Health Hazard Evaluation Report 2011-0146-3170 Page 1

Evaluation of Potential Employee Exposures 

During Crime and Death Investigations at a 

County Coroner’s Office 

Report No. 2011-0146-3170

March 2013

Bradley S. King, MPH, CIH; 

Kristin Musolin, DO, MS; 

JungHo Choi, MS

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health
Page 2 Health Hazard Evaluation Report 2011-0146-3170

Contents

Highlights...............................................i

Abbreviations ..................................... iv

Introduction......................................... 1

Methods ............................................... 4

Results .................................................. 6

Discussion .......................................... 16

Conclusions........................................ 19

Recommendations............................. 20

Appendix A ........................................ 23

Appendix B......................................... 25

Appendix C......................................... 29

References.......................................... 35

Acknowledgements........................... 41

The employer is required to post a copy of this report for 30 days at or near the 

workplace(s) of affected employees. The employer must take steps to ensure 

that the posted report is not altered, defaced, or covered by other material.
Health Hazard Evaluation Report 2011-0146-3170 Page i

We evaluated potential 

exposures among investigators 

at a county coroner’s office. We 

found that some exposures to 

formaldehyde in the autopsy 

suite exceeded recommended 

exposure levels. Lead 

contamination of surfaces in the 

firearms section and drug particle 

contamination of surfaces in 

the drug evidence laboratory 

may pose a health hazard. 

Recommendations are provided 

to improve work conditions and 

minimize exposures.

Highlights of this Evaluation

The Health Hazard Evaluation Program received a request from a coroner’s office in Ohio. 

The employer wanted to determine if conditions and work practices at the facility were 

posing a health hazard to employees.

What We Did

● We evaluated the facility in October 2011. We returned in January 2012 to complete 

our evaluation.

● We interviewed employees about their work and health. These interviews were confidential.

● We observed work practices and procedures 

in the autopsy suite, histology laboratory, 

fingerprint evidence laboratory, drug evidence 

laboratory, and firearms section.

● We sampled the air for formaldehyde and 

airborne particles during six autopsy procedures.

● We sampled the air for formaldehyde and 

volatile organic compounds. These samples 

were taken in the histology laboratory during 

tissue prepping and processing. 

● We took air samples for ethyl 2-cyanoacrylate. 

These samples were taken during fingerprint 

fuming operations.

● We took samples for residual drug particles. 

These samples were collected from the air and 

work surfaces in the drug evidence laboratory. 

● We sampled for lead. These samples were 

collected from the air and work surfaces in the firearms section.

● We evaluated the ventilation system in several areas.

What We Found

● Employees reported few health symptoms that they thought were related to their work.

● Some exposures to formaldehyde in the autopsy suite were above recommended ceiling limits.

● The number of air changes per hour in the autopsy suite was below recommended levels.

● Exposures to formaldehyde in the histology laboratory were below recommended 

ceiling limits. Air sampling for volatile organic compounds in the histology laboratory 

showed low levels of organic compounds commonly found in the indoor environment.

● Exposures to ethyl 2-cyanoacrylate during latent fingerprint development were low. 
Page ii Health Hazard Evaluation Report 2011-0146-3170

What We Found (continued)

● Airborne drug particles were found in the samples taken during drug analyses. Drug 

particles were also found on surfaces in the drug evidence laboratory. 

● Air did not flow from the shooter towards the target in the firing room as recommended 

for firing ranges. 

● Airborne concentrations of lead may be a health hazard to firearm examiners if they do 

multiple sessions of weapon testing during a work shift.

● We found lead contamination on surfaces in the firing room. The presence of lead could 

be a potential health hazard.

What the Employer Can Do

● Increase room exhaust in the autopsy suite. This will increase the number of air 

changes per hour in that area. 

● Install downdraft tables in the autopsy suite to help control formaldehyde exposures.

● Modify the supply and exhaust ventilation in the firing room to provide a laminar flow 

of air that passes from the shooter towards the bullet trap. Until modifications are made, 

limit the number of weapons tested in any one day.

● Perform procedures that could produce airborne particles of drugs under a highefficiency particulate air filtered hood. 

● Clean contaminated surfaces in the drug evidence laboratory and firearm examiners’

firing room. 

● Improve housekeeping practices to prevent build-up of surface contamination of lead 

in the firing room. This is also true for preventing build-up of drug particles in the drug 

evidence laboratory. 

● Use high-efficiency particulate air filtered vacuum or wet mopping methods to clean 

the firing range. Do not dry sweep in the firing range.

● Ensure exhaust vents are not blocked in the autopsy suites.

● Sample for lead and formaldehyde. This should be done as a follow-up to see if levels 

have changed after work practices are changed or controls introduced.

● Provide employees with recommended personal protective equipment including 

respirators, lab coats, gloves, safety goggles or glasses, and face shields. Make sure that 

employees are using this equipment for specific work practices taking place in the facility.

What Employees Can Do

● Use local exhaust ventilation attachments when using the saw for cranial autopsies.

● Only open containers of formaldehyde when needed during autopsies. 
Health Hazard Evaluation Report 2011-0146-3170 Page iii

What Employees Can Do (continued)

● Wash your hands with warm water and soap after completing work activities. Always 

wash after autopsies, weapon testing, and drug analysis. 

● Report any symptoms that you think may be related to your work to a supervisor. If you 

have concerns about safety, report those also. 

● Become active in the health and safety committee. Attend meetings and take any 

training that is related to your job. 

● Wear personal protective equipment that is recommended for the task you are doing. 

● Wear an N95 respirator approved by the National Institute for Occupational Safety and 

Health during autopsies.
Page iv Health Hazard Evaluation Report 2011-0146-3170

Mention of any company or product does not constitute endorsement by NIOSH. In 

addition, citations to websites external to NIOSH do not constitute NIOSH endorsement 

of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not 

responsible for the content of these websites. All web addresses referenced in this document 

were accessible as of the publication date of this report.

Abbreviations

μg Micrograms

μg/cm2 Micrograms per square centimeter

μg/dL Micrograms per deciliter

μg/m3 Micrograms per cubic meter

μm Micrometer

ACGIH® American Conference of Governmental Industrial Hygienists

BLL Blood lead level

C Ceiling limit

CDC Centers for Disease Control and Prevention

cfm Cubic feet per minute

CFR Code of Federal Regulations

HHE Health hazard evaluation

NAICS North American Industry Classification System

ND Not detected

ng/cm2 Nanograms per square centimeter

ng/m3 Nanograms per cubic meter

NIOSH National Institute for Occupational Safety and Health

OEL Occupational exposure limit

OSHA Occupational Safety and Health Administration

PEL Permissible exposure limit

ppm Parts per million

REL Recommended exposure limit

TLV® Threshold limit value

TWA Time-weighted average

WEELTM Workplace environmental exposure level
Health Hazard Evaluation Report 2011-0146-3170 Page 1

Introduction

The National Institute for Occupational Safety and Health (NIOSH) received a health 

hazard evaluation (HHE) request from managers at a county coroner’s office in Ohio. The 

request concerned possible health hazards associated with work practices in several sections 

including the autopsy suite of the coroner’s office during post-mortem examinations and 

various sections of the crime laboratory during the analysis of evidence related to criminal 

investigations. We evaluated the facility on October 7, 2011; October 20, 2011; and January 

10–12, 2012.

Facility Description

The coroner’s office occupied a four-story building completed in 1973. At the time of the 

evaluation, the office employed approximately 50 full-time and part-time staff. Two autopsy 

suites, coolers, a morgue, storage, and office areas occupied the first floor of the building. 

Administrative offices were on the second floor. The third floor housed the following sections 

of the crime laboratory: histology, toxicology, serology, firearms, trace evidence, arson, and 

documents. The fourth floor housed mechanical equipment. Separate air handling systems 

serviced the first three floors. On the first floor, the air handling system was a constant 

volume system designed to supply 10,800 cubic feet per minute (cfm) of air, providing eight 

different temperature control zones. Air supplied to the autopsy suites was exhausted directly 

outdoors, while air supplied to the first floor storage and offices areas was returned to the air 

handling unit for recirculation. The air handling system for the second floor was a constant 

volume system with a dual duct design to distribute 13,200 cfm of hot and cold conditioned 

air to terminal boxes where they were mixed to provide for temperature control for that area 

of the floor. Air was returned to the air handling unit from most spaces on this floor. For the 

third floor, the air handling system was a constant volume system also designed as a dual 

duct system that supplied 12,600 cfm of air. In general, air supplied to the laboratories was 

exhausted directly outside the building while air supplied to corridors and office areas was 

recirculated. However, because of space needs, laboratory functions were performed in some 

areas originally designed and used for office functions.

Work Process Descriptions

Employees in the coroner’s office performed a wide variety of specialized work processes to 

provide forensic services that supported local police investigations. 

In the autopsy suite, official autopsies were conducted for deaths from homicide, suicide, fires/

burns, certain accidents, and other suspicious or unusual deaths. During a typical autopsy, a 

pathologist and forensic assistant opened the decedent’s chest cavity to remove and examine 

the internal organs. Organ tissue samples were removed and placed in open containers of a 

formalin solution containing 37% formaldehyde in water and methanol. This solution was 

used to fix and preserve the tissue specimens for histologic examination. To gain access to the 

brain tissue, the skull cap of the decedent was removed with a hand-held oscillating Clean Cut 

Autopsy Saw system, model 04-NS3 (Leica Microsystems, Buffalo Grove, Illinois [formerly 
Page 2 Health Hazard Evaluation Report 2011-0146-3170

Surgipath Medical Industries, Richmond, Illinois]). No local exhaust ventilation system was 

employed when the bone-cutting oscillating saw was used.

Tissues collected during autopsies were 

fixed, processed, embedded in paraffin 

wax, sectioned, mounted on a slide, and 

stained for microscopic examination of 

the tissue cells in the histology laboratory. 

Following autopsies, these tissues were 

delivered to the laboratory in containers 

of 100–300 milliliters of formalin solution 

containing 37% formaldehyde. The tissues, 

contained in small cassettes, were removed 

from the containers and loaded into a tray 

for further processing. Typically, this work 

was done near a hood on the wall directly 

above the sink into which the formalin 

waste was poured after the cassettes were 

removed (Figure 1). Processing of the 

tissues sequentially removed the tissue 

fluids and replaced them with alcohol and 

paraffin so that the tissue was fixed in a 

block of paraffin. Chemicals used in the 

tissue processing included dehydrants such 

as ethyl, isopropyl, and methyl alcohol, 

and aliphatic hydrocarbons. The total time 

for loading tissue cassettes and tissue 

processing was 1–1.5 hours; this occurred 

once every other week at a minimum 

to twice a week at a maximum. After 

processing, the block was sliced, and the 

tissue specimens were mounted on a slide, 

stained, and viewed under a microscope.

In the fingerprint evidence laboratory, a 

latent fingerprint development process was 

used to recover fingerprints on a variety 

of evidentiary materials and objects. 

