Attachment 1 THE RESEARCH AND DEVELOPMENT BOARD Committee on Medical Sciences and Committee on Atomic Energy Washington 25, D.C. BAW 1/1 23 February 1949 DIRECTIVE JOINT PANEL ON MEDICAL ASPECTS OF ATOMIC WARFARE 1. ORGANIZATION The Panel on Medical Aspects of Atomic Warfare is established as a joint agency of the committee on Medical Sciences and the Committee on Atomic Energy. The Committee on Medical Sciences shall have administrative responsibility for the Panel. 2. OBJECTIVE The objective of the Panel on Medical Aspects of Atomic Warfare is to assist the Committee on Medical Science and the Committee on Atomic Energy in the implementation of their directives in the field of medical aspects of atomic warfare. 3. MEMBERSHIP 3.1 Members. The Panel on Medical Aspects of Atomic Warfare shall consist of: (l) Three civilian members, one of whom shall be designated chairman, to be appointed by the chairman of the Committee on Medical Sciences, subject to concurrence by the chairman of the Committee on Atomic Energy. (2) Not more than two members nominated by the Department of the Army. (3) Not more than two members nominated by the Department of the Navy. (4) Not more than two members nominated by the Department of the Airforce. Appointments of members are subject to approval by both Committees. AppointmentS 3.2 Deputy Members. A deputy with plenary powers for each member may be nominated by tho appropriate authority. Appointments of deputies are subject to approval by both Committees. 3.3 Associate Members. A major governmental agency may formally nominate, through the appropriate governmental department, a qualified representative to act as an associate member as specified by the Rules of Organization and Procedure of the Board. Appointments of associate members are subject to approval by both Committees. 3.I~ Term of Service. Members, deputies, and associateS shall serve for a term of one year or until their successors are appointed. PROCEDURE The Panel on Medical Aspects of Atomic Warfare is encouraged to function as an independent entity within the limits of its terms of reference. 4.l Administrative Functions. In accordance with the Rules of Organization and Procedure of the Board and the directive of the Committee, the panel is authorized: (l) To employ professional and other personnel as necessary to discharge its responsibilities under a budget authorized by the Board through the Executive Secretary and the executive director of the Committee on Medical Sciences. (2) To establish its own administrative procedures. (3) To establish such supporting subpanels and consultant agencies as it may require. 4.2 Limitations. On internal matters of procedures, administration, budgets, and personnel, and in relationships between the Panel and the Commissions. -2- or the Board or other panels, the executive director of the Committee on Medical Sciences is designated to act in accordance with the procedure established by the Executive Secretary, RDB. Action of the Panel shall be effectuated in accordance with the Rules of Organization and Procedure of the Board. 5. TERMS OF REFERENCE In pursuit of its stated objective, the Panel on Medical Aspects of Atomic Warfare shall be responsible for the operations outlined herein. 5.1 Collection of Information. The Panel shall continuously survey research and development activities in the field of medical aspects of atomic warfare, both within and without the Military Establishment, and obtain: (1) Necessary information concerning United States and foreign progress, programs, plans, and budgets in the field of medical aspects of atomic warfare. (2) Necessary information from the Committee on Medical Sciences and the Committee on Atomic Energy on such aspects or over-all planning for national defense as may be needed in formulating an adequate programs for research and development in the field of medical aspects of atomic warfare. 5.2 Evaluation and Coordination. The Panel shall analyze and evaluate information obtained in accordance with Section 5.1 in order to: (1) Determine the major goals and problems in the field of medical aspects of atomic warfare and direct constant emphasis from them. (2) Assess the adequacy of plans, programs, and projects and assess the merit and effectiveness with which programs are handled. (3) Determine the presence of unjustifiable duplication of effort in the field of medical aspects of atomic Warfare. (4) Determine the presence of serious gaps which exist in the programs. - 3 - (5) Assess the adequacy of facilities, personnel and equipment currently available and estimate future requirements. (6) Assess the degree of coordination obtained in programs, including that reflected in budget requests. 