Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns that their postdeployment medical symptoms could have been caused by hazardous exposures or other deployment-related factors. Potential exposure to a broad range of CB and other harmful agents was not unique to Gulf operations. Hazardous exposures have been a component of all military operations in this century. Nevertheless, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of CB agents in theater and symptoms reported by military personnel. Particular attention has been given to the potential long-term health effects of low-level exposures to CB agents. In the spring of 1996, Deputy Secretary of Defense John White met with the leadership of the National Academies to discuss the DoD's continuing efforts to improve protection of military personnel from adverse health effects during deployments in hostile environments. Although many lessons learned from previous assessments of Operation Desert Shield/Desert Storm have been reported, prospective analyses are still needed. Strategies to Protect the Health of Deployed U.S. Forces: Force Protection and Decontamination, which addresses the issues of physical protection and decontamination, is one of four initial reports that will be submitted in response to that request. Specifically, this report includes a review and evaluation of the following areas: the adequacy of current protective equipment and protective measures (as well as equipment in development) the efficacy of current and proposed methods for decontaminating personnel and equipment after exposures to CB agents current policies, doctrine, and training to protect and decontaminate personnel and equipment in future deployments (i.e., major regional conflicts [MRCs], lesser regional conflicts [LRCs], and operations other than war [OOTWs]) the impact of equipment and procedures on unit effectiveness and other human performance factors current and projected military capabilities to provide emergency response

Nine years after Operations Desert Shield and Desert Storm (the Gulf War) ended in June 1991, uncertainty and questions remain about illnesses reported in a substantial percentage of the 697,000 service members who were deployed. Even though it was a short conflict with very few battle casualties or immediately recognized disease or non-battle injuries, the events of the Gulf War and the experiences of the ensuing years have made clear many potentially instructive aspects of the deployment and its hazards. Since the Gulf War, several other large deployments have also occurred, including deployments to Haiti and Somalia. Major deployments to Bosnia, Southwest Asia, and, most recently, Kosovo are ongoing as this report is written. This report draws on lessons learned from some of these deployments to consider strategies to protect the health of troops in future deployments. In the spring of 1996, Deputy Secretary of Defense John White met with leadership of the National Research Council and the Institute of Medicine to explore the prospect of an independent, proactive effort to learn from lessons of the Gulf War and to develop a strategy to better protect the health of troops in future deployments.

To guide mission planning, military decision makers need information on the health risks of potential exposures to individual soldiers and their potential impact on mission operations. To help with the assessment of chemical hazards, the U.S. Army Center for Health Promotion and Preventive Medicine developed three technical guides for characterizing chemicals in terms of their risks to the mission and to the health of the force. The report reviews these guides for their scientific validity and conformance with current risk-assessment practices. The report finds that the military exposure guidelines are appropriate (with some modification) for providing force health protection, but that for assessing mission risk, a new set of exposure guidelines is needed that predict concentrations at which health effects would degrade the performance of enough soldiers to hinder mission accomplishment.

Since the Gulf War ended in 1991, various constituencies, including a significant number of veterans, speculate that unidentified risk factors led to chronic, medically unexplained illnesses, and these constituencies challenge the depth of the military's commitment to protect the health of deployed troops. Despite general concurrence in findings to support these claims, few changes have been made at the field level. The most important recommendations remain unimplemented, despite the compelling rationale for urgent action. Protecting Those Who Serve illuminates these recommendations and government-developed plans that remain inactive due to a lack of authority within the Department of Defense, while describing the dangers that may result from failure to protect our forces in the field.

From the origin of the leak, to the amount of oil released into the environment, to the spill's duration, the 2010 Gulf of Mexico oil spill poses unique challenges to human health. The risks associated with extensive, prolonged use of dispersants, with oil fumes, and with particulate matter from controlled burns are also uncertain. There have been concerns about the extent to which hazards, such as physical and chemical exposures and social and economic disruptions, will impact the overall health of people who live and work near the area of the oil spill. Although studies of previous oil spills provide some basis for identifying and mitigating the human health effects of these exposures, the existing data are insufficient to fully understand and predict the overall impact of hazards from the Deepwater Horizon oil spill on the health of workers, volunteers, residents, visitors, and special populations. Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health identifies populations at increased risks for adverse health effects and explores effective communication strategies to convey health information to these at-risk populations. The book also discusses the need for appropriate surveillance systems to monitor the spill's potential short- and long-term health effects on affected communities and individuals. Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health is a useful resource that can help policy makers, public health officials, academics, community advocates, scientists, and members of the public collaborate to create a monitoring and surveillance system that results in "actionable" information and that identifies emerging health risks in specific populations.

For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the National Academies of Sciences, Engineering, and Medicine has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. Some of the health effects identified by past reports include post-traumatic stress disorders, other mental health disorders, Gulf War illness, respiratory effects, and self-reported sexual dysfunction. Veterans' concerns regarding the impacts of deployment-related exposures on their health have grown to include potential adverse effects on the health of their children and grandchildren. These concerns now increasingly involve female veterans, as more women join the military and are deployed to war zones and areas that pose potential hazards. Gulf War and Health: Volume 11 evaluates the scientific and medical literature on reproductive and developmental effects and health outcomes associated with Gulf War and Post-9/11 exposures, and designates research areas requiring further scientific study on potential health effects in the descendants of veterans of any era.