Circular No. 02/2009/TT-BYT guiding hygiene in funeral activities and cremation

CIRCULAR

Guidelines on Sanitation in Funeral and Cremation Activities

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Pursuant to Decree No. 188/2007/NĐ-CP dated December 27, 2007 of the Government on the functions, tasks, powers, and organizational structure of the Ministry of Health;

Pursuant to the Environmental Protection Law No. 52/2005/QH11 dated November 29, 2005;

Pursuant to Law on Prevention and Control of Infectious Diseases No. 03/2007/QH12 dated November 21, 2007;

Pursuant to Decree No. 35/2008/NĐ-CP dated March 25, 2008 of the Government on Construction, Management, and Use of Cemeteries;

Pursuant to Decision No. 308/2005/QĐ-TTg dated November 25, 2005 of the Prime Minister promulgating Regulations on Civilized Practices in Weddings, Funerals, and Festivals;

The Ministry of Health issues guidelines on sanitation in funeral and cremation activities as follows:

This technical regulation sets out technical requirements, testing methods, sampling procedures; management requirements; responsibilities of organizations and individuals producing, trading, and importing cigarettes.

2. Applicability:

These guidelines provide guidance on sanitation in embalming, dressing the deceased, transporting corpses and remains for funeral and cremation purposes; sanitation in funerals and cremations; and sanitation in cemetery construction, management, and use, including crematoriums.

第二条 组织和实施奖励工作的支出水平，如政府第152/2025/NĐ-CP号决定关于分级授权和奖励领域的分权规定

These guidelines apply to domestic and foreign agencies, organizations, and individuals involved in funeral and cremation activities within the territory of Vietnam.

3. Definitions:

In this Circular, the following terms are understood as follows:

a) Corpse means the body of a deceased person or remaining parts of a deceased person's body;

b) Remains mean bones of a deceased person after exhumation;

c) Embalming means preserving the corpse or remains before burial or cremation;

d) Dressing the corpse means wrapping the corpse with cloth or other materials during embalming before placing it in a coffin;

đ) Burial means keeping the corpse or remains underground;

e) Permanent burial means permanently keeping the corpse in the ground;

g) Temporary burial means burying the corpse for a certain period before exhumation;

h) Exhumation means transferring bones from a temporary burial site to a permanent burial site or for cremation;

i) Permanent burial after exhumation means burying remains after exhumation;

k) Cremation means burning the corpse or remains at high temperatures until they become ashes;

l) Cemetery means a place for collective burials of corpses and remains according to various forms and managed and constructed according to planning;

m) Crematorium means a place for burning corpses and remains including furnaces and auxiliary areas.

4. General Principles on Sanitation in Funeral and Cremation Activities:

a) Ensuring no adverse impact on human health;

b) Ensuring no environmental pollution;

c) Respecting freedom of belief and customs but must comply with sanitation regulations;

d) Adhering to other relevant legal provisions.

II. SANITATION IN EMBALMING CORPSES

1. Time for Embalming Corpses:

a) For deaths due to ordinary causes.

- In normal conditions without cold storage: Embalming time shall not exceed 48 hours from the time of death;

- In cold storage conditions at temperatures between 2 degrees Celsius and 4 degrees Celsius or lower: Embalming time shall not exceed 7 days from the time of death;

b) For deaths due to infectious diseases classified under Group A and some infectious diseases classified under Group B (in the list of infectious diseases required to be quarantined according to the Minister of Health's regulations): Embalming time shall not exceed 24 hours from the time of death;

c) For corpses found in a state of decomposition: Maximum embalming time shall not exceed 12 hours from the time of discovery. If longer embalming is necessary for identification or determination of cause of death, the person requesting extension must contact the nearest local health authority for guidance on embalming methods, isolation measures to prevent environmental contamination and disease outbreaks;

d) In cases of multiple deaths due to natural disasters or catastrophes: Embalming time for corpses shall be determined by the responsible organization's leader tasked with disaster relief, but shall not exceed 48 hours from the time of death or 12 hours from the time of discovery. If longer embalming is needed for identification, it shall be carried out according to the provisions of point c Clause 1 Section III of this Circular.

