The concept of Disaster Victim Identification (DVI)

The outcome of a mass fatality incident (MFI) response requiring the identification of numerous victims, depends heavily on structured and efficient organization throughout the entire recovery process. Due to the complexity of such operations, they require the coordinated efforts of multidisciplinary, well-trained teams. In response to these needs, several international guidelines for post-disaster operations have been developed.

INTERPOL published its first Disaster Victim Identification (DVI) guidelines in 1984. These are maintained and continuously improved by an international DVI Working Group composed of forensic and law enforcement experts who meet annually to share experiences and refining procedures [1]. The primary aim of the INTERPOL DVI Guide is to establish baseline standards for conducting DVI operations globally. It also includes standardized forms for structured documentation of ante mortem (AM) and post mortem (PM) data to support accurate and consistent victim identification [8][9].

Following the 2004–2005 Southeast Asia tsunami (figure 1a-b), the guidelines were significantly expanded based on lessons learned during one of the largest international DVI operations to date. The most recent version was published in 2023. Widely accepted by INTERPOL’s 196 member states, the guidelines have been applied in numerous international DVI efforts [3]. The Nordic countries fully adhere to these standards and actively contribute to the INTERPOL DVI Working Group. In military contexts, DVI operations follow specific standards. For instance, NATO has issued a guideline on forensic dental identification, which aligns closely with the INTERPOL framework. Additionally, due to the ongoing challenge of identifying deceased migrants, new protocols have been developed for comparing post-mortem and ante-mortem facial images [10].

Figur 1

Identification methods in mass disasters

In mass disasters victim identification methods are chosen on the basis of the degree of damage and condition of human remains. The victims may be identified by so called identifiers, and we distinguish between primary and secondary identifiers. There are only three internationally accepted primary identifiers; comparative dental analysis, friction ridge analysis (fingerprints, palm prints or footprints) and DNA analysis. A positive conclusion from either of these three can independently establish identity, but in mass disasters two or more primary identifiers are preferred to reduce the risk of bias. Unique serial numbers from medical implants, such as hip joint implants, may also be used as reliable identifiers. To date no such serial number exists in dental implants, however some implant producers mark their implants with batch numbers. Secondary identifiers can support a conclusion based on primary identifiers, but are not strong enough to be used to establish identity independently. These include medical information and history, such as evidence of disease, fractures or surgical procedures, scars, heart pacemakers and prosthetic or other medical devices. Tattoos, piercings and moles may also be used as secondary identifiers in case AM data is available for comparison. Secondary identifiers can also be police technical and tactical information, such as all effects found on the remains of victims e.g. jewellery, clothing and personal identity documents, and observations on the crime scene. Visual identification by a witness or relatives causes extensive psychological stress in confrontation with the deceased and is not considered a reliable identification method [9].

The Organisation of DVI in the Nordic countries

The Nordic countries all apply to the INTERPOL DVI guidelines as member countries. Representatives of the DVI-teams in the Nordic countries actively participate in the INTERPOL DVI working group and the continuous update of the INTERPOL DVI guidelines. For decades the Nordic DVI-teams have a tradition of regular DVI conferences circulating between the Nordic countries. These meetings comprise mutual exercises and exchange of experience between the Nordic colleagues of the DVI disciplines (police, pathologists, forensic odontologists, geneticists, anthropologists. Regular Nordic meetings strengthen the collaboration between the Nordic DVI-teams. Nordic DVI-teams have collaborated successfully in relation to several international and Nordic DVI-actions e.g. Scandinavian Star (1990) and Thai Tsunami (2004–2005), to mention a few. For decades Nordic forensic odontology experts successfully collaborated on providing an international intensive training course on forensic dental disaster victim identification. Forensic odontologists also regularly participate in joint exercises with the Nordic countries (figure 2).

Figur 2

DVI: A Structured Approach from Scene Recovery to Repatriation

The DVI framework is composed of four structured phases. Proper execution of these phases ensures scientific accuracy, legal validity, and respectful handling of the deceased, culminating in repatriation and support for bereaved families.

Post mortem Data Collection

Once remains are transported to designated mortuary facilities, detailed post mortem (PM) examinations are conducted (figure 3). Forensic pathologists, odontologists, anthropologists, and DNA analysts collaborate to collect primary identifiers such as dental information, fingerprints, and DNA samples. Secondary identifiers, such as scars, tattoos, surgical implants, or personal items, are also recorded. In complex cases involving decomposition, fragmentation, or trauma, digital imaging tools including CT scans, 3D reconstruction, and virtual autopsy techniques are employed to enhance documentation and analysis [12]. Post mortem data is collected using Interpol’s standardized pink forms, ensuring consistent documentation across cases.

Figur 3

Challenges in Disaster Victim Identification

Challenges of DVI may arise when human remains are fragmented, burnt or comingled. Relevant expertise at the scene is needed in these cases, especially forensic archaeologists or anthropologists who can establish a grid over the site and record recovery location for accident reconstruction or criminal investigations. Highly fragmented and fragile human remains must be carefully packed for transportation from the field to the morgue by specialists [14]. In natural disasters and during armed conflicts dental identification may face unique problems due to compromised infrastructure, destruction of ante mortem records from local dental clinics, and loss of communication lines [3][15][16]. A presumed identity of the deceased must be known so that AM dental records can be located. The same concerns DNA analysis since familial AM comparison samples are needed for identification. One challenge is the fact that DNA testing cannot distinguish siblings of the same sex and from the same parents [17]. Although DNA analysis is an important and reliable identification method, the technique is sensitive and sometimes time-consuming procedure and requires sophisticated machines and fully trained laboratory specialists [3]. In the future the fully automated rapid DNA identification systems developed for the field work may have more important role in DNA analysis [19]. In mass disasters there is a high risk of DNA contamination, primarily from commingling with other human remains [18]. There may be delay in recovering human remains from the disaster causing decomposition which might complicate DNA and fingerprint analysis [19]. Since teeth are the hardest structures in the human body and are located within the mouth and jawbones protected largely from the environmental and physical conditions, intact teeth are good source for DNA analysis [20]. In high temperatures the DNA will decay but dental materials may provide forensic evidence even after exposure to 900 °C temperatures [21]. The new DNA technology enables from genetic samples to distinguish a person’s physical characteristics by identifying eye, hair or skin colour and thus providing an additional tool in identifying an individual [22].

In friction ridge analysis in decomposed and mummified extremities, however, multiple advanced processing techniques exist for rehydrating the skin. The advantage of friction ridge analysis is the worldwide collection of AM fingerprints for example for visa and passport databases which can be used for comparison. New digital fingerprint capture technology has been developed, and the Malaysian Airlines Flight 17 (MH17) incident is a recent example of a DVI event where it was utilized [17].

Conclusion

Mass disasters, whether natural or man-made, present significant challenges in the recovery and identification of victims. Dental professionals play a critical role in Disaster Victim Identification (DVI), particularly when other identification methods are compromised. Adherence to INTERPOL DVI guidelines ensures a standardized and effective approach. In the Nordic countries, well-established DVI collaboration and preparedness have contributed to successful international and national responses. As future mass disasters are inevitable, strengthening the integration of dental professionals into national DVI strategies is essential. This includes ongoing education in forensic odontology, participation in DVI networks, and a continued focus on accurate, comprehensive dental record keeping. Through readiness and collaboration, the dental community can support timely, dignified identification and repatriation of disaster victims, serving both humanitarian and legal purposes.