Circular No. 21/2021/TT-BYT on hygiene in funeral and cremation activities

CIRCULAR

Regulations on hygiene in funeral and cremation

Pursuant to the Law on Environmental Protection No. 72/2020/QH14 dated November 17, 2020;

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

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 on the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the proposal of the Director of the Health Environment Management Department,

The Minister of Health issues this Circular on hygiene in funeral and cremation.

Chapter 1

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular stipulates hygiene regulations for the preservation, viewing, funeral, cremation, transportation of corpses, and bones of deceased persons.

Article 2. Applicability

This Circular applies to agencies, organizations, and individuals both within and outside Vietnam that are related to activities ensuring hygiene in the preservation, viewing, funeral, cremation, and transportation of corpses and bones of deceased persons on the territory of Vietnam.

Article 3. Explanation of Terms

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

1. Corpse (body) is the body of a deceased person.

2. Bones are the bones of a deceased person when exhumed.

3. Ashes are the remaining parts after the complete cremation of a corpse or bones.

4. Viewing is the act of retaining and preserving the corpse of a deceased person before burial or cremation.

5. Embalming is the act of performing procedures to transfer the corpse into a coffin.

6. Burial is the act of retaining the corpse or bones, ashes of a deceased person at a location below ground.

7. Cremation is the act of burning a corpse or bones at high temperatures until they become ashes.

8. Exhumation is the act of transferring bones to continue burial or change to another form of burial.

Chapter 2

HYGIENE IN FUNERAL AND CREMATION FOR DECEASED PERSONS NOT CAUSED BY DANGEROUS DISEASES

Article 4. Hygiene in viewing corpses

1. The time for viewing corpses shall not exceed 48 hours from the time of death under conditions without cold storage.

2. The time for viewing corpses shall not exceed seven days from the time of death under conditions with cold storage at a temperature of 4°C or lower.

3. In cases where it is necessary to view corpses longer than the time specified in Clause 1 and Clause 2 of this Article, it must be stored under conditions with a temperature of -10°C or lower.

4. In cases of multiple deaths due to natural disasters or catastrophes, the time for viewing corpses shall be decided by the head of the organization responsible for mitigating natural disasters or catastrophes.

Article 5. Hygiene in embalming corpses

1. Embalm according to local customs, traditions, and beliefs. In cases where there is fluid leakage from the corpse, ensure that the embalming area is cleaned.

2. Seal the coffin tightly. Check and seal any gaps in the coffin (if any) to ensure no leakage, water seepage, breakage, or damage during transportation.

Article 6. Hygiene in transporting corpses, bones, and ashes

1. Hygiene in transporting corpses:

a) Transporting corpses within the territory of Vietnam: in cases of land transport, the corpse must be wrapped tightly in waterproof materials and transported in a separate vehicle. In cases of air, sea, or rail transport, the corpse must be placed in a separate and sealed container;

b) 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, non-leaking, lined with moisture-absorbing material, and welded shut; the middle layer made of wood; the outer layer made of plywood;

c) In cases of large numbers of deaths due to natural disasters or catastrophes, the means of transporting corpses shall be determined by the head of the organization responsible for mitigating natural disasters or catastrophes but must ensure that the corpse is tightly wrapped, does not leak, does not absorb water, and does not break or crack during transportation.

2. Hygiene in transporting bones and ashes: when transporting bones and ashes, they must be placed in containers that ensure no leakage, water absorption, breakage, or cracking during transportation.

Article 7. Hygiene for persons directly participating in funeral, embalming, moving, burial, and cremation activities involving corpses and remains.

Persons directly involved in funeral, embalming, moving corpses and remains, burial, and cremation activities shall wear masks and gloves throughout the entire process. After completing the work, they shall wash their hands with soap or sanitize their hands with hand sanitizer solution.

Article 8. Hygiene for funeral homes, burial and cremation areas, tools, means of transportation, and equipment serving burial and cremation activities.

1. Funeral homes and areas organizing funerals must ensure thorough cleanliness of all surfaces of the floor and surrounding walls where the corpse is placed and any objects that have come into contact with the corpse.

