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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Strategies to Protect the Health of Deployecl U.S. Forces Force Protection anc/ Decontamination Michael A. Wartell, Michael T. Kleinman, Beverly M. Huey, and Laura M. Duffy, Editors Strategies to Protect the Health of Deployed U.S. Forces: Physical Protection and Decontamination Division of Military Science and Technology Commission on Engineering and Technical Systems National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 13547--Deployed Forces FM 1 12128199, 1:28 PM

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 authors responsible for the report were chosen for their special competencies and with regard for appropriate balance. This is a report of work supported by Contract DASW01-97-C-0078 between the National Academy of Sciences and the Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authoress and do not necessarily reflect the view of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-06793-6 Limited copies are available from: Board on Army Science and Technology National Research Council, 2101 Constitution Avenue, N.W. Washington, D.C. 20418 (202) 334-3118 Additional copies are available from: National Academy Press 2101 Constitution Ave., N.W. Box 285 Washington, D.C. 20055 800-624-6242 /202-334-3313 (in the Washington metropolitan area) Copyright 1999 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. 13547--Deployed Forces FM 2 ~ 2/23/99, ~ :23 PM

National Acaclemy of Sciences National Acaclemy of Engineering Institute of Meclicine National Research Council The National Academy of Sciences is a private, nonprofit, self-perpetuating soci- ety of distinguished scholars engaged in scientific and engineering research, dedi- cated 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 mem- bers, sharing with the National Academy of Sciences the responsibility for advis- ing 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 Sci- ences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal gov- ernment. 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 pro- viding 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. . . . 13547--Deployed Forces FM 3 12/28/99, 1:28 PM

STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES: FORCE PROTECTION AND DECONTAMINATION Principal Investigators MICHAEL T. KLEINMAN, University of California, Irvine MICHAEL A. WARTELL, Indiana University-Purdue University Fort Wayne Advisory Panel WYETT H. COLCLASURE II, Environmental Technologies Group, Inc., Baltimore, Maryland STEPHEN HILL, Global Analytics, Inc., Orange, Virginia SIDNEY A. KATZ, Rutgers University, Camden, New Jersey FRANK K. KO, Drexel University, Philadelphia, Pennsylvania HOWARD IRA MAIBACH, University of California, San Francisco NArMEDIN MESHKATI, University of Southern California, Los Angeles Board on Army Science and Technology Liaison rOSEPH I. VERVIER, ENSCO, Inc., Melbourne, Florida Staff BRUCE A. BRAWN, Director, Division of Military Science and Technology BEVERLY M. HUEY, Study Director LAURA M. DUFFY, Research Associate PAMELA A. LEWIS, Senior Project Assistant ANDRE MORROW, Senior Project Assistant Department of Defense Liaisons MICHAEL KILPATRICK, Office of the Special Assistant for Gulf War Illnesses, Falls Church, Virginia FRANCIS L. O'DONNELL, Office of the Special Assistant for Gulf War Illnesses, Falls Church, Virginia IV 13547--Deployed Forces FM 4 12128199, 1:28 PM

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 I. HAUG, NADS and Simulation Center, The University of Iowa, Iowa City, Iowa ROBERT I. HEASTON, Guidance and Control Information Analysis Center (retired), Naperville, Illinois ELVIN R. HEIBERG, III, Heiberg Associates, Inc., Mason Neck, Virginia GERALD I. 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 rOHN 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 rOHN D. VENABLES, Venables and Associates, Towson, Maryland rOSEPH I. VERVIER, ENSCO, Inc., Melbourne, Florida ALLEN C. WARD, Ward Synthesis, Inc., Ann Arbor, Michigan Staff BRUCE A. BRAWN. Director MICHAEL A. CLARKE, Associate Director MARGO L. FRANCESCO, Staff Associate CHRIS TONES, Financial Associate DEANNA SPARGER, Senior Project Assistant v 13547--Deployed Forces FM 5 12128199, 1:28 PM

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 I. HATCH, (U.S. Army retired), Fluor Daniel Hanford, Inc., Richland, Washington 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, Bechtel Technology and Consulting, San Francisco, California BRADFORD W. PARKINSON, Stanford University, Stanford, California TERRY SCHUBEL, New England Aquarium, Boston, Massachusetts BARRY M. TROST, Stanford University, Stanford, California TAMES 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 Al 13547--Deployed Forces FM 6 i 12128199, 1:28 PM