Several methods were available including 

the use of cyanoacrylate adhesive glue 

(super glue) fuming. The super glue used 

in this method contained more than 50% 

ethyl 2-cyanoacrylate. In this process, the 

object with the fingerprint on it was hung 

in a fuming chamber (Figure 2). A small 

Figure 1. A histologist prepares to drain the formalin 

from a container through a strainer. The strainer 

catches the tissue cassettes prior to their placement 

in the processing tray.

Figure 2. A super glue fuming chamber for fingerprint 

development with a suspended knife inside. 
Health Hazard Evaluation Report 2011-0146-3170 Page 3

quantity of super glue was placed in a shallow open container at the bottom of the chamber. 

After the chamber door was closed, the super glue was heated to create gaseous cyanoacrylate 

that adhered to the fingerprint secretions on the object. Once the object was removed from 

the chamber after the process was complete, the fixed fingerprint was dyed with a fluorescent 

substance, examined under ultraviolet light, and photographed. The fingerprint specialist 

reported that latent fingerprint development tasks were performed 1–2 times per week on 

average, with 1–2 items per run.

Chemical identification and confirmation 

of confiscated drugs were done in the 

drug evidence laboratory. Samples 

were analyzed by drug analysts to 

determine the type and amount of drugs 

(Figure 3). Examples of drugs analyzed 

by the laboratory include marijuana, 

cocaine, heroin, methamphetamine, and 

pharmaceutical opioids (e.g., oxycodone, 

methadone). Drugs may have been present 

in several forms including powders, pills, 

and plant material; as injectable liquids; or 

as residues on objects such as syringes and 

pipes. Much of the analytical work was 

performed on a laboratory bench top. Four 

chemical fume hoods with ducted exhaust 

to the outside were in the laboratory as 

well as a ductless high-efficiency particulate 

air filtered hood that was used to open 

large (i.e., typically larger than 1 kilogram) 

packages of drugs.

Examinations of firearms and ammunition 

used in crimes were done in the firearms 

section. Within the firearms section, weapons 

were fired in two locations: a narrow work 

room with a bullet trap at one end (Figure 

4) and a water tank in a garage on the first 

floor (Figure 5). The water tank was used 

when the analyst needed to retrieve bullets 

for analysis. The bullet trap in the firing 

room was last cleaned in April 2010. For 

a typical case investigation, two shots per 

gun were required, with each case taking 

approximately 2 hours. Up to four cases may 

be investigated on a busy day, requiring the 

firing of weapons 10–12 times in a day.

Figure 3. A drug analyst analyzes a sample of illicit drugs. 

Figure 4. The firearms examiner fires a weapon into 

the bullet trap. The photo shows the visible cloud of 

airborne particles produced when firing. 
Page 4 Health Hazard Evaluation Report 2011-0146-3170

In addition to work described above, 

specialized work in other areas included 

serology investigations of dried biological 

fluid and deoxyribonucleic acid testing; 

toxicology investigations of drugs and 

poisons in body fluids and tissues; 

evaluation of trace evidence such as the 

analysis or comparison of hairs, fibers, 

particles, or residues; and analysis of 

evidence related to arson investigations.

Methods

Before our initial site visit, we reviewed 

the following documents: a list of current 

employees, copies of the Ohio Bureau 

of Workers’ Compensation Form 300P 

Logs of Work-Related Injuries and Illnesses from 2006–2010, the safety manual, a list of 

Occupational Safety and Health Administration (OSHA) training videos, and employee blood 

lead level (BLL) and audiometric testing results from 2005, 2007, and 2010. On October 7, 

2011, we visited the coroner’s office and met with employer and employee representatives 

to discuss the concerns described in the request. We toured the first floor autopsy suites and 

the third floor laboratory sections. During the tour, we observed work processes, practices, 

and workplace conditions and spoke briefly with employees in each area. We discussed and 

reviewed the facility’s safety plan and training programs as well as material safety data sheets 

for a variety of chemicals. On October 20, 2011, we returned to hold confidential medical 

interviews with 14 of 49 employees regarding health and workplace concerns. 

On the basis of our observations and review of the information provided, we returned to 

the facility to conduct exposure assessments on January 10–12, 2012, in the autopsy suite, 

the histology laboratory, the fingerprint evidence laboratory, the drug evidence laboratory, 

and the firearms section. Details of the methods used during the exposure assessments 

are included in Appendix A of this report. Diagrams of areas evaluated, including airflow 

measurements and locations of surface wipe samples, are included in Appendix B.

Autopsy Suite 

On January 10, 2012, we observed six autopsies in autopsy suite 1 on the first floor. Autopsy 

suite 1 had the capacity for two simultaneous autopsies, with each autopsy performed by 

a team of one pathologist and one forensic assistant. On the day of the evaluation, two 

teams conducted three back-to-back autopsies each. We observed the teams’ work practices. 

Personal protective equipment worn during autopsies included N95 filtering face piece 

respirators, surgical masks, safety glasses, face shields, latex gloves, aprons with sleeves, 

scrubs, booties, and head covers. Personal breathing zone air samples were taken for 

formaldehyde on the two pathologists and on the two forensic assistants. One pathologist 

Figure 5. The firearms examiner fires a weapon into the 

water tank. 
Health Hazard Evaluation Report 2011-0146-3170 Page 5

wore the same sampling equipment over the course of the three autopsies to collect a longerterm sample; the sampling equipment on the other pathologist was changed at the end of 

each autopsy to collect shorter-term, tasked-based samples. Task-based samples during each 

autopsy were taken on both of the forensic assistants. A general area air sample was collected 

on one of the autopsy tables over the time that work was going on in the autopsy suite. 

Because the oscillating saw used during the autopsies can create considerable quantities of 

airborne particulate matter, a direct-reading real-time aerosol monitor (Met One HHPC-6 

Handheld Airborne Particle Counter [Hach Ultra Analytics, Grants Pass, Oregon]) was placed 

above one of the autopsy tables to measure the concentration of airborne particles. We used 

an AccuBalance Plus model 8373 air capture hood (TSI Inc., Shoreview, Minnesota) after 

the autopsies were completed to determine the number of air changes per hour in the autopsy 

suite, and we used smoke tubes (Nextteq, Tampa, Florida) to visualize air flow patterns.

Histology Laboratory

On January 11, 2012, we assessed exposures in the histology laboratory where human 

tissue specimens collected during autopsies were received and processed. We observed the 

histologist’s work practices while she prepared, processed, and fixed tissues delivered from 

previous autopsies. Personal protective equipment worn during these tasks included powderfree latex gloves and a laboratory coat. She also wore non-safety prescription glasses. A

task-based breathing zone sample for formaldehyde was collected on the histologist while 

she changed chemicals in the tissue processor, removed tissue cassettes from the formalinholding containers, and placed the cassettes in the processing tray. These activities took about 

1–1.5 hours. General area air samples were also taken during these tasks for formaldehyde 

and volatile organic compounds in areas around the histology laboratory. The histologist did 

not load or process tissues for the rest of the day outside of this sampling period. 

Fingerprint Evidence Laboratory

On January 11, 2012, we observed the latent fingerprint specialist as he developed a latent 

fingerprint on a knife. Personal protective equipment worn during this task included nitrile 

gloves and a laboratory coat. A task-based breathing zone air sample was taken on the 

specialist for ethyl 2-cyanoacrylate during this activity. General area air samples for ethyl 

2-cyanoacrylate were collected inside and outside the room during the hour that he worked. 

The fingerprint specialist did not develop fingerprints for the rest of the day outside of this 

sampling period. 

Drug Evidence Laboratory

On January 12, 2012, we assessed exposures in the drug evidence laboratory that received 

samples of illicit drugs and drug paraphernalia collected at crime scenes. We observed work 

practices of three drug analysts working at their bench top work locations. They wore nitrile 

gloves during these activities; one analyst wore non-safety prescription glasses. Each analyst 

evaluated 10–12 cases on the day of the monitoring. Because a case may involve multiple 

samples, the total number of drug samples analyzed per analyst on this day was 21–36. 

Task-based breathing zone air samples were taken for airborne drug particles on each of the 
Page 6 Health Hazard Evaluation Report 2011-0146-3170

three analysts during this work. Two general area air samples in the drug evidence laboratory 

were taken during these activities, as was one area air sample in the drug storage vault. The 

analysts did not analyze drugs for the rest of the day outside of this sampling period. Several 

wipe samples for drug particles were taken from work surfaces throughout the drug evidence 

laboratory to investigate potential contamination with drug residues. 

Firearms Section

On January 12, 2012, we observed work practices in the firearms section. During the 

60-minute sampling period on the day of our assessment, the firearms examiner twice fired 

a .45 caliber automatic pistol with 230-grain copper full metal jacket bullets and twice fired 

a .38 caliber revolver with 158-grain lead rounds. These were shot directly into the bullet 

trap in the firearms room. Additionally, the firearms examiner shot the .45 caliber pistol once 

into the water tank. Personal protective equipment worn during these activities included 

safety glasses, ear muffs, and ear plugs; employees could select to wear one or both of the 

hearing protection devices. Lab coat use was discretionary. A task-based breathing zone 

air sample was taken on the firearms examiner for airborne lead during the period when he 

fired these weapons. General area air samples for lead were also collected inside and outside 

the weapons firing room while he conducted weapons firing. The firearms examiner did not 

fire weapons for the rest of the day outside of this sampling period. Nine wipe samples for 

lead were taken on the floor and work surfaces inside and outside the weapons firing room, 

at the water tank, and on the hands of the firearms examiner after he completed the series 

of weapon firings. Using the same methods we used in the autopsy suite, we measured the 

amount of air supplied to and exhausted from the firearms room and determined directional 

air flow patterns within the room and between the firearms room and an adjacent room. 

Results

Employee Interviews and Record Review

On October 20, 2011, we held voluntary, confidential medical interviews with a convenience 

sample of 14 of 49 employees. Interviewees included 9 women and 5 men; ages ranged from 24–

64 years, with an average of 41 years. We asked a series of questions about their job description, 

work practices, personal protective equipment use, and work-related health and safety concerns.

Interviewed employees worked in the clerical office; the autopsy suite; and the histology, 

drug evidence, fingerprint evidence, trace evidence, firearms, toxicology, and serology 

laboratories. Some interviewed employees also worked off-site at death scene investigation 

locations. Although medico-legal death investigators were interviewed, we did not 

evaluate death scene investigation locations for logistical reasons. Most employees worked 

approximately 40 hours a week, 9.5 hours a day, taking one day off every other week. The 

forensic medical assistants worked a rotating schedule of varying lengths of days on and 

off in order to have a minimum of three employees on duty at a time. The number of years 

worked at the facility ranged from 1 to 24 years, with an average of 10 years.

