USAARL Report No. 90-5

Health Hazard Assessment Primer0%

VBy

Bruce C. Leibrecht

Sensory Research Division

February 1990

Approved for public release; distribution unlimited.

United States Army Aeromedical Research LaboratoryFort Rucker, Alabama 36362-5292

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Health Ilazard Assessment Primer (U)12 PERSONAL AUTHOR(S)Leibrecht, Bruce C.

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16 SUPPLEMENTARY NOTATION

17 COSATI CODES 18 SUBJECT TERMS (Continue or. rtverS of rpectssary and identify by block number)

FIELD GROUP SUB-GROUP (U) health hazards, (U) materiel acquisition, (U) IWIPRINT,2 02 (U) health hazards research24 07

19 ABSTRFACT (Continue on reverse if necessary and idenrify by block number)

This primer provides an introductory orientation to the Health Hazard Assessment pr-gram sup orting the U.S. Anry's materiel acquisition efforts. The description of types andeffects of health hazards includes an inventory of those hazards commonly encxntered inArmy systems. Substantial text utlines the organizations and processes comprising the HHAsystem, along with an explanation of how the system is designed to work. A cceptualframework characterizes the steps involved in preparing a HHA report. A final sectiondescribes the program contributins made by HHA-related research and the organizationsperforming pertinent research. Swplement materials include a summary of the Army's lifecycle system management model, a listing of MHA points of contact, and a brief descriptionof risk assessment cdes.

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Preface

Developers of manned systems strive to field materiel whichis free of significant threats to the health of operators andsupport personnel. In pursuing this goal, the U.S. Army hasdeveloped a program for assessing health hazards of manned sys-tems such as combat weapons and vehicles. This document is anintroductory guide to that program. It is an integration of aseries of five articles which the author published in theMANPRINT Bulletin between June 1987 and January 1989. Sub-stantive materials have been added, especially regarding theArmy's materiel acquisition management model, risk assessmentcodes, and references.

COL J. D. LaMothe and COL Joel C. Gaydos provided invaluablecomments on the separate articles. Ms. Jimmie M. Henderson typedthe articles and subsequently collated them into a single docu-ment. MAJ Gary Shrum carefully reviewed drafts of the primer andmade recommendations for improvement.

This primer is dedicated to the memory of COL Edward L.Buescher, whose efforts were pivotal in establishing the Army'sHealth Hazard Assessment Program.

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II

Table of Contents

List of figures................................................. 2List of tables.................................................. 2Introduction.................................................... 3

Background................................................. 3Definitions................................................ 5Program objectives......................................... 5

The nature of health hazards.................................... 6Types of health hazards................................... 6Effects of health hazards.................................. 7

The HHA system.................................................. 8Participating organizations................................ 8Requirements documents review process..................... 8The HHA process............................................ 9

How the system works............................................ 11HHIA across the acquisition cycle........................... 11HHA services available.................................... 12

Preparing a health hazard assessment report..................... 13Format..................................................... 13Ingredients................................................ 13Preparation steps.......................................... 15

System analysis and hazard identification............ 15Data analysis......................................... 15Risk assessment...................................... 17Development of recommendations........................ 17Report finalization.................................. 19

Research supporting health hazard assessment.................... 19Research roles............................................. 19

Developing new tools................................. 19Special studies............... ....................... 21Test and evaluation.................................. 21

Research organizations.................................... 22Establishing research requirements......................... 23

conclusions..................................................... 23References...................................................... 25Glossary........................................................ 27

Appendix A. Inventory of systems health hazards............... 30Appendix B. Integrated life cycle system

management model................................. 35Appendix C. List of ERA points of contact...................... 38Appendix D. Risk assessment codes.............................. 39Appendix E. List of acronyms.................................. 41Appendix F. List of suggested readings......................... 43

.2......

List of figures

1. Diagram illustrating the six MANPRINT domains, withassociated policy documents .............................. 4

2. Schematic representing the system involved in gene-rating a HHAR .......................................... 10

3. Illustration of the sequence of steps involved in pre-paring a HHAR ......................................... 16

B-i. Schematic showing the sequential phases involved indeveloping Army materiel ............................. 36

B-2. Phase-by-phase depiction of the salient features of themanagement model which guides development of Armysystems ............................................. 37

List of tables

1. Categories of health hazards ................................. 62. Health hazard assessment services .......................... 123. HHAR format ................................................ 144. Health hazard control options ............................... 185. HHA tools ................................................. 206. MRDC health hazard laboratories ............................ 23

2

Introduction

The purpose of this primer is to provide an orientation tothe U.S. Army's Health Hazard Assessment (HHA) program formateriel systems. The primer is intended primarily for new HHAProgram participants, for doctrine and materiel developers, forparticipants in industry, and for biomedical researchers. Thefocus is on practical information in the context of the Army'smateriel acquisition process. The goal is to make available aready resource for individuals striving to eliminate or controlhealth hazards in Army systems.

Background

As Army institutions go, the HHA program is a relatively"new kid on the block." Although HHA-type activities wereconducted by the Army Medical Department during World War II(Gaydos, 1988), the current program's official beginnings traceback only to 1976, when questions about blast overpressurehazards surfaced in a general officer decision meeting for theArmy's new 155 mm towed howitzer. Early work was conductedinformally, and somewhat irregularly, by the U.S. Army MedicalResearch and Development Command, in alliance with the U.S. ArmyHuman Engineering Laboratory. In 1981, The Surgeon General ofthe Army approved the formal establishment of the HHA program,assigning specific responsibilities to participating elements ofthe Army Medical Department (AMEDD). It was not until late 1983that AR 40-10, the Army regulation governing HHA, was published.Since then the program has made great strides, providing keysupport to the Army's materiel acquisition efforts.

In 1985, the Army established a new program called MANPRINT,which stands for Manpower and Personnel Integration. MANPRINTemphasizes man-system integration--the incorporation of humanconsiderations into design and development of materiel systems toensure operability and supportability (AR 602-2). This new pro-gram places HHA under a common umbrella along with human factorsengineering, systems safety, manpower, personnel, and training(Figure 1). In terms of general approach and methods used, theHHA program shares much in common with the human factorsengineering and systems safety programs. The latter two havebeen involved intimately in HHA activities for many years andcontinue to play important roles. For example, safety assessmentreports (SAR) routinely address health hazard issues, as didhuman factors engineering assessments (HFEA) until recently.

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Definitions

A health hazard is defined as an existing or likely con-dition, inherent to the use of materiel, that can cause death,injury, acute or chronic illness, disability, and/or reduced jobperformance of personnel. Our materiel and operations are thefocus, not enemy weapons, operations or local infectious dis-eases. The "condition" referred to in the definition can stemfrom system design, the environment, doctrine, biogeography,operational peculiarities, misuse, or malfunction. Notice the"can cause" scope encompasses performance aspects; the interplaybetween biomedical effects and performance effects can be sub-stantive and complex.

Health hazard assessment refers to the process of identi-fying, evaluating, and controlling risks to the health and effec-tiveness of personnel who test, use, service, or support Armysystems. The HHA program mobilizes resources to apply biomedicalknowledge and principles in direct support of Army officials en-gaged in developing materiel systems. In civilian circles, HHAmost closely relates to aspects of occupational health, preven-tive medicine, environmental medicine, and industrial hygiene/safety. However, certain fundamentals, especially the emphasison operator-system interactions and unique aspects of militaryoperations, give the Army's HHA program a distinctive character.

