An overview of the heat-induced changes of the chemical composition of bone from fresh to calcined

When bone is exposed to thermal stress, the chemical composition changes. This affects bone tissue regeneration after surgery, and these changes can also aid in reconstructing ante-, peri-, and post-mortem events in forensic investigations and past activities on cremation practices in archaeology. However, to date, no complete overview exists on the chemical composition of both fresh and thermally altered bone. Therefore, we aimed (i) to present the chemical composition of fresh bone and (ii) to present an overview of heat-induced chemical changes in bone under both reducing and oxidizing conditions. From the overview, it became clear that some chemical changes occur at a consistent temperature, independent of exposure duration, meaning there is a temperature threshold. However, the occurrence of other chemical changes appeared to be more inter-experimentally variable, and therefore, it is recommended to further investigate these changes.

Unintentional persistent organic pollutants in cremation process: Emissions, characteristics, and inventory

Pollutants produced by cremation furnaces have gradually caused concern because of the increasing rate of cremation around the world. In this study, the levels, patterns, and emission factors of unintentional persistent organic pollutants (UPOPs) from cremation were investigated. The toxic equivalent (TEQ) concentrations (11 % O2 normalized) of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in flue gas ranged from 0.036 to 22 ng TEQ/Nm3, while the levels of polychlorinated biphenyls (PCBs) and polychlorinated naphthalenes (PCNs) in flue gas samples ranged from 0.0023 to 1.2 ng TEQ/Nm3 and 0.17-44 pg TEQ/Nm3, respectively. The average concentrations of UPOPs in flue gas from car-type furnaces were higher than those from flat-panel furnaces. Secondary chambers and air pollution control devices were effective for controlling UPOPs emissions. However, heat exchangers were not as effective for reducing UPOPs emissions. It was observed that the UPOPs profiles exhibited dissimilarities between fly ash and flue gas samples. HxCDF, OCDD, and PeCDF were the dominant homologs of PCDD/Fs in flue gas, while HxCDF, PeCDF, and HpCDF were the dominant homologs in fly ash. The fractions of MoCBs and MoCNs in fly ash were higher than those in flue gas. Finally, we conducted an assessment of the global emissions of UPOPs from cremation in the years of 2019 and 2021. The total emission of UPOPs in 47 countries was estimated at 239 g TEQ in 2021, which was during the peak period of the COVID-19 pandemic worldwide. The emissions in 2021 increased by approximately 24 % compared to 2019, with the impact of COVID-19 being a significant factor that cannot be disregarded.

Differentiating present-day from ancient bones by vibrational spectroscopy upon acetic acid treatment

Acetic acid treatment for an accurate differentiation between ancient and recent human bones was assessed using Raman and FTIR-ATR spectroscopies. Each set of skeletal samples was analysed by these techniques, prior and after chemical washing, in order to determine the variations in bone´s chemical composition and crystallinity. Bone samples were collected from several independent sources: recent bones burned under controlled experimental conditions or cremated, and archaeological (XVII century and Iron Age). The effect of acetic acid, expected to impact mostly on carbonates, was clearly evidenced in the spectra of all samples, particularly in FTIR-ATR, mainly through the bands typical of A- and B-carbonates. Furthermore, as seen for crematoria and archaeological samples, acetic acid was found to remove contaminants such as calcium hydroxide. Overall, acetic acid treatment can be an effective method for removing carbonates (exogenous but possibly also endogenous) and external contaminants from bone. However, these effects are dependent on the skeletal conditions (e.g. post-mortem interval and burning settings). In addition, this chemical washing was shown to be insufficient for an unequivocal discrimination between recent and archaeological skeletal remains. Based on the measured IR indexes, only cremated bones could be clearly distinguished.

[The patient has died … now what? : Step by step-what happens with patients after their death?]

The determination of a person's death, the subsequent post-mortem examination and the creation of the death certificate are part of regular medical work. The post-mortem examination, which is exclusively a medical duty, must be carried out immediately after the determination of death and includes in particular the definition of the cause of death and the type of death, which, in the case of a non-natural or unexplained death, entails further investigations by the police or public prosecutor and sometimes also forensic examinations. This article aims to shed more light on the possible processes after the death of a patient.

