Unseen Risks in Cemeteries, Crematoria, and Funeral Homes
October is National Safe Work Month, a time to commit to providing safe and healthy workplaces for all Australians. Cemeteries, crematoria and funeral homes can present some unique, unseen hazards such as exposure to silica, dust, chemicals and gases. Managing these risks is critical to keeping everyone safe.
Our guest, Micheal Lewis, is Principal Occupation Hygienist at Simtars and he has worked in the occupational health and hygiene fields for 30 years. Micheal will be talking about the unseen risks in cemeteries, crematoria and funeral homes, and how those risks can be managed within the workplace to support the safety of staff. Micheal is experienced in auditing drugs, poisons and hazardous chemicals management systems, complex health-based investigations, laboratory compliance auditing, and competency-based training package development and delivery.
So the webinar, the webinar has started so people will be able to start to join us now. So it looks like we’ve got participants starting to join now, which is great.
Micheal Lewis
Fantastic.
Lea-Ann McNeill
Welcome to those that are all starting to join us. We’ll obviously give it a few minutes before 11:00 for most of you. It’s nearly 10:00 a.m here in Brisbane and Micheal’s up here in Brisbane as well. So, yeah, we’ll just give it a couple more minutes for people to be able to join us.
Micheal Lewis
The Gold Coast is online.
Lea-Ann McNeill
What have we got? 17. Yeah, we’re joining quite quickly now. People from Sydney. Good when people from Queensland join as well, they’re not the only ones on the early time zone. I had a 6.30 meeting this morning trying to work in with a variety of time zones. Not fun at all.
Micheal Lewis
So is this actually, the seminar is actually going right around Australia, is it?
Lea-Ann McNeill
Yeah. We go to Australia and New Zealand and people from the UK and the US can join us as well if they’re registered. Obviously, it creates some time zone challenges for them. It’s starting to get a little bit later in the day. Hi from Western New South Wales, Dubbo. Nice area of the world Dubbo, been to the Zoo there. I loved that Zoo. A couple more minutes. Manyana. I hope that’s how I pronounce that, Manyana in New South Wales on the South Coast. Welcome. Correct. Good. Actually, while you’re in there and you’re starting to join and popping up a few chats, it’d be good to know what areas of the industry you’re all from. Are people predominantly working in the cemeteries and crematoria environment? Do we have any funeral directors with us? Certainly good in terms of helping to frame our conversation today. Got a celebrant. Nice. Welcome.
Lea-Ann McNeill
A couple of celebrants. That’s great. I know there’s some people from the Cemetery industry because I do know some of these people. Perth. Micheal, we’ve got a visitor from Perth.
Micheal Lewis
Wow. Okay.
Lea-Ann McNeill
Yeah. Local government.
Micheal Lewis
We got a good group by the look of it.
Lea-Ann McNeill
It is. And Fiona is joining us. I do know Fiona well, Fiona works in the area of training, and a lot of training in the cemeteries and Crematoria space, there’s a lot of grave safe training. So Fiona, this will be some great information for you to add into your session. So good. All right. Well, we have ticked over just after 10 o’clock and obviously people can continue to join us, but I will make a start. You might have noticed already that we are recording the session, but we do record these sessions for people that can’t make it and we also provide a transcript later on to support that as well. So, just so you are all aware. I’ll introduce myself. My name is Leanne McNeil, and those that have come along to the In Conversation series previously will have, I guess, seen my face and heard my voice before in these sessions. I’m the general manager for OpusXenta here in the Australia and New Zealand region, so welcome to you all. I’ll introduce our guest today. Micheal comes to us as an occupational hygienist, and he’s worked in that field for over 30 years, in a variety of different roles, both in the private and public sector.
Lea-Ann McNeill
I’ll come back to that in a little moment because I’ll tell you a little bit about how Micheal and I came to meet, which is a great segue into sort of handing the session over to him. But before I do, just a couple of other little bits and pieces that help us make these webinars flow really smoothly. We’ve been using the chat function today, which is okay, but what we would ask is throughout the session it’s actually our preference to use the Q and A button.
Lea-Ann McNeill
So if you have a look along the bottom of your screen, you should have a Q and A button. What that means is those questions come to me rather than directly to Micheal, and it just enables me to in some ways consolidate those questions and facilitate those into our conversation today. So rather than use the chat function, try and use the Q and A function, if you can. I’ve mentioned that it’s recorded so that’s great. Micheal will also ask some questions of you today in different settings.
So please also provide any responses to those through the Q and A as well. That would be great. All right. Without any further ado, then I’ve given you a basic introduction to who the lovely Micheal Lewis is. Good sense of humour I will add to all of his other repertoire of qualifications that were shared in advertising this session. But Micheal and I met through my previous involvement with local government. We had become concerned, given some of the media reports around silicosis and what we were seeing happening to people that in particular worked in that stonemason industry. And as a result, we involved Micheal in some testing and some work in our cemeteries with some really surprising results. So Micheal, I might just hand straight over to you and take it from there.
Micheal Lewis
Fantastic. Thank you very much Lea-Ann. Good morning, everyone. As Lea-Ann says, I’m a principal occupational hygienist to work at Simtars, which is the Safety in mines testing and research station. I’ve worked in a range of different fields, both in Australia and in New Zealand and private and government organisations, and my original qualification was registered nurse. So I’ve actually now come over into occupational hygiene looking more at health prevention, if you like, and investigating causes of potential disease. Now Brisbane City Council, as Lea-Ann said, was actually concerned about the potential or if there was a potential for silicosis risk. And the very first time we went out to, we had a look at the site but wasn’t entirely sure if there was going to be a risk as was stated, but certainly to try to identify what the potential sources of exposure were. And I took out some sampling equipment and we put it on a range of different operators on the day. And it was quite surprising the results that we got back, actually, the things that we thought were going to be a problem didn’t turn out to be the ones that was actually completely left of field was rather surprising.
Micheal Lewis
So what I’m going to do is actually try and share this slide with you. So just give us 2 seconds. How do I do that again? Sorry. I do apologise. Can you.
Lea-Ann McNeill
Got your Share screen button?
Micheal Lewis
That’s the one. Thank you very much.
