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are not. If no fluid sample can be obtained, muscle from three widely separated sites should be taken. Fluid
samples should be preserved in l per cent sodium fluoride; samples of solid tissues must be deep frozen.
The samples of urine, blood and muscle may also suffice for toxicological examination for drugs.
However, when specimens are being collected for drug analysis, it is advisable that at least 200 grams of
liver tissue are preserved. It is also desirable to retain the whole of one kidney and at least one lobe of lung,
particularly if blood and urine are not available. Tissues such as these may produce adequate blood for
gas/liquid chromatographic techniques. All these samples should be preserved in the deep frozen state.
Glass jars are too heavy and cumbersome for the preservation of the numerous specimens collected
during autopsy examinations following a large aircraft accident. Plastic bags are recommended as suitable
containers for specimens taken for histological examination. They must be of a standard or heavy gauge
plastic and be adequately sealed. A single size, 25 x 36 cm, will be found suitable for most specimens and
ICAO Preliminary Unedited Version — October 2008 IV-1-9
the stocking of many sizes can be avoided. These plastic bags are also suitable for samples collected for
toxicological examination except that it should be noted that volatile substances can pass through plastic. It
is necessary therefore to put samples for analysis for alcohol or other volatile substances into glass
containers, which should be filled as completely as possible to minimize contact with air.
On completion of the joint examination of all whole bodies and all remains making up more than half a
body, it will be necessary to examine the fragments. The possibility of important evidence concerning the
accident investigation itself being present in a dismembered part must not be overlooked. Commonly the
examination of the fragments will be of most value with regard to the final count of victims and with regard
to the individual identification of a major fragment. Since clues to identity may be present in a separated
part, the whole body may be identified when the various fragments can be associated on anatomic
comparison.
Provided that the judicial team and pathologists have carried out a thorough comprehensive examination
including making a full record of findings, and fully labelling and carefully preserving all suitable material
evidence for further reference and for laboratory tests or analysis, the bodies may then be casketed and, if
required, embalmed. It is, however, advised that individual bodies should not be released until the
pathological processes of investigation and identification are complete with respect to the accident as a
whole. In view of the possible need to re-examine bodies, the caskets should be left in such a state that they
can be re-opened if necessary.
The accurate identification of the bodies that the pathologist has examined can be essential to the
interpretation of his findings in the context of the accident investigation. His medical evidence may
contribute significantly to the identification in many instances. Some authorities regard his involvement as
very important in the assessment of all the evidence about the identity of a body and in the decision about
whether the evidence is conclusive. However, it would be superfluous to repeat here details of the
contribution of others in this field since it is discussed in Chapter 18 of the AIG Manual. Advice on an
expeditious way to deal with the comparison of records in which the pathologist may or may not find
himself involved is given in Chapter 18 and subsequent Appendix of that manual.
SUBSEQUENT LABORATORY INVESTIGATIONS
Histology
There are many reasons for performing histological examinations on tissues of air accident victims,
including the detection of pathology:
a) indicating the presence of causal or contributory disease states in flight crew;
b) influencing survivability or egress;
c) providing possible indication of drug usage through fixed tissue reactions;
d) corroborating evidence of severe artefactual change such as putrefaction and fermentation with
bacterial growth producing or reducing ethanol;
e) providing an indication of disease prevalence for research
Emphasis should be placed on obtaining well-labelled samples from the major organ systems and
well-documented specimens of specific lesions or areas of artefactual change. Precise descriptions are
extremely important. All specimens should be immediately placed in a container of 10 per cent buffered
formalin solution for preservation.
While it is beyond the scope of this section to comprehensively review the broad field of histology, the
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Manual of Civil Aviation Medicine 2(130)
