Review of the Department of Defense Research Program on Low-Level Exposures to Chemical Warfare Agents
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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 members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This project was supported by Contract No. W81K04-05-C-7006 and DAMD17-99-C-9049 between the National Academy of Sciences and the U.S. Army. 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 this project.
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COMMITTEE ON TOXICOLOGIC ASSESSMENT OF LOW-LEVEL EXPOSURES TO CHEMICAL WARFARE AGENTS
Members
GARY P. CARLSON (Chair),
Purdue University, West Lafayette, IN
A. JOHN BAILER,
Miami University, Oxford, OH
JONATHAN BORAK,
Yale School of Medicine, New Haven, CT
JANICE E. CHAMBERS,
Mississippi State University, Mississippi State
MARION EHRICH,
Virginia Tech, Blacksburg
LYNNE HABER,
Toxicology Excellence for Risk Assessment, Cincinnati, OH
SANFORD S. LEFFINGWELL,
HLM Consultants, Auburn, GA
DAVID H. MOORE,
Battelle Eastern Science and Technology Center, Aberdeen, MD
CAREY POPE,
Oklahoma State University, Stillwater
PETER S. SPENCER,
Oregon Health & Science University, Portland
NGA LIEN TRAN,
Exponent, Inc., Washington, DC
NRC Staff
KULBIR S. BAKSHI, Project Director
CAY BUTLER, Editor
AIDA C. NEEL, Program Associate
ALEXANDRA STUPPLE, Senior Editorial Assistant
COMMITTEE ON TOXICOLOGY
Members
BAILUS WALKER, JR. (Chair),
Howard University Medical Center and American Public Health Association, Washington, DC
MELVIN E. ANDERSEN,
CIIT-Centers for Health Research, Research Triangle Park, NC
EDWARD C. BISHOP,
Parsons Corporation, Fairfax, VA
GARY P. CARLSON,
Purdue University, West Lafayette, IN
JANICE E. CHAMBERS,
Mississippi State University, Mississippi State
LEONARD CHIAZZE, JR.,
Georgetown University, Washington, DC
JUDITH A. GRAHAM,
American Chemistry Council, Arlington, VA
SIDNEY GREEN,
Howard University, Washington, DC
MERYL KAROL,
University of Pittsburgh, Pittsburgh, PA
STEPHEN U. LESTER,
Center for Health Environment and Justice, Falls Church, VA
DAVID H. MOORE,
Battelle Memorial Institute, Bel Air, MD
CALVIN C. WILLHITE,
State of California, Berkeley, CA
GERALD WOGAN,
Massachusetts Institute of Technology, Cambridge
Staff
KULBIR S. BAKSHI, Project Director
SUSAN N.J. MARTEL, Senior Program Officer
ELLEN K. MANTUS, Senior Program Officer
AIDA NEEL, Program Associate
TAMARA DAWSON, Senior Program Assistant
ALEXANDRA STUPPLE, Senior Editorial Assistant
SAM BARDLEY, Librarian
BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY1
Members
JONATHAN M. SAMET (Chair),
The Johns Hopkins University, Baltimore, MD
RAMÓN ALVAREZ,
Environmental Defense, Austin, TX
THOMAS BURKE,
The Johns Hopkins University, Baltimore, MD
JUDITH C. CHOW,
Desert Research Institute, Reno, NV
RORY B. CONOLLY,
CIIT-Centers for Health Research, Research Triangle Park, NC
COSTEL D. DENSON,
University of Delaware, Newark
E. DONALD ELLIOTT,
Willkie Farr & Gallagher LLP, Washington, DC
CHRISTOPHER B. FIELD,
Carnegie Institution of Washington, Stanford, CA
SHERRI W. GOODMAN,
Center for Naval Analyses, Alexandria, VA
JUDITH A. GRAHAM,
American Chemistry Council, Arlington, VA
DANIEL S. GREENBAUM,
Health Effects Institute, Cambridge, MA
ROBERT HUGGETT,
Michigan State University, East Lansing
BARRY L. JOHNSON,
Emory University, Atlanta, GA
JAMES H. JOHNSON,
Howard University, Washington, DC
JUDITH L. MEYER,
University of Georgia, Athens
PATRICK Y. O’BRIEN,
ChevronTexaco Energy Technology Company, Richmond, CA
DOROTHY E. PATTON,
International Life Sciences Institute, Washington, DC
STEWARD T.A. PICKETT,
Institute of Ecosystem Studies, Millbrook, NY
JOSEPH V. RODRICKS,
ENVIRON Corp., Arlington, VA
ARMISTEAD G. RUSSELL,
Georgia Institute of Technology, Atlanta
MITCHELL J. SMALL,
Carnegie Mellon University, Pittsburgh, PA
LISA SPEER,
Natural Resources Defense Council, New York, NY
KIMBERLY M. THOMPSON,
Harvard School of Public Health, Boston, MA
G. DAVID TILMAN,
University of Minnesota, St. Paul
CHRIS G. WHIPPLE,
ENVIRON Corp., Emeryville, CA
LAUREN A. ZEISE,
California Environmental Protection Agency, Oakland
Senior Staff
JAMES J. REISA, Director