Of the 14 employees we interviewed, 10 reported concerns they felt were related to the 
Health Hazard Evaluation Report 2011-0146-3170 Page 7

workplace. These included general building ventilation concerns and lack of exhaust for 

the latent fingerprint chamber, overcrowding, stress related to budget cuts, and exposure 

to potentially harmful chemicals. Eight employees reported a history of seasonal allergies. 

Self-reported symptoms that employees felt were related to work included headaches in two 

employees, and work-related stress in one employee. Self-reports of work-related injuries 

included needlestick injuries (four employees), cuts from a scalpel blade (two employees), 

and eye splash (one employee). According to the employees, the needlestick injuries were 

reported and followed-up medically. Two employees were exposed to blood borne pathogens 

through contaminated needles (Hagedorn needles used for suturing, and intravenous needles 

used for drawing blood), two through contaminated scalpel and microtome blades, and one as 

a result of a water splash from the autopsy table. Gloves were worn during all incidents, but 

face shield use was initiated after the eye splash injury. 

The Logs for 2006–2010 included four injuries and two illnesses. Cuts were the most 

common event, accounting for 50% of reports. Fingers were the most commonly affected 

body part; other injuries and illnesses included contusions and a foreign body in the eye.

The employer provided personal protective equipment for employees. Employees reported 

wearing either latex or nitrile gloves for the following duties: opening evidence and drug 

packages, handling and mixing chemicals, handling serology material and biohazards, 

conducting death scene investigations, and removing personal items from bodies. Employees 

also said they used surgical masks when opening bags with large quantities of illicit drugs. 

The firearms examiners reported wearing either earmuffs only or both earmuffs and ear plugs 

when test firing weapons. All employees working in the autopsy suite reported that they 

wore either safety goggles or a face shield. Current policy at the facility was the voluntary 

use of respirators during activities such as autopsies. Employees specifically reported 

wearing NIOSH-approved N95 filtering facepiece respirators during autopsies of individuals 

suspected of having had tuberculosis. 

Each autopsy employee who operated the x-ray machine wore a dosimeter that monitored 

for radiation exposure and was read by an outside company every 3 months. Firearms 

examiners received a blood lead analysis and an audiogram to test hearing every 5 

years. We evaluated the most recent results of BLL and zinc protoporphyrin for the three 

employees who worked in the firearms section. The three tests we reviewed showed 

BLLs below 2.6 micrograms per deciliter (μg/dL) and zinc protoporphyrin levels below 

29 μg/dL, with no evidence of excessive body absorption of lead from 2007–2010. Lead 

testing appeared to be in compliance with the OSHA lead standard in regards to baseline 

and continued testing of BLL and zinc protoporphyrin. We evaluated audiograms from all 

firearms examiners from 2010 (two employees) and from 2007 (one employee) and found 

no evidence of noise-induced hearing loss. However, one employee reported during the 

interview that he/she did not receive the BLL and audiometric testing results. 
Page 8 Health Hazard Evaluation Report 2011-0146-3170

Autopsy Suite

We collected task-based personal breathing zone and area air samples for formaldehyde 

during six autopsies in autopsy suite 1 (Table 1). Sampling times ranged from 54 to 238 

minutes. All short-term personal breathing zone air sample results for formaldehyde were at 

or above the NIOSH ceiling limit of 0.1 parts per million (ppm) [NIOSH 2010b]. One of the 

forensic assistant’s breathing zone air sample results exceeded the American Conference of 

Governmental Industrial Hygienists (ACGIH®) ceiling limit of 0.3 ppm [ACGIH 2012]. 

Real-time aerosol measurements were taken with direct-reading instrumentation mounted 

above one of the autopsy tables (Figure B1). As shown in Figure 6, background aerosol 

concentrations (measured in particles per liter of air) begin at 8:43 a.m., before any 

autopsy procedures began. Most particles measured were 0.3–0.5 micrometers (μm) in 

diameter. The major source of additional aerosols produced during the autopsies was 

the use of the oscillating saw to cut through the cranial bone to remove the skull cap. 

No local exhaust ventilation was used during this procedure. Aerosol concentrations 

peaked when the saw was used during each autopsy. Typically, bone cutting with the 

saw lasted no longer than 5 minutes. Figure 6 shows three solid-line boxes that represent 

the time when the oscillating saw was used at the autopsy table where the particle counter 

was mounted. Figure 6 also shows three dashed-line boxes that represent the time when 

Table 1. Air sampling results for formaldehyde collected in autopsy suite 1 on January 10, 2012

Sample location Sample type Sampling period 

(minutes) Concentration (ppm)

PBZ 67 0.28

Pathologist 1 PBZ Equipment failure Not applicable

PBZ 54 0.13

Pathologist 2 PBZ 233 0.27

PBZ 102 0.29

Forensic assistant 1 PBZ 54 0.15

PBZ 83 0.10

PBZ 98 0.46

Forensic assistant 2 PBZ 80 0.23

PBZ 72 0.15

Autopsy table GA 238 0.18

NIOSH REL C 0.1

ACGIH TLV C 0.3

PBZ = personal breathing zone

GA = general area

C = ceiling
Health Hazard Evaluation Report 2011-0146-3170 Page 9

the oscillating saw was used at the second autopsy table on the opposite side of the autopsy 

suite. Although peaks were observed while the saws were in use, aerosol levels returned to 

background levels fairly rapidly after the saws were turned off. A peak observed between 

12:45 p.m. and 12:50 p.m. corresponded with activities related to completion of the day’s 

autopsy activities such as the final cleaning of the suite.

Ventilation measurements were taken at each of the supply and exhaust vents within the 

autopsy suite (Figure B1). The two supply vents were in the autopsy suite ceiling directly 

above the autopsy tables. Together they supplied 521 cfm of air to the room. Two vents in 

opposite corners of the suite exhausted air from the room directly outside. Combined, these 

two vents exhausted 431 cfm of air. We observed exhaust vents in the autopsy room blocked 

by boxes, trash bins, and other equipment that likely reduced their effectiveness. On the 

basis of the exhaust measurements and the measured dimensions of the autopsy suite, the 

calculated number of air changes per hour for the room was 5.4.

Observations made during autopsies revealed work practices that may increase the risk of 

sharps injuries. We observed some employees holding skin flaps with her hands instead of 

using forceps while suturing with string to close the skull cap and the chest cavity at the end 

of an autopsy. When filling test tubes with blood, vitreous fluid, or urine collected with a 

syringe, we observed a worker holding the test tube directly with their hands, increasing the 

chances of a needlestick injury when inserting the syringe into the tube. Autopsy personnel 

were observed to use their hands to put on and take off the blades of reusable scalpels 

Figure 6. Concentration of aerosols in autopsy suite during six autopsies.
Page 10 Health Hazard Evaluation Report 2011-0146-3170

instead of using forceps or a hemostat. Furthermore, neither disposable safety scalpels 

nor automatic blade removal devices for reusable scalpels were used. This was in contrast 

to our observations in the histology laboratory where the histologist used a scalpel blade 

removal device that automatically removed and sealed used blades inside a puncture-resistant 

container without the need to remove the blade from the scalpel by hand. We also observed 

that the sharps container in the autopsy suite was almost completely filled. Some autopsy 

employees chose to wear a surgical mask instead of an N95 filtering facepiece respirator; 

respirators were used voluntarily. Additionally, we observed that at least one employee did 

not wear booties to cover their shoes while in the autopsy suite. 

Histology Laboratory

We collected a task-based breathing zone air sample for formaldehyde on the histologist 

while she prepared, processed, and fixed tissue samples collected during autopsies. Area air 

samples were taken in the tissue preparation area and in the area next to the tissue processor 

during this same period (Table 2). Sampling times were approximately 75 minutes for each of 

the samples. The results were below the concentrations measured in the autopsy suite and did 

not exceed any short-term ceiling limits. 

Chemicals containing organic compounds were used in the tissue processor. We collected 

area air samples to screen for a wide range of organic compounds that may have volatilized 

into the ambient work environment. Results of two screening samples showed low levels of 

branched C8

–C12 aliphatic hydrocarbons, ethanol, and isopropanol. 

Fingerprint Evidence Laboratory

A task-based breathing zone air sample for ethyl 2-cyanoacrylate was taken on the latent 

fingerprint specialist during the processing of a piece of evidence. Three general area air 

samples were also taken in the area during this time (Table 3). Only the personal breathing 

zone sample returned a result (0.06 ppm) above the minimum quantifiable concentration 

(0.05 ppm). While no short-term occupational exposure limits (OELs) exist for ethyl 

Table 2. Air sampling results for formaldehyde collected in the histology laboratory on January 11, 2012

Sample location Sample type Sampling period 

(minutes)

Concentration 

(ppm)

Histologist PBZ 76 0.05

Tissue preparation GA 75 0.01

Tissue processing GA 74 0.01

NIOSH REL C 0.1

ACGIH TLV C 0.3

PBZ = personal breathing zone

GA = general area

C = ceiling
Health Hazard Evaluation Report 2011-0146-3170 Page 11

2-cyanoacrylate, ACGIH has set an 8-hour time-weighted average (TWA) threshold limit 

value (TLV) at 0.2 ppm.

Work practices in the fingerprint development room included evacuating vapors from the fuming 

chamber through an outlet on the side of the chamber. During the evacuation, a paper towel 

was draped over the outlet, and an adjacent ductless hood was turned on to capture emissions 

(Figure 7). This ductless hood was equipped with a high-efficiency particulate air filter. Highefficiency particulate air filters can capture particles successfully, but are not useful in removing 

vapors such as ethyl 2-cyanoacrylate. A 

carbon filter or combination carbon/highefficiency particulate air filter would be 

needed to remove vapor phase contaminants 

such as ethyl 2-cyanoacrylate. Independent 

cyanoacrylate fume extractors that can be 

attached directly to the outlet of the fuming 

chamber are available commercially and can 

be used as an alternative, if desired.

Ventilation measurements were taken at each 

of the exhaust and supply vents within the 

fingerprint evidence laboratory room (Figure 

B2). The supply vents supplied 322 cfm of 

air to the room. The exhaust vent exhausted 

474 cfm. Smoke tubes were used to generate 

small quantities of smoke at the doorway 

to the room to visualize air flow patterns. 

Measurements confirmed that the room was 

under negative pressure in relation to the 

adjacent room.

Table 3. Air sampling results for ethyl 2-cyanoacrylate collected on January 11, 2012

Sample location Sample type Sampling period 

(minutes) Concentration (ppm)

Fingerprint developer PBZ 56 0.06

Next to fuming chamber GA 57 [0.05]*

Next to room door GA 58 [0.04]

Outside fingerprint room GA 59 ND

PBZ = personal breathing zone

GA = general area

C = ceiling

*Concentrations between the minimum detectable concentration and minimum quantifiable 

concentration are shown in brackets.

