Developing Medical Surveillance Examination Guidance for New Occupational Hazards: The IMX-101 Experience

New materials are constantly being created to address the operational needs of the US Army. These materials provide challenges to occupational health practitioners by presenting unknown health risks and possible effects to workers they evaluate. The responsibility for developing a medical surveillance exam, as part of a comprehensive workplace surveillance program, may become the responsibility of the provider working in a clinic on a military installation where manufacturing, testing, and/or use of the material is being conducted. Insensitive munitions explosive (IMX) has presented such an opportunity for Army occupational medicine providers within the last few years. This article describes the course of action taken by the occupational health clinics, personnel of Army ammunition plants producing IMX-101, and the US Army Public Health Center-Army Institute of Public Health to address the situation of developing a medical surveillance examination during a time when little to no information existed about the components of this new explosive compound.