Clinical Guide: Alternate Light Sources: Part I (Identifying Fluids on the Body)

The issue of Wood’s Lamps and other alternate light sources (ALS) in sexual assault medical forensic exams comes up at courses and conferences regularly, which makes me reflect on how often we do things because we were taught we should, and not because they’ve been shown to be particularly useful or effective. So what follows is an overview of the literature on ALS in the detection of semen on the bodies of sexual assault patients.

The general gist of the literature is that Wood’s Lamps are ineffective for consistently identifying semen in the medical forensic exam; other types of ALS seem to be more effective. That being said, being able to document the presence of a glowing substance (since many things fluoresce under ALS) may still be of limited value for the forensic healthcare professional. Review the following articles for research and information on the subject. To be clear, the amount of research done on the subject is not overwhelming–there’s a definite need for more data as related to detection of semen on the human body with the tools generally found in clinical practice.

An important note: If you are using any type of alternate light source, you must be able to articulate how it works and the science to support its use. Should you go to court, this line of questioning is fair game.

BTW, don’t end your reading here. Continue on with Part II of this clinical guide, as there is some overlap in the issues between the two (e.g, what else absorbs light/fluoresces).

Articles (abstracts)

Alternate Light Sources In Sexual Assault Examinations: An Evidence-Based Practice Project

Eldredge K, Huggins E, Pugh LC. Alternate Light Sources In Sexual Assault Examinations: An Evidence-Based Practice Project. J Forensic Nurs. 2012 Mar;8(1):39-44. doi: 10.1111/j.1939-3938.2011.01128.x.
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An Alternate Light Source To Detect Semen

Nelson DG, Santucci KA. An Alternate Light Source To Detect Semen. Acad Emerg Med. 2002 Oct;9(10):1045-8.
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Comparison Of Laser And Ultraviolet Techniques Used In The Detection Of Body Secretions

Auvdel MJ. Comparison Of Laser And Ultraviolet Techniques Used In The Detection Of Body Secretions. J Forensic Sci. 1987 Mar;32(2):326-45.
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Fluorescent Identification Of Biological And Other Stains On Skin By The Use Of Alternative Light Sources

Wawryk J, Odell M. Fluorescent Identification Of Biological And Other Stains On Skin By The Use Of Alternative Light Sources. J Clin Forensic Med. 2005 Dec;12(6):296-301.
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Sexual Abuse Of Children. The Detection Of Semen On Skin

Gabby T, Winkleby MA, Boyce WT, Fisher DL, Lancaster A, Sensabaugh GF. Sexual Abuse Of Children. The Detection Of Semen On Skin. Am J Dis Child. 1992 Jun;146(6):700-3.
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The use of alternate light sources in the clinical evaluation of child abuse and sexual assault.

Mackenzie B, Jenny C. The use of alternate light sources in the clinical evaluation of child abuse and sexual assault. Pediatr Emerg Care. 2014 Mar;30(3):207-10. doi: 10.1097/PEC.0000000000000094.
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The Use Of An Alternative Light Source To Detect Semen In Clinical Forensic Medical Practice

Lincoln CA, McBride PM, Turbett GR, Garbin CD, MacDonald EJ. The Use Of An Alternative Light Source To Detect Semen In Clinical Forensic Medical Practice. J Clin Forensic Med. 2006 May;13(4):215-8.
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Wood's Lamp Utility in the Identification of Semen

Santucci KA, Nelson DG, McQuillen KK, Duffy SJ, Linakis JG. Wood's Lamp Utility in the Identification of Semen. Pediatrics. 1999 Dec;104(6):1342-4.
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