Program objectives

The overall goals of the HHA program are (1) to bolster war-fighting capabilities by conserving or enhancing fightingstrength, and (2) to help ensure successful Army modernization ina safe, efficient, cost-effective manner. Program objectivesinclude: (a) preventing combat casualties and performance decre-ments caused by routine operation of our own combat systems; (b)enhancing soldier performance and system effectiveness; (c)reducing health-related readiness deficiencies; (d) reducingsystem retrofit requirements; anC (e) reducing disability com-pensation liabilities. In terms of policy, HHA stresses keyprinciples common to every MANPRINT domain--early and continuinginvolvement in system development, total system and total lifecycle evaluation, and emphasis on realistic, empirical data forassessment efforts.

5

The nature of health hazards

Types of health hazards

A variety of health hazards can affect directly the soldieroperating military systems. These hazards arise from character-istics of the system and the environment in which it operates.Chemically active substances abound in manufacturing, operating,and maintaining most systems. Normal operation of materiel sys-tems, components, assemblies, etc. produces energy in specificforms--mechanical, electromagnetic, thermal--as well as chemicalbyproducts. In the operational setting, environmental aspects--most notably, temperature extremes, humidity, wind, hign alti-tude, and biological substances--interact intimately with thesystem and its crewmembers. For Army purposes, these factors canbe organized into five major categoriec, shown in Table 1. Appen-dix A inventories the primary health hazards associated with Armysystems, differentiates basic forms, and lists generic sources.

Table 1.

Categories of health hazards.

Category Type

Mechanical forces Steady noiseImpulse noiseBlast overpressureVibrationShockTrauma

Chemical substances LiquidsGasesSolids

Biological substances MicroorganismsRadiation Visible light

InfraredUltravioletRadiofrequency energyLaser energyIonizing radiation

Environmental extremes Ambient heatAmbient coldOxygen deficiency

6

Effects of health hazards

Exposure to one or more health hazards does not necessarilyinjure a soldier or make him sick. The effects of a hazardousenvironment depend on intensity or amplitude, duration, number ofrepetitions, and other aspects of the exposure. They also maydepend on the physiological and psychological state of thesoldier at the time of exposure. The immediate functional impacton the soldier can range widely from negligible effects tocomplete incapacitation, even death. However, three generalfunctional states can be distinguished--performance limited,physiologically distressed, and incapacitated. On the lesssevere end of the spectrum, sensory decrements and/or minorinjury characterize performance limiting effects, leaving thesoldier capable of performing at a constructive level with, atmost, minor medical attention. Examples of this category areminor hearing loss, mild hypoxia, and muscle strain. Movingtoward more severe impacts, physiologically distressing effectscompromise seriously the soldier's capability to perform hiscombat role; they frequently involve psychological distressand/or moderate injury, and may require substantial medicalattention. Examples of this category are dizziness, moderatenausea,and severe fatigue. Incapacitating effects render thesoldier nonfunctional and incapable of caring for himself orherself. Examples include carbon monoxide poisoning, combatexhaustion, and serious burns.

Many (.f the effects of health hazards are not immediate--they may appear only after months or years of exposure. Whilesuch effects may not rap..dly impact the soldier's performance,they can limit his longterm contributions tc the Army and maycause serious health problems in the future. Examples ofdelayed, or "chronic," effects include cancers, organ systemdisorders (e.g., liver damage, severe hearing 'oss), psychiatricdisorders, birth defects, and cenetic mutations.

7

The HHA system

Participating organizations

Three components of the AMEDD exercise major roles inimplementing the HHA program: the Office of The Surgeon General(OTSG), the U.S. Army Health Services Command (HSC), and the U.S.Army Medical Research and Development Command (MRDC). To imple-ment TSG's Army Staff responsibilities, OTSG establishes HHApolicy and provides central coordination of the HHA program. Thelatter is accomplished by the Health Hazard Assessment Coor-dinator, who works in the Preventive and Military Medicine Con-sultants Division of the Professional Services Directorate, partof the U.S. Army Health Professional Support Agency. HSC, as theoperational health services provider for the Army, has primaryresponsibility for providing direct HHA support. Within HSC, theAcademy of Health Sciences (AHS) reviews requirements documentsand provides medical input to them, while the U.S. Army Environ-mental Hygiene Agency (AEHA) normally performs HHAs. At instal-lation Medical Department Activities (MEDDAC) and Medical Centers(MEDCEN), preventive medicine personnel provide local support atthe working group level. Finally, MRDC conducts biomedical re-search in support of HHA requirements and assists in conductingHHAs.

In addition to the AMEDD organizations mentioned above, theHHA program depends critically on nonmedical elements for suc-cessful implementation. The nonmedical participants include keyArmy General Staff agencies (especially the Office of the DeputyChief of Staff for Personnel--ODCSPER), the U.S. Army Trainingand Doctrine Command (TRADOC), the U.S. Army Materiel Command --AMC (including the Human Engineering Laboratory--HEL, and ele-ments of the Test and Evaluation Command--TECOM), the CombatSystems Test Activity (CSTA), the Operational Test and EvaluationAgency (OTEA), program executive officers (PEO), project andproduct managers (PM), the Army's systems safety community, andspecialists in industry. As with the other domains of MANPRINT,then, HHA is clearly a teamwork affair.

Requirements documents review process

Medical input to development of a new system begins withreview of the system's requirements documents. These documentsdefine and validate the need for the system and outline itsessential operating characteristics. The combat developer(CBTDEV--usually the TRADOC proponent) or the materiel developer(MATDEV--the program, project, or product manager), as appro-priate, submits draft system requirements documents to the AHSfor official review and input. Focusing on identification ofpotential health hazards and applicable health standards, the

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Academy's Combat Developments Directorate prepares comments andsends them back directly to the requesting developer. In prac-tice, unofficial input or advice may be obtained from AEHA orMRDC.

The HHA process

By regulation, a HHA is required for each materiel system,component, item, and product improvement, including nondevelop-mental items. The primary mechanism for accomplishing a HHA isthe HHA report (HHAR). This document provides a standard struc-ture and approach for assessing systems-generated threats to thehealth of crewmembers, maintainers, trainers, and other troops.The system involved in generating a HHAR is represented in Figure2.

The MATDEV is responsible for developing the best system hecan, free of as many health hazards as pczsible. To that end, heis required to submit, through command channels to OTSG, awritten request for a HHAR. The CBTDEV also may request a HHAR,usually in conjunction with user testing. Along with the requestgoes descriptive information on the system and how it will beused and, importantly, any test results related to health hazardissues. As the request proceeds through channels, key way-stations are the Command Surgeon's Offices in AMC and/or TRADOC.AMC Headquarters maintains a HHA officer who coordinates AMC'sHHA actions, while the TRADOC Surgeon's Office includes a healthstandards officer who reviews and tracks HHA activities. Whenthe request reaches OTSG, the HHA Coordinator designates anindependent medical assessor--normally AEHA, but occasionallyMRDC--to prepare a draft HHAR. (Actual preparation of the HHARis discussed in a later section.) When ready, the draft HHAR issubmitted to OTSG for review and final coordination. Afterfinalizing the HHAR, OTSG approves the document and forwards itthrough channels to the requesting developer.

What happens after the developer receives the approved HHARis perhaps the most important part of the HHA process. Theresolution of identified health hazard problems--follow-through--yields the real payoff to the Army. The MATDEV incorporateshealth hazard issues and concerns into milestone decisiondocuments, while the CBTDEV provides the user position on theacceptability of health risks. The formal materiel acquisitiondecision body (i.e., Defense Acquisition Board, Army SystemsAcquisition Review Council or In-Process Review) is responsiblefor verifying that a proper HHAR is completed and that appro-priate action is taken to resolve health hazard issues. Inimplementing the HHAR's recommendations, the MATDEV takes cor-rective actions to eliminate, reduce, or control health risksbefore systems are fielded. If health protection criteria are

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compromised in the materiel acquisition decision process, theMATDEV must document formally the risks accepted. It isessential procedures adopted to control health risks be incor-porated in technical and training pubications and materials (bythe combat, materiel, and training developers).

