DEFINITIONS

Biohazard: Any biological agent (such as an infectious microorganism) or a medical condition that poses a threat to humans or the environment (such as HIV1, HIV2, or hepatitis) that can be found in blood, body fluids, body tissue and feces that when exposed to may cause harm, illness or death.

Bioload:  In the context of a crime scene, the term bioload relates to the micro-organic matter dispersed by traumatic action. The vast majority of environments on Earth, internal and external, carry some level of micro-organic activity. A crime scene will have a high bioload following a traumatic incident. The bioload will be significantly reduced by thorough cleaning of the scene. There are few environments on Earth without some sort of bioload. "Clean rooms" for computer research as well as other scientifically oriented environments are among the few places without a detectable bioload. (Return to Crime Scene Cleanup)

Bloodborne Pathogen: Infectious, pathogenic organisms in the blood such as HIV1, HIV2 or hepatitis, and are capable of causing disease. The predominant medical interest is the contamination of blood-soiled linens, towels, clothes, carpeting, floors, walls, sharps (See definition 6 below.), appliances, etc. 

Bloody Mary:  A hand-tool for cutting dense fabric, including carpet. The name arises from the tool's working end, which has a sharp cutting end on both sides of its blade.

Body Movers:  Body movers are found in government and small business activities. In government, local coroner and medical examiner offices emply body movers. In business, body movers may include morticians hired by cemeteries and mortuaries. There are individually ran business and small business concerns dedicated to the movement of human bodies following death. Dead body cleanup may follow the body movers.  When the body movers remove the deceased, residue often remain from trauma to the body or decomposition. These fluids invite insect and animal life. Such "effluents" require much effort and a frame of mind to remove, in many cases. Call at any time, any day of the week for help when you find a problem remaining after the deceased is removed.

Contaminated:  The presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

Contaminated Sharps:  Any contaminated object that is sharp or has the potential to be a sharp that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.

Decontamination:  The use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on an item or surface to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.  The process of removing pathogenic microorganisms from objects or surfaces, thereby rendering them safe for handling.

Effluents:  Usually used in the context of a biological discharge from a sewer system, in the context of human trauma cleaning, "effluents" is used to denote discharge from the body following death.

Embedding:  The use of sealers and other chemicals to pretreat the bioload for handling, transport, and storage. Embedding is also useful for reducing the odor and objectionable elements of a death scene.

OPIM  (Other Potentially Infectious Material):  Materials other than blood, which pose a potential health risk, including:

1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;

2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead);

3) All human or primate cell or tissue cultures, organ cultures, and cell lines (including established, continuous cell lines). HIV or HBV containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV should be considered potentially infectious;

4) Blood or body fluids of animals that have been intentionally or are suspected of having been exposed to pathogens in research, in production of biologicals, in the in vivo testing of pharmaceuticals, or other procedures.

PPE: Personal protective equipment, including but not limited to, safety eyewear, gloves, boot or shoe covers, etc.

Regulated Medical Waste Manifest: A form stating contaminated materials were incinerated at an approved medical waste incineration facility. This provides documentation proving you participated in best practices and helps protect from possible future litigation.

Regulated Waste (per OSHA): Liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials. Please note it does not matter how old blood, body fluids or tissue may be, OSHA still considers them Regulated Waste. 

Sharps:  Anything having a thin edge or a fine point capable of cutting or piercing such as hypodermic needles, broken glass, knives, razors, etc.

Surfactants:  A general term that includes soap. Surfactants lower water's surface tension. As they soften water's surface, the water carries away soiled matter more easily. Place oil in water gives a hint of the chemicle divide between water and oil. Placing a surfacant in a bucket containing water and oil removes the divide between the two.the surface tension of water by adsorbing at the liquid-gas interface.

Universal Precautions:  An approach to infection control, which treats all blood and other potentially infectious materials as if known to be infectious for HIV, HBV, and other blood borne pathogens. This approach includes the use of barrier precautions by employees to prevent direct skin, parenteral, or mucus membrane contact with blood or other body fluids that are visibly contaminated with blood.

