In 1996, NATO issued guidance for the exposure of military personnel to radiation doses different from occupational dose levels, but not high enough to cause acute health effects-and in doing so set policy in a new arena. Scientific and technological developments now permit small groups or individuals to use, or threaten to use, destructive devices (nuclear, biological, chemical, and cyber-based weaponry, among others) targeted anywhere in the world. Political developments, such as the loss of political balance once afforded by competing superpowers, have increased the focus on regional and subregional disputes. What doctrine should guide decisionmaking regarding the potential exposure of troops to radiation in this changed theater of military operations? In 1995, the Office of the U.S. Army Surgeon General asked the Medical Follow-up Agency of the Institute of Medicine to provide advice. This report is the final product of the Committee on Battlefield Radiation Exposure Criteria convened for that purpose. In its 1997 interim report, Evaluation of Radiation Exposure Guidance for Military Operations, the committee addressed the technical aspects of the NATO directive. In this final report, the committee reiterates that discussion and places it in an ethical context.

Growing public concern about releases of radiation into the environment has focused attention on the measurement of exposure of people living near nuclear weapons production facilities or in areas affected by accidental releases of radiation. Radiation-Dose Reconstruction for Epidemiologic Uses responds to the need for criteria for dose reconstruction studies, particularly if the doses are to be useful in epidemiology. This book provides specific and practical recommendations for whether, when, and how studies should be conducted, with an emphasis on public participation. Based on the expertise of scientists involved in dozens of dose reconstruction projects, this volume: Provides an overview of the basic requirements and technical aspects of dose reconstruction. Presents lessons to be learned from dose reconstructions after Chernobyl, Three Mile Island, and elsewhere. Explores the potential benefits and limitations of biological markers. Discusses how to establish the "source term"â€"that is, to determine what was released. Explores methods for identifying the environmental pathways by which radiation reaches the body. Offers details on three major categories of dose assessment.

The United States has long recognized and honored the service and sacrifices of its military and veterans. Veterans who have been injured by their service (whether their injury appears during service or afterwards) are owed appropriate health care and disability compensation. For some medical conditions that develop after military service, the scientific information needed to connect the health conditions to the circumstances of service may be incomplete. When information is incomplete, Congress or the Department of Veterans Affairs (VA) may need to make a "presumption" of service connection so that a group of veterans can be appropriately compensated. The missing information may be about the specific exposures of the veterans, or there may be incomplete scientific evidence as to whether an exposure during service causes the health condition of concern. For example, when the exposures of military personnel in Vietnam to Agent Orange could not be clearly documented, a presumption was established that all those who set foot on Vietnam soil were exposed to Agent Orange. The Institute of Medicine (IOM) Committee was charged with reviewing and describing how presumptions have been made in the past and, if needed, to make recommendations for an improved scientific framework that could be used in the future for determining if a presumption should be made. The Committee was asked to consider and describe the processes of all participants in the current presumptive disability decision-making process for veterans. The Committee was not asked to offer an opinion about past presumptive decisions or to suggest specific future presumptions. The Committee heard from a range of groups that figure into this decision-making process, including past and present staffers from Congress, the VA, the IOM, veterans service organizations, and individual veterans. The Department of Defense (DoD) briefed the Committee about its current activities and plans to better track the exposures and health conditions of military personnel. The Committee further documented the current process by developing case studies around exposures and health conditions for which presumptions had been made. Improving the Presumptive Disability Decision-Making Process for Veterans explains recommendations made by the committee general methods by which scientists, as well as government and other organizations, evaluate scientific evidence in order to determine if a specific exposure causes a health condition.

The Medical Follow-up Agency is a national treasure for veterans and for long-term studies of health. Its data resources provide incomparable opportunities to follow very important populations and to ask creative questions about their well-being as well as the occurrence and significance of illness. The Twin Registry provides an opportunity to understand the impact of heredity on health and disease in a population of more than 16,000 pairs of twins (i.e., 32,000 veterans). The Medical Follow-up Agency is a living tribute to the vision, energy, and effectiveness of Michael E. DeBakey, M.D. Dr. DeBakey created the idea for the agency, obtained the appropriate approvals, staffed its initial creation, and 50 years later, spoke on the occasion of its golden anniversary. This sequence of events must be unique in the history of veterans' health and medical research.

Personal protective equipment (PPE) is critical for those dealing with toxic, infectious, and radioactive materials. An easily accessible guide for professionals and researchers in all PPE fields, this book takes a fresh look at how PPE is designed, selected, and used in today's emergency response environment where users may need to be protected against deliberately used chemical, biological, or radiological agents in terrorism or warfare scenarios as well as more traditional hazards. Covering the physics, chemistry, and physiology of these hazards, the book explains how PPE protects from various forms of hazards as well as how to use this information to select PPE against these highly hazardous substances for first responder or military users. The design of PPE and components plus relevant performance and evaluation standards are also discussed.