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CHAPTER 1, FOOD SAFETY

Change 1
Rev May 2004

3-2.5 Pasteurized Eggs, Substitute for Shell Eggs for Certain


Recipes and Populations

Pasteurized liquid, frozen, or dry eggs or egg products shall be


substituted for shell eggs in the preparation of:

a. Foods such as Caesar salad dressing, hollandaise or


béarnaise sauce, mayonnaise, eggnog, ice cream, and egg-
fortified beverages.

b. Eggs for a highly immunocompromised or otherwise


susceptible population.

3-2.6 Washing Fruits and Vegetables

a. Fresh fruits and vegetables should be procured only from


approved sources.

b. Fresh fruits and vegetables from approved sources,


shall be thoroughly washed in clean, potable water to remove
soil and other contaminants before being cut, combined with
other ingredients, cooked, served, or offered for human
consumption in ready-to-eat form. Head/stalk produce such as
lettuce, cabbage and celery, etc. must be broken apart during
washing to enhance contact to head/stalk produce surfaces.
c. For fresh fruits and vegetables from unapproved sources,
as well as those suspected of being contaminated with pathogenic
organisms, the following is recommended:

1. First, wash fresh fruits and vegetables as described


in 3-2.6b.

2. Then subject the fresh fruits and vegetables to a


chemical wash (refer to 3-2.6d) using an approved direct food
contact additive.
3. Following the chemical wash, thoroughly rinse the
fresh fruits and vegetables with clean potable water before
being cooked and/or served to the consumer.

d. Recommended chemical wash solution and procedures.


Sodium hypochlorite 5% (unscented bleach) is generally
recommended for use. Fresh fruits and vegetables may be

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CHAPTER 1, FOOD SAFETY

Change 1
Rev May 2004

3-2.6 Washing Fruits and Vegetables (Continued)

chemically washed by immersion in a 50 ppm free available chlorine


(FAC) solution for 1-2 minutes. A 50 ppm FAC solution may be made
by adding 1.5 tablespoons of 5% Sodium hypochlorite to 5 gallons
of potable water or a Calcium hypochlorite (70%) FAC solution may
also be used. To make a Calcium hypochlorite 50 ppm FAC solution
add 1 tablespoon of Calcium hypochlorite (70%) to 25 gallons of
potable water. Use the correct chemical test paper (strips) to
match the chemical wash solution to periodically monitor the FAC
to verify that chemical strength (50 ppm FAC) is maintained. It
is especially important to follow these procedures due to quality
and taste of these food items. Note: other chemical solutions or
products may be used if approved as an FDA direct food contact
additive. Chemical sanitizers approved for dishware, utensils,
and other food contact surfaces are not necessarily FDA approved
for washing fresh fruits and vegetables.

3-2.7 Ice used as Exterior Coolant is Prohibited from Reuse

Ice may not be used as food after it has been used as a medium for
cooling the exterior surfaces of food such as melons or fish,
packaged foods, canned beverages, or cooling coils and tubes of
equipment.

3-2.8 Single use Gloves, used for one Purpose and Discarded

If used, single use gloves shall be used for only one task such as
working with ready-to-eat food or with raw animal food, used for
no other purpose, and discarded when damaged or soiled, or when
interruptions occur in the operation.

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Rev May 2004

THIS PAGE INTENTIONALLY LEFT BLANK

55b
Bureau of
Medicine and Surgery NAVMED P-501O-2 (Rev. 1995)
Washington, D.C. 20372-5300 0510-LP-753-5800

Manual of Naval Preventive Medicine

Chapter 2

SANITATION OF LIVING
SPACES AND RELATED
SERVICE FACILITIES

DISTRIBUTION STATEMENT “A”


TABLE OF CONTENTS

Section I. S a n i t a t i o n of Living S p a c e s Page


Article 2-1. Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
2-2. Habitability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
2-3. Construction Standards . .." . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
2-4. Berthing Aboard Ships and Barges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
2-5. Bachelor Quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
2-6. Temporary Lodging Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
2-7. Berthing for Watch Standers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
2-8. Civilian Contract Berthing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
2-9. Preventive Medicine Inspections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
2-10. Confinement Facilities/Ashore and Moat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4

Section II. Barbershop and Beauty


Shop Sanitation
Article 2-11. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
2-12. Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
2-13. Sanitation Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
2-14. Construction Standards for Barbershops and
Beauty Shops Ashore and Afloat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
2-15. Sanitary Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
2-16. Cleaning and Disinfection of Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
2-17. Abnormal Skin Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
2-18. Regulations/Inspections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8

Section III. Trailer Home/Recreation Vehicle (RV)


Camp Grounds and Mobile Home Court
Sanitation
Article 2-19. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
2-20. Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
2-21. Site Selection and Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2-22. Space Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2-23. Recreation Areas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2-24. Service Buildings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2-25. Water Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
2-26. Sewage and Liquid Waste Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
2-27. Refuse Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
2-28. Insect and Rodent Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
2-29. Pets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
2-30. Inspections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11 .

Section IV. Laundry and Dry Cleaning


Article 2-31. General. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
2-32. Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
2-33. Sanitary Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
2-34. Hospital/Health Care Facility Laundry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
2-35. Hygienically Safe Laundry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
2-36. Industrial Hygiene and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13

Section V . Children’s Playgrounds


Article 2-37. General. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15
2-38. Site Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15
2-39. Playground Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15

January 1995 II
Section VI. Campgrounds and Picnic Areas
Article 2-40. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
2-41. Site Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
2-42. Water Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
2-43. Water Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
2-44. Refuse Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
2-45. Comfort Stations . . . . . . . . . . . . . . . . ..` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-16 .

Section VII. Gymnasiums


Article 2-46. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17
2-47. Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
2-48. Structured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
2-49. Lighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
2-50. Toilet Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - 1 8
2-51. Drinking Fountains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
2-52. Recreational Clothing Rental/Issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18

Section VIII. Theaters


Article 2-53. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19
2-54. Construction Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19
2-55. Housekeeping Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19
2-56. Food Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19
2-57. Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19

Section IX. Riding Stables


Article 2-58. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
2-59. Stables and Corrals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
2-60. Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
2-61. Insect and Rodent Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
2-62. Waste Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
2-63. Veterinary Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-21

Section X. Sanitation of Administrative Spaces


Article 2-64. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-21
2-65. Habitability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-21
2-66. Sanitation and Housekeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-22

Section XI. Saunas and Steamrooms


Article 2-67. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-23
2-68. Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-23
2-69. Sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-23
2-70. Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-23

Section XII. References


Article 2-71. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-24
..

Illustrations
Table 2-1. Bachelor Quarters Standards of Adequacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
2-2. Comfort Stations for Campgrounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17
2-3. Comfort Stations for Picnic Areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17
2-4. Ratio of Plumbing Fixtures to Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-22

III January 1995


Chapter 2

SANITATION OF LIVING SPACES


AND RELATED SERVICE FACILITIES
Section 1. Sanitation of Living Spaces

Article
Scope ---------------------------------------------------------------------------------------------------------- 2-1
Habitability ------------------------------------------------------------------------------------------------- 2-2
Construction Standards ---------------------------------------------------------------------------------- 2-3
Berthing Aboard Ships and Barges ------------------------------------------------------------------- 2-4
Bachelor Officer Quarters (BOQ) and
Bachelor Enlisted Quarters (BEQ)----------------------------------------------------------------- 2-5
Temporary Lodging Facilities -------------------------------------------------------------------------- 2-6
Berthing for Watch Standers --------------------------------------------------------------------------- 2-7
Civilian Contract Berthing ------------------------------------------------------------------------------ 2-8
Preventive Medicine Inspections ---------------------------------------------------------------------- 2-9
Confinement Facilities/Ashore and Afloat ---------------------------------------------------------- 2-10

2-1. Scope. bat effectiveness, minimum standards for


sanitary facilities are not always attainable. In
1. Whenever people live or work in a close these circumstances, commanding officers
proximity, the possibility of adverse health must strive to achieve, within practicable lim-
conditions, e.g., respiratory disease transmis- its, the minimum standards necessary to opti-
sion, is magnified. In addition, human comfort mize sanitation.
during rest or recreation has a direct bearing
on morale. 2-3. Construction Standards.
2. Design plays an important role in elimi- 1. The Department of Defense Construc-
nating potentially adverse health conditions in tion Manual, DoD 4270.lM, contains technical
existing facilities. Cleanliness contributes to criteria and policy guidance for design and
morale and is aesthetically desirable. construction of berthing facilities ashore. De-
tailed design criteria procedures must be con-
2-2. Habitability. sistent with guidance provided in this
1. A habitable and healthful environment document. Renovation of existing structures
must prevail in living and berthing spaces must be undertaken in conjunction with the
ashore and afloat to maintain the efficiency of medical department to ensure that health and
Navy and Marine Corps Personnel. To this sanitation standards are incorporated at the
end, construction plans for both ships and earliest design phase of the project.
shore stations are under constant review to 2. Berthing compartment construction or
ensure that the latest developments in human modification aboard ship must be consistent
factors engineering are incorporated into facil- with the standards established in General
ity/ship design. Specifications for Ships of the U.S. Navy (Gen-
2. Major factors which pertain to living, rec- Spec).
reation, and berthing ashore and afloat in-
clude: floor area, ventilation, heating, sanitary 2-4. Berthing Aboard Ships and
fixtures, water supply, lighting and color. Barges.
3. Current manuals and publications must 1. The executive officer, medical officer or
be consulted for specific data on the above medical department representative, the OOD,
requirements and allowances. However, it JOOD, chief master at arms, division officer,
must be realized that due to demands for com- and division chief petty officers must make

January 1995 2-1


2 4 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-6

routine inspections of the sanitary condition of 2. With the exception of guide dogs for the
toilets, lavatories, and berthing spaces. blind and military working dogs, no dogs,
2. Berthing spaces must be clean at all cats or similar pets are allowed in berthing
times, well ventilated, and well illuminated. areas. Permission to maintain other animals
Head-to-foot sleeping arrangements for occu- as pets, such as fish, is the option of the
pants of adjacent beds are recommended to commanding officer.
reduce the potential of airborne disease 3. Berthing areas that are not air condi-
transmission unless privacy curtains are in- tioned must have screened windows and self
stalled at each bunk. closing doors. All spaces must be well venti-
3. Except for instances of operational ne- lated, illuminated, and heated to meet local
cessity, hot bunking is prohibited. The use of weather conditions.
polyurethane pillows aboard ship is prohib- 4. All head facilities and common areas
ited. Minimum requirements for pillows must be cleaned daily.
aboard ships are outlined in Federal Specifi- 5. Hot water must be delivered to the user
cation V-P-356D. Mattresses must conform at temperatures not to exceed 110° F in
to Military Specification MIL-M-18351. Mat- buildings with laundry and shower facilities.
tress foam inserts must be ‘low smoke” foam Hot water must be delivered at a tempera-
rubber per Military Specification MIL-R- ture not to exceed 100” F in buildings without
20092. laundry or showers, e.g., duty rooms.
4. A sufficient supply of clean bed linen 6. Complaints of unsanitary conditions
must be maintained. Bedding must be existing in unaccompanied personnel hous-
changed frequently to prevent odor accumu- ing must be investigated and promptly re-
lation. solved by the BQ management.
5. Water closets, urinals, lavatories, and 7. Living space standards for each grade
showers, must be clean and operable. are found in the current NAVPERS 15606,
Shower curtains, mats, bulkheads, and Navy Bachelor Quarters Manual. The infor-
decks must be cleaned and sanitized at suffi- mation is reproduced in Table 2-1.
cient intervals to prevent mildew, odor, and
soap accumulations. Sewage backflow 2-6. Temporary Lodging Facilities.
through deck drains and overflowing water
closets constitute extremely unsanitary con- 1. Temporary lodging facilities are those
ditions. If these conditions occur, the space or that are intended for use for short periods of
unit must be immediately secured until the time, such as awaiting permanent housing,
situation is corrected and the spaces are transfer, and at recreational areas where
cleaned and sanitized. housing, such as cabins are available.
2. With the exception of guide dogs for the
2-5. Bachelor Quarters blind and military working dogs, dogs, cats,
birds, or similar pets are prohibited in spaces
1. Department heads, division officers, intended for human occupancy. Permission
and division leading petty officers must to allow other types of pets is the option of
make routine inspections of enlisted the commanding officer.
berthing spaces in order to maintain Navy 3. Temporary lodging facilities must be
standards of sanitation. It is mandatory that cleaned thoroughly after each occupancy.
the building petty officer (BPO) accompany Dishes, pots and pans, blankets and bedding
all inspecting parties in their area of respon- must be inspected for cleanliness prior to
sibility and be familiar with standard room occupancy. Periodic inspections of these fa-
entry procedures outlined in OPNAVINST cilities must be made by medical department
11103.1A. personnel in conjunction with the facility

2-2 January 1995


2-6 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-6

Table 2-1. Bachelor Quarters Standards


of Adequacy for Reporting Purposes

Permanent Party.
Grade Transient Personnel Personnel and PCS
Students

Civilians 250 square feet net living See NAVPERS 15606,


area; private room; bath Navy Bachelor Quarters
shared with not more than Manual for equivalent
one other. grades.

03 — 010 400 square feet net living


area, living room, bed-
room, and private bath;
access to kitchen or offic-
ers’ dining facility receiv-
ing appropriated fund
support

01 — 02, W1 — W4 250 square feet net living


area; sleeping/living room
private bath.

E7 — E9 250 square feet net living 270 square feet net living
area; private room; bath area, private room and
shared with not more than bath
one other

E5 — E6 135 square feet net living area; no more than two to a room;
bath shared with not more’ than one other

El — E4 (other than 90 square feet net living area; 90 square feet net living
recruits/”A” School) room configured or open bay area; not more than four
space; not more than four to to a room; central bath.
a room except in open bay;
central bath.

E 1 — E4 “A” School 72 square feet net living area; semi-open bay; central bath.

E 1 Recruits 72 Square feet net living area; open bay; central bath.

1. Rooms will be measured per the guidance in Appendix D of NAVPERS 15606, Navy
Bachelor Quarters Manual.
2. For BQs not described in 1 above, request assistance from your major claimant and your
public works officer.

January 1995 2-3


2-6 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-10

manager. These inspections may only be con- their findings to the commanding officer. It is
ducted while individual units are vacant, recommended that preventive medicine per-
unless conditions warrant otherwise. Clean- sonnel accompany command representatives
ing gear must be readily available for use by during the course of their inspections.
patrons on a day-to-day basis. Facilities for 2. Contract berthing inspections must in-
pets should be made available adjacent to clude, but not be limited to, an evaluation of
the lodging facility. When such facilities are the facility location in relation to an indus-
available, it is each pet owner’s responsibil- trial area and messing facilities. Adminis-
ity to ensure that their animal does not be- trative consideration should be given to
come a sanitary nuisance. means of transportation to and from the
work site, recreational facilities, laundry,
2-7. Berthing for Watch Standers. and other personnel support facilities. If the
contract berthing facility is located near the
1. Most commands have responsibilities industrial site, noise levels must be deter-
which require individuals to remain over- mined, and walking routes evaluated to en-
night, such as: fire fighters, communications sure there is adequate lighting and that no
personnel, and other watch standers. The safety hazards exist to impede pedestrian
minimum requirements for the watch room traffic or cause injury.
are as follows: 3. The initial inspection should be con-
a. Each person must be furnished with ducted during normal working hours and
two clean sheets and a pillow case. In no case once again at night to identify any unique
will a person be required to use the same conditions which may exist.
linen that has been used by another person
(hot bunking). 2-9. Preventive Medicine Inspections.
b. Common use mattresses and pillows
must be protected from staining by body dis- 1. Medical Department personnel with
charges by the use of mattress and pillow preventive medicine responsibilities must
covers. conduct inspections at least quarterly.
c. The entire areas, including the 2. It is recommended that whenever pos-
heads, must be cleaned daily. Beds, sible medical department personnel conduct
nightstands, and other common use equip- their inspections in conjunction with com-
ment should be cleaned on a weekly basis. mand inspections.
d. Supervisory personnel are tasked 3. Inspection reports which identify dis-
with ensuring that optimum sanitary stan- crepancies and offer recommendations for
dards are maintained at all times. corrective action must be provided to re-
sponsible personnel.
2-8. Civilian Contract Berthing.
2-10. Confinement Facilities/Ashore
1. Whenever contracts are let for berthing and Afloat.
of military personnel in a non-military facil-
ity; e.g., civilian shipyards, such housing 1. Afloat
must meet the sanitary standards for a. Medical department personnel must
unaccompanied personnel housing as set report any unsanitary or unhealthy condi-
forth in this chapter. In no case will this tions, observed during daily sick call, to the
housing be approved until a medical officer commanding officer (per OPNAVINST
and supply officer, or their appointed repre- 1640.9.
sentatives inspect such housing and furnish b. The ship’s brig, if present, must be

2-4 January 1995


2-10 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-12

included with the quarterly habitability in- and a weekly inspection by a medical depart-
spection of living spaces. ment representative to ensure that cleaning
c. Cell dimensions and sanitary facili- and maintenance procedures are being car-
ties must conform to standards promulgated ried out. A copy of the weekly inspection
by Naval Sea Systems Command. Ventila- must be retained in the brig records.
tion, heating, and illumination standards b. A quarterly sanitation/habitability
must conform to those of the crew’s living inspection of brigs ashore must also be con-
spaces. For detailed information concerning ducted by preventive medicine personnel.
shipboard detention facilities, refer to the c. Sanitary standards must conform to
General Specifications for Ships of the U.S. those standards outlined in SECNAVINST
Navy and OPNAVINST 1640.8 series, 1640.9 series, Department of the Navy Cor-
Manual for the Administration of Afloat rections Manual, DoD Construction Criteria
Brigs. Manual, and other Department of Defense
2. Ashore instructions.
a. SECNAVINST 1640.9A requires a
daily sanitation inspection by the brig staff

Section Il. BARBER AND BEAUTY SHOP SANITATION

Article
General ------------------------------------------------------------------------------------------------------- 2-11
Employees ------------------------------------------------------------------------------------------------- 2-12
Sanitation Requirements -------------------------------------------------------------------------------- 2-13
Construction Standards for Barbershops and
Beauty Shops Ashore and Afloat ------------------------------------------------------------------ 2-14
Sanitary Practices ----------------------------------------------------------------------------------------- 2-15
Cleaning and Disinfection of Instruments ---------------------------------------------------------- 2-16
Abnormal Skin Conditions ------------------------------------------------------------------------------ 2-17
Regulation/Inspections ---------------------------------------------------------------------------------- 2-18

2-11. General. 2-12. Employees

Barbershops and beauty shops are oper- 1. Employees of barbershops and beauty
ated within the jurisdiction of the Navy and shops must adhere to the following physical
Marine Corps for convenience and to enable and personal hygiene requirements.
personnel to maintain a neat appearance at a. All barber and beauty shop employ-
minimum expense. Although these shops are ees, including personnel employed by a civil-
seldom incriminated in the spread of disease, ian contract, must be medically screened and
the potential exists if they are not operated determined to be free of communicable dis-
in a sanitary manner. The following informa- ease prior to their initial assignment. Unless
tion constitutes minimum requirements for required by local medical departments for
promulgating barbershop and beauty shop specific reasons, such as indigenous labor,
regulations. subsequent health screening, e.g., annual

January 1995 2-5


2-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-15

evaluation is not routinely required. The lo- 2. An adequate supply of hot and cold run-
cal medical officer may delegate this respon- ning water, with proper lavatory futures
sibility to non-physician civilian or military and waste disposal must be provided.
personnel, e.g., environmental health offic- 3. The interior of barber/beauty shops
ers, physician assistants, preventive medi- must be adequately lighted and ventilated.
cine technicians, i n d e p e n d e n t d u t y 4. Shops must be maintained in a clean
corpsmen, civilian nurses, and civilian envi- condition.
ronmental health technicians. The medical
screening must be sufficiently comprehen-
sive to detect acute or chronic diseases that 2-14. Construction Standards for
may be transmitted by direct or indirect con- Barbershops and Beauty Shops
tact during the performance of their services. Ashore and Afloat.
Depending upon the prevalence of communi-
cable diseases in the geographical location, 1. The Department of Defense Construc-
local medical officers may order specific test- tion Criteria Manual, DoD Instruction
ing they consider necessary. Barber and 4270. l-M, outlines the space allowance and
beauty shop employees may be screened by construction standards for barbershops and
local military medical departments or they beauty shops ashore.
may present documentary evidence, accept- 2. Afloat, the determination as to number
able to the local medical authority, that a and type of barber facilities, including female
complete and thorough medical screening requirements, is outlined in OPNAVINST
has been accomplished. 9640.1 series, Shipboard Habitability Pro-
b. Barbershop and beauty shop employ- gram.
ees must maintain good personal hygiene
when attending patrons. Hands must be
thoroughly washed with soap and warm wa- 2-15. Sanitary Practices.
ter:
(1) between patrons. 1. Only Food and Drug Administration
(2) after touching inanimate objects (FDA) approved tonics, lotions, bleaches,
that are likely to be contaminated. dyes, etc., are permitted in barbershops
(3) before leaving the shop. beauty shops. Only Environmental Protec-
c. Special care should be taken to avoid tion Agency (EPA) registered disinfectants
injuring the hands. Chapped, inflamed, or or sanitizing agents are acceptable in Navy
cut skin can allow bacteria and viruses to and Marine Corps Facilities. Questionable or
enter the bloodstream. unlabeled products must be referred to the
d. Wardrobe. A clean smock or other medical department for determination of
freshly laundered over garment must be suitability.
worn while attending patrons. 2. Therapeutic practices, such as treating
pimples, ingrown hair, etc., are prohibited.
3. The treatment of eye conditions is pro-
2-13. Sanitation Requirements. hibited.
4. The headrest of barber chairs must be
1. Barbershops/beauty shops are not to be covered with a clean towel or a clean sheet of
located in food service or berthing areas. Bar- paper for each patron.
bershops/beauty shops may be located 5. Common brushes, dusters, etc., are pro-
within BOQS and BEQs and officer and en- hibited.
listed clubs; a separate room is required.

2-4 January 1995


2-15 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-16

6. Because of the theoretical possibility for ties may not require this frequency. The la-
the transmission of bloodborne pathogens, bel and Material Safety Data Sheet (MSDS)
e.g., Hepatitis B Virus (HBV) and Human must be consulted for directions and infor-
Immunodeficiency Virus (HIV), the practice mation concerning handling and use precau-
of shaving is no longer permitted in Navy tions. Unless otherwise indicated by the
and Marine Corps barbershops and beauty label, all disinfecting solutions must be
shops. Therefore, the use of razors or dispos- changed at least weekly. The medical depart-
able razors is prohibited. ment representative (preventive medicine
7. Individual sanitary neck strips must be service) will determine the frequency for
used for each patron. changing solutions. All instruments disin-
8. Covering cloths must be changed daily fected in a chemical solution must be thor-
or as often as necessary to ensure cleanli- oughly rinsed in running potable water to
ness. remove the chemical prior to use.
9. Operator’s street clothing must be 2. Non-removable clipper heads must be
stored separately from that of patrons. wiped or dusted and sprayed with an EPA-
10. Barbershops or beauty shop employees registered disinfecting spray between each
are not permitted to eat, drink, or smoke patron. The spray must be used with cau-
while attending patrons. tion. Precautions include minimum use of
11. Clean, covered sanitary receptacles material (consistent with proper disinfec-
must be provided for waste materials and tion), directing the spray away from the
used linen. Receptacles should be lined with breathing zone of the user and any patrons
disposable bags. in the vicinity of the procedure, minimizing
12. The removal of cut hair from decks skin contact, and adequate hand washing
must be done frequently by dustless meth- after use. Material Safety Data Sheets
ods. Floors must be washed with detergent (MSDS) for the spray being used and con-
and water at frequent intervals to prevent tainer labels must also be consulted for infor-
the accumulation of dirt. mation concerning handling and use
13. When compressed air is used to remove precautions. Removable clipper heads may
hair from patrons, the pressure must be 15 be disinfected with the spray or the heads
pounds per square inch or less. may be removed and placed in a disinfecting
solution as prescribed for other instruments
in Paragraph 1, above.
2-16. Cleaning and Disinfection of 3. Formaldehyde cabinets and ultraviolet
Instruments. light are not acceptable methods of disinfec-
tion in Navy and Marine Corps barbershops
1. All instruments, metallic and non-me- and beauty shops.
tallic, in contact with patrons must be 4. Quantity of Instruments. Adequate
cleaned and disinfected between each pa- numbers of instruments and supplies must
tron. Cuticle nippers, nail clippers, combs, be available to accomplish disinfection. The
brushes, clipper heads and all other instru- following number of instruments per opera-
ments must be thoroughly washed with soap tor are recommended for an average shop.
or detergent and hot water to remove all a. Clipper heads (blades). Three sets of
film, oil, and debris after use on each patron. three, each set containing one size each of
Following cleaning, the instruments must 000, 1, and 1-1/2.
then be placed in an EPA-registered disin- b. Seven combs of various design.
fecting solution. Due to the patron load at c. Three pairs of scissors.
some facilities, the solutions may require d. Two pairs of thinning shears.
changing on a daily basis, while other facili- e. Two flattop brushes.

January 1995 2-7


2-16 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-20

f. Three hundred hair rollers with 2-18. Regulations/Inspections.


clips. 1. Each-barbershop or beauty shop must
g. Fifteen styling brushes. post a copy of these sanitary regulations in a
conspicuous place. Operators are expected to
read, understand, and comply with these re-
2-17. Abnormal Skin Conditions. quirements. In overseas locations, transla-
tion of the sanitation regulations into the
Serving patrons with inflamed or infec- host-nation language should be accom-
tious conditions of the scalp, face, or neck plished.
without the written consent of the medical 2. Inspection of barbershops and beauty
officer is prohibited. shops must be conducted at least quarterly
by medical department personnel.

Section Ill. Trailer Home/Recreation


Vehicle (RV) Camp Grounds
and Mobile Home Court Sanitation

Article
General ------------------------------------------------------------------------------------------------------- 2-19
Definitions ---------------------------------------------------------- --------------------------------------- 2-20
Site Selection and Considerations -------------------------------------------------------------------- 2-2 I
Space Limitations ----------------------------------------------------------------------------------------- 2-22
Recreation Areas ------------------------------------------------------------------------------------------- 2-23
Service Buildings ------------------------------------------------------------------------------------------ 2-24
Water Supply ----------------------------------------------------------------------------------------------- 2-25
Sewage and Liquid Waste Disposal ------------------------------------------------------------------ 2-26
Refuse Disposal -------------------------------------------------------------------------------------------- 2-27
Insect and Rodent Control ------------------------------------------------------------------------------ 2-28
Pets ------------------------------------------------------------------------------------------------------------ 2-29
Inspections ------------------------------------------------------------------------------------------------- 2-30

2-19. General. sure compliance. Safety professionals should


be consulted on a regular and as needed
The health of trailer home/recreation ve- basis to help determine adequacy of founda-
hicle and mobile home occupants, as well as tion systems, fuel supply, electrical, and life
residents of adjoining communities, is en- and fire safety considerations.
dangered if the facilities are not operated
and maintained in a sanitary manner. The 2-20. Definitions.
medical officer (or designated representa-
tive), must keep the commanding officer in- 1. Mobile Home. A permanent dwelling. It
formed as to the status of sanitation. This has kitchen facilities, flush toilets, and a
section serves as minimum sanitary require- bath or shower.
ments for the operation of trailer/recre- 2. Recreation Vehicle. A self-propelled
ational vehicle camp grounds and mobile and self-contained dwelling intended for
home courts. Significant variation is often temporary occupancy.
encountered in local ordinances in the areas 3. Trailer Home. A vehicle drawn by an
of space limitations, site selection, water automobile or truck; intended for temporary
supply, and sewage disposal. State and local occupancy. It may or may not be equipped
regulations must always be consulted to en- with toilet and bath facilities.

2-8 January 1995


2-20 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-24

4. Recreational Vehicle/Trailer Home These local regulations must be consulted


Campground. Sights for overnight or short- before proceeding in the planning or con-
term parking. It has facilities available for struction of a mobile home park. In general,
sanitary drop, potable water, and service each independent mobile home space must
buildings with bath and laundry facilities. contain a minimum of 2800 square feet and
5. Mobile Home Court. An area of ground be at least 40 feet wide. A minimum of 4500
upon which two or more mobile homes, occu- square feet must be available for double wide
pied for dwelling are located. units. Every mobile home space must abut a
6. Mobile Home Space. A plot of ground driveway or other clear area with
within a mobile home court designed to ac- unobstructed access to the public street. Mo-
commodate one mobile home. bile homes must be parked in spaces so that
7. Service Building(s). A building housing there will be a minimum of 15 feet between
toilet and bathing facilities for males and mobile homes (side to side, end to end, or end
females with laundry or other services that to side) and so that no mobile home is less
may be required. than 10 feet from the exterior boundary of
the mobile home park.
2. Recreational Vehicle Campgrounds.
2-21. Site Selection and Considerations. Local regulations must be considered. In
general, a recreational vehicle site must con-
1. Courts or campgrounds must not be lo- tain a minimum of 1000 square feet, not
cated adjacent to swamps, marshes, heavy including roads and streets. All recreational
industrial zones, or other areas where objec- vehicles must be located at least 25 feet from
tionable odors, noise, or other adverse condi- any park boundary line abutting a public
tions would expose individuals to health street or highway, and at least 15 feet from
hazards. The area must have good natural any other property lines.
drainage or a storm drainage system. The
drainage must not endanger any water sup-
ply. Wherever possible, the mobile home 2-23. Recreation Areas.
court or campground should be connected to
public water and sewerage systems. Recreation areas and facilities must be
2. The area of the mobile home park or provided to the extent that they are consid-
campground must be sufficient to accommo- ered necessary to meet the population of the
date the number of mobile home or recre- park. Because of the various age groups rep-
ational vehicle spaces for which the court resented, two or more separate recreation
was intended. It must have adequate park- areas are recommended for larger mobile
ing spaces for motor vehicles and access home courts. Recreation areas must be lo-
roads and walkways. Service and recreation cated in easily accessible areas that are free
areas must be free of traffic hazards, easily of traffic hazards.
accessible to all park residents, and meet the
population requirements the park or camp-
ground is designed to accommodate. 2-24. Service Buildings.

1. A trailer home or RV campground must


2-22. Space Limitations. provide one or more service buildings.
Service buildings must be of substantial
1. Mobile Home Court. Space limitations construction and equipped with flush type
are primarily governed by local regulation. fixtures. One service building for every 20

January 1995 2-9


2-24 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-26

units is recommended for parks or camp- water must be available at all times in
grounds intended for trailer homes or recre- service buildings. The source should be ca-
ational vehicles. One service building for pable of supplying at least 150 gallons per
every 100 units is recommended in mobile mobile home space per day.
home courts for use as an emergency sani- 2. In mobile home courts, potable water
tary facility. These buildings must contain must be provided at each site. An individual
no less than two toilets for females, one toilet water connection must be provided at an
and one urinal for males, one laundry tray, appropriate location at each trailer space.
two lavatories and a shower with hot and The water connection must consist of a riser
cold running water for each sex. Showers terminating at least 12-18 inches above the
may be located in several service buildings, ground surface, with two 3/4 inch valved
or one centrally located shower building. outlets. The connection must be located at
When toilet facilities for males and females least 10 feet from the sewer connection and
are located in the same building, they must be equipped with a backflow prevention de-
be completely separated by a partition. In vice. The potable water outlets must be
any case, service buildings must be located capped when not connected to a trailer.
within 500 feet of the sites served.
2. Laundry facilities and adequate drying
space must be provided for every 20 trailers. 2-26. Sewage and Liquid Waste
3. Standards for service buildings: Disposal.
a. Permanent construction provided
with adequate light, heat, and ventilation. 1. A vertical drainpipe with at least a 3-
b. Interior of moisture-resistant mate- inch connection to the sanitary sewer must
rial to permit frequent washing and clean- be provided at each site in mobile home
ing; floor impervious to water, easily courts. It is desirable that the connector be a
cleanable, and sloped to floor drains con- non-collapsible, flexible hose, 3 inches in di-
nected to the sewage system. ameter, and 4 to 5 feet in length. The con-
c. Effective screening of all openings. nection must be equipped with a suitable
d. Sanitary maintenance at all times. trap which is located below the frost line. The
e. Hard surfaced and well marked vertical drainpipes must be securely covered
walkways to permit easy access to the when not in use. The sewer connection must
service building from all spaces. be protected against “wheel damage” by a
curb or concrete collar at least 3 inches deep
and extending 12 inches from the connection
2-25. Water Supply. in all directions. The sewer connection must
be provided with suitable fittings to permit a
1. Mobile home courts and RV camp- watertight junction to be made with the
grounds must be supplied with a safe water trailer outlet. The connection between the
supply under pressure. The source and dis- mobile home drain and the sewer must be
tribution system must be satisfactorily con- watertight and self draining. The connection
structed and approved by the State, (in the between the vertical drain and trailer must
U.S. or territories) or Naval Facilities Engi- be made in such a manner to exclude insects
neering Command and the Bureau of Medi- and rodents, prevent leakage and the escape
cine and Surgery in overseas locations. of odors, and prevent other health hazards or
Water must comply with all the require- nuisances.
ments of the Safe Drinking Water Act (Na- 2. Water from toilets, showers, and lava-
tional Primary Drinking Water Regula- tories must be discharged into an approved
tions). A sufficient amount of hot and cold public or private sewage system.

2-10 January 1995


2-26 CHAPTER2. SANITATION OF LIVING SPACES, ETC. 2-30

3. Mobile home courts are high density 2. An effective pest management plan
communities. Because of this, when a court must be in place to eliminate insect breeding
is to be opened or expanded, special consider- sites and/or rodent harborages in and around
ation must be given to ensuring that the these locations (see Chapter 8).
environmental impact of any proposed sew-
age treatment system is considered and/or
the capacity of an existing system is ad- 2-29. Pets.
equate.
4. A sanitary or dump station must be 1. Pets maybe allowed in the mobile home
provided at RV campgrounds for the disposal park or RV campground area depending on
of sewage and other liquid wastes. It must local command policy. If pets are permitted,
consist, as a minimum, of a trapped 4-inch they must be under rigorous control at all
sewer riser pipe connected to an approved times. At no time are pets allowed to run
sewage disposal system. The riser must be loose, nor will they be allowed to create a
surrounded by a concrete apron sloped to the nuisance or health problem. Pet owners are
drain. It must have a suitable hinged cover responsible for cleanup and removal of feces.
or screw cap and a water outlet to permit 2. All pets will be required to have proof of
periodic wash down of adjacent areas. vaccination and registration as required by
local regulations.

7-27. Refuse Disposal.


2-30. Inspections.
1. All refuse must be stored in durable,
fly-tight, and rodent-proof containers. 1. Inspections of the mobile home courts/
Refuse containers must be clean, sanitary, campgrounds area must be routinely con-
and maintained in good repair. Sufficient ducted by management personnel to identify
capacity must be provided to prevent over- conditions which require preventive mainte-
flowing of any container between collections. nance or other corrective action.
2. All refuse must be collected at least 2. The medical officer or his/her desig-
weekly. nated representative must inspect at least
3. The burning of trash and refuse is pro- quarterly. A report of the conditions ob-
hibited. served must be forwarded to the command-
ing officer, the manager of the mobile home
court/campground, and other personnel as
2-28. Insect and Rodent Control. appropriate. Emphasis must be placed on
health and sanitation. Specific consideration
1. Mobile home parks and RV camp- should be paid to conditions which may im-
grounds must be periodically inspected by pact on water quality, insect and rodent
medical department personnel to identify control, and nuisance, or other health related
harborage areas or breeding sites for rodents conditions.
and insect vectors.

January 1995 2-11


2-31 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-33

Section IV. LAUNDRY AND DRY CLEANING

Article
General ------------------------------------------------------------------------------------------------------- 2-31
Employees --------------------------------------------------------------------------------------------------- 2-32
Sanitary Requirements ---------------------------------------------------------------------------------- 2-33
Hospital/Health Care Facility Laundry ------------------------------------------------------------- 2-34
Hygienically Safe Laundry ------------------------------------------------------------------------------ 2-35
Industrial Hygiene and Safety ------------------------------------------------------------------------- 2-36

2-31. General. must be placed in covered containers; lint


must be removed as necessary from bulk-
The purpose of a laundry or dry cleaners is heads, overheads, and structural supports.
to produce clean garments. Establishments 3. Plumbing fixtures and appliances must
for washing, drying, and dry cleaning range be installed in accordance with established
from hand laundries to highly mechanized standards, maintained in good repair, and
plants. Sanitary or industrial hazards may kept in a sanitary condition. These fixtures
occur at any point in the process from deliv- and appliances must be connected to prevent
ery of contaminated clothing to the finished backflow or cross-connections with the po-
product. table water supply. Shipboard washing ma-
chines have the ability to utilize both fresh
water or seawater connections. Fresh and
2-32. Employees.
sea water connections must be made in ac-
cordance with Naval Ships’ Technical
1. Employees of laundry and dry cleaning
Manual, Chapter 655. Sea water may be
establishments must adhere to the following
used when the ship is outside the 50-fathom
requirements:
curve, or 25 miles from shore but never when
a. Personnel exposed to dry cleaning
the ship is in polluted water.
solvents must receive pre-employment and
4. Sanitary angle jet type water fountains
periodic physical examinations on a schedule
must be provided to supply drinking water.
determined by the medical officer or higher
5. Adequate toilet facilities with a shower
authority.
and ample locker space must be provided
b. Personnel working in the processing
and maintained in a sanitary condition. A
area of laundries or dry cleaning plants must
sign stating ‘Wash Hands Before Leav-
wear clean, washable outer garments in lieu
ing” must be prominently displayed in all
of street clothing.
toilet areas.
c. Personal hygiene must be stressed.
6. Eating, cooking, smoking, or storage of
Frequent hand washing, particularly after
food, drinks, or smoking material is prohib-
visiting the toilet or handling soiled linen, is
ited in rooms where clothing is handled,
mandatory.
sorted, marked, washed, or dry cleaned. If
meals or lunches are eaten on the premises,
2-33. Sanitary Requirements. a separate room or space, approved by the
medical department, must be provided for
1. Laundry and dry cleaning premises this purpose.
must be maintained in a clean and sanitary 7. Laundries and dry cleaning plants
condition, free from infestation by rodents must have separate areas designated for re-
and insects. ceiving and issue. Unwashed clothes must
2. Floors must be cleaned at least once never be received, sorted, marked, or
daily by dustless methods. Paper and trash handled in close proximity to washed clothes.

2-12 January 1995


2-33 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-35

8. Rooms or spaces must be designed and forms, masks, and gloves. Sharp objects,
machines and equipment arranged so that a such as broken glass, surgical instruments,
separate flow of clean and soiled garments is etc., are sometimes inadvertently placed in
maintained throughout the laundry or clean- soiled linen. These objects must be carefully
ing process. This flow requires separate con- removed by sorting personnel. If not re-
tact surfaces, such as tables, carts, shelves, moved, the objects may damage machinery
etc. Ventilation must move air from clean to and linen.
soiled areas to prevent cross contamination. 3. Contaminated laundry from isolated
9. Vehicles and containers used for trans- rooms, surgical cases, etc., is often received
portation and storage of laundry and dry by laundries. When this occurs, special pre-
cleaning must be kept clean and in a sani- cautions are required and personnel must be
tary condition. specifically trained on procedures and po-
10. When present, laundries and dry tential health implications of handling con-
cleaning plants must be inspected quarterly. taminated articles. Contaminated linen
must be received in impervious, well sealed
double bags. The outer bag must be labeled
2-34. Hospital/Health Care Facility with the universal biohazard symbol or the
Laundry. word ‘Biohazard” or be red in color. The in-
ner bag must be hot water soluble. Con-
1. Linen management is included in the taminated linen must not be sorted.
standards established by the Joint Commiss-
ion on Accreditation of Health Care Orga- 2-35. Hygienically Safe Laundry.
nizations. Proper linen management is
probably best satisfied in Naval Hospitals 1. Normally, articles to be laundered are
through a joint effort of the Infection Control exposed to hot water at 1600 F containing
Committee, the Preventive Medicine alkalies, detergents, and/or other chemical
Service, and laundry supervisory personnel. cleaning agents. The laundry process is fol-
Hospitals/medical facilities using commer- lowed by a series of rinses and machine dry-
cial linen services are not relieved of the ing.
responsibility for establishing adequate 2. Recent studies indicate that hygieni-
quality assurance procedures. cally safe laundry can be processed with
2. Several aspects of the normal launder- warm water laundry formulations (not con-
ing process (hot water wash, bleach, and taining chlorine bleach) at temperatures of
ironing) reduce the chance of survival of 1200 to 1400 F. Hot air dryers area necessary
pathogenic microorganisms. Linen handling step when chlorine bleach is not included in
in hospitals/medical facilities is critical be- the formulation. The Centers for Disease
cause of the potential for bacterial contamin- Prevention and Control concurs. The
ation from infected patients. The BUMED requirement to add a disinfecting
recommended method of handling soiled agent (chlorine bleach) to warm water ( 120°-
linen is through the use of individual imper- 140” F) laundry formulations is hereby re-
vious laundry bags for each area. Linen carts scinded.
must be lined with washable material that 3. Laundered articles must be rendered
can be removed and replaced easily. Linen sufficiently free of animal, chemical, and bac-
must only be sorted in the laundry sorting terial substances or other materials that
room. Sorting must be done prior to washing may be harmful to persons handling or
by trained personnel wearing clean uni- wearing such articles.

January 1995 2-13


2-36 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-36

2-36. Industrial Hygiene and Safety initiated. Personnel exposed to sound pres-
sure levels greater than 84 dBA (decibels-A
1. Workrooms associated with laundry scale) must wear proper hearing protection
and dry cleaning operations where machin- devices and receive periodic audiometric
ery or apparatus emit steam, vapors, or heat testing and/or evaluation.
must be properly ventilated. Such spaces/ 6. Eye protection (safety glasses, goggles,
operations must be provided with general face shields, etc.) is required in operations
and/or local exhaust ventilation in order to where splashes may occur such as replenish-
reduce and/or maintain personnel exposure ment of dry cleaning fluid, or the addition of
to potentially hazardous materials/agents bleaches and detergents. An emergency eye
within permissible exposure levels. Clean, wash station must be provided within the
tempered replacement (or supply) air should work area.
be provided. The ventilation system of all dry 7. Automatic safety devices on all equip-
cleaning equipment must be designed to au- ment must be clearly identified, properly
tomatically draw air into the machine upon maintained, and must not be removed or
opening the loading door, thus preventing bypassed.
the release of vapors into the work area. Any 8. Guardrails must be constructed in con-
proposed changes/modifications to the venti- nection with ironers, compressors, and other
lation system must be referred to the local dangerous equipment. Drive shafts, exposed
medical department industrial hygienist for belts, and gears must be enclosed.
review. 9. Signs must be conspicuously posted to
2. All steam and hot water pipes must be warn unauthorized personnel to stay clear of
insulated with approved (non-asbestos) lag- dangerous or restricted areas.
ging. 10. First aid kits for emergency use must
3. Adequate lighting levels must be pro- be provided as required by applicable Occu-
vided in accordance with appropriate illumi- pational Safety and Health Administration
nation guidelines. (OSHA) regulations.
4. When the air concentration of dry 11. Slippery floors or decks and cluttered
cleaning materials exceeds permissible expo- aisles are prohibited.
sure levels, appropriate control measures 12. Only properly trained personnel may
must be initiated, i.e., administrative, engi- operate flat work ironing machines.
neering and/or personnel protective equip- 13. Training must be provided in safety,
ment. In the event of accidental spills, the first aid, and use of personal protective
proper personal protective equipment, to in- equipment.
clude respiratory protection, gloves, and 14. Storage of hazardous and flammable
apron must, be worn during cleanup opera- materials used in laundry and dry cleaning
tions. processes must be in accordance with cur-
5. Machinery producing potentially haz- rent directives.
ardous noise/vibration levels must be iden- 15. Fire regulations must be prominently
tified and proper corrective measures displayed and enforced.

