Autopsy Biosafety Precautions

Study Notes

Autopsy pathologists and staff members face potential biohazards during work, which can be limited by adhering to strict safety precautions, proper autopsy technique, and using proper instruments and equipment.
Pathologists must collaborate with local infection control and occupational health and safety departments to implement a complete biosafety plan, including ongoing review of safety concerns and a continuing program of safety education.

Global travel and bioterrorism threats have increased awareness of epidemics caused by highly transmissible agents, such as severe acute respiratory syndrome (SARS) due to coronavirus.
The experience with SARS has provided lessons in biosafety, with a high percentage of healthcare workers infected.

Precautions required for specialized lethal diseases are beyond the scope of this chapter, and suspected cases should be referred to the Centers for Disease Control and Prevention (CDC) as soon as possible, preferably before postmortem examination.
Local medical examiners or offices and public health laboratories may provide guidance, and the CDC has designated regional laboratories (Laboratory Response Network) to aid in diagnosis and containment.

Historically, physicians and healthcare workers have accepted the moral responsibility of caring for patients with contagious disease, but occupational exposure places them at risk for developing communicable diseases.

Infective agents such as viruses, bacteria, fungi, parasites, and prions can cause disease in healthcare workers exposed to sufficient inocula, especially when usual body defensive barriers are disrupted or bypassed.
Infective material is introduced through accidental puncture wounds, splashes into mucous membranes, inhalation, or passage through preexistent wounds.
To minimize risk, adequate barriers should be in place, and all autopsies should be considered as potential infective sources.

The cornerstone of any autopsy biosafety program is the practice of standard (universal) infection control precautions as established by the U.S.CDC, the National Institutes of Health, or the World Health Organization.
This approach includes proper attire, barrier protection, care while using sharp instruments, tissue fixation, decontamination of equipment and work surfaces, and hand washing.
Containment and treatment, proper cleaning of spills, immediate treatment of any injuries, and notification of the proper authorities are also essential.