Wash hair
- Take a shower
PPE (personal protective equipment) Includes
- Gown: A). long sleeved. B). Should cover all clothing. C). Should not extend pass shoes.
- Shoe covers: A). Should offer protection of infectious waste and chemicals. B). Should have some kind of tread on bottom.
- Mask: Evaluate for effectiveness.
- Im
Asepsis
Absence of significant contamination.
Bacterialcidal
Capable of destroying bacteria.
Bacteriostatic
Inhibits growth of bacteria.
Cleaning
The process of removing dirt, dust, blood, or other visible contaminants from a surface by scrubbing.
Decontamination
The removal or cleansing of dangerous chemicals and other dangerous or infectious materials.
Disinfectant
A chemical substance that kills harmful bacteria or viruses.
Sterilization
The process that completely destroys all microbial life, including spores.
Sanitizing the Environment
- Proper disposal of deceased clothing (clean and give it back to family or destroyed)
- Disposing of materials from the embalming procedure correctly:
- Sharp items include: hypodermic needles, suture needles, injector needles, scalpel blades, razor blad
Sanitizing the Deceased
- Bathing and external disinfection
- Disinfection of external orifices
- Use of internally disinfecting body chemicals (vascular and cavity)
- Thorough diffusion to all the tissues through:
1). multi point injections
2). Hypodermic injection
3). Adequate
What are the Types of Disinfection?
- Primary disinfection
- Concurrent (happening at the same time) disinfection
- Terminal disinfection
Primary Disinfection
Disinfection carried out prior to the embalming process.
Concurrent Disinfection
Disinfection practices carried out during the embalming process.
Terminal Disinfection
Institution of disinfection and decontamination measures after embalming.
Clostridium difficile
- Lethal diarrhea brought on by antibiotic overuse
- Found in fecal spores, diapers, gowns
Klebsiella pneumonia
- Hospital borne infection of the urinary tract, gut, and blood stream.
Ancinetobactor baumanii
- antibiotic resistant
- seen in traumatic injuries
- found in membranes lining the abdominal wall and urinary tract
Methicillin-resistant Staphylococcus aureus (MRSA)
- found in the blood, skin, nose, blood, and urine
- spread with direct contact
Vancomycin Resistant Enterococcus (VRE)
- found in open wounds and feces
- associated with invasive devices (feeding tubes, medical devices)
Vancomycin-resistant staphylococcus (VRSA)
- similar to VRE
Psuedomonas aeruginosa
- lower respiratory disease found in sick people
Cruetzfeldt-Jakob disease
- caused by a prion (protein folding error)
- very difficult to destroy
concentrated in cerebrospinal fluid
HIV
- spread through direct contact with contaminated body fluids
Hepatitis
A, B, and C.
- inflammation of the liver
- various modes of transmission
Microorganisms that Affect Pregnant Women in the Funeral Service
- Cytolomegavirus
- Hepatitis B and C
- Human Parvovirus
- Rubella
- Syphilis
- Chicken Pox
- Toxoplamosis
Bloodborne Pathogen Rule
OSHA REGULATION (29CFR 1910-1030) regulating the employee's exposure to blood and other body fluids. OSHA DEFINITIONS: Blood. Human blood, human blood components, and products made from human blood.
- applicable to many professions
- some states have empl
Bloodborne Pathogen Rule: Training
- regulatory text available to employees
- explanation of the epidemiology and symptoms of diseases
- explanation of exposure control plan
- how to recognize tasks that may create exposure
- ways to limit exposure
- PPE
- Hep B vaccine
- who to contact in
Bloodborne Pathogen Rule: Record keeping Training
- date of session
- summary of training
- names and qualifications of trainers
- names and jobs of people attending training
- records must be available to employees
- records should be available to follow people from place to place
Compliance with the Bloodborne Pathogen Rule
Minimal documentation includes:
- exposure determination
- Hep B vaccines
- post exposure evaluation and follow up
- hazard communication
- remove PPe before leaving the prep room
- Minimized contamination zone
- understand modes of transmission
- be awar
Compliance with the Bloodborne Pathogen Rule: Exposure Determination
- employers must determine a hazard
- who is affected by the hazard
- must list all the job titles that are affected in a funeral home: drivers, hairdressers, maintenance, housekeepers, funeral directors, clerical staff
Universal Precautions
- Treat every body as if it is a potential exposure hazard
Engineering Controls
- air exchange based on contact, shape, and temp
- how many embalmings are taking place
- single table rooms should have 12-20 air exchanges in an hour
Plumbing
- good water source
- good emergency water sources
- working sinks
- breakers on the waterline, hydrospirators
Work Practice Controls
- gathering of instrumentals with uncontaminated gloves
- handwashing
- handling and disposal of contaminated gloves
- use of PPE
- housekeeping
- cleanliness of instruments
- avoid splashing
- handling and disposal of contaminated sharps
Hepatitis B Vaccine
- offered at no cost to the employee
- offered at a reasonable time and place
- performed by a qualified health care professional
- provided at the recommendation of US public health service
Compliance with the Bloodborne Pathogen Rule: Embalming Practices
- minimize drainage on the table or body
- transparent shield
- avoid splatter
- avoid parenteral entry
- keep gloved hands away from face
- wash your gloved hands
- check for tears
- do laundry
- accident reporting
- handling of contaminated materials
-
Pathogen HAZCOM
- containers that are used to store, transport, or ship blood or potentially infectious agents.
- fluorescent orange labels
- orange and red labels
- predominantly red and orange labels
Record Keeping
- name, date, and SSN of employee
- copy of their Hep B vaccine
- medical record pertaining to exposure
- employers copy of health care evaluation