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Sandstorms, Oil Well Fires, Burning Trash--- Will that sand/smoke hurt me?

Sandstorms, Oil Well Fires, Burning Trash--- Will that sand/smoke hurt me?. Aug 2009. Coleen Baird, MD, MPH. UNCLAS. Aug2006. /MCHB-TS-MEM) 410-436-1010 / Veronique.Hauschild@amedd.army.mil. JCS MEMO, MCM 0006-02 Feb 2002 Updated Procedures for Deployment Health Surveillance. Requires:

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Sandstorms, Oil Well Fires, Burning Trash--- Will that sand/smoke hurt me?

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  1. Sandstorms, Oil Well Fires, Burning Trash--- Will that sand/smoke hurt me? Aug 2009 Coleen Baird, MD, MPH UNCLAS

  2. Aug2006 /MCHB-TS-MEM) 410-436-1010 / Veronique.Hauschild@amedd.army.mil JCS MEMO, MCM 0006-02 Feb 2002 Updated Procedures for Deployment Health Surveillance Requires: • Pre- and post- deployment health survey forms • Identification, assessment, and documentation • Immediate chain of command notification • Risk communication • Data available for epidemiologic evaluations • Documentation of area-specific exposure and monitoring summaries to be posted and accessible UNCLAS

  3. How are (chemical) OEH exposure Risk levels determined?

  4. Military Risk Matrix per FM 100-14 (FM 5-19); FM 3-100.12

  5. Army OEH Operational Risk Management (ORM) Assessments CY 2005

  6. Common OEH Hazards • Particular Matter (PM10 and increasingly PM 2.5) • Most common and significant deployment OEH hazards • Real-time health complaints • DNBI rates do not appear to be significantly impacted • Potential for long-term effects being investigated • Potable water quality • 3 types potable water • TB MED 577 standards often only hazards found • No real impact on DNBI rates or long-term health

  7. What is an OEH “incident”? • Presents a Moderate or higher level of operational risk • Presents a perceived or actual significant health risk to troops • Identified as a likely or known source of medically-related health outcomes NOTE: “Incidents” may be over before actual sampling is conducted or results are obtained

  8. Exposure Group A ▪ Military troop responders ▪ Critical>250 persons - mostly active duty ▪ Several reported acute effects during course of ~ 3 week response Exposure Group B ▪ Troops located a camp @ 5K away ▪ Exposures considered negligible Example Exposure Incidents of Interest Fire Incident, Iraq Summer 2004

  9. Example Exposure Incidents of Interest Ash Shuaiba Port/SPOD/E • Highly industrialized area • Routinely elevated PM10 levels (Moderate Risk) • Daily PM monitoring • Other sporadic short-term industrial chemical releases: • Sulfur dioxide, 2004 • Ammonia, 2006 • Standard SF600 has been generated and updated • For all troops medical records deployed to this site • Indicates no long term effects anticipated……..

  10. Example Exposure Incidents of Interest Sarin Incident, May 2004 • 2 Soldiers of EOD unit were exposed to Sarin (GB) • Signs: pin point pupils, blurred vision, nausea • Dx: Stable, no antidote administered • RBC indicated mild-moderate exposure • Non-symptomatic • Returned to light duty in 3 days • Other soldiers released with no signs/ symptoms • No long-term effects

  11. Example Exposure Incidents of Interest • Lead in air exposures exceed ‘no hazard’ criteria • Blood lead screening of returning troops per DoD Policy • No levels of concern noted • No additional follow up required • Current (2005-2006) air monitoring • Lower lead levels • PM10 Moderate Risk Camp War Eagle (Camp Hope) , Iraq 2004 – present

  12. Example Exposure Incidents of Interest • Collateral damage resulted in chemical release • 11 soldiers washed down, placed on oxygen, and observed • Equates to Critical severity/High risk • No specific follow up • Long-term effects not anticipated Bagdad Industrial Complex Chlorine Release, Iraq 2005

  13. Example Exposure Incidents of Interest • Prominent base with airfield • Notable dust/PM10 hazards – • Smoke from open trash-burning pits • Includes dioxins at Negligible risk • Routine health complaints • Several SF 600s developed (AF, Army) Balad (and Camp Anaconda) , Iraq 2004 – present

  14. Where does OEH related data go? • USACHPPM is designated DoD data repository for OEH data • Currently not capturing all DoD data • Moving towards DOEHRS - users can input and access info • Medical information (associated with OEH exposures) is not required to be reported with OEH data

  15. So, if you as a health care provider had a soldier report with complaintsof an chemical (e.g. chromium?) exposure during deployment …What would you do?Where would you go for information?What specific information/tools would you want?

  16. Deployment Exposures Website

  17. May 2006 /MCHB-TS-MEM) 410-436-1010 / Veronique.Hauschild@amedd.army.mil CHPPM POC INFORMATION Environmental Medicine Program US Army Ctr for Health Promotion and Preventive Medicine (USACHPPM) Bldg E1570 Stark Rd Aberdeen Proving Ground-Edgewood Area (APG-EA), MD 21010-5403 FAX 410-436-4117 Coleen B. Weese, MD, MPH(Program Manager) Coleen.Weese@amedd.army.mil ; coleen.weese@us.army.mil 410-436-2714 Veronique Hauschild, MPH Veronique.Hauschild@amedd.army.mil ; v.hauschild@us.army.mil 410-436-1010 UNCLAS

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