Chemical disinfection means to destroy disease producing micro-organisms by the use of chemicals. The purpose being to render the surgical instruments used by the embalmer safe to handle and to reduce or prevent cross contamination of organisms between the dead human bodies.

  Like embalming chemicals, liquid chemical disinfectants destroy micro-organisms by solidifying the protein substances (cytoplasm) and inactivating its chemical enzymes. The effectiveness and reaction time varies among chemicals, the materials to be disinfected and the individual specific organisms.

  Certain procedures must be carried out before successful chemical disinfection can be achieved. All instruments must be cleaned/scrubbed of all organic matter which could create a protective barrier against chemical contact and the organism. All instruments should be carefully rinsed and dried prior to placing in the chemical disinfectant. Failure to dry the instruments adds water to the disinfectant reducing its concentration, effectiveness and activity time.

  Hinged instruments should be opened and serration gripping surfaces scrubbed with a brush to get rid of debris then rinsed and dried. Complete submersion is essential. Every surface of the article or instrument to be disinfected must be reached by the solution. Air bubbles must be released by agitation of the solution. Bubbles form protective air pockets which prevent solution contact creating a potential hazard.

  Certain factors govern the choice of chemical disinfectants or combination of chemicals. A disinfectant having a broad spectrum of effectiveness and a visual indicator allows the practitioner to tell when the chemical is ineffective. As usefulness decreases the amber color lightens indicating loss of antimicrobial action. The solution should then be replaced by fresh mixture. Working dilution is 3 ounces per gallon (128 ounces).

  Problems can arise concerning the type of organisms to be killed or inactivated. These include stability of the disinfectant solution, the kill time, concentration of the disinfectant, cost of the solution, availability, and its action not retarded by organic matter. Solution cannot be destructive to body tissue or instruments and cannot stain nor have an unpleasant odor.

  Four main categories of microorganisms are of concern to the embalmer in handling the dead human remains. Contrary to old ideas that dead bodies do not harbor opportunistic pathogenic organisms we can isolate 25+ even after a person dies of a heart attack for example:

•     Vegetative organisms (strep and staphylococci, Mersa)

•     Capsules (Tubercle bacilli tuberculosis)

•     Spores (Anthrax, gas gangrene, tetanus)

•     Viruses (Flu, AIDS, Ebola)

  The most difficult organisms to destroy with chemical disinfectants are those which form spores. Clostridium perfringes is known to have destroyed even embalmed bodies. The next most difficult organism is the tubercle bacilli. This organism has been known to survive in anatomical bodies for years even after vatting in phenol. Today it has mutated into an antibiotic resistant super bug. Other organisms are enveloped with capsules of fatty substances which protect them. The thickness of these capsules indicates the disease producing ability of a variety of these organisms (virulence).

  There are many pathogenic organisms that may be recoverable from embalmed bodies if depth preservation is not practiced and many more opportunistic organisms are evolving. Prior to the embalming of these organisms, there is a potential hazard to those who handle the body from the place of death to the funeral home preparation room.

  Some other common organisms are Histoplasma capsulatum, Hemophilus influenzae, Nocardia asteroides, and Klebsiella pneumonia. Contrary to some claims that embalming makes a body sterile, we must understand there is no such thing as a safe body. A transmigration (translocation) of intestinal flora moves from the gastro-intestinal tract through the vascular system into the tissues of the body.

  Loss of blood and other body fluids/solids create a good media for growth outside the body for various organisms. Even after such material has dried, potential hazards still exist.

  Part 6 will deal with the viewing of the body.