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Orange Registry 2004 2019 Form : Custom-make, Finish and download

I want to welcome you all to Pease.let's see a lot of retirees out there.it's good to see you last time we met it.was in a hangar and both our hangars are.under construction so we've moved over.here to Lloyd but I think it's going to.be a good environment for us to discuss.a few things today so let me start off.with a couple of quick introductions.I'll start off with our edge in general.Major General Dave Mical itis up front.here if you don't all mine too just.raising your hand as I call your name.out just so people can make some.connections.it's Terry Garnett here as well Terry.are you here on his way okay.he's the national president of the.association of civilian technicians.representing senator Sheheen's office is.Peter Clark representing senator Maggie.Hassan is Carrie Holmes and Justin Troy.on oh okay congressman Christopher.Pappas we have Patrick Carroll and.Charlie Harris Charlotte she make it.okay and representing congresswoman.Kuster is Tom giallo all right thanks.very much I'll give you a brief history.again how we got here.so back in August of 18 we had some of.our retirees and widows express some.concerns about their health we responded.by getting our a group of experts.together here at peace and we only have.so many resources so we partnered with a.number of agencies around the base as.well on the national level and that.became our Pease health working group so.I like to look at knowledge though so.I'm going to introduce those as well.first our leader of that group.Lieutenant Colonel Derek Brindisi thanks.very much Mindy Mesmer from New.Hampshire safe water Alliance sure if.everybody's here but we'll go run.through Staff Sergeant Sarah Davidson.public health at Pease Amanda Goulet.bioengineering from Veterans Services we.have Bill Boudreau and Jamie Cummings.Veterans Affairs Jonah Joseph Lennart.our chief aerospace medicine lieutenant.colonel Petrowski from the agency of.toxic substance disease registry Gary.Pearlman National Institute of.Occupational Safety and Health we have.dr. Miriam Calkins in Cheryl Estill.from Dartmouth College Judith Reece also.a number of our retirees and widows.Nancy Eaton is here.Doris Brock Pamela bap Gary eNOS.Peter Sandin Ashley Williams from.University of New Hampshire Carla our.minty and from Department of Health.Human Services Karen Carver let's see we.also have mass sergeant mark Fillion.from the Pease health working group bio.engineering here is there anybody else.that's representing an organization that.I've forgotten all right so this group.got together we had a number of goals.the first one was to hear from our folks.you know what the concerns were so back.in December over in the hangar we.actually had our listening session and I.think we had about 250 people show up.for that it was a little over two hours.and we heard a whole bunch of.heartbreaking stories that came out of.that but that guts are really a focus.for us from the office of Veterans.Affairs we actually had a registry.started and we'll hear from those folks.today another goal was have a handout.that you could bring to your physician.to start a conversation and finally we.wanted to have a Health Study and so we.talked that we got our support from our.Codell and we've submitted a letter to.secretary defense in the VA and we're.starting to make some progress I don't.have any details of what that health.study is going to look like but I know.we are gonna have a Health Study here.and I would think it's going to be next.year sometime so for our agenda that.we're gonna have today we're gonna try.to update you on all those issues so.we'll start off with a service.connection guide.I think Jamie Cummings from office of.veteran services will speak to that will.then have a Derrick brand easy current.Petrowski talked about understanding.your health we have some handouts for.that and how to talk to your physician.about health we have our ATSDR Gary.Pearlman will be speaking about there's.a whole bunch of studies that are going.on in a local area and they all use the.term P's right so we're looking for a.study as I mentioned here but we're.call our is the 157 study so we can.separate it out from I believe there's.five different studies that are going on.right now so we'll hear about those.other studies as well from NIOSH we'll.have dr. Miriam Calkins speak about some.of the studies that they're doing Derek.will give us the latest we have on the.157th a study again we don't have a lot.of information but he's got a little bit.for you and then we'll open it up to.questions and answers as best we can.with our subject matter experts and then.we'll finally spill out in the hallway.we have five tables split up so if you.don't want to ask a question in front of.everybody here we'll have those experts.go out in the hallway and you can speak.to them 101 so does that sound good to.everybody all right with that then I'm.going to ask Jamie Cummings to come up.and if you don't mind just we are trying.to capture this for a video and we have.a microphone here that will help so if.you could good afternoon can you guys.hear me okay yes okay thank you so we.sent out if you're on our mailer that we.have going on we sent out this really.great little fact sheet it's not little.at 17 pages it's kind of long but.there's a lot of information the law.that governs the VA is probably like.five or six inches thick so this is the.Reader's Digest version of how to file a.claim so if you could go to on the right.hand side where it says Pease Air Force.Base health concerns and then.publications and then bulletin I believe.it's number four perfect okay if you.didn't get a copy of this yet we have.some on our table out in the hallway.there's a lot of information in here so.I just want to hit a couple key points.cuz I could probably do like a four hour.presentation on this for you it would be.very boring I just want to go through it.quickly and then I think the biggest.takeaway is if you have questions you.need help I want to get you connected to.a veteran's service organization my.agency the division of veterans services.VFW American Legion DAV they all have.veterans service officers that.help you so if you take away anything.today you should get hooked up with a.VSO so we can give you a hand even if.it's just to answer a question it's.worthwhile reaching out to us so on this.first page if we can just go to letter a.there's a couple different ways you can.get service connected I think we're most.interested in occupational exposure and.contaminated drinking water these are.two big ones that we get a lot of.questions about this handout has it's.like a step-by-step guide of what you.need to do to file a claim so the first.one occupational exposure second one is.contaminated drinking water we also have.some folks that might have maybe you.were exposed to both maybe you're not.sure we have some surviving spouses here.that have questions they think maybe.their loved one died from a condition.all of these things are relevant if we.could go to page 3 of the handout this.page talks about the different ways you.can get service-connected you can get.service-connected direct connection.secondary connection aggravation and.presumptive there is another one if you.it's kind of like a malpractice suit.against the VA if you were injured at a.hospital that's not really pertinent to.what we're talking about today direct.service connection is for an injury or.disability that happened while you're on.active duty while you're on drill or.active or on annual training a secondary.connection is I like to use maybe your.knee as an example you hurt your left.knee now your right knee is messed up.you have a lot of health problems with.your knee that would be a secondary.condition an aggravation would be a.condition that you had before you went.in the military and maybe you went in on.a waiver and it was fine and then you re.injured it that would be an aggravation.a presumptive condition would be.something like the Agent Orange or the.Camp Lejeune water contamination peas is.not considered a presumption yet that's.something that is being worked on it can.unfortunately take quite.sometime so we would be looking at a.direct service connection for this.contamination for you to do that you.need really strong evidence from a.doctor and if we could skip to page 16.when you meet with a VSO we help you.gather evidence then we submit your.claim with you then we hurry up and wait.for a response their response could be.approved or denied there is an appeal.process you can follow but to have the.best success with your claim you want to.have really good medical evidence when.you're doing that and this page on page.16 is the Nexus letter this is something.that you can go to your doctor and if.you're if they're the sciences behind it.and they support it they can write a.statement for you this talks about some.of the wording that the VA likes to see.in that statement it could be on.letterhead it could be in your progress.notes it doesn't necessarily have to be.a standalone page typically a specialist.will put it on letterhead and write some.sort of statement for something like.this but it's okay to be in your.progress notes as well so they're.looking for an event that happened in.service so a contamination and exposure.then they're looking at a present day.diagnosis that you have this condition.still then the doctor can link it to.your service so for