2-14 January 1995


2-37 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-39

Section V. CHILDREN’S PLAYGROUNDS

Article
General ------------------------------------------------------------------------------------------------------- 2-37
Site Requirements ----------------------------------------------------------------------------------------- 2-38
Playground Equipment ---------------------------------------------------------------------------------- 2-39

2-37. General. 6. Energy absorbing surfacing, such as


wood chips, sand, shredded tires (non-steel
Playgrounds are typically located at belted), or pebbles, must be used under
schools, child care centers, picnic areas, and swings, jungle gyms, slides, and other
in family housing. Sustained accident pre- equipment.
vention requires careful planning and con-
tinued vigilance to ensure that playgrounds 2-39. Playground Equipment.
remain free of hazards. Playgrounds must be
inspected quarterly by medical department When playground equipment is provided
personnel with preventive medicine respon- it must be located away from natural path-
sibilities. Complete information and re- ways of traffic. Steps leading up to slides
quirements concerning the operation of must have handrails. There should be
playgrounds is found in OPNAVINST guards on seesaws to prevent boards from
1700.9C. hitting the ground. Swings offer special haz-
ards which can be minimized by using seats
of light-weight material, such as belting,
2-38. Site Requirements. rubber or heavy canvas. Bolts and screws
with rounded surfaces must be used in con-
1. The site must be reasonably leveled and struction of playground equipment. The
drained to obtain dryness a maximum num- equipment should have supports of galva-
ber of days in the year. The site should not be nized or painted metal and be firmly an-
completely shaded. chored in concrete. Concrete anchors must be
2. It must be free of stone outcropping, sufficiently embedded in the soil to preclude
gullies, drop-offs, stumps, weeds, animal them from becoming a trip or fall hazard.
waste, and trash. Equipment that is improperly installed;
3. Play areas must be fenced to prevent rusted, badly worn, or otherwise deterio-
small children from wandering into road- rated must be repaired or replaced. Play-
ways or other dangerous sites, such as ground equipment must be carefully selected
abandoned wells, ravines, or bodies of water. and properly placed for the age group for
4. Walkways must be constructed of which it is intended. Sufficient space should
gravel, concrete, or other suitable materials. be allowed between play areas so that chil-
5. If present, trash receptacles must be dren may move freely and safely from one
covered. area to another.

January 1995 2-15


2-40 MANUAL OF NAVAL PREVENTIVE MEDICINE 245

Section VI. CAMPGROUNDS AND PICNIC AREAS

Al-tick
General ------------------------------------------------------------------------------------------------------- 2-40
Site Selection ----------------------------------------------------------------------------------------------- 2-41
Water Safety ------------------------------------------------------------------------------------------------ 2-42
Water Supply ----------------------------------------------------------------------------------------------- 2-43
Refuse Disposal -------------------------------------------------------------------------------------------- 2-44
Comfort Stations ------------------------------------------------------------------------------------------- 2-45

2-40. General. prevent standing water. In locations where a


water system is not possible, a portable wa-
When resources are developed for camp- ter source must be provided at a central pick-
ing and picnicking, adequate facilities to up station. Non-potable water systems must
protect the health and safety of patrons must be adequately identified to prevent con-
be provided. Campgrounds and picnic areas sumption. Campers must also be warned of
must be inspected on a quarterly basis. the dangers in using a stream, lake, or spring
as a source of drinking water. If temporary
2-41. Site Selection. facilities are provided for pop-up trailers and
recreational vehicles, adequate potable wa-
Campgrounds and picnic sites must be ter and sewage facilities must be provided.
located in such a manner as to protect the
areas needed for water-shed, range, and 2-44. Refuse Disposal.
other basic resources. A well drained, gently
sloping area is preferred. Sites should be free Durable, waterproof and rodent proof
of rock outcrops and heavy undergrowth. containers must be provided for refuse dis-
Weeds should be regularly cut to prevent posal. Refuse containers must be located
coarse stubble from developing and to reduce within 150 feet of any campsite. They should
insect, snake, and small animal hazards. be located near access roads to ease refuse
collection. Containers should be sufficiently
2-42. Water Safety. stable to resist being overturned by domestic
and wild animals. They must also have fly
Campgrounds and picnic areas are fre- tight covers and be maintained in a clean
quently located near a body of water. When and odor free condition at all times. The use
this is the case, disease, injury prevention, of 55-gallon drums as refuse containers
and water safety measures must be taken should be discouraged. Their large size
into consideration. Chapter 4 of this manual makes them difficult to empty and clean. The
should be consulted when a swimming pool absence of lids makes them attractants for
or natural bathing place is present. flies, wasps, and other insects. Trash and
garbage must be removed daily prior to
2-43. Water Supply. night-fall. More frequent collections may be
necessary. Ashes should be removed from
An adequate supply of safe drinking water barbecues and the grills cleaned frequently
must be provided at campgrounds and picnic with a coarse bristle wire brush.
areas. Water hydrant stations with non-
threaded, self-closing faucets must be pro- 2-45. Comfort Stations.
vided within 150 feet of a campsite and
individual picnic sites. The area around wa- Comfort stations providing flush toilets,
ter hydrants must be properly drained to lavatories, or other facilities for public use

2-16 January 1995


2-45 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 246

are among the most necessary structures easily cleanable. Comfort stations must be
built in the recreation area. well lighted, adequately ventilated, and
1. In areas where water under pressure is properly protected from the weather. All ex-
available, modern comfort stations must be terior openings must be covered with 16-inch
located within 300 feet of any campsite and mesh screen. Doors must open outward and
within 500 feet of individual picnic sites. The be self closing.
use of chemical toilets in remote areas may 3. When male and female facilities are
be the only practical solution to sewage dis- grouped under one roof, a suitably remote
posal, depending on state or local ordinances. entrance for each section is required. The
Frequent cleaning and maintenance are re- approaches and entrances must be clearly
quired to avoid objectionable odors and nui- marked and illuminated. A partition must
sances in comfort facilities. completely separate the two facilities.
2. Permanently constructed comfort sta- 4. Plumbing fixtures must be provided as
tions must be provided with an interior fin- outlined in figures 2 and 3. Soap (solid, liquid
ish of moisture resistant materials which or powder), paper towels or air dryers, and
will stand frequent washing and cleaning. trash containers must be provided. The fa-
The floors, walls, partitions, and interior cilities must be thoroughly cleaned daily or
surfaces must be impervious to water and more frequently if required.

Figure 2-2. Comfort Stations for Campgrounds

NUMBER COMMODES LAVATORIES


OF SITES MALE FEMALE MALE FEMALE URINALS

1-20 1 2 1 2 1

21-30 2 3 2 2 2

Figure 2-3. Comfort Stations for Picnic Areas

CAR PARKING COMMODES LAVATORIES


SPACES MALE FEMALE MALE FEMALE URINALS

1-40 1 2 1 2 1

41-80 2 4 2 2 2

Section WI. GYMNASIUMS

Article
General ------------------------------------------------------------------------------------------------------- 2-46
Equipment --------------------------------------------------------------------------------------------------- 2-47
Structural ---------------------------------------------------------------------------------------------------- 2-48
Lighting ------------------------------------------------------------------------------------------------------ 2-49
Toilet Facilities --------------------------------------------------------------------------------------------- 2-50
Drinking Fountains --------------------------------------------------------------------------------------- 2-51
Recreational Clothing Issue/Rental ------------------------------------------------------------------- 2-52

2-46. General.
health, and morale. These facilities must be
Gymnasiums and other similar facilities maintained in a safe, sanitary condition.
aid in the promotion of physical fitness, good Quarterly inspection of gymnasiums must be

January 1995 2-17


2-46 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-52

conducted by medical department personnel 2-50. Toilet Facilities.


with preventive medicine responsibilities.
Separate toilet facilities with water clos-
ets, lavatories and urinals as appropriate
2-47. Equipment. must be provided for male and female staff
and spectators. The facilities must be physi-
Sports and physical fitness related equip- cally separated from patron shower and
ment must be of an acceptable design and locker rooms. Shower/locker rooms must be
constructed to prevent injury due to struc- fitted with adequate lockers, showers, water
tural defects. All equipment must be main- closets, urinals, and lavatories to accommo-
tained in safe operating condition. date the needs of patrons. The handwashing
facilities must be provided with NSF ap-
proved cloth towel dispensers or disposable
2-48. Structural. towels and liquid, solid or powdered soap. All
toilet and shower facilities must be main-
1. Floors. All playing surfaces, running tained in a clean sanitary condition free from
tracks, passageways, and other floors must plumbing defects. Suitable trash containers
be maintained free of spills, debris, uneven must be placed in all toilet and locker rooms.
surfaces, protrusions and obstacles that may Refuse containers must be emptied at suffi-
increase the potential of injury. cient intervals to prevent overflow of refuse.
2. Walls and ceilings must be reasonably
smooth, easily cleanable, light colored, and
maintained in good repair. Walls in close 2-51. Drinking Fountains.
proximity to basketball and other similar
sports must be suitably padded to reduce Drinking fountains must be provided to
physical injury. accommodate staff, patrons and spectators.
3. Mats and other cushioning devices Drinking fountains must be cleaned daily
must be adequately maintained and cleaned with particular emphasis on the bowl, orifice
routinely. and orifice guard. Drinking fountains must
be the angle jet type.

2-49. Lighting.
2-52. Recreational Clothing Rental/
Gymnasiums must be adequately illumi- Issue.
nated for spectator or recreational sporting
activities. Locker rooms and other areas Some facilities have the capability of issu-
must also be properly illuminated. All lumi- ing or renting recreational clothing, (shorts,
naries must be adequately shielded to pro- towels, etc.) for use by patrons. The medical
tect them from damage or breakage from department (preventive medicine service)
projectiles. Mercury vapor and halide bulbs must review and approve the procedures as-
must be equipped with self-extinguishing sociated with the issue of such items. Laun-
mechanisms or be completely enclosed by a dry facilities within the facility, if adequate
shield that absorbs ultraviolet radiation. and approved, are acceptable.

2-18 January 1995


2-53 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-57

Section VIII. THEATERS

Al-tick
General ------------------------------------------------------------------------------------------------------- 2-53
Construction Standards ---------------------------------------------------------------------------------- 2-54
Housekeeping Requirements --------------------------------------------------------------------------- 2-55
Food Service ------------------------------------------------------------------------------------------------- 2-56
Safety --------------------------------------------------------------------------------------------------------- 2-57

2-53. General. seats should be cleaned daily before the


building is secured. Waste containers must
The head of Moral Welfare and Recreation be emptied as necessary and prior to closing.
is responsible to commanding officers for the Food or drink spillage should be cleaned as it
operation of theaters at Navy and Marine occurs or at the next intermission. Unneces-
Corps activities. Included in this responsibil- sary combustible material is not to be stored
ity is the elimination of any condition that in the building or immediate area. Evidence
could adversely affect the health of patrons. of insects and rodents must be promptly re-
Navy and Marine Corps theaters must be ported by trouble call or work request.
inspected periodically by management and
medical personnel with preventive medicine
responsibilities. These inspections should fo- 2-56. Food Service.
cus on identifying discrepancies in house-
keeping and insect and rodent control. Snack bars, refreshment stands, vending
machines, etc., must be operated in accor-
dance with NAVMED P-5010-1.
2-54. Construction Standards.

Minimum construction standards, includ- 2-57. Safety.


ing ventilation, heating and cooling are in-
cluded in the Department of Defense Seats must, be in good condition with no
Construction Criteria Manual. Adherence to splinters or protruding nails. Carpets and
these standards is required in order to pro- floors must be periodically checked for worn
tect the health, comfort, and safety of pa- or frayed edges which could result in trip-
trons. ping. Fire exits must open outward, be
equipped with illuminated signs, be properly
2-55. Housekeeping Requirements. located, adequate in number, and equipped
with panic bars. Fire exits must never be
The entire theater, all corridors, aisles, locked with chains or other devices which
stairways, drinking fountains, and patron may hinder safe egress.

January 1995 2-19


2-58 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-62

Section IX. RIDING STABLES

Article
General ----------------------------------------------------------------------------------------------------------2-58
Stables and Corrals -------------------------------------------------------------------------------------------- 2-59
Water -------------------------------------------------------------------------------------------------------------- 2-60
Insect and Rodent Control ----------------------------------------------------------------------------------- 2-61
Waste Disposal ------------------------------------------------------------------------------------------------- 2-62
Veterinary Service --------------------------------------------------------------------------------------------- 2-63

2-58. General. dock areas should be gently sloped to facili-


tate natural drainage and minimize stand-
1. The primary environmental health ing pools of surface water. A drinking water
concern associated with horses is the sta- trough must be provided in the corral for
bling of these animals and related waste dis- watering animals.
posal. Accumulation of animal feces provides
a breeding place’ for flies and creates a persis- 2-60. Water.
tent source of odors. Flies constitute a public
health hazard because of their potential for Water for employees and patrons must be
mechanically transmitting disease. Eliminat- provided in accordance with the Safe Drink-
ion of fly breeding sites is essential to fly ing Water Act. If a well is used as the source
control. of drinking water it must be located at least
2. Riding stables must be inspected at 100 feet from the stable and paddock sites or
least quarterly by preventive medicine per- the areas where they drain. Untreated well
sonnel. water may be used for watering animals, but
such supplies are not acceptable for employ-
2-59. Stables and Corrals. ees and patrons. To avoid accidental human
consumption, non-potable water systems
1. To minimize potential odor and nui- must be plainly labeled, ‘WATER UNSAFE
sance problems, horses must be stabled in a FOR DRINKING.” Every effort must be
location removed from, but accessible to, the made to ensure that no cross connections
main recreation center of the activity. exist between potable and non-potable sys-
2. Stables must be located on a well tems.
drained site. Buildings must be of durable
construction to prevent deterioration and/or 2-61. insect and Rodent Control.
rodent and insect infestations. Floors in
The stable must be of rodent proof con-
horse stalls must be paved with wooden
struction. Openings to the outside must be
blocks sealed in asphalt or other impervious
effectively screened when feasible to prevent
material, except concrete. Stall floors must
the entry of flies and other insects. Feed
be sloped to facilitate proper drainage. Floors
grains must be stored in rodent proof con-
in general storage rooms must be of concrete
tainers. Feed storage areas must be periodi-
construction so they can be hosed down and
cally inspected by medical department
maintained in a clean, odor free condition. A
representatives for evidence of insect or ro-
sufficient number of hose bib outlets,
dent infestation.
equipped with suitable backflow prevention
devices must be provided throughout the
2-62. Waste Disposal.
stable for this purpose.
3. The stable must be provided with an 1. Adequate toilet facilities must be pro-
adequate drainage system so that all liquid vided for employees and patrons. Separate
waste can be satisfactorily drained away facilities must be provided for males and fe-
from the stable facilities. Corrals and pad- males.

2-20 January 1995


2-62 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-65

2. Manure must be removed and stored or 2-63. Veterinary Service.


disposed of in accordance with state/local
laws and ordinances. Manure must be re- The operation of the stable must be under
moved from the stalls and corrals at least the professional guidance of a veterinarian,
once each day, preferably in the early morn- either military or contract civilian. If the
ing. boarding of privately owned horses is per-
3. Storage and disposal must be accom- mitted, health certification from a licensed
plished in a manner that prevents contami- veterinarian, including vaccination records,
nation of run-off water. must be provided before the animal is ac-
cepted into the stable.

Section X. SANITATION OF ADMINISTRATIVE SPACES

Article
General ----------------------------------------------------------------------------------------------------- 2-64
Habitability ----------------------------------------------------------------------------------------------- 2-65
Sanitation/Housekeeping ----------------------------------------------------------------------------- 2-66

2-64. General. ments, and responsibility are outlined in Na-


val Sea Systems Command directives and
A significant proportion of military and OPNAVINST 9640.1 series.
civilian personnel work in administrative a. Ventilation for surface ships requires
spaces. Clean administrative spaces with ad- minimum replenishment with outside air at
equate lighting, heating, cooling and ventila- the rate of 5 cubic feet per minute per occu-
tion enhances morale and promotes pant. OPNAVINST 5100.19C (Vol 1), con-
productivity. When compared to industrial cerning heat stress is applicable. Air
work spaces, such as shops, engineering conditioning of administrative spaces is a
spaces, storerooms, and warehouses, there is design goal which must be considered on an
less chance of occupational injury or disease individual basis.
transmission; nevertheless, injuries do occur b. Noise standards in administrative
and the possibility of disease transmission spaces are such that direct speech commun-
does exist. Surveys of administrative spaces ication must be understood with minimum
should be conducted in response to trouble error and without need for repetition.
calls or to resolve discrepancies identified c. General Specifications for Ships of
during administrative inspections. Evalua- the U.S. Navy require lighting fixtures to be
tions of health concerns in administrative arranged to provide uniform illumination so
spaces often require a multi-disciplined sur- that the ratio of maximum foot candles un-
vey team including environmental health of- der a lighting fixture to the minimum foot
ficers, industrial hygienists, etc. candles between it and the nearest adjacent
fixture is not greater than two to one.
2-65. Habitability. 3. Requirements for shore facilities are
found in the Department of Defense Con-
1. A healthy environment is essential in struction Criteria Manual. The following
administrative spaces ashore and afloat to standards apply to administrative offices
maintain the efficiency of Navy and Marine and spaces.
Corps personnel. a. The net floor area per building occu-
2. The shipboard habitability program, pant must not be less than 115 square feet
procedures, category standards, require- and not more than 130 square feet.

January 1995 2-21


2-65 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-66

b. The minimum ratio of plumbing fix- climatic zone in which the facility is located.
tures to the number of persons to be accom- Heating systems must, while operated at
modated appears in table 2-3. rated capacity, maintain an inside tempera-
c. Air conditioning, evaporative cool- ture of 68 degrees F in administrative
ing, dehumidification, mechanical ventila- spaces.
tion, and type of heating is determined by the

Table 2-3. Ratio of Plumbing Fixtures to Persons

WATER DRINKING
OCCUPANTS CLOSETS LAVATORIES URINALS FOUNTAIN

up to 30 1/15 1/20 1/30 1/75

31 to 120 1/20 1/20 1/40 1/75

FEMALE

up to 120 1/15 1/15 None 1/75

d. Lighting Intensities for Administrative sponsible for inspections and surveys; the
Spaces Ashore: Lighting intensities must public works department is responsible for
conform to the guidelines established in the treatment and control. Administrative per-
current edition of the Illuminating Engineer- sonnel must report the presence of insects or
ing Society (IES) Lighting Handbook. The rodents to public works by trouble call or
intensity of the general illumination for any work request.
area must not exceed 150 foot candles. If a 2. Floors should be cleaned daily. The type
higher intensity is required for a particular of floor determines the method of cleaning.
task, it must be achieved by supplementing Carpets and rugs should be maintained as
the general illumination with localized recommended by the manufacturer. Painted
(supplementary) lighting. The ratios be- surfaces must be cleaned periodically to pre-
tween general and supplementary illumina- vent accumulation of dirt.
tion must be at least those recommended by 3. Trash receptacles must be emptied
IES. Supplementary lighting fixtures must daily and cleaned periodically. Disposable
be reviewed and approved by safety person- liners are recommended.
nel prior to installation. 4. Drinking fountains should be cleaned
at least once daily with particular emphasis
on the bowl, orifice, and orifice guard.
2-66. Sanitation and Housekeeping. Drinking fountains must be of the angle jet
type.
1. Administrative spaces ashore and 5. Head facilities must be cleaned and
afloat must be kept clean with no evidence of resupplied daily.
insects and rodents. Afloat, insect and rodent 6. Mops, brooms, brushes, and other
control is a medical department responsibil- cleaning gear must be thoroughly cleaned
ity. Ashore, the medical department is re- and properly stored after each use.

2-22 January 1995


2-66 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-70

7. Cleaning contracts for administrative 8. Cooking is not permitted in administra-


areas must provide a specified cleaning tive areas; designated lounges can be uti-
schedule in the basic contract. lized, if inspected and approved by medical
department personnel,

Section XI. SAUNAS AND STEAM ROOMS

Article
General ------------------------------------------------------------------------------------------------------- 2-67
Structure ----------------------------------------------------------------------------------------------------- 2-68
Sanitation ---------------------------------------------------------------------------------------------------- 2-69
Safety --------------------------------------------------------------------------------------------------------- 2-70

2-67. General. tering, protruding nails, or other fasteners


that may cause injury.
Saunas and steam rooms are used for re- 3. Steam Rooms. Steam rooms must be
laxation or as part of an individual physical completely lined with impervious material
fitness program. Saunas operate on the prin- (e.g., ceramic tile) which will not deteriorate
ciple of inducing perspiration through high under moist heat conditions. The walls,
temperature dry heat, whereas steam rooms floors, and ceiling must be maintained in
use moist heat. Saunas and steam rooms good repair. Benches must be constructed
must be structurally sound, clean, and free of and installed to permit easy cleaning.
any potentially dangerous condition.

2-69. Sanitation.
2-68. Structure.
The interior of saunas, steam rooms, and
1. General. Constructive must be no less associated changing areas (see Article 2-50)
than industry standards and be approved for must be clean and free of debris, foul odors,
installation by the cognizant Engineering or other unsanitary conditions. The floor,
Field Division, Naval Facilities Engineering buckboards, benches, or platforms must be
Command. Electrical installation must be in scrubbed daily using a mild detergent fol-
accordance with current Naval Facilities En- lowed by an EPA registered disinfectant
gineering Command standards. Doors must (e.g., 50 ppm chlorine solution) or commer-
contain window(s) which allow observation cial cleaner/sanitizer. The consumption of
of the entire room. Lighting must be in accor- food or drink in saunas or steam rooms is
dance with current Illumination Engineer- strictly prohibited. The sanitary condition of
ing Society Standards. Carpet and/other a sauna or steam room should be determined
absorbent floor coverings are prohibited. in conjunction with the inspection of the fa-
2. Sauna. Saunas must be constructed of cility in which it is located.
rot resistant woods (e.g., redwood). The floor
must be covered with buckboards designed
for easy removal and cleaning. Benches must 2-70. Safety.
be designed to allow easy cleaning with no
hard-to-reach locations. Benches must be A thermostatic; control device must be in-
maintained in good structural repair. Seat- stalled which prevents saunas and steam
ing surfaces must be smooth without splin- rooms from exceeding 200° F (93° C) and 120°

January 1995 2-23


2-70 MANUAL OF NAVAL PREVENTIVE MEDICINE 2-71

F (49° C) respectively. Signs must be con- shielded to prevent burns. Saunas and steam
spicuously posted listing rules for operation rooms which are located in remote sites,
and use. If for any reason a sauna or steam away from pedestrian traffic, should be
room is equipped with a door lock, the door equipped with an alarm or equivalent sys-
must be easily opened from inside the room. tem which can be activated by the patron in
Steam outlets, piping, and heaters must be an emergency.

SECTION XII.

2-71. References. i. OPNAVINST 11103.1 series, Ad-


equacy, Assignment, and Utilization of
The following is a list of publications used Bachelor Quarters (BQ)
in the preparation of this chapter. Copies j. BUPERSINST 1710.11 series, Navy
should be on hand or available to medical Recreation Operational Policies
department personnel for reference and k. NAVMEDCOMINST 6260.5 series,
guidance. State and local guidance should Occupational Noise Control and Hearing
also be consulted, and procured as necessary. Conservation.
Revisions and supplements are published as 1. NAVMEDCOMINST 6770.1 series,
necessary and personnel must ensure that Linen Management
they are on the distribution list to receive 3. Navy Publications
current editions. a. General Specifications for Ships of
1. DoD Instructions the United Stats Navy, NAVSEA S9AAO-
DoD 4270. l-M, Department of Defense AA-SPN-010/GEN-SPEC.
Construction Criteria Manual b. Navy Bachelor Quarters Manual,
2. Navy Instructions NAVPERS 15606
a. SECNAVINST 1640.9 series, De- c. Naval Ships’ Technical Manual,
partment of the Navy Corrections Manual Chapter 655, Laundry
b. OPNAVINST 1700.9 series, Child d. Naval Ships’ Technical Manual,
Development Programs Chapter 670, Stowage Handling, and Dis-
c. OPNAVINST 1640.7 series, Manual posal o f h a z a r d o u s G e n e r a l U s e
for the Operation of a Waterfront Brig/Cor- Consumables
rectional Custody Unit. e. NAVFAC DM-4, Electrical Engi-
d. OPNAVINST 1640.8 series, Manual neering
for the Administration of Afloat Brigs. f. NAVFAC DM-37.4, Brigs, Detention
e. OPNAVINST 5090.1 series, Envi- Facilities
ronmental and Natural Resources Protec- g. NAVMED P-117, Manual of the
tion Manual. Medical Department
f. OPNAVINST 5100.19 series (Vol 1), h. NAVMED P-5010-3, Ventilation and
Navy Occupational Safety and Health Thermal Stress Ashore and Afloat
(NAVOSH) Program Manual for Forces 4. Non-DoD Publications
Afloat a. “Environmental Health Guide for
g. OPNAVINST 5100.23 series, Navy Mobile Home Communities,” U.S. Depart-
Occupational Safety and Health Program ment of Health Education, and Welfare,
Manual Public Health Service, Revised 1975. Avail-
h. OPNAVINST 9640.1 series, Ship- able from: Mobile Home Manufacturers As-
board Habitability Program. sociation, 14650 Lee Road, Chantilly, VA
22021

2-24 January 1995


2-71 CHAPTER 2. SANITATION OF LIVING SPACES, ETC. 2-71

b. Title 29, Code of Federal Regula- (IES) Handbook,” Illuminating Engineering


tions, Part 1910.37 (29 CFR 1910.37) “Gen- Society, 345 East 47th Street, New York, NY
eral Industry, ” OSHA Safety and Health 10017.
Standards g. “Manufactured Home Installations”
c. Title 29, Code of Federal Regula- American National Standards Institute
tions, Part 1910.1030 (29 CFR 1910.1030), A225.1, National Fire Protection Association
Control of Occupational Exposure to 501-A (joint publication)
Bloodborne Pathogens h. “Mobile Home Court Development
d. Title 29, Code of Federal Regula- Guide, ” U.S. Department of Housing and
tions, Part 1926.50 (29 CFR 1926.50), Medi- Urban Development
cal Services and First Aid i. PHS Publication No. 1195, “Envi-
e. “Health and Safety Hazards at Rec- ronmental Health Practice in Recreation Ar-
reation Areas, ” National Environmental eas, ” reprinted 1978.
Health Association, 1982. j. Sanitarian’s Handbook, 1977 Edi-
f. "Illuminating Engineering Society tion, Ben Freedman, M. D., M.P.H.

January 1995 2-25


Naval Medical Command
NAVMED P-5010-3
(1988)
DC 20372-5120 0510-LP-2O2-87OO

Manual Of Naval Preventive Medicine

Chapter 3

VENTILATION AND
THERMAL STRESS
ASHORE AND AFLOAT

DISTRIBUTION STATEMENT “A”


CONTENTS
Page
Section I. Definitions and Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Article 3-1. Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3-2. Definitions and Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3- I

Section II. Design Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4


Article 3-3. Objectives of Heating, Ventilation and Cooling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
3-4. Heating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
3-5. Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
3-6. Mechanical Cooling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
3-7. Additional Considerations Aboard Ship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
3-8. General Considerations Ashore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

Section III. Physiological Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9


Article 3-9. Effects of Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
3-10. Effects of Cold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17

Section IV. Thermal Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20


Article 3-11. General Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20
3-12. Assessment of Heat Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-22
3-13. Practical Heat Stress Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28
3-14. Practical Cold Stress Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-33

Illustrations
Table 3-1. Summary of Thermal Physiology Heat Stress Design Conditions for
Surface Vessels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
3-2. Recommended Threshold WBGT Values For Instituting Sound
Hot Weather Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
3-3. Percent Optimum Heat Acclimatization on Consecutive Days of
Heat-Work Exposures for Physically Trained Personnel . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
3-4. General Physiologic Impact of Fuel Combustion Gases and Fuel Vapors . . . . . 3-21
3-5. Approximation of Metabolic Rates for Various General Physical Activities . . . 3-24
3-6. Physiologic and Hygienic Implications of the Belding-Hatch HSI . . . . . . . . . . . . . . 3-25
3-7. Time-Weighted-Mean Metabolic Rates for PHEL Curves I - IV . . . . . . . . . . . . . . . . 3-27
3-8. Relationship of PHEL Curves I - VI to Intermittent Physical Work
and Rest Pauses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-27
3-9. WBGT as a Guide in Regulating Intensity of Physical Exertion
During First 12 Training Weeks in Hot Weather . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-29
3-10. PHEL Curve General Applicability Aboard Ships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30
3-11. PHEL Times for PHEL Curves I -VI versus WBGT Without Presence
of FuelCombustion Gases and/or Fuel Vapors [80- 125 F] . . . . . . . . . . . . . . . . . . 3-31
3-12. PHEL Times for PHEL Curves I - VI versus WBGT Index With Presence
of CombustionGases and/or Fuel Vapors [80- l15 F] . . . . . . . . . . . . . . . . . . . . . . . . . 3-32
3-13. Cooling Power of Wind unexposed Flesh Expressed as
an Equivalent Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-33
Figure 3-1. Psychrometric Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
3-2. Percent Optimum Cooling vs. Air Velocity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
3-3. Heat Acclimatization [Comparison of Methods] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10a
3-4. Pathogenesis of Complications of Excessive Physical Exercise . . . . . . . . . . . . . . . . . . . 3-12
3-5. Water Requirements For Heat, Work & 15.0 Gms NaCl . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
3-6. Water Requirements For Heat, Work & 25.5 Gms NaCl . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16

i
Page
3-7. Estimation of Mean Radiant Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-22
3-8. Body Temperatures vs. Mean Radiant Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23
3-9. Physiological Heat Exposure Limits Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-26
3-10. Mental Impairment Onset Vs. WBGT Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28
3-11. Lethal Hypothermia Exposures in Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-34
VENTILATION AND THERMAL
STRESS ASHORE AND AFLOAT
Chapter 3
Section I. DEFINITIONS AND INSTRUMENTATION

Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..3-1
Definitions and Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-2

3-1. Purpose the fine line between acceptable and unacceptable levels
(1) The purpose of this chapter is to provide informa- of heat stress and strain, extreme caution must be
tion on the fundamentals of heating, ventilating and exercised to avoid cumulative harm to individuals.
cooling, and to describe the physical and physiological (d) Thermal stress has been categorized as:
measurements which must be made ashore and afloat in (1) “Acceptable” when the human is able to
order to assess the effects of hot and cold atmospheric compensate without undue strain; or,
conditions on personnel. (2) “Unacceptable” when the human is able to
(2) Engineering aspects which relate to heating, ven- compensate but incurs severe strain, or is unable to
tilation and cooling design in shipboard situations come compensate and incurs excessive strain.
under the cognizance of the Naval Sea Systems Com- (e) Thermal strains have been categorized as:
mand; those applying to shore establishments are han- (1) Those interfering with work performance and
dled by the Naval Facilities Engineering Command. safety; and,
Health standards governing these installations are pro- (2) Those with more overt manifestations of
mulgated by the Naval Medical Command. In order to physiologic decomposition such as heat rash, heat
protect the health and well-being of all personnel, it is cramps, heat exhaustion, heat stroke, non-freezing or
important to be familiar with the fundamental principles freezing injuries.
involved in heating, ventilation and air-conditioning as (2) Climatic Measurements of Thermal Stress:
they apply to the human. (a) Dry-Bulb Temperature (DB) of air is that tem-
perature measured with an ordinary alcohol-in-glass, or
3-2. Definitions and Instrumentation mercury-in-glass, thermometer whose bulb is kept dry
(1) Stress and Strain and shielded from radiation. When laypersons speak of
(a) The thermal (heat or cold) stress of any given the prevailing air temperature, determined from a con-
working situation is the combination of all of those ventional thermometer, they are speaking of the dry-
factors which result in heat gains or losses relative to the bulb temperature. A variety of electronic sensors can be
body or which prevent the body’s regulatory mecha- used in place of conventional thermometers; if properly
nisms from working efficiently. Thus, it is necessary to constructed some of these (e.g., thermocouples and
consider the combined impact of climatic and non- thermistors) may require comparatively little shielding
climatic factors and to evaluate independent and inte- from radiant heat transfer. For routine monitoring of
grated influences associated with the human. dry-bulb temperatures in shipboard spaces, the Naval
(b) In accordance with engineering practices, envi- Sea Systems Command approved alcohol-in-glass
ronmental physiologists employ the term “stress” to dry-bulb thermometer has the stock number
designate the force or load acting upon the biological 9G-6685-00-243-9964.
system and the term “strain” to designate the resulting (b) Wet-Bulb Temperature (WB) is measured with a
distortion of the biological system. Thermal stress fac- thermometer, similar to that used for dry-bulb temper-
tors are conventionally given as heat, cold, humidity, ature, except that a wet wick is fitted closely over the
radiation, air movement and surface temperatures; ther- bulb (or sensor). A “natural” wet-bulb temperature is
mal strain manifests itself in specific cardiovascular, defined as that obtained with no additional movement
thermoregulatory, respiratory, renal, endocrine, etc., of air over the wick than that which occurs naturally in
responses which differ from accepted human norms. the environment. An “aspirated” wet-bulb temperature
(c) It must be understood that not all thermal stress is obtained by increasing air movement over the wick
and strain are adverse to humans. Within the range of with a fan, motorized psychrometer, or sling psychrom-
human adaptability, factors that do not impair perfor- eter. The “true” wet-bulb environmental temperature is
mance or increase susceptibility to other risks may be approximated with an air flow of at least 250 feet per
considered “acceptable” until proven otherwise. Due to minute (fpm) over the wick and the bulb is shielded from

3-1
3-2 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-2
radiant heat. Excessive air velocity (e. g., greater than alent); high unidirectional air velocities may be mea-
1500 fpm) may result in a significant degree of kinetic sured with a velometer or vane anemometer.
heating. Although the natural wet-bulb temperature (f) Radiant Heat is the transfer of thermal energy by
depends on the dry-bulb temperature and the moisture wave motion from one object to another without warm-
content of the air, it does not provide a direct indication ing of the intervening space. The wave lengths involved
of the amount of water vapor in the air. The aspirated range from the visible portion of the electromagnetic
wet-bulb temperature is therefore of greater value in spectrum (0.3-0.7 microns) to the longer radio waves. In
planning corrective engineering actions than the “nat- industrial situations any part of the heat radiation
ural” wet-bulb temperature, and the term wet-bulb will spectrum may be present. Natural environments, how-
hereafter refer to that which is aspirated unless otherwise ever, generally include two bands: solar radiation from
specified. ultra-violet to near infrared, and heat radiation in the far
When the wet- and dry-bulb temperatures are infrared portion of the spectrum. For recall it is easier to
identical the air is said to be “saturated;" and the relative remember that solar radiation is a shorter wavelength
humidity may be considered to be 100 percent. Any and heat radiation (e.g., indoors) is a longer wavelength.
decrease in the moisture content of the air will result in Both forms of radiation liberate thermal energy when
evaporation from the wetted wick of the wet-bulb ther- absorbed.
mometer, and in turn, the bulb of the thermometer will Not all of the radiant heat that strikes a surface is
be cooled to a temperature which reflects the reduced absorbed. Any surface which has a high reflectance will
moisture content of the air. minimize absorption of radiant heat; conversely, a sur-
(c) Measurements of Humidity. Humidity is an face with low reflectance will increase absorption of
expression of the quantity of water vapor mixed with the radiant heat. The portion that is absorbed is termed
other atmospheric gases. The Absolute Humidity (AH) “absorptance of the surface” while that which is not
is the mass of water vapor present per unit volume of air absorbed is reflected by the “reflectance of a surface”.
(kg/m’); the gas pressure (Torr) exerted by this water An exception exists for humans in that dark-pigmented
vapor is referred to as the Vapor Pressure (e or VP). The skin and light-colored skin are essentially alike in ab-
ratio of the actual amount of water in the air (absolute sorbing the longer wavelength radiant heat (e. g.,
humidity) to the maximum quantity of water that the air indoors); however, in the sunlight darker skin has a
can hold at a given temperature is the Relative Humidity higher absorptance than lighter skin. The intensity of
(RH). The temperature at which the absolute humidity radiant heat can be measured by use of a radiometer or
reaches a maximum and the air become saturated with pyrheliometer, or a globe thermometer.
water vapor is called the Dew Point (Td). (g) Globe Thermometer (G). The Vernon Globe
Vapor pressure is a measure of water content in Thermometer consists of a 6-inch hollow copper sphere,
the atmosphere under given conditions. Relative humid- with a 0.022 inch thick wall, painted matte (flat) black
ity is primarily a ratio of partial and saturated vapor on the outside, and contains a temperature sensor like
pressures, not a measure of water content. For example, that of an unshielded dry-bulb thermometer with its
one may find a 50 percent relative humidity at 50 F DB bulb, or an equivalent, at the center of the sphere. A
and 100 F DB, but the actual water content at 100 F DB Vernon globe requires about 20 minutes to achieve
will be nearly six-fold greater than that at 50 F DB (See equilibrium. Smaller globes, from 1.64-4.0 inch outside
Figure 3-1). Therefore, the proper evaluation of thermal diameter, have been developed which have shorted equi-
conditions requires specifying both dry- and wet-bulb librium times; however, few have been demonstrated to
temperatures. be equivalent with a Vernon Globe. Globe thermometers
(d) Psychrometer—an instrument for measuring are required in the assessment of thermal stress because
atmospheric humidity utilizing a dry- and wet-bulb they integrate radiant heat exchange and convective heat
thermometer and whirled manually or by motorized unit loss into a single value.
to provide the moderate air flow necessary to obtain an (h) Wet-Bulb GIobe Temperature (WBGT) Meter,
aspirated wet-bulb temperature reading. Psychometric also known as the Heat Stress Meter, is a compact
charts (Figure 3-1) help translate this information into electronic instrument that independently measures the
relative humidity and other thermodynamic characteris- dry-bulb, wet-bulb and globe temperatures. The instru-
tics of moist air. It is strongly recommended that ment displays each of these values as well as computes
motorized psychrometer be used for reproducibility of and displays the WBGT Index value (described in Sec-
measurements; in turn, the stock number for the ap- tion IV). The approved Navy Heat Stress Meter
proved unit is 1H-6685-00-935-1389, calibration is not (7G-6685-01-055-5298) is lightweight, self-contained,
required. Electronic, motorized psychrometer are avail- and equipped with a rechargeable power supply. A ven-
able to provide direct readout of DB, WB, RH and Td. tilating fan is included, in the shielded dry- and wet-bulb
(e) Air Movement or Velocity (V) is usually ex- sensor assembly, to obtain aspirated wet-bulb tempera-
pressed in feet per minute (fpm) or cubic feet per minute tures. The entire unit can be adapted for remote moni-
(cfm). It is measured by various instruments depending toring and recording. Use and maintenance of the
upon the velocities of air movement. Low velocities Navy’s Heat Stress Meter is described and portrayed in
(down to 10 fpm) require a heated Kata thermometer or the Navy educational film “Care and Use of the Heat
thermo-anemometer (“hot-wire” anemometer or equiv- Stress Meter” (35335-DN). Use of other electronic and

3-2
3-2 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-2
Figure 3-1. —Psychrometric Chart.

VAPOR PRESSURE mm of MERCURY

GRAINS OF WATER VAPOR PER POUND OF DRY AIR


(7000 Grains = one pound-mass)

3-3
3-2 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-3
manual heat stress monitoring devices, other than a weight, hand-held infrared thermometer allows scanning
motorized psychrometer, are not approved for shipboard of surfaces to detect the functional adequacy of insula-
purposes unless the proposed devices meet the accuracy tion, as well as to check overheating of equipments.
and response time test accuracy tolerances given in Table Analog and digital readout and imaging devices are
III and Figure 3 of Navy Procurement Specification commercially available. In all applications, extreme
0513487126-SGA of 20 May 1987. No manual “heat caution should be exercised in using infrared thermom-
stress monitors," which supposedly provide dry- and eters. A number of such devices require the instrument
wet-bulb and globe temperatures and/or a so-called to be four feet or more from the infrared sources to
facsimile of the WBGT Index, are approved for ship- avoid infrared “flare”. Electromagnetic radiation
board uses due to inherent measurement errors over the “flare” will result in erratic values, leading to misinter-
wide range of thermal environments that exist through- pretations of the data.
out Navy ships. Special heat stress survey teams, from (j) Effective Temperature (ET) is an empirical sen-
shore activities, should employ the most reliable, accu- sory index, combining into a single value the effects of
rate equipments available. Inquiries regarding approval temperature, humidity, air velocity and thermal radia-
for shipboard use and for comparative purposes should tion. Combinations of conditions which produce the
be brought to the attention of MED-22. Naval Medical same subjective feeling of warmth in reference to still air
Command approval for shipboard uses can only be are assigned the same effective temperature.
considered after receiving and evaluating a diversity of (k) Equivalent Temperature is commonly known as
comparative data for each type of proposed alternative “Wind Chill”. As noted by Burton in 1955, “Wind
heat stress monitoring device. Chill” lacks a scientific basis. The product of calculat-
Stock numbers for the Navy approved WBGT ing “Wind Chill” is a heat transfer factor, and the
Meter, accessories kit, globe assemblies alone and re- relationship of temperature and air movement provide
chargeable batteries, as of May 1988, are: the derived heat transfer. The temperature—air move-
(a) WBGT Meter 7G-6685-01-055-5298 ment relationship is known as the Equivalent Tempera-
(Shipboard AEL 2-870003051) ture. (See Article 3-14)
(b) Accessories (spare sensor/wind tunnel as- (1) The Mean Radiant Temperature (mrt) of a
sembly, globe, wicks, etc.) 9G-6685-01 - nonuniform environment (e.g., walls, overhead, deck
055-5299 (Shipboard APL 100110001) and objects of different emissivities and at different
(c) Globe Assemblies 9G-6665-01-149-8635 temperatures) is defined as the temperature of a uniform
(d) Standard Nickel-Cadmium Rechargeable black enclosure in which a solid body or an occupant
AA Batteries 9G-6140-00-449-6001 would exchange the same amount of radiant heat as in
(i) The Infrared Thermometer (self-contained elec- the given nonuniform environment. It is estimated from
tronic) is used to measure the temperature of infrared dry-bulb and globe temperatures and air movement and
energy emitted from various sources. The practical is useful in determining radiative heat transfer (net gain
aspects of an infrared thermometer are that no contact or loss) relative to humans. Section IV provides further
with surfaces is required. In industrial settings, a light- information on mean radiant temperature.

