Strategies To Protect The Health Of Deployed U S Forces

Since the Gulf War ended in 1991, various constituencies, including a significant number of veterans, speculate that unidentified risk factors led to chronic, medically unexplained illnesses, and these constituencies challenge the depth of the military's commitment to protect the health of deployed troops. Despite general concurrence in findings to support these claims, few changes have been made at the field level. The most important recommendations remain unimplemented, despite the compelling rationale for urgent action. Protecting Those Who Serve illuminates these recommendations and government-developed plans that remain inactive due to a lack of authority within the Department of Defense, while describing the dangers that may result from failure to protect our forces in the field.

Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns about health effects that could be associated with their deployment and service during the war. Although similar concerns were raised after other military operations, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of chemical and biological (CB) agents and other harmful agents in theater and health symptoms reported by military personnel. Strategies to Protect the Health of Deployed U.S. Forces which is one of the four two-year studies, examines the detection and tracking of exposures of deployed personnel to multiple harmful agents.

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

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

Nine years after Operations Desert Shield and Desert Storm (the Gulf War) ended in June 1991, uncertainty and questions remain about illnesses reported in a substantial percentage of the 697,000 service members who were deployed. Even though it was a short conflict with very few battle casualties or immediately recognized disease or non-battle injuries, the events of the Gulf War and the experiences of the ensuing years have made clear many potentially instructive aspects of the deployment and its hazards. Since the Gulf War, several other large deployments have also occurred, including deployments to Haiti and Somalia. Major deployments to Bosnia, Southwest Asia, and, most recently, Kosovo are ongoing as this report is written. This report draws on lessons learned from some of these deployments to consider strategies to protect the health of troops in future deployments. In the spring of 1996, Deputy Secretary of Defense John White met with leadership of the National Research Council and the Institute of Medicine to explore the prospect of an independent, proactive effort to learn from lessons of the Gulf War and to develop a strategy to better protect the health of troops in future deployments.

Risk management is especially important for military forces deployed in hostile and/or chemically contaminated environments, and on-line or rapid turn-around capabilities for assessing exposures can create viable options for preventing or minimizing incapaciting exposures or latent disease or disability in the years after the deployment. With military support for the development, testing, and validation of state-of-the-art personal and area sensors, telecommunications, and data management resources, the DOD can enhance its capabilities for meeting its novel and challenging tasks and create technologies that will find widespread civilian uses. Strategies to Protect the Health of Deployed U.S. Forces assesses currently available options and technologies for productive pre-deployment environmental surveillance, exposure surveillance during deployments, and retrospective exposure surveillance post-deployment. This report also considers some opportunities for technological and operational advancements in technology for more effective exposure surveillance and effects management options for force deployments in future years.

Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns about health effects that could be associated with their deployment and service during the war. Although similar concerns were raised after other military operations, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of chemical and biological (CB) agents and other harmful agents in theater and health symptoms reported by military personnel. Strategies to Protect the Health of Deployed U.S. Forces which is one of the four two-year studies, examines the detection and tracking of exposures of deployed personnel to multiple harmful agents.

Deployment of forces in hostile or unfamiliar environments is inherently risky. The changing missions and increasing use of U.S. forces around the globe in operations other than battle call for greater attention to threats of non-battle-related health problemsâ€"including infections, pathogen- and vector-borne diseases, exposure to toxicants, and psychological and physical stressâ€"all of which must be avoided or treated differently from battle casualties. The likelihood of exposure to chemical and biological weapons adds to the array of tactical threats against which protection is required. The health consequences of physical and psychological stress, by themselves or through interaction with other threats, are also increasingly recognized. In addition, the military's responsibility in examining potential health and safety risks to its troops is increasing, and the spectrum of health concerns is broadening, from acute illness and injury due to pathogens and accidents to possible influences of low-level chemical exposures, which can manifest themselves in reproductive health and chronic illnesses years later, perhaps even after cessation of military service. Strategies to Protect the Health of Deployed U.S. Forces develops an analytical framework for assessing risks, which would encompass the risks of adversed health effects from battle injuries, including those from chemical- and biological-warfare agents, and non-battle-related health problems. The presumed spectrum of deployment ranged from peacekeeping to full-scale conflict.