Arthur P Lee | PubMed Health

PubMed2003

Estimating selected disease and nonbattle injury Echelon I and Echelon II outpatient visits of United States soldiers and Marines in an operational setting from corresponding Echelon III (hospitalizations) admissions in the same theater of operation.

Currently, disease and nonbattle injury estimates are based on hospital admission logs and not on battalion aid stations nor medical company patient logs. A significant amount of morbidity can be overlooked and can mislead commanders and their staffs into believing that their unit is at a higher strength level. The objective of this article is to provide a tool for estimating these "hidden" disease and nonbattle injury cases. Nine weeks of military hospitalization data (687 admissions) separated into 14 diagnosis categories were compared with respective outpatient morbidity data (12,109 outpatient visits) during Operation Restore Hope in Somalia in 1993. Proportionate values and 95% confidence intervals were calculated for 5 of the 14 diagnostic categories and total morbidity. These proportionate values were then used to show how disease and nonbattle injury (total and diagnosis category) could be estimated based on hospitalization admissions during a similar military operation. Mission and geographical location information should be considered when using this model, along with other medical planning publications.

Ambulatory Care Facilities↗

PubMedDate not supplied

Traditional sampling with laboratory analysis and solid phase microextraction sampling with field gas chromatography/mass spectrometry by military industrial hygienists.

The opinions or assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the United States Department of Defense or the Uniformed Services University of the Health Sciences. Rapid on-site detection and identification of environmental contaminants to which personnel may be exposed is often needed during military deployment situations. The availability of military industrial hygienists with capabilities for "complete" on-site exposure assessment of chemical species should allow detection and identification of a number of important stressors almost immediately following sample collection. Portable gas chromatography/mass spectrometry (GC/MS) provides a rapid and efficient separation of volatile and semivolatile organic analytes, accompanied by sensitive electron impact ionization-mass spectrometry (EI-MS) detection. The use of GC/MS in the field is limited, however, by equipment cost, complexity of the equipment, and the analytical process. Additionally, a skilled operator is needed to obtain useful separations and to interpret mass spectral data. To demonstrate benefits and limitations of "complete" exposure assessment capabilities, a previously unidentified complex mixture, produced by thermal dispersion of riot control agents, was examined. Established active sampling methods were used with laboratory analyses. Solid phase microextraction, a passive sampling method that simplifies preparation for GC/MS analysis, also was used with a field-portable GC/MS system. Both sampling/analysis methods were used to detect CS riot control agent-derived air contaminants dispersed from riot control type canisters through oxidizer-supported combustion of a chemical fuel.

Chemistry Techniques, Analytical↗