A gap analysis of the United States death care sector to determine training and education needs pertaining to highly infectious disease mitigation and management

ABSTRACT

Purpose: A United States industry-specific gap analysis survey of the death care sector—which comprises organizations and businesses affiliated with the funeral industry and the handling of human remains— was developed, the results analyzed, and training and education needs in relation to highly infectious disease mitigation and management were explored in an effort to identify where occupational health and safety can be enhanced in this worker population.

Methods: Collaborating national death care organizations distributed the 47-question electronic survey. N = 424 surveys were initiated and results recorded. The survey collected death care sector-specific information pertaining to the comfortability and willingness to handle highly infectious remains; perceptions of readiness, current policies and procedures in place to address highly infectious diseases; current highly infectious disease training levels, available resources, and personal protective equipment.

Results: One-third of respondents have been trained on how to manage highly infectious remains. There was a discrepancy between Supervisor/Management and Employee/Worker perceptions on employees' willingness and comfortability to manage potentially highly infectious remains. More than 40% of respondents did not know the correct routes of transmission for viral hemorrhagic fevers.

Conclusions: Results suggest death care workers could benefit from increasing up-to-date industry-specific training and education on highly infectious disease risk mitigation and management. Professional death care sector organizations are positioned to disseminate information, training, and best practices.

KEYWORDS:

• Death care
• Ebola virus disease
• highly infectious remains
• infectious disease education
• infectious disease training

Acknowledgments

The National Funeral Directors Association (NFDA) and the Cremation Association of North America (CANA) were instrumental in providing subject matter expertise in the survey creation and in the distribution of our survey to their members.

Additionally, we acknowledge Ebola Biosafety and Infectious Disease Training Program, grant number UH4ES207055. While the grant funding did not contribute to the development and distribution of this gap analysis survey, the program did highlight the need. We also thank our consortium members in the Biosafety and Infectious Disease Training Initiative (BIDTI) at the University of Texas Health Science Center at Houston (UTHealth) School of Public Health: Janelle Rios, Robert Emery, and Scott Patlovich, and at Harvard T.H. Chan School of Public Health: Paul Biddinger for their partnership and support in for this training.