Maintenance

Contents

OVERVIEW 56

Abbreviations 98

PART A – POLICY AND SERVICE CONTEXT 119

Legislation, policies and international guidance 119

1. LEGISLATIVE CONTEXT 119

2. Further reference material and precedent: 119

3. INFECTION PREVENTION AND CONTROL LEGISLATION 1210

4. BUILDING LEGISLATION 1210

5. SOUTH AFRICAN BUILDING PRACTICE POLICY AND GUIDELINES 1210

6. INTERNATIONAL DESIGN GUIDANCE 1210

Service Context 1311

PART B – PLANNING AND DESIGN 1512

1. INTRODUCTION 1512

2. LOCATION OF THE MORTUARY AND ACCESS ROUTES 1613

3. FACILITY CAPACITY 1613

4. SELECTING BODY STORAGE SYSTEMS 1814

5. FACILITY LAYOUT 1815

6. MORTUARY EQUIPMENT REQUIREMENTS 2117

7. MOVEMENT WITHIN A MORTUARY 2218

8. SERVICES REQUIRED 2419

9. BIOLOGICAL SAFETY 2419

10. FINISHES TO FLOORS AND WALLS 2520

11. AUTOPSY EQUIPMENT/FIXTURES 2620

12. VENTILATION 2721

13. AIR CONDITIONING 2722

14. REFRIGERATION EQUIPMENT DESIGN AND INSTALLATION 2822

15. SECURITY ARRANGEMENTS 2822

PART C – OPERATION 3024

1. OBJECTIVES 3024

2. HEALTH AND SAFETY 3024

3. MAINTENANCE 3024

PART D –USER ROOM REQUIREMENTS 3232

Room Requirement Sheets 3232

PART E – EXAMPLES AND CASE STUDIES 3635

Layout Examples 3635

1. EXAMPLE 1: SMALL MORTUARY ATTACHED TO HOSPITAL 3836

2. EXAMPLE 2: LARGE MORTUARY WITH AUTOPSY FACILITIES 3937

3. EXAMPLE 3: LARGE MORTUARY WITH AUTOPSY FACILITIES 4340

BIBLIOGRAPHY 4642

Table of Figures

Figure 1  Adjacency Diagram 116

Figure 2: Access and Movement in a mortuary 118

Figure 3 Example 1: Layout 135

Figure 4 Example 1: Zoning & Access 136

Figure 5 Example 2: Layout 138

Figure 6 Example 2: Zoning and Access 139

Figure 7 Example 3: Layout 140

Table of Tables

Table 1 : IUSS Reference documents 87

Table 2 Service Requirements 1311

Table 3 Accommodation Schedule 3225

TABLE 4 ROOM SERVICES SHEET 3326

TABLE 5 ROOM FINISHES 3427

Version Control

Template	January 2013	Tobias van Reenen
Discussion Draft 1	February 2013	Steve Fourie
Discussion Draft 5	March 2013	Steve Fourie
Discussion Draft 6	May 2013	Steve Fourie
Development Draft  1	August 2013	Tobias van Reenen
Development Draft  3.1	February 2014	Tobias van Reenen
Development Draft  3.1	February 2014	Prof J Vellema

Page Break

OVERVIEW

This document outlines the policy and service context and attempts to illustrate the desired planning principles and design considerations for mortuary services.

• Part A outlines  the South African legislation, policies and international guidance reference documents and the service context with respect to mortuary services;
• Part B Planning and design;
• Part C operation;
• Part D user room requirements; and
• Part E provides case studies.  

Parts D and E are intended to demonstrate how the principles prescribed in Part A, B, and C can be applied in worked examples. Part D, if used directly, are deemed- to- satisfy the principles developed in Part B, but are not the only acceptable solutions.

Case studies (Part E) provide illustrative worked solutions and should not be adopted without appropriate contextual adaptation.

While this document outlines design requirements and acceptance criteria which have an impact on clinical services, these requirements are prescribed within the framework of the entire IUSS set of guidance documents and cannot be viewed in isolation. The following documents should be complied with, together with this document:

• IUSS: Regulations
• IUSS: Project Planning and Briefing
• IUSS: Environment and Sustainability
• IUSS: Hospital Design Principles
• IUSS: Infection Prevention and Control

Page Break

The following table identifies additional IUSS guideline documents which are recommended for reading in conjunction with this guideline.

Table 1 : IUSS Reference documents

CLINICAL   SERVICES	Essential	Recommended	SUPPORT   SERVICES	Essential	Recommended	HEALTHCARE ENVIRONMENT/ CROSSCUTTING ISSUES	Essential	Recommended	PROCUREMENT & OPERATION	Essential	Recommended
Adult Inpatient Services		X	Administration and Related Services			Generic Room Requirements			Integrated Infrastructure Planning
Clinical and Specialised Diagnostic Laboratory Guidelines		X	General Hospital Support Services		X	Hospital Design Principles			Briefing Manual		X
Mental Health			Catering Services for Hospitals			Building Engineering Services	X		Space Guidelines
Adult Critical Care			Laundry and Linen Department		X	Environment and Sustainability			Cost Guidelines
Emergency Centres			Hospital Mortuary Services			Materials and Finishes	X		Procurement
Maternity Care Facilities			Nursing Education Institutions			Future Healthcare Environments		X	Commissioning Health Facilities	X
Adult Oncology Facilities			Health Facility Residential			Healthcare Technology			Maintenance	X
Outpatient Facilities		X	Central Sterile Service Department			Inclusive Environments			Decommissioning	X
Paediatrics and Neonatal Facilities			Training and Resource Centre		X	Infection Preventive Control	X		Capacity Development
Pharmacy			Waste Disposal		X	Health Informatics
Primary Health Care Clinics and CHCs						Regulations
Diagnostic Radiology
Adult Physical Rehabilitation
Sub-acute services
Facilities for Surgical Procedures
TB Services

