Occupational Microbial Risk among Embalmers

Abstract

Embalmers are exposed to many pathogens present in bodily fluids. However, the risk posed by these pathogens has yet to be defined in terms of the nature of the hazard and the intensity of the exposure. The objective of this project was to monitor the exposure of embalmers to biological particles in real time and to characterize the microbiota found in the air during embalming activities in three thanatopraxy laboratories. An innovative approach, using a laser-induced fluorescence aerosol spectrometer (WIBS-NEO), made it possible to measure the concentrations and particle size distributions of the aerosols (biological and non-biological) emitted during embalming. At the same time, an Andersen impactor was used to sample the culturable microbiota present in the air and perform its characterization. The preferential aerosolization of the biological (fluorescent) fraction during embalming procedures, which was compared to the non-biological (non-fluorescent) fraction, showed that most of the tasks performed by the embalmer are likely to lead to microbial exposure via bioaerosols. The concentrations measured represented the equivalent of 2000 to 10,000 biological particles inhaled per minute. Although Mycobacterium tuberculosis was not identified in the air during this study, the presence of Streptococcus pneumoniae in some of the samples demonstrated that if a pathogen is present in the lungs of the deceased it can be aerosolized and inhaled by the embalmers. The size distribution showed that embalmers are exposed to a high proportion of small particles in the aerosols produced during their work. Thus, the respirable/total ratios calculated are between 58% and 78%. Finally, the detection of airborne Enterobacter, Serratia, Leclercia, and Hafnia tended to demonstrate the aerosolization of intestinal bacteria and their possible inhalation or ingestion. Due to the difficulty of identifying the presence of pathogenic agents before embalming, the presence of faecal bacteria in the air, the proximity of the embalmer to the body, and the limitations associated with the dilution of contaminants by general ventilation in the near field, local ventilation must be provided. Otherwise, minimally, a fitted N95-type respirator should be recommended.