To facilitate the U.S. Department of State (DOS) in implementing one of its responsibilities to protect U.S. government employees and their family members overseas, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine will form a Standing Committee to Advise DOS on Unexplained Health Effects on U.S. Government Employees and their Families at Overseas Embassies. This standing committee will discuss best practices with DOS Bureau of Medical Services on topics including but not limited to health monitoring, medical interventions, risk assessment, and exposure mitigation for overseas locations that may present a higher risk of adverse health effects. The standing committee will evaluate current DOS practices for pre- and post-assignment health screening, provide expertise on potential epidemiologic studies, help with characterizing and understanding the current cases of potential acoustic trauma, and develop a better understanding of possible causes of these cases and approaches for future incidents whether of an apparent acoustic nature or a different environmental or clinical presentation. The standing committee will also keep DOS abreast of any emerging concerns, interventions, and protective measures as these come available. The standing committee will organize ongoing discussions, take on specific tasks and possibly issue classified and unclassified reports and recommendations on a variety of topics of importance to the DOS in regards to health effects from potential exposures overseas.
The standing committee will provide a forum for discussion of scientific, technical, and social issues relevant to effective health management and protection of staff and family members assigned to overseas locations. The standing committee will consider relevant scientific, technical, and policy issues including but not limited to:

• Review the current situation, to include discussions of epidemiologic investigations, case definitions, study methods, controls, and alternative hypotheses;
• Review the active research agenda, including defining what types of information ought to be collected and archived against possible future needs, and any potential additional studies needed;
• Assist in the optimization and design of screening protocols and assessment of treatment options, to include a review of currently available screening devices and technologies, appropriate level of baseline testing for a large number of personnel, and policy needs;
• Review of data, findings and conclusions generated by and for the U.S. government;
• Review of scientific evidence of possible causes and approaches to addressing potential future incidents of unexplained clusters of medical symptoms;
• Determine the need for collection of relevant environmental data (e.g., biologic, acoustic, radiologic, chemical, toxicological) that might be useful in current and future situations;
• Provide guidance on determining a clinical case definition.

The standing committee should:

• Provide a venue to enable discussions (not open to the public) relevant to DOS on emerging issues, research, and activities through in-depth knowledge of the sponsor’s programs, goals, and activities;
• Serve as a focal point for DOS policy discussions by experts and other leaders in the field, and;
• Respond to DOS’s needs for continuing dialogue related to their strategic thinking, health and medical care management and tracking.