Moving and Handling Issues in the Mortuary Environment
This article highlights some areas for consideration when examining moving and handling in a
Mortuary environment, with particular emphasis on the load, tasks undertaken, equipment in
use, handlers and environmental aspects. A future article will discuss how safer manual
handling practices may be developed and promoted.
Introduction
The moving and handling of the deceased is a daily occurrence in health and social care, as
well as a significant component of work within the funeral industry (Revie, 2000). Both sectors
use mortuaries, and this particular environment will present a number of specific requirements
with regard to manual handling within the course of a working day. This is especially so given
the nature of the load(s), the tasks that are undertaken, the equipment associated with them
and the individuals involved.
As part of general legislation covering health and safety in the workplace, the Manual Handling
Operations Regulations (MHOR) 1992 set out specific measures concerning the safe manual
handling and management of loads. These include a requirement to avoid the manual handling
of loads wherever possible, assess hazardous operations and to reduce any risks involved. This
may be addressed through the provision of information, training and appropriate equipment as
well as an ongoing process of review.
It therefore follows that an examination of the working practices within a mortuary environment
will highlight those aspects of work which present manual handling hazards. This information
can then be used as a basis from which safer working practices may be established. Some
suggested areas for consideration are discussed below.
The Load
A detailed examination of the load to be moved is an essential element of any manual handling
risk assessment. The weight, size and shape of a person can present considerable difficulties
when it comes to moving and handling them in a dignified manner. Most adults and children are
considered too heavy and awkward to be manually lifted safely and this is reflected in Health
and Safety Executive (HSE) guidance on weights (1992). Putting weight aside, when viewed
purely in terms of a ‘load’, several other qualities become apparent, which lead to even a cooperative person being difficult to handle. The ‘load’ is often unstable, the weight unevenly
distributed and it is not always possible to secure sufficient grip or adopt a safe posture in order
to facilitate an effective transfer.
It therefore follows that the moving and handling of deceased persons is likely to be
problematic. Weight, again, is an issue because it is likely to be beyond the HSE guidelines.
Further factors that pose challenges to manual handling may also be present and it is important
to identify these so that the features of individual loads can be ascertained.
In the mortuary, bodies will differ in their presentation. The nature of the load to be handled may
be affected by factors such as the presence or absence of clothing or other covering; muscle
rigidity or flaccidity; general skin condition; and the accumulation of fluid. The presence or
suspicion of infection or contamination and the procedures required to manage this are also
important considerations.
The time and circumstances of death will influence the general condition of a body. A recently
deceased body that has been moved directly from a hospital ward to a hospital mortuary may
present very differently from a body that has been transferred from the community, having been
found in a neglected state. Similarly, the body of a person who has died in traumatic
circumstances may differ significantly from that of one who has died from natural causes.
Tasks Undertaken
The tasks undertaken in a mortuary environment will depend very much on its ownership,
location and size. A large NHS mortuary on an acute hospital site may serve the local
community and other NHS Trusts, as well as the hospital itself. Such a mortuary may provide a
clinical environment for post-mortems and a training resource, as well as storage for the
deceased on a short or long-term basis. On the other hand, a small mortuary within the funeral
industry may be used primarily for short-term storage, facilitating embalming prior to coffining.
Clearly, the tasks will vary between mortuaries and may be influenced by the available facilities,
equipment and number of staff (handlers). Some examples are given here, considering tasks in
terms of both transfers and clinical issues.
Transfers may include moving a body between:
 surfaces of equal height, such as a trolley to another of equal height
 surfaces of different heights, such as a fixed height trolley to a lower/higher fixed height
trolley
 storage facility and examination surface, such as fridge racking to post mortem table
 container and storage facility, such as concealment trolley to mortuary tray
 different rooms, such as storage room to relatives viewing room
 mortuary and vehicle, such as undertaker’s vehicle
Clinical issues may include:
 carrying out post-mortem examinations
 accurately weighing the body
 controlling infection
 dealing with contamination
 cleaning and decontamination of equipment
 facilitating relatives viewing
 maintaining appropriate working and storage temperatures
Equipment
Clearly, the equipment used within in a mortuary will reflect the precise environment and the
tasks carried out within it. A brief list of equipment that may be used in a mortuary is given here.
