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Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Strategies to Protect the Health of Deployed U.S. Forces

Detecting, Characterizing, and Documenting Exposures

Thomas E. McKone, Beverly M. Huey, Edward Downing, and Laura M. Duffy, Editors

Strategies to Protect the Health of Deployed U.S. Forces: Technology and Methods for Detection and Tracking of Exposures to a Subset of Harmful Agents

Division of Military Science and Technology

Commission on Engineering and Technical Systems

Board on Environmental Studies and Toxicology

Commission on Life Sciences

National Research Council

NATIONAL ACADEMY PRESS
WASHINGTON, D.C.

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The author responsible for the report was chosen for his special competencies.

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce Alberts is president of the National Academy of Sciences.

This is a report of a study supported by Contract DASW01-97-C-0078 between the Department of Defense and the National Academy of Sciences. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for the project.

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Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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THE NATIONAL ACADEMIES

National Academy of Sciences

National Academy of Engineering

Institute of Medicine

National Research Council

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES

Technology and Methods for Detection and Tracking of Exposures to a Subset of Harmful Agents

Principal Investigator

THOMAS E. MCKONE,

University of California, Berkeley, and Lawrence Berkeley National Laboratory, Berkeley, California

Advisory Panel

WYETT H. COLCLASURE II,

Environmental Technologies Group, Inc., Jarrettsville, Maryland

MARGARET L. JENKINS,

California Air Resources Board, Sacramento, California

TREVOR O. JONES,

BIOMEC, Inc., Cleveland, Ohio

MICHAEL LEBOWITZ,

University of Arizona College of Medicine, Tucson

KEITH MCDONALD,

Sat Tech Systems, Inc., Alexandria, Virginia

ROBERT SHOPE,

University of Texas Medical Branch, Galveston

ROBERT SPEAR,

University of California, Berkeley

PAUL SWITZER,

Stanford University, Stanford, California

DETLOF VON WINTERFELDT,

Decision Insights, Inc., Irvine, California

CHARLES J. WESCHLER,

Telcordia Technologies, Red Bank, New Jersey

Board on Army Science and Technology Liaisons

CLARENCE G. THORNTON,

Army Research Laboratories (retired), Colts Neck, New Jersey

JOSEPH J. VERVIER,

ENSCO, Inc., Melbourne, Florida

Department of Defense Liaisons

MICHAEL KILPATRICK,

Office of the Special Assistant for Gulf War Illnesses, Falls Church, Virginia

FRANCIS O'DONNELL,

Office of the Special Assistant for Gulf War Illnesses, Falls Church, Virginia

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

Staff

BRUCE A. BRAUN, Director,

Division of Military Science and Technology

JAMES REISA, Director,

Board on Environmental Studies and Toxicology

BEVERLY M. HUEY, Study Director

RAY WASSEL, Senior Program Officer

EDWARD J. DOWNING, Senior Program Officer

LAURA M. DUFFY, Research Associate

NORMAN M. HALLER, Technical Consultant

PAMELA A. LEWIS, Senior Project Assistant

ANDRE MORROW, Senior Project Assistant

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

BOARD ON ARMY SCIENCE AND TECHNOLOGY

WILLIAM H. FORSTER, chair,

Northrop Grumman Corporation, Baltimore, Maryland

THOMAS L. MCNAUGHER, vice chair,

RAND Corporation, Washington, D.C.

ELIOT A. COHEN,

School of Advanced International Studies, Johns Hopkins University, Washington, D.C.

