Review of Report on Long-Term Health Effects on Human Test Subjects from Army Testing of Biological and Chemical Agents, Drugs, Medications, and Substances

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Between 1942 and 1975, the U.S. Army conducted tests on human subjects to study the effects of a variety of agents, including chemical warfare agents, biological agents, medications, vaccines, and other substances. The tests investigated the immediate or short-term health effects from acute exposure to understand vulnerabilities to attack. Whether the exposures could have resulted in long-term health consequences to the test subjects has been assessed periodically, and the Army is required to notify subjects of information relating to potential health effects associated with exposure to the test agents. Most recently, a 2016 court injunction directed the Army to provide test subjects with new information about potential long-term health effects associated with their exposures, and to provide medical care if an injury or illness could be attributed to their participation in an Army chemical or biological testing program. In support of the first requirement, the Army contracted a report, Assessment of Potential Long-Term Health Effects on Army Human Test Subjects of Relevant Biological and Chemical Agents, Drugs, Medications and Substances: Literature Review and Analysis (the Report), to determine whether new information published since 2006 should be provided to the veterans.

At the request of the Army, the National Academies of Sciences, Engineering, and Medicine formed an ad hoc committee that was tasked with conducting an independent review of the Report. The committee assessed whether the Report appropriately identified potential long-term health effects that could have resulted from test exposures using an adequate weight-of-evidence approach. The general approach for evaluating agent- and outcome-specific associations as outlined in the Army Memorandum was also reviewed. An interim report of its overarching findings and their supporting evidence was prepared in February 2018. This final report provides additional detail about the basis of the committee's findings and recommendations. No new findings or recommendations have been added to this report.

Publication information

66 pages · 6 x 9 ·
ISBN Ebook: 0-309-47416-7
DOI: https://doi.org/10.17226/25065

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. Washington, DC: The National Academies Press.

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Ivan Rusyn

Ivan Rusyn is a professor in the Department of Veterinary Integrative Biosciences in the College of Veterinary Medicine and Biomedical Sciences, and chair of the Interdisciplinary Faculty of Toxicology at Texas A&M University. Before joining the university, he was a professor of environmental sciences and engineering at the University of North Carolina at Chapel Hill. Dr. Rusyn’s laboratory has an active research portfolio with a focus on the mechanisms of action of drugs and environmental toxicants, the genetic determinants of susceptibility to toxicant-induced injury, and computational toxicology. His studies on health effects of chemicals have resulted in over 190 peer-reviewed publications. He is currently on the Board of Scientific Councilors of the National Institute of Environmental Health Sciences and is a member of the Research Committee of the Health Effects Institute. He has served on several committees of the National Academies, including the Committee on Incorporating 21st Century Science into Risk-Based Evaluations and the Committee on the Design and Evaluation of Safer Chemical Substitutions. He currently serves as a member of the standing Committee on Toxicology. Dr. Rusyn received his MD from Ukrainian State Medical University in Kiev and his PhD in toxicology from the University of North Carolina at Chapel Hill.

Erin M. Bell

Erin M. Bell is associate professor in the Department of Epidemiology and Biostatistics and the Department of Environmental Health Sciences in the School of Public Health of the University of Albany. Her research interests are in environmental exposures, particularly to pesticides, as they are related to reproductive, immune, and cancer outcomes. She has served on several National Academies committees, including the Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides: Seventh, Eighth, and Tenth Biennial Updates. Dr. Bell received her MS in epidemiology from the University of Massachusetts–Amherst, and her PhD in epidemiology from the University of North Carolina at Chapel Hill.

Gerry R. Boss

Gerry R. Boss is professor of medicine at the University of California at San Diego. He is vice-chair for research in the Department of Medicine, and director of the physician-scientist training pathway. His research interests are in three areas, including signal transduction pathways involved in regulating cellular differentiation; nutrient control of purine synthesis and cellular metabolism; and developing the cobalamin (vitamin B12) analog cobinamide as a drug to treat cyanide, sulfide, and methanethiol poisoning, and to treat states of excess nitric oxide. Dr. Boss received his MD from the University of California at Irvine and completed an internal medicine residency at The Johns Hopkins Hospital.

James E. Cleaver

James E. Cleaver is professor emeritus in the Department of Dermatology and Department of Pharmaceutical Chemistry at the University of California at San Francisco. His research interests are in understanding human health risks from environmental carcinogens, with a particular focus on the relationship between DNA damage and repair and cancers of the skin, breast, colon, and hematopoietic system. Dr. Cleaver was elected to the National Academy of Sciences in 1999 for his discovery of the genetic defects in the initial steps of DNA excision repair in the human disease, xeroderma pigmentosum. He received his PhD from the Department of Radiotherapeutics from the University of Cambridge.