2. Place for Embalming Corpses:

a) At households: The corpse must be embalmed in a well-ventilated indoor location covered with blankets or cloth and must be guarded continuously to protect against insects and animals;

b) At funeral homes or hospital mortuaries: The corpse must be embalmed in a designated embalming room. It shall not be embalmed in a room used for organizing funerals except during the actual funeral service;

c) In cases where the deceased cannot be brought into a house, funeral home, or hospital mortuary, embalming must be conducted in a well-ventilated location protected from rain, sun, insects, and animals to prevent environmental contamination and disease outbreaks.

III. SANITATION IN DRESSING THE CORPSE

1. For deaths due to ordinary causes:

a) Time for Dressing the Corpse: Not exceeding 12 hours if the corpse is not refrigerated and not exceeding 7 days if the corpse is refrigerated at temperatures between 2 degrees Celsius and 4 degrees Celsius or lower, from the time of death;

b) The coffin must be sealed with materials such as glue, tung oil, clay to ensure no leakage;

c) When dressing the corpse, cotton may be used to plug natural cavities of the corpse and absorbent materials like dried tea leaves, water-absorbent cotton, popped corn, roasted rice, and paper can be placed inside the coffin according to custom practices;

2. For deaths due to infectious diseases classified under Group A and some infectious diseases classified under Group B (in the list of infectious diseases required to be quarantined according to the Minister of Health's regulations) or when the corpse is found in a state of decomposition:

In addition to complying with the provisions of Points b and c Clause 1 Section III of this Circular, dressing the corpse must also adhere to the following regulations:

a) Dressing the corpse must be completed within 6 hours from the time of death or discovery;

b) The corpse must be treated with bactericidal chemicals listed in the register of insecticides, bactericides for household and medical use before dressing. If using Chloramine B, treatment shall be as follows: Use cotton soaked in a 5% Chloramine B solution to plug natural cavities of the corpse, then spray a 5% Chloramine B solution over the entire corpse or wrap the entire corpse in Chloramine B-soaked cloth;

c) The corpse must be wrapped in non-permeable material before being placed in the coffin.

d) Must be treated with disinfectants from the list of chemicals and preparations for insecticides and disinfection in household and medical fields that have been registered for circulation immediately after the body is placed in the coffin. If using Chloramine B, it shall be handled as follows: Wipe or spray the entire surface of the floor, land area, surrounding walls where the body is placed, or objects that have come into contact with the body with a 5% Chloramine B solution and maintain the minimum contact time between the chemical and the floor, surrounding walls, or objects at 30 minutes.

IV. SANITATION IN THE TRANSPORT OF CORPSES AND BONES

1. Sanitation in the transport of corpses:

a) In cases where death is caused by infectious diseases in Group A, burial or cremation must be carried out at the nearest cemetery or crematorium. Before transporting the corpse for burial or cremation, the corpse must be placed in a coffin according to Clause 2, Section III of this Circular;

In cases where death is caused by infectious diseases in Group B (listed in the mandatory isolation list of infectious diseases as prescribed by the Minister of Health) or where the corpse has decomposed, before transportation, the corpse must be placed in a coffin according to Clause 2, Section III of this Circular.

b) The corpse during transportation must be completely wrapped in non-permeable materials and transported in a separate vehicle. If transported by air, waterway, maritime, or rail transport means, the corpse must be placed in a separate and enclosed compartment;

c) When transporting corpses across borders, the corpse must be placed in a three-layer coffin: The inner layer made of zinc or other material capable of withstanding force without leakage, lined with moisture-absorbent material and sealed; the middle layer made of wood; the outer layer made of plywood;

d) In cases of mass deaths due to natural disasters or catastrophes, the use of transportation means for corpses will be decided by the person in charge of the organization responsible for mitigating such disasters or catastrophes, but must follow the guidelines of health authorities to prevent the spread of infectious diseases.

