Health risks from dead bodies
Encyclopedia
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 disaster
s 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
. This is an inappropriate use of scarce resources and manpower
: the health risks from dead bodies in such cases are minimal.
, said that no scientific evidence exists that bodies of disaster victims increase the risk of epidemics, adding that cadaver
s posed less risk of contagion
than living people. In disasters involving trauma where there is competition for resources, they should be going into 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.
The situation is quite different in the case of a health disaster such as an epidemic
of certain diseases which can be spread by contact with the bodies of those who died of the disease.
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.
s is consistent with:
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".
from normal intestinal contents.
According to a PAHO article on the Infectious Disease Risks From Dead Bodies Following Natural Disasters:
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 C
, HIV
, enteric
(intestinal) pathogen
s, tuberculosis
, and others.
The substances cadaverine
and putrescine
are produced during the decomposition
of animal (including human) bodies, and both give off a foul odor. They are toxic if massive doses are ingested (2 g per kg of body weight of pure putrescine in rats, a larger dose for cadaverine), causing adverse effects. If these figures are assumed to apply to humans, a 60 kg (132 lb) person would be significantly affected by 120 g (4 oz) of pure putrescine, and would show no effects at all for a tenth of that dose. By way of comparison the similar substance spermine
, found in semen
, is over 3 times as toxic.
Embalming
Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for public display at a funeral. The three goals of embalming are thus sanitization, presentation and preservation of a corpse to achieve this...
, cremated
Cremation
Cremation is the process of reducing bodies to basic chemical compounds such as gasses and bone fragments. This is accomplished through high-temperature burning, vaporization and oxidation....
, or buried
Burial
Burial is the act of placing a person or object into the ground. This is accomplished by excavating a pit or trench, placing an object in it, and covering it over.-History:...
, natural and man-made disasters can quickly overwhelm and/or interrupt the established protocols for dealing with the dead. Under such circumstances, the decomposition
Decomposition
Decomposition is the process by which organic material is broken down into simpler forms of matter. The process is essential for recycling the finite matter that occupies physical space in the biome. Bodies of living organisms begin to decompose shortly after death...
and putrefaction
Putrefaction
Putrefaction is one of seven stages in the decomposition of the body of a dead animal. It can be viewed, in broad terms, as the decomposition of proteins, in a process that results in the eventual breakdown of cohesion between tissues and the liquefaction of most organs.-Description:In terms of...
of cadavers goes unchecked, and raises a series of health, logistical, and psychological issues. After disaster
Disaster
A disaster is a natural or man-made hazard that has come to fruition, resulting in an event of substantial extent causing significant physical damage or destruction, loss of life, or drastic change to the environment...
s with extensive loss of life due to trauma
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
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
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
. This is an inappropriate use of scarce resources and manpower
Manpower
Manpower may refer to:*Human resourcesOrganizations:*Manpower Inc., an international employment agency, headquartered in the United States*Manpower Incorporated, a criminal enterprise in the Honor Harrington science fiction series...
: the health risks from dead bodies in such cases are minimal.
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 DisastersUCLA School of Public Health
The UCLA School of Public Health is the graduate school of public health affiliated with UCLA, and is located within the Center for Health Sciences building on the UCLA campus. UCLA is located in the Westwood neighborhood of Los Angeles, California. The dean of the school is Linda Rosenstock, MD,...
, said that no scientific evidence exists that bodies of disaster victims increase the risk of epidemics, adding that cadaver
Cadaver
A cadaver is a dead human body.Cadaver may also refer to:* Cadaver tomb, tomb featuring an effigy in the form of a decomposing body* Cadaver , a video game* cadaver A command-line WebDAV client for Unix....
s posed less risk of contagion
Contagion
Contagion may refer to:In medicine:* Infectious disease, also known as contagious disease, with infection, or the infectious agent, also known as contagionIn media* Batman: Contagion, a story arc in the Batman comic book series...
than living people. In disasters involving trauma where there is competition for resources, they should be going into establishment of water supply, sanitation
Sanitation
Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...
, 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.
The situation is quite different in the case of a health disaster such as an epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...
of certain diseases which can be spread by contact with the bodies of those who died of the disease.
