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People increasingly look to the forensic autopsy as a way of determining whether a particular cancer death was environmentally caused. The forensic pathologist must be diligent pursuing evidence that links potential environmental causes to cancer but must also educate the public providing reassurance that most cancers are not due to industrial pollution. Cigarette smoking and various life-style factors appear to account for more cancers than do man-made environmental contaminants. Assessing the possibility that a cancer death is due to a specific environmental agent requires extensive information. First, one must obtain an accurate history of lifetime occupational and environmental exposures. Second, one must analyze this information in view of epidemiologic data on the cancer risks associated with each exposure. Finally, one should seek to document through the autopsy that exposure to a potentially harmful agent actually occurred. The carefully done forensic autopsy can alert the public to dangerous conditions and can provide individuals a basis for recovery in court for damages due to harmful exposures.

Reye's syndrome, encephalopathy and fatty change in the liver and other viscera, typically occurs suddenly in infants and children recovering from a viral illness, particularly influenza or varicella. Its rapid clinical course may suggest a drug-related insult and the differential diagnosis includes a variety of toxins. There are grounds for suspicion that exogenous substances--including aspirin--may be cofactors with recent viral illness in the syndrome's pathogenesis. For these reasons, medical examiners may be called upon to rule the diagnosis in or out, to assess the possibility of direct toxic injury, or to document presence or absence of possible cofactors. With these tasks in mind, this review summarizes the diagnostic, pathologic, and laboratory findings of Reye's syndrome and considers the roles of viral infection, heritable predispositions, and exogenous toxins in its causation. It singles out salicylate treatment for special considerations as a possible cofactor, and concludes with a suggested approach to the forensic medical investigation of possible cases of Reye's syndrome.