Chapter 6: Infectious Disease Control for Funeral Directors and Embalmers 4 CE Hours
By: Teresa Womble & Sueann Schwille Learning objectives
● Describe five CDC universal precautions for infection prevention and control for airborne, droplet, and contact transmission of pathogens. ● List five steps for personal protective equipment (PPE) compliance from the CDC guidelines for infection prevention and control procedures in the funeral home setting. ● Explain how pathogenic organisms may be spread in funeral home settingsand identify factors that influence exposure and transmission. ● Identify five types of infectious disease that require the use of barriers, personal protective equipment, and control strategies to protect personnel from pathogens according to CDC and WHO guidelines. ● Define epidemiologically important organisms and discuss four types, including modes of transmission. ● List and discuss OSHA guidelines and strategies, including cleaning, sterilization, chemical disinfection, and barriers to protect personnel and the public from infectious disease. Introduction Funeral directors in the 1980s faced new concerns related to containment of infectious disease pathogens due to the number of casualties from the HIV/AIDs virus. Funeral directors and staff were asked to deliver post-mortem services for premature deaths of HIV/AIDS victims of all ages. In addition to assisting grieving families, funeral service professionals had to address serious health risks and fears surrounding embalming, funeral services, and burial of victims with the contagious disease. The demand for infection control for postmortem care of HIV/AIDS victims resulted in a detailed review and modernization of procedures for the first time in over a century. Misinformation, fear, and hysteria led to myths of environmental contamination, which spread throughout the funeral industry. Many directors and embalmers refused to offer services to HIV/AIDS victims during this time. To address these concerns the Centers for Disease Control (CDC), the World Health Organization (WHO), and the Occupational Health and Safety Administration (OSHA) developed detailed, extensive, uniform procedures to contain infectious pathogens in the healthcare field. These precautions were extended and refined for the practice of mortuary science and all areas of funeral services. Guidelines created by the CDC, and adopted by OSHA in 1991, were called “universal precautions” which provided standardized procedures for postmortem services. Robert Mayer, author of embalming textbooks, explained that using universal precaution means an embalmer will ‘‘treat all human remains as if they were infected with HIV, hepatitis B (HBV) or other pathogens. In other words, the embalmers should treat all bodies with the same caution that would be applied for extremely hazardous, potentially fatal infections (Mayer, 2012).” Changes in handling the body were implemented and different postmortem technologies in all levels of thought and practices were developed and deployed by the American funeral industry (Kennedy and Nisbett, 2015). New procedures for health, safety, and training for funeral personnel helped ease fears and build confidence surrounding postmortem care of victims of infectious disease. In 2014 mortuary science encountered the Ebola epidemic, leading to a complete transformation in postmortem care to
● Describe CDC guidelines for barriers, protective equipment, and control procedures for personnel to prevent exposure to infectious material during the embalming process. ● Define CDC and OSHA guidelines for handling, cleaning, disinfection, sterilization and waste disposal procedures to during post mortem procedures to prevent disease transmission. ● Discuss the professional funeral director and embalmer’s responsibility for maintaining a safe environment for personnel, the public, and the environment. ● Identify strategies and procedures for preventing transmission and controlling Ebola and HIV/AIDS virus during all post-mortem procedures. ● Select five myths concerning infectious disease contamination from embalming and burial and discuss facts from PAHO and WHO research studies that dispel them. protect personnel and the public from exposure to deadly pathogens. The CDC, OSHA, and the WHO revolutionized infection control and prevention procedures from transport to and from the hospital, to burial or cremation. Some myths have persisted concerning the potential environmental contamination related to the burial of victims of infectious, communicable diseases. Misinformation and anxiety grew due to public fear over media reports of the spread of other diseases such as bovine spongiform encephalopathy (BSE), more commonly known as mad cow disease; the human variant Creutzfeldt-Jakob Disease (CJD); and transmissible spongiform encephalopathy (TSE), also known as prion diseases. This course will address the facts and detail the CDC, WHO, and OSHA standards and guidelines to address procedures to contain these diseases during all phases of mortuary practice. The National Funeral Directors Association (NFDA) is the guiding funeral service association, with 19,700 individual members and serving over 10,000 funeral homes in the United States and forty-three countries around the world. The NFDA provides information, education, and advocates for members to enhance quality funeral services, including high ethical standards and meaningful service to families (NFDA, 2015). The NFDA offers resources and materials to assist members to comply with federal, state, and county laws along with conducting and funding research on topics of health, safety, environmental, and consumer concerns. John Erik Troyer is a leading author and researcher addressing the social and technological control of the dead body, including legal, scientific, and medical protocols and aesthetics. Troyer cautions that people addressing the issues of infectious disease in mortuary services funeral directors, “Need a dose of humility and effective approaches at household, community, societal and global levels. At the household level, we need to promote family-centered interactions and interventions. Cultural practices such as embalming, burial, and caregiving are family-based as well as community-based activities.” Professionals in the funeral industry must have knowledge concerning different types of infectious disease, modes of transmission, and virulence that make them dangerous and difficult to contain. The global nature of travel today leads to
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Book Code: FFL1223
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