Page 129 - policy and procedure infection control

Policies and Procedures on Infection Control

6.7 Mortuary

6.7.1 Introduction
With cessation of life, there is neither the reticulo-endothelial system nor the blood brain barrier
presence to restrict the translocation of microorganisms within the dead human remains. Therefore,
these microorganisms and bacteria pose serious threat to forensic pathology personnel working
in mortuary.

The post mortem room is a source of potential hazards and risk, not only to pathologist and
anatomical pathology technician, but also to visitors to the mortuary and those handling the body
after necropsy. Post mortem staffs have legal responsibilities to be aware of and to minimize
these changes.
Safety and infection control policy in mortuary is an issue not only relevant to the team performing
the autopsy, but also has direct implications regarding the protection of environment. For the
purpose of infection control, the mortuary complex may be seen operationally as comprising of;
1) Clean areas – reception areas, offices, consultation and viewing room.
2) Transitional areas – vehicle bay, areas of body freezers, specimen preparation
room and changing room.
3) Dirty areas – post mortem rooms.
The principal biological risks faced by mortuary workers are the infection caused by Mycobacterium
tuberculosis, the blood borne hepatitides, HIV and agents responsible for Transmissable
Spongiform Encephalopathy (TSE) such as variant Creutzfeldt Jacob Disease (vCJD). All of these
pathogens retain their infectivity after death. The presence of such pathogen may not become
known until the gross examination.
Risks of health during post mortem examinations are primarily related to airborne and blood
borne infection routes. Autopsy transmitted infections may occur via several routes such as:
- Percutaneous injury leading to direct cutaneous inoculation
- Contact with droplets via preexisting breaks in skin and mucosal surfaces (eyes,
mouth and nose)
- Aerosol exposure
- Ingestion
In mortuary setting there are ten areas to be covered in order to achieve the safety level as
explained below.

6.7.2 Collection of body from ward
In performing the duty to collect body from ward, medical attendants are at risk of in
contact with infectious material. The following precautions must be taken:

1. When handling bodies never smoke, eat, chew, drink or take any other actions that
will bring hands into contact with the mouth, eyes or nose.

118 Ministry of Health Malaysia