Section II. DESIGN OBJECTIVES


Article
Objectives of Heating, Ventilation and Cooling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Heating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...3-5
Mechanical Cooling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Additional Considerations Aboard Ship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
General Considerations Ashore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8

3-3. Objectives of Heating, Ventilation and ductivity and recovery from undue physical stress rather
Cooling than thermal comfort alone.
(2) In addition to temperature considerations, envi-
(1) Major objectives of heating, ventilation and cool- ronmental control systems must assure that the air in
ing include maintaining physical fitness, mental alert- confined spaces contains sufficient quantities of oxygen
ness, fighting ability and the general well-being of and no harmful components.
personnel in the performance of their duties ashore or (3) Special use areas such as selected Medical Depart-
afloat. This should include consideration for the stresses ment spaces, and those containing equipment and ma-
of watches, prolonged cruising and battle or general terials which require individually controlled surround-
quarters situations. The design and maintenance of ings, must be designed to guarantee optimal mission
environmental control systems should assure useful pro- performance under variable environmental conditions.

3-4
3-2 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-3
manual heat stress monitoring devices, other than a weight, hand-held infrared thermometer allows scanning
motorized psychrometer, are not approved for shipboard of surfaces to detect the functional adequacy of insula-
purposes unless the proposed devices meet the accuracy tion, as well as to check overheating of equipments.
and response time test accuracy tolerances given in Table Analog and digital readout and imaging devices are
III and Figure 3 of Navy Procurement Specification commercially available. In all applications, extreme
0513487126-SGA of 20 May 1987. No manual “heat caution should be exercised in using infrared thermom-
stress monitors," which supposedly provide dry- and eters. A number of such devices require the instrument
wet-bulb and globe temperatures and/or a so-called to be four feet or more from the infrared sources to
facsimile of the WBGT Index, are approved for ship- avoid infrared “flare”. Electromagnetic radiation
board uses due to inherent measurement errors over the “flare” will result in erratic values, leading to misinter-
wide range of thermal environments that exist through- pretations of the data.
out Navy ships. Special heat stress survey teams, from (j) Effective Temperature (ET) is an empirical sen-
shore activities, should employ the most reliable, accu- sory index, combining into a single value the effects of
rate equipments available. Inquiries regarding approval temperature, humidity, air velocity and thermal radia-
for shipboard use and for comparative purposes should tion. Combinations of conditions which produce the
be brought to the attention of MED-22. Naval Medical same subjective feeling of warmth in reference to still air
Command approval for shipboard uses can only be are assigned the same effective temperature.
considered after receiving and evaluating a diversity of (k) Equivalent Temperature is commonly known as
comparative data for each type of proposed alternative “Wind Chill”. As noted by Burton in 1955, “Wind
heat stress monitoring device. Chill” lacks a scientific basis. The product of calculat-
Stock numbers for the Navy approved WBGT ing “Wind Chill” is a heat transfer factor, and the
Meter, accessories kit, globe assemblies alone and re- relationship of temperature and air movement provide
chargeable batteries, as of May 1988, are: the derived heat transfer. The temperature—air move-
(a) WBGT Meter 7G-6685-01-055-5298 ment relationship is known as the Equivalent Tempera-
(Shipboard AEL 2-870003051) ture. (See Article 3-14)
(b) Accessories (spare sensor/wind tunnel as- (1) The Mean Radiant Temperature (mrt) of a
sembly, globe, wicks, etc.) 9G-6685-01 - nonuniform environment (e.g., walls, overhead, deck
055-5299 (Shipboard APL 100110001) and objects of different emissivities and at different
(c) Globe Assemblies 9G-6665-01-149-8635 temperatures) is defined as the temperature of a uniform
(d) Standard Nickel-Cadmium Rechargeable black enclosure in which a solid body or an occupant
AA Batteries 9G-6140-00-449-6001 would exchange the same amount of radiant heat as in
(i) The Infrared Thermometer (self-contained elec- the given nonuniform environment. It is estimated from
tronic) is used to measure the temperature of infrared dry-bulb and globe temperatures and air movement and
energy emitted from various sources. The practical is useful in determining radiative heat transfer (net gain
aspects of an infrared thermometer are that no contact or loss) relative to humans. Section IV provides further
with surfaces is required. In industrial settings, a light- information on mean radiant temperature.

Section II. DESIGN OBJECTIVES


Article
Objectives of Heating, Ventilation and Cooling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Heating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...3-5
Mechanical Cooling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Additional Considerations Aboard Ship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
General Considerations Ashore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8

3-3. Objectives of Heating, Ventilation and ductivity and recovery from undue physical stress rather
Cooling than thermal comfort alone.
(2) In addition to temperature considerations, envi-
(1) Major objectives of heating, ventilation and cool- ronmental control systems must assure that the air in
ing include maintaining physical fitness, mental alert- confined spaces contains sufficient quantities of oxygen
ness, fighting ability and the general well-being of and no harmful components.
personnel in the performance of their duties ashore or (3) Special use areas such as selected Medical Depart-
afloat. This should include consideration for the stresses ment spaces, and those containing equipment and ma-
of watches, prolonged cruising and battle or general terials which require individually controlled surround-
quarters situations. The design and maintenance of ings, must be designed to guarantee optimal mission
environmental control systems should assure useful pro- performance under variable environmental conditions.

3-4
3-3 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-5
Designs must address exhaust of gases and vapors which cases where atmospheric heating and cooling needs of
are heavier than air, therefore, in both shipboard and the individual cannot be met there is the added problem
ashore applications, exhaust ventilation is required nine of adding or removing protective clothing; all normally
inches from the deck. Furthermore, just because the worn clothing must be viewed as protective in nature
design supply air volumes and exhaust volumes meet when considering the potential hazards aboard ships and
design specification, optimal distribution within the ashore.
space or the work site must be assured.
3-5. Ventilation
3-4. Heating (1) The purpose of ventilation is to remove toxic
(1) In designing a heating system ashore, the relatively substances, offensive odors and excessive heat and mois-
narrow range of climatic conditions in a given locale can ture, and to provide an adequate oxygen supply. Naval
usually be anticipated and the system designed accord- ventilation should be designed not only to prevent
ingly. This sort of planning is obviously difficult for conditions aboard ship which could lead to acute over-
naval vessels on which heating systems must be designed heating, but also to maintain an atmosphere conducive
to provide for a wide range of climatic conditions from to the physical and mental efficiency of personnel.
arctic cold in winter to tropical heat in summer. The Ventilation of work spaces must be adequate to control
need for design flexibility is further extended by variable toxic substances such as; solvents (e.g., perchloroethy-
requirements for space, weight and power sources. In lene in dry cleaning plants, PD-680 Type II as a
addition, the distance of the heating (or cooling) unit degreaser, etc.), fuel combustion gases (e.g., “stack gas”
from the point of delivery must be considered. For in firerooms), fuel vapors (e.g., fuel pump rooms,
general purposes in cold weather, the amount of heat firerooms, auxiliary machinery rooms), hydrogen sul-
supplied should be planned to balance heat loss when fide in CHT pump rooms, etc. Ships with conventional
the outside air temperature is 10 F DB and the sea water ventilation system shall have the capability to electri-
temperature is 28 F, the air temperature at normal work cally secure ventilation to prevent ingestion or spread of
stations should be sustained at least to 65 F. NBC contamination within the ships. In 1983 Navy
(2) Aboard ship the conventional approach for heat- policy was established that the Circle William material
ing is accomplished by drawing fresh outside air over condition must not be set for longer than 5 minutes in
heating coils and discharging the heated air into various machinery spaces during training evolutions. The venti-
compartments where it is required. In order to avoid lation systems in ships with Collective Protection Sys-
condensation of moisture on and inside the air ducts and tems (CPS) shall provide clean, filtered air within the
to provide a flexible heating system, outside air is CPS zones.
initially preheated to 42-50 F DB. The air is then heated Ventilation systems must be as flexible as those
to the desired delivery zone temperature and distributed designed for heating. Hot weather cooling of given
to the various compartments and spaces within that spaces by ventilation should be planned so that the
zone. A “heating zone” is defined as a group of adja- temperature within those spaces will remain below spec-
cent spaces with approximately the same heating ified limits. These limits are determined, using as a base
requirements. the highest anticipated hot weather (outside) tempera-
(3) A zone temperature of 70 F DB is required aboard tures. For general planning purposes the design weather
surface vessels for berthing, dressing, lounge, messing, conditions are 90 F DB, 81 F WB and 85 F sea water
medical, dental, office and control spaces. No effort is temperature. Special considerations must be made for
made to maintain a controlled moisture level in these external ambient environmental conditions in the Per-
spaces during cold weather; therefore, Medical Depart- sian Gulf; these design weather conditions are: 105 F
ment personnel should anticipate increased symptoms DB, 95 F WB and up to 90 F sea water temperature.
associated with the drying of respiratory membranes (2) Air circulation within manned compartments must
among individuals working in these areas. be sufficient to eliminate “dead spaces”. An adequate
(4) Heating designs for submarines differ from those air exchange will insure the removal of odors and will
of surface vessels in that they provide a regulated prevent the accumulation of moisture on surfaces of the
humidity for the living and control spaces noted above. spaces. Ventilation exhaust from sanitary spaces, food
Symptoms associated with the drying of the respiratory preparation and dining areas, sculleries and garbage
membranes may be less pronounced than those noted disposal areas must not be recirculated or introduced
aboard surface vessels. The heating design for subma- into any other spaces. Ventilation of food preparation,
rine berthing, dressing, lounge, messing, medical, den- laundry, dry cleaning and propulsion spaces must be
tal, office and control spaces should adhere to the balanced to provide a negative pressure within those
following specifications: dry-bulb 79 F, wet-bulb 59 F, areas, i.e., allowing for a net flow of air into the spaces.
relative humidity 50% and WBGT Index 63 F. Propulsion spaces should have exhaust at 115070 of
(5) With the exception of the above noted living and supply air in 600 pound per square inch (psi), gas
control spaces and areas containing engineering propul- turbine and diesel propulsion plants and aircraft carrier
sion components, inside working spaces should be main- machinery spaces; exhaust 125% of supply in all other
tained at approximately the given temperatures for pur- 1200 psi propulsion plants.
poses of efficiency and comfort of personnel. In those (3) Cooling by ventilation is a process of diluting

3-5
3-5 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-7
inside air with cooler outside air. It has proved to be of peratures of engine rooms, firerooms, galleys, laundries,
value aboard ships in reducing excessive temperatures in etc. Persons entering cold rooms (e.g., walk-in freezers,
manned spaces. In those cases where steam and water cold storage boxes, cold test chambers, etc.) need pro-
leaks are minimal, negative pressure ventilation may tection from “cold shock”; protection can be achieved
partially offset the adverse impact of high temperatures by the temporary use of suitable clothing or limiting the
upon personnel. However, as the ventilation systems of frequency and duration of exposures. (Also see
ships deteriorate it is unlikely that ventilation alone will NAVMED P-5052-29)
compensate for the increased environmental heat upon
personnel. To achieve optimal exhaust ventilation in 3-7. Additional Considerations Aboard Ship
machinery spaces the size of the screens over the exhaust (1) Excessive moisture may be generated in multiple
uptake ducts should be 1½ inch grid mesh, and the shipboard conditions. In firerooms and engine rooms
ventilation systems must be maintained at optimal ca- steam and water leaks are common sources of increased
pability. In other spaces within a ship the exhaust uptake water vapor. Inadequate steam exhausting from dish-
ducts of nine inches or less across should have ½ inch washers creates a high moisture content in sculleries and
grid mesh; if the exhaust uptake ducts are greater than in the air of passageways adjacent to sculleries. Water
nine inches across the screening must be 1½ inch grid vapor in the air is increased by the evaporation of sweat
mesh. It should be evident that usually it will not be from the human body. Individuals performing heavy
possible to cool spaces to needed temperatures by ven- work in a warm to hot environment may lose as much as
tilation alone; although this is the general practice in 1.5 liter (1.6 quarts) per hour in evaporated sweat. More
engineering machinery spaces. sedentary personnel may lose 0.2 liters (200 ml., 0.2
quarts) of sweat per hour in hot spaces. Air-
3-6. Mechanical Cooling conditioning and dehumidification are the only effective
(1) Mechanical cooling and dehumidification of air is ways to sufficiently adjust the ambient moisture content
accomplished by passing incoming air over coils and fins of living and working spaces; cooling by ventilation
cooled with a suitabIe refrigerant. As the warm humid alone results in humidity that is always above that of
air circulates over the coils, it loses heat and the moisture outside air.
condenses on the fins. The conditioned air is then (2) Mechanical air supply and exhaust systems are
circulated through a ducting system to appropriate provided for most working and living spaces; the quan-
spaces and compartments. Cooling coils may be located tity for each should be balanced respectively within the
in an air supply duct with the refrigerating unit and fan major sections of a ship. Ventilation of spaces in which
placed remotely, or the entire apparatus may be assem- excessive heat or undesirable odors are produced (fire-
bled into a single unit. rooms, engine rooms, galleys, laundries, heads, etc.)
(2) Air-conditioning is frequently required in spaces requires a special design in order to provide a greater
containing precision instruments which are sensitive to volume of mechanical exhaust than supply (negative
extremes of temperature and humidity. Appropriate pressure); this maintains an induced air flow into the
filtering of air will assure air purity within tolerance compartment and prevents the spread of heat and odors
limits for equipments and personnel working in the to adjacent spaces. Compartments used for living, ber-
spaces. thing, etc., should be provided with a greater volume of
(3) Mechanical cooling is a current feature of the mechanical supply than exhaust (positive pressure) in
living areas and office spaces of combatant ships and order to maintain an induced air flow out of the space
most auxiliaries. Basic medical areas are air- and thus prevent the entrance of possibly contaminated
conditioned; this is done to improve the recovery of air from adjacent spaces.
patients, which takes precedence over the customary (3) Ventilation and air-conditioning designs for living
space and weight limitations aboard ships. compartments, recreation spaces, mess decks (excluding
(4) “Cold shock” may be produced when personnel serving lines), sick bay and inpatient wards, operating
pass from heated areas into air-conditioned spaces. rooms and intensive care spaces, administrative areas,
Individuals experience a rapid loss of body heat due to control, and all operating electronic spaces aboard
an increased evaporation of sweat from wet skin and surface vessels encountering the hot-weather outside
damp clothing. Chilly sensations and shivering are temperatures of 90 F DB and 81 F WB (design limits,
common manifestations. A corollary is seen in persons Article 3-5) or higher should favor conditions that
who move into outdoor heat from excessively cooled optimize recovery from heat stress and maximize perfor-
environments. Personnel in this situation experience mance in hot and subtropical climates. The upper
sudden dilation of superficial blood vessels and flush- thermal design limits within the above noted spaces
ing. “Cold shock” and its thermal counterpart may be should be 80 F DB, 68 F WB, 55% RH (14.3 Torr VP),
minimized by regulating air-conditioned spaces so that with 72 F WBGT (as ET). For comparable spaces
the differential temperature between those areas and aboard submarines the design limits should be slightly
heated or outdoor environments does not exceed 15 F lower in terms of moisture content of the air; 80 F DB,
DB. Medical personnel should be alert to the occurrence 67 F WB, 50% RH, with 71 F WBGT (as ET).
of these phenomena in individuals who work in the (4) A preferred WBGT temperature of 78 F applies to
daytime heat of natural environments or the high tem- prescribed hot-weather operational conditions in: laun-

3-6
3-7 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-7
dries, galleys, sculleries, passageways not open directly (6) Radiant heat control is essential relative to the
on weather decks, and food serving lines. However, the worker. In the design of shipboard spaces which have
upper thermal physiology shipboard heat stress design radiant heat sources it is necessary to insulate the
environments should not exceed that given in Table 3-1. radiating surfaces wherever possible. In those situations
Aboard submarines the overall demands within the where metal surfaces cannot be insulated, they should be
vessel should preclude the environmental conditions painted with a low emissivity paint (emissivity less than
reaching 78 F WBGT during normal operations. 0.4). Thermal insulation should have the lowest possible
(5) Fireroom and engine room spaces require a special thermal conductivity (k) value. The insulating material
application of the method of cooling spaces with outside should be well-fitted together, should be of proper
air. Frequently so much “wild heat” is produced and thickness for the source temperature, should be kept
uncontrolled that it is neither practical nor feasible to intact, and protected by metal sheathing where high
reduce the temperatures within the entire space to the traffic and abuse may occur. A reflective aluminized
point of maintaining high physiological efficiency with- outside surface of thermal insulation pads will reduce
out unique engineering techniques. Some ships have radiant heat transfer into the space. In all cases, thermal
control booths in the propulsion spaces, the recirculat- insulation should be kept dry to remain effective; which
ing air-conditioning units for these booths need to be requires that steam and water leaks must be eliminated.
designed to permit ready access for frequent cleaning. Merely reinsulating radiating surfaces without first cor-
Outside of the control booths, and aboard those ships recting the steam and water leaks leads to frequent
without control booths, personnel must have immediate replacement of insulation.
access to spot cooling. Spot cooling is effected by Commercial industry statistical data, from multiple
delivering outside air at high velocity via ventilation samplings, show that the lowest k values for given
ducts to the respective watchstander’s stations. By this densities of thermal insulation are achieved with ceramic
method a “cone” of air is provided to watchstanders, (refractory) fiber insulation, as compared with fiber-
even though the Effective Temperature outside the glass. Commercially available ceramic fiber at 8 pounds
“cone” of air is very high. per cubic foot density has a lower k value than fiberglass
Misconceptions have evolved regarding spot cool- insulation at 11 pounds per cubic foot density; where
ing, it has been widely believed: (1) that air velocities of both insulating materials are of equal thickness. The
2,000 fpm or more at a supply terminal provides optimal lower the k value results in lower surface temperature
spot cooling; (2) that increasing the volume of air flow and lower radiant heat transfer, furthermore, the ce-
through a fireroom or engine room will automatically
reduce the level of heat stress at watch stations; and, (3)
that in a very hot space the watch standers will be kept
cool by putting their heads up to or just inside a supply
terminal. In reality, the key element in spot cooling is not
high velocities of air flow at the supply terminal but an
optimal effective air velocity flowing over the worker.
This can be best accomplished by positioning the supply
terminal so as to assure a direct, unobstructed air stream
at an equitable distance from the individual.
Figure 3-2 illustrates the relationship of air flow
over workers versus the Percent Optimum Cooling
achieved by the air flow. It can be seen that approxi-
mately 72% optimum cooling is achieved at 250 fpm air
movement, 82% at 500 fpm, 90% at 750 fpm and 100%
at approximately 1500 fpm; air flows over the worker
which exceed 1500 fpm result in a rapid decrease in the
percent optimum cooling of the worker in a hot-humid
environment. The very high air velocities cause turbu-
lence and friction at exposed skin surfaces, which in
turn, leads to heating of the skin and drying of the eyes
and respiratory membranes. Unless the increased air
flow is needed for engineering purposes, it is unecono-
mical to increase the air flow six-fold (from 250 to 1500
fpm) to obtain the remaining 28% optimum cooling.
Furthermore, when air velocities over workers are 2,000
fpm or higher the percent optimum cooling will have
dropped to 36% or less. The reason that percent opti-
mum cooling is essentially O% at 47 fpm air flow is due
to the natural “chimney effect” associated with standing
man.
3-7 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-7
ramic fiber insulation is lighter by approximately 3 least 6 hours of uninterrupted sleep per 24 hours. The
pounds per cubic foot. Until recently, the use of ceramic thermal design limits given in Table 3-1 apply to acute
fiber insulation aboard Navy ships was only permitted at (short term) exposures only. No definitive information
temperatures above 850 F. Military Standards exists at this time relative to the physiological effects of
MIL-I-23 128 and MIL-STD-769 were revised, 1982 long term (repetitive exposures over a number of years)
and 1983 respectively, to permit use of ceramic fiber exposures in hot-humid shipboard spaces; however, one
insulation on machinery and piping surfaces below 850 can assume that repeatedly exceeding the physiological
F. At the present time, all airborne thermal insulation limits of man is not conducive to the long term physio-
materials should be considered as potentially health logical well-being of the worker. (See Article 3-12.(8)
hazardous. regarding exceeding the PHEL values)
(7) For many years the design of firerooms and engine (8) The need for keeping the ventilation systems clean
rooms was based on equipment failure due to overheat-
cannot be overemphasized. It has been estimated that a
ing and the potential of heat transfer of excessive heat to
adjacent compartments. It was believed that workers large naval vessel may take in as much as several tons of
could adapt or become “acclimatized” to the high levels dirt a day into its ventilation system. Most of this is
of heat. These concepts have been proven erroneous; the composed of fine, particulate matter which passes
limiting factor is the worker not the equipment. The through filters but accumulate within ducting in high
physiological capability of workers cannot be altered to moisture environments. A significant amount accumu-
tolerate excessively hot-humid and hot-dry shipboard lates on the filters, screens, heaters, fans and cooling
spaces, therefore, it is essential to design such spaces to coils and thus reduces the system’s capacity for deliver-
permit personnel to perform their watch standing and ing the rated quantity of air. In order to obtain the
equipment maintenance safely. Table 3-1 is the Thermal maximum ventilation from existing equipment, all ven-
Physiology Design Criteria based on advanced, inte- tilation equipment should be cleaned and maintained on
grated technology. Allowances must be made for suffi- an established schedule. Use of a single layer of “cheese-
cient thermal recovery periods in thermal conditions cloth” may be used such as in galleys and laundries
similar to that noted in Article 3-7(3). Even with the provided the cloth is changed frequently and dirt is not
exposure and recovery thermal design criteria given allowed to buildup. Maintenance of sufficient supply
herein, mental impairment of workers maybe detectable ventilation to control heat stress within a space should
after the first third of the respective exposure times. The be given priority over the use of “cheese-cloth” over
environmental conditions for recovery must permit at supply terminals.
Table 3-1. Summary of Thermal Physiology Heat Stress Design Conditions for Surface Vessels*
Thermal Values At Actual Work Sites*
SPACE/LEVEL Dry-Bulb Wet-Bulb Globe Effective
Velocity**
[F] [F] [F] [FPM]
PROPULSION SPACES: (NON-GAS TURBINE)
Upper Level 4 Hrs 107 86 115 250
6 Hrs 102 83 106 250
8 Hrs 98 79 105 250
Lower Level 4 Hrs 98 84 108 250
6 Hrs 92 81 100 250
8 Hrs 89 78 96 250
PROPULSION SPACES: (GAS TURBINE)
Upper Level 6 Hrs 98 85 100 250
8 Hrs 93 82 97 250
Lower Level 6 Hrs 97 83 100 250
8 Hrs 91 81 94 250
CATAPULT LAUNCH CONTROL ROOMS:
8 Hrs 92 80 97 250
LAUNDRIES: 4 Hrs 96 85 103 250
SCULLERIES: 3½ Hrs 92 83 94 250
GALLEYS:
Food Prep. Area 4 Hrs 86 72 92 150
Food Serving Area 3 Hrs 86 77 94 150

*During normal work, excluding emergency or casualty control work rates. Environmental design conditions apply in work areas
regardless of external ambient weather and sea water temperatures.

3-8
3-8 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9
3-8. General Considerations Ashore tuted; PHEL applies to safe physiological limits for
(1) Although the Navy has promulgated sound work exposures. PHEL applications are discussed in detail in
practices for hot environments in its preventive medicine Section IV of this chapter.
manuals for many years, they were directed primarily
toward military personnel As a result of the Navy’s Table 3-2. Recommended Threshold WBGT Values For
Occupational Safety and Health (NAVOSH) Program, it Instituting Sound Hot Weather Practices
is appropriate for the basic principles of heating, venti- Threshold 2-Hour
lation and cooling, contained in this chapter, to be Work Load Exposure WBGT
applied to both military and civilian workers ashore and (F)
afloat. Implementing sound hot weather practices
should be done in accordance with thermal conditions Light Work
given in Table 3-2. (time-weighted-mean metabolic
(2) The WBGT threshold values illustrated in Table rate of 82 KcaI*m -2*hr -1) 86
3-2 are needed for identification of heat stress levels at
which sound systemic heat injury preventive measures Moderate Work
should be instituted. They are based upon the hottest (time-weighted-mean metabolic
2-hour period of a day ashore. The various preventive rate of 104 Kcal*m-2*hr - 1) 82
measures are given in Section III. These threshold
2-hour exposure WBGT values must not be confused Heavy Work
with the Physiological Heat Exposure Limits (PHEL) (time-weighted-mean metabolic
that apply to the exposure limits of workers in hot rate of 125 Kcal*m -2 *hr-1) 77
environments. WBGT threshold values apply to situa-
tions where sound preventive measures must be insti-

Section III. PHYSIOLOGICAL PRINCIPLES


Article
Effects of Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Effects of Cold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10

3-9. Effects of Heat function of metabolism must occur, therefore, heat will
(1) General Effects. Heat stress and heat strain have be produced. Heat transfer by radiation (R), convection
both immediate and long-term effects on humans. The and conduction (C) between man and its environment
immediate effects are a significant loss of performance, may result in a positive or negative heat balance. For
efficiency and loss of duty time due to systemic heat injury. example, if the environment is cooler than man a
Generally, the long-term effects of heat stress and strain arc negative (toward the environment) heat balance will
not as apparent as the immediate effects. Prolonged expo- result. Conversely, when the environment is warmer
sure, however, is viewed as contributing to: than the subject, a positive heat balance (toward the
(a) Progressive loss of performance capability. subject) results. If uncompensated, this latter state
(b) Increased susceptibility to other forms of stress. results in excessive heat storage and leads to the various
(c) Reduced heat tolerance. physiological states we recognize as “heat strain”. Loss
(d) Potentially increased physical disability com- of body heat by evaporation (E) is the fourth means by
pensation. which man is able to maintain thermal equilibrium.
(2) Heat Balance Equation. In order to understand the Evaporation by sensitive and insensitive perspiration
interaction between man and a heat stress environment, results in cooling of the body surface. Evaporation does
it is necessary to examine the concept of the empirical not occur when the partial vapor pressure of water in the
“Heat Balance Equation;” which is given as: environment equals that of the body surface. Further, if
M ± R ± C – E =S the partial vapor pressure of water in the environment
where; M = metabolic rate or heat production of man exceeds that of the skin, environmental moisture con-
R = radiative heat gain to or loss from man denses on the skin with a resultant positive conductive
C = convective and conductive heat gain to or heat transfer by no evaporation. Evaporative heat loss
loss from man from the respiratory mucosal surfaces is minimal, rep-
E = evaporative cooling resenting perhaps only 2070 of the matabolic heat (M).
S = heat storage in man (3) Thermoregulatory Mechanisms. Body heat is reg-
Man’s internal heat (M) is produced by basic metabolic ulated by a complex interactions of physical environ-
function and heat of variable physical activity (work). In mental factors (temperature, humidity, air movement,
the “Heat Balance Equation” this factor (M) always radiant heat, etc.) and the physiologic and behavioral
results in a positive value; to be a living body the response of the subject. The skin surface is the primary

3-9
3-8 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9
3-8. General Considerations Ashore tuted; PHEL applies to safe physiological limits for
(1) Although the Navy has promulgated sound work exposures. PHEL applications are discussed in detail in
practices for hot environments in its preventive medicine Section IV of this chapter.
manuals for many years, they were directed primarily
toward military personnel As a result of the Navy’s Table 3-2. Recommended Threshold WBGT Values For
Occupational Safety and Health (NAVOSH) Program, it Instituting Sound Hot Weather Practices
is appropriate for the basic principles of heating, venti- Threshold 2-Hour
lation and cooling, contained in this chapter, to be Work Load Exposure WBGT
applied to both military and civilian workers ashore and (F)
afloat. Implementing sound hot weather practices
should be done in accordance with thermal conditions Light Work
given in Table 3-2. (time-weighted-mean metabolic
(2) The WBGT threshold values illustrated in Table rate of 82 KcaI*m -2*hr -1) 86
3-2 are needed for identification of heat stress levels at
which sound systemic heat injury preventive measures Moderate Work
should be instituted. They are based upon the hottest (time-weighted-mean metabolic
2-hour period of a day ashore. The various preventive rate of 104 Kcal*m-2*hr - 1) 82
measures are given in Section III. These threshold
2-hour exposure WBGT values must not be confused Heavy Work
with the Physiological Heat Exposure Limits (PHEL) (time-weighted-mean metabolic
that apply to the exposure limits of workers in hot rate of 125 Kcal*m -2 *hr-1) 77
environments. WBGT threshold values apply to situa-
tions where sound preventive measures must be insti-

Section III. PHYSIOLOGICAL PRINCIPLES


Article
Effects of Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Effects of Cold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10

3-9. Effects of Heat function of metabolism must occur, therefore, heat will
(1) General Effects. Heat stress and heat strain have be produced. Heat transfer by radiation (R), convection
both immediate and long-term effects on humans. The and conduction (C) between man and its environment
immediate effects are a significant loss of performance, may result in a positive or negative heat balance. For
efficiency and loss of duty time due to systemic heat injury. example, if the environment is cooler than man a
Generally, the long-term effects of heat stress and strain arc negative (toward the environment) heat balance will
not as apparent as the immediate effects. Prolonged expo- result. Conversely, when the environment is warmer
sure, however, is viewed as contributing to: than the subject, a positive heat balance (toward the
(a) Progressive loss of performance capability. subject) results. If uncompensated, this latter state
(b) Increased susceptibility to other forms of stress. results in excessive heat storage and leads to the various
(c) Reduced heat tolerance. physiological states we recognize as “heat strain”. Loss
(d) Potentially increased physical disability com- of body heat by evaporation (E) is the fourth means by
pensation. which man is able to maintain thermal equilibrium.
(2) Heat Balance Equation. In order to understand the Evaporation by sensitive and insensitive perspiration
interaction between man and a heat stress environment, results in cooling of the body surface. Evaporation does
it is necessary to examine the concept of the empirical not occur when the partial vapor pressure of water in the
“Heat Balance Equation;” which is given as: environment equals that of the body surface. Further, if
M ± R ± C – E =S the partial vapor pressure of water in the environment
where; M = metabolic rate or heat production of man exceeds that of the skin, environmental moisture con-
R = radiative heat gain to or loss from man denses on the skin with a resultant positive conductive
C = convective and conductive heat gain to or heat transfer by no evaporation. Evaporative heat loss
loss from man from the respiratory mucosal surfaces is minimal, rep-
E = evaporative cooling resenting perhaps only 2070 of the matabolic heat (M).
S = heat storage in man (3) Thermoregulatory Mechanisms. Body heat is reg-
Man’s internal heat (M) is produced by basic metabolic ulated by a complex interactions of physical environ-
function and heat of variable physical activity (work). In mental factors (temperature, humidity, air movement,
the “Heat Balance Equation” this factor (M) always radiant heat, etc.) and the physiologic and behavioral
results in a positive value; to be a living body the response of the subject. The skin surface is the primary

3-9
3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9
site of heat exchange between the body anti the sur- the findings of the Navy medical researchers were borne
rounding environment. Thermoregulation is mediated out by a research team in South Africa, who comprehen-
by circulatory (e.g., central and capillary blood flow), sively studied energy exchanges, body temperatures, sweat-
neural (e.g., hypothalamic, autonomic pathways), and ing, cardiovascular adjustments, body fluid adjustments,
biochemical (e.g., ionic and endocrine) functions involv- body weight deficits and circulating protein changes.
ing central or peripheral levels of response and by Clearly, there are 3 distinct stages of acclimatization, of
individual behavioral variants. If man is to compensate which the third stage begins after the seventh consecutive
for environmental heat stress, this intricate physiologic day of inducing heat acclimatization.
network must remain functionally intact. The degree Special consideration must be given to various
and reversibility of heat strain in any given case is other factors. Heat acclimatization is not applicable to
directly related to the duration and severity of the overall heat stress levels indicated in Table 3–2; thus,
disturbance of mechanisms for heat regulation. personnel working in areas such as firerooms, engine
(4) Failure of Thermoregulation. When temperature rooms, laundries and steam catapult launch control
balance mechanisms for the body fail, spiraling of body rooms should not be expected to adapt physiologically
temperature is initiated. Heat storage increases; skin and to their environment. In order to achieve maximum
deep-tissue temperatures rise; cardiovascular, respiratory benefits from acclimatization, it is extremely important
and metabolic functions accelerate; and, renal function that moderate (more than sedentary) work be performed
is depressed. Increased metabolic heat pushes the cycle during the adaptation process. Even fully acclimatized
faster to the point of cardiovascular and renal failure personnel are rendered more susceptible to heat injury in
and irreversible damage to the nervous system and the event of excessive fatigue; alcoholic intoxication;
muscular tissues. The cycle can be broken only by timely acute infectious disease; obesity; inadequate water, salt
and definitive therapy. or caloric balance; and the use of medications contain-
(5) Acclimatization. Physiologic response to heat ing belladonna alkaloids. The rate of achievement of
stress has been treated thus far as a rapidly occurring heat acclimatization is retarded by the use of commer-
process with decompensation resulting in relatively im- cially prepared electrolyte-type beverages as well as
mediate damage or in cumulative injury over a more supplementary sodium chloride (“salt”] in excess of 2
prolonged time period. Under more favorable thermal
conditions, the body can “acclimatize” or adapt to Table 3-3. Percent Optimum Heat Acclimatization on
environmental heat stress. Until 1971 it was accepted Consecutive Days of Heat-Work Exposures
that acclimatization to heat stress could be descriptively for Physically Trained Personnel
characterized by near normalization of heart rate and Percent Achievement On:
skin and rectal temperatures during 4 to 6 days of Physiologic Parameter
successive heat exposure. In addition, sweat production Day 1 Day 7 Day 14 Day 21
during adaptation was expected to increase to levels of 100
Rectal Temperature 6 38 72
1.5 or more liters per hour. In 1971 Navy medical
researchers indicated that these parameters were inade- Tympanic Membrane
quate to describe acclimatization accurately; the re- Temperature 6 37 71 100
search indicated the earlier studies were premature in the Deep Esophageal
assessment of heat acclimatization on consecutive days, Temperature 51 82 93 100
as a number of other physiological parameters had not
reached an adapted state. Using both untrained and Mean Skin Temperature 80 93 98 100
trained test subjects, the studies extended exposures out
to 90 days. It was learned that heat acclimatization was Heart Rate 8 37 67 100
only 78% complete after 14 consecutive days of work in Systolic Blood Pressure 11 38 56 100
hot-humid heat. Diastolic Blood Pressure 7 36 70 100
Application of advanced criteria for optimum heat Pulse Pressure 9 36 63 100
acclimatization revealed, when personnel were previ- Mean Arterial Blood
ously trained to perform moderate physical work with- Pressure 4 35 79 100
out physiological strain in a thermally neutral environ-
Est. Total Vascular
ment, that various body systems adapt at different rates. 100
Resistance 8 37 70
Table 3-3 illustrates the percent achievement of opti-
mum heat acclimatization for 13 physiological parame- Est. Cardiovascular
ters at 4 time intervals of consecutive days exposure Reserve 7 36 69 100
while performing moderate physical work. Overall opti-
mum heat acclimatization to hot-humid conditions of 95 Sweat Rate 3 37 76 100
F DB, 88 F WB and air movement of 100 fpm was
achieved in 22 consecutive days of heat-work exposures. Urine Osmolality 3 39 82 98
As can be seen in Figure 3-3, the rationale prior to Overall Percent
1971 overestimated how much heat acclimatization could Achievement 13 45 78 99.6
be achieved in time periods as short as one week. In 1976

3-10
3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9
Figure 3-3.—Heat Acclimatization (Comparison of Methods).
3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9
grams per day, this is discussed in more detail in this elevated temperature. Muscular soreness (myalgia), a
section. Finally, a degree of stable acclimatization at any normal finding following heat cramps, must be differ-
one level of heat stress does not guarantee full acclima- entiated from that occurring in association with rhab-
tization to a higher level of heat stress. domyolysis which is associated with necrosis of muscle
(6) Heat Illnesses. There are various reasons why tissue. Whereas salt depletion appears to be instrumen-
military populations are more prone to heat disorders. tal in the evolution of heat cramps, “salt loading” may
The constant influx of unseasoned and unacclimatized be contributory in the pathogenesis of rhabdomyolysis.
personnel into recruit training creates a potential for an Therefore, until definitive evidence is available, “salt
increased incidence of heat illnesses. Following recruit loading” should be avoided in the prevention and ther-
training, exposure to a variety of environmental stresses apy of heat cramps.
can be expected, with little opportunity for prior adap- (c) Heat Exhaustion
tation. In combat situations, with mass movements of (1) Heat exhaustion occurs as the result of pe-
military units to tropical and desert climates, well ripheral vascular collapse due to excessive dehydration
trained personnel may be exposed to a higher level of and salt depletion, however, the usual case involves
heat stress. A common-sense preventive measure pro- dehydration and over-exertion during physical work.
gram, emphasizing moderate physical activity and gen- The syndrome is characterized by profuse sweating,
eral health maintenance, will lead to the early adapta- headache, tingling sensations in extremities, pallor,
tion of physically fit personnel to the more stressful dyspnea, palpitations associated with gastrointestinal
environment. Heat disorders have a world-wide distri- symptoms of anorexia, and, occasionally nausea and
bution and may even occur in cold climates where vomiting. Neuromuscular disturbances with trembling,
metabolic heat production exceeds an individual’s adap- weakness, and incoordination coupled with cerebral
tive abilities. They may, in severe cases, be accompanied signs ranging from slight clouding of the sensorium to
by changes in serum electrolytes (hyponatremia, hypoch- actual loss of consciousness complete the picture. Heat
loremia, acidosis, hyperkalemia), urinary electrolyte cramps may be present. Physical examination reveals a
concentrations (decreased sodium and chloride excre- mild to severe peripheral circulatory collapse with a pale,
tion, increased loss of potassium and hydrogen ions), moist, cool skin and a rapid (120-200 beats per minute
proteinuria, increased consumption of protein, and coa- at rest), thready pulse. Systolic blood pressure will
gulopathy (disseminated intravascular coagulation generally have been quite elevated (180 mm Hg or higher
defects). Acute overheating may thus lead to numerous during work) prior to the onset of the illness, followed
heat related illnesses. In order to describe expeditiously by a rapid drop while work continued, and within
these diseases and their management, they have been normal range by the time of examination; however, the
consolidated into 4 basic categories, excluding local heat wide pulse pressure during work will usually be de-
injury due to burns: (1) heat rash, (2) heat cramps, (3) creased at the time of physical examination. The oral
heat exhaustion (including anhidrosis, salt-deficiency, temperature may be subnormal (as in the case of hyper-
water-deficiency, exercise-related heat exhaustion and ventilation being present) or slightly elevated. It is not
heat syncope, and (4) heat stroke (including uncommon to find rectal temperatures of heat exhaus-
hyperpyrexia). tion patients between 101-104 F, dependent upon the
(a) Heat Rash. The clinical picture of heat rash type and duration of physical activity prior to the overt
(miliaria rubra) is too well-known to require description. illness.
It is prevalent among military populations living in hot (2) Heat exhaustion is an accepted clinical diag-
climates or working in hot spaces ashore or aboard ship. nosis and, as a classification of heat disorder, it consti-
It interferes with sleep, resulting in decreased efficiency tutes the majority of reported cases of heat illnesses.
and cumulative fatigue, and thus, predisposes the indi- However, from the standpoint of pathogenesis, heat
vidual to heat exhaustion. Heat rash impairs sweating exhaustion is not one but several entities. Exhaustion or
and decreases evaporative cooling on the skin surface; it collapse in the heat can occur from physical work alone,
may, therefore, favor the evolution of heat stroke. even in the absence of dehydration or salt deficiency.
(b) Heat Cramps. Heat cramps may occur as an Nevertheless, in some cases, more frequently in unaccli-
isolated syndrome with normal body temperature or in matized personnel, water or salt deficiency is present to
conjunction with heat exhaustion. They are precipitated some degree and may be primarily responsible for the
by the replacement of body water losses without concur- clinical picture. Once again the problem of body salt
rent replacement of sodium chloride deficits. Heavily content arises. Figure 3-4 illustrates numerous interact-
sweating individuals drinking large volumes of water ing factors predisposing heat cramps, heat exhaustion,
with insufficient salt replacement are particularly at heat stroke and rhabdomyolysis (noted under “Heat
risk. Heat cramps may be localized or generalized with Cramps”). Unless salt deficiency has been clearly dem-
recently stressed muscle groups, particularly those of the onstrated by laboratory analysis of serum or urine, one
extremities and abdominal wall are most frequently should be suspicious of salt loading if a reasonably
involved. Minimal serum and urinary electrolyte normal diet has been maintained and supplementary salt
changes, as well as hemoconcentration, may be observed has been taken indiscriminately. Prior to 1972 there were
but should not be expected. Clinically the patient usu- numerous reports indicating heat exhaustion patients
ally exhibits moist, cool skin and normal or slightly having consumed between 6-24 salt tablets per 24 hours,

3-11
3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9

even when eating a well balanced diet. Since 1972 the eral vessels. The disparity between vascular capacity and
Navy Medical Department placed use of salt tablets on circulating blood volume leads to cerebral ischemia.
a controlled basis, the high consumption of sodium Vagotonia may be a contributing factor.
chloride has been primarily limited to eating field (4) Anhidrotic Heat Exhaustion maybe the result
rations without sufficient water intake (See “Salt and of a preexisting dermatologic lesion (usually heat rash or
Water Intake” in Article (8)(b)(2) of this Section). All sunburn) which interferes with sweat secretion. Person-
patients suffering an episode of severe heat exhaustion nel may not be aware of progressive heat intolerance
should be assigned light duty for 24-48 hours following associated with impairment or absence of sweating. Salt
their initial recovery. Should a patient experience addi- and water deficiencies are not prominent in this form of
tional bouts of heat exhaustion, a careful review of the heat illness. Clinical examination reveals a warm, dry
medical history and working situation should be under- skin and an elevated deep body temperature, sometimes
taken and corrective actions instituted. Strong considera- as high as 104–106 F. Exhaustion is present, but distur-
tion should be given to personnel being more suscep- bance of consciousness is uncommon in the early stages
tible to recurrence of heat exhaustion or possibly heat of the disorder. Some individuals with the disorder may
stroke. Recurrence of serious disorders are usually more develop true heat stroke.
severe than the preceding bout. It is believed that the (5) When prompt first-aid is available, the mor-
susceptibility lasts, which requires affected personnel to tality rate from heat exhaustion syndromes is extremely
be reintroduced into the work situations in gradual steps low. As a rule, removal of the victim from a hot
to determine their safe limitations. Documentation of environment to a cool area, rest and fluid replacement
the heat illness should be included in the individual’s when indicated will satisfy the needs of all but the most
health record, details should be provided to guide fol- severe cases of this disorder.
lowups or a clear history for future reviews. (d) Heat Stroke — HEAT STROKE IS A MEDICAL
(3) Heat Syncope is a familiar form of heat EMERGENCY and is associated with a potentially high
illness, not related to salt or water deficiency or to mortality rate. Whereas heat exhaustion may be re-
excessive physical work. This type of heat illness is garded as the end result of overactive heat-balance
typically seen in troops standing in parade formation in mechanisms which are still functioning, heat stroke
hot outdoor climates. It is the result of pooling of blood results when thermoregulatory mechanisms are not
in dependent parts of the body and dilation of periph- functional, and the main avenue of heat loss (evapora-
tion of sweat) is blocked. There may be prodromal
PATHOGENESIS OF COMPLICATIONS symptoms of headache, malaise and excessive warmth,
or a general picture of heat exhaustion. The onset is
OF usually abrupt with sudden loss of consciousness, con-
EXCESSIVE PHYSICAL EXERCISE vulsions, or delirium. Sweating may or may not be
absent in the typical case. Inquiry may reveal that the
cessation of sweating was noted by the patient prior to
onset of the other symptoms, however, with marked
central nervous system (CNS) involvement (e. g., uncon-
sciousness) this information usually comes too late.
Since water intake may continue in the absence or
reduction of sweating, overhydration rather than dehy-
dration may occur. This is manifested by diuresis which
is an added signal of impending disaster. During the
early stages of this condition, after the body temperature
has risen, the patient may exhibit euphoria. On physical
examination the skin is hot, flushed and dry; in severe
cases petechiae may be present. Deep body temperature
is high, frequently in excess of 106 F. A rectal tempera-
ture exceeding 108 F is not uncommon and indicates a
poor prognosis. The pulse is full and rapid, while the
systolic blood pressure may be normal or elevated and
the diastolic pressure may be markedly depressed (60
mm Hg or lower). Respirations are rapid and deep and
simulate Kussmaul breathing. As the patient’s condition
worsens, cyanosis is usually noted together with a pe-
ripheral vascular collapse manifested by a rapid pulse
and hypotension. The breathing becomes shallow and
irregular. Pulmonary edema, incontinence, vomiting,
hemorrhagic tendencies, disturbance of muscle tone,
myocardial necrosis, menigismus, opisthotonos, jaun-
Figure 3-4. dice, albuminuria, thrombocytopenia and prolongation

