Health risks from dead bodies

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The health risks of dead bodies are dangers related to the improper preparation and disposal of cadavers. While normal circumstances allow cadavers to be quickly embalmed, cremated, or buried; natural and man-made disasters can quickly overwhelm and/or interrupt the established protocols for dealing with the dead. Under such circumstances, the decomposition and putrefaction of cadavers goes unchecked, and raises a series of health, logistical, and psychological issues. After disasters with extensive loss of life due to trauma rather than disease—earthquakes, storms, human conflict, etc.—many resources are often expended on burying the dead quickly, and applying disinfectant to bodies for the specific purpose of preventing disease. Specialists say that spraying is a waste of disinfectant and manpower, that "resources that should be going into establishment of water supply, sanitation, shelter, warmth and hygienic food for the survivors are being applied to digging mass graves", and that "Time and time again, eminent and authoritative experts have pointed out that dead bodies do not constitute a health hazard". [1]

Contents

False risks

According to health professionals, the fear of spread of disease by bodies killed by trauma rather than disease is not justified. Among others, Steven Rottman, director of the UCLA Center for Public Health and Disasters, said that no scientific evidence exists that bodies of disaster victims increase the risk of epidemics, adding that cadavers posed less risk of contagion than living people. In disasters involving trauma where there is competition for resources, efforts should be focused on establishment of water supply, sanitation, shelter, warmth and hygienic food for the survivors, not digging mass graves. Spraying is a waste of disinfectant and manpower. Indiscriminate burial of corpses demoralises survivors and the lack of death certificates can cause practical problems to survivors. [1] Other considerations which are very important, but not directly relevant to the topic of health risks, include religious and cultural practices, the stench, and the effect on morale.

Roots of incorrect notion

The incorrect notion that all dead bodies inherently cause diseases is consistent with:

  1. The incorrect historical miasma theory of disease, which held that diseases are spread by foul air —in this case fouled by the stench of decomposing corpses.
  2. Confusion between normal decay processes and signs of disease; and the incorrect idea that microorganisms responsible for decomposition are dangerous to living people. "Microorganisms involved in the decay process (putrefaction) are not pathogenic". [2]
  3. After a major disaster disease among survivors is indeed a problem, but is actually due to living in harsh conditions with poor sanitation. "Survivors present a much more important reservoir for disease [than cadavers]". [2]
  4. Noting that corpses of those who died from certain contagious diseases (for example, in epidemics) do, indeed, spread disease, such as is the case with ebola, smallpox, and the 1918 flu, and incorrectly generalising this to all corpses.

According to the Pan American Health Organization (PAHO) "concern that dead bodies are infectious can be considered a 'natural' reaction by persons wanting to protect themselves from disease" although "the risk that bodies [of those killed in a natural disaster] pose for the public is extremely small". [2]

Real risks

Contamination of water supplies by unburied bodies, burial sites, or temporary storage sites may result in the spread of gastroenteritis from normal intestinal contents. [3]

According to a PAHO article on the Infectious Disease Risks From Dead Bodies Following Natural Disasters: [2]

There is little evidence of microbiological contamination of groundwater from burial. Where dead bodies have contaminated water supplies, gastroenteritis has been the most notable problem, although communities will rarely use a water supply where they know it to be contaminated by dead bodies. Microorganisms involved in the decay process (putrefaction) are not pathogenic.

To those in close contact with the dead, such as rescue workers, there is a health risk from chronic infectious diseases which those killed may have been suffering from and which spread by direct contact, including hepatitis B and hepatitis C, HIV, enteric intestinal pathogens, tuberculosis, cholera and others. [2]

The substances cadaverine and putrescine are produced during the decomposition of animal (including human) bodies, and both give off a foul odor. [4] They are toxic if massive doses are ingested (acute oral toxicity of 2 g per kg of body weight of pure putrescine in rats, a larger dose for cadaverine); there are no effects at all for a tenth of that dose. [5] While figures for humans are not available, allometric scaling, which takes into account body surface area, is often used to compare doses in different animals, with useful results. [6] Scaling 2g/kg from rats suggests that a 60 kg (132 lb) person would be significantly affected by 27 grams (0.95 oz) [7] of pure putrescine. For comparison the similar substance spermine, found in semen, is over 3 times as toxic.

