TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Controlled Human Inhalation-Exposure Studies at EPA SN - DO - 10.17226/24618 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24618/controlled-human-inhalation-exposure-studies-at-epa PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - The U.S. Environmental Protection Agency (EPA) has a mission and regulatory responsibility to protect human health and the environment. EPA’s pursuit of that goal includes a variety of research activities involving human subjects, such as epidemiologic studies and surveys. Those research activities also involve studies of individuals who volunteer to be exposed to air pollutants intentionally in controlled laboratory settings so that measurements can be made of transient and reversible biomarker or physiologic responses to those exposures that can indicate pathways of toxicity and mechanisms of air-pollution responses. The results of those controlled human inhalation exposure (CHIE) studies, also referred to as human clinical studies or human challenge studies, are used to inform policy decisions and help establish or revise standards to protect public health and improve air quality. Controlled Human Inhalation-Exposure Studies at EPA addresses scientific issues and provides guidance on the conduct of CHIE studies. This report assesses the utility of CHIE studies to inform and reduce uncertainties in setting air-pollution standards to protect public health and assess whether continuation of such studies is warranted. It also evaluates the potential health risks to test subjects who participated in recent studies of air pollutants at EPA’s clinical research facility. ER - TY - BOOK AU - Institute of Medicine TI - The Utility of Proximity-Based Herbicide Exposure Assessment in Epidemiologic Studies of Vietnam Veterans SN - DO - 10.17226/12059 PY - 2008 UR - https://nap.nationalacademies.org/catalog/12059/the-utility-of-proximity-based-herbicide-exposure-assessment-in-epidemiologic-studies-of-vietnam-veterans PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - 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. ER - TY - BOOK AU - National Research Council TI - Review of Submarine Escape Action Levels for Selected Chemicals SN - DO - 10.17226/10242 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10242/review-of-submarine-escape-action-levels-for-selected-chemicals PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - On-board fires can occur on submarines after events such as collision or explosion. These fires expose crew members to toxic concentrations of combustion products such as ammonia, carbon monoxide, hydrogen chloride, and hydrogen sulfide. Exposure to these substances at high concentrations may cause toxic effects to the respiratory and central nervous system; leading possible to death. T protect crew members on disabled submarines, scientists at the U.S. Navy Health Research Center's Toxicology Detachment have proposed two exposure levels, called submarine escape action level (SEAL) 1 and SEAL 2, for each substance. SEAL 1 is the maximum concentration of a gas in a disabled submarine below which healthy submariners can be exposed for up to 10 days without encountering irreversible health effects while SEAL 2 the maximum concentration of a gas in below which healthy submariners can be exposed for up to 24 hours without experiencing irreversible health effects. SEAL 1 and SEAL 2 will not impair the functions of the respiratory system and central nervous system to the extent of impairing the ability of crew members in a disabled submarine to escape, be rescued, or perform specific tasks. Hoping to better protect the safety of submariners, the chief of the Bureau of Medicine and Surgery requested that the National Research Council (NRC) review the available toxicologic and epidemiologic data on eight gases that are likely to be produced in a disabled submarine and to evaluate independently the scientific validity of the Navy's proposed SEALs for those gases. The NRC assigned the task to the Committee on Toxicology's (COT's) Subcommittee on Submarine Escape Action Levels. The specific task of the subcommittee was to review the toxicologic, epidemiologic, and related data on ammonia, carbon monoxide, chlorine, hydrogen chloride, hydrogen cyanide, hydrogen sulfide, nitrogen dioxide, and sulfur dioxide in order to validate the Navy's proposed SEALs. The subcommittee also considered the implications of exposures at hyperbaric conditions and potential interactions between the eight gases. Review of Submarine Escape Action Levels for Selected Chemicals presents the subcommittee's findings after evaluation human data from experimental, occupational, and epidemiologic studies; data from accident reports; and experimental-animal data. The evaluations focused primarily on high-concentration inhalation exposure studies. The subcommittee's recommended SEALs are based solely on scientific data relevant to health effects. The report includes the recommendations for each gas as determined by the subcommittee as well as the Navy's original instructions for these substances. ER - TY - BOOK AU - Institute of Medicine TI - Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam: Interim Findings and Recommendations SN - DO - 10.17226/10687 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10687/characterizing-exposure-of-veterans-to-agent-orange-and-other-herbicides-used-in-vietnam PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - From 1962 to 1971, US military forces sprayed more than 19 million gallons of herbicides over Vietnam to strip the thick jungle canopy that helped conceal opposition forces, to destroy crops that enemy forces might depend on, and to clear tall grass and bushes from around the perimeters of US base camps and outlying fire-support bases. Most large-scale spraying operations were conducted from airplanes and helicopters, but herbicides were also sprayed from boats and ground vehicles, and by soldiers wearing back-mounted equipment. After a scientific report concluded that a contaminant of one of the primary chemicals used in the herbicide called Agent Orange could cause birth defects in laboratory animals, US forces suspended use of the herbicide; they subsequently halted all herbicide spraying in Vietnam in 1971. At the request of the Veteran's Administration, the Institute of Medicine established a committee to oversee the development and evaluation of models of herbicide exposure for use in studies of Vietnam veterans. That committee would develop and disseminate a request for proposals (RFP) consistent with the recommendations; evaluate the proposals received in response to the RFP and select one or more academic or other nongovernmental research groups to develop the exposure reconstruction model; provide scientific and administrative oversight of the work of the researchers; and evaluate the models developed by the researchers in a report to VA, which would be published for a broader audience. Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam is the IOM's report that evaluates models of herbicide reconstruction to develop and test models of herbicide exposure for use in studies of Vietnam veterans. ER - TY - BOOK AU - National Research Council TI - Estimating Mortality Risk Reduction and Economic Benefits from Controlling Ozone Air Pollution SN - DO - 10.17226/12198 PY - 2008 UR - https://nap.nationalacademies.org/catalog/12198/estimating-mortality-risk-reduction-and-economic-benefits-from-controlling-ozone-air-pollution PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - In light of recent evidence on the relationship of ozone to mortality and questions about its implications for benefit analysis, the Environmental Protection Agency asked the National Research Council to establish a committee of experts to evaluate independently the contributions of recent epidemiologic studies to understanding the size of the ozone-mortality effect in the context of benefit analysis. The committee was also asked to assess methods for estimating how much a reduction in short-term exposure to ozone would reduce premature deaths, to assess methods for estimating associated increases in life expectancy, and to assess methods for estimating the monetary value of the reduced risk of premature death and increased life expectancy in the context of health-benefits analysis. Estimating Mortality Risk Reduction and Economic Benefits from Controlling Ozone Air Pollution details the committee's findings and posits several recommendations to address these issues. ER - TY - BOOK AU - National Research Council TI - Research Priorities for Airborne Particulate Matter: III. Early Research Progress SN - DO - 10.17226/10065 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10065/research-priorities-for-airborne-particulate-matter-iii-early-research-progress PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Transportation and Infrastructure AB - Regulatory standards are already on the books at the the U.S. Environmental Protection Agency (EPA) to address health risks posed by inhaling tiny particles from smoke, vehicle exhaust, and other sources. At the same time, Congress and EPA have initiated a multimillion dollar research effort to better understand the sources of these airborne particles, the levels of exposure to people, and the ways that these particles cause damage. To provide independent guidance to the EPA, Congress asked the National Research Council to study the relevant issues. The result is a series of four reports on the particulate-matter research program. The first two books offered a conceptual framework for a national research program, identified the 10 most critical research needs, and described the recommended timing and estimated costs of such research. This, the third volume, begins the task of assessing the progress made in implementing the research program. The National Research Council ultimately concludes that the ongoing program is appropriately addressing many of the key uncertainties. However, it also identifies a number of critical specific subjects that should be given greater attention. Research Priorities for Airborne Particulate Matter focuses on the most current and planned research projects with an eye toward the fourth and final report, which will contain an updated assessment. