1. Introduction December 3 rd, 2003 Presenting: DSBR Literature Recommendations VenusVal Hammack

2. Servicemen Workplace In the heat of battle/ conflict or training maneuvers, the serviceman occasionally does not have the time or supplies to protect themselves in a Chemical agent environment. This is where inadvertent adverse health exposures occur. During the 90-91 KTO troops where told to ignore the sounding NBC alarms.

3. Acta Medica (Hradec Kralove 9 articles from 1999 to 2003 treatment in rats Address Long term influence of low level sarin Japanese Research

4. Chromato Analysis J Chromatogr B Biomed Sci Appl J Chromatogr Sci J Mol Spectrosc J Chromatogr A Rapid detection & ID of chem agents immunoassay and enzyme inhibition

5. Chemical Analysis Chem Biol Interact Anal Chem J Am Chem Soc Analyst J Biol Chem. Catalyzed hydrolysis of nerve agent by metal compunds and dection of byproducts Recommended for Committee Review

6. Military Medicine Mil Med (3ea) J R Army Med Corps Mar 2003 study long term health effects sarin & other anticholinesterase Dec 2001 psycho- physiological effect of sarin Demonstrates Spin by DoD to minimalize health effects

7. Publications JAMA Sci Am Lancet BMJ Nature Better Kill through chemistry Address quality of life issues

8. Occupational Int J Occup Environ Health Environ Health Perspect J Hazard Mater Environ Sci Technol Close Review by Committee Recommended

9. Applied Toxicology Toxicol Appl Pharmacol Regul Toxicol Pharmacol Toxicol Ind Health Toxicol Lett Toxicol Sci Chem Res Toxicol Toxicology Recommended for Committee Review

10. Forensic J Health Polit Policy Law Int J Legal Med Leg Med (Tokyo). Forensic Sci Int Harefuah -Hebrew J Assoc Acad Minor Phys Recommended for Committee Review

11. Genetics Structure (Camb Nat Struct Biol Nat Med Nat Genet Clin Chim Acta - Laboratory Medicine Recommended for Committee Review

12. Toxicology Drug Chem Toxicol Food Chem Toxicol Fundam Appl Toxicol Hum Exp Toxicol. Bull Environ Contam Toxicol Arch Toxicol. J Anal Toxicol Recommended for Committee Review

13. Neurotoxicology J Clin Neurosci Neurochem Res Neurosci Biobehav Rev Neuroscience Synapse Need much closer attention

14. Pharmacogenetics J Pharmacol Exp Ther Indian J Physiol Pharmacol Med Lett Drugs Ther Trends Pharmacol Sci J Pharm Pharmacol Address prophilica interactions

15. Environmental Int J Occup Environ Health Environ Health Perspect Environ Sci Technol J Hazard Mater J Environ Health Address adverse exposures

16. Biotech Biotechnol Adv Biochemistry Biomed Environ Sci Biotechnol Adv. Biotechnol Bioeng Bioorg Med Chem Address sarin in human physiology

17. Summary Veterans demand that this Committee obtain and review the data from The U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) specifically Cholinesterase Reference Laboratory manages the external quality assurance and quality control program for RBC-ChE activity determinations in support of the nerve agent medical surveillance program.

18. Summary Red-blood cell-cholinesterase monitoring. Monitoring RBC-ChE by DOD contractors. Contractor may send the blood specimens to the USACHPPM Cholinesterase Reference Laboratory for primary Analysis. See study Evaluation of Airborne Exposure Limits for G- Agents: Occupational and General Population Exposure Criteria; ERDEC TR-489, Mioduszewski et al., April 1998 and an ERRATA, SAB, Johnson, 2000. Also other studies citations in handout.