Health and safety hazards and associated organisational and social support factors for deathcare workers: a global scoping review

Abstract

BACKGROUND: Contrary to the guidelines of International Labour Organisation and the World Health Organization (WHO), most deathcare facilities lacked appropriate and adequate engineering and administrative controls, as well as the personal protective equipment (PPE) necessary for the safe management of dead bodies. This review explored work practices of deathcare workers, focusing on work-related health and safety hazards and associated organisational and social support systems utilised by these workers. METHODS: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and the JBI methodological guidelines for scoping reviews. A comprehensive literature search was performed across multiple databases, including PubMed, Dimensions, Embase, ProQuest, Academia, Web of Science, WHO Global Index Medicus, ScienceDirect, EBSCOhost, CINAHL Complete, WorldWideScience, JSTOR, Mendeley Data, University of Minnesota Libraries, Taylor & Francis, Wiley, Cambridge Core, Journal of Death and Dying, and Google Scholar. Consistent with the inclusion and exclusion criteria, thorough screening and data extraction were performed. In addition, qualitative thematic analysis and synthesis were employed to present the findings. RESULTS: 64 peer-reviewed, full-text articles were included in this review. The findings identified physical or ergonomic, biological, chemical, and psychosocial hazards, as well as indoor air pollution, as common work-related risks faced by deathcare workers worldwide, with significant variations in exposure rates. Furthermore, safety controls and sociodemographic characteristics of workers influenced their participation in safety practices and the overall workplace safety climate. Inadequate engineering and administrative safety controls, inadequate supply and use of PPE, and improper adherence to donning and doffing protocols contributed to the high exposures among these workers. Unfortunately, deathcare facilities lacked clear social support systems and compensation schemes for their employees. Meanwhile, workers employed both positive and negative coping strategies to manage work-related hazards. CONCLUSION: The use of inappropriate working tools and equipment, insufficient training, lack of supportive monitoring and supervision, inadequate medical screening, inadequate vaccination, and absence of post-exposure prophylaxes negatively impacted deathcare workers' safety participation and the overall workplace safety climate. Robust policy interventions are necessary to ensure effective implementation of counseling services, compensation schemes, supportive monitoring and supervision, and the consistent supply and use of PPE by these vulnerable workers.