This page on PDHealth was created to provide information and assistance to healthcare providers
and Service members regarding potential deployment-related exposures. It contains links to fact sheets,
articles, Web pages and training materials. "The information includes materials targeted to the deployment-related
exposures listed on DD Form 2796, Post-Deployment Health Assessment (PDHA) and DD Form 2900, Post-Deployment
Health Reassessment (PDHRA).
GENERAL REFERENCES FOR DEPLOYMENT-RELATED EXPOSURES
- VA, Veterans Health Initiative
Healthcare Provider Training Program on the following topics: Agent Orange, Caring for War Wounded, Cold Injury, Endemic
Infectious Diseases of SW Asia, Gulf War, Health Effects from CBR Weapons, Hearing Impairment, Military Sexual Trauma, POW,
PTSD, Radiation, Spinal Cord Injury, Traumatic Amputation, Traumatic Brain Injury, Visual Impairment.
Disease Exposure References
- USAPHC PHN No: 0811-01, Clinical Protocol for the Management of Pneumonitis/Pneumonia in the US Central Command Area of Responsibility, Aug 11
- Institute of Medicine, Gulf War and Health Reports: Volume 5 Infectious Disease, 16 Oct 06 (including OIF and OEF)
This report is the fifth volume produced by IOM for VA in response to a congressional mandate. A committee of nationally recognized experts in infectious diseases was appointed to evaluate the scientific and medical literature on long-term adverse human health outcomes associated with selected infectious diseases pertinent to Gulf War veterans. The following pathogens were selected: Brucella species (spp.), the cause of brucellosis; Campylobacter spp., nontyphoidal Salmonella spp. and Shigella spp., which cause diarrheal disease; Coxiella burnetii, the cause of Q fever; Leishmania spp., the cause of leishmaniasis; Mycobacterium tuberculosis, which causes tuberculosis; Plasmodium spp., the cause of malaria; and West Nile virus, the cause of West Nile fever.
- USAPHC TG 273, Diagnosis and Treatment of Diseases of Tactical Importance to US Central Command, Oct 05
This Technical Guide was compiled to assist military physicians and physician assistants operating outside the continental United States (OCONUS) under the U.S. Central Command (USCENTCOM) manage diseases potentially found in that Area of Operations. The focus is on initial, not definitive, management outside of the hospital in assumed level of care I or II facility and a worst-case evacuation policy of 7 days.
- Emerging Health Concerns
(DHCC Web Page with information on the following topics: Acinetobacter, Acute Eosinophilic Pneumonia, Combat/Operational Stress, Depleted Uranium, Influenza, Leishmaniasis, Malaria, Mefloquine/Lariam, Metal Fragments, SARS, Sexually Transmitted Diseases, Traumatic Brain Injury, Tuberculosis and West Nile Virus.)
- Specific Conditions and Concerns (A-Z)
(DHCC Web Page with specific health conditions and concerns listed alphabetically.)
Chemical Exposure References
- USAPHC TG 230, Environmental Health Risk Assessment and
Chemical Exposure Guidelines for Deployed Military Personnel, Jun 10 This guide is a standard tool to assess and characterize chemical
exposures during deployments in a manner that is consistent with established joint military risk management doctrine. It provides a range of
military exposure guidelines (MEGs) that are health-based chemical concentrations in air, water, and soil for various military exposure scenarios
during deployments. (Supersedes USACHPPM TG 230,
- USAPHC Reference Document 230 Methodology for Determining Chemical Exposure Guidelines for Deployed
Military Personnel, Jun 10 Revision (This is the support document for USAPHC TG 230.)
- ATSDR Toxic Substances Portal
Department of Health and Human Services Agency for Toxic Substances and Disease Registry Web portal provides access to the best science, the latest research, and the most important information about toxic substances and how they affect health.
- NIOSH Pocket Guide to Chemical Hazards, NIOSH Publication No. 2005-149, Sep 05
The National Institute of Occupational Safety and Health produced this guide as a source of general industrial hygiene information on several hundred chemicals/classes for workers, employers, and occupational health professionals.
- TB MED 593, Guidelines for Field Waste Management, Sep 06
This bulletin provides technical guidance to the preventive medicine community on the proper management of waste in field settings. Types of waste include: solid nonhazardous waste (garbage and rubbish), hazardous and special waste, medical waste, human waste, and wastewater.)
- Weapons of Mass Destruction(DHCC Web Pages with information on biological, chemical and radiological WMDs and stress-related responses.)
Occupational/Environmental Health Surveillance References
- Air Force Manual 48-146, Occupational and Environmental Health Program Management, 9 Oct 12
(This manual implements requirements of AFPD 48-1, Aerospace Medicine Enterprise and AFI 48-145, Occupational and Environmental Health Program. It provides guidance on overall
Occupational and Environmental Health (OEH) program management and incorporates Risk Management (RM) principles into the OEH program.)
