1. AFGHANISTAN

2. Environmental Health Risks Greatest short-term risks are associated with ingestion of contaminated food/water, extreme heat/cold, high altitudeGreatest short-term risks are associated with ingestion of contaminated food/water, extreme heat/cold, high altitude Greatest long-term risks associated with air contamination and chemical contamination of food/waterGreatest long-term risks associated with air contamination and chemical contamination of food/water

3. Environmental Issues Air Quality ContaminationAir Quality Contamination –Low Risk: Minimal health effects –High levels of particulate matter (PM10) able to reach the lungs recorded at Salerno, Kandahar, & Bagram –Short-term (less than or equal to 14 days duration) exposure presents a risk of temporary respiratory symptoms such as coughing, wheezing, and reduced lung function

4. Environmental Issues Soil ContaminationSoil Contamination –Localized to specific areas around industrial facilities, waste disposal ditches, and open sewage ditches –Significant exposure is unlikely Drinking Water ContaminationDrinking Water Contamination –Contaminated with raw sewage –One of the most significant health threats to deployed personnel –Sewage contamination of drinking water in urban areas is common

5. Infectious Disease Risk HIGH RISK for infectious diseases Inadequate Force Health Protection (FHP) measures, will place service members at risk and seriously jeopardize mission effectiveness

6. Infectious Diseases Foodborne and Waterborne DiseasesFoodborne and Waterborne Diseases –High Risk = Diarrhea, Hepatitis A, Typhoid Fever –Intermediate Risk = Brucellosis, Cholera, Hepatitis E FHP PrioritiesFHP Priorities –Consume food, water, ice only from US- approved sources –Wash your hands after using latrines and before eating (hand washing stations should be near latrines and dining facilities)

7. Infectious Diseases Vector-borne DiseasesVector-borne Diseases –High Risk = Malaria –Intermediate Risk = Crimean-Congo hemorrhagic fever, leishmaniasis, sand fly fever, typhus, West Nile fever FHP PrioritiesFHP Priorities –Use DEET on all exposed skin –Treat field uniforms with permethrin –Use bed nets in field conditions, treat with permethrin –Take your malaria medication as directed – if you have questions, ask!

8. Infectious Diseases Vector-borne DiseasesVector-borne Diseases –High Risk = Malaria –Intermediate Risk = Crimean-Congo hemorrhagic fever, leishmaniasis, sand fly fever, typhus, West Nile fever FHP PrioritiesFHP Priorities –Use DEET on all exposed skin –Treat field uniforms with permethrin –Use bed nets in field conditions, treat with permethrin –Take your malaria medication as directed – if you have questions, ask!

9. Infectious Diseases Animal-contact DiseasesAnimal-contact Diseases –High Risk = Rabies: among the highest in the world –Intermediate Risk = Anthrax, Q-fever FHP PrioritiesFHP Priorities –Avoid animal contact, especially if the animal exhibits strange behavior –No mascots –Report all animal bites and scratches

10. Infectious Diseases Sexually Transmitted DiseasesSexually Transmitted Diseases –Intermediate Risk = Gonorrhea, Chlamydia, HIV, Hepatitis B FHP PrioritiesFHP Priorities –Refrain from any sexual activity while on deployment (Adhere to General Order regarding this issue)

11. There will not be a sign like this. Water-borne Disease Intermediate Risk = leptospirosis FHP Priorities Avoid unnecessary contact with lakes, rivers, streams, and other surface water Infectious Diseases

12. Respiratory Diseases –Intermediate Risk = Tuberculosis, meningococcal meningitis FHP PrioritiesFHP Priorities –Tuberculin skin test before and after deployment –72 sq ft/person and head-to-toe sleeping arrangement –Cough or sneeze into your upper sleeve instead of your hands –Wash hands at every opportunity –Avoid close contact with local population

13. Hazardous Animals AnimalsAnimals –Rabid dogs, poisonous snakes, centipedes, scorpions, spiders PlantsPlants –Mexican Poppy, Fetid Nightshade FHP PrioritiesFHP Priorities –Do not handle or feed animals –Shake out boots, clothing, & bedding –Do not touch, chew, eat, or burn unfamiliar plants

14. Summary Physical EnvironmentPhysical Environment Infectious Diseases = High RiskInfectious Diseases = High Risk Hazardous AnimalsHazardous Animals FHP measures are simple and effectiveFHP measures are simple and effective –Use and Enforce –Will conserve the fighting strength –Help ensure mission success COME HOME HEALTHY!!!COME HOME HEALTHY!!!

15. Summary Physical EnvironmentPhysical Environment Infectious Diseases = High RiskInfectious Diseases = High Risk Hazardous AnimalsHazardous Animals FHP measures are simple and effectiveFHP measures are simple and effective –Use and Enforce –Will conserve the fighting strength –Help ensure mission success COME HOME HEALTHY!!!COME HOME HEALTHY!!!