Findings and Recommendations - Occupational Health and Workplace Monitoring at Chemical Agent Disposal Facilities - page 29

Recommendation 5c. The Army and its operating con-
tractors should automate as much as feasible important
medical information related to worker exposure to
facilitate epidemiological studies. Automated informa-
tion, available at the programmatic level, should
include, but should not be limited to, results of medical
examinations, evaluations of exposure to agents, mea-
surements of cholinesterase levels, heat-stress data, and
accident/injury information.

Recommendation 6b. The Army should thoroughly
investigate the need and opportunities for population-
based comparisons and/or epidemiological studies.

Finding 7. Just as advancing technology can be ex-
pected to provide better workplace chemical monitor-
ing techniques, rapidly advancing biotechnology can
be expected to provide more sensitive and specific
methods of measuring worker exposure to harmful sub-
stances. For instance, adducts of DNA and protein
formed by carcinogens that are alkylating agents, such
as sulfur mustard, can now be detected at very low lev-
els of exposure. Measurements of sulfur mustard ad-
ducts could be incorporated into the Army's medical
surveillance program for assessing low-level exposures
to blister agents. Future advances in genetics may pro-
vide new methods of screening for low-level exposures
in individuals and populations.

Recommendation 5d. The Army should consider
requiring that electronic records relating to potential
worker exposure to agent or other toxic chemicals be
stored in a common format and be available at a pro-
grammatic level.

Finding 6. Ongoing analyses of worker medical data
across disposal facilities could be a valuable tool for
identifying and minimizing health threats to workers.

Recommendation 7. The Army should keep abreast
of, and adopt where appropriate, developments in medi-
cal diagnostic techniques for detecting and quantifying
low-level exposures to toxic substances, including
research related to the use of DNA and protein adducts
as measures of toxicologically relevant metabolites.

Recommendation 6a. The Army should provide sum-
mary facility and cross-facility statistics annually on
the outcomes of key medical surveillance programs,
such as programs for exposures to chemical agents and
heat stress.