Follow applicable OSHA standards ● Employers must ensure that they comply with OSHA’s Bloodborne Pathogens standard, 29 CFR 1910.1030, to protect workers who may be exposed to blood or other potentially infectious materials. ● OSHA’s Personal Protective Equipment (PPE) standard, 29 CFR 1910.132, provides additional information about how to select and use appropriate PPE, training, and other requirements. ● Employers must comply with OSHA’s Hazard Communication standard, 29 CFR 1910.1200, when their workers use certain chemicals for cleaning and decontamination. Worker training is essential ● Employers must train workers about sources of exposure to Ebola and appropriate precautions. ● Where workers may be exposed to blood or other potentially infectious materials, such as in the waste handling, treatment, transport, and disposal industry, employers must provide the training required by OSHA’s Bloodborne Pathogens standard, 29 CFR 1910.1030. This includes information about how to Assistance for employers OSHA’s On-Site Consultation Program offers free and confidential advice to small and medium-sized businesses in all states across the country, with priority given to high- hazard worksites. On-Site consultation services are separate from enforcement and do not result in penalties or citations. Consultants from state agencies or universities work with
● OSHA’s Lockout/Tagout standard, 29 CFR 1910.147, contains requirements on controlling hazardous energy when working with machinery. ● In some cases, where a specific OSHA standard doesn’t apply, the General Duty Clause (Sec. 5[a][1]) of the Occupational Safety and Health Act requires employers to furnish to each employee a place of employment that is free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees. ● Employers may also be required to follow state regulations that cover potentially infectious medical waste, sometimes referred to as regulated medical waste. recognize tasks that may involve exposure and the methods to reduce exposure, including engineering controls, work practices, and PPE. ● Employers must train workers required to use PPE on what equipment is necessary, how to put it on and take it off safely and effectively, when and how they must use it, and how to dispose of the equipment. employers to identify workplace hazards, provide advice on compliance with OSHA standards, and assist in establishing safety and health management systems. To locate the nearest OSHA On-Site Consultation Program, call 1-800-321-6742 (OSHA) or visit https://www.osha.gov/consultation.
CDC AND WHO 2015 GUIDELINES FOR CONTAINING CREUTZFELDT-JAKOB DISEASE (CJD) Practitioners at funeral homes, cemeteries, and crematories encounter many potentially fatal and infectious diseases including Creutzfeldt-Jakob Disease (CJD). As described earlier in this course, CJD is a rare brain disease. It affects one person per million each year and occurs when a normal type of protein called a prion spontaneously changes into an infectious abnormal form that is capable of causing abnormal folding of other proteins that then accumulate in the brain. Individuals with CJD experience a rapid onset of dementia and a range of neurological symptoms, including walking difficulties, sudden jerky movements, and sometimes, visual disturbances. CJD patients usually die within one year following the onset of symptoms. An autopsy is very important in the diagnosis of CJD because it is the best way to confirm presence of the disease. it is not spread by airborne droplets, as are tuberculosis (TB), influenza, and COVID-19, or by blood or sexual contact, as are hepatitis B and human immunodeficiency virus (HIV). CJD transmission can occur during invasive medical procedures involving the central nervous system due to exposure to contaminated brain tissue or during corneal transplants (CDC, 2021a). This accounts for less than 1 percent of all CJD cases. Most cases occur sporadically, but some individuals can also develop CJD because of an inherited mutation. Standard disinfection procedures and routine embalming solutions are ineffective against prions; however, studies show that chemical solutions and physical processes involving bleach, sodium hydroxide, or autoclaving can inactivate the prion. If the bodies
of CJD patients have not been autopsied, transportation, preparation, disinfection, and final disposition can be safely performed when standard precautions are strictly enforced.
CJD is not transmissible from person to person by normal contact or through environmental contamination. For example, Transporting Funeral service workers can safely remove the body of a CJD patient from the place of death and transport it to the funeral home preparation room for mortuary procedures using appropriate standard infection control measures, which includes wearing personal protective gear. The WHO recommends Preparation and dressing An autopsied or traumatized body of a suspected or confirmed CJD patient can be embalmed, using the precautions outlined in the WHO CJD infection control guidelines. CJD patients who have not been autopsied or whose bodies have not been traumatized can be embalmed using standard precautions. Family members of CJD patients should be advised to avoid Embalming bodies that have not been autopsied Embalming bodies of CJD patients who have not been autopsied can be performed using standard precautions. However, it may be prudent to place the body on a waterproof sheet to collect bodily fluids and use disposable instruments. The bodily fluids should be collected in a suitable container.
placing the body in a leakproof pouch prior to moving. The bag should be lined with absorbent material to prevent leakage of body fluids. In instances where there is excess fluid, a double bag can be utilized. After transporting, all surfaces (e.g., stretchers, cots) should be disinfected with bleach (CDC, 2021b). superficial contact, such as touching or kissing the patient’s face, with the body of a CJD patient who has been autopsied. However, if the patient has not been autopsied, and the body has not been traumatized, staff need not discourage such contact.
Incision sites should be closed with superglue, wiped down with bleach, and the body washed prior to dressing. Cosmetic restorative work may also be undertaken.
Book Code: FTX1624
Page 97
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