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Robert Pool TI - The Interplay Between Environmental Chemical Exposures and Obesity: Proceedings of a Workshop SN - DO - 10.17226/21880 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21880/the-interplay-between-environmental-chemical-exposures-and-obesity-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Environment and Environmental Studies AB - In March 2015, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore the role that chemical exposures may play in the development of obesity. The obesity epidemic that has gripped the United States and much of the developed world for the past several decades has proved remarkably resistant to the various approaches tried by clinicians and public health officials to fight it. This raises the possibility that, in addition to the continued exploration of consumer understanding and behavior, new approaches that go beyond the standard focus on energy intake and expenditure may also be needed to combat the multifactorial problem of obesity. The speakers at the workshop discussed evidence from both studies with animal models and human epidemiological studies that exposure to environmental chemicals is linked both to weight gain and to glucose tolerance, insulin sensitivity, inflammation, and other aspects of the metabolic syndrome. In addition to conventional environmental chemical exposures, this workshop also included one panel to discuss the potential role of other exposures, including sugar, artificial sweeteners, and antibiotics, in aiding or causing obesity. The participants also examined possible biological pathways and mechanisms underlying the potential linkages. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Research Council TI - Review of the Formaldehyde Assessment in the National Toxicology Program 12th Report on Carcinogens SN - DO - 10.17226/18948 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18948/review-of-the-formaldehyde-assessment-in-the-national-toxicology-program-12th-report-on-carcinogens PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - Many people in the United States are exposed to formaldehyde. Exposure can occur from environmental sources (for example, combustion processes, building materials, and tobacco smoke) or in occupational settings (for example, the furniture, textile, and construction industries). Formaldehyde exposure also has endogenous sources—it is produced intracellularly as a component of the one carbon pool intermediary metabolism pathway. Scientists have studied formaldehyde for decades to determine whether exogenous formaldehyde exposure may be associated with cancer in humans. In 1981, The National Toxicology Program (NTP) first listed formaldehyde in the 2nd Report on Carcinogens as "reasonably anticipated to be a human carcinogen". In 2011, NTP upgraded the listing of formaldehyde to "known to be a human carcinogen". Following the new listing, Congress directed the Department of Health and Human Services to arrange for the National Academy of Sciences to independently review formaldehyde's substance profile and listing. This report presents the findings and conclusions of the committee formed in response to the congressional request. Review of the Formaldehyde Assessment in the National Toxicology Program 12th Report on Carcinogens concurs with NTP that there is sufficient evidence in studies that had adequate characterization of relevant exposure metrics to enable a strong conclusion about the association between formaldehyde exposure and cancer in humans. Additionally, the authoring committee independently reviewed the scientific evidence from studies in humans, experimental animals, and other studies relevant to the mechanisms of carcinogenesis and made level-of-evidence conclusions. This report finds clear and convincing epidemiologic evidence of an association between formaldehyde exposure and nasopharyngeal and sinonasal cancers in humans. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Refinements to the Methods for Developing Spacecraft Exposure Guidelines SN - DO - 10.17226/21888 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21888/refinements-to-the-methods-for-developing-spacecraft-exposure-guidelines PB - The National Academies Press CY - Washington, DC LA - English KW - Space and Aeronautics KW - Environment and Environmental Studies AB - Human spaceflight is inherently risky, with numerous potential hazards posed at each phase of a mission. Potential health risks during spaceflights include short-term health consequences from being in microgravity, as well as long-term health consequences that arise, or continue, months or years after a flight. Additional health considerations are risks posed by exposure to environmental contaminants onboard spacecraft. Because the International Space Station and spacecraft are closed environments that require recirculation of air and water supplies, some contamination of the air and water will occur. Even with onboard air and water purification systems, chemicals will accumulate in the air and water as they recirculate or are recycled onboard. Therefore, it is necessary for the National Aeronautics and Space