example say the.doctor did genetic testing on you and.your form of cancer is not genetic in.nature.they've reviewed your personnel records.when you were on active duty and they.agree that you were exposed to exposed.to some type of hazardous chemical or.are you something that was contaminated.they can write a statement saying that.it was a high-probability more likely.than not related something with those.words it doesn't have to be a hundred.percent if they weren't there when it.happened they're not going to say this a.hundred percent absolutely is what.happened but more likely than not will.do the trick high probability of.highly likely that's very strong wording.highly likely a strong Nexus will show.the doctor reviewed your records already.so your personnel maybe your service.medical records if you had symptoms that.started while you're on active duty and.they can pull in different sorts of.different research that people have.already done maybe there was a study.that was done that was similar that they.can reference in the letter this will.make your statement very very strong so.they can pull all this stuff in if you.have any medical journal articles that.we can attach to your claim that is also.very helpful so all of these things come.together in this letter and this is what.you're going to need for a hazardous.chemical or a contamination service.connection because it's not a.presumptive condition yet it would be.really easy if it was a presumptive.condition already but since it's not.this is the way we have to do it for now.so I would say as a VSO don't wait to.put your claim in we don't know how long.it's gonna take for it to become a.presumptive condition if it's going to.become a presumptive condition so this.would be your best bet at the moment.this can be very confusing it can be.very overwhelming you may have a lot of.health things going on right now hook up.with a good VSO so they can help you.wade through all of this and we'll make.sense of all of it for you we're here to.help on the second page or the next.pages IV page 17 it talks a little bit.more about the rationale that's needed.the VA needs to see a rationale it needs.to be black-and-white there can be no.gray area with this doctor statement so.they can use statements such as it's.well known in the medical community.medical journals and research they can.also rule out other possible ways that.you got this condition so like I said.it's not genetic I'm not a medical.professional so whatever if the doctors.ruled out a bunch of different things.and has already done a bunch of testing.on you.they can put that in their letter which.also makes it quite a strong statement.you should have your doctor add their.credentials oncologists environmental.clinicians surgeon hematologists.whatever their specialty is that's also.very strong if they're a specialist it's.gonna hold more weight than someone.who's in djenne med for instance so all.of these things can be added to your.letter so again you really really really.should contact a VSO to help you with.this maybe you've already started.pulling some stuff together maybe you've.tried to file a claim and you've been.denied we can do a file a review on you.and go through your evidence to say okay.this statement is good but it could be a.little stronger maybe you can go back to.your doctor and ask them to clarify this.statement that they made and maybe that.will help you more than the document.that you previously had other forms of.evidence that you can use maybe you.could get somebody letters from folks.that you served with maybe you have your.service treatment records maybe you have.something already that you don't even.realize that you have that a trained eye.would catch very quickly if you brought.it to a VSO appointment pictures can.also count maybe you have some pictures.of something that chemical you were.using and you could use that in support.of your claim so any of these things can.be used as forms of evidence and they're.really really important the VA it looks.at service connection as a scale it.doesn't have to the scale doesn't have.to tip a hundred percent in your favor.it just has to be a little over fifty.percent in your favor so when you start.grabbing all these different pieces of.evidence together a doctor's letter.buddy statements pictures anything like.that that can tip the scales your way.and that's what the VA is looking to do.we have to give them good evidence ok so.again I would like you guys to hook up.with a VSO we have all the contact.information out on the table I think the.biggest thing is don't let this.overwhelm you there's a lot of.information here you guys are gonna get.a lot more information later on this.afternoon let us help you even if you.don't even know what questions to.ask come and see us we'll pull.information out of you will ask you a.series of questions to kind of get you.where you need to be nice think that's.it I don't know are we doing question.answer right now or maybe later out in.the hallway I didn't know if that was.appropriate for now but so it could be a.drill weekend if you got a line of duty.or you had something in your medical.records if something happened so it's.not out of the question it's easier if.you were on active duty orders but it's.not out of the question if you weren't.but that would be something to bring up.if you met with a VSO to let them know.what the the scenario is and if you do.have any evidence or maybe you went off.base for medical treatment so you have.that that happened at the same time so.we can kind of piece the timeline.together for you to help you build a.case yeah absolutely great question and.if anyone has any specific questions.that they don't feel comfortable asking.we're gonna be out in the hallway my.director Bill's here two of my other.co-workers are standing up in the back.back there they'll be here to answer.questions as well we really want to help.you guys so please don't hesitate no.question is a bad question because if.you're thinking it someone probably else.has thought it and asked it as well so.we'd rather you just ask us versus going.you know with a question that's been.unanswered alright Oh yet one more.question so like the Camp Lejeune water.a dress but Pease has it right those.people coming forward like I've never.gone through the VA when I've had cancer.twice at a young age and I was here.through the 80s.2019 but I've never filed anything with.a VA does that help when people find out.something like that does that help make.the case for a you know peace water.wasn't that good it could I would say.also just for your your own coverage.being service-connected with the VA can.provide health care for you which is.really important I would say look into.it especially you know cancer at a young.age it's not you know doesn't run in.your family all these things start.popping into my head like oh we need to.get you in for an appointment to talk.about this stuff but it sounds like you.should if you haven't before I would.really suggest you meet with someone and.Camp Lejeune that water contamination.started in 1950 and it just became a.presumptive in 2017 so I hope this.doesn't take as long but if you are.looking to get service-connected.following this guide getting a nexus.statement pulling together other sources.of evidence is really going to be a good.way to get service-connected please.don't wait 50 years to you know to look.into this you should do it now that's a.great question pay back here.I'm not sure you can get.service-connected before it becomes a.presumptive you know whatever list comes.out with presumptive conditions on it.it's easy if you can say I was at Pease.I was in the right union unit I was.exposed to this contamination.it's a presumptive I have the condition.on the presumptive lists really easy to.get service-connected if you meet all.the requirements boom it goes through.pretty quickly but if it isn't a.presumptive yet it's not out of the.question to get service connect and.that's the biggest thing I want you guys.to know get hooked up with a VSO look.into this stuff now because if you can.get support from your doctor and get a.nexus a really good nexus statement it's.not out of the question to get.service-connected now but I wouldn't.wait fifty years to look into it that.would be unfortunate I think there's a.lot of great benefits that could help.you now and it depends if you have a.doctor that's supportive that can write.you a statement so that kind of that.kind of answer your question.is darker conditions out there - trade.center toxic study on for them and in.this case with the water if you remember.I was the first people to get out there.and tell you about that they tested.water here factories and actually also.for a couple of colleagues trooper I.don't like to what I don't want to hear.I guess this speak for everyone it's.gonna take years to get this certified.see for decontamination is here is.probably before so and I just read this.I mean I don't work for the VA so I.couldn't even put a timeline on that but.I would say if you can if you have.support from your medical team you could.look at service connection now and not.waiting for it to become a presumptive.so I don't know how long it's gonna take.but I would I would say work with your.medical team get the documentation put.the claim in now and not to wait if I.had my way this would go through various.it would go through very quickly for you.my director would like to say something.but all the process starts with