Has
OSHA Forgotten Embalmers?
By Gary Finch
OSHA inspectors are divided into
two major divisions, industrial and health care. In most cases, funeral homes
draw inspectors from the healthcare division. It makes sense on the surface
because embalmers are exposed to bloodborne pathogens and work with many of the
instruments that are used in the operating room. The problem is, we are not
healthcare. No embalmer is so good that any of their patients have been cured
and walked out of the facility.
This division often leads to other
problems during OSHA inspections. Consider the Annual Summary of Occupation
Injuries report that healthcare is required to post each year. Funeral homes
receive an SIC exemption, and in most cases, are not required to file it. Yet,
in a number of cases, neither the inspector nor the funeral home safety officer
was aware of the exemption. The funeral homes were cited. Some paid fines
when all they had to do was point out that they were exempt from the rule. In
these cases, both OSHA and the funeral homes were unaware of the exemption.
The 2002 safe sharps amendment to
the Bloodborne Pathogen Standard requires businesses to hold certified annual
interactive training sessions on sharps safety, but because we are not healthcare,
we are not required to conduct comparative sharps evaluations as a hospital is
required to do. Funeral homes are required to stock safe sharps as they become
available on the market and make them available to employees. Sharps related
items that are available now include:
·
Disposable scalpels
·
Safe syringes
·
Slip-resistance latex gloves
·
Some instruments designed for safe operations
The suppliers that serve
healthcare offer these items months or years before most funeral suppliers
offer them. If you want to see a look of disbelief on an OSHA inspector’s
face, try telling them that safe instruments that have been used in operating
rooms for a year are not yet offered by suppliers to our industry.
Thus, we have become in a sense,
one of OSHA’s bastard children. To make matters worse, under Bush, OSHA is
targeting industries that have the highest incident rates for general
inspections. Funeral homes have a very low incident rate. We rank right up
there with barber shops and real estate agencies. Thus, in states under
federal OSHA, the only time OSHA even makes an inspection is when an employee
files a complaint. And then, the inspection is limited to the areas of the
complaint. In other words, if there was a complaint regarding safe sharps, the
inspector can inspect anything that falls within the bloodborne pathogen
standard, but they aren’t going to be checking the fire extinguishers like they
might in a general inspection.
Back in the days when OSHA was
actively making planned funeral home inspections, there were safety problems
the inspections did not address. In my own private inspections of preparation
rooms, I have found large coffee cans that were full of plutonium charged pace
makers. The plutonium has a shelf life of 4000 years. In many cases, the pace
makers were unmarked. In other cases, the hospital where they were installed
is located in another state. There are pace maker pick-up services that call
on hospitals, but none that call on funeral homes. Most hospitals will not accept
a pace maker for disposal that was not installed in their hospital. I have
alerted OSHA to the problem and am waiting for their answer. I have now been
waiting for four years. By contrast, a funeral home has 15 days to respond to
OSHA.
I can enumerate multiple examples
of a funeral home picking up a CJD case, only to learn later (after the
embalming) that it was a suspected CJD case. It is little comfort to the
embalmer that they remain free of symptoms after two years when the time
between exposure and the onset of symptoms can be 20 years or longer. These
are very real problems, but not the type in which OSHA has shown any interest
in solving.
Funeral homes are also caught in a
cross fire between OSHA and the new HIPPA that deals with privacy in medical
records. Two years ago, the politicians told us this would keep physicians
from trading our private medical records around like baseball cards. That was
the spin, but if you have been to a physician in the past year, you can attest
to the waivers (that forfeit your privacy rights) you have to sign before you
see your doctor. The reality is that now, more than ever, insurance companies
can trade your private health information around like baseball cards, and we
have no recourse.
An OSHA inspector went to one of
my clients this past year requesting a copy of an accident victim’s death
certificate. My client refused his request, citing privacy laws enacted by
HIPPA. He was right to refuse OSHA since it is clear a death certificate is
considered a medical record. The inspector stormed out saying he would be
back. Imagine a funeral home that gets in trouble for complying with a
federal law. Is this a great country or what?
The point is, if OSHA inspects
you, the inspector may ask to view an employee embalming a body. It will serve
you well to tell the inspector that due to HIPPA and privacy rights, he or she
must first obtain written permission from the next of kin or a court order.
Under those circumstances, the funeral home would not be expected to delay the
injection. To do otherwise, risks non-compliance with HIPPA.
Under OSHA, particularly during
the past 15 years, funeral homes have made tremendous advances in ensuring a
safer workplace for embalmers. Yet, there are probably areas in your own
workplace that OSHA has not specifically addressed. As an embalmer, you should
be familiar with OSHA’s General Duty Clause. This provision allows the employee
to present a unique problem to their employer, and requires the employer to
address the problem. Failure of the employer to address any safety issues that
an employee has reported is a violation and can result in fines.
OSHA does not claim to be a
cure-all for every safety problem. There is no substitute for an employee
using self-reliance. That means be alert for problems, alert your superior to
them, and if their action does not address the problem to your satisfaction,
report them to OSHA. Don’t be thrown off-course because you believe OSHA
inspectors are ignorant when it comes to embalming practices. The same
inspectors that inspect funeral homes also inspect neurosurgeons. They don’t
have to have intimate knowledge of a field to be effective. They are
intimately familiar with the process, and if they need to, they will ask you to
explain a particular problem to them.
In the past, employees might
choose to wait around and do nothing, thinking that someday, OSHA will be
inspecting your employer. The fact is, that is not very likely to happen.
Now, more than ever, it is up to you to initiate action. You must alert your
employer when you have a safety issue or problem. If it is not corrected, you
must notify OSHA to report it. If you are unwilling to do that, don’t expect
anything to change.