During the course OSAGWI’s pesticide exposure investigation, analysts identified several lessons learned. The recommended areas for improvements include: increased monitoring of host nation pesticide application; revised delousing procedures; improved training; improved supply distribution; formalized local purchase procedures; increased emphasis on personal protective equipment; revised record-keeping procedures; and more thorough occupational health surveillance. In addition, in October 1992, the Armed Forces Pest Management Board conducted a survey of several entomologists and PM personnel from the Army, Navy and Air Force on lessons learned during the Gulf War deployment.[101] Many of the issues identified in the completed questionnaires such as supply problems, communication difficulties and inconsistent command support parallel the issues and lessons learned resulting from the OSAGWI pesticides investigation. Tab C-4 includes a detailed overview of the Pest Management Board’s questionnaire.

A.  Host Nation Application

Host nation contractors frequently applied pesticides in and around areas where US servicemembers were quartered. Some US servicemembers indicated concerns with what they perceived as unsafe and improper handling procedures, or use of unknown or unsafe pesticides. An analysis of the Gulf War by the British Ministry of Defence identified a similar problem with pesticide applications by host nation personnel or by non-British servicemembers. The British have since adopted a procedure requiring supervision or monitoring of host nation applications.[102]

B.  Delousing

Delousing personnel were poorly prepared. They lacked adequate training, dependable lindane dispersal equipment, proper personal protective equipment, and effective oversight by PM personnel. In March 1994, the Armed Forces Pest Management Board (AFPMB) sent out a message directing that all military stocks of 1 percent lindane dust be turned in for disposal, as DoD was changing the treatment procedures for mass delousing. The message outlined three reasons for this action, including: 1) DoD is revising its delousing procedures; the indiscriminate application to all individuals without determining whether anyone is infected with lice is not a sound pest management practice; 2) Lindane is very persistent in the environment and has "suggestive evidence of carcinogenicity" according to the Environmental Protection Agency; and 3) discontinuing the use of lindane is consistent with the pesticide reduction goals established by the Defense Environmental Security Council.[103] Currently, DoD depends on showers, laundries, permethrin treated clothing, and international agencies (such as the Red Cross) to control the lice infestations of EPWs, displaced persons, and other infested populations.

C.  Training and Experience

The pesticides exposure investigation uncovered a significant number of incidents of pesticide misuse. Among these were personnel wearing flea and tick collars as personal repellents. Additionally, the inappropriate uses of pesticides (e.g., use of fly baits on dining tables and under cots) occurred on an individual basis.

The military placed inadequate emphasis on field sanitation supplies, equipment, preparation, and training prior to deployment. In-theater field sanitation team training varied from several hours to two or three days, and appears to have included only a brief discussion on pest control and pesticide issues.

The level of experience and hands-on training for pesticide applicators varied considerably, with many applicators having little or no application experience prior to their deployment to the Gulf. Some had expired certifications or had never been certified.

D.  Supply Distribution and Local Purchase

Supply distribution problems affected the availability of pesticide supplies and pest control equipment during the Gulf War. These problems resulted in the purchase of pesticides on the local market, some of which were not labeled in English, possibly leading to improper or inappropriate use.

E.  Equipment and Facilities

Pesticide applicators, including field sanitation team members, were ill-prepared to accomplish their mission because of missing or inoperable pest control equipment and inadequate personal protective equipment (PPE), including coveralls, goggles, and respiratory protection. There was also insufficient water for cleanup, along with a lack of cleanup and laundry facilities, which resulted in applicators wearing contaminated uniforms for extended time periods. In some instances, the inability to store equipment and pesticides properly contributed to concerns of equipment maintenance and pesticide stability.

F.  Record-keeping

Little information is known about which pesticide products military units actually had in their possession at the outset of the Gulf War. Similarly, while there is some information on which pesticides were turned in to the supply system, the amounts those units retained or disposed of are unknown. Since very little documentation exists on the levels of pesticides actually applied, the information contained in this report on pesticide usage was largely obtained through veteran interviews and based on veteran recall.

In 1996, Department of Defense Instruction 4150.7, "DoD Pest Management Program," initiated the requirement to record, report, and archive pesticide use. This requirement states, "Ensure that any pesticide applications, excluding arthropod skin and clothing repellents, performed during military operations are recorded using DD Form 1532-1, ‘Pest Management Maintenance Report,’ or a computer generated equivalent. The DoD Components shall establish a method to archive these records for permanent retention." In response to an August 1997 memorandum from the Under Secretary of Defense (Acquisition and Technology), the Army, Navy and Air Force[106] described the procedures in place for recording, reporting and archiving information on pesticide application. In addition, the Armed Forces Pest Management Board (AFPMB) issued an information paper, "DoD and Service Policy and Guidance on Recording, Reporting, and Archiving Pesticide Use During Military Operations,"[107] in May 2000. The paper provides a summary of DoD service policy and guidance related to pesticide use during military operations.

G.  Occupational Medical Surveillance

The services have inconsistent requirements for occupational health surveillance of pesticide applicators. Investigators found no evidence that an occupational medical surveillance program was in effect immediately before, during, or after personnel deployed to the Gulf. Also, in a contingency operation that involves Army units, the level of pesticide application done by field sanitation teams probably warrants their inclusion in a medical surveillance program.

Some steps have been taken to address the occupational health surveillance issue, but additional action is needed. DoD 6055.5-M Occupational Medical Surveillance Manual,[108] revised in May 1998, provides requirements for implementing a medical surveillance program. The pesticide applicator evaluations include the worker’s medical and occupational history, a physical examination (including a complete neurological exam), and cholinesterase testing. Field sanitation teams and delousing personnel should be considered for inclusion in the DoD 6055.5M medical surveillance program if it is likely they would apply organophosphate or carbamate pesticides. A capability for conducting cholinesterase tests in-theater needs to be developed. Post-deployment examinations of applicators should also be conducted.

H.  Communications

There is little documentation available indicating that there was any close communication between the various echelons of the PM community. While PM leadership personnel met periodically in Al Jubayl, many individuals were unable to attend, and no formal system existed to disseminate the information developed in these sessions throughout the theatre.

I.  Command Support

Command support for PM varied from poor to excellent. Historically, three times as many US soldiers have been lost to disease and nonbattle injury (DNBI) as to enemy action. The ultimate objective of a military force-success in battle-demands that servicemembers maintain a constant state of good health. That many early deploying Army units did not have trained field sanitation team members is an indicator that PM and field sanitation were not given adequate emphasis prior to deployment.

The Combat Lifesaver concept (to assure rapid response to medical emergencies in combat) might serve as a model for reinforcing the importance of PM and field sanitation teams.

To conserve the fighting strength, military leaders must emphasize effective PM and field sanitation measures during training and when deployed on contingency missions. As a minimum, the importance of the DoD Repellent System needs to be understood and emphasized.

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