Keeping in mind the era of global immigration and bioterrorism, awareness of possibility of epidemics is essential. Experience of experts working with diseases like SARS, bird flu, swine flu, Ebola, corona virus, hanta viruses, etc. have heightened the biosafety requirements to perform medico-legal autopsy.
Every occupation in the medical field has increased exposure and risk of infection and so does autopsy practice. Infective agents like bacteria, virus, fungi, helminths, parasites and prions are some common threats mortuary personnel are routinely exposed to. These infective pathogens are introduced through pricks, cuts, inhalations, ingestion or passage through pre-existing wounds.
Cuts and puncture wounds should be irrigated immediately with soap and running water. In case of conjunctival splashes, the eyes should be washed immediately. Injured employees should go to the emergency department. Any individual with open wounds or dermatitis should not assist in autopsy procedures, or when required the open wound must be completely covered with a waterproof barrier.
Simple rules practiced in mortuary can help reduce the risk of transmission. A board/notice must be kept outside the mortuary written ‘hazard’ in big letters to avoid entry of unauthorized personnel. Autopsy suite must be well ventilated and nylon suits are preferred since they do not absorb fluid. Only trained staffs must handle the body and instruments. One trained staff must stay clean and assist in recording the findings and help with logistics. The risk of splashes, spills, droplets, or aerosols must be minimized. Following completion of autopsy, all material – every instrument, suit and even paper used for recording needs to be replaced. Disposable logistics must be used in all cases even remotely doubtful of causing a biological hazard at the mortuary.
Personal protective equipment (PPE) is required to establish minimum biosafety levels. This includes double sets of gloves, gowns, scrub suits, plastic aprons and sleeves, N95 masks, googles or face shields, shoe covers and gumboots confined to non-contaminated areas. Cut-resistant and puncture-resistant hand protection (plastic or steel gloves) are available and highly recommended for high-risk procedures.
Everyone working in mortuary must be vaccinated against Hepatitis B and tetanus.