stones.and that's I think we are in the right.place it's not being done just here.snakes bees and all those events there's.all these are all the United States so.it's being addressed.I've heard potential five to seven years.for decision is solidly made but again.based on the veto it is very difficult.to get an oncologist or a surgeon.perhaps maybe is that Mass General of.Bremen women's and isn't as involved.image as we all are here in Hampshire.their reputation on the line it's it.might happen we just open up to one more.question is what it make sure all our.presenters so one word and move on we'll.have another space in the end this isn't.so much a question but it's a statement.having gone through the last thirty four.months of medically retiring out of the.United States Army I can tell you that.to get a VA doctor to write a statement.with words like more than likely and.they're wonderful I'm going Webb River.Junction for everything it is extremely.difficult because that you work in the.medical community where their.reputations are on the line and there's.small communities you know and those.reports go to the state of New Hampshire.with their names on it so it's great to.say five to seven years and I understand.what you're saying sir but it is.extremely hard to get those doctors who.genuinely want to help us to use work.like more than likely absolutely in.those terms and in their hands our time.so just throwing it out there no we need.that perspective.all right dad Eric I think you're up.next good afternoon so thank you Jamie.for your presentation I hope everybody.had a chance when you walked in there's.a document out front it's titled.understanding your health and so as.Jamie pointed out that in order to file.a claim you need to provide evidence and.so what this document is geared towards.doing is to try to give you a little bit.information to empower yourself so you.can control your own health in your own.health outcomes so if I could walk you.through this document just for a few.minutes if we would go back for those of.you that attended the December 8th.meeting a year ago in the hangar the.conversation I think started about P.fasten P for water contamination but as.you recall the conversation ended with.many people talking about occupational.health exposures and what they were.exposed to during their time serving.here at PS so this document here is.really to try to address some of those.occupational health concerns and try to.give you the information that you may be.able to use in order to have a.conversation in your physician so the.first link here is a it's a link that.focuses on occupational health hazards.so these are military occupational.hazards that have been identified across.the spectrum so if you went to that link.you can learn more about occupational.health hazards and some of you that were.in some of these environments get a.better understanding what you may or may.not have been exposed to if we scroll.down just a little bit here for all you.that's served in the Air Force in your.medical records you should have two.documents if you were on an occupational.health program one was known as a 2755.which is now known as the Oh head the.other document is a 2766.which is now known as the cholera so.those of you that have retired you know.less than well more than five years ago.you would have a 27.five or and or 2766 in your medical.records so how do you gain access to.that if you go to archives.gov we could.click on that sir.so well while it thinks I'll explain a.little bit when you go to archives.gov.there will be a link there for veterans.services records behind that once you.click on that there'll be another button.that specifically allows you to request.your medical records requests medical.and health record so request your.medical records and I think miss Brock.has done that I think you said five to.six weeks before you get a five to six.before you get a copy of your medical.records now in those medical records you.should have those two documents so the.2755 is a document that our bio.environmental shop would annotate any.occupational health hazards that you.were exposed to depending on your a FSC.so if you were working on the flightline.and you were exposed to hazardous noise.the 2755 would identify the hazardous.nodes levels that were identified and.what the protective measures are so you.know wearing hearing protection for.example that's a protective measure the.public health shop then takes that 2755.and then they they develop what is known.as a 2766 and that's the medical.surveillance program that you put on so.using the same example of a hazardous.noise environment the public health shop.would require that you do hang annual.hearing exams and that's how the public.health would monitor you during your.life time in that shop for that specific.health hazard so again if you were.working in another shop say fuel cell.and you were exposed to benzene or.another chemical a heavy metal in your.20 the 2755 of one identified that the.2766 would identify what medical.surveillance programs you will put on so.in that case you'd have we take blood.samples to monitor your blood you know.blood levels you.can use those documents to start to have.a conversation when you're physician.about what your exposures were in.whether or not you exceeded any action.levels based upon the medical.surveillance requirements if we scroll.down so and just keep in mind in that.medical record all of your lab results.all your hearing exam should all be in.that medical record so it'll quickly.identify whether or not you had levels.exceeding the action levels so in order.again to give you more information.better information we have two other.links here one by ATSDR and the other.one by toxnet if you go to those links.those links are just federal resources.so you could look up benzene or look up.chromium and I and and identify and.learn more about what some of target.organs were so we heard conversations a.year ago about some folks who may have.been diagnosed with certain types of.cancers well if you exposed to a certain.metal you can go learn more whether or.not your cancer is associated with that.type of metal by going to these by going.to these two links so again.the whole goal is to empower you with.information so that you can make choices.when you meet with your physician the.last half of the document is focused.merely on the P Fast and P follow-up.conversation we know that there was P.fast I was found back in 2014 in the.public drinking water supply ATSDR has a.lot of great resources around patient.information conversations to have a.physician I think so I mentioned already.that physicians in Boston may not be.aware of this you're absolutely right.physicians in Boston Massachusetts.really has even addressed this issue.yeah the p thousand people issue I know.that site I work in Massachusetts my.full-time job so you can take this.information when you go meet with your.physicians and start to educate them and.inform them about maybe some of the.exposures that you may or may not have.had during your time here at Pease any.questions.ma'am iodide in 2017 and then at the.States.I was Harry gear 79 to 80 after two and.then I came back in December 2001 so I.was here when we were told about just.fast beating in the water was that 27.something said state that so the the.medical records to my knowledge will not.have the P fast PF OA exposure it would.that would not be in the 2755 all the.2766 those two documents are.specifically for occupational health.explosions so not for the exposure to.the drinking water that was found in.2014 sir I would have to find out when I.did ask that question and the folks that.I talked to said that this program was.in place all for the 80s and 90s I can't.speak to the 70s though they had a.hazardous communication program back in.the 80s and some of the retired Chiefs.who have I who I have talked to said.that these were programs that they are.well aware of in the 80s whether or not.they heated some of the precautions.that's a that's a different conversation.they should being it if you up a part of.a surveillance program so if you were.working in finance you wouldn't have a.27:55 or a 2766 because there was no.occupational health exposure if I could.adjust to things so I started my career.in 1993 in public health.these programs were in place in 1993.that I do know because that's when I.started my career as far as a fire I did.hear that there was a fire and that.there were a lot of records that were.lost I don't know if those were medical.records or personnel records but I know.that there was a fire years ago that.meant that some records were lost but I.would encourage you to go to the.archives.gov website and request your.medical records and take a look at those.and happy to help you review those as.well if you need to if you need me to.from what I was instructed by NGB yes.right.so does a widow have access to her.husband.when you filed for the medical records.I'm not very well okay but these two.forms you're talking about have nothing.to do with the drinking water that's.picked up something on the way to a.doctor's appointment today.now unlike some people in this group.people here are pretty fired up very.educated most people spend more time.considering what they're putting in the.car or what type of antifreeze to pick.up the gas station or looking through.the circulars they got in the mailbox.before they head off to a docs.appointment role very very busy people.many of these exposures for