Factors Influencing the Identification of Unknown Corpses in the State of Minas Gerais, Brazil

Identity is defined as an individual’s set of distinct characteristics which differentiates him/her from others, singularizing that person [1]. This is fundamental for the characterization of an individual, being a primary approach in interpersonal relations [2]. 

On a global scale, there have been continuous efforts to track down and identify the largest possible number of missing persons, an important task to provide closure to the grieving families of unidentified decedents, in addition to the legal significance with regard to estate inventory and collection of insurance and compensations by family members [2]. 

Brazilian law number 13.812/2019 has instituted the National Policy on the Search for Missing Persons and created the National Registry for Missing Persons, setting the search of missing persons and operational cooperation as a priority for public security agencies [3]. In this context, the Brazilian legal medicine plays an active role by technically identifying decedents admitted into forensic agencies [4]. 

Identification is the technical process in which one’s identity is established by comparing ante mortem and post mortem data. The main methods of technical identification used to classify unidentified bodies are papiloscopy, odontology, anthropology and comparative DNA analysis [2,5]. 

The establishment or confirmation of one's identity is made by means of one of the aforementioned scientific methods. The most adequate choice depends on each case, considering both the financial and emotional costs and the time it requires to provide the highest resolution rate and lowest cost to families and the State [2]. The dactyloscopy method stands out as the oldest, most used option with the best value for money [6,7]. 

Considering that human identification is fundamental to the characterization of an individual, that there is legal and social significance in identifying non-classified decedents, and that there are regulatory standards that prioritize the search for missing persons in operational cooperation with public security agencies, the relevance of this study is substantiated insofar as it aims to assess the factors related to the identification of decedents admitted into the Legal Medical Institute André Roquette (IMLAR).

This is a transversal, epidemiological study that aims to describe the characteristics of unidentified individuals admitted into the IMLAR in 2021, as well as factors related to their identification. 

Belo Horizonte is a city in the State of Minas Gerais. According to data from 2022 (IBGE), the resident population of Belo Horizonte totaled 2,315,560 people. The Municipal Human Development Index was 0.810 [8]. 

The study population consisted of deceased individuals admitted into the IMLAR in 2021 for investigation or suspicion of violent death. The study didn’t include products of conception, non-human material and victims of the Brumadinho DVI, as they present unique characteristics, as well as material sent from the State for suitability to genetic test, as they were previously necropsied. Out of the 3,748 assessed cases in 2021, 99 weren’t included in the study due to the previous reasons. 

The data was exported from the registration system of IMLAR's Control of Official Investigations, in a Microsoft Excel® sheet. The variables of the study related to the decedent’s identification, sociodemographic characteristics and the characteristics of the death. 

A descriptive analysis was initially carried out to assess the distribution of simple and relative frequencies, measures of central tendency (average and mean) and variability (standard deviation). The comparison between proportions to assess the distribution independence of the end variable, correlated with the independent variables, was carried out by means of Pearson’s chi-squared test by Monte Carlo simulation, with the significance level set to 5%. 

In order to assess the potential factors related to each outcome, the Prevalence Rates (PR) were calculated with robust variance, by means of Poisson log-linear regression; starting with a bivariate analysis between the outcome and each explicative variable, followed by a multivariate analysis exclusively of those with a p-value ≤ 0,20. Only the variables with p-value ≤ 0,05 were included in the final model. In order to verify the adequacy of the final model, this study utilized the log-likelihood and AIC (Akaike information criterion) and BIC (Bayesian information criterion) criteria.

This research project was submitted and approved by the Research Ethics Committee of UFMG under the number CAAE 67610223.1.0000.8307.

Case description 

In 2021, a total of 3,649 necropsies were carried out, among which 29% were of unidentified decedents. The month of June had the lowest number of cases (264) while December had the highest (345). June was also the least prevalent for the admission of unidentified decedents (67), while November was the most prevalent (107) (Figure 1).

 Figure 1: Distribution of cases at IMLAR by month (IMLAR/2021). 

Regarding weekdays, Monday and Sunday had the highest number of cases (280 each), while Thursday had the lowest (467). Friday was the least prevalent for the admission of unidentified decedents (132), while Monday was the most prevalent (186) (Figure 2).

 Figure 2: Distribution of cases at IMLAR by weekday (IMLAR/2021). 

Most victims were male (75.3%). There was a proportionally higher number of male unidentified decedents when compared to identified individuals (Table 1). 

Most decedents were black. There was a higher proportion of black decedents among the unidentified in comparison with the identified (Table 1). The average age of decedents was 47.95 years (sd 21.58 / CI 47.25 – 48,54 / Missing 169). (Non-tabulated data). 