Lea-Ann McNeill
There you go.
Micheal Lewis
Yeah. Come on. Share screen. There we go.
Lea-Ann McNeill
Right. It can take a little second for it to come up. Here it comes. It’s starting to load now. Okay.
Micheal Lewis
So you guys can see that well enough.
Lea-Ann McNeill
I certainly can. Yes.
Micheal Lewis
Okay. So for those of you who don’t know what our occupational hygienist is, there’s a couple of things that we’re not, we don’t clean your teeth. So we’re not dental hygiene technicians, we don’t teach you how to wash your hands, and we certainly don’t investigate or inspect food premises. We are for want of a better way to describe it industrial forensic scientists. So we go out into the field with a range of instruments, trying to answer a question about what the potential exposures happen to be and come back to you with a quantifiable data to explain what we’ve actually discovered.
Micheal Lewis
What I’m going to be covering off is actually a very brief thing. It’s actually looking at unseen risks in cemeteries, crematory and funeral homes. Now I have a little bit of background knowledge here in the industry. I used to be a senior Inspector of Workplace Health and Safety Queensland up in Townsville, and I do remember back in the early 2000s, Workplace South and Safety Queensland actually did an audit of the funeral industries across Queensland just to have a look and see what the relative risks are and to clarify whether the industry itself is actually aware of the then being generated Code of Practise.
Micheal Lewis
So the session outline, we’re going to cover off. We’re going to talk about general discussion about known hazards as it was listed in the Code of Practise. Now, what I found interesting when I was doing a search trying to find a similar code didn’t have a lot of success in actually finding workplace health and safety centred risk codes for the funeral industry. In fact, if you do a search on the net nearly all the time the Queensland code comes up, there’s a couple of other bits and pieces from other jurisdictions, but mainly the Queensland code seems to be the premium point source of discussion.
Micheal Lewis
Now what we’re going to be covering off and we’re going to have a look at the hazards that are actually listed in that code of Practise and some of those shouldn’t come as a surprise. You’ve been working in the industry for a while, and I suggest that you probably know most of these anyway, if you haven’t, you might be aware that they’re actually in the background or part of the industry. Then going to have a look at observations that come about from conducting respirable dust and inhalable dust monitoring and the cemeteries and crematoria at the Brisbane City Council area. And as a result of a question that was raised by BCC, do we have a risk for silicosis? Now the findings, as I said, were essentially unremarkable. I didn’t think at the time actually, we were walking around even when we put in the pumps on that there was going to be a problem. But when we got the results back, there was actually one particular group that was actually not part of the original discussion if you like or not part of the original scope of work, they come back with an exceedance.
Micheal Lewis
And it was really quite interesting trying to explain how that come about. So common hazards in the fuel and industry, and I suggest that most of you would actually be aware of this in one form or another. The manual tasks, obviously moving the remains around the burial processes, moving the coffins, everything else, preparing the bodies, lifting, pushing, pulling, carrying, raising and lowering. So they are a significant risk, obviously, from manual handling tasks. You’re actually carrying weights that are essentially noncompliant. They don’t really, you’ve got decent grips, different handles, maybe moving around. You may be using hoists and lowering devices, et cetera, but it still is actually a difficult weight to actually control and move. Infectious diseases are certainly a common thing in all healthcare industries, and I would consider the funeral industry to be a part of the health care environment. Hepatitis B, hepatitis C, HIV. They were the common ones that we would actually find in the health care industry. But of course, these days we’ve actually got this additional challenge of COVID-19. So the SARS variant that is actually coming up and the various mutations that are coming from that.
Micheal Lewis
I have actually found some advice in regards to suggested actions to take when you’re dealing with a potentially infectious or COVID-19 deceased person, but it’s only really come from one jurisdiction. I couldn’t find a lot else actually around the place. It was rather interesting what I managed to find. Hazardous chemicals and I have to advise you that this is my penchant. I deal with basically chemicals management programmes essentially, but embalming fluids, some of the old formaldehyde based products that was actually replaced by Glutaraldehyde and Glycols.
Micheal Lewis
There can be cytotoxic drugs actually still present in the system that could be around for quite some time. Some of the cleaning agents that you might be using to prepare the body prior to burial or cremation, wood dusts when you’re actually either manufacturing or actually making changes to the coffins whatever or actually making available receptacles to actually bring the body to. Poisons now this might sound a little bit strange, but if you have somebody that is actually passed through ingestion either intentional, unintentional poisons, they can still exist for quite some time afterwards.
Micheal Lewis
Dusts coming from the manufacturing the memorials or actually drilling the benches to actually put down the plaques, or even the cremation services themselves. The cremation products. They can all be potential hazardous chemicals or hazardous materials that are actually come in to play. Now, from an occupational hygiene point of view, the main route of exposure for any external hazardous chemical or substance is through inhalation. So if you’re looking at things like cytotoxic drugs, cleaning agents wood dust, et cetera. It is whether these products are actually in the atmosphere and whether you can actually inhale them or they’re actually part of the overall environment.
Micheal Lewis
Work related violence and aggression. Let’s face it, the industry itself, it’s a very challenging time for the family. It’s a very challenging time for those that actually attend the funeral. There’s a lot of emotions in play at that time. There might be some questions about how did this happen, what went on, and those heightened sense of awareness can sometimes lead to physical or psychological injuries for the people actually working in the industry, maybe going into a site where you’re actually picking up a deceased person and there’s actually been a significant amount of trauma involved. Fatigue, working long hours or actually working after hours. Possible trauma. These are all things that come about. And the interesting thing about it is that over the last couple of years, there has actually been now authentic discussions about occupational health related disease conditions, which includes psychosocial. So they’re looking at fatigue management. They’re looking at psychological injury, they’re looking at psychosocial stresses that occur in the industries across the board. So they’re actually looking at the whole person, not just looking at safety related incidents. Visible hazards can be noise, it can be vibration. This is actually maybe operating the plant equipment to actually dig the graves or to actually move equipment or even set up grave site materials using the vehicles, for instance. Heat stress, let’s face it, it actually operates all year round. Heat stress, uv radiation, particularly during the hotter summer months, can actually be a real problem. Radioactive or radiation radioactive devices. Now, it’s not unusual for people to actually have, say radioactive implants actually put in things like the prostate gland or inside the body would have it to actually create a point source treatment for cancers, unless they’re actually removed, they could still be there and they can still be active. They can be still active for quite some time. Unstable memorials. I’m sure all of you would have actually seen grave sites or graveyards. What have you where the memorials have actually been there for a number of years. The ground has moved or there’s actually been storms or whatever going through and the memorials are actually leaning at a precarious angle and they could actually fall over. So you can see there’s actually, these are the more common hazards that Workplace Health and Safety Queensland have actually identified and actually listed in their code of Practise, but by no means this is an exhaustive list.
