Mass Fatality Incidents Research Articles

Room temperature DNA preservation of soft tissue for rapid DNA extraction: An addition to the disaster victim identification investigators toolkit?

In mass fatality incidents, for example following a vehicle accident or terrorist event, severe fragmentation of bodies may occur, making identification by the use of traditional techniques such as fingerprinting or odontology difficult. In such situations DNA profiling can be employed for individualisation and re-association of fragmented remains. As at times disrupted soft tissue may be the predominate tissue type requiring identification and re-association. We have investigated the use of two buffer solutions for preservation of soft tissue samples that may be collected during such investigations, when buccal cells, blood samples or teeth or bone may not be available. Both buffer solutions have shown sufficient DNA preservation over a 12-month period of storage at room temperature to allow for DNA profiling to be successfully performed when 5–1000 mg muscle tissue was stored in each solution.

Mechanism and strategies for preventing post-traumatic stress disorder in forensic workers responding to mass fatality incidents

Mass fatality incidents (MFIs) expose medical examiners/coroners and associated staff to circumstances that may increase their risk for developing post-traumatic stress disorder (PTSD). The aim of this paper is to provide guidance for efforts to prevent the development of PTSD in forensic teams who respond to mass disasters. We present a model of the paths through which exposure to mass fatality incidents may lead to PTSD symptoms in forensic and recovery workers. The model is based on current research in stress and coping and the psychophysiology of PTSD and is used to generate worksite intervention strategies to reduce the risk for PTSD.

Bioinformatics and Human Identification in Mass Fatality Incidents: The World Trade Center Disaster*

Victim identification initiatives undertaken in the wake of Mass Fatality Incidents (MFIs) where high-body fragmentation has been sustained are often dependent on DNA typing technologies to complete their mandate. The success of these endeavors is linked to the choice of DNA typing methods and the bioinformatic tools required to make the necessary associations. Several bioinformatic tools were developed to assist with the identification of the victims of the World Trade Center attacks, one of the most complex incidents to date. This report describes one of these tools, the Mass Disaster Kinship Analysis Program (MDKAP), a pair-wise comparison software designed to handle large numbers of complete or partial Short Tandem Repeats (STR) genotypes, and infer identity of, or biological relationships between tested samples. The software performs all functions required to take full advantage of the information content of processed genotypic data sets from large-scale MFIs, including the collapse of victims data sets, remains re-association, virtual genotype generation through gap-filling, parentage trio searching, and a consistency check of reported/inferred biological relationships within families. Although very few WTC victims were genetically related, the software can detect parentage trios from within a victim's genotype data set through a nontriangulated approach that screens all possible parentage trios. All software-inferred relationships from WTC data were confirmed by independent statistical analysis. With a 13 STR loci complement, a fortuitous parentage trio (FPT) involving nonrelated individuals was detected. Additional STR loci would be required to reduce the risk of an FPT going undetected in large-scale MFIs involving related individuals among the victims. Kinship analysis has proven successful in this incident but its continued success in larger scale MFIs is contingent on the use of a sufficient number of STR loci to reduce the risk of undetected FPTs, the use of mtDNA and Y-STRs to confirm parentage and of bioinformatics that can support large-scale comparative genotyping schemes capable of detecting parentage trios from within a group of related victims.

Disaster victim identification.

In the event of any mass fatality incident, despite the cause, disaster victim identification must be undertaken; the humanitarian and legal responsibility for this falls on the forensic community. Mass fatality incidents can be natural (e.g., tsunamis, earthquakes, hurricanes), accidental (e.g., building collapse, ship sinking) or can occur as a result of a terrorist attack. Terrorism alone has been responsible for thousands of deaths in recent years and can be encountered in many forms (e.g., suicide bombings, airplane hijackings). In mass fatality situations, the experitise of many specialities are called on to assist in the identification efforts and to allow for the speedy return of recovered human remains to the relatives of the deceased. Today, DNA plays a vital but never solitary role in disaster victim identification.

Some mathematical problems in the DNA identification of victims in the 2004 tsunami and similar mass fatalities

DNA is a major and essential identification tool for mass fatality incidents including the hundreds of thousands of victims of the 2004 Indian Ocean tsunami. Mathematical complications characteristic of this sort of mass fatality include prevalence of related victims, the many races represented among the victims, and various identification modalities in tandem with DNA. Four mathematical problems of interest are discussed in this paper. (1) Other quantifiable factors (i.e. geography) can be formally accounted for by including a likelihood ratio that can be thought of as reducing the “effective number of victims.” (2) When a victim is found and tentatively identified as V, but then it comes to light that the victim has a relative W who is also missing, confidence in the identity is depressed. To account for the existence of W, increment the effective number of victims by the likelihood ratio supporting W as the identity of the victim. (3) When several apparently related victims are found, their mutual identities should be calculated simultaneously. Compared to one-at-a-time, serial identifications, this is both logical and may lead to much more confidence in the identities. (4) Although there may be many different population groups represented among the missing, it is generally sufficient to consider population statistics for only a few of them in deciding whether to declare an identification.