Administration (NASA) to identify hazardous contaminants and determine exposure levels that are not expected to pose a health risk to astronauts. NASA uses spacecraft maximum allowance concentrations (SMACs) and spacecraft water exposure guidelines (SWEGs) to provide guidance on acceptable exposures to air and water contaminants during normal operations and emergency situations. Refinements to the Methods for Developing Spacecraft Exposure Guidelines updates the methods for establishing SMACs and SWEGs and assists NASA with identifying chemicals that need updated SMACs or SWEGs and new chemicals for which these guidelines should be developed. ER - TY - BOOK AU - National Research Council TI - Fluoride in Drinking Water: A Scientific Review of EPA's Standards SN - DO - 10.17226/11571 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11571/fluoride-in-drinking-water-a-scientific-review-of-epas-standards PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - Most people associate fluoride with the practice of intentionally adding fluoride to public drinking water supplies for the prevention of tooth decay. However, fluoride can also enter public water systems from natural sources, including runoff from the weathering of fluoride-containing rocks and soils and leaching from soil into groundwater. Fluoride pollution from various industrial emissions can also contaminate water supplies. In a few areas of the United States fluoride concentrations in water are much higher than normal, mostly from natural sources. Fluoride is one of the drinking water contaminants regulated by the U.S. Environmental Protection Agency (EPA) because it can occur at these toxic levels. In 1986, the EPA established a maximum allowable concentration for fluoride in drinking water of 4 milligrams per liter, a guideline designed to prevent the public from being exposed to harmful levels of fluoride. Fluoride in Drinking Water reviews research on various health effects from exposure to fluoride, including studies conducted in the last 10 years. ER - TY - BOOK AU - National Research Council TI - Identification of Research Needs Relating to Potential Biological or Adverse Health Effects of Wireless Communication Devices SN - DO - 10.17226/12036 PY - 2008 UR - https://nap.nationalacademies.org/catalog/12036/identification-of-research-needs-relating-to-potential-biological-or-adverse-health-effects-of-wireless-communication-devices PB - The National Academies Press CY - Washington, DC LA - English KW - Computers and Information Technology AB - In recent years there has been a rapid increase in the use of wireless communications devices and a great deal of research has been carried out to investigate possible biological or human health effects resulting from their use. The U.S. Food and Drug Administration asked the National Research Council to organize a workshop to identify research needs and gaps in knowledge in the areas of dosimetry and exposure, epidemiology, human laboratory studies, mechanisms, and animal and cell biology. The workshop did not include the evaluation of health effects or the generation of recommendations relating to how identified research needs should be met. Some needs and gaps identified at the workshop include: (1) characterization of exposures from wireless devices and RF base station antennas in juveniles, children, fetuses, and pregnant women and (2) evaluation of devices that use newer technologies (e.g., texting, web-surfing). ER - TY - BOOK TI - PY - UR - PB - The National Academies Press CY - Washington, DC LA - English ER - TY - BOOK AU - National Research Council TI - Assessing the Human Health Risks of Trichloroethylene: Key Scientific Issues SN - DO - 10.17226/11707 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11707/assessing-the-human-health-risks-of-trichloroethylene-key-scientific-issues PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Health and Medicine AB - Trichloroethylene is a chlorinated solvent widely used as a degreasing agent in industrial and manufacturing settings. It is also used as a chemical intermediate in making other chemicals and is a component of products such as typewriter correction fluid, paint removers, adhesives, and spot removers. In 2001, EPA issued a draft health risk assessment and proposed exposure standards for trichloroethylene. PA's Scientific Advisory Board (SAB) reviewed the draft and it was issued for public comment. A number of scientific issues were raised during the course of these reviews. Assessing the Human Health Risks of Trichloroethylene identifies and assesses the key scientific issues relevant to analyzing the human health risks of trichloroethylene, considering pertinent toxicologic, epidemiologic, population susceptibility, and other available information, including relevant published scientific literature, EPA's 2001 draft health risk assessment of trichloroethylene, scientific and technical comments received by EPA from public and private sources, and additional relevant information to be provided by the sponsoring agencies. This report highlights issues critical to the development of an objective, realistic, and scientifically balanced trichloroethylene health