BLOODBORNE PATHOGENS

Many people are aware of HIV1; unfortunately, that may be the extent of their understanding. The last two decades have produced great advancements in scientific research that hopefully will better educate the general public and increase awareness of health and safety issues.

Hepatitis A

Hepatitis A has traditionally been regarded as a flu-like illness, affecting only school-age children. A Dallas Morning News article, dated 15 November 2003, disclosed a hepatitis A outbreak in Western Pennsylvania that had killed 3 people and infected more than 500. The fatality rate for hepatitis A is approximately 1 per 1000 infected. However, these fatalities are usually due to the victims being young children or occurring in conjunction with some other illness. Noting hepatitis A as the cause of death in three otherwise healthy adults should set off some alarms at the U.S. Center for Disease Control.

Hepatitis A is a liver disease caused by the hepatitis A virus and can affect anyone. Hepatitis A is transmitted via the human fecal/oral route. This commonly occurs when a person 1 touches an object that is tainted with microscopic amounts of human feces from person 2 (who is infected with hepatitis A) and then person 1 touches their own mouth.

Hepatitis A outbreaks can occur from one isolated case to a widespread epidemic. Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis A infection in persons two years of age and older.

A vaccination does exist for hepatitis A but a cure does NOT.

Hepatitis B

Hepatitis B, the most contagious of the hepatitis viruses, is a very serious disease that attacks the liver. The hepatitis B virus can cause lifelong infections, such as cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Depending on the source of information, it is believed that under some circumstances hepatitis B can survive and be transmittable from 10 days to 2 months in dried blood.

Imagine this scenario: A maintenance worker walks on a contaminated carpet or tile at a scene, then walks into an office. He/she has now contaminated the floor of the office. Later a resident enters that same office with a small child who crawls on the contaminated floor. If this child has cuts or open skin on his/her hands or knees, he/she could potentially contract hepatitis B and suffer lifelong complications from a vicious disease.

The good news is there is a vaccination series for hepatitis B; this vaccination series includes three injections over a six-month period. However, it is only effective in approximately 70% of those vaccinated.

There is no known cure for hepatitis B at this time.

Hepatitis C

Hepatitis C was discovered in 1988 and runs rampant among drug users; although, it can be transmitted several other ways.

Approximately 100 people per day contract hepatitis C. Anyone and everyone is at risk for hepatitis C and should contact a medical care provider for a blood test if they meet the following criteria:

Were notified of having received blood from a donor who later tested positive for hepatitis C.

Have ever injected illegal drugs, even if they only experimented a few times many years ago.

Received a blood transfusion or solid organ transplant before July 1992.

Were a recipient of clotting factor(s) made before 1987.

Have ever been on long-term kidney dialysis.

Have evidence of liver disease (e.g., persistently abnormal ALT levels).

Have ever had contaminated blood on a physical "port of entry." Points of entry may include, but are not limited to, cuts on any area of the body, mucus membranes, eyes nose, mouth, rectum, or vagina.

There is no vaccine or cure for hepatitis C.

Approximately one quarter of HIV (human immunodeficiency virus)-infected persons in the United States are also infected with the hepatitis C virus (HCV). HCV is a predominate cause of chronic liver disease in the United States and HCV infection progresses more rapidly to liver damage in HIV-infected persons. HCV infection may also impact the course and management of HIV infection.

Hepatitis D, Hepatitis E, and Hepatitis G

Hepatitis D, E, and G are all liver diseases caused by different viruses. All three are transmitted much in the same way as the other hepatitis viruses. Very little is known about these three except that hepatitis D requires that the infected person also be infected with hepatitis B; otherwise, hepatitis D is incapable of existing alone. Hepatitis G was discovered in Canada in 1993 and almost no information exists on it due to its �newness� and lack of long-term research.

Shelba Durston, RN, CCRN, MSN, states in her article, What you need to know about viral Hepatitis, dated August 2005, in the online journal, Nursing2005,

A few cases of hepatitis that didn't quite fit the A, B, C, D, or E profile were identified in the early 1980s and labeled hepatitis F in 1994. These viruses have now been identified as variants of hepatitis C. The hepatitis F label isn't currently used for any virus.