5.3 Presentation of Reports and Recommendations. The Panel shall prepare and present reports and informative papers in order to: (l) Inform the Committee on Medical Sciences and the Committee on Atomic Energy of the facts and trends in the field of medical aspects of atomic warfare. (2) Inform the Committee on Medical Sciences and the Committee on Atomic Energy as to the implications on plans, operations, and strategy of new weapons, equipment, and techniques in the field of medical aspects of atomic warfare. (3) Inform the Committee on Medical Sciences and the Committee on Atomic energy of the requirements for materials and components in the research and development programs of the Military' Establishment in the field of medical aspects of atomic warfare. 5.1. Furtherance of the Directives of the Committee on Medical Sciences and the Committee on Atomic Energy. The Panel shall recommend in the form of completed staff action and in accordance with regular procedures of the Board and Committees: (1) An integrated plan of research and development for military purposes in the field of medical aspects of atomic warfare not less frequently than once a year. (2) Allocation and, when desirable, reallocation of responsibility among the military Departments for research and development programs in the field of medical aspects of atomic warfare. (3) Means whereby maxims advantage mad be taken of critical resources and new advances, solution of problems may be speeded, undesirable application, waste, or neglect may be avoided, and liaison and cooperation and direct dealing among agencies may be furthered. (4) Present to the Committees at appropriate times, as specified in the current RDB schedule of operations, recommendations regarding -4- funds for research and development programs and facilities in the field of medical aspects of atomic warfare. 6. FIELD OF INTEREST The subject matter for which the Panel is responsible shall include research and development in the medical aspects of atomic warfare with specific emphasis on human tolerance to and protection against radioactivity, decontamination of exposed individuals, and treatment of radiation casualties, except those fields where jurisdiction has been allocated to other RDB committee and panels. 7. LIAISON The Panel shall maintain liaison with other groups and agencies both within and outside the RDB which have related interests. The executive director of the Committee on Medical Sciences and/or the executive director of the Committee on Atomic Energy, through the Executive Secretary, RDB, will collaborate in arranging effective liaison. Questions arising because of overlapping or conflicting interests between panels of the Committee on Medical Sciences and the Committee on Atomic Energy or agencies of the Board shall be resolved through the executive directors of the Committees and the Executive Secretary of the Board. By Direction of the Committee JOSEPH F. SADUSK, JR., M.D. Executive Director Committee on Medical Sciences Approved by the Committees on Atomic Warfare and Medical Sciences and by the Executive council at its 94th meeting held 15 February 1949. -5- RESTRICTED BAW 1O7/5 12 September 1952 PROGRAM GUIDANCE REPORT JOINT PANEL ON THE MEDICAL ASPECTS OF ATOMIC WARFARE THIS DOCUMENT CONTAINS INFORMATION AFFECTING THE NATIONAL DEFENSE OF THE UNITED STATES WITHIN THE MEANING OF THE ESPIONAGE LAWS, TITLE 18, U.S.C., SECTIONS 793 AND 794. THE TRANSMISSION OR THE REVELATION OF ITS CONTENTS IN ANY MANNER TO AN UNAUTHORIZED PERSON IN PROHIBITED BY LAW. The Department of Defense RESEARCH AND DEVELOPMENT BOARD Washington 25 D.C. Approved: DR. JOSEPH C. AUB, Chairman DECLASSIFIED Authority NND 81 3070 By NARA Date 2/17/94 RESTRICTED SECURITY INFORMATION BAW 107/5 TABLE OF CONTENTS PAGE Detection, Measurement and Evaluation of Radiation 1 Protection of Personnel 4 Decontamination 7 Blast 9 Burns 11 Biological Effects of Radiation 14 Treatment of Radiation Injury 16 Development of Methods for Protecting Personnel Against Radioactivity 18 Recommendations for Research and Development Emphasis 19 RESTRICTED SECURITY INFORMATION DETECTION, MEASUREMENT AND EVALUATION OF RADIATION 1. Military Goals 1.1 Immediate Goals 1.1.1 A device should be developed for the purpose of detecting and evaluating airborne alpha and beta hazards. This device is to measure the radiation levels of filter papers obtained through the use of standard sampling apparatus. These devices should record long lived alpha emitters in air at levels of 0.1 to 100 microcuries per cubic mater of air (log scale). The beta emitters should be recorded at levels of 1 to 100 microcuries per cubic meter of air, an accuracy to be achieved of plus or minus 20% from 5% of full scale to full scale. The discrimination of particle size does not appear to be a feasible technical requirement for this instrument. 