- Change 141, Manual of the Medical Department, U.S. Navy NAVMED P-117, 8 Jun 12 Chapter 22, Preventive
Medicine and Occupational Health (Totally revised content on Preventive Medicine and Occupational Health Programs.)
- Air Force Instruction 48-145, Occupational and Environmental Health Program,
15 Sep 11 (This AFI implements Air Force Policy Directive (AFPD) 48-1, Aerospace Medical Programs, DoD Instruction (DoDI) 6055.05, Occupational and Environmental Health and is
consistent with AFPD 90-8, Environment, Safety, and Occupational Health.)
- DoDI 6490.03, Deployment Health, 11 Aug 06, Certified Current as of 30 Sep 11
(Implements policies and prescribes procedures for deployment health activities, including deployment health assessments, for Joint and Service-specific deployments.)
USAPHC Technical Information Paper No., 64-002-1110, The Periodic Occupational and Environmental Monitoring Summary (POEMS)—History, Intent, and Relationship to
Individual Exposures and Health Outcomes, Nov 10
- CENTCOM Reg 220-1, Deployment
Health Surveillance and Force Health Protection, 24 Feb 10 (Implements policies and prescribes procedures for deployment health activities for Joint
and Service-specific deployments and exercises.)
- AR 11-35 Deployment Occupational Health and Environmental Health Risk Management, 16 May 07
Army Regulation which covers the policies, responsibilities, and procedures for managing risks associated with occupational
and environmental health threats during deployments.
- DoDI 6055.05, Occupational and Environmental Health (OEH), 11 Nov 08
This Department of Defense Instruction provides guidance for all activities related to preventing OEH-related illnesses for DoD personnel. OEH includes,
but is not limited to, industrial hygiene (IH), ergonomics, occupational and environmental medicine (OEM), epidemiology, hearing conservation, radiation
protection, OEH surveillance in military operations, engineering, and risk management of health hazards.
DoD 6055.05-M Occupational Medical Examinations and Surveillance Manual, 2 May 07, Incorporating Change 1, 16 Sep 08
This Department of Defense Manual provides health professionals with information and references appropriate for
developing, performing, interpreting, and conducting occupational medical examinations and surveillance for Service
members as well as DoD civilian based on identified health risks associated with specific jobs, processes, and exposures
- Navy And Marine Corps Public Health Center Technical Manual NMCPHC-TM OM 6260, Medical Surveillance Procedures Manual and Medical Matrix (Edition 11), Jul 11 (This manual establishes the minimum requirements for medical surveillance and certification examinations aimed at protecting workers who are exposed or potentially exposed to hazardous substances in the workplace.)
- Air Force Manual 48-155, Occupational and Environmental Health Exposure Controls, 1 Oct 08 This manual implements AFPD 48-1 and establishes procedures for determination of Occupational and Environmental Health (OEH) exposure controls.
- Air Force Manual 48-154 Occupational and Environmental Health Site Assessment, 28 Mar 07 .This manual standardizes procedures for developing and executing occupational and environmental health site assessments (OEHSA). This manual also provides guidance for occupational and environmental health (OEH) surveillance activities in both home station (i.e., garrison) and expeditionary (i.e., deployed) settings.
Environmental Surveillance References
CENTAF Memorandum, Policy for Documentation of Occupational and Environmental Conditions and Exposures, 10 Sep 03
This policy from US Central Command Air Forces: (a) directs CENTAF Medical Units to generate a site Environmental and Occupational Health Workplace Exposure Data (EOHWED) summary and place a copy into each members’ deployed medical record, (b) directs Bioenvironmental Engineering (BE) use of the Global Expeditionary Medical System (GEMS), (c) establishes new BE industrial hygiene program instructions, and (d) provides direction for documentation of deployment-site environmental conditions in an Environmental Health Site Assessment (EHSA).
- AF Handbook 10-222, Environmental Considerations for Overseas Contingency
Operations, 1 Sep 12 (This handbook contains guidance on environmental considerations for Air Force civil engineer personnel, including Air National Guard and AF
Reserve personnel deployed in support of OCONUS contingency operations. It outlines strategies for use in minimizing negative impacts on the mission resulting
from environmental health and safety hazards and environmental neglect.)
- USAPHC Fact Sheet 64-018-1111,
Summary of Evidence Statement: Chronic Respiratory Conditions and Military Deployment, May 12 (This document is intended to provide technical audiences with a
summary of the current scientific evidence regarding potential associations between deployment-related exposures and post-deployment chronic respiratory conditions.
This information may be used by health care personnel to brief leaders, other health care professionals, etc., as well as to assist with counseling individual
Service members and their Family members.)
- GAO Report 12-412, DOD Can Improve Its Response to Environmental Exposures on Military Installations,
1 May 12 (This report contains GAO's assessment of DoD policies on environmental exposures and DoD healthcare and compensation programs for individuals who sustained
environmental exposures. It also reviewed other federal programs for features that may aid in designing future compensation programs.)
