TAB D - Methodology

To estimate the health risks from such exposures, DoD adopted a health risk assessment methodology based on that used by the US Environmental Protection Agency. This process, illustrated in Figure 11, estimates the health risk from contaminant concentrations, site exposure, and contaminant toxicity characteristics. It consists of four steps: Hazard Identification, Dose Assessment, Toxicity Assessment, and Risk Characterization.

Figure 11. Health Risk Assessment Process

Hazard Identification determines who was exposed and how. This includes identification of: a) the possible contaminants (DU); b) individuals exposed to that contaminant; c) exposure pathways (such as inhalation); and d) which incidents need to be evaluated. Dose Assessment estimates the intensity, frequency, and duration of exposures to DU and what the chemical and radiological intakes these doses represent. Toxicity Assessment involves researching the medical effects of exposure to DU and at what levels of exposure these effects occurs. Risk characterization is the "bottom line" of the health risk methodology. Using both dose-assessment and toxicity assessment data, the risk assessment provides an explanation of the health risk from a given activity or exposure scenario. To arrive at this assessment, the Office of the Special Assistant for Gulf War Illnesses (OSAGWI) developed an investigation and validation process that includes:

• A detailed reconstruction of the conditions and circumstances surrounding the various exposure scenarios.
• Evaluation of available, pertinent environmental factors—e.g., radiological surveys, air quality monitoring, and other data as appropriate.
• Eyewitness testimonies.
• A review of operative policies, guidance, and directives in place at the time of the incidents in question.
• A review of actual practices and compliance with policies, guidance, and directives in force during the events in question, and identifying issues not adequately addressed by that guidance.
• A review of the existing body of scientific and medical data relative to known Gulf War exposure conditions and variables.
• Identification of information gaps and essential elements of information.
• Review of the current body of scientific and medical information on the health effects of DU.
• Preparation of detailed health risk assessments for each of the activities identified with potential DU exposure.

Performing this assessment for DU involves the cooperative efforts of several organizations, specifically;

• The Office of the Special Assistant for Gulf War Illnesses - Hazard Identification and Risk Characterization.
• US Army Center for Health Promotion and Preventive Medicine (USACHPPM) – Exposure and Risk Assessment.
• RAND Corporation - Toxicity Assessment.

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