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An unusual occupational accident: fall into a sewage plant tank with lethal outcome
Forensic Science International 149 (2005) 39–45
An unusual occupational accident: fall into a sewage plant tank with lethal outcome$ Stephan A. Padosch*, Reinhard B. Dettmeyer, Lars U. Kro¨ner1, Johanna Preuss, Burkhard Madea Department of Legal Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany Received 19 December 2003; accepted 25 May 2004 Available online 23 August 2004
Abstract Occupational accidents, often presenting with lethal outcomes, are a rarely reported issue in forensic literature. However, these incidents are part of medicolegal casework with special regard to reconstruction, liabilities and insurance law-related issues, respectively. We report on a lethal occupational accident in a metropolitan sewage plant. When performing routine controls, a technician fell into an overflow sewer and was immediately pulled into a 30 cm diameter drain. Rescue efforts were initiated immediately, but had to be terminated due to gas warning. Rescue teams continued the search, however, the body remained undiscoverable. Forty-eight hours later, the cadaver was found in an adjacent digester tank, from where it was finally rescued. It was concluded, that the body had been transported between the overflow sewer and the digester tank through a 120 m pipeline with several 908 bendings and branch connections with a minimum diameter of 25 cm at the discharge valve. On medicolegal examination, the cadaver showed marked signs of advanced decomposition caused by anaerobic microorganisms in the 378 C biomass environment. Moreover, as a consequence of the passage of the pipeline system, signs of massive trauma (several comminuted and compound fractures) were disclosed at autopsy. To us, this is the first report on a lethal occupational accident in a sewage plant; our observations demonstrate the rapid progress of putrefaction in a warm anaerobic bacterial environment and the massive trauma sustained. # 2004 Elsevier Ireland Ltd. All rights reserved. Keywords: Lethal occupational accident; Sewage plant; Decomposition; Putrefaction; Anaerobic biomass; Medicolegal reconstruction
1. Case report After refurbishment, the Bonn municipal sewage plant major digester tank tower (9200 m3 total volume) was started up again. Therefore, it was filled with 378 C water and biomass (sludge slurry; pH ¼ 7.2, organic acids 1.83 mval/l, 31% CO2, 69% CH4) to start up the decomposition processes. $ Presented at the 82nd Annual Meeting of the German Society of Legal Medicine (DGRM), Mu¨nster, September 2003. * Corresponding author. Tel.: þ49-228-73-83-10; fax: þ49-228-73-83-39. E-mail address: [email protected] (S.A. Padosch). 1 Present address.: Department of Legal Medicine, University of Cologne, Melatengu¨rtel 60-62, D-50823 Cologne, Germany.
In order to monitor the start up, technicians had performed several controls of the biomass. Due to safety prescriptions, the tower platform of the digester tank (Fig. 1) was only allowed to be entered by two people, equipped with gas (methane, CO2) warning devices. At about 1 p.m., a 43-year-old female and a male technician entered the platform again to check the current sludge slurry composition and biomass temperature, respectively. When the male technician looked into the tank through an inspection window, his colleague presumably wanted to draw a sludge slurry sample for analysis from a overflow sewer (Fig. 2a). For this reason, she had used a small bucket fastened on a rope, which she had wrapped around her right wrist. The male technician later reported, that he had heard a scream and as he turned round, he had just seen the legs of his colleague disappearing in the overflow sewer.
0379-0738/$ – see front matter # 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.forsciint.2004.05.011
40 S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
Fig. 1. Overview of scene of accident. Digester tank tower with overflow sewer on top platform (white arrow). Adjacent secondary digester tank (scene of recovery, black arrow).
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
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Fig. 2. (a) Digester tank tower top platform with overflow sewer (white arrow). (b) View into overflow sewer, notice steps on the wall and 30 cm diameter drainage pipe on the bottom. Note overflow pipe on the right (white arrow; cf. (c)). According to the witnessing colleague, the sludge slurry foam layer had reached the fourth step. (c) Overflow sewer, right side wall view. The overflow pipe was located on the wall above the drainage pipe. Most probably, the sample bucket fastened on a rope, attached on the female technicians right wrist had been suddenly swept away with the biomass pouring out of the pipe into the sewer’s drain, pulling the technician into the overflow sewer.