the P Foss.or occupational health exposure or cause.chronic things it's not like you fell.down broke your ankle you can't walk you.have a sore shoulder you have just.fatigue maybe your doctor told you your.kidney functions are a little bit off.that's where we rely on some the great.the wonderful things that some of the.folks here have done that are available.to understand your health if you were in.one occupational health exposure program.and you have some of those documents you.can bring them in also say you find a.hey you know I was the one of the guys.worked in the fuels in had a lot.exposure to this one particular.substance but down here you can pull.some of this specific information on.that substance bringing into your doctor.when you go in other thing when I was.out there looking at the desk that.Public Health will be coming up to talk.a little bit later one paper says.talking to your doctor about exposure to.key Foss or P fellow he Faust befo it is.a very new thing that doctors getting.educated about right now the work the.United States.in the fix of dealing with this opiate.epidemic and both doctors have to do so.many hours every year on opiates we're.not doing educational required.educational times 1p fast keepo yeah.it'll get there but this is where you as.the patient.no one cares more about your health than.you do your doctor may or may not know a.lot about it he might but you can bring.stuff in such as one of these forms you.can educate yourself there's another.great one here.how are people affected and even another.one that I found eyes out there taking a.look at the table this one here actually.shows that hey guess what P Foskey.fellas and a lot of things it is in our.Teflon pans let me do up Teflon pans at.home how many people ate at McDonalds.okay guess what some of our food product.some of the packaging has P pasta.fellows in it it's not just fire.retardant material or actually it's um a.fire truck.how many people have won this cool.Columbia jackets that I've whipped off.water guess what there's P five people.on that and some of those things so many.of our water repellent substances had.this so it's ubiquitous and we're now.dealing with hey we use this maybe it.wasn't the best thing to be doing so.when you come and see a doctor.what do you need to do number one write.down your concerns you're coming in for.15 maybe a 30 minute point if you're.lucky how many people actually said hey.this is what I want to dress with my dog.because most of time what I experiences.people come in you have all these.worries and concerns and they see one of.these things here outside the cone of.silence goes up I'm like you have any.questions just or hurts a little bit no.nothing else so oftentimes the white.coat or the stethoscope people just all.of a sudden they get nervous they forget.to ask their questions or if you have a.lot of questions maybe you don't have.enough time if you write some of this.things down your doctor well better can.see to go through it or if you don't.have enough time to go through multiple.issues he needs a little bit of time to.go through.do a little research or if you're trying.to get that nexus letter which I haven't.written the nexus letter yet.fortunately the merchants Department I.don't typically do that but I've done.primary care clinics on active duty.before you know that'd be something that.your primary care doctor may not be.familiar with even we have awesome.incredibly smart folks all throughout.the Boston area world-class Muslim have.never written a letter for Nexus letter.so you have to help educate them you.know the military does a lot of really.dangerous things we do it really well.but most people don't know what you do.but you do so help educate doc you know.things like if they're going to do a.blood test why are we doing a test what.are the steps during a side-effect.anybody have colonoscopy you know that.bowel prep has a little bit of side.effects that are up go lightly I think.they also call it truck quickly so you.need to know the side effects and when.you do get the diagnosis what are we.going to do with that information or if.you're like hey I think I got exposed to.this I need this letter you need to tell.the doc this is why I need you to give.an opinion that this may be more likely.than not and this will help me in this.manner he may not understand the VA.system at all now as Doc's many of them.are very scientific and they're like.well if I can't connect got a B and C.and I can't break this letter he said.well no they're not asking you to come.percent prove it.they're saying is there a likelihood.that my exposure the burn pit my exposed.to these chemicals may have caused this.problem I think it is here's why I think.it is so I just kicked it off you'd be a.surprise it may be how willing they are.once they understand what you're doing.because military does things very.different the VA is not normal - most.people have never served so there's a.lot of good things out there that you.have to be the advocate it's been 10 15.minutes some of the people here have.spent a lot of time and are very well.educated and many of our service members.I have had.challenges that had to work through the.VA system are very good at that.there's a lot of great resources making.sure you plug in with your veterans.disability officers to kind of go.through this and say hey what else do I.need.I was reading an article about recently.it came out about someone that was.exposed to the phone the firefighting.phone and he had a picture of him in Nam.range you know with firefighting calling.a bunch of firefighters and they had.full all around him they're working on.their gear well that would have been a.supporting document that you could write.your doctor and said hey I've been.exposed here's proof so those are some.of the things to work with your doctors.because many of these things are very.day you know your kidneys they don't.hurt typically until you're having.significant problems autoimmune stuff.it's hard to turn it down so many of the.stuff that in cholesterol.well does the Peapod stopping your.cholesterol or is it the Big Mac you.just these lots of different things you.have to help educate folks questions see.I have my stethoscope no questions.so I'm with the agency for toxic.substances and disease registry it's a.federal public health agency located.Atlanta Georgia and we have 10 regional.offices.I'm from the Boston office in region 1.which covers all of New England so I'm.going to talk to you today about many.things the first thing is about some of.the PAS contamination that we found on.the base primarily that's going to come.from a document that we released for.public comment is actually called a.health consultation may have seen this.so this looks at drinking water.exposures from 1993 to 2014 and again P.fast just just you know it's uh.it stands for purr and Polly floral.alkyl substances it's a compound that.was used in firefighting foam also known.as to a triple F for aqueous film.forming foam sort of mouthful well let's.just I'm going to go right into this so.we can go into the next slide so we had.sampling data that was collected in 2014.EPA had identified this compound as a.containment of concern and because of.that they suggested entities start.sampling for it so it was sampled for on.dates and is found to be quite elevated.in one of the three wells that services.the Pease trade port there's three well.is the Haven the Harrison and the Smith.The Haven well is the one that had the.highest level as an aside that well is.also contaminated in the past with very.high levels of trichloroethylene OTC ii.which is a degreaser known to be used on.the base in early 2014 the Haven well.again was determined to have elevated.levels and then it was shut down so we.need to determine what were people.exposed to prior to 2014 which there was.no sampling data and people didn't.really have this on the radar.so we developed what's known as a.mathematical model that's just a simple.thing where we had two three wells here.that each well contribute equally to.this main storage unit and that all the.end points in the distribution systems.have the same concentration so we call.it a simple mixing model so that.approach then allowed us determine what.levels of people were exposed to in the.past and we had developed a model and on.the next slide this table depicts what.those models the maximum levels were so.it costs the health-based comparison.value of HP cv is quite low here you can.see but the numbers that we found really.quite nice it was elevated at that point.and it's probably elevated from that.point going back in time we don't know.how far back in time when we looked at.it as if it was that value back to 1993.some of the other contaminants were also.looked at not really about we're.concerned some don't have comparison.values where we had looked at them.nonetheless well we also have in.comparison though on the next slide you.can see if we did some measuring of the.data that Department of Defense in New.Hampshire des Department Environmental.Services had collected working with the.department defense the Air Force in DES.they've instituted the installation of a.treatment system that's really taking.out these contaminants and we look.forward to the time when that Haley wall.can be put back online when it takes out.all the rest of the contaminants because.of the P straight port also has to child.care centers we also want to look at.what is the numbers of contaminants in.those wells on the