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Occupational Medicine & Health Affairs Tamuno-Opubo, Occup Med Health 2023, 11:7
CARDIOPULMONARY FUNCTIONS OF MORTICIANS IN RIVERS STATE
1Tamuno-Opubo Abiye, 2Owhondah Golden 3Stanley Rosemary Oluchi, 2Austin-
Asomeji Iyingiala 4George Abiye 4Abolo Akunna Sandra 5Obi-Wali Annabel
Chiburoma
1
Department of Human physiology, Rivers state University, Rivers state Nigeria.
2
Department of Community Medicine, Rivers state University, Rivers state Nigeria.
3
Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Rivers state, Nigeria
4
Department of Anaesthesiology, Rivers state University, Rivers state Nigeria.
5
Rivers state Ministry of Health, Port Harcourt, Rivers state.
*corresponding author: tamunoopubo.abiye@gmail.com

ABSTRACT

The current study was carried out to assess the respiratory function and symptoms of
morticians in the Port Harcourt Metropolis. A comparative assessment of respiratory
function of morticians and non-morticians in Port Harcourt was carried out. Respiratory
indices of 67 morticians and an equal number of non-morticians were carried out according
to guidelines of the American Lung Association and using the Vitalograph Compact
spirometer. The study showed that 57.5% of morticians reported having respiratory
symptoms, while 32.5% of control (non-morticians) had respiratory symptoms. Chi-square
analysis showed that the occurrence of respiratory symptoms among the morticians was
significantly higher compared to controls. Logistic regress analysis showed that morticians
were 2.8 times (95% C.I: 1.1 – 6.9) likely to develop respiratory symptoms compared to
non-morticians. Also, FEV of morticians was found to be 39.93 ± 13.38 compared to 58.08
± 19.01 in controls and the FEV1/FVC ratio of morticians was 93.08 ± 22.93 compared to
58.22 ± 19.17 in controls. Analysis showed that the FEV1/FVC ratio of morticians was
significantly higher than that of non-morticians. These findings highlight the need for
proactive measures to protect the respiratory health of morticians, including improved
occupational safety practices, enhanced training, proper ventilation, and regular health
monitoring. Addressing these implications can help mitigate the respiratory risks faced by
morticians and promote a safer and healthier work environment within the profession.

Keywords: Morticians, Cardiopulmonary functions, Respiratory symptoms, Occupational exposure

1.0 INTRODUCTION

Morticians, also known as funeral directors or undertakers, play a crucial role in handling and
preparing deceased individuals for their final arrangements. While their profession focuses on
providing respectful and dignified funeral services, morticians may face specific
cardiopulmonary risks and diseases due to the nature of their work.1,2 Morticians are regularly
exposed to embalming fluids, which typically contain chemicals such as formaldehyde, phenol,
and methanol. Prolonged or excessive exposure to these substances may lead to respiratory

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tract irritation, lung damage, and increased risk of developing respiratory diseases.2,3 Similarly,
morticians frequently use disinfectants and cleaning agents to sanitize and maintain the
mortuary environment.4–6 These chemicals, including bleach, ammonium compounds, and
hydrogen peroxide, can potentially cause respiratory distress, bronchial irritation, and
exacerbate pre-existing respiratory conditions. The inadequate or improper use of personal
protective equipment, such as gloves, masks, goggles, and respirators, can heighten the risk of
exposure to hazardous chemicals.7,8 Morticians must adhere to strict safety protocols and
ensure the proper use of PPE to minimize respiratory and cardiovascular risks. Morticians face
specific cardiopulmonary risks and potential exposure to diseases due to the nature of their
profession.4,9 These risks include exposure to hazardous chemicals, transmission of infectious
diseases, and workplace hazards that can impact their respiratory and cardiovascular health.
The current study was carried out to assess the cardiopulmonary functions of Morticians in
Rivers state, Nigeria.