RICHARD A. CONWAY,

Union Carbide Corporation (retired), Charleston, West Virginia

GILBERT F. DECKER,

Walt Disney Imagineering, Glendale, California

PATRICK F. FLYNN,

Cummins Engine Company, Inc., Columbus, Indiana

EDWARD J. HAUG,

NADS and Simulation Center, The University of Iowa, Iowa City, Iowa

ROBERT J. HEASTON,

Guidance and Control Information Analysis Center (retired), Naperville, Illinois

ELVIN R. HEIBERG, III,

Heiberg Associates, Inc., Mason Neck, Virginia

GERALD J. IAFRATE,

University of Notre Dame, Notre Dame, Indiana

DONALD R. KEITH,

Cypress International, Alexandria, Virginia

KATHRYN V. LOGAN,

Georgia Institute of Technology, Atlanta, Georgia

JOHN E. MILLER,

Oracle Corporation, Reston, Virginia

JOHN H. MOXLEY,

Korn/Ferry International, Los Angeles, California

STEWART D. PERSONICK,

Drexel University, Philadelphia, Pennsylvania

MILLARD F. ROSE,

NASA Marshall Space Flight Center, Huntsville, Alabama

GEORGE T. SINGLEY, III,

Hicks and Associates, Inc., McLean, Virginia

CLARENCE G. THORNTON,

Army Research Laboratories (retired), Colts Neck, New Jersey

JOHN D. VENABLES,

Venables and Associates, Towson, Maryland

JOSEPH J. VERVIER,

ENSCO, Inc., Melbourne, Florida

ALLEN C. WARD,

Ward Synthesis, Inc., Ann Arbor, Michigan

Staff

BRUCE A. BRAUN, Director

MICHAEL A. CLARKE, Associate Director

MARGO L. FRANCESCO, Staff Associate

CHRIS JONES, Financial Associate

DEANNA SPARGER, Senior Project Assistant

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

COMMISSION ON ENGINEERING AND TECHNICAL SYSTEMS

W. DALE COMPTON, chair,

Purdue University, West Lafayette, Indiana

ELEANOR BAUM,

Cooper Union for the Advancement of Science and Art, New York, New York

RUTH M. DAVIS,

Pymatuning Group, Inc., Alexandria, Virginia

HENRY J. HATCH,

American Society of Civil Engineers, Reston, Virginia

STUART L. KNOOP,

Oudens and Knoop, Architects, PC, Chevy Chase, Maryland

NANCY G. LEVESON,

Massachusetts Institute of Technology, Cambridge

CORA B. MARRETT,

University of Massachusetts, Amherst

ROBERT M. NEREM,

Georgia Institute of Technology, Atlanta

LAWRENCE T. PAPAY,

SAIC, San Diego, California

BRADFORD W. PARKINSON,

Stanford University, Stanford, California

JERRY SCHUBEL,

New England Aquarium, Boston, Massachusetts

BARRY M. TROST,

Stanford University, Stanford, California

JAMES C. WILLIAMS,

GE Aircraft Engines, Cincinnati, Ohio

RONALD W. YATES,

U.S. Air Force (retired), Monument, Colorado

Staff

DOUGLAS BAUER, Executive Director

DENNIS CHAMOT, Deputy Executive Director

CAROL R. ARENBERG, Technical Editor

Page viii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY

GORDON ORIANS, chair,

University of Washington, Seattle

DONALD MATTISON, vice chair,

March of Dimes, White Plains, New York

DAVID ALLEN,

University of Texas, Austin

INGRID C. BURKE,

Colorado State University, Fort Collins

WILLIAM L. CHAMEIDES,

Georgia Institute of Technology, Atlanta

JOHN DOULL,

University of Kansas Medical Center, Kansas City

CHRISTOPHER B. FIELD,

Carnegie Institute of Washington, Stanford, California

JOHN GERHART,

University of California, Berkeley

J. PAUL GILMAN,

Celera Genomics, Rockville, Maryland

BRUCE D. HAMMOCK,

University of California, Davis

MARK HARWELL,

University of Miami, Miami, Florida

ROGENE HENDERSON,

Lovelace Respiratory Research Institute, Albuquerque, New Mexico

CAROL HENRY,

Chemical Manufacturers Association, Arlington, Virginia

BARBARA HULKA,

University of North Carolina, Chapel Hill

JAMES F. KITCHELL,

University of Wisconsin, Madison

DANIEL KREWSKI,

University of Ottawa, Ottawa, Ontario

JAMES A. MACMAHON,

Utah State University, Logan

MARIO J. MOLINA,

Massachusetts Institute of Technology, Cambridge

CHARLES O'MELIA,

Johns Hopkins University, Baltimore, Maryland

WILLEM F. PASSCHIER,

Health Council of the Netherlands, The Hague

KIRK SMITH,

University of California, Berkeley

MARGARET STRAND,

Oppenheimer, Wolff, Donnelly & Bayh, LLP, Washington, D.C.

