An ad hoc committee of the National Academies of Sciences, Engineering, and Medicine (the National Academies) will recommend guidance on clinical actions that can be taken to monitor the health of community members exposed during the events associated with the May and November 2021 releases of Jet Propellant 5 (JP-5) aviation fuel from the Red Hill Bulk Fuel Storage Facility into the Joint Base Pearl Harbor-Hickam water distribution system. Specifically, the committee will undertake the following tasks:

• Engage with those exposed during the Red Hill fuel release, to gain knowledge and understanding of the issues, such as health conditions and symptoms; experiences with clinical care following the Red Hill exposure; and other pertinent information.
• Review current scientific evidence to determine potential long-term health risks of exposure to JP-5. The review will consider reports from authoritative bodies (such as the Veterans Health Administration, Environmental Protection Agency, National Toxicology Program, International Agency for Research on Cancer, and Agency for Toxic Substances and Disease Registry) that describe putative health effects following JP-5 exposure.
• Determine the strength of evidence for the spectrum of putative health effects following the Red Hill exposure, based on the review of current evidence. The committee will pay particular attention to health conditions and symptoms noted by those exposed during the Red Hill fuel release.
• Review existing clinical guidance for the health risks associated with exposure to JP-5, and, considering the harms and benefits of potential increased clinical follow-up for patients, issue evidence-informed clinical management recommendations in caring for patients exposed during the fuel release.
• Review any available exposure assessments and models created during the public health response to the Red Hill fuel release to determine how estimates of an individual’s exposure level could best inform clinical follow-up and care of patients.
• Provide recommendations on clinical surveillance, testing, and care for those exposed at Red Hill that the sponsoring agencies can consider when developing their clinical guidance for exposed patients.
• Identify research needs to support improved patient follow-up and decision-making for benefits for those exposed at Red Hill.