- US Medicine, Article in 2011 Compendium of Federal Medicine, Where There's Smoke: DoD Investigates Causes of Deployment-Related Pulmonary Symptoms Reported by Troops
- Is Deployment Associated with an Increased Risk of Respiratory Outcomes? What Do We Know? What Do We Think?, The Army Medical Department Journal, pages 80-86, Jul-Sep 11
- VA 211A Training Letter 10-03, Environmental Hazards in Iraq, Afghanistan, and Other Military Installations, 26 Apr 10
- 2010 Military Health System Conference, Environmental Health Threats in Theater -- Lessons Learned Power Point Presentation, 26 Jan 10
- USAPHC Deployment Environmental Surveillance Program (DESP)
The primary function of DESP is deployment occupational and environmental health site (OEHS) data analysis, information production on detecting, assessing and
countering environmental health risks during deployments for world-wide Combatant Command locations. For Occupational and Environmental Surveillance Data at
Deployment Locations worldwide see:
- Military Exposure Surveillance Library (The MESL is a military information management
system available via the Internet. The system was developed to meet the requirements of Department of Defense (DoD) Directive 6490.2 which mandates the
establishment of a centralized repository for the collection of deployment occupational and environmental health surveillance (DOEHS) related data.
MESL Brochure, Feb 12)
- Periodic Occupational and Environmental Health Monitoring Summaries (POEMS) are available on the MESL. POEMS summarize the results of environmental
monitoring (e.g., air, water, soil) and surveys (e.g., endemic and infectious disease, noise, heat/cold, and other hazards) performed in theater.
History of POEMS
Exposure by Location References
- Deployments by Operation
This DHCC Web Page contains information relating to specific deployments organized by name of the operation.
The information includes backgrounds, health outcomes and concerns, climate and geography, preventive measures,
environmental exposures, and related links.
Deployments by Country
This DHCC Web Page contains information relating to specific deployments arranged by country. The information includes backgrounds, health outcomes and concerns, climate and geography, preventive measures, environmental exposures, and related links.
Deployment Atlas, Feb 04
This atlas was produced by the Deployment Health Clinical Center to provide Service members with important
information to help them stay healthy and safe during deployment. The information includes area-specific
descriptions of diseases and environmental exposures with recommendations for practical preventive measures.
The areas included in the atlas are: Afghanistan, Balkans, Iraq, Kuwait, Philippines, South Korea, West Africa,
and United States and Territories.)
CDC Health Information for International Travel (Yellow Book)
CDC publishes the Yellow Book every two years as a reference for those who advise
international travelers of health risks. The Yellow Book is written primarily for health care providers,
although others might find it useful.)
- World Health Organization (WHO) International Travel and Health Book
This report, which is updated annually, provides information on the main health risks for travelers.
PDHA/PDHRA-SPECIFIC DEPLOYMENT-RELATED EXPOSURES
Air Pollution (Sand/Dust/Particulate Matter)
Health Care Provider
Animal Bites (Rabies)
- CDC Rabies Web Page
- USAPHC Rabies Page
- Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2009 National Association of State Public Health Veterinarians, Inc. (NASPHV). MMWR 2009; 58 (RR-5)
Biological Warfare Agents
Blast or Motor Vehicle Accident
Health Care Provider
Chemical Warfare Agents
Fog Oils (Smoke Screen)
Human Body, Body Fluids, Body Parts, or Dead Bodies
Industrial Pollution - Toxic Chemicals
Health Care Provider
JP8 or Other Fuels
Other Exposures to Toxic Chemicals or Materials
Smoke from Burning Trash or Feces (Burn Pits)
Health Care Provider
- DoDI 4715.19, Use of Open-Air Burn Pits in Contingency Operations, 15 Feb 11
- Burn Pits Action Center Web Site (Created for people who would like more information about the burn pits, including the studies released by the military by a spokesperson for Congressman Tim Bishop.).
- USAPHC Just the Facts - Commander’s Guide to Medical Concerns Regarding Use of Burn Pits to Dispose of Solid Waste, December 2009 (Army Knowledge on Line)
- CNN.com Article, VA to Look into Effects of 'Burn Pits' on Veterans, 17 Mar 09
- USAPHC Fact Sheet, Balad Burn Pit, Dec 08
- Deployment Health and Family Readiness Library Fact Sheet, Burning Trash and Human Waste Exposures For Service Members and their Families, 1 Jul 08
- AFIOH Fact Sheet, Open Pit Burning, 23 Aug 04
- Agency for Toxic Substances and Disease Registry (ATSDR), Toxic Substances Portal - Polycyclic Aromatic Hydrocarbons (PAH)
Smoke from Oil Fire
Traumatic Brain Injury
Vehicle or Truck Exhaust Fumes