Periodic Occupational and Environmental Monitoring Summary (POEMS)
The history of compensating Veterans for adverse health effects resulting from Service-connected exposures is long and complex. The key issue is determining that the health condition resulted from military service (Service-connection) i.e., the individual was exposed to the causative agent during service, and that exposure caused the health condition.
The first Gulf War ended with a lack of reliable data on potential occupational and environmental exposures (such as chemical warfare agents, pesticides, particulate material, oil well fire emissions, depleted uranium, chemical agent resistant paints, etc.) suspected of causing Veterans’ health problems. As a result, the Department of Defense (DOD) developed policy which requires the Services to:
· collect environmental samples and other exposure related information
· perform and consistently update health risk assessments
· track troop locations on a daily basis
· and assess service member’s post-deployment health outcomes
· archive all this information for future use
Tangible advances have been made with environmental sample collection (to include better equipment, analytical techniques, and training), data archiving, policy/doctrine, and electronic data systems. The most difficult task that remains is determining an individual’s Service-connected exposure and the resultant health consequences.
Occupational and environmental health (OEH) surveillance sampling is now routinely done by preventive medicine at base camps, airbases, seaports, forward operating bases, forward operating locations, etc. The purpose of this environmental sampling is to document potential exposures and the resulting health risk to the population at resides these deployment locations. Environmental surveillance data and the resulting health risk associated with potential exposure are summarized in the Periodic Occupational and Environmental Monitoring Summary (POEMS).
POEMS are the DOD approved multi-Service documents that summarize medical interpretation of OEH surveillance data for deployment sites. POEMS describe the sources of exposure possible at a location (for example, airborne pollutants, water pollutants, infectious disease, noise, heat/cold), summarize the available environmental data, and provide an assessment of the significance of any known or potential acute (short-term) and long-term (post-deployment) health risks to the population deployed to the site.
POEMS have been developed, and continue to evolve, to comply with the requirements of DOD instruction 6490.03 and DOD instruction 6055.05, Occupational and Environmental Health, 2008, and Memorandum, Joint Chiefs of Staff, MCM 0028-07, 2007, subject: Procedures for Deployment Health Surveillance, 2007. The general requirements of the instructions state that the information contained in the POEMS should include monitoring results, assessment of whether exposures are acceptable, and identification of standards used to analyze the hazards. The information in the POEMS is summarized and focused on the health implications for service members deployed to that site.