Abbreviations

ACH	Air changes per hour
ASHRAE	American Society of Heating, Refrigerating, and Air-Conditioning Engineers
BMS	Building Management System
BSL	Biological safety level
CDC	Centers for Disease Control (USA)
CSIR	Council for Scientific and Industrial Research
FD	Floor drain
FPS	Forensic Pathology Service
HVAC	Heating Ventilation Air Conditioning
HBA	Hazardous biological agents
HCS	Hazardous chemical substances
HEPA	High efficiency particulate air filters
IPC	Infection prevention and control
ISO	International Standards Organisation
MDR TB	Multi-drug resistant TB
NDoH	National Department of Health
NBR	National Building Regulations
NDoH	National Department of Health
NHS	National Health Service (UK health service)
NIOSH	National Institute of Occupational Safety and Health (US agency)
O&M	Operating and Maintenance (manual)
OHS	Occupational health and safety
OQ	Operational qualification
PGWCDoH	Provincial Government Western Cape Department of Health
PPE	Personal protective equipment
PQ	Performance qualification
RDS	Room data sheets
RH	Relative humidity
SABS	South African Bureau of Standards
SAO	Senior Administrative Officer
SAPS	South African Police Service
SI	Le Systeme International d' Unites Le Système International d’Unités
SOP	Standard Operating Procedures
SS	Stainless steel
TB	Tuberculosis
WC	Toilet
WHB	Wash-hand basin
WHO	World Health Organisation
XDR TB	Extreme (or extensively) -drug- resistant TB

PART A – Policy and service context 

1. LEGISLATIVE CONTEXT

The following documents, as amended (though not an exhaustive list) pertain and contain an additional resource of information which would supplement and provide the basis of a design brief. A finer sense of standard operating procedures and legislative context is likely to inform and enhance the design process, so the professional teams are encouraged to use these as an additional resource:

• Inquest Act, 58, 1959
• National Health Act, 61, 2003
• Government Notice R363, 2013 [Regulations relating to the management of human remains]
• Government Notice R178, 2012 [Regulations relating to the registration of microbiological laboratories and the acquisition, importation, handling, maintenance and supply of human pathogens]

• Health Professions Amendment Act, 29, 2007
• Criminal Procedures Act, 51, 1977
• Births and Deaths Registration Act, 51, 1992
• National Environmental Management: Waste Act, 59, 2008
• National Archives of South Africa Act, 42, 1996

• Regulations regarding the Rendering of Forensic Pathology Service, Government Gazette No 30075. No R636, 20 July 2007
• Space Planning Norms and Standards for Office Accommodation used by Organs of State, Government Gazette No 27985.  No 1665, 2 Sept 2005
• Western Cape Health Care Waste Management Draft Bill
• Municipal by-laws, as applicable
• National Code of Guidelines for Forensic Pathology Practice in South Africa, 20 Aug 2007

• Standard Operating Procedures, Forensic Pathology Service, PGWCDoH, 2006
• Biosafety in Microbiological and Biomedical Laboratories, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention and National Institutes of Health, Fifth Edition, 2007 US Government Printing Office, Washington: 2007

2. Further reference material and precedent:

• Standard specification for air-conditioning and ventilation systems, Western Cape Department of Public Works, 1998
• Fire security: a guide for architects, Western Cape Department of Public Works, 1998
• Standard electrical specification, South African Department of Public Works, 2005
• Facilities for mortuary and post-mortem room services, NHS Estates, 2001, ISBN 0-11-322000-00
• Part B – Health facility briefing and planning, Australasian Health Facilities Guidelines, 2007

• CKS 336: 2013 Mortuary Trolleys - SABS

3. INFECTION PREVENTION AND CONTROL LEGISLATION

The National Infection Prevention and Control Policy and Strategy document makes specific reference to certain Acts and their relevant regulations, which bear relevance to the development and implementation of these health facility guidelines. These are:

• The South African Constitution, 1996 [Sections 2, 24, 27, 36 and 39], as amended
• The Occupational Health and Safety Act of 1993, Act No 85 of 1993 [Section 8(1)]

• Government notice R1390 of 27 December 2001 [Hazardous Biological Agents Regulation] as promulgated under Section 43 of the Occupational Health and Safety Act of 1993
• Government notice R908 of 27 June 2003 [Hazard Analysis Critical Control Point Regulation] as promulgated under Section 15(1) of the Foodstuffs, Cosmetic and Disinfectants Act of 1972
• The Environmental Conservation Act of 1989, Act No 73 of 1989
• The Foodstuffs, Cosmetic and Disinfectants Act of 1972, Act No 45 of 1972
  

4. BUILDING LEGISLATION

The following legislation and regulations impact and provide guidance on the provision and design of health care facilities as above:

• The National Environmental Management Act 107 of 1998, as amended
• Building regulations and Building Standards Act 103 of 1977, as amended
• National Building Regulations; SANS 10400:2010, Code of Practice for the Application of the National Building Regulations

• Promotion of Equality and Prevention of Unfair Discrimination Act No 4 of 2000
• General Procedures and Loadings adopted in the Design of Buildings, SABS 0160, 1993
• Structural Use of Concrete Design, SABS 0100-1, 1992
• Structural Use of Concrete – Materials and Execution of Work, SABS 0100-2, 1992
• Specification for Civil Engineering Construction SABS 1200
  

5. SOUTH AFRICAN BUILDING PRACTICE POLICY AND GUIDELINES

• R158 of 1980 regulations pertaining to Private Hospitals and Unattached Operating Theatres – R198
• Good Pharmacy Practice, Board Notice 129 of 2004, as amended [see Chapter 1].

6. INTERNATIONAL DESIGN GUIDANCE

• ASHRAE Standard 52.2, “Method of Testing General Ventilation Air-Cleaning Devices for Removal Efficiency by Particle Size”, 1992, 1999b
• ASHRAE Standard 62, “Ventilation for Acceptable Indoor Air Quality”, 1989
• ASHRAE. “HVAC Design Manual for Hospitals and Clinics, 2003”, 1989
• CIBSE Applications Manual AM10:1997 “Natural Ventilation in Non-Domestic Buildings”, 1998  
• CIBSE Applications Manual AM13:2000 “Mixed Mode Ventilation,” 2000  

• ASHRAE Standard 170, “Ventilation of Health Care Facilities”, 2008
• QASA. “Know Your Rights”  [Accessibility & the Built Environment]
• Department of Health and Human Services. “Environmental Control for Tuberculosis: Basic Upper-Room Ultraviolet Germicidal Irradiation - Guidelines for Healthcare Settings”, 2009
• WHO. “WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households”, 2009

Guidance has also been provided by AIA (USA), NHS (UK), and Australian Health Facility Guidelines on Healthcare Building Design. Additional references can be sourced from www.tb-ipcp.co.za

Service Context 

The following table gives an indication of the service requirements for mortuaries within different types of public hospitals.

Table 2: Service Requirements

Service	District	Regional	Tertiary	Central	Specialised
Small (beds)	50-150	Min 300	Min 400
Medium (beds)	150-300
Large (beds)	300-600	Max 800	Max 800	Max 1200	Max 600
Training	Where practical	Where practical	Optional	Yes. Attached to medical school
Conduct research				Yes
Mortuary
Short-term stay (2˚C)	Yes	Yes	Yes	Yes
Long-term stay (-15˚C)	Yes	Yes	Yes	Yes
Autopsies (20°C -21°C)	Yes	Yes	Yes	Yes	Yes

For the determination of capacity requirements of mortuaries refer to the recommendations further on in this document.