How the system works

HHA across the acquisition cycle

As with the other MANPRINT domains, HHA activities are inte-grated throughout all phases of a system's development and acqui-sition cycle. The basic cycle is illustrated in Appendix B.During the program initiation phase (Mission Area Analysis), theCBTDEV incorporates health hazard considerations and criteria inthe requirements document (Operational and Organizational Plan,Mission Need Statement, Training Device Need Statement), based oninput from the AHS and other AMEDD elements. Responsibilitiesand tasks needed to control potential health hazards are iden-tified in the System MANPRINT Management Plan (SMMP) prepared bythe MANPRINT Joint Working Group (MJWG), which includes medicalrepresentatives typically from a MEDDAC/MEDCEN.

In the concept exploration/definition phase, the CBTDEV andMATDEV ensure HHA requirements are included in program managementdocuments, especially the Test and Evaluation Master Plan (TEMP),the Integrated Logistics Support Plan (ILSP), and the AcquisitionPlan. They also obtain a HHAR from OTSG, submitting test andevaluation data related to health hazards for evaluation, ifavailable. Medical representatives on the MJWG help update theSMMP. The MATDEV incorporates HHA requirements in the requestfor proposal (RFP), based on AMEDD input. Responsible organ-izations obtain medical input to the System Safety Program Plan(SSPP), SAR, and related safety documents. OTSG, AEHA, MRDC, andMEDDACs/MEDCENs provide health hazard consultation as required.

During concept demonstration/validation, the formal require-ments document (Required Operational Capability--ROC, or TrainingDevice Requirement--TDR) specifically addresses health hazardconsiderations peculiar to the system. Medical personnel inputHHA requirements to the RFP for this phase. The CBTDEV, MATDEV,and independent evaluator collect health hazard data, which formthe basis for an updated HHAR. In turn, the updated HHAR pro-vides irput to the updated TEMP, SMMP, SSPP, and safety docu-ments. Actions to control health hazards are implemented by theMATDEV. AMEDD elements continue to furnish health hazard con-sultation, including direct test support when required in specialcases.

In the full-scale development phase, testers collect data

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requirred to address unresolved health hazard issues. To deter-mine the system's status in terms of health risks, the MATDEV ob-tains an updated HHAR from OTSG. The results of this evaluationare incorporated in the updated SMMP and safety documents. Con-tract specifications are developed and refined to ensure healthhazard requirements are met. The MATDEV implements correctiveactions required to control remaining health risks, and documentsmanagement decisions to accept risks compromising health protec-tion criteria.

As the system enters production and deployment, health haz-ard control procedures adopted as a result of HHAR recommend-ations are incorporated into technical publications and trainingmaterials. Where health hazard issues remain unresolved, testerscollect required data during postproduction testing (e.g., fol-low-on operational test and evaluation) and submit them to theAMEDD for review. Production testing yields data documentingsystem conforming with HHA-related contract specifications. TheMATDEV ensures engineering change proposals (ECP) receive properreview for health hazard implications. Decisions resolvingremaining health hazard issues are documented and implemented.

HHA services available

MATDEVs, CBTDEVs, training developers, testers, independentevaluators, logistics support developers, users, and others canobtain a variety of HHA services. Table 2 summarizes these ser-vices and the AMEDD organizations involved in providing them.

Table 2.

Health hazard assessment services.

SupportService Provider organizations

Consultation OTSG, AHS, AEHA, MRDC,MEDDAC/MEDCEN

Requirements document review AHS AEHA, MRDCProgram document review OTSG AEHA, MRDCWorking group representation OTSG AEHA, MRDC

MEDDAC/MEDCENSafety release approval OTSG MRDC,AEHA,

TRADOC SurgeonHuman volunteer approval OTSG MRDCData collection/analysis OTSG MRDC, AEHAHHAR OTSG AEHA, MRDCSpecial studies OTSG MRDC, AEHA

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To obtain the HHA services listed above, contact the appro-priate office from the list in Appendix C. ODCSPER updates per-iodically a list of MANPRINT participants which can be obtainedby writing: MANPRINT Points of Contact, HQDA (DAPE-MR), Wash-ington, DC 20310-0300.

Preparing a health hazard assessment report

To accommodate the lack of empirical data characteristic ofa system's early development, AR 40-10 defines two types ofHHARs. The Initial HHAR (IHHAR) comes into play during the con-cept exploration and early demonstration/validation phases. Thisreport addresses health hazards generically, identifyingpotential hazards and pertinent health standards based on fairlygross information about the system. During later phases ofdevelopment, as system prototypes and actual test data emerge,the regular HHAR provides a reasonably definitive accounting ofactual or prospective hazards. In the IHHAR, recommended actionstend to focus on future data requirements, while recommendationsin the HHAR typically specify corrective or precautionaryactions. The flexibility afforded by the IHHAR enables earlyinvolvement in the development cycle, a cardinal principle in theMANPRINT program.

Format

The HHAR embodies a standardized, systematic methodology forevaluating the health risks of materiel systems. By providing aspecified structure and common elements of information, the HHARhelps ensure comprehensive medical input consistent across thespectrum of Army systems. AR 40-10 defines the standard formatfor the HHAR (Table 3), which is designed to document clearly thelogical process by which recommended actions are developed.

Ingredients

What key ingredients are essential in preparing a HHAR? Ingeneral terms, two types of information must be available--descriptive and quantitative information about the system itself,and health standards against which to judge the health-threaten-ing characteristics of the system. Descriptive informationshould include a comprehensive accounting of components, sub-systems, special materials, simulators and other trainingdevices, special support and maintenance equipment, and specialsalvaqe or disposal equipment. Also important is a completedescription of how the system will be employed--operating/train-

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Table 3.

HHAR format.

Paragraph Contents

1. References Listing of source materials2. Summary Executive overview3. Background System description, predecessor system,

usage scenario(s), prior assessments4. Identification Component-based inventory

of issues of potential/actual hazards5. Assessment Data analysis and conclusions vis-a-

of issues vis health standards6. Recommen- Recommended actions for hazard con-

dations trol, with risk assessment codes7. Preparer Preparing organization,

POC, date prepared

ing doctrine, logistics support concepts (including all levels ofmaintenance), salvage/ disposal concepts, NBC requirements, andenvironmental conditions expected to be encountered. Obviously,considering the complete life cycle of the system is imperative.

Quantitative information about the system will includehazard-related data (e.g., noise and vibration signatures) fromtechnical testing, user testing, special hazard evaluations, pre-vious health hazard assessments, mishap reports, safety in-cidents, and sometimes modelling efforts. In the case of anIHHAR, only data from a predecessor system may be available, ifdata are available at all. In the absence of quantitative data,definitive statements about levels of risk are impossible.

Health standards provide the yardsticks with which to gagethe severity of quantified hazards. These standards can takeseveral forms--medical exposure limits, health conservationstandards, and materiel design standards. Usually they arepublished Army documents (medical technical bulletins, militarystandards, military specifications, Army regulations), butoccasionally they are national standards (e.g., OccupationalSafety and Health Administration, American National StandardsInstitute) or international standards (e.g., InternationalStandards Organization). Rules, both formal and informal, forapplying these standards are necessary to ensure relevance and

14

consistency. Though often not available, comprehensive bio-medical databases are very helpful in gaging real levels of risk,especially when quantified hazards exceed established limits.

