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Adequacy of the Comprehensive Clinical Evaluation Program: A Focused Assessment (1997)
Institute of Medicine (IOM)

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. "Appendix A." Adequacy of the Comprehensive Clinical Evaluation Program: A Focused Assessment. Washington, DC: The National Academies Press, 1997.

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    • the downwind footprint of the potential distribution of agent at the general population exposure level (or lower threshold, if appropriate);
    • When a downwind footprint is established, a conservative, presumptive-exposure area should be defined that reflects the uncertainties of the modeling effort. The presumptive-exposure area should, at a minimum, include all sites within a circle that has a radius equal to the length of the downwind footprint; and
    • Troops within the presumptive-exposure area should be notified and encouraged to enroll in the CCEP or Registry.
  • All reports of positive M256 kits and Fox detections must be thoroughly investigated. Where unit logs record positive detections by either type of equipment, members of that unit should be notified and encouraged to enroll in VA's Persian Gulf Health Registry or DOD's Comprehensive Clinical Evaluation Program.
  • To ensure credibility and thoroughness, further investigation of possible chemical or biological warfare agent exposures during the Gulf War should be conducted by a group independent of DOD. Openness in oversight activities including public access to information and veteran participation-public notice of meetings, opportunity for public comment, and regular reporting are essential. Full public accountability is critical.

Coordination

  • A Presidential Review Directive (PRD) should be issued to instruct the National Science and Technology Council to develop an interagency plan to address health preparedness for and readjustment of veterans and families after future conflicts and peacekeeping missions. The President's Committee of Advisors on Science and Technology and other nongovernmental experts, as appropriate, should be asked to review the plan 12 months after the PRD is issued and again at 18 months to ensure national expertise is brought to bear on these issues.
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