This guidance document relates to mortuaries located within and serving hospitals, with respect to persons that die due to natural causes in that hospital. This document excludes mortuaries exclusively dealing exclusively with cases that require medico-legal investigation of deaths from unnatural causes.

Post mortems conducted in hospital mortuaries should be limited to conducting investigations and procedures where no medico-legal investigation is required and death from natural causes is suspected.

Hospital deaths from natural causes and those suspected to be of unnatural cases should not be managed in the same facility unless the hospital mortuary is equipped to comply with the specific legal requirements as it they relates to the chain of evidence, etc. The requirements for forensic- pathology service mortuaries are not exhaustively detailed in this document.

It is also noted that some hospitals may opt to contract out the removal and storage of decedents to private undertakers and these hospitals may only require only the minimum in terms of refrigerated body storage.

PART B – Planning and Design 

1. INTRODUCTION

1. All state- run mortuary facilities fall within the domain of the Department of Health, both National and Provincial;, and in an effort to provide engineers and architects who are required to either design new facilities or upgrade existing facilities, this document provides the minimum standards necessary to comply with existing legislation.
2. This document will provide designers of this type of facility with guidelines as to what is required in terms of the following:

• Type of service and package of care being provided
• Mortality rate
• Access and egress
• Discreet management of human remains

• Size and dimensions of the actual facility
• Positioning of mortuaries within hospitals
• Finishes of surfaces in these facilities
• Water- supply requirements
• Drainage requirements

• Electrical supply and lighting requirements
• Installation requirements for equipment and services
• Body-storage requirements
• Body-handling facilities
• Body-holding areas

• Body-viewing area
• Autopsy equipment (tables)
• Air conditioning and ventilation requirements (for infection and indoor air quality control)
• Security of the facility

1. In addition to the items listed above, it is also necessary to consider the needs of visitors to these facilities, particularly those wishing to, or who are required to, identify bodies. In line with this it is also necessary to take the handling of bodies into consideration as it pertains to issues of patient dignity.
2. Forensic pathology mortuaries are not considered exhaustively described in this document, although the majority of mortuaries do have basic facilities for general autopsies that are not necessarily medico-legal in nature. A forensic pathology mortuary has laboratory facilities attached that are outside the scope of regular mortuaries found in hospitals and at police stations. It should be noted that there are a number of principles that hold true for both hospital and forensic pathology mortuaries.
3. Compliance with the requirements of the Occupational Health and Safety Act (Act 85 of 1993 as amended) are to be complied with at all times during the design of a mortuary.

2. LOCATION OF THE MORTUARY AND ACCESS ROUTES

1. The position of the mortuary in a hospital should be such that the mortuary is easily accessible to mortuary staff and related service providers without presenting either aesthetic, emotional or ethical problems for unrelated hospital staff, patients or visitors. Visitors to the mortuary, however, should be provided with clear and direct access to the mortuary upon arrival at the hospital, without having to travel unnecessarily through hospital departments.
2. Where bodies are moved into or out of the mortuary, they should not be moved through general public-access areas. Appropriate routes would include technical service or goods corridors and through the hospital’s support services yard.
3. Special considerations should be given to plans for contingency access to the mortuary in the event of case- load surges, which may be result from disasters.
4. Bodies should not be held for any period in any locations between the body- holding rooms within clinical areas and the mortuary.
5. Where a mortuary unit is used jointly between the hospital and the local authority it is beneficial for the mortuary to be in a building separate from the main hospital building.
6. The delivery of bodies to the mortuary and their subsequent removal from the facility is to be such that it is carried out in a manner that is not visible to the general public, preferably in a covered and enclosed area.
7. While siting and access are important aspects when locating a mortuary, it is also important to provide the mortuary with pleasant surroundings in order to promote the dignity of those working in or visiting the mortuary.
   

3. FACILITY CAPACITY

1. The layout and size of a mortuary is largely determined by the number of bodies stored and whether body storage needs to be in cabinets or in refrigerated rooms.
2. In order to determine the storage capacity of a hospital mortuary it is recommended that historical data, where available, should be used. In the South African context it is suggested that a storage capacity of between 5 and 10 bodies per 100 beds should be used. This varies with the rural or urban location of the facility. This capacity should not take into account the need to store bodies from deaths which are not hospital related, typically motor-vehicle accident deaths and deaths from criminal activity. Requirements for contingency storage capacity related to disaster management should be considered.
3. The body storage capacity required can be estimated on the basis of the number of deaths per year in the hospital, the length of time of holding and the required body store occupancy rate. The number of body trays can be calculated from Equation 1Equation 1 below.

 -Equation 1

Where:  

BT = Number of body trays

D = Number of deaths per year requiring body trays

S = Average length of stay (in days)

R = Required body tray occupancy rate

[Text Box]

1. The estimated storage capacity for bodies in a mortuary could be confounded by a number of local factors, such as:

• Mortality rate from natural causes.
• Mortality rate from infectious disease. (Highly contagious disease deaths require special storage facilities.)

1. Where the hospital is expected to place the body in cold storage until collection by forensic pathology services the following additional factors should be considered:

• Mortality rate from foul play.
• Mortality rate from traffic incidents.

4. SELECTING BODY-STORAGE SYSTEMS

1. Body-storage systems are principally divided into refrigerated rooms or body cabinets. Differences within these system types occur where specific temperatures or sizes are required based on risk, need and capacity requirements.
2. Where a system of functionally separate body cabinets is selected, this system would have an inherent redundancy against failure, as the failure of a single unit would not necessarily imply a system failure. In contrast, a refrigerated room would require less maintenance and would have a lower frequency of failure; however a single component failure could be critical if standby condensing units are not installed. For this reason, multiple- cabinet systems are recommended for areas where expected maintenance response times would negatively affect the mortuary’s operations.
3. It is possible to have a requirement for a mixture of refrigerated rooms and body cabinets. This could be affected by local cultural requirements such as for families which who object to bodies sharing storage space, the case load of the facility or the case profile.
4. Where there is a requirement for the long-term storage of bodies, these are to be kept at a lower temperature than would be the case in a refrigerated room. In this instance separate body cabinets are required. Long- term storage of bodies is most often required when an indigent person dies and difficulty is experienced in locating the next of kin, as the person cannot legally be buried until this process has been completed.
5. In general, smaller facilities rely on body cabinets for the storage as these facilities do not have the space or the need for the large-scale storage of bodies, and they do notthey would not appreciate the functional flexibility offered by these systems. By rule of thumb, any facility that has the requirement to store less fewer than 12 bodies at any given time should use body cabinets. This provides gives the option of providing both short- and long-term storage with the smallest facility and equipment footprint.
6. Bodies suspected of having succumbed to a highly contagious and dangerous disease require special treatment. These should be stored in such a manner that they do not present a hazard to personnel working in the mortuary. Typically these bodies should be stored at the same temperatures the same as for long- stay bodies, e.g. -15˚C, and should be placed in hermetically sealed plastic body-bags.
7. Provision for the secure cold storage of body parts should also be provided.  
   