1.1.2 A requirement exists for the development and construction of survey type meters. These meters should serve not only to measure general environmental radiation but also as a detector for personnel contamination and may consist of the following types: a) Alpha meter. This meter would be used in the survey of contamination of personnel, areas, filter papers, laboratory procedures, weapon dads, etc. b) Beta and gamma meter. This would be a combined meter with a relatively high accuracy for the presence and measurement of gamma radiation, plus a window or other device which provides an indication of the qualitative presence of beta radiation, and should be provided with a shield capable of full exclusion of beta radiation. This beta radiation measurement is not required in reps, but as a representation of a relative change in the reading of total beta plus gamma as compared to gamma alone. The gamma ray ranges should extend from the order of 5 milliroentgens per hour to 500 roentgens per hour. 1.1.3 Procurement and issues of the phosphate glass personnel dosimetric devices and indoctrination in their usage ia urgently needed for purposes of field testing, troop training and morale. 1 1.2 Future Goals 1.2.1 The continued improvement of existing equipment and techniques and correction of shortcomings determined from field tests is indicated. 2. Deficiencies of Present Equipment and Systems in Meeting Requirements 2.1 The deficiencies must be sought in field tests of detection, dosage and monitoring instruments by trained personnel, and a summarization of these observations should be referred to the Radiological Instrument Panel and other cognizant groups. 2.2 A deficiency exists in adequate evaluation of the role of cloud rise and dispersion, yield, latitude, low tropopause, and extreme meteorological conditions as related to operational procedures in the determination of cloud hazard. 3. Present Research and Development Program in Support of Requirements. 3.1 There are no serious problems of a technical nature. 3.2 Complete, accurate, temporal and spatial information concerning the thermal, nuclear radiation, and blast hazards of atomic bomb detonation, together with information permitting the equation of sublethal radiation dosages and effects in humans, will continue to furnish the only true foundation for effective personnel defense against atomic warfare, and therefore, is of unlimited military value. 3.3 The probability of successful outcome of the program is good. 3.4 No alternative programs need be considered. 3.5 No evidence of duplication of any consequence. 3.6 There are no factors seriously interfering, but better organization and dissemination of information might be accomplished. 4. Conclusions and Recommendations 4.1 Procurement, distribution and indoctrination in the use of the selected personnel dose meters and area survey matters must be given greater emphasis in order to realize a capability for effective defense, 2 RESTRICTED SECURITY INFORMATION 4.2 The immediate procurements recommended in paragraph 4.1 should not prejudice the continuation of the improvement, testing, and development of the types of radiation instruments which will be needed eventually. 4.3 Definitive evaluation of the cloud hazard in areas of the cited parameters (2.2) should be accomplished with emphasis on arctic air operations. 4.4 More quantitative information should be obtained on the contamination of air by many men (such as troops) moving through contaminated areas. Since the available evidence suggests serious hazard, this and the instrument requirement of 1.1.1 are not assigned high priorities. 3 RESTRICTED SECURITY INFORMATION PROTECTION OF PERSONNEL 1. Military Goals 1.1 Immediate Goals Considerable data are now available on the response of critical systems of the body to radiation. The overall defense program would be served best if the following were considered as immediate goals. 1.1.1 Organization and dissemination of information with regard to methods of attenuating radiation to innocuous levels on general external ionizing radiation, radioactive particulates, and thermal radiation. 