Combined Exposures to Hydrogen Cyanide and Carbon Monoxide in Army Operations

To determine whether the air quality inside armored-vehicle cabins can meet exposure guidelines under deployment conditions, the Army assessed possible synergistic toxic effects from potentially harmful substances. This book, the final of two reports on the subject from the National Research Council, addresses whether the approach discussed in the technical context section of the Army's proposed guidance is appropriate, or whether an alternative assessment method should be developed. Combined Exposures to Hydrogen Cyanide and Carbon Monoxide in Army Operations provides several conclusions and recommendations, including the use of alternative instrumentation for monitoring gas, conducting experiments on human subjects, and seeking advice from additional groups involved with personnel training and field deployment. Table of ContentsFront MatterSummary1 Introduction2 Is There a Role for the Use of Portable Multi-Agent Monitors to Assess the Armored-Vehicle Environment During Varied Operations?3 Is the Coburn-Forster-Kane Prediction Equation Valid at Low or Spiking Levels of Carbon Monoxide or Under Conditions of Rapid Changes in Ventilation?4 Is There Dose-Related Performance Degradation Resulting from Exposure to Carbon Monoxide?5 Is There Dose-Related Performance Degradation Resulting from Combined Exposures to Carbon Monoxide and Hydrogen Cyanide?6 Are There Other Deleterious Effects of Varying Exposures to Carbon Monoxide and Hydrogen Cyanide?7 Moving ForwardReferencesAppendix A: Biographical Information on the Committee on Combined Exposures to Hydrogen Cyanide and Carbon Monoxide in Army OperationsAppendix B: Previous Applications of the Coburn-Forster-Kane Equation to Predict Carboxyhemoglobin Levels Resulting from Varying Carbon Monoxide ExposuresAppendix C: Proposed Experiments to Study Effects of Rapid Changes in Inspired Carbon Monoxide Concentrations and Effects of Rapid Changes in Pulmonary Ventilation