2. Transporting bones:

a) Bones must be transported in closed, non-permeable containers.

b) When transporting bones across borders, they must be completely wrapped in two layers, the inner layer being non-permeable material, and the outer layer being a wooden or ceramic/silicate coffin.

V. SANITATION IN BURIAL AND CREMATION

1. Corpses and bones must be buried in cemeteries as prescribed in Clause 2, Article 3 of Decree No. 35/2008/NĐ-CP dated March 25, 2008 of the Government on the construction, management, and use of cemeteries, except in cases stipulated in Clause 3 of this Section.

2. In cases of burying corpses of those who died from infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list of infectious diseases as prescribed by the Minister of Health) or decomposed corpses, the following measures must be taken:

a) Before placing the coffin in the grave, spray the disinfectant solution from the list of chemicals and preparations for insecticides and disinfection in household and medical fields that have been registered for circulation, such as a 5% Chloramine B solution, or sprinkle a layer of lime around the sides and bottom of the grave.

b) Before filling the grave, spray the disinfectant solution from the list of chemicals and preparations for insecticides and disinfection in household and medical fields that have been registered for circulation, such as a 5% Chloramine B solution, or sprinkle a layer of lime around and on top of the coffin.

3. In cases of burying corpses in flood conditions, choose a cemetery or high ground not at risk of flooding for burial.

4. In cases of mass deaths without the condition for individual burials, collective burials may be conducted but must meet the following requirements:

a) Only corpses can be buried in collective graves in cemeteries or locations that comply with technical standards for cemetery planning issued by the Ministry of Construction;

b) The minimum distance between two adjacent corpses in a collective grave is 50 cm;

c) If arranging corpses in multiple layers, the distance between layers is 50 cm and must alternate between upper and lower layers. The top layer of corpses must be at least 100 cm above ground level, and the bottom of the grave must be at least 120 cm or 150 cm above the groundwater level in sandy areas;

d) There must be a ventilation system and a collection and treatment system for seepage water from collective graves.

5. Corpses and bones must be cremated in crematoria that meet the conditions specified in Section X of this Circular.

VI. SANITATION FOR PERSONS ENGAGED IN BURIAL AND CREMATION ACTIVITIES

1. Persons directly involved in placing corpses in coffins, embalming, burying, or cremating corpses of those who died from infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list of infectious diseases as prescribed by the Minister of Health) or decomposed corpses must:

a) Use personal protective equipment such as hats, goggles, masks, clothing, boots, gloves throughout the work process;

b) Disinfect hands with a 2% Chloramine B solution or other disinfectants from the list of chemicals and preparations for insecticides and disinfection in household and medical fields that have been registered for circulation, and perform other personal hygiene activities after completing the work.

2. Professional undertakers, cremators, and exhumers must undergo regular health check-ups at least once every six months.

3. Persons directly involved in exhumation must use personal protective equipment such as masks and gloves throughout the work process.

4. Persons directly participating in the embalming, refrigeration, burial, and cremation of deceased persons due to common causes: Encourage the use of personal protective equipment such as masks and gloves throughout the process. After completing the work, hands must be washed with soap or disinfected with Chloramine B at a concentration of 2% or other bactericidal chemicals listed in the catalog of chemicals and preparations for insect and bacterial control in household and medical fields that have been registered for circulation.

VII. SANITATION OF TOOLS, MEANS, AND EQUIPMENT USED IN FUNERAL AND CREMATION ACTIVITIES

1. In cases of burial or cremation of deceased persons due to common causes, tools and equipment used in funeral activities must be cleaned thoroughly after the completion of the work.

2. In cases of burial or cremation of deceased persons due to infectious diseases classified in Group A and certain infectious diseases classified in Group B (listed in the catalog of infectious diseases required to be isolated according to the regulations of the Minister of Health) or decomposed corpses, tools, means, and equipment used in funeral and cremation activities must be treated with bactericidal chemicals listed in the catalog of chemicals and preparations for insect and bacterial control in household and medical fields that have been registered for circulation or destroyed after the completion of the work. If Chloramine B is used for treatment, it shall be carried out as follows: Wipe and wash all surfaces of the tools, means, and equipment to be treated with a Chloramine B solution at a concentration of 5%, and maintain the contact time between the chemical and the tools and equipment for a minimum of 30 minutes.