1.1.2 The case of external ionizing and thermal radiation, the further understanding of the use of: (1) Barriers. This would include the study of utilization of available buildings, underground structures, trenches, specially constructed barriers and fixed installations. (2) Distance. This might best be utilized by examining methods and effectiveness of dispersal of personnel. (3) Evasive Action. The possible utilization of this means would be obtained by examination of the time-intensity relationship of radiation following an atomic explosion. (4) Partial Body Shielding. This is considered in the section on therapy. It may also be useful as a protective measure. 1.1.3 In the cause of radioactive particulars, determination of the capability of presently available filter devices should be accomplished and information disseminated. 1.1.4 In the case of thermal radiation additional information the protective effect of fabric and better organization and dissemination of information already available should be accomplished. 4 RESTRICTED SECURITY INFORMATION 1.2 Future Goals 1.2.1 The future goals Are testing for RW effectiveness, new types of filters and gas absorbers as developed for biological and chemical warfare. 1.2.2. Insuring that new types of protective clothing and equipment give maximum protection against RW and thermal radiation. 1.2.3 Development of prophylactic medication for individuals potentially exposed to radiation (AW-6). 1.2.4 Continuous revision of organized data and emphasis on dissemination. 2. Deficiencies of Present Equipment and Systems in Meeting Requirements 2.1 In the case of thermal radiation, considerable information is now available on time-intensity relationships, the physical factor of burning and the special distribution. Additional data are needed in all the aspects to provide a more nearly complete understanding, particularly for new types of weapons. 3. Present Research and Development Program in Support of Requirements 3.1 There are no obstacles to organization and dissemination of information. 3.2 No difficulties with regard to collection, organization and dissemination of information. 3.3 Alternative programs concern themselves with pharmacologic and physiologic means of protecting against radiation. Of doubtful present value. 3.4 No duplication nor gaps are evident. 3.5 There are no factors interfering with the conduct of this program. 4. Conclusions and Recommendations 4.1 Recommendations 4.1.1 The primary problem of organization and dissemination of information, together with continuous review of present manuals, still exists. 5 4.1.2 Additional manuals together with review and modification of existing ones on the subject of personnel protection against AW and are desirable. 4.2 Justifiable duplication may occur, primarily in the development of the best treatment for thermal burns and ionizing radiation injury. (AW-6). 6 RESTRICTED SECURITY INFORMATION DECONTAMINATION 1. Military Goals Research and development directed toward obtaining new and/or improved methods for decontaminating military personnel and equipment from contaminants produced during an atomic explosion or produced through the use of RW agents. 1.1 Immediate Military Goals It is important that effort be directed toward obtaining rapid methods for decontaminating personnel and materials from radioactive substances in all environments of present or future operational significance. 1.1.1 Techniques of decontamination in extreme environmental situations, as in arctic, sub-arctic, other cold weather areas, tropic, desert and humid localities. 1.1.2 The more accurate determination maximum permissible levels of exposure, continuous or intermittent, to contamination under field conditions. (AW-6) 1.2 Future Military Goals In addition to continuing the efforts under paragraph 1.1 future military goals will include the following: 1.2.1 Methods for rapidly reducing internal contamination by effective pharmacologic agents. (Aw-6) 1.2. 2 Establishing standards of permissible contamination levels for man, i.e., the time-intensity relationships for continuous or intermittent exposure. 1.2.3 Continued search for new types of easily decontaminatable protective coatings and strippings. 1.2.4 Testing and evaluation of decontamination techniques, materials and equipment. 2. Deficiencies of Present Equipment and Systems in Meeting Requirements 2.1 Lack of decontamination information in extreme environmental conditions such as in the arctic or tropic areas. 7 RESTRICTED SECURITY INFORMATION 2.2 Lack of information relating injuries to radiation levels, including repeated radiation exposures. 3. Present Research and Development Program in Support of Requirements The present program in the field of decontamination is insufficient with respect to extreme environmental conditions. The program should include such studies. 