Figure 7. Ductless hood used during evacuation 

of vapors.
Page 12 Health Hazard Evaluation Report 2011-0146-3170

Drug Evidence Laboratory

Personal breathing zone and general area air samples were collected and analyzed for cocaine, 

heroin, tetrahydrocannabinol, and methamphetamine. Specifically, a task-based breathing zone 

sample for airborne drug particles was collected on each of the three forensic drug analysts 

during their normal case work activities. During this sampling period, each forensic drug 

analyst analyzed the 10–12 cases assigned for the work shift. Because certain cases required 

multiple drug analyses, each forensic analyst analyzed 21–36 samples. This represented a 

typical quantity of analyses during a work shift. The time sampled represented the period during 

the work shift of greatest potential exposures to aerosolized drug particles. The forensic drug 

analysts do not do activities that require manipulation of drug samples during the rest of the 

shift. Three general area air samples were also collected during this period. Two of these were 

collected near the gas chromatography/mass spectrometry instruments in the drug evidence 

laboratory. The third was collected outside of the laboratory in the drug storage vault. Results 

are shown in Table 4. No OELs exist for the drugs we sampled. In a previous HHE at a police 

officer drug vault, similar sampling was conducted. Results from that evaluation ranged from 

not detected to 28 nanograms per cubic meter (ng/m3

) for methamphetamine, from not detected 

to 12,000 ng/m3

 for cocaine, and from not detected to > 54 ng/m3 for tetrahydrocannabinol 

[NIOSH 2011]. Differences in concentrations compared to this previous evaluation may reflect 

the types of drugs with which the analysts worked. Heroin was described by each of the three 

forensic drug analysts sampled as the main drug analyzed during the sampling period. As in the 

previous NIOSH evaluation, personal breathing zone air concentrations were higher than area 

air concentrations.

Table 4. Personal breathing zone and general area air concentrations of methamphetamine, 

cocaine, THC particles, and heroin measured in the drug evidence laboratory on January 12, 2012

Sample location Sample 

type

Time 

(minutes)

Concentrations (ng/m3)

Methamphetamine Cocaine THC Heroin

Drug analyst 1 PBZ 55 140 ND ND 1,900

Drug analyst 2 PBZ 112 60 ND ND 190

Drug analyst 3 PBZ 90 63 200 1.4 2,900

On GC/MS 4 GA 174 38 ND ND 120

On GC/MS 1 GA 174 12 ND 0.76 86

Drug storage vault GA 173 ND ND ND ND

Minimum 

detectable 

concentrations*

6–19 70–220 0.43–1.3 2.3–7.2

PBZ = personal breathing zone

GA = general area

THC = tetrahydrocannabinol

ND = not detected

GC/MS = gas chromatography/mass spectrometry

*Minimum detectable concentrations were established for each sample and varied on the basis of 

individual sample volumes.
Health Hazard Evaluation Report 2011-0146-3170 Page 13

Ten surface wipe samples for drug particles were collected in various areas of the drug 

evidence laboratory. The ten samples were collected in side-by-side pairs (as requested by 

the analytical laboratory) so that five locations were sampled (Figure B3). Three of the pairs 

were collected at the workstations of the three drug forensic scientists. One pair was collected 

next to a balance used to weigh samples in one of the work areas. The final pair was collected 

at a computer workstation to the left of gas chromatography/mass spectrometry 1 where no 

drug analysis work was done and where it was suggested that the likelihood of drug particle 

contamination would be less. 

Wipe sample results are shown in Table 5. Currently, no criteria exist for hazardous levels of 

drug particle contamination on surfaces in the workplace. The highest surface concentration 

of drug particles was for cocaine. The highest concentrations were measured at 190,000 

nanograms per square centimeter (ng/100 cm2

) for the pair of samples collected next to 

the balance across from chemical safety hood 2B. Surface concentrations of cocaine at the 

workstations where the three forensic drug analysts worked ranged from 1,600–82,000 

ng/100 cm2

. Cocaine contamination at a concentration of 10,000–11,000 ng/100 cm2 was 

found on the desk surface of the computer station to the left of gas chromatography/mass 

spectrometry 1, indicating possible migration of contamination because no drugs were 

analyzed on this desktop. For comparison, wipe sampling for cocaine in a previous HHE at a 

police officers’ drug vault returned maximum concentrations of 7,300 ng/100 cm2

 [NIOSH 2011].

Table 5. Drugs on surfaces in the drug evidence laboratory on January 12, 2012

Sample location

Mass per area (ng/100 cm2

)

Methamphetamine Cocaine THC Heroin

Next to balance across from hood 2B 3,200 190,000 ND 40,000

Next to balance across from hood 2B 2,200 190,000 ND 16,000

Workstation surface to the right of hood 2B ND 82,000 ND 4,200

Workstation surface to the right of hood 2B ND 9,600 ND 9,100

Workstation surface to the right of hood 2C ND 16,000 ND 5,700

Workstation surface to the right of hood 2C ND 7,400 ND 4,700

Workstation surface across from hood 1B 8,700 1,600 ND 5,300

Workstation surface across from hood 1B 9,600 4,600 ND 5,400

Computer workstation near GC/MS 1 1,300 10,000 ND 1,900

Computer workstation near GC/MS 1 ND 11,000 ND 1,400

Limits of detection* 390–2000 860–30,000 2.2 13–350

THC = tetrahydrocannabinol

ND = not detected

GC/MS = gas chromatography/mass spectrometry

*Limits of detection were established for each sample and varied on the basis of dilution factors. 

Higher drug concentrations on samples required dilution during analysis to achieve a response in 

the analytical range of the assay, resulting in higher limits of detection for those samples.
Page 14 Health Hazard Evaluation Report 2011-0146-3170

All heroin samples returned results above the limit of detection. Concentrations of heroin 

particles were also greatest at the sampling location next to the balance (16,000–40,000 

ng/100 cm2

). Concentrations in all other locations measured between 1,400 (at gas 

chromatography/mass spectrometry 1) and 9,100 ng/100 cm2

 (at a workstation of one of the 

drug forensic scientists). 

Half of the methamphetamine samples returned results above the limit of detection. 

Methamphetamine concentrations were greatest at one of the scientist’s workstations 

(8,700–9,600 ng/100 cm2

) followed by the sample location next to the balance (2,200–3,200 

ng/100 cm2

). For comparison, wipe sampling for methamphetamine in a previous police 

officers’ drug vault HHE returned maximum concentrations of 79 ng/100 cm2

 [NIOSH 2011].

Results of all wipe samples for tetrahydrocannabinol were below the limit of detection. 

Ventilation measurements were taken at each of the exhaust and supply vents within the 

drug evidence laboratory as well as at face of each of the ducted fume hoods (Figure B3). 

The supply vents supplied 2,176 cfm of air to the laboratory. The exhaust vent and hoods 

exhausted 2,144 cfm. Measurements confirmed the laboratory was under approximately 

neutral pressure in relation to the adjacent room.

Firearms Section

A breathing zone sample for lead was taken on the firearms examiner who fired several 

weapons in the firing room and into the water tank. Two general area air samples for lead 

were taken in the firing room during shooting, and one was taken directly outside the firing 

room (Table 6). The highest concentration of lead was found in the breathing zone of the 

firearms examiner at 100 μg/m3

. The concentration of lead in both general area air samples 

collected in the firing room while shooting were similar: 37 μg/m3

 near the bullet trap and 

44 μg/m3

 near the door. The door to the firing room was kept closed during the weapons 

firing, which likely explains why the concentration of lead collected by the general area 

air sample in the anteroom outside the firing room was below the minimum quantifiable 

concentration during shooting. There is no short-term or ceiling OEL for lead to directly 

Table 6. Air sampling results for lead collected on January 12, 2012

Sample location Sample type Sampling period 

(minutes)

Concentration 

(μg/m3

)

Firearms examiner PBZ 60 100

Near bullet trap GA 60 37

Near back wall next to firing room door GA 62 44

Outside room GA 60 [2.0]*

PBZ = personal breathing zone

GA = general area

*Concentrations between the minimum detectable concentration and minimum quantifiable 

concentration are shown in brackets.
Health Hazard Evaluation Report 2011-0146-3170 Page 15

compare these results. If the firearms examiner were to continue these same activities 

throughout the shift, the exposure to lead at this concentration could exceed full-shift OELs 

including the OSHA permissible exposure limit (PEL) and the NIOSH recommended 

exposure limit (REL), both set 

at 50 μg/m3

.

Nine surface wipe samples 

were collected for lead. 

One of these samples was 

collected on the hands of the 

firearms examiner after he 

fired weapons. Several were 

collected on floors and work 

surfaces inside and outside 

the firing room (Figure 

B4). Two were collected on 

surfaces on or around the 

water tank. Results of lead 

wipe samples are shown in 

Table 7. Not surprisingly, 

the highest concentration of 

lead was found on the floor 

in front of the bullet trap at 

750 μg/100 cm2

. The next 

highest concentration (380 

μg/100 cm2

) was found on the bench top on the right hand side of the firing room. The result 

of wiping the hands of the firearms examiner after firing revealed 120 μg of lead. The result 

for the surface of a desk in the firing room’s anteroom was below the minimum quantifiable 

concentration. No criteria exist for lead contamination on surfaces in the workplace. 

However, the presence of lead indicates a need for improved controls and administrative 

practices.

The firing room had a supply vent in the ceiling at the far end of the room near the bullet 

trap and an exhaust vent in the ceiling near the door. The exhaust vent was controlled by a 

switch in the firing room near the door. Standard practice during firings was to close the door 

between the firing room and the adjacent anteroom and to turn on the exhaust fan. The door 

was opened and the exhaust fan was turned off when firings were not occurring. Ventilation 

measurements were taken at the exhaust and supply vents within the firing room (Figure 

B4). The supply vent supplied 492 cfm of air to the room. When turned on, the exhaust vent 

exhausted 553 cfm of air. Smoke tubes were used to generate small quantities of smoke 

at points in the firing room to visualize airflow patterns. When the exhaust was turned on, 

smoke tube testing at the door showed no airflow in or out of the room; therefore, the room 

was under neutral pressure relative to the adjacent anteroom. Additionally, because of the 

configuration of the supply vent near the bullet trap and exhaust vent near the door, air did 

not flow from the point where the weapons were fired away from the firearms examiner 

Table 7. Surface sampling results for lead collected on 

January 12, 2012

Sample location Mass per area

(μg/100 cm2

)

Firearms examiner’s hands

Water tank surface

Water tank floor

Range floor near door

Range floor where fired

Range floor next to bullet trap

Range bench top

Desk surface in anteroom

Anteroom floor near far door

 120*

37

23

20

25

750

380

[1.3]†

4.9

*The sample was wiped from the firearms examiner’s 

hands and does not represent a 100-square-centimeter 

measured area. 

†Concentrations between the minimum detectable 

concentration and minimum quantifiable concentration are 

shown in brackets.
Page 16 Health Hazard Evaluation Report 2011-0146-3170

toward the bullet trap as is recommended for firing ranges. When the exhaust was turned off, 

the room was under positive pressure relative to the adjacent anteroom, meaning air flowed 

from the firing room to the anteroom. 