Preface Chemical and biological (CB) warfare has been the subject of numer- ous studies supported by a wide spectrum of sponsoring groups, ranging from the military to private sector foundations. Given how much has already been said on the subject, one might conclude that little remains on which to comment. However, the subject is complex and controversial enough that with each new hostile military encounter, with each potential new threat, with each report of a possible terrorist action using CB agents, our defensive preparedness comes under new scrutiny. The military experience in the Gulf War, while overwhelmingly posi- tive by almost any measure, raised some concerns. One obvious uncer- tainty was that there might be a causal relationship between the presence of CB agents in theater and the symptoms reported by returning military personnel, later named the "Gulf War Syndrome." Studies focused ini- tially on whether personnel might have been exposed to low-level doses of chemical agents, and if this exposure could have resulted in the re- ported symptoms. More recent studies have been expanded to cover the whole range of CB defense, from medical issues to materiel development to doctrine and training. Responding to the need for an evaluation of the military's ability to prosecute missions in CB environments, the Department of Defense Of- fice of the Special Assistant for Gulf War Illnesses, through the National Academies, sponsored a study of strategies to protect the health of de- ployed U.S. forces, focused on CB defense. The first part of this three-year study was divided into four parallel studies (1) to develop an analytical framework for assessing the risks to deployed forces; (2) to review and . . V11 13547--Deployed Forces FM 7 12128199, 1:28 PM

V111 PREFACE evaluate technologies and methods for detection and tracking exposures to those risks; (3) to review and evaluate physical protection and decon- tamination; and (4) to review and evaluate medical protection, health consequences and treatment, and medical record keeping. Now, at the end of the second year of the study, each group is providing a report to DoD and the public on its findings and recommendations in these areas. These four documents will be used as a basis for a new National Acad- emies consensus committee that will prepare a synthesis report for DoD in the third year of the project. The consensus committee will consider, not only the topics covered in the four two-year studies, but also overarching issues relevant to its broader charge. This report responds to the third of the first four studies, physical protection and decontamination. The task, which is more fully described in the first chapter, includes (1) an assessment of DoD's approaches and technologies for physical protection both individual and collective- against CB warfare agents and decontamination of personnel and equip- ment, and (2) an assessment of DoD's current policies, doctrine, and train- ing. The issues of space, budget, and staffing allocations for these programs, although extremely important, are beyond the scope of this report. Unlike most National Academies studies, two principal investiga- tors conducted this study, with the assistance and guidance of an advi- sory panel. The expertise of this advisory panel covered various topics addressed by the study. During the data-gathering phase, we received extensive briefings, visited various facilities, consulted with numerous experts, solicited com- missioned papers on specialized topics, attended many related national conferences and symposia, and reviewed other material provided by DoD and from the open literature. We also held one workshop to gather addi- tional information on focussed topics. We are indebted to the organiza- tions and individuals that gave freely of their time and talents to this project. A special note of thanks to the individuals, listed by name, ap- pears in Appendix F of this report. Given the countless individuals who shared their expertise with us, there is no doubt the list is incomplete; and we apologize for the oversights. In responding to our Statement of Task, we attempted to cover each aspect of the requested information, adding introductory and historical information. No single study, however, can do justice to the entire breadth of topics included in our study charge. Therefore, we decided to focus on issues on which we believed we could provide especially helpful advice to the military. During the course of the study, we were struck by several aspects of the CB defense community: (1) their dedication to their professions, in general, and to CB protection, in particular; (2) the extent to which 13547--Deployed Forces FM 8 12/28/99, 1:28 PM

