Chapter XXXII: Appendix: J (2)

_3._ Supertropical bleach and DS2 can be used on the
polyethylene menu bag for up to 24 hours without a significant
change in appearance, tensile properties, and size of the
plastic. The use of DS2 will cause significant degradative
changes to most other plastics, while STB will cause little
or no change. Also, DS2 may cause false positive readings
when using M8 or M9 paper, or the M256 Detector Kit to check
completeness of decontamination.

(_c_) Group III will consist of unpackaged or poorly packaged
items which have been exposed to an agent in either vapor or
liquid form. Foodstuffs in this group should be decontaminated
only when absolutely necessary. =The decision to use foods
that have been contaminated is to be made by the commander.=
Decontamination procedure to be followed, in order, is: trim
surface fat and grossly contaminated areas; wash with water or
2-percent sodium bicarbonate solution; then boil in water.

_1._ Boiling in water may be eliminated when the contamination
has been only with the vapors of irritant agents. When such an
exposure has been light, aeration for a short time may be used
for decontamination.

_2._ Frying, roasting, or broiling will not remove traces of
blister agents from meats. In general, salvage of foods heavily
contaminated with droplets of the blister agents, especially
the arsenical blister agents, is not practical. Foods of high
water or fat content are unfit for consumption and reclamation
is not practical when contaminated with liquid mustard or a
liquid nitrogen mustard.

_3._ When foods have been exposed to blister agent vapor, they
can be reclaimed by washing with sodium bicarbonate solutions
and rinsing with clear water, by intensive cooking, or in
the case of dry provisions, by 24 to 48 hours of aeration.
Lean meat contaminated with mustard vapor can be reclaimed by
boiling in water for 30 minutes or more. With nitrogen mustard
vapor contamination, the meat should be boiled in a 2-percent
sodium bicarbonate solution. Discard the water used to boil the
meat.

_4._ Nerve agent contamination is treated the same as blister
agent contamination.

_5._ Foods, such as potatoes and hard-skinned fruits and
vegetables, can be decontaminated by washing or scrubbing,
followed by peeling or scraping, then washing again.

_6._ Prepared food in open containers will be contaminated;
it must be temporarily isolated, or disposed of (bury or as
directed by commander).

_7._ A food Item that is contaminated with irritants can be
decontaminated by airing. Consumability is determined by taste
rather than toxicity.

_8._ Phosgene is rapidly hydrolyzed, therefore, washing the
food with water or airing it will usually suffice.

_9._ Food contaminated with white phosphorous should be
destroyed.

_10._ Normally, hydrocyanic acid will have little effect on
food supplies. The exposures will most likely be as a vapor.
However, foods with a high water content may become unfit for
consumption after exposure to high concentrations.

_11._ The effect of CK on foods is not known. Foods exposed to
CK vapors are considered toxic.

_12._ Table J-8 lists the decontamination procedures for
unpackaged food contaminated with a chemical agent.

(9) Decontaminating cattle, poultry, and other livestock is
only attempted when other sources of food are not available.
Heavily contaminated animals should be destroyed. Livestock
contaminated lightly by phosgene, nerve agents, mustards, and
arsenicals (such as vapor or liquid) may be slaughtered in the
early stages of poisoning before the full effects of exposure
are shown. If these animals are slaughtered in the preliminary
stages of poisoning and all tissues exposed to the agent (the
head, blood, lungs, organs, and local areas) are discarded,
there is no danger in consumption of the meat, provided the
animal passes a pre-slaughter and slaughter inspection.
This is true even of animals poisoned by arsenical agents
since the edible tissue will contain amounts of arsenic too
small to be toxic. Organs (liver, brain, heart, kidney, and
lungs) will contain more arsenic than the musculature and are
discarded. The meat must be well cooked. Personnel involved in
slaughtering procedures must be careful to prevent spreading
contamination to the meat and to themselves.

(10) Decontaminating forage and grain exposed to only chemical
agent vapors is by aeration. Aerated supplies, especially if
mixed with larger amounts of uncontaminated supplies, produces
no ill effects when fed to animals. Forage or grain heavily
contaminated by liquid vesicants, especially arsenicals, should
not be used.

