Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure

Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure
Author: National Research Council
Publisher: National Academies Press
Total Pages: 199
Release: 2013-04-20
Genre: Medical
ISBN: 0309267366

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Lead is a ubiquitous metal in the environment, and its adverse effects on human health are well documented. Lead interacts at multiple cellular sites and can alter protein function in part through binding to amino acid sulfhydryl and carboxyl groups on a wide variety of structural and functional proteins. In addition, lead mimics calcium and other divalent cations, and it induces the increased production of cytotoxic reactive oxygen species. Adverse effects associated with lead exposure can be observed in multiple body systems, including the nervous, cardiovascular, renal, hematologic, immunologic, and reproductive systems. Lead exposure is also known to induce adverse developmental effects in utero and in the developing neonate. Lead poses an occupational health hazard, and the Occupational Safety and Health Administration (OSHA) developed a lead standard for general industry that regulates many workplace exposures to this metal. The standard was promulgated in 1978 and encompasses several approaches for reducing exposure to lead, including the establishment of a permissible exposure limit (PEL) of 50 μg/m3 in air (an 8-hour time-weighted average [TWA]), exposure guidelines for instituting medical surveillance, guidelines for removal from and return to work, and other risk-management strategies. An action level of 30 μg/m3 (an 8-hour TWA) for lead was established to trigger medical surveillance in employees exposed above that level for more than 30 days per year. Another provision is that any employee who has a blood lead level (BLL) of 60 μg/dL or higher or three consecutive BLLs averaging 50 μg/dL or higher must be removed from work involving lead exposure. An employee may resume work associated with lead exposure only after two BLLs are lower than 40 μg/dL. Thus, maintaining BLLs lower than 40 μg/dL was judged by OSHA to protect workers from adverse health effects. The OSHA standard also includes a recommendation that BLLs of workers who are planning a pregnancy be under 30μg/dL. In light of knowledge about the hazards posed by occupational lead exposure, the Department of Defense (DOD) asked the National Research Council to evaluate potential health risks from recurrent lead exposure of firing-range personnel. Specifically, DOD asked the National Research Council to determine whether current exposure standards for lead on DOD firing ranges protect its workers adequately.The committee also considered measures of cumulative lead dose. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure will help to inform decisions about setting new air exposure limits for lead on firing ranges, about whether to implement limits for surface contamination, and about how to design lead-surveillance programs for range personnel appropriately.

Noise and Military Service

Noise and Military Service
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 339
Release: 2006-01-20
Genre: Medical
ISBN: 0309099498

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The Institute of Medicine carried out a study mandated by Congress and sponsored by the Department of Veterans Affairs to provide an assessment of several issues related to noise-induced hearing loss and tinnitus associated with service in the Armed Forces since World War II. The resulting book, Noise and Military Service: Implications for Hearing Loss and Tinnitus, presents findings on the presence of hazardous noise in military settings, levels of noise exposure necessary to cause hearing loss or tinnitus, risk factors for noise-induced hearing loss and tinnitus, the timing of the effects of noise exposure on hearing, and the adequacy of military hearing conservation programs and audiometric testing. The book stresses the importance of conducting hearing tests (audiograms) at the beginning and end of military service for all military personnel and recommends several steps aimed at improving the military services' prevention of and surveillance for hearing loss and tinnitus. The book also identifies research needs, emphasizing topics specifically related to military service.

The 71F Advantage

The 71F Advantage
Author: National Defense University Press
Publisher: NDU Press
Total Pages: 529
Release: 2010-09
Genre: Psychology
ISBN: 1907521658

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Includes a foreword by Major General David A. Rubenstein. From the editor: "71F, or "71 Foxtrot," is the AOC (area of concentration) code assigned by the U.S. Army to the specialty of Research Psychology. Qualifying as an Army research psychologist requires, first of all, a Ph.D. from a research (not clinical) intensive graduate psychology program. Due to their advanced education, research psychologists receive a direct commission as Army officers in the Medical Service Corps at the rank of captain. In terms of numbers, the 71F AOC is a small one, with only 25 to 30 officers serving in any given year. However, the 71F impact is much bigger than this small cadre suggests. Army research psychologists apply their extensive training and expertise in the science of psychology and social behavior toward understanding, preserving, and enhancing the health, well being, morale, and performance of Soldiers and military families. As is clear throughout the pages of this book, they do this in many ways and in many areas, but always with a scientific approach. This is the 71F advantage: applying the science of psychology to understand the human dimension, and developing programs, policies, and products to benefit the person in military operations. This book grew out of the April 2008 biennial conference of U.S. Army Research Psychologists, held in Bethesda, Maryland. This meeting was to be my last as Consultant to the Surgeon General for Research Psychology, and I thought it would be a good idea to publish proceedings, which had not been done before. As Consultant, I'd often wished for such a document to help explain to people what it is that Army Research Psychologists "do for a living." In addition to our core group of 71Fs, at the Bethesda 2008 meeting we had several brand-new members, and a number of distinguished retirees, the "grey-beards" of the 71F clan. Together with longtime 71F colleagues Ross Pastel and Mark Vaitkus, I also saw an unusual opportunity to capture some of the history of the Army Research Psychology specialty while providing a representative sample of current 71F research and activities. It seemed to us especially important to do this at a time when the operational demands on the Army and the total force were reaching unprecedented levels, with no sign of easing, and with the Army in turn relying more heavily on research psychology to inform its programs for protecting the health, well being, and performance of Soldiers and their families."