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3-9 MANUAL OF NAVAL. PREVENTIVE MEDICINE 3-9

of the prothrombin time may occur. Renal failure with perpyrexia, the greater is the threat to life; the hyper-
rapidly developing hyperkalemia and azotemia is not thermia accelerates metabolic heat production, causing
uncommon. Death may ensue very rapidly, but if the the body temperature to spiral upward at an ever-
patient survives until the second day, recovery chances increasing rate. In the field, the patient’s clothing should
improve. Rectal temperatures of 102-103 F may persist be removed, except for underwear. If there is a source of
for several days during which time mental disturbances, cool water nearby, the patient should be immersed in
excitement and delirium may continue or recur. Head- it—otherwise water should be sprinkled over the patient
ache may persist for several weeks after the attack. In the and its evaporation hastened by fanning. In addition to
first few days after the temperature has been reduced these cooling measures, attendants should rub the vic-
from a critical level severe relapses may occur. The tim’s extremities and trunk briskly to increase the circu-
patient should, therefore, be observed carefully during lation to the skin. Arrangements should be made for the
this period and rectal temperatures should be recorded immediate removal of the individual to a hospital or
frequently. Treatment, as outlined below, should be properly equipped treatment facility; cooling measures
started again at the first indication of relapse. It is also should be continued during the transfer. Upon reaching
important to emphasize that the heat regulating centers the medical facility, the patient should be placed in a tub
may be extremely labile for many weeks after an attack. of water and ice. W bile in the ice-water the extremities
One attack of heat stroke predisposes to a second attack, should be massaged continuously as noted above. When
and care should be taken by the individual to avoid a the rectal temperature drops to between 100-101 F, the
second exposure to the precipitating condition. An victim may be removed to a hospital bed. The rectal
alternative view is that the individual is a member of a temperature should be monitored every 10 minutes until
susceptible population and remains susceptible. Careful stable. Within the first few days of hospital treatment
documentation of all factors associated with the occur- there should be careful observation for a relapse; the
rence and treatment of this illness are essential. patient may readily become hyperthermic or hypother-
(7) Treatment of Heat Casualties mic. It is desirable to maintain the rectal temperature
(a) Heat rash is best treated by keeping the skin dry between 100-101 F. Rapidly increasing temperatures can
for part of the day at least. Cooled sleeping quarters will usually be managed with ice water sponge baths and
remedy the situation and permit personnel to work in fanning; precipitous drops in temperature may require
hot-humid conditions without developing heat rash. the judicious use of warm blankets. Shivering, involun-
Calamine lotion may be useful under appropriate envi- tary muscular activity, is undesirable because it accen-
ronmental conditions. When the environment or physi- tuates tissue hypoxia and lactic acid acidosis. Again, the
ological climate does not permit the skin to remain dry patient’s rectal temperature should be monitored every
for more than a few minutes a day, calamine liniment 10 minutes during a hyperthermic or hypothermic
may offer some relief. condition.
(b) Heat cramps are initially treated by relieving the (2) Drugs:
severe pain and evaluating serum/urine chemistries for (a) Sedative Drugs. Sedative drugs should be
evidence of salt depletion. If such a deficiency exists, the avoided if possible since by their depressive effect they
administration of O. 1% or physiologic saline solution by may disturb central thermoregulatory centers. Restless-
mouth or physiological saline intravenously may be ness can usually be controlled with gentle restraint.
indicated. Care should be taken not to give excessive Sedatives are indicated in the treatment of convulsions.
amounts. If a longer acting drug is needed, pentobarbital should
(c) Heat exhaustion generally requires only rest in a be administered intramuscularly. Sodium amytal and
cool place and adequate water intake. As in the case of morphine are contraindicated.
heat cramps, saline solutions are indicated only when (b) Other Drugs. Atropine or other drugs
salt depletion has been documented in the laboratory. which may interfere with sweating are contraindicated.
When physical exertion preceded the onset of heat Ephinephrine and other adrenergic drugs should not be
exhaustion, and a salt deficiency exists, the judicious used. However, when hypotension occurs accompanied
intravenous administration of physiologic saline or 5% by low cardiac output (elevated central venous pressure,
glucose and saline may accelerate recovery. Recovery is congestive heart failure) isoproterenol (or dopamine)
usually prompt, but immediate return to duty is inad- can be effective in improving cardiovascular dynamics.
visable except in the mildest cases. Intravenous administration of mannitol to induce os-
(d) Anhidrotic heat exhaustion must be treated as if motic diuresis may be useful where renal tubular necro-
it is heat stroke. Prompt intervention is essential. Until sis is suspected. The use of aspirin, or like medications,
the normal skin function can be restored the patient is not indicated, since there is no evidence that it will
should not return to the environmental situation which lower body temperature in the noninfectious state. Small
precipitated the illness. doses of diazepam (Valium— 10 mg) may be adminis-
(e) Heat stroke is a MEDICAL EMERGENCY. tered intravenously to control convulsions as needed.
Treatment principles are outlined below: (3) Intravenous Fluids. Parenteral administration
(1) Restore Normal Temperature. The body tem- of physiological saline solution in moderate amounts
perature must be lowered promptly to safe levels (rectal (1,000-1,500 cc.) may be indicated. However, extreme
temperature 100-101 F). The more prolonged the hy- caution must be exercised if a hyperthermic state exists;

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3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9

in a hyperthermic state the patient may appear hypovo- wicking characteristics, or by use of loose-fitting cover-
lemic but would be normovolemic in a normothermic alls through which cool air is circulated. The latter also
state. Subsequent fluid administration must be deter- requires an unrestrictive air supply which provides clean,
mined by hourly urinary output and serum electrolyte filtered breathing air. The temperature of air striking a
determinations. Plasma volume expanders should be worker within the spot cooling cone should not be less
administered with caution if there is evidence of shock, than 80 F; for continuous exposure the velocity should
especially if the patient is reasonably normothermic; a be approximately 250 fpm (See Article 3-7). Short
rapid pulse, of small volume, is an indication for exposures to higher velocities, below those associated
considering their use. Care should be taken in the with skin friction (about 1500 fmp), are sometimes
administration of parenteral fluids if there are signs of beneficial in partially offsetting the presence of low
pulmonary congestion or rising central venous pressure. levels of radiant heat. Workers can adjust their exposure
Close observation of the patient for renal failure is by moving in and out of the spot cooling cone. Flexible
necessary. Rapidly developing hyperkalemia and azote- ducts provide a means to regulate the location of spot
mia necessitates hemodialysis or peritoneal dialysis. cooling, thus avoiding excessive chilling of the head,
(4) Venesection. Venesection is ineffective in shoulders and back. Engineering practice, however,
treating the pulmonary edema which occurs with heat should include proper positioning of supply terminals so
stroke. that maximal effective air velocities may be obtained.
(5) Oxygen. Oxygen may be desirable to combat (2) Control of radiant heat is essential, in terms
tissue anoxia. Oxygen should be administered by face of economy in operating the systems as well as the
mask or nasal catheter if cynosis or pulmonary conges- well-being of personnel. As indicated in Article 3-7(6),
tion is present. The use of a nasal catheter rather than a thermal insulation should be well-fitted, no gaps, should
face mask is recommended if the patient has been be of proper thickness for the source temperature,
vomiting, because of the danger of aspiration from the should be kept intact and protected by metal sheathing
face mask. where high traffic of abuse may occur. Furthermore,
(6) Other Complications. Spontaneous hemor- multiple layers of paint reduce the effectiveness of
rhage may occur as the result of hypofibrinogenemia or thermal insulation in controlling radiant heat. Snow
consumptive coagulopathy. Renal failure, pulmonary white paint has an emissivity of approximately 0.9,
congestion and cerebral edema may complicate the whereas some highly buffed or polished stainless steels
clinical course. Details of therapy are beyond the scope (e.g., Type 18-8, Allegheny metal No. 4 or No. 66) have
of this manual. Readers are referred to current texts and emissivities from 0.11-0.16. The lower the emissivity of
technical papers on this subject. the outer covering the better the control of radiant heat.
(7) Disposition. All episodes of heat stroke However, it must be noted that applying thermal insu-
should be fully documented and made a part of the lation over a low emissivity surface (e.g., pipes painted
patient’s permanent medical record. Evidence suggests with low emissivity paint) does not effectively control
that serious physiologic damage may persist long after radiant heat transfer from the insulation surface. The
apparent recovery from heat stroke. Heat stroke victims exposed surface emissivity is the important aspect of
may thus be more susceptible to recurrent episodes of radiant heat transfer. On bare, uninsulated metal the
heat illness under less intense conditions. Heat stroke application of low emissivity paints (with emissivities of
victims never be returned to heat stress similar to that 0.4 or less) will assist in controlling radiant heat transfer
which precipitated the illness without the approval of an to the space. Since the Navy undertook major replace-
appropriate medical authority (Medical Board). A per- ment of asbestos thermal insulation with soft (fibrous)
sonnel heat injury report (“Heat/Cold Injury Report”, fiberglass there were many complaints that radiant heat
NAVMED 6500/1) should be submitted to Commander, increased abroad ships. Part of the problem is associated
Naval Medical Command, Attention MED 22, Depart- with the quality of workmanship, but one cannot over-
ment of the Navy, Washington, D. C., 20372. look the thermal conductivity (k) factors, densities and
(8) Prevention of Heat Injuries thicknesses of fiberglass replacement material. The
(a) Engineering Control: lower the k factor of thermal insulation the better the
(1) Engineering measures begin with adequate control of radiant heat. Ceramic has a lower k factor at
isolation or insulation of the principal sources of heat 8 pounds per cubic foot density than the fiberglass at 11
and humidity. Sound engineering practice should be pounds per cubic foot density. Therefore, given equal
maximum reduction of steam and water leaks, proper thicknesses of ceramic (“refractory”) fiber insulation
ventilation and maximum control of radiant heat. In and fiberglass, the ceramic fiber insulation is superior in
some situations the source should be completely en- controlling radiant heat. It is essential that the quality of
closed and connected to an exhaust. Special industrial all thermal insulation materials must be checked to
settings may not permit the general atmosphere to be ensure that specific characteristics of the materials are
cooled by ventilation or mechanical means, therefore, actually received to meet system design criteria. When
isolation of the workers from the sources of heat must be extreme radiant heat is present, personnel should be
practiced. When only a few workers are exposed in a protected by use of reflective devices (e.g., clothing or
large space, control can be accomplished by spot cooling screens) and protection of hands, face and eyes. Also
and use of clothing which is unstarched and has good whenever personnel handle asbestos, fiberglass or ce-

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3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9

ramic insulation materials, they should be protected; in for many years was that large quantities of salt were
particular their respiratory systems should be protected. being lost in the sweat and that the body was unable to
Asbestos and fiberglass have been proven to be delite- manage physiologic conservation of salt. Thus, it had
rious to the health of human, and recently ceramic fibers been widely assumed that large quantities of supplemen-
have been shown to be deleterious to the health of tary salt were necessary, and that excessive amounts
animals. would be excreted without harmful effects. Unfortu-
(3) In very special situations the use of vortex nately, many deleterious side effects were ignored for
cooling garments may be used, but the objective liabil- years. The potential relationship of rhabdomyolysis and
ities may outweigh the subjective false sense of well- excessive sale loading (Figure 3-4) lead to extensive
being which they impart; furthermore, as in the case of investigation of the relative value of supplementary
compressed air cooling, the air must be free of all sodium chloride intake by healthy young men (ages
possible contaminants (e.g., same quality standard of 19-3 1) during training and heat acclimatization. It was
air used for diving). Other important preventive mea- determined that:
sures include an adequate number of showers for the (1) The current estimated “normal” dietary
workers, clean rooms for changing into dry clothes after intake of sodium chloride in the general United States
work and a thermal environment with the design char- population is approximately 15 gms daily. This estimate
acteristics noted in Articles 3-7(3), 3-13(6) and 3-13(7). includes the common practice of salt shaker supplemen-
(b) Medical Measures. Engineering methods are not tation prior to tasting of served food.
always effective and often must be supplemented or (2) Field rations contain a variable amount
preceded by medical measures. In physiologically com- of sodium chloride, dependent upon the Federal Stock
pensable environments, performance in the heat can be Number and the manufacture dates. Individual Combat
improved greatly by proper selection and acclimatization Meals (FSN 8970-577-4513) manufactured prior to 1975
of workers. In all hot environments, improved perfor- contain 22.1 gms of salt for those eating 3 meals per day,
mance can be achieved by controlling fatigue, nutrition without using the salt packets. Individual Combat Meals
and alcoholic usage, and by periodic examination for of the same stock number but manufactured as of 1975
underlying illness and the early symptoms of heat strain. contain 9.0 gms of sodium chloride for three meals per
The reasons for different persons developing different day, without using the salt packets. Long Range Patrol
forms of heat illness are not clear. Until such informa- Food Packets (FSN 8970-926-9222) contain 25.5 gms of
tion becomes available, every effort should be made to sodium chloride, without using the salt packets. Indi-
relieve excessive stress on each individual’s heat regulat- vidual Ready-to-Eat Meals, replacing the Individual
ing mechanism. The following measures will assist in Combat Meals noted above, contain 19.9 gms of sodium
reducing systemic heat injuries: chloride, without using salt packets. Each sodium chlo-
(1) Acclimatization. Heat acclimatization applies ride (salt) packet contains 4 gms of salt, and up to 3
to those environments which permit physiological com- packets are provided per day. Therefore, it is possible to
pensation such as outdoors, or in those indoors situa- have an intake of 37.5 gms of NaCl per day. The high
tions which are not excessively hot; for excessively hot salt content of field rations is basically to preserve the
indoors environments see Article 3-9(8)(b)(6). Heat food for a longer storage life.
acclimatization can only be acquired satisfactorily by (3) An individual’s greatest need would oc-
working in a compensable hot environment over a cur during the combined stresses of initial physical
period of time (See Article 3-9(5)). Rapid acclimatiza- training and heat acclimatization in a hot-humid envi-
tion in raw recruits is impossible except under close ronment without water restriction. However, judicious
medical supervision; even then, it may be difficult to use of sodium chloride is recommended.
avoid some heat casualties. A “break-in” period of (4) The field grade salt tablets are 10 grain
about two weeks, with progressive degrees of heat (0.648 gins; 0.255 gms of sodium and 0.393 gms of
exposure and physical exertion will minimize the number chloride) each.
of systemic heat injuries and improve productivity over (c) The investigative results to date suggest that
a longer time period. the free use of supplementary sodium chloride or salt
(2) Salt and Water Intake. (Medical personnel tablets is contraindicated under most conditions of heat
will find detailed information on salt and water require- stress. Proper sodium chloride level can be achieved by
ments in NAVMEDCOMINST 6260.6 series. ) providing adequate water a normal diet and a salt
(a) Indoctrination of supervisory personnel in shaker on the table for conservative use, with no more
recognizing the need for liberal allowance of water will than the equivalent of 2.0 gms of supplementary salt
help abolish the false notion that men can be trained to (preferably not salt tablets) per day. Deviations from
resist dehydration. “Water discipline” must be replaced these recommendations must be governed by the past
with the doctrine of “water freedom” in which drinking and present medical histories of individual workers and
moderate amounts of cooled water at frequent intervals adjusted according to individual need by the Medical
is encouraged. Department representative. There is clear evidence that
(b) Maintenance of a proper salt content is of use of commercially prepared electrolyte-type beverages
greatest importance, particularly to individuals in the reduce physiologic performance. Furthermore, supple-
early stages of heat acclimatization. The rationale used mentary sodium chloride produces a 20% reduction of

3-15
3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-9
the optimal work capacity of personnel in the heat, symptoms of excessive heat strain and impending heat
reduces the rate of achievement of optimal heat accli- stroke and heat exhaustion in these men.
matization and alters cardiac function. There are numer- (4) Clothing. Clothing should be worn loosely at
ous deleterious physiologic changes which increase the the neck, and at the cuffs of sleeves, and at the bottom
risk of incurring heat illnesses when more than 2 gms of of trousers to facilitate convective cooling. Some syn-
supplementary sodium chloride is ingested per day in thetic clothing materials interfere with evaporative cool-
hot environments. Use of supplementary sodium chlo- ing, although they may subjectively feel cooler. Poplin
ride must be based upon the medical history and current or other high natural fiber content clothes have good
physical status of each individual. “wicking” characteristics and are superior materials for
(d) Water intake requirements are a function of evaporative cooling. Navy dungarees are made from a
work performed, the level of heat stress and the amount mixed fabric, 35% cotton and 65% synthetic fiber,
of salt consumed. Figure 3-5 shows the relationship of which does not seriously interfere with evaporative
liters of water intake required as a function of heat cooling. Physiological heat transfer comparisons have
been made between Navy 100 percent cotton fire retar-
stress, physical work and a “normal diet” sodium dant coveralls (e.g., those used outside of engineering
chloride intake of 15.0 gms per day. Figure 3-6 shows spaces) and mixed synthetic (5% Kevlar and 95% No-
the same relationships but for 25.5 gms of sodium mex, known as “Aramid” and MIL-C–87093) fire retar-
chloride per day with the Long Range Patrol Food dant coveralls (e.g., engineering coveralls); no objective
Packet (FSN 8970-926-9222). In both Figures, no sup- differences were found although personnel thought the
plementary salt (salt packets) have been taken into mixed synthetic fiber coveralls were hotter. When the
account. The water requirements in both Figures need to given mixed synthetic fiber coveralls were worn over
be increased by 1 liter per day for every 6 gms of sodium underwear, like that with dungarees, there was no sig-
chloride (e.g., 2 liters per day for 3 salt packets (12 gms nificant thermal difference between wearing the cover-
of NaCl) per day in field rations). alls or dungarees. Physiological Heat Exposure Limit
(3) Special Programs. A program of special train- (PHEL) values do not need to be adjusted provided the
ing schedules for obese personnel and other groups coveralls are worn only over underwear. However, wear-
suspected of heat susceptibility will reduce systemic heat ing either of the Navy coveralls over dungarees and
injuries. Training supervisory and administrative per- underwear results in imposing a major heat load upon
sonnel should be taught to recognize the signs and the body due to added insulation and weight; obviously

Figure 3-5. Figure 3-6.

3-16
3-9 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-10
this is a serious problem in the case of personnel being 3-10. Effects of Cold
protected in damage control situations, but one must (1) The adverse effects of low environmental temper-
consider the added protection from fires. It is strongly atures on the human body may be localized or general-
recommended that coveralls not be worn over dungarees ized, or a combination of both. They may occur at
during damage or casualty control drills in hot and/or temperatures above or below freezing and under wet or
unventilated spaces, as this may readily induce heat dry conditions. The pathophysiologic features of cold
exhaustion and heat stroke. Starch must not be utilized injury are dependent on the environmental temperature,
where evaporative cooling from clothing is a major exposure time and individual susceptibility or resistance.
factor. Outdoors, helmet liners or headgear of similar One form of adverse cold response has already been
design provide more cooling and protection of the head discussed under “cold shock” in Section 11, Article
than caps. 3-6(4).
(5) Field Training Exercises. Training exercises (2) General Physiologic Effects of Acute Cold Expo-
requiring sustained or severe physical effort, and those sure. The physiologic response to total body cooling is
conducted in the prone position should be scheduled, manifested by the conservation of thermal energy and an
when possible, in early morning or at night. Outdoor increase in heat production. With prolonged or severe
classes should be conducted in the shade with adequate exposure, the defense mechanisms fail, heat loss exceeds
exposure to cooling wind. Even when training exercises heat production, and the body temperature falls. During
are performed in early morning or at night, high meta- the initial response to cold exposure, stimulation of the
bolic heat production by those performing physical sympathetic nervous system causes a reflex superficial
activity can induce heat exhaustion or heat stroke. One vasoconstriction with shunting of blood to the internal
must, therefore, continue to be aware of all factors that organs. This is accompanied by reflex shivering which
may precipitate systemic heat injuries. increases muscular activity, heat production and oxygen
(6) Excessive Heat Stress. When environmental consumption. Constriction of cutaneous capillary beds
heat stress exceeds levels specified in Section IV, heat is manifested by pallor, mottling or cyanosis of the skin;
illness can be prevented by curtailing or suspending in hypersensitive individuals histamine release may cause
non-essential physical training and undue heat stress urticaria. In responding to stress the body secretes
exposure. Obviously, operational mission requirements, epinephrine which accelerates the cardiac rate, increases
excluding training programs, may preclude application blood pressure and mobilizes liver glycogen stores.
of pertinent heat stress guides; in such cases the Medical Blood coagulability is increased and pooling of water in
Department must be forewarned in order to adequately the extravascular spaces (skin, muscle, subcutaneous
prepare facilities and staff for the anticipated increased tissues) results in hemoconcentration. Sudden exposure
number of heat illnesses. Mental and physical dysfunc- to extreme cold causes reflex muscle spasm and respira-
tion under thermal stress may be expected to amplify the tory arrest. More gradual cooling eventually causes
frequency of accidental injury. unconsciousness (88-89 F rectal) and is accompanied by
(7) Other Medical Measures. Other medical mea- slowing of respiration and heart rate, and falling of the
sures which will minimize the incidence of heat illnesses blood pressure. Although some individuals have sur-
should be considered. Adequate recovery from acute or vived rectal temperatures as low as 72 F, ventricular
cumulative fatigue (at least 6 hours of uninterrupted arrhythmias (fibrillation) and cardiac arrest may be
sleep per 24 hours in a comfortable thermal environ- expected when rectal temperature falls below 80 F. In
ment), optimal physical fitness for the work to be done, persons exposed to rain, snow, wind and cold, the onset
absence of intercurrent illnesses, absence of febrile of hypothermia may be insidious. The first warning may
reactions (e. g., elevated body temperature due to immu- come with violent shivering, marked fatigue, stubbor-
nizations), and absence of or minimal susceptibility to nest and hallucinations as the body temperature drops
heat illnesses will aid in increased productivity of work- below 91-95 F. Unconsciousness and cardiorespiratory
ers and help safe-guard their well being. Use of Navy arrest may rapidly follow unless resuscitative efforts are
educational films is strongly recommended (See Article begun immediately.
3-9(9) below). (3) Chronic Effects of Cold Exposure. It has been
(9) Educational Films. Navy educational films are suggested that recurrent exposure to cold and to changes
available relative to the effects of heat stress, physical in environmental temperature may lower individual re-
work, water requirements, sodium chloride intake and sistance to infectious disease. Research in this area is
predisposing factors relative to heat disorders. The “all incomplete; therefore, definitive conclusions cannot be
hands” film, “Heat Stress Monster” (35025-DN), is an stated.
animated film portrayal of multiple aspects of heat (4) Characteristics of Localized Cold Injury:
stress both ashore and afloat. On the other hand, “If (a) Nonfreezing Injury. Non-freezing injuries occur
You Can’t Stand The Heat . . .” (35026-DN) is a at ambient temperatures above 32 F, but below 50 F, and
counterpart film for supervisory level personnel afloat. are most frequently manifested as chilblain (pernio) and
Many of the informational aspects of this Chapter are cold water immersion foot (trench foot). Exposure time
presented in these films. Also see Article 3-2(2)(h) is variable but is usually measured in hours. A high
regarding the Navy educational film on “Care and Use environmental moisture favors non-freezing injuries by
of the Heat Stress Meter”. accelerating heat loss. Peripheral vasoconstriction, ve-

3-17
3-10 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-10
nostasis and increased blood viscosity impair normal sons with previous cold injury, especially that of recent
tissue oxygenation and the removal of cellular metabo- origin, heavy smokers and those taking medications
lites. This may be accompanied by increased capillary which affect the vasomotor tone are at special risk in
permeability and intravascular agglutination or sludging cold environments. Seriously wounded individuals with
of red blood cells. Chilblain is characterized by initial significant blood loss and decreased activity are predis-
blanching and pallor—followed on rewarming by flush- posed to cold injury as are those on starvation or
ing, itching and edema. Blistering may be present and near-starvation diets. Consumption of alcoholic bever-
continued cold exposure may lead to hemorrhagic or ages causes vasodilation and accelerates heat loss, thus
ulcerative lesions. Cold water immersion foot may ini- favoring the development of frostbite and hypothermia.
tially be no more troublesome than chilblain; however, (d) Personal Characteristics. Although the epide-
prolonged exposure leads to more severe anoxic impair- miologic reasons are unclear, younger lower ranking
ment. During the hyperemic phase the pain is usually personnel, Caucasians from United States climates with
severe, tissue destruction is more pronounced and gan- minimum January temperatures above 20 F, and Amer-
grene may supervene with the resultant loss of the limb. ican Blacks appear to share an increased hazard of
Late complications of cold water immersion foot include developing cold injury. Persons with negativistic behav-
dyshidrosis, Raynaud’s phenomenon and causalgia. Sec- ior patterns are also at risk. Therefore, line commanders
ondary complications, including infection and throm- and Medical Department personnel may find it particu-
bophlebitis, are not uncommon. larly valuable to concentrate preventive education
(b) Freezing Injury (Frostbite). The pathophysiol- among these individuals.
ogy of frostbite is presently uncertain. It occurs only at (e) Clothing. Protective clothing, available when
environmental temperatures below freezing and the ex- needed and properly worn, is essential to conservation
tent of tissue destruction depends primarily on the of body heat. Garments should be clean, dry and allow
temperature and length of exposure. The freezing of for adequate air circulation between and through layers.
intracellular and extracellular fluid results in the forma- Apparel should be fitted so as to avoid peripheral limb
tion of ice crystals which mechanically disrupt cell constriction with attending circulatory impairment. The
membranes. There is a lack of agreement as to whether feet and hands require special care in order to avoid
the injury is due to cellular injury and changes in maceration of the skin and secondary infection. This is
vascular permeability or to the vascular stasis and tissue best accomplished by adequate changes of socks and
hypoxia. First degree frostbite is similar to mild chilblain gloves and liberal use of soap and water cleansing. When
with hyperemia, mild itching and edema; no blistering possible, footgear should be dried between periods of
or peeling of the skin occurs. Second degree frostbite is use.
characterized by blistering and desquamation. In third (f) Preventive Education. All personnel should be
degree frostbite there is necrosis of the skin and subcu- oriented to their individual responsibility in the preven-
taneous tissues with ulceration. The most severe tissue tion of cold injuries. Predisposing and preventive factors
damage is seen in fourth degree frostbite with destruc- should be widely promulgated, and negative attitudes
tion of connective tissues and bone accompanied by discouraged.
gangrene. Secondary infections and the sequelae noted (6) Treatment of Local Cold Injuries
for non-freezing injuries are not infrequent. (a) First Aid. Frozen body parts should be re-
(5) Factors Influencing Cold Injury warmed until thawed. This can be accomplished by
(a) Weather The prevention of cold injury is facil- immersion in a water bath of 104-106 F; temperatures
itated by the availability of accurate meteorological above this level should be strictly avoided. In the field
information, including air temperature, humidity and where water is not available, the part may be-warmed in
wind velocity. For practical purposes, the cooling effect the axilla of a normothermic companion. In most cases
of air temperature and wind velocity have been com- the frozen body part has already thawed by the time the
bined in the Equivalent Temperature standard (Wind victim comes for initial treatment and further active
Chill Index Chart) which is presented in Section IV. warming measures are not required. Wet clothing should
(b) Physical Work. Heavy physical activity may be removed and body parts dried and protected from
accentuate heat loss by perspiration; in addition, the trauma. Blisters should be left intact and sterile fluff
moisture becomes trapped in-excess clothing and reduces dressings applied. Deep body temperature should be
its insulating capacity. Prolonged excessive activity leads maintained with blankets and warm liquids. All individ-
to mental and physical fatigue which may lead to fatal uals with cold injury of the extremities should be
hypothermia in a cold environment. Total immobility, managed as litter patients with the limb slightly elevated.
on the other hand, decreases the production of body All cold injury victims should be evaluated by qualified
heat with cooling of the extremities and circulatory Medical Department personnel as soon as possible.
impairment in dependent parts. It is advisable, there- (b) AVOID: COLD-INJURED PARTS SHOULD
fore, to tread the middle ground and recommend mod- NOT BE RUBBED WITH SNOW OR ICE WATER OR
erate activity with adequate rest. Increased exercise of OTHERWISE TRAUMATIZED. BECAUSE OF
the extremities should be encouraged when personnel are THEIR EFFECTS ON CAPILLARY CIRCULATION,
in confined positions in cold climates. THE USE OF ALCOHOLIC BEVERAGES AND
(c) Physical Well-Being and General Health. Per- TOBACCO IS STRICTLY CONTRAINDICATED.

3-18
3-10 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-10
OINTMENTS AND CREAMS SHOULD NOT BE imperative that resuscitative measures be instituted im-
APPLIED. mediately in all cases of accidental hypothermia. Car-
(c) Symptomatic Care. Pain is sometimes severe in diovascular and respiratory support should ideally be
rewarmed limbs and may require administration of continued until it can be confirmed by more sophisti-
narcotics for relief. Itching and urtication may be re- cated means that all signs of life are absent.
lieved by antihistaminics and milder analgesics. (b) Clinical Manifestation of Hypothermia. The
(d) Definitive Therapy: patient is pale, comatose, and may appear dead. Respi-
(1) Affected parts should be kept clean and either rations are slow and shallow and may be difficult to
treated “closed” with sterile dressings or “open” with detect. The pulse is faint or absent, the precordial
sterile sheets and proper nursing precautions. impulse may be inapparent and the blood pressure is
(2) Tetanus boosters should be given where indi- frequently unobtainable. The victim is hyporeflexic and
cated. unresponsive to painful stimuli. Pupils are unreactive to
(3) Since frostbite victims are frequently dehy- light, but are usually not dilated. The body tissues are
drated, they may benefit from the administration of semirigid and resist passive movement. Body tempera-
Lactated Ringer’s Solution. Low-molecular-weight dex- tures are frequently below 82 F (rectally), and cannot be
tran or Heparin may be indicated if vascular “sludging” measured with the usual clinical thermometers (See
or thrombophlebitis are suspected. below for Subnormal Clinical Thermometer). Urine
(4) In frostbite devitalized and gangrenous tissues output is negligible. Death may occur in spite of appar-
may separate spontaneously after 60-90 days. Sympa- ently successful resuscitative measures.
thectomy may be indicated in severe cases of frostbite For clinical monitoring of hypothermic patients,
and immersion foot to relieve causalgic pain. Surgical there is a special thermometer available. The following
debridement may become necessary as well as skin information is provided:
grafting. Amputation should be conservative. Thermometer, Clinical Human, Oral/Rectal,
(5) Physical therapy includes early active and Subnormal(Range 70-100 F) Stock number
passive movement of affected parts and later rehabilita- 9L-6515-00-139-4593
tion of compromised function. (c) Therapy of Accidental Hypothermia:
(6) Antibiotic therapy may be necessary if sec- (1) Genera{ Measures. Initial resuscitative mea-
ondary infection becomes a problem, and should ideally sures should concentrate on the restoration of vital
be guided by bacterial culture and sensitivity testing functions. If respirations are present and ventilation is
evidence. adequate, the therapists attention may be diverted to
(e) Disposition. All episodes of cold injury should other resuscitative measures. Otherwise mouth-to-
be documented in the patient’s medical records. Recur- mouth resuscitation and external cardiac massage (if
rent episodes may be cause for reassignment or medical indicated) should be initiated in the field. The patient
board. should be kept warm during transportation to a medical
(7) Clinical Manifestations and Treatment of Gener- facility and examined for concurrent injury and drug or
alized Hypothermia: ethanol intoxication. Supplemental oxygen will usually
(a) Generalized hypothermia may be classified as be indicated. An oral airway should be inserted. Upon
induced or accidental. Induced hypothermia is a valued arrival at a medical facility, the apneic patient should
adjunct to general anesthesia for select surgical proce- have an endotracheal airway inserted to aid mechanical
dures. It is implemented under controlled conditions by ventilation and suction. Intravenous lines should be
qualified personnel. Vital functions (circulatory, respi- established for the administration of resuscitative fluids
ratory, cardiovascular) are carefully monitored as the and the measurement of central venous or pulmonary
body temperature is lowered and maintained for the wedge pressures. A nasogastric tube will allow evacua-
duration of the surgery. Temperatures are generally tion of stomach contents and prevent aspiration, and an
maintained above 82 F. Accidental hypothermia may be indwelling urinary catheter will serve to monitor urine
observed in newborns, in the elderly and in association output. Blood gas, pH, and electrolyte determinations
with certain lesions of the endocrine and central nervous will aid in effective management. Body temperature is
systems. In the military, it is most frequently seen in best monitored by rectal thermistor probe, otherwise use
individuals who have been exposed to cold for prolonged the subnormal clinical thermometer noted above.
periods of time. Fatigue, severe wounds, cold water (2) Rewarming. Rewarming must be approached
immersion (aircraft, ship and submarine accidents), and with caution in order to avoid serious consequences.
inadequate cold weather gear contribute to the evolution Controversy still exists as to the most effective and safest
of accidental hypothermia. Case reports suggest that means by which to restore normal body temperature.
tolerance to deep hypothermia (77 F) may occasionally Rapid rewarming appears to be the most effective in
be enchanced by the depressant effect of alcoholic cases where cold exposure (most frequently cold water
intoxication and excessive doses of sedative drugs. This immersion) has been brief. It is accomplished by total
phenomenon, however, is unpredictable and should body immersion in warm water (about 104 F). Hypo-
never be considered in the context of therapy. Individual thermic patients, however, may be inadvertently burned
cold tolerance and the unreliability of the clinical signs by this approach and are subject to the poorly under-
of “death” during severe hypothermic episodes make it stood phenomenon of “rewarming shock”. Slow re-

3-19
3-10 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-11
warming may be accomplished by the use of blankets, choice, and may be supplemented with sodium bicar-
hot water bottles, etc.; however, care should again be bonate solution as indicated. Overzealous measures can
taken that the differential temperature between the lead to serious fluid overloading of the cardiopulmonary
patient and the rewarming medium is not too great. The circulation. Marked hypoglycemia is best managed by
age old method of vigorously massaging the patient is the administration of glucose. Physical exhaustion and
dangerous and is contraindicated. prolonged stress can lead to adrenal insufficiency; there-
(3) Cardiopulmonary Care. Vital signs should be fore, the administration of 200 mg of hydrocortisone
closely monitored under intensive care nursing proce- intravenously may be indicated in some cases. Hypoka-
dures. After restoration of respirations assisted ventila- lemia is common, but is probably due to intravascular
tion and oxygen may be continued. Electrocardio- electrolyte shifts and does not usually require vigorous
graphic monitoring is indicated. Ventricular arrhythmias replacement.
(ventricular premature beats, tachycardia, and fibrilla- (5) Lute Measures and Complications. Associ-
tion) are not infrequent in severe hypothermia; intraven- ated injuries can be dealt with when rewarming is
tricular conduction delays are common and a “J-point” completed. Intensive care measures are needed only until
may be seen at the very end of each QRS complex. the cardiopulmonary, metabolic, and thermoregulatory
Digitalis may be indicated for rapid atrial fibrillation
associated with a rapid ventricular response. Ventricular functions have stabilized. Patients must be watched for
arrhythmias may be treated with lidocaine or procaina- acute renal failure and pulmonary infection.
mide; however, recent evidence suggests that quinidine (8) Sensitivity to Cold. Sensitization to further cold
and beta-adrenergic blocking agents (propranalol) may exposure frequently follows all forms of cold injury. The
have a more predictable pharmacologic effect. sensitivity may be brief with milder injuries or last for
(4) Metabolic and Fluid Balance. Restoration of years after severe episodes. Hypersensitivity to cold
circulating fluid volume should be monitored by central (cold allergy) may be observed as a familial trait or a
venous or pulmonary wedge pressures. Blood gas and sequela of cold injury. It is manifested by the appearance
pH determinations are useful in following repair of the of generalized urticaria following cold exposure and
severe metabolic acidosis which accompany profound may occasionally be complicated by bronchospasm
hypothermia. Ringer’s lactate is the restorative fluid of (asthma) and shock.

Section IV. THERMAL STANDARDS


Article
General Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
Assessment of Heat Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...3-12
Practical Heat Stress Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13
Practical Cold Stress Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14

3-11. General Requirements ited in spaces where the carbon monoxide content of the
(1) The major objectives of the thermal standards are to air exceeds the following limits:
facilitate mission accomplishment by maximizing produc- (a) 25 parts per million and continuous exposure for
tivity and maintaining the well-being of personnel. 90 days.
(2) Elimination of Smoke and Noxious Odors. Smoke (b) 50 parts per million and exposure for 8 hours
and noxious odors are readily detectable in closed spaces. daily.
Ventilation rates to eliminate odors from berthing areas (Other standards exist depending on the length of
and living quarters are considerably in excess of those exposure, physical activity performed and requirements
required to supply oxygen and remove carbon dioxide. for mental acuity.)
Attempts to filter or mask unpleasant odors have not (3) Elimination of Fuel Combustion Gases and/or
met with significant success. Tobacco smoke is likewise Fuel Vapors. Fuel combustion gases and fuel vapors
difficult to remove from confined spaces aboard ship, have toxic effects upon personnel. In the area of thermal
particularly in submarines where air is recirculated. physiology, these gases and vapors cause vasodilation of
Noxious odors are not physically harmful, but tend to the peripheral blood vessels at times when cardiovascu-
exert an unfavorable effect on appetite and morale. lar stability has already been compromised. Since hu-
Tobacco smoke, on the other hand, may have varied mans cannot increase their existing circulating blood
harmful effects on smokers as well as non-smokers. volume to compensate for the marked increase of their
Personnel exhibit a variable tolerance for tobacco smoke cardiovascular system capacity, the resultant effect is to
with some individuals developing symptoms of hyper- incur further impairment of the cardiovascular system to
sensitivity (allergy). Smoke acts as an irritant to the eyes meet the physiologic demands of the work and environ-
and respiratory membranes. Smoking should be prohib- ment. This produces a critical impact when the added

3-20
3-10 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-11
warming may be accomplished by the use of blankets, choice, and may be supplemented with sodium bicar-
hot water bottles, etc.; however, care should again be bonate solution as indicated. Overzealous measures can
taken that the differential temperature between the lead to serious fluid overloading of the cardiopulmonary
patient and the rewarming medium is not too great. The circulation. Marked hypoglycemia is best managed by
age old method of vigorously massaging the patient is the administration of glucose. Physical exhaustion and
dangerous and is contraindicated. prolonged stress can lead to adrenal insufficiency; there-
(3) Cardiopulmonary Care. Vital signs should be fore, the administration of 200 mg of hydrocortisone
closely monitored under intensive care nursing proce- intravenously may be indicated in some cases. Hypoka-
dures. After restoration of respirations assisted ventila- lemia is common, but is probably due to intravascular
tion and oxygen may be continued. Electrocardio- electrolyte shifts and does not usually require vigorous
graphic monitoring is indicated. Ventricular arrhythmias replacement.
(ventricular premature beats, tachycardia, and fibrilla- (5) Lute Measures and Complications. Associ-
tion) are not infrequent in severe hypothermia; intraven- ated injuries can be dealt with when rewarming is
tricular conduction delays are common and a “J-point” completed. Intensive care measures are needed only until
may be seen at the very end of each QRS complex. the cardiopulmonary, metabolic, and thermoregulatory
Digitalis may be indicated for rapid atrial fibrillation
associated with a rapid ventricular response. Ventricular functions have stabilized. Patients must be watched for
arrhythmias may be treated with lidocaine or procaina- acute renal failure and pulmonary infection.
mide; however, recent evidence suggests that quinidine (8) Sensitivity to Cold. Sensitization to further cold
and beta-adrenergic blocking agents (propranalol) may exposure frequently follows all forms of cold injury. The
have a more predictable pharmacologic effect. sensitivity may be brief with milder injuries or last for
(4) Metabolic and Fluid Balance. Restoration of years after severe episodes. Hypersensitivity to cold
circulating fluid volume should be monitored by central (cold allergy) may be observed as a familial trait or a
venous or pulmonary wedge pressures. Blood gas and sequela of cold injury. It is manifested by the appearance
pH determinations are useful in following repair of the of generalized urticaria following cold exposure and
severe metabolic acidosis which accompany profound may occasionally be complicated by bronchospasm
hypothermia. Ringer’s lactate is the restorative fluid of (asthma) and shock.