Obviously, the female technician had put down the bucket into the sewer to take a biomass sample and had subsequently been pulled into the sludge slurry, pouring out of a big pipe into the sewers drain (Figs. 2b and c); i.e. the bucket had been swept along with the biomass pouring out of the overflow pipe, pulling the rope and technician, respectively, into the sewer. As the male technician had reported, that he had seen the woman’s legs disappearing in the sewer, the possibility could be ruled out, that the female had climbed down into the sewer to take a biomass sample and subsequently had lost consciousness due to gas and fell into the sludge slurry. The male technician immediately climbed down a few steps in the sewer, but he could not find the body in the foamy and turbid wastewater, as the foam layer was approxi-
mately 0.5 m high. Moreover, his gas warning device alerted, therefore, he had to cancel the rescue attempt and left the sewer. Fire rescue and emergency medical teams were called to the scene immediately, but the body could not be recovered; after the wastewater had been drained from the overflow sewer, it was found empty (Figs. 2b and c). Therefore, it was concluded, that the woman had been pulled into the 30 cm diameter outlet on the bottom of the sewer into the sewage plant pipeline system connecting the tanks and pools. Due to the fact, that the major digester tank tower had been started up again, it was initially not clear, which valves of the pipeline system had been open at the time of the accident, additionally complicating a precise search for the missing body.
42 S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
Fig. 3. Overview of cadaver after recovery from secondary digester tank. Note torsion of the torso and extensive bloating of soft tissues (cf. buttocks).
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
At that point, criminal investigators contacted our department to answer the question about the state of decomposition in the sludge slurry environment at temperatures about 37–398 C, to exclude the possibility that the body could become completely decomposed, making a successful recovery impossible. As there was little information available with regard to such kinds of accidents [1–3], based on general knowledge on decomposition in similar environments, we did not expect a full decomposition within a 24 h time period; especially a complete decomposition of the skeleton (as feared by investigators and rescue teams, respectively) could be ruled out. Indeed, about noon the next day, employees espied the body for a few seconds in the foam layer covering wastewater in an adjacent secondary digester tank (2500 m3 total volume), 15 m geodetic level below the digester tank, from where the body was rescued by fire rescue divers 48 h after the accident. It was concluded, that the cadaver had been transported through a 120 m pipeline system, being the only connection between the two tanks, with a minimal diameter of 25 cm (discharge valve) and at least two 908 bendings and branch connections and a pressure difference (suction) of approximately 1.5 bar (1.5 105 Pa). Subsequently, the cadaver was brought to our institution for further medicolegal examination and autopsy, respectively.
2. Autopsy findings The cadaver was 172 cm in size and weighed 54 kg; the clothing had gone lost, except for the trousers and the shoes (Fig. 3). No livores were observed, rigor mortis was completely resolved.
43
External examination revealed signs of advanced decomposition and putrefaction (Fig. 3), all the hair had gone as well as all finger nails and toe nails (Fig. 4). The skin was brown-greyish discoloured and showed large-area superficial loss of epidermis in small crater-shaped formations, most due to bacterial decomposition assumably (Fig. 5a). The soft tissues were markedly bloated, as well as the abdomen; the fat tissue showed marked oily transformation. Large-area oblique superficial parallel streaky mark formations of the epidermis according to the wall of the pipeline system were noted on the whole torso (Fig. 5b). Moreover, compound fractures of the left clavicle and humerus were found (Fig. 6). The right hand had been torn off. The thorax showed signs of massive trauma: the left thoracic cavity had been opened extensively, showing multiple serial rib fractures on both sides. The lower part of the cervical spine was missing, leaving the skull attached to the torso solely on a skin flap. A fracture at the base of the skull was also noted. Furthermore, multiple other extremity fractures were observed: lumbar cervical spine (torsion fracture), comminuted pelvic fracture, bilateral femur fractures. Both lungs, pancreas, spleen and the left kidney were missing. As all the skin and soft tissues were brownish discoloured and markedly decomposed, the lesions could not be doubtlessly judged as vital or postmortal with regard to haemorrhagic borders. Microscopic investigation of internal organs revealed signs of advanced decomposition; in most cases, the organ structures had become unrecognisable. Toxicological assays of autopsy specimens for drugs of abuse and ethanol applying routine methods revealed negative results.
Fig. 4. Left hand. Note missing finger nails and discolouration due to bacterial decomposition; also missing skin above prominent joints, caused during transport through the narrow pipeline system.
