The US Centers for Disease Control and Prevention (CDC) says New York City's chief medical examiner had to issue 2734 death certificates for people killed in last year's attacks on the World Trade Center (WTC). The attacks also forced the CDC to alter its mortality-classification system.
A special Sept. 11 issue of the Morbidity and Mortality Weekly Report (MMWR) stated that death certificates had been issued for 1373 people whose remains have been found and for 1361 whose remains were not found. Methods used to identify the dead included DNA screening (645), dental radiographs (188), fingerprints (71), personal effects (19) and photographs (16). Multiple methods were used to identify 407 people, while 966 were identified using a single method.
The WTC attacks created an unprecedented need to issue death certificates in the absence of human remains. The MMWR says certificates for those whose remains were found listed specific causes of death. Certificates for those whose remains were not found listed the cause of death as “physical injuries (body not found).”
The WTC attacks also forced the CDC to include deaths due to terrorist attack in its classification system. Terrorism is defined as “the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives.” — CMAJ