LA coroner’s office could use new HVAC
But don’t hold your breath, officials say
The Los Angeles coroner’s office has a little problem with its ventilation system, and suddenly, it seems everyone in town knows about it."I came to work on Friday, and there were TV cameras all over the place," says Diane Franklin, assistant health and safety officer for the city. "My family started calling me, saying, Hey, you didn’t tell us you were having a TB epidemic at the coroner’s office.’"
The reason Franklin hadn’t mentioned it was because the episode had taken place in 1995. That year, ten employees had converted, and three had developed active disease, apparently because bodies of people who’d died of TB were autopsied in rooms that weren’t under negative pressure, by employees not wearing respiratory protection.
There followed a flurry of visits by inspectors and investigators, who duly issued citations and made recommendations. Respirators were donned, additional HEPA filters were installed, a tougher PPD skin-testing program was implemented, and things settled back down to normal.
Until, that is, the county Board of Supervisors held its weekly Tuesday meeting one day last month. At that point, administrators from the coroner’s office made an urgent plea, within earshot of assorted news services who happened to be at the scene, for enough money for a new building — or at least enough to patch up the present building’s decrepit ventilation system.
Simply to repair the system and place the autopsy suites under negative pressure is going to run an estimated $357,000, Franklin says, a sum the county has decided it can pry out of capital funds. To replace the system altogether would cost at least $1,000,000, she adds. But what employees at the coroner’s office are really yearning for is a new building altogether, she says. (For an example of the state-of-the-art coroner’s facilities, see story, at right.)
Yet the county contends it’s already spent all the money in the budget on repairs to the building after damage sustained during the 94 earthquake, Franklin says.
A place to park 19,000 bodies a year
"This building was constructed in 1972, when the homicide caseload was a lot smaller," says Franklin. "We simply don’t have the storage capability we need." Last year, the coroner’s office took in 19,000 bodies and autopsied about 5,000 of them, Franklin says.Even with 27 forensic physicians and 18 forensic technicians, the office is short on staff. Workers wish they had a lunchroom in the administrative building, which stands adjacent to the building where autopsies are carried out. As it is, many forensic employees now take their lunch breaks in the so-called "service area," Franklin says. Workers also say they wish they had better equipment, such as more vacuum-equipped saws, to prevent aerosols and dust.
An investigation by the Centers for Disease Control and Prevention (CDC) at the time of the outbreak determined that poor ventilation was just one of the office’s problems. Employees hadn’t been wearing respiratory equipment, claiming it impeded communication during procedures. The skin-testing program was lax, with testing not enforced and not carried out on an annual basis; in fact, skin testing wasn’t performed at all on relief workers and part-time employees.
Not surprisingly, the CDC report found employees were at significant risk for developing TB infection, with an 81% probability of conversion after ten years on the job. Indeed, though, there haven’t been any more conversions discovered since 1995, all but two of the 17 physicians, and all but two of the 27 techs are already skin-test positive, says Franklin.
She doesn’t expect to see any new buildings get built either, she says. "We could certainly use one, but I know they don’t have the money," she says. "It’s a hazardous job, and it’s a low-paying job," she adds. "Still, it’s an interesting place to work."
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content