Physicochemical Changes in Bone Bioapatite During the Late Postmortem Interval Pre- and Post-Burning

Postmortem chemical transformation of bone bioapatite can take place during early diagenesis, resulting in a more thermodynamically stable mineral phase. This paper examines the impact of a one year postmortem interval on unburnt and burnt bone's structural and chemical alterations. This question is of importance for the reconstruction of funerary practices involving cremation in the archaeological record, as well as forensic anthropological investigations. Fleshed pig (Sus scrofa) tibiae were left exposed in a field, then collected at 14, 34, 91, 180, and 365 day intervals prior to being burnt in an outdoor fire (≤750 °C bone temperature). Fresh (fleshed) tibiae acted as unburnt and burnt controls. Also included in the study were two cremated human bone fragments from Middle-Late Neolithic (ca. 3300-2500 BCE) Ireland. Samples were analyzed for major and trace elements using an electron microprobe wavelength dispersive analyzer and molecular structures using Fourier transform infrared spectroscopy. Linear regression, principal component analysis, linear discriminant analysis, and multivariate analysis of variance were performed for statistical analysis. Results indicate that the concentrations of elements associated with extracellular fluid (K, Na, and Cl) change with the postmortem interval (PMI) and survive burning. K values under 0.07 ± 0.01 wt% in the inner and mid-cortical zones of burnt bones suggest that bones were not burnt immediately after death. Using this criterion, results from the archaeological samples would indicate a PMI of at least weeks to months prior to cremation. Ca, P, Fe, Al, Si, and Sr are not significantly altered with burning, and Fe, Al, Si, and Sr are also unaffected by the PMI. In unburnt bones increased crystallinity and carbonate loss are detectable in <1 year, but both are obscured by burning. Structurally, the carbonate to phosphate ratio (C/P), the phosphate high temperature, and cyanamide to phosphate (CN/P) are the most useful ratios for discriminating between unburnt and burnt bones.

Effectiveness and limitations of human identification from cremains: A report of two cases

The present study of two case reports of the victims of the Great East Japan Earthquake demonstrates the effectiveness and limitations of using dental cone-beam computed tomography (CBCT) imaging of cremains as a means of identification. In case 1, identification was assisted by further expanding the age range of the cremains evaluated on macroscopy by obtaining CBCT images of the cremated maxilla. The findings of case 2 presented the possibility that the deceased and the candidate were the same person by superimposing the CBCT images of the cremated patella on the X-ray of the candidate. However, since cremated bones are deformed to varying degrees, it is clear that the images obtained before, rather than after, cremation are more effective in comparing post-mortem and ante-mortem images. Thus, it is necessary to collect extensive and diverse data on the deceased before cremation.

Cut or burnt? - Categorizing morphological characteristics of heat-induced fractures and sharp force trauma

Distinguishing trauma from heat-induced fractures is a challenge faced by forensic anthropologists and pathologists during medicolegal investigations in which fire has been used by the perpetrators to destroy evidence. This paper aims to validate the provided identification features to distinguish between fire induced alterations and sharp force trauma. A total of 80 cremated adult individuals were used in this paper: 3 recently deceased embalmed cadavers from Cementerio Sur de Madrid for the sharp force trauma experiment in which 55 pre-burning injuries were inflicted using a machete and a serrated knife in different anatomical regions. And 77 cremated individuals from the Forensic Anthropology and Odontology Laboratory osteological collection. Five cremated long bones from this collection were selected, and 10 cuts were manually inflicted using a serrated knife to analyse post-burning trauma. Heat-induced changes and trauma morphologic characteristics were thus documented and analysed. The examination and documentation of morphological traits enabled the production of a heat-induced changes visual guide and a flow-chart. Two intraclass correlation tests were performed to validate the capacity of the observer to distinguish between fire related alterations and toolmarks. The results obtained in the statistical analysis indicate that, even if the toolmarks are visible and recognizable upon macroscopic observation by the observers, some features, such as the step and the transverse fractures can be mistaken with inflicted trauma. The use of the proposed features coupled with careful anthropological examination is recommended and has been found functional for participants with no prior knowledge in the analysis of cremated remains.

