Prosector - Occupational Risks

Occupational Risks

Generally, the risks to prosectors are low. Cadavers used for teaching purposes are embalmed before they are encountered by a prosector and students. Embalming fluid usually contains formaldehyde, phenol, dettol and glycerine which disinfect and kill pathogens within the cadaver. With exposure to embalming fluid, tissues and bodily fluids, such as blood, become fixed. Prosectors and students working with embalmed cadavers must always wear protective gloves, however this is more for protection against the harsh chemicals used in embalming such as formaldehyde and dettol which can cause moderate to severe skin irritation.

Further to the protection that embalming allows against disease, educational institutions take great care in screening the cadavers accepted into their body donation programs. Cadavers are not accepted if they have a medical history of infectious disease such as tuberculosis and AIDs/HIV.

Prosectors for autopsies of diseased cadavers may run a high risk of suffering from health problems when caution is not used as cadavers are not fixed when being dissected for autopsy. At least two diseases are named after prosectors:

• Prosector's paronychia: a primary inoculation of tuberculosis of the skin and nails.
• Prosector's wart, a skin lesion, also caused by contamination with tuberculous material

Contracting infections caused by contaminated cadavers is a constant danger among prosectors, particularly if a skin puncture accident results from the sharp surgical instruments used in this kind of work (about 70% of pathology workers report having at least one percutaneous incident). In this case, thin surgical gloves are not enough to protect. There are many cases of pathologists who died of acute septicemia (blood poisoning) because of this. Another example, a famous historical case, is that of Dr. Ernst von Fleischl-Marxow, an Austrian physician, pathologist and physiologist, who infected his finger during an autopsy and became dependent on morphine, due to the pain; and, later, on cocaine, by instigation of his friend, Sigmund Freud.

Presently, AIDS presents a problem. Although it is difficult to contract it by a single puncture incident (the overall personal risk has been estimated to be 0.11%), at least one case has been reported among pathologists.

The continuous respiratory exposure to formaldehyde, used to preserve cadavers, is also an occupational risk of prosectors as well as medical students, anatomists and pathologists. Inhaled formaldehyde can irritate the eyes and mucous membranes, resulting in watery eyes, headache, a burning sensation in the throat, and difficulty breathing. Formaldehyde is listed as a potential human carcinogen.