Between 1963 and 1969, the U.S. military carried out a series of tests, termed Project SHAD (Shipboard Hazard and Defense), to evaluate the vulnerabilities of U.S. Navy ships to chemical and biological warfare agents. These tests involved use of active chemical and biological agents, stimulants, tracers, and decontaminants. Approximately 5,900 military personnel, primarily from the Navy and Marine Corps, are reported to have been included in Project SHAD testing. In the 1990s some veterans who participated in the SHAD tests expressed concerns to the Department of Veterans Affairs (VA) that they were experiencing health problems that might be the result of exposures in the testing. These concerns led to a 2002 request from VA to the Institute of Medicine (IOM) to carry out an epidemiological study of the health of SHAD veterans and a comparison population of veterans who had served on similar ships or in similar units during the same time period. In response to continuing concerns, Congress in 2010 requested an additional IOM study. This second study expands on the previous IOM work by making use of additional years of follow up and some analysis of diagnostic data from Medicare and the VA health care system.

Between 1942 and 1975, the U.S. Army conducted tests on human subjects to study the effects of a variety of agents, including chemical warfare agents, biological agents, medications, vaccines, and other substances. The tests investigated the immediate or short-term health effects from acute exposure to understand vulnerabilities to attack. Whether the exposures could have resulted in long-term health consequences to the test subjects has been assessed periodically, and the Army is required to notify subjects of information relating to potential health effects associated with exposure to the test agents. Most recently, a 2016 court injunction directed the Army to provide test subjects with new information about potential long-term health effects associated with their exposures, and to provide medical care if an injury or illness could be attributed to their participation in an Army chemical or biological testing program. In support of the first requirement, the Army contracted a report, Assessment of Potential Long-Term Health Effects on Army Human Test Subjects of Relevant Biological and Chemical Agents, Drugs, Medications and Substances: Literature Review and Analysis (the Report), to determine whether new information published since 2006 should be provided to the veterans. At the request of the Army, the National Academies of Sciences, Engineering, and Medicine formed an ad hoc committee that was tasked with conducting an independent review of the Report. The committee assessed whether the Report appropriately identified potential long-term health effects that could have resulted from test exposures using an adequate weight-of-evidence approach. The general approach for evaluating agent- and outcome-specific associations as outlined in the Army Memorandum was also reviewed. An interim report of its overarching findings and their supporting evidence was prepared in February 2018. This final report provides additional detail about the basis of the committee's findings and recommendations. No new findings or recommendations have been added to this report.

In the early 1980s, two water-supply systems on the Marine Corps Base Camp Lejeune in North Carolina were found to be contaminated with the industrial solvents trichloroethylene (TCE) and perchloroethylene (PCE). The water systems were supplied by the Tarawa Terrace and Hadnot Point watertreatment plants, which served enlisted-family housing, barracks for unmarried service personnel, base administrative offices, schools, and recreational areas. The Hadnot Point water system also served the base hospital and an industrial area and supplied water to housing on the Holcomb Boulevard water system (full-time until 1972 and periodically thereafter). This book examines what is known about the contamination of the water supplies at Camp Lejeune and whether the contamination can be linked to any adverse health outcomes in former residents and workers at the base.

More than 5,800 military personnel, mostly Navy personnel and Marines, participated in a series of tests of U.S. warship vulnerability to biological and chemical warfare agents, Project SHAD (Shipboard Hazard and Defense), in the period 1962-1973. Only some of the involved military personnel were aware of these tests at the time. Many of these tests used simulants, substances with the physical properties of a chemical or biological warfare agent, thought at the time to have been harmless. The existence of these tests did not come to light until many decades later. In September 2002, the Institute of Medicine (IOM) agreed to undertake a scientific study, funded by the Veterans' Affairs, of potential long-term health effects of participation in Project SHAD. In general, there was no difference in all-cause mortality between Project SHAD participants and nonparticipant controls, although participants statistically had a significantly higher risk of death due to heart disease, had higher levels of neurodegenerative medical conditions and higher rates of symptoms with no medical basis. Long-Term Health Effects of Participation in Project SHAD focuses on the potential health effects of participation in Project SHAD. It is a useful resource for government defense agencies, scientists and health professionals.