44
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
Fig. 5. (a) Brown-greyish discolouration of the skin. Large-area superficial loss of epidermis with small crater-shaped formations, most probably due to anaerobic bacterial decomposition. (b) Large-area oblique superficial parallel streaky mark formations, caused by transport through the pipeline system on the torso. Note umbilicus; weak remnants of tattoo in the left groin (white arrow).
Massive polytrauma, most probably in combination with drowning in wastewater and asphyxiation by gases was ruled as cause of death. However, the extent of these single factors contributing to death could not be determined, as the lungs were missing.
3. Discussion We report on a unique occupational accident in a municipal sewage plant, in detail, a lethal fall into a digester tank with subsequent transport of the corpse through a 120 m pipeline system with a pressure difference (suction) of approximately 1.5 bar (1.5 105 Pa) and a minimal diameter at the discharge valve of 25 cm. Until its recovery, the cadaver had been in a 378 C wastewater sludge slurry
environment, consisting of highly active anaerobic decomposition bacteria. To our knowledge, this is the first report in the literature on such an event and the subsequent medicolegal examination and autopsy, respectively. Previous reports describe the deposition of victims in private septic tanks, whose remains were recovered after 1.5 [4] and 15.5 years [1], respectively; moreover a lethal fall into a septic tank on a farm, where an acute necrotising pancreatitis was diagnosed at autopsy, which was assumed to be the cause of the fall due to an acute pain attack [2]. It should be also mentioned here that in former decades, neonaticides were committed by drowning the infants in liquid manure pits [5–7]. The reported case demonstrates two major facts: intriguingly, the warm anaerobic biomass containing wastewater
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
45
Fig. 6. Detailed view of upper part of the body and head. Total loss of hair, bloated lips, loss of teeth, compound fracture of left clavicle and humerus.
environment—consisting of highly active anaerobic decomposition bacteria [8,9]—caused marked and advanced decomposition and putrefaction within a relatively short period of time. However, these processes did not cause a full decomposition of the corpse, as initially assumed by the rescue teams. On the other hand, the cadaver exhibited signs of severe (poly-)trauma, i.e. multiple injuries and fractures, caused by blunt forces during the passage of a curved narrow pipeline system, connecting the location of accident and the location of discovery and recovery, respectively.
Acknowledgements The authors are indebted to P. Feldmann, Bonn Criminal Investigation Bureau, for the constructive discussion and his support. A. Fuchs and J. Bru¨ nig, Department of Legal Medicine, University of Bonn, for technical assistance. H. Bru¨ ckner, Bonn Metropolitan Administration, Dept. 66–3, for providing background information about sewage plant technologies, wastewater conditioning and decomposition bacteria.
References [1] E.O. Lew, B.G. Bannach, W.C. Rodriguez, Septic tank burial: not just another skeleton in the closet, J. Forensic Sci. 41 (1996) 887–890. [2] O. Prokop, F. Schleyer, Ertrinken in der Jauchegrube bei akuter Pankreasnekrose, Zeitsch. f. Gerichtl. Medizin 40 (1951) 452–454. [3] J. Payne-James, A. Busuttil, W.E. Smock, Forensic Medicine: Clinical and Pathological Aspects, Greenwich Medical Media Ltd., London, San Francisco, 2003, pp. 111–112. [4] T. Sigrist, H. Patscheider, H.K. Schegg, Ungewo¨ hnliche Leichenbeseitigung, Arch. Kriminol. 170 (1982) 146–158. [5] A. Haberda, Zur Lehre vom Kindesmorde, Beitra¨ ge z. Ger. Med. 1 (1911) 38–191. [6] J. Kratter, Lehrbuch der Gerichtlichen Medizin, Part 1, Enke Verlag, Stuttgart, 1921, p. 299. [7] E.v. Hofmann, A. Haberda, Lehrbuch der Gerichlichen Medizin, Part 2, Urban & Schwarzenberg Verlag, Berlin, Wien, 1927, p. 957. [8] K. Mudrack, S. Kunst (Eds.), Biologie der Abwasserreinigung, Gustav Fischer Verlag, Stuttgart, 1988, pp. 13–15, 43–51, 143– 154. [9] E. Lebscher, U. Loll (Eds.), ATV Handbuch Kla¨ rschlamm, Ernst & Sohn Verlag, Berlin, 1996, pp. 79–109, 137–161.
