APPENDIX A

UNIT LEVEL PREVENTIVEMEDICINE MEASURES TASKS

TASK 1: Control biting insects.

EQUIPMENT NEEDED: 2-gallon sprayer, ready touse insecticide. Rodenttraps and individualrepellent.

STEPS OF PERFORMANCE:

STEP 1:

MOSQUITOES:

Identify common mosquitobreeding areas:

Standing water.

Artificial water containers.

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STEP 2: Control:

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FLEAS:

STEP 1:

If possible drain standingwater.

Empty artificial watercontainers.

Spray, using 2-gallonsprayer (see Task 2).

Identify rodent infestations inunit area (rodents carry fleas).

STEP 2: Control:

Have soldiers in unit useindividual insectrepellent.

Apply insecticide dust torodent burrows and har-borage.

LICE:

STEP 1:

Use traps to catchrodents in infested areas.

Identify lice infestation:

Head Lice–normally at-tached to the hairthe scalp. Eggstached directlyhairs.

close toare at-to the

Crab Lice–usuallyassociated with the pubicarea (groin), but can alsobe found attached to bodyhairs. The eggs are at-tached directly to thehair.

Body Lice–generallyfound in the seams ofclothing of infested per-sons. The eggs are attach-ed on the fibers of the 77

STEP 2:

TICKS AND MITES:

STEP 1:

garments. The body lousetends to move to the bodyof the host only duringthe actual feeding pro-cess.

Control:

Refer individuals with liceinfestation for medicaltreatment.

Enforce high standards ofpersonal hygiene.

Require frequent launder-ing of bedding andclothing.

Identify tick infested areas.

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STEP 2:

BITING FLIES:

STEP 1:

STEP 2:

NONBITING FLIES:

STEP 1:

Control:

Enforce individual use ofinsect repellent.

Spray, using 2-gallonsprayer (see Task 2).

Identify problems with bitingflies.

Control: Enforce individualuse of insect repellent.

Identify infestations andbreeding areas, such as:

Open latrines.

Uncovered food and waste.7 9

STEP 2: Control:

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SPIDERS:

STEP 1:

STEP 2:

Frequently cover latrinewaste.

Keep food and wastecovered.

Use aerosol spray inenclosed areas (be surenot to use in food serviceoperations).

Use 2-gallon sprayer tospray resting sites (seeTask 2).

Identify infestations ofmedically important spiders.

Control:

Spray using the 2-gallonsprayer (See Task 2)

SCORPIONS:

STEP 1:

STEP 2:

around tents, fieldlatrines, or other spiderhabitats.

Identify places where scor-pions are a problem.

Control:

Spray using the 2-gallonsprayer (See Task 2)around the entire tent, orother structure, forming aband 2 feet high from theground level. Saturate allcracks and crevices withinsecticide.

BEES, WASPS, AND ANTS:

STEP 1: Identify places where these in-sects are a problem. Locate thenests.

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STEP 2: Control:

Spray using the 2-gallonsprayer (See Task 2) onthe nesting sites. Use cau-tion to avoid stings fromdisturbed insects. If thetask is too great or toodangerous, contactpreventive medicine per-sonnel for assistance.

TASK 2: Using the 2-gallon sprayer.

EQUIPMENT NEEDED: 2-gallon sprayer andauthorized insecticide.

STEPS OF PERFORMANCE:

STEP 1: Determine the job to be done.

STEP 2: Select correct nozzle.

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STEP 3:

STEP 4:

Read the insecticide label.

Always read the label beforedoing anything. Always followall instructions on the label.

CAUTION

Wear gloves and an approvedpesticide mask. The NBC pro-tective mask is not for usewhen applying pesticides.

Avoid skin contact with insec-ticide.

Put insecticide in sprayer. Donot fill the sprayer to the top.Leave space to allow for pump-ing air pressure into the tank.

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STEP 5:

STEP 6:

STEP 7:

Pump the sprayer.

Put in pump assembly andpump 30-35 times to achieve40-60 pounds PSI pressure oruntil there is a slight resistance.Do not over pump.

Spray insecticide.

Point nozzle at area to besprayed and squeeze thehandle on the wand. Con-tinue spraying until areais covered or pesticideruns out.