The latest virus to be named is hepatitis G, a single-stranded, enveloped RNA virus similar to hepatitis C. As with hepatitis B and C, this virus is transmitted by blood and body fluids and can probably be found in all body tissues. Two variants of hepatitis G have been identified, and researchers are working to identify other suspected variants.

The long-term effects of hepatitis G aren't known.

No vaccine has been developed against hepatitis G.

Symptoms:

Tiredness

Loss of appetite

Stomach pain

Dark urine

Yellowing of skin or eyes (jaundice) in rare cases

Short, mild, flu-like illness

Nausea and vomiting

Diarrhea

Weight loss

Itchy skin

Incubation Period For Hepatitis

All strains of hepatitis may incubate for several weeks before the infected person begins experiencing any symptoms. This is a very dangerous time because the infected person could be passing the disease on to others without even knowing he/she is infected.

 

HIV-1, HIV-2, and AIDS

A person cannot contract AIDS. A person contracts HIV-1 or HIV-2, and these may develop the condition known as AIDS. There are an estimated 800,000-900,000 people currently living with HIV in the United States with approximately 40,000 newly-contracted HIV infections per year. By gender, 70% of new HIV infections occur among men. Homosexual and bisexual men represent the largest proportion of new infections, followed by men and women infected through heterosexual sex and intravenous drug use. More than half of new HIV infections occur among African-Americans although they represent only 13% of the total U.S. population. Hispanics, who comprise only 12% of the total U.S. population, are also disproportionately affected.

As of December 2000, an approximate 774,467 AIDS cases had been reported in the U.S. with 640,022 cases reported among men, 134,441 among women, and 8,908 among children ages twelve and under. By race/ethnicity, 330,160 AIDS cases were attributable to Caucasians, 292,522 to African/Americans, and 141,694 to Hispanics. In 2003 alone, 44,232 new cases had been reported in the U.S.

Since the discovery of the disease, every year sees an increasing number of people of who are living with AIDS. Better treatments have led to a better control of symptoms, associated complications, and their severity, as well as a decreased number of fatalities from AIDS. This has all attributed to the increased numbers of people living and working with AIDS. This growing population represents an increasing need for HIV prevention services for infected individuals, treatment, and care services.

The incubation period for HIV is 20-60 days before a test will produce a positive result. There is no vaccination and no cure at this time.

There is much to consider when dealing with crime and trauma scenes that have been contaminated with human blood, body fluids, body tissue, and feces. The importance of taking safety precautions when dealing with these types of scenes cannot be stressed enough.

AIRBORNE PATHOGENS

Tuberculosis

Tuberculosis (TB) is spread primarily through droplet nuclei suspended in air such as from coughing and sneezing, etc. The symptoms include weight loss, weakness, fever, night sweats, coughing, chest pain, and coughing up blood.

Employees with an increased occupational exposure to bloodborne pathogens also have the potential for occupational exposure to persons with the Tuberculosis disease. Tuberculosis can cause disease in any organ, however, it most commonly affects the lungs, which account for approximately 85% of all infection sites. Other commonly affected sites are the lymph nodes, central nervous system, kidneys, and the skeletal system.

TB is a serious and often fatal disease if left untreated. Between 1985 and 1992, the incidence of TB in the total U.S. population increased approximately 14%, reversing a 30-year downward trend. Increased funding and attention to the disease instigated a brief decline in the number of new TB victims. However, complacency and cutbacks in funding have resulted in a recent rise of TB cases. More than 16,000 new cases were reported in the U.S. in 2000 alone.

Hantavirus

Hantavirus Pulmonary Syndrome (HPS) is a deadly lung disease transmitted by the urine, feces, or saliva of infected rodents. Humans are susceptible to contracting the disease from breathing the virus in aerosolized form, found when stirring up dust when sweeping. HPS was first recognized in 1993 and although rare is still potentially fatal. Rodent control in and around the home remains the primary strategy for preventing the Hantavirus infection.