TERRY F. YOSIE,

Chemical Manufacturers Association, Arlington, Virginia

Staff

JAMES J. REISA, Executive Director

DAVID J. POLICANSKY, Associate Director

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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COMMISSION ON LIFE SCIENCES

MICHAEL T. CLEGG, chair,

University of California, Riverside

PAUL BERG, vice chair,

Stanford University, Stanford, California

FREDERICK R. ANDERSON,

Cadwalader, Wickersham and Taft, Washington, D.C.

JOHN C. BAILAR, III,

University of Chicago, Chicago, Illinois

JOANNA BURGER,

Rutgers University, Piscataway, New Jersey

SHARON L. DUNWOODY,

University of Wisconsin, Madison

DAVID EISENBERG,

University of California, Los Angeles

JOHN EMMERSON,

Consultant, Portland, Oregon

NEAL FIRST,

University of Wisconsin, Madison

DAVID J. GALAS,

Chiroscience R&D, Inc., Bothell, Washington

DAVID V. GOEDDEL,

Tularik, Inc., South San Francisco, California

ARTURO GOMEZ-POMPA,

University of California, Riverside

COREY S. GOODMAN,

University of California, Berkeley

HENRY HEIKKINEN,

University of Northern Colorado, Greeley

BARBARA S. HULKA,

University of North Carolina, Chapel Hill

HANS J. KENDE,

Michigan State University, East Lansing

CYNTHIA KENYON,

University of California, San Francisco

MARGARET G. KIDWELL,

University of Arizona, Tucson

BRUCE R. LEVIN,

Emory University, Atlanta, Georgia

OLGA F. LINARES,

Smithsonian Tropical Research Institute, Miami, Florida

DAVID LIVINGSTON,

Dana-Farber Cancer Institute, Boston, Massachusetts

DONALD R. MATTISON,

March of Dimes, White Plains, New York

ELLIOT M. MEYEROWITZ,

California Institute of Technology, Pasadena

ROBERT T. PAINE,

University of Washington, Seattle

RONALD R. SEDEROFF,

North Carolina State University, Raleigh

ROBERT R. SOKAL,

State University of New York, Stony Brook

CHARLES F. STEVENS,

Salk Institute, La Jolla, California

SHIRLEY M. TILGHMAN,

Princeton University, Princeton, New Jersey

JOHN L. VANDERBERG,

Southwest Foundation for Biomedical Research, San Antonio, Texas

RAYMOND L. WHITE,

University of Utah, Salt Lake City

Staff

WARREN R. MUIR, Executive Director

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

Preface

Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns about health effects that could be associated with their deployment and service during the war. Although similar concerns were raised after other military operations, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of chemical and biological (CB) agents and other harmful agents in theater and health symptoms reported by military personnel.

A number of studies have addressed the issues of veterans' health and the potential health effects of their service, focused mostly on understanding the current health of veterans, ensuring that they are receiving appropriate evaluation and care, and determining the connections between veterans' current health status and service in, and specific exposures during, the Gulf War. As a result of these studies, the U.S. Department of Defense (DoD) has begun to focus more on better monitoring and control of exposures to multiple harmful agents.