Preparation steps

Once the necessary ingredients are on hand, what steps doesa medical assessor follow in developing a HHAR? Depicted inFigure 3 is an idealized sequence of steps characterizing thepreparation process.

System analysis and hazard identification

The foundation of the HHAR process is the careful analysisof the physical system and the doctrine for its utilization inorder to identify potential health hazards. All components andsubsystems; all phases of the system's life cycle (manufac-turing, fielding, shipping, operational use, repair, salvage, andeventual disposal); all personnel who will interact with thesystem (operators, passengers, nearby troops, maintainers,logistics support personnel, trainers); special operatingconditions (e.g., NBC operations, river crossing, airdrop);anticipated environmental conditions (night, rain, desert,tropics, arctic, high altitude)--all provide important clues orcontributing factors regarding potential health hazards.Components which generate microwaves, vibration, or toxic fumes,for example, usually are obvious health hazard indicators; lessobvious may be heat build-up during NBC operations or infraredradiation from light sources. From the system-based analysiscomes a comprehensive inventory of hazardous entities which couldreasonably be expected to place personnel at risk.

Data analysis

For each hazard inventoried, the medical assessor nextanalyzes the quantitative data available. The quality, complete-ness, and validity (conforming with operational concepts) of thedata are determined first; serious deficiencies prompt recommen-dations for future data collection. Raw or intermediate data mayneed to be reduced, converted to different units of measure, orreorganized to be suitable for interpretation. Those dataadequate for interpretation are compared to pertinent healthstandards to ascertain whether the quantified levels areacceptable, given the frequency and duration of exposure expectedfrom relevant scenarios (training, maintenance, resupply,disposal, etc.). Where appropriate, the effects of required oravailable protective equipment (e.g., helmets, hearing

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protectors) must be accounted for in determining effectiveexposure profiles.

Risk assessment

The next step is to estimate the degree of risk associatedwith each hazard by assigning a risk assessment code (RAC). TheRAC (Appendix D) is an index of a hazard's criticality and isuseful in establishing priorities for control actions. Twofactors determine the actual RAC--hazard severity and hazardprobability. Reflecting the worst potential consequence, hazardseverity is defined in terms of degree of injury or occupationalillness which could result. Categories of severity include:negligible (less than minor), marginal (minor), critical(severe), and catastrophic (death). Hazard probability reflectsthe likelihood of occurrence, ranging from improbable to fre-quent. The RAC integrates both hazard severity and probabilityto yield a number between 1 and 5, with 1 reflecting the highestdegree of risk.

Development of recommendations

Based on the analysis of each hazard, the medical assessornext formulates recommended actions to reduce, control, or elimi-nate hazards posing unacceptable degrees of risk. The types ofcontrol options available appear in Table 4.

Effective design features during early system developmentare obviously the most desirable of all options, but redesigningor retrofitting the system may be necessary to reduce theintensity or level of hazards at crew locations. Engineeringmeasures may focus on hazard source, transmission routes, oractive crew station conditioning options.

Protective devices are primarily systems worn by individualsto protect the head, eyes, ears, or face (e.g., helmets, laserprotective goggles), other portions of the body (e.g., protectiveclothing or gloves), and the respiratory tract. They also mayregulate body temperature (e.g., cooling vests, cold weatherclothing). Most protective systems are passive, but they mayoperate actively, as in the case of cooling vests and activehearing protectors.

Administrative controls usually are geared around thesoldier's medical or physiological state. Personnel selectioncriteria might exclude soldiers already exhibiting substantialhearing loss from operating a very noisy system. Examples ofoccupational health monitoring procedures are periodic audio-metric testing and radiation film badges. Environmental

17

Table 4.

Health hazard control options.

Type Option

Engineering controls Source modificationMaterials substitutionContainment/isolation/shielding

Environmental con-ditioning/filtering/

ventilation

Protective equipment Trauma/burn protectionRespiratory protectionSensory protectionBody temperature protection

Administrative controls Personnel selection/retentioncriteria

Occupational health monitoringEnvironmental criteria

Operating controls Training/conditioning/adaptation

Operating cycle/timingCrew positioningSystem configuration and mode

criteria might take the form of limiting training during very hotclimatic conditions.

Operating controls encompass limitations on operating cycle(duration or frequency), crew locations or posturing (considercrouched mortarmen), operating mode (e.g., vehicle speed), andsystem configuration (e.g., tank hatches closed). Training insafe operations, to include use of protective devices, istypically an important consideration. Physical conditioning orenvironmental adaptation also may be appropriate to consider.

For each hazard exceeding established exposure standards,there should be one or more control measures recommended.Selection of control options must be tailored to the specificsystem and its operational requirements. Hazard controls may be

18

needed for maintenance and support personnel as well as crewmem-bers and passengers. More than one type of control option may benecessary for some hazards. Likewise, both short-term and long-term measures may be necessitated by practical considerations.If the analysis of data revealed deficiencies in available data,the recommendations also should include requirements foradditional data collection.

Report finalization

By the time recommended actions have been formulated, thebulk of the work on the HHAR is done. The major effort remainingis to commit the results of the foregoing steps to paper, usingthe prescribed format. This may involve merging inputs from mul-tiple organizational elements sharing the task of preparing theHHAR. The final step in completing the HHAR consists of staffingand approval by OTSG. When the latter step is finished, the HHARis ready for delivery to the requesting office.

Research supportinQ health hazard assessment

Research roles

Though often operating "behind the scenes," research playsthree major roles in the HHA program: developing new tools, con-ducting special studies, and performing medically related testand evaluation.

Developing new tools

Routine functioning of the HHA program relies on key toolswhich include biomedical databases, methods for evaluating mate-riel, health standards, methods for evaluating protection, pre-diction models, improved protection, and troop health indicators(see Table 5). For a given health hazard, some or even all ofthese tools may be deficient or lacking. For example, the exist-ing health standard for impulse noise is based on a very limiteddata-base and has never been validated (Leibrecht and Patterson,1986). Forward looking research serves to develop new or im-proved tools in order to advance HHA capabilities. Such researchusually consists of laboratory investigations (using both animalsand humans), technology or methodology development, and mathe-matical modeling. It also may involve field evaluations (moreoften with humans, but occasionally with animals) andepidemiology. To reach maturity, these types of researchnormally require multiphase programs, substantive resources, and

19

long-term commitment. Thus, they depend on formal planning,programming, and budgeting to provide a stable funding environ-ment.

Table 5.

HHA tools.

Type Description

Health standards Documents (e. g., noise exposur6 limits)specifying conditions of acceptablerisk for individual hazards.

Biomedical Systematic collections of empirical datadatabases on basic bioeffects, exposure-

injury relationships, mechanisms ofinjury, and material character-istics.

Prediction models Mathematical or analog models forpredicting extent of injury basedon quantitative exposure character-istics.

Protection Systems, components, and subsystems fortechnology reducing effective exposure to ac-

ceptable levels, given unacceptablesource levels.

Methodology for: Equipment, facilities, and proceduresfor:

a) Protection de- Measuring effectiveness of protectivevice evaluation systems.

b) Hazard Quantifying nealth hazard character-measurement istics of material

c) Health Assessing key health characteristics ofmonitoring personnel.