Micheal Lewis
I’m sure that if we had a longer time to discuss this, your members would actually be able to come up with a range of other hazards that they have found in their time in the industry, both emerging and past ones that have come through. Now you see there are actually the hazardous substances or hazardous chemicals. I’ve actually put an asterisk against that. There is actually four airborne contaminants, so all forms of airborne contaminants, there are actually workplace exposure standards that apply. Now, these are actually standards that they’re not safe, unsafe standards they’re not go no go standards. They just basically state that if you’re exposed to the substance over a period of an eight hour day or a 40 hours week, that the chances of actually developing any form of adverse health effects is actually greatly reduced and WorkSafe Australia is the premier body that actually holds the database for the Workplace exposure standards, and what I’ve actually done is I’ve gone through and did a search on some of the chemicals or some of the substances that may apply to the funeral industry.
Micheal Lewis
Now, obviously, the first question itself was asked about quartz, otherwise known as respirable, in the respirable dust range. It can be known as silica can be known as respirable crystalline silica. There’s certainly been some significant changes in recent times about the exposure standard for that and if you can actually have a look there, it says the time weighted average, which is actually an eight hour day, 40 hours week exposure. You cannot be exposed to anything more average of 0.5 milligrammes per metre cubed. And that’s not a lot.
Micheal Lewis
That really isn’t a lot out there. Respirable dust itself is actually any dust that actually are within the respirable range, and these are dust that will actually get down into the alveolar region, the gas exchange region of the lungs, and they can cause some form of disease process, the fibrogenic disease process. I’ve certainly seen in the time that I’ve actually been working as an occupational hygienist, respirable quartz or respirable crystalline silica has at least halved in certainly the last two years there is a suggestion that they may actually have again in the not too distant future.
Micheal Lewis
So if you look at a .0 25 milligrammes per metre cubed, that’s not much of anything. The interesting thing about it is the rest of the dust itself is actually you can’t typically see it. The dust that you do see is actually more or less in the inhalable range, which is actually 100 microns or less. Respirable crystalline silica starts at ten microns. It’s actually quite fine. Potential sources could actually be scraping the cremator refractory bricks, depending on what the bricks have to be made of if they’ve actually got silica on them, and some of them may do, the cremations themselves, there might be some respectable dust in there and so we’ll cover up on the potential exposures there in a short while. Back filling your grains with decomposed granite. Now, the bit of a hint here is actually just keep that in the back of your mind, decomposed granite that is actually used for back filling. Glutaraldehyde itself was actually many years ago, was actually seen as a safer alternative to formaldehyde. I remember that formaldehyde itself back in 2004 went from a group 2A probable human carcinogen to a group 1 known human carcinogen and through not only the funeral industry, but also the pathology industries. And oddly enough, the construction industry into a tailspin. If you have a look at things like laminated beams that are used in the building industry, they actually use formaldehyde glue to actually tie it all together it’s a very good activating agent. Now you can see there that I’ve suggested that it’s actually in the embalming fluids, and certainly some of the older embalming fluids actually had formaldehyde in them. The time weighted average for that, if you have a look, there’s actually two standards that are basically the same.
Micheal Lewis
0.1 parts per million. Again, that’s not much in the atmosphere. Okay, now Glutaraldehyde. I remember actually using that stuff back in the 1980s as a cold sterilant for endoscopes in urology Theatre in Wellington hospital and I used to make the stuff. Used to actually pour into a tray, put in the powder as the activator stirred up and it would actually be in an open tray sitting on the bench. We’d actually soak the scopes and you couldn’t do that these days they have to actually be inside basically an enclosed booth or ventilated booth.
Micheal Lewis
See formaldehyde there, again you can see there’s a significant difference actually between the two. Formaldehyde is one part per million. Gluteraldehyde is 0.1 parts per million and the difference between the two of them. The glutaraldehyde says peak limitation. If you exceed that limit just once, it doesn’t have to be an average. That’s it no more exposure. Everybody go home. Formaldehyde however is a slightly different case. There is an average concentration over the course of the day there will be one part per million for an eight hour day. The Stell is an interesting one. It is what’s known as a short term exposure limit. So typically the way that it works is that you’re exposed to the substance for 15 minutes, then you have an hour break away from it. You don’t go anywhere near it. Then another 15 minutes, another hour, another 15 minutes, another hour, another 15 minutes. And that’s it. That’s the end of the day. So it’s 4×15 minutes periods in the course of a day, and you can’t exceed those concentrations that are actually listed there. And again, two parts per million or 2.5 milligrammes per metre cubed. There’s not a lot in the atmosphere you can see there that it’s actually also listed as a carcinogen 1B, which is basically it’s an older classification, but it means it’s actually a carcinogen or it will cause cancer in human beings with exposure over a period of time.
Now. The disease associated with it could actually be short term or long term depends on the concentration that can take between ten and 30 years before you actually start developing some of most disease processes associated with chemicals in the atmosphere. Again, it’s actually used in embalming fluids, and it’s typically mixed with methanol, and it comes as a material known as formalin. Sodium hydroxide, this is actually a relative new one it was actually probably about a month ago I was actually called by somebody who was looking at doing green cremations.It’s something I hadn’t heard of before, but they were saying that they actually have basically a processed Chamber. They put the body into the Chamber. They actually have a high concentration of sodium hydroxide, which is basically a very strong alkaline solution. Drain cleaner is actually a form of it if you like, and they leave the body in there and it’s basically a very advanced or very fast decomposition under a chemical environment. Now I was talking to Lea-Ann before actually, I don’t think there’s actually much in the way green cremation is actually doing here in Australia.
