Autopsy, thanatopraxy, cemeteries and crematoria as hotspots of toxic organic contaminants in the funeral industry continuum.

The occurrence and health risks of toxic organic contaminants (TOCs) in the funeral industry are relatively under-studied compared to other industries. An increasing body of literature reports TOCs including emerging contaminants in the funeral industry, but comprehensive reviews of the evidence are still lacking. Hence, evidence was analysed to address the proposition that, the funeral industry constitutes several hotspot reservoirs of a wide spectrum of TOCs posing ecological and human health risks. TOCs detected include embalming products, persistent organic pollutants, synthetic pesticides, pharmaceuticals, personal care products and illicit drugs. Human cadavers, solid wastes, wastewaters and air-borne particulates from autopsy, thanatopraxy care facilities (mortuaries, funeral homes), cemeteries and crematoria are hotspots of TOCs. Ingestion of contaminated water, and aquatic and marine foods constitutes non-occupational human exposure, while occupational exposure occurs via inhalation and dermal intake. Risk factors promoting exposure to TOCs include unhygienic burial practices, poor solid waste and wastewater disposal, and weak and poorly enforced regulations. The generic health risks of TOCs are quite diverse, and include; (1) genotoxicity, endocrine disruption, teratogenicity and neurodevelopmental disorders, (2) development of antimicrobial resistance, (3) info-disruption via biomimicry, and (4) disruption of ecosystem functions and trophic interactions. Barring formaldehyde and inferential evidence, the epidemiological studies linking TOCs in the funeral industry to specific health outcomes are scarce. The reasons for the lack of evidence, and limitations of current health risk assessment protocols are discussed. A comprehensive framework for hazard identification, risk assessment and mitigation (HIRAM) in the funeral industry is proposed. The HIRAM includes regulatory, surveillance and control systems such as prevention and removal of TOCs. Future directions on the ecotoxicology of mixtures, behaviour, and health risks of TOCs are highlighted. The opportunities presented by emerging tools, including isotopic labelling, genomics, big data analytics (e.g., machine learning), and in silico techniques in toxicokinetic modelling are highlighted.