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FORENSIC MEDICAL DIAGNOSIS OF ACUTE RADIATION TRAUM
S.A.Khakimov
B.Z.Safarov
Tashkent state medical university, Republican scientific and practical center for forensic
medicine
ANNOTATION
Current issues of forensic medical diagnostics of acute radiation injuries were considered. Based
on the generalization of the personal experience of the authors and literature data, general and
specific issues of organizing and conducting forensic medical work in various variants of radiation
injuries were thoroughly covered. Special attention was paid to the specifics of retrieving and
referring autopsy materials for additional laboratory studies, as well as measures for radiation
protection of medical personnel.
Keywords:
forensic medical examination of the corpse, acute radiation sickness, autopsy technique.
The events of the 20th and early 21st centuries (particularly, the accident at Japan's Fukushima-1 nuclear
power plant) demonstrate that the possibility of large-scale radiogenic emergencies has become a reality.
Under such conditions, it is quite possible for people to be massively infected, leading to the development of
acute radiation sickness, which often leads to death. In this regard, it is clear that specialist physicians in the
field of forensic medicine must have an objective understanding of the specifics of organizing and conducting
examinations for this type of injury. However, due to the relative rarity of cases of acute radiation damage in
expert practice, these issues have not been sufficiently covered in domestic and foreign specialized literature.
The above led the authors to summarize their own many years of experience in conducting such examinations,
presenting them in the form of practical recommendations presented in this publication.
First of all, it should be borne in mind that the procedure for forensic medical examination of the bodies of
persons who died from acute radiation sickness has a number of features determined by the radiation situation,
information about which must be provided to the expert responsible for the examination before the start of
the examination. In this case, it is necessary to take into account the possible contamination of the div's skin
with radionuclides and/or the presence of radioactive substances in the div of the deceased. In this regard,
before the start of forensic medical examination of the corpse, if there is a suspicion of exposure to radioactive
substances, a physician-dosimetrist summoned by the investigative authorities conducts a thorough
dosimetric examination of the clothing on the corpse (if any) and the corpse itself. Clothing is removed and,
depending on the level of radioactive contamination, is either subjected to preliminary mechanical
decontamination or examined by an expert without such conduct. In cases where radioactive contamination
of the div's skin is detected during dosimetric control, it is thoroughly examined to determine whether there
are other contaminations on the victim's div that may be relevant to the investigation of the accident. In the
absence of such substances, the skin of the corpses is also subject to mechanical decontamination, for which
it is washed three times with soap or conventional detergent, followed by additional treatment with special
agents (preparations "Zashita," "Radez," etc.). Due to the fact that such processing can lead to the loss and/or
significant change in the appearance of external injuries, both in terms of severity and size, before the start of
decontamination measures, it is necessary to carry out a detailed description of the external changes on the
div of the deceased in parallel with their photo and video recording. The duration of work with the div in
cases of contamination with radioactive substances must be such that it does not allow the absorbed dose to
exceed the permitted regulatory levels according to the parameters of the "Radiation Safety Standards" of the
Russian Federation, approved by the IAEA.
Contamination of the corpse with radioactive substances is considered dangerous for the work
of medical personnel if the exposure dose at a distance of 1-1.5 cm from the div surface
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exceeds 100-200 mR/h. If the above-mentioned decontamination measures do not ensure
compliance with the permissible levels of radiation exposure for medical personnel, a control
time for working with the corpse is established, and radiation protection measures are specified.
The specified data are entered in the certificate, which is compiled by the dosimetric service
and transferred to the expert responsible for organizing the forensic examination of the corpse.
Based on the specific radiation situation and the level of radiation from the victim's div, the
necessary number of expert teams is formed. Each team must include at least 2 forensic medical
experts, a laboratory assistant, and a orderly. The circle of persons allowed to participate in the
work with the corpse is determined by the investigative bodies and the expert responsible for
the examination. With the permission of investigative bodies, in cases of death of victims of
radiation exposure, the presence of a pathologist and clinicians of specialized medical
institutions is advisable during the examination of corpses.