An unusual occupational accident: fall into a sewage plant tank with lethal outcome$ Stephan A. Padosch*, Reinhard B. Dettmeyer, Lars U. Kro¨ner1, Johanna Preuss, Burkhard Madea Department of Legal Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany Received 19 December 2003; accepted 25 May 2004 Available online 23 August 2004
Abstract Occupational accidents, often presenting with lethal outcomes, are a rarely reported issue in forensic literature. However, these incidents are part of medicolegal casework with special regard to reconstruction, liabilities and insurance law-related issues, respectively. We report on a lethal occupational accident in a metropolitan sewage plant. When performing routine controls, a technician fell into an overflow sewer and was immediately pulled into a 30 cm diameter drain. Rescue efforts were initiated immediately, but had to be terminated due to gas warning. Rescue teams continued the search, however, the body remained undiscoverable. Forty-eight hours later, the cadaver was found in an adjacent digester tank, from where it was finally rescued. It was concluded, that the body had been transported between the overflow sewer and the digester tank through a 120 m pipeline with several 908 bendings and branch connections with a minimum diameter of 25 cm at the discharge valve. On medicolegal examination, the cadaver showed marked signs of advanced decomposition caused by anaerobic microorganisms in the 378 C biomass environment. Moreover, as a consequence of the passage of the pipeline system, signs of massive trauma (several comminuted and compound fractures) were disclosed at autopsy. To us, this is the first report on a lethal occupational accident in a sewage plant; our observations demonstrate the rapid progress of putrefaction in a warm anaerobic bacterial environment and the massive trauma sustained. # 2004 Elsevier Ireland Ltd. All rights reserved. Keywords: Lethal occupational accident; Sewage plant; Decomposition; Putrefaction; Anaerobic biomass; Medicolegal reconstruction
1. Case report After refurbishment, the Bonn municipal sewage plant major digester tank tower (9200 m3 total volume) was started up again. Therefore, it was filled with 378 C water and biomass (sludge slurry; pH ¼ 7.2, organic acids 1.83 mval/l, 31% CO2, 69% CH4) to start up the decomposition processes. $ Presented at the 82nd Annual Meeting of the German Society of Legal Medicine (DGRM), Mu¨nster, September 2003. * Corresponding author. Tel.: þ49-228-73-83-10; fax: þ49-228-73-83-39. E-mail address: [email protected] (S.A. Padosch). 1 Present address.: Department of Legal Medicine, University of Cologne, Melatengu¨rtel 60-62, D-50823 Cologne, Germany.
In order to monitor the start up, technicians had performed several controls of the biomass. Due to safety prescriptions, the tower platform of the digester tank (Fig. 1) was only allowed to be entered by two people, equipped with gas (methane, CO2) warning devices. At about 1 p.m., a 43-year-old female and a male technician entered the platform again to check the current sludge slurry composition and biomass temperature, respectively. When the male technician looked into the tank through an inspection window, his colleague presumably wanted to draw a sludge slurry sample for analysis from a overflow sewer (Fig. 2a). For this reason, she had used a small bucket fastened on a rope, which she had wrapped around her right wrist. The male technician later reported, that he had heard a scream and as he turned round, he had just seen the legs of his colleague disappearing in the overflow sewer.
0379-0738/$ – see front matter # 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.forsciint.2004.05.011
40 S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
Fig. 1. Overview of scene of accident. Digester tank tower with overflow sewer on top platform (white arrow). Adjacent secondary digester tank (scene of recovery, black arrow).
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
41
Fig. 2. (a) Digester tank tower top platform with overflow sewer (white arrow). (b) View into overflow sewer, notice steps on the wall and 30 cm diameter drainage pipe on the bottom. Note overflow pipe on the right (white arrow; cf. (c)). According to the witnessing colleague, the sludge slurry foam layer had reached the fourth step. (c) Overflow sewer, right side wall view. The overflow pipe was located on the wall above the drainage pipe. Most probably, the sample bucket fastened on a rope, attached on the female technicians right wrist had been suddenly swept away with the biomass pouring out of the pipe into the sewer’s drain, pulling the technician into the overflow sewer.