Responding to this need, the DoD Office of the Special Assistant for Gulf War Illnesses, through the National Academies, sponsored Strategies to Protect the Health of Deployed U.S. Forces, a study that consists of four two-year studies followed by a consensus study. At the end of the second year (November 1999), the four study groups are issuing reports to DoD and the public on their findings and recommendations. These reports will then be used as a basis for a consensus study by a new National Academies committee in the third year of the project. The consensus committee's report will include the issues raised in the four

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

two-year studies, as well as overarching issues relevant to its broader charge.

This report, which is one of the four two-year studies, examines the detection and tracking of exposures of deployed personnel to multiple harmful agents. Unlike most National Academies studies, which are conducted by a committee led by a chair, this study was conducted by a principal investigator who was supported by a panel of technical advisors. As principal investigator, I worked with the National Research Council (NRC) staff to identify potential advisors, collect and synthesize data and information from relevant sources, and prepare this report, including its conclusions and recommendations. The members of the technical advisory panel participated in the report development process and the planning and management of workshops, the commissioning of papers, and gathering of information.

During this study, the panel, staff, and I received numerous briefings, visited facilities, consulted with experts, solicitated commissioned papers, attended symposia, and reviewed the open literature. Relevant sources of information used in this study include reports and databases from regulatory and research organizations, as well as information from experts in relevant disciplines. We visited and/or were briefed by individuals from numerous organizations, including the U.S. Army Soldier and Biological Chemical Command (SBCCOM), the U.S. Army Chemical School, the U.S. Army Center for Health Promotion and Preventive Medicine (CHPPM), the U.S. Army Center for Environmental Health Research (CEHR), and Brooks Air Force Base Crew Systems Division. Five meetings were held: one in March 1998 and one in August 1998, both at the NRC in Washington, D.C.; one at Woods Hole, Massachusetts, in September 1998; and two at the Beckman Center in Irvine, California, one in December 1998 and one in April 1999. A workshop was held in January 1999 at the NRC in Washington, D.C. At each meeting, the principal investigator, advisory panel members, and NRC staff attended presentations of technical information related to specific issues, were given briefings by DoD experts, and discussed key issues with invited participants.

The overall purpose of this study (discussed in Chapter 1) was to assess current and potential approaches to detecting and tracking exposures of deployed military personnel to a number of harmful agents. These agents include CB warfare agents, as well as environmental contaminants, such as hazardous air pollutants, soil contaminants, pesticides, particulate matter, fuels, metals, and microbial agents. This assessment also includes an evaluation of the efficacy and extent of implementation

Page xiii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

of current military policies, doctrine, and training. Based on this evaluation, opportunities are identified for adjusting or augmenting strategies to improve the protection of military personnel in future deployments.

From the very beginning of this study, it became apparent that characterizing troop exposures requires many different types of information, as well as information collection and storage technologies. The focus of this study is on the overall practice of collecting, managing, and using information on potential exposures to deployed forces. The study addresses not only detection, monitoring, and tracking technologies, but also the framework in which these technologies are applied.

Understanding exposure requires knowing (1) which agents to look for; (2) whether, in what medium, and at what concentrations they were detected; (3) the space and time distribution of agent concentrations; and (4) the space and time distribution of the troops at risk. Tracking individuals and their exposures over time and space requires methods of determining and recording time-specific locations, detectors, and monitors, as well as methods of assessing harmful agent concentrations and environmental exposure pathways, including meteorological conditions over a wide area and, sometimes, groundwater-flow vectors. Detecting, monitoring, and tracking exposures of deployed forces to multiple agents requires making decisions with multiple, often competing, objectives. In response to a critical situation, the requirements for new equipment and monitoring must be defined and ranked according to the value of the information they will provide.

This study was completed with the full and timely cooperation of the DoD. Our requests for information were quickly and thoroughly answered. This made our work easier and our findings more credible. The members of the advisory panel and I were impressed with the level of research and development, training, and application that DoD is currently devoting to the issues addressed in this report. In fact, the rapid pace of change made it necessary for us to update and revise our findings continually, and many of the issues raised in this report may be resolved before the report has been widely circulated.