Are cranial peri-mortem fractures identifiable in cremated remains? A study on 38 known cases

Accurate identification and analysis of signs of trauma on human bone is one of the mainstays of forensic pathology. However, when a forensic pathologist has to deal with charred remains, the task become extremely difficult, because tissues are subjected to severe morphological alterations and their assessment can be critically distorted. We analyzed 38 individuals with peri-mortem skull fractures due to falls from height (17 cases), traffic accidents (16 cases), gunshots wounds (5 cases), of which we had the demographic and clinical data and the autopsy report with the description and photographic records of the fracture lines. After autopsy, the bodies were cremated in gas furnaces and the analysis of cremated cranial remains was conducted in order to verify if it was possible to reconstruct the original peri-mortem fractures and verify differences between known peri-mortem and post-mortem fractures. After 90 min and exposure to temperatures up to 1280 °C, in less than a third of cases (11-29%) the original peri-mortem fracture pattern could be found and reconstructed. The edges and the surface of the fractures can preserve their proper morphology, or they can be affected by post-mortem heat-induced fractures and deformations. Interestingly whenever peri-mortem fracture margins showed the evidence of yellow/brownish colouration, a matte appearance was observed, much different from post-mortem fractures, which may provide further food for thought for the identification of peri-mortem fractures after the cremation process.

Phosphorescence of thermally altered human bone

Bone has photoluminescent characteristics that can aid the analysis of thermally altered human skeletal remains as part of the forensic anthropological investigation. Photoluminescence stands collectively for fluorescence and phosphorescence. Because the difference in lifetime between fluorescence and phosphorescence is usually in the range of nano- to microseconds, it is only possible to visually determine whether bone phosphoresces when the lifetime is long enough to be observed. For this study, a distinction was made between long-decay and short-decay phosphorescence. So far, it was unknown whether (thermally altered) human bone emits long-decay phosphorescence after being illuminated and, thus, whether phosphorescence contributes to the observed photoluminescence. If so, whether the observable phosphorescence is dependent on temperature, exposure duration, surrounding medium, bone type, skeletal element, and excitation light and could aid the temperature estimation of heated bone fragments. In this study, bone samples were subjected to heat in the range of from room temperature to 900 °C for various durations in either air or adipose as surrounding medium. In addition, different skeletal elements of a human cadaver were recollected after cremation in a crematorium. Both sample collections were illuminated with light of different bandwidths and visually inspected for phosphorescence and photoluminescence. The samples were scored by means of a scoring index for the intensity of long-decay phosphorescence and photographically documented. The results show that thermally altered human bone fragments do phosphoresce. The observed phosphorescence is more dependent on temperature than on exposure duration, surrounding medium or skeletal element. Of the used wavelength bands, ultraviolet light provided the most temperature-related information, showing changes in both phosphorescence intensity and emission spectrum. Long-decay phosphorescence and fluorescence with short-decay phosphorescence coincide; however, there are also temperature-dependent differences. It is therefore concluded that phosphorescence contributes to the observable photoluminescence and that the visibly observable phosphorescent characteristics can aid the temperature estimation of cremated human skeletal fragments.

Mercury from crematoriums: human health risk assessment and estimate of total emissions in British Columbia

OBJECTIVES

Mercury occurs in the environment as a result of natural processes and human activities, including when individuals with amalgam dental fillings are cremated. This work aimed to estimate the quantity of mercury emitted to the atmosphere from crematoriums in British Columbia (BC) and assess the human health risk.

METHODS

A BC-specific emissions factor for mercury from crematoriums was developed and applied to an estimate of the quantity of mercury released annually to the atmosphere from crematoriums. The maximum ground-level mercury vapour concentrations resulting from crematorium emissions were estimated.

RESULTS

In BC, it is estimated that approximately 1.20 g of mercury is emitted to the atmosphere per body cremated and about 30,000 cremations were conducted in the province in 2016. It is estimated that almost 36 kg of elemental mercury was released to the atmosphere as a result. The maximum estimated peak short-term and long-term average ground-level mercury vapour concentrations associated with crematorium emissions were 0.31 μg/m³ and 7.9 × 10^-3 μg/m³ respectively, which are far lower than the reference concentration (hazard quotient of less than 1).

CONCLUSION

Mercury from crematoriums accounts for more than 7% of total mercury emissions to the atmosphere in BC, but risk assessment found no indication that ground-level exposures to elemental mercury vapour from crematoriums poses a significant risk to human health. If the number of cremations increases, it might reach considerable levels, highlighting the need for developing a national plan similar to other countries.

The postmortem examination prior to cremation: Still a necessary safety measure?

BACKGROUND

The postmortem external examination has repeatedly been the subject of political and medicolegal disputes. This study was performed to examine whether the postmortem external examination at the crematory provides additional benefits and to determine whether any differences in the quality of medical death certificates exist between hospital and non-hospital postmortem external examinations.

