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MINISTRY OF
HEALTH
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SOCIALIST
REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
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No. 21/2021/TT-BYT
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Hanoi, November
26, 2021
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CIRCULAR
SANITATION IN BURIAL
AND CREMATION
Pursuant to Law on Environmental Protection No.
72/2020/QH14 dated November 17, 2020;
Pursuant to Law on Prevention of Infectious Diseases
dated November 21, 2007;
Pursuant to Decree No. 75/2017/ND-CP dated June
20, 2017 of Government on functions, tasks, powers, and organizational
structure of Ministry of Health;
At request of Director General of Health
Environment Management Agency,
Minister of Health promulgates Circular on
sanitation in burial and cremation.
Chapter 1.
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Article 1. Scope
This Circular deals
with sanitation in preservation, embalming, burial, cremation, and
transportation of dead bodies and skeletal remains.
Article 2.
Regulated entities
This Circular
applies to Vietnamese and foreign agencies, organizations, and individuals
related to sanitation matter in preservation, embalming, burial, cremation, and
transportation of dead bodies and skeletal remains in Vietnamese territory.
Article 3.
Definition
In this Circular,
terms below are construed as follows:
1. “dead body”
(corpse) refers to the body of a deceased person.
2. “skeletal
remains” refer to bones of a deceased person in bone collecting process.
3. “cremains”
refer to the remains of a human body after cremating their dead body and
skeletal remains.
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5. “shrouding”
refers to procedures to be adopted in order to move the dead body into a
coffin.
6. “burial”
refers to the act of placing a dead body or skeletal remains or cremains of a
deceased person into the ground.
7. “cremation”
refers to the act of incinerating a dead body or skeletal remains into cremains
at a high temperature.
8. “bone
collecting” refers to the act of moving skeletal remains for further burial
or other forms of final disposition.
Chapter 2.
SANITATION IN BURIAL AND CREMATION OF PERSONS WHO DIED
OF CAUSES OTHER THAN DANGEROUS DISEASES
Article 4.
Sanitation in embalming
1. Embalming shall
last no longer than 48 hours since the time of death without refrigeration.
2. Embalming shall
last no longer than 7 days since the time of death in 4oC or lower.
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4. In case many
people are killed as a result of natural disasters or emergencies, embalming
duration shall be decided by individuals in charge of remediation affairs.
Article 5.
Sanitation in shrouding
1. Enshroud in
accordance with local customs, tradition, and religion. Any seepage of bodily
fluid must be cleaned completely at shrouding sites.
2. Close the coffin.
Check and seal the coffins to prevent leakage, seepage, crack, and damage
during transportation.
Article 6.
Sanitation in transportation of corpses, skeletal remains, and cremains
1. Sanitation in
corpse transportation:
a) When transport
corpses within Vietnamese territory: during transportation via road, the
corpses must be wrapped in watertight materials and carried by separate
vehicles. During transportation via airway, waterway, or railway, the corpses
must be placed in separate and closed coffins;
b) When transport
corpses across borders: the corpses must be placed in 3-layer coffins: the
inner layer is made of zinc or other materials that can withstand load, prevent
leak, is lined with desiccant and welded tight; the middle layer is made of
wood; the outer layer is made of plywood;
c) In case of heavy
casualties caused by natural disasters or emergencies, the use of transport
vehicles shall be decided by heads of organizations in charge of remediation
affairs as long as the corpses are tightly wrapped to prevent leakage, seepage,
and damage during transportation.
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Article 7.
Sanitation for individuals engaging in embalming, shrouding, transportation,
burial, and cremation of corpses, skeletal remains
Individuals engaging
in embalming, shrouding, transportation of corpses and skeletal remains,
burial, and cremation must wear face masks and gloves throughout the process.
Upon finishing, wash hands with soap or hand sanitizer.
Article 8.
Sanitation of funeral parlors, burial grounds, cremation areas, instruments and
equipment serving burial, cremation
1. Funeral parlors
and funeral areas must have their floor and walls surrounding the corpses and
items making contact with the corpses cleaned properly.
2. Tools and
equipment serving burial and cremation must be cleaned thoroughly once burial
and/or cremation are done.
3. Keep burial
grounds and cremation areas clean; collect, transport, and treat wastes in
accordance with regulations and law on waste management.
Article 9. Sanitation
in bone collecting
1. Interval between
burial and bone collecting: depending on soil quality, traditions, customs, and
religion of the locals, interval between burial and bone collecting must not be
lower than 36 months.
2. Wastes produced
during bone collecting must be collected, transported, and treated in
accordance with regulations on waste management.
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4. Individuals performing
bone collecting must wear face masks and gloves throughout the process. Upon
finishing, wash hands with soap or hand sanitizer.
Article 10.
Sanitation in burial and cremation of persons who died of causes other than
dangerous diseases in areas under quarantine
1. Sanitation in
embalming, shrouding, corpse transportation, burial, and cremation of the
deceased in areas under quarantine shall conform to Article 4 through Article 8
hereof.
2. Funerals shall be
organized in a manner that conforms to epidemic control regulations of areas
under quarantine.
3. Sanitation for
vehicles and individuals engaging in transportation of corpses out of areas
under quarantine shall conform to Article 14 hereof.
Article 11.
