Employee Infectious Disease Risks at Cadaver Anatomical Donation Center

The CDC is investigating reports of potential occupational exposure to human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Mycobacterium tuberculosis among workers performing preparation and dissection procedures on human non-transplant anatomical materials at a non-transplant anatomical donation center in Arizona. The CDC is working with Arizona public health officials to inform persons exposed to these potentially infected materials.


Non-transplant anatomical centers around the United States process thousands of donated cadavers annually. These materials (which might be fresh, frozen, or chemically preserved) are used by universities and surgical instrument and pharmaceutical companies for medical education and research.


The American Association of Tissue Banks has developed accreditation policies for non-transplant anatomical donation organizations. It also has written standards that specify exclusion criteria for donor material, as well as use of proper environmental controls and safe work practices to prevent transmission of infectious agents during receipt and handling of non-transplant anatomical materials. At the center under investigation, which is now closed, these standards might not have been consistently implemented.


The CDC has assisted Arizona public health officials in notifying former workers at the center regarding potential exposure to HIV, HBV, and HCV, and M. tuberculosis while preparing non-transplant anatomical materials. These blood borne pathogens can be transmitted when blood or other potentially infectious materials contact mucous membranes, such as the eyes, mouth, or non-intact skin, or when they enter the body through a percutaneous injury such as a needle stick or scalpel wound. M. tuberculosis can be transmitted by infectious aerosols generated by manipulation of infectious tissues.


Arizona public health officials have offered former workers at the center cost-free testing for HIV, HBV, and HCV, and M. tuberculosis infection as well as counseling regarding these infections. End users of non-transplant anatomical materials for medical training or research purposes are thought to be at considerably lower risk for infection because of the reduced survival and infectivity of these organisms over time, and are being notified separately where possible. Waste treatment, storage, and transportation workers handling containers or packaged non-transplant anatomical materials would not directly contact these materials during regular work and are not considered to be at risk unless there is a spill of infectious material. If a spill were to occur, proper disinfection procedures, determination of employee exposure, and worker follow-up with an assessment of transmission risk should take place, per facility protocols and the Bloodborne Pathogens Standard of the Occupational Safety and Health Administration (OSHA).


Employers and employees in the non-transplant anatomical donation industry and end users should recognize that cadavers and non-transplant anatomical materials are considered potentially infectious with M. tuberculosis and other pathogens, even if they are known to test negative for HIV, HBV, and HCV. Employers must comply with the OSHA Bloodborne Pathogens Standard, which requires a written exposure control plan, use of engineering and work practice controls, appropriate personal protective equipment, and provision of hepatitis B vaccine to employees assigned to jobs with occupational exposure risk.


See the CDC Report