Distributional records from the U.S. Air Force ovitrapping program--1991.

During 1991, ovitrapping was conducted by 37 U.S. Air Force installations. Sixteen installations were positive for Aedes albopictus. The number (449) and percent (21.5%) of Ae. albopictus-positive ovipaddles was almost 4 times that of the previous year. The collections of Ae. albopictus at Columbus Air Force Base (AFB), MS, and Shaw AFB, SC, are new records for Lowndes and Sumter counties, respectively. Nine installations were positive for Ae. aegypti; 21 were positive for Ae. triseriatus.     

Personal exposure to JP-8 jet fuel vapors and exhaust at air force bases

JP-8 jet fuel (similar to commercial/international jet A-1 fuel) is the standard military fuel for all types of vehicles, including the U.S. Air Force aircraft inventory. As such, JP-8 presents the most common chemical exposure in the Air Force, particularly for flight and ground crew personnel during preflight operations and for maintenance personnel performing routine tasks. Personal exposure at an Air Force base occurs through occupational exposure for personnel involved with fuel and aircraft handling and/or through incidental exposure, primarily through inhalation of ambient fuel vapors. Because JP-8 is less volatile than its predecessor fuel (JP-4), contact with liquid fuel on skin and clothing may result in prolonged exposure. The slowly evaporating JP-8 fuel tends to linger on exposed personnel during their interaction with their previously unexposed colleagues. To begin to assess the relative exposures, we made ambient air measurements and used recently developed methods for collecting exhaled breath in special containers. We then analyzed for certain volatile marker compounds for JP-8, as well as for some aromatic hydrocarbons (especially benzene) that are related to long-term health risks. Ambient samples were collected by using compact, battery-operated, personal whole-air samplers that have recently been developed as commercial products; breath samples were collected using our single-breath canister method that uses 1-L canisters fitted with valves and small disposable breathing tubes. We collected breath samples from various groups of Air Force personnel and found a demonstrable JP-8 exposure for all subjects, ranging from slight elevations as compared to a control cohort to > 100 [mutilpe] the control values. This work suggests that further studies should be performed on specific issues to obtain pertinent exposure data. The data can be applied to assessments of health outcomes and to recommendations for changes in the use of personal protective equipment that optimize risk reduction without undue impact on a mission.     

Records of Aedes albopictus, Ae. aegypti and Ae. triseriatus from the U.S. Air Force ovitrapping program--1989

During 1989, ovitrapping was conducted by 36 U.S. Air Force bases, Ft. Sam Houston, TX, and the San Antonio Metropolitan Health District. Eleven organizations were positive for Aedes albopictus; the collection of Ae. albopictus at Arnold Air Force Base, TN, is a new record for Coffee County. Ten organizations were positive for Ae. aegypti; 18 were positive for Ae. triseriatus.     

Distributional records from the U.S. Air Force ovitrapping program--1990.

During 1990, ovitrapping was conducted at 38 U.S. Air Force installations. Twelve installations were positive for Aedes albopictus. The August 24 collection of Ae. albopictus at Tinker Air Force Base, OK, is a first record for Oklahoma County. Four installations recorded the presence of Ae. aegypti; 14 installations were positive for Ae. triseriatus. During the previous 3 years, an increase in the distribution and abundance of Ae. albopictus coincided with a decline in Ae. aegypti.     

Family practice in the US Air Force

The United States Air Force Medical Service is well suited for family practice because of its early identification with the small community hospital. A plan was originally developed in 1968 to bring family practice to every Air Force member. This paper traces the progress of the program, identifies problem areas, specifies the planning factors and implementation plan, and gives the final goal for full family practice in the USAF.     

