Biohazard protection needed at multifatality incidents
William M. Martin
President
Paratus Enterprises
Nashua, New Hampshire
I read with interest and appreciation Leonard S. Murry`s “Handling Multifatality Incidents” (December 1994). The article was very thought-provoking and informative, complete with useful information for the fire service relating to the organization for and coordination of incidents involving mass fatalities.
One operational issue not contained within the article, however, and certainly worthy of mention concerns the safe handling of human remains. Of special concern is the implementation of biohazard protective measures for public safety response personnel and support staff, both at the scene and within any temporary morgue facilities established to process large numbers of deceased.
This is especially critical during incidents involving major physical trauma. In such incidents as explosions, air crashes, major structural collapse, and other mass-casualty situations, vast amounts of human blood, other body fluids, soft tissue, bone and skeletal fragments, and interior body organ remnants may be strewn across a wide area. These unconfined body parts and fluids pose a risk of potential exposure to pathogens and communicable disease, transmitted by inhalation or even casual contact. At a debris-laden accident site, typical at aviation accidents, it is quite easy for response personnel to come in contact with exposed body parts and fluids, just by moving around the impact zone.
Along with all the other issues needed to be addressed in any preincident mass-fatality plan, a section concerning the safe movement of response personnel through contaminated areas and the sanitary handling of human remains should be incorporated into any planning document. The use of biohazard protective equipment (i.e., gloves, masks, respirators, overalls, goggles, etc.) should be enforced at all such incidents, with necessary protective resources made available for all involved response and recovery personnel.
In addition to the implementation of personnel protection and safe operating practices, operational procedures should be developed for the decontamination of response personnel, equipment, transportation vehicles, post-mortem processing facilities, and even personal effects of the deceased. Moreover, in some cases, human remains may have to be isolated if suspected of being carriers of highly contagious diseases.
Although the urge is strong to rapidly recover, remove, identify, and dispose of human remains for the purpose of restoring normalcy to an incident scene and providing some sense of mental and emotional closure to family members and survivors, care should be exercised to avoid unnecessary exposure to human or substance biohazards. It should be remembered that few communities maintain readily available facilities to safely process multiple fatalities. Temporary morgue sites, no matter how well pre-selected, are rarely equipped in the same manner or to the same degree as a dedicated morgue, medical facility, or mortuary.
Inclusion of specific policies and procedures in multifatality incident response plans dealing with enforcement of safe handling practices and the provision of appropriate personnel protective equipment at the scene and within temporary morgue facilities will lessen the potential for accidental exposure to in-transit etiologic agents, bloodborne and airborne pathogens, and other easily transmitted communicable diseases.
