The Infection Connection: Is the Opiate Epidemic Putting Funeral Home Employees at Greater Risk of Contracting Bloodborne Diseases?
By Barb Garrison, M.S., CHMM, PCP
The recent explosive increase in the misuse of prescription opioids in the U.S. has sparked growing public recognition and concern. Every week, there is a headline relating to the impact the crisis is having on our communities:
- Ohio sees alarming jump in drug overdose deaths – Columbus Dispatch
- Opioid addiction among parents leads to more grandparents raising grandchildren – Boston Globe
- Overdoses force Ohio coroner to use a funeral home to store bodies – Dayton Daily News
While these headlines can be real attention-getters, there are other, less prominent headlines that should grab the attention of embalmers and anyone in the funeral service profession who handles un-embalmed remains:
- Hepatitis C and opioid abuse epidemics combine to pose new crisis – Institute for Patient Access
- Opioid and heroin epidemic stalls decline in HIV infections – CBS news
Think about it. People who inject drugs can become infected with HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), or other bloodborne pathogens from:
- Sharing needles or reusing needles and syringes;
- Sharing drug preparation equipment such as cookers, cottons, water, ties, and alcohol swabs;
- Reusing personal-care items (e.g., razors, nail clippers, and toothbrushes) from someone infected with a virus; or
- Sexual contact.
According to the Centers for Disease Control and Prevention (CDC), hepatitis B and C infections have reached epidemic proportions in most states because of the increase in injection drug users, and because these viruses are very infectious. People who have direct contact with surfaces, equipment, or objects contaminated with infected blood, even in amounts too small to see, can become infected. Hepatitis B can survive outside of the body for at least one week, and hepatitis C can survive on equipment and surfaces for up to three weeks.
Why is this increase in infectious important for funeral home employees? There are two answers to this question:
Answer 1 (not the best answer): Because people who handle the remains of infected individuals can themselves become infected if they do not take appropriate protective measures.
Answer 2 (the best answer): The increase in infections is NOT important because, per OSHA requirements, you should be observing Universal Precautions whenever there is a chance you could be exposed to bloodborne pathogens. In other words, you should ALWAYS treat remains as if they are infectious.
If you are an embalmer or you assist with the removal or handling of un-embalmed remains, always be cognizant of the fact that blood and other potentially infectious materials (OPIMs), such as cerebral-spinal fluid, should be treated as if they are, indeed, infectious. And remember that there are four ways in which bloodborne pathogens can enter your bloodstream and cause an infectious:
- Through non-intact skin (i.e., cuts, burns, etc.) or mucous membranes (e.g., splashes to the eyes, nose and mouth);
- Through the inhalation of aerosolized fluids;
- Through punctures or cuts from contaminated needles, scalpels, etc.; and
- Through inadvertent ingestion of contaminants that can occur if you do not wash your hands before eating, drinking, or smoking.
To protect yourself:
- Always cover your hands, skin, eyes, and face with fluid-resistant barriers if there is a chance you could be splashed with blood or OPIMs;
- Immediately dispose of contaminated sharps in an approved sharps container; and
- Wash your hands with soap and water after removing gloves.
Refer to your funeral home’s Bloodborne Pathogen Exposure Control Plan for more information on measures you should take to protect yourself from bloodborne pathogens.
While the current opioid epidemic should not change the manner in which you handle remains or protect yourself from bloodborne pathogens, it does provide a good opportunity to remind your staff about the importance of following Universal Precautions whenever they handle human remains.