5. FACILITY LAYOUT

1. As mentioned, the layout and size of a mortuary is going to be largely determined by case load and whether storage is in cabinets or refrigerated rooms. It is acceptable to have a mixture of refrigerated rooms and body cabinets.
2. In a mortuary facility there are a number of separate areas that need to be considered other than the body- storage areas. These include:
3. Reception area for members of the public who are required to visit the mortuary on official business – typically to identify bodies or to pay their last respects to a deceased person.
4. Ablution areas for staff. Where unisex ablutions are provided it is recommended that the no urinal is provided.
5. Visitor’s Visitors’ admin space close to the reception area, where any admin or official business related to the identifying of a body can be completed.
6. Staff admin space close to the point where a body is delivered to the mortuary, so that pertinent documentation can be completed – both with respect to the delivery of the body, as well as when the body is released from the mortuary again.
7. Office space for pathologists to write up reports for in instances where this could be required. This is dependent on the size of the mortuary as small facilities would not require a separate room(s) for this function.
8. Waiting and circulation areas for visitors to the mortuary.
9. Viewing room, from where a body can be viewed through a curtained glass window between this space and the body- display room.
10. Body- display room, where a body is placed for identification purposes. There is to be access to this area via a lockable door to the viewing room for in instances where it is necessary for non-mortuary personnel to have direct access to a body in the viewing room. There is to be access to this room from the body- storage area to allow bodies to be brought in for display purposes.
11. Body preparation area, where a body that is delivered to the mortuary needs to be attended to prior to it being placed in the viewing room.
12. Shower facilities (staff)
13. Changing room (staff)
14. Storage space for equipment and clothing that is worn in the body-preparation and autopsy spaces.
15. Body-storage facility (cold room or refrigerated cabinets), depending on the length of time that bodies are expected to be kept in the facility.
16. Autopsy facility, where the cause of death can be determined. This facility will differ from mortuary to mortuary, depending on whether forensic or standard medical autopsies to determine the cause of death are conducted.

[GroupDrawing]

1. Figure 1Figure 1 is an example of an adjacency diagram for a typical mortuary. In this instance the proximity also relates to visual and physical access. It is also understood that not all mortuaries would require all of the spaces indicated in this diagram, and that some of the spaces shown as being immediately adjacent could be included as a single area if functionality and privacy considerations permit it.
2. There remains abundant scope for variations in the planning of the layouts making up the mortuary. and the hospital architect should consult with all stakeholders to arrive at an ideal solution.
3. When developing the facility layout, careful consideration should be given to the routes through the facility of staff, bodies and visitors. These routes should overlap as little as possible and there should never be a common entrance for bodies and staff or visitors.
4. The room requirement sheets are presented in PART D – User Room RequirementsPART D –User Room Requirementsof this document.
5. Storage space for body lifts must be provided.
6. Suitable sluicing facilities are required to be able to clean equipment and fabrics after completion of any work in the mortuary facility.

6. MORTUARY EQUIPMENT REQUIREMENTS

1. Equipment for storage and transportation of bodies should meet environmental hygiene standards.
2. For mortuary trolley design and supply, the SABS published standard CKS336:2013 Mortuary Trolleys is recommended. It should be noted that this is not a normative South African National Standard, and individual requirements may differ.  
3. Body-cabinet selection and installation requires the following considerations:
4. Three-level body cabinets could be selected which have a single door to give access to all of the body trays, for instances where separation between bodies is required. Alternatively, cabinets that provide a single door for access to all the body trays are acceptable.
5. It is critical that bariatric (obese) bodies are catered for in each cabinet. The lowest-level tray should be designed for this purpose.
6. Special consideration is to be given to the provision of capacity for storage of juvenile and infant decedents. The handling of these bodies is an especially sensitive and emotive issue, and separate storage in dedicated cabinets is recommended.
7. Body lifts must be supplied to facilitate the loading of bodies into and removal of bodies from the cabinets. Body lifts help to preserve dignity when handling bodies, while at the same time making it easier and safer for mortuary personnel to handle bodies.
8. A clear space must be provided in front of the body cabinets to allow for the placing of a corpse into the cabinets. It is recommended that there be at least a 3m clearance between the front of the cabinet and any fixed structure. This is to accommodate whatever means of conveyance is used to transport a corpse to ?? and then load it into the cabinet.
9. Due to the vast array of cabinets available on the market and the lack of an appropriate national standard, it is not yet possible to prescribe sizes for refrigerated cabinets in this guide.
10. The required cabinet size is fundamental when designing a mortuary. Where space is not too limited and there are no indications that there may be cultural concerns relating to the storage of bodies together in a cold room, it is recommended that cold rooms be used. Cold rooms offer space savings when compared to cabinets.
11. A temperature gauge must be installed close to the door of the facility to indicate the storage-space temperature. This gauge should have an alarm system connected to it to give a warning should there be an unacceptable rise in temperature in the storage space. Typically, if the temperature should rise more than 2˚C above the set temperature, an alarm should be activated at a point that is manned at all times.
12. Body cabinets and refrigerated rooms must be supplied with electrical power from the hospital’s essential services electrical supply.
13. A slop hopper is to be provided to allow for the cleaning of the body preparation and autopsy areas, in particular after the completion of any work carried out in these areas.
14. To allow for the rinsing of body parts and organs, during an autopsy procedure it is important that suitable basins be provided in close proximity to thea downdraft autopsy table.
15. Where there is transition between “clean” and “dirty” areas, provision is to be made to allow for the cleaning of footwear in a “transitional” area. This helps prevent the transport of contaminants from dirty areas.