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 diseaseDisease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s is consistent with:
- The incorrect historical miasma theory of diseaseMiasma theory of diseaseThe miasma theory held that diseases such as cholera, chlamydia or the Black Death were caused by a miasma , a noxious form of "bad air"....
, which held that diseases are spread by foul airJoseph BazalgetteSir Joseph William Bazalgette, CB was an English civil engineer of the 19th century. As chief engineer of London's Metropolitan Board of Works his major achievement was the creation of a sewer network for central London which was instrumental in relieving the city from cholera epidemics, while...
—in this case fouled by the stench of decomposing corpses. - 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".
- 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]".
- Noting that corpses of those who died from certain contagious diseaseContagious diseaseA contagious disease is a subset category of infectious diseases , which are easily transmitted by physical contact with the person suffering the disease, or by their secretions or objects touched by them....
s (for example, in epidemics) do, indeed, spread disease, such as the case with smallpoxSmallpoxSmallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...
and the 1918 flu, and incorrectly generalising this to all corpses.
According to the Pan American Health Organization
Pan American Health Organization
The Pan American Health Organization is an international public health agency with over 100 years of experience working to improve health and living standards of the people of the Americas...
(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".
Real risks
Contamination of water supplies by unburied bodies, burial sites, or temporary storage sites may result in the spread of gastroenteritisGastroenteritis
Gastroenteritis is marked by severe inflammation of the gastrointestinal tract involving both the stomach and small intestine resulting in acute diarrhea and vomiting. It can be transferred by contact with contaminated food and water...
from normal intestinal contents.
According to a PAHO article on the Infectious Disease Risks From Dead Bodies Following Natural Disasters:
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 C
Hepatitis C
Hepatitis C is an infectious disease primarily affecting the liver, caused by the hepatitis C virus . The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years...
, HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
, enteric
Enteric
Enteric can refer to:* A general term describing something related to or associated with the intestines** Microorganisms that inhabit the intestines are commonly known as enteric bacteria* Enteric nervous system...
(intestinal) pathogen
Pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...
s, tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, and others.
The substances cadaverine
Cadaverine
Cadaverine is a foul-smelling compound produced by protein hydrolysis during putrefaction of animal tissue. Cadaverine is a toxic diamine with the formula NH25NH2, which is similar to putrescine...
and putrescine
Putrescine
Putrescine is a foul-smelling organic chemical compound NH24NH2 that is related to cadaverine; both are produced by the breakdown of amino acids in living and dead organisms and both are toxic in large doses...
are produced during the decomposition
Decomposition
Decomposition is the process by which organic material is broken down into simpler forms of matter. The process is essential for recycling the finite matter that occupies physical space in the biome. Bodies of living organisms begin to decompose shortly after death...
of animal (including human) bodies, and both give off a foul odor. They are toxic if massive doses are ingested (2 g per kg of body weight of pure putrescine in rats, a larger dose for cadaverine), causing adverse effects. If these figures are assumed to apply to humans, a 60 kg (132 lb) person would be significantly affected by 120 g (4 oz) of pure putrescine, and would show no effects at all for a tenth of that dose. By way of comparison the similar substance spermine
Spermine
Spermine is a polyamine involved in cellular metabolism found in all eukaryotic cells. Formed from spermidine, it is found in a wide variety of organisms and tissues and is an essential growth factor in some bacteria. It is found as a polycation at physiological pH...
, found in semen
Semen
Semen is an organic fluid, also known as seminal fluid, that may contain spermatozoa. It is secreted by the gonads and other sexual organs of male or hermaphroditic animals and can fertilize female ova...
, is over 3 times as toxic.
External links
- WHO guidelines on hygiene precautions when dealing with disposal of remains
- Health and safety information related to water purification, disease prevention, and management of dead bodies
- CNN — WHO: Corpses pose little threat
- slate.msn — Are Dead Bodies Dangerous?
- psandman.com Talking About Dead Bodies: Risk Communication After a Catastrophe
- Management of Dead Bodies After Disasters: A Field Manual for First Responders, Pan American Health OrganizationPan American Health OrganizationThe Pan American Health Organization is an international public health agency with over 100 years of experience working to improve health and living standards of the people of the Americas...
, 2009. Downloadable book and downloadable Dead bodies identification form, Missing persons form, Sequential Numbers for Unique Referencing, Body Inventory Sheet