For most cases, necropsy was the performed examination. Regarding anthropological examinations, 97% were performed in unidentified decedents. All skeletal remains belonged to unidentified victims. Regarding the place of death, Belo Horizonte was the most prevalent (61.4%). There was a proportionally higher number of decedents from the inland region of the State (Table 1). 

Defining the cause of death still remains a challenge, considering that this information was unavailable in 47.4% of cases. However, there was a significantly higher proportion of unidentified decedents in cases with an undetermined cause of death or cases of homicide. 

Table 1: General characteristics of decedents (IMLAR/2021). 

Key: Anthrop. = Forensic Anthropology / BH = Belo Horizonte / MG = Minas Gerais

* Chi-squared. 

The average age of identified decedents was higher (50.18 years) than the unidentified (41.18) (p ≤ 0.01) (Table 2). 

Table 2: Average age of decedents (IMLAR/2021). 

Analysis of unidentified decedents 

In regard to the classification unidentified decedents, 58.8% were recognized by family members, 30.30% were technically identified, and 118 cases remain unidentified. Out of the technically identified, most were identified by means of papiloscopy (80.13%) (Figure 3). 

For most cases in which the decedent was recognized by family members, the collection of fingerprints (81.32%) and biological material for genetic testing (97.26%) was performed. Some DNA and papiloscopy reports, issued after the victim was recognized by the family, confirmed the identification of these decedents (Figure 3). 

For most unidentified victims, the collection of fingerprints couldn’t be performed (67.79%) in case of skeletal remains or the lack of upper extremities with viable digital pulps (presence of viable ridges and papillary grooves), although biological material was collected for genetic testing (79.66%) (Figure 3). Some DNA and papiloscopy reports issued for unidentified decedents came back as inconclusive or didn’t include all hypotheses for the case (Figure 3).

 Figure 3: Classification of unidentified decedents by method of identification (IMLAR/2021). 

Key: FAS – Forensic Anthropology Division 

Among the unclassified individuals, there was a higher proportion of unidentified decedents with no information on sex, color, age and cause of death, when compared to classified individuals (Table 3). 

Table 3: General characteristics of unidentified decedents (IMLAR/2021).  

Key: Anthrop. = Forensic Anthropology / BH = Belo Horizonte / MG = Minas Gerais* Chi-squared. 

The decedents who couldn’t have their sex or color determined had 1.22 and 1.07, respectively, more chances of not being identified when compared to those who had their sex and color determined. Similarly, in cases where the decedent's age couldn’t be determined, they had 1.92 more chances of not being identified. 

In cases where it wasn’t determined if the death was an Occupational Accident (OA), the decedent had 1.05 more chances of not being identified when compared to those whose death was not OA related. 

After performing the papiloscopy and concluding the technical report, the bodies had approximately 0.96 (96%) more chances of being identified when compared to those that couldn’t undergo these procedures. The cases in which DNA wasn’t collected implied in 1.05 more chances of not being able to identify the body (Table 4). 

Table 4: Final Model - Prevalence Ratio (CI 95%) obtained by means of Poisson Log-linear Regression for variables associated with the identification of decedents (IMLAR / 2021). 

Observation: according to the Omnibus test, the present model surpasses the null model with a probability < 0.01.

A total of 3,649 necropsied decedents were assessed in 2021. Most of the assessed individuals were black, male adults, whose cause of death was undetermined. Approximately 30% of decedents were admitted into the institute without identification. There was a proportionally higher number of black, young men with undetermined cause of death among the unidentified decedents when compared to those identified at the moment of admittance in the IMLAR. Most unidentified decedents were recognized by family members, while 30% were technically identified, most of which by papiloscopy. Among the unclassified individuals, there was a higher proportion of unidentified decedents with no DNA sampling and no information on sex, color, age and cause of death, when compared to classified individuals. 

According to the Brazilian Public Security Yearbook of 2022, there was an estimated total of 65,225 missing persons in Brazil in 2021. In this year, a total of 2,768 unidentified decedents were registered in the Brazilian Mortality Information System (SIM), representing 0.15% of deaths in the country. In 2021 at the IMLAR, 1,056 necropsied individuals were unidentified, out of which, after appraisal, 118 remained unclassified (3.23% of total cases), surpassing the national average (0.15%). However, it was observed in a historical assessment of the above-mentioned report that, between 2015 and 2021, Minas Gerais represented 5.3% of Brazil's total unidentified decedents, less than the states of RJ (26.1%), SP (22.5%), PB (9.3%) and BA (6.2%), which points out an improvement of the internal processes of control and identification, corroborated by the lower percentage of unidentified decedents in 2021 (3.23%) in comparison with the preceding historical series [9]. This improvement can be attributed to the creation of the Reference Group of Unidentified Victims at IMLAR in 2016, which expanded the institute's tools for identification and implemented an internal control of traffic, providing quality of information and active monitoring of the cases.  