next slide we can see.that the great base.they're all below comparison deities we.know that hamper has developed maximum.contaminant levels the fairly new.we had based our numbers on what was.known as a maximum minimum risk level.which came out of a toxicological.profile and so our numbers may not be.quite the same as New Hampshire but.they're very similar many cases so it's.it's good to know that now of concern in.the past they were on the next slide.just sort of the bottom line of the.results of this consultation which.looked at the drinking water.contamination of the Peethas workers who.spent any time on the base as well as.children in attending the daycare.centers were exposed to levels of PFS.that could result in harmful effects to.the health so we also it is such a low.level that is not expected to result in.any health concerns but we just want to.let you know that it's not zero they're.actually now able to detect these.concentrations with these contaminants.down to the parts per quadrillion which.is amazingly low parts per trillion is.law but quadrillion is just.astronomically low but so the further.you go you probably into the planet so.after this discussion you know we have.tables set up on the side we have a lot.of fact sheets to discuss health effects.of pee past exposure talking to your.doctor about pee fast exposure the.results of these consults and also what.is an exposure in general and also just.want to say that if anyone has any.questions and you want to talk privately.feel free to call me my contact.information up there I know sometimes.it's sensitive information and we.understand that we're glad to talk to.you at any time so now that's the.drinking water levels for pee fast on.the base we're going to go switch gears.a little bit to talk about some of the.studies you may have heard of and on the.next slide I'm going to discuss these.studies here.so we have the tea study exposure.assessments multi-site study and then.the two consultations the first one was.looking at public water and the next one.is going to look at the private wells.which is private wells that are within.one mile of the radius of the Air Force.Base which working without the Air Force.on that so let's just go right onto the.next slide here so the piece study the.piece study is looking at residents that.were exposed to drinking water.contamination primarily exclusively PFS.in the drinking water recruitment is.ongoing now people can enroll in the.study there are exclusion criteria such.as you could not have been a firefighter.and you could not have worked with it.you could not work with there a triple F.as part of your work but if you were.active duty on base you were eligible to.be in the study there is a timeline at.which you must have been on base and I.go over that in a few minutes but the.reason why we're doing this study and.all of the others is because really pee.fast as an emerging contaminants EPA.indicated and we really don't have a.good handle as to what are the health.effects that occur after an exposure to.this we have some idea looking at animal.models some idea looking at some studies.as a CH study we won't have a.comprehensive understanding with clarity.what do these compounds cause so that's.the gist of this I want to also indicate.we're talking about something known as.the multi-site study the piece study is.going to be part of the multi-site study.but because Pease was the first instance.Oh exposure that we looked at it's going.to be looked at more thoroughly perhaps.than the other ones we're going to look.at them in total to get more what they.know an epidemic we power to see what is.the health impacts of this exposure so.I'm going to discuss those shortly but.again I want to go into the next slide.to talk about if you wanted to join the.peace study who is eligible adults 18 or.over at the first category who worked or.attended a date school on the p's trade.port any time.from January 2004 through May of 2014 so.you could have spent time before that.but you must have had some exposure.during that window so he could have been.there in 93 through 2005 any time as.long as some any amount of time you.spent on this in addition we're looking.at those who lived in Newington.Newington had private wells some of the.private wells were contaminated by the.plumed migrated off the site so we're.looking at that criteria is slightly.different if they spent any time from.January 2004 through the present and.they had a private well-documented PFS.contamination they can be in the study.we're looking to accumulate perhaps a.thousand people in the study we have a.ways to go and we'll help him to achieve.that if another age group is the.children then a 4 through 17 and they.attended one of the two day care or.child care centres after May 2014 the.Haven was shut off and contamination was.reduced or born were breastfed by a.mother who had meets the eligibility.criteria above we will also look at a.small group of adults who are never.exposed to these contaminants generally.that's a comparison group to see if.their rates are different than others.that's some of the eligibility criteria.you know questions any time I don't want.it ok so on the next slide I just want.to look at just so when we get the study.starts will be collecting various things.urine blood to be so medical testing all.the information collected will be coded.and no personally identifiable.information will be recorded in the file.it cannot be self-identified to any one.individual to be used as a group however.those who are participate in the study.will get their own results sent to them.that they can then share with their.physician and see how you know what does.this mean for me again we want to use.these results to tell look at what are.the health effects relate to pee fast.exposure and once the study does.conclude we will have a public meeting.we would discuss this in the report this.guess what we have Lauren from the P is.studying so next slide indicates what.are the type of tests again we're.looking at blood and urine some body.measurements there could be a variety of.things are you measured in that case sir.I'm cholesterol maybe one of those.asthma medical history and we will also.be looking at some of behaviors and.child participants with some indication.that this may impact some developmental.issues among children we want to capture.the entire suite of possibilities in.this case there are benefits to being.enrolled in the study in the next slide.highlights those again we're trying to.help have clarity as to what are the.health effects following PFS exposure.sort of entering into the base of.scientific knowledge here individuals as.indicated will get the results sent to.them individually they can discuss that.with the doctor and there is a gift card.option for those who participate up to.seventy-five dollars they can get that.you know as an incentive and then then.the next slide just to just a summary of.the process capsule eats quite nicely.the process that were being involved in.this study any questions so on the next.slide then if you did have questions.about this there's a website in addition.if you are interested in joining the.study and you want to enroll contact me.at the table outside and I'll give you a.phone number to call and they can hook.you up and get you enrolled in the study.but there's some criteria again you.can't be a firefighter it couldn't have.been exposed to the phone but if you.want to be enrolled feel free to contact.me we'll get you the phone number for.that any questions here oh yes please.my name is Lorin ball I was here on the.first hearing back in December 2018 but.back in 2014 I received a letter to the.office of Secretary of the Air Force.pretty much okay the letter regarding.excuse was a little upset because of.what I'm hearing no one paid attention.before this when I was here that was.that time in December I brought up the.fact that I caught a person from the.civil engineer representing the.government who had trip around and find.all these spots that were classified and.what had what chemicals were in that.course.Brock's husband have to do work at the.facility where I had them but they.willand.and say how long do you pump this out.the hydraulic floor six six seconds of.silence okay.that means never been pumped up you're.going back and you're limiting it to the.parameters of 2004 and beyond that we.stopped air be in 2014 as always well.nothing was well it's nothing the.organization is huge.report to here is the agency to toxic.substances.again it's it's an advisory.non-regulatory organization okay.it has its administrative functions I.seen that in 2010 they had a 78 million.dollar budget that was 2010 they don't.give they only make recommendations okay.you only make recommendations you don't.have the solutions we just gotta gather.all the information get big bucks and.can't get in there but certainly she.even letter she wrote the December 13.five days after that December 7th area.this letter comes out and it's aimed at.the agency for toxic substances disease.registry signed by 18 senators should a.new house key and a bunch of others okay.they'd already made the deal for these.people to be doing that survey you.people will be doing that survey I'm.disgusted disappointed and outraged guys.thing more.one of these things they highlight in.their little in your little um what is.the fact World Trade Center registry for.9/11 attacks the registry contains more.than emergency response personnel who.are involved in