Publicado

2019-11-01

Biosafety in autopsy room: an systematic review

Bioseguridad en la sala de autopsia: una revisión sistemática

DOI:

https://doi.org/10.15446/rsap.v21n6.81593

Palabras clave:

Autopsy, containment of bioharzads, biosafety (en)
Autopsia, contención de riesgos biológicos, bioseguridad (es)

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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.

Objetivo Discutir los riesgos relacionados con las posibilidades de accidentes y contaminación en las salas de autopsias, especialmente el riesgo biológico.

Método Este es un estudio exploratorio. Se realizaron búsquedas en las bases de datos Lilacs, MEDLINE y la biblioteca virtual SciELO, desde 2000 hasta 2017, de los siguientes criterios de inclusión: artículos disponibles en su totalidad en portugués, inglés y español, y aquellos que retrataron el tema central del artículo.

Resultados Se analizaron 53 artículos, siguiendo los subtemas agentes químicos, ergonómicos, biológicos y de accidentes; exposición a materiales radiactivos; equipos eléctricos y electrónicos.

Conclusiones La causa de muerte es esencial para la vigilancia epidemiológica. La prevalencia de enfermedades en la población representa un riesgo para los profesionales de la sala de autopsias. A menudo, estas enfermedades no se detectan antes de la muerte; pueden coexistir con otras condiciones y ser ignoradas, o no se tiene evidencia morfológica en la autopsia. M. tuberculosis, virus de la hepatitis, VIH y priones fueron los principales patógenos identificados. Se pueden transmitir por sangre y aerosoles; pero existen otros riesgos como objetos punzantes, productos químicos y materiales radiactivos.

 

Referencias

Dehner LP. The Medical Autopsy: past, present, and dubious future. Mo Med. 2010 [cited 2019 Jul 25]; 107(2):94-100. Available from: https://bit.ly/3jDDICj.

Lucas S. Autopsies of people with high-risk infections. In: Burton JL, Rutty GN (eds). The Hospital Autopsy: a manual of fundamental autopsy practice. London: Hodder Arnold; 2010, p.71-97. DOI: https://doi.org/10.1201/b13395-7

Wilson ML. Infectious Diseases and the Autopsy. Clin Infect Dis. 2006; 43(5):602-3. DOI:10.1086/506574.

Squier W, Ironside J. Falling necropsy and risks to public health. Arch Dis Child. 2006; 91(7):551-3. DOI:10.1136/adc.2005.087742.

Bonds L, Gaido L, Woods J, Cohn D, Wilson ML. Infectious diseases detected at autopsy among patients at an urban public hospital: 1996 2001. Am J Clin Pathol. 2003; 119(6):866-72. DOI:10.1086/506574.

Vij K, Krishan K. Risk fators and prevention of infection in autopsy room-a review. IIJFMT. 2003 [cited 2019 Jul 25];1(1):1-14. Available from: https://bit.ly/3gdCbRr.

Nolte K, Taylor D, Richmond J. Biosafety considerations for autopsy. Am J Forensic Med Pathol. 2002; 23(2):107-22. DOI:10.1097/00000433-200206000-00001.

Sharma BR, Reader MD. Autopsy room: a potential source of infection at work place in developing countries. Am J Infect Dis. 2005; 1(1):25-33. DOI:10.3844/ajidsp.2005.25.33.

Mendes KDS, Silveira RCCP, Galvão CM. Revisão Integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto. 2016 [cited 2019 Jul 25]; 17(4):758-64. Available from: https://bit.ly/30Fs3Kk. DOI: https://doi.org/10.1590/S0104-07072008000400018

Flavin N, Gibbons N, O’Brian DS. Mycobacterium tuberculosis at autopsy-exposure and protection: an old adversary revisited. J Clin Patholol. 2007; 60(5):487-91. DOI:10.1136/jcp.2005.032276.

Winters B, Custer J, Galvagno SM, Colantuoni E, Kapoor SG, Lee H, et al. Diagnostic errors in the intensive care unit: a systematic review of autopsy studies. BMJ Qual Saf. 2012; 21(11):894-902. DOI:10.1136/bmjqs-2012-000803.

Burton JL. Health and safety at necropsy. J Clin Pathol. 2003; 56(4):254-60. DOI:10.1136/jcp.56.4.254.

Hoda SA. More Than Just a Pain in the Neck: Occupational Hazards of Pathologists. Am J Surg Pathol. 2016; 40(10):1303-4. DOI:10.1097/PAS.0000000000000701.