Clean the sprayer

Clean after spraying withsoap and water, thenflush tank 3 times withclear water.

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STEP 8:

Rinse all parts in clear water.

Reassemble and sprayclear water through noz-zle. If the sprayer is notcleaned after use, vitalparts will corrode.

Store cleaned sprayer.

Turn the sprayer upsidedown with pumpassembly separated tokeep tank dry.

CAUTION

Always wash your hands afterspraying.

TASK 3: Inspect unit food service operations.

EQUIPMENT NEEDED: Thermometer, bimetallic,NSN 6685-00-444-6500.

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BACKGROUND INFORMATION:

Some foods support therapid growth of diseasegerms that cause diar-rhea; these foods are call-ed:

POTENTIALLYHAZARDOUS FOODS

Examples of potentially hazar-dous foods include but are notlimited to: Meats, fish, milk,creamed beef, gravies, soupsand chicken. Extra care andprecautions must be takenwith these potentiality hazar-dous foods.

Five factors most often involved in outbreaks of diarrheacaused by contaminated foods are:

Failure to keep potentiallyhazardous food cold (below45°F), or hot (above 140°F).

Allowing potentially hazar-dous foods to remain at warmtemperatures (46°F to 139°F).Preparing foods 3 hours to aday or more before being served.

Allowing sick employees towork.Poor personal hygiene orsanitation practices of foodhandlers.Example: not washing handsafter using the latrine.

STEPS OF PERFORMANCE:

IN GARRISON OR FIXED FACILITIES:

STEP 1: Have the supervisor check thetemperature of potentiallyhazardous foods.

If hot–food should be140°F or above.

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STEP 2:

STEP 3:

STEP 4:

STEP 5:

STEP 6:

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If cold–food should be45°F or below.

Check personnel for illness andskin infection.

Check food handling techni-ques and personal hygiene.

Have the supervisor check thefood temperature in coldstorage units.

Check handwashing facilities–are they being used by foodhandlers?

Check doors and windows–arethey closed or screened to pre-vent flies from entering?

NOTESee FM 10-23 for the correctoperating procedures for a fieldkitchen facility (MKT-75)mobile field kitchen or(M-1948) kitchen tent.

IN THE FIELD WHEN FOOD ISBROUGHT TO YOUR UNIT

STEP 1: Check the preparation of in-sulated containers.

For hot foods the con-tainer should bepreheated by the use ofboiling water. Foodsshould be placed in thecontainer while they arehot (above 140°F).

For cold foods the con-tainer should be prechill-ed by the use of ice. Foodsplaced in the containershould be cooler than45°F. Always check thecontainer and insert sealsto ensure that they are in-tact and in good conditionto aid in keeping food atits required temperature. 89

NOTE

STEP 2:

STEP 3:

STEP 4:

See FM 8-34 and FM 10-23 forthe correct procedures forpreparing the insulated con-tainers.

When the insulated containerarrives the supervisor mustcheck the temperature beforeserving. Make sure it is 140°For above for hot foods and45°F or below for cold foods. Ifthe temperatures are in thedanger zone, contact themedical authority for instruc-tions.

Check for handwashing devicesfor use by soldiers.

Check the mess kit laundry.Make sure soldiers are usingthe mess kit laundry correctly.The food waste is placed in ascrap can. Wash by using a

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long handle brush to scrub themess kit in warm soapy water(120°F to 150°F). Rinse themess kit in clear boiling water.Disinfect the mess kit by im-mersing it in clear boilingwater for 10 seconds. Each hotwater setup of four cans willsupport 80 personnel.

NOTEIf immersion heaters are not inuse, food service disinfectantmay be used. Make sure thelabel directions are beingfollowed. Each setup of fourcans will support 100 person-nel.

TASK 4: Inspect water containers.

EQUIPMENT NEEDED: None

WHEN TO INSPECT WATER CONTAINERS:

Quarterly in garrison when not being used.Before filling at water distribution points.Prior to deployment. 91

STEPS OF PERFORMANCE:

UNIT WATER TRAILER:

QUARTERLY:

STEP 1:

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STEP 2:

STEP 3:

Manhole cover: Make sure thesealing gasket is in place, freeof excessive cracks and dry rot.Cover should provide effectiveseal.