rescue and recovery.effort and study of helped efforts to.lose Astor's and development public.health a lot of BS okay that's this guy.he was at 9/11 he was at Ground Zero he.got anything no.try to help put the parameters 2004 to.2014.well Trade Center Health Program because.your they went all the way that and I.don't see any reason here at these.why do you limit that window because.you've got people here from the 80s like.to us the seventies 1860 and in your.first slide it talked about most likely.you know there was contamination back.then and like I said in my testimony.short a quest they came around the base.house and went testing where every two.weeks I could he ain't so somebody needs.to relook at this especially based on.your first slide I would just like to.say though this is just one study you.saw this five studies thrown out in the.area is this one is really targeted I.believe which means so when it was take.care centers they have some goals that.they're trying to get the state to the.157th is not up there we have a way.we're going to craft that still with our.partners we're going to talk about that.in just a little bit blue those are so.we need to hear your voices but realize.this is just one of a few studies so I.think you got five up there artists to.be a 6-1 I will tell you peas when it.comes to know this is really the t past.people our studies gonna go beyond that.and look at occupational health.exposures as well but we're kind of the.epicenter for this stuff here the Air.Force has promised to give us clean.drinking water.they're also cleaning up the aquifer as.well there's a lot of plants that are.around here for that so I think they're.doing their best but I think you need to.take it to the next level these studies.will do that as you look at the health.effects so don't be too frustrated that.maybe this isn't targeting your interest.it's one of things out of here.90 inches over two years yes but so I.haven't seen the healthcare yeah big.ears yeah I brought my kids to do.daycares they were born in 94 95 so.they've over there 95 96 so they were no.longer there when this other stuff was.going on so I guess my point is is the.big day tears started earlier it wasn't.like at the beginning in today's but.they started earlier I think 93 was the.first hand that came on - so I'm just.wondering where the two thousand four.people they're just with that one there.I know my kids.first like an hour it's possible though.the results of the study it's just a.sample they may be eligible i'ma try.this is sort of like the first phase of.studies I need to know what do we know.now looking at this exposure.what are they should with the timeline.is if someone drinks water with PBS in.it and they stop drinking water with PFS.in it it can stay in the body and half.of it goes away in eight years so it's.an issue of how long it retains in the.body and gets out of your body so we.looked at half-life issues how long it.takes till half goes away so that's.where I went with 2004 I understand the.concerns people have a past exposure and.I you know I've been exposed to.chemicals and I know it's very.unsettling feeling I really understand.that but right now we're trying to do it.so baby steps what do we know now about.this chemical for this duration of.exposure which is that be the highest.level of exposure and what can we find.out from there and then from there maybe.bridge on to further past exposures but.if you go further back in time we won't.be able to determine what's in the blood.anymore because that would have gone out.we're not sure what it was in the past.so we can't really say with certainty if.a health effect is related to past.exposure because I don't know what they.are yet so first we can see what are the.exposures what are the outcomes that.could occur then based on that maybe we.can then say this fingerprint of listed.items if you have these things maybe.that's because yet P faster earlier I.mean it's a complicated mix you know.some of them could be increased serum.cholesterol women could have more.trouble getting pregnant they could.affect their hormones in the body it.could also affect immunology so.sometimes kids may have a hard time.getting a vaccination to take and.there's some indication may be linked to.some cancers so there's a variety of.things we know from animal studies but.we need to have more clarity looking at.these human investigation so again just.bear with us this is the beginning.stages or perhaps more work that needs.to be done but I understand your.concerns and I I do feel that.you went and got the tfaf blood testing.during the time that was made available.for free to go and you searched prior to.2004.you most certainly can be in that peace.study that's terrifically that confusion.they probably should not call the.complete study but they have this was.the meeting that took place last week.you had your blood tested when that came.out of the newspaper when I came out on.many other social media if you worked at.Pease you ain't got your PFA yes.test done which my husband did you then.are entitled and we have signed up and.are in this piece right so I think.that's important parameter you're.looking at 2000 or 2014 and those of us.that were here in the 90s girl wait what.happened to us but if you've got.yourself tested then you can be in that.starting correct yes you know there's a.lot of information that the a triple F.usage on peas resulted in contamination.so that's how the name gets tied to it.you know that's how it's probably being.studied right but it doesn't necessarily.mean like princes Newlands and residents.can join up they don't knock on peers.but their contamination came from yeah.man you've got yourself tested when that.is available most definitely I can sign.up in the EMS but that's the first.problem people were going to.[Music].or something if you unless you have the.blood test but those of us crying mm.cool right so you could if you clarify.that and said did you go and have your.PFA has testing done and if you did then.you are in that stud1 phone call away to.get in it even if you retired in 1990 92.93 is that correct.[Music].and then ideally it was people that were.exposed during that time frame so we.introduced the half-life issues but if.you joined up and became part of the.serum testing that New Hampshire DHHS.enrolling people in that's another.subset right it isn't listed per se that.way you're not quite sure what okay I'm.not the subject matter expert for the.Pease study but if I can't answer that.question will thoroughly I'll be glad to.get back to enough I know what you're.saying I know I know I agree but I.understand so my questions to my agency.so why doesn't the literature say this.putting people I don't have an answer to.them sorry well but I don't think we're.limiting them now I think they're.already being asked to join your house.oh that's what I'm saying okay yep you.most definitely received a letter in the.mail Darce.in here and the others of them testing.herpes or put that letter up if you've.got that latter you say don't throw away.my blood sample and you most definitely.will be in the thousands people who.think so there should be like another.for statement that says I hope that was.thank you for bringing it up thank you.well we do have a fact sheet in the back.on the table that describes different.tests you can have blood tests and.others there may be a good place to.stuff I've not had experience with.working directly with the VA on that.particular form but that may be a good.place to start.we also access to occupational.physicians that may be help giving.advice to your physician as to what to.look for we're not I'm not certain that.may be a good place to start.colonel well I just want to keep we have.two more speakers to go so don't want.any questions down but what we said was.so we work with a civil engineer who.looked at how are these wells used in.the past and essentially what we were.indicated to us was that when the needed.water that took him equally from each.well you know that was an approach that.we use based on information provided to.us I mean I don't know if the Haven well.gave more or less than others yeah so I.mean that that's the first approach you.know that we used and that's how we got.indicated concern I just wanted if I may.talk a little bit more um so the net so.that's the piece study again there's a.lot of studies I want to make some.clarity as to what these studies all are.the next slide so there's also something.known as the P pass exposure assessments.these are conducted in eight communities.nationwide on current and former.military bases that have had P fast.exposure and drinking water these is.part of this but it almost is by default.because of all the work we're doing.essentially we are doing an exposure.assessment it's just not set as such but.the closest one is in Westfield.Massachusetts so my team went to about.900 homes to solicit people to join up.for that study in that study we're.looking at my urine and blood samples as.well as a subset of those without.drinking water levels that will not look.at health outcome data now a strictly.look at levels in your blood levels in.the water and see this a correlation so.that's the exposure assessment for that.I do want to just because I know that it.is confusing what the exposure.assessment is the next slide has a very.brief video describing this and it's.quite nice it's just a miniature.what our pas pas are man-made chemicals.that have been used in industry and.consumer products worldwide since the.1950s they have been used in nonstick.cookware water repellent clothing stain.resistant fabrics and carpets some.cosmetics some firefighting foams and.products that resist grease water and.oil what is a pas exposure assessment an.exposure assessment is a way to look at.whether people in a community may have.been exposed to pee fast in their.environment the primary goal is to.provide information to communities about.levels of PFS in their bodies the.results of these assessments will help.communities better understand the extent.of their environmental exposures to pee.fasts first CDC ATSDR staff will meet.with community members and answer.questions about the exposure assessment.next households will be randomly.selected and invited to participate.participants will provide blood and.urine samples a sampling center will be.set up in the community environmental.samples will be collected from some.participants homes then environmental.and biological samples will be processed.and analyzed at a lab after that.individual test results will be sent to.participants CDC ATSDR will analyze all.the results and write a report.describing their findings and.recommendations once completed CDC ATSDR.staff will host a community event to.discuss results for more information.call 1-800.is a ATSDR cdc gov.a male pas at CDC gov.