Discussion

Employees in the coroner’s office autopsy suites faced a number of occupational hazards 

inherent to their work. These included potential exposures to infectious agents because of the 

procedures performed and the population being assessed [CDC 2012]. All autopsies involve 

potential exposures to blood and other body fluids, a risk of being splashed or splattered 

upon, and a risk of percutaneous injury [Nolte et al. 2002]. In fact, employee interviews and 

injury record reviews identified at least four needlestick and two scalpel injuries in the past 

few years. Exposure to sharp objects within the body and bone fragments may also result in 

cuts, and the manipulation of large organs may result in body splashes [CDC 2012]. During 

these procedures, autopsy suite employees may be at risk of exposure to infectious agents 

such as Mycobacterium tuberculosis and bloodborne pathogens such as Hepatitis B and C, 

and human immunodeficiency virus [Nolte et al. 2002]. 

Procedures that involve the use of oscillating saws may create airborne particles that contain 

infectious pathogens such as Mycobacterium tuberculosis as well as those not normally 

transmitted by the inhalation route; such particles can also contaminate inanimate surfaces 

[Nolte et al. 2002]. A procedure that potentially generates high concentrations of infectious 

aerosols is skull cap removal [Green and Yoshida 1990]. Droplets of blood and cerebrospinal 

fluid as well as the interstices of bone matrix may contain these infectious agents, but they 

could also be carried on the surface of particles formed by the combination of bone dust 

particles with fluid droplets [Green and Yoshida 1990]. The median diameter of bone dust 

particles in the breathing zone of a saw operator generated during a cranial autopsy has been 

reported to be 0.37 μm, which can remain airborne for long periods of time, be inhaled, and 

easily penetrate the alveolar region of the lung [Green and Yoshida 1990]. No local exhaust 

ventilation was used with the oscillating saw. 

Past NIOSH evaluations of cranial autopsies with and without the aid of local exhaust 

ventilation indicate that the use of local exhaust ventilation had a significant effect on 

reducing the aerosols produced by the saws [NIOSH 1997]. Our data also indicate that peaks 

in aerosol concentrations were produced during use of the oscillating saw in the autopsy 

suite. The highest peaks were observed during the use of the saw at the autopsy table under 

the aerosol monitor. We observed only one small peak during the times of saw use at the 

far autopsy table, approximately 10–15 feet away. Given the distance, this suggests that air 

mixing in the room was limited and the greatest potential for employee exposures occurred 

at the table where they were removing the skull cap. Capture of the aerosols produced by 

the saw through local exhaust ventilation would assist in reducing the potential for exposure 

of saw operators to infectious aerosols. We observed an autopsy employee handling the 

oscillating saw to remove skull caps while wearing a surgical mask, which does not provide 

respiratory protection. A NIOSH-approved N95 respirator is the minimum recommended 

level of respiratory protection for work in autopsy suites [CDC 2012].
Health Hazard Evaluation Report 2011-0146-3170 Page 17

Formaldehyde, as a component of formalin used for specimen preservation, is the most 

common chemical to which autopsy employees are exposed [CDC 2012]. The most 

commonly reported health complaints due to exposure to low concentrations of formaldehyde 

include irritation of the eyes, nose, and throat; nasal congestion; headaches; skin rash; and 

asthma [NRC 1981]. It is often difficult to attribute specific health effects to particular 

concentrations of formaldehyde because some people may have symptoms at levels where 

others may experience no symptoms [NRC 1981]. Most employees did not report such 

symptoms during the medical interviews, with the exception of headaches being reported by 

two employees. The work-relatedness of these could not be determined. 

Formaldehyde concentrations during short-term sampling periods during autopsies ranged 

from 0.10–0.46 ppm. All short-term samples returned results that were at or above the ceiling 

limit of 0.1 ppm recommended by NIOSH, with one result above the ceiling limit of 0.3 ppm 

recommended by ACGIH. Sample results were not calculated for full work shift exposures 

but may have exceeded the NIOSH full-shift REL of 0.016 ppm. However, this full-shift 

REL was established in 1981 when NIOSH first recognized formaldehyde as a potential 

occupational carcinogen. On the basis of the carcinogen policy in existence at the time, 

NIOSH set the REL to the “lowest feasible concentration,” which for formaldehyde was 

defined as the analytical limit of quantification of 0.016 ppm for up to a 10-hour TWA and 

a ceiling limit of 0.10 ppm that should not be exceeded [NIOSH 1981]. However, research 

has shown that concentrations of formaldehyde in ambient air can approach or exceed 

this level [Lemen 1987]. Additionally, the subsequent revision of the NIOSH carcinogen 

policy [NIOSH 1995], combined with better exposure characterization and advances in 

risk assessment and management strategies, support the need for NIOSH to reassess the 

formaldehyde REL. 

On the basis of the exhaust measurements and the measured dimensions of the autopsy 

suite, the calculated number of air changes per hour for the room was 5.4. This is below the 

recommended 12 air changes per hour for autopsy rooms. However, this calculated number 

of air changes per hour for this room is likely an underestimation. Smoke tube testing 

identified a considerable pressure differential between the autopsy room and the adjacent 

main cooler room, which had a garage-type roll-up door that opened between them. This 

cooler room was one location where bodies were stored before and after autopsies. Although 

this door closed during autopsies, we observed that air from the autopsy room was pulled 

around the edges of the closed door into the main cooler room as a result of an exhaust 

fan operating in the main cooler room. The main cooler room was under greater negative 

pressure. Therefore, air from the autopsy room was also exhausted through the cooler room 

in addition to the exhaust vents. Nevertheless, improved ventilation exhaust rates in the 

autopsy room are recommended. One way to increase exhaust is to use downdraft tables that 

provide local exhaust ventilation at the table level. NIOSH has researched the use of local 

exhaust ventilation to reduce formaldehyde exposures during embalming procedures [Gressel 

and Hughes 1992]. Because of its effectiveness in reducing formaldehyde exposures, 

NIOSH recommended using this type of local exhaust ventilation as a primary exposure 

control rather than increasing the general room (dilution) ventilation. It was determined 
Page 18 Health Hazard Evaluation Report 2011-0146-3170

that, depending on how well the air in the room is mixed, 4–13 times more general dilution 

exhaust air would be needed to achieve the same control as from the local exhaust ventilation 

system at the embalming table [NIOSH 1998a]. Reducing the time formalin-containing jars 

are open is also important in minimizing formaldehyde exposures in the autopsy suite.

Work processes in the histology lab required opening formalin-containing tissue specimen 

jars to prepare specimens for mounting on slides. Formaldehyde sampling during these 

processes revealed lower airborne formaldehyde concentrations than those in the autopsy 

suite, ranging from 0.01–0.05 ppm. This may be due to a number of factors including the 

presence of an exhaust hood where the histologist opened the specimen jars and the shorter 

periods for which the formalin-containing jars remained opened in the histology laboratory 

compared to the autopsy suite. 

Similar to practices observed in the autopsy suites, drug forensic scientists did not use 

disposable safety scalpels or blade removal devices. The drug section employees should 

use particular caution while cutting pills and substances for analysis and when handling 

hypodermic needles. Exposures to airborne drug particles were present, but appeared to be 

low. Despite this, repeated exposures may present a health hazard, even at low concentrations 

and through routes that are not typical for these drugs. Additionally, the possibility of 

unknown interactions with drug or prescription medication can be a concern. No OELs 

exist for comparing these airborne concentrations. However, concentrations were roughly 

in the same ranges as in a past HHE of a police officers’ drug vault, with personal breathing 

zone air concentrations of methamphetamine being slightly higher, while concentrations of 

cocaine and tetrahydrocannabinol were lower. Le et al. [1992] reported airborne cocaine 

concentrations as high as 6,400,000 ng/m3

 during sampling of criminalists during simulations 

of field situations in which the contents of 25 or 50 one-kilo packages of cocaine were 

transferred. The study emphasized the need to use caution, particularly during work on large 

cocaine-seizure cases, and suggested limiting the generation of airborne cocaine dust to 

reduce the levels of exposure [Le et al. 1992]. 

Also of concern was evidence of contamination of work surfaces with drug particles. While 

there are no criteria for comparison, it is wise to reduce exposure to all drug particles as much 

as feasible. Particles can be transferred from surfaces to hands, and in the absence of adequate 

hand washing, can then be transferred from hands to mouth or eyes, representing a possible 

route of exposure to the drugs. No federal standards exist for drug surface contamination; 

however several states have established feasibility-based surface contamination limits when 

remediating clandestine laboratories for methamphetamine. These range from ≤ 100 ng/100 

cm2

 to 500 ng/100 cm2 [NAMSDL 2008]. Results of surface sampling in the drug evidence 

laboratory for methamphetamine ranged up to 9,600 ng/100 cm2

.

Firearms examiners are exposed to lead and occupational noise in the course of their job 

tasks. Air sampling during shooting identified the possibility of high levels of lead exposure 

to the firearms examiner. During the 60 minutes we sampled, only five gunshots were fired, 

but they resulted in a high concentration of airborne lead. The concentration of airborne lead 

produced by these few shots was high enough that exposures could have exceeded full-shift 
Health Hazard Evaluation Report 2011-0146-3170 Page 19

occupational limits if similar shooting activities had continued throughout the 8-hour shift. 

Description of work practices provided by the firearms examiners indicated that shooting at 

that frequency consistently throughout an 8-hour shift was not a typical occurrence. However, 

it was noted that some days did require multiple weapons firings throughout the day to process 

a heavy case load. In these instances, lead exposure is a concern and further evaluation of 

full shift exposures is warranted. Surface sampling, particularly around the area of the bullet 

trap and on the bench tops of the firing room, identified the need to improve cleaning and 

maintenance practices to avoid dermal contamination and hand-to-mouth transmission of lead 

which may lead to ingestion. The current ventilation configuration may have pulled leadcontaminated air through the employee’s breathing zone instead of away from it.

Noise-induced hearing loss is one of the most common occupational diseases [NIOSH 2001]. 

Although we did not monitor noise exposures during the evaluation, the firearms examiners 

were exposed to impulsive noise when firing weapons. While their exposures were typically 

short, prolonged exposures to impulse noise may lead to noise-induced hearing loss [Chan 

et al. 2001]. Individual employees’ annual audiograms were compared to their baseline 

audiogram to determine if a standard threshold shift had occurred. OSHA states that a 

standard threshold shift is a change in hearing threshold, relative to the baseline audiogram, 

of an average of 10 decibels or more at 2,000, 3,000, and 4,000 hertz in one or both ears 

[29 CFR 1904.10; 29 CFR 1910.95]. The NIOSH-recommended threshold shift criterion 

is a 15 decibel shift at any frequency from 500–6000 hertz in either ear measured twice in 

succession [NIOSH 1998b]. The firearms examiners had neither an OSHA standard threshold 

shift nor a NIOSH threshold shift on their 5-year follow-up audiograms compared to their 

baseline audiograms in either ear.

