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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Review of Report and Approach to Evaluating Long-Term
Health Effects in Army Test Subjects

Interim Report

Committee to Review Report on Long-Term Health Effects on Army Test Subjects

Board on Environmental Studies and Toxicology

Division on Earth and Life Studies

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×

THE NATIONAL ACADEMIES PRESS 500 FIFTH STREET, NW WASHINGTON, DC 20001

This activity was supported by Contract W81K04-16-D-0036, Task 0002 between the National Academy of Sciences and the Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

Digital Object Identifier: https://doi.org/10.17226/25025

Copyright 2018 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. https://doi.org/10.17226/25025.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×

COMMITTEE TO REVIEW REPORT ON LONG-TERM HEALTH EFFECTS ON ARMY TEST SUBJECTS

Members

IVAN RUSYN (Chair), Texas A&M University, College Station

ERIN M. BELL, University of Albany, NY

GERRY R. BOSS, University of California, San Diego

JAMES E. CLEAVER, University of California, San Francisco

PAMELA J. LEIN, University of California, Davis

CATHERINE A. MCCARTY, University of Minnesota, Duluth

NU-MAY RUBY REED, California Environmental Protection Agency (retired), Davis

KENNETH R. STILL, Portland State University, Portland, OR

VASILIS VASILIOU, Yale University, New Haven, CT

Staff

SUSAN N.J. MARTEL, Senior Program Officer

TAMARA DAWSON, Program Associate

Sponsor

U.S. ARMY

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×

BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY

Members

WILLIAM H. FARLAND (Chair), Colorado State University, Fort Collins, CO

RICHARD A. BECKER, American Chemistry Council, Washington, DC

WILLIAM E. COLGLAZIER, AAAS, Washington, DC

DOMINIC M. DITORO, University of Delaware, Newark, DE

DAVID C. DORMAN, North Carolina State University, Raleigh, NC

CHARLES T. DRISCOLL, JR., Syracuse University, Syracuse, NY

ANNE FAIRBROTHER, Exponent, Inc., Philomath, OR

GEORGE GRAY, The George Washington University, Washington, DC

STEVEN P. HAMBURG, Environmental Defense Fund, New York, NY

ROBERT A. HIATT, University of California, San Francisco, CA

SAMUEL KACEW, University of Ottawa, Ontario

H. SCOTT MATTHEWS, Carnegie Mellon University, Pittsburgh, PA

ROBERT PERCIASEPE, Center for Climate and Energy Solutions, Arlington, VA

R. CRAIG POSTLEWAITE, Department of Defense, Burke, VA

MARK A. RATNER, Northwestern University, Evanston, IL

JOAN B. ROSE, Michigan State University, East Lansing, MI

GINA M. SOLOMON, California Environmental Protection Agency, Sacramento, CA

ROBERT M. SUSSMAN, Sussman and Associates, Washington, DC

DEBORAH L. SWACKHAMER, University of Minnesota, St. Paul, MN

PETER S. THORNE, University of Iowa, Iowa City, IA

Staff

TERESA A. FRYBERGER, Director

ELLEN K. MANTUS, Scholar and Director of Risk Assessment

RAYMOND A. WASSEL, Scholar and Director of Environmental Studies

SUSAN N.J. MARTEL, Senior Program Officer for Toxicology

ELIZABETH BOYLE, Program Officer

TAMARA DAWSON, Program Associate

BERNIDEAN WILLIAMS-SMITH, Financial Associate

SUZANNE THILENIUS, Administrative Coordinator

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×

Acknowledgments

This interim report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

Dan G. Blazer, Duke University

David C. Dorman, North Carolina State University

David R. Franz, Independent Consultant

Philip J. Landrigan, Icahn School of Medicine at Mount Sinai

Sheryl A. Milz, University of Toledo

Joshua M. Sharfstein, Johns Hopkins Bloomberg School of Public Health

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Martin Philbert, University of Michigan. He was responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Review of Report and Approach to Evaluating Long-Term Health Effects in Army Test Subjects: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/25025.
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Between 1942 and 1975, the U.S. Army conducted tests with human subjects to study the effects of a variety of agents, including chemical warfare and biological agents. The potential long-term health effects on the test subjects from their exposures have been evaluated periodically, most recently in a report titled Assessment of Potential Long-Term Health Effects on Army Human Test Subjects of Relevant Biological and Chemical Agents, Drugs, Medications and Substances: Literature Review and Analysis (the Report), which was prepared by a contractor to assist the Army with making determinations about providing medical care to former test subjects. In response to a request by the Army, the National Academies of Sciences, Engineering, and Medicine formed a committee that was tasked with examining whether the Report appropriately identified potential long-term health effects from exposure to the test agents and whether an adequate weight-of-evidence approach was used to characterize the strength of the associations between the agents and their potential health effects. The committee was made aware at its first meeting on November 30, 2017, that the Army had already begun to receive applications for medical care and that some determinations may need to be made before the committee’s evaluation of the Report was completed. Because of this urgency, the Army developed a process by which applications for medical care will be reviewed, and as a result, the committee was given the additional task of reviewing the Army’s Memorandum that describes the approach that will be used by the Army to evaluate agent- and outcome-specific associations. This interim report was prepared to facilitate the Army’s deliberations. A review of the Report is presented first, followed by a review of the Memorandum.

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