PREFACE decades-old threat information continues to influence current require- ments and considerations; (3) the willingness of policy makers to accept "worst case" assessments against which to develop programs, as opposed to developing more valid benchmarks based on more up-to-date informa- tion; (4) the continuing need for basic science information on the chemi- cal, physical, and toxicological properties of CB agents to facilitate the development of modeling and simulations; (5) the need for more and better uses of modeling and simulations; and (6) the contrast between the high quality doctrine and training approaches available and inconsistent CB training across services and across units. We wish to emphasize that the CB defense community is competent, caring, and dedicated. Although we suggest areas for improvement in this report, we retain a strongly positive overall impression of the work of the CB community. The individuals who reviewed the draft report were especially im- portant to the construction of the final report. They provided thoughtful and constructive comments that significantly enhanced the quality of the final report. Finally, we gratefully acknowledge the work and support of Beverly Huey, the National Academies study director for this project. Her dedication, intelligence, and flexibility were invaluable and are deeply appreciated. We also thank Laura Duffy, the research associate, for her efforts in acquiring and organizing data that were central to our analyses. Michael T. Kleinman Michael A. Wartell Principal Investigators Strategies to Protect the Health of Deployed U.S. Forces: Physical Protection and Decontamination 13547--Deployed Forces FM 9 12/28/99, 1:28 PM

13547--Deployed Forces FM 10 12128199, 1:28 PM

Acknowledgments We are appreciative of the cooperation we received from the many individuals and organizations who provided valuable information and guidance to us in the course of our work. First, we extend our sincere thanks to the members of the advisory panel who provided assistance and guidance during the information gathering process, gave thought- provoking presentations in their respective areas of expertise, participated in briefings from various organizations, and provided thoughtful com- ments on the initial drafts of this report. We are also indebted to those individuals who prepared commissioned papers for our use: William Hinds, who wrote a paper on respiratory protection; Sidney Katz on air contaminant removal; Frank Ko on textiles and garments for chemical and biological protection; Howard I. Maibach and Hongbo Zhai on bar- rier creams, percutaneous absorption, and skin decontamination tech- niques; and Maher Todios on decontamination. We are grateful for the guidance and support from others at the Na- tional Academies, including Toseph Cassells and Suzanne Woolsey, who assisted in the coordination of the four separate study efforts as they were simultaneously being conducted; Bruce Braun, who assisted in scoping the study, nurtured it throughout its execution and provided ongoing oversight; and Douglas Bauer and Dennis Chamot, who adeptly dealt with stumbling blocks when they occurred in the process and provided thoughtful insights throughout the course of the study. We also appreci- ate the work of Pamela Lewis who provided administrative assistance in preparing this document for review and publication, and Carol Arenberg, who edited this document, enhancing its clarity. Finally, we are indebted X1 13547--Deployed Forces FM 11 12128199, 1:28 PM

X11 ACKNOWLEDGMENTS to numerous other NRC staff for their individual contributions: Mike Clarke, associate division director; Margo Francesco, staff associate; Delphine Glaze, Jacqueline Campbell-Tohnson, and Andre Morrow, se- nior project assistants; and Alvera Wilson, financial associate. Without the extensive contributions and thought-provoking com- ments so freely given by so many individuals throughout the course of this study, we could not have completed the task set before us. We would like to acknowledge those individuals who provided briefings, arranged site visits to their organizations, gave presentations at the workshop, sup- plied invaluable information and reports critical to our charge, answered our searching questions very honestly, and assisted us in contacting other sources who could provide additional information and documentation not easily accessible. There is no doubt the list is incomplete, and we apologize for any oversights (see Appendix F). This report has also been reviewed by individuals chosen for their diverse perspectives and technical expertise, in accordance with proce- dures approved by the National Research Council's Report Review Com- mittee. The purpose of this independent review is to provide candid and critical comments that will assist the authors and the National Research Council in making the published report as sound as possible and to en- sure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The content of the review com- ments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report: Robert E. Boyle, Department of the Army (retired) Gerald T. Dinneen, Honeywell, Inc. (retired) Stephen W. Drew, Merck & Co., Inc. Valerie T. Gawron, Veridian Engineering Trevor T. Little, North Carolina State University John Nelson, NBC Defense Systems (retired) Donald F. Petersen, Department of Defense Health Effects Programs (retired) Ellen Raber, Lawrence Livermore National Laboratory William G. Reifenrath, Reifenrath Consulting & Research Bruce 0. Stuart, Schering-Plough Research Institute While all of the advisors and reviewers listed above have provided many constructive comments and suggestions, responsibility for the final content of this report rests solely with the authoring principal investiga- tors and the National Research Council. 13547--Deployed Forces FM 12 12128199, 1:28 PM

