Longevity and potential reusability of cardiac implantable electronic devices explanted in funeral homes.

BACKGROUND: While in high-income countries (HICs) the implantation of cardiac implantable electronic devices (CIEDs) is common, in certain low- and middle-income countries (LMICs) access to devices is limited and insufficient to meet the demand. Between 17% and 30% of CIEDs explanted post-mortem in HICs appears to have enough battery life to be reused but devices are not routinely programmed to no pacing output and continue to consume battery after the patient's death. Therefore, we conducted a prospective analysis of CIEDs collected from funeral homes, controlling variables such as the date of explantation and limiting the time until the date of interrogation to 6 months. The objective was to perform an accurate analysis of the reusability of post-mortem explanted CIEDs to assess the possibility of implementing a local effort of CIED reuse in LMICs. METHODS: A descriptive study of post-mortem explanted CIEDs in funeral homes was conducted. Participating centers stored all devices explanted between December 2020 to December 2021 for collection and interrogation. RESULTS: The participating centers attended 6472 deaths (28.05% of total deaths registered in the region). Two hundred fourteen CIEDs were collected (90.2% pacemakers and 9.8% defibrillators). Of the 214 collected devices, 100 CIEDs (46.7%) had >4 years or >75% battery remaining, preserved external integrity, and no evidence of malfunction and therefore were considered reusable. CONCLUSIONS: Based on stablished criteria 46.7% of recovered devices were considered reusable. Therefore, recovery from funeral homes of HICs comprises a potential source of reusable devices for LMICs.

Are funeral homes in the United States safe spaces for sexual and gender minorities? A website content analysis.

LGBTQIA+ people, particularly those aging into end-of-life care decisions, need safety cues to identify safe spaces to access equitable death care. We conducted a website content analysis of 90 randomly selected funeral homes across the United States to evaluate the presence of LGBTQIA+ safety cues, such as inclusive language, symbols, imagery, and LGBTQIA+-friendly collaborations. Results showed that none of the selected funeral homes displayed any kind of safety cues. A significant change in funeral home marketing strategies is warranted so sexual and gender minorities can easily locate inclusive and affirming death care services.

High rates of SARS-CoV-2 infection in funeral home workers in Ecuador: Is it an occupational risk for COVID-19?

Aim: The COVID-19 outbreak has already caused more than 6.5 million deaths, overwhelming health systems worldwide. The unusual demand for funeral home services could make these workers a potential risk group for occupational exposure to SARS-CoV-2 associated with corpses management for COVID-19 patients. Methodology: This is a cross-sectional study aimed to describe the infection rate of SARS-CoV-2 in funeral home staff by testing them with RT-qPCR in Quito, Ecuador. A total of 232 funeral home workers, representing more than 40% of funeral home personnel in Quito, were included in the study, in June 2020, immediately after the population lockdown was lifted in Ecuador. Results: A total of 48 individuals tested positive for SARS-CoV-2, yielding an infection rate of 20.7%. The SARS-CoV-2 infection rate was 18.1 and 20.0% among personnel managing corpses or not managing corpses, respectively. Among the SARS-CoV-2 positive patients, 81.3% reported no symptoms related to COVID-19, and 3 individuals had high viral loads over 108 copies/ml. Conclusion: The high SARS-CoV-2 infection rate in funeral home staff suggested a potential occupational risk for COVID-19 but not related to corpses management. Public health guidelines for safe corpses management for COVID-19 victims and safe funeral services should be reinforced.

Battery life of cardiac implantable electronic devices explanted in funeral homes: a potential resource for underserved nations.

INTRODUCTION: Cardiac implantable electronic devices (CIEDs) could still have adequate battery life and functionality when they are explanted after the death of the carrier, supposing an important resource for low- and middle- income countries where patients cannot afford new devices. OBJECTIVE: The aim was to analyze the remaining battery life and reusability of CIEDs recovered from funeral homes. METHOD: A descriptive study of postmortem explanted CIEDs was conducted. Devices were collected from three funeral homes in the Spanish region of the Basque Country (participation rate 33.3%). Devices with a remaining battery life of >75% or > 4 years, preserved external integrity and no evidence of malfunction were considered reusable. RESULTS: A total of 188 CIEDs were collected (175 pacemakers and 13 defibrillators). Of the total number of devices, 95 (50.5%) had enough battery to be interrogated. Among the interrogable devices, a total of 20 pacemakers (22.4%) had an estimated battery life of more than 4 years, as well as preserved integrity and no record of malfunction. CONCLUSIONS: A non-negligible number of postmortem explanted devices had battery life, external integrity and functionality to be considered reusable. Postmortem CIED donation could provide treatment to patients unable to afford new devices.

Assessment of formaldehyde exposures under contemporary embalming conditions in U.S. funeral homes.

