Review of the Army's Technical Guides on Assessing and Managing Chemical Hazards to Deployed Personnel (2004) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-15
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now promotes a unified and comprehensive force health protection plan that advocates full consideration of all potential health hazards across the deployment spectrum and throughout the deployment process. As part of mission planning, it is necessary for operational decision makers to have information on health hazards to individual soldiers and their potential impact on the options being considered for achieving the mission (i.e., the impacts on courses of action)
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was asked to independently reviewTG-248,TG-230,andRD-230fortheirscientificvalidity,completeness, and conformance to current risk-assessment practices. The NRC assigned this task to the standing Committee on Toxicology and convened the Subcommittee on Assessing Toxicological Risks to Deployed Military Personnel.
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who will be using MEGs in the field. THE ARMY'S PROCESS TO EVALUATE CHEMICAL HAZARDS The goals of TG-230 areto "characterize the level of health and mission risks associated with identified or anticipated exposures to chemicals in the deployment environment" (italics added)
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Risk Levels E Extremely high risk: Loss of ability to accomplish the mission if threats occur during mis sion. A frequent or likely probability of catastrophic loss (IA or IB)
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However, the subcommittee found that USACHPPM's approach of using one set of chemical exposure guidelines (the MEGs) was inadequateforachievingthetwogoalsof assessing mission risksandproviding force health protection.
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, which made it necessary for USACHPPM to adjust the values to make them relevant to the deployment setting. The subcommittee found the application of these adjustments was not sufficient to ensure that the resulting values provide comparable levels of protection among various chemicals.
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· Soilcontaminants. Forsoilcontaminants,thesubcommitteeidentified a number of concerns, including the use of older data or assumptions that have been recently updated or have been superceded by new guidance; failure to develop MEGs for volatile chemicals; flaws in the description of how dermal toxicity values are derived; and the use of a high and uncertain soil ingestion rate.
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Forthegeneralpublic, susceptible subpopulations typically include embryos and fetuses, the very young, the elderly, individuals with pre-existing disease, and those with genetic susceptibilities. In establishing health-protective exposure values, uncertainty factors are conventionally applied to provide a margin of safety to protect the portion of the general population that might be at increased risk.
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However, the subcommittee decided it could help address that issue by reviewing acceptable risk levelsselectedby otherorganizationsandmakingobservationsaboutwhere the Army's acceptable cancer risk threshold lies in comparison. The subcommittee found that risk of 1 in 10,000 falls within the range used by other
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It was clear that USACHPPM considered long-term health consequences along with shortterm effects during the development of the chemical hazard ranking scheme for mission risk assessment. However, the subcommittee found that a more formalized procedure for communicating long-term and delayed health effects simultaneously with mission risk information is needed to ensure thatthosepotentialeffectsareexplicitly considered.
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Although the technical guides provide a procedure that is intended to facilitate the consistent evaluation and interpretation of chemical threats that might be encountered during deployment, the subcommittee found that professional judgment of trained personnel is necessary to use the guides properly and to effectively communicate risks to nontechnical decision makers. Another element of the task question is whether the prod
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RECOMMENDATIONS Use Two Sets of Exposure Guidelines The subcommittee recommends that two sets of chemical exposure values be used to assess health risks and mission risks separately. This will ensurethattheguidelinevaluesarebasedonhealthconsiderationsappropriate to the intended goal.
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· If the Army chooses to use MEGs in the interim, TG-230 should be revised to warn users regarding the deficiencies and limitations of MEGs when applied to assess mission-related performance risks. Exposure Guidelines for Assessing Health Risks Another goal of TG-248 and TG-230 is to provide force health protection across a range of scenarios that might be encountered during deployment, recognizing that some health risks might have to be accepted to achieve military objectives.
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These are revisions to improve the qual ity of the MEGs that require relatively modest resources. They include revising the MEGs with updated values from other organizations, en suring consistent use of uncertainty factors and adjustments relevant to the deployed population, ensuring that the MEGs are not based on data from subpopulations not expected to be among the deployed forces (e.g., asthmatics, children)
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The resulting evaluations should be provided to decision makers simultaneously and consideration should be given to the risk-management options available for reducing or eliminating the risks. This will help decision makers explicitly balance the competing health and mission risks with respect to the military objective.
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