Kadam SS, Akhade S, Desouza K. Autopsy Practice, Potential Sources of Occupational Hazards: a review for safety and prevention. J Indian Acad Forensic Med. 2015; 37(2):196-201. DOI:10.5958/0974-0848.2015.00048.2.

Shaha KK, Patra AP, Das S, Sukumar S, Mohanty MK. Awareness of Risks, Hazards and Preventions in Autopsy Practice: a review. JEMDS. 2013; 2(22):4030-41. DOI:10.14260/jemds/797.

Azevedo CC, Almada RH. Bioseguridad Microbiológica en Sala de Autopsias. Gac Int Cienc Forense. 2013 [cited 2019 Jul 25]; 9:11-22. Available from: https://bit.ly/300iab3.

Patwary MA, Sarker MH. Quantitative assessment of mortuary waste: occupational safety and environmental health. J Hosp Adm. 2012; 1(1):49-60. DOI:10.5430/jha.v1n1p49.

Waisman J, George E. More on occupational hazards for pathologists. Am J Clin Pathol. 2010; 134(5):850. DOI:10.1309/AJCPI2Y0HCKGLWWP.

Patwary MA, O’Hare WT, Hassan MM, Elahi KM, Sarker MH. Domesand the Dead: an example of extreme fatalism among mortuary workers in Bangladesh. Kaleidoscope. 2010 [cited 2019 Jul 25]; 4(1):10-8. Available from: https://bit.ly/2EaMreP.

Franklin SL, Bettini DR, Mattos UAO, Fortes JDN. Avaliação das condições ambientais no laboratório de anatomia patológica de um hospital universitário no município do Rio de Janeiro. J Bras Patol Med Lab. 2009; 45(6):463-70. DOI:10.1590/S1676-24442009000600005.

Orellana AS, Muñoz JAG, Sánchez JMS, Serrano TG, García ES. Seguridad y salud laboral en autopsias. EJA Autopsy. 2008 [cited 2019 Jul 25]; 6:32-41. Available from: https://bit.ly/3f19GEM.

Charles V, Welti MD. Autopsy Safety. Lab Medicine. 2001 [cited 2019 Jul 25]; 32(8):2-4. Available from: https://bit.ly/32VKOw8. DOI: https://doi.org/10.1309/0D95-H3J8-KVWU-05JU

Cardoso TAO, Vieira, DN. Study of mortality from infectious diseases in Brazil from 2005 to 2010: risks involved in handling corpses. Cien Saude Colet. 2016 [cited 2019 Jul 25]; 21(2):485-95. Available from: https://bit.ly/2CLz4kU. DOI: https://doi.org/10.1590/1413-81232015212.12652014

Ahmad H, Kousar A, Altaf J. Occupational Hazards in Pathology Laboratories. JRMC. 2016 [cited 2019 Jul 25]; 20(S-1):52-6. Available from: https://bit.ly/32VKi0P.

Bhullar DS. Safety measures in dealing with dead. J Punjab Acad Forensic Med Toxicol. 2012 [cited 2019 Jul 25]; 12(2):69-75. Available from: https://bit.ly/3eUfiAU.

Pritt BS, Waters BL. Cutting injuries in an academic pathology department. Arch Pathol Lab Med. 2005; 129(8):1022-6. DOI: https://doi.org/10.5858/2005-129-1022-CIIAAP

Hutchins KD, Williams AW, Natarajan GA. Neck needle foreign bodies: an added risk for autopsy pathologists. Arch Pathol Lab Med. 2001; 125(6):790-2. DOI:10.1043/0003-9985(2001)125<0790:NNFB>2.0.CO;2.

Bakri FG, Al-Abdallat IM, Ababneh N, Al Ali R, Idhair AKF, Mahafzah A. Prevalence of blood-borne viral infections among autopsy cases in Jordan. Qatar Med J. 2017; 2016(2):14-9. DOI:10.5339/qmj.2016.14.

Nolte KB, Yoon SS. Theoretical risk for occupational blood-borne infections in forensic pathologists. Infect Control Hosp Epidemiol. 2003; 24(10):772-3. DOI:10.1086/502131.

Babb JR, Hall AJ, Marlin R, Ayliffe GA. Bacteriological Sampling of Postmortem Rooms. J Clin Pathol. 1989; 42(7):682-8. DOI:10.1086/502131.

Abraham JL, Greenfield LJ. Hazard to pathologists and anatomists from vena-caval (Greenfield) filters. Lancet. 1995; 346(8982):1100.