Clinical Case Studies for the Family Nurse Practitioner

Clinical Case Studies for the Family Nurse Practitioner
Author: Leslie Neal-Boylan
Publisher: John Wiley & Sons
Total Pages: 432
Release: 2011-11-28
Genre: Medical
ISBN: 1118277856

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Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use.

Gulf War and Health

Gulf War and Health
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 358
Release: 2008-03-25
Genre: Technology & Engineering
ISBN: 0309101778

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The sixth in a series of congressionally mandated reports on Gulf War veterans' health, this volume evaluates the health effects associated with stress. Since the launch of Operation Desert Storm in 1991, there has been growing concern about the physical and psychological health of Gulf War and other veterans. In the late 1990s, Congress responded by asking the National Academy of Sciences (NAS) to review and evaluate the scientific and medical literature regarding associations between illness and exposure to toxic agents, environmental or wartime hazards, and preventive medicines or vaccines in members of the armed forces who were exposed to such agents. Deployment to a war zone has a profound impact on the lives of troops and on their family members. There are a plethora of stressors associated with deployment, including constant vigilance against unexpected attack, difficulty distinguishing enemy combatants from civilians, concerns about survival, caring for the badly injured, and witnessing the death of a person. Less traumatic but more pervasive stressors include anxiety about home life, such as loss of a job and income, impacts on relationships, and absence from family. The focus of this report, by the Institute of Medicine (IOM) Committee on Gulf War and Health: Physiologic, and Psychosocial Effects of Deployment-Related Stress, is the long-term effects of deployment-related stress. Gulf War and Health: Volume 6. Physiologic, and Psychosocial Effects of Development Related Stress evaluates the scientific literature regarding association between deployment-related stressors and health effects, and provides meaningful recommendations to remedy this problem.

Review of the Department of Defense Biokinetic Modeling Approach in Support of Establishing an Airborne Lead Exposure Limit

Review of the Department of Defense Biokinetic Modeling Approach in Support of Establishing an Airborne Lead Exposure Limit
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 49
Release: 2020-04-30
Genre: Nature
ISBN: 0309671922

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Biokinetic modeling provides a mathematical technique for estimating absorption, distribution, metabolism, and excretion of chemicals, including particles and metals, in humans. Such models can be used to relate the amount of lead external exposure to the amount of lead found in the blood and other tissues at different points in time. At the request of the Department of Defense (DoD), Review of the Department of Defense Biokinetic Modeling Approach in Support of Establishing an Airborne Lead Exposure Limit evaluates whether the model used by DoD to derive airborne lead concentrations from blood lead levels is appropriate. This report also considers whether DoD's modifications to the model are appropriately justified, and whether the assumptions in and inputs to the model are reasonable.

Neurological Effects of Repeated Exposure to Military Occupational Levels of Blast

Neurological Effects of Repeated Exposure to Military Occupational Levels of Blast
Author: Molly M. Simmons
Publisher:
Total Pages: 0
Release: 2020-06-30
Genre: Business & Economics
ISBN: 9781977402929

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There is increasing concern over the common, repetitive forms of blast to which military members are exposed during service, and how those exposures could affect the central nervous system. The authors of this report review the relevant literature.

Framework for environmental health risk management

Framework for environmental health risk management
Author: United States. Presidential/Congressional Commission on Risk Assessment and Risk Management
Publisher:
Total Pages: 80
Release: 1997
Genre: Administrative agencies
ISBN:

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Characterizing Lead Exposure at a U.S. Coast Guard Indoor Firing Range

Characterizing Lead Exposure at a U.S. Coast Guard Indoor Firing Range
Author: Melvin Alexis Torres
Publisher:
Total Pages: 127
Release: 2014
Genre:
ISBN:

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Exposure to airborne and settled dust at firing ranges is a well-known hazard that puts employees at risk for lead poisoning. Nine firearms instructors (FAIs) were studied over a 4-week period while working at a U. S. Coast Guard indoor firing range to determine if their work placed them at risk of overexposure to lead. Blood was collected at the beginning and end of the study to determine if a change in blood lead levels (BLLs) had occurred throughout the study. Questionnaires were also issued to obtain demographic, occupational, & extracurricular activity information to determine any other potential sources of lead exposure. Personal air lead exposures were measured for the instructors during weaponry qualification. To determine the effectiveness of range cleaning, surface wipes of lead dust before and after cleaning were collected from the floor. Mean BLLs from FAIs at baseline was 2.4 μg/dL compared to 2.3 μg/dL at the end of the study, more than 20 times below OSHA's standard of 40 μg/dL. Furthermore, the mean airborne lead was 2.7 μg/m3, also more than 20 times below OSHA's standard of 50 μg/m3. One of our hypotheses was to find a relationship between changes in BLL and mean airborne lead; however, no correlation was found. We also found no relationship between changes in BLL, mean airborne lead, the number of hours per month spent inside the range and the number of lead and jacketed rounds fired at the range. When evaluating the cleaning methods, paired t-tests were used to measure the post- to pre-cleaning differences for weekly and monthly cleaning practices. Statistically significant differences were found (p