The death care profession has changed significantly in the past 40 years. But the concept of universal precautions when dealing with cross-contamination is frequently overlooked.

  This is important because – when ignored – the entire facility may be contaminated, creating long-term effects that spill over to the facility’s staff and the community it serves.

  The cross-contamination discussion begins with the stretchers used to make removals. The stretchers are taken into morgues and hospitals, long-term care facilities, and residences to transport deceased. They are then placed in removal vehicles, which often have carpeted flooring, before the stretcher arrives in the embalming room or another area to transfer the deceased onto an embalming or dressing table or refrigeration tray.

  Addressing the cross-contamination from transportation begins with the stretcher wheels, which must be disinfected; they are likely the home of unknown pathogens. Next is the floor in the removal vehicle. Many funeral homes use their removal vehicle for general purposes as well. Theoretically, anything placed in the back of the van could be contaminated with unknown pathogens. Even the route the stretcher is taken through in the facility must be disinfected to prevent cross-contamination.

  Continuing with the stretcher, the mattress should be sprayed with disinfectant after each deceased is transferred. And even as important, the stretcher cover and the metal tubing the stretcher is made of must be considered. Disposable gloves should always be used when making the transfer from the place of death, but during the transfer the stretcher is adjusted with the gloves on, which can transfer pathogens from the deceased to the frame.

  This creates more problems: Many times the stretcher is moved without the protection of disposable gloves, and the person does not wash his or her hands immediately. Worse yet, he or she moves the stretcher then handles paperwork for the deceased – paperwork that is then taken to the office for processing.

  Another opportunity for cross-contamination is shoes worn by staff. A majority of embalmers embalm in their everyday shoes without any protective covering. When they complete their work they remove their personal protective equipment, hopefully wash their hands, and proceed into the general public area with those shoes. Now the facility may be cross-contaminated.

  Because this list of opportunities for cross-contamination is not nearly exhaustive, it shows only a few ways that cross-contamination tends to happen. Locations must analyze their facility and develop policies and procedures to reduce the level of possible cross-contamination, including what areas and equipment must be disinfected with an appropriate chemical or treatment on a regular basis. This process must be documented when completed to maintain accountability in the work environment.