Human identification can be characterized as a set of traits that allow the singularization of an individual [1]. It is usually achieved with technical methods of papiloscopy, forensic odontology, forensic anthropology and DNA tests. Such methods assess the physical, chemical and biological phenomena in individuals, dead or alive (FREITAS, 2013). According to Rodolfo Barbosa de Freitas (2013): 

It is fundamental for the process of identification to use a method capable of establishing an unequivocal relation between the assessed elements, creating a set of particular characteristics that allow the distinction of people or things among them.  After all, more than just recognizing people, we must individualize them, establishing an identity.” 

We point out that there’s no protocol for the identification of victims at IMLAR, and the Civil Police officer responsible for transporting the body from the place of death to the IMLAR is in charge of classifying the decedent. Basically, when a decedent has no identification documents and the institution isn’t able to contact any family members to proceed with their burial, even in case of death by natural causes, the decedent is admitted into the IMLAR as unidentified. This misreports the real number of unidentified decedents, which represented approximately 30% of all examinations performed at the IMLAR in 2021. 

Out of 1,046 unidentified decedents assessed at the IMLAR, around 60% were recognized by family members. In Indonesia, 2004, a tsunami claimed approximately 217,000 victims, out of which 5,395 died in Thailand. The Department of Forensic Medicine of Chiang Mai University (CMU) assessed 193 cases, among which 49 could be classified thanks to the recognition by family members [10]. The recognition by family members usually happens in a moment of high emotional demand and, considering the transformation of the bodies due to the process of putrefaction and the artifacts used in the medico-legal procedures of necropsy, the family may end up mistakenly classifying the individual. Therefore, it is not recommended [5,11]. 

Considering that technical identification should be standard in every case, among the decedents identified by an internationally recognized method, 80.1% had a positive confirmation with papiloscopy at IMLAR. The papiloscopy method stands out as the oldest, most used option with the best value for money [6,7]. It is important to note, however, that the efficiency of this method relies on the recency of the death, and can become unviable in case the hands are modified by different factors, such as heat, destructive or conservative phenomena, etc., as well as in assessments of body parts where the hands aren’t available [12].

It was observed that 97% of the cases at IMLAR were assessed by the teams on duty, while the other 3% were skeletal remains, usually assigned to forensic anthropology.  This means that papiloscopy could solve most classifications, considering that on-duty teams don’t usually work with bodies in special conditions (advanced decomposition, mummification, skeletal remains, advanced carbonization). 

In case of bodies with modified hands, necropapiloscopy shouldn’t be completely discarded, but obtaining an adequate record can be more complex than just applying routine techniques (standard procedure) [2,13]. The higher the variety of available technical tools for fingerprint collection, the better the chances of obtaining an accurate record; therefore, developing new techniques is key [13]. The IMLAR has been specializing in fingerprint collection under special conditions, having already published several innovative techniques, such as necropapiloscopy by high-temperature vesication, refraction of indirect light in carbonized bodies, among others [14,15]. Since there’s no papiloscopy team at IMLAR, the Civil Police celebrated a grant, along with the Federal Police and the Federal University of Minas Gerais, which helps the identification of decedents, especially those who require fingerprint collection by advanced necropapiloscopy, when the standard tenprint collection isn’t possible. By using an information system (Automated Fingerprint Identification System (AFIS) / Automated Biometric Identification System (ABIS)), the identification of such cases is facilitated, since it doesn’t depend on the tenprint system (using all ten fingers from the hands), and requires confirmation of 12 coinciding particular points between the unidentified decedent and the suspected individual. This is crucial for cases in which both hands containing all fingers are not available for analysis, as just a fragment of a fingerprint can be enough for the technical identification to be successful [14-16]. 