Obviously, the female technician had put down the bucket into the sewer to take a biomass sample and had subsequently been pulled into the sludge slurry, pouring out of a big pipe into the sewers drain (Figs. 2b and c); i.e. the bucket had been swept along with the biomass pouring out of the overflow pipe, pulling the rope and technician, respectively, into the sewer. As the male technician had reported, that he had seen the woman’s legs disappearing in the sewer, the possibility could be ruled out, that the female had climbed down into the sewer to take a biomass sample and subsequently had lost consciousness due to gas and fell into the sludge slurry. The male technician immediately climbed down a few steps in the sewer, but he could not find the body in the foamy and turbid wastewater, as the foam layer was approxi-
mately 0.5 m high. Moreover, his gas warning device alerted, therefore, he had to cancel the rescue attempt and left the sewer. Fire rescue and emergency medical teams were called to the scene immediately, but the body could not be recovered; after the wastewater had been drained from the overflow sewer, it was found empty (Figs. 2b and c). Therefore, it was concluded, that the woman had been pulled into the 30 cm diameter outlet on the bottom of the sewer into the sewage plant pipeline system connecting the tanks and pools. Due to the fact, that the major digester tank tower had been started up again, it was initially not clear, which valves of the pipeline system had been open at the time of the accident, additionally complicating a precise search for the missing body.
42 S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
Fig. 3. Overview of cadaver after recovery from secondary digester tank. Note torsion of the torso and extensive bloating of soft tissues (cf. buttocks).
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
At that point, criminal investigators contacted our department to answer the question about the state of decomposition in the sludge slurry environment at temperatures about 37–398 C, to exclude the possibility that the body could become completely decomposed, making a successful recovery impossible. As there was little information available with regard to such kinds of accidents [1–3], based on general knowledge on decomposition in similar environments, we did not expect a full decomposition within a 24 h time period; especially a complete decomposition of the skeleton (as feared by investigators and rescue teams, respectively) could be ruled out. Indeed, about noon the next day, employees espied the body for a few seconds in the foam layer covering wastewater in an adjacent secondary digester tank (2500 m3 total volume), 15 m geodetic level below the digester tank, from where the body was rescued by fire rescue divers 48 h after the accident. It was concluded, that the cadaver had been transported through a 120 m pipeline system, being the only connection between the two tanks, with a minimal diameter of 25 cm (discharge valve) and at least two 908 bendings and branch connections and a pressure difference (suction) of approximately 1.5 bar (1.5 105 Pa). Subsequently, the cadaver was brought to our institution for further medicolegal examination and autopsy, respectively.
2. Autopsy findings The cadaver was 172 cm in size and weighed 54 kg; the clothing had gone lost, except for the trousers and the shoes (Fig. 3). No livores were observed, rigor mortis was completely resolved.
43
External examination revealed signs of advanced decomposition and putrefaction (Fig. 3), all the hair had gone as well as all finger nails and toe nails (Fig. 4). The skin was brown-greyish discoloured and showed large-area superficial loss of epidermis in small crater-shaped formations, most due to bacterial decomposition assumably (Fig. 5a). The soft tissues were markedly bloated, as well as the abdomen; the fat tissue showed marked oily transformation. Large-area oblique superficial parallel streaky mark formations of the epidermis according to the wall of the pipeline system were noted on the whole torso (Fig. 5b). Moreover, compound fractures of the left clavicle and humerus were found (Fig. 6). The right hand had been torn off. The thorax showed signs of massive trauma: the left thoracic cavity had been opened extensively, showing multiple serial rib fractures on both sides. The lower part of the cervical spine was missing, leaving the skull attached to the torso solely on a skin flap. A fracture at the base of the skull was also noted. Furthermore, multiple other extremity fractures were observed: lumbar cervical spine (torsion fracture), comminuted pelvic fracture, bilateral femur fractures. Both lungs, pancreas, spleen and the left kidney were missing. As all the skin and soft tissues were brownish discoloured and markedly decomposed, the lesions could not be doubtlessly judged as vital or postmortal with regard to haemorrhagic borders. Microscopic investigation of internal organs revealed signs of advanced decomposition; in most cases, the organ structures had become unrecognisable. Toxicological assays of autopsy specimens for drugs of abuse and ethanol applying routine methods revealed negative results.
Fig. 4. Left hand. Note missing finger nails and discolouration due to bacterial decomposition; also missing skin above prominent joints, caused during transport through the narrow pipeline system.