Application of automation and information systems to forensic genetic specimen processing

During the last 10 years, the introduction of PCR-based DNA typing technologies in forensic applications has been highly successful. This technology has become pervasive throughout forensic laboratories and it continues to grow in prevalence. For many criminal cases, it provides the most probative evidence. Criminal genotype data banking and victim identification initiatives that follow mass-fatality incidents have benefited the most from the introduction of automation for sample processing and data analysis. Attributes of offender specimens including large numbers, high quality and identical collection and processing are ideal for the application of laboratory automation. The magnitude of kinship analysis required by mass-fatality incidents necessitates the application of computing solutions to automate the task. More recently, the development activities of many forensic laboratories are focused on leveraging experience from these two applications to casework sample processing. The trend toward increased prevalence of forensic genetic analysis will continue to drive additional innovations in high-throughput laboratory automation and information systems.

Enhanced Kinship Analysis and STR-based DNA Typing for Human Identification in Mass Fatality Incidents: The Swissair Flight 111 Disaster

A bioinformatic tool was developed to assist with the victim identification initiative that followed the Swissair Flight 111 disaster. Making use of short tandem repeat (STR) DNA typing data generated with AmpFlSTR Profiler Plus (PP) and AmpFlSTR COfiler(CO) kits, the software systematically compared each available STR genotype with every other genotype. The matching algorithm was based on the search for: (i) direct matches to genotypes derived from personal effects; and (ii) potential kinship associations between victims and next-of-kin, as measured by allele sharing at individual loci. The software greatly assisted parentage analysis by enabling kinship evaluation in situations where complete parentage trios were unavailable and, in some situations, with distantly related relatives. Exclusion of fortuitous kinship associations (FKA) was made possible through the recovery at the disaster site of at least one remains for every sought-after victim, and was incorporated into the kinship software. The data from the 13 combined STR loci produced 6 and 23 times fewer FKAs when compared with PP alone and AmpFlSTR Profiler (PR) alone, respectively. Identification leads or confirmations of identification were obtained for 218 victims for which DNA reference samples (personal effects and kin) had been submitted. Confirmation of an inferred kinship association was sought through frequency and likelihood calculations, as well as corroborative data from other identification modalities. The use of a simple, yet powerful, automated genotype comparison approach and the use of megaplexes with high power of discrimination (PD) values extended considerably the identification capabilities in the case of the Swissair disaster. The DNA typing identification modality proved to be a valuable component of the large arsenal of identification tools deployed in the aftermath of this disaster.

Mass Fatality Incidents: Are California Dentists Ready to Respond?

The role of dentists in identifying victims of mass disasters is well documented. The organization of dentists who are trained in identification procedures at a local, state, or federal level may be a valuable resource in the event of a mass disaster in California. This article explores the organization of dentists available to assist in a mass disaster at the state and federal level.

Large-scale comparative genotyping and kinship analysis: evolution in its use for human identification in mass fatality incidents and missing persons databasing

The discovery of mass graves and the advent of the World Trade Center tragedy have underscored the necessity to better harness the information content of large DNA typing data sets with bioinformatic tools. This presentation will review the evolution of a bioinformatic tool originally created to assist with the identification of the victims of the Swissair Air Disaster in 1998. This tool was re-built in 2001 to handle the much more demanding complexities of the WTC tragedy. This second generation included the capability to process very large STR and SNP data sets, to collapse remains data, to build composite profiles from overlapping partial remains profiles, to search for potential kinship associations on a purely genetic basis, to verify the consistency of complete family pedigrees, and to perform likelihood ratio calculations. The next generation of this tool is under construction as a stand-alone application under a new database architecture. It will provide functionalities to meet the needs of very large mass fatality incidents (MFIs), and of missing persons databasing initiatives. The considerable benefits of integrated, systematic “data mining” approaches will be discussed.

