3 Nevertheless, concerns persisted among those who were at the facility. The USACHPPM team also concluded that the potential for long-term adverse effects was low to negligible, and no further future medical surveillance was indicated such conclusions were subsequently upheld following a review by the Defense Health Board in 2008. Whole blood chromium levels were not elevated. An assessment by the USACHPPM of the medical surveillance results concluded that the self-reported symptoms (e.g., irritation-type symptoms related to the eyes, nose, throat, and lungs) and physical findings were nonspecific and consistent with exposure to the desert environment and austere living conditions. Medical evaluations offered to available personnel included occupational (including hours spent on the site) and medical history, physical examination (with attention to the nose and skin), pulmonary function testing, chest X-rays, and laboratory testing to include whole blood chromium levels. Postremediation environmental soil, air, surface, and personal breathing zone measurements for chromium were taken. Army Public Health Command, conducted site characterization between Septemand November 2, 2003. Army Center for Health Promotion and Preventive Medicine (USACHPPM), now part of the U.S. 2 A formal evaluation of the health risk was requested through Army channels, and a team composed of medical, industrial hygiene, and environmental personnel from the U.S. The potential chromate exposures occurred from early April, 2003 (when the first individuals arrived) until hazard remediation took place sometime before the end of September 2003. These personnel were housed in Kuwait and traveled daily to QA. Government contractors and civilians working to restore operation to the damaged plant as quickly as possible. SMs performed escort and security duties for U.S. Yellow-stained soil was reported on site because of contamination. Sodium dichromate, stored in bags at the site, was released before the coalition forces arrival. 1 Sodium dichromate (containing CrVI) was used as a corrosion inhibitor to support Iraq's oil drilling operations at the facility. Service members (SMs) and civilian Department of Defense (DoD) employees (838 National Guard SMs eligible for VA evaluations, 74 Active Duty SMs and civilians eligible for DoD evaluations) were potentially exposed to hexavalent chromium (CrVI) dust and contaminated soil at the Qarmat Ali (QA) industrial water treatment facility near Basrah, Iraq, during deployment to Operation Iraqi Freedom in 2003. Regardless, since the actual level of exposure to CrVI will never be known with certainty, the VA will continue to monitor these Veterans with periodic evaluations to identify and manage any pathologic findings that might be associated with past CrVI exposure. However, the overall low participation rate (15%) severely compromises any ability to generalize to the entire potentially exposed population. Conclusions: The lack of severe nasal abnormalities in the VA evaluations supports a time-limited peak exposure. No abnormalities that were specific to chromium exposure (e.g., nasal septum perforation) were found. A history of respiratory ( n = 78) and skin ( n = 38) symptoms were reported during the period of exposure. Results: Mean reported number of days exposed was 21 (median 10). In addition, a mortality analysis was conducted for the 808 unique personal identifiers available to Veterans Health Administration. The evaluations were reviewed to define population level effects. Methods: Retrospective review of medical records of the 124 Veterans that participated in standardized, in-person clinical evaluations for possible CrVI exposure during the incident in question. Objective: To review the Veterans Affairs (VA) medical surveillance program for Veterans with potential hexavalent chromium (CrVI) exposure that occurred during 2003.
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