Characteristics and toxicological processing of postmortem pilot specimens* from fatal civil aviation accidents

Introduction: Autopsied biosamples from civil aviation accident pilot fatalities are submitted to the Civil Aerospace Medical Institute (CAMI) for toxicological evaluation. However, such evaluation is dependent on types and amounts of submitted samples, and obtaining suitable samples is governed by the nature of the accident. Characteristics of those samples and associated toxicological processing have not been well documented in the literature. Method: Therefore, the CAMI Toxicology Database was searched for these aspects. Results. CAMI received samples from the pilot fatalities (CAMI cases) of approximately 80% of the 1990-2000 aviation accidents reported by the National Transportation Safety Board. Accidents and cases during June-September were higher than the other months, and more than half of the received cases had multiple samples in sufficient amounts. For example, out of 1891 cases processed for the 1996-2000 accidents, 1211 had at least adequate amounts of blood, urine, and/or vitreous humor; 324 had inadequate amounts of blood and urine; and 356 had no blood or urine. Muscle, liver, lung, and/or kidney samples were submitted in 90% of the cases, while cerebrospinal fluids were submitted in only 8% of the cases. The toxicologically preferred samples, blood and urine, were available in 78% and 56% of the 1891 cases, respectively. Out of 51 cases containing only one sample type, 46 had muscle and the remaining 5 had other sample types. Samples were primarily analyzed for combustion gases, alcohol/volatiles, and drugs. Generally, the presence of analytes is demonstrated in at least two different sample types by using two different analytical techniques for reporting a particular case as "positive." An effective quality-assurance/quality-control is maintained throughout the process. Conclusion: In the majority of the aviation accidents, sufficient amounts and types of biological samples were submitted for toxicological evaluation.