Section 8.3: Post-Mortem Transport & Shipping Requirements

Post-Mortem Transport and Shipping Requirements

Mortuary transport requires strict adherence to legal, physical, and biological safety standards. When remains are shipped across state lines or international borders, they are subjected to regulations from health departments, transportation authorities, airlines, and foreign consulates. The professional embalmer must know how to select proper shipping containers, prepare legal documentation, and handle infectious cases safely.

Shipping Containers

Different types of transport require specific containers to protect the remains, the public, and transportation workers. The shipping containers used in the funeral industry must meet the standards set by the Air Transport Association (ATA) and the Transportation Security Administration (TSA).

1. Air Tray

An air tray is a shipping container designed for casketed remains.

• Construction: It features a solid wood base (usually plywood) and a heavy-duty, water-resistant cardboard top and sides. It has sturdy straps to secure the casket inside.
• Purpose: The wood base provides structural support so the casket can be handled by forklifts and airport cargo personnel, while the cardboard cover protects the exterior finish of the casket from scratches and damage.

2. Combination Unit (Combo Case)

A combination unit is a shipping container designed for uncasketed remains.

• Construction: It consists of a solid wood base and a heavy cardboard outer sleeve. The interior is padded and contains safety straps to secure the remains directly, along with a headrest.
• Purpose: Combos are used when a body is shipped by common carrier without a casket (e.g., when the body is being sent to another funeral home for cremation or a casket selection will occur at the destination).

3. Ziegler Case

A Ziegler case is a metal container that can be hermetically (airtight) sealed.

• Construction: It is a gasketed container made of heavy-gauge zinc, steel, or copper. The lid is secured with screws or clamps against a rubber gasket, creating an airtight and leak-proof seal. It is small enough to fit inside a standard casket or a wooden shipping box.
• Purpose: Ziegler cases are used in three primary scenarios:
  1. Advanced Decomposition: To contain gas buildup, fluids, and severe odors.
  2. Highly Infectious Diseases: To prevent the escape of airborne pathogens or fluids.
  3. International Shipping: Many foreign countries legally require a hermetically sealed metal liner for any remains entering their borders.

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Transport Documentation and Regulations

Legal compliance is paramount when shipping remains. The transport of a body without proper permits can result in heavy fines, delays, and criminal charges.

1. Burial-Transit Permit

The burial-transit permit (also known as a disposition permit) is the primary legal document required for the transport and final disposition of remains.

• Source: It is issued by the local registrar of vital statistics in the district where the death occurred or where the body was found.
• Requirements: To secure the permit, the funeral director must file a completed (or pending) death certificate signed by a physician or medical examiner.
• Function: This permit must accompany the remains during transit and must be presented to the cemetery sexton, crematory authority, or airline agent at the destination.

2. Embalmer's Affidavit / Certificate of Embalming

Many states and common carriers require an embalming certificate or affidavit signed by a licensed embalmer. This document certifies that the body has been properly sanitized and preserved, and that all cavities have been treated. If a body is shipped non-embalmed (often for religious reasons), some states require a special transit permit and dictate that the body must be shipped in a sealed container or on dry ice.

3. TSA Known Shipper Program

Under federal law, remains shipped as cargo on passenger airlines must comply with the Transportation Security Administration (TSA) regulations.

• Known Shipper Status: A funeral home must be registered and verified as a "Known Shipper" with the airline or shipping broker.
• Inspection: The cargo is subject to screening. The shipping container must be clearly labeled, and the paperwork must match the label exactly. Unregistered shippers cannot book cargo on passenger flights.

4. International Shipping Requirements

Shipping remains internationally is highly complex and requires coordination with the embassy or consulate of the receiving country. The typical requirements include:

• Consular Documents: Certified copies of the death certificate, embalmer's affidavit, transit permit, and a passport (if available).
• Non-Contagious Letter: A statement from the local health authority certifying that no contagious or communicable diseases were present in the area where the death occurred.
• Consular Seal: The consulate will inspect the paperwork and place an official seal (wax or stamp) on the container. This seal must not be broken during transit.
• Airtight Container: A Ziegler case or metal-lined casket is almost universally required for international transport.

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Handling and Preparing Infectious Cases

When preparing and transporting remains with highly infectious or contagious diseases, the embalmer must prioritize public health and personal safety by adhering to strict sanitization protocols.

1. Universal Precautions

All remains must be treated under Standard/Universal Precautions, assuming that all bodily fluids contain transmissible pathogens. Embalmers must wear full personal protective equipment (PPE), including fluid-resistant gowns, double gloves, face shields, and NIOSH-approved respirators (such as N95 masks).

2. High-Risk Pathogens and Preparation Protocols

• Tuberculosis (Mycobacterium tuberculosis): An airborne pathogen that can survive in post-mortem tissues. The embalmer should wear a respirator and pack the oral and nasal cavities tightly with cotton saturated in a high-index cavity fluid or phenol solution to block the escape of airborne droplets.
• Prion Diseases (Creutzfeldt-Jakob Disease - CJD): CJD is caused by abnormal proteins (prions) that are highly resistant to standard formaldehyde preservation and heat. If the remains have been autopsied, the brain and cranial cavity must be treated with extraordinary care. Instruments must be soaked in 1N Sodium Hydroxide (NaOH) or sodium hypochlorite (household bleach) for at least one hour, and disposable materials must be incinerated.
• Quarantinable Diseases (e.g., Ebola, Lassa Fever): In cases of viral hemorrhagic fevers, state and federal regulations may forbid embalming. The remains are typically placed directly into hermetically sealed body bags and cremated or buried immediately without embalming.

3. Containerization for Infectious Cases

For long-distance transit of infectious remains, the body should be placed inside a leak-proof disaster pouch (body bag) before being placed in the shipping container. The outer container should ideally be a Ziegler case to provide a hermetic barrier, ensuring that no fluids or pathogens can escape during flight or handling.