Contents EXECUTIVE SUMMARY 1 INTRODUCTION Background of the Study, 18 Charge to the National Academies, 19 Scope of the Study, 19 Limitations, 20 Approach of the Study, 21 Overview of the Report, 21 2 THREAT AND RISK ASSESSMENT Historical Perspective of the Chemical/Biological Battle Space, 23 U.S. Response, 26 Relationships among Policy; Doctrine; Research, Development and Acquisition; and Threat, 29 Contamination Avoidance, 31 Individual Protection, 31 Collective Protection, 32 Decontamination, 32 Medical Systems, 32 Characteristics of Current and Future Chemical and Biological Agents, 32 Effects and Tactical Utility of Chemical Agents, 32 Effects and Tactical Utility of Biological Agents, 34 . . . x''' 13547--Deployed Forces FM 13 1 16 23 12128199, 1:28 PM

XIV Proliferation of Chemical and Biological Agents, 36 Production, Weaponization, and Dispersion, 38 Threatened Use of Chemical and Biological Weapons, 39 Assessment of Chemical and Biological Warfare Risks, 39 Hazards: Routes and Levels of Exposure, 40 Threat Assessment, 52 Risk Minimization/Protection of Personnel, 53 Findings and Recommendation, 56 3 PHILOSOPHY, DOCTRINE, AND TRAINING FOR CHEMICAL AND BIOLOGICAL WARFARE Philosophy, 58 Chemical/Biological Warfare Doctrine, 60 Past Doctrine: "Fight Dirty," 60 Current Doctrine: Contamination Avoidance, 61 Chemical/Biological Warfare Training, 61 Understanding the Risk, 63 Findings and Recommendations, 66 4 PHYSICAL PROTECTION Individual Protection, 67 Risks and Challenges, 67 Current Doctrine and Training, 68 Textiles and Garments, 73 Barrier Creams, 89 Impacts on Effectiveness, 89 Patient Protective Equipment, 93 Summary, 94 Collective Protection, 94 Risks, Challenges, and Requirements, 94 Filters, 95 Filter Systems, 95 Protective Structures and Systems, 97 Advanced Filters and Adsorbents, 99 Filters, 100 Absorbers, 101 Service-Life Indicators, 102 Regeneration, 103 Catalytic Oxidation, 103 Findings and Recommendations, 104 13547--Deployed Forces FM 14 CONTENTS 58 67 12128199, 1:28 PM

CONTENTS 5 DECONTAMINATION Decontamination of Skin, 110 Risks and Challenges, 110 Technologies, 111 Decontamination of Equipment, Facilities, and Large Areas, 113 Risks and Challenges, 113 Technologies, 113 Reactions and Mechanisms, 117 Current Doctrine and Training, 132 Findings and Recommendations, 136 6 TESTING AND EVALUATION Toxicological Testing, 138 Evaluation of Percutaneous Penetration, 139 Evaluation of Barrier Creams, 143 Test Equipment, 143 Predictive Models and Simulations, 149 Exercises and Systems Evaluations, 149 Findings and Recommendations, 150 7 ASSESSMENT OF MILITARY CAPABILITIES TO PROVIDE EMERGENCY RESPONSE Findings and Recommendations, 153 8 SUMMARY AND GENERAL RECOMMENDATIONS Threat, 156 Policy, Doctrine, and Training, 157 Chemical/Biological Protective Equipment, 157 Threat-Based Requirements and the Development of Equipment, 157 Physical Protection, 159 Decontamination, 160 Testing, 161 Program Objective Memorandum for Funding Research, 162 Summary, 163 REFERENCES APPENDICES A Funding Levels B Textiles and Garments for Chemical and Biological Protection 13547--Deployed Forces FM 15 XV 108 138 151 155 164 181 182 12128199, 1:28 PM

%711 age ~ Evaluat10ns of Barrier Creams D EvaluaUng Skin Decontaminabon Techniques ~ Percutaneous ZUbsorpt10n F Conh~utors to This Study Biographical Sketches of Frincipal Investigators and \4enibers of tile Advisory Panel 1~-Depl~d Fog Fly 16 Cam 217 221 224 230 Too ~ 2~8/gg, ~ :28 Pa