Micheal Lewis
I’ll stand corrected on that, obviously because I’m not working in the industry, but certainly it’s actually something that has gained popularity overseas where they’re actually worried about the potential of gases from cremations what have you and they want to try and find something that is essentially a greener alternative. The material that’s actually left over after the sodium hydroxide has done it stuff. There’s some bone left over. It’s been completely denatured. The rest of the organic material itself is basically just flushed down the drain, get strained away from the container, and then the bones, I believe, are actually treated the exact same way as they are for cremations, where they’re actually put through a cremulator and actually crushed and ready for passing on to the family.
Micheal Lewis
Phenyl or phenyl can actually be part of a phenyl formaldehyde compound. It’s actually again, it’s an embalming fluid. Ethylene glycol is also an embalming fluid. Oddly enough, ethylene Glycol is the same stuff you use as Antifreeze in the radiator of your car. So you can see there it actually has a significantly higher time weighted averages compared to things like glutaraldehyde. Rogue dust. Now, rogue dust itself is actually a general term that is used for dusts in the inhalable range. So this is one you can actually see and it’s actually dust that are actually less than 100 microns, ten milligrammes per metre cubed as an average.
Micheal Lewis
Now, dust themselves are not really classified. They just say the dust that could be from the cremator or cremulator, could be servicing of the cremulator tweers. So when they’re actually doing service and maintenance of the furnaces and the air injection systems, actually getting in there and cleaning out some of the dust and whatever that are actually left behind. And in some cases, some of the dust that are actually generated during either the digging of the grave or back filling the grave, or even actually back filling after it’s been settled for a while.
Micheal Lewis
So it covers a whole range of different types of dust. That long winded one the next one. I’m not even going to attempt to actually pronounce that. I can tell you if you guys can. Fantastic. But basically it’s a methylene glycol. Again, it’s actually an embalming fluid as a liquid and then you’ve actually got the vapour that comes from the Ethylene Glycol. You can see there are actually two significant differences there. One is actually 16 milligrammes per metre cubed, and the other one is 52 milligrammes per metre cubed, so you can see it’s actually raising in concentrations depending on the type of things, the type of products are being used. Methanol. Oddly enough again, it’s an embalming fluid. It’s a known poison. If you come in contact with stuff you can actually cause, if you actually drink it, for instance, you can actually end up with blindness, that sort of thing. But its got a habit of concentration in the vapour of 262 milligrammes per metre cubed, and it also has a STEL quite high but I don’t think you would actually typically be using methanol in isolation. It will be part of the formaldehyde. When you apply in these standards, you actually apply the one that actually has the greatest risk. If you have formalin products, for instance, you would actually use formaldehyde as the exposure standard, not methanol, even though the methanol is there. The formaldehyde actually drives the system if you like. If you have a look down the bottom of the table there, it actually shows the different types of classifications.
These are actually relatively up to date. IARC stands for the International Agency for Research on Cancer. They’re actually part of the World Health Organisation, and they produce what’s known as monographs. So they have a look at the data that’s available for different types of chemicals and they classify those chemicals in four different groups depending on their potential to cause cancer in human beings. Now literally out of the thousands of chemicals that are actually used in industry. So far, there’s actually 121 substances that are unknown human carcinogens. There are 89 substances that are actually probable human carcinogens, 319 that are possible human carcinogens. Both of those are actually classed on limited human data or animal trials or cellular trials and Group 3 500 agents they’ve been looked at. They’re not classified as carcinogenic to humans doesn’t mean that they don’t have some health effects. It’s just they won’t cause cancer. Now I’ve got a question for the team. Got everybody out there. I’ve got six pictures up there at the moment, and we’re just thinking about dusts. Okay. What I would like you to do is actually have a look at those six pictures and tell me which one do you think actually has the highest dust risk?
Lea-Ann McNeill
Okay, monitoring both the chat and the Q and A Micheal to see what comes through.
Micheal Lewis
Okay.
Lea-Ann McNeill
Nobody’s game enough yet by the looks.
Micheal Lewis
Okay, so describing what we’ve actually got there.
Lea-Ann McNeill
Irene says B, B. Okay, yeah, I’ve got a C as well. Someone says C, so B and C at the minute. Okay, that seems pretty consistent.
Micheal Lewis
B and C. Okay, you’d be surprised that you’re wrong. Now the reason I say that actually. Okay so what we got there is actually we’ve got A is actually drilling a concrete bench to actually put down the plaques. Now the guys they’re actually drilling it with just an impact drill, and afterwards they actually blow it out with a handheld battery operator blower. Okay. B itself. Yes, there can be a risk with that that is actually drilling obviously a monument stone or a monument headstone. But what you might not be aware of is that they’re actually doing point source extraction. So that little vacuum plane that he’s got in the hand is actually connected to a device that’s got a H class filter. So H class filter is actually one designed for toxic dust, asbestos silicosis, lead dust that sort of carry on. So, yes, there can be some dust actually generated drilling the drilling thing, but they’ve actually got it under significant control. They’re actually sucking it up at point source as it’s been generated and been removed from the environment. So there’s very little of any actually released into the atmosphere.
Micheal Lewis
See, yes, it is a dusty job. And in fact, if you can have a look there, you will actually see there’s a pump on the gentleman’s belt. There’s some chips coming up. I’ve actually got the sampling head right up near his breathing zone. We did respirable dust and inhalable dust while they’re actually doing the cleaning out of the furnace just to see if there was actually anything come up. D and E are obviously the Alpha Omega of the burials. So it’s actually initially digging the grave itself, actually pulling the dirt out of the ground, and E is actually returning the dirt to the ground after the coffins have been made to rest.
Micheal Lewis
F is actually lawn mowing just simply running across the lawns, keeping the grave looking nice, keeping it basically pristine. You’d be surprised to know that the one that actually has the highest risk is the lawn mower. Now this actually really surprised both of us. Actually, both myself and Lea-Ann were actually left scratching her head. How did this happen? What was the story? So what you’ve got there is actually the test results that are actually done. I have to advise you, this is actually limited data.
