Pt: 2 NFDA Cremation Standards

Crematory Operator Attire:

- During all operations, proper PPE should be maintained - OSHA signage should be displayed on site and safety standards and instructions available on request - To minimize injuries, every crematory should make PPE available: heat resistant gloves and aprons, protective face shields, and other materials - Back support: for lifting bodies - Eye protection: goggles/face shield and face mask to protect eyes from heat exposure and possible debris - Dust protection: Respiratory PPE to protect against airborne/ambient dust - Gloves: insulated, heat resistant gloves to protect against flames, sparks, and abrasions; latex gloves for handling the container - Hearing protection - Heat reflective apparel - aprons/jackets that protect up to 1000℉ - Shoe covers - non-slip dust covers

Cremation Procedures:

- Ensure the correct body is being removed - Paperwork must be signed before cremation - Get identification of the body by the NOK in writing - The body should never be taken from removal to the crematory - take back to the funeral home - The crematory is responsible for maintaining the proper identification of the remains delivered for cremation throughout the entire process

Vinyl/Plastic Body Bags/Disaster Pouches:

- First cremation of the day; may result in visible emissions; suppliers now offer "green" body bags for cremation purposes

Successive Cremations and Disposition of Residue:

- Follow manufacturer's instructions for successive cremations - Cool down time must occur between cases - Periodically, accumulation of incidental and unavoidable human remains residue in the chamber is removed and interred in a dedicated cemetery property per state law and local ordinances

(Step 7) Cool Down:

- For safety reasons, let cremated remains cool down before removal for an additional period of 30-40 minutes

Misrepresentations and Unfair Practices:

- Funeral providers may not represent that a deceased person is required to be embalmed for direct cremation - It is a deceptive act or practice to tell families that the law requires a casket for direct cremations - It is an unfair practice for a funeral provider to require that a casket be purchased for direct cremation - Funeral providers must make an alternative container available for direct cremation

A cremation authorization form should include:

- Identification of the decedent - Identification of the funeral home and crematory - Name of the funeral director who obtained cremation authorization - Relationship of the NOK - Notification if the decedent died from communicable disease - List of any devices and implants in the decedent (pacemaker, silicone, prostheses, etc.) - Final disposition arrangements - Date and time of cremation

Infant and Stillborn Infant Cases (Special Cremation Procedures):

- Due to lack of skeletal formation, there may be a small amount or even no cremated remains at the end of the cremation process - Always begin with a warm retort - not recommended for the first cases of the day but after 2-3 cremations Use a small-sized stainless steel pan; place the pan near but not directly under the flame in the front of the retort - Reduction of the cremated remains must be performed manually with a mortar and pestle

Identification Viewings:

- If a funeral home does not require identification, they can be held liable if the wrong body is cremated - ID viewings listed on the GPL should list a specific time limit (5-10 min), as well as the maximum number of people allowed, and any other restrictions that are applicable - If multiple family members wish to participate, a private family viewing service may be listed on the GPL - A funeral home may not require embalming if the viewing of the body is limited to immediate family

How would human remains must be delivered to the crematory?

- In a cremation container - Identification documents, permits, and any other documentation must accompany the remains

(Step 9) Clean Out:

- It is impossible to remove all residues and skeletal fragments, but reasonable effort must be made to sweep the chamber out as clean as possible - Incidental residue may remain in the retort

Cremation Identification System:

- It is recommended that every crematory implement and maintain an identification system - The funeral home should maintain identification documents in its permanent records - The crematory must assign a permanent, unique number that is recorded on all paperwork regarding the decedent - A personal identification disk should be placed with the body throughout the time at the crematory (metal identification disk with a unique I.D. number) - When cremated remains are packaged, the I.D. disk should be secured with a lock strap on the outside of the plastic bag holding the remains

Transferring/Packing Cremated Remains:

- Many new processors automatically fill the container/urn to eliminate hand loading - After pulverization, the processed remains are placed in a sturdy plastic bag fastened with a lock strap that secures the identification disk or tag - Any overage of cremated remains that do not fit in the temporary container or urn must be placed in a separate, additional container and should be attached to the first container with labeling indicating that the containers belong together - The cremated remains must only be released to the family member or agent written on the cremation authorization and disposition form - Document in writing when the person picks up cremated remains

Disposition of Unclaimed Cremated Remains:

- Most states have laws to relieve funeral homes and crematories from having to indefinitely store unclaimed cremated remains - Varies from state to state: 30 days (NC/SD) to 4 years (ME) Mississippi Senate Bill 2782: "Any crematory or funeral establishment may dispose of any remains unclaimed by the family after twelve (12) months after cremation by delivering the remains to any person listed in Section 73-11-58, releasing the remains to a veterans' service organization in accordance with Sections 1 through 5 of this act, or scattering or burial upon a final notification to the next of kin by certified mail to their last-known address."

