MYTHS SURROUNDING POSTMORTEM PROCEDURES AND INFECTIOUS DISEASE CONTAMINATION The following information applies to infectious diseases that do not carry specific regulations for burial and cremation, as previously outlined above. Care should be taken to review the federal guidelines in this course as well as laws and regulations of the state and local jurisdictions. cutting into them may be vulnerable in rare instances, with little or no risk if proper precautions are taken. To refuse to present a body unembalmed because of public health risk is unfounded. On rare occasions of certain deaths resulting
from contagious disease, our office may encourage placing a facemask on the decedent before and during transportation and containment, and disposing without embalming or viewing. In the event, however, it becomes necessary to hold a body for an extended period of time before public services can be held, arterial embalming is recommended. Riding on an airplane or a bus may be a public health risk; the presence of an unembalmed body is not. (as quoted in Mortuary Management , October 2006) Embalming is practiced more often in the United States than anywhere else (Walsh, 2017), although all nations and cultures have customs for dealing with the dead. In 2006, speaking for the CDC, Bernadette Burden stated: “We have not at any point prescribed embalming as a method of protecting public health” (Burden, 2006). Another unfounded myth is that infectious disease epidemics can occur after natural disasters, such as earthquakes or tsunamis, which cause mass casualties. According to the International Committee of the Red Cross (2013), this is not the case. In fact, it is essential after a natural disaster “to avoid hasty and uncoordinated disposal of bodies” because this can later cause difficulties in identifying victims. One myth holds that sealed caskets are necessary to protect against groundwater pollution. Although there is evidence that buried bodies can cause groundwater pollution (Żychowski & Bryndal, 2015), there is also evidence that sealed caskets do not remain indefinitely sealed. A study conducted in 1994 by Monument Builders of North America (MBNA) showed that even sealed caskets in vaults were subject to failure, which allowed outside elements in and fluids to leak out over time. These results were published in the F uneral Ethics Organization Newsletter as follows: MBNA found that the Catholic Cemetery Association was documenting an 86 percent failure rate or problems with wood and cloth-covered caskets, 62 percent for nonsealing metal, and 46 percent for “protective” or “sealer” caskets. Though sealed caskets yielded lower failure numbers the report states in bold print, “It is highly unlikely that protective sealer metal caskets employ sufficient mechanisms to contain body fluids or gases.” (2006) ● Be aware of the proper disposal of all waste materials and be certain that any disposal firms dealt with are reputable. ● Use products containing solvents only topically, if at all. For a more detailed list, see: https://nfda.org/resources/ business-technical/embalming/environmental-best-practices. When new diseases emerge, as has happened in the case of the COVID-19 pandemic, or when old diseases such as polio reappear, it will be important for funeral directors to be aware of any special dangers to mortuary personnel, grieving families, the public, and the environment.
In the past, many personnel in the funeral industry believed that embalming was necessary to protect the public from environmental contaminants and the spread of infectious disease. There is also a myth that embalming is legally required. According to the U.S. Federal Trade Commission (FTC; 2012), however, “no state law requires routine embalming for every death.” Some states do require that a body be embalmed or refrigerated if not buried or cremated within a certain time, but refrigeration is often an acceptable alternative. However, states do not routinely require embalming for viewing. In Florida, a body must be embalmed or refrigerated or otherwise preserved in an acceptable manner if final disposition does not occur within 24 hours (Florida Statute 497.386). New Hampshire mandates that bodies not be exposed to the public for more than 24 hours without embalming (New Hampshire Statute 325:40-a, (although a bill to repeal the law was introduced in 2022; Brown, 2022). Embalming is mandated when a body crosses state lines from Alabama, unless it is to be used for medical research (National Home Funeral Alliance, 2019). Some believe that a body contains dangerous bacteria that can spread infection. According to Oliver Morgan of the London School of Hygiene and Tropical Medicine, The microorganisms that are involved in decomposition are not the kind that cause disease, and most viruses and bacteria that do cause disease cannot survive more than a few hours in a dead body. An apparent exception is the human immunodeficiency virus, HIV, which has been shown to live up to 16 days in a corpse under refrigeration. (2004) Morgan further explains that exposure to a body with HIV, as well as most diseases, is no more dangerous in terms of contamination than exposure to a live person with HIV. The same precautions to prevent contact with bodily fluids from a person with HIV/AIDS would apply to contact with the body postmortem. Dr. Lakshmanan Sathyavagiswaran, former Chief Medical Examiner of Los Angeles County, provides the following clarification: There is no reason that an unembalmed human body should be infectious to anyone attending visitation or public services. Persons transporting and handling bodies or Environmental health and safety The National Funeral Directors Association (n.d.) has published a list of environmental best practices. Funeral directors must ● Be familiar with and follow all federal, state, and local requirements concerning embalming. ● Re-evaluate the products they are using periodically, and review and be familiar with the products’ material safety data sheets. They must try to limit the chemicals’ toxicity and the waste produced. When possible, avoid products containing phenol and cresol. Substitute environmentally friendly products as they become available. ● Be sure that onsite wastewater, septic, or other systems used for disposing of embalming and sanitary fluids are properly sized and in good condition.
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