The conditions and the character of the work of the mortuary personnel in the Great Britain: the problems of health protection, anti-infectious prophylaxis, and reduction of the risk of contamination

• Published in: Sudebno-meditsinskaia ekspertiza Vol. 61; no. 4; p. 54
• Main Authors: Shigeev, S V, Fetisov, V A, Minaeva, P V, Gusarov, A A
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2018
• Subjects: Autopsy - standards; Coroners and Medical Examiners; Humans; Morgue; Occupational Exposure - prevention & control; Pathologists; Safety Management - organization & administration; United Kingdom; Universal Precautions - methods; United Kingdom; coroner’s autopsy Great Britain; mortuary; causative agents of infectious pathology; department of pathology; anti-infectious prophylaxis; prevention of morbidity of personnel
• ISSN: 0039-4521
• DOI: 10.17116/sudmed201861454

The objective of the present work was to study the specific approaches to the organization of the work of the foreign specialists performing post-mortem autopsies of the subjects who died from infectious pathology and consider the proposals of the representatives of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) concerning accreditation of mortuaries in the Great Britain. It is shown that the algorithm for the evaluation of the possible risks of contamination of the medical personnel suggests the solution of five problems that envisages obtaining the answers to the following questions: (1) what biological agents can be present in a particular case? (2) what is their virulence factor? (3) what are the transmission routes (mechanisms)? (4) what are the manner of their realization? (5) what is the amount of the pathogen(s) needed to cause a given infectious disease? The anti-infectious prophylactic measures and the prevention of the contamination risks for the medical personnel of the British mortuaries are designed to safeguard the people against the infection with the causative agents of tuberculosis, viral hepatitis B and C, HIV, and Kreutsfield- Jacob's disease. All the employees engaged in the pathological studies must wear specialized clothing in a mandatory manner and make use of the equipment for the personal and collective protection. An indispensable condition for the safe work in a mortuary is the efficient ventilation system, the special viewing equipment, and separate premises. The NCEPOD experts maintain that the general approach to the investigations of the cases of infectious diseases presently adopted in the country needs to be radically re-considered and standardized. Diagnostics of contamination and morbidity of the medical personnel from the corpses has not yet become a routine practice. The principal recommendation to be implemented at the national level consists of the strict observance of the safety precautions as opposed to the total pre-mortem testing of the suspicious cases.