Micheal Lewis
So it’s actually, I think we did about half a dozen different grave sites or half a dozen different graveyards. And we took some samples and this particular site was actually the one that flagged up the lawn mower operation. So drilling concrete benches, if you have a look down the bottom, we can actually see the workplace exposure hazard. Now, the interesting thing in Australia at the moment, respirable dust itself doesn’t have a workplace exposure standard. There is actually one on Safe Work Australia, but it’s actually dealing with respirable dust that are coal, less than 5% quartz.
Micheal Lewis
The exposure standard there are three milligrammes per metre cubed is actually sourced from the ACGIH, which is the American Congress of Governmental and Industrial Hygienists. So we applied that to general workplaces. There are respirable dust exposure standards for coal mines, and they are ones for methyl mines and quarries, but nothing really for general workplaces. So Simtars itself have actually adopted the ACGIH standard in the absence of any other information. So we do a bit of a comparison there. Green means good, Orange okay. Warning Will Robinson, we got a bit of a problem Red okay, this is a bit of a problem. We need to investigate it. So if you have a look there, drilling the concrete benches. So just simply just throwing it out in the open, there was .03 milligrammes per minute cubed of respirable dust. Anything that’s actually less than 0.3 on crystalline silica means it’s actually below the limit of proportion from the laboratory. So there was not much there at all. And respirable Crystalline silica. The same thing with drilling the marble bench rests. Again, part of it would have been due to the exposure being controlled through the use of the vacuum cleaner.
Micheal Lewis
The other part would have been there wasn’t a hell of a lot of dust that should be generated when doing the drilling. It was actually quite well controlled and it wasn’t being drilled using air or anything on those lines. So what little was being actually generated was very large sized particles that actually immediately deposited just on the outside of the hole. Cleaning the Ashes from the cremulator or the cremator sorry. Okay the inhalable dust was 1.33. Now what that suggests me is that yes, there is actually inhalable dust generated by scraping the stuff out. And inhalable dust themselves, say, a dust that 100 microns or less. Respirable dust is less than ten microns. We got a slightly higher level of .05 milligrammes per metre cubed for respirable dust. And again, there was actually nothing there crystalline silica. Okay, that’s good. Processing the Ashes. I actually followed the person around when they’re actually doing this as a different site. And there was a little bit of inhalable dust when they’re actually processing the Ashes, getting the ready, removing metal implants, if you like, from the bones of what’s left over and actually putting in the cremulator and basically putting into the container.
Micheal Lewis
So there’s a little bit of dust generated during the process, and that was certainly evident in the area. Again, the respirable dust itself was comparable. Okay. And there was no crystalline Silicon there. The difference between cleaning the Ashes and the processing the Ashes is actually a slightly different analytical method, but even still less than zero one milligrammes per metre cubed. There was nothing there. Okay. Digging the grave yeah, There was a little bit coming out of that. The soil was actually relatively dry there was a little bit of dampness in it, but again, not much in the respirable dust range. In fact, there’s not much dust itself actually be generated at all. Filling the grave, very similar, slightly higher, because the stuff is actually dried out a little bit. And obviously when they’re pouring it in, it actually has a chance to generate some dust but the concentrations themselves are actually taken from the workers. He was actually sitting inside the cabin of the dump truck and/or the excavator at the time. So the risk of exposure to dust is actually incredibly low. Mowing the lawns, however, was actually a different thing. We got not a lot, it was sort of over half of the relative exposure standard for respirable dust so 1.69. So anything that’s greater than 50%, we actually call the action zone, so it needs to be investigated to find out what the cause is, what’s going on here.
Micheal Lewis
Respirable Crystalline silica was very high. 0.11 milligrammes per metre cubed. And it was that one that actually got both myself and Lea-Ann and the rest of the team scratching their heads trying to work out what was going on. I had to do a little bit of forensic investigation. That’s probably the best way to describe it and what we managed to find out through discussions is that on occasion when the grave is actually settling, you end up obviously with a dip in the lawn.
Micheal Lewis
They were actually back filling that dip with decomposed granite or rotten Rockets, otherwise known as it’s actually been bought in from a quarry as additional soil, if you like for the site. And they were actually gently spreading it by shovel over the top of this thing, and it’s very good. It actually compacts down. It actually doesn’t really move too far it’s relatively stable material. In fact, it’s actually used on things like some garden paths around the place. It was actually used on back filling holes around the site.
Micheal Lewis
That sort of carry on. What we managed to work out. What we believe was happening is that when the lawn mower was actually going on top of it, when the stuff is being used for backfill, it’s actually relatively damp after it’s been sitting around for a while and actually try the lawmaker goes over the top of it, and lawn mowers by their very nature have a great way of actually picking up dust from off the ground and spreading it evenly and finally divided across the countryside.
Micheal Lewis
The lawmaker operator themselves has actually been exposed to high concentrations of dust that were containing very high levels of crystalline silica. And when we actually had a look at the percent content of the quartz that was actually in there, it was about 6%. So what you learn from that is you don’t need to have a lot of respirable dust to actually have high levels of respirable crystalline silica. And obviously this is actually something that needs to be looked at to find out what’s going on and to be aware that if you’re bringing in products, then that could potentially have quartz in it. If you don’t know, ask the supplier, get them to provide you a safety data sheet to the product. So you know what you’re dealing with at the very least, a thing called a petrographic analysis, which is actually something that’s done by geologists. They will actually have a look at where the stuff is coming from, typically from the quarries, and they will give you a rough idea what percent quartz happens to exist. So out of all of the activities are going on, that one was certainly the most surprising out of the lot.