[Music].you.[Music].the leg in the investigator work that.we're doing to determine levels of.exposure and health outcomes and levels.in the blood the next one is called the.multi-site study so again we've had that.piece study the exposure assessment now.this is the multi-site study essentially.it's going to be the first major health.study to look at health effects from PFS.exposures in drinking water it's going.to assess lipids thyroids you know such.as cholesterol thyroid level function.kidney function immune system and liver.function tests there's a request for.Proposal and we had sent it out.nationwide seven participants were.selected from those that were submitted.and I'm going to discuss those briefly.but essentially again the piece study is.going to be folded into this multi-site.study so you didn't need to apply at.Pease you're already in it but it's a.separate study that's now being merged.with this study and it was part of the.National Defense Authorization acts of.2018 2019 which many senators and.congressmen helped us get enacted so we.can get this funding for us it's a.several million dollars I'm not sure the.exact amount but it's going to be a.multi-year study so I will just go to.the next slide to it just to show you.the partners that we're working with.that it got funding to do this effort.the closest one here is the Silent.Spring so again these seven partners.qalaat are going to collaborate with the.P study to get a holistic approach to.see what does P fats exposure do to.people it's a way to have more power to.determine what the outcomes could be so.this is again the multi-site study and I.want to go to two more studies and then.I'll be done I'm just trying to clarity.so we are focusing we're here for you.and trying to focus on what if he fast.due to people the next slide is just a.discussion really quickly of the health.consultations so the first one.looks at public water we reviewed.drinking water exposures that indicated.to workers and children it was released.in 2019 April for public comment we had.about a 60 day comment period and we.received about 80 comments we got a lot.of comments I'm addressing all of those.me and a colleague in Atlanta did this.report and so we had valuing each.comment modifying the document is needed.because the very good comments.incorporating those and currently.they're an internal scientific review.and will be released shortly and a.public meeting the last one is of health.the health consultation looking at.private wells again these are within one.mile radius of the Pease trade port.that's in Newington in Greenland it's.about 40 or so wells it's currently I'm.working on it and it's going undergoing.scientific internal review we hope to.have that release for public comment and.we'll have a public meeting sort of like.this will also have availability.sessions people can drop in and ask us.questions we may go door-to-door to.people's homes to talk to them if they.wish since there's about forty is so.private wells will be looking at so that.again and the last leg this summarizes.the studies that 80s Jara's isn't.working on I hope this does provide some.clarity and maybe a level of assurance.that we are working on these and many.different factors all at once.any questions you can feel free to.contact me in confidence if you wish.contact information is here and I'll be.on the table in the back table number.three so if there's any questions I'll.be glad to take.thanks very much there appreciate that.alright next is going to be nine option.dr. Hawkins SP and we'll hear about the.organization some of the site here let's.get the stand up anyone else will stand.up for a minute please feel free to do.so sitting great so I'm Miriam Hawkins.I'm from NIOSH for anyone who's not.familiar with NIOSH we are part of the.Centers for Disease Control and.Prevention and we do occupational safety.and health research and surveillance so.I'm gonna give a very quick background.some information about occupational.research and why we keep us and then.talk about a few studies that are.basically in their infancy they're just.starting so I'd be happy to answer any.questions probably for the sake of time.maybe a few after this but we'll be in.the hallway as well so so we often find.that some of the highest exposures for.various chemicals occur in working.populations so this this can happen at.basically any stage in a chemicals life.so we've talked a lot today with be fast.about products that contain the PFS.compounds so foam cosmetics we mentioned.stain resistant materials but I think.for an occupational discussion we really.need to talk about the people who make.the products integrate them into indoor.make the compounds excuse me.integrate those chemicals into products.use the products maintain the equipment.and interact with the products in.various ways and then all the way down.to even remediation of some of the sites.that are contaminated so there are.workers all across the spectrum that may.be exposed and that we need to find ways.to protect basically there are often.differences in exposure based on the.industry the occupation the tasks and.the very specific work activities that.somebody may be completing these may.have to do with the either the quantity.a product or a compound that someone's.using the concentration of the chemical.in that product may be the frequency.that they're coming in contact with it.so we all probably at some point in our.lives.eat some fast food maybe some more than.others but if you're someone who's.working in a fast food restaurant.dealing with those materials every day.you probably have an even higher.exposure to just handling that material.and then additionally there may be.different routes of exposure so I think.this is particularly important when we.talk about P fast because often the.route that we're concerned with is.drinking water right so we're we're.worried about how it's getting into our.bodies from drinking workers may be.exposed through their skin they may be.exposed to inhalation they may be.exposed through hand to mouth contact.and often there just isn't quite as much.information about those types of routes.of exposure so we're really trying to.figure out how people might be exposed.in and how to tackle this.so occupational exposure research is.important not only for identifying and.understanding how an individual may be.exposed to a compound or a certain agent.and then how that relates maybe some.sort of a health effect that they're.experiencing but also because it gives.us a sense for the spectrum in which we.are basically experiencing this compound.and some of those higher exposures and.how those relate to health so for P pass.in particular there's been some changes.in the past few decades transitioning.she's transitioning from some of the.longer chain compounds to shorter chain.or alternative compounds and that's left.a lot of room for unknowns in my opinion.we don't know what's being used we don't.know where it's being used which.industries have moved away from it and.which are just using a different product.that maybe we don't know what's in it.right now so we have three studies that.we are conducting two of them are.specific to firefighter populations and.then one is targeting other industries.at least that's currently the plan the.results of all these studies will when.they're done be available.to the public and communicated to the.public we're also hoping that they'll.inform future research and be used to.help its basically develop.recommendations for how to manage and.reduce exposure to pee fast just a quick.disclaimer I I mentioned these are all.in their infancy some of the details are.subject to change so we are still.developing protocols and just as a you.know please be aware of that there are.some things that may be tweaked over the.next six to nine months as we finalize.plans so so for the two firefighters.studies both of these build on an.existing large collaboration called the.firefighter cancer cohort study or the.ffs CCS this is a collaboration between.NIOSH the University of Arizona the.University of Miami the fire service and.a few firefighting organizations and.it's an existing