Drain plug: Make sure it isoperable—it should beremovable without excessiveeffort.

Interior: Check surface for ex-cessive cracks; check for signsof being used for storage ofproducts other than water suchas oil products and gasoline.Rust stains and otherdiscoloration caused by com-mon natural chemicals in water(iron, manganese) pose nohealth problem.

STEP 4: Spigots: Make sure spigotsare clean and operable. Coversover spigots should open andclose with ease. Spigot handlesshould operate freely.

NOTE

Questions concerning ex-cessive interior cracks or chipp-ing and use after storage ofproducts other than watershould be directed to preven-tive medicine. Refer to TM9-2330-267-14 & P (mainten-ance circular for 400 gallonwater trailer) for maintenanceinstructions.

BEFORE FILLING AT WATERDISTRIBUTION POINTS:

STEP 1: Check interior for gross con-tamination.

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STEP 2:

STEP 3:

LYSTER BAGS:

STEP 1:

Check hose used to fill trailer.Water point fill hose shouldnot come in contact with theground. If the hose is lying onthe ground, wash the endbefore use.

After filling, check manholecover and drain plug to ensurethat they are secure.

CAUTION

Personnel detailed to fill watertrailers must be directed to fillthe trailers only at approvedwater points.

Interior: Check for dirt andother contamination; check forholes.

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,,

STEP 2:

STEP 3:

STEP 4:

Cover: Check to make sure itfits; Check for holes.

Spigots: Make sure spigots areclean and in place.

Location: Elevate Lyster bagsufficiently to prevent con-tamination of spigots bywildlife.

NOTE

Always clean the Lyster bagprior to its first use.

WATER CANS: Check interior for contamina-tion; if can has a fuel odor suchas gasoline, do not use fordrinking water.

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TASK 5. Check unit water supply for chlorine residual.

EQUIPMENT NEEDED: Chlorination kit contain-ing 3 color comparisontubes with color bandsand bottle of chlorine testtablets.

Check the chlorine residual when:

Filling unit containers at water distributionpoints.

Water containers arrive in unit area.

Directed by command medical authority.

Treating a raw water supply.

STEPS OF PERFORMANCE:

STEP 1: Determine the desired chlorineresidual in parts-per-million(ppm).

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STEP 2:

At the point of consump-tion, water obtained from anapproved water distributionpoint should have at least 1ppm chlorine residual.

When the unit must obtainwater from a raw water sup-ply, or from another source,such as a stream or pond, thefinished product should havea 5 ppm chlorine residualafter 30 minutes. Under cer-tain conditions the localmedical authority may directa higher residual of 10 ppm.

Select the desired color comparisontube (marked 1, 5, or 10) based onthe desired chlorine residual fromSTEP 1.

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NOTE

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STEP 3:

STEP 4:

STEP 5:

The test tablets in all 3 colorcomparison tubes are the same.They can be used to test waterin any of the tubes.

Flush the spigots of the watercontainer being checked andfill the tube to a point justbelow the bottom of the colorband.

Place one test tablet in the col-or comparison tube cap andcrush it with the top of the testtablet bottle. Put the crushedtablet into the color com-parison tube.

Place the cap on the color com-parison tube and shake untilthe test tablet is completelydissolved.

STEP 6: Compare the color shade of thewater with the color band onthe comparison tube.

The water is safe to use ifthe color of the water isthe same shade or darkerthan the color band on thetube.

The water must bedechlorinated if the coloris lighter than the colorband on the tube (seeTASK 6).

TASK 6: Chlorinate water supplies.

EQUIPMENT NEEDED: Chlorination Kit, 6 oz jarof calcium hypochlorite(70% chlorine) or con-tainer of 5% householdbleach.

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Chlorinate the water supply when:

Water supply has no chlorine residual.

Chlorine residual is below required level.

Raw (untreated) or unapproved water supplymust be used.

STEPS OF PERFORMANCE:

STEP 1: Before adding chlorine, checkthe chlorine residual followingprocedures in TASK 5.

STEP 2:

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If the chlorine residual is lessthan the desired olevel, addenough chlorine to raise theresidual to 5 ppm. Use thetable below to determine theamount to add to untreatedwater. If a 10 ppm chlorineresidual is required, doublethese amounts. To increase theresidual in treated water,smaller quantities of chlorinewill be needed.

