Environmental surveillance protects troops from invisible enemies

WASHINGTON, February 12, 2001 (GulfLINK) - Being deployed to foreign countries in support of humanitarian assistance, disaster relief, peacekeeping or the enforcement of arms sanctions means that U.S. servicemembers may be faced with potential exposures and risks that could have an impact on their future health. One agency working to reduce the impact of potentially harmful exposures to the health of deployed U.S. forces is the U.S. Army's Center for Health Promotion and Preventive Medicine.

The center - known as CHPPM - dispatches teams worldwide to provide technical expertise and services in the areas for occupational health, industrial hygiene, medical surveillance, laboratory and health promotion and services to commands located worldwide. Its history can be traced back more than 50 years to the Army Industrial Hygiene Laboratory, established at the beginning of World War II, under the direct jurisdiction of the Army Surgeon General.

Headquartered in Aberdeen Proving Ground, Md., with sub-commands in Maryland, Georgia, Washington, Germany and Japan, CHPPM is divided into seven directorates - Clinical Preventive Medicine, Environmental Health Engineering, Epidemiology and Disease Surveillance, Health Promotion and Wellness, Laboratory Sciences, Occupational Health Sciences and Toxiciology.

"When I started here, we were very concerned about the environmental impact of our garrison operations: our sewage plants, our incinerators, our power plants and the like," said John Resta, a program manager and 20-year employee. "Then we were concerned about the public health impact of our abandoned hazardous waste sites."

That all changed in 1991, when CHPPM personnel were sent to Kuwait to observe the more than 600 burning oil well fires set by retreating Iraqi forces. Many were concerned that exposure to the smoke from those fires could possible threaten the health of the troops. The information and data collected by Center personnel has helped investigators in the Special Assistant's Office for Gulf War Illnesses determine the possible health effects of servicemembers and has led them to play a greater role today in environmental surveillance for deployed troops.

"It's only been since Desert Storm that we became concerned about the modern environmental health aspect of deployment," said Resta. "It's mostly associated with industrial facilities. You can look at the Kuwaiti oil well fires as an example of an industrial facility gone bad."

As program manager for the deployment environmental surveillance program, Resta is responsible for overseeing environmental and occupational health surveillance for U.S. forces deployed to Bosnia and Kosovo. A team deployed to Bosnia in January 1996 to help augment active duty troops charged with collecting samples needed for environmental monitoring. His team of chemists, physicists, engineers, physicians, industrial hygienists, toxicologists, optometrists, audiologists, nurses and entomologists and other professionals test samples of the environment - air, water and soil - provided by active duty units to determine if there might be any potential harmful toxins.

"They're collecting samples, and we are supporting them back here with the laboratories," continued Resta. "We do the analysis and the health risk assessments associated with those samples."

At main base camp locations they assess whether air, soil, or water is contaminated to the point where it poses a health risk. Resta says these assessments are needed between two and four times each year, depending on local conditions.

"For things like soil and water, the conditions don't change that much," he says. "Air conditions change due to seasonal changes in weather. Also the frequency of testing is influenced by whether the industrial facilities adjacent to base camps are operating or have been shut down due to war damage."

More recently, CHPPM deployed a team of scientists from its Germany command in June 2000 to Macedonia to conduct an environmental health assessment of the Kosovo Forces rear headquarters area, home to approximately 400 KFOR troops. The headquarters is located in an abandoned shoe factory outside Skopje, which raised concerns of possible health affects because of the chemicals, glues and dyes used when the factory was operational.

The scientists performed an indoor air quality assessment, checking for heavy metals and particulates. They also tested building materials for asbestos and analyzed the communication equipment for any radiation hazards. Additionally, samples of the water and soil were tested for potentially harmful toxins. Although preliminary results revealed only a minimal risk, Center personnel continue monitor and make assessments at its laboratories.

The environmental surveillance project officer for Operations Allied Force and Joint Guardian in Bosnia and Kosovo is environmental engineer John Litynski. Litynski says that from an environmental standpoint, our forces are in safe places.

"There are no places over there where we have troops that we find any health hazard right now," Litynski said.

Resta is pleased with that assessment, and says that part of the reason for the good results is the work that was done before the deployment.

"In February 1999, we worked with the Armed Forces Medical Intelligence Center to identify where industrial hazards are present in Kosovo," said Resta. "They were able to identify the locations and the types of hazards that were present. We then made recommendations to the medical planners at U.S. Army Europe."

Based on those recommendations, no U.S. troop locations are near industrial facilities. According to Resta, because other allied forces did not perform this kind of pre-deployment assessment, they are experiencing some problems.

In addition to continued monitoring in Bosnia and its surrounding countries, Resta and his team have also done environmental monitoring in Haiti, Venezuela, Nicaragua, El Salvador and Honduras. Resta is also responsible for the ongoing efforts investigating potential adverse environmental health exposures during the Gulf War.

Resta says his team's work allows the Defense Department to document what exposures do occur so military doctors can determine if our servicemembers are at increased health risk and, if so, what kind of medical follow-up they would require.

While those field activities are vital, he says he has one other responsibility that might be even more important. He chairs the Joint Environmental Surveillance Workgroup, which is working to get this type of activity institutionalized throughout the military.

"The working group, which includes the Army, Navy and Air Force intelligence communities and joint staff, will come up with the necessary policy, guidance, procedures and equipment to make this a normal way of doing business," said Resta.

He says his team can do its job better if all the services use uniform procedures and take samples with the same equipment. He's been able to get good cooperation in the working group, and expects to see multi-service implementing guidance in the next few months.

"Within a year we hope everyone will do it the same way. We're very involved in that here because all data generated by DoD comes here. We are the data repository."

By monitoring and analyzing that data, CHPPM's engineers and scientists of the Deployment Environmental Surveillance Program work to keep American servicemembers from being exposed to potential environmental hazards wherever they deploy.