MATERIAL AND METHODS

All cases of death that had been examined within the context of a second postmortem external examination at crematories performed by medicolegal specialists from the Hamburg Department of Legal Medicine were analyzed during a 6-month investigation period.

RESULTS

A second postmortem external examination was carried out on 9981 decedents prior to cremation during the investigation period. In the interim, the second postmortem medical examiner did not release 474 bodies (4.7%) for cremation. Suspicion of death caused by trauma was the most frequent cause for delaying the release of the body. The quality of information stated on the medical death certificate was good in 112 certificates issued by clinicians (48.9%, n = 229) and in 51 issued by general practitioners (31.3%, n = 163).

DISCUSSION

This study verified deficiencies in the initial postmortem external examination. A postmortem external examination prior to cremation by a medical professional specialized in this field is currently an indispensable component for quality assurance.

[Postmortem examination at crematories: experiences and forensic medical evaluations]

Cremation is the most common type of burial in Germany. Evidence is lost when cremating the body. A second postmortem external examination (postmortem external examination at the crematory) is required by law in almost all German federal states prior to cremation. This duty is often performed by a legal medical specialist.This article provides an overview of different, mostly legal, medical assessments of the postmortem examination at the crematory and reports on personal experience in postmortem external examinations at crematories.The second postmortem medical examiner detects formal, content-related, and in some cases serious errors on medical death certificates on a regular basis. In cases with indications for a non-natural death or uncertain identity of the body, the cremation is stopped and some cases are reported to the investigative authority. Indications of death caused by physical trauma or malpractice are the most common reasons for delaying a cremation during the postmortem medical examination at the crematory. The percentage of delayed cremations is minimal (up to 5%). The second postmortem examiner reports approximately 0.5-2% of cases to the investigating authorities. The number of court-ordered autopsies of decedents that had been reported as being conspicuous has always been low (approximately 1%).Currently, the postmortem external examination by a specialist postmortem medical examiner at the crematory remains a vital prerequisite for identifying non-natural cases of death. Only a high number of autopsy orders can significantly improve the cause-of-death statistics of the postmortem external examinations at the crematory.

Luminescence of thermally altered human skeletal remains

Literature on luminescent properties of thermally altered human remains is scarce and contradictory. Therefore, the luminescence of heated bone was systemically reinvestigated. A heating experiment was conducted on fresh human bone, in two different media, and cremated human remains were recovered from a modern crematory. Luminescence was excited with light sources within the range of 350 to 560 nm. The excitation light was filtered out by using different long pass filters, and the luminescence was analysed by means of a scoring method. The results show that temperature, duration and surrounding medium determine the observed emission intensity and bandwidth. It is concluded that the luminescent characteristic of bone can be useful for identifying thermally altered human remains in a difficult context as well as yield information on the perimortem and postmortem events.

Burning Issues: Cremation and Incineration in Modern India

The cremation of human bodies and the incineration of urban waste provide two interrelated examples of technologies using the destructive power of fire that "travelled" in both directions between India and the West in the nineteenth and twentieth centuries. Rather than granting an automatic ascendency to western ways of burning the dead or disposing of urban rubbish, these case studies indicate the manner in which culture and environment inhibited or prevented their advance and favoured the survival or re-articulation of pre-existing technological practices and the socio-political infrastructure in which they were embedded. In the process of travelling, in part made possible by the agency of colonial personnel and the instruments of imperial exchange, but also through Indian opinion and diasporic dissemination, some technologies substantially changed their meaning, context and material form while others, seemingly untouched, underwent more subtle transformation.

Death Rituals Reported by White, Black, and Hispanic Parents Following the ICU Death of an Infant or Child

To examine rituals (disposing remains, wakes, funerals/burials, celebrations) of White, Black, Hispanic parents post ICU infant/child death.

DESIGN AND METHODS

Qualitative design, 63 parents completed English or Spanish semi-structured interviews at 7 & 13months after infant's/child's death. Interviews were audio-recorded, transcribed verbatim, and entered into Atlas.ti for analysis. An inductive approach to thematization was used to develop codes.

RESULTS

Parents: mean age 35.1years (SD=9.03); 33% Black, 27% White, 40% Hispanic; from 17 countries. Three themes emerged: immediately after death - shock and stress, needing help with arrangements, decisions on burial or cremation (conflicts due to finances, religion, culture), when and where to hold wakes, funerals/burials. Wakes and funerals--who prepares child's body, appropriate dress (deceased child, mourners), who can come (cultural restrictions),--by child age, parent choice, culture, religion, country. After burial/cremation--being with family, milestone celebrations.

