During the 1950s, with the Cold War looming, military planners sought to know more about how to keep fighting forces fit and capable in the harsh Alaskan environment. In 1956 and 1957, the U.S. Air Force's former Arctic Aeromedical Laboratory conducted a study of the role of the thyroid in human acclimatization to cold. To measure thyroid function under various conditions, the researchers administered a radioactive medical trace, Iodine-131, to Alaska Natives and white military personnel; based on the study results, the researchers determined that the thyroid did not play a significant role in human acclimatization to cold. When this study of thyroid function was revisited at a 1993 conference on the Cold War legacy in the Arctic, serious questions were raised about the appropriateness of the activity--whether it posed risks to the people involved and whether the research had been conducted within the bounds of accepted guidelines for research using human participants. In particular, there was concern over the relatively large proportion of Alaska Natives used as subjects and whether they understood the nature of the study. This book evaluates the research in detail, looking at both the possible health effects of Iodine-131 administration in humans and the ethics of human subjects research. This book presents conclusions and recommendations and is a significant addition to the nation's current reevaluation of human radiation experiments conducted during the Cold War. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1 Introduction</li>
<li>2 Health Effect of I131 Administration in Humans</li>
<li>3 The Ethics of Human Subjects Research</li>
<li>4 Conclusions and Recommendations</li>
<li>5 References</li>
<li>A. Thyroid Function in Health and Disease</li>
<li>B. Summary of the Public Session</li>
<li>C. Thyroid Radaition Dose Estimates for I131
</li>
<li>D. Secretary of Defense Letter</li>
<li>E. Informed Consent Elements of Disclosure</li>
<li>F. Principles for the Conduct of Research in the Arctic</li>
<li>G. Biographical Sketches of Committee Members</li>
<li>H. Glossary</li>
</ul>

The Arctic Aeromedical Laboratory's Thyroid Function Study: A Radiological Risk and Ethical Analysis

Medical Books

Division on Earth and Life Studies

Commission on Life Sciences

Board on Radiation Effects Research

Polar Research Board

Commission on Geosciences, Environment, and Resources

Board on Health Promotion and Disease Prevention

INSTITUTE OF MEDICINE

Committee on Evaluation of 1950s Air Force Human Health Testing in Alaska Using Radioactive Iodine-131

National, Research Council

Medicine

National Academies Press

Risk Communication and Vaccination: Workshop Summary (Compass Series)

Administration & Medicine Economics

On November 6, 1995, the Institute of Medicine's Vaccine Safety Forum convened a workshop on detecting and responding to adverse events following vaccination. Workshop speakers and participants discussed the difficulties in detecting adverse events, current adverse events detection and response methods and procedures, suggestions for improving the means of detecting and responding to adverse events following vaccination, and future areas of research. This document represents a summary of that workshop.

Vaccine Safety Forum: Summaries of Two Workshops (Compass Series)

Despite overwhelming evidence of tobacco's harmful effects and pressure from anti-smoking advocates, current surveys show that about one-quarter of all adults in the United States are smokers. This audience is the target for a wave of tobacco products and pharmaceuticals that claim to preserve tobacco pleasure while reducing its toxic effects. Clearing the Smoke addresses the problems in evaluating whether such products actually do reduce the health risks of tobacco use. Within the context of regulating such products, the committee explores key questions: <ul>
<li>Does the use of such products decrease exposure to harmful substances in tobacco?</li> <li>Is decreased exposure associated with decreased harm to health?</li> <li>Are there surrogate indicators of harm that could be measured quickly enough for regulation of these products?</li> <li>What are the public health implications? 
</li> </ul>
This book looks at the types of products that could reduce harm and reviews the available evidence for their impact on various forms of cancer and other major ailments. It also recommends approaches to governing these products and tracking their public health effects. With an attitude of healthy skepticism, Clearing the Smoke will be important to health policy makers, public health officials, medical practitioners, manufacturers and marketers of "reduced-harm" tobacco products, and anyone trying to sort through product claims. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1 Introduction</li>
<li>2 Principles of Harm Reduction</li>
<li>3 Historical Perspective and Lessons Learned</li>
<li>4 Products for Tobacco Exposure Reduction</li>
<li>5 The Scientific Basis for Pres Assessment</li>
<li>6 Surveillance for the Health and Behavioral Consequences of Exposure Reduction</li>
<li>7 Implementation of a Science-Based Policy of Harm Reduction</li>
<li>8 Principal Conclusions</li>
<li>9 Nicotine Pharmacology</li>
<li>10 Tobacco Smoke and Toxicology</li>
<li>11 Exposure and Biomarker Assessment in Humans</li>
<li>12 Cancer</li>
<li>13 Cardiovascular Disease</li>
<li>14 Nonneoplastic Respiratory Diseases</li>
<li>15 Reproductive and Developmental Effects</li>
<li>16 Other Health Effects</li>
<li>Appendix A: Presentations and Submissions</li>
<li>Appendix B: Committee Biographical Sketches</li>
<li>Appendix C: Time Line of Tobacco Events</li>
<li>Index</li>
</ul>