2.0 METHODS
2.1 Study Population
The study population includes Morticians that currently working in Obio/Akpor Local
Government Area of Rivers state, Nigeria for at least one (1) year. Purposive sampling was
used to select a total of forty (40) morticians and 40 non-morticians were selected as control
subjects for the study.
2.3 Ethical Consideration
Ethical approval to carry out the study was obtained from the research and ethics committee of
the Rivers state University. A willing informed consent was obtained from each participant
before their inclusion into the study.
2.4 Determination of Respiratory Indices and Data Collection
A questionnaire including demographic information was completed for each participant. A new
spirometry was performed according to the guidelines of the American Lung Association and
using the Vitalograph Compact spirometer that was calibrated twice, first at starting and second
every four hours.10 The spirometries were conducted for all workers under the same standard
conditions.
2.5 Data analysis
The data collected was analysed using the Statistical Package for Social Sciences (SPSS) v25
software. The spirometric indices of the morticians and control subjects were compared using
the independent T-test. The Chi-square statistic was used to assess the distribution of
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respiratory symptoms in morticians compared to control participants. A p-value less than 0.05
was considered statistically significant.

3.0 RESULTS

Table 1 shows the demographic distribution of the study participants. The Table showed that
57.5% the morticians were between that age of 30 – 39 years, while 25% of the participants
were between 20 – 29 years and 17.5% of the participants were between 40 – 49 years.

Table 1: Demographic Characteristics of Participants

Morticians Non-morticians
n=40, (%) n=40, (%)
Age Groups (years)
20 – 29 10(25.0) 10(25.0)
30 – 39 23(57.5) 23(57.5)
40 – 49 7(17.5) 7(17.5)

Table 2 shows the distribution of respiratory symptoms in morticians and control participants.
The table showed that 57.5% of morticians have reported having respiratory symptoms, while
32.5% of control (non-morticians) had respiratory symptoms. Chi-square analysis showed that
the occurrence of respiratory symptoms among the morticians was significantly higher
compared to controls. Logistic regressions analysis showed that morticians were 2.8 times
(95% C.I: 1.1 – 6.9) likely to develop respiratory symptoms compared to non-morticians.
Table 2: Distribution of respiratory symptoms in morticians and control participants

Symptoms Morticians Non-morticians Chi-square O.R (95% C.I)

n=40, (%) n=40, (%) (p-value)
Respiratory Symptoms 23(57.5) 13(32.5) 5.05 (0.024)* 2.8 (1.1 – 6.9)

No Respiratory Symptoms 17(42.5) 27(67.5)

* statistically significant (p<0.05)

Table 3 shows a comparative analysis of the respiratory indices and blood pressure
measurements in morticians and non-morticians.

Table 3:Comparison of average respiratory indices in morticians and controls

Respiratory indices Morticians Non-morticians

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FVC (%) 37.53 ± 9.45 55.56 ± 26.83

FEV1 (%) 39.93 ± 13.38 58.08 ± 19.01*
FEV6 (l/s) 1.81 ± 0.50 2.37 ± 1.10
FEV1/FVC (%) 93.08 ± 22.93 58.22 ± 19.17*
PEF (%) 55.72 ± 22.77 54.41 ± 20.91
MMEF (l/s) 4.66 ± 1.99 3.27 ± 1.33*
Systolic blood pressure (mmHg) 138.3± 18.5 123.7 ± 10.1
Diastolic blood pressure (mmHg) 85.5 ± 8.50 76.5 ± 10.9
*difference in comparison to morticians is statistically significant (p<0.05)
4.0 DISCUSSION