The report was refined and improved by reviewers both on the National Academies' staff and external to the Academies. Their thoughtful and constructive comments significantly enhanced the quality of the final report.

Finally, I gratefully acknowledge the work and support provided by NRC staff members: Beverly Huey, the NRC study director for this project, whose dedication, intelligence, and enthusiasm were invaluable; Jack

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

Downing, who spent long hours editing and revising initial drafts; Ray Wassel, who assisted in the development and preparation of this study; Norm Haller, who served as technical consultant; and Laura Duffy, who helped organize the multiple sources of information and was particularly adept at finding information resources on the Worldwide Web.

Thomas E. McKone

Principal Investigator

Strategies to Protect the Health of Deployed U.S. Forces: Technology and Methods for Detection and Tracking of Exposures to a Subset of Harmful Agents

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

Acknowledgments

We are appreciative of the cooperation we received from the many individuals and organizations who provided us with valuable information and guidance in the course of our work. First, we extend our sincere thanks to the members of the advisory panel who provided assistance and guidance during the information-gathering process, gave thought-provoking presentations in their respective areas of expertise, participated in briefings from various organizations, and provided thoughtful comments on the initial drafts of this report. We are deeply indebted to those individuals who prepared commissioned papers for our use and who gave presentations at the January workshop: COL Mike Brown, on predeployment operational decision making; Roy Reuter, on a situational framework for future deployments; Detlof von Winterfeldt, on dimensions of harm; Don Stedman and Murray Johnston, on the analysis of chemical detection technologies; Linda Stetzenbach, on the analysis of biological detection technologies; Peggy Jenkins, on strategies for tracking people; Michael Lebowitz, on tracking exposures; Keith McDonald, on GPS technologies; and Robert Spear, on GPS applications.

We are grateful for the guidance and support of others at the National Academies, including Joseph Cassells and Suzanne Woolsey, who assisted in the coordination of the four studies as they were being conducted simultaneously; Bruce Braun, who assisted in defining the scope of the study and provided ongoing oversight; and Douglas Bauer an Dennis Chamot, who adeptly dealt with stumbling blocks and provided

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

thoughtful insights. We also appreciate the work of Andre Morrow and Pamela Lewis, who provided administrative assistance in preparing this document for review and publication, and Carol Arenberg, who edited this document for technical content and clarity. Finally, we are indebted to numerous other National Research Council staff: Mike Clarke, associate division director; Margo Francesco, staff associate; Delphine Glaze, Tracie Holby, and Jacqueline Campbell-Johnson, senior project assistants; and Alvera Wilson, financial associate.

The extensive contributions and thought-provoking comments freely given by so many individuals throughout the course of this study enabled us to complete our task. We would like to acknowledge individuals who provided briefings, prepared commissioned papers, arranged site visits to their organizations, gave presentations at the workshop, supplied invaluable information and reports critical to our charge, answered our searching questions honestly, and assisted us in contacting other sources who could provide additional information and documentation. No doubt the list is incomplete, and we apologize for any oversights (see Appendix F).

This report has also been reviewed by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the authors and the National Research Council in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The content of the review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report:

Elizabeth Barrett-Connor, University of California San Diego, LaJolla

Robert E. Boyle, Office of the Deputy Chief of Staff for Operations, Plans, and Policies, Department of the Army (retired)

John Carrico, SRI International

Robert Clemen, Duke University

Craig H. Curtis, Tracor Aerospace

Christopher C. Green, General Motors Research and Development Center

Orlando J. Illi, SRA International, Inc.

Charles Kolb, Aerodyne Research, Inc.

David Layton, Lawrence Livermore National Laboratory

Sanford S. Leffingwell, HLM Consultants

Harrison Shull, Professor Emeritus, U.S. Naval Postgraduate School

George Whitesides, Harvard University

Page xvii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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While all of the advisors and the reviewers listed above have provided many constructive comments and suggestions, responsibility for the final content of this report rests solely with the authoring principal investigator and the National Research Council.