The funeral service profession has used formaldehyde-containing embalming solutions for the preparation of decedents since the early 1900s. The available literature regarding funeral director exposure to formaldehyde largely consists of data collected prior to 2000, with most studies reporting task-length exposure concentrations rather than full-shift time-weighted average concentrations. As formaldehyde undergoes review in the U.S. Environmental Protection Agency Toxic Substances Control Act (TSCA) risk evaluation process, accurately characterizing long-term exposure potential in this profession is critical. This study presents passive badge sampling and air change rate measurement results conducted at 13 funeral home locations across the United States. Full-shift (approximately 8-hr) samples were collected on one embalmer per day in each funeral home and on one occupational non-user (ONU), e.g., a receptionist. Additionally, task-length samples were collected during each embalming that occurred during the shift, were one to occur. Full-shift concentrations ranged from 0.007 to 1.1 ppm and 0.007 to 0.042 ppm for embalmers and ONUs, respectively. Task-length formaldehyde concentrations ranged from 0.058 to 1.4 ppm, with the average embalming taking 72.8 min to complete. Air change rates in the preparation rooms ranged from 2.8 to 28.3 air changes per hour; however, no correlation between task-length formaldehyde concentrations and air change rate was observed. Following empirical data collection, a Monte Carlo analysis of estimated annual 8-hr time-weighted average (TWA) exposure was conducted to determine the potential exposure distribution for embalmers employed at private funeral homes. Inputs to the simulation were derived from responses to a National Funeral Directors Association survey and from empirical measurements collected during the study. With respect to the reconstructed 8-hr TWAs, the median 8-hr TWA was 0.037 ppm, with 93.6% of the predicted concentrations below 0.1 ppm. This study provides a robust characterization of contemporary formaldehyde exposures in the funeral service profession. Further, it provides a strategy for interpreting the results along with surveyed responses regarding embalming frequency to better inform risks associated with formaldehyde exposure in this profession.

Molecular analysis of black coatings and anointing fluids from ancient Egyptian coffins, mummy cases, and funerary objects.

Black organic coatings and ritual deposits on ancient Egyptian coffins and cartonnage cases are important and understudied sources of evidence about the rituals of funerary practice. Sometimes, the coatings were applied extensively over the surface of the coffin, resembling paint; in other cases, they were poured over the mummy case or wrapped body, presumably as part of a funerary ritual. For this study, multiple samples of black coatings and ritual liquids were taken from 20 Egyptian funerary items dating to a specific time period (c. 943 to 716 BC). Multiple sampling from each object enabled several comparisons to be made: the variability of the black coating within one application, the variability between two applications on one object, and the variability from object to object. All samples were analyzed for lipids using gas chromatography-mass spectrometry (GC-MS), and 51 samples from across the 20 items were further analyzed for the presence of bitumen using solid phase separation followed by selected ion monitoring GC-MS. The majority of the black substances were found to comprise a complex mixture of organic materials, including bitumen from the Dead Sea, conifer resin, and Pistacia resin, providing evidence for a continuation in international trade between Egypt and the eastern Mediterranean after the Late Bronze Age. Both the coating and the anointing liquid are very similar to mummification balms, pointing to parallels with Egyptian embalming rituals and raising questions about the practical aspects of Egyptian funerary practice.

Social Work in Funeral Homes, a Unique Chinese Practice?

Social workers were introduced to funeral homes in China amid the transition and expansion of both the funeral home industry and the social work profession and are proving to play a valuable, though under-researched role in serving not just clients but also communities and funeral home staff. Funeral home social work fills gaps in after-death care and mental health and is distinct from palliative, hospice, end-of-life, and bereavement social work. Based on the experiences of funeral homes that employ social workers, this article argues that this innovation may bring new ideas to bridge some of the service gaps in after-death care in China and globally. This article outlines the support that will be needed from funeral homes, social work service agencies, and educational and research institutes to facilitate further development of funeral home mental health and social services and to promote the professionalization of funeral home social workers in China.

Brain donation in the era of COVID 19: challenges to the harvest in the face of a pandemic.

We have experienced numerous new challenges during the process of brain harvesting in the period of COVID-19. Although brain harvests have continued successfully during this time period, the numerous uncertainties and challenges described in this paper have nearly derailed the process several times. While the interface of the medical profession with patients in the context of a pandemic has been well-documented on several fronts, and particularly for those health care workers on the front lines, we are not aware of any documentary accounts of the challenges facing research and tissue donation programs. With this paper, we contribute an additional perspective and describe the lessons we have learned in addressing these novel issues.

Saúde em Pauta 05 Bloco 3

Programa exibido na Tv Aperipê 6.1 - 22.06.2019

Localización, identificación, traslado y entrega de cadáveres / Location, identification, transfer and delivery of corpses

Objetivo del documento: disponer de lineamientos básicos de desinfección para las personas que realizan el proceso de la localización, identificación, traslado y entrega en cementerios de cadáveres por COVID-19, evitando así la propagación del mismo.