Early symptoms of HPS include fatigue, fever, and muscle ache. Other symptoms may include dizziness, chills, and abdominal distress such as nausea, diarrhea, and pain. Approximately half of all HPS patients experience these symptoms.

Late stage symptoms occur within four to ten days after the initial phase of the illness. These symptoms include coughing, shortness of breath, and a tightening sensation in the chest. Survivors describe this sensation as feeling as though they had a "tight band" around their chest and a pillow over their face. This sensation is due to the lungs filling with fluid.

Uncommon symptoms may include earache, sore throat, runny nose, and rash.

Due to the rarity of Hantavirus, the number of existing victims is relatively low and does not allow for extensive or prolonged research. A lack of research subjects has left the precise period of incubation as yet undetermined. On the basis of what limited information in existence, it appears that symptoms may develop between one and five weeks after initial exposure to urine, feces, or saliva of the infected rodents.

Data from the CDC indicates that many victims became ill even though they were not in any situations in which they saw rodents or evidence of rodent activity. Yet others reported having had frequent multiple contact with rodents and their droppings before becoming ill. This inconsistency in reporting makes it difficult to determine a more precise time of viral transmission.

Treatment for HPS

At present, there is no specific treatment or cure for Hantavirus disease. However, if the symptoms are recognized early enough and the victim seeks medical attention immediately, the chances for recovery are increased significantly. If someone shows signs of the disease, they should be taken to an intensive care unit immediately to be intubated and given oxygen therapy to aid them through the period of respiratory distress. The earlier a patient receives medical care, the better the chances of recovery. The more advanced the distress, the less likely the treatment will be effective. If someone displays symptoms of fever, deep muscle aches, and severe shortness of breath, he/she should tell a physician if he/she has been exposed to rodents so the physician will be alerted to the possibility of HPS or other rodent associated disease.

 

Clandestine Drug Labs

The Texas Department of Public Safety (DPS) Narcotics seized 122 clandestine methamphetamine labs in 2002. This number was more than 542% increase from the 19 labs seized in 1998. A growing demand and easy accessibility to the chemicals necessary to make methamphetamine have led to an increase in its production and usage.

The growing meth problem is a threat to the public, law enforcement, firefighters, and hazardous-materials personnel. The production of methamphetamine involves the use of explosive, flammable, and carcinogenic (cancer-causing) chemicals. Any person coming in contact with these chemicals can face a variety of life-threatening symptoms, including chest pains, shortness of breath, dizziness, and burns.

Colonel Thomas A. Davis, Jr. states, "The production of meth is dangerous to those who cook it and use it, but the danger is not limited only to them. Anyone who comes in contact with these labs is exposed to dangers that can produce life-threatening injury, death and destruction of property."

The ease of manufacturing meth has caused a rise in the number of new labs and the creativity of the locations of these new labs. These labs are not always located in a dwelling, and are being found with increasing frequency in vehicles. The advantages to having an easily mobile lab is very appealing to manufacturers of methamphetamine.

Many of the contaminants present during the methamphetamine cooking process can be harmful if someone is simply exposed to the materials in the raw. The cooking process will change the nature of these chemicals making them more volatile. These contaminants can cause health problems including respiratory distress, skin and eye irritation, headaches, dizziness and nausea. Exposure to meth residues may cause symptoms similar to those experienced by meth users. Exposure to volatile organic compounds (VOCs) may include nose and throat irritation, headaches, dizziness, nausea, vomiting, disorientation/confusion, and difficulty breathing.

Benzene, a main ingredient in meth, is known to cause cancer. Acids and/or bases involved in the production of meth can cause a burning sensation on the skin and in mucous membranes, and can cause severe eye damage. Exposure to metals and salts used in making meth can cause a wide range of health problems including respiratory irritation, decreased mental function, anemia, kidney damage, and birth defects.

Different manufacturers of meth use different recipes and cooking methods. These differences can create different and unknown by-products. The unknown is where the real risk and danger lies when dealing with clandestine drug labs. A professional company trained specifically in decontaminating drug labs is the only way to ensure that a site or residence is truly safe for your maintenance personnel, leasing agents, and future tenants.

TIPS FOR LANDLORDS

 

At the time a rental application is submitted:

Ensure application is complete.