Conclusions 

Most interviewed employees expressed workplace-related concerns, including concerns 

about building ventilation and potential chemical exposures. Additionally, they mentioned 

overcrowding and insufficient workspace, and we observed equipment stored or used in 

rooms or halls where they were not originally intended to be used. We also observed boxes 

and equipment stored in locations such as in front of autopsy suite exhaust vents, which 

may have affected the potential for exposures because of their impact on ventilation airflow. 

A small number of employees reported headaches and stress as symptoms they felt were 

work-related although we were not able to assess the work-relatedness of these symptoms. 

Self-reports of injuries mainly involved those incurred from needlesticks and scalpel blades. 

Task-based sampling for formaldehyde in the autopsy suite identified results at or above 

recommended ceiling limits, suggesting that further controls were necessary to reduce 

this hazard. Additionally, observations of work practices in the autopsy suite identified the 

need for improved use of personal protective equipment and additional controls (practices, 

devices, or both) to help reduce the possibility of sharps injuries. Task-based air sampling for 

drug particles showed the presence of aerosolized drugs in the breathing zone of analysts as 

they analyzed drugs. Surface sampling showed that drug particle contamination in the drug 

evidence laboratory and lead contamination in the firing room were potential hazards. Air 
Page 20 Health Hazard Evaluation Report 2011-0146-3170

sampling for lead indicated that airborne lead exposures could pose a hazard if weapons were fired 

throughout a work shift at the rate observed during sampling. Implementing the recommendations 

below will help limit exposures and reduce occupational hazards. Future facility changes should 

involve the input of employees and should use a prevention-through-design approach, a concept 

in which occupational injuries and illnesses are prevented and controlled by “designing out” or 

minimizing the hazards and risks early in the design process [Howard 2008].

Recommendations 

On the basis of our findings, we recommend the actions listed below. We encourage the 

coroner’s office to use a labor-management health and safety committee or working group 

to discuss our recommendations and develop an action plan. Those involved in the work can 

best set priorities and assess the feasibility of our recommendations for the specific situation 

at the coroner’s office. 

Our recommendations are based on an approach known as the hierarchy of controls 

(Appendix C). This approach groups actions by their likely effectiveness in reducing or 

removing hazards. In most cases, the preferred approach is to eliminate hazardous materials 

or processes and install engineering controls to reduce exposure or shield employees. Until 

such controls are in place, or if they are not effective or feasible, administrative measures and 

personal protective equipment may be needed.

Engineering Controls

Engineering controls reduce exposures to employees by removing the hazard from the 

process or placing a barrier between the hazard and the employee. Engineering controls 

are very effective at protecting employees without placing primary responsibility of 

implementation on the employee. 

1. Increase the number of air changes per hour in the autopsy suite. 

2. Use downdraft tables that are exhausted outside to capture airborne contaminants 

such as formaldehyde originating from the autopsy work processes at their source 

or point of generation. 

3. Use local exhaust ventilation attachments when using the saw for cranial autopsies.

4. Modify the existing supply and exhaust ventilation in the firing room to provide a 

laminar flow of air that passes from the shooter toward the bullet trap. Ensure that 

slightly more air is exhausted than supplied to maintain appropriate negative pressure 

in the firing room [NIOSH 2009]. In the interim, limit the number of weapons tested 

in one day.

5. Use high-efficiency particulate air filtered hoods for work processes during which 

drug particles may become aerosolized.

6. Install a carbon filter or combination carbon/high-efficiency particulate air filter 

for the ductless hood adjacent to the fuming chamber, or use an independent 

cyanoacrylate fume extractor that can be directly attached to the outlet of the fuming 

chamber during evacuation of the fingerprint development chamber.
Health Hazard Evaluation Report 2011-0146-3170 Page 21

Administrative Controls

The term administrative controls refers to employer-dictated work practices and policies 

to reduce or prevent hazardous exposures. Their effectiveness depends on employer 

commitment and employee acceptance. Regular monitoring and reinforcement are necessary 

to ensure that policies and procedures are followed consistently.

1. Replace lids on containers of formaldehyde as soon as possible after use.

2. Improve cleaning practices in the drug evidence laboratory to remove drug particles 

on work surfaces. Use either a high-efficiency particulate air filtered vacuum or 

wet cleaning techniques with detergent and water to clean nonporous surfaces. 

Eliminating porous surfaces, joints, and crevices is also recommended.

3. Improve cleaning practices in the firing room to clean up lead contamination on 

floor and work surfaces. Do not dry sweep in the firing room; use a high-efficiency 

particulate air filtered vacuum or wet mopping methods. Use mops and cleaning tools 

that are dedicated to this activity. The OSHA general industry lead standard states that 

shoveling, dry or wet sweeping, and brushing may be used only where vacuuming 

or other equally effective methods have been tried and found ineffective [29 CFR 

1910.1025].

4. Do full-shift monitoring periodically for lead exposures in the firing range on days 

when multiple firearm shootings will be performed consistently throughout the shift.

5. Do periodic short-term and full-shift follow-up monitoring for formaldehyde in the 

autopsy suite. 

6. Advise all shooters to wash their hands thoroughly after firing weapons. Provide soap 

or wipes that have been formulated specifically to remove lead from the skin. 

7. Wash hands before leaving the autopsy suite. After noticing a glove puncture, wash 

hands immediately with soap and water before resuming the autopsy. Consider all 

surfaces to be potentially contaminated. 

8. Use disposable safety scalpels. However, if reusable scalpels are used, then use 

scalpel blade removal devices rather than removing blades manually [Perry et al. 

2003]. 

9. Instruct employees to hold skin flaps with forceps and not with the hands when 

suturing with string or other suture materials at the end of an autopsy on the skull cap, 

chest cavity, or other part of the body.

10. Use a test tube rack to hold test tubes while filling them with blood, vitreous fluid, 

or urine samples rather than holding the test tube itself to help prevent accidental 

needlesticks.

11. Ensure sharps containers are not filled greater than two-thirds full. When two-thirds 

full, close and dispose of the container properly and replace it with a new container.

12. Move items such as trash cans, boxes, and equipment from in front of exhaust vents 

in the autopsy suite, and do not use these locations for storage.

13. Use a colorimetric wipe method periodically to disclose the presence of lead on 

skin surfaces as a part of health and safety training. This method allows direct 

and timely observation of contamination by lead and allows shooters to see that 

evidence on their hands.
Page 22 Health Hazard Evaluation Report 2011-0146-3170

14. Continue audiometric testing to compare to baseline levels upon initial assignment 

in a noisy work area and at the time of reassignment out of the area. Audiograms 

should be done annually as long as the employee is assigned to a job where the TWA 

exposure level is equal to or greater than 85 A-weighted decibels. If an audiogram 

indicates a standard threshold shift, refer the employee for a medical evaluation. 

15. Provide employees access to their records upon request, and review medical tests 

such as audiograms and BLLs with employees.

Personal Protective Equipment

Personal protective equipment is the least effective means for controlling hazardous 

exposures. Proper use of personal protective equipment requires a comprehensive program 

and requires a high level of employee involvement and commitment. The right personal 

protective equipment must be chosen for each hazard. Supporting programs such as 

training, change-out schedules, and medical assessment may be needed. Personal protective 

equipment should not be the sole method for controlling hazardous exposures. Rather, 

personal protective equipment should be used until effective engineering and administrative 

controls are in place.

1. Require, at a minimum, NIOSH-approved N95 filtering facepiece respirators for 

employees in the autopsy suite [CDC 2012]. Surgical masks do not protect autopsy 

personnel from inhaling airborne particles. A respiratory protection program as 

defined in the OSHA respiratory protection standard [29 CFR 1910.134] should 

be implemented. If personnel are unable to wear a NIOSH-approved N95 negative 

pressure respirator because of facial hair or other limitation, then they should wear a 

NIOSH-approved loose-fitting powered air purifying respirator with high efficiency 

filters.

2. Use the following additional personal protective equipment during autopsies: fluidresistant apron and sleeves; booties; surgical caps; and eye and face protection such 

as goggles and a transparent shield that covers the face, mouth, and neck (unless 

a powered air purifying respirator is worn). Eyeglasses alone are not adequate 

protection. Use double gloves and change both gloves every hour. Select a cutresistant glove of fine-woven steel to prevent cuts from bone and scalpels, and 

cover with a rubber glove for slip resistance. These gloves do not protect against 

needlesticks [CDC 2012]. 

3. Wear protective safety goggles that prevent exposure to splashes from formaldehyde 

or other chemicals while fixing tissues in the histology laboratory. 

4. Wear lab coats and safety glasses during work in the drug evidence laboratory. 

5. Use double hearing protection (earmuffs and ear plugs) for impulsive noise generated 

during weapons firing [NIOSH 2009].
Health Hazard Evaluation Report 2011-0146-3170 Page 23

Appendix A: Methods

Formaldehyde

Personal breathing zone and general area air samples for formaldehyde were collected on 

2,4-dinitrophenylhydrazine-treated silica gel cartridges. Tygon® tubing connecting the 

sampler and sampling pump allowed air to be drawn at a calibrated flow rate of 50 milliliters 

per minute and 200 milliliters per minute, depending on the anticipated sampling time. For 

personal breathing zone air samples, the sampling media was attached to the employee’s lapel 

within the breathing zone, roughly defined as an area in front of the shoulders with a radius 

of 6 to 9 inches. Analysis of the cartridges was performed according to NIOSH Method 

2016, with modifications [NIOSH 2010a]. The limit of detection was 0.02 micrograms (μg) 

formaldehyde per sample, and the limit of quantitation was 0.051 μg formaldehyde/sample.

Air Sampling for Lead

Personal breathing zone and general area air samples for lead were collected on 

37-millimeter diameter, 0.8-μm pore size mixed cellulose ester filters using Aircheck 2000S 

air sampling pumps (SKC, Inc, Eighty Four, Pennsylvania) calibrated at a flow rate of 2 liters 

per minute. The inlet port of the sampling pump was connected to the sampling media with 

Tygon® tubing. For personal breathing zone air samples, the sampling media was attached to 

the employee’s lapel within the breathing zone. Air samples were analyzed using inductively 

coupled plasma according to NIOSH Method 7303 [NIOSH 2010a]. The limit of detection 

was 0.2 μg/sample, and the limit of quantitation was 0.55 μg/sample.