_Table J-8. Chemical Decontamination of Unpackaged Food_

========================================================================
FATTY FOODS NONFATTY FOODS, NONFATTY FOODS,
(BUTTER, BACON, High WATER CONTENT LOW WATER CONTENT,
CHEMICAL AGENT MILK, CHEESE, CRYSTALLINE (FRUITS, AMORPHOUS (FLOUR,
HAM). VEGETABLES, SALT, CEREALS, BREAD,
SUGAR). PEAS).
------------------------------------------------------------------------
=NERVE AGENTS=

VAPOR, HEAVY DESTROY DESTROY, UNLESS AIR FOR 48 HOURS,
POSSIBLE TO BOIL THEN BOIL.
AFTER AIRING 48
HOURS.

VAPOR, LIGHT DESTROY AIR FOR 48 HOURS, AIR FOR 48 HOURS,
THEN BOIL. THEN BOIL.

LIQUID DESTROY DESTROY DESTROY

=MUSTARDS=

VAPOR REMOVE 1-3 cm WASH WITH WATER. WASH WITH WATER.
OF OUTER LAYER AIR FOR 48 HOURS. AIR FOR 48 HOURS.
AND WASH WITH 2%
SODIUM BICARB-
ONATE SOLUTION.
BOIL FOR AT
LEAST 30 MINUTES.
DESTROY MILK.

LIQUID DESTROY DESTROY DESTROY

=ARSENICALS=
DESTROY DESTROY DESTROY
========================================================================

GLOSSARY

ABBREVIATION, ACRONYMS, AND DEFINITIONS

=ABCA= American, British, Canadian, and Australian

=ABO= agents of biological origin

=AC= hydrogen cyanide

=AFJMAN= Air Force Joint Manual

=amb= ambulance

=AMEDD= Army Medical Department

=AMEDDC&S= Army Medical Department Center and School

=AMedP= Allied Medical Publication

=AML= area medical laboratory

=AN/PDR27= radiac meter

=AN/PDR77= radiac meter

=AN/VDR2= radiac meter

=AO= area of operations

=AR= Army regulation

=ATM= advanced trauma management

=ATTN= attention

=AXP= ambulance exchange point

=BAS= battalion aid station

=BAT= Biological Augmentation Team

=BC= blood culture

=bde= brigade

=BDU= battle dress uniform

=BI= battle injury

=BIDS= Biological Integrated Detection System

=Biological Warfare Agent Field Confirmation Identification= Identification of a suspect biological warfare agent by means of devices/materials/technologies that are based on detecting biological markers using two or more independent biomarker results. Examples might include the findings of the presumptive biomarker identification with the addition of a positive PCR, ELISA, or electrochemiluminescence (ECL) results, using specific target nucleic acid sequences for the organism and antibody recognition of agent-specific antigen sites, respectively. (Field sample/ specimen identification by forward deployed or forward positioned laboratories [such as the US Air Force Biological Augmentation Team (BAT), theater army medical laboratory, or forward deployed preventive medicine unit (US Navy) and homeland security Laboratory Response Network (LRN) Level B or C, US Army Community Hospitals or Medical Centers].)

=Biological Warfare Agent Definitive Identification And Confirmation= The specific identification of a suspect biological agent as to genus and species, serological type, or toxin. This level of identification is by means of devices/materials/technologies that are based on two or more independent biomarker results and using different methodologies. This level of identification is performed in a reference laboratory with a broader variety of methodologies available and highly skilled testing personnel, thus providing the highest levels of accuracy. (Sample/specimen identification is accomplished by homeland security LRN Level C and D and nationally recognized laboratory such as the US Army Medical Research Institute of Infectious Disease or Centers for Disease Control and Prevention.)

=Biological Marker= Characteristics of a biological agent (organism, virus, toxin, or product) that are specific to the agent. This includes (1) recognition of specific nucleic add sequences (DNA or ribonucleic acid [RNA]) unique to the bacteria or virus by a technique such as PCR; (2) identification of specific ECL assay; (3) specific growth properties as seen on selective media such as characteristic colony morphology on culture along with phage inhibition; (4) Identification using specific microscopic characteristics such as Gram stain, fluorescent antibody stain, immunohistochemical stain, or cytopathic effects.