4. Conclusions and Recommendations 4.1 Process in the development of new techniques of decontamination is dependent upon progress made in other fields of atomic energy, including radiation protection, dosimetry and monitoring. Decontamination problems cannot be separated from those related studies. More information is needed for successful large scale decontamination operations. 4.1.1 It is recommended that efforts be directed toward the solution of decontamination problems in the arctic, tropic, and other extreme environmental conditions using available facilities. 4.1.2 It is considered essential that rapid techniques be developed for the economical field decontamination of personnel, including burn and wound casualties, food, water and equipment. 4.1.3 Continuing research efforts should be directed toward developing new decontaminating agents, equipment, and protective coatings. 4.1.4 Obtain maxim permissible levels of exposure in man to continuous or intermittent contamination. 4.1.5 It is desirable to compile and collate continually data regarding decontamination and related areas for incorporation into operational manuals. 4.1.6 There is need for exchange of information and coordination of activities among all governmental agencies concerned with research and development in the field of decontamination. 8 RESTRICTED SECURITY INFORMATION 1. Military Goals 1.1 Immediate Goals 1.1.1 With the reality of much higher KT equivalent weapons and their probable adaptability to deep underwater detonations, it is considered important to pursue primary blast studies and to evaluate thoroughly the possible effects of direct blast injuries to personnel from overpressures in both air and underwater environments. The critical pressures required to produce these injuries under varying conditions have not been accurately determined for the blast wave forms incident to atomic detonations. 1.1.2 To determine the extent of displacement of personnel by the blast wave. This information should be provided as a function of distance and of yield, and should include information on acceleration as well as distance displaced. As a first approximation this information can be obtained from existing physical data available at the Los Alamos Scientific Laboratory. 1.2 Future Goals 1.2.1 When overpressures necessary to produce pathologic changes have been established, it will then be feasible to determine whether these critical pressures can exist under any environmental conditions without concomitant incapacitating secondary blast, thermal, or radiation injuries. 1.2.2 If this situation is found to exist, an assessment of protective measures against it must then be made. 1.2.3 Since pressure waves similar in time and intensity characteristics to those incident in an atomic explosion are difficult to duplicate in the laboratory, an evaluation of this primary blast problem is greatly desired under field test conditions. 2. Deficiencies of Present Equipment and Systems in Meeting Requirements 2.1 Since it has been found, however, that the practical difficulties 9 RESTRICTED SECURITY INFORMATION encountered under field conditions in disassociating primary blast from concomitant injuries from other sources, it is necessary to pursue parallel investigations in blast chambers in the laboratory. These studies should be done utilizing test animals with a thoracic cage and abdominal wall approximating as closely as possible those of man. 2.2 Unexpected problems have been encountered in the construction of experimental blast chambers that have delayed the laboratory approach to the problem. 2.2.1 Several types of animal holding devices have been evaluated under field test conditions which have been designed to give the desired information. Although none of these systems have proven to be entirely satisfactory, an adaptation of the Greenhouse type animal exposure chamber has indicated the most feasible approach to the problem. 3. Present Research and Development Program in Support of Requirements 3.1 The goals are technically attainable. An experimental blast tube capable Of studying the primary blast effects on animals comparable in size to rats and mice will be in operation by the end of this calendar year. A blast tube capable of studying the effects on animals comparable in size to rabbits and dogs will be in operation during the first part of the next calendar year. The effects on animals comparable in size to mice and dogs will be evaluated under field test conditions. Definite answers are expected. 