Micheal Lewis
Now touching briefly on COVID-19. And I have to profess that I’m not actually microbiology expert so I’m taking this at face value. I tried to find some information, actually about how COVID-19 could potentially affect the funeral industry or what is coming about and let’s face it, it’s not going to go away anytime soon. There’s certainly going to be challenges actually faced with people that actually have COVID-19 or passed from COVID-19. What is the risk to you? What could be the potential controls that you need to put into place? Now, I did a search again on the net, just casting around to see what I could find and I actually found this advice from the office of the Australian Capital Territory Chief Health Officer that was issued June last year. So this is general advice. Maintain standard droplet and contact infection control procedures when the handling of transporting bodies confirmed or suspected to have COVID-19, I would suggest that you’re probably doing that anyway. If you’re picking up somebody that has an unknown infectious state, you certainly want to make sure that you’re not exposed to any potentially exhaled particles that may actually be coming from the person. And certainly they made mention that if you’re actually moving the person around, there is a very strong possibility that they may exhale just simply from moving the body or reposition them and getting onto a trolley whatever. Wear appropriate personal protective equipment at all times. Now, as it stands at the moment, the mask that we are wearing for protection in the field, just the general paper masks. They’re really only there to actually stop you from coughing at someone else. If you’re looking at trying to protect yourself against potential inhalation. You really need to be wearing what’s equivalent to a P2 mask, doesn’t have the exhalation valve on it, but it actually fits on your face a little bit better and provides a slightly better protection against any airborne droplets. They were suggesting that you possibly double bag a body with a leak proof body bag and put on a label on the outside COVID-19 handle with care, and that should be used for actually the storage and transport of the body. I’m not entirely sure if that’s the case that you guys are doing at the moment, but this is advice that actually suggested. Avoid unnecessary manipulation of the body that may expel air or food from the lungs.
Micheal Lewis
If an airway like a ventilated airway, an endotracheal tube is still in place and sometimes the medical devices are actually left in situ. They suggest that maybe put a tape, put a tape actually over the airway hole to prevent air from actually being expelled into the environment as you’re moving the person around, moving the body around. They can’t confirm at the time whether the embalming of the body is actually going to have any significant effect, or if there’s going to be increased risk of exposure to COVID-19 So at the time until they actually had something to the contrary, they suggested that maybe embalming is not something that should be done. That’s interesting.
Micheal Lewis
Family viewing the deceased may occur however, family members should avoid contact with the body. Again, this is actually a difficult place to be. The family members may wish to view the body. They may actually be preparing the body for burial, different cultural practises and what have you may require them to actually interact with the deceased person? How you prevent them from actually being exposed to potential COVID-19? You could suggest that they wear a mask when actually working with a person but again, it’s going to be a case by case basis about how you’re going to do it.
Micheal Lewis
Maintaining recommended social distancing from friends and family. Let’s face it, in the last two years, it’s been very challenging. There have been limited numbers at funerals. They’ve been limited numbers at grave sides, some have actually been delayed either through COVID shutdowns or what have you. I think you would find that COVID-19 itself is actually still very much a moving feast in regards to advice and guidance. Ultimately, it’s just try to prevent exposure to any aerosols that may actually be expelled from the deceased person and to protect yourself against any potential exposure, particularly if you’re collecting a person who’s recently passed from COVID-19. The sources that are actually going together as part of the presentation and these are just a couple of examples of things I’ve pulled up. Obviously the guide to the funeral industry, which is from Workplace Health and Safety, Queensland. That’s one of the source documents you can see there, there’s actually the COVID-19 guidance for funeral industry workers that come from out of the chief health officer in the ACT. Again, if you haven’t got a copy of it, do a search find it, have a look at it, see if the practises themselves apply to you and whether they’re actually appropriate for your business or not. Having a look overseas, actually, to see if there’s actually any more comprehensive view like advice, the Occupational Safety and Health Administration from Oregon in the US have actually got this guide: Occupational Health and Safety in the death care industry. It’s quite comprehensive, actually. It goes on if you like in a little more detail and offers potential control mechanisms that the guide to the funeral industry from here may not necessarily address or discuss. The other one itself is actually an article that I found that actually talks about mortal exposures, and it’s actually talking about a range of potential biological chemical exposures that may come about from actually just working in the funeral industry alone and discuss the relative risks associated with the handling or proximity to the substances or the person when you’re actually working in the industry.
A Final thing, Simtars itself. This is actually the web page for Simtars. We are part of the Queensland government. We’re part of Resources Safety and Health Queensland. Resources Safety and Health. Queensland is actually now a statutory body, so we’re no longer a Department, but we are still part of Queensland government. That being said, Simtars itself is actually a fee for service organisation. So we operate like a private consultancy. We deal with a range of different industries and if you have a look there, you’ll actually see my smiling face actually helping out the training services side of things back in the days, when we used to wear bowties. There are a range of different services and make available and certainly if you’ve got any questions or in the occupational health or hygiene space, I’ll be happy enough to actually field those questions through Lea-Ann or you can contact us directly through the Simtars inquiry line. Thank you for your time.
Lea-Ann McNeill
So, Micheal, I have had a couple of questions and comments made throughout your session. I’m just going back to COVID-19. Fiona asked, obviously there were risks at the time of moving the body, making funeral arrangements. What about if there was an exhumation of a body that potentially was believed to have died from COVID-19, exhumation risks?
Micheal Lewis
Yeah, I don’t know if they’ve actually really got a handle on exactly how long the virus itself actually lasts outside the body as it stands at the moment, viruses themselves, by their very nature, actually need to have a living host to actually be maintained and they can survive outside the body for periods of time. A classic example is hepatitis. It is a form of virus that can actually lay dormant for a number of years. COVID-19 itself. I don’t know yet whether we’ve actually got any significant data about the viability of COVID-19 virus outside of the human body and if there is actually data or evidence, how long it would be, would it be two days, three weeks, 24 hours? Really don’t know. I would suggest that you probably want to treat the exhumation as you would any other potentially infectious material substance, provide yourself a level of protection. Obviously, the risk of exposure itself is through inhalation only. So if you’re wearing a mask, if you’re protecting yourself against the dust or biologicals or radiologicals, whatever else may actually occur as part of the exhumation process, you’ve got a pretty good chance of actually preventing potential exposure.
Lea-Ann McNeill
Yeah, COVID is certainly one of those things I think we’ll be learning about yet for years to come.