See also

Related Research Articles

<span class="mw-page-title-main">Putrescine</span> Foul-smelling organic chemical compound

Putrescine is an organic compound with the formula (CH2)4(NH2)2. It is a colorless solid that melts near room temperature. It is classified as a diamine. Together with cadaverine, it is largely responsible for the foul odor of putrefying flesh, but also contributes to other unpleasant odors.

<span class="mw-page-title-main">Cadaverine</span> Foul-smelling diamine compound

Cadaverine is an organic compound with the formula (CH2)5(NH2)2. Classified as diamine, it is a colorless liquid with an unpleasant odor. It is present in small quantities in living organisms but is often associated with the putrefaction of animal tissue.

Rigor mortis, or postmortem rigidity, is the fourth stage of death. It is one of the recognizable signs of death, characterized by stiffening of the limbs of the corpse caused by chemical changes in the muscles postmortem. In humans, rigor mortis can occur as soon as four hours after death. Contrary to folklore and common belief, rigor mortis is not permanent and begins to pass within hours of onset. Typically, it lasts no longer than eight hours at "room temperature".

<span class="mw-page-title-main">Decomposition</span> Process in which organic substances are broken down into simpler organic matter

Decomposition or rot is the process by which dead organic substances are broken down into simpler organic or inorganic matter such as carbon dioxide, water, simple sugars and mineral salts. The process is a part of the nutrient cycle and is essential for recycling the finite matter that occupies physical space in the biosphere. Bodies of living organisms begin to decompose shortly after death. Animals, such as worms, also help decompose the organic materials. Organisms that do this are known as decomposers or detritivores. Although no two organisms decompose in the same way, they all undergo the same sequential stages of decomposition. The science which studies decomposition is generally referred to as taphonomy from the Greek word taphos, meaning tomb. Decomposition can also be a gradual process for organisms that have extended periods of dormancy.

<span class="mw-page-title-main">Carrion</span> Dead and decaying flesh of an animal

Carrion is the decaying flesh of dead animals, including human flesh.

A biocide is defined in the European legislation as a chemical substance or microorganism intended to destroy, deter, render harmless, or exert a controlling effect on any harmful organism. The US Environmental Protection Agency (EPA) uses a slightly different definition for biocides as "a diverse group of poisonous substances including preservatives, insecticides, disinfectants, and pesticides used for the control of organisms that are harmful to human or animal health or that cause damage to natural or manufactured products". When compared, the two definitions roughly imply the same, although the US EPA definition includes plant protection products and some veterinary medicines.

Putrefaction is the fifth stage of death, following pallor mortis, algor mortis, rigor mortis, and livor mortis. This process references the breaking down of a body of an animal post-mortem. In broad terms, it can be viewed as the decomposition of proteins, and the eventual breakdown of the cohesiveness between tissues, and the liquefaction of most organs. This is caused by the decomposition of organic matter by bacterial or fungal digestion, which causes the release of gases that infiltrate the body's tissues, and leads to the deterioration of the tissues and organs. The approximate time it takes putrefaction to occur is dependent on various factors. Internal factors that affect the rate of putrefaction include the age at which death has occurred, the overall structure and condition of the body, the cause of death, and external injuries arising before or after death. External factors include environmental temperature, moisture and air exposure, clothing, burial factors, and light exposure.

<span class="mw-page-title-main">Morgue</span> Place for the storage of human corpses awaiting identification or burial

A morgue or mortuary is a place used for the storage of human corpses awaiting identification (ID), removal for autopsy, respectful burial, cremation or other methods of disposal. In modern times, corpses have customarily been refrigerated to delay decomposition.

<span class="mw-page-title-main">Disinfectant</span> Antimicrobial agent that inactivates or destroys microbes

A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilization, which is an extreme physical or chemical process that kills all types of life. Disinfectants are generally distinguished from other antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue. Disinfectants are also different from biocides—the latter are intended to destroy all forms of life, not just microorganisms. Disinfectants work by destroying the cell wall of microbes or interfering with their metabolism. It is also a form of decontamination, and can be defined as the process whereby physical or chemical methods are used to reduce the amount of pathogenic microorganisms on a surface.

An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals are used against fungi. They can also be classified according to their function. The use of antimicrobial medicines to treat infection is known as antimicrobial chemotherapy, while the use of antimicrobial medicines to prevent infection is known as antimicrobial prophylaxis.

Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from healthcare into a component in public health, known as "infection protection". It is an essential part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.

<span class="mw-page-title-main">Putrefying bacteria</span> Bacteria involved in decay of living matter

Putrefying/decay bacteria are bacteria involved in putrefaction of living matter. Along with other decomposers, they play a critical role in recycling nitrogen from dead organisms. Putrefying bacteria also play a role in putrefaction and fermentation of proteins in the human gastrointestinal tract.

<span class="mw-page-title-main">Cadaver</span> Dead body used for study or instruction

A cadaver or corpse is a dead human body. Cadavers are used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Students in medical school study and dissect cadavers as a part of their education. Others who study cadavers include archaeologists and arts students. In addition, a cadaver may be used in the development and evaluation of surgical instruments.

<span class="mw-page-title-main">Effects of nuclear explosions on human health</span>

The medical effects of the atomic bomb upon humans can be put into the four categories below, with the effects of larger thermonuclear weapons producing blast and thermal effects so large that there would be a negligible number of survivors close enough to the center of the blast who would experience prompt/acute radiation effects, which were observed after the 16 kiloton yield Hiroshima bomb, due to its relatively low yield:

<span class="mw-page-title-main">Microbiology of decomposition</span>

Microbiology of decomposition is the study of all microorganisms involved in decomposition, the chemical and physical processes during which organic matter is broken down and reduced to its original elements.

Decomposition in animals is a process that begins immediately after death and involves the destruction of soft tissue, leaving behind skeletonized remains. The chemical process of decomposition is complex and involves the breakdown of soft tissue, as the body passes through the sequential stages of decomposition. Autolysis and putrefaction also play major roles in the disintegration of cells and tissues.

The following outline is provided as an overview of and topical guide to death:

The smell of death is a smell occurring during decomposition. It is made up of over 800 different chemicals. There have been efforts to synthesize the smell of death. It has also been used as evidence in court trials involving murder.

<span class="mw-page-title-main">Corpse decomposition</span> Process in which animal bodies break down

Decomposition is the process in which the organs and complex molecules of animal and human bodies break down into simple organic matter over time. In vertebrates, five stages of decomposition are typically recognized: fresh, bloat, active decay, advanced decay, and dry/skeletonized. Knowing the different stages of decomposition can help investigators in determining the Post Mortem Interval (PMI). The rate of decomposition of human remains can vary due to environmental factors and other factors. Environmental factors include temperature, burning, humidity, and the availability of oxygen. Other factors include body size, clothing, and the cause of death.

Diving equipment may be exposed to contamination in use and when this happens it must be decontaminated. This is a particular issue for hazmat diving, but incidental contamination can occur in other environments. Personal diving equipment shared by more than one user requires disinfection before use. Shared use is common for expensive commercial diving equipment, and for rental recreational equipment, and some items such as demand valves, masks, helmets and snorkels which are worn over the face or held in the mouth are possible vectors for infection by a variety of pathogens. Diving suits are also likely to be contaminated, but less likely to transmit infection directly.

References

  1. 1 2 "Mass burials do more harm than good-experts - Iran (Islamic Republic of)". reliefweb. 30 Dec 2003. Archived from the original on 2012-09-05. Retrieved 30 July 2018.
  2. 1 2 3 4 5 "Infectious Disease Risks From Dead Bodies Following Natural Disasters" (PDF). Archived from the original (PDF) on 2019-02-09. Retrieved 2005-01-09.
  3. ↑ Disposal of dead bodies in emergency conditions. WHO Technical Note 8
  4. ↑ Lewis, Robert Alan (1998). Lewis' Dictionary of Toxicology . CRC Press. p.  212. ISBN   1-56670-223-2.
  5. ↑ Til, H.P.; Falke, H.E.; Prinsen, M.K.; Willems, M.I. (1997). "Acute and subacute toxicity of tyramine, spermidine, spermine, putrescine and cadaverine in rats". Food and Chemical Toxicology. 35 (3–4): 337–348. doi:10.1016/S0278-6915(97)00121-X. ISSN   0278-6915. PMID   9207896.
  6. ↑ "Allometric Scaling Calculator". Clymer.altervista.org. 13 May 2012. Retrieved 15 December 2015. Online allometric scaling calculator, with explanation and source.
  7. ↑ Using allometric calculator cited, with rat weight=0.15kg, usual exponent of 0.75
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