Operation Sequence under Normal Conditions:

- Never begin a cremation and walk away - The first 30 minutes of the cremation process are critical, especially in obese cases. Emissions output and temperature must be monitored - Before the first cremation of the day: check the time on the control timer; check that the primary chamber is clean and empty; check that the hopper/sweep-out tray is clean and in proper position

Pre-Cremation Assessment of Human Remains:

- No unauthorized person should ever be permitted in the crematory where any deceased human body is awaiting cremation, being cremated, or being removed from cremation chamber - Weight of the casket/container and the decedent must be determined prior to the start of the cremation process - Check for medical devices, jewelry, and implants - the crematory must require the funeral home to list all contents and verify there are no objects that will hinder the process and equipment (ex: pacemakers) - Medical devices that are powered by lithium-ion batteries may cause violent combustion or explosions that will damage equipment - Only licensed embalmers can remove a pacemaker without written authorization for the cremation process

Plywood container:

- Plywood is an odd number of thin layers of wood glued together under pressure with the grain of one layer at right angles to the adjoining layer; use normal procedures unless the container has a highly polished finish

High-polished caskets:

- Recommended to be first case of the day because the varnish is highly flammable and will generate extreme heat (should be placed in cold cremator - no operation having occurred in 4 hours; or coat the casket with water before placement

Radioactive Seeds:

- Some cancer treatments (brachytherapy - most often used to treat prostate cancer) involve implantation of radioactive "seeds" - If the human remains contain radioactive seeds that were implanted within the past 12 months, it is recommended not to cremate - If the crematory proceeds with cremation: use universal precautions in handling remains and cleaning the retort; do NOT pulverize the cremated remains; do NOT bury or have final disposition for at least two years from the date of implantation of seeds; place in a metal urn

Time Lapse between Death and the Act of Cremation:

- Some states have regulations on the amount of time that must be between the time of death and the time of cremation - Indiana requires 48 hours after the time of death indicated on the medical examiner or coroner's certificate of death - Illinois requires 24 hours

Simultaneous Cremations:

- The simultaneous cremation of more than one dead human body within the same cremator is not permitted in certain states - Risky - If it is permitted, ensure all written authorizations are in place and check with applicable state laws

Is there a weight limit on cremation?

- There is not a weight limit for cremation, though cremating larger bodies can be more complex and costly. - Some providers charge additional fees for persons weighing more than 300 pounds for this reason

Authorization to Witness Cremation:

- Under no circumstances should the family be present when the cremator operator is repositioning the remains - Never have another cremation in process while family representatives are present as witnesses - Significant to some religions, such as Hindu: the symbolic tradition of the eldest male lighting the funeral pyre (press the button) - Once the process is started, the family leaves the facility

(Step 6) Completion of Cremation Process:

- Usually combustion is complete when no flames are present - some containers may need additional time - The cremation process might be completed in as few at 60 minutes to as long as 3 hours

(Step 8) Removing Cremated Remains:

- When cooled, remains are removed using specialized rakes, brushes, and other tools such as a heat-resistant vacuum - try to remove all residue in the chamber - The remains will weigh on average between 4-8lbs and be swept into the hopper tray

(Step 3) Loading:

- feet first into the chamber (unless in the case of the obese body), resting on heavy duty cardboard rollers - When the primary chamber start-button is engaged, the burner will ignite and the main burner will begin to time down. - During the cremation process, all substances are incinerated except for bone fragments and non-combustible material (prostheses, jewelry, etc)

The crematory has the right to refuse custody if:

1) State, local, medical, and civil authorizations as required are missing or incomplete 2) The container is unacceptable (must be readily combustible- no metal) 3) Excess weight of the decedent

Cremation authorization form:

A legal document that gives the crematory the authority to cremate human remains

The authorizing agent must sign a written cremation authorization form ________ cremation (45 states have this regulation).

Before

(Step 5) Monitoring Operations during the Cremation Process:

During the process, continuously monitor temperature, air flow, emissions, and general safety equipment

Upon receipt of the decedent, where is the body is placed until the cremation process commences?

In a holding facility

Should a crematory should take custody of a casket/container when there is evidence of leakage (health and safety of employees and public)?

No

Can a crematory refuse to accept unembalmed human remains - refrigeration?

