Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council

www.national-academies.org

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Sponsor: U.S. Department of Defense

Air Quality Management in the United States (2004)

Endangered and Threatened Species of the Platte River (2004)

Atlantic Salmon in Maine (2004)

Endangered and Threatened Fishes in the Klamath River Basin (2004)

Cumulative Environmental Effects of Alaska North Slope Oil and Gas Development (2003)

Estimating the Public Health Benefits of Proposed Air Pollution Regulations (2002)

Biosolids Applied to Land: Advancing Standards and Practices (2002)

Ecological Dynamics on Yellowstone’s Northern Range (2002)

The Airliner Cabin Environment and Health of Passengers and Crew (2002)

Arsenic in Drinking Water: 2001 Update (2001)

Evaluating Vehicle Emissions Inspection and Maintenance Programs (2001)

Compensating for Wetland Losses Under the Clean Water Act (2001)

A Risk-Management Strategy for PCB-Contaminated Sediments (2001)

Acute Exposure Guideline Levels for Selected Airborne Chemicals (4 volumes, 2000-2003)

Toxicological Effects of Methylmercury (2000)

Strengthening Science at the U.S. Environmental Protection Agency (2000)

Scientific Frontiers in Developmental Toxicology and Risk Assessment (2000)

Ecological Indicators for the Nation (2000)

Modeling Mobile-Source Emissions (2000)

Waste Incineration and Public Health (1999)

Hormonally Active Agents in the Environment (1999)

Research Priorities for Airborne Particulate Matter (4 volumes, 1998-2003)

Ozone-Forming Potential of Reformulated Gasoline (1999)

The National Research Council’s Committee on Toxicology: The First 50 Years (1997)

Carcinogens and Anticarcinogens in the Human Diet (1996)

Upstream: Salmon and Society in the Pacific Northwest (1996)

Science and the Endangered Species Act (1995)

Wetlands: Characteristics and Boundaries (1995)

Biologic Markers (5 volumes, 1989-1995)

Review of EPA's Environmental Monitoring and Assessment Program (3 volumes, 1994-1995)

Science and Judgment in Risk Assessment (1994)

Pesticides in the Diets of Infants and Children (1993)

Dolphins and the Tuna Industry (1992)

Science and the National Parks (1992)

Human Exposure Assessment for Airborne Pollutants (1991)

Rethinking the Ozone Problem in Urban and Regional Air Pollution (1991)

Decline of the Sea Turtles (1990)

Copies of these reports may be ordered from the National Academies Press

(800) 624-6242 or (202) 334-3313

www.nap.edu

Spacecraft Water Exposure Guidelines for Selected Contaminants, Volume 1 (2004)

Toxicologic Assessment of Jet-Propulsion Fuel 8 (2003)

Review of Submarine Escape Action Levels for Selected Chemicals (2002)

Standing Operating Procedures for Developing Acute Exposure Guideline Levels for Hazardous Chemicals (2001)

Evaluating Chemical and Other Agent Exposures for Reproductive and Developmental Toxicity (2001)

Acute Exposure Guideline Levels for Selected Airborne Contaminants, Volume 1 (2000), Volume 2 (2002), Volume 3 (2003), Volume 4 (2004)

Review of the US Navy’s Human Health Risk Assessment of the Naval Air Facility at Atsugi, Japan (2000)

Methods for Developing Spacecraft Water Exposure Guidelines (2000)

Review of the U.S. Navy Environmental Health Center’s Health-Hazard Assessment Process (2000)

Review of the U.S. Navy's Exposure Standard for Manufactured Vitreous Fibers (2000)

Re-Evaluation of Drinking-Water Guidelines for Diisopropyl Methylphosphonate (2000)

Submarine Exposure Guidance Levels for Selected Hydrofluorocarbons: HFC-236fa, HFC-23, and HFC-404a (2000)

Review of the U.S. Army’s Health Risk Assessments for Oral Exposure to Six Chemical-Warfare Agents (1999)

Toxicity of Military Smokes and Obscurants, Volume 1(1997), Volume 2 (1999), Volume 3 (1999)

Assessment of Exposure-Response Functions for Rocket-Emission Toxicants (1998)

Toxicity of Alternatives to Chlorofluorocarbons: HFC-134a and HCFC-123 (1996)

Permissible Exposure Levels for Selected Military Fuel Vapors (1996)

Spacecraft Maximum Allowable Concentrations for Selected Airborne Contaminants, Volume 1 (1994), Volume 2 (1996), Volume 3 (1996), Volume 4 (2000)

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Military deployments include a spectrum of military activities ranging from peace-keeping, humanitarian, and nation-building missions to combat. In deployment situations, commanders must consider and balance a variety of hazards to the mission and to the health of their troops. To facilitate consideration of chemical threats in the decision-making process for mission planning, the U.S. Army has developed two technical guides (Technical Guide 230 and Technical Guide 248) and one reference guide (Reference Document 230) that outline a process by which chemical hazards can be characterized in terms of their health risks and categorized in terms of their impact on the mission (e.g., mission capable, combat ineffective). A key element of the guidance was the establishment of military exposure guidelines (MEGs) for air, water, and soil that are to be used for assessing the significance of field exposures to chemical hazards during deployment.

