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
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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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.

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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. International Standard Book Number 0-309-06875-4 Limited copies are available from: Board on Army Science and Technology National Research Council 2101 Constitution Avenue, N.W. Washington, DC 20418 (202) 334-3118 Additional copies are available for sale from: National Academy Press Box 285 2101 Constitution Ave., N.W. Washington, DC 20055 (800) 624-6242 (202) 334-3313 (in the Washington Metropolitan Area) http://www.nas.edu Copyright 2000 by the National Academy of Sciences. All rights reserved. Printed in the United States of America.

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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.

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures     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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures     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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures     Preventing Acute Exposures   121     Estimating Long-Term Exposures   122     Findings and Recommendations   123 7   STRATEGY CONSIDERATIONS   125     Recommended Adjustments in Strategy   126     Technical Aspects   127     Recommendations   127     Defining Needs   127     Determining Exposure   128     Handling Data   128     Doctrine, Training, and Administration   129     REFERENCES   130     APPENDICES         A Defining the Decision Framework and the Value of Exposure Information in Military Deployments   147     B Harmful Properties of Chemical Agents   161     C Harmful Properties of Biological Agents   184     D Detecting and Monitoring Chemical Agents   191     E Detecting and Monitoring Biological Agents   212     F Contributors to This Study   225     G Biographical Sketches of Principal Investigator and Members of the Advisory Panel   230     H Meetings and Activities   235

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures 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

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Strategies to Protect the Health of Deployed U.S. Forces: Detecting, Characterizing, and Documenting Exposures Strategies to Protect the Health of Deployed U.S. Forces

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