Transcript CHAPTER 3

CHAPTER 3
Personal & Public
Health Considerations
RESPONSIBILITY
 The embalmer is responsible for:
• public health safety and
• personal health safety
 Don’t forget to protect YOURSELF!!!!
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.
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
OCCUPATIONAL RISK
 The longer you’re an embalmer the higher the risk factor of
contracting an HBV infection.
 So Please, Please, Please BE CAREFUL!!!
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.
NON-CHEMICAL HAZARDS
 Non-Chemical Hazards Include
• Heat
• Ionizing Radiation
• Non-Ionizing Radiation
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 you’re sweating is not good.
If the ventilation system in the funeral home is not
enough, an additional fan on the embalmer may be
necessary.
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.
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.)
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.
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
EXPOSURE DETERMINATION
 In a funeral home exposure most often includes:
•
•
•
•
•
embalmers
transfer personnel
hairdressers
funeral directors
housekeepers (laundry workers)
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?
METHODS OF COMPLIANCE
 Compliance with the Blood-borne Pathogens Rule is
accomplished by:
• universal precautions engineering controls
• work practice controls
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
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
PRACTICING UNIVERSAL
PRECAUTIONS
• Applying appropriate measures to control leaks, drips,
and spills of infectious materials.
• Applying proper work practice skills.
• Properly handle contaminated laundry.
ENGINEERING CONTROLS
 Engineering controls are parts of the design of the building
and include:
• Adequate Ventilation
• Proper Plumbing
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.
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
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
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
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.
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
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.
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
POST-EXPOSURE
EVALUATION
• Taking steps necessary to assist in the prevention of
infection or disease
• offering counseling
• conducting an evaluation of any reported illnesses
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.
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.
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.
TERMS REFERRING TO
D I S I N F E C T I O N & S T E R I L I Z AT I O N
 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).
TERMS REFERRING TO
D I S I N F E C T I O N & S T E R I L I Z AT I O N
 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.
TERMS REFERRING TO
D I S I N F E C T I O N & S T E R I L I Z AT I O N
 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.
TERMS REFERRING TO
D I S I N F E C T I O N & S T E R I L I Z AT I O N
 Sterilization- a process that renders a substance free of all
microorganisms.
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.
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.
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 retesting must be done, and
• the short-term exposure level (STEL) done over a
15 minute period which must read below 0.2ppm or retesting must be done.
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.