7. MOVEMENT WITHIN A MORTUARY

1. Movement of members of the public visiting the mortuary is to be restricted such that they do not have access to the body- preparation or autopsy areas. (Figure 2Figure 2)
2. The facility must be available within the mortuary where body identification can be conducted in a private and dignified manner. This viewing area should consist of a body- display or layout room with an adjacent viewing room, where the body can be viewed through a curtained shatter-proof glass window.
3. The requirement for a viewing and identification area also pertains to hospitals which outsource their mortuary services.
4. The viewing room and visitors’ admin rooms should be designed such that counselling can be conducted in a pleasant environment for bereaved persons.
5. The design of the viewing facility should allow for adequate space for persons to view a body in a dignified manner.
6. Direct access to the body- layout room from the viewing room is to be provided via a lockable door, to allow visitors access to the body.
7. Ablution facilities are to be available to members of the public who are required to visit the mortuary complex.
8. [GroupDrawing]Where a dedicated room, as described above, cannot be allocated for placing a body for viewing purposes, the persons who are viewing a body should be given a private space for viewing the body through a curtained shatter-proof glass window, as a minimum.
9. Adequate facilities to accommodate at least 7 visitors are to be provided.
10. Staff access to the mortuary facility is to be separate from the general public. (Figure 2)
11. Mortuary staff change rooms should be provided with secure lockers for storage of street garments, lab coats, personal protective equipment and valuables. Street garments and lab garments  
12. Mortuary staff may have completely separate ablution facilities from those used by the general public requiring access to the mortuary facility.
13. In a free- standing mortuary building the delivery to and removal of bodies from the facility may be via the same access point to the building.
14. A mortuary that forms an integral part of a hospital will require separate routes for receiving bodies and the subsequent removal thereof.
15. In the unusual event that a body arrives from outside of the hospital, the normal route of removal should be used for receipt of the body.
16. A clear distinction is to be made between “clean”,” “dirty” / “wet” and “transitional” areas. This is best achieved by creating a physical “RED LINE” on the floor indicating the separation of these areas, with “yellow lines” used to demarcate “transitional” areas. Receptacles for the collections of dirty clothing, etc, must be made available at the transition area from a dirty to clean areas and in change rooms.
17. A well-drained facility for washing of vehicles which have been contaminated with decomposed bodies or bodily body fluids should be provided in an enclosed area, near to the mortuary.

8. SERVICES REQUIRED

1. Hygienic floor drains that are resistant to corrosion from blood and chlorine should be provided in all “wet areas” of the mortuary and should be directly connected to the sewer system. These areas include body preparation, autopsy space, etc. These areas require thorough cleaning after every procedure, using large quantities of water and decontaminating and disinfecting chemicals and soaps..
2. Sluicing facilities are to be provided in both the body- preparation and autopsy areas if they are not a common area.
3. Open floor channels should be avoided. Where this is not possible, these should be covered by durable, flush- fitted stainless steel grids.
4. No sewer connections external to the mortuary services should be made to the line between the wet area drains and the main sewer system in order to prevent backflow to other areas.
5. The provision of hot and cold water in the facility is imperative, with all basins, sinks, ablution areas and autopsy tables being provided with both.
6. Anti-backflow devices should be fitted to the water- supply lines serving mortuary table faucets to prevent backflow should supply water pressure fail.
7. Electricity supply to the mortuary – particularly for refrigeration purposes – is to be provided from the essential supply system for the hospital. Alternatively, a back-up generator is to be supplied to allow for the maintenance of required temperatures in the cooling/freezing facilities in the mortuary.

9. BIOLOGICAL SAFETY

1. A Biosafety Laboratory Level 3 (BSL3) designation (R178-2012) is applicable for any decomposing bodies post-mortem area. This area is identified as a level-3 containment facility.
2. BSL3 areas shall have restricted access and shall be separated from regular traffic flow routes.
3. All doors opening into the BSL3 areas shall be appropriately labelled with biological safety hazard signage.  
4. Access to the BSL3 areas shall be through dedicated ventilated airlocks. A pressure differential of minimum +15Pa shall be maintained for the airlock relative to the BSL3 area. This pressure differential is relevant for when the doors are closed only. Room pressure differential gauges are to be fitted at the entrance to the BSL3 area.
5. Airlock doors shall be interlocked such that only one door can be opened at a time, thereby preventing direct passage between the corridor and the BSL3 area.
6. It is recommended to createthat a transfer hatch be created for the transfer of goods between areas with differing biosafety-level classifications. This device shall be designed to preserve the integrity of the containment system and the mechanical ventilation design.
7. Air exhausted from biosafety areas should be safely discharged to the outside with no chance for re-entrainment or contamination of other indoor spaces. Exhausts from biosafety areas should be vented at 3m above the roof level. Where such measures are not possible, exhaust air shall be EN1822 H13 HEPA filtered. Exhausts from biosafety areas should include anti-backflow devices.

10. FINISHES TO FLOORS AND WALLS

1. Walls and floor coverings within a mortuary should be easily cleanable and impervious to liquids and staining.
2. Floors are to be of such a nature that they are not easily damaged by wheeled items that are moved over them. Vinyl floor coverings are not considered to be resilient enough for this purpose.
3. Epoxy floor coverings are preferable, as these are easily maintained and do not have joints in them where liquids can accumulate to become a health risk.
4. Corners between walls and floors shall be coved to facilitate the cleaning of these areas. These coving details should be solid and continuous without hidden formwork and cavities.
5. Walls are to be coated with hard- wearing and washable materials/paint with provision made for trolley “bumpers” along walls exposed to high traffic. Wall coatings shall be impervious to damage from trolleys and mobile equipment.
6. Materials such as vinyl sheeting should not be used to cover walls in wet areas. The risk of growth between the sheeting and the wall presents a health hazard to personnel working in the mortuary wet areas.
7. Due to the potential presence of water on flooring it is essential that flooring be non-slip.
8. Refer to the room requirement sheets herein and the IUSS Materials and Finishes guidance documents for further information.
9. Surface- mounted services should be avoided to ensure smooth and washable surfaces. Where surface mounting of piping is unavoidable, this piping should be mounted on batons, such that the space behind the piping is readily accessible for cleaning.

