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value when there are many survivors but pathological assistance will be required whenever there are
fatalities.
Particularly in the event of a totally fatal accident, the pathological evidence is an essential part of the
medical investigation. The Investigator-in-Charge must ensure that important investigative information is
not sacrificed to meet social and legal desires for rapid identification and disposal of bodies. To this end, he
should, if possible, obtain the services of a pathologist familiar with aircraft accident investigation who is
capable of co-ordinating the two interdependent functions of investigation and identification.
The prime object of the pathologist should be to obtain evidence as to the cause, sequence and effect of
the accident through an examination of the operating crew, the cabin crew and the passengers.
Coincidentally with this investigation, evidence of medico-legal significance as to identification will
automatically emerge, particularly if each examination is enhanced by the co-ordinated efforts of the
pathologists, police, odontologists, radiologists, etc.
The pathological examination will be greatly helped by adequate preplanning - particularly in relation to
the recovery of bodies and the provision of whole body refrigeration. In the event that plans do not exist, the
Investigator-in-Charge should ensure facilities for the pathologist to carry out the following minimal
requirements based on investigative, medico-legal and sociological needs:
ICAO Preliminary Unedited Version — October 2008 IV-1-19
a) identification and complete examination of the operating crew on the flight deck or in the cockpit;
b) a full external examination of all fatal casualties;
c) identification of the cabin crew and comparison with the passengers;
d) minimal internal autopsy on all casualties to include:
1) establishment of the cause of death;
2) discovery of major disease likely to influence life expectancy; and
3) assessment of deceleration injury to:
- cardiovascular system, liver and diaphragm
- head, sternum, spine and pelvis;
e) selection of blood specimens from all casualties for carboxyhaemoglobin studies;
f) collection of lung specimens from all casualties for estimation of the mode of death.
An experienced pathologist will interpret his findings with caution. For their part, the head of the Human
Factors Group and the Investigator-in-Charge must ensure that the pathological findings are taken as but
part of the investigation as a whole and are fully correlated with evidence adduced within the Group and by
other Groups. Experience has shown that this is facilitated and maximum advantage gained if the
pathologist attends the periodic briefings by the Investigator-in-Charge.
FURTHER READING
1. I R Hill and S A Cullen: 2006: Accident investigation. In Ernsting’s Aviation Medicine 4th Ed. D J
Rainford and DP Gradwell (Eds). Hodder Arnold.
2. S A Cullen and IR Hill: 2006: Aviation pathology and toxicology. In Ernsting’s Aviation Medicine 4th
Ed. D J Rainford and DP Gradwell ( Eds). Hodder Arnold.
3. S A Cullen and H C Drysdale: 1998: Aviation accidents. In Pathology of Trauma, 3rd Ed. J K Mason
and P Purdue (Eds). Edward Arnold.
4. J K F Mason and W J Reals (Eds). 1973: Aerospace Pathology, College of American Pathologists,
Chicago.
5. SJH Véronneau: 2002: Aircraft accidents: Investigation and Prevention. In Fundamentals of aerospace
medicine. 3rd Ed. R DeHart (Ed). Lippincott, Williams and Wilkins.
6. R E Yanowitch, S R Mohler and E A Nichols: 1972: The psychosocial reconstruction inventory: a
postdictal tool in aircraft accident investigation. Aerospace Medicine 43 (5): 551-4.
7. INTERPOL: http://www.interpol.int/default.asp
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ICAO Preliminary Unedited Version — October 2008 IV-1A-1
ATTACHMENT A. AIR ACCIDENT LABORATORY SUPPORT
Some of the reasons for a national reference laboratory include the following:
a) to ensure standard results across the country, with a high level of expertise;
b) to provide rapid response to investigators;
c) to offer special tests not performed by other forensic laboratories, but which are required by air
accident investigators;
d) to work at levels of sensitivity which would pick up sub-therapeutic and trace concentrations of
analysed compounds;
e) to provide forensic analyses on tissue samples in cases where fluids are unavailable;
f) to assist in the interpretation of results with respect to a causal, contributory or incidental role in
accident occurrence or impact on survivability;
g) to undertake special studies as may be required to determine human factor input to the accident;
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本文链接地址：Manual of Civil Aviation Medicine 2(137)
