Reduction in lead exposures with lead-free ammunition in an advanced urban assault course

Environmental and health hazards of military metal pollution

An increasing body of literature has demonstrated that armed conflicts and military activity may contribute to environmental pollution with metals, although the existing data are inconsistent. Therefore, in this paper, we discuss potential sources of military-related metal emissions, environmental metal contamination, as well as routes of metal exposure and their health hazards in relation to military activities. Emission of metals into the environment upon military activity occurs from weapon residues containing high levels of particles containing lead (Pb; leaded ammunition), copper (Cu; unleaded), and depleted uranium (DU). As a consequence, military activity results in soil contamination with Pb and Cu, as well as other metals including Cd, Sb, Cr, Ni, Zn, with subsequent metal translocation to water, thus increasing the risk of human exposure. Biomonitoring studies have demonstrated increased accumulation of metals in plants, invertebrates, and vertebrate species (fish, birds, mammals). Correspondingly, military activity is associated with human metal exposure that results from inhalation or ingestion of released particles, as well as injuries with subsequent metal release from embedded fragments. It is also notable that local metal accumulation following military injury may occur even without detectable fragments. Nonetheless, data on health effects of military-related metal exposures have yet to be systematized. The existing data demonstrate adverse neurological, cardiovascular, and reproductive outcomes in exposed military personnel. Moreover, military-related metal exposures also result in adverse neurodevelopmental outcome in children living within adulterated territories. Experimental in vivo and in vitro studies also demonstrated toxic effects of specific metals as well as widely used metal alloys, although laboratory data report much wider spectrum of adverse effects as compared to epidemiological studies. Therefore, further epidemiological, biomonitoring and laboratory studies are required to better characterize military-related metal exposures and their underlying mechanisms of their adverse toxic effects.

Exposures to lead during urban combat training

Lead exposure is still a major concern for occupations that regularly train or work with firearms, such as law enforcement and military personnel. Due to the increasing number of women of fertile age in such professions, there is a strong incentive to monitor lead exposures during firearms training. Personal air sampling was performed during two sessions of a nine-day urban combat training (UCT) course for cadets in the Swedish Armed Forces, one session employing leaded ammunition (leaded scenario) and one session employing unleaded ammunition (unleaded scenario). Blood lead levels (BLLs) were measured before and after the course for 42 cadets and five instructors. During the leaded scenario, the instructors' airborne exposure (geometric mean, GM, 72.0 μg/m³) was higher than that of cadets (GM 42.9 μg/m³). During the unleaded scenario, airborne concentrations were similar for instructors and cadets and considerably lower than during the leaded scenario (GM 2.9 μg/m³). Despite comparably low external lead exposures during the course, we saw a statistically significant increase in systemic exposure for cadets (BLL GM increased from 1.09 to 1.71 μg/dL, p < 0.001). For the five instructors, notable differences were seen depending on task. The largest increase was seen for the two instructors performing close supervision during the leaded scenario (BLL GM increased from 2.41 μg/dL to 4.83 μg/dL). For the remaining three instructors the BLLs were unchanged (BLL GMs were 1.25 μg/dL before the course and 1.26 μg/dL after). None of the participants exceeded the applicable biological exposure limits, but extrapolating our findings shows that instructors in the leaded scenario may reach levels around 10 μg/dL after a year of repeated exposures. We conclude that comparably low airborne concentrations can contribute to the body burden of lead and that additional measures to reduce exposure are warranted, particularly for instructors.

Probabilistic pharmacokinetic modeling of airborne lead corresponding to toxicologically relevant blood lead levels in workers

The Department of Defense (DOD) commissioned the National Research Council (NRC) to assess the potential health effects associated with exposure of DOD personnel to lead (Pb) at firing ranges. In that report, NRC concluded that the current Occupational Safety and Health Administration permissible exposure limit and the blood lead levels (BLLs) on which it was based were not sufficiently protective of worker populations covered under the general industry standard. In support of future selection of an occupational exposure limit, the relationship of airborne Pb levels to BLLs is of interest to the DOD. A subset of the BLLs identified as relevant to the management of health risks of exposed workers was selected as targets for extrapolation to equivalent airborne Pb values. The existing O'Flaherty physiologically based pharmacokinetic model for Pb in humans was modified to facilitate probabilistic predictions of DOD worker population BLLs, including 95th percentile values, based on current worker characteristics. Workplace airborne Pb 8-h time-weighted average concentrations of 1.1, 4.0, 6.8, or 9.8 μg/m³ are anticipated to maintain BLLs below 5, 10, 15, or 20 μg/dl, respectively, in the vast majority of DOD workers exposed to Pb under full-time working lifetime occupational exposure.