In the case of death from external gamma radiation, the examination of the corpse is carried
out in the usual manner according to the generally accepted methodology, examining the organs
of three main cavities - the chest, abdomen, and skull cavity. In cases where it is known or
presumed that the incorporation of radionuclides with selective deposition in certain organs
and tissues of the div (in particular, iodine-131, which selectively accumulates in the thyroid
gland) has taken place, it is necessary at the initial stage of forensic medical examination of the
corpse to extract the corresponding organs with subsequent separate radiometric and
pathomorphological examination.
Forensic examination of the corpse is carried out in separate, specially designated sectional
rooms equipped with special sewage system devices. In the absence of such premises, in order
to prevent the possible spread of radioactive contamination, it is necessary to have sealed
containers for collecting biological fluids and waste at the time of opening, with their
subsequent dispatch to centralized burial points. Upon completion of the autopsy procedure,
the sectional rooms are disinfected by washing the walls, ceiling, and floor using special and
household detergents, including washing powders, followed by jet washing. The same
decontamination measures are carried out in auxiliary premises and in div storage facilities.
During the entire period of the corpses' stay in the morgue, during the autopsy, and until the
completion of the decontamination procedures, all affected premises are enclosed with standard
warning signs "radiation hazard." Visiting these premises is strictly controlled. The bodies of
the deceased are not handed over to relatives and are buried in closed coffins.
All participants in forensic medical examinations of the bodies of persons who died as a result
of radiation incidents and accidents must be provided with individual dosimeters. Upon
completion of the autopsy, all participating medical personnel leave the used work clothes in
the section block, undergo sanitary treatment, and upon leaving the section block, are subject
to mandatory dosimetric control.
During forensic medical examination of corpses, if radiation injury is suspected, material must
be taken for additional laboratory tests (forensic histological, radiometric, bacteriological).
From the corpses of persons who died during or after a radiation incident, the following objects
must be taken for forensic histological examination: blood-forming organs (bone marrow and
lymph nodes of at least 5 anatomical locations, spleen, thymus); digestive organs (tongue,
salivary glands, pharynx, esophagus, stomach, duodenum, jejunum, ileum, cecum, transverse
colon, sigmoid colon, rectum, liver); lungs, trachea; cardiovascular system (right and left
atrium, right and left ventricles, interventricular septum, papillary muscle, aorta); urogenital
system (kidneys, bladder, prostate gland, uterus); nervous system (head and spinal cord);
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endocrine system (pituitary gland, thyroid gland, adrenal glands, pancreas, testes, epididymis,
ovaries); skin (head, neck, chest, abdomen; in cases of fresh and old radiation injuries, chronic
radiation ulcers, traces of previous The need for detailed microscopic examination is due to the
possible variety of radiation conditions (including sharply uneven) of various parts of the div,
for example, during accidental shielding, which allows for the over-radiation of some regional
sections in combination with low radiation of others. In the order for forensic histological
examination, in addition to generally accepted data, information is indicated on the possible
radioactive contamination of biological samples, the duration of radiation exposure, the
detected macroscopic changes, and all seized objects are listed according to the numbers.
For radiometric (biophysical) research during the incorporation of radioactive substances, the
material is taken and marked according to the same scheme as for forensic histological
examinations. In this case, pieces of skeletal muscles, liver, lungs, and subcutaneous fat are
additionally removed. Mass of each sample
tissue or organ should be at least 20 g (optimally 30 - 50 g).
