Hazard to pathologists and anatomists from vena-caval (Greenfield) filters

Risk of occupational infection in forensic workers: a review

The occupational risk of infection in forensic workers is a cause for concern, furthermore in the current context of the coronavirus disease-19 (COVID-19) pandemic. In order to characterize this risk, we performed an extended review of the literature on occupational infections occurring in forensic workers. Seventeen articles were included. Direct contamination by aerosolization was the main mode of transmission reported, with 17 cases of tuberculosis. Indirect contamination was described as the mode of transmission in 10 cases (five cases of blastomycosis, two cases of tuberculosis, two Streptococcus pyogenes, and one case of human immunodeficiency virus). In all the other included cases, the mode of transmission was unknown. For two of them, the information provided was sufficient to link them to occupational exposure (one case of toxoplasmosis, one case of tuberculosis). For the remaining 10 cases, the link was uncertain (six cases of tuberculosis, three of hepatitis B, and one of COVID-19). Even if there is probably significant under-declaration, the number of infections linked to an occupational risk in forensic workers is not alarming, thanks to effective preventive measures.

Biosafety in autopsy room: an systematic review

Objective To discuss the risks related to the possibilities of accidents and contamination in autopsy rooms, especially the biological risk.Methods This is an exploratory study. The databases Lilacs, MEDLINE and SciELO virtual library were searched; from 2000 until 2017; from the following inclusion criteria: articles available in full, in Portuguese, English and Spanish languages; and those that portrayed the central theme of the article.Results 53 articles were analyzed, to following the sub-themes: chemical, ergonomic, biological and accident agents; exposure to radioactive materials; electrical and electronic equipment.Conclusions The death cause is essential for epidemiological surveillance. The prevalence of diseases in the population poses risk to autopsy room professionals. Often these diseases are not detected before death; can coexist with other conditions and be ignored; or don’t have morphological evidence at autopsy. M.tuberculosis, hepatitis virus, HIV and prions were the main pathogens identified. They can be transmitted by blood and aerosols; but there are other risks such as sharps, chemicals and radioactive materials.

The Greenfield filter as a potential hazard to the operating surgeon

The Greenfield filter and similar devices are placed in the vena cava of patients who have contraindications to anticoagulation, but who would otherwise be at risk of pulmonary embolism without such anticoagulation. Injury to a health care worker from one of these devices has been reported in the case of a pathologist performing a necropsy. To the author's knowledge, injury or near-injury to a member of the surgical team during operation has not been reported in the literature. The authors report on a near-miss injury from such a device to the surgical first assistant during the performance of a pancreaticoduodenectomy. Simple guidelines to avoid similar injuries are provided.

Health and safety at necropsy

The postmortem room is a source of potential hazards and risks, not only to the pathologist and anatomical pathology technician, but also to visitors to the mortuary and those handling the body after necropsy. Postmortem staff have a legal responsibility to make themselves aware of, and to minimise, these dangers. This review focuses specifically on those hazards and risks associated with the necropsy of infected patients, with foreign objects present in the body, and with bodies that have been contaminated by chemicals or radioactive sources.