risk assessment. Guidance for hazard characterization of trichloroethylene is presented in Chapters 2 through 10. Chapter 2 provides guidance for evaluating large sets of epidemiologic data. In Chapter 3, the committee applies this guidance as an example in its evaluation of the epidemiologic data on trichloroethylene and kidney cancer, and this example should help guide evaluations of other cancer risks. Chapter 3 also assesses new information on the kidney toxicity of trichloroethylene and its metabolites and potential modes of action. Chapters 4, 5, 6, 7, and 8 evaluate the key issues regarding liver toxicity and cancer, reproductive and developmental toxicity, neurotoxicity, respiratory tract toxicity and cancer, and immunotoxicity, respectively. However, the committee's review focused on mode-of-action information to understand how trichloroethylene might affect certain processes differently in different species. Chapter 9 discusses susceptibility to trichloroethylene and its metabolites, and Chapter 10 describes important factors in considering trichloroethylene in mixtures. Physiologically based pharmacokinetic models are evaluated in Chapter 11, and guidance is provided on future directions for model development. Finally, Chapter 12 considers issues related to dose-response assessment and quantitative assessment of risk. ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Update 2000 SN - DO - 10.17226/10098 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10098/veterans-and-agent-orange-update-2000 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - Veterans and Agent Orange: Update 2000 examines the state of the scientific evidence regarding associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. It is the fourth in a series of comprehensive reviews of epidemiologic and toxicologic studies of the agents used as defoliants during the Vietnam War. Over forty health outcomes in veterans and their children are addressed. Among the report's conclusions is that there is sufficient evidence of a link between exposure and the development of soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne in veterans. Additionally, it found that scientific studies offer "limited or suggestive" evidence of an association with other diseases in veterans—including Type 2 diabetes, respiratory cancers, prostate cancer, multiple myeloma and some forms of transient peripheral neuropathy—as well as the congenital birth defect spina bifida in veterans' children. ER - TY - BOOK AU - National Research Council TI - Toxicological Effects of Methylmercury SN - DO - 10.17226/9899 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9899/toxicological-effects-of-methylmercury PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Space and Aeronautics AB - Mercury is widespread in our environment. Methylmercury, one organic form of mercury, can accumulate up the aquatic food chain and lead to high concentrations in predatory fish. When consumed by humans, contaminated fish represent a public health risk. Combustion processes, especially coal-fired power plants, are major sources of mercury contamination in the environment. The U.S. Environmental Protection Agency (EPA) is considering regulating mercury emissions from those plants. Toxicological Effects of Methylmercury reviews the health effects of methylmercury and discusses the estimation of mercury exposure from measured biomarkers, how differences between individuals affect mercury toxicity, and appropriate statistical methods for analysis of the data and thoroughly compares the epidemiological studies available on methylmercury. Included are discussions of current mercury levels on public health and a delineation of the scientific aspects and policy decisions involved in the regulation of mercury. This report is a valuable resource for individuals interested in the public health effects and regulation of mercury. The report also provides an excellent example of the implications of decisions in the risk assessment process for a larger audience. ER - TY - BOOK AU - Institute of Medicine TI - Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence SN - DO - 10.17226/12649 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12649/secondhand-smoke-exposure-and-cardiovascular-effects-making-sense-of-the PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Data suggest that exposure to secondhand smoke can result in heart disease in nonsmoking adults. Recently, progress has been made in reducing involuntary exposure to secondhand smoke through legislation banning smoking in workplaces, restaurants, and other public places. The effect of legislation to ban smoking and its effects on the cardiovascular health of nonsmoking adults, however, remains a question. Secondhand Smoke Exposure and Cardiovascular Effects reviews available scientific literature to assess the relationship between secondhand smoke exposure and acute coronary events. The authors, experts in secondhand smoke exposure and toxicology, clinical cardiology, epidemiology, and statistics, find that there is about a 25 to 30 percent increase in the risk of coronary heart disease from exposure to secondhand smoke. Their