In addition to the biological samples mentioned above, to retrospectively assess the absorbed
dose based on the magnitude of electron paramagnetic resonance (EPR), teeth (1-2 molars
without pathological changes), as well as nails, bone fragments, and the victim's clothing items
(primarily made of white/undyed cotton fabric with minimal contamination) are sent for
biophysical examination. Due to the fact that only local absorbed doses of γ-radiation are
evaluated by the EPR spectrometry method, the selection of biopreparations for EPR analysis
(in particular, bone fragments) should be carried out in the maximum possible number of
anatomical localizations, allowing for the restoration of uneven external γ-radiation doses
according to the assumed radiation geometry.
In cases where biophysical examination can be conducted shortly after autopsy, each taken
biological tissue sample with a label is placed in a separate dry container and immediately
transferred to a specialized laboratory. If it is located in another settlement, then the biological
material is placed in a refrigeration chamber or formalin and is kept in this state until the
beginning of the study. The material is delivered personally to the institution staffed by the
state biophysical laboratory (in Moscow - the A.I. Burnazyan Federal Medical Biophysical
Center).
If there is suspicion of the presence of a neutron component among the radiation factors
affecting the div of the deceased, to assess the dose of neutron radiation based on the
products of neutron activation, it is necessary to additionally take blood samples (volume of
at least 100 ml) and hair samples from the head and other areas of natural hair growth (face,
pubis, armpit, chest, upper and lower extremities). Due to the short half-lives (several hours)
of neutron activation products (in particular, 24Na, 32P, etc.), the selected biological samples
must be transferred to a specialized biophysical laboratory as soon as possible after the
radiation incident. In the direction for biophysical research, in addition to the previously listed
data, information about the deceased's profession, possible radiation exposure and radioactive
contamination conditions, duration of stay in the affected area, radiation level in the work
area, composition of nuclides in this zone, individual and group dosimeter indicators are
indicated. In addition, it is necessary to indicate the location of the injured person relative to
the "epicenter" of the accident and whether they had special or accidental protection during
work, as well as the medical institution where the patient was observed, blood test indicators
in dynamics, the surname of the treating physician and the expert who performed the autopsy.
For bacteriological examination, biological objects (blood and internal organ fragments)
should be taken within the first 24 hours from the moment of death, using sterile instruments,
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
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slides, and dishes. The cadaver's blood (5-10 ml) is taken from the heart before the brain is
removed. Pieces of the lungs, liver, and brain measuring 1×1×2 cm are taken with a scalpel
heated on a spirit lamp after preliminary burning of the corresponding areas of the organ
surface with a heated spatula. Samples of lung tissue are taken from the root areas and (if
necessary) from the middle of each lobe. The retrieved autopsy material is placed in sterile
jars or test tubes, sealed with coated stoppers, labeled and sealed as for forensic chemical
analysis, carefully packaged, and sent to the bacteriological laboratory.
Forensic medical examination conclusions are formulated after the completion of all
additional laboratory studies, taking into account the known circumstances of the case,
investigation materials, medical documents, and conclusions of specialists in the field of
radiation medicine and other specialties, depending on the specific situation. At the same time,
such examinations should be commission-based, taking into account their particular
complexity and specifics.
LITERATURE
1.
Weinstock D.M., Case C., Bader J.L. et al.
Radiological and nuclear events:
contingency planning for hematologists/oncologists. Blood 2008; 111: 12:
5440—5445.
2.
Иванов А.Е., Мудрецов Н.И., Куршакова Н.Н.
Патологическая анатомия
острой лучевой болезни (практическое руководство для патоло- гоанатомов и
судебно-медицинских экспертов). М: Военное изда- тельство 1987.
3.
Нормативно-методический
документ
«Нормы
радиационной
безо-
пасности/НРБ-99/2009; СанПиН 2.1.6.2523-09».
4.
Организация
санитарно-гигиенических
и
лечебно-профилактических
мероприятий при радиационных авариях (руководство). М: ФГУ Всероссийский
центр медицины катастроф «Защита» 2005.
5.
Singleton M., Start R.D., Tindale W. et al.
The radioactive autopsy: safe
working practices. Histopathology 2007; 51: 3: 289—304.