20

Special studies

What happens when existing tools prove inadequate to addresscurrent questions, yet system-specific answers are needed beforenew tools will be available? Biomedical research can step inwith special studies in the form of laboratory investigations anddirect hazard assessments. A system-specific laboratory investi-gation harnesses an actual or simulated system or component todetermine its hazardous effects in the laboratory, usually usirganimal models. For example, a new type of millimeter wavegenerator could function as an exposure source to assess possibleeffects on the ocular lens of an appropriate animal model. Incontrast, direct hazard assessment involves the study of soldiersand actual weapons exposures in the field. As a classic exampleof direct hazard assessment, consider the case of the M198 towedhowitzer. When the developmental system exceeded impulse noiseexposure limits in 1976, the AMEDD developed a speciai procedureto determine the adequacy of available hearing protection.Investigators exposed volunteer troops to actual howitzer fir-ings, monitoring hearing as noise intensity increased (Pattersonet al., 1985). However, the direct hazard assessment is a courtif last resort because it answers only narrow questions, is veryresource intensive, and takes excessive time to plan, coordinate,and execute.

Another type of special study is the health survey. Mosttypically an epidemiological "snapshot" of some troop population,the health survey captures data on the status of selected healthindicators, such as hearing acility. For example, in the early1970s medical investigators conducted extensive surveys of thefrequency and severity of hearing loss among infantry, armor,artillery, and other troops (Walden et al., 1975). As with thosesurveys, the general methodology usually in, olves measurements onsoldiers in the field, though it can involve reviewing healthrecords or computerized databases (such as the Aviation Epidemi-ology Data Register). The results of health surveys providevaluable information about how well the HHA program is working aswell as baseline data against which to gage future weaponseffects and protective technology. The results also car, influ-ence health policy issues, including selection and retentionstandards.

Test and evaluation

The final category of health hazard research is medicallyrelated test and evaluation (T&E). Here the focus is onmeasuring pertinent characteristics of two types of materiel--systems/components which generate health hazards, and systams/components which protect against health hazards. In the firstcase, nonmedical T&E organizations normally collect health hazard

21

data for subsequent review by a medical organization. However,on occasion an AMEDD organization collects data using specialinstrumentation or data analysis capabilities. For example, suchis frequently the case when it comes to toxic substances andvibration hazards (e.g., Butler and Maday, 1986). In discerninghow well a protective system actually protects personnel, anevaluator (Government and/or contractor) performs standardmeasurements to quantify hazard reduction. As an excellentexample of this, consider the routine evaluation of helmets forimpact and noise attenuation efficacy (e.g., Mozo et al., 1988).Such evaluation occurs during prototype development, firstarticle and initial production, and routine production (i.e.,quality assurance testing).

Research organizations

By regulation, TSG is responsible for the primary healthhazard research mission. In reality, MRDC--a field operatingagency of TSG--performs health hazard research as part of itslarger medical research and development programs. OTSG staffestablishes health hazard research requirements, prioritizesthem, and makes technical input to specific objectives. MRDCplans, programs, and budgets for recognized research efforts,generally by problem area. Five of MRDC's laboratories partici-pate in executing the health hazard research program (Lam andGrubbs, 1987): U.S. Army Aeromedical Research Laboratory(USAARL); Walter Reed Army Institute of Research (WRAIR); U.S.Army Biomedical Research and Development Laboratory (USABRDL);Letterman Army Institute of Research (LAIR); and U.S. ArmyResearch Institute of Environmental Medicine (USARIEM). Table 6shows the general areas in which each laboratory conducts healthhazard research.

While the organizations mentioned above account for theprimary health hazard research programs, several other organi-zations participate also. AEHA has limited T&E capabilities andcontributes to proposed health standards. The U.S. Army MedicalMateriel Development Activity (USAMMDA) assists in the develop-ment of medically-oriented protective devices, such as ballistic/laser protective spectacles. HEL conducts some research relatedto health hazards, including impulse noise injury and carbon mon-oxide poisoning. The Product Manager (PM) for Clothing and Indi-vidual Equipment and the PM for Aviation Life Support Equipmentdevelop protective systems such as helmets, protective clothing,and laser protection. Also playing a role are AMC's Research,Development, and Engineering Centers (RDEC), such as Natick RDEC(NRDEC) and Chemical RDEC (CRDEC), which develop new technologyfor helmets, microclimate cooling systems, and other clothing andprotective systems. Finally, TECOM, CSTA, and OTEA all collecthealth hazard data on developmental systems.

22

Table 6.

MRDC health hazard research laboratories.

USAARL WRAIR USABRDL LAIR USARIEM

BOP* BOP* Smokes Lasers HeatNoise Microwaves Obscurants Light ColdVibration MM-waves Combustion OverexertionShock products AltitudeThermal stress Toxic effluents02 deficit

* Note: BOP = Blast overpressure

Establishing research requirements

Ideally, the Army's long range planning process should indi-cate health hazard research needs alongside appropriate defi-ciencies and requirements identified in key planning documentssuch as the Battlefield Development Plan. Incorporating healthhazard research requirements in these planning documents demandsclose coordination between planning agencies (especially TRADOC),MRDC, and OTSG. In practice, requirements more typically resultfrom formal or informal dialog between a combat or materieldeveloper and an element of the AMEDD. As the MANPRINT programmatures, we should expect to see MANPRINT Joint Working Groupsdocumenting health hazard research requirements in SMMPs. Inreality, combat developers, system developers, technologydevelopers, T&E personnel, human factors and system safetypersonnel--all should notify OTSG when potential health hazardresearch requirements come to their attention. The importantthing is to identify and plan for such requirements as early in asystem's life cycle as possible.

Conclusions

Early and continuing review of system/subsystem/componenthealth hazards is essential to successful materiel design anddevelopment efforts. Effective medical input and evaluation isimperative to ensure threats to troop health are eliminated orminimized. The Army's HHA program provides the resources, tools,and procedures to properly address systems health hazards. Insupporting the full spectrum of a system's life cycle, a varietyof HHA services is available.

23

As a major mechanism for effectively integrating human con-siderations into materiel acquisition, HHA is a key component ofthe MANPRINT program. To be optimally effective, HHA effortsshould be conducted in concert with other MANPRINT activities.There must be careful coordination and interaction between HHAactivities and efforts of the other MANPRINT domains to ensurecohesive, comprehensive, and efficient program coverage. TheMANPRINT Joint Working Group forms the primary body forintegrating HHA with other MANPRINT domains.

Through membership in the MANPRINT team, the HHA communityshares important responsibilities in the Army's modernizationefforts. Applying biomedical knowledge and principles to fieldsafer, more effective combat systems yields invaluable payoff.The ultimate benefits--protecting the health of troops, enhancingsystem effectiveness and conserving warfighting assets--translateinto improved combat readiness for the entire Army.

24

References

Butler, B. P., and Maday, R. E. 1986. A comparative analysis ofwhole-body vibration exposure at the gunner position ofthe Vulcan wheeled-carrier and towed Vulcan air-defensesystem. Fort Rucker, AL: U.S. Army AeromedicalResearch Laboratory. USAARL LR-86-6-4-2.

Department of the Army. 1983. Health hazard assessment programin support of the Army materiel accquisition decisionprocess, AR 40-10, dated 15 Sep 1983. Washington, DC.

Department of the Army. 1988. Systems acquisition policy andprocedures, AR 70-1, dated 10 Oct 3938. Washington,DC.

Department of the Army. 1982. Basis of issue plans (BOIPs) andqualitative and quantitative personnel requirementsinformation (O07RI), AR 71-2, dated 15 Jun 82. Wash-ington, DC.

Department of the Army. 1984. Army modernization training, AR350-35, dated 15 Jul 84. Washington, DC.

Department of the Army. 1985. System safety engineering andmanagement, AR 385-16, dated 3 Sep 1985. Washington,DC.

Department of the Army. 1984. Manpower staffing standardssystem, AR 570-5, dated 15 Apr 84. Washington, DC.

