• ensuring that Phase I primary physicians have ready access to a referral neurologist and a referral psychiatrist;
  • ensuring that more complete histories are taken, particularly regarding personal and family histories, the onset of health problems, and the occupational and environmental exposures for each patient;
  • standardization—to the extent possible—of predeployment physical examinations given members of the armed forces across the services;
  • increased uniformity of CCEP forms and reporting procedures across sites;
  • for each patient, the physician should provide written evidence that all organ systems were evaluated; and
  • DoD should offer group education and counseling to soldiers and their families concerned about exposure to toxic agents.

The committee emphasizes that the CCEP is not an appropriate vehicle for addressing questions about the possible long-term health effects of low-level exposure to nerve agents. Those questions must be addressed through rigorous scientific research. The CCEP is a treatment program. Therefore, it is important not to attempt to use the findings of the CCEP to answer research questions. The committee believes strongly that although data from the CCEP cannot be used to test for potential associations between exposures and health effects, it can, combined with other information, be used to identify promising directions for separate research studies.

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