DOI:10.1016/s0140-6736(95)91773-x.

Schieffer S, Jürgens S, Wehner HD, Flehming B. Evidence of multiple hepatitis virus infections in autopsied materials of intravenous drug addicts. Ig Sanita Pubbl. 2005 [cited 2019 Jul 25]; 61(5):435-50. Available from: https://bit.ly/2BvZXsx.

Wenner L, Pauli U, Summermatter K, Gantenbein H, Vidondo B, Posthaus H. Aerosol Generation During Bone-Sawing Procedures in Veterinary Autopsies. Vet Pathol. 2017; 54(3):425-36. DOI:10.1177/0300985816688744.

Weitzman JB. Electronic medical devices: a primer for pathologists. Arch Pathol Lab Med. 2003; 127(7):814-25. DOI:10.1043/1543-2165(2

127<814:EMD>2.0.CO;2.

Padmakumar K. Postmortem Examination Cases of Cyanide Poisoning A Biological Hazard. J Indian Acad Forensic Med. 2010 [cited 2019

Jul 25]; 32(1):80-1. Available from: https://bit.ly/2DbmYBp.

Marin MM, Calvo TA, Umañe FM. Medidas de Bioseguridad en una Sala de Disección de Anatomia Patológica. Med Leg Costa Rica. 2010

[cited 2019 Jul 25]; 27(1):35-9. Available from: https://bit.ly/2OYiTDj.

Nolte KB, Fischer M, Reagan S, Lynfield R. Guidelines to implement medical examiner/coroner-based surveillance for fatal infectious diseases and bioterrorism (“Med-X”). Am J Forensic Med Pathol. 2010; 31(4):308-12. DOI:10.1097/PAF.0b013e3181c187b5.

Inoue N. [Neurological effects of chemical and biological weapons. Rinsho Shinkeigaku]. Rinsho Shinkeigaku. 2003; 43(11):880-2. PMID:

Demiryürek D, Bayramoglu A, Ustacelebi S. Infective Agents in Fixed Human Cadavers: a brief review and suggested guidelines. Anat Rec. 2002; 269(4):194-7. DOI:10.1002/ar.10143.

Gharehdaghi J, Khorasgani MHA, Ghadiani MH, Kazemifar AM, Solhi H, Solhi S. Prevalence of HCV, HBV, and HIV Seropositivity among Cadavers Referred to Autopsy Hall of Legal Medicine Bureau of Tehran, Iran. Adv Prev Med. 2017; 1:1-4. DOI:10.1155/2017/2043840.

Chhillar D, Dhattarwal SK, Kataria U. Health hazards at autopsy: a review article. IAIM. 2015 [cited 2019 Jul 25]; 2(8):130-3. Available from: https://bit.ly/2CQvO83.

Peonim V, Sujirachato K, Srisont S, Udnoon J. Pathology of HIV seropositive: forensic autopsy study in a tertiary care hospital, Bangkok, Thailand. J Med Assoc Thai. 2012 [cited 2019 Jul 25]; 95(8):1059-65. Available from: https://bit.ly/3f21nIS.

Hostiuc S, Curca GC, Ceausu M, Rusu MC, Niculescu E, Dermengiu D. Infectious risks in autopsy practice. Rom J Leg Med. 2011 [cited 2019 Jul 25]; 19(3):183-8. Available from: https://bit.ly/3002ZPp. DOI: https://doi.org/10.4323/rjlm.2011.183

Ropmay AD. Precautions against infection at autopsy. Indian J Forensic Med Toxicol. 2011; 5(1):29-31.

Sterling TR, Pope RN, Bishai WR, Harrington S, Gershon RR, Chaisson RE. Transmission of M. tuberculosis from a cadaver to an embalmer. N Engl J Med. 2000; 342(4):246-8. DOI:10.1056/NEJM200001273420404.

Hardin NJ. Infection control at autopsy: a guide for pathologists and autopsy personnel. Curr Diagn Pathol. 2000; 6(2):75-83. DOI:10.1054/

cdip.2000.0021.

Babb JR, Hall AJ, Marlin R, Ayliffe GA. Bacteriological Sampling of Postmortem Rooms. J Clin Pathol. 1989; 42(7):682-8. DOI:10.1136/jcp.42.7.682.

Marks SM, Magee E, Robison V. Patients diagnosed with tuberculosis at death or who died during therapy: association with the human immunodeficiency virus. Int J Tuberc Lung Dis. 2011; 15(4):465-70. DOI:10.5588/ijtld.10.0259.