Conduct a background check for:

Rental history

Employment history

Credit report

Criminal background

Meet every adult moving into the unit and require picture identification.

Be aware of renters appearances and behavior.

Make every tenant living in the unit complete an application with full background checks.

 

Walk the property often and look for signs of clandestine drug labs operation:

Excessive garbage: Specific to making methamphetamine, such as ether, benzene, Toluene/paint thinner containers, Freon, acetone, starting fluid, anhydrous ammonia, Red Devil Lye, hydrochloric acid, propane cylinders, over-the-counter cold tablets (especially Sudafed).

Blackened windows or drawn curtains.

Frequent visitors at all or odd hours.

Paranoid/odd behavior.

Extensive security: Extra deadbolts, bars across doors, never allowing maintenance personnel in the apartment, etc.

Chemical odors: Over 50% of residential drug labs are found on rental property and the property owners are responsible for alerting law enforcement and must bear the burden of the decontamination costs.

 

When drug dealers operate out of rental property, owners pay a high price:

Loss of rent

Damaged Property

Decline in property values

Dangerous, threatening tenants

Resentful and angry neighbors

Loss of other valued tenants.

Remember, small changes can prevent BIG problems!

GROSS FILTH PROPERTIES

 

Gross filth properties are residences, businesses, or other areas include, but are not limited to being full of trash, newspapers, old clothes, cans, food, food wrappers, human feces, rodents and their droppings, urine, live and dead animals, etc.

Gross filth properties present three obvious health risks:

Human feces: risk of bloodborne pathogens and hepatitis A. Someone living in these conditions usually do not have good personal hygiene habits.

Hantavirus: refer to section on Airborne Pathogens.

Sharp Objects: gross filth properties are often associated with someone with major medical problems or drug use. This increases the risk of the presence of hypodermic needles, broken glass, sharp metal objects, etc. Refer to section on Bloodborne Pathogens.

These properties pose serious health hazards to those living in them, working around them and the future tenants. Imagine if you were the next tenant to move into the pictured property. Wouldn't you want to know it had been properly decontaminated?

Suicide, Homicide, Assault, Accident, and Human Decomposition Scenes

The following information may be unpleasant, but it is necessary to describe what to expect to see and smell at these scenes.

 

Suicides/Homicides

A common occurrence is an apartment manager, family member or maintenance personnel entering an apartment, observing a two-foot circular blood spot on the carpet, and focusing on that alone. Often that is nowhere near the extent of the contamination.

 

Our decontamination crews often cannot gauge the extent of the contamination until they are inside the unit in the process of decontaminating the scene. Often, this is when the crew discovers the blood spatters on the walls and ceilings, brain tissue and hair on walls and ceilings, and skull fragments that have ricocheted and scattered throughout the unit.

 

High velocity weapons can make the brain tissue act as Frisbees and fly around corners as it leaves the decedent's skull. Many times what appears to be a small area of blood is actually a highly contaminated scene. Not all scenes are contaminated to such an extent, however, nine times out of ten, the scene is much worse than people initially perceive.

 

Assaults

Assaults can be very similar to suicides and/or homicides in regards to the areas and level of contamination of a scene. The only difference may be is the victim did not die.

 

Accidents

Accidents include everything from shootings to esophageal rupture. Our crews often clean up pools of blood at airports where people were running with luggage and fell down, especially on escalators. Many people with terminal illnesses may lose control of their bowels and bleed internally causing bloody feces to be deposited throughout a dwelling. Accidents take many forms and many of them can be quite messy. An independent decontamination crew accustomed to such scenes can help properly clean this type of scene and make the dwelling safe for reentering.

 

Human Decomposition

How quickly a body decomposes depends on many factors including temperature and humidity. Decomposition is accelerated in warmer weather and decelerated in cooler climates or if the body is submerged in water. The human body begins the decay process approximately fifteen minutes after all life functions such as breathing and heartbeat have ceased.