Section IV. THERMAL STANDARDS


Article
General Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
Assessment of Heat Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...3-12
Practical Heat Stress Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13
Practical Cold Stress Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14

3-11. General Requirements ited in spaces where the carbon monoxide content of the
(1) The major objectives of the thermal standards are to air exceeds the following limits:
facilitate mission accomplishment by maximizing produc- (a) 25 parts per million and continuous exposure for
tivity and maintaining the well-being of personnel. 90 days.
(2) Elimination of Smoke and Noxious Odors. Smoke (b) 50 parts per million and exposure for 8 hours
and noxious odors are readily detectable in closed spaces. daily.
Ventilation rates to eliminate odors from berthing areas (Other standards exist depending on the length of
and living quarters are considerably in excess of those exposure, physical activity performed and requirements
required to supply oxygen and remove carbon dioxide. for mental acuity.)
Attempts to filter or mask unpleasant odors have not (3) Elimination of Fuel Combustion Gases and/or
met with significant success. Tobacco smoke is likewise Fuel Vapors. Fuel combustion gases and fuel vapors
difficult to remove from confined spaces aboard ship, have toxic effects upon personnel. In the area of thermal
particularly in submarines where air is recirculated. physiology, these gases and vapors cause vasodilation of
Noxious odors are not physically harmful, but tend to the peripheral blood vessels at times when cardiovascu-
exert an unfavorable effect on appetite and morale. lar stability has already been compromised. Since hu-
Tobacco smoke, on the other hand, may have varied mans cannot increase their existing circulating blood
harmful effects on smokers as well as non-smokers. volume to compensate for the marked increase of their
Personnel exhibit a variable tolerance for tobacco smoke cardiovascular system capacity, the resultant effect is to
with some individuals developing symptoms of hyper- incur further impairment of the cardiovascular system to
sensitivity (allergy). Smoke acts as an irritant to the eyes meet the physiologic demands of the work and environ-
and respiratory membranes. Smoking should be prohib- ment. This produces a critical impact when the added

3-20
3-11 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-11
load of heat stress is present. The ambient concentrations reactions to occur in the detector tubes. Gas free engi-
of aromatic hydrocarbons, using hexane as the reference neering methods, generally available aboard ships, can-
gas for quantitative analysis, which produce such re- not reliably measure these low levels of likely toxic
sponses in humans is between 10-14 mg/m3 of air. Higher components in fuel combustion gases and fuel vapors
concentrations of aromatic hydrocarbons have relatively that are pertinent to this subject. Portable, direct read-
little further effect on human short-term exposure; concen- ing instrumentation which is durable, accurate at low
trations as high as 690 mg/m3 have not resulted in signif- concentrations, has specificity for a variety of atmos-
icant changes from that measured at the lower concentra- pheric components, has a high degree of reproducibility,
tions. One must be aware that the threshold concentrations maintains calibration and has an adequate response time
for aromatic hydrocarbons and oxides of nitrogen and is extremely expensive. We are left with the difficulty of
sulfur, in combined environmental stress situations, appear estimating the presence of physiologically significant
to be quite low. Cardiovascular “shock” occurs without levels of atmospheric contaminants and what to do to
significant hyperthermic responses. Table 3-4 generalizes minimize the impact upon personnel, especially if the
some of the physiologic impact of fuel combustion gases contaminants are permitted to remain in work spaces.
and fuel vapors where 135 personnel exhibited and sensed Fortunately, the Physiological Heat Exposure Lim-
body changes due to the presence of these gases and vapors its (PHEL) Chart and information available regarding
aboard Navy ships in mild heat stress situations. In all the sensory, eyes and respiratory responses of shipboard
cases, the Physiological Heat Exposure Limits (PHEL) personnel in such environments exists. During what
times alone were 4–6 hours, but the personnel exposures would normally be 4-6 hour heat stress exposure limits,
had to be terminated quite prematurely when the overall it was repeatedly found that the physiologically safe
effects justified removal for physiological safety purposes. exposure times could be determined by use of the PHEL
Since the physiologic thresholds of the gases and Chart. Using the methods described in this Chapter and
vapors are low, the results from calorimetric detector the OPNAVINST 5100.20 series for determining the
tubes used aboard ships should be considered unreliable. WBGT Index and PHEL times, reduction of the deter-
Research has shown that ambient water vapor results in mined PHEL exposure times by 66% would minimize
false low values from a variety of calorimetric detector the reduced physiologic performance of personnel. For
tubes, water molecules occupy sites in the chemical beds example, a PHEL stay time of 4 hours becomes 1.4
and thereby reduce the number of available sites for hours (1 hr 24 reins) and 6 hours becomes 2.1 hours (2
hrs 6 reins). Therefore, adjustment of the PHEL values
Table 3-4. General Physiologic Impact of Fuel Com- for heat stress exposures provides a simplified means of
bustion Gases and Fuel Vapors estimating physiological exposure times to fuel combus-
Parameters Change tion gas and fuel vapor pressures, with and without the
presence of limiting heat stress. Regardless, long-term,
Cardiovascular: repetitive exposures to such atmospheric contaminants
Heart Rate Slight increase may have other far more serious consequences to the
Systolic Blood Pressure Marked reduction well-being of personnel. Obviously, the elimination of
Diastolic Blood Pressure Marked reduction personnel exposures to fuel combustion gases and fuel
Mean Arterial Blood Pressure Very marked vapors that adversely impact upon the health of person-
reduction nel should be an engineering and operational goal.
Estimated Cardiac Output Marked increase Personnel exposures to fuel combustion gases and fuel
Total Vascular Resistance Very marked vapors must be prohibited on a routine basis, emergency
reduction exposure situations should be the only exception.
Overall Cardiovascular Reserve Very marked (4) Air Supply for Ventilation. One of the most
reduction important factors in the design of a ventilating system is
the uniform distribution of air. Under favorable condi-
tions the required air supply can be obtained by natural
Sensory: ventilation methods without creating objectionable
Tip of Tongue Tingling/numbness drafts. The maximal air supply should be governed by
Nose Tingling/numbness thermal requirements for maintaining the desired work-
Finger Tips Tingling/numbness ing, living and messing space conditions indicated in
Toes Tingling/numbness Section II of this chapter. In cool or cold atmospheres,
it is desirable to limit the velocity of air currents to
Eyes Lacrimation within the threshold of perceptibility so far as to impart
a sense of freshness without producing unpleasant
Respiratory Distress drafts. The velocity at which room currents become
noticeable varies with the dry- and wet-bulb tempera-
tures, and ranges from a low of 10 fpm in cold environ-
Body Temperatures No apparent change ments to about 80 fpm or higher in warm environments.
at time of exiting In order to avoid drafty conditions, air movement in
environment cool atmospheres should be maintained at less than 50

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3-11 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-12
fpm; in warm conditions it should be kept between (2) Mean Radiant Temperature (mrt). In calculating
100-200 fpm. Intermittent exposure to much higher the radiant heat balance between man and his environ-
velocities is indicated in the presence of radiant heat; ment, one must first estimate the mean radiant temper-
however, reference should be made to the special con- ature of the surroundings. This may be calculated in
siderations indicated in Section H, 3-7 (5) and (6). For various ways using the globe and dry-bulb temperatures,
natural ventilation it is good practice to select the point and the air velocity data noted above. The simplest
of air entry in order to control the volume and distribu- method is by use of the nomogram illustrated in Figure
tion. Selective entry of air through specific openings or 3-7. The difference between the globe and dry-bulb
by “infiltration” allows for thermal tempering before it
reaches living or working spaces. When untempered air
passes over personnel, it can result in chilling and
complaints of drafts. Some individuals may then de-
mand increased heating of a space to the dissatisfaction
of other occupants. “Foot drafts” may be due to faulty
ventilation or to variable vasomotor circulatory response
in the extremities. It is best managed by selective use of
suitable clothing. In firerooms and engine rooms the
preferred minimal effective air velocity over personnel is
250 fpm. Air blowing between 250-1500 fpm on the
head and shoulders will result in relatively little gains in
effective cooling, beyond 1500 fpm there will be reduced
effective cooling, while above 2080 fpm will result in
heating of dry skin (See Figure 3-2).
(5) Air Supply Requirements for Respiration and
Elimination of Smoke and Odors. Outside air supply to
spaces where light work is performed should not be less
than 425 liters (15 cubic feet) per minute per person; or
2 air changes per hour, whichever is greater. Where the
work load is heavy, the outside air supply should be
increased to 566 liters (20 cubic feet) per minute per
man, or 3 air changes per hour. In spaces where smoking
is permitted, 850 liters (30 cubic feet) of air should be
provided per minute for each smoker. In living spaces
850 liters (30 cubic feet) of air should be supplied per
minute per designed occupancy; messing areas should be
provided with 566 (20 cubic feet) per minute per person
eating during maximum occupancy. These are minimal
air quantities for the removal of noxious odors and
smoke and are not intended as standards for the removal
of potential industrial contaminants.

3-12. Assessment of Heat Stress


(1) The empirical heat balance equation presented in
Section 111 summarizes the environmental and metabolic
parameters which constitute an individual’s thermal load
in a given environment. Efforts to develop an
all-encompassing heat stress index, that unconditionally
describes all thermal variables in all situations, have met
with varying degrees of both success and failure. The
usefulness of a single thermometer in the measurement of
heat stress conditions is extremely limited. Engineering
surveys of heat stress require separate readings (dry-bulb,
wet-bulb, globe, and surface temperatures plus air veloci-
ties) at the supply duct face (opening) and at the work
location. Environmental physiology studies of heat stress
require the foregoing measurements in addition to the
assessment of human body temperatures and individual
work loads. The evacuation of heat strain requires all of the
above measurements as well as a worker’s heart rates,
blood pressures and pre- and post-exposure body weights.

3-22
I

3-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-12


temperatures is entered on Scale A; a line is then drawn proximately 1 F of that obtained by the simplified
from this point through the point representing the method using the nomogram.
appropriate air velocity on Scale B, and continuing until Frequently persons overlook the importance of mean
it intercepts Scale C, lastly, a line is drawn from the point radiant temperature on workers. Figure 3–8 illustrates the
representing the globe temperature on Scale D, so that it mean radiant temperatures where low, moderate, high and
meets the intercept point on Scale C the mean radiant excessive body heat storage occurs. Therefore, in our
temperature is read from the point at which the second example given above, the mean radiant temperature of
line crosses Scale E. To illustrate, let us suppose that the 161.5 F is within the range of excessive body heat storage.
globe temperature = 119 F, the dry-bulb temperature = This emphasizes the need for radiant heat control in
110 F, and the air velocity = 1500 fpm; the mean radiant workplaces.
temperature is read from Scale E as being equal to (3) Radiation. The radiant heat transfer balance be-
approximately 161.5 F. tween a given subject and the environment may now be
The more precise means of obtaining mean radiant calculated using the following formula:
temperature is by use of the following fourth power R = 6.27 (m.r.t. – Tsk) assuming no clothing
equation: on the subject
9 4 -9
(Ts + 460) 4 X 1 0- = (T G + 460) X 1 0 where
0.5
+ 0.1028 V (T G – TD B) R = radiation (Kilocalories per hour)
m.r.t. = mean radiant temperature (°F)
where Tsk = mean skin temperature (°F)
Ts = temperature of the surrounding
environment (°F) The value for R should be reduced by 30-40% for
TG = globe temperature (°F) individuals insulated by clothing (the use of blue denim
TDB = dry-bulb temperature (ºF) dungarees requires a 30% reduction factor).
V = air velocity (fpm) (4) Convection. Heat exchange by convection is cal-
culated by using the following formula:
The calculated mean radiant temperature is within ap-
C = 0.27 V0.6 ( TDB – Tsk) assuming an
unclothed subject

where
C = convection (Kcal/hour)
T DB = dry-bulb temperature (°F)
Tsk = mean skin temperature (°F)

The value for C should be reduced by 30-40% to


account for the insulative effects of clothing (again 30%
reduction for blue denim dungarees).
(5) Evaporation Estimates
(a) Evaporation Required (Ereq): Evaporation re-
quired to maintain a normal heat balance within the
human subject is calculated using the following
equation:
E req = M ± R ± C
where
E req evaporation required to maintain heat
=

balance (Kcal/hr) assuming no heat


storage if heat loss by Ereq can be
accepted by the environment
M = metabolic heat production by the
subject (Kcal/hr)
R = radiation (Kcal/hr)
C = convection (Kcal/hr)
The equation assumes that conduction will be minimal
if the subject is not in contact with a surface hotter or
colder than his surface temperature and if heat transfer
through the shoes is negligible.

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3-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-12
(b) Maximum Evaporative Capacity (Emax): The (7) Wet-Bulb Globe Temperature Index (WBGT). As
maximum amount of heat, lost by evaporation, which derived, the WBGT Index was unique in that it took into
can be accepted by the environment (maximum evapo- account the four physical variables of the thermal
rative capacity of the environment) is calculated from environment (air temperature, humidity, radiant heat
the following equation: and air movement). The simplicity of the approach was
0.6
that one need not perform direct measurement of air
E max = 1.01 V (42 – VPa) velocity and that the globe thermometer integrates radi-
where ant heat and convective heating or cooling into one
Em a xmaximum evaporative capacity (Kcal/hr) value. [Note: The globe temperature is neither radiant
v = air velocity (fpm) heat by itself nor what is known as the mean radiant
v Pa = Partial vapor pressure of the environ-
ment (mm Hg.) at the combined dry-
bulb and wet-bulb temperatures. Table 3-5. Identification Of Approximate Metabolic
42 = vapor pressure at the skin of the Rates
subject assuming a mean skin tem-
perature of 95° F; this figure will Average
differ by approximately 1.3 mm Hg Physical Activity Metabolic Rate
for each 1°F change in the mean skin KCal*m -2* h r-1
temperature from 95ºF. a) Sitting
The value for Emax should be reduced by 30-40% to
Moderate arm & trunk movement
account for the insulative effect of clothing (blue denim
dungarees require a 30% reduction factor). (e.g., typing, drafting, driving a car
in light traffic) 68
(6) Heat Stress Index (Belding-Hatch): The Heat
Stress Index (HSI) is calculated as the ratio of the
Evaporation Required (Ereq) to the Maximum Evapora- Moderate arm & leg movement
tive Capacity (Emax): (e.g., general laboratory work, slow
movement about an office) 82
HSI = E req X 100
E max Heavy arm & leg movement (e.g.,
The HSI is an expression of heat load in terms of the driving a car in moderate traffic) 99
amount of sweat which needs to be evaporated in order
to maintain heat balance. The index compares the b) Standing
amount of heat lost by evaporative cooling from com-
pletely wetted skin to the maximum evaporative capacity Light work at machine or bench,
of the environment. The HSI was considered useful in mostly arms 82
subjectively estimating metabolic heat production dur-
ing different categories of physical activity. Estimates of Light work at machine or bench,
various types of metabolic rates during different physical some moving about (e.g., using a
activities are given in Table 3-5. table saw, driving a truck in light
The Heat Stress Index was originally intended for traffic) 99
application among men working 8-hour shifts in civilian
industry. Investigation, however, has shown that a neg- Moderate work at machine or
ative ( – ) index occurs when the vapor pressure of the bench, some walking about (e.g.,
skin is lower than the partial vapor pressure of the replacing tires, driving a car in
environment; this can happen even when the mean skin heavy traffic) 119
temperature is in the range of 101-110 F. Thus, although
a negative HSI theoretically indicates cold strain (See c) Walking About, with Moderate
Table 3-6) it can, in fact, occur in the presence of severe Lifting or Pushing (e.g., driving a
heat strain. The limitations of the HSI required devel- truck in moderate traffic, scrubbing
opment of a more reliable means of assessing maximum in a standing position) 164
safe exposure time in the presence of heat stress. A more
reliable exposure limit index has been developed and is d) Intermittent Heavy Lifting, Pushing
discussed later in this section under the heading of or Pulling (e.g., sawing wood by
Physiological Heat Exposure Limits (PHEL). Notwith- hand, calisthenic exercise, pick and
standing the contradictory nature of the HSI, the equa- shovel work) 238
tions given in the preceding text are of use in partitioning
the avenues of heat loss and gain between the subject
e) Hardest Sustained Work 300
and the environment.

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3-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-12
temperature; the globe temperature value is a composite equations were to estimate ranges of heat stress that
of radiant and convective heat transfers. ] warranted decreasing physical activity in order to mini-
Initial practical applications of the WBGT Index mize incidence of heat injuries outdoors. It has been
assumed by many persons over at least the last 20 years
Table 3-6. Physiological Implications Of The HSI that the two-variable combination of wet and dry bulb
(Belding-Hatch) temperatures applies indoors, while the three-variable
equation applies only outdoors. In reality, there are no
HSI Physiologic and Behavioral Implications less than eight equations for obtaining the WBGT
-20 to Mild cold strain. (See implication of negative HSI Index; therefore, selection of the most appropriate
WBGT Index equation became a serious matter in terms
-10 above) This condition frequently exists in areas
where men recover from exposure to heat. of the limitations of some of the equations.
From 1963-1968, volumes of data were reviewed and
compared with the Navy Bureau of Ship files. Literature
0 No thermal strain.
searches and computer plotting of all available data indi-
cated that maximum utility, for both engineering and
+ 10 to Mild to moderate heat strain. Where a job involve! environmental physiology purposes, would be obtained by
+30 higher intellectual function, dexterity, or alterness, use of the below WBGT equation. This was a major
subtle to substantial decrements in performance change from the comfort assessment concept of Effective
may be expected. In performance of heavy physics Temperature and use of the WBGT Index.
work, little decrement unless ability of individuals WBGT = [(0.7 * Shielded Psychometric Wet Bulb)
to perform such work under no thermal strain is + (0.2 * Matte Black Globe Temp.)
marginal. + (O. 1 * Shielded Dry Bulb Temp.)]
Extremely complex heat-work physiology experi-
+40 to Severe heat strain, involving a threat to health ments were conducted between 1968– 1975 in a large
+60 unless personnel are physically fit. Break-in period number of heat stress and work situations ashore and
required for those not previously acclimatized. afloat. Seventeen physiological factors were employed,
Some decrement in performance of physical work along with environmental variables and a wide range of
is to be expected. Medical selection of personnel work loads, to develop comprehensive physiological
desirable because these conditions are unsuitable heat exposure limits criteria. Therefore, combining the
for those with cardiovascular or respiratory given WBGT equation with the physiological responses
impairment or with chronic dermatitis. These led to development of the Physiological Heat Exposure
working conditions are also unsuitable for Limits (PHEL). [Refer to: National Bureau of Stan-
activities requiring sustained mental effort. dards, Special Pub. 491, pp 65-92, September 1977.]
Application of WBGT equations other than that
+70 to Very severe heat strain. Only a small percentage of given above for determining PHEL values is an ex-
+90 the population may be expected to qualify for this tremely dangerous practice. There is too great a chance
work. Personnel should be selected (a) by medical of being wrong in terms of physiologically safe but
examination, and (b) by trial on the job (after reversible limits of human heat stress exposures with
acclimatization). Special measures are warranted to other WBGT equations. Obviously one may find some
assure adequate water and salt intake (See Section theoretical situations where it makes no difference which
III). Amelioration of working conditions by any equation is applied, however, for practical purposes,
feasible means is highly desirable, and may be maximizing the utility of environmental data for many
expected to decrease the health hazard while constructive and corrective engineering and environ-
increasing efficiency on the job. Slight mental physiologic purposes, minimizing the risks to
“indisposition” which in most jobs would render humans yet obtaining the longest safe stay times, there
workers unfit for this exposure. must be consistency in applying the above WBGT
equation. The Navy heat stress meter is designed to be
+ 100 The maximum strain tolerated by fit, acclimatized consistent with use of the given WBGT equation.
young men for 8-hour exposures. Only by use of above given WBGT equation, provid-
ing the raw data used for the calculations, including the
Above Overstrain, for 8-hour exposures. Tolerance of air velocity over man, indicating what clothing is worn
+ 100 brief exposures will depend not on the amount by and providing sufficient information whereby human
which the HSI exceeds + 100 but on the rate of metabolic rates can be predicted will permit maximum
heat accumulation by the body. analyses of the environmental physiologic situation.
[Note: In steam, diesel and nuclear shipboard situations the
Whenever possible all available information should be
level of heat stress frequently exceed physiological limits for at provided ! Furthermore, extreme care should be taken to
least 4-hour exposures. Therefore, one must consider a com- specify the presence or absence of air contaminants that
posite of heat stress and strain, behavioral, other physiological may combine to have either a positive or negative impact
and time factors before application of the HSI to work upon humans at even low levels of heat stress. One must
situations less than the 8-hour design criteria.] be continually aware of the fact that it is impossible for

3-25
3-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-12
humans to be exposed to only one variable simulta- were made before, during and following sustained phys-
neously in a non-laboratory environment. It is essential ical work in controlled heat stress conditions. These
to think in terms of dynamic situations where multiple findings were compared with a wide range of environ-
environmental stresses result in various physiologic mental conditions aboard ships from 197 1-1976; the
changes that occur in compensable or intolerable situa- field data, using over 200 healthy Navy personnel,
tions. One must know as many possible individual compared equally with the involved laboratory studies.
variables to constructively analyze the work situation in Time-weighted-means were calculated for both
terms of the physiological well-being of workers. metabolic heat production and WBGT exposures. This
(8) Physiological Heat Exposure Limits (PHEL). U.S. allowed for the subsequent development of maximum
Navy Physiologic Exposure Limits (PEL) were first heat exposure limits which were described by a family of
established in 1971, however, in 1973 the Environmental six curves that fit power regression equations. Figure 3-9
Protection Agency circulated a series of Public Exposure illustrates the six major PHEL curves.
Limits (PEL) covering a broad range of exposure limits (b) Time Weighted Mean Metabolic Rates (twin).
which did not include heat stress. Furthermore, aware of The “time-weighted-mean” (Twin) concept must be ap-
the Navy’s PEL for heat stress, the National Institute of plied in unique situations not addressed as part of
Occupational Safety and Health (NIOSH) published Physiological Heat Exposure Limits (PHEL) for ship-
their Permissible Exposure Limits (PEL) for heat stress board applications. PHEL Curve Selection Tables for
in September 1973. In order to avoid confusion regard-
shipboard applications have taken into account the
ing the acronyms PEL the Navy, in December 1973,
adopted the more descriptive title “Physiological Heat
various work rates of personnel during various types of
Exposure Limits” (PHEL). These criteria consisted of and lengths of time each activity is performed (normal
the previously published Physiological Exposure Limits watch, casualty control exercise and repair involving
of 1971 with an additional curve for heavy work as in heavy work), therefore, do not apply the Twm concept to
casualty control. The Navy limits recognize that under those situations. In cases where new or additional Twm
conditions of maximum work and heat stress the heat situations occur it is essential to determine both the Twm
strain will be readily apparent, but that it will be Metabolic Rate, and may be necessary to determine the
reversible; NIOSH Permissible Exposure Limits, on the
other hand, were designed to restrict deep body temper-
ature rises to a maximum of 100.4 F. In numerous work
situations it is unrealistic to limit work at a rectal
temperature of 100.4 F.
Compliance with the Navy’s PHEL takes into ac-
count the multiple physiological factors relative to the
welI-being of personnel. The PHEL applies to greater
than 95070 of the population, as there will always be
someone who may occasionally exceed the limits before
incurring heat exhaustion or heat stroke. For the pur-
pose of comparison, exceeding the PHEL is the same as
stretching a rubber band close to its break point; sooner
or later the rubber band is going to break. Serious
personnel heat injuries can be expected whenever the
PHEL are exceeded, therefore, stretching the rubber
band close to its limits too many times is courting
disaster.
(a) Criteria for PHEL Chart Development. T h e
development of the PHEL curves entailed considerable
heat stress research among personnel whose ages ranged
from 18-40 years. Physiologic measurements included
nine cardiovascular and four respiratory functions and
related them to the total cardiovascular reserves. Three
internal body temperatures and 10 skin temperatures
were serially recorded. The criteria for determining
maximum safe physiological exposures was based upon
a composite of the above parameters (Refer to National
Bureau of Standards, Special Publication 491, pp 65-92,
September 1977). The absence of muscle damage under
variable conditions of heat stress was verified by enzyme
assay. In addition, subjects were monitored for the
occurrence of hyperventilation and changes in mental
status, particularly for euphoria. The measurements Figure 3-9.

3-26
3-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-12
Twm WBGT value and calculate the Twm PHEL Spe- Table 3-8
cific value.
(c) Procedure for Time-Weighted-Mean Applica- PHEL Curve Selection Tables
tions: For No. Minutes Work vs.
Type of Physical Activity No. Minutes Rest
1. Identify the metabolic rates (MR) for each segment
of the total time under consideration, using Table
3-5.
2. Calculation of Twm Metabolic Rate Sitting

Twm MR = [(MR1 * tl) + (MR2 * t2) + . . . + (MRn Moderate arm & trunk
* tn)] / [tl + t2 + . . . + tn)] movement
where;
Twm MR = time-weighted-mean metabolic rate Moderate arm & leg
movement
(KCal*m -2* h r -1)
MR1 = metabolic rate (Kcal*m -2*hr –1) work for
exposure time #1 Heavy arm & leg
tl = length of time (in decimal hours) for MR1 movement
MR2 = metabolic rate (Kcal*m –2*hr -1) work for
exposure time #2 Standing
t2 = length of time (in decimal hours) for MR2
MRn = metabolic rate (Kcal*m –2*hr –1) work for Light work at machine or
exposure time #n bench, mostly arms
tn = length of time (in decimal hours) for MRn
3. Relationship of Twm Metabolic Rates to PHEL Light work at machine or
Curves bench, some walking
4. Identification Of Appropriate WBGT Curves about
If the Twm MR from #2 above is close to a Twm
MR in #3 above, then proceed with Table 3-8 Moderate work at
below in selecting the appropriate PHEL Curve: machine or bench, some
5. Determination of Twm WBGT walking about
Determine WBGT values for each of the locations
were the Twm Metabolic Rates apply. Then apply the
WBGT values and times for the respective Twm Meta- Walking About, with
bolic Rates to the equation given in Step #6 below. Moderate Lifting or
Pushing
6. Calculation of Twm WBGT Values
Twm WBGT = [(WBGT1 * tl) + (WBGT2 * t2) + . . . Intermittent Heavy Lifting,
+ (WBGTn * tn)] / [tl + t2 + . . . +tn)] Pushing or Pulling

where; Hardest Sustained Work


Twm
WBGT = time-weighted-mean WBGT Index degrees
Lowest Metabolic Rate
F
WBGT1 = WBGT at time #1
tl = length of time (in decimal hours) for Average & High
WBGT1 Metabolic Rate
WBGT2 = WBGT at time #2 NOTES:
t2 = length of time (in decimal hours) for 1. Do Not Attempt To Apply The PHEL Curves and/or Work
WBGT2 Rates In Those Situations Indicated As “NA” (Not Applicable)
Above. If the amount of work is underestimated it is likely that
Table 3-7 personnel systemic heat injuries will be incurred.
PHEL Curve Twm Metabolic Rate 2. If the types of physical activity are more mixed than noted
above, then there is no alternative but to resort to calculations
I 76 using the TWM concept.
II 86 3. TWM metabolic rate calculations require restarting with Step
111 96 #l above and selecting the metabolic activity for the specific
Iv 106 type of work given above, as well as the length of time that
v 116 applies to the selected metabolic rate situation. Then apply the
VI selected metabolic rate and time values to the below calcula-
126
tions. Do likewise for the WBGT and respective time values.

3-27
3-12 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-13
WBGTn = WBGT for exposure time #n estimating the amount of water needed when personnel
tn = length of time (in decimal hours) for perform work. Use of the WGT units may be expedient
WBGTn but application of the WGT values has extremely limited
7. Calculation of Twm Approximated PHEL Values value. NAVMEDCOM has not approved the use of the
Twm Approximated PHEL = Antilog [(1/0. 13) * WGT (“Botsball”) units.
(A-Log Twm WBGT)] = hours (11) Predicting Onset Of Mental Impairment Due To
A = Log [111.0461 + (0.2377 * Twm MR) – Heat Stress. In 1972 the Department of Health, Educa-
(0.0027 * Twm MR 2)] WBGT = degrees F tion and Welfare (HSM 72-10269, 1972, pg 188) pub-
PHEL values greater than 8 hours should be lished a curve entitled “Upper Limits of Exposure for
read as “ >8 hours” for the upper limits. Unimpaired Mental Performance”. Figure 3-10 illus-
8. Reduction of PHEL Times Due to Fuel Combus- trates the curves for detectable onset of mental impair-
tion Gases and/or Pre-Combustion Fuel Vapors ment as a function of the same metabolic rates for the
PHEL times (hours) must be reduced by 65.6070 PHEL curves; the decrements of cardiovascular reserve
when there is the presence of fuel combustion also have been taken into account. It is readily apparent,
gases and/or pre-combustion fuel vapors. by comparing Figure 3-9 (in Article 3-12) with Figure
(d) Relationships of PHEL Curves to Rest/Work 3-10, that mental impairment begins much earlier and at
Ratios. The laboratory data which led to the generation lower heat stress conditions than persons reaching their
of the PHEL curves allowed for the development of a physiological exposure limits. In heat stress conditions it
related series of rest/work ratios for different degrees of can be expected that mental acuity will have been
physical activity. These relationships are illustrated in impaired long before workers reach their physiological
Table 3-8 above. limits, physical performance decays in a similar fashion
(e) Precautions. It must be emphasized that the as that shown for mental impairment but in a different
Physiological Heat Exposure Limits are maximum al- time frame.
lowable standards and that they should be applied only
in cases of short-term work exposures of up to 8 hours 3-13. Practical Heat Stress Standards
duration. The limits presume that no prior heat injury is (1) General. Sound health, physical conditioning for
present and that no cumulative heat fatigue exists prior the specific task, and adequate rest and nutrition are
to re-exposure. essential in minimizing the effects of thermal stress.
(9) Other Indices. Other indices of heat stress and Drinking water should be unrestricted and readily avail-
strain are available but are of limited use. The value of able. Threshold WBGT values for the hottest 2-hour
any index is dependent upon the nature and extent of the
problem, the availability of resources, and the experi-
ence of local personnel in regard to heat stress analyses.
Consultation will be provided to commands if inquiries
are directed to the Naval Medical Command through
official channels.
(10) Information Regarding the “Wet Globe Temper-
ature” ( WGT) Index. The WGT Index (“Botsball”) has
been used in a number of situations, however, it is not
appropriate to utilize the WGT to determine Physiolog-
ical Heat Exposure Limits. Army meteorological studies
have shown that in identically the same environmental
conditions no two WGT thermometers indicated the
same value, there was a marked bleaching of the black
cloth coverings after one month in use, the cloth cover-
ings had various degrees of bristle formations, the
coverings occasionally did not wet uniformly, the water
reservoirs frequently need refilling at one hour intervals,
WGT units required at least 5 minutes of stabilization
after replenishing water in the reservoir, and the WGT
values do not permit availability of essential data (dry-
and wet-bulb and globe temperatures) for thermal anal-
yses. Since 1971 there have been 8 equations published
that claim to permit conversion of WGT values to
WBGT values, there is a tremendous disparity between
the products from these equations. Application of avail-
able data, with and without conversion to estimated
WBGT values, to the PHEL chart has yielded unrealistic
safe exposure times. There have been similar unaccept-
able findings regarding the use of WGT values for Figure 3-10.

3-28
3-13 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-13
period of industrial-type work shifts should be deter- the same spaces noted for the heating standards above.
mined using the work load of personnel as described in In addition, air-conditioning and ventilation are re-
Section 3-8 and Table 3-5. The threshold WBGT values quired for manned electronics spaces and compartments
versus work levels are repeated below: with equipment sensitive to changes in temperature and
humidity.
Work Level WBGT (F) (b) Submarines. The standards for comparable
spaces aboard submarines are as follows: 80 F DB, 67 F
Light 86 WB, 50% RH, with 71 F WBGT.
Moderate 82 (c) Other Compartments. Laundries, galleys, scul-
Heavy leries, passages not opening directly on weather decks,
(2) Limitations on Physical Exertion. During the first and areas above food serving lines present situations in
12 weeks of hot weather training the limits of physical which it is difficult to contain heat and humidity within
exertion should be determined by the degree of environ- specific narrow limits. Standards for these areas, how-
mental heat stress, metabolic heat production, the status ever, should allow for physical health and well-being; the
of acclimatization, and the physical status of individual WBGT Index should not exceed 78 F during normal
personnel. The availability of adequate drinking water operations. In addition, ventilation and cooling of such
and the frequency of rest periods should also receive spaces should be consistent with the information given
consideration. Individuals who are over 35 years of age,
those who are obese or whose nutritional status is poor, in Articles 3-6 and 3-7 (Section H) and Article 3-11
and those with evidence of chronic or acute cardiopul- (Section IV) of this chapter. Design criteria presented in
monary dysfunction should be medically screen prior to Table 3-1 (Article 3-7, Section 11) must be considered in
physical exertion under thermal stress. Table 3-9 out- planning ventilation for firerooms, engine rooms, laun-
lines the recommendations for different physical activi- dries, sculleries, galleys and steam catapult launch con-
ties at five WBGT Index ranges. It applies especially to Table 3-9. WBGT as a Guide in Regulating Intensity of
personnel during training and recreational exercises in Physical Exertion During First 12 Training
hot weather. The below table is not a substitute for the Weeks in Hot Weather*
PHEL curves nor is it possible to comply with the table
in combat situations. WBGT Index Flag
Intensity of Physical Exercise
(3) Heating Standards. [F] color
(a) Surface Vessels. The recommended standards Less Than 82 Blue Extremely intense physical exertion
for heating aboard surface vessels imply an optimum may precipitate heat exhaustion or
dry-bulb temperature of 70 F for the following spaces: heat stroke, therefore, caution should
(1) Living compartments, recreation and messing be taken.
spaces.
(2) Medical and dental spaces.
(3) Office and control spaces. 82-84.9 Green Discretion required in planning heavy
Humidity control is not usually provided. Special re- exercise for unseasoned personnel.
quirements should be reviewed by the Medical Depart- This is a marginal heat stress limit
ment before any action is taken. for all personnel.
(b) Submarines. Aboard submarines environmental
conditions are more closely controlled. Heating stan- 85-87.9 Amber Strenuous exercise and activity (e.g.,
dards should fall within the optimal limits of 79 F DB, close order drill) should be curtailed
59 F WB, 50% RI-I with 63 F WBGT. These standards for new and unseasoned personnel
apply to: during the first 3 weeks of heat
(1) Living compartments, recreation and messing exposure.
spaces.
(2) Medical and dental spaces. 88-88.9 Red Strenuous exercise curtailedfor all
(3) Office and control spaces. personnel with less than 12 weeks
(c) Other Compartments. Excluding the above training in hot weather.
noted spaces and those associated with engineering
propulsion components, inside working spaces are usu- 90 and Black Physical training and strenuous
ally maintained at lower temperatures during the winter. Above exercise suspended for all personnel
In these spaces, the control of personal warmth is (excludes operational commitment
facilitated by the proper use of available clothing. not for training purposes).
(4) Ventilation and Air-Conditioning
* This table must not be used in lieu of the Physiological
(a) Surface Vessels. Ventilation and air-conditioning Heat Exposure Limits (PHEL). The time-weighted-mean met-
standards for surface vessels should include the follow- abolic rates applicable to Table 3-8 are considerably higher than
ing upper limits for physical comfort and functional those for PHEL Curves. For an analogy, Table 3-8 would apply
well-being: 80 F DB, 68 F WB, 55070 RH (14.3 Torr VP), to Marine Corps personnel in the field, whereas the PHEL
with 72 F WBGT Index. The recommendations appIy to concept applies to industrial settings.

3-29
3-13 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-13
trol rooms. In situations where the heat stress is excessive 2. Lower Levelman II II
and ventilation or cooling cannot be improved, the
D. Steam Catapult Launch
Physiological Heat Exposure Limits need to be em-
Control Room:
ployed to minimize the incidence of personnel heat
injuries. 1. All Watch Personnel II II
(5) Shipboard Heat Stress Situations Section 11. Diesel Propelled Ships
(a) Physiological Heat Exposure Limits (PHEL) A. Engineering Officer of the
Chart. The PHEL chart illustrated in Figure 3-9 (Article Watch [EOOW] I I
3-12) provides the relationships of various metabolic B. Petty Officer of the Watch
rates, heat stress and maximum safe exposure times. [POOW] II III
Applicability of PHEL curves to routine watches and C. Electrician Mate of the
casualty control exercises are given in Table 3-10 below, Watch [EMOW] I I
and the PHEL times for Figure 3-9 and Table 3-10 D. Throttleman I I
PHEL curves are given in Table 3-11; where there is no E. Repair Electrician I I
apparent presence of fuel combustion gases (or “stack F. Ship’s Service Diesel
gas”) and/or fuel vapors. In all given situations the Twm Generator Watch I I
metabolic rates have been utilized, whereby the varied G. Boiler Watch I 1
activities (including movements about the spaces) and
H. Evaporator Watch II I
lengths of time for the various activities have been taken
into account. For Remaining Safe Stay Time situations, 1. Oiler/Messenger III IV
where different heat stress conditions, actual exposure Section III. Gas Turbine
times and/or recovery times apply, see Section (5)(b) Propelled Ships
below. When it is apparent that fuel combustion gases A. All Engineering Watch
(or “stack gas”) and/or fuel vapors are present, use Personnel I II
PHEL times given in Table 3-12. Section IV. All Ships and
Submarines
Table 3-10. Physiological Heat Exposure Limit Curve A. Engineering Casualty
General Applicability Control Evaluation Team Not
[ECCET] Applicable II
* Casualty
Routine B. Roving Watch Personnel III III
Personnel Control
Watch C. Laundry Personnel III Not
Exercise
Applicable
Section 1. Steam Propelled Ships D. Scullery Personnel V Not
A. Fire Room: Applicable
1. Boiler Tech. of the Watch E. Galley and Food Serving Not
(BTOW) II II Line Personnel II Applicable
2. ABC Console Operator I I F. Fleet Training Group
3. Upper Levelman II III Instructors and Other
4. Lower Levelman III IV Off-Ship Engineering
5. Burnerman II III Observers I II
6. Messenger III IV G. Personnel Conducting
B. Engine Room: [Including Heavy Repairs or Other
Nuclear] Strenuous Work VI VI
I. Engineering Officer of the * The work rate during Casualty Control Exercise is much
Watch [EOOW] I I less than that needed for repair involving heavy work. Different
PHEL Curve selections are required for different work rates
2. Machinist Mate of the during the Exercise Phase, however, all heavy work situations
Watch [MMOW] II III require use of PHEL Curve VI.
3. Throttleman I I
4. Electrician Mate of the (b) Remaining Safe Stay Times. There are a number
Watch [EMOWJ I I of situations where it is necessary to estimate the
5. Upper Levelman II III remaining safe stay times relative to various heat stress
6. Lower Levelman II III conditions, different work levels and/or to account for
7. Evaporator Watch I Not recovery periods. Generally this is a complex task,
Applicable however, a simplified approach is given in the below
8. Messenger III IV equation:
C. Auxiliary Spaces [CV’S and
FF 1052’s]: RSSt = [(1 – (Et – R/2)) / Atl] * At2
1. Upper Levelman II II
where:

3-30
3-13 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-13
RSST = remaining safe stay time (in minutes)
Table 3-11. PHEL Time Limits for PHEL Curves I - Et = elapsed time on station (in minutes)
VI Without the Presence of Fuel Combus- R = recovery time in a cool environment (in
tion Gases and/or Fuel Vapors [WBGT minutes)
80.0 -125.0 F] Atl = allowed PHEL time in first environment
Six PHEL Curves (in minutes)
WBGT
(Total Exposure Times In Hours: Minutes) At2 = allowed PHEL time in second environ-
Index
ment (in minutes)
(F) I II III IV V VI
80.0 >8:00 >8:00 >8:00 8:00 6:35 4:30 Four examples will help illustrate the importance of
81.0 >8:00 >8:00 >8:00 7:45 6:00 4:05 calculating Remaining Safe Stay Times:
82.0 >8:00 >8:00 8:00 7:05 5:25
1. The level of physical work was changed from heavy
3:40
83.0 >8:00 7:45
to light work and the heat stress is higher in the
>8:00 6:25 4:55 3:20
light work phase, the elapse time of the first
84.0 >8:00 8:00 7:05 5:55 4:30 3:05
exposure is known, and no recovery is permitted
85.0 6:00 6:00 6:00 5:20 4:05 2:50 between the two levels of physical work.
86.0 6:00 6:00 5:55 4:55 3:45 2:35 a. Elapsed exposure time in the first heat stress
87.0 6:00 6:00 5:25 4:30 3:25 2:20 condition was 3 hours (180 minutes).
88.0 6:00 5:55 4:55 4:05 3:10 2:10 b. The first heat stress condition had a WBGT of
89.0 6:00 5:25 4:30 3:45 2:50 2:00 83.0 F and work was consistent with PHEL
90.0 5:40 5:00 4:10 3:25 2:40 1:50 Curve VI. [PHEL VI at 83.0 F permits a
91.0 5:15 4:35 3:50 3:10 2:25 1:40 maximum of 3 hours 20 minutes (200 minutes)]
92.0 4:50 4:10 3:30 2:55 2:15 1:30 c. There was no recovery in a cool environment
93.0 4:25 3:50 3:15 2:40 2:00 1:25 between the first environment and the second
94.0 4:05 3:35 3:00 2:25 1:50 1:15 (WBGT 94.3 with work equal to PHEL Curve
95.0 3:45
I). [PHEL I at 94.3 F permits a maximum of 4
3:15 2:45 2:15 1:45 1:10
hours (240 minutes).]
96.0 3:25 3:00 2:30 2:05 1:35 1:05 Therefore, RSSt#l = [(1 – (180 – (0/2))/ 200]
97.0 3:10 2:45 2:20 1:55 1:25 1:00 * 240 = 24 minutes. The second exposure situa-
98.0 2:55 2:35 2:10 1:45 1:20 0:55 tion should not exceed 24 minutes.
99.0 2:40 2:20 2:00 1:40 1:15 0:50 2. The level of physical work was unchanged at the
100.0 2:30 2:10 1:50 1:30 1:10 0:45 same heat stress level but the two exposures were
101.0 2:20 2:00 1:40 1:25 1:05 0:45 separated by a 40 minute recovery period in a cool
102.0 2:10 1:50 1:35 1:15 1:00 0:40 environment; the elapsed time was known for the
103.0 2:00 1:45 1:25 1:10 0:55 0:35 first exposure.
104.0 1:50 1:35 1:20 1:05 0:50 0:35 a. Elapsed exposure time in the first heat stress
105.0 1:40 1:30 1:15 1:00 0:45 0:30 condition was 3 hours (180 minutes).
b. Both heat stress conditions had WBGT values
106.0 1:35 1:25 1:10 0:55 0:45 0:30 of 91.3 F and the level of work was consistent to
107.0 1:30 1:15 1:05 0:50 0:40 0:25 PHEL Curve I in both cases. [PHEL I at 91.3 F
108.0 1:20 1:10 1:00 0:50 0:35 0:25 permits a maximum of 5 hours 8 minutes (308
109.0 1:15 1:05 0:55 0:45 0:35 0:25 minutes) each]
110.0 1:10 1:00 0:50 0:40 0:30 0:20 c. Recovery, between the two exposures, was per-
111.0 1:05 1:00 0:50 0:40 0:30 0:20 mitted for 40 minutes.
112.0 1:00 0:55 0:45 0:35 0:25 0:20 Therefore, RSSt#2 = [(1 - (180 - (40/2))/ 308]
113.0 0:55 0:55 0:40 0:35 0:25 0:15 * 308 = 148 minutes or 2 hours 28 minutes. The
114.0 0:55 0:45 0:40 0:30 0:25 0:15 second exposure situation should not exceed 2
115.0 0:50
hours 28 minutes.
0:45 0:35 0:30 0:20 0:15
3. The level of physical work was the same in two
116.0 0:45 0:40 0:35 0:25 0:20 0:15 different heat stress environments, the exposure
117.0 0:45 0:40 0:30 0:25 0:20 0:10 time in the first condition was known, and the two
118.0 0:40 0:35 0:30 0:25 0:15 0:10 exposures were separated by a 40 minute recovery
119.0 0:35 0:35 0:25 0:20 0:15 0:10 in a cool environment.
120.0 0:35 0:30 0:25 0:20 0:15 0:10 a. Elapsed exposure time in the first heat stress
121.0 0:35 0:30 0:25 0:20 0:15 0:10 condition was 3 hours (180 minutes).
122.0 0:30 0:25 0:20 0:15 0:15 0:10 b. The first heat stress condition had a WBGT of
123.0 0:30 0:25 0:20 0:15 0:10 0:10 91.3 F and work equalled that for PHEL Curve
124.0 0:25 0:25 0:20 0:15 0:10 0:05 I. [PHEL I at 91.3 F permits a maximum of 5
hours 8 minutes (308 minutes)]
125.0 0:25 0:20 0:20 0:15 0:10 0:05
c. There was 40 minutes recovery in a cool envi-