CONCLUSION

Child death is devastating for parents, other children, grandparents, and family members.

PRACTICE IMPLICATIONS

Rituals after child death require decisions about the child's remains, wakes, funerals/burials at time of great pain for parents. This is especially true for newly immigrated parents and those with language barriers where making arrangements is especially hard and often very isolating. Health professionals who provide support need to be cognizant of practice differences based on religion, culture, economics, family traditions, and individual preference and provide as much support and resource as possible. A list of religious leaders representing the community's cultures and funeral service providers who may provide lower cost burials/cremations is helpful.

Postmortem radiation safety and issues pertaining to permanent prostate seed implantation in Japan

PURPOSE

If a prostate cancer patient treated with (125)I brachytherapy dies within 12 months after the treatment, prostate removal before cremation is recommended to avoid problems related to radioactivity in the ashes, such as inhalation of airborne particulate matter by crematorium staff or nearby residents. To provide guidance for such cases, a manual prepared under the editorial supervision of several professional associations was issued in 2008 in Japan. Herein, we investigated the incidence and causes of death, and the actions taken subsequent to death, among prostate cancer patients who died within 12 months after (125)I brachytherapy over a 10-year period in Japan; and we compared the results before and after the manual was issued.

METHODS AND MATERIALS

Data extracted from the Japan Radioisotope Association database for the period from September 2003 to the end of December 2013 were used.

RESULTS

Of 27,976 patients who underwent (125)I brachytherapy during the specified period, 79 died within 12 months after implantation, including 3 who died in the 2011 earthquake and tsunami. The prostate and brachytherapy source were retrieved at autopsy from 69 of the 79 patients. Autopsy could not be performed on the other 10 patients, 2 of whom died in the earthquake. Autopsy and retrieval of the brachytherapy source were significantly more common after issuance of the manual than before (22/28 cases before; 47/49 cases after; p=0.021).

CONCLUSION

In most cases of early death after (125)I brachytherapy in Japan, the brachytherapy source was retrieved.

Forensic aspect of cremations on wooden pyre

Three cases of cremation on open-air pyres are described. One was classified as a suicide and two as homicides. Fire duration was estimated at approximately 1 h, close to 2 h and more than 3 h, respectively. The position of the remains, the colour alteration of bone and the burned bone fractures biomechanics are discussed. Knowledge of normal burn patterns in fire and detection of perimortem lesions are essential. These three cases highlight the specific thermal alterations and burning processes in accordance with fire duration. In each case, careful investigation yielded clues as to the manner of death. Close cooperation between law enforcement and forensic pathology investigators is required in order to correctly identify the circumstances of death.

New pitfalls of high-density postmortem computed tomography

An 80-year-old female was transferred to the hospital due to a traffic accident. Multiple cranial bone fractures with intracranial hemorrhage and intracranial air were detected. Despite treatment, the patient died after 6h. Twenty-one hours after the patient died, her whole body was scanned by postmortem CT, and a region of high density was detected within the left putamen. The autopsy revealed a cerebral contusion and multiple skull base fractures. Moreover, superabsorbent polymers (SAPs) were found within the left lateral ventricle and adjacent to the putamen, which appeared as a high-density lesion on postmortem CT at the left putamen, where the SAPs were compacted. Both ante- and postmortem conditions should be considered to prevent misdiagnoses based only on postmortem CT.

The effect of victim age on burnt bone fragmentation: implications for remains recovery

This research investigates how victim bone age affects the fragmentation and subsequent recovery of burnt bone. It could be inferred that the lower density and higher organic content of bone from younger individuals results in more significant bone breakdown compared to bone from older individuals. Previous research has suggested that while neonate bone can be difficult to destroy in a burn environment it is more fragile post-burning. Results comparing fragmentation of calcined piglet and fattening-pig remains reveal that, while consisting of smaller fragments, the younger material is less fragmented with more complete or almost complete bone elements. These observations have significant implications for remains recovery, especially of younger remains, as it highlights the value of this material as well as the importance of utilising search and recovery strategies that minimise post-burning disturbance. Younger bone responds differently to the burn environment and, therefore; it needs to be taken into consideration when planning remains discovery and retrieval to ensure maximum benefit to the investigation and individuals involved.