Biomedical subjects

Arthur P Lee

Publications and source records attributed to Arthur P Lee.

5 recordsLinked to original sources

PubMed2004

The recommended role of exposure biomarkers for the surveillance of environmental and occupational chemical exposures in military deployments: policy considerations.

A lack of individual exposure information limited the evaluation of exposure-outcome relationships after the Gulf War. Exposure concerns during Operation Enduring Freedom and Iraqi Freedom deployments have increased interest in individual environmental and occupational chemical exposure assessment. Currently, deployment assessments are conducted using intermittent ambient air monitoring, occasional focused evaluations based on these results, and postdeployment questionnaire documentation of exposure and/or health concerns. Although this strategy is an improvement over previous practice, it has limitations, including a reliance on evidence of an acute problem, to initiate in-depth health evaluation. Exposure biomarkers may have the potential to overcome some of the limitations of current environmental and occupational exposure assessment tools. This article examines current exposure assessment methods, reviews emerging technologies, and recommends a phased approach to introducing exposure biomarkers into a comprehensive occupational and environmental health surveillance program.

Biomarkers↗

PubMed2004

Assessing chemical exposures during military deployments.

Before the first Persian Gulf War, military chemical concerns were focused on life-threatening/performance-impairing effects from exposures to chemical warfare agents. Now, hazards of concern include both high and low levels of chemical warfare agents and toxic industrial chemicals in air, soil, and water. The types of health effects considered have expanded to include both immediate, acute effects (mild and severe), and delayed or chronic outcomes. Because federal exposure standards are not applicable to deployed personnel, the U.S. Army Center for Health Promotion and Preventive Medicine established military-specific exposure guidelines in Technical Guide 230, Chemical Exposure Guidelines for Deployed Military Personnel. Methods used to develop the guidelines address toxicological data limitations, uniqueness of military populations and exposure scenarios, and a risk assessment process compatible with existing military operational risk management doctrine. The Technical Guide 230 helps ensure chemical hazards are addressed in various deployment scenarios.

Air Pollutants↗

PubMed2003

Estimating selected disease and nonbattle injury Echelon I and Echelon II outpatient visits of United States soldiers and Marines in an operational setting from corresponding Echelon III (hospitalizations) admissions in the same theater of operation.

Currently, disease and nonbattle injury estimates are based on hospital admission logs and not on battalion aid stations nor medical company patient logs. A significant amount of morbidity can be overlooked and can mislead commanders and their staffs into believing that their unit is at a higher strength level. The objective of this article is to provide a tool for estimating these "hidden" disease and nonbattle injury cases. Nine weeks of military hospitalization data (687 admissions) separated into 14 diagnosis categories were compared with respective outpatient morbidity data (12,109 outpatient visits) during Operation Restore Hope in Somalia in 1993. Proportionate values and 95% confidence intervals were calculated for 5 of the 14 diagnostic categories and total morbidity. These proportionate values were then used to show how disease and nonbattle injury (total and diagnosis category) could be estimated based on hospitalization admissions during a similar military operation. Mission and geographical location information should be considered when using this model, along with other medical planning publications.

Ambulatory Care Facilities↗

PubMedDate not supplied

Military deployment human exposure assessment: urine total and isotopic uranium sampling results.

Currently the Department of Defense (DoD) does not use exposure biomarkers to measure service members' exposure to environmental chemicals. Blood and urine exposure biomarkers for volatile organic compounds (VOC), selected heavy metals, depleted uranium (DU), and chemical warfare agents are currently available but have not been field tested or validated by the DoD in military deployments as a tool to document exposures. The Military Deployment Human Exposure Assessment Study, a prospective cohort of 46 soldiers deployed to Bosnia, was designed to field test blood and urine exposure biomarkers as a mechanism to document exposures to these chemicals during military deployments. Blood and urine were collected before, during, and after deployment. Standard questionnaire, environmental, and occupational monitoring data collection methods were conducted for comparison to the exposure biomarker results. This article compares and reports the pre-, during, and postdeployment urine total and isotopic uranium measurements and compares them to perceived exposures captured on questionnaire, to environmental data collected by the United Nations Environmental Program in Bosnia, and to standard U.S. urine uranium reference levels (CDC, 2003). Additionally, the questionnaire and environmental and occupational measurements are reported. The results of the study indicate that exposure biomarkers may be a valuable tool to the DoD in exposure and risk assessment with regard to environmental and occupational exposures to uranium.

Bosnia and Herzegovina↗

PubMedDate not supplied

Traditional sampling with laboratory analysis and solid phase microextraction sampling with field gas chromatography/mass spectrometry by military industrial hygienists.

The opinions or assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the United States Department of Defense or the Uniformed Services University of the Health Sciences. Rapid on-site detection and identification of environmental contaminants to which personnel may be exposed is often needed during military deployment situations. The availability of military industrial hygienists with capabilities for "complete" on-site exposure assessment of chemical species should allow detection and identification of a number of important stressors almost immediately following sample collection. Portable gas chromatography/mass spectrometry (GC/MS) provides a rapid and efficient separation of volatile and semivolatile organic analytes, accompanied by sensitive electron impact ionization-mass spectrometry (EI-MS) detection. The use of GC/MS in the field is limited, however, by equipment cost, complexity of the equipment, and the analytical process. Additionally, a skilled operator is needed to obtain useful separations and to interpret mass spectral data. To demonstrate benefits and limitations of "complete" exposure assessment capabilities, a previously unidentified complex mixture, produced by thermal dispersion of riot control agents, was examined. Established active sampling methods were used with laboratory analyses. Solid phase microextraction, a passive sampling method that simplifies preparation for GC/MS analysis, also was used with a field-portable GC/MS system. Both sampling/analysis methods were used to detect CS riot control agent-derived air contaminants dispersed from riot control type canisters through oxidizer-supported combustion of a chemical fuel.

Chemistry Techniques, Analytical↗