=Biological Warfare Agent Presumptive Identification= Identification of a suspect biological warfare agent by means of devices/materials/technologies that are based detecting biological markers (biomarkers) using a single methodology. The biomarkers and/or methodologies used at this level of testing have significant limits to their accuracy. Agent identification to species level, or differentiation among a family of similar agents, may not be possible. This is equivalent to the LRN Level A and the US Army BIDS. (EXAMPLES: Identification by sensor triggering, hand-held devices [hand-held assays] or initial systems, or laboratory analysis employing one screening methodology [such as microscopic morphology, antibody/protein, or nucleic acid-based test].)

=bot/pkg= bottle/package

=BSA= brigade support area

=BW= biological warfare

=BZ= an incapacitating chemical warfare agent

=C= Centigrade/Celsius

=C2= command and control

=C4I= Command, Control, Communications, Computers, and Intelligence

=CaCl= calcium hypochlorite

=cal/cm^2= calories per square centimeter

=cal/cm^2/sec= calories per square centimeter per second

=CAM= chemical agent monitor

=CANA= convulsant antidote for nerve agent (diazepam)

=CB= chemical/biological

=CBDA= Chemical Biological Defense Agency

=CBPS= chemically biologically protected shelter

=CBRNE= chemical, biological, radiological, nuclear, and high-yield explosive

=CBSCC= Chemical-Biological Sampling Control Center

=CBSCE= Chemical-Biological Sampling Control Element

=cc= cubic centimeter

=CG= phosgene

=cGy= centigray

=CIS= Commonwealth of Independent States (Russia)

=CK= cyanogen chloride

=Cl= chlorine

=CLASS VIII= Classification of medical supplies and equipment within the Federal Stock Classification System

=CLS= combat lifesaver

=cm= centimeter

=cm^2= square centimeter

=CNS= central nervous system

=CO_{2}= carbon dioxide

=CONUS= continental United States

=COSC= combat operational stress control

=CP= chemically protected

=CP DEPMEDS= chemically protected deployable medical system

=CPS= collective protection shelter

=CREST= Casualty Requirements Estimation Tool

=CS= combat support

=Cs-137= Cesium 137

=CSF= cerebrospinal fluid

=CSH= combat support hospital

=CSS= combat service support

=CW= chemical warfare

=CX= phosgene oxime

=DA= Department of the Army

=DAP= decontamination apparatus, portable

=DCS= division clearing station

DD Department of Defense

decon decontamination

DEPMEDS Deployable Medical System

DNA deoxyribonucleic acid

DNBI disease and nonbattle Injury

DOD Department of Defense

DP diphosgene

DS2 decontaminating solution Number 2

DTF dental treatment facility

E EDTA

EAC echelons above corps

ECL electochemiluminescence

ECP entry control point

ECU environmental control units

EDTA ethylenediaminetetraacetate

EEE eastern equine encephalitis

ELISA enzyme-linked immunosorbent assay

EM electron microscopy

EMP electromagnetic pulse

EMS emergency medical services

EMT emergency medical treatment

EOD explosive ordnance disposal

EPW enemy prisoner of war

ER emergency room

evac evacuation

F Fahrenheit

F-1 Fraction-1

FA fluorescent antibody

FDECU field deployable environmental control unit

FH field hospital

FLOT forward line of own troops

FM field manual

FMC Field Medical Card

FSOP field standing operating procedures

FST forward surgical team

g gram

G1 Assistant Chief of Staff (Adjutant)

G2 Assistant Chief of Staff (Intelligence)

G3 Assistant Chief of Staff (Operations and Training)

G4 Assistant Chief of Staff (Logistics)

GA Tabun

gal gallon

GB Sarin

GD Soman

=GF= a nerve agent

=GH= general hospital

=gm= gram

=GP= general purpose

=GVO= green vinyl overboots

=Gy= gray (100 cGy)

=H= heparin

=HD= sulfur mustard (a blister agent)

