Ensuring Safety of Forensic Medical Examiners during Autopsy of Suspected or Detected Cases of Deadly Communicable Diseases
https://doi.org/10.35627/2219-5238/2022-30-1-55-60
Abstract
Background: Forensic medical examiners are known to be exposed to a combined effect of occupational risk factors potentially leading to adverse health outcomes. In the current epidemiologic situation largely influenced by the ongoing COVID-19 pandemic, postmortem examination of the bodies having signs of deadly communicable diseases, including the novel coronavirus disease, poses a high infection risk, thus making the development and implementation of appropriate preventive measures an urgent and important task.
Objective: To summarize and systematize the results of scientific research and requirements of legal and regulatory documents in the field of ensuring workplace safety of forensic medical examiners
Materials and methods: We searched for literary sources published in Russian and English in 2000–2021 in the PubMed, eLibrary, and Cyberleninka databases using such keywords as “healthcare workers”, “safety”, “forensic medical examiner”, “prosector”, and “deadly infections”. We conducted an analytical review of legal documents regulating safety in the conduct of forensic medical examination. Based on the relevance of search results, we selected 30 articles and five legal and regulatory documents for this review and carried out their content analysis using descriptive and analytical methods.
Results: As a solution to the problem of epidemiological surveillance, a series of modular buildings for postmortem examination of patients with suspected or confirmed deadly infectious diseases, including COVID-19, was developed and introduced.
Conclusions: Our findings indicate that in the context of the current pandemic, it is critical to update the requirements for biological safety of forensic experts stipulated in sanitary rules and norms. Construction of modular special purpose buildings in the city of Kazan contributed to improvement of biological safety during autopsy of COVID-19 victims.
About the Authors
O. A. IlinaRussian Federation
Olga A. Ilina, Assistant, Department of General Hygiene
49 Butlerov Street, Kazan, 420012
O. Yu. Milushkina
Russian Federation
Olga Yu. Milushkina, Dr. Sci. (Med.), Associate Professor; Vice-Rector for Academic Work, Head of the Department of Hygiene, Pediatric Faculty
1 Ostrovityanov Street, Moscow, 117997
M. I. Timerzyanov
Russian Federation
Marat I. Timerzyanov, Dr. Sci. (Med.), Associate Professor, Department of General Hygiene
49 Butlerov Street, Kazan, 420012
A. V. Shulaev
Russian Federation
Alexey V. Shulaev, Dr. Sci. (Med.), Professor, Vice-Rector, Head of the Department of General Hygiene
49 Butlerov Street, Kazan, 420012
References
1. Amirov NKh, Berkheeva ZM, Garipova RV. Assessment of occupational risk of violations for health of medical workers by results of periodic medical examination. Vestnik Sovremennoy Klinicheskoy Meditsiny. 2014;7(2):10–14. (In Russ.)
2. Burakova OA, Syurin SA, Frolova NM. Features of occupational diseases in health care workers of Murmansk region. Profilakticheskaya i Klinicheskaya Meditsina. 2011;(3(40)):272–275. (In Russ.)
3. Rostikov VP, Rod’kin VP, Brusentsova AV, Kapustina LP, Butorin AV. [Hygienic characteristics of working conditions of employees in ambulance station in Оmsk.] Omskiy Nauchnyy Vestnik. 2012;(2(114)):18–20. (In Russ.)
4. Sisin EI, Golubkova AA, Malyova SV, Bayakaev DA. The actual questions of occupational morbidity of medical personnel. Vestnik Ural’skoy Meditsinskoy Akademicheskoy Nauki. 2008;(4(22)):13–15. (In Russ.)
5. Ruzhenkov VA, Sergeeva EL, Moskvitina US. [The quality of life of healthcare workers.] Nauchnye Vedomosti Belgorodskogo Gosudarstvennogo Universiteta. Seriya: Meditsina. Farmatsiya. 2013;(18(161)):23–32. (In Russ.)
6. Bektasova MV, Kaptsov VA, Sheparev AA. Sociohygienic study of incidence, lifestyle and working conditions of medical institutions personnel in the context of Primorsky Krai. Put’ Nauki. 2014;(6):109–111. (In Russ.)
7. Timerzyanov MI, Minaeva PV, Morozyuk NV. Improvement of measures to ensure safe working conditions for staff of the bureau of forensic medicine. Sudebno-Meditsinskaya Ekspertisa. 2021;.(6):8-12. (In Russ.).
8. Kornachev AS, Rebeshchenko AP, Kal’gina GA, et al. [Evaluation of the effectiveness of monitoring of occupational biological safety of personnel of the Bureau of Forensic Medical Expertise in prevention of hospital-acquired tuberculosis.] Infektsiya i Immunitet. 2012;2(1-2):222–223. (In Russ.)
9. Kondrashov DL, Grinberg LM. [Algorithms of diagnosis and diagnosis building for tuberculosis in forensic medical practice.] Problemy Ekspertizy v Meditsine. 2006;6(2(22)):37–40. (In Russ.)
10. Kolkutin VV, Dzhuvalyakov PG, Ivanova EB. [Problems of sanitary and hygienic provision of activities of state forensic medical expert institutions.] Dezinfektsiya. Antiseptika. 2012;3(4(12)):44–49. (In Russ.)