3.2 Similar studies of underwater blast effects should be well under way by the end of the next calendar year. 3.3 Excellent progress in both laboratory and field studies is anticipated at moderate cost. The inclusion of underwater blast effects in the program indicates that the problem will not be completely solved for approximately two to three years. 3.4 Adequate facilities and personnel are available. 4. Conclusions and Recommendations 4.1 Further studies including both field and laboratory tests are indicated in evaluating the effects of direct blast damage to personnel. These must include an evaluation of the anti-personnel effects of overpressures accompanying both underwater and air detonations. 4.2 No unjustifiable duplication exists. 10 RESTRICTED SECURITY INFORMATION 1. Military Goals 1.1 Immediate Goals 1.1.1 To develop and evaluate simplified techniques in the first aid, treatment and handling of mass numbers of burn casualties resulting from an atomic explosion, including those complicated by ionizing radiation or other injury. 1.1.2 To develop improved techniques for stimulating thermal radiation injuries for experimental study in the laboratory with emphasis on large area burns and their systemic effects. 1.1.3 To evaluate treatment and protective methods for the burn casualty; this to index (a) dextran for the prevention and treatment of shock in the burn patient, (b) proteolytic enzymes for the rapid removal of slough from third degree burns, (c) Universal Protective dressings, and (4) military fabrics to protect against thermal radiation. 1.2 Future Goals 1.2.1 To determine the mechanisms involved in the metabolic abnormalities and death in severe thermal radiation burns so as to develop more adequate methods of combatting those effects. 1.2.2 To develop methods for treating thermal injuries of the respiratory tract. 2. Deficiencies of Present Equipment and Methods in Meeting Requirements 2.1 No practical procedure has been evaluated for the handling and treating of massive numbers of burn casualties. 2.2 Techniques are essential which accurately simulate the thermal injuries of an atomic explosion, for the production of larger area burns. Such methods are urgently needed to facilitate realistic experimental studies. 11 RESTRICTED SECURITY INFORMATION 2.3 No adequate method exists for the treatment of thermal injuries of the respiratory tract. 2.4 Knowledge of the exact causes of systemic injuries and death is lacking. This lack seriously handicaps the saving of life from severe thermal burns. 2.S There is lack of knowledge of the effects of combined injuries of burns with radiation and with traumatic injury. 3. Present Research and Development Program in Support of Requirements 3.1 There has been overemphasis on the local changes involved in small area burns and insufficient emphasis on metabolic changes which result from more extensive burns. Simplification of methods for dealing with large numbers of burn casualties needs greater emphasis as also do the studies on combination of thermal radiation burns with ionizing radiation and traumatic injuries. 3.2 Reasonable accomplishment of this program should result in an increased saving of life and a decrease in morbidity and disability from burn casualties together with decreased mortality and improved rehabilitation of the seriously burned patient. Shortened periods of hospitalization and better functional results for the majority of burn cases are within sight and can be attained at a cost which is low in comparison with the anticipated economic gains. 3.3 Of especial importance in the presently proposed program are the following studies which need special emphasis: a) The metabolic and endocrine studies including: l)lipid metabolism of the burn patient; 2) nitrogen metabolism together with identification of the "unknown nitrogen fraction"; 3) endocrine imbalances and the interrelationship caused by stress reaction burns; 4) the mechanisms involved in anemia and the other blood changes which follow burns. b) Nutritional support of the burn patient. c) Development of simplified methods for treating the moderately burned patient which can be applied by nonprofessional personnel or by the patient himself, thus freeing the medical personnel to care for the severely burned patient. It is anticipated that there will not be sufficient medical personnel to deal 12 RESTRICTED SECURITY INFORMATION 2.3 No alternative program is feasible. 4. Conclusions and Recommendations 4.1 Recommendations 4.1.1 The following evaluations should be concluded in 1953: a. The Universal Protective Dressings. b. Dextran for the prevention and treatment of burn shock. c. Presently available proteolytic enzymes for rapid removal of slough from third degree burns. 