ROLE OF THE DENTAL TEAM IN MASS FATALITY INCIDENTS*

The process of dental identification for a mass fatality incident has unique aspects in comparison with that of a routine dental identification, outside of the obvious increase in the number of victims and responders. The dental team is a small part of a large effort to resolve the incident. Incident command structure applies to the dental team as a unit as well as to the entire organization of the response. Teamwork and planning are essential on all levels. Discussing the casework is limited to the public information officer; only the public information officer is authorized to talk to anyone outside the medical examiner's office. For the team, communication is essential between the team members and between the team and other morgue sections. Daily meetings not only update progress, but also identify and solve problems as they arise. Redundancy and cross-checking occur each step in each section. A core team of trained individuals provides a framework for the use of less experienced members. Use of a dental identification computer program is extremely beneficial, especially as the amount of fragmentation or number of victims increases. Because of the magnitude of the response, the physical and mental stresses require critical incident stress debriefing for all responders, regardless of their experience. The past and future service of the dental profession to the victims of mass fatality incidents and their families is an excellent example of the ideal of service on which the profession is based.

Review of: Mass Fatality and Casualty Incidents. A Field Guide

Abstract The author recommends that you read through this entire “field guide,” and that you ask yourself how you or your agency fits into the response to mass fatality and casualty incidents. This seemed like strange advice for a book with a “field guide” format, including numerous lists and outlines of procedures. However, having followed the author's advice, I concur with his recommendation.

The Role Of The American Red Cross In Aviation Disasters

The American Red Cross is internationally recognized as the leader in disaster relief, but less well known is its role in providing psychological support services to those impacted by disasters, ranging from single family fires to mass fatality incidents. The American Red Cross Disaster Mental Health program is comprised of licensed or certified mental health professionals, trained to provide the effective, appropriate inventions in the highly chaotic, emotional charged environment that frequently surrounds a disaster. These skills are even more valued after aviation disasters. In the fall of 1996, the Congress of the United States passed the Aviation Disaster Family Assistance Act, which gave the National Transportation Safety Board (NTSB) the responsibility to oversee support services to families of passengers involved in commercial aviation disasters in the United States and its territories. The NTSB then tasked the American Red Cross with the role of coordinating emotional support services to those involved in aviation disasters. Since that time, the American Red Cross has developed a specialized Aviation Incident Response Team (AIR), with the capability and responsibility to travel anywhere in the US within four hours of an incident. A key component of the AIR Team is the Red Cross mental health leadership team which works closely with local professionals in the impacted area, as well as clergy, to ensure that appropriate support is available for affected families as well as disaster workers around the clock. Central to meeting the needs of the families is insuring they have a private area in which to grieve, while awaiting information about the crash, and identification of their loved ones. Usually family members are sequestered in a hotel near the crash site, where they can develop mutual support systems, while waiting for information. Aviation disasters are not unlike other mass casualty events, in that there is usually a tremendous outpouring of volunteers who wish to contribute their services to help those grieving. Though well meaning, these volunteers can quickly overwhelm those they are trying to help. The Red Cross has developed a system to manage this inflow of volunteers. A Staff Processing Center (SPC) is often set up in or near the relief operations headquarters. All volunteer and paid staff must process in and out of this center. Licenses and credentials are checked, volunteers are screened for appropriate assignment and availability, and all staff are given an orientation specific to the incident, including self care guidance. Once workers have been screened and given an orientation, they are assigned to specific service delivery sites, and given an ID specific to that site to ensure that security is maintained. The majority of mental health volunteers will find themselves assigned to the Family Assistance Center. Services may range from basic comfort measures, to grief counseling, education, and information about the recovery and identification process, support through the anteand post-mortem interviews, assistance arranging appropriate memorial services, and referral to support groups specific to aviation disasters. Other services for family members include child and spiritual support. These programs are provided in collaboration with Red Cross, and are comprised of specially trained child care workers and chaplains who represent a broad range of religious and spiritual backgrounds. Red Cross services may also extend to those working at the recovery site, and other locations where workers may be assigned as part of the response. The Red Cross works closely with other agencies and organizations to ensure that everyone involved has access to support services including Critical Incident Stress Debriefing as part of an overall Critical Incident Stress Management program. Red Cross mental health services are not limited to The Role Of The American Red Cross In Aviation Disasters 2 of 3 families who choose to come to the disaster site, but are provided to affected families around the country, who, for their own reasons may not choose to, or be able to travel to the crash site. Mental health volunteers from their local chapters will reach out to provide similar support, ensuring the same quality of care. These local volunteers will also provide follow up support to families returning home after the crash. The American Red Cross Disaster Mental Health program continues to expand in new directions, from support to individual families affected by single family disasters to aviation disasters, so that the same level of support is provided to people affected by traumatic events around the country and around the world. The Red Cross is ready whenever and wherever needed.