Decedent Handling is a High Risk Task
Providing care for others is a primary mission of funeral home owners. This compassionate work should not come at the expense of your health and safety or that of your staff. This article will highlight the most prevalent and preventable ergonomic injury in the work environment today: back injuries. The back can be damaged during an acute accident, such as lifting a heavy object, or the damage may occur from repetitive trauma over a period of months or years. Both of these activities occur daily in funeral home operations.

Reducing risks should be included in your business planning. The significant costs associated with job-related injuries can be minimized through effective interventions and controls.

Did you know? There are over 1 million back injuries per year in U.S. associated with manual handling.

• Lifting is associated with 75% of these1

• They account for 25% of all workman’s compensation claims1

• Low back injuries average $39,643 per claim2

• They account for the highest percentage of injuries with days away from work, at 19.9%2

The direct costs of an injury from medical and legal expenses are unfortunately only the “tip of the iceberg.” The total cost also includes “indirect” costs such as business disruption expenses, employee replacement costs, absenteeism, decreased morale and higher insurance costs. Intangible damage to customer service may be difficult to measure but is very significant in an industry dependent on “just-in-time” response to the needs of the decedent’s family. Indirect costs average three to ten times the direct cost. Furthermore, many on-the-job injuries are not reported through the Workers’ Comp system, but are processed through group medical insurance, which is also an industry expense. Injured employees are often forced to leave their profession due to partial or total disability. They may also face chronic pain and an increased risk of another back injury.

Improper Ergonomics, Lack of Technology, and the Growing Bariatric Population are Contributing to Injuries in the Funeral Home Environment

How does a back injury happen? There are three primary reasons, or ergonomic risk factors that can cause an injury.

• Force is exerting physical effort to accomplish a task. An important note: all soft tissue, including tendons and nerves, as well as the spinal cord, is at risk of damage during forceful exertion.

• Repetition is movement of all or part of the body in an identical way, over and over. This repeated trauma weakens and eventually damages the affected body part.

• Awkward or static postures strain the body. Examples of awkward positions include leaning forward, sideways, or bending down. When body parts, such as arms, are in awkward positions, muscle strength is low, making tasks more difficult to complete and reducing efficiency. Static posture is when the whole body or a certain part, such as an arm, is held still with no movement, for a period of time.

It is important to note that tasks generally include more than just one risk factor.

Where do ergonomic risk factors exist in funeral home operations?

• Forceful exertions: lifting and moving the deceased & the casket onto cots, tables, church trucks and coaches.

• Repetition: the repetition rate can be estimated by calculating how many deceased are handled per day or per week, and then calculating how many times the deceased is transferred and lifted in the course of the full-servicing of the body.

• Awkward or static postures: bending over an embalming table, standing for long periods, reaching to pull a body over to a mortuary cot.

Are there any other conditions increasing risk?

• The condition of equipment, working environments, staffing levels, and the increasing weight of the US population.

• Older mortuary equipment may be substantially heavier and lack height-adjustability to accommodate the individual working over the deceased for extended periods, resulting in awkward, static postures. More force is required to perform a lateral transfer if the heights of the two surfaces being used cannot be adjusted to match.

• Hazardous walking surfaces, such as ramps, and terrain that is slippery or uneven add additional levels of difficulty for moving the deceased and increase risk of both an acute or repetitive back injury.

• Staffing levels and aging staff: Employees working alone usually face elevated levels of risk; they are performing all of the tasks and are working for long periods of time until all the tasks are completed. Older employees often have a higher probability of repetitive trauma from performing work tasks under risky conditions for many months or years.

• Obesity in the U.S.: Without the appropriate technology to eliminate manual handling of obese decedents, safety risks remain high. According to the latest published data,
– Over 33% of American adults are obese
– 17% of American youth are obese

Mitigate Risk by Establishing Procedures for High Risk Tasks, Use of Technology, and Training

The cumulative effect of ergonomic risk most likely will result in symptoms and injuries in the funeral home industry until tasks and equipment are improved. Improvements in safety can yield significant results, saving profits, eliminating risk of business disruptions and ensuring valued staff remain safe and on-the-job. There are new tools available to transfer, lift and transport bodies. Simple processes can be established to identify and address risks.

Step 1: Know your risks. Review your injury data, obtain loss reports from insurers, identify all of your morgue tasks and catalog your existing equipment. Document your working environments. Use this information to identify ergonomic and safety situations that put your staff at risk of back injuries. It is important to understand that not all devices are equally as effective in reducing the risks. Before investing in improvements, compare the force reductions and other operational requirements of different types of assistive technologies.

Step 2: Learn about the technologies and tools that can eliminate manual handling of bodies.

• Air-assisted devices can transfer bodies weighing up to 1200 lbs. from one lateral surface to another, even if there are slight gaps between the surfaces. These devices can also be used to extract bodies from difficult locations. Force reductions are approximately 80-90% with this technology.

• Portable and installed lifts can be used to transfer bodies. These lift devices also reduce force significantly. Other lateral transfer and turning aids, such as slide sheets, can be implemented.

• For transport equipment, seek out light-weight models, with wheels designed to move easily over difficult surfaces. Then maintain the wheels in clean condition to keep the friction-reducing properties at a high level.

• Devices for handling obese decedents should be considered if this task is frequent. Consider asking your vendors if rentals are available, or talk to other mortuary owners about sharing this type of equipment within a geographical area.

• When replacing older morgue tables, consider purchasing adjustable tables to allow staff members of varying heights avoid awkward working postures.

Step 3: Recognition and education are important keys for prevention. Staying informed about ergonomic risk and the latest control technologies will help insure that you, your staff and your business avoid the serious consequences of debilitating back injuries. FBA

1 Back Injuries Nation’s Number One Workplace Safety Problem, Fact Sheet No.OSHA 89-09. U.S. Department of Labor, 1989. Print & Electronic.

2 National Safety Council Injury Facts ®, 2015 Edition. Itasca, Illinois: National Safety Council, 2016. Print & Electronic.

3 Cynthia L. Ogden, PhD1; Margaret D. Carroll, MSPH1; Brian K. Kit, MD, MPH1,2; Katherine M. Flegal, PhD1. “Prevalence of Childhood and Adult Obesity in the United States.” JAMA. 311.8 (2014): 806-814. Web. http://jama.jamanetwork.com/article.aspx?articleid=1832542.

Patti Wawzyniecki HeadshotPatti Wawzyniecki, MS, CSPHP, is a Safety Programs Manager with HoverTech International. She has 30 years of experience in employee health & safety and is a Certified Safe Patient Handling Professional. Patti performs ergonomic assessments and education at healthcare organizations throughout the U.S.  She has spoken on this topic at state and national conferences and is currently serving on the Board of Directors of the Association of Safe Patient Handling Professionals.