=HG= chemical symbol for mercury

=HL= mustard and Lewisite mix

=HMMWV= high mobility multi-purpose wheeled vehicle

=HN= nitrogen mustard

=HPLC= high-pressure liquid chromatography

=HSL= health service logistics

=HSS= health service support

=HUB= hospital unit base

=HUH= hospital unit holding

=HUM= hospital unit medical

=HUS= hospital unit surgical

=HTH= high test hypochlorite (70% available chlorine)

=I-131= Iodine-131

=IATA= International Air Transportation Association

=IAW= in accordance with

=IC= intensive care

=ICAM= improved chemical agent monitor

=ICC= incident command center

=ICU= intensive care unit

=ICW= intensive care ward

=ID= Incapacitation dose

=IgG= immunoglobulin class G

=IgM= immunoglobulin class M

=IMA= installation medical authority

=ISO= International Organization for Standardization

=IV= intravenous

=J2= Joint Intelligence Directorate

=J3= Joint Operations Directorate

=kg= kilogram

=km= kilometer(s)

=kph= kilometers per hour

=KT= kiloton

=L= Lewisite

=LAB= laboratory

=lb= pound

=LCE= load-carrying equipment

=LD= lethal dose

=LD 50/60= lethal dose for 50 percent of exposed persons within a period of 60 days

=LRN= Laboratory Response Network

=LSD= d-lysergic acid diethylamide

=LZ= landing zone

=µ= micron

=m= meters

=m3= milligrams per minute

=MCRP= Marine Corps Reference Publication

=MEDEVAC= medical evacuation

=Medical Countermeasures= Those measures taken to maintain soldier sustainability through the prevention and pretreatment of injury from NBC agent hazards; and following injury those measures taken to treat NBC casualties and improve medical capability for diagnosis, physiological resuscitation and continued medical management of NBC casualties.

=MES= medical equipment set

=MF2K= Medical Force 2000 (Army of Excellence Organizations)

=mg= milligram

=mg/kg= milligrams per kilogram

=MILVAN= military-owned demountable container

=ml= milliliter

=mm= millimeter

=MOPP= mission-oriented protective posture

=MOS= military occupational specialty

=MRE= meal ready-to-eat

=MRI= Medical Reengineering Initiative

=MSR= main supply route

=m/sec= meters per second

=MT= megaton

=MTF= medical treatment facility

=NaCl= sodium chloride (salt)

=NATO= North Atlantic Treaty Organization

=NAVMED P= Naval Medical Publication

=NBC= nuclear, biological, and chemical

=NBCC= nuclear, biological, and chemical control

=NBCWRS= nuclear, biological, and chemical warning and reporting system

=NCO= noncommissioned officer

=NL= no limit

=NTTP= Navy Tactics Techniques and Procedures

=O_{2}= oxygen

=OEG= operational exposure guide

=OPLAN= operation plan

=OPSEC= operations security

=Patient Decontamination=--The removal and/or the neutralization of hazardous levels of nuclear, biological, and chemical contamination from patients at a medical treatment facility. Patient decontamination is performed under the supervision of medical personnel to prevent further injury to the patient and to maintain the patient's health status during the decontamination process. Patient decontamination serves multiple purposes; it protects the patient from further injury, it prevents exposing medical personnel to the contamination, and it prevents contamination of the medical treatment facility.

=PCR= polymerase chain reaction

=PDS= patient decontamination station

=pH= symbol relating the hydrogen ion activity in gram equivalents per liter used in expressing the acidity and alkalinity on a scale whose values run from 0 to 14 with 7 representing neutrality. Numbers less than 7 indicate increasing acidity, and numbers greater than 7 indicate increasing alkalinity.

=PMM= preventive medicine measures

=pnt= patient

=ppm= parts per million

=PPW= patient protective wrap

=PS= chloropicrin

=PVF= polyvinyl fluoride

=PVNTMED= preventive medicine

=QSTA= Quadripartite Standardization Agreement

=RDD= radiological dispersal device

=recon= reconnaissance

=RES= radiation exposure status

=RNA= ribonucleic acid

=ROWPU= reverse osmosis water purification unit

=RT= red top

=RT-PCR= reverse transcriptase/polymerase chain reaction

=RTD= return to duty

=S1= Adjutant (US Army)

=S2= Intelligence Officer (U.S. Army)