DAVID J. POLICANSKY, Scholar
RAYMOND A. WASSEL, Senior Program Officer for Environmental Sciences and Engineering
KULBIR BAKSHI, Senior Program Officer for Toxicology
EILEEN N. ABT, Senior Program Officer for Risk Analysis
K. JOHN HOLMES, Senior Program Officer
SUSAN N.J. MARTEL, Senior Program Officer
SUZANNE VAN DRUNICK, Senior Program Officer
ELLEN K. MANTUS, Senior Program Officer
RUTH E. CROSSGROVE, Senior Editor
OTHER REPORTS OF THE BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY
Health Implications of Perchlorate Ingestion (2005)
Air Quality Management in the United States (2004)
Endangered and Threatened Species of the Platte River (2004)
Atlantic Salmon in Maine (2004)
Endangered and Threatened Fishes in the Klamath River Basin (2004)
Cumulative Environmental Effects of Alaska North Slope Oil and Gas Development (2003)
Estimating the Public Health Benefits of Proposed Air Pollution Regulations (2002)
Biosolids Applied to Land: Advancing Standards and Practices (2002)
The Airliner Cabin Environment and Health of Passengers and Crew (2002)
Arsenic in Drinking Water: 2001 Update (2001)
Evaluating Vehicle Emissions Inspection and Maintenance Programs (2001)
Compensating for Wetland Losses Under the Clean Water Act (2001)
A Risk-Management Strategy for PCB-Contaminated Sediments (2001)
Acute Exposure Guideline Levels for Selected Airborne Chemicals (4 volumes, 2000-2004)
Toxicological Effects of Methylmercury (2000)
Strengthening Science at the U.S. Environmental Protection Agency (2000)
Scientific Frontiers in Developmental Toxicology and Risk Assessment (2000)
Ecological Indicators for the Nation (2000)
Waste Incineration and Public Health (1999)
Hormonally Active Agents in the Environment (1999)
Research Priorities for Airborne Particulate Matter (4 volumes, 1998-2004)
The National Research Council’s Committee on Toxicology: The First 50 Years (1997)
Carcinogens and Anticarcinogens in the Human Diet (1996)
Upstream: Salmon and Society in the Pacific Northwest (1996)
Science and the Endangered Species Act (1995)
Wetlands: Characteristics and Boundaries (1995)
Biologic Markers (5 volumes, 1989-1995)
Review of EPA's Environmental Monitoring and Assessment Program (3 volumes, 1994-1995)
Science and Judgment in Risk Assessment (1994)
Pesticides in the Diets of Infants and Children (1993)
Dolphins and the Tuna Industry (1992)
Science and the National Parks (1992)
Human Exposure Assessment for Airborne Pollutants (1991)
Rethinking the Ozone Problem in Urban and Regional Air Pollution (1991)
Decline of the Sea Turtles (1990)
Copies of these reports may be ordered from the National Academies Press
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OTHER REPORTS OF THE COMMITTEE ON TOXICOLOGY
Spacecraft Water Exposure Guidelines for Selected Contaminants, Volume 1 (2004)
Toxicologic Assessment of Jet-Propulsion Fuel 8 (2003)
Review of Submarine Escape Action Levels for Selected Chemicals (2002)
Standing Operating Procedures for Developing Acute Exposure Guideline Levels for Hazardous Chemicals (2001)
Evaluating Chemical and Other Agent Exposures for Reproductive and Developmental Toxicity (2001)
Acute Exposure Guideline Levels for Selected Airborne Contaminants, Volume 1 (2000), Volume 2 (2002), Volume 3 (2003), Volume 4 (2004)
Review of the US Navy’s Human Health Risk Assessment of the Naval Air Facility at Atsugi, Japan (2000)
Methods for Developing Spacecraft Water Exposure Guidelines (2000)
Review of the U.S. Navy Environmental Health Center’s Health-Hazard Assessment Process (2000)
Review of the U.S. Navy’s Exposure Standard for Manufactured Vitreous Fibers (2000)
Re-Evaluation of Drinking-Water Guidelines for Diisopropyl Methylphosphonate (2000)
Submarine Exposure Guidance Levels for Selected Hydrofluorocarbons: HFC-236fa, HFC-23, and HFC-404a (2000)
Review of the U.S. Army’s Health Risk Assessments for Oral Exposure to Six Chemical-Warfare Agents (1999)
Toxicity of Military Smokes and Obscurants, Volume 1(1997), Volume 2 (1999), Volume 3 (1999)
Assessment of Exposure-Response Functions for Rocket-Emission Toxicants (1998)
Toxicity of Alternatives to Chlorofluorocarbons: HFC-134a and HCFC-123 (1996)