In this report, the National Research Council’s (NRC) Subcommittee on Toxicological Risks to Deployed Military Personnel evaluates the Army’s three guidance documents for their scientific validity and adequacy in characterizing chemical risks for comparison with other health and operational risks. Specifically, the subcommittee evaluated the adequacy of the proposed MEGs for assessing risks to soldier health and missions, the methods and special military considerations that should be used in developing exposure guidelines, and the application of the guidelines.

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of

this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Germaine Buck, National Institute of Child Health and Human Development

Jeffrey Fisher, University of Georgia

Howard Kipen, University of Medicine and Dentistry of New Jersey

David Macys, University of Washington

Roger O. McClellan, Albuquerque, New Mexico

Lorenz Rhomberg, Gradient Corporation

Joseph Rodricks, ENVIRON International Corporation

Smita Siddhanti, EnDyna, Inc.

Palmer W. Taylor, University of California, San Diego

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Gilbert Omenn, University of Michigan, and Raymond Wymer, Oak Ridge, Tennessee. Appointed by the NRC, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

The subcommittee gratefully acknowledges the following individuals for making presentations and providing information to the subcommittee: LTC John Ciesla, U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM); Ellen Embry, Deputy Assistant Secretary of Defense for Force Health Protection; Robert Garrett, Armed Forces Medical Intelligence Center; Veronique Hauschild, USACHPPM; Jack Heller, USACHPPM; Joleen Mobley, USACHPPM; and Tony Pitrat, USACHPPM.

The subcommittee is also grateful for the assistance of the NRC staff in preparing this report. It particularly wishes to acknowledge the contributions of Susan Martel, project director, who coordinated the project and

contributed to the subcommittee’s report. Other staff members who contributed to this effort are Kulbir Bakshi, senior program officer for toxicology; Kelly Clark, assistant editor; Mirsada Karalic-Loncarevic, research associate; and Tamara Dawson, program assistant.

We would especially like to thank all the members of the subcommittee for their efforts throughout the development of this report.

Richard J. Bull, Chair

Subcommittee on Toxicological Risks to Deployed Military Personnel

Bailus Walker, Chair

Committee on Toxicology

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ACGIH

American Conference of Governmental Industrial Hygienists

AEGL

acute exposure guideline level

ATSDR

Agency for Toxic Substances and Disease Registry

BW

body weight

CCEG

chemical casualty estimating guideline

CEGL

continuous exposure guidance level

CSF

cancer slope factors

CWA

chemical warfare agent

EEGL

emergency exposure guidance level

ERPG

emergency response planning guideline

FDWS

field drinking water standards

GSD

geometric standard deviation

HA

health advisory

HEAST

health effects assessment summary tables

HI

hazard index

HQ

hazard quotient

HSDB

hazardous substance databank

IOM

Institute of Medicine

IRIS

Integrated Risk Information System

LOAEL

lowest-observed-adverse-effect level

MAF

military adjustment factor

MCGL

maximum contaminant level goal

MCL

maximum contaminant level

MEG

military exposure guideline

MCRC

military cancer risk concentration

MF

modifying factor

MRC

military risk concentration

MRL

minimal risk level

NAAQS

national ambient air quality standards

NIOSH

National Institute of Safety and Occupational Health

NOAEL

no-observed-adverse-effect level

NRC

National Research Council

OEH/ED

occupational and environmental health/endemic disease

ORM

operational risk management

OSHA

Occupational Safety and Health Administration

PEF

particulate emission factor

PEGL

permissible exposure guideline level

PEL

permissible exposure limit

PMEG-L

preliminary military exposure guidelines—long-term

PPE

personal protective equipment

PRG

preliminary remediation goal

PSI

pollution standard index

RBC

risk-based concentration

REL

recommended exposure level

RfC

reference concentration

RfD

reference dose

SPEGL

short-term public guidance level

SSL

soil screening level

STEL

short-term exposure level

TEEL

temporary emergency exposure limit

THQ

target hazard quotient

TLV

Threshold Limit Value

UF

uncertainty factor

VOC

volatile organic compound

Review of the Army’s Technical Guides on Assessing and Managing Chemical Hazards to Deployed Personnel

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