11. AUTOPSY EQUIPMENT/FIXTURES

1. Equipment for the storage and transportation of bodies should meet environmental hygiene standards.
2. In the majority of instances an downdraft autopsy table is required within a hospital mortuary facility. This table should be one that is designed in such a way that there is a hot and cold water supply that is integral to table installation, as well as a drainage system that can automatically drain water/waste from the table to the sewer system of the facility.
3. The autopsy table should have an integrated ventilation extraction or “downdraft” system in order to entrain noxious odours and infectious material that may emanate from a body. This can function to minimise the spread of any airborne pathogens from the body.
4. Adequate stainless steel washing basins (at least one per autopsy table) must be provided in close proximity to the autopsy table for the use of personnel working in the facility.
5. Electrical power must be provided from a 5 amp IPX5 waterproof single-socket outlet near the autopsy table to allow for the safe use of any electrical equipment that may be required during an autopsy.
6. Lighting quality over the autopsy table must be exceptionally good. Refer to the lighting requirements specified in the room- requirement sheets herein and the IUSS Building Engineering Services guidance document for specifications.
7. Adequately sized worktops must be provided along the walls of the autopsy area for equipment and specimens prior to storage.
8. It is recommended that working surfaces of at least 500x2500mm be provided per autopsy table.
9. A balance table for a bench-top scale is required. The scale can be either permanently mounted on the work surface or stored in the autopsy equipment store.
10. A platform scale for measuring the weight of an entire body prior to any possible dissection/autopsy work being conducted is to be accommodated.
11. Lockable Ccabinets are required for the storage of autopsy equipment, as well as for any personal protective equipment morticians or medical examiners may require.
12. Trolleys for the conveyance of bodies must be provided in the mortuary and adequate provision for the storage of these units must be available.
13. The use of wood, such as for wooden doorframes, is not allowed in wet areas.  
14. Stainless steel bump rails or plates should be fitted in areas prone to damage from trolleys. These devices shall be fitted such that that they do not affect the integrity and cleanability of the walls and floors. These devices shall not create crevices or gaps which could would harbour pathogens or create a hygiene problem. Welded stainless steel sections shall be stainless steel Grade 316L  

12. VENTILATION

1. Mortuaries Mortuary areas require good ventilation. The exhaust air is to be discharged to atmosphere such that it cannot be drawn back into the mortuary, any other ventilation inlet, or any indoor portion of the hospital.
2. All external ventilation openings should be fly- and vermin- proof.
3. Exhausted air may not pose a hazard to any person who is outside the mortuary. (See room-requirement sheets) Air exhausted from clinical areas should be safely discharged to outside with no chance for re-entrainment or contamination of other indoor spaces. Where these precautions are by no means possible, exhaust air shall be EN1822 H13 HEPA filtered.
4. Sufficient ventilation is required for controlling noxious odours present in mortuaries and should also provide a means of protection to personnel working in the facility from possible airborne infections originating from corpses.
5. Airborne- infection control is of particular concern and must be designed for in terms of the ventilation system. Tuberculosis, Hepatitis and HIV are of among the most regularly encountered diseases in mortuaries in South Africa and, as such, the spread of these pathogens beyond the mortuary, via a ventilation system, must be avoided by implementing the airborne- contamination control principles for high- risk areas in the ventilation system design. Refer to the IUSS Building Engineering Services guidance document for further guidance on airborne- contamination control principles.
6. The ventilation system must be designed such that airborne pathogens that may be present in the body- holding area and autopsy room do not contaminate the remainder of the mortuary facility.
7. No recirculation of air extracted from the clinical areas is permitted.
8. Air from public areas, with the exception of viewing rooms, may be recirculated where this is in accordance with the National Building Regulations.
9. Exhaust ventilation is to be designed in such a manner that this extracts from the areas with the highest risk of infection, while “clean” air is to be supplied into the lower- risk areas. This is to create a pressure cascade with cleaner areas being at a relatively higher air pressure than dirty areas.
10. Air- supply registers should be at a high level and the extraction registers should be at a low level. The low- level extraction grilles shall not be more than 500mm above the finished floor level of the room where from which the extraction is taken from. Low- level air- register positions shall consider locations of water points and potential splashing during washing.

13. AIR CONDITIONING

1. The mortuary and autopsy area must have a temperature maintained at between 20˚C to and 21˚C.
2. Public areas must be kept at a constant temperature between 23˚C and 25˚C.
3. Air extracted from the mortuary may not be used for energy recovery or recirculation.

14. REFRIGERATION EQUIPMENT DESIGN AND INSTALLATION

1. All heat- rejection equipment associated with refrigeration in the body- storage facilities must be located on the outside of the mortuary, in a well-ventilated space at the rear of the fridge(s). Compressors installed on top of body cabinets on the inside of the mortuary are not acceptable. Heat build-up within the mortuary, as a result of this type of arrangement, potentially leads to equipment failure.
2. Regularly serviced refrigeration equipment components should not be situated within the confines of the mortuary. Refrigeration technicians should not be required to climb onto or over a body cabinet to carry out any maintenance work. It is preferable to have refrigeration equipment situated in a separate ventilated area to the rear of the body cabinets. The designer is to refer to the selected heat- rejection equipment’s installation manual to determine free space and ventilation openings required around this equipment, since these details can vary between system types.
3. Gauges indicating the temperature within the body cabinet must be clearly visible above the door of the unit in order that this can be readily monitored.
4. The acceptable average temperature within a normal body cabinet or refrigerated room is between 2.0˚C and 6˚C. In instances where a body has to be kept for an extended period of time a cabinet temperature of at least -20˚C is required.  
5. In facilities where large quantities of bodies are kept, cold rooms for the storage of multiple bodies on trays are recommended.
6. The materials used for the construction of the units are to be of stainless steel to facilitate cleaning and long-term maintenance of the equipment. Grade 316 stainless steel (18/10) is preferable over Grade 304 (18/8), as it offers better corrosion resistance.
7. For welded stainless steel construction, Grade 316L or similar is required.
8. If a facility is required to collect and retain forensic samples, refrigeration equipment should be provided for the preservation of these samples. Preferably this equipment should be placed in an area where they it can readily be secured from unauthorised access and tampering.

15. SECURITY ARRANGEMENTS

1. Due to the medical and legal nature of the contents of a mortuary, it is essential that a mortuary has good access control and security systems.
2. Theft from mortuaries should be forestalled by, inter alia, constantly monitoring all entrances and preventing free access to mortuary areas. This is especially important for the body- storage areas. Access card or tag systems are open to misuse and are not an appropriate access- control measure. Combinations of tag and biometric access- control systems are recommended.
3. Door closers with a “hold-open” mechanism should be installed on the mortuary room doors. This enables doors to close automatically with normal traffic, but can also be held open when moving equipment or trolleys through. “Crash”- type doors should be avoided as these are not easily cleanable and are subject to damage and abuse.
4. It is recommended that a timed alarm be fitted to doors to ensure that they are closed shortly after any entrance or exit. This is to mitigate militate against the tendency of keeping doors open with some form of door stopper.
5. Body cabinets are to be fitted with locks to prevent the unauthorised opening of these units to forestall the theft of any personal items of the deceased.
6. In instances where historical problems relating to unauthorized entry into mortuaries is evident, it is recommended that closed-circuit TV systems be installed to help in monitoring and securing the facility.