=S3= Operations and Training Officer (U.S. Army)

=S4= Supply Officer (U.S. Army)

=SCUD= ballistic missile

=SDK= skin decontaminating kit

=SFG= Special Forces Group

=SMART= special medical assistance response team

=SOF= Special Operations Forces

=SOP= standing operating procedure

=Sr-89= Strontium-89

=Sr-90= Strontium-90

=STANAG= Standardization Agreement (NATO)

=STAT= statim

=STB= supertropical bleach

=Sv= Sievert

=T2= trichothecene

=TAML= theater Army medical laboratory

=TC= training circular

=TEU= technical escort unit

=TEMPER= tent, expandable, modular, personnel

=Toxic Industrial Biological (TIB)= Biological materials (bacteria, viruses, and toxins) found in medical research, pharmaceutical, and other manufacturing processes that are toxic to humans and animals, or cause damage to plants.

=Toxic Industrial Chemical (TIC)= Chemical compounds used or produced in industrial processes that are toxic to humans and animals, or cause damage to plants. EXAMPLES include fuels, solvents, heavy metals, and chemicals used in manufacturing processes.

=Toxic Industrial Material (TIM)= Toxic industrial materials may be toxic industrial chemical (TIC), toxic industrial biological (TIB) and toxic industrial radiological (TIR) materials.

=Toxic Industrial Radiological (TIR)= Radiation-emitting materials used in research, power generation, medical treatment, and other non-weapon developmental activities that are harmful to humans and animals if released outside their controlled environment.

=TIR= toxic industrial radiological

=TM= technical manual

^{=TM=} trademark

=TOE= table of organization and equipment (US Army organizational structure document)

=TO= theater of operations

=trmt= treatment

=TSOP= tactical standing operating procedures

=TT= tiger top

=µ= microns

=UGR= unit group rations

=UN= United Nations

=US= United States

=USAF= United States Air Force

=V-agent= a nerve agent

=VEE= Venezuelan equine encephalitis

=VX= a persistent nerve agent

=WBGT= wet bulb globe temperature

=WEE= western equine encephalitis

=WMD-IST= weapons of mass destruction--installation support team

REFERENCES

=NATO=

_NATO Emergency War Surgery Handbook._ 1988.

=NATO STANAGs=

These agreements are available on request (using DD Form 1425) from the Standardization Documents Order Desk, 700 Robins Avenue, Building 4, Section D, Philadelphia, Pennsylvania 19111-5094.

2002. _Warning Signs for the Marking of Contaminated or
Dangerous Land Areas, Complete Equipments, Supplies and Stores.
Edition 8._ 29 January 1999.

2047. _Emergency Alarms of Hazard or Attack (NBC and Air Attack
Only). Edition 7._ 24 July 1998. (Latest Amendment, 7 February
2000.)

2068. _Emergency War Surgery. Edition 4._ 28 October 1986.
(Latest Amendment, 17 October 1991.)

2083. _Commander's Guide on Nuclear Radiation Exposure of
Groups. Edition 5._ 19 September 1986. (Latest Amendment, 26
June 1994.)

2103. _Reporting Nuclear Detonations, Biological and Chemical
Attacks, and Predicting and Warning of Associated Hazards and
Hazard Areas--ATP 45(A). Edition 8._ 31 August 2000.

2104. _Friendly Nuclear Strike Warning. Edition 7._ 28 June
1994. (Latest Amendment, 28 June 1995.)

2112. _Nuclear, Biological, and Chemical Reconnaissance.
Edition 4._ 6 March 1998.

2475. _Medical Planning Guide for the Estimation of NBC Battle
Casualties (Nuclear)--AmedP-8(A), Volume I._ December 2000.

2476. _Medical Planning Guide of NBC Battle Casualties
(Biological)--AmedP-8(A), Volume II._ March 2001.

2477. _Planning Guide for the Estimation of NBC Battle
Casualties (Chemical)--AmedP-8(A), Volume III._ March 2001.

2500. _NATO Handbook on the Medical Aspects of NBC Defensive
Operations--AMedP-6(B). Edition 4._ 11 February 1997.