Surface Wipe Sampling for Lead

Surface wipe samples were collected with premoistened Wash n’ Dri wipes (Colgate USA, 

New York). The collection procedure was as follows: (1) identify the area to be sampled; 

(2) put on a pair of gloves; (3) place the wipe flat on the surface as defined by the 10 

centimeter × 10 centimeter (100-square-centimeter area) disposable template and wipe the 

surface using three to four vertical S-strokes, side-to-side so that the entire surface is covered; 

(4) fold the exposed side of the wipe in and wipe the area with three or four horizontal 

S-strokes; (5) fold the wipe once more and wipe the area with three or four vertical S-strokes; 

and (6) fold the pad, exposed side in, and place in a sterile container. A new template and 

a pair of disposable gloves were used for each surface wipe sample. The surface wipe 

samples were digested and analyzed by inductively coupled argon plasma-atomic emission 

spectroscopy according to NIOSH Method 9102 [NIOSH 2010a]. The limit of detection was 

0.4 μg/sample, and the limit of quantitation was 1.5 μg/sample.

Volatile Organic Compounds

Personal breathing zone and general area air sampling for volatile organic compounds used 

thermal desorption tubes attached to SKC pocket pumps calibrated at 200 milliliters per 

minute (SKC Inc., Eighty Four, Pennsylvania). The thermal desorption tubes contained 
Page 24 Health Hazard Evaluation Report 2011-0146-3170

three beds of sorbent material: (1) 90 milligrams of CarbopackTM Y, (2) 115 milligrams of 

Carbopack B, and (3) 150 milligrams CarboxenTM. For personal breathing zone air samples, 

the sampling media was attached to the employee’s lapel within the breathing zone. After 

sampling, the thermal desorption tubes were stored in a cooler and then qualitatively 

analyzed for volatile organic compounds according to NIOSH Method 2549 [NIOSH 2010a]. 

Air and Surface Sampling for Drugs

Personal breathing zone and general area air sampling for particle phase drugs was conducted 

using SKC 37-millimeter diameter, 2-μm pore size polytetrafluoroethylene filters attached to 

SKC Aircheck XR5000S pumps calibrated at 4 liters per minute. For personal breathing zone 

air samples, the sampling media was attached to the employee’s lapel within the breathing 

zone. Surface sampling for drugs used cotton wipes pre-moistened with surface sampling 

buffer. For most sampling locations, a 10 centimeter × 10 centimeter template was placed 

over the surface and wiped using the pre-moistened cotton wipe in the same manner as 

surface wipe sampling for lead. 

After sampling, the polytetrafluoroethylene filters and wipes were stored in a cooler and 

then analyzed for methamphetamine, heroin, cocaine, and tetrahydrocannabinol with a 

fluorescence covalent microbead immunosorbent assay as described by Smith et al. [2010]. 

A standard curve for each drug was generated to calculate equivalent values. The values 

of the drugs collected from the surfaces were corrected using the surface recovery values 

determined previously [Smith et al. 2010]. For the air samples, extraction was done in 

methanol; the extraction solutions were then dried, and the residue was re-extracted with 

the surface sampling buffer. The detection and quantitation limits were provided for each 

analyte. However, because trace drugs (or interfering compounds) were identified on the field 

and laboratory blanks, the detection limits were adjusted. Adjustments were made by adding 

the average analyte concentration measured on the field or laboratory blank (whichever was 

higher) to the respective detection limits. 

Ethyl 2-Cyanoacrylate 

Personal breathing zone and general area air samples were collected by drawing a flow rate 

of 100 milliliters per minute through the phosphoric acid-treated XAD-7 sampling tubes. 

For personal breathing zone air samples, the sampling media was attached to the employee’s 

lapel within the breathing zone. Following desorption of the sample with 2 milliliters of 

0.2% phosphoric acid in acetonitrile, the samples were analyzed by high pressure liquid 

chromatography with ultraviolet detection according to OSHA Method 55 [OSHA 1985].
Health Hazard Evaluation Report 2011-0146-3170 Page 25

Appendix B: Diagrams of Four Coroner’s Office 

Sections

Figure B1. Diagram of ventilation measurements and the aerosol monitor location in autopsy suite 1.
Page 26 Health Hazard Evaluation Report 2011-0146-3170

Figure B2. Diagram of ventilation measurements in the fingerprint evidence laboratory room.
Health Hazard Evaluation Report 2011-0146-3170 Page 27

Figure B3. Diagram of ventilation measurements and wipe sample locations in the drug evidence laboratory.
Page 28 Health Hazard Evaluation Report 2011-0146-3170

Figure B4. Diagram of ventilation measurements and wipe sample locations in the firearms section.
Health Hazard Evaluation Report 2011-0146-3170 Page 29

Appendix C: Occupational Exposure Limits and 

Health Effects

NIOSH investigators refer to mandatory (legally enforceable) and recommended OELs for 

chemical, physical, and biological agents when evaluating workplace hazards. OELs have 

been developed by federal agencies and safety and health organizations to prevent adverse 

health effects from workplace exposures. Generally, OELs suggest levels of exposure that 

most employees may be exposed to for up to 10 hours per day, 40 hours per week, for a 

working lifetime, without experiencing adverse health effects. However, not all employees 

will be protected if their exposures are maintained below these levels. Some may have 

adverse health effects because of individual susceptibility, a preexisting medical condition, or 

a hypersensitivity (allergy). In addition, some hazardous substances act in combination with 

other exposures, with the general environment, or with medications or personal habits of the 

employee to produce adverse health effects. Most OELs address airborne exposures. But, 

some substances can be absorbed directly through the skin and mucous membranes.

Most OELs are expressed as a TWA exposure. A TWA refers to the average exposure during 

a normal 8- to 10-hour workday. Some chemical substances and physical agents have 

recommended short-term exposure limit (STEL) or ceiling values. Unless otherwise noted, 

the short-term exposure limit is a 15-minute TWA exposure. It should not be exceeded at any 

time during a workday. The ceiling limit should not be exceeded at any time.

In the United States, OELs have been established by federal agencies, professional 

organizations, state and local governments, and other entities. Some OELs are legally 

enforceable limits; others are recommendations. 

● The U.S. Department of Labor OSHA PELs (29 CFR 1910 [general industry]; 29 CFR 

1926 [construction industry]; and 29 CFR 1917 [maritime industry]) are legal limits. 

These limits are enforceable in workplaces covered under the Occupational Safety and 

Health Act of 1970. 

● NIOSH RELs are recommendations based on a critical review of the scientific and 

technical information and the adequacy of methods to identify and control the hazard. 

NIOSH RELs are published in the NIOSH Pocket Guide to Chemical Hazards [NIOSH 

2010b]. NIOSH also recommends risk management practices (e.g., engineering 

controls, safe work practices, employee education/training, personal protective 

equipment, and exposure and medical monitoring) to minimize the risk of exposure and 

adverse health effects. 

● Other OELs commonly used and cited in the United States include (a) the TLVs, which 

are recommended by ACGIH, a professional organization, and (b) the workplace 

environmental exposure levels (WEELs), which are recommended by the American 

Industrial Hygiene Association, another professional organization. The TLVs and 
Page 30 Health Hazard Evaluation Report 2011-0146-3170

WEELs are developed by committee members of these associations from a review of 

the published, peer-reviewed literature. These OELs are not consensus standards. TLVs 

are considered voluntary exposure guidelines for use by industrial hygienists and others 

trained in this discipline “to assist in the control of health hazards” [ACGIH 2012]. 

WEELs have been established for some chemicals “when no other legal or authoritative 

limits exist” [AIHA 2012].

Outside the United States, OELs have been established by various agencies and organizations 

and include legal and recommended limits. The Institut für Arbeitsschutz der Deutschen 

Gesetzlichen Unfallversicherung (IFA, Institute for Occupational Safety and Health of 

the German Social Accident Insurance) maintains a database of international OELs from 

European Union member states, Canada (Québec), Japan, Switzerland, and the United States. 

The database, available at http://www.dguv.de/ifa/en/gestis/limit_values/index.jsp, contains 

international limits for more than 1,500 hazardous substances and is updated periodically. 

OSHA requires an employer to furnish employees a place of employment free from 

recognized hazards that cause or are likely to cause death or serious physical harm 

[Occupational Safety and Health Act of 1970 (Public Law 91–596, sec. 5(a)(1))]. This is 

true in the absence of a specific OEL. It also is important to keep in mind that OELs may not 

reflect current health-based information.

When multiple OELs exist for a substance or agent, NIOSH investigators generally encourage 

employers to use the lowest OEL when making risk assessment and risk management decisions. 

NIOSH investigators also encourage use of the hierarchy of controls approach to eliminate or 

minimize workplace hazards. This includes, in order of preference, the use of (1) substitution 

or elimination of the hazardous agent, (2) engineering controls (e.g., local exhaust ventilation, 

process enclosure, dilution ventilation), (3) administrative controls (e.g., limiting time of 

exposure, employee training, work practice changes, medical surveillance), and (4) personal 

protective equipment (e.g., respiratory protection, gloves, eye protection, hearing protection). 

Control banding, a qualitative risk assessment and risk management tool, is a complementary 

approach to protecting employee health. Control banding focuses on how broad categories of 

risk should be managed. Information on control banding is available at http://www.cdc.gov/

niosh/topics/ctrlbanding/. This approach can be applied in situations where OELs have not been 

established or can be used to supplement existing OELs.

Below we provide the OELs and surface contamination limits for the compounds we measured, 

as well as a discussion of the potential health effects from exposure to these compounds.

Formaldehyde

Under the OSHA general industry standard for airborne exposure to formaldehyde [29 CFR 

1910.1048], the PEL is 0.75 ppm for an 8-hour TWA, the action level is 0.5 ppm for an 

8-hour TWA, and the short-term exposure limit is 2 ppm for a 15-minute TWA. The standard 

requires medical surveillance for employees exposed to formaldehyde at or above the action 

level or short-term exposure limit.
Health Hazard Evaluation Report 2011-0146-3170 Page 31

The NIOSH REL for formaldehyde is 0.016 ppm for up to an 8-hour TWA. NIOSH also has 

a 15-minute ceiling limit of 0.1 ppm that is not to be exceeded during a work shift [NIOSH 

2010b]. NIOSH recognized formaldehyde as a potential occupational carcinogen in 1981 

and, following the NIOSH carcinogen policy in existence at the time, set the REL to the 

“lowest feasible concentration,” which for formaldehyde was defined as the analytical limit 

of quantification of 0.016 ppm for up to 8 hours [NIOSH 1981]. Since then, experience has 

shown that this REL is actually not the “lowest feasible concentration” because formaldehyde 

in the ambient air can exceed 0.016 ppm, a fact later acknowledged by NIOSH [Lemen 

1987]. Additionally, the subsequent revision of the NIOSH carcinogen policy [NIOSH 

1995], combined with better exposure characterization and advances in risk assessment and 

management strategies, support the need for NIOSH to reassess the formaldehyde REL. This 

effort is in progress.

ACGIH lists formaldehyde as a sensitizer with a ceiling limit of 0.3 ppm [ACGIH 2012]. An 

ACGIH ceiling limit is an exposure that should not be exceeded at any time during the work shift.