 

While living, the lining in our intestinal tract protects our body from the acids and bacterium that would otherwise be harmful. Upon death, our protective coating in our intestines breaks down releasing the bacteria to begin feeding and consuming our body. The bacterium in the gastrointestinal tract produces gas as a waste product which causes the body to bloat. When the bloating has reached a maximum, the body ruptures and fluids drain out. These fluids will be extremely foul-smelling. Veteran police officers will often gag and/or vomit upon smelling these odors. They are very powerful and usually overwhelming even for people who have worked around them for many years.

 

This odor will permeate everything and every material such as wood, brick, metal, linoleum, etc. Carpets and all the padding usually must be replaced at scenes of decomposition. Depending upon weather conditions, size of the dwelling, number of porous materials in the dwelling and the amount of time the decedent was decomposing in the dwelling, it could possibly take several weeks to neutralize this odor. All contaminated items and materials must be removed or else this odor will remain for an indefinite period of time.

 

Throughout this process, insects are almost continually present. Flies can sense death and decay odor within minutes of the death of an organism. Research has proven flies can smell this odor from up to thirty-nine miles away under field testing conditions.

 

Flies lay eggs in soft tissue and moist areas such as the eyes, wounds, nose, mouth, rectum and vagina. The eggs develop into larvae, more commonly known as maggots. These maggots usually appear to be small, white and worm-like and will consume the soft tissue of the body. They will then mature into flies, lay more eggs, and the cycle repeats itself. A forensic entomologist (study of insects/arthropods) can determine the time of death very closely due to the activities of the insects being very time specific and predictable. It is imperative that a crime scene be disturbed as little as possible by non-professional personnel so as not to lose any potentially valuable forensic evidence.

 

When a body decomposes on cold concrete, it will produce a residue that is white/opaque in color called adipocere, or more commonly known by the funeral industry as Grave Wax. Grave wax is actually comprised of body fat. This grave wax could be used to make candles in the same manner as any animal fat is used to make candles.

 

When bodies decompose, they change and they change dramatically. DryHero/DeconHero has performed crime and trauma scene decontamination in which bodies had been lying undisturbed and decomposing for more than ten months. The odor was still very strong even after ten months. This is the reason why fluid-soaked carpet, padding, lightweight concrete, plywood and sheetrock must often be removed from the property. Body fluids do not evaporate and can take months or even years to dry.

 

It is a common scenario for people to die while lying in bed or sitting on their couch/recliners. The blood and body fluids will seep into and usually all the way through the couch, chair, mattress, box springs, carpet, carpet padding, and into the lightweight concrete floor. If the unit is an upstairs apartment, the fluids can seep into the space between the floors and onto the sheetrock of the ceiling below.

 

A professional company specializing in this type of work with the necessary experience will know where to look for these fluids and will know how to decontaminate the scene properly. If this work is not performed properly, continual odor and insect problems will manifest themselves in this unit and possibly adjacent units. Imagine a new tenant taking his/her first hot shower in their new apartment. The bathroom becomes all hot and steamy and the blood begins to seep out from underneath the commode or bathtub or the odor of decomposing human remains filters in through the ceiling tiles. Imagine the nightmare this will cause for the new tenant and for your company.

 

Crime and trauma scenes and human decomposition can be and cause nightmares for all personnel involved. Apartment maintenance and other employees are not usually trained or prepared to handle such scenes. Those entering a scene without being emotionally capable of handling what they see and/or smell may be at risk for Post Traumatic Stress Disorder and a myriad of other problems.

 

Remember: viewing crime and trauma scenes can be a life-altering event. You cannot undo seeing or smelling such scenes. Once the damage is done, it cannot be undone.

 

Critical Incident Stress Syndrome

Critical Incident Stress Syndrome (CISS) can occur after a person has been involved in or witnessed a traumatic event or several events which accrue over time. These events may include an auto accident, natural disasters (hurricanes, tornados, homicides, suicides, natural death of relative or friend, or even the death of a pet. The greater significance with which you view the event in your personal life, the greater the stress it brings into your life. When involved in an emotionally charged incident in which a human or animal has lost his/her life, been raped, brutalized or injured, it is difficult not to be affected personally and emotionally.