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STEP 3:

STEP 4:

STEP 5:

Wait 10 minutes, then checkthe chlorine residual.

If the residual is less than 5ppm, repeat steps 2 and 3 us-ing a smaller amount ofchlorine.

If the residual is at least 5ppm, wait an additional 20minutes before drinking.

TASK 7: Construct and maintain field waste disposaldevices.

EQUIPMENT NEEDED:

Material as required for type of facilities to beconstructed.

Additionally, a detail will be required to con-struct the devices.

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FIELD METHODS OF DISPOSAL THAT MAY BEUSED:

Garbage/rubbish disposal.

Burial–Less than 1 week.

Incineration—Longer than aweek.

Liquid kitchen or bathing waste disposal.

Grease trap.

Soakage pits.

Soakage trenches.

Evaporation beds.

Human waste disposal.

Cat-hole latrine for marches.

Straddle trench for 1-3 daybivouac sites. 103

Deep pit latrine for temporarycamps.

Burn-out latrine or pail-latrinewhen the ground is too harderthe water table is too high (soilis very wet).

Soakage pits for urinals at tem-porary camps:

Trough urinal.

Pipe urinal.

Urinoil.

STEPS OF PERFORMANCE:

STEP 1: Use the chart below to determine disposalrequirements.

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STEP 2: Select site of construction.

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Garbage and soakage pits should beat least 30 yards from food service.

Latrine should be as far as possiblefrom food service (100 yards or moreis best).

Latrine should be located on levelground. Never uphill from the camp-site or water supplies.

STEP 3: Construct disposal facility.

Garbage pit--Used to prevent ac-cumulation of garbage in the unitarea.

NOTE

Garbage and rubbish must be buried orburned. For short stays, bury and cover dai-ly. For longer periods, garbage and rubbishmay have to be burned; however, the ashesshould be buried.

Soakage pit/trench--Used to preventaccumulation of liquid waste (waterfrom showers, sinks, and field kit-chens).

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Grease trap--Used with bothsoakage pit and trench to preventclogging of the soil.

Cat-hole latrine--Used only on themarch and covered immediatelyafter use.

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Straddle trench latrine--Used onshort bivouacs and FTXs. Two tren-ches per 100 males and three tren-ches per 100 females.

Deep pit latrine--Used for longerperiods of time and in build up areas.Collapsible 2-seat boxes areavailable in the supply system.

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NOTE

If ground is too hard for digging, or ifthe water table is too high, use a pail-latrine or burn-out latrine.

Pail-latrine

Burn-out latrine

Chemical toilets--Use when local, state,or host nation laws prevent construc-tion of standard field latrine.

Urinals--For male latrines, constructone of the following urinals:

Trough urinal

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STEP 4: Inspect daily to make sure that the follow-ing is done:

Straddle trench latrines and garbagepits are covered with dirt daily.

Pail-latrines are emptied and cleaneddaily.

Burn-out latrine containers are rotatedand contents burned daily.

When flies or other insects are a pro-blem the field sanitation team hassprayed the facilities with insecticidenot the pit contents..

STEP 5: Closing: Close latrines and gar-bage pits when filled to within 1 footof the ground surface. Havechemical toilet contents removedfrequently.

Close out by--

Spraying with residual in-secticide.

Packing earth in successive3-inch layers until mounded1 foot above ground level.Spraying again withresidual insecticide.

Posting a sign stating,“Closed latrine/garbage pit,and date” (except incombat).

TASK 8: Construct and maintain field handwashing andshower devices.

EQUIPMENT NEEDED: Personnel detailed to con-struct and maintain fieldhandwashing and showerdevices. Material as re-quired for type offacilities to be con-structed.

STEPS OF PERFORMANCE:

STEP 1: Select device to be constructed:

Handwashing devices 113

Shower devices

STEP 2: Construct devices.

Collocate handwashingdevices at food serviceand latrine locations.

NOTE

A soakage pit should beprovided for all hand-washing and showerfacilities.

STEP 3: Maintain devices. A supply ofsoap and watermust be avail-able at alltimes.

STEP 4: Close devices.114