Deployment of forces in hostile or unfamiliar environments is inherently risky. The changing missions and increasing use of U.S. forces around the globe in operations other than battle call for greater attention to threats of non-battle-related health problems--including infections, pathogen- and vector-borne diseases, exposure to toxicants, and psychological and physical stress--all of which must be avoided or treated differently from battle casualties. The likelihood of exposure to chemical and biological weapons adds to the array of tactical threats against which protection is required. The health consequences of physical and psychological stress, by themselves or through interaction with other threats, are also increasingly recognized. In addition, the military's responsibility in examining potential health and safety risks to its troops is increasing, and the spectrum of health concerns is broadening, from acute illness and injury due to pathogens and accidents to possible influences of low-level chemical exposures, which can manifest themselves in reproductive health and chronic illnesses years later, perhaps even after cessation of military service.

Strategies to Protect the Health of Deployed U.S. Forces develops an analytical framework for assessing risks, which would encompass the risks of adversed health effects from battle injuries, including those from chemical- and biological-warfare agents, and non-battle-related health problems. The presumed spectrum of deployment ranged from peacekeeping to full-scale conflict.

Contents

• THE NATIONAL ACADEMIES
• PRINCIPAL INVESTIGATOR
• BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY
• COMMISSION ON LIFE SCIENCES
• OTHER REPORTS OF THE BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY
• Preface
• Executive Summary
  • Approach to the Charge
  • Description of the Framework
  • Recommendations
• 1. Introduction
  • Assessing Health Risks to Deployed Forces
  • The Approach to the Task
  • Organization of the Report
• 2. Rationale and Objectives for Examining Risks to Deployed Forces
  • Deployment Environment
  • Degree and Nature of the Threat
  • Chemical and Biological Warfare Agents
  • Changing Nature of Deployment and Warfare
  • Changing Expectations and Establishing Trust
  • Need for Openness
  • Objectives for a Program of Assessing Risk to Deployed Forces
  • Summary and Conclusions
• 3. Existing Frameworks and Special Considerations
  • Existing Frameworks for Risk Assessment
  • Special Considerations about Risk Assessment for Deployment
  • Summary and Conclusions
• 4. A Framework for Assessing Risk to Deployed Forces
  • Ongoing Strategic Baseline Preparation and Planning
  • Specific Deployment Activities
  • Post-Deployment Activities
  • Summary and Conclusions
• 5. Considerations and Recommendations for Implementing the Framework
  • Areas of Emphasis for Implementing the Framework
  • Meeting the Stated Objectives for the Framework
  • Recommendations
• References
• Appendixes
  • A Abstracts of Commissioned Papers
  • B Biographical Information on Principal Investigator and Advisory Group

This project was supported by Contract No. DASW01-97-C-0078 between the National Academy of Sciences and the Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.