Specifics of Organizational and Design Solutions for Buildings of the Bureau of Forensic Medical Examination

Abstract

Introduction: Nowadays, biosafety of medical personnel and visitors of the Bureau of Forensic Medical Examination (BFME) is of special importance. One of the most significant issues in terms of infection prevention and control is the design solution for premises of the BFME and departments of anatomic pathology. Up-to-date forensic medical examination institutions shall combine functionality, good technical equipment, and engineering design, all ensuring human comfort and safety. Objective: To evaluate sanitary and hygienic measures, especially organizational and design solutions for BFME buildings ensuring occupational safety and health of the personnel and proper infection control, based on the analysis of scientific publications and valid regulatory documents. Materials and methods: We have reviewed recent Russian and English-language scientific papers on current approaches to infection prevention and control in bureaus of forensic medical examination published in 2018–2022. They were selected using a logical search on such platforms as eLIBRARY.ru, PubMed, CyberLeninka, and Google Scholar. The criteria for inclusion of publications in the review were a non-zero Hirsch index (h-index) or the Russian Science Citation Index (RSCI) and the presence of the following phrases in the title, abstract, and/or keywords: autopsy biosafety, infection of medical staff, infection prevention and control, design of forensic medical examination premises, and occupational safety in forensic medical services. Of 143 sources selected, 47 articles contained a proven risk assessment of biosafety of medical personnel and description of preventive measures and were thus found eligible for inclusion in the review. Results: We established problems in the design of construction or reconstruction of BFME premises in terms of creating a safe working environment. We have noted that the workflow, functionality of the premises, and the level of sanitary measures aimed at prevention of infection in staff and visitors is often disregarded. The procedure of instrument sterilization is not regulated by documents of the Russian Federation. Organization of forensic activities in areas remote from large cities and in towns of 25,000 residents or less remains challenging. It is essential to revise and supplement current regulations to ensure biosafety of forensic medical services. Conclusion: The article describes the shortcomings of design solutions that must be taken into account in construction and/or reconstruction of BFME premises. The design of such buildings in terms of infection control shall be specified in regulatory documents.