Micheal Lewis
Very much so. It is still very much a moving feast. You have a look now. COVID is actually mutating rather quickly. There are actually a number of variants out there that showing up more rapidly than we probably originally thought. Certainly the World Health Organisation at the very beginning actually said that this virus was actually not demonstrating mutation. I think what was happening was that it was mutating so quickly that they couldn’t actually pick up the individual genome types quick enough. We’re in that space now, basically.
Lea-Ann McNeill
Yeah. A question was also asked early on when you were talking about those different risks across the industry more broadly, somebody asked about the risk of asbestos in older crypts. Obviously, if there’s crypts being reopened or there might be an exhumation, these Crypts are being reopened. Thoughts about asbestos risk?
Micheal Lewis
It depends on how the asbestos has actually been presented. If it’s actually being used as like an insulation rope. Okay. If it’s actually like a seal that’s actually pressed into the outside edges of the crypt face, you can end up with a thing called friable asbestos, which is actually where the dust or the fibres themselves can be released into the atmosphere with very little disturbance. So there’s a potential risk there of exposure to friable asbestos. If, however, it’s actually been used as part of a mortar or a cement, the chances of actually releasing dust into the atmosphere is actually quite low. As long as you’re not using any form of mechanical generation. And we’re talking about things like grinders or chipping handles.
Lea-Ann McNeill
Jackhammeers
Micheal Lewis
Yeah. So if you’re actually generating large amounts of dust as a result, quick cuts all that sort of carry on. There is an increased risk of exposure to dust and certainly increased risk of exposure to whatever happens to be in the cements like asbestos.
Lea-Ann McNeill
We’ve gone back to COVID. Actually, a question just come through and it’s a longer one so I’ll run through it. The comment is made if embalming is not allowed for COVID-19, and I’m not sure that it’s not allowed, it’s just not recommended. But what would then happen next? Is there a requirement specifically for the body to be buried or cremated? Are there any recommendations on that sort of front? I think we’ve answered the question around exhumation and around the safety for that, we really don’t know how long this virus is going to live, despite the fact that it hasn’t got a living host.I guess would those virus particles then move on to cremators. My understanding is the heat from the cremator would destroy most viruses, but I’m not sure if that’s quite correct. So I don’t know if you’ve got any comments about those.
Micheal Lewis
I think it would be fair to say if you’re looking at the cremation process itself is actually a rather clean process, as long as the body itself is actually introduced into the cremator based in a sealed container or sealed coffin or body bag, whatever it happens to be, the chances of any form of infectious material or any form of biological or chemical material being released prior to the body being put into the cremator is actually incredibly low. And obviously the temperatures and the holding temperatures inside the cremator itself is likely to destroy and denature any form of organic material.
Micheal Lewis
That’s basically the principle of it. So what’s left over is essentially the minerals, the Mineralogy in the shapes of bones and bone structures. The virus itself I don’t have a lot of information about the virus, about it’s viability outside the human host. I don’t think we actually really got a handle on that at the moment.
Certainly the principle is that you actually treat any potential body fluids as infectious. That’s general principles, that’s been around for quite a few years, actually, certainly in the nursing and healthcare profession. If there’s anything that’s coming from out of the person, you have to treat it potentially as infectious and you take the necessary precautions to do so. And you’re doing that at the moment, in regards to the embalming, you got to remember that guidance document itself actually come from the chief health officer at the ACT early in the piece and this is June last year, where they still didn’t have quite a good handle on what the potential infection or transmission is coming from COVID or basically it’s a SARS derivative, SARS virus derivative. And what they were suggesting is if you can decrease the risk of exposure to body fluids, to materials coming from the body in an untreated or on sterilised or sensitive state, that’s probably the best option. I would suggest that if you’re actually going to be doing in the embalming process, you would certainly want to be protecting yourself against any potential exposures to the vapours of things coming off the embalming fluid in the first place.
Micheal Lewis
If you’re doing this, you’re by very nature also provided protection against any potential biological materials that might be released as an aerosol into the atmosphere.
Lea-Ann McNeill
I’ve just had a couple of questions coming through, I guess, about cremation, about the radioactive nature of things. I’ve just asked Fiona to clarify a quick question that she’s asked, but the comment was made, which I did respond to fairly early on in the piece, about the risks of pacemakers in cremators and the risk of explosion. And I know you and I talked about this, Micheal, but I also shared with the person who asked the question that pacemakers are supposed to be removed by doctors prior to cremation, although there are some modern ones now that are being tested and trialled because the belief is that they shouldn’t explode in a cremator. I don’t know if you’ve got an experience around that.
Micheal Lewis
I haven’t actually seen it for myself personally, but I have actually heard that, particularly when we were doing the work originally lean that any medical devices are supposed to be removed from the body prior to Cremation and the certificate was supposed to be provided to actually state that had occurred. It was mainly to do with things like heparin pumps or insulin pumps or any sort of battery operated device, including pacemakers, and the original thought process behind that was that, because they actually have basically a long life lithium ion battery, that when they’re subjected to very high heat and temperatures for a long period of time, they will thermally decompose basically, rapidly.
Micheal Lewis
You end up with a bang going on inside the thing you want what’s going on now? Certainly, if you have a look at I would encourage your team or your members to actually have a look at that advice from the ACT chief Health officer because I think they make mention in there they suggest that maybe the pacemaker shouldn’t be removed, again because they thought there might be a risk of exposure to biological load, actually coming from COVID-19. Yeah, that’s right. So I think that one again, it has to be a case by case basis. It really depends on what you will accept coming into the cremator and certainly the industry standard of actually removing devices from the body when it is possible, usually at the healthcare setting or in the funeral directors if they need to is probably still appropriate until we’ve actually got advice or guidance about whether the pacemakers themselves can actually go through cremator without causing significant damage to the cremator or actually causing an adverse risk from some sort of lithium ion gas explosion or something inside the cremator. It’s probably best to actually err on the side of the caution and actually look at trying to remove the devices to remove any potential risk.
Lea-Ann McNeill
You also talked about radiation and Fiona has asked, do seeds increase the radioactive risks during cremation? So those sorts of things implanted for the likes of prostate cancer.