Department of the Army. 1983. Human factors engineering pro-gram, AR 602-1, dated 15 Feb 1983. Washington, DC.

Department of the Army. 1987. Manpower and personnel inte-gration (MANPRINT) in the materiel acquisition process,AR 602-2, dated 17 Apr 87. Washington, DC.

Department of Defense. 1984. System safety-program require-ments, MIL-STD 882B, dated 30 Mar 1984, with Notice 1,1 Jul 1987. Washington, DC.

Gaydos, J. C. 1988. A historical view of occupational healthfor the soldier. Medical bulletin. (February) 4-6.

Lam, D.M., and Grubbs, F.K. 1987. The health hazard assessmentresearch program. Army research. development &acquisition bulletin. (September-October) 5-8.

25

Leibrecht, B.C. 1987a. Health hazard assessment: The bigpicture. MANPRINT bulletin. I(12):1-3.

Leibrecht, B.C. 1987b. Health hazard assessment: How thesystem works. MANPRINT bulletin. II(4):1-3.

Leibrecht, B.C. 1988a. Health hazards: Their habits andhaunts. MANPRINT bulletin. II(6):1-4.

Leibrecht, B.C. 1988b. Preparing a health hazard assessmentreport. MANPRINT bulletin. III(2):3-6.

Leibrecht, B.C. 1989. Research supporting health hazard assess-ment. MANPRINT bulletin. III(4):4-5.

Leibrecht, B.C., and Patterson, J.H. 1986. Controlling impulsenoise hazards: Programmatic model for developing vali-dated exposure standards. In Proceedings of the 1986Army Science Conference, Vol. I, 233-241. Washington,DC: Deputy Chief of Staff for Research, Development,and Acquisition, Department of the Army.

Mozo, B. T., Nelson, W. R., and Haley, J. L. 1988. Militarymotorcycle helmet acoustic and impact evaluation. FortRucker, AL: U.S. Army Aeromedical Research Laboratory.USAARL LR-88-15-2-5.

Patterson, J. H., Mozo, B. T., Marrow, R. H., McConnell, R. W.,Lomba Gautier, I., Curd, D. L., Phillips, Y. Y., andHenderson, R. 1985. Direct determination of the ade-quacy of hearing protective devices for use with theM198, 155mm towed howitzer. Fort Rucker, AL: U.S.Army Aeromedical Research Laboratory. USAARL ReportNo. 85-14.

Walden, B. E., Prosek, R. A., and Worthington, D. W. 1975. Theprevalence of hearing loss within selected U. S. Armybranches. Washington, DC: Walter Reed Army MedicalCenter.

26

Glossary

Combat developer (CBTDEV): Command or organization responsiblefor formulating fighting doctrine, materielrequirements, and organizational concepts.

Concept demonstration/validation: Normally the second phase inthe materiel acquisition process. Includes steps toresolve logistics problems identified earlier, verifypreliminary design and engineering, fully analyzetrade-oft proposals, and prepare for full scaledevelopment.

Concept exploration/definition: Initial phase of the materielacquisition process. Includes development ofacquisition strategy, evaluation of systemalternatives, refinement of requirements document, andpreparation for concept demonstration/validation.

Full scale development (FSD): Normally the third phase in themateriel acquisition process during which a system,including all items necessary for its support, is fullydeveloped, engineered, fabricated, tested, andinitially type classified.

Health hazard: An existing or likely condition, inherent to theuse of materiel, that can cause death, injury, acute orchronic illness, disability, and/or reduced jobperformance of personnel.

Health hazard assessment (HHA): The process of identifying,evaluating, and controlling risks to the health andeffectiveness of personnel who test, use, service, orsupport Army systems.

Health hazard assessment report (HHAR): The formal reportdocumenting, for a given system, the assessment ofhealth hazard issues and risks, recommended actions,and training requirements.

Health standards: Published documents specifying conditions ofacceptable risk for individual health hazards; thesecan include medical exposure limits, healthconservation criteria, and materiel design standards.

Human factors engineering (HFE): A comprehensive technicaleffort to integrate all personnel characteristics(skills, training implications, behavioral reactions,performance, anthropometric characteristics, andbiomedical factors) into Army doctrine and systems.

27

Independent medical assessor: Personnel, independent of materieldevelopers and combat developers, normally tasked bythe Army Medical Department to provide health hazardassessment support of Army materiel systems.

Life cycle system management model (LCSMM): An integrated modelof phases, activities, documentation, and decisionpoints guiding the acquisition of Army materiel.

Manpower and personnel integration (M.ANPRINT): The comprehensiveprocess of integrating the full range of human factorsengineering, manpower, personnel, training, healthhazard assessment, and system safety throughout theentire materiel acquisition process.

MANPRINT Joint Working Group (MJWG): A multiagency groupconstituted to manage and integrate MANPRINT activitiesfor a given materiel system.

Man-system integration: The technical process of integrating thehuman operator with a materiel system to ensure safe,effective operability and supportability.

Materiel acquisition: The process of acquiring supplies andequipment, facilities and services; includes life cyclesystems management of hardware and software,formulation of requirements, research, development,testing, procurement, production, fielding, operation,support, and disposal.

Materiel acquisition decision process (MADP): The formal processfor reviewing a program or project at critical pointsto evaluate status and make recommendations to thedecision authority.

Materiel developer (MATDEV): Command or organization responsiblLfor developing or modifying materiel.

Production/deployment: Normally the fourth phase in the materielacquisition process. Involves procurement anddistribution of equipment, training of operationalunits, and logistical support.

Requirements document: A document establishing officially therequirement for a specific materiel system andauthorizing planning, budgeting, and execution. Aninformal requirements document (normally theOperational and Organizational Plan) usually authorizesprogram initiation. A formal requirements document(normally the Required Operational Capability) commitsthe Army to program development and describes the

28

system's required operational features and performancecharacteristics.

Risk assessment code (RAC): A quantitative expression of levelof risk, formulated on the basis of hazard severity andhazard probability.

System MANPRINT management plan (SMMP): A planning andmanagement guide used to ensure MANPRINT issues areaddressed throughout a system's life cycle; alsoprovides an audit trail.

System safety engineering: The application of system safetymanagement and engineering principles throughout asystem's life cycle.

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Appendix A

Inventory of systems health hazards

A health hazard is some health-threatening condition whichtroops encounter in using materiel. The hazard can occur duringnormal use of equipment, interactions with environmental factors,maintenance and repair activities, logistics support functions,misuse, and malfunction. This appendix inventories the morefrequently encountered health hazards and where they occurcommonly in Army systems. The inventory is structured aroundfive major categories: mechanical forces, chemical substances,biological substances, radiation energy, and environmentalextremes.

Mechanical forces

Among Army systems, the mechanical forces which can injurepersonnel include acoustical energy (noise), vibration, shock,and trauma. That these hazards tend to occur together is notsurprising, since they go hand in hand with engines, drivetrains, tracks and wheels, transmissions, rotors, guns/cannons,and munitions--components of Army vehicles or aircraft. Outlinedhere are the basic forms, generic sources, and commonsystem/component sources of each type of mechanical force.

Noise, steady state: intermittent, sustained, narrow band,wide band. Arises from generating, transmitting, and convertingpower; drive elements interacting with ground or air; electronicreproduction or amplification of sound; gas or fluidflow/friction; steady combustion. System source examples:tracked vehicles, wheeled vehicles, self-propelled artillery;aircraft (rotary- and fixed-wing); communication headsets andspeakers; alerting or warning signals; power generators; trainingsimulators; maintenance tools and equipment; gas torches; andcompressed air/gas.