Clearing the Smoke : Assessing the Science Base for Tobacco Harm Reduction

Health, Fitness & Dieting

Committee to Assess the Science Base for Tobacco Harm Reduction

Addiction & Recovery

Immunization is widely regarded as one of the most effective and beneficial tools for protecting the public's health. In the United States, immunization programs have resulted in the eradication of smallpox, the elimination of polio, and the control and near elimination of once-common, often debilitating and potentially life-threatening diseases, including measles, mumps, rubella, diphtheria, pertussis, tetanus, and Haemophilus influenza type b.  Along with the benefits of widespread immunization, however, have come concerns about the safety of vaccines. No vaccine is perfectly safe or effective, and vaccines may lead to serious adverse effects in some instances. Furthermore, if a serious illness is observed after vaccination, it is often unclear whether that sequence is coincidental or causal, and it can be difficult to determine the true nature of the relationship, if any, between the vaccination and the illness. Ironically, the successes of vaccine coverage in the United States have made it more difficult for the public to weigh the benefits and complications of vaccines because the now-controlled diseases and their often-serious risks are no longer familiar. However, because vaccines are so widely used-and because state laws require that children be vaccinated before entering daycare and school, in part to protect others-it is essential that safety concerns be fully and carefully studied.  Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism, the first of a series from the Institute of Medicine (IOM) Immunization Safety Review Committee, presents an assessment of the evidence regarding a hypothesized causal association between the measles-mumps-rubella (MMR) vaccine and autism, an assessment of the broader significance for society of the issues surrounding the MMR-autism hypothesis, and the committee's conclusions and recommendations based on those assessments.

Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism

Immunization Safety Review Committee

Basic Sciences

Vaccine Safety Forum: Summaries of Two Workshops

Risk Communication and Vaccination: Workshop Summary

Ten years after the end of the Gulf War, questions continue to be raised about the health of U.S. service personnel who fought in that war. A primary concern is whether Gulf War veterans are receiving effective treatments for their health problems. Section 105 of the Veterans Program Enhancement Act of 1998 mandates that the Department of Veterans Affairs (VA) ask the Institute of Medicine (IOM) to convene a committee that would identify a method for assessing treatment effectiveness and describe already-validated treatments for Gulf War veterans' health problems, including the problem of medically unexplained symptoms. The specific charge to the committee is to (1) identify and describe approaches for assessing treatment effectiveness; (2) identify illnesses and conditions among veterans of the Gulf War, using data obtained from the VA and the Department of Defense (DoD) Gulf War Registries, as well as information in published articles; and (3) for these identified conditions and illnesses, identify validated models of treatment (to the extent that such treatments exist), or identify new approaches, theories, or research on the management of patients with these conditions if validated treatment models are not available. Table of ContentsFront MatterExecutive Summary1. Introduction2. Identifying Conditions for Study3. Determining Treatment Effectiveness4. General Approach to Treating Patients5. Effective Treatments6. ConclusionReferencesAppendix A: Coalition Forces and Force StrengthAppendix B: Workshop SummaryAppendix C: Unique Considerations in Chronic Fatigue Syndrome

Gulf War Veterans: Treating Symptoms and Syndromes

History

Committee on Identifying Effective Treatments for Gulf War Veterans' Health Problems

Military

National Academy Press

By two years of age, healthy infants in the United States can receive up to 20 vaccinations to protect against 11 diseases. Although most people know that vaccines effectively protect against serious infectious diseases, approximately one-quarter of parents in a recent survey believe that infants get more vaccines than are good for them, and that too many immunizations could overwhelm an infant's immune system. The Immunization Safety Review Committee reviewed the evidence regarding the hypothesis that multiple immunizations increase the risk for immune dysfunction. Specifically, the committee looked at evidence of potential biological mechanisms and at epidemiological evidence for or against causality related to risk for infections, the autoimmune disease type 1 diabetes, and allergic disorders.

Immunization Safety Review: Multiple Immunizations and Immune Dysfunction

Gulf War and Health, Volume 2, is the second in a series of congressionally-mandated studies by the Institute of Medicine that provides a comprehensive assessment of the available scientific literature on potential health effects of exposure to certain biological, chemical, and environmental agents associated with the Gulf War. In this second study, the committee evaluated the published, peer-reviewed literature on exposure to insecticides and solvents thought to have been present during the 1990-1991 war. Because little information exists on actual exposure levels â€" a critical factor when assessing health effects â€" the committee could not draw specific conclusions about the health problems of Gulf War veterans. However, the study found some evidence, although usually limited, to link specific long-term health outcomes with exposure to certain insecticides and solvents. The next phase of the series will examine the literature on potential health effects associated with exposure to selected environmental pollutants and particulates, such as oil-well fires and jet fuels. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1. Introduction</li>
<li>2. Identifying and Evaluating the Literature</li>
<li>3. Insecticide Toxicology</li>
<li>4. Solvent Toxicology</li>
<li>5. Cancer and Exposure to Insecticides</li>
<li>6. Cancer and Exposure to Solvents</li>
<li>7. Neurologic Effects</li>
<li>8. Reproductive and Developmental Effects</li>
<li>9. Additional Health Effects</li>
<li>Appendix A: Overview of Illnesses in Gulf War Veterens</li>
<li>Appendix B: Conclusions and Recommendations: Gulf War and Health, Volume 1</li>
<li>Appendix C: Identifying the Literature</li>
<li>Appendix D: Insecticides and Solvents Sent to the Gulf War</li>
<li>Appendix E: Relative Risks for Lung Cancer</li>
<li>Appendix F: Neurologic Examination</li>
<li>Appendix G: Consensus Conclusions Arranged by Health Outcome</li>
<li>Index</li>
</ul>

Gulf War and Health: Volume 2: Insecticides and Solvents

Science & Math

Committee on Gulf War and Health: Literature Review of Pesticides and Solvents

Earth Sciences

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