Shoja MM, Benninger B, Agutter P, Loukas M, Tubbs RS. A historical perspective: infection from cadaveric dissection from the 18th to 20th centuries. Clin Anat. 2013; 26(2):154-60. DOI:10.1002/ca.22169.

Sanael-Zadeh H. Seroprevalence of HIV, HBV and HCV in forensic autopsies, of presumed low risk, in Tehran, the capital of Iran. J Clin Forensic Med. 2002 [cited 2019 Jul 25]; 9(4):179-81. Available from: https://bit.ly/2OWYdvu. DOI: https://doi.org/10.1016/S1353-1131(02)00132-3

Ganczak M, Kaczmarska AB, Dziuba I. Pathologist and HIV--are safe autopsies possible? Pol J Pathol. 2003; 54(2):143-6.

Garg M, Aggarwal AD, Singh S, Kataria SP. Tuberculous Lesions at Autopsy. J Indian Acad Forensic Med. 2011; 33(2):116-9.

Idota N, Nakamura M, Masui K, Kakiuchi Y, Yamada K, Ikegaya H. Lessons learned from autopsying an undentified body with iodine-125 seeds implanted for prostate brachytherapy. J Forensic Sci. 2017; 62(2):536-40. DOI:10.1111/1556-4029.13296.

Start RD, Tindale W, Singleton M, Conway M, Richardson C. Radioactive prostatic implants: a potential autopsy hazard. Histopathology. 2007; 51(2):246-8. DOI:10.1111/j.1365-2559.2007.02753.x.

Singleton M, Start RD, Tindale W, Richardson C, Conway M. The radioactive autopsy: safe working practice. Histopathology. 2007; 51(3):289-304. DOI:10.1111/j.1365-2559.2007.02768.x.

Osborn S. Care of a helpless patient and handling of the radioactive corpse. J Radiol Prot. 2002; 22(2):185-7. DOI:10.1088/0952-4746/22/2/101.

Idrobo-Avila EF, Vasquez-lópez JA, Vargas-Cañas R. La exposición ocupacional al formol y la nueva table de enfermedades laborales. Rev. Salud Pública. (Bogotá) 2017; 19(3):382-5. DOI:10.15446/rsap.v19n3.47740.

Akhgari M, Baghdadi F, Kadkhodaei A. Cyanide poisoning related deaths, a four-year experience and review of the literature. Aust J Forensic Sci. 2015; 48(2):1-9. DOI:10.1080/00450618.2015.1045552.

Vimercati L, Carrus A, Martino T, Galise I, Minunni V, Caputo F, et al. Formaldehyde exposure and irritative effects on medical examiners, pathologic anatomy post-graduate students and technicians. Iran J Public Health. 2010 [cited 2019 Jul 25]; 39(4):26-34. Available from: https://bit.ly/2ZXUIv6.

World Health Organization (WHO). IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 88. Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol. Geneva: WHO; 2006. Available from: https://bit.ly/32Vy5Jy.

Occupational Safety and Health Administration. Formaldehyde. 29CFR1910.1048. Los Angeles: OSHA; 2005.

Stevanovic G, Tucakovic G, Dotlic R, Kanjuh V. Correlation of clinical diagnoses with autopsy findings: a retrospective study of 2.145 consecutive autopsies. Hum Pathol. 1986; 17(12):1225-30. DOI:10.1016/s0046-8177(86)80564-0.

Cardoso TAO. Biossegurança e qualidade dos serviços de saúde. Curitiba: Intersaberes; 2016.

Hemachander SS, Khaja S, Kaza S. Occupational hazard with “PRIONS” in autopsy workers. J Indian Acad Forensic Med. 2008; 30(1):26-8. Available from: https://bit.ly/32PPROy.

Cardoso TAO, Navarro MBMA, Neto CC, Moreira JC. Health surveillance, biosafety and emergence ande re-emergence of infectious diseases in Brazil. Braz J Infect Dis. 2010; 14(5):526-35. DOI:10.1590/S1413-86702010000500018.

Cómo citar

APA

Abdalla de Oliveira Cardoso, T., Bueno de Azevedo Neto, F. de P., Cynamon Cohen, S. & Chein Bueno de Azevedo, D. (2019). Biosafety in autopsy room: an systematic review. Revista de Salud Pública, 21(6), 634–642. https://doi.org/10.15446/rsap.v21n6.81593

ACM

[1]
Abdalla de Oliveira Cardoso, T., Bueno de Azevedo Neto, F. de P., Cynamon Cohen, S. y Chein Bueno de Azevedo, D. 2019. Biosafety in autopsy room: an systematic review. Revista de Salud Pública. 21, 6 (nov. 2019), 634–642. DOI:https://doi.org/10.15446/rsap.v21n6.81593.