2. Tools and equipment serving burial and cremation activities must be thoroughly cleaned after completion of the work.

3. Ensure that burial and cremation areas are clean; collect, transport, and dispose of generated waste according to general waste management regulations.

Article 9. Hygiene during exhumation activities.

1. Exhumation time: Depending on soil conditions, customs, and beliefs of the ethnic group and locality, the exhumation time may vary, but the period from burial to exhumation must not be less than thirty-six months.

2. Waste generated during the entire exhumation process must be collected, transported, and disposed of according to general waste management regulations.

3. Tools and equipment serving exhumation activities must be thoroughly cleaned after completion of the work.

4. Persons directly involved in exhumation activities must wear masks and gloves throughout the entire process. After completing the work, they shall wash their hands with soap or sanitize their hands with hand sanitizer solution.

Article 10. Hygiene during burial and cremation of deceased persons who did not die from dangerous infectious diseases in areas implementing medical quarantine measures.

1. Hygiene during funeral, embalming, moving corpses, and burial and cremation of deceased persons in areas implementing medical quarantine measures shall be carried out in accordance with the provisions of Articles 4, 5, 6, 7, and 8 of this Circular.

2. Organizing funerals must comply with disease prevention and control regulations in areas implementing medical quarantine measures.

3. Hygiene for vehicles and persons involved in transporting corpses out of areas implementing medical quarantine measures shall be carried out in accordance with the provisions of Article 14 of this Circular.

Article 11. Hygiene during burial and cremation of large numbers of deceased persons due to natural disasters, catastrophes, and decomposing corpses.

1. For large numbers of deceased persons due to natural disasters and catastrophes:

a) Wrap the bodies tightly in materials that prevent leakage, water absorption, tearing, or breaking;

b) Hygiene during funeral, embalming, moving corpses, and burial and cremation shall be carried out in accordance with the provisions of Articles 4, 5, 6, 7, and 8 of this Circular.

2. For decomposing corpses:

a) Hygiene during handling, funeral, and embalming of corpses shall be carried out in accordance with the provisions of Articles 12 and 13 of this Circular;

b) Hygiene for funeral homes, burial and cremation areas, tools, means of transportation, and equipment serving burial and cremation activities, and moving corpses shall be carried out in accordance with the provisions of Clause 1 of Article 6 and Article 8 of this Circular;

c) Persons directly involved in moving corpses, burial, and cremation activities shall follow the provisions of Article 7 of this Circular.

Chapter 3

HYGIENE IN THE BURIAL AND CREMATION OF DECEASED PERSONS DUE TO DANGEROUS DISEASES

Article 12. Handling of Deceased Bodies

1. Relatives of the deceased person or persons who discover the body of a deceased person due to a dangerous epidemic shall immediately report to the People's Committee of the commune where the body was discovered.

2. Persons participating in handling the body shall be trained on measures for preventing and controlling epidemics and handling bodies. When participating in handling the body, they must wear full personal protective equipment (protective clothing, eye shields, rubber gloves, medical masks, shoes or boots).

3. The body shall be completely sealed in a body bag made of waterproof material that is opaque, sturdy, and not prone to tearing or puncturing, with a thickness of ≥ 150µm; the zipper must be securely closed and fastened with ties or tape; disinfect the outer surface of the body bag with a solution containing 0.1% active chlorine. In case there is no body bag, wrap the body tightly in two layers of fabric, then seal it in two layers of plastic; disinfect the outer surface of the first layer of plastic with a solution containing 0.1% active chlorine. Perform similarly with the second layer of plastic.

4. Disinfect all surfaces in the area where the deceased person was present and all objects that came into contact with the body using a solution containing 0.1% active chlorine, 70% alcohol, or other surface disinfectants; infectious waste generated during the handling of the body shall be collected and treated as infectious waste.

5. After completing the work, persons participating in handling the body must remove and dispose of their personal protective equipment as infectious waste; wash hands with soap or sanitize hands with hand sanitizer.

6. For dangerous epidemics requiring different procedures for handling bodies than those stipulated in this Article, follow the specialized guidance of the Ministry of Health.