VIII. SANITATION OF FUNERAL HOMES

Funeral homes must ensure the following sanitation requirements:

1. They must be separated from surrounding residential areas and surrounded by walls. In cases where funeral homes are also mortuaries of hospitals, the location of the funeral home must be arranged separately from other departments of the hospital.

2. There must be separate rooms for organizing funerals and embalming corpses.

3. Embalming rooms must ensure that insects and animals cannot enter.

4. Floors and pathways must be covered with cement, glazed tiles, or other materials that are waterproof and easy to clean.

5. There must be lighting, water supply, drainage, and ventilation systems that meet sanitation standards.

6. There must be a sanitary area.

7. They must be cleaned thoroughly immediately after each funeral. In cases where funerals are organized for deceased persons due to infectious diseases classified in Group A and certain infectious diseases classified in Group B (listed in the catalog of infectious diseases required to be isolated according to the regulations of the Minister of Health) or decomposed corpses, after the funeral ends, the floor, walls around the corpse placement area, and objects that have come into contact with the corpse must be treated with bactericidal chemicals listed in the catalog of chemicals and preparations for insect and bacterial control in household and medical fields that have been registered for circulation. If the chemical used is Chloramine B, it shall be carried out as follows: Wipe or spray the entire surface of the floor, walls around the corpse placement area, and objects that have come into contact with the corpse with a Chloramine B solution at a concentration of 5%, and maintain the contact time between the chemical and the floor, walls, and objects for a minimum of 30 minutes.

8. There must be records documenting information such as name, address, cause of death, time of arrival, time of departure, body code (number); name, address of the next of kin; confirmation by the delivering and receiving parties. The records must be regularly updated and stored according to national archive storage regulations by the managing unit of the funeral home.

IX. SANITATION OF CEMETERIES

1. Selection and planning of cemetery construction sites:

The selection of locations and planning of cemetery construction must comply with technical standards for cemetery construction planning issued by the Ministry of Construction.

2. Water supply, drainage, and waste management:

a) Water used for personal hygiene and sanitation of tools, means, and equipment used in funeral activities at the cemetery must meet hygiene standards;

b) Wastewater discharged from the cemetery must be collected and treated to meet the standard TCVN 7382:2004;

c) Waste generated during funeral activities must be concentrated in a designated area and treated to ensure no environmental pollution;

d) Waste related directly to deceased persons due to infectious diseases classified in Group A and certain infectious diseases classified in Group B (listed in the catalog of infectious diseases required to be isolated according to the regulations of the Minister of Health) or decomposed corpses must be treated according to the regulations on the disposal of infectious medical waste stipulated in the Medical Waste Management Regulation issued together with Decision No. 43/2007/QĐ-BYT dated November 30, 2007 of the Minister of Health.

3. Time for exhumation:

Depending on soil conditions, customs, and beliefs in different regions, the time for exhumation may vary, but the period from burial to exhumation should not be less than 36 months.

4. Moving corpses and bones in cases of cemetery relocation before the prescribed exhumation period:

a) When all the soil above the coffin lid has been excavated, spray a bactericidal chemical solution listed in the catalog of chemicals and preparations for insect and bacterial control in household and medical fields that have been registered for circulation, such as a Chloramine B solution at a concentration of 5% on the top surface of the coffin, wait for 30 minutes before opening the coffin lid.

If the corpse has not completely decomposed, the corpse must be transferred to another coffin. The handling of the corpse and the surrounding environment will be conducted as if embalming a decomposing corpse as stipulated in Clause 2, Section III of this Circular.

