embalming 3-4

What is the two-tiered spectrum an embalmer is responsible for?

1.) Public Health Safety

2) Personal Health Safety

How does an embalmer practice public and personal health?

1.) Application of chemicals

2.) Disposing of contaminants properly

3.) Keeping a clean and safe work environment

What are ways an embalmer can come in contact with blood?

73%-Blood Contact

39%-Needle Sticks

11% Cuts

What are the most frequently reported infectious diseases amongst surveyed funeral directors?

1.) Hepatitis

2.) Staphylococcal

3.) Pulmonary & Skin Tuberculosis

Why are embalmers more at risk now for contraction of rare & tropical diseases than ever before?

Global Travel

Embalmers are how much more likely to contract Hepatitis B (HBV)?

2x More Likely

Who have the same amount of exposure to infectious diseases as a Clinical Pathologist?

Embalmers

What is CJD caused by and is there a cure?

A pathogen smaller than a virus called a PRION. There is no cure.

Hepatitis is caused by?

Several Viruses

What variant of Hepatitis is transmitted through the fecal-oral route?

Hepatitis A&E

What variants of Hepatitis are bloodborne?

Hepatitis B, C, D, G, and GBV

What should embalmers be immunized against?

Hepatitis B

What does Human Immunodeficiency Virus (HIV) cause?

Acquired Immunodeficiency Syndrome (AIDS)

What can chronic exposure to HCHO (formaldehyde) cause?

Cancers of the oropharynx, nasopharynx, nasal passages, and the lungs

The state regulatory agencies are?

The Board of Health / The State Board of Embalmers & Funeral Directors.

The federal regulatory agencies are?

CDC / EPA / FTC / OSHA

What is the minimum ethic of a community?

The Law

How are funeral directors appointed to oversee the disposition of the dead?

By the law & trust.

According to the state, who are authorized to practice embalming?

Only qualified persons

Due respect and reverent care of the deceased and those bereaved is required by?

The issuance of a license to practice Mortuary Science.

Embalming is subject to control the public interest because it affects what?

Public health, safety, and welfare.

Who regulates a coroner, M.E., or donor service agency to take custody of the deceased?

States

Who has authority over the disposition of indigent bodies and the procurement of bodies for science?

Coroners, Medical Examiners, and Donor Service Agencies

Who enforce laws and regulations for the disposition of dead human bodies?

Regulatory Agencies

Who enacted the "Funeral Rule"?

The Federal Trade Commission (FTC)

Does the "Funeral Rule" apply to all states?

YES

What law is broken if a funeral home tells a family that embalming is required for direct cremation?

The Misrepresentation section of the FTC's Funeral Rule

Is it deceptive to charge a fee for an embalming if laws require it?

NO

Is it deceptive to charge a fee for an embalming if the family cannot be found?

NO

What is the Bloodborne Pathogen Rule administered through?

The United States Department of Labor through OSHA

What does the Bloodborne Pathogen Rule regulate?

An employee's exposure to blood & other bodily fluids

What is the Bloodborne Pathogen Rule directly applicable to?

Occupations that have direct exposure to infectious agents.

What is a written plan to control, minimize, or eliminate employee exposure to infectious agents?

Exposure Control Plan

How often should an Exposure Control Plan be updated?

Once a year (annually)

Minimum documentation for an Employee includes:

1.) Name & SSN

2.) HBV Vaccination record

3.) Exposure events & follow up

4.) Health care professional evaluation

What is Exposure Determination?

A process to identify what employees have exposure to infectious materials.

What IS and what IS NOT an example of Exposure Determination?

IS: Removals

IS NOT: Hairdressers & Clergy

How is the Bloodborne Pathogen Rule accomplished?

1.) Universal Precautions

2.) Engineering Controls

3.) Work Practice Controls

What classifies as universal precautions?

Treating every decedent as if they were fatally infected.

An embalmer prevents exposure to bloodborne pathogens through the following routes:

1.) Parenteral (skin)

2.) Mucous Membranes (nose & mouth)

3.) Nonintact Skin (cuts & scratches)

Engineering controls include:

Adequate Ventilation and Proper Plumbing

What is the purpose of ventilation?

Removal of contaminated air and replacing it with fresh air.

Where should the exhaust in the prep room be located?

At the foot of the embalming table, below the countertop.

Where should the air replacement in the prep room be located?

High on the opposite wall of exhaust.

What is the air exchange for a single table room?

12-20 per hour

Why should a funeral home have proper plumbing?

To ensure infectious substances do not end up in the potable (drinkable) water supply.

List ways to reduce splashing, spraying, or splattering when working with infectious agents:

1.) Drain-Tubes

2.) Stainless-Steel Tables

3.) Covering sinks, basins, and commodes

Whose responsibility is it to provide appropriate PPE and ensure the employees wear it?

The employer's

What is a rule of thumb for an embalmer's PPE?

There should be NO exposed skin.

Is it a good idea to cover broken bones during an embalming?