The International Agency for Research on Cancer classifies formaldehyde as a human 

carcinogen (group 1) on the basis of associations between formaldehyde exposure and 

nasopharyngeal cancer and leukemia [Baan et al. 2009]. NIOSH considers formaldehyde 

as a potential occupational carcinogen, ACGIH lists formaldehyde as a suspected human 

carcinogen, and the U.S. Department of Health and Human Services lists formaldehyde as 

reasonably anticipated to be a human carcinogen in its 11th report on carcinogens [NIOSH 

1981; DHHS 2011; ACGIH 2012].

Lead

Lead is ubiquitous in U.S. urban environments because of the widespread use of lead 

compounds in industry, gasoline, and paints during the past century. Exposure to lead occurs 

via inhalation of dust and fume and via ingestion through contact with lead-contaminated 

hands, food, cigarettes, and clothing. Absorbed lead accumulates in the body in the soft 

tissues and bones. Lead is stored in bones for decades, and may cause health effects long 

after exposure as it is slowly released in the body.

Symptoms of chronic lead poisoning may include headache, joint and muscle aches, weakness, 

fatigue, irritability, depression, constipation, anorexia, and abdominal discomfort [Moline 

and Landrigan 2005]. Overexposure to lead has been associated with kidney damage, anemia, 

high blood pressure, infertility and reduced sex drive in both sexes, and impotence. In most 

cases, an individual’s BLL is a good indication of recent exposure to lead, with a half-life 

(the time interval it takes for the quantity in the body to be reduced by half its initial value) of 

1–2 months [Lauwerys and Hoet 2001; Moline and Landrigan 2005; NCEH 2005]. Elevated 

zinc protoporphyrin levels have also been used as an indicator of chronic lead intoxication; 

however, other factors, such as iron deficiency, can cause an elevated zinc protoporphyrin 

level, so the BLL is a more specific test for evaluating occupational lead exposure.
Page 32 Health Hazard Evaluation Report 2011-0146-3170

Under the OSHA general industry lead standard (29 CFR 1910.1025), the PEL for airborne 

exposure to lead is 50 μg/m3 for an 8-hour TWA. The standard requires lowering the PEL 

for shifts exceeding 8 hours, medical monitoring for employees exposed to airborne lead 

at or above the action level of 30 μg/m3

 (8-hour TWA), medical removal of employees 

whose average BLL is 50 μg/dL or greater, and economic protection for medically removed 

employees. Medically removed employees cannot return to jobs involving lead exposure 

until their BLL is below 40 μg/dL. NIOSH has an REL for lead of 50 μg/m3

 averaged over an 

8-hour work shift [NIOSH 2010b]. ACGIH has a TLV for lead of 50 μg/m3

 (8-hour TWA), 

with worker BLLs to be controlled to or below 30 μg/dL, and designation of lead as an 

animal carcinogen [ACGIH 2012].

The NIOSH REL is consistent with the OSHA PEL, which is intended to maintain worker 

BLLs below 40 μg/dL. This is also intended to prevent overt symptoms of lead poisoning, 

but is not sufficient to protect employees from more subtle adverse health effects like 

hypertension, renal dysfunction, and reproductive and cognitive effects [Schwartz and 

Stewart 2007; Schwartz and Hu 2007; Brown-Williams et al. 2009]. Adverse effects on the 

adult reproductive, cardiovascular, and hematologic systems, and on the development of 

children of exposed employees, can occur at BLLs as low as 10 μg/dL [Sussell 1998]. The 

Council of State and Territorial Epidemiologists has recommended lowering the definition of 

elevated blood lead in adults to 10 μg/dL to avoid long-term health risks [CSTE 2009].

In homes with a family member occupationally exposed to lead, care must be taken to prevent 

“take home” of lead, that is, lead carried into the home on clothing, skin, hair, and in vehicles. 

High BLLs in resident children and elevated concentrations of lead in the house dust have been 

found in the homes of employees employed in industries associated with high lead exposure 

[Grandjean and Bach 1986]. Particular effort should be made to ensure that children of persons 

who work in areas of high lead exposure receive a BLL test. Cognitive and neurological 

impairment in children from lead exposure is irreversible and can result in lowered intelligence, 

learning impairment, and behavior issues. CDC has just lowered the reference value for children 

from 10 to 5 μg/dL with evidence showing impairment at even lower levels [MMWR 2012].

Lead-contaminated surface dust represents a potential source of lead exposure, particularly 

for young children. This may occur either by direct hand-to-mouth contact, or indirectly 

from hand-to-mouth contact with contaminated clothing, cigarettes, or food. Previous studies 

have found a significant correlation between resident children’s BLLs and house dust lead 

levels [Farfel and Chisholm 1990]. In the workplace, generally there is little or no correlation 

between surface lead levels and employee exposures because ingestion exposures are highly 

dependent on personal hygiene practices and available facilities for maintaining personal 

hygiene. No current federal standard provides a permissible limit for lead contamination of 

surfaces in occupational settings. 

Ethyl 2-cyanoacrylate

Ethyl 2-cyanoacrylate, which has an unpleasant, acrid odor, is a common ingredient in 

adhesive super glues. Neither OSHA nor NIOSH has issued OELs for ethyl 2-cyanoacrylate. 
Health Hazard Evaluation Report 2011-0146-3170 Page 33

The ACGIH TLV (0.2 ppm) is based upon the potential for eye, skin, and upper respiratory 

tract irritation, dermatitis, and possible respiratory sensitization or asthma [ACGIH 2001]. 

Although the TLV does not have a skin notation, skin contact has been shown to cause 

adhesions resulting in tissue damage [ACGIH 2001].

Drugs of Abuse

Methamphetamine, cocaine, heroin, and tetrahydrocannabinol (drugs we sampled for in 

this evaluation) can produce neurological and physiological effects at relatively high doses 

(milligram levels) [Gable 2004; DEA 2011]. However, the effects from low doses (nanogram 

levels of indirect exposure) are not well understood. 

Methamphetamine and Cocaine

Methamphetamine and cocaine are classified as stimulants. The possible health effects from 

an effective dose of stimulants include increased alertness, excitation, euphoria, increased 

pulse rate and blood pressure, extended wakefulness, and loss of appetite [DEA 2011]. 

Studies investigating health effects from lower exposures to these compounds are few. In one 

notable study, investigators administered surveys to law enforcement personnel to determine 

symptoms experienced while they investigated clandestine methamphetamine laboratories 

(after ventilation of the laboratories). More than 70% of the respondents reported headaches, 

central nervous system symptoms, respiratory symptoms, sore throat, and other symptoms. 

There was also a positive relationship between the number of laboratories investigated and 

risk of symptoms [Burgess et al. 1996]. 

Because of the large number of clandestine methamphetamine laboratories requiring 

remediation, several states have adopted feasibility-based surface contamination limits 

for methamphetamine. Presently, 16 states have adopted surface contamination limits for 

methamphetamine ranging from ≤ 100 ng/100 cm2

 to 500 ng/100 cm2 [NAMSDL 2008]. 

These limits are intended to prevent adverse health effects to future inhabitants of buildings 

that once contained clandestine laboratories. Unlike OELs, these limits consider possible 

exposures to children, who are more susceptible to the health effects of drugs than adults, as 

well as economic factors associated with remediation. It is reasonable to assume, then, that 

maintaining surface contamination levels of methamphetamine below these limits should 

protect the drug evidence laboratory employees from experiencing adverse health effects.

Tetrahydrocannabinol

Tetrahydrocannabinol is the effective drug in marijuana and is classified as cannabis. It 

is typically smoked. The effects from an effective dose of cannabis can include euphoria, 

relaxed inhibitions, and disorientation. Short-term health effects may include increased heart 

rate, coughing from lung irritation, increased appetite, and decreased blood pressure. Longterm users may experience serious health problems such as bronchitis, emphysema, and 

bronchial asthma. [DEA 2011].
Page 34 Health Hazard Evaluation Report 2011-0146-3170

Heroin

Heroin is a rapidly acting opiate often seen as a white or brown powder or as a black 

sticky substance known as black tar heroin. Heroin can be injected, smoked, or sniffed/

snorted. Users report a rush or surge of euphoria, followed by a twilight state of sleep and 

wakefulness. Health effects can include drowsiness, respiratory depression, nausea, a warm 

flushing of the skin, dry mouth, and heavy extremities [DEA 2011].
Health Hazard Evaluation Report 2011-0146-3170 Page 35

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Health Hazard Evaluation Report 2011-0146-3170 Page 39

Keywords: NAICS 922120 (Police Protection) and 923120 (Administration of 

Public Health Programs), coroner, autopsies, histology, firearms, fingerprints, 

drugs, evidence, formaldehyde, lead, ethyl 2-cyanoacrylate, cocaine, marijuana, 

methamphetamine, heroin, surface contamination
Page 40 Health Hazard Evaluation Report 2011-0146-3170

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Health Hazard Evaluation Report 2011-0146-3170 Page 41

The Health Hazard Evaluation Program investigates possible health hazards in the 

workplace under the authority of Section 20(a)(6) of the Occupational Safety and 

Health Act of 1970, 29 U.S.C. 669(a)(6). The Health Hazard Evaluation Program also 

provides, upon request, technical assistance to federal, state, and local agencies to control 

occupational health hazards and to prevent occupational illness and disease. Regulations 

guiding the Program can be found in Title 42, Code of Federal Regulations, Part 85; 

Requests for Health Hazard Evaluations (42 CFR 85).

Acknowledgments

Analytical Support: Jennifer Roberts, Jerry Smith, Deborah Sammons, John Snawder, and 

Bureau Veritas North America (Fort Lauderdale, Florida)

Desktop Publishers: Greg Hartle and Mary Winfree 

Editor: Ellen Galloway 

Health Communicator: Stefanie Brown 

Industrial Hygiene Field Assistance: Steven Ahrenholz

Logistics: Donnie Booher and Karl Feldmann

Availability of Report

Copies of this report have been sent to the employer, employees, and union at the 

facility. The state and local health department and the Occupational Safety and Health 

Administration Regional Office have also received a copy. This report is not copyrighted 

and may be freely reproduced.

This report is available at http://www.cdc.gov/niosh/hhe/reports/pdfs/2011-0146-3170.pdf.

Recommended citation for this report:

NIOSH [2013]. Health hazard evaluation report: evaluation of potential 

employee exposures during crime and death investigations at a 

county coroner’s office. By King B, Musolin K, Choi J. Cincinnati, OH: U.S. 

Department of Health and Human Services, Centers for Disease Control 

and Prevention, National Institute for Occupational Safety and Health, 

NIOSH HETA No. 2011-0146-3170.
To receive documents or other information about

occupational safety and health topics, contact NIOSH

Telephone: 1-800-CDC-INFO (1-800-232-4636)

TTY: 1-888-232-6348

email: cdcinfo@cdc.gov

or visit the NIOSH website at http://www.cdc.gov/niosh

Delivering on the Nation’s promise:

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