The U.S. Air Force HEART Program: The Air Force perspective

The U.S. Air Force Health Evaluation and Risk Tabulation (HEART) Program was initiated to design and test a preventive cardiology program for active-duty Air Force members. Most cardiovascular incidents in active-duty personnel occur at a career point which significantly magnifies their operational and fiscal effect as the bulk of events disable or kill personnel during their years of peak productivity. A registered nurse managed the program at each of the four demonstration bases. The number of medical technicians and health counselors varied according to base population. The program includes risk factor screening, risk ranking, basewide education, and focal group intervention for those at high risk. Screening consisted of a health and habits questionnaire, blood pressure measurement, serum glucose, serum total and HDL cholesterol, as well as serum thiocyanate and exhaled carbon monoxide. The total population screened at first screen was 12,000 and 8,000 are expected at second screen. It is likely that due to the military capability for long-term follow-up, primary prevention begun at the time of entry to active duty could effectively reduce the number of cardiovascular events experienced yearly in the Air Force. The final product of HEART will be a detailed plan for an Air Force-wide preventive cardiology plan.     

A population comparison of participants and nonparticipants in a health survey.

OBJECTIVES: This study examined the characteristics of Air Force recruits willing to take part in a health survey vs those unwilling to participate. METHODS: US Air Force recruits undergoing basic military training (n = 32,144) were surveyed regarding demographic and health variables. RESULTS: Respondents indicating an unwillingness to participate in a health survey reported less healthy lifestyles than those willing to participate. Prediction equations modeling the characteristics of those engaging in 4 risky behaviors were nearly identical regardless of whether those refusing to participate were included. CONCLUSIONS: Results suggest that, despite some low estimates of health behaviors due to response bias, relationships between most risk factors are generally unaffected by those not responding to health surveys.     

Costs of smoking among active duty U.S. Air Force personnel--United States, 1997

Smoking is the leading cause of preventable disease and death in the United States (1). The health consequences of smoking impose a substantial economic toll on persons, employers, and society. Smoking accounts for $50-$73 billion in annual medical-care expenditures, or 6%-12% of all U.S. medical costs (2-5). The costs associated with lost productivity also are extensive (2). In 1997, approximately 25% of male and 27% of female active duty Air Force (ADAF) personnel aged 17-64 years were smokers (6). A 1997 retrospective cohort study was conducted among ADAF personnel to estimate the short-term medical and lost productivity costs of current smoking to the U.S. Air Force (USAF). This report summarizes the results of the study, which indicate that current smoking costs the USAF approximately $107.2 million per year: $20 million from medical-care expenditures and $87 million from lost workdays.     

Delegation of clinical dietetic tasks in military and civilian hospitals: implications for practice

The purposes of our research were two-fold: to determine perceptions of the quality of task performance and to identify dietetic personnel currently performing clinical dietetic tasks in military and civilian hospitals. Questionnaires were returned from 309 dietitians and 208 dietetic support personnel at 151 military and civilian hospitals (73% response overall). For tasks completed by support personnel, no task was rated as having optimum quality, 1 was rated as highly acceptable, 6 as acceptable, 19 as somewhat unacceptable, and 4 as unacceptable. Current performance ratings indicated that 1 task was performed solely by dietitians, 21 were completed by dietitians with assistance, 6 were completed jointly by dietitians and support personnel, 2 were completed by support personnel with supervision by dietitians, and no task was completed independently by support personnel. Tasks were grouped into four categories: basic clinical dietetics (11 tasks), intermediate and in-depth clinical dietetics (12 tasks), outpatient nutrition clinic (5 tasks), and nutrition education (community) (4 tasks). Quality scores for the US Air Force (USAF) hospitals were higher for all task categories except intermediate and in-depth clinical dietetic tasks. The quality scores of support personnel were higher than those of dietitians for all task categories. The USAF performance scores indicated significantly more involvement of support personnel. Generally, the performance scores of dietitians increased with experience; the scores of support personnel decreased with experience. Correlations between quality and performance ratings for individual tasks revealed low to moderate relationships. Our results suggest that additional delegation of tasks to dietetic support personnel may be possible without negatively affecting perceptions of the quality of task outcome.(ABSTRACT TRUNCATED AT 250 WORDS)     

Predictors of low physical fitness in a cohort of active-duty U.S. Air Force members