study we already have.firefighters enrolled and we're looking.at various exposures.it's a prospective study so we're.enrolling people now and then following.them into the future we're also focusing.on cancer outcomes with this study as.well so we're not looking so much at.acute outcomes or some of the other may.be target organs that some chemicals may.affect but really looking trying to dig.into cancer so one of the firefighters.studies is a p-pass specific study.basically this is a three year study and.we are trying the best we can with what.we have available to measure acute and.chronic exposure to pee fast so short.term long term exposure and some.epigenetic markers of cancer these are.basically doesn't mean that person has.cancer it just means that there may be.some people using that they may get.cancer in the future it's a subclinical.marker basically of an effect we're.doing some acute toxicity testing doing.a few surveys to try to characterize how.people have used these phones in.particular as one of the ones that comes.up but also turnout here and other.potential exposure pathways of interest.I think the what I call off-label use of.the phone comes up when we talk about.how people may have been exposed in the.past so capturing that information and.then also doing some bulk sample testing.we are using some existing participants.for this study and then we're also.enrolling some Airport firefighters or a.RF firefighters and we're actually in.the process of currently enrolling.people already out of a couple different.fire departments the second firefighter.study is a one-year study this study.specifically looks at Wildman urban.interface firefighters and P fast is one.of the things for analyzing for so that.one will be done much sooner but it is.specific to that population the third.study we're completely over working on.is a targeted industry assessment this.is a three year study where we're.focusing on some of the moderate to high.exposure industries so currently we're.anticipating that will include.manufacturing and services sectors but.as I mentioned before that may be.subject to change and it's really.focusing on some of the ongoing PFS.exposures so what are people exposed to.right now in the work environment so.that we can help plan and and work on.exposures in the coming years there are.three goals for the study the first is.to understand what industries and.compounds are still using peat baths and.what those compounds are I should say.since we have had some of that.transition over the past couple of.decades the second is to conduct an.exposure assessment where we'd actually.go to a worksite monitor the worker.collect blood and urine as well as air.to test for PFS and then we are.including some health indicators as part.of the study these would be blood tests.for things such as cholesterol hormones.thyroid function and immune function.this study we're finalizing the protocol.probably the next year and then we'll be.collecting data about a year from now so.hi that's that's sort of got I'm trying.to keep it short and sweet since Andover.tight on time but if there's any very.quick questions I can probably take them.now other way.we'll be here and I'm happy to speak.with you in the hallway I see directed.towards he have always he is no not at.this time the results of the study.should translate to people at Pease Air.Force Base so we're trying to study some.populations that are similar but.currently Peace employees are not or.Keys workers are not a nice place for.you here there's we had five of the.original three more here we're gonna.talk to Derek in a second about a ninth.one that we'll have here but all these.studies do build on each other I think.we we've seen some evidence in the.scientific world that maybe animals.there's there's some health effects for.people as people we know the study we're.looking for years beyond that a.computational exposure as well but these.will all parlay into having some some.claims to be able to make so I think.they're all important but Derek if you.could talk a little bit I know it's so.I'll make my comments brief also studies.studies and more studies right and I.think everyone's here because they.really want to learn more about what.Pease means to them and what their time.here their service here what that meant.to them as far as their health outcomes.and so you know again the reason why you.keep hearing about peafowl simply follow.the previous eight studies because it's.emergent contaminant right and and so.there's not a lot of data on that so.that's why there's such a big focus on a.national level to learn more about P.fastened P follow so based upon the.conversations that had taken place a.year ago the public health working group.and wanted to shift a little to the.right and say well well we've heard a.lot of conversations a lot of concerns.about misuse of JPA fuel water.contamination high rates of cancers from.folks that served here high rates of.infant mortality from folks that serve.yeah so we knew that was a top priority.that came out of last year's.conversation and we collectively put.together a request.went to the garbha arrow and.subsequently went to Yusef Sam which is.the school of aerospace medicine out of.wright-patterson Air Force Base in.Dayton Ohio that's where the others the.Air Force's epidemiologists and.scientists work out of and we asked them.our request was to conduct a cancer.study for those members that serve from.1970 to the present day cancer study.from those members that serve from 1970.to the present day so that is still a.push we wish that we would have more.information to provide today we were.hoping that today's forum was to.announce a study when we put that.initial request in that goes back to I.want to say the spring we got a little.bit of pushback because these scientists.were already working on previous studies.for the Air Force and they said that.this fall is when they'd have more time.to once they wrapped up those studies to.focus on this on this request as it.stands today they have access their.counterproposal to our 1970s a.present-day request was to conduct a.cancer study from 2020 19 and what.they're saying is the reason being is.because that's the only initial data.they have access to.they have readily access to those.medical records over that 20-year period.but they've also said is those folks.have served in the 80's and 90's and.retired post 2000 would be a part of.that study as well because they have.access to those studies to those medical.records so we're working with them we'll.hope to have a conference call in next.couple weeks to learn more about what.their proposal is we don't think it.meets amok and in its entirety based.upon our initial request but we can only.work on what the data that they have.access to the reason being why they.don't have access to the other data is.because the other date has been archived.and that data would have to be requested.by the individual or the individuals.widow specifically and obviously they.can't do that for that large cohort so.we continue to work on that study we.hope in the next couple of months we'll.have more informed.to provide but as Colonel pagará pointed.out that's called the 157th health study.so if you hit Pease health study or.assessment or exposure analysis forget.about those the one that we're focused.on is on the goose call the 157th health.study so if you hear more about that.and you want to enroll we'll keep you at.2 and we know Doris has a listserv those.folks we encourage you to sign up to.veteran services let's serve because.we've try to push information out that.way as well so you don't have to look.for yourself so please sign up to any.one of those two lists know so we can.continue to keep you engaged ok came.here you all that have the interest in.your own health then everybody else that.have served here I know the tag supports.the sport enhance your concept if you.were in the National Guard or where you.serve anywhere in any service and you.are you live here work here in Hampshire.we're all about taking care so we take.this seriously and we leave that so.thank you for coming here it is a team.effort though we need all of our experts.here our hotel support we need a.retirees we need all of you we need more.people to be at this meeting because.that's where we're going to get the.attention of resources that week so.thank you for everybody that presented.it today I know it's got a little bit.long behind me the hallway but behind.that is bathrooms so go through this.door and another door comes out through.the bedroom is right behind using.women's room is right over here we can.ask some questions right here right now.or we can take the back of rake and push.out in the hallway what would you like.alright let's do that and we'll meet you.on the hallway there thank you.

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How do I fill out a CLAT 2019 application form?

How do I fill out the college preference form of the CLAT 2019? If you are AIR 1 and eligible for admission to all 21 NLUs, which one would you prefer? That is your first choice. Your first choice is not available. Out of the remaining 20, you are eligible for all 20. Which one will you prefer? That is your second choice. Your second choice is not available. Out of the remaining 19, you are eligible for all 19. Which one will you prefer? That is your third choice. Repeat the process till you have ranked all 21 NLUs. All the best.

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