3-31
3-13 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-13
ronment between the first environmental expo- (7) Eliminate the presence of fuel combustion
sure, and the second exposure at a WBGT of gases and fuel vapors.
94.3 F with work equivalent to PHEL Curve I. (8) Automate and isolate operations which gen-
[PHEL Curve I at WBGT of 94.3 F permits 4 erate excessive heat (not always feasible).
hours (240 minutes) stay time] (6) Compressed Air and Vortex Cooling. Compressed
Therefore, RSSt#3 = [(1 – (180 – (40/2))/ 308] air and vortex-type cooling methods present individual-
* 240 = 115 minutes or 1 hour 55 minutes. The ized assets and liabilities. Plans to utilize these tech-
second exposure situation should not exceed 1 niques should be reviewed by the Naval Medical Com-
hour 55 minutes. mand prior to their operation/ use. The subjective sense
4. The level of physical work changed from an inter- of well-being afforded by these methods is not always
mediate level to lighter level and the heat stress was synonymous with the maintenance of object physiologic
considerably higher in during the second exposure.
Both the elapsed time for the first exposure and the Table 3-12. PHEL Time Limits for PHEL Curves I -
recovery time between exposures were known. VI With the Presence of Fuel Combustion
Gases and/or Fuel Vapors [WBGT 80.0-
a. Elapsed exposure time in the first heat stress
115.0 F]
condition was 3 hours 15 minutes (195 minutes)
b. The first heat stress condition had a WBGT of WBGT Six PHEL Curves
87.7 F and work was consistent with PHEL Index (Total Exposure Times In Hours: Minutes)
Curve IV. [PHEL IV at 87.7 F permits a (F)
maximum of 4 hours 15 minutes (255 minutes)] I II III IV V VI
c. There was 50 minutes recovery in a cool envi- 80.0 4:50 4:15 3:30 2:55 2:15 1:30
ronment between the first exposure and the 81.0 4:25 3:50 3:10 2:40 2:00 1:20
second, the work during the second exposure 82.0 4:00 3:30 2:55 2:25 1:50 1:15
was equivalent to PHEL Curve II, but the 83.0 3:40 3:10 2:40 2:10 1:40 1:10
WBGT value was 100.9 F for the second expo- 84.0 3:20 2:55 2:25 2:00 1:30 1:00
sure. [PHEL 11 at 100.9 F allows a maximum of 85.0 3:00 2:40 2:10 1:50 1:25 0:55
2 hours 5 minutes (125 minutes)]
86.0 2:45 2:25 2:00 1:40 1:15 0:50
Therefore, RSSt#4 = [(1 – (195 – (50/2))/ 255]
* 125 = 42 minutes. The second exposure situa- 87.0 2:30 2:10 1:50 1:30 1:10 0:45
tion should not exceed 42 minutes. 88.0 2:20 2:00 1:40 1:25 1:05 0:40
NOTE: In application of the Remaining Safe Stay Time 89.0 2:05 1:50 1:30 1:15 1:00 0:40
equation it must be acknowledged that some 90.0 1:55 1:40 1:25 1:10 0:55 0:35
cumulative fatigue will take place. 91.0 1:45 1:30 1:15 1:05 0:50 0:30
(c) Presence of Fuel Combustion Gases and/or Fuel 92.0 1:35 1:25 1:10 1:00 0:45 0:30
Vapors. As indicated in Article 3-11(3), the apparent 93.0 1:30 1:20 1:05 0:55 0:40 0:25
presence of fuel combustion gases (or “stack gas”) 94.0 1:20 1:10 1:00 0:50 0:35 0:25
and/or fuel vapors has a deleterious impact upon work- 95.0 1:15 1:05 0:55 0:45 0:35 0:20
ers. To minimize excessive exposures it is possible to 96.0 1:10 1:00 0:50 0:40 0:30 0:20
utilize the PHEL Curves provided the stay times are 97.0 1:05 0:55 0:45 0:40 0:30 0:20
reduced 66%. Table 3-12 provides the reduced PHEL
98.0 1:00 0:50 0:40 0:35 0:25 0:15
values compared with those given in Table 3-11.
(d) Alternative Options for Regulating Heat Stress. 99.0 0:55 0:45 0:40 0:30 0:25 0:15
It is sometimes impossible to control environmental heat 100.0 0:50 0:45 0:35 0:30 0:20 0:15
within the specified limits in the face of increased 101.0 0:45 0:40 0:35 0:25 0:20 0:15
operational demands. Alternative measures may there- 102.0 0:40 0:35 0:30 0:25 0:20 0:10
fore be useful in limiting heat stress and reducing 103.0 0:40 0:35 0:30 0:25 0:15 0:10
the incidence of heat casualties. Several options are 104.0 0:35 0:30 0:25 0:20 0:15 0:10
possible: 105.0 0:35 0:30 0:25 0:20 0:15 0:10
(1) Insulate the source of heat. 106.0 0:30 0:25 0:20 0:20 0:15 0:10
(2) Ventilation with cool air (Section II of this 107.0 0:30 0:25 0:20 0:15 0:10 0:10
chapter). 108.0 0:25 0:25 0:20 0:15 0:10 0:05
(3) Reduce humidity (partial water vapor content) 109.0 0:25 0:20 0:15 0:15 0:10 0:05
by stopping steam leaks and venting steam to the 110.0 0:25 0:20 0:15 0:15 0:10 0:05
outside. 111.0 0:20 0:20 0:15 0:10 0:10 0:05
(4) Provide clothing which will maximize evapo- 0:15
112.0 0:20 0:15 0:10 0:10 0:05
rative cooling.
113.0 0:20 0:15 0:15 0:10 0:05 0:05
(5) Limit exposure time (refer to PHEL Chart).
114.0 0:15 0:15 0:10 0:10 0:05 0:05
(6) Avoid cumulative fatigue; maintain overall
physical health. 115.0 0:15 0:15 0:10 0:10 0:05 0:05

3-32
3-13 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-14
well-being. Furthermore, there is a need to ensure that tempts at pre-cooling deep body temperatures prior to
the quality of the air used in these methods meets excessive high heat stress exposures were relatively inef-
breathing quality air standards. In describing the in- fective in markedly extending personnel exposure times.
tended use it is essential that the potential ability to
provide a continuous air supply, while man is tethered to 3-14. Practical Cold Stress Standards
the filtered air supply outlet, is a reality. Commonly (1) Equivalent Temperature (Wind Chill Index). The
available vortex tubes have no means of ensuring the human body is continually producing heat internally
maximum cooling fraction setting, therefore, it is nec- and losing it externally to the environment. A portion of
essary to describe the positive means of controlling the this heat exchange is accounted for by the circulation of
cooling fraction and locking the control knob in the air at the skin surface. Increased air velocity thus
optimum cooling fraction position (which is rarely at the proportionately increases the loss of body heat. If the
fully open setting on the vortex tube control valve). ambient air temperature is below freezing and the wind
Fractional distribution of “cooling” air over the body velocity is such that it removes heat from the body
surface needs to be proportional to that surface area of surface more rapidly than it can be replaced, frostbite
the body and active muscle sites involved in performing may occur. The combined effect of wind and tempera-
the intended physical work. ture are given in the Equivalent Temperature Chart,
(7) Other Body Cooling Devices/Attempts. Compre- commonly referred to as the Wind Chill Index (Table
hensive physiological and environmental information 3-13). This chart is an expression of the effective
available to date has not supported the use of liquid temperature acting on exposed body surfaces. In using
cooling, solid carbon dioxide vests, or other such gar- the chart the estimated (or actual) wind velocity is
ments worn under regular work clothing in terms of compared to the dry-bulb air temperature. The equiva-
economics, unrestricted body movement, and optimum lent temperature is found where the two columns inter-
safety of personnel in shipboard non-emergency situa- sect. For example, at a temperature of – 10 F under calm
tions. There may be highly specialized applications of conditions, the equivalent temperature on exposed body
such units, but each remains to be carefully examined surfaces is the same as that of ambient air, i.e., – 10 F.
with sufficient supporting data. The key issue is to On the other hand, if the wind velocity increases to 10
perform the necessary corrective engineering actions to miles per hour, the loss of body heat at the skin surface
eliminate impedances of the workers and permit the is equivalent to that experienced with no wind at – 33 F.
workers to perform their normal duties in an effective For figures intermediate to those listed in Table 3-13,
manner without physical encumbrances. In emergency proportionate interpolations may be made as needed.
situations, limited use of such body cooling devices may Table 3-13 also indicates the variabIe dangers of the
be required, however, the personnel wearing the devices different equivalent temperatures.
must be fit individuals who are under very close super- (2) Additional Considerations Regarding Equivalent
vision during the emergency events. Historically, at- Temperature. It should be noted that Equivalent Tem-

Table 3-13. Cooling Power of Wind on Exposed Flesh Expressed as a Equivalent Temperature

Trenchfoot and immersion foot may occur at any point on this chart.
3-14 MANUAL OF NAVAL PREVENTIVE MEDICINE 3-14
perature (Wind Chill Index) applies only to dry skin and (c) There are five cold water immersion “DO
does not take account of the effect of evaporative NOT’S”:
cooling. The insulation provided by clothing and the 1. Do not panic! Actions within the first 10
accentuation of heat loss by wet garments are similarly seconds can mean survival or death.
not considered. When estimating the Equivalent Tem- 2. Do not strugg[e. Struggling will squeeze insula-
perature (Wind Chill Index) other causes of increased air tive air out of clothing and ingesting cold water may
constrict breathing passages and induce “dry drowning. ”
circulation over the body should be noted. For instance,
3. Do not swim for [and that’s over a mile away.
the estimated air speed occasioned by walking, running, 4. Do not remove clothing.
or riding in an open vehicle must be added to the actual 5. Do not use so-called “drownproofing” tech-
(or estimated) wind velocity when estimating the equiv- niques in water that is colder than 72 F. Drownproofing
alent surface temperatures. Finally, it is worth remem- involves floating almost motionless for long periods,
bering that regardless of the wind velocity, the danger of relying on the natural bouyancy of the body and its
frostbite to dry exposed body surfaces is negligible as tendency to hand in a semi-vertical position in water,
long as the dry-bulb air temperature is above freezing. with the head just breaking the water surface. In cold
(3) Special Applications of Equivalent Temperature. water, the greatest heat loss is from the head and neck.
Although the Equivalent Temperature (Wind Chill In- Since drownproofing requires immersion of those areas,
the onset of hypothermia, followed by death, can be
dex) can be taken as a practical cold stress standard, brought about with distressing swiftness.
special situations may require referral to the Naval
Medical Command, Department of the Navy, Washing- Figure 3-11 illustrates the Hypothermia Median Lethal
ton, D. C., 20372–5 100, for consultation. Exposure (Survival Time Versus Water Temperature) for
(4) Median Lethal Exposure Limits: HELP position, huddling, normal floating with a per-
(a) Frigid water triggers complex physiological re- sonal flotation device, treading water and swimming.
sponses that shut down the blood circulation to most Hypothermia median lethal exposure times assume that
parts of the body except heart, lungs and brain. Though the victim has survived the initial thermal and physical
the blood contains only a limited amount of oxygen, it shock of entry into the water.
can be enough to sustain life and prevent damage to
brain tissue for considerable periods of time, once the
body’s internal temperature has dropped. A cooled-
down brain needs less oxygen than one at normal
temperature. It takes 10-15 minutes before the deep
body temperatures start to drop, surface tissues cool
quickly. A victim may experience labored breathing and
stiffness of limbs. As core temperature drops to 95 F
there will be violent shivering; at 90–95 F, mental
facilities cloud; at 86-90 F there is muscular rigidity and
loss of consciousness. Below 86 F there is diminished
respiration and possible heart failure. Below 80 F,
respiration becomes almost undetectable and death is
imminent.
(b) There are five cold water immersion “DO’s”:
1. Wear a personal flotation device (PFD) or
several layers of clothing.
2. Try to keep lungs inflated with air to maintain
bouyancy.
3. Use minimum movement to prevent the escape
of trapped air in clothing, which acts as an insulator.
4. Maintain HELP (Heat Escape Lessening Pos-
ture) until help arrives. The HELP position is basically
a fetal position with arms and legs withdrawn close to
the body. An alternative is to huddle with two or more
persons in the water.
5. Take advantage of floating objects.

3-34
NAVMED P—5010-4

Chapter 4
Manual of Naval Preventive Medicine
Swimming Pools and Bathing Places

6 June 2002
To: Holders of the Manual of Naval Preventive Medicine

1. Purpose. This revision reflects the latest swimming pooi and spa safety and
water quality recommendations of the National Swimming Pool and Spa Institute.

2. Action. Replace entire chapter 4 with this version.

D. C. ARTHUR
Deputy Chief, Bureau of
Medicine and Surgery
Medicine and Surgery NAVMED P-5010-5 (Rev 1990)
Washington. D.C. 20372-5120 0510-LP-206-6200

Manual of Naval Preventive Medicine

Chapter 5
Water Supply Ashore

DISTRIBUTION STATEMENT “A”

O51OLP2O662OO
CONTENTS
Page
Section I. General Information
Article 5-1. Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 5-1
5-2. Background . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 5-1
5-3. Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .............................. 5-1
5-4. Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............ 5-2

Section II. Importance of Potable Water

Article 5-5. General . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ...............


5-4
5-6. Microbiological Consideration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...5-4
5-7. Physical-Chemical Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5-4
5-8. Radiological Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4

Section III. Water Sources

Article 5-9. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..........................5-5


5-10. Selection of Water Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...5-5
5-11. Wells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..............................5-6
5-12. Springs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................ 5-7
5-13. Surface Water Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
5-14. Rainwater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... 5-3..............
5-15. Snow and Ice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 5-8
5-16. Sea Water . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 5-9
5-17. Bottled water .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............... 5-9

Section IV. Water Distribution System

Article 5-18. General . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................... 5-10


5-19. Cross-Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 5-10
5-20. Water Main Flushing and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-10
5-21. Pressure .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...................... 5-11
5-22. Use of Non-potable Water. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-11

Section V. Potable Water Storage

Article 5-23. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................... 5-12


5-24. Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 5-12
5-25. Sanitary Standards for Water Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12
5-26. Disinfection of Water Storage Tanks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-13

Section VI. Water Treatment

Article
5-28. Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................... 5-13
5-29. Fluoridation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 5-16
5-30. Corrosion Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 5-17

Section VII. Water Quality Standards

Article 5-31. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......................... 5-18


5-32. Treated Water Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-18

Section VIII. Water Quality Surveillance

Article 5-33. 5-20


Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......................
5-34. Surveillance Sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-20 ....
5-35. Surveillance Sampling Overseas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-22
5-36. Military-Unique Chemicals and Other Potentially Hazardous Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-22

November 1990 II
Page
5-37. Operational Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-22
5-38. Procedures for Sampling and Preservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-23
5-39. Reporting and Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-23
5-40. Remedial Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 5-23

Section IX. Contingency Planning


Article 5-41. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......................... 5-24
5-42. Points to Consider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 5-24
5-43. Additional Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-25
5-44. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..................... 5-25

Appendices.
A. Model Potable Water Monitoring Program for the Instillation Medical Authority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-25
B. Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................................................ 5-26
C. Principal Waterborne Diseaes of Concern Within CONUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-28
D. Safe Operation of Chlorination Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-30
E. Navy Environmental and Preventive Medicine Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-31
F. Treated Water Quality Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 5-32
G. NPDWR Surveillance Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... 5-37
H. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .............................................. 5-37
I. Microbiological Sampling Technique for Drinking Water Quality Determination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-39
J. Remedial Actions To Be Taken In Event Contaminated Water Samples Are Found . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-40

Figures and Tables

5-1. Minimum distance between wells, springs, etc., various potential sources of contamination . . . . . . . . . . 5-7
5-2. Volume of water in different sizes of pipe. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-11
5-3. Water main disinfecting procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-11
5-4. Color coding for shore-to-ship water connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12
5-5. Chlorine-pH relationship 100% bacteria kill in 60 minutes (at 72ºF). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-14
5-6. Minimum free and combined bactericidal chlorine residual recommended in the event of water
system problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................. 5-15
5-Cl. Minimum 30 minute free chlorine and chloramine residuals naturally clear or filtered water . . . . . . . . 5-29
5-F1 Total Coliform Ssmpling Requirement according to Population Served . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-34
5-F2 Monitoring Requirements Following a Positive Coliform Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-34
5-F3 Sanitary Survey Frequency for Public Water Systems collecting Fewer than Five Samples/Month . . 5-34

III
CHAPTER 5
WATER SUPPLY ASHORE
Section L GENERAL INFORMATION

Article
Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4

5-1. Purpose. of the Navy.


5. MEDCOM Instruction 6240.1 Series, Stan-
This chapter gives public health and preven- dards for Potable Water, set drinking water
tive medicine information and guidance to De- standards in the naval establishment ashore and
partment of the Navy personnel concerned with afloat as well as outside the Continental United
the production and surveillance of potable water States. The use of forms DD 686, Fluoride Bacte-
at fixed shore facilities and advanced bases. De- riological Examination of Water, and DD 710,
partment of the Navy personnel include military Physical and Chemical Analysis of Water, was
and civilian members of the Navy and Marine also directed.
corps.
5-3. Policy.
5-2. Background.
1. In states where primacy has been granted
1. The Safe Drinking Water Act (SDWA) by EPA, Navy and Marine Corps installations,
(Public Law 93-523) was signed into law on 16 classified as suppliers of water must follow sub-
December 1974. The SDWA and later amend- stantive and procedural requirements of
ments direct the U.S. Environmental Protection NPDWR to conform with the SDWA as may be
Agency (EPA) to develop National Primary published by state regulatory authorities.
Drinking Water Regulations (NPDWR) for all 2. In states and territories not having pri-
public water systems from a health standpoint. macy, Navy and Marine Corps installations
As a result of this legislation, primary enforce- classified as suppliers of water (owner or opera-
ment authority (Primacy) is to be adopted by tor of a public water system) must follow the
the individual states. substantive and procedure requirements of
2. Under the SDWA, EPA has developed Na- NPDWR to conform with the SDWA as admin-
tional Secondary Drinking Water Regulations istrated by the applicable EPA regional office.
(NSDWR) for all public systems. Contaminants 3. Navy and Marine Corps installations clas-
covered by NSDWR may adversely affect the sified as suppliers of water located outside the
aesthetic quality of drinking water. The continental limits of the United States
NSDWR are not federally enforceable, as are (CONUS) shall comply with the substantive and
NPDWR; rather they are intended as guide- procedural requirements of NPDWR to con-
lines for the states, but may be incorporated form with the SDWA, or the host country
into state law and enforced by the respective whichever is more stringent. If compliance is
state. inconsistent with international agreements,
3. The NPDWR are published in Title 40, status of forces agreements, host country laws,
Code of Federal Regulations part 141(40 CFR or cannot be achieved for any reason, requests
141); NSDWR are published as 40 CFR 143. for deviation from CONUS drinking water stan-
4. OPNAV Instruction 5090.1, Environmental dards must be submitted in writing to Chief, Bu-
and Natural Resources Protection Manual, pub- reau of Medicine and Surgery (B UMED), Wash-
lished procedures and requirements of SDWA ington, DC 20372-5120. This request must be for-
and 40 CFR 141 and 143 within the Department warded via the cognizant Navy Environmental

November 1990 5-1


5-3 CHAPTER 5. WATER SUPPLY ASHORE

and Preventive Medicine Unit (NAVENPVNT- erating procedure for potable water monitoring.
MEDU and the Navy Environmental Health b. Keeping EFDs and activities informed
Center (NAVENVIRHLTHCEN). of related legislative and regulatory changes via
4. The establishment of drinking water system directives from NEESA, Point Hueneme, Cali-
standards and monitoring requirements aboard fornia.
Navy ships, both USS and USNS is a responsi- c. Giving Navy-wide defense environ-
bility of BUMED, and are published in Chapter mental status reports to NAVFAC, CNO, ma-
6, Water Supply Afloat, of this manual. jor claimants and DOD as needed.
5. Field water supply standards and monitor- d. Helping EFDs concerning the devel-
ing requirements are a responsibility of opment of water conservation projects and wa-
BUMED, and are published in Chapter 9 of this ter contingency planning criteria. See Appendix
manual, titled “Preventive Medicine for Ground H, H-3.1.
Forces.” 3. Per OPNAV Instruction 5090.1, major
6. When considered necessary, BUMED may claimants and activity Commanding Officers
publish additional standards of water quality and with public water system are responsible for:
monitoring requirements for Navy drinking wa- a. Operating, and maintaining facilities
ter systems, ashore and afloat. to manufacture drinking water which meets ap-
plicable standards.
5-4. Responsibilities. b. Sampling, conducting analysis, report-
ing to EPA or states, and keeping records per 40
1. NAVFACENGCOM Engineering Field CFR 141. Copies of all records or reports sent to
Divisions (EFDs) are responsible for: EPA or states must be forwarded to the proper
a. Giving technical and regulatory advice EFD.
to major claimants and activities concerning ac- c. Giving notification per 40 CFR 141 to
tions necessary for compliance with SDWA, 40 the state, or EPA and to all persons served by a
CFR 141 and those states which have primacy. community water system, if there is any failure
b. Conducting periodic surveys of activity to follow applicable substantive and procedural
water systems and reporting technical and ad- regulations.
ministrative deficiencies to activities via Utility d. Ensuring that water treatment plant
Systems Assessments (USA). personnel are trained and certified as required
c. Determining activity needs and help- by EPA or state regulations.
ing activities with respect to training and certi- 4. Public Works officers (USN) and Mainte-
fication of water treatment plant personnel. nance Officers (USMC) are responsible for:
d. Helping activities in the development a. Developing, in coordination with the,
of contracts and selection of laboratory services installation medical authority, (preventive
for potable water analyses. medicine department), adequate water supply
e. At the request of activities, negotiat- treatment techniques to ensure water supply
ing with state regulatory officials to ensure that is free of disease-producing organisms, haz-
equitable and realistic terms for compliance be- ardous concentrations of toxic materials, and
tween activities, state agencies, and EPA. objectionable color, odor, and taste. As a mini-
f. Serving as the focal point for liaison mum, ensure the water supply meets all appli-
between activities, state agencies, and EPA. cable NPDWR and the state water quality stan-
g. Checking overall regulatory compli- dards.
ance for activities within respective geographic b. Pursuing, in coordination with the in-
regions. stallation medical authority (preventive medi-
h. Timely review and action with respect cine department), an aggressive program to
to public notification during incidence of activ- identify, isolate, and correct potential sources of
ity non-compliance as required by EPA and contamination to the distribution system.
those states having primacy. c. Coordinating with federal, state, and
2. The Navy Energy and Environmental Sup- local agencies to set up a meaningful exchange
port Activity (NEESA) is responsible for: of information regarding local water resources,
a. Updating, as needed, the standard op- NPDWR and NSDWR.

5 - 2 November 1990
MANUAL OF NAVAL PREVENTIVE MEDICINE

d. Ensuring local water treatment person- water surveillance program tailored to each in-
nel are trained to meet levels of proficiency con- dividual water system is required. Appendix A
sistent with the operator certification require- is a model potable water monitoring program.
ments applicable to their location. The water surveillance program should include
e. Encouraging operating personnel to but is not limited to the following:
attend seminars, short courses, and other for- a. Maintaining liaison with federal, state,
mal instruction to remain abreast of new devel- and local regulatory authorities regarding cur-
opments in water treatment practices. - rent drinking water regulations to ensure com-
f. Maintaining quality control data to en- pliance.
sure NPDWR or state requirements are fol- b. Conducting periodic sanitary surveys
lowed. to locate and identify possible health hazards in
g. Developing a program to correct sys- the potable water system.
tem deficiencies, and upgrading equipment as c. Conducting tests for halogen residu-
needed. als, bacteriological quality and other tests as
h. Collecting and shipping water samples needed to supplement sanitary surveys.
following NPDWR, and NSDWR. d. Maintaining, or having access to, a
i. Notifying the installation medical au- copy of the plumbing diagram of the potable wa-
thority (preventive medicine department) upon ter, fire fighting (if separate), and sanitary
discovery that a water main break or similar oc- waste systems.
currence has taken place. e. Maintaining records that reflect the
j. Ensuring that all new mains and ex- chemical, radiological, and microbiological qual-
tensions are flushed and disinfected before plac- ity of the installation potable water supply sys-
ing them into service. tem.
5. Installation medical authority (preventive f. Monitoring and giving recommenda-
medicine department). The installation medical tions, when needed, regarding the disinfection of
authority, aided by the environmental health of- all new additions or repairs to water mains,
ficer and/or preventive medicine technicians, wells, pumps, storage tanks, and other units of
has an advisory role and recommends corrective the water supply system.
measures when any phase of water sanitation is g. Ensuring that all types of chemical ad-
unsatisfactory. Normally, adequate water qual- ditives to potable water supplies are approved by
ity can be maintained through cooperation and the supplier of water, the state, and the National
communication with the public works or mainte- Sanitation Foundation (NSF) and are used in
nance officer. TO carry out this advisory role, a proper concentrations.
5 - 5 CHAPTER 5. WATER SUPPLY ASHORE

Section II. IMPORTANCE OF POTABLE WATER

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Microbiological Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Physical-Chemical Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Radiological Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

5-5. General. a period of days, a long-term relationship may


appear when examining the effects of physical-
There are few environmental factors that af- chemical contaminants. Physical-chemical con-
fect the individual’s well-being more than the taminants may be present in the water supply as
availability of an adequate potable water supply. a result of a variety of factors. Naturally occur-
As water is a necessity to sustain life, a closely ring inorganic and organic contaminants are
controlled and adequate potable water supply is plentiful in the environment and are readily as-
mandatory. similated by water which acts as a solvent for
many of them. Trace metals, other inorganic,
5-6. Microbiological Considerations. and organics may also be assimilated by water as
a result of the waste disposal and industrial ac-
tions of man. Recent trends lead one to believe
1. One of the greatest deficiencies of custom-
that increasing concern will be generated by both
ary methods for evaluating the bacteriological
the regulating agencies and the using public over
quality of water is that results from tests are
the presence of both naturally occurring and
unknown until after the sampled water has en-
man-made organics in drinking water.
tered the distribution system. Successful regu-
lation of the microbiological quality of drinking
water depends on the use of raw water supplies 5-8. Radiological Considerations
of relatively unchanging high quality. Localized
contamination characteristics of leaking or bro- 1. As with physical-chemical contaminants,
ken water lines, back siphonage and cross con- minute traces of radioactivity are normally
nections are unlikely to be detected early found in all drinking water. These levels vary
enough to prevent exposure. Also, the low re- considerably throughout the United States and
sidual disinfectant maintained in the distribu- the. world. The concentration and composition of
tion system will almost certainly be overcome these radioactive constituents depend princi-
by such contamination. Despite the shortfalls of pally on the radiochemical composition of the
current microbiological monitoring techniques, soil and rock strata through which the raw wa-
it is essential that these methods continue to be ter has passed.
used. The goals of microbiological monitoring 2. The long-term effects of radiological con-
are: taminants in drinking water continues to be ex-
a. Provide an indicator of the effectiveness amined. Radioactivity in water systems may be
of disinfection. broadly categorized as either naturally occur-
b. Detect sanitary defects in the water dis- ring or man-made. Radium-226 is the most im-
tribution system. portant of the naturally occurring radionuclides
2. In overseas areas, water continues to be a likely to occur in public water systems. Al-
major consideration in the spread of disease. though radium may occasionally be found in sur-
Special attention to water handling and treat- face water due to man’s activities, it is usually
ment in these areas is needed to minimize the found in ground water as the result of geological
spread of such disease. conditions. In contrast to radium, man-made ra-
dioactivity is widespread in surface water be-
5-7. Physical-Chemical Considerations. cause of fallout from nuclear weapons testing. In
some localities this radioactivity is increased by
small releases from nuclear facilities (e.g., nu-
While the effects of microbiological contamina-
clear power plants, hospitals, and scientific and
tion of potable water may manifest themselves in

November 1990
MANUAL OF NAVAL PREVENTIVE MEDICINE 5-10

industrial uses of radioactive materials). The re- due to atmospheric nuclear weapons testing is
sidual radioactivity in surface waters from fallout mainly strontium-90 and tritium.

Section III. WATER SOURCES

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Selection of Water Source .. . .. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-10
Wells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . .-. . l l
Springs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12
Surface Water Sources ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-13
Rainwater... . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5--14
Snow and Ice . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-15
Sea Water. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-16
Bottled Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-17

5-9. General. as field sources. Sanitary control of field sources


is addressed in Chapter 9 of this manual, “Pre-
1. Depending on local conditions, water sup- ventive Medicine for Ground Forces.”
plies for installations may be obtained from any
of a number of sources. Commonly used water 5-10. Selection of Water Source.
sources include underground sources, such as
springs or wells, and surface sources, such as riv- 1. To ensure the selection of an adequate
ers, streams or lakes. Most Navy or Marine source, the average daily demand and the peak
Corps installations obtain their water supply demand rate must be determined. The average
from adjacent municipal facilities. Information daily demand may be estimated to meet con-
concerning the development and maintenance of tinuing demands during periods when surface
water sources can be found in Civil Engineering flows and ground water elevations are reduced.
Water Supply Systems, Design Manual 5.7 The peak demand rate, including fire protection
(NAVFAC DM-5.7). usage, may be estimated to determine plumbing
2. A properly conducted sanitary survey will needs, pressure losses, and storage require-
furnish sufficient data to base the acceptance or ments in order to supply enough water to all
rejection of the water as a present or potential parts of a distribution system during peak de-
source. This survey will be aided by chemical mand periods. Use of peak demand data will
and bacteriological analyses, and a knowledge of give the system enough contact time to ensure
the significance of the factors involved. Person- adequate disinfection under worst-case condi-
nel, trained and competent in environmental en- tions.
gineering and the epidemiology of waterborne 2. Cost Estimate. Besides capacity, consid-
diseases, will conduct the sanitary survey. A eration till also be given to the proximity and
sanitary survey of an existing supply will be quality of the source, the expected development
conducted when considered essential for the costs, and life of the project. Annual operating
maintenance of good sanitary quality. An annual expenses that include the cost of power and
sanitary survey is recommended. A sanitary chemicals, as well as personnel salaries, will be
survey of a new source may be made in conjunc- considered over the expected life of the project
tion with the collection of initial engineering to arrive at a sound final selection.
data covering the development of the source. 3. Public Water Systems. Where practical,
3. Many installations have isolated water approved public water systems will be consid-
sources, such as wells and springs, for service of ered for use. An evaluation of the municipality’s
training areas. In many cases, these isolated ability to produce enough potable water over an
water sources do not service residents and are extended period of time will be carried out. The
not classified as public water systems. Water mission of the base or unit will be considered if
systems that meet these criteria will be classified the water supply depends on an outside source.

November 1990 5-5


MANUAL OF NAVAL PREVENTIVE MEDICINE 5-10

industrial uses of radioactive materials). The re- due to atmospheric nuclear weapons testing is
sidual radioactivity in surface waters from fallout mainly strontium-90 and tritium.

Section III. WATER SOURCES

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Selection of Water Source .. . .. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-10
Wells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . .-. . l l
Springs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12
Surface Water Sources ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-13
Rainwater... . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5--14
Snow and Ice . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-15
Sea Water. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-16
Bottled Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-17

5-9. General. as field sources. Sanitary control of field sources


is addressed in Chapter 9 of this manual, “Pre-
1. Depending on local conditions, water sup- ventive Medicine for Ground Forces.”
plies for installations may be obtained from any
of a number of sources. Commonly used water 5-10. Selection of Water Source.
sources include underground sources, such as
springs or wells, and surface sources, such as riv- 1. To ensure the selection of an adequate
ers, streams or lakes. Most Navy or Marine source, the average daily demand and the peak
Corps installations obtain their water supply demand rate must be determined. The average
from adjacent municipal facilities. Information daily demand may be estimated to meet con-
concerning the development and maintenance of tinuing demands during periods when surface
water sources can be found in Civil Engineering flows and ground water elevations are reduced.
Water Supply Systems, Design Manual 5.7 The peak demand rate, including fire protection
(NAVFAC DM-5.7). usage, may be estimated to determine plumbing
2. A properly conducted sanitary survey will needs, pressure losses, and storage require-
furnish sufficient data to base the acceptance or ments in order to supply enough water to all
rejection of the water as a present or potential parts of a distribution system during peak de-
source. This survey will be aided by chemical mand periods. Use of peak demand data will
and bacteriological analyses, and a knowledge of give the system enough contact time to ensure
the significance of the factors involved. Person- adequate disinfection under worst-case condi-
nel, trained and competent in environmental en- tions.
gineering and the epidemiology of waterborne 2. Cost Estimate. Besides capacity, consid-
diseases, will conduct the sanitary survey. A eration till also be given to the proximity and
sanitary survey of an existing supply will be quality of the source, the expected development
conducted when considered essential for the costs, and life of the project. Annual operating
maintenance of good sanitary quality. An annual expenses that include the cost of power and
sanitary survey is recommended. A sanitary chemicals, as well as personnel salaries, will be
survey of a new source may be made in conjunc- considered over the expected life of the project
tion with the collection of initial engineering to arrive at a sound final selection.
data covering the development of the source. 3. Public Water Systems. Where practical,
3. Many installations have isolated water approved public water systems will be consid-
sources, such as wells and springs, for service of ered for use. An evaluation of the municipality’s
training areas. In many cases, these isolated ability to produce enough potable water over an
water sources do not service residents and are extended period of time will be carried out. The
not classified as public water systems. Water mission of the base or unit will be considered if
systems that meet these criteria will be classified the water supply depends on an outside source.

November 1990 5-5


5-10 CHAPTER 5. WATER SUPPLY ASHORE 5-11

Also, the projected mobilization needs for water wells:


will be considered in evaluating a public water a. The annular space outside the casing will
source. Public water systems may also be consid- be filled with water-tight cement grout per
ered for their applicability as backup water sys- EPA Manual of Individual Water Supply Sys-
tems. If two independent potable water supplies tems.
are to be interconnected, approval of the produc- b. For artesian aquifers, the casing must be
ers must be obtained. See NAVFAC DM-5.7 for sealed into the overlying impermeable forma-
more information. tions to retain the artesian pressure.
c. When a water-bearing formation contain-
5-11. Wells. ing water of poor quality is penetrated, the for-
mation must be sealed off to prevent the infil-
1. Ground water occurs in geologic forma- tration of water into the well and developed
tions called aquifers. Aquifers contain saturated aquifer.
permeable material which yields water to wells d. Every well will be provided with an over-
and springs. An aquifer serves as a transmis- lapping watertight cover at the top of the cas-
sion conduit and storage reservoir that trans- ing, or a raised pipe sleeve to prevent contami-
ports water under a hydraulic or pressure gra- nated water or other harmful materials from
dient from recharge areas to water-collecting entering the well.
areas. Ground water, when available, is usually e. All abandoned wells must be plugged and
an excellent source of water supply. Such water properly sealed, as required by Federal, State,
can be expected to be clear, cool, colorless, and or local authority, to prevent contamination of
quite uniform in character. It is generally of the ground water formation and for safety rea-
better microbiological quality and contains sons. The basic concept behind the proper seal-
much less organic material than surface water, ing of any abandoned well is that of restoration,
but may be more highly mineralized. At pres- of the controlling geological conditions that ex-
ent, wells serve small to medium-size installa- isted before the well was drilled or constructed.
tions although a system of multiple wells may If this restoration can be done, an abandoned
be used to develop a supply for large installa- well will not create a physical or health hazard.
tion. Consult NAVFAC DM-5.7 on this subject. AWWA Standard A100-66 provides further
More information may be found in NAVFAC guidance on this subject, Table 5-1 is the sug-
Guide Specification NFGS 02734, Rotary- gested minimum distance a well will be located
Drilled Water Wells and AWWA A-100-66, from sources of contamination. In many areas,
American Water Works Association Standard various soils and rock formations may require
for Deep Wells. increased distance. State and local health de-
2. Types of Wells. Wells are classified accord- partments may have requirements for various
ing to the construction method, i.e., dug, bored, distances. A sanitary survey, conducted by
driven, drilled, and jetted. Each type of well has qualified individuals, must be a matter of policy
distinguishing physical characteristics which in the construction or drilling of any new well
are best used to satisfiy a particular need. with nearby potential contamination sources.
NAVFAC DM-5.7 gives descriptions of particu- States and local health departments will be con-
lar well types and design considerations. tacted in each area.
3. Sanitary Protection. Proper sanitary meas- f. Disinfection.
ures must be taken to ensure the purity of the (1) Drilled, jetted, bored, and driven wells
water whenever ground water is pumped from a must be disinfected after construction, cleaning,
well for human consumption. Potential sources of or the removal of equipment for repair. When
contamination may exist either above or below the well equipment is ready for operation, the
ground level. Where possible, wells will be lo- well will be flushed by pumping to waste until
cated on ground that is higher than a potential the water is clear. Calculate the quantity of water
source of contamination. The area will be well in the well based on the depth of water and the
drained to divert surface waters from the well diameter of the casing. Introduce enough chorine
and reduce the possibility of flooding. Listed be- solution to obtain 100 parts per million (ppm)
low are guidelines for the sanitary protection of through a clean hose that is raised and lowered to

November 1990
5-11 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-13

TABLE 5-1. an artesian aquifer through a fracture or solution


zone. Contrary to popular belief, spring water is
Minimum distance between wells, springs, not always of good microbiological quality. Ex-
etc. and various potential sources of contam- treme caution must be exercised in the develop-
ination ment of springs. Generally, the same principles
that apply to location, protection, development,
Potential Contamination Well, spring,etc. and operation of wells apply to springs. The fac-
Source (distance in feet) tors presented above for well location must also
Sewer Line 50 be considered when conducting a sanitary survey
Septic Tank (Watertight) 50 of a spring.
Pit Privy 100 2. Protection. When used as a water source,
Disposal Field 150 spring water is usually captured in a small
Seepage pit 150
Cesspool 150 catchment reservoir to enclose and intercept as
much of the spring as possible.
all depths of the well water. A spray nozzle will 3. Spring Disinfection. Spring encasements
be used to disinfect the inside of the casing and will be disinfected by scrubbing the inside of the
the outside of the riser. Operate the pump until a encasement above the water line with a stiff
distinct odor of chlorine can be detected. Check brush or broom and 100 ppm chlorine solution.
the free available chlorine (FAC). When 100 ppm When the flow can be stopped or maintained
FAC is obtained, allow the well to stand for 24 within the encasement, determine the volume of
hours and then pump to waste until the chlorine water and add enough chlorine solution to the
drops to approximately 1 ppm FAC. Obtain wa- water to obtain a 100 ppm FAC residual in the
ter samples for bacteriological analysis and de- water. Let the spring stand 24 hours and dis-
termine potability before putting the well in charge to waste until the FAC residual is ap-
service. proximately 1.0 ppm. Take samples and place in
(2) Dug Wells. After the casing/lining is service as described for wells. When the spring
completed and prior to placing the cover over flow cannot be stopped, enough chlorine must
the well, disinfection is accomplished by the fol- be continuously fed into the contained water in
lowing steps: Remove every-thing, (e.g., tools, the spring encasement, near the inlet, to result
equipment, and structures) that will not be part in 100 ppm FAC in the outlet. This residual will
of the well. Determine the quantity of water in be maintained for at least 24 hours.
the well and the amount of disinfecting solution
needed. Scrub the casing or lining wall with a 5-13 Surface Water Source.
stiff broom or brush and a 100 ppm chlorine so-
lution. Place the well cover in position and in- 1. Surface water supplies are obtained from
troduce the disinfecting solution through a clean rivers, streams, lakes, and ponds. Because of
hose that is raised and lowered to all depths of the ease of physical and microbiological con-
the well water. Wash the outside of the pump tamination of surface water, additional factors
. cylinder and piping as the unit is lowered into not usually associated with ground water
the well. After the pump is in place, pump the sources, must be considered when selecting sur-
water until a distinct odor of chlorine is detected. face water sources. As a general rule, surface
Check the chlorine residual; when 100 ppm FAC water should be used only when ground water
is measured allow the well to stand for 24 hours. sources are not economically justifiable or are of
Pump the well until the chlorine residual is re- an inadequate quality or quantity.
duced to 1 ppm. Take samples for bacteriological 2. Source Selection. In examining surface wa-
analysis. When negative results are obtained, ters for potential use as drinking water sources,
place the well in service. care must be exercised. A number of interrelated
factors need to be considered. These include, but
5-12. Springs. are not limited to, sources of pollution, hydrologi-
cal studies, proposed intake location, and water
1. Springs are formed at the intersection of an uses identified for the particular water source by
aquifer with the ground surface, or by leakage of responsible governmental agencies. Raw water

November 1990 5-7


5-13 CHAPTER 5. WATER SUPPLY ASHORE 5-15

quality should be examined and a treatment 4. Rainwater may be stored either above or
scheme proposed to make sure applicable regula- below ground in tanks or containers. Potable
tions are followed and to give the best possible water tank coatings must be accepted by NSF
water supply for Navy and Marine Corps use be- Standard No. 61 or state regulations for contact
fore a final determination regarding the accepta- with potable water. Storing rainwater in under-
bility of the source is made. ground cisterns reduces evaporation, keeps the
3. Recreational Use of Surface Sources. Sur- water cooler and more palatable. Storage tanks
face waters that are used as a potable water must be protected from contamination by pol-
source may have desirable recreational quali- luted surface and ground water. Storage tanks
ties, e.g., fishing, boating, picnicking, and bath- must be covered and the vents or other openings
ing. A surface water source will not be used for screened to protect the water from dust, dirt,
recreational purposes if the water treatment mosquito breeding and the entrance of vermin.
plant does not include filtration and if sedimen- 5. The surfaces from which rain is collected are
tation, resulting from storage in reservoirs fol- subject to contamination by birds, animals, dust
lowed by chlorination, is the only treatment and, if at ground level, by human wastes. The
provided. Care will be exercised in determining first rain which falls during a storm flushes these
what types of recreational activities (swimming, substances from the surface and must be di-
boating, etc.) are suitable and may be author- verted to waste. Rainwater must be considered
ized for these waters. Periodic sanitary sur- contaminated until treated similar to other sur-
veys, will be used to evaluate the impact of rec- face water sources, (e.g., filtration, coagulation,
reational uses on these water sources. chlorination). The treated water must conform
with SDWA as published by EPA in 40 CFR 141.
5-14. Rainwater.
5-15. Snow and Ice.
1. Rain, including snow and ice can be used as
a source for potable water. In most climates it 1. While almost any place in the Arctic will
only augments the supplies from other sources. be near water in one form or another during the
2. Because of its softness (freedom from min- year, the provision of an adequate and safe wa-
erals), rainwater may be used for cooking, bath- ter supply for more than 50 persons is likely to
ing, laundry, and in boilers. Due to the absence be a major problem. If possible, get water from
of minerals, rainwater lacks palatability and running streams or lakes instead of melting ice
may contain dissolved gases, dust particles, and or snow. The melting of ice or snow uses large
bacteria swept from the air. In some cases, rain- quantities of fuel. In winter, surface water
water may be an important source of fresh wa- points may freeze to a depth of 6 to 8 feet. The
ter, (e.g., small islands and isolated areas), where water source must be deep enough to prevent
ground water is salty and surface water is inade- freezing to the bottom. Freezing of the intake
quate. Under some conditions. where usage rates can be prevented by constructing a wooden box
are small and precipitation heavy, rain may fur- with insulating materials to cover the opening
nish an adequate source. In many places, rain can in the ice. The raw water pump, when used,
be used to supplement other sources. Rainwater, may be protected by an insulated cover or an
like any water source, must be properly treated, insulated box may be constructed. In some situ-
disinfected, and handled. ations, a skid-mounted, heated shelter may be
3. Rainwater is collected from impervious constructed over the water intake to house raw
surfaces, (e.g., roofs, concrete pavement and water pumps and settling tanks. This water can
aprons, paved catchment areas, and barren be loaded into ski-mounted water tankers and
rocks). The volume obtained depends on the size transported to the camp where it is treated. If
of the catchment and the amount of rainfall. An the water is filtered, heated buildings will be
estimate of the volume (in gallons) that may be needed in winter. Standard water treatment
collected from an impervious surface can be equipment will need special heating and insulat-
made by multiplying the total catchment vol- ing when used in below freezing weather. Nor-
ume, in square feet, by one half the rainfall in mally, water hoses may be laid directly on the
inches. snow as long as water in them is circulating.