Yes, bones are very sharp.

What vaccine should all employers make available FOR FREE to all employees?

Hepatitis B Vaccine

What should all post-exposure evaluations include?

1.) HBV and HIV Testing

2.) Future exposure reduction strategies

When should employers provide training to employees?

On the date of hire or date of employee becoming responsible for infectious tasks.

What should biohazard containers be labeled with?

A red or orange label with a biohazard legend

Who is responsible to maintain employee records under the Hazard Communication Standard?

Employers

How long should employee training records be kept?

3 Years

What is an important weapon in the fight against infectious diseases?

Disinfection

What are Quaternary Compounds?

Surface Disinfectant and Germicide

What is Sodium Hypochlorite?

Household Bleach

What are Iodophors?

Betadine and Germicide

What is Glutaraldehyde?

A Cold Liquid Sterilant

What is Formaldehyde (HCHO)?

Sporicidal (kills spores)

What is 70% Isopropanol?

Alcohol and Sporicidal

What mandate has the Federal Government implemented stating employers must communicate with employees the hazardous substances of a given workplace?

The Hazard Communication Standard

Chemicals are considered hazardous if they contain 0.1% or more of ingredients considered what?

A Carcinogen, Teratogen, or Mutagen

What does the Hazard Communication Rule require to be shipped with each hazardous material?

A Safety Data Sheet (SDS)

What OSHA requirement addresses hazards associated with HCHO, HCHO gas, and HCHO solutions?

The Formaldehyde Standard

What is the specific point at which an 8-hour exposure of HCHO is unsafe?

Action Level

What is the Permissible Exposure Level (PEL) for HCHO?

0.75 Parts Per Mission (PPM) over 8 hours

What is the Action Level of HCHO?

0.5 Parts Per Mission (PPM) over 8 hours

What happens if the HCHO level reaches the Action Level?

Employers are required to take steps to reduce exposure.

What is the Short-Term Exposure Level (STEL) of HCHO?

Below 2.0 Parts Per Million (PPM) over 15 minutes.

What should employers do if HCHO reaches the PEL?

1.) Begin medical surveillance

2.) Post warning signs around work area

3.) Fit and assign respirators to all employees

Is it possible to become less sensitive to the effects of HCHO overexposure?

NO

According to the CDC, what do Funeral Directors have an elevated risk of?

Contracting Tuberculosis

What does the FTC's Funeral Rule state?

Everyone must be treated the same.

What is the equation for risk?

RISK=Toxicity x Exposure

Specific group of disease or conditions which are indicative of severe immunosuppression; dead persons may exhibit wasting syndrome, extrapulmonary tuberculosis, and Kaposi's sarcoma:

Acquired immunodeficiency syndrome/AIDS

Levels established to ensure adequate protection of employees at exposures below the OSHA limits:

Action Level / AL-Exposure Limits

Organization of professional personnel in government agencies or educational institutions employed in occupational safety and health programs.

American Congress of Governmental Industrial Hygienists (ACGIH)

Freedom from infection and from any form of life; sterility:

Asepsis

Bactericidal Agent V.S. Bacteriostatic Agent

Bactericidal Agent--->Destroys Bacteria

Bacteriostatic Agent--->Inhibits Bacteria

Destruction or inhibition of pathogenic organisms:

Disinfection

Consideration given to the dead body prior to, during, and after the embalming procedure is completed:

Embalming analysis (Case analysis)

Report filled out for each body prepared and received:

Embalming report (Case Report)

Mechanical systems engineered into the architecture of a building such as exhaust and plumbing.

Engineering Controls

Plans accessible to employees by law to control, minimize, or eliminate employee exposure to bloodborne pathogens:

Exposure Control Plan

What is inflammation of the liver?

Hepatitis

What is an inflammatory skin disease marked by small vesicles in clusters.

Herpes

What is an often-fatal bacterial disease characterized by pneumonia and sometimes gastrointestinal symptoms?

Legionnaires Disease

Limits established by OSHA to which workers can be exposed for a short period of time without damage or injury.

Short Term Exposure Limit / STEL

Sterilization V.S. Sanitation

Sterilization--->Eliminates microorganisms

Sanitation--->Minimizes microorganisms.

What is a disease that affects the respiratory system caused by Mycobacterium?

Tuberculosis

Which type of Hepatitis is transmitted via bodily fluids and which type is transmitted via blood?

Hepatitis B--->Bodily Fluids

Hepatitis C--->Blood

What is the primary purpose of a well-designed & organized preparation room?

To provide a safe and comfortable workplace.

Is it necessary to identify the prep room with a sign?

YES

What should a funeral home do if they are handling the remains of a high-profile personnel?

Establish a security plan for handling the remains.

What should an embalmer do to maintain the dignity of the remains?

Identify and cover the deceased.

How are OSHA requirements enforced?

Inspections, Warnings, and Citations.

What should be done with the clothing of the deceased?

It should either be laundered and returned or destroyed.