44
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
Fig. 5. (a) Brown-greyish discolouration of the skin. Large-area superficial loss of epidermis with small crater-shaped formations, most probably due to anaerobic bacterial decomposition. (b) Large-area oblique superficial parallel streaky mark formations, caused by transport through the pipeline system on the torso. Note umbilicus; weak remnants of tattoo in the left groin (white arrow).
Massive polytrauma, most probably in combination with drowning in wastewater and asphyxiation by gases was ruled as cause of death. However, the extent of these single factors contributing to death could not be determined, as the lungs were missing.
3. Discussion We report on a unique occupational accident in a municipal sewage plant, in detail, a lethal fall into a digester tank with subsequent transport of the corpse through a 120 m pipeline system with a pressure difference (suction) of approximately 1.5 bar (1.5 105 Pa) and a minimal diameter at the discharge valve of 25 cm. Until its recovery, the cadaver had been in a 378 C wastewater sludge slurry
environment, consisting of highly active anaerobic decomposition bacteria. To our knowledge, this is the first report in the literature on such an event and the subsequent medicolegal examination and autopsy, respectively. Previous reports describe the deposition of victims in private septic tanks, whose remains were recovered after 1.5 [4] and 15.5 years [1], respectively; moreover a lethal fall into a septic tank on a farm, where an acute necrotising pancreatitis was diagnosed at autopsy, which was assumed to be the cause of the fall due to an acute pain attack [2]. It should be also mentioned here that in former decades, neonaticides were committed by drowning the infants in liquid manure pits [5–7]. The reported case demonstrates two major facts: intriguingly, the warm anaerobic biomass containing wastewater
S.A. Padosch et al. / Forensic Science International 149 (2005) 39–45
45
Fig. 6. Detailed view of upper part of the body and head. Total loss of hair, bloated lips, loss of teeth, compound fracture of left clavicle and humerus.
environment—consisting of highly active anaerobic decomposition bacteria [8,9]—caused marked and advanced decomposition and putrefaction within a relatively short period of time. However, these processes did not cause a full decomposition of the corpse, as initially assumed by the rescue teams. On the other hand, the cadaver exhibited signs of severe (poly-)trauma, i.e. multiple injuries and fractures, caused by blunt forces during the passage of a curved narrow pipeline system, connecting the location of accident and the location of discovery and recovery, respectively.
Acknowledgements The authors are indebted to P. Feldmann, Bonn Criminal Investigation Bureau, for the constructive discussion and his support. A. Fuchs and J. Bru¨ nig, Department of Legal Medicine, University of Bonn, for technical assistance. H. Bru¨ ckner, Bonn Metropolitan Administration, Dept. 66–3, for providing background information about sewage plant technologies, wastewater conditioning and decomposition bacteria.
References [1] E.O. Lew, B.G. Bannach, W.C. Rodriguez, Septic tank burial: not just another skeleton in the closet, J. Forensic Sci. 41 (1996) 887–890. [2] O. Prokop, F. Schleyer, Ertrinken in der Jauchegrube bei akuter Pankreasnekrose, Zeitsch. f. Gerichtl. Medizin 40 (1951) 452–454. [3] J. Payne-James, A. Busuttil, W.E. Smock, Forensic Medicine: Clinical and Pathological Aspects, Greenwich Medical Media Ltd., London, San Francisco, 2003, pp. 111–112. [4] T. Sigrist, H. Patscheider, H.K. Schegg, Ungewo¨ hnliche Leichenbeseitigung, Arch. Kriminol. 170 (1982) 146–158. [5] A. Haberda, Zur Lehre vom Kindesmorde, Beitra¨ ge z. Ger. Med. 1 (1911) 38–191. [6] J. Kratter, Lehrbuch der Gerichtlichen Medizin, Part 1, Enke Verlag, Stuttgart, 1921, p. 299. [7] E.v. Hofmann, A. Haberda, Lehrbuch der Gerichlichen Medizin, Part 2, Urban & Schwarzenberg Verlag, Berlin, Wien, 1927, p. 957. [8] K. Mudrack, S. Kunst (Eds.), Biologie der Abwasserreinigung, Gustav Fischer Verlag, Stuttgart, 1988, pp. 13–15, 43–51, 143– 154. [9] E. Lebscher, U. Loll (Eds.), ATV Handbuch Kla¨ rschlamm, Ernst & Sohn Verlag, Berlin, 1996, pp. 79–109, 137–161.