Page xviii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Proximate Sampling

 

34

   

Personal Sampling

 

34

   

Biological Markers

 

35

   

Modeling, Simulations, and Decision Analyses

 

36

   

Exposure Modeling

 

36

   

Models of Daily Intake

 

38

   

Simulations

 

38

   

Needs, Capabilities, and Opportunities

 

39

   

Tracking Strategies and Emerging Needs

 

39

   

Real-Time Monitoring Strategies

 

39

   

Prospective Monitoring Strategies

 

40

   

Retrospective Monitoring Strategies

 

42

   

Data Storage, Management, and Analyses

 

42

   

Use of Scenarios, Training, and Exercises

 

42

   

Making Exposure Assessment Operational

 

42

   

Findings and Recommendations

 

43

   

TECHNICAL ANNEX

 

46

   

Components of An Exposure Assessment

 

46

   

Dimensions of Harm

 

48

3

 

THRESHOLDS OF HEALTH EFFECTS FOR CHEMICAL AND BIOLOGICAL AGENTS

 

50

   

Chemical Agents

 

51

   

Chemical Warfare Agents

 

53

   

Toxic Industrial Chemicals

 

53

   

Biological Agents

 

56

   

Biological Warfare Agents

 

56

   

Endemic Biological Organisms

 

57

   

Relationship between Exposure and Toxicity for Chemical and Biological Agents

 

57

   

Findings and Recommendations

 

65

4

 

ENVIRONMENTAL AND EXPOSURE PATHWAYS

 

68

   

Environmental Transport, Environmental Pathways, and Exposure Routes

 

68

   

Defining and Ranking Required Information

 

70

   

Sources and Emissions

 

72

   

Environmental Transport and Transformation

 

73

   

Exposure Routes

 

78

   

Exposure Scenarios and Environmental Pathways

 

79

   

Potential Exposures, Classified by Time Scale and Plausibility

 

80

   

Past and Present Threats

 

80

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Agents of Concern During the Persian Gulf War

 

81

   

Future Threats

 

83

   

Ranking Potential Exposures Based on Dimensions of Harm

 

83

   

Multiple (Concurrent/Sequential) Exposures

 

84

   

Findings and Recommendations

 

85

5

 

DETECTING AND MONITORING HARMFUL AGENTS

 

86

   

Detecting and Monitoring Chemical Agents

 

87

   

Measuring Chemical Concentrations

 

89

   

Sampling

 

90

   

Separating and Detecting Chemical Agents

 

92

   

Aerosol-Phase Detection

 

95

   

Current Methods

 

95

   

Detecting Chemicals in Water, Food, and Soil

 

97

   

Summary Evaluation of Chemical Detection Technologies

 

98

   

Detecting and Monitoring Biological Agents

 

99

   

Measuring Biological Organisms

 

99

   

Emerging and Traditional Detection Technologies

 

102

   

Emerging Technologies

 

103

   

Fielded Equipment for Biological Agents

 

104

   

Emerging Equipment

 

105

   

Data Collection, Recording, and Storage

 

105

   

Multipurpose Integrated Chemical Alarm

 

106

   

Joint Warning and Reporting Network (JWARN)

 

106

   

System Goals

 

107

   

Monitoring, Simulation, and Decision Making

 

107

   

Testing Equipment and Field Demonstration

 

108

   

Findings and Recommendations

 

108

6

 

TRACKING THE LOCATIONS AND TIME-ACTIVITY BUDGETS OF DEPLOYED MILITARY PERSONNEL

 

110

   

Activity Pattern Data

 

110

   

Methods of Obtaining Time-Activity Data

 

111

   

Global Positioning System

 

112

   

Activity Diaries and Logs

 

113

   

Questionnaires

 

118

   

Videotaping

 

119

   

Observers

 

119

   

Other Methods of Tracking Activities

 

119

   

Factors That Determine Human Activities and Locations

 

120

   