ACS

(1)
Abdalla de Oliveira Cardoso, T.; Bueno de Azevedo Neto, F. de P.; Cynamon Cohen, S.; Chein Bueno de Azevedo, D. Biosafety in autopsy room: an systematic review. Rev. salud pública 2019, 21, 634-642.

ABNT

ABDALLA DE OLIVEIRA CARDOSO, T.; BUENO DE AZEVEDO NETO, F. de P.; CYNAMON COHEN, S.; CHEIN BUENO DE AZEVEDO, D. Biosafety in autopsy room: an systematic review. Revista de Salud Pública, [S. l.], v. 21, n. 6, p. 634–642, 2019. DOI: 10.15446/rsap.v21n6.81593. Disponível em: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/81593. Acesso em: 28 dic. 2025.

Chicago

Abdalla de Oliveira Cardoso, Telma, Francisco de Paula Bueno de Azevedo Neto, Simone Cynamon Cohen, y Deborah Chein Bueno de Azevedo. 2019. «Biosafety in autopsy room: an systematic review». Revista De Salud Pública 21 (6):634-42. https://doi.org/10.15446/rsap.v21n6.81593.

Harvard

Abdalla de Oliveira Cardoso, T., Bueno de Azevedo Neto, F. de P., Cynamon Cohen, S. y Chein Bueno de Azevedo, D. (2019) «Biosafety in autopsy room: an systematic review», Revista de Salud Pública, 21(6), pp. 634–642. doi: 10.15446/rsap.v21n6.81593.

IEEE

[1]
T. Abdalla de Oliveira Cardoso, F. de P. Bueno de Azevedo Neto, S. Cynamon Cohen, y D. Chein Bueno de Azevedo, «Biosafety in autopsy room: an systematic review», Rev. salud pública, vol. 21, n.º 6, pp. 634–642, nov. 2019.

MLA

Abdalla de Oliveira Cardoso, T., F. de P. Bueno de Azevedo Neto, S. Cynamon Cohen, y D. Chein Bueno de Azevedo. «Biosafety in autopsy room: an systematic review». Revista de Salud Pública, vol. 21, n.º 6, noviembre de 2019, pp. 634-42, doi:10.15446/rsap.v21n6.81593.

Turabian

Abdalla de Oliveira Cardoso, Telma, Francisco de Paula Bueno de Azevedo Neto, Simone Cynamon Cohen, y Deborah Chein Bueno de Azevedo. «Biosafety in autopsy room: an systematic review». Revista de Salud Pública 21, no. 6 (noviembre 1, 2019): 634–642. Accedido diciembre 28, 2025. https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/81593.

Vancouver

1.
Abdalla de Oliveira Cardoso T, Bueno de Azevedo Neto F de P, Cynamon Cohen S, Chein Bueno de Azevedo D. Biosafety in autopsy room: an systematic review. Rev. salud pública [Internet]. 1 de noviembre de 2019 [citado 28 de diciembre de 2025];21(6):634-42. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/81593

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CrossRef Cited-by

CrossRef citations3

1. Wadhyane Sampaio Ferreira Silva, Vital Vieira de Fontes Filho, Adijacilda de Luna Rodrigues, Jorge Belém Oliveira Júnior. (2025). Occupational hazards in autopsy laboratories: An integrative analysis of biosafety measures. Research, Society and Development, 14(11), p.e207141150191. https://doi.org/10.33448/rsd-v14i11.50191.

2. Abhishek Sharma, Kirti Parmar, Sunite A. Ganju, Manoj Sharma, Saurabh Rattan. (2025). Postmortem Testing for HIV, HBV, and HCV: Insights from Autopsy Findings. International Journal of Legal Medicine, 139(6), p.3033. https://doi.org/10.1007/s00414-025-03525-y.

3. Keisuke Okaba, Ayumi Motomura, Naoki Saito, Koji Yamaguchi, Namiko Ishii, Shizuru Hara, Misako Ohkusu, Noriko Takeuchi, Naruhiko Ishiwada, Daisuke Yajima. (2025). A case of suspected transmission of group A Streptococcus from a dead body with streptococcal toxic shock syndrome to an autopsy worker. International Journal of Legal Medicine, 139(6), p.2789. https://doi.org/10.1007/s00414-025-03545-8.

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