Micheal Lewis
They could possibly. The problem is with radioactive devices themselves or radioactive seeds, as you call them, is that they’re actually still essentially active when they’re planted in the body. That’s why they’re there, they are like a localised radiation source, almost like a targeted radiotherapy. That’s what they’re designed to do now, ideally, these things would actually be removed before the bodies actually passed the funeral directors and there should be some certificates to state that they have been done so.
Micheal Lewis
Probably the best thing to do is actually get in touch with the medical institution to find out if they’ve actually what their control measures are for somebody who has deceased in regards to radioactive devices, do they remove them? Or at least try and find out what the source is. What is the potential risk to your team? Your members? Is this actually likely to cause a radiation risk? It could be that the device itself has actually have a very low radioactive potential but again, you don’t want to be inhaling the dust.
Micheal Lewis
That’s the significant thing. You don’t want to actually inhale the material when it comes down to radioactive devices or radiation, risk of radiation. Alpha particles are the ones that actually carry the greatest risk. Alpha particles are actually very large particles that have a high radioactive load. They’re typically found in things like dusts, right? You have them land on your skin not a problem, you might get a little bit of localised irritation that’s about it, but generally it doesn’t cause a concern. You inhale a radioactive material or an Alpha particle they’re relatively large size particles compared to the other types. They can actually settle into the tissue because they’ve actually got such a high energy. They can actually migrate through tissue over a long period of time and actually cause localised chronic effect through inhalation.
Lea-Ann McNeill
I was going to say, Micheal, you clearly talk about inhalation. And I know with my team when we started to identify some of those risks, there were a range of different mask types that we did look at. I guess one of the reasons that we at Opus put this ‘in conversation’ on today was because October has been safe work month. So we’ve got a few minutes remaining. Are there things, kind of broad things that our audience and those that they work with can and should be doing to kind of manage these inhalation risks.
Micheal Lewis
Yeah, very much so. If you’re looking at different types of respiratory protective equipment, okay. So you’ve got to take into account there is actually a significant shift in control hierarchy measures in the safety industry, and it’s literally been in the last three, four months. In the past, personal protective equipment, administrative procedures were actually seen as the be all and end all. When it comes down to things like point source ventilation extraction systems, ventilation systems, isolation systems. High end engineering controls were very often not entertained because they were seen as being in the too hard basket.
Micheal Lewis
I could advise your members now that the safety regulators are actually no longer accepting personal protective equipment as the be all and end all. It’s a good interim measure, but they will be wanting you to explore high order controls to prevent exposure. Brisbane City Council, they should actually congratulated actually, because when we’re looking at the guys that are actually doing the work in the Cemetery and particularly the guy that was actually operating the lawn mower, which was actually encouraging. He was actually wearing a PAPR, which is actually a very high order respiratory protective equipment. It’s known as a purified air powered respirator. So it’s actually a battery pack with two large size canisters that actually draws air through the canisters, up through a tube and place it into a semi sealed face mask, like a face shield that sits over the top, and it has a gusset around it and provides a positive pressure environment to prevent against exposure. PAPRs themselves can actually be used for toxic dust, things like as best as silicosis, etc. For and depending on the type of cartridge you can put on, they can also be used for various types of chemicals. Right.
Micheal Lewis
So if you’re looking at things like formaldehydes, all those types of things, you can actually get a high absorption organic vapour cartridge that actually fit onto the PAPRs and it gives you purified air going past your face. Very good pieces of kit. Unfortunately, they are also relatively expensive, it’s a significant investment. They do, however, offer an additional benefit that they actually provide protection for the mucus membranes to the eyes, the mouth and nose, whatever. So any potential splashes and everything that actually hits a big, large plastic face shield.
Lea-Ann McNeill
I was going to say you talk about them. Yes, they’re certainly a costly piece of equipment, but I do talk very personally. I know there were members of my staff that said their lungs have never been so good after they, it had almost corrected maybe some health problems that they’ve had previously.
Micheal Lewis
Well, exactly. And the thing you’re going to take into account as well, actually, there’s an added benefit for using something that actually has a cartridge, whether it be a half face reusable respirator, a full face reusable respirator, or a PAPR. The cartridges themselves typically have a filter that is actually rated P3. Now, P3 itself is effective against biologicals, viruses and bacteria, they will actually filter out viruses and bacteria. And certainly I remember back in the early 2000s, one particular respirator company was actually trying to provide full face masks with the organic vapour cartridges and the P3 filters on it to surgeons working in the orthopaedic theatres because it provided facial protection protection against viruses and bacteria.
Micheal Lewis
If you were looking at a higher order control, you would actually be looking at something on those lines. A P2 disposable respirator, they are perfectly fine for low order controls, potential dust exposures, that sort of carry on. But I can tell you now, if you’ve actually got a face like mine, you got a bit of fungus on it. It’s not going to work. It’s going to lift off. It’s just going to go straight past it. So you have to be clean shaven.
Lea-Ann McNeill
All right. Well, look, I am just conscious of time. Honestly, Micheal, thank you so much for joining us today.
Micheal Lewis
My pleasure.
Lea-Ann McNeill
I think everybody who works in this industry. We know that there’s risks and mitigation strategies that we need to employ, but I don’t think we ever truly know just how many risks that they are. So thank you today for talking us through that. As I mentioned, the session has been recorded, so we will be able to provide that later to you all so you can share that within your organisations, if you need to.
Lea-Ann McNeill
Also thank you to everybody that has joined us today. Some great questions. It’s certainly been a great session. I would say that our ‘in conversation’ series will pretty much be taking a little break now until the new year. So we certainly look forward to seeing you all again in January. I did mention that one of the reasons that we ran this session today was because October has been safe work month. But of course, safe work for our people doesn’t start and end with the month of October.
Lea-Ann McNeill
If Micheal’s session today has raised any questions for you, I guess, and things that you want to look at in your organisation, please don’t hesitate to reach out. We can put you in contact with Micheal or of course, you can contact Simtars yourself directly. So thank you again, Micheal, for your time and thank you to everybody out there in Zoomworld.
Micheal Lewis
Take care guys. Merry Christmas and a happy New Year. I’ll see when you get back in 2022.
Lea-Ann McNeill
Thanks, Micheal. Thanks, everybody.
Micheal Lewis
Bye bye.