4.1.2 Much of the effort on small area burns should be transferred from the histological to histochemical and biochemical factors and extended to large areas. 4.1.3 The study of large area burn wounds should be continued with special emphasis on a) control of infection, b) removal of slough, c) better rehabilitation of the severely burned hands, and d) prevention of scarring and contractures, especially on the face. 4.4 Increased emphasis should be on studies of metabolic and endocrine changes involved in severe burns so as to establish the mechanisms of systemic injuries and death. 4.1.5 Efforts to simplify the mass first aid and treatment of burns of moderate severity should be greatly increased. 4.1.6 Thermal burns continue to be a major problem and it is recommended that the program as outlined for FY 1953 and 1954, with the modifications indicated, be continued. 4.2 No unjustifiable duplication exists. Tn view of the urgent need for further information on the burned, burned-irradiated, and burned-traumatized casualty, duplication is desirable at this time. 13 BIOLOGICAL EFFECTS OF RADIATION 1. Military Goals 1.1 Immediate goals The immediate goals are to obtain new and meaningful information on the biological effects of ionizing radiation concerning: 1.1.1 Maximum single and repeated doses of radiation which may be tolerated by man with reasonable safety. 1.1.2 Hazardous doses which may cause incapacity for performance of diverse military missions with or without permanent damage or death. Determine critical dose to incapacitate within a matter of hours. 1.1.3 Casualty-producing doses which should lead to evacuation from contaminated areas whenever possible. 1.1.4. Toxicology of radioactive materials. 1.1.5 Effects on man of moderate doses. 1.1.6 The effects of radiation as modified by various concurrent factors such as burns, trauma, infections, on environments. 1.1.7 Effects of radiation on the central nervous system and its function in man and mammals. 1.2 Future Goals The future goal is to understand the biologic mechanisms underlying radiation damage so the potential radiation injury may be prevented, minimized or treated. 2. Deficiencies of Present Equipments and Systems in Meeting Requirements 2.1 Lack of accurate information concerning effects of various dose levels of external radiation on man. 2.2 Lack of accurate information concerning toxicology of absorbed radioactive materials. 2.3 There is lack of existing knowledge concerning the combined effects or radiation, thermal, and traumatic injury. (c.f. Burns 2.5) 14 3. Present Research and Development Program in Support of Requirements 3.1 The attainment of immediate goals is technically feasible provided that effects of moderate dose levels of external radiation may be observed on human patients and volunteers. 3.2 The obtaining and disinformation of necessary information is a military necessity. 3.3 Most of the immediate goals can be achieved in five years provided there is adequate financial and scientific stimulus. 3.4 Alternative programs - none. 3.5 Some duplication is inevitable and desirable in the present state of progress. The most serious gap is failure to secure adequate quantitative data on the efforts of ionizing radiation on man. 3.6 The program shows no evidence of suffering from lack of planning personnel, facilities or money. 4. Conclusions and Recommendations 4.1 Researches in biological effects of radiation should be continued. 4.1.1 Continue the study of the deterioration of motor and sensory functions attending sublethal and lethal irradiation in mammals. 4.1.2 Decrease the emphasis on primates (monkeys). 4.1.3 Increase the emphasis on the mutual influence of radiation injury combined with thermal and with traumatic injury. 4.2 It is still necessary to initiate measurements of the effects of moderate doses of radiation in man. 4.3 Advantage should be take of any opportunities for the study of the biological effects of radiation particularly in man. 4.4 Some duplication of effort in all phases of the program is justifiable and necessary for rapid progress. This refers both to duplication (a) within the Services, and (b) between the Services and the world of science. 15 TREATMENT OF RADIATION INJURY 1. Military Goals 1.1 Immediate goals 1.1.1 Intensified research for a biological factor which promotes recovery from radiation injury. 1.1.2 Development of practical methods of segregating casualties into serious and non-serious groups and possibly into other categories with special reference to concurrent factors such as burns, trauma and infection. 