BACKGROUND: Each branch of the U.S. armed forces has standards for physical fitness as well as programs for ensuring compliance with these standards. In the U.S. Air Force (USAF), physical fitness is assessed using submaximal cycle ergometry to estimate maximal oxygen uptake (VO2(max)). The purpose of this study was to identify the independent effects of demographic and behavioral factors on risk of failure to meet USAF fitness standards (hereafter called low fitness). METHODS: A retrospective cohort study (N=38,837) was conducted using self-reported health risk assessment data and cycle ergometry data from active-duty Air Force (ADAF) members. Poisson regression techniques were used to estimate the associations between the factors studied and low fitness. RESULTS: The factors studied had different effects depending on whether members passed or failed fitness testing in the previous year. All predictors had weaker effects among those with previous failure. Among those with a previous pass, demographic groups at increased risk were toward the upper end of the ADAF age distribution, senior enlisted men, and blacks. Overweight/obesity was the behavioral factor with the largest effect among men, with aerobic exercise frequency ranked second; among women, the order of these two factors was reversed. Cigarette smoking only had an adverse effect among men. For a hypothetical ADAF man who was sedentary, obese, and smoked, the results suggested that aggressive behavioral risk factor modification would produce a 77% relative decrease in risk of low fitness. CONCLUSIONS: Among ADAF members, both demographic and behavioral factors play important roles in physical fitness. Behavioral risk factors are prevalent and potentially modifiable. These data suggest that, depending on a member's risk factor profile, behavioral risk factor modification may produce impressive reductions in risk of low fitness among ADAF personnel.     

用于武警部队能力倾向测验的编制

目的为武警部队兵员筛选、工作安排等提供能力状况的简明评估。方法根据武警部队任务,在武警部队大量样本使用长-鞍团体智力测验和多项能力倾向测验结果的基础上进行编制。在武警某机动师随机整群取样884人实测。对其中56人相隔9d重测。结果条目分析：各分测验难度在0．35～0．47之间,总体难度是0．41,具有有效区分效度的条目占89％以上。信度检验：重测相关系数为0.86。效度检验：与训练成绩总分相关系数为0．63,画圆测验以纸笔文具测验代替器械操作测验,达到0．4的效标效度。结论武警心理评估系统能力部分的编制符合心理测量学指标,达到了编制目的。     

FORUM: The U.S. Air Force HEART program model

The goal of the Health Evaluation and Risk Tabulation (HEART) Program is to reduce the incidence of cardiovascular disease in the U.S. Air Force. The program is midway through a demonstration phase operating at four Air Force bases in the United States. At each base, active-duty personnel are given a selective clinical screen to assess their risk of a cardiovascular incident in the next 8 years. At two of the four bases, intervention in the form of behavior modification, small-group treatment for smoking cessation and/or blood lipid/weight reduction is offered to volunteers who have been found at above-average risk. In addition, two bases (one with the intervention present and one with the intervention absent) have a basewide education component consisting of events and activities which teach specific techniques of CVD prevention.     

Serum dioxin and immunologic response in veterans of Operation Ranch Hand.

The authors studied immune response and exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) among veterans of Operation Ranch Hand, the US Air Force unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971. A comparison group of Air Force veterans who served in Southeast Asia but were not involved in spraying herbicides was included. The authors studied delayed-type hypersensitivity skin test responses to Candida albicans, mumps, Trichophyton, and a bacterial antigen made from lysed Staphylococcus aureus. Lymphocyte measurements included total lymphocyte counts; T-cell (CD3, CD4, CD5, and CD8), B-cell (CD20), and NK-cell (CD16 and CD56) subsets; and expression of the activation antigen CD25 on CD3 T cells. The authors quantitated the serum concentrations of immunoglobulin (Ig)A, IgG, and IgM; examined sera for the presence of monoclonal immunoglobulins (M proteins); and looked for a broad range of autoantibodies (rheumatoid factor, antinuclear antibody, smooth muscle autoantibody, mitochondrial autoantibody, parietal cell autoantibody, and thyroid microsomal autoantibodies). They measured the level of dioxin in 1987 or 1992, extrapolated the result to the time of service in Vietnam, and assigned each veteran to one of four exposure categories: Comparison and three Ranch Hand groups (Background, Low, or High). Overall, the authors found no evidence of a consistent relation between dioxin exposure category and immune system alteration.     