11. Romanov BK. Coronavirus disease COVID-2019. Bezopasnost` i Risk Farmakoterapii. 2020; 8(1):3–8. (In Russ.) doi: 10.30895/2312-7821-2020-8-1-3-8
12. Dekhkonboev F, Toshmatov D, Alty`baev G. [Occupational diseases in healthcare professionals.] Vestnik Nauchnykh Konferentsiy. 2017;(3-5(19)):66–68. (In Russ.)
13. Stepanova TF, Bakshtanovskaya IV, Rebeshchenko AP, Mazurkevich VV. Assessing efficiency of epidemiological security system for the medical organization. Infektsiya i Immunitet. 2019;9(3-4):568–576. (In Russ.) doi: 10.15789/2220-7619-2019-3-4-568-576
14. Pluim JME, Jimenez-Bou L, Gerretsen RRR, Loeve AJ. Aerosol production during autopsies: The risk of sawing in bone. Forensic Sci Int. 2018;289:260–267. doi: 10.1016/j. forsciint.2018.05.046
15. Dijkhuizen LGM, Gelderman HT, Duijst WLJM. Review: The safe handling of a corpse (suspected) with COVID-19. J Forensic Leg Med. 2020;73:101999. doi: 10.1016/j.jflm.2020.101999
16. van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564–1567. doi: 10.1056/NEJMc2004973
17. Krishan K, Kanchan T. Aerosol and surface persistence: Novel SARS-CoV-2 versus other coronaviruses. J Infect Dev Ctries. 2020;14(7):748–749. doi: 10.3855/ jidc.12887
18. Nafeev AA, Mertsalova SL, Poseriaev AV, Sibiriakova RN, Nafeev NA. The profession contamination of medical personnel with tuberculosis. Problemy Sotsial’noy Gigieny, Zdravookhraneniya i Istorii Meditsiny. 2014;22(5):20–22. (In Russ.)
19. Loibner M, Langner C, Regitnig P, Gorkiewicz G, Zatloukal K. Biosafety requirements for autopsies of patients with COVID-19: Example of a BSL-3 autopsy facility designed for highly pathogenic agents. Pathobiology. 2021;88(1):37–45. doi: 10.1159/000513438
20. Yaacoub S, Schünemann HJ, Khabsa J, et al. COVID-19 Systematic Urgent Reviews Group Effort (SURGE) group. Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review. BMJ Glob Health. 2020;5(5):e002650. doi: 10.1136/bmjgh-2020-002650
21. Kritselis M, Remick DG. Universal precautions provide appropriate protection during autopsies of patients with infectious diseases. Am J Pathol. 2020;190(11):2180–2184. doi: 10.1016/j.ajpath.2020.08.005
22. Nolte KB, Yoon SS. Theoretical risk for occupational blood-borne infections in forensic pathologists. Infect Control Hosp Epidemiol. 2003;24(10):772–773. doi: 10.1086/502131
23. Kil′dyushov EM, Doronina OA, Amiyev GN, Kashirin I.A. Morozov Yu.E. Amieva N.G. [Topical issues of ensuring sanitary and epidemiological well-being in the bureau of forensic medical examination.] Meditsinskiy Al′manakh. 2016;(3):159–160.
24. Prikhodko AN, Maksimov AV, Frolova IA, Krupin KN. Work experience bureau of forensic medicine of Moscow region in the context of a pandemic caused by a new coronavirus infection. Sudebnaya Meditsina. 2020;6(4):35–40. doi: 10.19048/fm333
25. Ivanov SF. Mortality from COVID-19 against the backdrop of other twentieth century mortality bursts. Demograficheskoe Obozrenie. 2020;7(2):143–151. (In Russ.) doi: 10.17323/demreview.v7i2.11141
26. Pasnick S, Carlos WG, Dela Cruz CS, Gross JE, Garrison G, Jamil S. SARS-CoV-2 transmission and the risk of aerosol-generating procedures. Am J Respir Crit Care Med. 2020;202(4):P13–P14. doi: 10.1164/rccm.2024P13
27. Keten D, Okdemir E, Keten A. Precautions in postmortem examinations in COVID-19 – Related deaths: Recommendations from Germany. J Forensic Leg Med. 2020 Jul;73:102000. doi: 10.1016/j.jflm.2020.102000
28. Pang HB, Xu LM, Niu Y. Protection of forensic scene investigation and postmortem examination during the epidemic period of COVID-19. Fa Yi Xue Za Zhi. 2020;36(1):29–34. doi: 10.12116/j.issn.1004-5619.2020.01.007
29. Davis GG, Williamson AK. Risk of coronavirus disease 2019 transmission during autopsy. Arch Pathol Lab Med. 2020;144(12):1445a–1445. doi: 10.5858/arpa.2020-0345- LE
30. Hasmi AH, Khoo LS, Koo ZP, et al. The craniotomy box: an innovative method of containing hazardous aerosols generated during skull saw use in autopsy on a COVID-19 body. Forensic Sci Med Pathol. 2020;16(3):477–480. doi: 10.1007/s12024-020-00270-z
Review
For citations:
Ilina O.A., Milushkina O.Yu., Timerzyanov M.I., Shulaev A.V. Ensuring Safety of Forensic Medical Examiners during Autopsy of Suspected or Detected Cases of Deadly Communicable Diseases. Public Health and Life Environment – PH&LE. 2022;1(1):55-60. (In Russ.) https://doi.org/10.35627/2219-5238/2022-30-1-55-60