Noise, impulse: blast, impact, repetitive, nonrepetitive.Arises from propellant combustion; detonation of explosives;sudden release of pressure; forceful impact. System sourceexamples: pistols, machine guns; grenades; mortars, cannons,tank guns, howitzers; recoilless rifles, rockets, missiles;nuclear warheads; explosives; training simulators; impact toolsand equipment.

Blast overpressure: freefield, complex (reverberant),repetitive, nonrepetitive. Arises from propellant combustion anddetonation of explosives. System source examples: mortars,cannons, tank guns, howitzers; recoilless rifles, rockets,missiles, explosives, nuclear warheads.

30

Vibration: high frequency, low frequency, linear,rotational, intermittent, sustained. Arises from generating,transmitting, and converting power; drive elements interactingwith ground or air; resonance dynamics; induced changes oroscillations in system attitude or position. System sourceexamples: tracked vehicles, wheeled vehicles, self-propelledartillery; aircraft (rotary- and fixed-wing); trainingsimulators; maintenance tools and equipment.

Shock: acceleration, deceleration, force loading. Arisesfrom system impact (crash, collision, hard landing); systemrecoil; sudden aircraft displacement due to air turbulence;windblast; parachute opening. System source examples: aircraft(rotary- and fixed-wing); wheeled vehicles, tracked vehicles,self-propelled artillery; parachute systems.

Trauma: blunt, sharp, musculoskeletal. Arises from objectsor components impacting soldier; weapons blast; weapons recoil;shattering of components or materials; limb or head flail due tovehicle/terrain interaction; airblast; musculoskeletal overload.System source examples: tracked vehicles, wheeled vehicles;artillery (towed, self-propelled); tank guns; aircraft (rotary-and fixed-wing); hand-held guns, shoulder fired rockets/missiles;maintenance tools and equipment; compressed air/gas; explosivetraining devices; excessive operator force/exertion.

Chemical substances

Usually thought of as toxic substances, these are among themost pervasive health hazards. Chemically active compounds enterthe picture frequently in basic system construction (e.g.,paints, sealants, adhesives), routine operations and logisticalsupport (e.g., fuels, coolants), maintenance (e.g., solvents,cleaning agents), and special functions (e.g., fire/flamesuppression, decontamination). Contrasting with these is anotherfamily of substances generated by normal system operations,usually byproducts of engine combustion and weapons combustion.Of course, the specific fuels and propellants used will influencethe byproducts encountered, as will a host of other factors. Thebasic forms in which primary substances and byproductsoccur--liquids, gases, and solids--will guide the followingsummaries.

Liquids: including mists, aerosols. Associated withfueling, maintaining, and repairing systems; systems salvage anddisposal; pest and plant control; decontamination; generation ofobscurants; sewage handling and treatment. Common types includefuels, lubricants, coolants, hydraulic fluids, solvents, cleaningagents, paints, adhesives, pesticides, herbicides, defoliants,decontamination solutions. System source examples: systemsincorporating combustion engines (piston, turbine), hydraulics,

31

air conditioners; systems for handling, storing, and transportingfuels and other petroleum products; maintenance shop; paint shop;repair shop; sewage handling and treatment systems; systems forhandling, storing, transporting, and dispensing pesticides,herbicides, and defoliants; decontamination systems; fog oilgenerators.

Gases and vapors: Arise from vaporization of liquids orsolids; engine combustion; weapons combustion; compressed gas;air filtration; electric motors; welding; flame/fire suppression.System source examples: systems incorporating combustion engines(piston, turbine), hydraulics, air conditioners; systems forhandling, storing, and transporting fuels and other petroleumproducts; maintenance shop; paint shop; repair shop; gas torches;machine guns, tank guns, cannons, mortars, howitzers, recoillessrifles, rockets, missiles; gaseous fire suppression systems(e.g., Halon); systems for handling, storing, transporting, anddispensing liquid pesticides, herbicides, and defoliants; sewagehandling and treatment systems; compressed gas systems andcontainers; liquid decontamination systems; protective filters.

Solids: coatings, aerosols, fumes, dusts, particulates.Arise from system-environment interaction; burning materials;generation of smokes/obscurants; construction activities;blasting; welding, brazing, soldering; cutting, grinding, andsanding of metals, plastics, wood; decontamination; pest andplant control; air filtration. System source examples: trackedvehicles; wheeled vehicles; aircraft (rotary- and fixed-wing);artillery (towed, self-propelled); munitions; explosives;smoke/obscurant systems; construction equipment; maintenanceshop; paint shop; repair shop; power saws, grinders, sanders;welding, brazing, and soldering equipment; powder-formdecontamination systems; systems for handling, storing,transporting, and dispensing pesticide and herbicide dusts;protective filters.

Biological substances

This category arises mainly from contamination orinfiltration of systems by disease-causing microorganisms whichreside in the earth's environment. Common types includebacteria, viruses, parasites, Rickettsia, molds, and fungi.These organisms may grow (or at least survive) wherever there isa "reservoir" containing a hospitable medium, such as water ornutrified liquid. System reservoir examples: containers, tanks,lines, tubes, compartments, and receptacles where a hospitableliquid may occur, collect, or circulate; systems for processing,handling, storing, transporting, preparing, and dispensingfoodstuffs (both solid and liquid form) and water; medicalsupplies and biologicals; waste disposal equipment; sanitationsystems; sewage handling and treatment systems.

32

Radiation energy

The common types of radiation which accompany Army systemsinclude visible light, infrared, ultraviolet, radiofrequencyenergy, laser energy, and ionizing radiation. Systems orsubsystems designed for special functions, especially of anelectrical or electronic nature, most frequently give rise tothese types of energy. The sections below summarize the basicforms and generic sources of each type of radiation.

Radiofreauency energy: microwaves, millimeter waves,transient, sustained. Generic sources: telecommunicationssystems, radar systems, microwave ovens.

Infrared: sustained, transient. Generic sources: heatingelements (such as those used in food preparation equipment andspace heaters), gas torches, soldering equipment, electronicrepair equipment.

Visible light, high intensity: artificial, natural,transient, sustained. Generic sources: search lights, landinglightr', strobes, high-intensity lamps, light amplificationdevices, cathode ray tubes, natural sunlight, highly reflectivesurfaces, laser reflection, gas torches, nuclear flash.

Ultraviolet: near UV, far UV, artificial, natural,transient, sustained. Generic sources: ultraviolet lamps, gastorches, gas discharge tubes, natural sunlight (varies withseason, altitude, etc.).

Laser energy: pulsed, transient, sustained. Genericsources: rangefinders, target designators, training simulators,sensor-targeted countermeasure systems, material processingsystems.

Ionizing radiation: transient, sustained. Generic sources:high-voltage electronics, X-ray equipment, radioluminescentmaterials, nuclear weapons, depleted uranium munitions.

Environmental extremes

On the training range and the battlefield, environmentalfactors such as temperature, humidity, wind, and altitudeobviously interact with combat systems and their operators. Intheir extreme forms and combinations, these factors may threatenthe soldier's health. In the case of Army materiel, we areconcerned with three categories of environmentalextremes--ambient heat, ambient cold, and oxygen deficiency.

Ambient heat: convective, radiant, natural, artificial,

33

20

transient, sustained. Arises from environmental heat, sunlight;heat-generating systems and subsystems; human metabolism. Systemsource examples: tracked vehicles, wheeled vehicles;self-propelled artillery; aircraft (rotary- and fixed-wing);cannons, guns, rockets, missiles (as components of systems withenclosed crew compartments); training simulators; collectiveshelters; protective clothing, helmets, masks, respirators,gloves, boots; food preparation equipment; heaters; lamps;electrical/electronic equipment. Contributing factors:humidity, wind, clothing, workload.