No, they can't refuse unembalmed bodies

Recordkeeping

Regardless of state reporting requirements, it is recommended to keep a permanent record (daily log book) that tracks each cremation that takes place at the facility

Plain-finished caskets:

Should be run as first cremations; run same risk as high-polished caskets

(Step 2) Ignition of Secondary Burner/Afterburner:

Some crematories place the case into the retort chamber and then preheat; some wait until the temperature is reached and then place the case into the retort. Either way, the secondary burner must reach desired temperature before the primary chamber is ignited

Authorizing agent:

the person(s) legally entitled to order and direct the cremation and final disposition of specific human remains (the NOK) - The person signing authorization forms is deemed to warrant truthfulness of any facts (identity and authority) - The order of the next of kin varies state by state - Typically: spouse, adult children, parents, siblings, grandparents, aunts and uncles

Air Trays:

usually wood-based with plywood or corrugated base

Cremation Casket and Container Guidelines:

- A cremation container must be composed of readily combustible materials suitable for cremation, must be resistant to spillage, and of sufficient strength and rigidity for easy handling - Metal caskets should not be accepted for cremation - Shipping containers (air trays) are acceptable for use, particularly for decedents whose weight exceeds normal standards - Caskets specifically made for cremation are usually composed of wood or cardboard - may be cloth-covered and usually weigh less than 70lbs - Environmentally friendly cremation caskets may be made of sustainable materials such as bamboo, seagrass, willow, and even paper

Due Diligence Prior to Taking Custody:

- A crematory is not a holding facility for the funeral home - Good practice: inform funeral homes that they cannot show up unannounced at the crematory with a decedent - If a crematory does not have a refrigerated holding facility, the funeral home must be informed - IDENTIFICATION CHECK

Processing/Pulverization of Cremated Remains:

- Allow cremated remains to cool before processing - Remove all metal from remains with magnet from the manufacturer - Remove any foreign objects (belt buckles, buttons, coins, etc) - Do not process any hot items that may remain with the cremated remains - this will lead to cremated remains turning a charcoal color - Cremated remains should not be recognized as skeletal fragments and should be milky white in color - During processing the remains are usually reduced to less than 200 cubic inches

FTC Rule Definitions:

- Alternative container - an unfinished wood box or other non-metal receptacle without ornamentation or a fixed interior lining (can be fiberboard, pressed-wood, etc) - Crematory - any person, partnership, or corporation that performs cremations and sells funeral goods - Direct cremation - disposition of human remains by cremation without formal viewing or ceremony with the body present - Funeral goods - merchandise for use in connection with services - Funeral provider - crematories are defined as funeral providers if they sell or offer both goods and services

Options for Final Disposition of Cremated Remains:

- Burial/Scattering at Sea: must take place at least three nautical miles from land (about 3.5 miles) - Entombment: columbarium niche indoor/outdoor; placement of urn in crypt in mausoleum - Interment: cemetery or private land (follow cemetery and state regulations) - Scattering: (many cemeteries have memorial and scattering gardens) Aerial scattering; casting; ossuary; raking; trenching; water scattering Memorial reefs, keepsake urns, send to space, etc.

Large Cases (Special Cremation Procedures):

- Cases over 300lbs - Always first cremation of the day - placement into an already hot retort is a fire hazard - The retort must have been cooled down for a period of 12 hours

Rental Caskets:

- Ceremonial (rental) caskets may be offered to families for public visitation before cremation - Rental caskets are used for multiple services as long as the outer shell maintains its appearance - Rental caskets are not covered by the FTC Funeral Rule (doesn't have to be listed on the GPL)

The minimum requirement for a cremation container is that it be __________.

- Completely enclosed, rigid, leak resistant, and combustible. - You may select a cardboard or particle board container, rental casket, a wooden casket, or even a highly polished casket, provided it is combustible and non-toxic

(Step 4) Repositioning Remains during the Cremation Process:

- Do not open the loading door during the first hour of the cremation process - After an hour, carefully raise the door a maximum of six inches and position the decedent near the flame (wear PPE during this)

Shipping Cremated Remains:

- Domestic shipping: use only USPS Priority Mail Express service to ship cremated remains (USPS offer 1 or 2-day guaranteed delivery) - The postal service requires two separate containers to be used: an inner and outer box Ensure proper padding; make sure to include all required documents Recommended to select Signature upon Delivery to establish an additional level of security - USPS offer 1 or 2-day guaranteed delivery - International shipping: many countries do not allow shipment of cremated remains; airlines do not allow cremated remains to be in checked luggage - must be carried on the plane

Crematories must meet ________ __________ regarding the operations and design of the cremator unit as well as state the authorization and disposition of cremated remains

state regulations

(Step 1) Cremation Blower Started:

This begins a purge cycle that must occur before the secondary chamber after burner is ignited - this ensures that all chambers are pressurized with air and contain no flammable substances. When the cycle is complete, an indicator light is illuminated.

Can a funeral director refuse to arrange a cremations if authorization/disposition forms are not in place or correct?

Yes

Corrugated Cardboard/Fiberboard Containers:

paper-based material consisting of a fluted corrugated sheet and one or two flat liner boards; often cloth covered; least problematic