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APPENDIX B UPDATED MORTALITY STUDY (SUMMARY) by Robert J. Keehn The mortality analysis reported in Possible Lona-Term Health Effects of Short-Term Exposure to Chemical Agents: Volume 1 was based on 12,195 chemical exposures reported by the Army, including 548 exposures to unclassifiable substances (chemicals of uncertain identity). Further searching by the Army has established the identity of most of the unclassifiable chemicals, reducing the number from 548 to 187. In its search, the Army found 1,454 tests that had not been included in the reported mortality analysis (see Table B-1~. As a result, the total number of exposures has increased from the 20,851 of the reported mortality analysis to 22,305. Of the 1,454 additional exposures, 1,024 were to some chemical and 430 involved equipment testing without chemicals. Increases in numbers of exposures to the various types of chemicals range from zero (analgesics) to 379 (irritants and vesicants). Percentage increases in numbers of exposures were large in the cases of stimulants (356%), psycho- chemicals (185%), LSD derivatives (51Yo), and miscellaneous exposures (31%~. The number of volunteers who participated in the tests did not change. However, the reporting of 1,454 additional tests by the Army has changed the numbers of men in the various groups used in the mor- tality comparisons (Table B-2~. The number of men who participated only in tests of equipment (no chemical exposure) decreased from 1,719 to 1,587. The number of men exposed to each class of chemicals, except the unclassifiable, increased; the numbers of participants exposed only to the cholinesterase Deactivators, the irritants and vesicants, and the LSD derivatives increased; and numbers of parti- cipants exposed only to the anticholinesterases and the anticholin- ergics decreased. The shifting of men and the corresponding deaths among the comparison groups necessitated that the experience be reanalyzed (Tables B-3 and B-4~. The numbers of observed and expected deaths and the standard mortality ratios differ somewhat from those previously reported. But the conclusion in Volume 1 is unchanged: "It can be concluded that over the time span examined here, there is no evidence that volunteer participation in the testing programs had any long-term adverse effect on mortality." -75-

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TABLE B-1 Numbers of Test Exposures Reported to the Army Initially and in Revision No. Test Exposures Reported by Army Initial Revised Changes Type of Exposure Report Report No. % Chemical 12,195 13,219 1,024 8.4 Anticholinesterase 1,697 1,820 123 7.2 Anticholinergic 2,656 2,739 83 3.1 Cholinesterase deactivator 1,004 1,072 68 6.8 Psychochemical (Sernyl) 40 114 74 185.0 Irritant or vesicant 2,482 2,861 379 15.3 Analgesic 47 47 0 0.0 Stimulant 18 82 64 355.6 Cannabinoid 259 260 1 0.4 Miscellaneous 118 155 37 31.4 LSD derivative 511 772 261 51.1 Innocuous chemical 502 562 60 12.0 Approved drug 1,636 1,786 150 9.2 Control substance 677 762 85 12.6 Unclassifiable 548 187 -361 -65.9 Equipment (no chemical) 8 , 656 9, 086 430 5.0 Total 20,851 22,305 1,454 7.0 a From initially reported numbers; unclassifiable chemical exposures decreased, and all other categories except analgesics increased. -76-

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TABLE B-2 Numbers of Test Subjects Included in First and Second Mortality Analysesa No. Subjects in First AnalYsis No. Subjects in Second Anal~sis Type of Exposure Total Onlv Not Onlv Total Only Not Onlv Anticholinesterase Anticholinergic Cholinesterase reactivator Psychochemical (Sernyl) Irritant or vesicant Analgesic Stimulant Cannabinoid Miscellaneous LSD derivative Innocuous or control chemical Approved drug Unclassifiable Equipment (no chemical) 1,465 1,749 690 NI 1,901 NI NI 252 NI NI NI NI NI NI 507 570 83 NI 855 NI NI NI NI 103 958 1,179 607 NI 1,046 NI NI NI NI NI 106 NI 159 NI NI NI 1,719 NI 1,567 1,794 745 NI 2,125 NI NI 253 NI NI NI NI NI NI 496 1,071 544 1,250 92 653 NI NI 877 1,248 NI NI NI NI NI NI NI NI 184 NI 101 NI 160 NI NI NI 1,587 NI Total 6,620 4,102 2,518 6,620 4,041 2,579 a NI = test group not included in mortality study -77- .

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TABLE B-4 Observed and Expected Deaths Among Test Subjects, by Chemical No. No. Deaths Chemical Subjects Observed Expected O/E Anticholinesterase only 496 20 28.9 0.69 Sarin only 135 9 10.0 0.90 VX only 290 11 15.7 0.70 Remainder of group 71 0 3.2 0.0 Anticholinergic only 544 21 17.0 1.24 BZ only 102 5 5.4 0.93 EA 3443 only 27 . 1 1.1 0.91 EA 3580 only 38 0 1.1 0.0 Scopolamine only 58 4 1.4 2.86 Atropine only 40 3 1.3 2.31 EA 3834 only 56 1 1.1 0.91 Remainder of group 223 7 5.6 1.25 Irritant only Mustard only Remainder of group 877 14 31.0 0.45 52 2 ~ 2.0 1.00 825 12 -81- 29.0 0.41

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