Ambient cold: natural, artificial, transient, sustained.Arises from environmental cold, ice; cooling subsystems. Systemsource examples: tracked vehicles, wheeled vehicles;self-propelled artillery; aircraft (rotary- and fixed-wing);systems/subsystems for air conditioning, refrigeration, andfrozen storage; training simulators; collective shelters.Contributing factors: humidity, moisture, wind, clothing,workload.

Oxygen deficiency: natural, artificial, transient,sustained. Arises from high altitude (terrestrial, airborne);oxygen displacement in confined spaces; systems which constrainbreathing. System source examples: aircraft (fixed- androtary-wing); airborne operations; high altitude operations;altitude chamber; gaseous fire suppression systems; protectivemasks, respirators. Contributing factors: workload, ambienttemperature, engine combustion fumes, weapons combustion fumes,fuel %apors.

34

Ap~pendix B

Integrated life cycle system maanagement model

Source: Adapted from AR 70-1

35

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37

Appendix C

List of HHA points of contact

OTSG: HQDA (SGPS-PSP-E) AV 289-0129

5109 Leesburg Pike (202) 756-0129Falls Church, VA 22041-3258

AHS: Commandant AV 471-5775Academy of Health Sciences, US Army (512) 221-5775ATTN: HSHA-CDMFort Sam Houston, TX 78234-6100

AEHA: Commander AV 584-2925US Army Environmental Hygiene Agency (301) 671-2925ATTN: HSHB-MO-AAberdeen Proving Ground, MD 21010-5422

MRDC: Commander AV 343-7301US Army Medical Research and (301) 663-7301

Development CommandATTN: SGRD-PLCFort DetrickFrederick, MD 21701-5012

AMC: Commander AV 284-8975US Army Materiel Command (202) 274-8975ATTN: AMCSG5001 Eisenhower AvenueAlexandria, VA 22333-0001

TRADOC: Commander AV 680-2226

US Army Training and Doctrine Command (804) 727-2226

ATTN: ATMDFort Monroe, VA 23651-5000

38

Appendix D

Risk assessment codes

Source: AR 40-10

39

Table D-1. Hazard probability

Descriptor Level Srecific individual item Fleet orinventory

Frequent A Likely to occur frequently Continuouslyexperienced

Probable B Will occur several times Will occurin life of an item frequently

Occasional C Likely to occur sometime Will occurin life of an item several times

Remote D Unlikely but possible to Unlikely but

occur in life of an item can reason-ably be ex-pected to occur

Improbable E So unlikely, it can be Unlikely toassumed occurrence may occur, butnot be experienced possible

Table D-2. Risk assessment codes

Hazard severity categories Hazard probabilitylevels

A B C D E

I 1 1 1 2 3II 1 1 2 3 4III 2 3 3 4 5IV 4 5 5 5 5

40

Appendix E

Acronyms

AEHA ............. U.S. Army Environmental Hygiene AgencyAHS .............. Academy of Health Sciences, U.S. ArmyAMC .............. U.S. Army Materiel CommandAMEDD ............ Army Medical DepartmentAR ............... Army regulationASARC ............ Army Systems Acquisition Review CouncilBOP .............. blast overpressureCOEA ............. cost and operational effectiveness analysisCRDEC ............ U.S. Army Chemical Research, Development,

and Engineering CenterCBTDEV ........... combat developerCSTA ............. Combat Systems Test ActivityDAB .............. Defense Acquisition BoardDCSPER ........... Deputy Chief of Staff for PersonnelECP .............. engineering change proposalEUT&E ............ early user test and evaluationFOTE ............. follow-on operational test and evaluationHEL .............. U.S. Army Human Engineering LaboratoryHFEA ............. human factors engineering assessmentHHA .............. Health Hazard AssessmentHHAR ............. Health Hazard Assessment ReportHSC .............. U.S. ArmyHealth Services CommandIHHAR ............ Initial Health Hazard Assessment ReportILSP ............. integrated logistics support planIOTE ............. initial operational test and evaluationIPR .............. in-process reviewJSOR ............. Joint Services Operational RequirementLAIR ............. Letterman Army Institute of ResearchLLT .............. long lead timeLRIP ............. low rate initial productionLSA .............. logistic support analysisLSAR ............. logistic support analysis recordMANPRINT ......... Manpower and Personnel IntegrationMATDEV ........... materiel developerMEDCEN ........... Medical CentersMEDDAC ........... Medical Department ActivitiesMER .............. manpower estimate reportMJWG ............. MANPRINT Joint Working GroupMNS .............. mission need statementMRDC ............. U.S. Army Medical Research

and Development CommandNBC .............. nuclear, biological, chemicalNRDEC ............ U.S. Army Natick Research, Development,

and Engineering CenterODCSPER .......... Office of the Deputy Chief of Staff

for Personnel

41.

OFT .............. operational feasibility testingO&O Plan ......... Operational and Organizational PlanOT&E ............. operational test and evaluationOTEA ............. Operational Test and Evaluation AgencyOTSG ............. Office of The Surgeon GeneralPEO .............. program executive officerPM ............... project/product managerPPT .............. production proveout testPPQT ............. preproduction qualification testPQT .............. production qualification testRAC .............. risk assessment codeRFP .............. Request for ProposalROC .............. Required Operational CapabilitySAR .............. safety assessment reportSMMP ............. System MANPRINT Management PlanSSPP ............. System Safety Program PlanTC ............... type classificationTDR .............. Training Device RequirementT&E .............. test and evaluationTECOM ............ U.S. Army Test and Evaluation CommandTEMP ............. test and evaluation master planTFT .............. technical feasibility testingTNGDEV ........... training developerTRADOC ........... U.S. Army Training and Doctrine CommandTSG .............. The Surgeon GeneralTT ............... technical testingUSAARL ........... U.S. Army Aeromedical Research LaboratoryUSAMMDA .......... U.S. Army Medical Materiel Development

ActivityUSABRDL .......... U.S. Army Biomedical Research

and Development LaboratoryUSARIEM .......... U.S. Army Research Institute

of Environmental MedicineWRAIR ............ Walter Reed Army Institute of Research

42

Appendix F

List of suggested readings

Blackwood, W.O., and Dice, J.W., eds. 1988. MANPRINT PRIMER.Alexandria, VA: Automation Research Systems, Limited.AD-A197-681.

Guidotti, T.L. 1988. Exposure to hazard and individual risk:When occupational medicine gets personal. Journal ofoccupational medicine, 30:570-577.

Levy, B.S., and Wegman, D.H., eds. 1983. Occupational health:Recognizing and preventing work-related disease.Boston: Little, Brown and Company.

Mayers, M.R. 1969. Occupational health: Hazards of the workenvironment. Baltimore: Williams and Wilkins Company.

Parmeggiani, L., ed. 1983. Encyclopaedia of occupational healthand safety. 2 vols. 3rd ed. Geneva: InternationalLabour Office.

Ridley, J.R., ed. 1983. Safety at work. Boston: Butterworthand Company.

Rowden, S.E. and McIntosh, R.M. 1988. The health hazard assess-ment program: Occupational health for the soldier inthe field. Medical bulletin. (February) 7-10.

U.S. Department of Health, Education and Welfare. 1977. Humanhealth and the environment--some research needs. DHEWPublication No. NIH 77-1277. Washington, DC.

World Health Organization. 1972. Health hazards of the humanenvironment. Geneva: World Health Organization.

Zenz, C., ed. 1975. Occupational medicine: Principles andpractical applications. Chicago: Year Book MedicalPublishers.

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