Sanitation in burial and cremation of heavy casualties caused by natural
disasters, emergencies and decomposing corpses
1. In case of heavy
casualties caused by natural disasters and emergencies:
a) Wrap the corpses
in materials that can prevent leakage, seepage, and damage;
b) Sanitation in
embalming, shrouding, corpse transportation, burial, and cremation shall
conform to Article 4 through Article 8 hereof.
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a) Sanitation in
processing, embalming, and shrouding shall conform to Article 12 and Article 13
hereof;
b) Sanitation in
funeral parlors, burial grounds, cremation areas, tools, and equipment serving
burial, cremation, and transportation of corpses shall conform to Clause 1
Article 6 and Article 8 hereof;
c) Individuals
engaging in transportation, burial, and cremation of corpses shall conform to
Article 7 hereof.
Chapter 3.
SANITATION IN BURIAL AND CREMATION OF PERSONS WHO DIED
OF DANGEROUS DISEASES
Article 12.
Corpse processing
1. Relatives of the
deceased or individuals discovering corpses of the deceased who died of
dangerous diseases must immediately inform People’s Committees of communes
where the corpses are discovered.
2. Individuals
processing corpses must receive training in disease prevention, control, and
corpse processing. Wear proper personal protective equipment when processing
corpses (protective suit, eyewear, rubber gloves, medical face masks, shoes or
boots).
3. Wrap corpses with
body bags made of non-absorbent, non-transparent, firm materials with thickness
≥ 150µm; zip fasteners must be tight and fixed by strings or tapes;
sterilize exterior of body bags with 0,1% activated Chlorine solution. In case
body bags are not available, tightly wrap corpses with 2 layers of cloth then 2
layers of nylon; sterilize exterior of the first nylon layer with 0,1%
activated Chlorine solution. Follow suit for the second nylon layer.
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5. Once the work is
done, individuals carrying out the work must take off personal protective
equipment and treat them as infectious wastes; wash hands with soap or hand
sanitizer.
6. In case dangerous
diseases require corpses to be processed in manners other than those mentioned
under this Article, comply with professional guidance of Ministry of Health.
Article 13.
Sanitation in embalming and shrouding
1. Embalming shall
last no longer than 24 hours since death or corpse discovery. Embalming must
take place at -10oC or lower in order to last longer than 24 hours.
2. Close the coffin.
Seal the coffin tightly to prevent leakage, seepage, and damage during
transportation.
3. Wastes produced
in the process must be collected and treated in the same manner as infectious
wastes.
Article 14.
Sanitation in transportation of coffins containing corpses
1. Passengers of vehicles
carrying coffins containing corpses muse wear proper personal protective
equipment (eyewear, rubber gloves, medical face masks, shoes or boots).
2. As soon as
coffins reach burial grounds or cremation locations, the vehicles carrying the
coffins must be sterilized with 0,1% activated Chlorine solution, 70% alcohol,
or surface disinfectant preparations.
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Article 15.
Sanitation in funeral organization
1. Individuals
organizing and participating in funeral must adopt epidemic control measures in
accordance with guidance of Ministry of Health.
2. Sanitation of
funeral parlors and funeral locations must conform to Clause 1 Article 8
hereof; wastes that make direct contact with the coffin shall be collected and
treated in the same manner as infectious wastes.
Article 16.
Sanitation in burial and cremation
1. During burial
process, dust lime powder around and in the grave prior to lowering the coffins
into the grave. Prior to filling the grave, dust lime powder around and on the
coffins.
2. Once burial or
cremation process is complete, sanitize and sterilize equipment involved in
burial process, transportation to crematoriums, burial grounds, cremation areas
with 0,1% activated Chlorine solution, 70% alcohol, or surface disinfectant
preparations.
3. Persons engaging
in burial and cremation must wear proper personal protective equipment
(eyewear, rubber gloves, medical face masks, shoes or boots) throughout the
process. Once the work is done, take off personal protective equipment and wash
hands with soap or hand sanitizer.
4. Wastes making direct
contact with coffins and personal protective equipment shall be collected and
treated in the same manner as infectious wastes.
Article 17.
Sanitation in bone collecting
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Chapter 4.
IMPLEMENTATION
Article 18.
Responsibilities for implementation
1. Responsibilities
of Health Environment Management Agency: directing, guiding disseminating, and
inspecting implementation of this Circular.
2. Responsibilities
of Departments of Health of provinces and central-affiliated cities:
a) directing,
guiding, disseminating, and examining implementation of this Circular;
b) taking charge and
cooperating with Departments of Natural Resources and Environment in directing
entities to inspect sanitation in burial and cremation in their provinces and
central-affiliated cities;
c) disseminating,
guiding, and mobilizing the community to ensure sanitation in burial and
cremation in their provinces and central-affiliated cities;
d) organizing
training in epidemic control and handling of corpses of persons who died of
dangerous diseases;
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Article 19. Entry
into force
1. This Circular
comes into force from January 10, 2022.
2. Circular No.
02/2009/TT-BYT dated May 26, 2009 of Minister of Health expires from the
effective date hereof.
Article 20.
Organization for implementation
Director General of
Health Environment Management Agency, Chief of the Ministry Office, Chief Ministry
Inspectorates, Directors, Directors General, General Directors of Departments
and General Departments affiliated to Ministry of Health are responsible for
the implementation of this Circular.
Difficulties that arise
during the implementation of this Circular should be reported to the Ministry
for consideration./.
PP. MINISTER
DEPUTY MINISTER
Nguyen Truong Son
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