Disaster Victim Identification (DVI) is the method used in the aftermath of tragic events caused by natural phenomena or human activity, intentional or not, with the goal of identifying the highest possible number of deceased (KOBIYAMA et al, 2014) (BORDONI et. al., 2022) (INTERPOL, 2018). In the DVI following Brumadinho, Minas Gerais, Brazil (2019), caused by the rupture of a tailings dam (iron ore mine), 270 people lost their lives. One year later, many of the 603 cases resulting from this DVI were fragmented, and were all examined at the IMLAR. The assessment included body parts (86.2%) and whole bodies (13.8%), out of which 259 victims were identified (primary identification) and 344 cases referred to reidentifications. Out of 259 primary identifications, 176 (68.0%) were classified by means of papiloscopy. 58 days after the incident, 214 victims had been primarily identified, 170 of which by fingerprint methods, having to resort to previously mentioned special techniques for some, which highlights the increasing difficulty of obtaining good results with the passing of time, due to the conservative/transformative phenomena of putrefaction [12]. This also applies to elderly people who passed recently as a result of the epidermal thinning and the wearing down of friction ridges, making the standard process of recording papillary impressions (ink and paper) more difficult. This is corroborated by the present study, in which age was an important aspect related to identification. Even though age had no primary statistical significance, elderly individuals (> 60 years old) presented marginal chances, approximately 3%, of not being identified.

In the DVI that took place in the mountain region of Rio de Janeiro in January, 2011, 895 people lost their lives during a landslide. Among the victims, 515 were identified (57.5%), out of which 94.6% were identified by means of papiloscopy [17]. In the aviation accident that happened in the Amazon rainforest in 2006, there were 154 casualties, out of which 83.8% were identified by papiloscopy [17]. In Thailand, 2004, after a tsunami took the lives of several people (Thailand DVI), a committee of identification was created. The committee was able to identify 1,112 individuals of different nationalities by creating a robust ante mortem database (4,082 entries). Among the identified decedents, 71 cases (6.4%) were identified using fingerprints [11]. 

In cases where papiloscopy identification can’t be applied, forensic odontology is an excellent option. The human tooth has high-temperature resistance, enduring heats over 1,000 °C. The post mortem duration and ability of teeth to remain viable for a longer period of time allow them to be used for identification purposes up to one year after the victim’s death [14].  Estimating identities is important to filter unidentified decedents, especially in cases without suspects or possibilities of identification by alternative methods [18]. When it comes to forensic odontology, the younger the decedent, the more precise the age estimation. This is on account of the indicators of dental development being more distinctive in the first years of life, in addition to their tendency of following a typical pattern, with little variation [18]. In the Thailand DVI, 86.5% of decedents were identified by means of forensic odontology [11]. On the other hand, in the Brumadinho DVI, the methods of forensic odontology allowed the primary identification of 9.2% of cases and 5.1% of all identifications (primary and reidentifications). The relatively low percentage of dental identification at the IMLAR was a result of body dismemberment (86.2 % of cases involved body parts), as well as the unavailability of ante mortem data of some of the decedents [12].  In the Rio de Janeiro DVI, the method of forensic odontology was responsible for the identification of 0.2% of decedents, and was used to identify 7.8% of the decedents in the Amazon rainforest accident [17].  The ante mortem database depends on the classification of previous dental records, which is one of the main limitations for the application of legal dentistry in these cases.

Forensic anthropology studies the aspects of an individual, especially the bones, and helps identify humans through the indication / estimation of their biological profile (sex, age, height and color/race), in the scope of legal and criminal justice. It is also responsible for determining the cause of death in cases where medico-legal examinations are performed [16]. Usually, the anatomic structures are morphologically analyzed, especially the pelvis, long bones and cranium. The anthropological identification by tattoo analysis has been increasingly utilized, especially in case of peculiar tattoos.  However, since they are limited to the epidermis and dermis, it is not a viable identification method in case of skeletal remains and most cases of carbonized remains or high degree of decomposition [16]. At IMLAR, 23 of 317 technically identified decedents were classified by means of anthropology which, at the Institute, comprehends both anthropology and forensic odontology. In the Thailand DVI, the anthropological method was responsible for identifying 0.9% of the cases, while, in Brumadinho, it was responsible for 0.8% of primary identifications and reidentifications [11,12]. 

Forensic biology, among its legal roles, is used for the identification of decedents through the analysis of DNA (deoxyribonucleic acid) found in several biological matrices, such as blood, bone fragments, cartilage, muscles, hair and skin [19]. However, since this process is more complex, expensive and time-consuming, it is considered as a last resort. The biologic comparison of the decedent's genetic material with the family members’ allows the inclusion/exclusion of genetic bond, making it an indispensable tool for the process of identification of the body/unidentified decedent [19]. It is worth noting that it's not possible to distinguish brothers by comparing their genetic material with their family members’, since they share the same genetic origin. This distinction is only possible by comparing their material with a direct sample (such as tooth brush, removable braces, etc.) [19]. 