 Mortuary tray
 Fixed height trolley
 Variable height trolley
 Refrigerator
 Refrigerator racking system
 Post-mortem table
 Weighing scales
 Concealment trolley
 Body bag
 Stretcher
 Coffin
 Undertaker’s trolley
Handlers
The roles, backgrounds and numbers of handlers who will be carrying out moving and handling
tasks within a mortuary will be determined by the wider context and environment in which the
mortuary is situated and the demands that are placed upon it. As with many manual handling
situations, the procedures and techniques that are routinely used in a mortuary will be
influenced by the employing organisation and it’s particular approach to manual handling
operations in terms of the 1992 regulations. This will inform the general awareness of the tasks
that take place in a mortuary and consequently the hazards that are present and the risks posed
by them. This, in turn, will be reflected in the number of mortuary staff employed and the
particular roles and responsibilities that they are required of them.
On an individual level, mortuary employees will have various degrees of occupational fitness,
experience and training and their understanding of risks and approaches to safety will differ
accordingly. If staff have not been sufficiently educated in the dangers of manual handling, it is
unlikely that they will be aware of undertaking manual handling operations that could be
hazardous. The tradition, policies and procedures of their employing organisation and an
industry as a whole may also give the impression that certain activities are expected of them.
For example, if an employee is expected to work alone he may believe that he is expected to
carry out all tasks independently. If there is no equipment made available to him, he may
presume that it is not needed. Custom and practice within a workplace may cause employees to
establish routines and carry out activities in such a way that they believe it to be acceptable, and
any suggested change is viewed as unnecessary, even if current practice is deemed to be
unsafe.
Environment
As with any other area in which the moving and handling of loads is necessary, the structure
and layout of a mortuary will impact upon the ease with which tasks can be undertaken. Basic
internal structural and environmental factors such as floor space, levels and surfaces, along with
doorways, ceiling heights and lighting are important. Aspects such as low lighting levels, wet
floors, tiled surfaces and frequently used doors can present additional hazards to the movement
of loads.
Some mortuaries may comprise several different rooms and areas, each with different purposes
and features to consider. For example, a clinical area, such as a post-mortem room, is likely to
have a floor covering that facilitates ease of cleaning and de-contamination, but this may also
mean that it can become slippery. A post-mortem room is likely to be more spacious than a
relative’s viewing room, which is often carpeted and lit less brightly. The need to move the
deceased between areas, such as from a storage area to a relatives viewing room may require
movement through doorways as well as across different floor surfaces.
The area in which bodies are received at the mortuary, and that from where they are later
transferred onward also needs to be considered, particularly if there is a requirement to move
bodies through security doors or to and from vehicles. The location of parking bays, the space
around them and the type of ground covering can present significant hazards to the handling of
loads in and out of vehicles.
Conclusion
It can be seen that there are many factors that require attention when moving and handling
within a mortuary environment. Although these will vary significantly between different
mortuaries, there is a need for practitioners to apply two underlying principles, regardless of
where such tasks are undertaken or which employing organisation is ultimately responsible for
them.
The first principle is that all moving and handling tasks should be implemented in accordance
with the requirements set out in the Manual Handling Operations Regulations 1992, to ensure
the safety of the handlers, the load and others using the working environment. The second
principle is that the dignity of the deceased should not be compromised and thus all moving and
handling tasks should be fulfilled in a professional and respectful manner.
END
References
Health and Safety Executive (1992) The Manual Handling Operations Regulations London:
HMSO
Health and Safety Executive (1992) Manual Handling Guidance Regulations London: HMSO
Revie, M. (2000) ‘Manual handling of the deceased in the funeral industry’ in The Column 12 (3)
17-20
Author
Debra Hall, MSc (OT), Dip COT, SROT, Moving and Handling Specialist, Chiltern Invadex Ltd,
Chiltern House, 6 Wedgwood Road, Bicester, Oxfordshire OX26 4UL
Date
19th July 2002