Feasibility study for human biomonitoring in peace operations

The Swedish Armed Forces are increasingly involved in peace operations1. Contemporary peace operation deployments present many hazards to the life and health of soldiers as well as deployed civilians. The obvious risks from battle injuries aside, disease and other non-battle injuries (DNBI) have historically accounted for the vast majority of casualties in almost all military operations. In addition risks of exposure to toxic chemicals as well as biological and radiological substances may exist in theatre. As SwAF transitions from a conscript force to a professional force, the potential of long-term health effects from exposures during repeat deployments are of greater concern. There is hence a need for the Swedish Armed Forces and other organisations that deploy field staff to develop strategies on how to protect their personnel from any potential future health effects from hazards they may encounter during mission deployments. One tool in the toolbox in doing so might be to perform biomonitoring. The aim of this study was to evaluate the feasibility of biomonitoring within the Swedish Armed Forces by examining the potential need for biomonitoring, reviewing what potential biomarkers that exist for implementation and considering the logistical, economical, and ethical constraints for conducting biomonitoring specific for the SwAF. The need for biomonitoring was examined based on the level of environmental health hazards in deployment areas and exposure potential. Case studies were presented that provide conclusive evidence that a number of hazards in fact also exist in the field and that exposures can occur. A large number of biomarkers for a wide array of environmental hazards also exist. However, the precise markers for implementation are dictated by the specific suspected exposure and questions to be answered. While logistical, economical, and ethical considerations exist that add complexity to biomonitoring, no obstacles were however identified that could not be addressed or overcome if the identified problem justifies the study.