If the corpse has completely decomposed, proceed with exhumation as usual to move the remains to another location.

b) Immediately after moving the corpse or remains to another location, a chemical disinfectant solution listed in the catalog of chemicals and preparations for insect and bacterial control used in household and medical fields, such as a 5% Cloramin B solution, must be sprayed, or a layer of lime powder must be scattered over the grave site.

5. Utilization of land after exhumation:

The land where the grave was located after exhumation must remain unused for at least 12 months before it can be used for burial purposes.

6. Utilization of land after relocation of cemetery:

a) The cemetery grounds (including the protective buffer zone around the cemetery) after all graves have been relocated shall not be used for the following purposes for a minimum period of 10 years:

- Extraction of underground water for domestic use, drinking, and food processing;

- Construction of public facilities such as tourist areas, recreational parks, kindergartens, schools, and convalescent homes;

b) In cases where usage is necessary before the 10-year period, an environmental pollution assessment must be conducted, and appropriate environmental sanitation measures must be implemented based on the level of pollution.

7. Record Keeping and Storage:

The cemetery must maintain records documenting information including name, address, cause of death, time of burial, and the name of the deceased's relatives. There must also be a layout diagram describing the various sections of the cemetery. These records must be regularly updated and stored according to national archival regulations.

X. SANITATION IN CREMATORIUMS

1. Selection of Location and Planning for Construction of Crematoriums:

The selection of location and planning for construction of crematoriums must comply with technical standards for cemetery planning issued by the Ministry of Construction.

2. Cremation Technology:

The technology used for cremation must ensure that waste products (emissions, wastewater, solid waste) meet the standards TCVN 5937:2005, TCVN 5938:2005 regarding ambient air quality and TCVN 6560:1999 regarding emissions from incinerators for medical waste before being discharged into the environment.

3. General Sanitation Requirements:

a) The crematorium and surrounding areas, as well as equipment and facilities related to the transportation of corpses and remains, must be thoroughly cleaned after each operation;

b) In cases where the deceased died from infectious diseases classified under Group A or certain infectious diseases under Group B (listed in the mandatory isolation list of the Minister of Health) or if the corpse has decomposed, disinfection must immediately follow the placement of the corpse in the cremation chamber using chemical disinfectants listed in the catalog of chemicals and preparations for insect and bacterial control used in household and medical fields, such as a 5% Cloramin B solution.

4. Time Limit for Corpse Storage in Crematoriums:

a) For deaths due to ordinary causes:

- Not exceeding 6 hours for crematoriums without cold storage facilities for corpses.

- Not exceeding 24 hours for crematoriums with cold storage facilities for corpses.

b) For deaths due to infectious diseases classified under Group A or certain infectious diseases under Group B (listed in the mandatory isolation list of the Minister of Health) or if the corpse has decomposed, cremation must be carried out within 3 hours from the time the corpse is transferred to the crematorium.

5. Record Keeping and Storage:

The crematorium must maintain records documenting information including name, address, cause of death, time of corpse reception, name of the deceased's relatives, confirmation by the delivering and receiving parties, start and end times of cremation. These records must be regularly updated and stored according to national archival regulations.

XI. SANITATION IN FUNERAL ORGANIZATION

During funeral organization, the family or organizing unit must:

1. Ensure food safety. Limit food service to prevent food poisoning and disease spread.

2. Comply with noise limits for public and residential areas as specified in standard TCVN 5949-1998.

3. Adhere to regulations on the use of funeral music during funeral organization as stipulated in Circular No. 04/1998/TT-BVHTT dated July 11, 1998, issued by the Ministry of Culture and Information (now the Ministry of Culture, Sports and Tourism), guiding civilized practices in weddings, funerals, and festivals.

XII. IMPLEMENTATION

1. Provincial People's Committees (referred to hereafter as provinces) are responsible for directing relevant departments and agencies to implement:

a) Develop and implement plans for investigating, assessing the current status of sanitation in burial, cremation activities, and cemetery sanitation. Develop and implement plans to handle cemeteries, crematoriums, and funeral homes that do not meet sanitation requirements;

b) Plan and implement construction plans for cemeteries and crematoriums ensuring that all newly constructed cemeteries and crematoriums comply with current legal regulations on planning, design, and construction;

c) Promote, guide, and mobilize the community to ensure sanitation in burial and cremation activities;

d) Inspect and audit the implementation of sanitation in burial and cremation activities.

