Exposure science for terrorist attacks and theaters of military conflict: minimizing contact with toxicants

Associations between environmental exposures in the Middle East Area of Operations and pregnancy outcomes in Australian Defence Force veterans

Military personnel deployed on operations may encounter a variety of hazards with the capacity to adversely affect reproductive health. This paper investigates the association between self-reported exposure to reproductive toxicants and adverse pregnancy outcomes in Australian Defence Force veterans who deployed to Iraq and Afghanistan during the period 2001-2009. Utilising the Middle East Area of Operations (MEAO) Census Study data set, descriptive analyses of participants' self-reported exposure were compared with the occupational environmental monitoring data taken at their reported deployment location. Univariate analyses assessed the significance of unadjusted associations between self-reported exposures and reproductive outcomes. There is no systematic or consistent relationship between deployment to the MEAO and adverse pregnancy outcomes. Overall, self-reported adverse reproductive outcomes were significantly increased in veterans who deployed to both Afghanistan and Iraq (p = 0.04) compared to those who only deployed to only one of those locations; particularly in women (p = 0.009). Miscarriage was the most likely of these (p = 0.008). These figures would benefit from being confirmed against medical records but are worthy of further study. In this historical cohort study, causal inference cannot be made due to absence of control groups to exclude sources of potential bias. Imprecision in the assessment of environmental hazards in the MEAO and other methodological constraints make it impossible to calculate precise estimates of risk. The results warrant continued investigation, especially when combined with previous findings related to pregnancy outcomes in this population, the importance of reproductive outcomes, and the potential emergence of new hazards.

Preparedness and response to chemical and biological threats: the role of exposure science

There are multiple components to emergency preparedness and the response to chemical and biological threat agents. The 5Rs framework (rescue, reentry, recovery, restoration, and rehabitation) outlines opportunities to apply exposure science in emergency events. Exposure science provides guidance and refined tools for characterizing, assessing, and reducing risks from catastrophic events, such as the release of hazardous airborne chemicals or biological agents. Important challenges to be met include deployment of assets, including medications, before and after an emergency response situation. Assessment of past studies demonstrates the value of integrating exposure science methods into risk analysis and the management of catastrophic events.

A method for evaluating aerosol leakage through the interface between protective suits and full-face respirators

Military personnel and first responders use a range of personal equipment including protective suits, gloves, boots, and respirators to prevent exposure of their skin and airways to hazardous chemical, biological, radiological, and/or nuclear substances. Although each individual item of personal protective equipment is well tested against existing standards, it is also necessary to consider the performance of the interfaces between items in terms of prevention from exposure, and the protection system as a whole. This article presents an aerosol challenge method for assessing the performance of the interface between a respirator and the hood of a protective suit. The interface is formed between the sealing strip of the hood and the surface of the respirator's outer sealing area and is affected by how well the sealing strip can cover and adapt to the sealing area. The method evaluates the leakage of particles of different sizes into the hood via the interface by particle counting at sampling points around the respirator's perimeter. Three different respirators were tested together with a single hood having a tight-fitting seal. The method variation between measurements was low but increased appreciably when the protective ensemble was re-dressed between measurements. This demonstrates the difficulty of achieving a reliable and reproducible seal between respirator and hood under normal conditions. Different leakage patterns were observed for the three respirators and were linked to some specific design features, namely the respirator's sealing area at the chin and its width at cheek level. Induced leak experiments showed that to detect substantial particle leakage, channels at the hood-respirator interface must be quite large. The method outlined herein provides a straightforward way of evaluating hood-respirator interfaces and could be useful in the further development of personal protective equipment.

Exposures of concern to veterans returning from Afghanistan and Iraq

There is a long history of Veterans returning from war with concerns regarding environmental hazards that they may have experienced while in theater. The author describes some of the tools in place within the Department of Defense to capture the frequency and nature of exposure concerns of returning troops. This article then reviews the exposures of concern to Service members returning from military service in the current and recent conflicts in Afghanistan and Iraq. The author then presents some of the recent published literature on these concerns. To address these exposure concerns of Veterans, there is then a brief discussion of a new program being put in place at the Department of Veterans Affairs.