Tables, Figures, and Box TABLES 2-1 2-2 3-1 4-1 4-2 4-3 4-4 4-5 Integrated CINC Priorities, 29 Nuclear, Biological, Chemical (NBC) Nonmedical Defense Program Priorities, 30 Categorization of Chemical Agents, 33 Categorization of Biological Agents, 35 Inhalation/Respiratory Agents, 42 Dermal Absorption Agents, 46 Dermal Necrotic Agents, 48 Inhalation/Respiratory Agents, 48 Ingestion Agents, 50 Agents Absorbed via Mucous Membranes or the Skin, 50 Arthropod Vectors, 52 Time to Achieve MOPP 4, 54 Levels of Mission-Oriented Protective Posture (MOPP), 55 Service Requirements for JSLIST, 63 Approximate Toxicity of Chemical Agents, 69 Time to Achieve MOPP 4, 71 Requirements for Chemical Protective Textiles, 74 Evolution of Performance Requirements for Protective Textiles, 75 Summary of Required Improvements in Fibrous Material Properties, 76 13547--Deployed Forces FM 17 . . XVII 12128199, 1:28 PM

XVIII 4-6 5-1 5-2 5-3 5-4 6-1 TABLES, FIGURES, AND BOX Requirements for the C2 Air-Purification Device, 100 Differences between the Decontamination of Fixed Sites and Mobile Forces, 109 Decontamination Coatings, 114 Characteristics of Oxidizing Decontaminants, 120 Advantages and Disadvantages of Enzymatic Decontamination, 125 Military Air Guidelines for Chemical Warfare Agents, 135 Efficacy of Barrier Creams, 144 FIGURES 2-1 Management structure of the DoD Chemical and Biological Defense Program, 28 3-1 Summary of appropriations for the Chemical and Biological Defense Program, 59 4-1 Construction of a selectively permeable barrier, 77 4-2 Components of a tv~ical current barrier system 78 5-1 5-2 5-3 5-4 5-5 5-6 5-8 Secondary products formed by hydrolysis of sulfur mustard, 118 Catalytic acceleration of soman by iodobenzoate, 118 Oxidation of VX in acidic solution, 122 Molecular approaches to enhancing the solubility of chemical agents in liquid media, 123 Decontamination of paper treated with 25 mg VX per 25 cm2, 126 3)P NMR study of the decontamination of O-ethyl-S-ethyl phenyl phosphonothioate, 127 Foam decontamination of Bacillus subtilis spores after one hour of treatment, 128 (a) High-energy accelerator fitted on a truck. (b) Schematic drawing of large-area decontamination with ionizing radiation, 132 BOX 2-1 Persistence of Biological Agents, 36 13547--Deployed Forces FM 18 12128199, 1:28 PM

Abbreviations and Acronyms 2D 3D cfm CG C1 CK Ct CX Dlo DS2 DS2P ECt50 GA GB GD g/den 13547--Deployed Forces FM 19 ABBREVIATIONS two dimensional three dimensional cubic foot per minute phosgene chlorine cyanogen chloride concentration x time phosgene oxime the dose level required to reduce the sample population by a factor of 10 decontaminating solution number 2 propylene glycol monomethyl ether the Ct dose that causes a defined effect (e.g., edema or death) in 50 percent of a given population tabun Saran soman gram per denier X1 ~ 12/28/991 1:28 PM

XX ABBREVIATIONS AND ACRONYMS H Levinstein mustard H2S hydrogen sulfide HD distilled mustard HL mustard-lewisite mixture HN nitrogen mustard ICt50 the Ct dose that incapacitates 50 percent of a given population ID50 the dose that incapacitates 50 percent of a given population L Lewisite 1pm liters per minute MeV million electron volts m2/g square meter per gram mg x min/m3 milligram times minute per cubed meter mm millimeter rim nanometers NOx nitrogen oxides ppb parts per billion Q-kg/m2 ohm kilogram per square meter ACRONYMS AERP ALERT ASTM AUIB BDO BDU BWC CB CBIRF CINC CONUS CPE CPU 13547--Deployed Forces FM 20 aircrew eye/respiratory protection attack and launch early reporting to theater American Society for Testing and Materials aircrew uniform integrated battlefield battle dress overgarment battle dress uniform Biological and Toxic Weapons Convention chemical and/or biological Chemical Biological Incident Response Force commander-in-chief continental United States collective protection equipment chemical protective undergarment 12/28/99, 1:28 PM