Lineamientos para el manejo de cadáveres Coronavirus COVID- 19 / Guidelines for the management of corpses Coronavirus COVID- 19

Establece los lineamientos a seguir durante en el proceso del manejo de cadáveres infectados con el Coronavirus COVID-19 en todo el territorio nacional. Describe procedimientos para servicios de salud y funerarias, en el trato de los cuerpos.

Lineamientos para el manejo de cadáveres Coronavirus COVID- 19: 03 de abril 2020 / Guidelines for the management of corpses Coronavirus COVID- 19

Versión 03 de abril 2020. Establece los lineamientos a seguir durante en el proceso del manejo de cadáveres infectados con el Coronavirus COVID-19 en todo el territorio nacional. Describe procedimientos para servicios de salud y funerarias, en el trato de los cuerpos.

Brief report: Challenges of conducting research within the funeral services sector in South Africa.

Funeral services sector personnel are at risk of contracting infectious diseases and have poor adherence to universal safety precautions. More work needs to be done to understand this industry; however, there is limited information on conducting research within this sector. This manuscript draws on experiences and observations of funeral services study describing lessons learned in the field, particularly emphasizing attempts to engage funeral homes in research and the impact of this work on the research team. Factors to be considered before researching in this sector: obtaining approvals, identification as researchers, and in-house emotional support for the research team.

Selling in a Dying Business: An Analysis of Trends During a Period of Major Market Transition in the Funeral Industry.

As a result of recent economic changes in the United States and cultural changes among the population, the funeral industry has experienced a "legitimation crisis." The objective of this research is to examine new advertising and marketing strategies engaged in by professionals in the funeral industry to respond to market and cultural changes that have affected both the funeral industry at large and the role of the funeral director as a participant in this industry. A meta-analysis of articles from issues of the industry trade journal American Funeral Director for the years 2008 through 2015 was conducted. Two major themes emerged from the data. First, that funeral home owners should respond to market changes by using their assets for diverse reasons and second that forms of community engagement can create feelings of goodwill that will increase usage and loyalty from families. Within each of these major themes, a variety of subthemes emerged from the data.

An observational study of safe and risky practices in funeral homes in South Africa.

BACKGROUND: Funeral home personnel are at risk of exposure to infectious hazards. The high prevalence of infectious diseases in South Africa means that these workers and family members of deceased individuals are vulnerable to infection if proper safety measures and equipment are not used. OBJECTIVES:  To collect observational information on funeral industry practices in order to assess the safety of handling corpses and exposure to risk that could result in disease transmission. METHODS: A cross-sectional study was conducted across two locations from August to October 2015. Funeral homes in Klerksdorp and Soweto were approached. The study team did facility assessments and observed preparation practices, focusing on safety equipment, personal protective equipment (PPE) and contact with hazardous materials. Interviews with funeral home personnel and relatives of the deceased were also conducted. RESULTS: Of the funeral homes, 23.0% (20/87) agreed to participate. A median of 5 personnel (interquartile range 4 - 8) were employed per facility. It was observed that not all PPE was used despite availability. Gloves, aprons and face masks were most commonly worn, and no personnel were observed wearing boots, gowns or plastic sleeves. Funeral homes were located near food outlets, schools and open public spaces, and not all had access to proper biohazardous waste disposal services. Of 5 family members who were interviewed for the study, none reported being willing to partake in the funeral preparation procedure. CONCLUSIONS: There is a need to standardise the use of safety equipment, waste disposal methods and location designation in the funeral industry.

The final discharge: Quantifying contaminants in embalming process effluents discharged to sewers in ontario, Canada.

The process of embalming human remains as part of the funeral home industry, entails replacing blood with embalming fluid. Typically the unused/excess fluids are disposed of directly to the sewershed or septic system. The presence of select contaminants in sewer discharges from 8 funeral homes (facilities) in York Region, Ontario during active embalming processes was studied. A wide range of contaminants including embalming fluids (formaldehyde and triclosan); metals, conventional parameters, persistent organic pollutants (polycyclic aromatic hydrocarbons, pesticides, and polychlorinated byphenyls), nonyl phenols and active pharmaceutical ingredients (APIs) were measured in the final embalming effluent and compared to regulatory sewer limits where available. Two main constituents of embalming fluids-formaldehyde and triclosan-were detected at maximum concentrations of 561,000 µg/L and 505 µg/L respectively. Other persistent organic pollutants detected in embalming effluent included banned pesticides lindane (83 ng/L) and metabolites of DDT (DDE; 2,300 ng/L). Elevated APIs found in over-the-counter drugs and products were also frequently detected at elevated concentrations (oxybenzone, hydrocortisone, lidocaine, naproxen, ibuprofen, ciprofloxacin and DEET). Most contaminants did not exceed regulatory sewer limits where available, however others including biochemical oxygen demand (cBOD5) and conventional parameters were consistently above regulatory limits. Large amounts of formaldehyde and triclosan may pose a risk to receiving sewersheds and receiving sewage treatment plants due to their antimicrobial activities.