REVIEW OF REPORT AND APPROACH TO
EVALUATING LONG-TERM HEALTH EFFECTS
IN ARMY TEST SUBJECTS
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
A Consensus Study Report of
THE NATIONAL ACADEMIES PRESS
Washington, DC
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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/10.17226/25065
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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: Final Report. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25065.
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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
BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY
Members
WILLIAM H. FARLAND (Chair), Colorado State University, Fort Collins, CO
LESA AYLWARD, Summit Toxicology, LLP, Falls Church, VA
RICHARD A. BECKER, American Chemistry Council, Washington, DC
E. WILLIAM COLGLAZIER, AAAS, Washington, DC
DOMINIC M. DITORO, University of Delaware, Newark, DE
DAVID C. DORMAN, North Carolina State University, Raleigh, NC
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
R. JEFFREY LEWIS, ExxonMobil Biomedical Sciences, Inc., Annandale, NJ
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
REZA J. RASOULPOUR, Dow AgroSciences, Indianapolis, IN
MARK A. RATNER, Northwestern University, Evanston, IL
JOAN B. ROSE, Michigan State University, East Lansing, MI
GINA M. SOLOMON, University of California, San Francisco, 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
JESSICA WOLFMAN, Senior Program Assistant
Acknowledgments
This Consensus Study 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:
Edward C. Bishop, HDR, Inc. (retired)
David C. Dorman, North Carolina State University
David R. Franz, Independent Consultant
Philip J. Landrigan, Icahn School of Medicine at Mount Sinai
Joel E. Michalek, University of Texas Health Science Center
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 David Eaton, University of Washington, and Martin Philbert, University of Michigan. They were 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.
The committee gratefully acknowledges the following individuals for their presentations to the committee during its open session: Coleen Baird, U.S. Army Public Health Center; Weihsueh Chiu, Texas A&M University; Jonathan Samet, Colorado School of Public Health; and Rick Weidman, Vietnam Veterans of America. The committee also thanks Kathleen Stratton and Roberta Wedge of the Health and Medicine Division (HMD) of the National Academies for their assistance in providing background on the methods HMD has used in past projects to evaluate the adverse effects of vaccines and to evaluate potential health hazards to veterans of the Vietnam and Gulf Wars.
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Contents
The Committee’s Task and Approach
Best Practices in Hazard Identification
Examples of Missed Studies and Health Effects
3 EVALUATION OF THE ARMY’S CAUSATION METHODOLOGY
Review and Adjudication Process
4 STRATEGY FOR EVALUATING POTENTIAL LONG-TERM HEALTH EFFECTS IN ARMY TEST SUBJECTS
Step 3: Literature Search and Screening
Step 4: Data Analysis and Evidence Synthesis