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Q. What is an environmental exposure report?
A. The Environmental and Occupational Exposures Division
is looking at experiences in the 1990-1991 Gulf War from a more universal approach
than previous investigations in general. An Environmental Exposures Report
looks to describe any of a variety of exposure opportunities in the 1990-1991 Gulf
War that would have occurred more universally, and that may have had an
impact on the health of 1990-1991 Gulf War participants.
Q. How do they differ from the case narratives that have
been published?
A. While previous case narratives mostly focused
on discrete events or specifically identifiable occurrences, the Environmental
Exposures Reports address events or exposures that had the potential to
be experienced by anyone participating in the 1990-1991 Gulf War. The approach comes
from a more universal perspective and includes personnel who share, or
may share, common exposure potentials as relates to their environment.
Q. How do these exposure papers affect previously announced
initiatives and actions?
A. The Environmental Exposures Reports will enhance
the body of knowledge OSAGWI, DoD, and the veteran population will have
at their disposal to better understand what occurred in the 1990-1991 Gulf War and
how it may relate to illnesses 1990-1991 Gulf War veterans may be experiencing.
Announced initiatives and actions will continue as appropriate. Additional
initiatives or actions may come from the findings reported in these papers.
Q. What is the significance of these reports?
A. Consistent with one of the charters of OSAGWI
to “leave no stone unturned,” Environmental Exposure Reports
will further describe events experienced by personnel in the 1990-1991 Gulf War
that may have had a long-term effect on their health. These reports will
add to the completeness of the story and better enable veterans, politicians,
medical personnel, media, and other interested parties to understand the
significance of 1990-1991 Gulf War events as they relate to illnesses experienced
by the veterans.
Q. What methodology do you use in developing the exposure
reports?
A. We have adopted an assessment methodology patterned
on that used by the U.S. Environmental Protection Agency. This process
estimates the health risk from contaminant concentrations, site exposure,
and contaminant toxicity characteristics. It consists of four steps: Hazard
Identification, Toxicity Assessment, Dose Assessment, and Risk Characterization,
defined below:
- Hazard Identification - who was exposed, and how? Which incidents
warrant a full investigation?
- Toxicity Assessment - what are the known medical effects of human
exposure? At what levels of exposure do these effects occur? How can
the effects be mitigated?
- Dose Assessment - how much of the contaminant were the troops exposed
to? What chemical or radiological doses do these intakes represent?
- Risk Characterization - using validated toxicity and dose information,
what medical effects can be anticipated? How serious are those effects?
How can the effects be communicated to those affected?
The former Office of the Special Assistant for Gulf War Illnesses (now Force Health Protection & Readiness Policy & Programs) has focused
its investigation on determining what happened, what exposures may have
occurred, and who may have been exposed. Exposures have been subdivided
into levels and scenarios so they can be related to toxicity and dose
information.
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