Exposure Science in U.S. Military Operations: A Review

Martin, Nicholas J.; Richards, Erin; Kirkpatrick, Jeffrey S.

doi:10.7205/milmed-d-11-00098

Cited by 9 publications

(3 citation statements)

References 5 publications

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“…Deployment occupational and environmental health surveillance activities began during Operations Desert Shield and Storm but did not fully address exposure concerns related to the deployed environment. 51 Despite the 1998 Presidential Review Directive 5, which required the Services to conduct occupational and environmental exposure assessments and document the results of medical surveillance in the medical record, 52 the Institute of Medicine noted in 2011 that the DoD collected little information on service members' individual exposures. 53 Today, the public, scientific community, and US Congress expect comprehensive exposure assessments supporting risk assessments for deployed personnel.…”

Section: Environmentalmentioning

confidence: 99%

The Future of Military Occupational and Environmental Medicine in the Department of Defense

Krahl

Thomas

Gaydos

et al. 2021

Journal of Occupational &Amp; Environmental Medicine

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Objective: Transfer of military medical facilities to the Defense Health Agency is transforming the Military Health System. Our objective is to inform this transformation with respect to optimum application of occupational and environmental medicine (OEM) expertise. Methods: We defined and analyzed the external influences on military OEM practice using a structured framework to identify key drivers. Results: Key drivers are political and economic factors. These may change the size or military/ civilian ratio of the specialty. Limited career development pathways should prompt consideration of making OEM a second or combined residency, and military-funded training of civilian physicians may be required. OEM specialist utilization should be reassessed. Conclusions: OEM is a highly adaptable specialty defined by the needs of its stakeholders. Comprehensive analysis of external influences can ensure that OEM practice remains in step with changing needs.

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Section: Environmentalmentioning

confidence: 99%

The Future of Military Occupational and Environmental Medicine in the Department of Defense

Krahl

Thomas

Gaydos

et al. 2021

Journal of Occupational &Amp; Environmental Medicine

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“…Exposure assessment occurs during occupational and environmental health “intelligence preparation of the battlefield” to provide base-line data prior to force deployment to an operations theater. In theater, routine surveillance continues in line with civilian practice, surveys may be carried out in response to incidents, and post activity reports may give preliminary insights into risks ( 25 ). Environmental surveillance procedures required at military camps or bases [e.g., air, water, soil, and bulk sample testing for hazard, or risk management activities ( 24 , 26 , 27 )], may serve a different purpose than the collection of measurements to serve as individual-level exposure proxies in epidemiological studies.…”

Section: Exposure Data Sourcesmentioning

confidence: 99%

“…Environmental surveillance procedures required at military camps or bases [e.g., air, water, soil, and bulk sample testing for hazard, or risk management activities ( 24 , 26 , 27 )], may serve a different purpose than the collection of measurements to serve as individual-level exposure proxies in epidemiological studies. For example, some defense risk assessment models place greater emphasis on acute effects that may impact operations in the short term, rather than on delayed health effects ( 25 ).…”

Section: Exposure Data Sourcesmentioning

confidence: 99%

Considering Exposure Assessment in Epidemiological Studies of Chronic Health in Military Populations

Hall

MacLean

VanTil

et al. 2020

Front. Public Health

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Exposure assessment is an important factor in all epidemiological research seeking to identify, evaluate, and control health risks. In the military and veteran context, population health research to explore exposure-response links is complicated by the wide variety of environments and hazards encountered during active service, long latency periods, and a lack of information on exposures in potentially vulnerable subgroups. This paper summarizes some key considerations for exposure assessment in long-term health studies of military populations, including the identification of hazards related to military service, characterization of potentially exposed groups, exposure data collection, and assignment of exposures to estimate health risks. Opportunities and future directions for exposure assessment in this field are also discussed.

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Physiological Employment Standards III: physiological challenges and consequences encountered during international military deployments

Nindl¹,

Castellani

Warr

et al. 2013

Eur J Appl Physiol

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Modern international military deployments in austere environments (i.e., Iraq and Afghanistan) place considerable physiological demands on soldiers. Significant physiological challenges exist: maintenance of physical fitness and body composition, rigors of external load carriage, environmental extremes (heat, cold, and altitude), medical illnesses, musculoskeletal injuries, traumatic brain injuries, post-traumatic stress disorder, and environmental exposure hazards (i.e., burn pits, vehicle exhaust, etc.). To date there is very little published research and no comprehensive reviews on the physiological effects of deployments. The purpose of this paper is to overview what is currently known from the literature related mainly to current military conflicts with regard to the challenges and consequences from deployments. Summary findings include: (1) aerobic capacity declines while muscle strength, power and muscular endurance appear to be maintained, (2) load carriage continues to tax the physical capacities of the Soldier, (3) musculoskeletal injuries comprise the highest proportion of all injury categories, (4) environmental insults occur from both terrestrial extremes and pollutant exposure, and (5) post-deployment concerns linger for traumatic brain injury and post-traumatic stress disorder. A full understanding of these responses will assist in identifying the most effective risk mitigation strategies to ensure deployment readiness and to assist in establishment of military employment standards.

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Exposure Science in U.S. Military Operations: A Review

Cited by 9 publications

References 5 publications

The Future of Military Occupational and Environmental Medicine in the Department of Defense

The Future of Military Occupational and Environmental Medicine in the Department of Defense

Considering Exposure Assessment in Epidemiological Studies of Chronic Health in Military Populations

Physiological Employment Standards III: physiological challenges and consequences encountered during international military deployments

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