 

The most effective method for preventing CISS is to not subject yourself or your personnel to these situations. These incidents should be handled by workers who are trained to handle these specific situations and are trained in CISS management techniques and strategies as part of their occupational hazard training.

 

If your personnel have been exposed to a disturbing scene or traumatic event, please conduct a CISS debriefing by a trained mental health professional or ensure that the person seeks some type of counseling immediately.

 

Post Traumatic Stress Disorder

Post traumatic stress disorder (PTSD) is a psychiatric injury incurred by experiencing an event that is extremely traumatic for the person confronted with the incident. It is generally a single, traumatic event such as the sudden death of a loved one, witnessing someone�s death, a horrific accident, a police officer shooting someone in the line of duty, hostage situations, a bank robbery, rape, assault or torture, natural disasters such as hurricanes or tornados, or terrorist attacks. There are an infinite number of incidents that can lead to the development of PTSD. The list could go on and on.

 

PTSD became almost a household word after Vietnam veterans returned to the U.S. in the 70s and began displaying psychological and physical problems such as flashbacks, spontaneous outbursts of anger/rage, depression, and high incidences of drug and alcohol abuse. PTSD received a great deal of attention after a number of workplace (mostly postal services offices) shootings occurred and the gunmen were found to be veterans suffering from PTSD.

 

Some of the recent events that have been attributed to causing PTSD include the 2004 Christmas tsunami, the terrorist attacks on 9-11-2001, the Oklahoma Federal Building bombing, Hurricane Katrina, etc.

 

The fundamental element of PTSD is that the symptoms develop after a traumatic event that is outside the range of usual human experience. This excludes events outside of simple grief and/or bereavement, long-term or chronic illness, financial losses, and marital conflict (DSM-III-R 1987, p. 247).

 

After a person has been exposed to a traumatic event (an event in which they have experienced, witnessed or were confronted with life threat, serious injury or physical threat to themselves or others), and has experienced intense fear, helplessness, or horror (for children, disorganization or agitation), he or she may develop PTSD or some trauma symptoms. (Nader 2001).

 

Symptoms of PTSD are generally divided into two categories: physical and emotional. Some physical symptoms may include restlessness, nausea, tenseness, digestive trouble, headaches, insomnia, tremors and sexual problems. (Texas Department of State Health Services 2005).

 

According to the DSM-III-R, the diagnostic criteria for PTSD is as follows:

The person has experienced an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone, e.g., serious threat to one�s life or physical integrity; serious threat or harm to one�s children, spouse, or other close relatives and friends; sudden destruction of one�s home or community; or seeing another person who has recently been, or is being seriously injured or killed as a result of an accident or physical violence.

 

The traumatic event is persistently re-experienced in at least one of the following ways:

Recurrent and intrusive distressing recollections of the event (in young children, repetitive play in which themes or aspects of the trauma are expressed)

Recurring distressing dreams of the event

Sudden acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative [flashback] episodes, even those that occur upon awakening or when intoxicated)

Intense psychological distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma

Persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

Efforts to avoid thoughts or feelings associated with the trauma

Efforts to avoid activities or situations that arouse recollections of the trauma

Inability to recall an important aspect of the trauma (psychogenic amnesia)

Markedly diminished interest in significant activities (in young children, loss of recently acquired developmental skills such as toilet training or language skills)

Feeling of detachment or estrangement from others

Restricted range of affect, e.g., unable to have loving feelings

Sense of a foreshortened future, e.g., does not expect to have a career, marriage, or children, or a long life

 

Persistent symptoms of increased arousal (not present before the trauma), as indicated by at least two of the following:

1.     Difficulty falling or staying asleep

2.     Irritability or outbursts of anger

3.     Difficulty concentrating

4.     Hypervigilance

5.     Exaggerated startle response

6.     Physiologic reactivity upon exposure to events that symbolize or resemble an aspect of the traumatic event (e.g., a woman who was raped in an elevator breaks out in a sweat when entering any elevator)

Duration of the disturbance (symptoms in B, C, and D) of at least one month (DSM-III-R 1987, p. 250-51).