2873. _Concept of Operations of Medical Support in Nuclear,
Biological, and Chemical Environments--AmedP-7(A). Edition 3._
16 October 1996.

2879. _Principles of Medical Policy in the Management of a Mass
Casualty Situation. Edition 3._ 7 September 1998.

2941. _Guidelines for Air and Ground Personnel Using Fixed and
Transportable Collective Protection Facilities on Land. Edition
2._ 19 June 1992. (Latest Amendment, 30 October 1995.)

2954. _Training of Medical Personnel for NBC Operations.
Edition 1._ 28 December 1987. (Latest Amendment, 6 June 1995.)

=ABCA QSTAGs=

These agreements are available on request (using DD Form 1425) from the Standardization Documents Order Desk, 700 Robins Avenue, Building 4, Section D, Philadelphia, Pennsylvania 19111-5094.

183. _Emergency Warning Signals and Alarms for NBCD Hazards or
Attacks (NBC and Air Attacks Only). Edition 3._ 12 August 1991.

187. _Reporting Nuclear Detonations Biological and Chemical
Attacks and Predicting and Warning of Associated Hazards and
Hazard Areas. Edition 5._ 21 May 1998.

189. _Friendly Nuclear Strike Warning. Edition 3._ 12 August
1991.

501. _Warning Signs for the Marking of Contaminated or
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Edition 2._ 11 May 1982.

608. _Interoperable Chemical Agent Detector Kits. Edition 3._
13 December 2000.

816. _Medical Aspects of Mass Casualty Situations. Edition 1._
August 1990.

1330. _Medical Aspects of NBC Defensive Operations._ Draft.

2000. _Guidelines on Entry and Exit Procedures for Using
Collective Protection Facilities._ 17 December 1996.

=JOINT OR MULTISERVICE PUBLICATIONS=

AR 40-535. _Worldwide Aeromedical Evacuation._ AFR 164-5;
OPNAVINST 4630.9C; MCO P4630.9A. 1 December 1975. (Reprinted
with basic including Change 1, 10 May 1979.)

AR 40-562. _Immunizations and Chemoprophylaxis._ AFJI 48-110;
BUMEDINST 6230.15; CG COMDTINST M6230.4E. 1 November 1995.

AR 40-656. _Veterinary Surveillance Inspection of Subsistence._
NAVSUPINST 4355.10; MCO 10110.45. 15 October 1986.

AR 40-657. _Veterinary/Medical Food Inspection and Laboratory
Service._ NAVSUPINST 4355.4F; MCO P10110.31G. 6 November 1997.

FM 3-3. _Chemical and Biological Contamination Avoidance._ FMFM
11-17. 16 November 1992. (Change 1, 29 September 1994.)

FM 3-4. _NBC Protection._ FMFM 11-9. 29 May 1992. (Reprinted
with basic including Changes 1-2, 21 February 1996.)

FM 3-5. _NBC Decontamination._ MCWP 3-37.3. 28 July 2000.

FM 3-6. _Field Behavior of NBC Agents (Including Smoke and
Incendiaries)._ AMF 105-7; FMFM 7-11 H. 3 November 1986.

FM 3-9. _Potential Military Chemical/Biological Agents and
Compounds._ NAVFAC P-467, AFR 355-7. 12 December 1990.

FM 3-11.34. _Multiservice Procedures for Nuclear, Biological,
and Chemical (NBC) Defense of Theater Fixed Sites, Ports, and
Airfields._ MCWP 3.37.5; NTTP 3-11.23; AFTTP(I) 3-2.33. 29
September 2000.

FM 3-19. _Nuclear, Biological and Chemical Reconnaissance._
FMFM 11-20. 19 November 1993.

FM 3-100. _Chemical Operations, Principles and Fundamentals._
MCWP 3-3.7.1. 8 May 1996.

FM 4-02.33. _Control of Communicable Diseases Manual._ 17th
Edition. NAVMED P-5038. 31 December 1999.

FM 4-02.283. _Treatment of Nuclear and Radiological
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December 2001.

FM 6-22.5. _Combat Stress._ MCRP 6-11C; NTTP 1-15M. 23 June
2000.

FM 8-9. _NATO Handbook on the Medical Aspects of NBC Defensive
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