Article 13. Sanitation in Embalming and Wrapping of Deceased Bodies

1. The time for embalming the body shall not exceed 24 hours from the time of death or discovery of the body. If embalming the body for longer than 24 hours is necessary, it must be stored under conditions with a temperature of ≤ -10°C.

2. Seal the coffin. Seal any gaps in the coffin (if any) to ensure no leakage, water seepage, tearing, or breaking during transportation.

3. Infectious waste generated shall be collected and treated as infectious waste.

Article 14. Sanitation in Transporting Coffins Containing Deceased Bodies

1. Persons accompanying the vehicle transporting the coffin containing the body must wear full personal protective equipment (eye shields, rubber gloves, medical masks, shoes or boots).

2. Immediately after transporting the coffin containing the body to the burial or cremation site, disinfect the entire surface of the transport vehicle carrying the coffin with a solution containing 0.1% active chlorine, 70% alcohol, or other surface disinfectants.

3. After completing the work, persons accompanying the vehicle transporting the coffin containing the body must remove and dispose of their personal protective equipment as infectious waste; wash hands with soap or sanitize hands with hand sanitizer.

Article 15. Sanitation in Organizing Funerals

1. Persons organizing and participating in funerals shall implement epidemic prevention and control measures according to the guidance of the Ministry of Health.

2. Sanitation of funeral houses and funeral areas shall be carried out in accordance with Clause 1 of Article 8 of this Circular; infectious waste directly contacting the coffin shall be collected and treated as infectious waste.

Article 16. Sanitation in Burial and Cremation Activities

1. When burying a corpse, a layer of lime powder shall be scattered around the walls and bottom of the grave before placing the coffin inside. Before covering with soil, a layer of lime powder shall be scattered around and on top of the coffin.

2. After burial and cremation, tools and equipment used for burial and transportation of corpses to cremation facilities, as well as areas for burial and cremation, shall be sanitized and disinfected using a solution containing 0.1% active chlorine, 70% alcohol, or other surface disinfectants.

3. Individuals directly involved in burial and cremation activities shall wear full personal protective equipment (safety goggles, rubber gloves, medical masks, shoes or boots) throughout the process. Upon completion of the work, they shall remove their personal protective equipment and wash their hands with soap or sanitize their hands with hand sanitizer.

4. Waste that has direct contact with coffins and personal protective equipment shall be collected and treated as infectious waste.

Article 17. Sanitation in Exhumation Activities

Sanitation in exhumation activities shall be carried out in accordance with the provisions of Article 9 of this Circular.

Chapter 4

IMPLEMENTING PROVISIONS

Article 18. Responsibility for Implementation

1. Responsibilities of the Department of Environmental Health Management: directing, guiding, disseminating, and inspecting the implementation of this Circular.

2. Responsibilities of the Provincial Departments of Health under the Central Government:

a) Directing, guiding, disseminating, and inspecting the implementation of this Circular;

b) Taking the lead and coordinating with the Provincial Departments of Natural Resources and Environment to direct units in inspecting sanitation in burial and cremation activities within their jurisdiction;

c) Promoting, guiding, and mobilizing the community to ensure sanitation in burial and cremation activities within their jurisdiction;

d) Organizing training on preventive measures against epidemics and handling of corpses due to dangerous diseases for those involved in corpse handling;

e) Allocating necessary resources for organizing sanitation in burial and cremation activities.

Article 19. Effective Date

1. This Circular takes effect from January 10, 2022.

2. Circular No. 02/2009/TT-BYT dated May 26, 2009, issued by the Minister of Health, guiding sanitation in burial and cremation activities, shall cease to be effective from the date this Circular comes into force.

Article 20. Implementation

The Director of the Department of Environmental Health Management, the Head of the Ministry's Office, the Inspector General of the Ministry, the Heads of Departments, Directors of Bureaus, and Directors of General Departments under the Ministry of Health are responsible for implementing this Circular. Any difficulties encountered during implementation should be promptly reported to the Ministry of Health (Department of Environmental Health Management) for consideration and resolution.

Any difficulties encountered during implementation should be promptly reported to the Ministry of Health (Department of Environmental Health Management) for consideration and resolution./.