Hiring a professional company that is trained to emotionally handle a crime or trauma scene is the best way to assure your employees are not placed at great risk of developing Post Traumatic Stress Disorder.

OSHA

OSHA generally has two meanings: one refers to Public Law 91-596-Occupational Safety and Health Act of 1970. The other refers to the governmental entity, the Occupational Safety and Health Administration. This agency oversees and enforces the Occupational Safety and Health Act.

 

OSHA requirements for an employee to be exposed to blood, body fluids, human tissue or feces: Federal Regulations 29CFR1910.1030 states that no employee can be placed in a position to be exposed to blood spills without first:

Employees have received Bloodborne Pathogen (BBP) training. This article does not satisfy this requirement.

The company has a written Bloodborne Pathogen exposure control plan and all employees must have access to it.

Employees have been provided the proper personal protective equipment and instructed in the proper sizing and use of this equipment.

Employees have been offered the hepatitis B vaccine, exposure evaluation and follow-up.

Employees are provided with a method to remove and properly store the bio-hazardous waste in properly marked containers for disposal at an approved site.

Even if your company meets all the above specifications, psychological dangers still exist for your employees. Maintenance personnel were hired to maintain the property not to emotionally handle situations such as crime, trauma or decomposition scenes.

 

The best way to ensure a scene is handled under OSHA compliance standards is to hire an OSHA compliant contractor to clean and decontaminate this type of scene.

 

Liability Issues

One concern that should be in the forefront of your company's mind is the issue of legal liability. Unfortunately, anyone can sue anybody, about anything, anywhere, anytime and often do. Anytime proper action is not taken, your company becomes vulnerable to lawsuits no matter how frivolous.

 

Crime and trauma scenes need to be properly cleaned and decontaminated to assure future residents, employees and neighbors are not at risk of exposure to bloodborne pathogens.

 

What is the possibility of a lawsuit arising after a new tenant takes a hot bath and blood seeps from underneath the bathtub?

 

Imagine the lawsuit and the bad business reputation gained when brain tissue on the ceiling which has been painted over falls onto the new resident's dining table during dinnertime?

 

How do you explain to a new resident that the odor in their new apartment is from human decomposition?

 

How will you explain to a mother that her child has potentially contaminated blood on their skin, hair, and/or clothes because he/she touched something in the dumpster that was contaminated with biohazardous fluids such as a bloody carpet? The apartment complex's dumpster is not considered a place of proper disposal. Businesses and residents place contaminated materials in their dumpsters all the time in complete disregard for their potential liability or other residents' health and welfare.

 

Make sure every action taken by your employees is as professional as possible and falls under the premise of best practices when performing any type of work. Quality workmanship and attention to detail should never be scrimped on just to save a few dollars. Lawsuits are very expensive.

 

Summary

To assure the safety of employees, residents, and others, one must always assume that any blood, body fluids, human tissue, or feces could be infected with a number of pathogens that can cause illness and even death.

 

There is no need to overreact and burn down a building to decontaminate a site just because someone died or had an accident in it. These scenes can be properly decontaminated by a professional company that specializes in this type of work.

 

ALWAYS PROCEED WITH CAUTION AND ERR ON THE SIDE OF SAFETY.

About the Author

Mr. Michael Tillman founded Amdecon, Inc. in 1999 after discovering that in the aftermath of a suicide, homicide, or decomposition scene investigation was completed, the family, property owner, or property manager was left with the overwhelming task of cleaning up the scene as best as they possibly could.

Mr. Tillman believed that as a society, we could do better. He did not believe these families, property owners, and property managers should be traumatized any further by performing the cleanup and decontamination themselves.

Mr. Tillman is an OSHA certified trainer and is also certified in Hazardous Materials, Weapons of Mass Destruction, and HAZMAT & Safety of Clandestine Drug Labs.

Since 1999, Amdecon has become the leader in crime and trauma scene services and training. Amdecon strives to treat each client as they would their own friends or family members. Amdecon�s goal is to take a terribly tragic situation and, in our own way, bring a little light into the darkness. We do everything possible to make a bad situation a little better for the families, friends, property staff or owners and to help speed the healing process.