PART C – Operation 

1. OBJECTIVES

The project planning, design, construction and commissioning should aim to provide:  

1. a safe, secure and functional environment for visitors and staff;
2. low capital and ongoing operating costs (service, staffing and maintenance);  
3. an environmentally appropriate design solution; and
4. a fully accessible, inclusive environment.  
   

2. HEALTH AND SAFETY

In light of the above it is essential that every effort be made to ensure that personnel working in the mortuary are provided with all required personal protective equipment (PPE), as this is essentially an area where pathogens could be present and present a health risk to staff. The following items should be available to staff as a minimum:

1. Rubber aprons (or similar impervious material)
2. Latex gloves (or similar impervious material)
3. Mesh gloves in facilities where post mortems are performed
4. Disposable gowns
5. Safety glasses or full-face visors.
6. Waterproof footwear
7. Face masks
8. Respirators with the appropriate filters must be available for use in high-risk situations.
9. Storage space for PPE

No one should be permitted to enter the body storage and preparation areas without donning appropriate gowns and footwear.

3. MAINTENANCE

When designing the facility, every effort must be made to limit the amount of maintenance that would be necessary to keep it in good condition. Seamless surfaces for walls and floors are critical, as this will reduce ongoing maintenance costs. The following minimum requirements should be complied with:

1. Seamless floor coverings required
2. Radiuses corners ??? required between floors and walls.
3. No sharp corners on any work surfaces that could injure people working in the area.
4. Ceilings to be readily cleanable.
5. Work surfaces are to be impervious to liquids and resistant to staining and corrosion.
6. Refer to the room- requirement sheets herein and the IUSS Materials and Finishes guidance documents for further information on the general requirements for materials and finishes.
7. All equipment requiring calibration, such as fridges and scales, are to be attended to on an annual basis or when it is suspected that they are defective in respect of their expected/intended performance

PART D – User Room Requirements 

Table 3: Accommodation schedule

Room Name	Service Description	Area (m²)	Min. Ceiling Height (m)	Occupancy (Persons)	Nominal Utilisation per day (hours)
Ablution areas	Ablution areas – male  and female One WHB per WC or urinal	3 (per cubicle)	2.8	1	4
Shower facilities	Shower facilities – male  and female	3 (per cubicle)	2.8	1	2
Changing room	Staff changing room - lockers to be provided	8	2.8	2	2
Storage space	Equipment and PPE storage space	8	2.8	1	1
Offices	Office space – interview, body receiving, pathologist	9	2.8	2	8
Body/bier room	Area where a body can be laid out for viewing and identification	9	2.8	1	8
Viewing room	Viewing room – external to body- layout area	9	2.8	4	1
Autopsy room	Autopsy facility – Autopsy table with water supply and discharge and extraction ventilation. WHBs and stainless steel working surfaces	27	2.8	3	3

Table 4: Room services sheet

Room Name	Temp (°C)	Ventilation (AC/h)	Ventilation Type	Pressure Relative to Ambient	Wet Services	SSO 400V	SSO 230V	Task Illuminance (lux)	Data Points	Colour Rendering (Ra)
Reception area	22-25°C	2	Forced supply	=		0	0	100 at floor level	0	80
Visitors ablution areas	22-25°C	15	Forced extraction	-	WC,   WHB	0	0	150 at floor level	0	80
Public waiting area	22-25°C	2	Forced supply	+		0	0	100 at floor level	0	80
Offices	22-25°C	2	Forced supply/ recirc.	=		0	2	300 at desk level	1	80
Circulation Spaces	22-25°C	10	Forced supply/ recirc.	=		0	0	200 at floor level	0	80
Viewing room	22-25°C	2	Forced supply	+		0	0	100 at floor level	0	80
Layout room	20-21°C	2	Forced extraction	-	WHB	0	0	300 at table level	1	80
Storage space	22-25°C	4	Forced supply	=		0	1	200 at floor level	0	80
Mortuary	20-21°C	12	Forced extraction	-	WHB,   FD	0	1	200 at floor level	0	80
Mortuary plant area	n/a	n/a	Natural ventilation	=		1	1	150 at floor level	0	80
Autopsy table	20-21°C	20	Forced extraction	-	CW Faucet	0	1	5200 at table level	0	90
Autopsy room	20-21°C	20	Forced extraction	-	WHBs,   FD	0	2	500 at floor level	1	90
Changing room	22-25°C	15	Forced extraction	-	WHB	0	1	150 at floor level	0	80
Staff ablution areas	22-25°C	15	Forced extraction	-	WHB, WC	0	0	150 at floor level	0	80
Shower facilities	22-25°C	15	Forced extraction	-	CW + HW Faucet	0	0	150 at floor level	0	80

Table 5: Room finishes

Room Name	Floor Material	Wall / Floor Interface	Walls Finish	Ceiling Finish	Glazing Type	WHB	Doors Type
Ablution areas (all)	Jointless vinyl sheet	Skirting coved and finished as per floor	Ceramic wall tiles with epoxy grout	Washable acrylic paint	Obscure  laminate safety glass	1 per WC or urinal	Solid wood with galvanised steel or stainless steel sheet trolley plates
Public waiting area	Jointless vinyl sheet	Coved vinyl skirting	Washable acrylic paint	Washable acrylic paint	Clear  laminate safety glass	0	Lockable glazed entrance door
Changing room	Jointless vinyl sheet	Skirting coved and finished as per floor	Washable acrylic paint	Washable acrylic paint	Obscure  laminate safety glass	0	Solid wood with galvanised steel or stainless steel sheet trolley plates
Storage space	Jointless vinyl sheet	Skirting coved and finished as per floor	Washable acrylic paint	Washable acrylic paint	Clear  laminate safety glass	0	Solid wood with galvanised steel or stainless steel sheet cladding
Offices	Jointless vinyl sheet	Coved vinyl skirting	Washable acrylic paint	Washable acrylic paint	Clear  laminate safety glass	0	Solid wood
Body Room	Self- levelling epoxy	Skirting coved and finished as per floor	Washable acrylic paint	Washable acrylic paint	Clear  laminate safety glass	0	Solid wood
Viewing Room	Self- levelling epoxy	Skirting coved and finished as per floor	Washable acrylic paint	Washable acrylic paint	Clear  laminate safety glass	0	Solid wood
Autopsy Room	Self- levelling epoxy	Skirting coved and finished as per floor	Washable acrylic paint	Washable acrylic paint	Obscure  laminate safety glass	Min 1 per autopsy table	Solid wood with galvanised steel or stainless steel sheet cladding
Circulation Spaces	Jointless vinyl sheet	Coved vinyl skirting	Washable acrylic paint	Washable acrylic paint	Clear  laminate safety glass	0

PART E – Examples and case studies 

Figure 4 demonstrates the relationships between the zones within the mortuary. In this example it is evident how visitors are managed and kept out of the working portions of the mortuary through segregation in the internal layout. The process flow of the bodies into, through and out of the mortuary has been well considered in that the flow is linear with bodies entering the mortuary onat one end of the facility and exiting at the other. Unfortunately, the restrictions presented by the location of the mortuary, as can be studied in Figure 3, has forced the design into a number of compromises relating to the external flow and access to the mortuary. Staff access is quite severely compromised in being through the mortuary lobby. This mortuary lobby, in the absence of a dedicated preparation room, has the potential of being used as one. This arrangement may impact negatively on the dignity of some staff, the dignity of the deceased, and mortuary security.