2. Other relevant ministries, sectors, and social political organizations shall coordinate with the Ministry of Health and provincial people's committees based on their functions and responsibilities to direct, organize, and guide the implementation of sanitation in burial and cremation activities as prescribed in this Circular.

3. Units within the Health Sector:

a) The Preventive Medicine and Environment Department of the Ministry of Health is responsible for:

- Directing, supervising, guiding, and inspecting the implementation of sanitation in burial and cremation activities nationwide.

- Organizing the development, revision, supplementation, and submission to competent authorities for issuance of related guidance documents on sanitation in burial and cremation activities.

b) Institutes: The Institute of Occupational Health and Environmental Hygiene, the Central Institute of Hygiene and Epidemiology, the Nha Trang Pasteur Institute, the West Central Institute of Hygiene and Epidemiology, the Ho Chi Minh City Public Health Institute, and the Ho Chi Minh City Pasteur Institute shall be responsible for:

- Researching and proposing technical solutions to ensure hygiene in funeral activities, especially in funerals and cremations of deceased persons due to infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list according to the regulations of the Minister of Health) to protect the environment and public health;

- Providing professional technical guidance to local healthcare units within their jurisdiction in funeral and cremation activities;

- Participating in activities to ensure hygiene in funerals and cremations when natural disasters, catastrophes, or epidemics occur within their jurisdiction or upon request.

c) Provincial Departments of Health shall be responsible for directing subordinate units in guiding and inspecting the implementation of hygiene in funeral and cremation activities within the province or city.

d) Provincial Centers for Preventive Medicine, District Centers for Preventive Medicine, County Centers for Preventive Medicine, Town Centers for Preventive Medicine, or Town Centers for Preventive Medicine (hereinafter referred to as district centers), or District Health Centers shall be responsible for:

- Providing professional technical guidance to healthcare units and communities within their jurisdiction on ensuring hygiene in funerals and cremations, cemetery hygiene, and crematorium hygiene.

- Cooperating with relevant agencies to participate in planning cemeteries and crematoriums within their jurisdiction.

- Handling corpses and environments in cases of death due to infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list according to the regulations of the Minister of Health) or in cases of large-scale deaths due to natural disasters or catastrophes.

- Inspecting hygiene at funeral homes, hospital morgues, cemeteries, and crematoriums within their jurisdiction.

đ) Provincial International Health Quarantine Centers shall be responsible for guiding, inspecting, and supervising the implementation of hygiene in the transportation of corpses and bones across borders.

e) Commune Health Stations, Ward Health Stations, and Town Health Stations shall be responsible for:

- Guiding, inspecting, and supervising the implementation of hygiene in funeral and cremation activities within their jurisdiction;

- Cooperating with related healthcare units to handle corpses and environments in cases of death due to infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list according to the regulations of the Minister of Health) or in cases of decomposed corpses in the community.

g) Healthcare facilities where patients diagnosed or suspected of having infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list according to the regulations of the Minister of Health) die must carry out corpse and environmental handling according to this Circular before transporting the corpse out of the facility.

4. Households, when a family member dies, must comply with hygiene regulations in funeral and cremation activities as stipulated in this Circular. In cases where the deceased is determined or suspected to have died from infectious diseases in Group A and certain infectious diseases in Group B (listed in the mandatory isolation list according to the regulations of the Minister of Health), they must immediately report to the commune or ward health station to proceed with hygiene handling according to this Circular.

XIII. IMPLEMENTATION PROVISIONS

This Circular shall take effect 45 days from the date of issuance.

During implementation, if there are any difficulties, units are requested to report to the Ministry of Health (Preventive Medicine and Environment Department) for consideration and resolution./.