Evaluation of Current and Emerging Tracking Methods

 

120

Page xxiii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

Box, Tables, and Figures

BOX

4-1

 

U.S. Demolition Operations at the Khamisiyah Ammunition Storage Point

 

75

TABLES

2-1

 

Questions To Be Answered by a CB Training Exercise

 

43

3-1

 

Exposure Factors for Selected Biological Warfare Agents

 

58

3-2

 

Characteristics of Selected Biological Toxins

 

60

4-1

 

Potential Exposures of Deployed Personnel

 

82

5-1

 

Information Needs and Timing for Measuring Short-Term Threats and Long-Term Health Risks

 

88

5-2

 

Criteria for Selecting Analytical Methods for Detecting Biological Contaminants

 

100

6-1

 

Time Spent in Major Locations by U.S. Adults over 17 Years of Age

 

111

6-2

 

Expected Evolution of GPS Performance

 

114

B-1

 

Lethal Chemical Warfare Agents

 

162

B-2

 

Debilitating and Incapacitating Chemical Warfare Agents

 

164

B-3

 

Chemical Categories of Toxic Industrial Chemicals

 

173

C-1

 

Exposure Factors for Selected Biological Warfare Agents

 

186

C-2

 

Characteristics of Selected Biological Toxins

 

188

Page xxiv Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

D-1

 

Estimates of Chemical Agent Exposure Limits

 

193

D-2

 

Sensitivity of Chemical Agent Detection and Monitoring Equipment

 

194

FIGURES

2-1

 

Links between concentration data and time-activity data

 

47

2-2

 

The dimensions-of-harm scale

 

49

3-1

 

Variations in the median lethal air exposure, LCt50, and median incapacitating air exposure, ICt50, for some chemical warfare agents

 

62

3-2

 

The EC50 (the 30-minute average air concentration that would result in the LCT50) compared to the estimated safe dose and the Surgeon General's AELs

 

62

3-3

 

Estimated safe air concentrations for some TICs regulated by the EPA and some chemical agents

 

63

3-4

 

Estimated safe water concentrations for some TICs regulated by EPA

 

64

4-1

 

Links among environmental media, exposure media, and exposure routes

 

69

5-1

 

The three steps for measuring chemical concentrations in an environmental medium (air, water, soil, or food)

 

89

5-2

 

Detection sensitivities for detection equipment compared to the EC50 (the 30-minute average air concentration that would result in the LCT50), DoD's estimated safe concentration, and the AEL

 

98

A-1

 

A taxonomy of information needs

 

151

A-2

 

Influence diagram showing the relationships and effects of uncertainty on exposure information, health effects, and decisions

 

151

A-3

 

Decision tree for using protective clothing

 

152

A-4

 

Analyzed decision tree for using protective clothing

 

153

A-5

 

Decision tree with perfect information

 

153

A-6

 

Analyzed decision tree with perfect information

 

154

A-7

 

Decision tree with imperfect information

 

155

A-8

 

Decision tree with imperfect information (simplified)

 

156

A-9

 

Analyzed decision tree with imperfect information (simplified)

 

157

A-10

 

Decision tree illustrating the value of new information

 

158

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

Abbreviations and Acronyms


AC

hydrogen cyanide (blood chemical agent)

AEL

allowable exposure limit

ATOFMS

aerosol time-of-flight mass spectrometry


B(a)P

benzo(a)pyrene


CARC

chemical-agent resistant coatings

CATI

computer-assisted telephone interview system

CB

chemical and/or biological

CDC

Centers for Disease Control and Prevention

CEHR

Center for Environmental Health Research

CG

phosgene (chemical choking agent)

CHPPM

Center for Health Promotion and Preventive Medicine

COT

Committee on Toxicology

CX

phosgene oxime (urticant chemical agent)


DEHP

di-2-ethylhexylphthalate

DNA

deoxyribonucleic acid

DoD

U.S. Department of Defense

Page xxvi Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

EC50

the airborne concentration of a chemical agent sufficient to produce severe effects in 50 percent of those exposed for 30 minutes