November 1990
5-15 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-17

When the pumps are stopped, water in the be used as a water source. Muskeg is a resilient
hoses must be drained immediately to prevent soil covered with bog and has a high water
freezing. All water lines will be pitched to allow table. Muskeg water can be collected by build-
for rapid draining when the pump stops. Ade- ing ditches.
quate provisions must be made to prevent
freezing of stored water. Small tanks or open 5-16. Sea Water.
basins must be located in heated shelters. Out-
side or elevated tanks must be properly insu- 1. The sea serves as the major source of drink-
lated. ing water for the fleet. Ashore, the sea may be
2. In winter, if water is not available, it will used as a water source by processing it with re-
be necessary to obtain water by melting snow verse osmosis water purification units (ROW-
or ice. To save fuel, use ice or the most compact PUS) or stills.
snow available. Ice is preferred to snow because 2. Sea water contains up to 37,000 parts per
it will yield more water for a given volume. million of dissolved salts which must be re-
About 1 cubic foot of water can be obtained moved by distillation or reverse osmosis. Since
from melting 5 cubic feet of snow. Freshly fro- coastal water may carry considerable organic
zen sea ice is salty, but year old sea ice has the material and turbidity or be polluted with oil or
salt leached out. Freshly frozen ice must be other waste, it may be desirable to settle sea
tested for salt content because, in some areas, water before processing. The natural filtration
where tidal action and currents are small, there and diluting effect of ground water may be used
is a layer of fresh water ice lying on top of the by processing water from shallow wells located
new sea ice. In some cases, this layer of salt along the shore. Since the production of potable
free ice may be 2 to 4 feet in depth. Old sea ice water from brackish or fresh water is more effi-
is rounded where broken and is Likely to be pit- cient, these sources will be used as soon as the
ted and have pools on it. The submerged portion military situation permits. Hot, arid climates
of old sea ice has a bluish appearance. Fresh sea contain few, if any, fresh water sources large
ice has a milky appearance and is angular w-here enough to support major military operations,
broken. Small quantities of water may be ob-
tained by melting snow or ice over a heat 5-17. Bottled Water.
source. Store the snow or ice to be melted just
outside the shelter and bring it inside as Bottled water may be used on Navy and Ma-
needed. If necessary, keep pots of snow or ice rine Corps installations in the United States or
on the stove, when not cooking, to increase the overseas as a source of drinking water. Bottled
water supply. Several models of ice and snow water is derived from surface or subsurface wa-
melters are available in the supply system. ter sources, depending on the bottler, and has
They are batch units into which ice or snow is been shown to be of variable quality. It is com-
manually loaded. Most units are portable, can be monly contended that bottled water may be of
operated indoors or outdoors, and can be fueled better quality than locally available public wa-
with gasoline or diesel fuel. ter supplies. This may not be the case. Bottled
3. In arctic areas during the summer, surface water will be only as good as the source from
sources are obtained and treated the same as which obtained and the quality of treatment re-
surface supplies in other geographic regions. ceived. Bottled water used at Navy and Marine
The milky water of a glacial stream is not harm- Corps installations must meet all the require-
ful. Sedimentation will settle out most of the ments of the NPDWR for physical, chemical, bac-
color. In summer, a muskeg area can sometimes teriological, and radiological parameters.

November 1990 5-9


5-18 CHAPTER 5. WATER SUPPLY ASHORE 5-20

Section IV. WATER DISTRIBUTION SYSTEMS

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 –18
Cross-Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-19
Water Main Flushing and Disinfection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-20
Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-21
Use of Non-potable Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-22

5-18. General. 5-20. Water Main Flushing and Disinfection.

The use of substandard facilities for water dis- 1. Computation of Water Volume. Chlorine
tribution will adversely affect the quality of the dosage needed to disinfect any unit depends on
water being supplied even though the water the contact time and the organic, chlorine-con-
leaving a treatment facility is of satisfactory suming material present. The volume of water in
chemical and microbiological quality. The safety the unit to be disinfected must be computed be-
and palatability of the water must not be im- fore chlorine dosage can be estimated. Volumes
paired by defects in the system. The distribution of water contained in different sizes of pipe are
system must not leak, and, when possible, its listed in Table 5-2.
various mains and branches will not be sub- 2. Water Main Flushing. Public works or
merged in surface water or ground water. Dead- maintenance personnel must make sure that all
end mains must be reduced to ensure effective new or repaired mains and extensions are
circulation of the water. Water mains must be cleaned and flushed with potable water prior to
laid above the elevation of sanitary sewers and at disinfecting them and placing them into service.
least 10 feet horizontally from such sanitary sew- The purpose of this flushing is to clear all dirt,
ers when they are parallel. Where a sanitary mud, and debris from the new or repaired
sewer crosses over a water supply, the sanitary mains. A velocity of at least 3 feet per second is
sewer must be in pressure pipe or encased in con- needed for adequate flushing.
crete for 10 feet on both sides. 3. Disinfection of New, Repaired, or Ac-
cidently Polluted Water Mains.
5-19. Cross-Connections. a. When the number of gallons of water
the component or system contains or will con-
1. Sanitary Standards. Interconnections be- tain has been determined, the correct dosage of
tween a potable water distribution system and a calcium hypochlorite (65-70 percent available
non-potable system must not be permitted. chlorine) or sodium hypochlorite (5-10 percent
Each potable water distribution system must be available chlorine) may be found by referring to
periodically inspected to detect and remove all the “Chlorine Dosage Calculator” in Chapter 6,
potential or existing cross-connections and to Water Supply Afloat, of this manual. This calcu-
ensure that proper engineering measures, (e.g., lator gives the approximate dosage of chemicals
air gaps and back-flow prevention devices) are needed for the desired disinfecting FAC residual.
in place and properly operating. Only through These residuals must be checked with the DPD
routine inspections can the control and elimina- calorimetric procedure.
tion of hazards be achieved. EPA-570/9-89-007, b. When portable gas chlorinators are
Cross-connection Control Manual, gives excellent used to disinfect mains, tanks or other units, the
information on methods and devices for backflow operator’s instruction manual must be con-
prevention, testing procedures for backflow pre- sulted. The desired disinfecting residuals must
vention, and administration of a cross-connection be checked with the DPD calorimetric procedure.
control program. NAVFACINST 11330.11 series c. Residuals and specified contact times
contains a list of backflow prevention devices ap- listed in Table 5-3, are acceptable for disinfecting
proved for use at Navy and Marine Corps shore water mains, tanks and other appurtenances pro-
installations, See Appendix B for definitions of viding they are first cleaned, and flushed, as
terms used in this chapter. above, with potable water.

5-10 November 1990


5-20 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-22

TABLE 5-2. length if the direction of flow is variable or un-


Volume of Water in Different Sizes of Pipe known. These samples must be checked for mi-
crobiological contamination to make sure that
Pipe Diameter Gallons Per Foot disinfection has been adequate. Once it has been
(Inches) of Pipe. shown that disinfection has been adequate (based
2 0.16 upon appropriate microbiological test results),
2½ 0.26 the new or repaired main can be returned to
3 0.37 service.
3½ 0.50
4 0.66 5-21. Pressure.
6 1.50
8 2.62 1. Water distribution systems will be de-
10 4.10 signed to provide an acceptable operating pres-
12 5.90 sure in distribution mains, building service con-
14 8.04 nections, and within buildings. Areas on high
16 10.50 ground or with high pressure needs will have a
separate high service system for maintaining
2
(a) D x .041 = gallons per foot of pipe or foot depth in a pressures by pumping, backed by elevated stor-
round tank. D = diameter of pipe or round tank in inches. age, where possible.
(b) One cubic foot of water = 7.48 U.S. gallons. 2. No main in a distribution system will be
(c) One U.S. gallon = 8.34 pounds. less than 6 inches in diameter. Sizes 4 inches
(d) One U.S. gallon. 3,785 ml. and smaller are to be used only upon approval of
NAVFAC Headquarters. Within these con-
TABLE 5-3. straints select the smallest pipe satisfying the
Water Main Disinfecting Procedures following conditions:
a. Supports not less than 20 pounds per
Initial FAC PPM After square inch residual pressure at all hydrants.
FAC PPM Contact Time Required Contact Time b. Supports residual pressure meeting the
50 PPM 24 hours 25 PPM needs of automatic fire extinguishing systems
500 PPM 30 minutes 500 PPM while giving 50 percent of the average domestic
100 PPM 4 hours 50 PPM and industrial flows, and the fire flow.
c. For pressure needs for graving docks
d. Swabbing Repair Pipe Lengths and Fit- see NAVFAC DM-29, Drydocking Facilities.
tings. Besides the flushing and disinfecting pro- d. For pressure needs for berthing piers
cedures described above, the interior of all repair and wharves see NAVFAC DM-25, Waterfront
pipe lengths and fittings w-ill be swabbed with 5 Operational Facilities.
percent chlorine solution (50,000 PPM) before in-
stalling. After the repairs are completed, the re- 5-22. Use of Non-potable Water.
paired section must be flushed and disinfected as
discussed above. The purpose of swabbing is to 1. Non-potable distribution systems must be
make sure that the residue in the joints and fit- designed to prevent interconnection (e.g., by
tings is oxidized.
use of incompatible coupling devices) with a po-
e. Post Disinfection Flushing and Micro- table system. Also, the marking “NON-PO-
biological Analysis. Regardless of the method TABLE” must be stenciled on the non-potable
used to disinfect new or repaired mains, the high
distribution system to identify it from the po-
concentration chlorine solutions must be flushed
table system. On shore stations, color-coding of
from the line after disinfection is complete. pipes will be used to distinguish potable from
Samples must, then be collected downflow from non-potable systems.
the affected pipe length, or on both sides of the

November 1990 5-11


5-23 CHAPTER 5. WATER SUPPLY ASHORE 5-25

Section V. POTABLE WATER STORAGE

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-23
.
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-24
Sanitary Standards for Water Storage .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-25
Disinfection of Water Storage Tanks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-26

rated from all potable water distribution sys-


5-23. General. tems. Whenever possible, precautions will be
implemented (i.e., removal of control valves, etc.)
Potable water distribution reservoirs are nec- so that only authorized personnel can operate the
essary for fire fighting, to satisfy peak demands, non-potable system.
to support uniform water pressure, to meet in- 2. Non-potable fresh or salt water supplies
dustrial needs, and to avoid continuous pumping. must be used for fire protection, flushing, and
Storage tanks permit the operation of pumps industrial uses only when the potable supply is
during periods of low electrical use rates. The lo- insufficient for all requirements.
cation of water storage tanks close to the source 3. The use of non-potable water for personal
of supply will allow the use of the most economi- hygiene (e.g., laundering, showering, and bath-
cal pipe sizes and pumping capacities; NAVFAC ing) is prohibited for Navy and Marine Corps in-
DM-5.7 gives detailed information on selection of stallations.
storage tanks for use on Navy and Marine Corps
installations. 5-25. Sanitary Standards for Water Storage.

5-24. Maintenance. 1. When potable water tanks are below


ground level:
1. Inspection, maintenance, and repair of stor- a. The overflows, (e.g., manhole covers,
age tanks is essential to the efficient operation vents) must be located with their tops 6 inches
of a distribution system. Corrosion and scaling above grade.
in storage tanks may adversely affect the qual- b. The bottom of the tank will be higher
ity of the stored water, and ultimately result in than the water table or flood water design for a
minimum depth of 8 feet.
their structural failure. All tank coatings, in-
cluding sealing compounds and other materials, c. The ground around the tank must be
must be accepted by NSF Standard No. 61 or the sloped away from the tank to provide drainage.
state having primacy, for contact with and in po- d. The tanks must be located at a level
which is higher than any sewers or sewage dis-
table water. AWWA standards D102-78 and
D101-53 contain more information on inspection, posal systems.
painting, and repairing of tanks, standpipes, and e. Sewers or sewage disposal systems
reservoirs. must be located at least 50 feet from water stor-
age tanks.
2. All Potable Water Tanks.
TABLE 5-4 a. Potable water storage tanks must be
Color coding for shore-to-ship water con- covered to prevent contamination by dust, rain,
nections. insects, animals, birds, and to discourage algae
growth.
a. Potable Water
b. All vents and overflows must be
Blue, Dark
b. Water Provided for Fire screened with 20-mesh bronze insect screens.
Protection Red The vents must be rain proofed by using goose-
c. Chilled Water Striped Blue/White neck or vent caps.
d. Oily Waste-Water Striped Yellow/Black.
e. Sewer
c. The construction and location of man-
Gold
holes must minimize the possibility of contamina-
Non-potable systems must be physically sepa- tion. Manholes (roof hatch) will be designed with

5-12 November 1990


5-25 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-28

a coaming or curb 2 to 6 inches high around the (confined space) entry and work.
opening. The manhole covers will overlap this b. Ladders, with approved safety cages will be
coaming by at least 2 inches. Except when in ac- used on all standpipes and elevated storage
tual use, manhole covers will be locked. tanks.
d. Overflow and drain pipes must not be di- c. Install a wire fence and locked gate around
rectly connected to sewers. storage tanks prevent unauthorized entrance.
3. Safety Precautions, All Tanks.
a. Precautions must be taken before enter- 5-26. Disinfection of Water Storage Tanks.
ing the storage tank to prevent accidents due to
oxygen deficient atmospheres or harmful concen- 1 . Potable water tanks must be disinfected
tration of toxic or explosive gases or vapors. The before new, rehabilitated, or repaired tanks are
NAVSEA Gas Free Engineering Manual put into service or when entered for inspection
(NAVSEA S6470-AA-SAF-010) or other local in- or any other reason. Tanks will also be disin-
structions must be consulted for correct entry fected when bacteriological evidence shows that
procedures. The local safety and health officer or the tank has become contaminated.
an industrial hygienist (available at Naval hospi- 2. Disinfecting procedures may be one of the
tals, clinics commands and NAVENPVNTME- techniques described in Article 5-20 or a method
DUS) will be contacted for safety information on which uses spraying or swabbing the walls and
working in tanks and other confined spaces. The surfaces with a 500 PPM FAC solution. This con-
industrial hygienist or safety officer can outline centration gives almost immediate disinfection.
entry procedures, specify respirators, and recom- After complete application, all surfaces must be
mend other safety equipment necessary for tank flushed with potable water. This operation must
Water, like many other natural resources, is be coordinated with facility medical personnel
procured as a raw material, manufactured into a and entry and work must follow 5-25.3.a. above.
commodity suitable for use and distributed for

Section VI. WATER TREATMENT

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-27
Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-28 ....
Fluoridation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-29
Corrosion Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-30

5-27. General.

Water, like many other natural resources, is must also make sure that, as a minimum, the wa-
procured as a raw material, manufactured into a ter supply meets or exceeds all applicable
commodity suitable for use and distributed for NPDWR and state water quality standards as
consumption. A safe and dependable water sup- required by OPNAVINST 5090.1. NAVFAC
ply greatly enhances the physical and mental DM-5.7 gives further information on the specifics
well-being of the individual. Each water source of various treatment methods.
will be evaluated individually to determine the
type and degree of treatment needed. Disinfec- 5-28. Disinfection.
tion is a must for all water used for drinking. Dis-
infection alone may suffice for a deep well, where 1. Potable water sources are disinfected be-
sedimentation, coagulation, flocculation, filtra- cause no other treatment process, or combination
tion, and disinfection are usually needed for most of processes, will reliably remove all disease-pro-
surface sources. It is the responsibility of the in- ducing organisms from water. All acceptable
stallation commander to make sure that the wa- methods of disinfection satisfy the following cri-
ter supply is safe and palatible. The commander teria. The disinfectant must:
a. Mix uniformly to provide intimate con-

November 1990 5-13


5-25 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-28

a coaming or curb 2 to 6 inches high around the (confined space) entry and work.
opening. The manhole covers will overlap this b. Ladders, with approved safety cages will be
coaming by at least 2 inches. Except when in ac- used on all standpipes and elevated storage
tual use, manhole covers will be locked. tanks.
d. Overflow and drain pipes must not be di- c. Install a wire fence and locked gate around
rectly connected to sewers. storage tanks prevent unauthorized entrance.
3. Safety Precautions, All Tanks.
a. Precautions must be taken before enter- 5-26. Disinfection of Water Storage Tanks.
ing the storage tank to prevent accidents due to
oxygen deficient atmospheres or harmful concen- 1 . Potable water tanks must be disinfected
tration of toxic or explosive gases or vapors. The before new, rehabilitated, or repaired tanks are
NAVSEA Gas Free Engineering Manual put into service or when entered for inspection
(NAVSEA S6470-AA-SAF-010) or other local in- or any other reason. Tanks will also be disin-
structions must be consulted for correct entry fected when bacteriological evidence shows that
procedures. The local safety and health officer or the tank has become contaminated.
an industrial hygienist (available at Naval hospi- 2. Disinfecting procedures may be one of the
tals, clinics commands and NAVENPVNTME- techniques described in Article 5-20 or a method
DUS) will be contacted for safety information on which uses spraying or swabbing the walls and
working in tanks and other confined spaces. The surfaces with a 500 PPM FAC solution. This con-
industrial hygienist or safety officer can outline centration gives almost immediate disinfection.
entry procedures, specify respirators, and recom- After complete application, all surfaces must be
mend other safety equipment necessary for tank flushed with potable water. This operation must
Water, like many other natural resources, is be coordinated with facility medical personnel
procured as a raw material, manufactured into a and entry and work must follow 5-25.3.a. above.
commodity suitable for use and distributed for

Section VI. WATER TREATMENT

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-27
Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-28 ....
Fluoridation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-29
Corrosion Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-30

5-27. General.

Water, like many other natural resources, is must also make sure that, as a minimum, the wa-
procured as a raw material, manufactured into a ter supply meets or exceeds all applicable
commodity suitable for use and distributed for NPDWR and state water quality standards as
consumption. A safe and dependable water sup- required by OPNAVINST 5090.1. NAVFAC
ply greatly enhances the physical and mental DM-5.7 gives further information on the specifics
well-being of the individual. Each water source of various treatment methods.
will be evaluated individually to determine the
type and degree of treatment needed. Disinfec- 5-28. Disinfection.
tion is a must for all water used for drinking. Dis-
infection alone may suffice for a deep well, where 1. Potable water sources are disinfected be-
sedimentation, coagulation, flocculation, filtra- cause no other treatment process, or combination
tion, and disinfection are usually needed for most of processes, will reliably remove all disease-pro-
surface sources. It is the responsibility of the in- ducing organisms from water. All acceptable
stallation commander to make sure that the wa- methods of disinfection satisfy the following cri-
ter supply is safe and palatible. The commander teria. The disinfectant must:
a. Mix uniformly to provide intimate con-

November 1990 5-13


5-28 CHAPTER 5. WATER SUPPLY ASHORE 5-28

tact with microbial populations potentially pres- rus, bacteria, protozoa, helminth, or others). Of
ent. all the waterborne diseases, those caused by bac-
b. Have a wide range of effectiveness to ac- teria are the most easily prevented by chlorine
count for the expected changes in the conditions disinfection. At the other extreme, certain patho-
of treatment or in the characteristics of the water genic organisms such as the cysts of the protozoa
being treated. E. histolytica and Giardia lamblia are the most
c. Not be toxic to burn-ans at the concentra- resistant. Therefore, two parallel recommenda-
tion levels present in the finished water. tions for chlorine residuals are often made. The
d. Have enough residual to protect the dis- lower one for bactericidal purposes and the
tribution system from microbial growth and act higher one for cysticidal purposes. Available in-
as an indicator of recontamination after initial formation suggests that cysticidal residuals are
disinfection. also viracidal. Figure 5-Cl, (Appendix C), pres-
e. Be readily measured in water in the con- ents data on the bactericidal and cysticidal effec-
centrations expected to be effective for disinfec- tiveness of free available chlorine (FAC) and
tion. combined chlorine residuals at various pH and
f. Destroy virtually all disease-producing temperature levels. Bactericidal levels are rou-
microorganisms. tinely used for all water supplies at Navy and
g. Be practical to use and store. Marine Corps installations in the United States
2. Chlorination. since waterborne bacteria are likely to be the
a. Under normal operating conditions, most prevalent organisms. Cysticidal levels will
chlorination is the most widely used procedure be used whenever epidemiological evidence
for the routine disinfection of water. The effi- shows the presence of nonbacterial waterborne
ciency of chlorine is affected by the following diseases such as amebiasis, viral hepatitis A, or
variables: giardiasis.
(4) The contact time of the organisms with
TABLE 5-5. the chlorine.
(5) The temperature of the water. At lower
Chlorine-pH Relationship 100 Percent Bacte- temperatures, bacterial kill tends to be slower
ria Kill in 60 Minutes (At 72° F) and higher residuals are needed. The effect of
low temperatures is greater with combined
Combined Chlorine chlorine than with free available chlorine.
PPM
(6) The concentration of substances exert-
pH
6.5 0.3
ing other demands on the chlorine. During dis-
7.0 0.6 infection, chlorine demand can be exerted by
7.7 0.9 chemical compounds including those containing
8.0 1.0 ammonia and the whole spectrum of organics.
8.5 1.2 Many of these compounds are not effectively
9.5 1.5 removed in conventional water treatment proc-
10.5 1.8
esses.
(7) Mixing of chlorine and chlorine demand-
ing substances. The agent must be well dis-
(1) The types and concentrations of the persed and homogeneously mixed to assure that
chlorine forms present. the contact time for disinfection is applied
(2) The pH of the water. At pH 6.5 and a throughout the water supply.
temperature of 70° F (22° C), 0.3 ppm of com- (8) Appendix D discusses the safe opera-
bined residual causes a 100 percent bacterial kill tion of chlorination facilities,
in 60 minutes. With the same temperature and b. Chlorine Residual. A measurable chlo-
time, at pH 7.0 the combined residual must be in- rine residual (FAC or combined) must be main-
creased to 0.6 ppm, to accomplish the same de- tained in all parts of the potable water distribu-
gree of bacterial kill. Data for this pH-chlorine tion system under constant circulation. This ap-
residual relationship are presented in Table 5-5. plies to Navy and Marine Corps owned and op-
(3) The type and density of organisms (vi- erated. supplies from ground and surface

5-14 November 1990


5 - 2 8 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-28

sources. This does not apply to water supplied been granted) or with regional EPA officials (if in
directly to installations, leased buildings, or like a nonprimacy state).
facilities by a satisfactory public water supply c. Chlorination in the Event of System
distribution system, or from a supplier of Problems. Water from systems where sanitary,
bottled water that has been approved by the physical, or operating defects or other special
State or host nation health authority. If water hazards are known to exist, or where microbio-
supplied to an installation from an approved logical examinations show that satisfactory qual-
outside source does not have a measurable chlo- ity cannot be obtained without dechlorination,
rine residual (FAC or combined), then this must be chlorinated to bactericidal levels shown
should be considered in the microbiological in Table 5-6.
monitoring program of the installation medical d. Health Effects of Chlorination. Concern
authority. Coordination between the supplier, has been generated over the health effects of
the public works or maintenance officer and the chlorinated organics. Specifically, trihalom-
preventive medicine department is essential in ethanes (THMs) were placed into the maximum
this situation. Installation of a chlorination sys- contaminant levels (MCLS) of NPDWR. THMs
tem for the supplied water (dechlorination) are commonly found in chlorinated drinking wa-
must be considered if an unhealthful situation ter, particularly in drinking waters obtained
exists. Not all disinfectants or chemicals added from surface water sources. THMs are formed
to purchased water will be compatible with by the reaction of naturally occurring organic
chemicals used by the supplier. For example, substances with chlorine during drinking water
the addition of chlorine (sufficient to produce treatment and distribution. Chlorination meth-
FAC) to water disinfected with combined chlo- ods used by the installation may have a dra-
rine (chloramine), which delays formation of matic affect on the resultant level of THMs. As
trihalomethanes (THM), may result in a product a minimum, installations obtaining their raw
which exceeds the maximum contaminant level water from surface sources and practicing pre-
(MCL) for THM. Hence, the supplier and state and postchlorination must practice chlorination
or EPA authorities must approve chemicals optimization. Prechlorination dosages must be
added to purchased water. Dechlorination (or reduced to the lowest level consistent, with the
other chemical addition) of purchased water maintenance of a trace chlorine residual thro-
could make the installation commander a new ugh the treatment system before postchlorina-
supplier of water responsible for all require- tion. Postchlorination will then be used to
ments of the SDWA implemented by NPDWR. achieve needed chlorine residuals for the distri-
Final interpretation of whether or not an installa- bution system. Use of this technique allows for
tion is classified as a supplier of water rests with the most effective use of chlorine consistent with
the state regulatory authorities (if primacy has minimizing THM formation. Potable water trans-

TABLE 5-6

Minimum Free and Combined Bactericidal Chlorine Residual


Recommended in the Event of Water System Problems

Minimum concentration of
Minimum concentration of free combined chlorine
chlorine residual after 10 residual after 60 minutes
pH value minutes. ppm (mg/L) ppm (mg/L)

6.0 0.2 1.0


7.0 0.2 1.5
8.0 0.4 1.8
9.0 0.8 Not applicable
10.0 0.8 Not applicable

November 1990 5-15


5-28 CHAPTER 5. WATER SUPPLY ASHORE 5-29

ferred from shore to ship will normally contain at chloramine disinfection techniques, (e.g., ratio of
least 0.2 ppm FAC; still, ships may be supplied ammonia and chlorine, point in treatment where
with water disinfected with chloramine. In this chlorine is added, and point where ammonia is
case, the area NAVENPVNTMEDU may be added) are designed for the water being treated.
contacted for instructions on testing, treatment All proposed treatment processes, to remove
and surveillance procedures. THM, must be approved by the state or EPA re-
e. Determination of Chlorine Residuals. gional office.
Both FAC and combined chlorine residuals are g. Surveillance. Water plant personnel must
applicable at facilities located in the United ensure that proper chlorine levels are maintained
States and overseas. Residual FAC will be found by regular and frequent chlorine analyses, both
by using the diethyl-p-phenylene, diamine (DPD) at the point of application and at various points in
method or other EPA approved method that the water distribution system. Testing of treated
measures specifically for FAC. Combined chlo- water for chlorine residual before distribution
rine residuals can be found by tests that give the must be accomplished at least daily, more often if
total chlorine present from which the free compo- the character and variability of the water supply
nent can be subtracted. dictates, and at least daily at various points in the
f. Chlorination Methods. water distribution system. Also, the installation
(1) Marginal Chlorination. In marginal medical authority must test for chlorine residuals
chlorination, the initial chlorine demand has when microbiological surveillance samples are
been satisfied but some oxidizable substances taken (see Appendix A).
remain. 3. Other Methods. Methods of disinfection
(2) Superchlorination-dechlorination. This other than chlorination are being used through-
procedure involves the application of chlorine in out the world. Requests for the Navy and Ma-
greater concentrations than are needed to af- rine Corps to use a method of disinfection other
ford acceptable bactericidal efficiency. This than chlorination must be forwarded to BUMED
practice gives control over taste and odor pro- Code 03B4 via the area Navy Environmental and
ducing substances as well as control of bacteria. Preventive Medicine Unit (NAVE NPVNT-
Surplus chlorine is removed by dechlorination MEDU). See Appendix E.
with sulfur dioxide, aeration, or activated car-
bon before the water enters the distribution 5-29. Fluoridation.
system.
(3) Break-point chlorination. In break-point Fluorides are a small but important element
chlorination enough chlorine is applied to pro- in the human diet. Part of the concentration
duce a chlorine residual composed of predomi- may be obtained in food, but the greatest por-
nantly FAC with little or no combined chlorine tion will come from the potable water supply.
present. Application of fluoride to water supplies, is rec-
(4) Chloramines (Combined Chlorine and ommended when the natural fluoride content of
Ammonia). Depending on the population served, the water supply is below levels necessary for
EPA has established the maximum contaminant prevention of dental caries in children. The
limit (MCL) for trihalomethanes at 0.10 mg/1. maximum contaminant fluoride level is estab-
Some raw water sources contain naturally Oc- lished by the NPDWR (See Appendix F). If lev-
curring organic substances (precursors) which els exceed NPDWR in a public water systems,
react with chlorine to form THM. When chlo- control methods must be installed. Although
ramines, rather than free available chlorine, are fluorides, when taken internally in recommended
used to disinfect water containing precursors, concentrations, are beneficial in the prevention
the formation of THM may be delayed until the of dental caries, excessive amounts may pro-
water is used. When compared to free available duce objectionable dental fluorosis (mottling of
chlorine, the disinfection capabilities of chloram- tooth enamel). The fluorosis increases in severity
ines are less effective. A longer contact time is as fluoride concentration rises above the
needed to obtain complete disinfection. Specific NSDWR maximum contaminant level.

5-16 November 1990


5-30 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-30

5-30. Corrosion Control. they may be large and somewhat remote from
one another causing pitting, with or without tu-
1. Corrosion is a phenomenon associated with berculation (small knobby prominences). Elec-
a metal and the water within a water distribution trode areas may be induced by various condi-
system. Corrosion in water distribution systems tions. Some due to the characteristics of the
can be described as a two-phase process. In the metal and some to the character of the water at
first phase, the metal dissolves in the water. in the boundary surface.
the second phase, the oxide of the dissolved 3. A number of installations practice chemical
metal deposits itself at the corrosion site. For a corrosion control to increase the longevity of the
metal to corrode, thus reverting to its native distribution system. protective measures that
stable state as an oxide, is a natural tendency. may be necessary to control corrosion include the
Because of the differences in mineral and gas use of different alloys in pipe manufacture, the
content of water supplies, some waters promote use of protective coatings in new main installa-
the solution of metal more rapidly than others. tion, and in-place coating/lining after main clean-
Some water may help to develop a mineral or ox- ing. Chemical control is a supplement to
ide layer that protects against continued corro- protective control; not a substitute for it. Chemi-
sion. Waters that generally let corrosion take cal control cannot be expected to overcome im-
place are called corrosive waters; and waters in proper flow conditions, poor design, defective
which the metal does not corrode are called non- materials, and faulty coatings. Polyphosphates
corrosive or protective. Physical factors that af- and silicates are routinely used for chemical cor-
fect corrosion and corrosion control are tempera- rosion control. Polyphosphates have been re-
ture, velocity of water moving over the metal, ported to be effective in reducing corrosion by
changes in direction and velocity of flow, and con- domestic waters; but, a case-by-case evaluation
tact with a second metal or nonmetal. Simplified must be made as to the potential for effective-
indexes have been developed for determining the ness. Polyphosphates may also result in substan-
relative corrosiveness of the water which take tial phosphorus loadings in receiving wastewater
into account pH, temperature, alkalinity, hard- treatment facilities. silicates are popular for
ness and total dissolved solids of the water. chemical corrosion control in waters of low hard-
2. Corrosion results from the flow of electric ness or alkalinity.
current between two electrodes (anode and cath- 4. Further Information. Consult AWWA Stan-
ode) on the metal surface. These areas may be dard No. 10008 for a more detailed discussion of
microscopic and in close proximity causing gen- corrosion control.
eral, uniform corrosion and often red water, or,

November 1990 5-17


5-31 CHAPTER 5. WATER SUPPLY ASHORE

Section VIl. WATER QUALITY STANDARDS

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 5-31
Treated Water Standards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-32

5-31. General. with regulatory authorities is also needed.


3. Chemical Quality. The chemical quality of
The suitability of water for any given use is water is determined by all the chemical constitu-
determined by its quality in terms of its physical, ents present and any interactions between these
chemical, radiological, and microbiological con- constituents. The chemical quality of water may
stituents. For water to be acceptable for human be described in terms of inclusive characteristics
consumption it must be palatable, and, more im- (e.g., total hardness, alkalinity, pH) or it may be
portantly, free of any constituents that would described in terms of a particular cation or anion
cause adverse physiological effects. Also, it must (e.g., arsenic, barium, or calcium).
not be destructive to the materials used in its a. Basis. Chemical water quality standards
transportation and storage. Potable water must have been set up based on the following criteria
also be suitable for the ancillary uses associated the physiological impact and attendant effect the
with human habitation, (i.e., personal hygiene, water will have on humans; and the consumer
laundering of clothes, and dishwashing). The pur- response to the palatability or useability of the
pose of setting drinking water quality standards water. The effect of a particular chemical con-
is to give a basis for the selection or rejection of a stituent or of an inclusive characteristic of chemi-
water supply intended for human consumption. cal quality will determine whether a mandatory
It should be emphasized that the standards are limit or desirable limit is set for that chemical.
maximum values and every reasonable attempt Chemical constituents having deleterious physio-
must be made to obtain water of a better quality. logical effects must have a mandatory limit that
Interpretation of water quality data must be can not be exceeded under any circumstances.
made only by a qualified sanitary engineer, envi- Other constituents, such as iron and manganese,
ronmental health officer, or medical officer. have no significant adverse physiological effect,
but may restrict the uses of the water for laun-
5-32. Treated Water Standards. dering of clothes. These constituents normally
have a desirable limit that will not be exceeded
1. General. Water made available for human unless a water supply of better quality is not
consumption must be of the highest quality. available. Appendix F lists the chemical water
Quality standards for treated water reflect the quality standards for potable water.
maximum values of various constituents that b. Pesticides. Pesticide chemicals are toxic
may be present in drinking water. Quality stan- and must be properly stored, handled, and used
dards are presented in Appendix F. to achieve the desired results without creation of
2. Physical Quality. The principal physical unwanted toxic hazards and environmental con-
characteristics of’ water are color, odor, and tur- tamination. Their persistence in the environment
bidity. Temperature may also be considered a makes it necessary that limits be placed on the
physical quality. The basis for physical quality concentrations of these pesticides in drinking
standards is primarily related to consumer accep- water. Reference limits are provided in Appen-
tance of the water. Waters having physical char- dix F.
acteristics exceeding the limits in Appendix F 4. Microbiological Quality.
will not, as a general rule, be used for drinking. a. The microbiological quality of drinking
When water of a lesser physical quality is used water indicates its potential for transmitting wa-
due to local conditions, concurrence must be ob- terborne diseases. These diseases may be caused
tained from the installation medical authority. by viruses, bacteria, protozoa, or by higher or-
Note: If water quality does not meet the stan- ganisms. Microbiological examinations will reveal
dards of NPDWR (Appendix F), coordination the quality of the raw water source and is an aid
in deciding the treatment needed. These exami-

5-18 November 1990


5-32 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-32

nations are essential to keeping the water quality sample limit the use of the membrane falter tech-
within established potability standards. The di- nique.
rect measurement, of pathogenic organisms in a (3) MMO-MUG Test. The MMO-MUG Test
water sample is extremely difficult. The density is based on the ability of coliform bacteria to pro-
of these organisms is usually very low, even in a duce the enzyme beta-galatosidase which
badly polluted water supply, and the analytical hydrolzes o-nitrophehyl-betad-glactopyranoside
techniques used in their identification are com- (ONPG) present in the chemically defined me-
plex. For these reasons, indicator organisms are dium to form a yellow color. The formulation of
used to show the presence of fecal contamination the test medium poorly supports the growth of
in a water supply. The most common organisms non-coliform microorganisms, the target coliform
used as indicators of possible contamination are microorganisms produce the yellow color within
bacteria of the coliform group such as Escheric- 24 hours.
hiu coli, Klebsiella pneumoniae, and Entero- (4) Presence-Absence (P-A) Coliform Test.
bacter aerogenes. These organisms occur in large The P-A Test is described in Standard Methods
quantities in the intestines of warm-blooded ani- for the Examination of Water and Wastewater.
mals and are used as presumptive evidence of It is a simple modification of the multiple-tube
fecal contamination of water. Their occurrence, procedure. Simplification is accomplished by the
particularly in low densities, does not always use of one large test portion (100 ml) in a single
mean that human fecal contamination has oc- test tube.
curred. But, the presence of any coliform organ- (5) Standard Plate Count. Although the
ism in treated drinking water is a sign of either standard plate count is not directed by the EPA
inadequate treatment or the introduction of un- NPDWR, its use may be needed in conjunction
desirable materials to the water after treatment. with modification of the turbidity limit. This test
b. Microbiological examinations of potable gives the number of bacteria that can grow under
waters are usually conducted to show either the the conditions of the test. It has varying signifi-
presence or absence of the coliform group. 40 cance for finished water, particularly if the plat-
CFR 141, refers to the membrane filter (MF) ing is not completed within 6 hours after collec-
Technique and the Multiple Tube Fermentation tion of the sample. The testis valuable in finding
(MTF) Technique. In addition EPA has recently the microbiological efficiency of the various units
approved two additional tests, the Autoanalysis in a water treatment process. Excessively high
Coilert Test, henceforth called the Minimal Me- counts may indicate serious contamination in the
dia ONPG-MUG (MMO-MUG) Test, and the system and warrant further investigation.
Presence-Absence (P-A) Coliform Test as ap- c. Other Microbiological Tests. Other
proved methods for satisfying the NPDWR. methods exist to more specifically identify the
(1) Membrane Filter Technique. Because origin of bacteriological contamination. Fecal
of its relative simplicity, the membrane filter coliform and fecal strep techniques are two com-
technique has gained wide acceptance through- monly used methods. Specific testing procedures,
out the military as the preferred technique for such as these, are recommended for drinking
identifying coliform organisms in drinking water. water when more generalized testing yields posi-
The membrane filter technique, as described in tive results. Fecal coliform bacterial testing may
the current edition of Standard Methods for the be determined by using either the multiple tube
Examination of Water and Wastewater, must be or the membrane filter procedure. The mem-
used except when the facility is located in a state brane filter technique has been shown to have 93
which has been granted primacy and that state percent accuracy for differentiating between coli-
mandates the multiple tube fermentation tech- forms from warm-blooded animals and coliforms
nique. A step-by-step description is included in from other sources. Fecal streptococcal group or-
Chapter 6 of this manual. ganisms can also be identified by using either
(2) Multiple Tube Fermentation Tech- membrane filter or multiple tube methods. The
nique. This method can be found in a current edi- normal habitat of fecal streptococci is the intes-
tion of Standard Methods of Examination of tines of man and animals, making these organ-
Water and Wastewater. This test can be used isms one indicator of fecal pollution. Because of
when high amounts of suspended solids in the organism survival characteristics, other fecal in-

November 1990 5-19


5-32 CHAPTER 5. WATER SUPPLY ASHORE 5-34

dicators (fecal coliforms and total coliforms) must industrial radionuclides as well as a result of
be used concurrently. Further discussion on the leakage from reactors.
microbiology of drinking water and testing meth- b. Radiological Standards. Radiological water
ods can be found in Drinking Water and Health quality standards are based on the premise that
and Standard Methods for the Examination of radiation has an adverse physiological effect on
Water and Wastewater. Consultation on this sub- humans and any unnecessary exposure must be
ject can be obtained by contacting the area Navy avoided. The physiological effects that are associ-
Environmental and Preventive Unit (NAV- ated with overexposure to radiation demands the
ENPVNTMEDU). rejection of any treated water containing excess
5. Radiological Quality. quantities of radionuclides. Proper treatment
a. Radioactive elements can appear in water methods will provide drinking water of desired
supplies as a result of naturally occurring con- radiological quality in most cases. The NPDWR
tamination. Radioactive elements can also enter standards for radionuclide are summarized in
water from indiscriminate disposal of hospital or Appendix F.

Section VIII. WATER QUALITY SURVEILLANCE

Article
Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-33
Surveillance Sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-34
Surveillance Sampling Overseas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-35
Military-Unique Chemicals and Other Potentially Hazardous Materials . . . . . . . . . . . ...5-36
Operational Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-37
Procedures for Sampling and Preservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-38
Reporting and Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-39
Remedial Action .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-40
.....

5-33 OBJECTIVES ter is defined to include any treatment of raw


surface or ground water sources and may include
The objectives of water quality surveillance dechlorination or fluoridation of purchased water.
are to make sure that the quality of drinking wa- Also, Navy and Marine Corps installations which
ter on Navy and Marine Corps installations sell or give treated water to non-department of
meets the minimum health standards of NPDWR the Navy military authorities or to civilian com-
and any additional standards mandated by munities are considered suppliers of water and
BUMED, to assure that the distribution system must perform surveillance monitoring services,
is protected from undue corrosion or scaling and for the areas covered by their treated waters, fol-
that economically thorough treatment is carried lowing the NPDWR and NSDWR, as applicable.
out by the treatment plant. These objectives are A “supplier of water” owns or operates a public
met by a program of water quality monitoring water system. Compliance with state drinking
under the direction of NAVFACENGCOM in co- water regulations or NPDWR requires surveil-
ordination with BUMED. Consult Appendix F lance monitoring. Drinking water must be ana-
for treated water quality standards. lyzed at laboratories certified by state regulatory
agencies (in states having primacy) or by the
5-34. Surveillance Sampling. Regional EPA office (in states not having pri-
macy).
1. Treated Water at Navy and Marine Corps a. Surveillance Responsibility. The installa-
Owned and Operated Facilities. Surveillance tion commanding officer is responsible for sam-
sampling to meet the goals of the preceding para- pling, conducting analyses, reporting to EPA or
graph must be carried out on treated waters sup- states and keeping records per the NPDWR. The
plied by the installation at Navy and Marine public works or maintenance department is nor-
Corps owned or operated facilities. Treated wa- mally assigned responsibility for collecting

5-20 November 1993


5-32 CHAPTER 5. WATER SUPPLY ASHORE 5-34

dicators (fecal coliforms and total coliforms) must industrial radionuclides as well as a result of
be used concurrently. Further discussion on the leakage from reactors.
microbiology of drinking water and testing meth- b. Radiological Standards. Radiological water
ods can be found in Drinking Water and Health quality standards are based on the premise that
and Standard Methods for the Examination of radiation has an adverse physiological effect on
Water and Wastewater. Consultation on this sub- humans and any unnecessary exposure must be
ject can be obtained by contacting the area Navy avoided. The physiological effects that are associ-
Environmental and Preventive Unit (NAV- ated with overexposure to radiation demands the
ENPVNTMEDU). rejection of any treated water containing excess
5. Radiological Quality. quantities of radionuclides. Proper treatment
a. Radioactive elements can appear in water methods will provide drinking water of desired
supplies as a result of naturally occurring con- radiological quality in most cases. The NPDWR
tamination. Radioactive elements can also enter standards for radionuclide are summarized in
water from indiscriminate disposal of hospital or Appendix F.