ABBREVIATIONS AND ACRONYMS CWC DARPA DATSD (CP/CBD) DEPMEDS DoD DMMP DPD DPK ERDEC FF FM FOC FR FY ICBPG IOM JCS JPO-BD JSAPE JSAM JSGPM JSIG JSLIST JSMG LCBPG LRC LSC MAG MCBAT MIST 13547--Deployed Forces FM 21 XXI Chemical Weapons Convention Defense Advanced Research Projects Agency Deputy Assistant to the Secretary of Defense for Counter-proliferation and Chemical/Biological Defense deployable medical system U.S. Department of Defense dimethyl methylphosphate dermatopharmac o dynamic dermatopharmacokinetic Edgewood Research, Development, and Engineering Center (now known as the Chemical- Biological Center of Excellence of the Soldier and Biological Chemical Command) fit factor field manual functional operational capability flame resistance fiscal year improved chemical and biological protective glove Institute of Medicine Joint Chiefs of Staff Joint Program Office for Biological Defense joint service aircrew protective ensemble . . . . ~owt service aircrew mas~ ~ joint service general purpose mask Joint Service Integration Group joint service lightweight integrated suit technology Joint Service Materiel Group lightweight chemicalibiological protective garment lesser regional conflicts liquid scintillation counting military air guideline Medical Chemical-Biological Advisory Team Man-in-Simulant Test (program) 12/23/99, 1:23 PM i

X- 11 MLRS MNS MOPP MRC MULO MURI NATO NBC NMR OOTW OPAA OPH P3I PF POM PPE PVC R&D RDA RDIC RDT&E RSDL SAW SBCCOM SCALP SLS SMART-CB SMART-PM SRT STEPO TAP TEMPER TG VHP VPU 13547--Deployed Forces FM 22 ABBREVIATIONS AND ACRONYMS multiple launch rocket system mission needs statement mission-oriented protective posture major regional conflicts multipurpose rain/snow/CB overboot multidisciplinary university research initiative North Atlantic Treaty Organization nuclear, biological, chemical nuclear magnetic resonance operations other than war organophosphorous acid anhydrolase organophosphorous hydrolase preplanned product improvement (program) protection factor program objective memorandum personal protective equipment polyvinyl chloride research and development research, development and acquisition resuscitation device individual chemical research, development, test and evaluation reactive skin decontaminant lotion surface acoustic wave Soldier and Biological Chemical Command suit, contamination avoidance, liquid protection sodium lauryl sulfate special medical augmentation response team- chemical /biological special medical augmentation response team- preventative medicine Specialty Response Team self-contained toxic environment protective outfit toxicological agent protective tent, expandable modular personnel technical guide vapor of hydrogen peroxide vapor protective undergarment ~ 2/23/99, ~ :23 PM

Strategies to Protect the Health of Deployecl U.S. Forces 13547--Deployed Forces FM 23 ~ 2/23/99, ~ :23 PM

13547--Deployed Forces FM 24 12128199, 1:28 PM

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Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns that their postdeployment medical symptoms could have been caused by hazardous exposures or other deployment-related factors. Potential exposure to a broad range of CB and other harmful agents was not unique to Gulf operations. Hazardous exposures have been a component of all military operations in this century. Nevertheless, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of CB agents in theater and symptoms reported by military personnel. Particular attention has been given to the potential long-term health effects of low-level exposures to CB agents.

In the spring of 1996, Deputy Secretary of Defense John White met with the leadership of the National Academies to discuss the DoD's continuing efforts to improve protection of military personnel from adverse health effects during deployments in hostile environments. Although many lessons learned from previous assessments of Operation Desert Shield/Desert Storm have been reported, prospective analyses are still needed. Strategies to Protect the Health of Deployed U.S. Forces: Force Protection and Decontamination, which addresses the issues of physical protection and decontamination, is one of four initial reports that will be submitted in response to that request.

Specifically, this report includes a review and evaluation of the following areas:

  • the adequacy of current protective equipment and protective measures (as well as equipment in development)
  • the efficacy of current and proposed methods for decontaminating personnel and equipment after exposures to CB agents
  • current policies, doctrine, and training to protect and decontaminate personnel and equipment in future deployments (i.e., major regional conflicts [MRCs], lesser regional conflicts [LRCs], and operations other than war [OOTWs])
  • the impact of equipment and procedures on unit effectiveness and other human performance factors
  • current and projected military capabilities to provide emergency response

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