Strategies to Protect the Health of Deployed U.S. Forces Analytical Framework for Assessing Risks (2000) / Chapter Skim
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Appendix A: Abstracts of Commissioned Papers
Appendix A: Abstracts of Commissioned Papers
Pages 99-110
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Appendixes
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They do not realize that they are studying extreme parts of a spectrum under liminal conditions (e.g., a highly reversible effect on a short time scale) , and they use experimental models with insufficient time resolution.
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New York University School of Medicine, Tuxedo, NY Abstract Risk management is especially important for military forces deployed in hostile or chemically contaminated environments. On-line communications or rapid turnaround capabilities for assessing exposures can create viable options for preventing or minimizing incapacitating exposures or latent disease or disability in the years after the deployment.
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on-line communications access to remote sensing devices and continuous monitoring of data for tactical planning; (2) data review by medical staff personnel to determine the need for monitoring military personnel for possible effects of toxic exposures, provide countermeasures during deployments, and set priorities for medical examinations and biomarker sample collections and analyses in the early post-deployment period; (3)
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Combined, the future battlefield and force deployment scenarios will, in spite of extensive training, provide for extremely high levels of stress. The threats from emerging bacteria and viruses, chemical weapons and industrial compounds, and the urban battlefield will additionally inhibit and stress combat forces.
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It recognizes that the purpose of the risk-assessment process is not to set standards that can be used for "yes-no" decision-making. Rather, in the current context, its purpose is to allow the Department of Defense decision-makers sufficient information to examine a range of risks that might arise in rapidly changing deployment conditions, and to balance competing risks so that overall risks to deployed forces can be minimized.
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Although health outcomes and morbidity and mortality statistics are available from numerous databases and surveillance programs, the data lacking are often the long-term assessments and chronic outcomes. The exposure assessment, particularly during deployment, is more suspect to uncertainty, especially in terms of quantitative evaluations.
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For biological weapons, dose-response models should be developed and time and concentration exposure and consequence scenarios should be built and evaluated. Finally, the formal expansion of DOD's mission on emerging infectious diseases in tune 1996 by Presidential Decision Directive NSTC-7 now includes global surveillance, training, research, and response.
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The original charge for this paper was to conceptualize the role of toxicokinetics in the risk assessment of deployed forces exposed to chemicals. Most toxicologists familiar with current trends in toxicology are aware of the tremendous proliferation of publications combining physiologically based pharmacokinetic (PBPK)
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Thus, there are three liminal conditions: 1. When the toxicokinetic half-life is very long, it keeps the frequency of exposure essentially infinite (continuous exposure)
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forces to prevent future illness from toxicological interactions from potentially harmful agents. By doing so, it is implicit that potential health risks exist in deployments because of possible exposures to multiple chemicals, drugs, and biologics under stressful environmental and occupational conditions similar to those in the Persian Gulf War.
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, seeks expert advice because of the limited information in the area of adverse health effects resulting from multiple stressors, including exposure to chemical mixtures, drug mixtures, vaccine mixtures, and physical and biological agents under highly stressful and hazardous environmental and occupational conditions. Furthermore, psychological stress undoubtedly plays a role in the potential development of such adverse health effects.
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