Volume 6: Human Health, 1989-96
8.
Development of guidance on occupational risks from BSE and other TSEs
1996
Guidance for neuropathologists and mortuary workers: 1991-95
Update on guidance
8.145 On 2 January 1996, Mr M Sebastian (Livestock NIG, HSE) wrote to Mr Lister referring to the recent meeting of the CDTFZ & BSE, pointing out that his NIG had not been invited to attend and that the Livestock NIG had a crucial interest in the issue. 1
8.146 Also, in January 1996, HSE/Meat Trades Joint Working Party issued a revised edition of Guidance Note 5 to all abattoirs slaughtering cattle. 2
8.147 On 15 January 1996, Mr Lister wrote to Dr Ailsa Wight, the DH representative on the CDTFZ & BSE and also the DH observer on SEAC. He said that HSE had been granted observer status on SEAC and that he would, for the time being, fill that role. 3 He stated that at the last SEAC meeting (5 January 1996) the recent case of suspected CJD in an abattoir worker was to be discussed but was not raised. He asked for a list of dates for forthcoming meetings and prior notice of any information or issue connected to occupational risks from BSE exposure.
Guidance for neuropathologists and mortuary workers: 1991-95
8.148 This section describes the various sets of guidance that were developed during 1991 through to 1995, to address the occupational hazards from BSE and other TSEs to laboratory workers and mortuary workers. Some of this guidance, as described below, was developed independently from the HSE.
8.149 In 1991, Dr Jeanne Bell, a neuropathologist from Edinburgh and member of the CJD Surveillance Unit, produced a protocol entitled 'Department of Health CJD Surveillance - Neuropathology; Guidance for autopsy protocols in suspected CJD cases, in relation to differing local facilities', 4 which was incorporated in a Medical Research Council (MRC) clinical booklet. 5
8.150 Also, in 1991, guidance entitled 'Safety In Health Service Laboratories: Safe Working and the prevention of infection in the mortuary and post-mortem room' was produced by a Technical Sub-Committee Working Group of the Health Services Advisory Committee (an advisory Committee for the HSC). 6 Mr Lister was a member of this Working Group. The guidance did not mention BSE or CJD but focused on good hygiene practice and the safe handling of instruments likely to cause puncture wounds or cuts. 7 In 1993, Dr Bell and Dr Ironside prepared detailed guidance entitled 'How to tackle a possible Creutzfeldt-Jakob disease necropsy'. 8
8.151 In July 1994, a report entitled 'Precautions for work with human and animal Transmissible Spongiform Encephalopathies' was issued by the ACDP. 9 This report contained a section that gave more detailed guidance for neuropathologists and mortuary workers. The development of this guidance is described in the next section.
8.152 On 28 April 1995, the Communicable Disease Report Review published an article entitled 'The infection hazards of human cadavers' by T D Healing of the London Communicable Disease Surveillance Project, P N Hoffman of the Laboratory of Hospital Infection, Public Health Laboratory Service, and S E J Young, Fellow of the Royal College of Physicians, London. 10 This included a section on TSEs. The guidance contained in the article was addressed to doctors (especially pathologists), technical staff in pathology, morticians, funeral directors, embalmers and members of the emergency service who were exposed to risks from the recently deceased.
1 YB96/01.02/3.1
2 YB96/01.00/12.1-12.3
3 YB96/1.15/9.1
4 YB91/06.00/3.1-3.8
5 YB91/8.06/3.4. Dr Bell was also an expert member of the Advisory Committee on Dangerous Pathogens Working (ACDP) Group on SEs (for full discussion about this group see later in this chapter). The group during their deliberations endorsed her protocol as it was recognised that neuropathologists were in need of urgent guidance
6 Health and Safety Executive, HMSO, 1991. The guidance stated that it was 'an authoritative document which will be used by health and safety Inspectors in describing reliable and fully acceptable methods of achieving health and safety in the workplace'. It remained open to employers to achieve equivalent levels of health and safety using other acceptable means: if so, reference was likely to be made to the document by Inspectors to demonstrate the level that had to be achieved. Although it had no legal force, its standing as agreed practical guidance meant that it could be referred to in a court or tribunal to demonstrate the standards that need to be met under the law. - Preface (v)
7 Health and Safety Executive, HMSO, 1991, p. 18
8 Journal of Clinical Pathology, 1993, 46, 193-7
9 M69A tab 5
10 YB95/4.28/5.1-5.8
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