1.2 Ultimate goals 1.2.1 Development of more effective methods of therapy. 2. Deficiencies of Present Equipment and Systems in Meeting Requirements 2.1 Lack of effective methods of treatment and early classification of casualties. 3. Present Research and Development in Support of Requirements 3.1 Development of adequate therapy depends upon understanding the basic physiological changes as they affect survival. 3.2 Military value - enormous. 3.3 Probability of successful outcome - possibility of success. 3.4 There is no alterative program but see succeeding section on prophylactic measures. 3.5 Considerable duplication exists, particularly in this study of available antibiotics. Too little work is being done in the field of development of new drugs, immune bodies, and antibiotics effective against normally nonpathogenic intestinal micro-organisms, including anaerobes and possibly even fungi and protozoa, in relation to radiation injury. 3.6 No interfering factors are evident. 16 4. Conclusions and Recommendations 4.1 Additional emphasis should be placed upon development of new methods and decreased emphasis on the evaluation or present therapeutic methods, such as blood and presently available antibiotics, in uncomplicated radiation injury. 4.2 No unjustifiable duplication exists. 17 DEVELOPMENT OF METHODS FOR PROTECTING PERSONNEL AGAINST RADIOACTIVITY 1. Military goals 1.1 Immediate goals The testing of present methods of protecting personnel against radiation damage and the development of new methods. 1.2 Future goals The increase to a maximum extent of man's ability' to withstand ionizing radiation. 2. Deficiencies of Present Equipment and Systems in Meeting Requirements 2.1 Testing on man of methods now showing promise. 3. Present Research and Development Program in Support of Requirements 3.1 Present research, especially that on partial body shielding and possibly that on drugs, indicates that an increase in man's ability to withstand acute exposure to ionizing radiation appears possible. 3.2 Such development would be of considerable military value physiologically as well as psychologically. 3.3 Outcome of future research and development in this field is uncertain, but the rewards of success are so great the work must not be neglected. 3.4 There is no alternate program. 3.5 Considerable duplication within and outside military services now exists and is desirable. 3.6 Work is proceeding at proper level and is being pursued as fast as new scientific leads develop. 4. Conclusions and Recommendations 4.1 Consistent with the great difficulties inherent in the problem, progress is satisfactory. 4.2 No justifiable duplIcation exists. 18 RECOMMENDATIONS FOR RESEARCH AND DEVELOPMENT EMPHASIS TECHNICAL OBJECTIVE AND ITEM EMPHASIS AW-5 Continued correlation and verification of measurements of thermal and nuclear radiations as new weapons and weapon systems are developed. Maintain A-5a Procurement and distribution of accepted personnel dosimeters and portable survey instruments together with suitable indoctrination should be accomplished. Increase Hazards of flying through an atomic cloud. Assumptions and theoretical calculations require verification in terms of multiple parameters of this problem, including time variables, thermal and gamma radiation hazards, and evaluation of operational procedures under extreme meteorological conditions. Increase AW-5c Development and evaluation of decontamination procedures in extreme environmental conditions (arctic, tropic and desert). Initiate AW-6 Evaluation of present therapy of uncomplicated radiation injury (Transfusions, antibiotics, plasma, fluids, etc.) Decrease Determination 0œ hazard of ingestion and inhalation of radioactive materials. Decrease Determination of single, repeated, and protracted dosages of radiation in relation to military effectiveness. Increase Markedly Determination of critical dose to incapacitate within a matter of hours. Increase markedly Search for a biological factor which promotes recovery from radiation injury. Maintain Evalu ation of Universal Protective Dressings, Dextran for burn shock and proteolytic enzymes presently proposed for rapid slough removal. Conclude in 1953 19 TECHNICAL OBJECTIVE AND ITEM (CONTINUED) EMPHASIS Studies of small area local burns in human volunteers. Maintain Studies of large area burn wounds Maintain Mechanism of systemic effects and death from burns. Increase Studies of combined effects of Thermal Burns with radiation trauma and infection. Increase Simplify methods for handling and treatment of mass burn casualties. Greatly Increase 20