Visitors’ access to the mortuary and their adjacent toilets is near the hearse bay and turning areas. There is no natural screening of this entrance from the activities in the hearse bay and it is not inconceivable that visitors may inadvertently wander into the wrong area and be exposed to operational activities not appropriate for the bereaved.

The door sizes of the body storage rooms seem too small for the easy passage of a body trolley when compared to the double doors made available for the passage of the body from there through the remainder of the facility. Door size selection should not be limited by the fact that these are cold room doors. Where doors are too small for free passage of trolleys and porters, their the doors’ service life would be severely shortened and any savings made on the door selection would be lost to maintenance or retrofitting an improved solution.

The access to the technical area for maintenance of the refrigeration equipment in this example meets the recommendations. Here technicians do not need to enter the mortuary to perform the majority of their work and these areas are quite well separated from the admin and visitors’ areas.

2. EXAMPLE 2: LARGE MORTUARY WITH AUTOPSY FACILITIES

Figure 5 shows the layout of a standardised mortuary design. This is a large facility with autopsy capacity. Figure 6 has been presented in order to promote an understanding of the interrelationship between the various functional parts of the mortuary.

Considering the entrances shown in Figure 5, it is clear that the designer has taken somemade an effort to screen the visitor’s visitors’ entrance from the hearses’ entrance. The staff entrance is also well positioned. The staff ablutions facilities and showers are located between the clinical areas and the admin areas. This arrangement encourages good segregation and gowning practice when moving between the mortuary activities and external movement.

The staff and visitors’ access positions are located well away from the working clinical areas of the mortuary and are also relatively remote from each other. This aids in improving security as it discourages the staff and visitors from using the wrong entrances and thereby assists in identifying persons who are present in areas where they do not belong.

This design doesn’t have a dedicated body prep area and it is assumed that the weighing and measuring area is therefore used for this purpose.

The large sliding doors of the cold room in this example can be compared to the cold-room doors in Figure 3 as an indication of what the door size should be like to enable easy passage.

The layout in this example does not provide for a dedicated exit yard and bodies and hearses entering and leaving the facility do so through the same entrance. This arrangement increases the potential for mistakes in body handling.

The common use of the bier room as access to the ID room seems to be a compromise resulting from the limited space provided for these rooms.

3. EXAMPLE 3: LARGE MORTUARY WITH AUTOPSY FACILITIES

The example shown in Figure 7Figure 7 is a standard facility layout, very similar to that of Figure 5Figure 5, with the most notable changes being the inclusion of a dedicated vehicle- exit yard and the omission of the technical service area. The addition of the exit detail resolves the criticism of the arrangement in Example 2, while the omission of the technical service area for the refrigeration equipment could present an access problem for maintenance technicians, as discussed earlier in this document.

The example in Figure 7Figure 7 has also resolved the compromises to in the arrangement of the bier rooms and ID/viewing rooms’ available space, discussed in the previous example.

DEFINITIONS

In the context of this document the following definitions pertain:

Autopsy room: Synonymous with post–mortem examination area or suite.

Containment facility:  The part within the demarcated zone in which the most malodorous activities occur. This facility includes the decomposing bodies’ post-mortem examination room, airlock ante room, and a decontamination unit each for men and women.  The containment facility is sealed off from the rest of the demarcated area.

Demarcated area:  The demarcated area, including the post-mortem examination rooms and all supporting functional spaces is the area where most sensitive, costly and specialised processes occur.

Dignity of deceased: The principle that bodies are treated with the respect and dignity befitting any person prior to death.

Dissection room or suite: Synonymous with post-mortem examination area or suite.

Mortuary:  A mortuary is a facility for temporary storage of the deceased pending identification, medico-legal investigation and despatch.

Natural death: A death byfrom natural causes which is are determined to have been the cause of illness ofor an internal malfunction of the body which was not caused by external forces.

Post-mortem examination area or suite: A room and its attached service rooms designed for the performing of post-mortem examinations.

Post-mortem examination: Examination after death, which may include performance of an autopsy.

Unnatural death: A death which is not classified as being a Natural Death

Work bench (or bench): Unless otherwise specified, this is a surface ergonomically dimensioned for use from the standing position. This is normally 900mm.

Work-station: Unless otherwise specified, this  is a surface ergonomically dimensioned for use from the seated position. This is normally 750mm.  ??

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BIBLIOGRAPHY

To be sorted out and made consistent - as advised to Mr Van Reenen

REQUIREMENTS FOR THE FACILITIES AND OPERATION OF MORTUARIES (Second Edition 2009), NPAAC Tier 4 Standard. Australian Government Department of Health and Ageing.

MANAGING HEALTH AND SAFETY RISKS IN NEW ZEALAND MORTUARIES.(November 2000) Dr Chris Wells and Dr Jeff Brownless

Mortuary design and hazards. J. clin. Path. (1961), 14, 103

Health Authority Abu Dhabi. Part B- Version 3.1, June 2011

Design and layout of Mortuary Complex for a Medical College and Peripheral Hospitals. (2011) BasantLalSirohiwal, Paliwal PK, Luv Sharma and Hitesh Charlwa

Planning and design of modern mortuary complex in tertiary care. IIJFMT 4(1) 2006.  Dr Sanju Singh, Dr U.S. Sinha, Dr A.K. Kapoor, Dr S.K. Verma, Dr Dalbir Singh, Dr Susheel Sharma

Australian Health Facility guidelines. Revision v.4.0 16-Dec-10

Mortuary Facilities – Design and improvement guide. CSIR March 2002

Project development brief for the new academic M6 pathology forensic laboratory.  Western Cape Department of Health, August 2009

National Code of Guidelines for Forensic Pathology Practice in South Africa. Edited by NFPSC Academic Sub-committee 20 August 2007

IUSS Building Engineering Services guidance document