The present study recorded comparatively higher incidences of respiratory symptoms among the
morticians compared to non- morticians. While this finding is similar to an earlier findings
which reported that aerosol exposure of more than 0.1 ppm of the chemical can cause adverse
effects like coughing, nausea, watery eyes, skin irritation and a burning sensation around the nose
and eyes.2,6,11 This is an indication of possible traumatic respiratory health effects by the subjects’
exposure to formaldehyde. It thus, implies that longer exposure to the chemical may result several
respiratory system related disorders. As seen in the subjects of the current study, students and
Faculty members of Anatomy, histopathology laboratory workers and other biomedical
researchers, who may be continually exposed to the toxic effects of formaldehyde, could be
prone to same respiratory conditions.2,3,8 The foregoing has shown that there could be medical
emergencies overtime of exposure to formaldehyde. The above finding of the present study
thus, reveal the need for job- related health risk training and the proper use of appropriate
personal protective equipment (PPE) amongst professional morticians in our locality, as this
will help improve occupational health amongst this set of workforces.
The present study also found a comparatively higher systolic and diastolic blood pressures
values in the surveyed mortician subjects; the sedentary nature of their job amongst other risks
can predispose them to some forms of cardiopulmonary disorders. The above finding of the
current study has also shown that individuals exposed to formaldehyde, like the morticians,
may be at an increased risk of suffering from not only respiratory disorders but other
cardiopulmonary diseases and more. It is thus, suggestive to state that, professional mortician
practice may require regular medical follow-up to guarantee or mitigate traumatic effect on the
cardiopulmonary system due to long term exposure to formaldehyde.
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The comparative lung function indices evaluation revealed remarkably lower levels of
FEV1/FVC ratio and MMEF in the male morticians with respect to the non-male morticians.
Meanwhile there was a remarkably higher level of FEV1 in the mortician subjects than the
non- mortician subjects. As identified by Ogunnowo et al.,12 the three key spirometry
measurements (FVC, FEV1 and FEV1/FVC ratio) for a given individual are often compared to
normal/reference values in order to draw credible inferences. Abnormalities of the FEV1 and
FEV1/FVC are the result of a decrease in the airflow through the lung, which may be caused
by obstructive lung diseases. The above finding could be an indication of a possible subsisting
obstructive pulmonary disease in the mortician subjects. While it may be true that other
advanced prevailing disease conditions associated with continuous exposure to formaldehyde,
like Kelly et al.,4 report on the possible link between formaldehyde exposure and
lymphohematopoietic malignancies, it is important to state that the above of the current may
serve as very early indicator or warning signal for the possibility of impending incidences of
multiple and perhaps advanced disease.
Occupational safety and health are key issues today, with growing industrialization and labour
environment. To ensure a high standard of safety and health at workplace, it is crucial to have
an overall depiction of the present workplace settling, different hazards and probable health
effects.7–9 Going by the assertion, the finding of the present study on the possible adverse
effect on pulmonary function indices by significant exposure to formaldehyde amongst
morticians in our environment negates the earlier report of Lakshmi et al.,5. The researcher
submitted that employee exposures to formaldehyde in their location did not approach existing
limits established by the occupational safety and health bodies. In the same vein, the present study
finding is contrary to an initial report by Levine (1984), who said that among morticians, relatively
high exposure was not associated with chronic bronchitis or pulmonary function limitations and
concluded that long-term intermittent exposure to low levels of formaldehyde gas could exerts no
meaningful chronic effect on respiratory health. The position of the current study is valid as the
combination of the remarkably raised BMI, blood pressure and reductions in FEV1/FVC ratio
and MMEF is sufficient to indicate a possible debilitating health effect, particularly the
cardiopulmonary system, upon long exposure period to formaldehyde.
5.0 CONCLUSION
The present study was able to find out comparatively higher incidences of respiratory
symptoms and past cardio-pulmonary illness amongst the male morticians thus indicating the need
for job-related health risk training and the proper use of appropriate personal protective equipment
(PPE) amongst professional morticians in our locality, as to improve occupational health amongst
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this set of workforce. Further, another revelation of the present study showed a relatively higher
BMI and systolic and diastolic blood pressures values in the mortician subjects; and remarkably
lower levels of FEV1/FVC ratio and MMEF in the male morticians with respect to the non-male
morticians. The above finding has shown the tendencies of the incidence cardiopulmonary
disorders in the mortician subjects.
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ISSN: 2329-6879