CHAPTER 3
description
Transcript of CHAPTER 3
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CHAPTER 3
Personal & Public
Health Considerations
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RESPONSIBILITY
T
he embalmer is responsible for:• public health safety and• personal health safety
D
on’t forget to protect YOURSELF!!!!
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OCCUPATIONAL RISKS
T
he 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
T
he most frequently reported diseases include:• hepatitis• staphylococcal and other skin infection• pulmonary and skin tuberculosis.
E
xpose occurs most often by• direct contact with blood• needle sticks
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OCCUPATIONAL RISK
T
he longer you’re an embalmer the higher the risk
factor of contracting an HBV infection.
S
o Please, Please, Please BE CAREFUL!!!
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EXPOSURE TO CHEMICALS
E
xposure to formaldehyde is probably the most significant
chemical exposure an embalmer has to face.
T
he 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
N
on-Chemical Hazards Include• Heat• Ionizing Radiation• Non-Ionizing Radiation
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HEAT
W
ith all of the Personal Protective Equipment an embalmer
is required to wear it is no wonder why they can get so hot.
B
reathing 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.
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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.
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IONIZING RADIATION
I
f 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.)
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NON-IONIZING RADIATION
T
his 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
E
very 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
I
n a funeral home exposure most often includes:• embalmers• transfer personnel• hairdressers• funeral directors• housekeepers (laundry workers)
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EXPOSURE DETERMINATION
M
any 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.
W
hat can you do to prevent “unauthorized” individuals
from entering the preparation areas or room?
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METHODS OF COMPLIANCE
C
ompliance with the Blood-borne Pathogens
Rule is accomplished by:• universal precautions engineering
controls• work practice controls
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UNIVERSAL PRECAUTIONS
U
niversal Precautions is the act of treating every deceased as
if they have a potential communicable disease.
M
any embalmers never see a death certificate or cause of
death which makes Universal Precautions very important.
G
eneral Washington Pancake
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PRACTICING UNIVERSAL PRECAUTIONS
P
racticing 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
E
ngineering controls are parts of the design of
the building and include:• Adequate Ventilation• Proper Plumbing
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ADEQUATE VENTILATION
T
he purpose of the ventilation system is to remove the
airborne contaminates which include embalming
fluid vapors and replace them with fresh air.
T
he 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
E
xamples 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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• 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
PROPER PLUMBING
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WORK PRACTICE CONTROLS
W
ork 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
O
nce 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
A
n 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
I
f 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
L
abels must used to mark infectious hazards.
E
mployees must be provided training on the infectious hazards in
the work place.
T
he 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
R
ecord Keeping in this case refers to the
documentation of training with respect to
occupational exposure to blood-borne pathogens.
E
mployers are required to make all records available
to the employees.
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TERMS REFERRING TO DISINFECTION & STERILIZATION
A
sepis- freedom from infection and from any form of life;
sterility.
B
actericidal- destructive to bacteria
B
acteriostatic- inhibiting the growth or multiplication of
bacteria (no destruction of viability implied).
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C
leaning- removal of infectious agents by scrubbing and
washing, as with hot water, soap, or a suitable detergent.
D
isinfectant- 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 DISINFECTION & STERILIZATION
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TERMS REFERRING TO DISINFECTION & STERILIZATION
G
ermicide- A germicide is the same thing as a disinfectant
except it can also be applied to living tissue.
S
anitizer- 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
S
terilization- a process that renders a substance
free of all microorganisms.
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HAZARD COMMUNICATIONS
T
he 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
U
nder the Formaldehyde Standard, employers must
monitor employees to determine how much
exposure exists in the workplace.
T
he specific point at which exposure is unsafe in called the
action level.
T
he permissible exposure limit (PEL)sets the maximum
exposure that is allowed.
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FORMALDEHYDE STANDARD
T
he 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
T
here are many things that you can be exposed to as an embalmer.
Y
our best defense is education.
K
now how to protect yourself and know your rights.
A
bove all, use common sense.