Personal

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CHAPTER 3

• Personal Public
• Health Considerations

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Responsibility

• The embalmer is responsible for
• public health safety and
• personal health safety
• Dont forget to protect YOURSELF!!!!

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Occupational Risks

• The CDC has concluded that funeral directors have
  an increased risk of contracting tuberculosis as
  a result of direct contact with the deceased.

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Occupational Risk

• The most frequently reported diseases include
• hepatitis
• staphylococcal and other skin infection
• pulmonary and skin tuberculosis.
• Expose occurs most often by
• direct contact with blood
• needle sticks

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Occupational Risk

• The longer youre an embalmer the higher the risk
  factor of contracting an HBV infection.
• So Please, Please, Please BE CAREFUL!!!

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Exposure to Chemicals

• Exposure to formaldehyde is probably the most
  significant chemical exposure an embalmer has to
  face.
• The most common health problems in the prep room
  include chemical contact with the skin, eye and
  nose irritation, and upper respiratory
  irritation.

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Non-Chemical Hazards

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

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Heat

• With all of the Personal Protective Equipment an
  embalmer is required to wear it is no wonder why
  they can get so hot.
• Breathing in chemicals while youre sweating is
  not good. If the ventilation system in the
  funeral home is not enough, an additional fan on
  the embalmer may be necessary.

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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.

10
Ionizing Radiation

• If 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.)

11
Non-Ionizing Radiation

• This 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.

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Exposure Control Plan

• Every funeral home should have an Exposure
  Control Plan that includes
• exposure determination
• methods of compliance
• hepatitis B vaccination
• hazard communication
• record keeping

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Exposure Determination

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

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Exposure Determination

• Many 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.
• What can you do to prevent unauthorized
  individuals from entering the preparation areas
  or room?

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Methods of Compliance

• Compliance with the Blood-borne Pathogens Rule is
  accomplished by
• universal precautions engineering controls
• work practice controls

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Universal Precautions

• Universal Precautions is the act of treating
  every deceased as if they have a potential
  communicable disease.
• Many embalmers never see a death certificate or
  cause of death which makes Universal Precautions
  very important.
• General Washington Pancake

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Practicing Universal Precautions

• Practicing 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

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Practicing Universal Precautions

• Applying appropriate measures to control leaks,
  drips, and spills of infectious materials.
• Applying proper work practice skills.
• Properly handle contaminated laundry.

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Engineering Controls

• Engineering controls are parts of the design of
  the building and include
• Adequate Ventilation
• Proper Plumbing

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Adequate Ventilation

• The purpose of the ventilation system is to
  remove the airborne contaminates which include
  embalming fluid vapors and replace them with
  fresh air.
• The number of exchanges per hour vary but the
  average for a room with 1 table is 12 to 20 air
  exchanges.

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Proper Plumbing

• Examples 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

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Proper Plumbing

• 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

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Work Practice Controls

• Work 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

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Personal Protective Equipment

• A 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.

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Hepatitis B Vaccination

• Once 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

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Hepatitis B Vaccination

• An 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.

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Post-exposure Evaluation

• If 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

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Post-exposure Evaluation

• Taking steps necessary to assist in the
  prevention of infection or disease
• offering counseling
• conducting an evaluation of any reported illnesses

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Hazard Communication

• Labels must used to mark infectious hazards.
• Employees must be provided training on the
  infectious hazards in the work place.
• The training program is very extensive and is
  outlined on page 40 of your book. You should
  read this information carefully.

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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.

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Record Keeping

• Record Keeping in this case refers to the
  documentation of training with respect to
  occupational exposure to blood-borne pathogens.
• Employers are required to make all records
  available to the employees.

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Terms referring to disinfection sterilization

• Asepis- freedom from infection and from any form
  of life sterility.
• Bactericidal- destructive to bacteria
• Bacteriostatic- inhibiting the growth or
  multiplication of bacteria (no destruction of
  viability implied).

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Terms referring to disinfection sterilization

• Cleaning- removal of infectious agents by
  scrubbing and washing, as with hot water, soap,
  or a suitable detergent.
• Disinfectant- an agent, usually chemical, applied
  to inanimate objects/surfaces for the purpose of
  destroying disease causing microbial agents, but
  usually not bacterial spores.

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Terms referring to disinfection sterilization

• Germicide- A germicide is the same thing as a
  disinfectant except it can also be applied to
  living tissue.
• Sanitizer- An agent, usually chemical, that
  possesses disinfecting properties when applied
  to a pre-cleaned object/surface.

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Terms referring to disinfection sterilization

• Sterilization- a process that renders a substance
  free of all microorganisms.

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Hazard Communications

• The 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.

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Formaldehyde Standard

• Under the Formaldehyde Standard, employers must
  monitor employees to determine how much exposure
  exists in the workplace.
• The specific point at which exposure is unsafe in
  called the action level.
• The permissible exposure limit (PEL)sets the
  maximum exposure that is allowed.

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Formaldehyde Standard

• The 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.

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Conclusion

• There are many things that you can be exposed to
  as an embalmer.
• Your best defense is education.
• Know how to protect yourself and know your
  rights.
• Above all, use common sense.