Review of the Army's Technical Guides on Assessing and Managing Chemical Hazards to Deployed Personnel (2004) / Chapter Skim
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2 Review of the Army's Technical Guidance
2 Review of the Army's Technical Guidance
Pages 27-46
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From page 27... ...
Second, the adequacy of the technical guides for providing appropriate characterizations of health and mission risks from exposure to chemicals is evaluated. EARLIER ACADEMIES REPORTS ON DEVELOPING RELIABLE COMPARATIVE RISK ASSESSMENTS FOR DEPLOYMENTS The Institute of Medicine report Protecting Those Who Serve (IOM 2000)
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From page 28... ...
Exposures that are individually tolerable without appreciable risk might not be so when several are experienced together, and the question of interactions among agents looms particularly large for deployment risk assessment" (NRC 2000, p.
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From page 29... ...
The italicized portions focus on the critical need for comparative risk analysis that would allow commanders to make trade-off decisions concerning uncertain risks in the contextofpotentially competinggoals,rangingfromcombatsuccesstopreventive public or occupational health, that might differ in urgency. Such tradeoffs should reflect unbiased assessments of net risk associated with alternative courses of action (NRC 2000)
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From page 30... ...
These two dimensions are combined to comprise 20 cells that are separated into four qualitative categories of mission-related risk: extremely high, high, moderate, and low. These risk categories pertain specifically to the qualitative likelihood of mission success, which refers to mission-specific military goals including, but not limited to, the minimization of health risks to deployed military personnel.
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From page 31... ...
exists. M Moderate risk: Expected degraded mission capabilities in terms of the required mission standard will have a reduced mission capability if threats occur during mission.
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From page 32... ...
. In both guidance documents, these probabilistic unit strength levels are related to hazard severity levels and hazards probability categories, but those relationships are made quantitatively explicit in TG230 insofar as that document defines the hazard probability categories discussed above in terms of corresponding troop exposure probability ranges (see Table 2-5)
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From page 33... ...
33 pe Ty Hazard NO HEALTH THREAT HEALTH THREAT MEDICAL THREAT ontinued) C( verityeS Hazard Rank NONE NEGLIGIBLE MARGINAL ntsem s tompm Deploy Sy THE THE of TER Onset AF MISSION DURING MISSION Military for e <1 and or illness Chart Outcom or might might ande chronic might might Exposure illness eas 10,000 or severe Health to impair illness illness ine irritation to capabilities a of dis personnel ildm Ranking cas of illness personnel of ildm personnel personnel reom ciatedos e of of cases eas porary begins As Attributable (General)
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From page 34... ...
34 pe Ty should large EDICAL Hazard M THREAT in evaluatedeb tables MEG present the verityeS are should ofn icals tables l. colum Hazard Rank CRITICAL CATASTROPHIC chem MEG velestc s the certain tompm if ofn otes"N" ffee the re mission in ve Sy se of the colum trophic ation catas Onset During factors.
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From page 35... ...
35 or Incapacitation Death atastrophicC Catastrophic Critical Critical Impairs Guideline That the Capabilities Illness ntsem Near Mission or the Injury Functional Catastrophic Critical Marginal Marginal Exposures Deploy During with b ated rringuc Military Oc or Irritation for Associ Illness porary mptoms Chart Effects Sy Mild Tem Critical Marginal Marginal Negligible Health ng Ranking rriuc anent a Individual Oc rmeP Mission Disease Severity of mso or ther or 2001. mpt Nature Sy Afte Chronic Injury Marginal Negligible Negligible Negligible Hazard nuisance.
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From page 36... ...
cThe unit rates provided under "Unit Status" are tobe determined by the commander. Charts similar to the example hazard probability and severity ranking charts presented in Tables 21, 2-2, and 2-3 should be aligned with the acceptable risk levels provided by the commander.
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From page 37... ...
The generalized framework in TG-248 also comprises innovative features that are suited for practical use in the field. The framework attempts a quantitative implementation of a matrix approach to assess risk levels that are implied by different categories of hazard severity and hazard probability.
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From page 38... ...
. The approach also incorporates traditional procedures used to identify noncompliance with occupational safety and health guidelines pertaining to chemical exposures that are expected to produce health effects (i.e., hazards of "negligible" severity)
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From page 39... ...
CCEGs would be media and duration-specific chemical concentrations expected to cause health impairments that degrade the performance of enough individuals to reduce unit strength, also known as medical threats. As discussed in more detail in Chapter 4, CCEGs cannot be established from existing exposure
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From page 40... ...
Although this will be a significant undertaking, the number of chemicals and the scope of the data needed for evaluation are expected to be far less than those that were required to set the MEGs. USACHPPM should further prioritize the general risks posed by specific media of exposure, including air, soil, and water, and the available risk-management options for various durations of missions.
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From page 41... ...
The other route is paved but goes by a chemical plant that has structural damage and is believed to be leaking chemical X Chemical X can cause irritation of the mucous membranes and respiratory system, headache, and nausea that could impair the functional capabilities of the troops.
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From page 42... ...
matewouldbeitsexpectedvalue,or"populationmean,"definedmathematically as the arithmetic average of all possible likelihood-weighted values.2 · TG-230 makes it clear that "unit strength" should refer not only to directly affected personnel but also to individuals affected to a lesser extent 2"Likelihood"weightsinthiscontextmeanprobabilitiesfromadistributionthatreflects uncertainty in a true but unknown value that must be estimated. Expected values have two key properties that do not generally apply to other measures of central tendency, such as medians or modes.
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From page 43... ...
(TG-230 also mentions that severe toxic effects will lead to increased medical support requirements for affected personnel, but it was not clear to the subcommittee how that supportnecessarilywouldreduceuniteffectiveness,insofarasrequiredmedical support personnel would be performing their intended function.) · The need for a categorical confidence-level scheme (high vs medium vs low)
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From page 44... ...
Depending on the particulars of the deployment scenario, commanders could decide whether the benefits of the mission outweigh the possible health risks to individual soldiers. In cases where commanders decide to accept the health risks to soldiers, MEGs could be used to determine what kinds of health-management actions to take, such as documenting exposures in soldiers' records, conducting additional environmental sampling, or conducting follow-up health monitoring.
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From page 45... ...
CCEGs would be media and duration-specific chemical concentrations expected to cause health impairments that debilitate the performance of enough individuals to significantly reduce unit strength and effectiveness. They would be predictive values that provide unbiased quantitative exposure-response and population-response information that enables commanders to compare the risks from chemical threats to those from other mission threats (e.g., combat casualties, logistical problems)
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From page 46... ...
A Companion Docu ment to USACHPPM Technical Guide (TG) 230 Chemical Exposure Guidelines for Deployed Military Personnel.
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