ED50

the amount of liquid agent on the skin sufficient to produce severe effects in 50 percent of the exposed population

ELISA

enzyme-linked immunoassay

PA

Environmental Protection Agency


FTIR

Fourier transform infrared


GA

tabun

GAO

General Accounting Office

GB

sarin

GD

soman

GPS

global positioning system


H

Levinstein mustard

HAP

hazardous air pollutant

HCB

hexachlorobenzene

HCH

hexachlorocyclohexane

HD

distilled mustard

HEPA

high-efficiency particulate air filters

HL

mustard-lewisite mixture

HN

nitrogen mustard

HVAC

heating, ventilation, and air-conditioning

H2S

hydrogen sulfide


ICt50

the incapacitating effect of a vapor or aerosol agent, which is the product of the concentration and exposure time, sufficient to disable 50 percent of a group of exposed and unprotected personnel at an assumed breathing rate (active or resting)

ID50

the dose in mg or mg/kg of liquid agent expected to incapacitate 50 percent of a group of exposed unprotected personnel

IDLH

immediately dangerous to life and health

IMS

ion mobility spectrometry

IPT

Integrated Product Team


JCS

joint Chiefs of Staff

JSMG

Joint Service Materiel Group

JWARN

Joint Warning and Reporting Network

Page xxvii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

L

lewisite

LCt50

a measure of vapor or aerosol agent lethality, which is the product of the concentration and exposure time that is lethal to 50 percent of a group of exposed and unprotected personnel at an assumed breathing rate (active or resting)

LD50

a measure of liquid agent lethality; the dose in milligrams (kg) of liquid agent or mg of agent delivered per kilogram (kg) of body weight expected to kill 50 percent of a group of exposed, unprotected personnel


MICAD

multipurpose integrated chemical agent alarm

MIST

Man-in-Simulant Test Program


NBC

nuclear, biological, chemical

NHEXAS

National Human Exposure Assessment Studies

NOx

nitrogen oxides

NRC

National Research Council


OSHA

Occupational Safety and Health Administration


PAH

polycyclic aromatic hydrocarbon

PCB

polychlorinated biphenyls

PCD

phosphorous chemiluminescence detector

PCE

Tetrachloroethylene

PCR

polymerase chain reaction

PD, ED, MD

double chlorinated arsines

P-DCB

1, 4-dichlorobenzene

PEP

propellants, explosives, and pyrotechnics

PIC

personal information carrier

PIDS

photo-ionization detectors

PIRS

photoacoustic infrared spectroscopy

PVC

polyvinylchloride


R&D

research and development

RfC

chronic reference safe concentration

RfD

chronic reference safe dose

RNA

ribonucleic acid


SAW

surface acoustic wave

SBCCOM

Soldier and Biological Chemical Command

Page xxviii Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
×

TEAM

total exposure assessment methodology

TIC

toxic industrial chemicals

TIME

total isolated by microenvironment exposure (monitor)

TCDD

2,3,7,8 tetetrachloro-dibenzo-p-dioxin

TCE

trichloroethylene

TWA

time-weighted average


VX

nerve agent

VX2

binary form of nerve agent VX

Vx

volatile nerve agent similar to VX

VOC

volatile organic compound

VOI

value of information

Page xxix Cite
Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Strategies to Protect the Health of Deployed U.S. Forces

Suggested Citation:"Front Matter." National Research Council. 2000. Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures. Washington, DC: The National Academies Press. doi: 10.17226/9767.
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Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns about health effects that could be associated with their deployment and service during the war. Although similar concerns were raised after other military operations, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of chemical and biological (CB) agents and other harmful agents in theater and health symptoms reported by military personnel.

Strategies to Protect the Health of Deployed U.S. Forces which is one of the four two-year studies, examines the detection and tracking of exposures of deployed personnel to multiple harmful agents.

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