In the Brumadinho DVI, DNA was responsible for 59.2% of the primary identifications and reidentifications, given that most cases referred to the Institute involved body parts in advanced state of decomposition (most examinations were performed in saponified bodies or skeletal remains). 10 months after the disaster, all 350 reported identifications / reidentifications were performed through DNA examination, corroborating that most decedents were classified using this method [12]. In the Thailand DVI, this method was used to identify 0.3% of the cases [11]. In the Rio de Janeiro DVI, DNA was responsible for 5.2% of identifications, while in the aviation accident that took place in Amazon rainforest, 8.4% of the cases were identified using this method [17]. In the present study, the IMLAR had 12.9% out of 317 cases technically identified by DNA. 

There was a significantly higher number of unidentified decedents who remained unclassified with no information on sex, color, age and cause of death, when compared to classified individuals. Regarding the examinations performed in unidentified bodies, especially those considered to be in special conditions (advanced decomposition, mummification, saponification, skeletonization, semiskeletonization, etc.), forensic anthropology and odontology are fundamental tools for the biological profiling of individuals, which consists in either defining or estimating sex, age, color and height, pieces of information that could direct the investigation more specifically for identification purposes, by filtering cases and reducing the range of possibilities [16]. In the present study, the lack of information on sex, color, and age was a factor associated with the unsuccessful identification of decedents admitted into the IMLAR during the assessed period, emphasizing that these characteristics should be investigated, whenever possible, through the available methods. 

The identification of a body is essential from the legal perspective because, with the death certificate at hand, it is possible to carry out the annulment of the individual’s personal documents, both in the criminal and civil scope. Moreover, it is essential for matters of estate inventory, as well as collection of insurance and compensations [16]. It is of great social impact for the families of missing persons to be aware of their location and condition, if they are still alive, and to give families the opportunity to perform religious/burial rites, as a way of celebrating the deceased and closing this chapter in the process of grief [16]. 

In the present study, in the assessed year, the highest prevalence was of adult, male, black individuals, whose cause of death was undetermined, especially among unidentified decedents. Similar data regarding the profile of unidentified decedents was observed in the Ministry of Health Report, regarding the death of unidentified individuals between 2015 and 2021 (80.7% male, 58.5% black) [9]. In Salvador, between 1998 and 2003, it was reported that, among the death by external causes, black men died more prematurely when compared to white men. The latter tend to have access to better education, higher socioeconomic level and access to health promotion initiatives, as well as being less exposed to violence [20]. Between 2009 and 2019, there was a nationwide increase in homicide among blacks (1.16%), even though a reduction in the number of victims among non-blacks was observed (15,249 in 2009, 10,217 in 2019). This data corroborates the social position of vulnerability of blacks in social hierarchy, limiting their access to fundamental conditions for pursuing a good life [20]. 

The number of deaths with undetermined intention / cause has been increasing all over Brazil, which may represent a deterioration of the quality of information in official records. This inefficiency also tends to result in the misreport of data on homicides, which, apparently, had decreased rates [9,21]. At the IMLAR, the cause of death remained undetermined in 47.4% of cases. However, cases of homicide were more prevalent among unidentified decedents.

It is noteworthy that the present study had the following limitations: the information was collected from secondary sources; the information on the detailed records of the cause of death were not available in the assessed reports; the extrapolation of conclusions must be done selectively, considering that the data was collected in a specific geographic region and there are administrative and technical particularities in regard to the operation of different Legal Medical Institutes in different Brazilian states and other countries, which affects which cases are referred to necropsy, which individuals are considered unidentified, what is the modus operandi for identification examinations and how the reports are carried out.

Papiloscopy was the most used method for the identification of decedents, both in standard and special collections of the assessed sample. The definition or prediction of the biological profile (sex, age and color) of unidentified decedents, as well as the indication of cause of death and DNA sampling, revealed to be fundamental to reduce the number of open cases. In this regard, the present study corroborates the importance of necropapiloscopy and forensic anthropology teams in medico-legal forensic agencies. 

The victims of external causes of death, especially unidentified decedents, tend to have lower education, socioeconomic level, access to health promotion initiatives, as well as being more exposed to violence, which confirms their position of vulnerability in the social hierarchy, limiting their access to fundamental conditions for pursuing a good life. 

The number of deaths with undetermined intention / cause has been increasing all over Brazil, which may represent a deterioration of the quality of information in official records. This inefficiency also tends to result in the misreport of data on homicides, which was observed at the IMLAR, especially among unidentified decedents.

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