Pamela J. Lein

Pamela J. Lein is professor of neurotoxicology in the Department of Molecular Biosciences at the University of California at Davis School of Veterinary Medicine. Her research interests are in how environmental stressors interact with genetic susceptibilities to influence the risk and severity of neurodevelopmental disorders and neurodegeneration. Because altered patterns of connectivity are associated with neurological deficits, her research focuses on investigating how environmental contaminants, chemical convulsants, and inflammation perturb neuronal connectivity as determined using biochemical, morphogenic, and electrophysiological end points. Her group is also developing biomarkers of organophospate neurotoxicity and testing novel therapeutic approaches for protecting against the neurodegenerative effects associated with neurotoxic proconvulsants. Dr. Lein received her MS in environmental health East Tennessee State University and her PhD in pharmacology and toxicology from the State University of New York at Buffalo.

Catherine A. McCarty

Catherine A. McCarty is associate dean for research and professor in the Department of Biobehavioral Health and Population Sciences at the University of Minnesota Medical School. Before joining the university, she was head of the Epidemiology Research Unit in the Department of Ophthamology at the University of Melbourne, Australia, for eight years, and then was as a senior research scientist at the Marshfield Clinic Research Foundation, where she was principal investigator for the Personalized Medicine Research Project, a population-based biobank with more than 20,000 adult participants and 20 active research projects. Most recently, she was the Director of the Research Division at Essentia Institute of Rural Health in Duluth, MN. Dr. McCarty received her BS and MPH in nutrition from the University of Minnesota and her PhD in epidemiology from the University of Pittsburgh. She recently obtained an MS in bioethics from Clarkson University and Icahn School of Medicine at Mount Sinai.

Nu-May R. Reed

Nu-May Ruby Reed is a retired toxicologist with the California Environmental Protection Agency (Cal/EPA) Department of Pesticide Regulation, where she led risk-assessment issues in the Health Assessment Section. Her research interests are in evaluating health risks and developing risk assessment guidelines for pesticides. She has been on several Cal/EPA working groups that initiate, research, and revise risk-assessment guidelines and policies. Dr. Reed represented her department in task forces on community concerns and emergency response, risk-management guidance, and public education. She taught health risk assessment at the University of California, Davis, for more than 15 years. Dr. Reed served on several committees of the National Academies, including the Subcommittee on Fluoride in Drinking Water, the Standing Committee on Risk Analysis Issues and Reviews, and the Committee on Acute Exposure Guideline Levels. She received her PhD from the University of California at Davis.

Kenneth R. Still

Kenneth R. Still is a retired US Navy Captain in the Medical Service Corps. He served as the Senior Director of Safety and Occupational Health for the Commander of the US Pacific Fleet, Pearl Harbor, Hawaii, as well as the Officer-in-Charge of the Navy’s Toxicology Research Laboratory Program in Dayton, Ohio. He is currently an adjunct assistant professor at Portland State University in the OHSU-PSU School of Public Health where he teaches both graduate and undergraduate courses in environmental health. Dr. Still is also the scientific director and senior toxicology and industrial hygiene consultant for Occupational Toxicology Associates, Inc. which provides consulting services to industry, academia and governmental groups. His research interests include human health risk assessment, exposure assessment, occupational exposure guideline development, regulatory and inhalation toxicology. Dr. Still was a member of the National Academies Committee on Acute Exposure Guideline Levels, the Committee on Shipboard Hazard and Defense II, the Committee on Blue Water Navy Vietnam Veterans and Agent Orange Exposure, Committee on Evaluation of the VA’s Presumptive Disability Decision-Making Process and is a current member of the Committee on Toxicology. He received his PhD in physiological ecology from Oklahoma State University. He is a Fellow of the Academy of Toxicological Sciences and the American Industrial Hygiene Association.

Vasilis Vasiliou

Vasilis Vasiliou is professor and chair of the Department of Environmental Health Sciences at Yale University. His research interests include mechanisms of cellular responses to environmental stress, gene-environment interactions, alcohol toxicity, pharmacogenetics and the evolution of gene families. His research focuses on the role of aldehyde dehydrogenases (ALDHs) and glutathione (GSH) in metabolism, cellular responses to environmental stress and disease. He is a past president of the Mechanisms Specialty Section of the Society of Toxicology. He received his PhD in biochemistry from the Medical School of University of Ioannina, Greece.

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Review of Report on Long-Term Health Effects on Human Test Subjects from Army Testing of Biological and Chemical Agents, Drugs, Medications, and Substances

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