This edited volume surveys a variety of topics in statistics and the social sciences in memory of the late Stephen Fienberg. The book collects submissions from a wide range of contemporary authors to explore the fields in which Fienberg made significant contributions, including contingency tables and log-linear models, privacy and confidentiality, forensics and the law, the decennial census and other surveys, the National Academies, Bayesian theory and methods, causal inference and causes of effects, mixed membership models, and computing and machine learning. Each section begins with an overview of Fienberg’s contributions and continues with chapters by Fienberg’s students, colleagues, and collaborators exploring recent advances and the current state of research on the topic. In addition, this volume includes a biographical introduction as well as a memorial concluding chapter comprised of entries from Stephen and Joyce Fienberg’s close friends, former students, colleagues, and other loved ones, as well as a photographic tribute.

Gulf War and Health, Volume 2, is the second in a series of congressionally-mandated studies by the Institute of Medicine that provides a comprehensive assessment of the available scientific literature on potential health effects of exposure to certain biological, chemical, and environmental agents associated with the Gulf War. In this second study, the committee evaluated the published, peer-reviewed literature on exposure to insecticides and solvents thought to have been present during the 1990-1991 war. Because little information exists on actual exposure levels â€" a critical factor when assessing health effects â€" the committee could not draw specific conclusions about the health problems of Gulf War veterans. However, the study found some evidence, although usually limited, to link specific long-term health outcomes with exposure to certain insecticides and solvents. The next phase of the series will examine the literature on potential health effects associated with exposure to selected environmental pollutants and particulates, such as oil-well fires and jet fuels.

"In the fall of 1962, at the height of the Cold War, officers representing the three main military services, the Army, the Navy, and the Air Force, arrived at the Smithsonian Institution, in Washington. The officers were from the Desert Test Center, a new military installation in Fort Douglas, Utah. The chapter describes how these officers outlined a biological survey of various Pacific islands that they wanted to be undertaken. They were not forthcoming with their motives in wanting the survey, but Smithsonian officials volunteered to perform the survey using their own scientists and others to be hired as needed"--

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.

A fundamental challenge in past studies evaluating whether health problems experienced by Vietnam veterans might be linked to wartime use of Agent Orange or other herbicides has been a lack of information about the veterans' level of exposure to these herbicides. To address that problem, researchers developed a model to assess the opportunity for herbicide exposure among these veterans. The Utility of Proximity-Based Herbicide Exposure Assessment in Epidemiologic Studies of Vietnam Veterans presents the conclusions and recommendations of an Institute of Medicine committee (IOM) that was convened to provide guidance to the Department of Veterans Affairs (VA) about the best use of a model to characterize exposure to the troops based on their proximity to herbicide spraying in Vietnam. This book's assessment is guided by four primary considerations: to be clear about what the assessment model does and does not claim to do; to gain understanding of the strengths and limitations of data on herbicide spraying, troop locations, and health outcomes; to consider whether the model locates spraying and troops accurately to consider the potential contributions and pitfalls of using it in epidemiologic studies. Of particular interest in these deliberations were the degree to which exposure classification might be improved if the model were to be used, and the appropriate interpretation of the results of any such studies. In light of the questions that remain concerning herbicide exposure and health among Vietnam veterans and the array of evidence that has thus far been brought to bear on that issue, The Utility of Proximity-Based Herbicide Exposure Assessment in Epidemiologic Studies of Vietnam Veterans concludes that the application of this model offers a constructive approach to extending knowledge about the effects of herbicides on the health of these veterans and merits the initial steps recommended in our report.