Review of the Department of Defense Enhanced Particulate Matter Surveillance Program Report (2010) / Chapter Skim
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Studies of other populations have suggested that the increase in reported respiratory effects might be attributable, in part, to PM, among other exposures. With the renewed activity in the Middle East over the last few years, deployed military personnel are again exposed to dust storms and daily windblown dust in addition to other types of PM, such as diesel exhaust and particles from open-pit burning.
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Finally, because of differences in the concentrations and composition of PM and differences in the population of deployed military personnel, extrapolating from population-based epidemiologic studies in the United States and Europe to military populations deployed to the Middle East may not be valid. THE DEPARTMENT OF DEFENSE ENHANCED PARTICULATE MATTER SURVEILLANCE PROGRAM In 2005, the assistant secretary of defense for health affairs chartered the Joint Particulate Matter Working Group to identify the potential health risks associated with exposure to PM.
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From page 5... ...
It was also asked to consider epidemiologic and health-surveillance data collected by the USACHPPM, to assess potential health implications for deployed personnel, and to make recommendations for reducing or characterizing health risks. In response, the National Research Council convened the Committee for Review of the DOD's Enhanced Particulate Matter Surveillance Program Report, which prepared the present report.
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DEPARTMENT OF DEFENSE HEALTH-EFFECTS STUDIES In addition to the data collected in the EPMSP, the USACHPPM conducted two epidemiologic studies that examined acute and chronic outcomes and a medical-surveillance project to investigate the potential for adverse health effects of exposure to PM during military deployment in the Middle East. Toxicologic studies were conducted by the Navy to test specific hypotheses related to the exposures that may be encountered in the field.5 One of the epidemiologic studies described by USACHPPM used a casecrossover design to evaluate the association between daily average PM2.5, PM10, and TSP concentrations collected at the 15 sites in the EPMSP and cardiovascular and respiratory health outcomes on the basis of data collected from various military medical-record databases.
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Although the ability to conduct such a study is a critical milestone, the design and conduct of the EPMSP and health-effects studies limit their usefulness.6 The EPMSP achieved data recovery of 88%, which is impressive in light of the challenges of implementing protocols and operating samplers in a Middle East war zone. In addition, the sampling design and analysis captured many of the important physical and chemical properties of PM that have been shown in previous studies to affect health outcomes.
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From page 8... ...
Although interpretation of the epidemiologic and health-surveillance studies was encumbered by uncertainties regarding the actual exposures, the small number of study subjects, and the limited amount of exposure data, the EPMSP results clearly document that military personnel deployed in the Middle East during the current Afghanistan and Iraq conflicts are exposed to high concentrations of PM and that the particle composition varies considerably over time and space. The committee concludes that it is indeed plausible that exposure to ambient pollution in the Middle East theater is associated with adverse health outcomes.
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An example is the Millennium Cohort Study, which has explored the impact of deployment on respiratory health. Given the complexities of pollutant exposures and the potential acute and chronic health effects associated with these exposures, the military should consider establishing an independent multidisciplinary advisory group composed of internal and external members to provide guidance in the development and conduct of future exposure-assessment and epidemiologic studies of military personnel in combat.
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CONCLUDING REMARKS The committee recognizes the importance of this initial effort to characterize the composition of PM and to understand the potential for health effects of exposures in the active theater. The feasibility of conducting future exposure assessment and health surveillance has been demonstrated.
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From page 11... ...
could be located downwind of bases. For periodic emissions, such as from waste-burning, burns should take place when the prevailing meteorologic conditions favor dispersion of the emissions.
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