Etiology of gastroenteritis among Americans living in the Philippines.

Between December 1975 and June 1976, American military personnel with diarrhea who were seen at an outpatient clinic at Clark Air Force Base Hospital were investigated to determine the etiology of their disease. Enterotoxigenic Escherichia coli were detected in 16% (18/115), rotavirus in 4% (4/111), salmonellae in 3% (3/115), shigellae in 2% (2/115) and Giardia lamblia in 2% (3/152) of patients with diarrhea. Thus from only 27% of the subjects studied were identifiable potential pathogenic agents found. The incidence of gastroenteritis increased in May and June with the increase in rainfall; however, there was no increase in the proportion of diarrhea caused by any of these identifiable enteric pathogens. Americans experienced a seasonal increase of diarrhea similar to that affecting the Philippine population in Manila. Enterotoxigenic E. coli was the most common identifiable enteric pathogen among Americans with diarrhea at Clark Air Force Base in the Philippines during the study, though even in these cases, it may not have been the agent responsible for their illness.     

Dose-dependent production of urinary naphthols among workers exposed to jet fuel (JP-8)

BACKGROUND: Jet propulsion fuel-8 (JP-8) is one of the largest sources of chemical exposures among Air Force personnel. Urinary naphthols have been suggested as useful biomarkers of exposure to JP-8. METHODS: Multivariate linear regression models were applied to evaluate the effects of environmental and work-related factors upon production of urinary naphthols among 323 Air Force personnel. RESULTS: Naphthalene exposure, smoking status, and their interaction, plus self-reported skin irritation explained about two-thirds of the variation in naphthol levels. The exposure-smoking interaction was consistent with induction by smoking of one or more steps in the metabolism of naphthalene and naphthalene-1,2-oxide (NapO). A supralinear dose-response relationship was observed between urinary naphthols and naphthalene exposure. CONCLUSIONS: Urinary naphthols were associated with specific sources of exposure to JP-8, arising from both inhalation and dermal contact. Smokers and nonsmokers metabolized naphthalene at different rates, consistent with induction of at least two metabolic pathways by smoking.     

A Comparison of the Rates of Sickness Absence between the Male Population of Royal Air Force Waddington and the Lincolnshire Police Force During November 1980

A survey of male sickness absence notifications during the monthof November 1980 was performed at Royal Air Force Waddingtonand at the Lincolnshire Police Force Headquarters. The results,when analysed, showed a statistically significant (P<0.05)lower absence rate amongst RAF personnel, independent of theparameters used for comparison. The study points to the existence of an occupational healthservice as a major contribution to lower sickness absence ratesamongst RAF personnel. Accepted        1 January 1982 Flight Lieutenant R. Guest, Medical Centre, United Kingdom Support Unit, Ramstein Air Base, BFPO 109     

The Air Force health study: an epidemiologic retrospective

In 1979, the U.S. Air Force announced that an epidemiologic study would be undertaken to determine whether the Air Force personnel involved in Operation Ranch Hand-the program responsible for herbicide spraying in Vietnam-had experienced adverse health effects as a result of that service. In January 1982 the Air Force Health Study (AFHS) protocol was approved and the 20 year matched cohort study consisting of independent mortality, morbidity and reproductive health components was initiated. This controversial study has been criticized regarding the study's potential scientific limitations as well as some of the administrative aspects of its conduct. Now, almost 30 years since the implementation of the AFHS and nearly a decade since the final follow up examinations, an appraisal of the study indicates that the results of the AFHS do not provide evidence of disease in the Ranch Hand veterans caused by their elevated levels of exposure to Agent Orange.     

Toxicity of jet fuels to several terrestrial insects

The acute toxicity of a variety of Air Force jet fuels was evaluated for several terrestrial insects. The most toxic fuel was a shale-derived JP-8. In general, shale fuels were more toxic than their petroleum-derived counterparts. The order of decreasing susceptibility to the current standard Air Force fuel, petroleum-derived JP-4, was earwigs, rice weevils, flour beetles, lady beetles, tenebrionid beetles, and cockroaches. However, species response varied with different jet fuel types.