findings agree with the 2006 Surgeon General's Report conclusion that there are increased risks of coronary heart disease morbidity and mortality among men and women exposed to secondhand smoke. However, the authors note that the evidence for determining the magnitude of the relationship between chronic secondhand smoke exposure and coronary heart disease is not very strong. Public health professionals will rely upon Secondhand Smoke Exposure and Cardiovascular Effects for its survey of critical epidemiological studies on the effects of smoking bans and evidence of links between secondhand smoke exposure and cardiovascular events, as well as its findings and recommendations. ER - TY - BOOK AU - Institute of Medicine A2 - Susan Thaul A2 - William F. Page A2 - Harriet Crawford A2 - Heather O'Maonaigh TI - The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests SN - DO - 10.17226/9697 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9697/the-five-series-study-mortality-of-military-participants-in-us PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues KW - Health and Medicine AB - More than 200,000 U.S. military personnel participated in atmospheric nuclear weapons tests between 1945 and the 1963 Limited Nuclear Test Ban Treaty. Questions persist, such as whether that test participation is associated with the timing and causes of death among those individuals. This is the report of a mortality study of the approximately 70,000 soldiers, sailors, and airmen who participated in at least one of five selected U.S. nuclear weapons test series1 in the 1950s and nearly 65,000 comparable nonparticipants, the referents. The investigation described in this report, based on more than 5 million person-years of mortality follow-up, represents one of the largest cohort studies of military veterans ever conducted. ER - TY - BOOK TI - Community Response to High-Energy Impulsive Sounds: An Assessment of the Field Since 1981 DO - 10.17226/9135 PY - 1996 UR - https://nap.nationalacademies.org/catalog/9135/community-response-to-high-energy-impulsive-sounds-an-assessment-of PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues KW - ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Update 1998 SN - DO - 10.17226/6415 PY - 1999 UR - https://nap.nationalacademies.org/catalog/6415/veterans-and-agent-orange-update-1998 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Third in a series of six congressionally mandated studies occurring biennially, this book is an updated review and evaluation of the available scientific evidence regarding the statistical association between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposures. As part of the review, the committee convened a workshop at which issues surrounding the reanalysis and the combination of existing data on the health effects of herbicide and dioxin exposure were addressed. This book builds upon the information developed by the IOM committees responsible for the 1994 original report, Veterans and Agent Orange, and Veterans and Agent Orange: Update 1996, but will focus on scientific studies and other information developed since the release of these reports. The two previous volumes have noted that sufficient evidence exists to link soft tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne with exposure. The books also noted that there is "limited or suggestive" evidence to show an association with exposure and a neurological disorder in veterans and with the congenital birth defect spina bifida in veterans' children. This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans organizations, researchers, and health professionals. ER - TY - BOOK AU - National Research Council TI - Environmental Epidemiology, Volume 2: Use of the Gray Literature and Other Data in Environmental Epidemiology SN - DO - 10.17226/5804 PY - 1997 UR - https://nap.nationalacademies.org/catalog/5804/environmental-epidemiology-volume-2-use-of-the-gray-literature-and PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Health and Medicine AB - Determining the health risks to humans of exposure to toxic substances in the environment is made difficult by problems such as measuring the degree to which people have been exposed and determining causation—whether observed health effects are due to exposure to a suspected toxicant. Building on the well-received first volume, Environmental Epidemiology: Hazardous Wastes and Public Health, this second volume continues the examination of ways to address these difficulties. It describes effective epidemiological methods for analyzing data and focuses on errors that may occur in the course of analyses. The book also investigates the utility of the gray literature in helping to identify the often elusive causative agent behind reported health effects. Although gray literature studies are often based on a study group that is quite small, use inadequate measures of exposure, and are not published, many of the reports from about 20 states that were examined by the committee were judged to be publishable with some additional work. The committee makes recommendations to improve the utility of the gray literature by enhancing quality and availability. ER -