Permissible Exposure Levels for Selected Military Fuel Vapors (1996)
Spacecraft Maximum Allowable Concentrations for Selected Airborne Contaminants, Volume 1 (1994), Volume 2 (1996), Volume 3 (1996), Volume 4 (2000)
Preface
In 1998, Congress directed the Secretary of Defense to review and modify U.S. Department of Defense (DOD) policies and doctrines that relate to protecting personnel from low-level exposure to chemical warfare agents (CWAs). In response to that congressional mandate, the Secretary of Defense directed DOD’s Nuclear, Chemical, and Biological Defense Program to develop a research plan to obtain toxicologic and other data to assess health risks to U.S. forces. The data obtained from the proposed research would provide information to the Secretary of Defense to reassess policies and doctrines related to low-level exposures to CWAs. The research is intended to accomplish two objectives. The first is to support operational commanders in the field with information for real-time decision making required to accomplish their missions while not unduly jeopardizing the health and performance capability of their forces. The second is to understand, prevent, or reduce operationally relevant performance decrements, as well as the potential health consequences of low-level exposures that might not manifest immediately but could become evident months or years after exposure.
In response, DOD developed the multiyear research program on low-level exposures to chemical warfare agents entitled Department of Defense Low-Level Chemical Warfare Agents (CWAs) Exposure Research Master Plan. DOD requested that the National Research Council (NRC) review that research plan and comment on its adequacy and appropriateness, provide guidance on appropriate risk assessment methods for assessing toxicologic risk from low-level exposures to CWAs, and identify gaps and make recommendations for further research. The NRC
convened the Committee on Toxicologic Assessment of Low-Level Exposures to Chemical Warfare Agents. The committee’s report is intended to be helpful in focusing research efforts to improve operational management.
The DOD Low-Level CWA Exposure Research Master Plan (Research Plan) details the military’s priorities for research needs and methods to address the effects of low-level agent exposure on operationally relevant performance in military personnel at the time of exposure and on potential delayed adverse health effects at some point after exposure. As stated in the Research Plan, both of these aspects of low-dose exposure “represent different points along the dose-response continuum—not separate problems.”
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its 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 review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: Barbara Callahan (University Research Engineers and Associates), Donald J. Ecobichon (consultant), Jeffrey W. Fisher (University of Georgia), David Gaylor (Gaylor & Associates), Ramesh C. Gupta (Murray State University), Rogene Henderson (Lovelace Respiratory Research Institute), Robert MacPhail (U.S. Environmental Protection Agency), and George M. Rusch (Honeywell International).
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Edward C. Bishop of Parsons Corporation. Appointed by the NRC, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
The committee gratefully acknowledges the valuable presentations made by Stephen Channel, Keith R.Vesely, Douglas Somerville, Jeffrey
Gearhart, Sandra Thomson, and Robert Sheridan, all from the Department of Defense. Aida Neel was the program associate, and Cay Butler was the editor. We are grateful to James J. Reisa, director of the Board on Environmental Studies and Toxicology, for his helpful guidance. The committee particularly acknowledges Kulbir Bakshi, project director for the committee, for bringing the report to completion. Finally, we thank all members of the committee for their expertise and dedicated efforts throughout the development of this report.
Gary P. Carlson, Chair
Committee on Toxicologic Assessment of Low Level Exposures to Chemical Warfare Agents
Bailus Walker, Chair
Committee on Toxicology