Section VIII. WATER QUALITY SURVEILLANCE

Article
Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-33
Surveillance Sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-34
Surveillance Sampling Overseas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-35
Military-Unique Chemicals and Other Potentially Hazardous Materials . . . . . . . . . . . ...5-36
Operational Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-37
Procedures for Sampling and Preservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-38
Reporting and Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-39
Remedial Action .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-40
.....

5-33 OBJECTIVES ter is defined to include any treatment of raw


surface or ground water sources and may include
The objectives of water quality surveillance dechlorination or fluoridation of purchased water.
are to make sure that the quality of drinking wa- Also, Navy and Marine Corps installations which
ter on Navy and Marine Corps installations sell or give treated water to non-department of
meets the minimum health standards of NPDWR the Navy military authorities or to civilian com-
and any additional standards mandated by munities are considered suppliers of water and
BUMED, to assure that the distribution system must perform surveillance monitoring services,
is protected from undue corrosion or scaling and for the areas covered by their treated waters, fol-
that economically thorough treatment is carried lowing the NPDWR and NSDWR, as applicable.
out by the treatment plant. These objectives are A “supplier of water” owns or operates a public
met by a program of water quality monitoring water system. Compliance with state drinking
under the direction of NAVFACENGCOM in co- water regulations or NPDWR requires surveil-
ordination with BUMED. Consult Appendix F lance monitoring. Drinking water must be ana-
for treated water quality standards. lyzed at laboratories certified by state regulatory
agencies (in states having primacy) or by the
5-34. Surveillance Sampling. Regional EPA office (in states not having pri-
macy).
1. Treated Water at Navy and Marine Corps a. Surveillance Responsibility. The installa-
Owned and Operated Facilities. Surveillance tion commanding officer is responsible for sam-
sampling to meet the goals of the preceding para- pling, conducting analyses, reporting to EPA or
graph must be carried out on treated waters sup- states and keeping records per the NPDWR. The
plied by the installation at Navy and Marine public works or maintenance department is nor-
Corps owned or operated facilities. Treated wa- mally assigned responsibility for collecting

5-20 November 1993


5-34 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-34

samples and doing laboratory analyses, The in- by the state. Organic and radiological analyses
stallation medical authority (preventive medicine are not directed for noncommunity systems.
department) must work closely with the certified (2) Ground Water Sources. Community
laboratory, the water supplier, and the federal, water systems using only ground water sources
state, or local regulatory authority. The medical must have the inorganic analyses conducted at
authority will review results of the analyses and least every third year per the NPDWR. Organic
make recommendations to assure compliance analyses must be conducted as specified by the
with NPDWR and NSDWR. All water analyses state. Analyses for natural radioactive sub-
must be conducted by an EPA or state certified stances must be as specified for surface water
military or civilian laboratory. NAVFACENG- sources. Analyses of ground water sources for
COM helps activities in the development of con- man-made radioactive substances must be as
tracts and selection of laboratory services for specified by the state. Turbidity need not be
potable water analyses. monitored for ground water sources. Nitrate
b. Physical, Inorganic, Organic and Radio- analyses for ground water supplied noncommu-
logical Surveillance. nity systems must be conducted as specified by
(1) Surface Water Sources. Analyses for the state.
the inorganic chemicals specified in the NPDWR c. Microbiological Surveillance. For commu-
must be conducted at yearly intervals for com- nity water systems, the, number of samples col-
munity water systems. Analyses for the specified lected from the installation distribution systems
organic chemicals, excluding trihalomethanes, will be no less than that required by the
must be at a frequency specified by the state but NPDWR for the population served. For noncom-
never less often than 3 year intervals for commu- munity water systems, at least one microbiologi-
nity water systems. Trihalomethanes must be cal sample per month must be collected unless
monitored quarterly as directed by the states increased by a state mandate.
having primacy or EPA. For community water d. Supporting Laboratories. Analyses of
systems, analyses for radiological activity must samples from public water systems in the U.S.
be conducted at least once every 4 years. Initial must be conducted by laboratories certified by
radiological analysis must be conducted on either EPA or the state. Measurements for turbidity
the analyses of an annual composite of four con- and free chlorine residual may be conducted by
secutive quarterly samples or the average of the anyone acceptable to the state. Technical help for
analyses of four samples obtained at quarterly radionuclide analyses may be obtained from the
intervals. Once an acceptable data base is avail- USAF Occupational and Environmental Health
able, the state may modify the sampling scheme. Laboratory, Brooks Air Force Base, Texas and
Likewise, where there is reason for concern, the the U.S. Army Environmental Hygiene, Agency,
state may decrease monitoring intervals. Water Aberdeen Proving Grounds, Maryland. This
must be analyzed for man-made radioactivity in service may be used only if state certified labora-
those systems serving over 100,000 persons or tories are not available. Approval to use these
those systems specified by the state. Few, if any laboratories must be obtained from
Navy or Marine Corps systems will be affected NAVFACENGCOM, Code 1122 via the cogni-
by this portion of the NPDWR; but, guidance and zant EFD.
sampling mandates of the various states must be 2. Treated Water at Navy and Marine Corps
followed. Turbidity analysis must be conducted Owned and Contractor Operated Facilities.
at least once daily for both community and non- a. Surveillance Responsibility. The installa-
community systems using the Nephelometric tion commanding officer is responsible for sur-
Method on a sample collected at an entry point veillance monitoring (see Appendix (G). Actual
into the distribution system (refer to the current collection and submission of samples is normally
edition of Standard Methods for the Examina- assigned to the public works or maintenance offi-
tion of Water and Wastewater. Turbidity analy- cer. The Medical Department, (preventive medi-
sis is the public works or maintenance officer’s cine department) will routinely review surveil-
responsibility. Nitrate analysis is the only inor- lance monitoring results to see that all NPDWR
ganic analysis directed for noncommunity sys- or corresponding state drinking water regulation
tems; but, additional analyses may be specified mandates are met. In cases where the contractor

November 1990 5-21


5-34 CHAPTER 5. WATER SUPPLY ASHORE 5-37

must accomplish NPDWR or corresponding state department) is satisfied that the federal, state
drinking water regulations, the installation medi- and local mandates are being fulfilled. The instal-
cal authority (preventive medicine department) lation medical authority will conduct bacteriologi-
must institute a parallel surveillance program to cal surveillance of the purchased water in accor-
include the following: dance with Appendix I.
(1) Verify that a potable water quality 4. Bottled Water. Bottled water is a type of
survey is done every 3 years. purchased water. Bottled water must comply
(2) Conduct medical bacteriological sur- with the requirements of NPDWR and NSDWR
veillance of the distribution system per Appendix for physical, chemical, bacteriological, and radio-
A, Section A-7. logical contaminants. The installation medical
(3) Conduct monthly reviews of drinking authority is responsible for verifying the quality
water records. of this supply source and must approve, from a
(4) Make sure that the sampling and pres- medical perspective, the purchase of a bottled
ervation procedures, discussed in Article 5-38, water for distribution on an installation. A pro-
are followed when samples are taken for medical gram of microbiological monitoring of bottled
surveillance testing. drinking water must be instituted if this source is
3. Purchased Water. used.
a. NPDWR and NSDWR Application. The
NPDWR and NSDWR will apply to Navy and 5-35. Surveillance Sampling Overseas.
Marine Corps purchased water if:
(1) The system has collection and treat- All Navy and Marine Corps installations lo-
ment facilities. cated outside CONUS must maintain the same
(2) The purchased water is obtained drinking water standards as prescribed for
from a water system to which NPDWR and CONUS installations. Any requests for deviation
NSDWR do not apply. from CONUS drinking water standards must be
(3) Water is sold for potable use. submitted in writing to BUMED via the area
(4) The purchased water is supple- NAVENPVNTMEDU and The Navy Environ-
mented with water from Navy or Marine Corps mental Health Center (NAVENVIRHLTH-
sources. CEN).
(5) Additional treatment, (e.g., rechlori-
nation, fluoridation, or addition of chemicals for 5-36. Military-Unique Chemicals and Other
corrosion control) is conducted. Potentially Hazardous Materials.
(6) Note: Final interpretation of whether
or not an installation is classified as a “supplier of The area NAVENPVNTMEDU must be con-
water” rests with the state (for states that have sulted immediately upon suspicion of contamina-
assumed primacy) or EPA region (for states that tion of a water source by military-unique chemi-
have not assumed primacy). If final determina- cals or other potentially hazardous materials. The
tion is made that an installation which purchases NAVENPVNTMEDU can arrange analysis
its potable water is a “supplier of water,” then from laboratories capable of performing the nec-
that installation must comply with the require- essary tests.
ments of NPDWR and NSDWR. Suppliers of
water are required by the NPDWR and NSDWR 5-37. Operational Surveillance.
to conduct physical, inorganic, organic, radiologi-
cal, and microbiological monitoring of the water
Besides the surveillance sampling program
system.
previously mentioned, water treatment person-
b. Surveillance Responsibility. The installa-
nel will collect additional samples to provide
tion medical authority must coordinate with the
quality control for any treatment processes that
supplier of water to see that the requirements of
are used. Examples of this type of analyses are:
NPDWR and NSDWR are being fulfilled. Inde-
coagulant demand, turbidity, color, odor, chlorine
pendent analyses are not needed for physical,
residual, fluoride, iron, manganese, pH, tempera-
chemical, and radiological contaminants if the in-
ture, hardness, total alkalinity, and total dis-
stallation medical authority (preventive medicine

5-22 November 1990


5-37 MANUAL OF NAVAL PREVENTIVE MEDICINE 5-40

solved solids. The latter five analyses are needed tions of the distribution system will be spot
for the determination of the Langlier Index (See checked, but need not be the subject of routine
Appendix H, H- 8.10.) which is used as an indica- monitoring. On those installations where more
tor of corrosive properties of treated water. Op- than one independent distribution system is in
erational sampling will be done as often as neces- use, each system must be considered as separate
sary to assure the maintenance of effective treat- and distinct for the purpose of calculating the
ment control and to reduce the cost of treatment. number and frequency of samples to be drawn.
4. Analytical Methodology.
5-38. Procedures for Sampling and Preser- a. Physical, Inorganic, Organic and Radio-
vation logical Surveillance. The NPDWR, NSDWR, and
corresponding state drinking water regulations
1. Physical, Inorganic, Organic and Radiologi- contain analytical methods for surveillance of
cal Surveillance. For those installations having public water systems. For other types of surveil-
public water systems, sampling and sample pres- lance, the current edition of Standard Methods
ervation guidelines are contained in NPDWR For The Examination of Water and Wastewater
and NSDWR, or corresponding state drinking will be used.
water regulations. Installations not having public b. Microbiological Surveillance. For those
water systems must contact the supporting labo- installations having public water systems, ap-
ratory or activity to verify laboratory capability, proved analytical methods are contained in
appropriateness of the analytical request, sam- NPDWR or corresponding state drinking water
pling techniques, and sample preservation guide- regulations. The MF, the MTF, the MMO-MUG
lines. and then P-A tests are approved methods. The
2. Microbiological Surveillance. Sampling and standard sample for the examination of finished
preservation guidelines for installations not hav- water is 100 ml. The MF, because of ease, maybe
ing public water systems must be identical to used by Navy and Marine Corps facilities unless
those stated in NPDWR and NSDWR, or corre- the facilities are located in states which require
sponding state regulations. AS a general guide, another approved total coliform test. The stan-
Appendix I presents the sampling techniques to dard sample using the MF technique is 100 ml.
be used in determining the microbiological qual- This 100 ml sample may be distributed among
ity of water. Samples collected for microbiologi- multiple membranes if necessary. For other
cal analysis must be examined as soon as possible types of surveillance, not governed by drinking
after collection. Ideally, samples will not be held water regulations, the MF technique can be used.
for more than 6 hours between collection and
analysis. The exception to this rule is for samples 5-39. Reporting and Record Keeping.
mailed from distant installations. These samples
may be held for Up to 30 hours. Samples must be The NPDWR directs operators of public wa-
shipped in ice. This is important because of the ter systems to give to the regulatory agency
extensive changes that take place in the bacterial chemical and microbiological results within 40
flora even though the samples are stored at tem- days following the analyses. Records of microbio-
peratures as low as 4° C. logical analysis must be kept for 5 years, and
3. Sampling Location Plan. A map of the in- chemical analysis records must be kept for 10
stallation water distribution system, showing all years. Other information on sample collection and
sampling points, must be kept by the installation laboratory analyses must also be kept. Consult
medical authority. Only those samples of water the NPDWR, subpart D, or corresponding state
distributed for drinking and culinary purposes regulations for complete reporting and record
will be used in the evaluation of potability. Sam- keeping details.
pling points, such as dining facilities, hospitals,
barracks, and residential and administrative ar- 5-40. Remedial Action.
eas will be chosen to be representative of princi-
pal use. Hot water faucets, mixing faucets fix- 1. Suspected Bacteriologic Contamination.
tures that are leaking, drinking fountains, fire Appendix J presents information as to the type
hydrants, or outlets connected to dead end sec- of action to be taken when bacteriological con-

November 1990 5-23


5-40 CHAPTER 5. WATER SUPPLY ASHORE 5-42

tamination is suspected. The important fact to re- community water system. DD Form 1535, re-
member is not to unduly alarm the consumer. quest/approval for Authority to Advertise, will
Overreaction on the part of responsible person- be completed and sent along with a copy of the
nel results in increasing the magnitude of the proposed notification, to the NAVFACENG-
suspected problem, often to an extent entirely COM, Engineering Field Division (EFD), Envi-
out of proportion to the seriousness of the prob- ronmental Branch, for approval before the publi-
lem. If coliform positive samples are found and cation of the notice of non-compliance.
the required follow-up samples are also positive, (2) Provide alternative drinking water un-
then consultation is recommended with the area til the supply is again known to be safe.
NAVENPVNTMEDU. Specialized testing, to in- b. For those installations operating public
dicate the source of contamination, maybe called water systems, there is a public notification re-
for. quirement under NPDWR when Maximum Con-
2. Noncompliance with NPDWR. (NSDWR taminant Levels (MCLS) are exceeded. Public
for Fluoride) notification is called for when applicable testing
a. If a particular sampling point has been procedures are not followed; schedules of a vari-
confirmed to be in noncompliance with the stan- ance or an exemption are not followed; when a
dards listed in Appendix F, the installation com- variance or an exception is granted; and when
mander will: monitoring is not done. Public notification is ex-
(1) Give notification, per NPDWR, to plained in detail in NPDWR, subpart D, or corre-
the state or EPA and to all persons served by the sponding state drinking water regulations.

Section IX. CONTINGENCY PLANNING

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-41
Points to Consider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-42
Additional Information . . . . . . . . . ... ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-43
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-44

5-41. General. areas and users on the installation.


2. Locate major valves and backflow preven-
The management and operation of a water tion devices for isolating damaged areas to pre-
supply, treatment, and distribution system are vent the spread of contamination.
complex tasks directed towards guaranteeing a 3. Find alternate water storage, purification,
continuous supply” of high quality water for do- and power generation equipment, (e.g., use of
mestic and industrial use. This chapter is con- swimming pool treatment facilities, use of field
cerned with highlighting the need for contin- water treatment equipment from the Marine
gency planning that can aid an installation in Corps or construction battalions, Army and Air
maintaining an uninterrupted water supply dur- Force active and reserve components).
ing natural and man-made disasters. 4. Setup procedures to elevate disinfectant
(chlorine) residual levels to give added disinfec-
5-42. Points to Consider. tant capability.
5. Setup procedures for notification of instal-
When making contingency plans, coordination lation residents and work force of emergency po-
between the public works or maintenance officer table water considerations.
and the installation medical authority is essential. 6.1 through 5 above are not intended to be all
Specific responsibility must be defined for each inclusive. These paragraphs show potential areas
organization. other factors to be considered in- that need further analysis on a case-by-case ba-
clude: sis.
1. Create a priority of service listing for major

5-24 November 1990


5-40 CHAPTER 5. WATER SUPPLY ASHORE 5-42

tamination is suspected. The important fact to re- community water system. DD Form 1535, re-
member is not to unduly alarm the consumer. quest/approval for Authority to Advertise, will
Overreaction on the part of responsible person- be completed and sent along with a copy of the
nel results in increasing the magnitude of the proposed notification, to the NAVFACENG-
suspected problem, often to an extent entirely COM, Engineering Field Division (EFD), Envi-
out of proportion to the seriousness of the prob- ronmental Branch, for approval before the publi-
lem. If coliform positive samples are found and cation of the notice of non-compliance.
the required follow-up samples are also positive, (2) Provide alternative drinking water un-
then consultation is recommended with the area til the supply is again known to be safe.
NAVENPVNTMEDU. Specialized testing, to in- b. For those installations operating public
dicate the source of contamination, maybe called water systems, there is a public notification re-
for. quirement under NPDWR when Maximum Con-
2. Noncompliance with NPDWR. (NSDWR taminant Levels (MCLS) are exceeded. Public
for Fluoride) notification is called for when applicable testing
a. If a particular sampling point has been procedures are not followed; schedules of a vari-
confirmed to be in noncompliance with the stan- ance or an exemption are not followed; when a
dards listed in Appendix F, the installation com- variance or an exception is granted; and when
mander will: monitoring is not done. Public notification is ex-
(1) Give notification, per NPDWR, to plained in detail in NPDWR, subpart D, or corre-
the state or EPA and to all persons served by the sponding state drinking water regulations.

Section IX. CONTINGENCY PLANNING

Article
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-41
Points to Consider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-42
Additional Information . . . . . . . . . ... ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-43
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-44

5-41. General. areas and users on the installation.


2. Locate major valves and backflow preven-
The management and operation of a water tion devices for isolating damaged areas to pre-
supply, treatment, and distribution system are vent the spread of contamination.
complex tasks directed towards guaranteeing a 3. Find alternate water storage, purification,
continuous supply” of high quality water for do- and power generation equipment, (e.g., use of
mestic and industrial use. This chapter is con- swimming pool treatment facilities, use of field
cerned with highlighting the need for contin- water treatment equipment from the Marine
gency planning that can aid an installation in Corps or construction battalions, Army and Air
maintaining an uninterrupted water supply dur- Force active and reserve components).
ing natural and man-made disasters. 4. Setup procedures to elevate disinfectant
(chlorine) residual levels to give added disinfec-
5-42. Points to Consider. tant capability.
5. Setup procedures for notification of instal-
When making contingency plans, coordination lation residents and work force of emergency po-
between the public works or maintenance officer table water considerations.
and the installation medical authority is essential. 6.1 through 5 above are not intended to be all
Specific responsibility must be defined for each inclusive. These paragraphs show potential areas
organization. other factors to be considered in- that need further analysis on a case-by-case ba-
clude: sis.
1. Create a priority of service listing for major

5-24 November 1990


MANUAL OF NAVAL PREVENTIVE MEDICINE A-15

5-43. Additional Information. Management Contingency Planning Criteria.

For help in developing contingency plans to


cope with an emergency or disaster, consult the 5-44. References Appendix H is a list of refer-
AWWA Manual M19 and NEESA 1-38, Water ence materials used in the preparation of this
chapter.

APPENDIX A
MODEL POTABLE WATER
MONITORING PROGRAM FOR
THE INSTALLATION MEDICAL
AUTHORITY
A-1. Coordinate liaison with applicable federal, ratories and local analyses performed in A-7 and
state, and local regulatory agencies for informa- A-8 above.
tion and guidance with the medical monitoring A-10. Inspect the water source, treatment
program. The area NAVENPVNTMEDU can be plant (when located on the installation), and the
a source of guidance on this subject. storage and distribution systems at least quar-
A-2. Write a SOP detailing the potable water terly.
monitoring program to be followed by your A-Il. Approve or ensure that all chemical ad-
branch or activity. ditions and concentrations to potable water sup-
A-3. Keep a updated list of all water sources plies are as listed in NSF Standard No. 60. Also,
including the type, location quality, and quantity make sure that water tank coatings, water hoses,
of each. Maintain information on the treatment and other materials used in, or in contact with,
provided to each water source. potable water are listed in applicable NSF Stan-
A-4. Keep a current set of plans of the water dards.
distribution system. A-12. Where applicable, inspect the water
A-5. Keep records of surveys, analyses, ac- treatment plant laboratory and review analytical
tions and other information pertinent to the sani- procedures to assure compliance with Standard
tary surveillance of the potable water system. Methods quarterly.
A-6. Keep copies of all regulatory agency and A-13. Set up a program to inspect for and do
Navy/Marine Corps water regulations, instructions, away with cross-connections.
and orders. A-14. Coordinate with the facilities public
A-7. Collect samples for bacteriological analy- works or maintenance officer to:
ses as directed, (e.g., after system or main disin- 1. Give feedback on inspections and analyses.
fection, consumer complaints, special samples for 2. Make sure that medical department (pre-
studies in connection with positive EPA or state ventive medicine department) personnel are told
samples, monthly spot checks from points repre- of distribution system breakage, modification,
sentative of major sections of the distribution flushing, shutdown, or when component or main
system, etc.). disinfection occurs.
A-8. Do chlorine residual tests to investigate 3. Insure that adequate chlorine residuals are
water problems (e.g., taste and odor, consumer maintained in all portions of the distribution sys-
complaints, and with each above bacteriological tem under constant circulation.
analyses). 4. Develop contingency plans for natural or
A-9. Review the results of all EPA or state po- manmade disasters.
table water analyses done at certified water labo- A-15. Pursue an aggressive continuing educa-

November 1990 5-25


MANUAL OF NAVAL PREVENTIVE MEDICINE A-15

5-43. Additional Information. Management Contingency Planning Criteria.

For help in developing contingency plans to


cope with an emergency or disaster, consult the 5-44. References Appendix H is a list of refer-
AWWA Manual M19 and NEESA 1-38, Water ence materials used in the preparation of this
chapter.

APPENDIX A
MODEL POTABLE WATER
MONITORING PROGRAM FOR
THE INSTALLATION MEDICAL
AUTHORITY
A-1. Coordinate liaison with applicable federal, ratories and local analyses performed in A-7 and
state, and local regulatory agencies for informa- A-8 above.
tion and guidance with the medical monitoring A-10. Inspect the water source, treatment
program. The area NAVENPVNTMEDU can be plant (when located on the installation), and the
a source of guidance on this subject. storage and distribution systems at least quar-
A-2. Write a SOP detailing the potable water terly.
monitoring program to be followed by your A-Il. Approve or ensure that all chemical ad-
branch or activity. ditions and concentrations to potable water sup-
A-3. Keep a updated list of all water sources plies are as listed in NSF Standard No. 60. Also,
including the type, location quality, and quantity make sure that water tank coatings, water hoses,
of each. Maintain information on the treatment and other materials used in, or in contact with,
provided to each water source. potable water are listed in applicable NSF Stan-
A-4. Keep a current set of plans of the water dards.
distribution system. A-12. Where applicable, inspect the water
A-5. Keep records of surveys, analyses, ac- treatment plant laboratory and review analytical
tions and other information pertinent to the sani- procedures to assure compliance with Standard
tary surveillance of the potable water system. Methods quarterly.
A-6. Keep copies of all regulatory agency and A-13. Set up a program to inspect for and do
Navy/Marine Corps water regulations, instructions, away with cross-connections.
and orders. A-14. Coordinate with the facilities public
A-7. Collect samples for bacteriological analy- works or maintenance officer to:
ses as directed, (e.g., after system or main disin- 1. Give feedback on inspections and analyses.
fection, consumer complaints, special samples for 2. Make sure that medical department (pre-
studies in connection with positive EPA or state ventive medicine department) personnel are told
samples, monthly spot checks from points repre- of distribution system breakage, modification,
sentative of major sections of the distribution flushing, shutdown, or when component or main
system, etc.). disinfection occurs.
A-8. Do chlorine residual tests to investigate 3. Insure that adequate chlorine residuals are
water problems (e.g., taste and odor, consumer maintained in all portions of the distribution sys-
complaints, and with each above bacteriological tem under constant circulation.
analyses). 4. Develop contingency plans for natural or
A-9. Review the results of all EPA or state po- manmade disasters.
table water analyses done at certified water labo- A-15. Pursue an aggressive continuing educa-

November 1990 5-25


A-15 CHAPTER 5. WATER SUPPLY ASHORE B-21

tion program in health related potable water health guidance found in OPNAV, NAVFAC,
training. and BUMED instructions, appropriate state
A-16. Give applicable command environmental drinking water regulations, 40 CFR, and this
publication.

APPENDIX B
DEFINITIONS
B-1. AIRGAP A physical separation sufficient impair the quality of the water to a degree that it
to prevent backflow between the free-flowing creates a serious health hazard to the public lead-
discharge end of the potable water system and ing to poisoning or the spread of disease.
any other system. An airgap is physically defined B-1l. CROSSOVER POINT Any point or
as a distance equal to twice the diameter but points where a potable water main makes contact
never less than one (1) inch. or crosses over or under a non-potable liquid con-
B-2. AQUIFER A permeable, water-bearing duit (sewer, nonpotable water supply).
geologic formation. B-12. CROSS-CONNECTION Any actual or
B-3. BACKFLOW The flow of water or other potential connection between the public water
liquids, mixtures, or substances into the distribu- supply and a source of contamination or pollution.
tion pipes of a potable system of water from any B-13. DISINFECTION The act of inactivat-
source or sources other than its intended source. ing the larger portion of microorganisms in or on
Backsiphonage is one type of backflow. a substance with the probability that all patho-
B4. BACKFLOW PREVENTER A device or genic bacteria are killed by the agent used.
means designed to prevent backflow or back- B-14. EPA The United States Environmental
siphonage. Most commonly categorized as air Protection Agency.
gap, reduced pressure principle device, double B-15. FIELD WATER SUPPLY SYSTEM
check valve assembly, pressure vacuum breaker, That assemblage of collection, purification, stor-
atmosphere vacuum breaker, hose bib vacuum age, transportation, and distribution equipment
breaker, residential dual check, double check and personnel to provide potable water to field
with intermediate atmosphere vent, and baro- units in training and actual deployment environ-
metric loop. ments.
B-5. BACKSIPHONAGE Backflow resulting B-16. FINISHED WATER Treated Water.
from negative pressures in the distribution pipes B-17. FIXED INSTALLATION An installa-
of a potable water system. tion that, through extended use, has gained those
B-6. BREAK-POINT CHLORINATION The structures and facilities not initially found or in-
application of chlorine to produce a residual of tended for use at a “temporary” facility, (e.g.,
free available chlorine with little or no combined paved roads, fixed electrical distribution sys-
chlorine present. tems, fixed water treatment facilities, and under-
B-7. CHECK VALVE A self-closing device ground distribution lines).
which is designed to allow the flow of fluids in B-18. FLOOD-LEVEL RIM The edge of the
one direction and to close if there is a reversal of receptacle from which water overflows.
flow. B-19. FREE AVAILABLE CHLORINE
B-8. COMBINED AVAILABLE CHLO- Chlorine available (after chlorine demand has
RINE The chlorine products formed by the reac- been satisfied) in the. forms of hypochlorous acid
tion of equilibrium products of ammonia with the and hypochlorite ions.
equilibrium products of chlorine to form chloram- B-20. HEALTH HAZARDS Any condition,
ines. Combined available chlorine has signifi- including any device or water treatment practice,
cantly less disinfecting power. that may create an adverse effect on a person’s
B-9. COMMUNITY WATER SYSTEM A well-being.
public water system that serves at least 15 serv- B-21. INSTALLATION MEDICAL AU-
ice connections used by year-round residents or THORITY In medical commands, the Command-
regularly serves at least 25 year-round residents. ing Officers and Officers in Charge; in other than
B-10. CONTAMINANT A substance that will naval medical commands, the medical officer or

5-26 November 1990


A-15 CHAPTER 5. WATER SUPPLY ASHORE B-21

tion program in health related potable water health guidance found in OPNAV, NAVFAC,
training. and BUMED instructions, appropriate state
A-16. Give applicable command environmental drinking water regulations, 40 CFR, and this
publication.

APPENDIX B
DEFINITIONS
B-1. AIRGAP A physical separation sufficient impair the quality of the water to a degree that it
to prevent backflow between the free-flowing creates a serious health hazard to the public lead-
discharge end of the potable water system and ing to poisoning or the spread of disease.
any other system. An airgap is physically defined B-1l. CROSSOVER POINT Any point or
as a distance equal to twice the diameter but points where a potable water main makes contact
never less than one (1) inch. or crosses over or under a non-potable liquid con-
B-2. AQUIFER A permeable, water-bearing duit (sewer, nonpotable water supply).
geologic formation. B-12. CROSS-CONNECTION Any actual or
B-3. BACKFLOW The flow of water or other potential connection between the public water
liquids, mixtures, or substances into the distribu- supply and a source of contamination or pollution.
tion pipes of a potable system of water from any B-13. DISINFECTION The act of inactivat-
source or sources other than its intended source. ing the larger portion of microorganisms in or on
Backsiphonage is one type of backflow. a substance with the probability that all patho-
B4. BACKFLOW PREVENTER A device or genic bacteria are killed by the agent used.
means designed to prevent backflow or back- B-14. EPA The United States Environmental
siphonage. Most commonly categorized as air Protection Agency.
gap, reduced pressure principle device, double B-15. FIELD WATER SUPPLY SYSTEM
check valve assembly, pressure vacuum breaker, That assemblage of collection, purification, stor-
atmosphere vacuum breaker, hose bib vacuum age, transportation, and distribution equipment
breaker, residential dual check, double check and personnel to provide potable water to field
with intermediate atmosphere vent, and baro- units in training and actual deployment environ-
metric loop. ments.
B-5. BACKSIPHONAGE Backflow resulting B-16. FINISHED WATER Treated Water.
from negative pressures in the distribution pipes B-17. FIXED INSTALLATION An installa-
of a potable water system. tion that, through extended use, has gained those
B-6. BREAK-POINT CHLORINATION The structures and facilities not initially found or in-
application of chlorine to produce a residual of tended for use at a “temporary” facility, (e.g.,
free available chlorine with little or no combined paved roads, fixed electrical distribution sys-
chlorine present. tems, fixed water treatment facilities, and under-
B-7. CHECK VALVE A self-closing device ground distribution lines).
which is designed to allow the flow of fluids in B-18. FLOOD-LEVEL RIM The edge of the
one direction and to close if there is a reversal of receptacle from which water overflows.
flow. B-19. FREE AVAILABLE CHLORINE
B-8. COMBINED AVAILABLE CHLO- Chlorine available (after chlorine demand has
RINE The chlorine products formed by the reac- been satisfied) in the. forms of hypochlorous acid
tion of equilibrium products of ammonia with the and hypochlorite ions.
equilibrium products of chlorine to form chloram- B-20. HEALTH HAZARDS Any condition,
ines. Combined available chlorine has signifi- including any device or water treatment practice,
cantly less disinfecting power. that may create an adverse effect on a person’s
B-9. COMMUNITY WATER SYSTEM A well-being.
public water system that serves at least 15 serv- B-21. INSTALLATION MEDICAL AU-
ice connections used by year-round residents or THORITY In medical commands, the Command-
regularly serves at least 25 year-round residents. ing Officers and Officers in Charge; in other than
B-10. CONTAMINANT A substance that will naval medical commands, the medical officer or

5-26 November 1990


B-21 MANUAL OF NAVAL PREVENTIVE MEDICINE B-40

medical department representative; and in the 15 service connections or regularly serves an av-
Marine Corps, the installation surgeon. erage of at least 25 individuals daily at least 60
B-22. MARGINAL CHLORINATION Appli- days out of the year. This term includes:
cation of chlorine to produce the desired total 1. Any collection, treatment, storage, or distri-
chlorine residual without reference to the bution facility under the control of the operator
amounts of free or combined chlorine present. of such systems and used primarily in connection
B-23. MAXIMUM CONTAMINANT LEVEL with such system.
The maximum permissible level of a contaminant 2. Any collection or pretreatment storage fa-
in water that is delivered to the free-flowing out- cilities not under such control that are used pri-
let of the ultimate user of a public water system marily in connection with such system. A public
except for turbidity where the maximum permis- water system is either a “community water sys-
sible level is measured at the point of entry to the tem” or a “noncommunity water system.”
distribution system. Substances added to the
water under circumstances controlled by the B-32. RAW WATER
user, are excluded ii-em this definition. 1. Untreated water usually the water enter-
B-24. MEDICAL BACTERIOLOGICAL ing the first treatment unit of a water treatment
SAMPLING Independent bacteriological sam- plant.
pling, conducted by the medical department, of 2. Water used as a source of water supply
the water distribution system to augment sam- taken from a natural or impounded body of wa-
pling required by NPDWR. ter, such as a stream, lake, pond, or a ground
B-25. MUST Indicates a requirement that is water aquifer.
necessary or essential to meet current accepted B-33. REDUCED PRESSURE PRINCIPLE
standards of protection of federal rules and regu- BACKFLOW PREVENTER An assembly of
lations. differential valves and check valves including an
B-26. NONCOMMUNITY WATER SYSTEM automatically opened spillage port to the atmos-
A public water system that is not a community phere designed to prevent backflow.
water system. B-34. SANITARY DEFECTS Conditions that
B-27. NON-POTABLE WATER Water that may cause the contamination of a water supply
has not been examined, properly treated, or ap- during or after treatment. These include connec-
proved by proper authorities as being safe for tions to unsafe water supplies, raw water by-
domestic consumption. All waters are considered passes in treatment plants, plumbing fixtures
non-potable until declared potable. improperly designed and installed, and leaking
B-28. PALATABLE WATER Water that is water and sewer pipes in the same trench.
pleasing to the taste and is significantly free from B-35. SANITARY SURVEY An on site re-
color, turbidity, and odor. Does not imply potabil- view of the water source, facilities, equipment,
ity. operation, and maintenance of a public water sys-
B-29. POTABLE WATER Water that has tem for evaluating adequacy of such source, fa-
been examined and treated to meet appropriate cilities, equipment, operation, and maintenance
standards and declared fit for domestic consump- for producing and distributing safe drinking wa-
tion by responsible installation medical authori- ter.
ties. B-36. SHOULD Indicates an advisory recom-
B-30. PRIMACY Primary enforcement au- mendation that is to be applied when practicable.
thority. A state government has primary en- B-37. SPRING A spring is a concentrated dis-
forcement authority under the Safe Drinking charge of ground water appearing at the ground
Water Act. primacy is delegated to the state by surface.
the EPA Administrator. Before assuming pri- B-38. STANDARD SAMPLE The aliquot (100
macy, the state shall establish drinking water ml) of finished drinking water that is examined
regulations no less stringent than the present for the presence of coliform bacteria.
NPDWR. B-39. SUPERCHLORINATION The applica-
B-31. PUBLIC WATER SYSTEM A system tion of chlorine in dosages far in excess of the
for the provision to the public of piped water for chlorine demand for disinfection.
human consumption. A system that has at least B-40. SUPPLIER OF WATER Any person

November 1990 5-27


B-40 CHAPTER 5. WATER SUPPLY ASHORE

who owns or operates a public water system. operations and distribution. The four organic
B-41. TOTAL AVAILABLE CHLORINE halogen compounds that make up total trihalom-
The sum of the chlorine forms present as free ethanes are: Trichloromethane (chloroform), bro-
available chlorine and combined available chlo- modichloromethane, dibromochloromethane and
rine. tribromomethane (bromoform).
B-42. TREATED WATER Water that has B-44. WATER QUALITY The chemical,
undergone processing such as sedimentation, fil- physical, radiological, and microbiological charac-
tration, softening, disinfection, etc., and is ready teristics of water with respect to its suitability
for consumption. Included is purchased potable for a particular purpose.
water that is retreated (chlorinated, fluoridated, B45. VACUUM BREAKER, NONPRES-
etc.). SURE TYPE A device or means to prevent
B-43. TRIHALOMETHANES (THM) A class backflow designed not to be subjected to static
of organic compounds, commonly found in chlo- line pressure.
rinated or brominated drinking waters. THM are B-46. VACUUM BREAKER, PRESSURE
formed by the reaction of naturally occurring TYPE A device or means to prevent backflow
organic substances (commonly called precursors) designed to operate under conditions of static
with chlorine or bromine during water treatment line pressure.

APPENDIX C
PRINCIPAL WATERBORNE
DISEASES OF CONCERN WITHIN
CONUS
C-1. The principal diseases contracted by man ment plant.
from ingesting contaminated water are gastroen- C-3. Figure 5-C 1 shows a single line for bacte-
teritis, (both viral and bacterial), giardiasis and ricidal chlorine residuals over the temperature
other protozoal diseases, typhoid fever, salmonel- range 0°—2° C. The same is true for bactericidal
losis, shigellosis, and viral hepatitis. Also, the lar- chloramine residuals. Also shown are curves for
vae of certain schistosomes of birds and mam- cysticidal residual for free chlorine for the low
mals can penetrate human skin and cause a der- and normal temperature ranges.
matitis upon exposure to raw water in the Great C-4. NAVMED P-5010-6, Water Supply
Lakes of North America. These schistosomes do Afloat, discusses disinfection of water manufac-
not mature in man; the resulting dermatitis is tured on Navy ships both on the open sea and
sometime known as “swimmer’s itch.” from areas where amebiasis or hepatitis is en-
C-2. The transmission of these diseases is not demic. NAVMED P-5010-9 discusses water sup-
limited only to water. With the exception of the ply procedures for field units of the Navy and
bird or mammal schistosome, they all enter man Marine Corps. Control of Communicable Dis-
by the fecal-oral route. The impact of waterborne eases in Man, NAVMED P-5038, published by
disease may be catastrophic since a single con- the American Public Health Association dis-
taminated water supply may affect an entire cusses the infectious agents, reservoirs, incuba-
population rather than isolated individuals. The tion periods, and methods of control for water-
incidence of waterborne outbreaks is on the in- borne diseases found both in CONUS and in
crease, possibly due to accident, negligence, or a overseas areas.
drastic change in conditions at an existing treat-

5-28 November 1990


B-40 CHAPTER 5. WATER SUPPLY ASHORE

who owns or operates a public water system. operations and distribution. The four organic
B-41. TOTAL AVAILABLE CHLORINE halogen compounds that make up total trihalom-
The sum of the chlorine forms present as free ethanes are: Trichloromethane (chloroform), bro-
available chlorine and combined available chlo- modichloromethane, dibromochloromethane and
rine. tribromomethane (bromoform).
B-42. TREATED WATER Water that has B-44. WATER QUALITY The chemical,
undergone processing such as sedimentation, fil- physical, radiological, and microbiological charac-
tration, softening, disinfection, etc., and is ready teristics of water with respect to its suitability
for consumption. Included is purchased potable for a particular purpose.
water that is retreated (chlorinated, fluoridated, B45. VACUUM BREAKER, NONPRES-
etc.). SURE TYPE A device or means to prevent
B-43. TRIHALOMETHANES (THM) A class backflow designed not to be subjected to static
of organic compounds, commonly found in chlo- line pressure.
rinated or brominated drinking waters. THM are B-46. VACUUM BREAKER, PRESSURE
formed by the reaction of naturally occurring TYPE A device or means to prevent backflow
organic substances (commonly called precursors) designed to operate under conditions of static
with chlorine or bromine during water treatment line pressure.

APPENDIX C
PRINCIPAL WATERBORNE
DISEASES OF CONCERN WITHIN
CONUS
C-1. The principal diseases contracted by man ment plant.
from ingesting contaminated water are gastroen- C-3. Figure 5-C 1 shows a single line for bacte-
teritis, (both viral and bacterial), giardiasis and ricidal chlorine residuals over the temperature
other protozoal diseases, typhoid fever, salmonel- range 0°—2° C. The same is true for bactericidal
losis, shigellosis, and viral hepatitis. Also, the lar- chloramine residuals. Also shown are curves for
vae of certain schistosomes of birds and mam- cysticidal residual for free chlorine for the low
mals can penetrate human skin and cause a der- and normal temperature ranges.
matitis upon exposure to raw water in the Great C-4. NAVMED P-5010-6, Water Supply
Lakes of North America. These schistosomes do Afloat, discusses disinfection of water manufac-
not mature in man; the resulting dermatitis is tured on Navy ships both on the open sea and
sometime known as “swimmer’s itch.” from areas where amebiasis or hepatitis is en-
C-2. The transmission of these diseases is not demic. NAVMED P-5010-9 discusses water sup-
limited only to water. With the exception of the ply procedures for field units of the Navy and
bird or mammal schistosome, they all enter man Marine Corps. Control of Communicable Dis-
by the fecal-oral route. The impact of waterborne eases in Man, NAVMED P-5038, published by
disease may be catastrophic since a single con- the American Public Health Association dis-
taminated water supply may affect an entire cusses the infectious agents, reservoirs, incuba-
population rather than isolated individuals. The tion periods, and methods of control for water-
incidence of waterborne outbreaks is on the in- borne diseases found both in CONUS and in
crease, possibly due to accident, negligence, or a overseas areas.
drastic change in conditions at an existing treat-

5-28 November 1990


MANUAL OF NAVAL PREVENTIVE MEDICINE

FIGURE 5-C1 — Minimum 30 minutes free chlorine


and chloramine residuals for naturally clear or filtered water

November 1990 5-29


D-1 CHAPTER 5. WATER SUPPLY ASHORE

APPENDIX D
SAFE OPERATION OF
CHLORINATION FACILITIES
D-1. Chlorine storage and use areas must be D-5. Personal Protection Equipment.
isolated from other work areas and kept in a dry 1. Employees will be provided with and
condition. All chlorine cylinders must be secured required to use impervious clothing, gloves, face
to prevent rolling or falling. Empty containers shields (eight inch minimum), and other protec-
will be segregated from full containers and tive clothing necessary to prevent any possibility
tagged. Cylinders must not be stored near heat of skin contact with liquid chlorine.
sources, or areas of elevated temperature. Stor- 2. Where there is any possibility of expo-
age will be above ground in a well-ventilated sure of an employee’s body to liquid chlorine, fa-
area separated from other occupied areas by a cilities for quick drenching of the body will be
gas tight partition. “ provided within the immediate work area for
D-2. The room must be continuously venti- emergency use.
lated at a rate of one air change every 2 minutes 3. Non-impervious clothing which be-
through exhaust grilles located not more than 6 comes contaminated with chlorine will be re-
inches above the floor level and make up air moved immediately and not reworn until the
vents located high on the opposite wall. The ven- chlorine is removed from the clothing.
tilated air must be exhausted to the outdoors and 4. Employees will be provided with and
not into interior areas. All doors must be hinged required to use splash-proof safety goggles
to open outward and at least one door will have a where there is any possibility of liquid chlorine
viewport to let operators look into the room be- contacting the eyes.
fore entering. Written operating instructions 5. Where there is any possibility that
developed by the local safety officer, must be employees’ eyes may be exposed to liquid chlo-
posted near the chlorination facility. Operating rine, an eye wash fountain will be provided
switches for lights and ventilation fan must be within the immediate work area for emergency
located exterior to and adjacent to the chlorine use.
room access door. D-6. In the event of a chlorine leak or spill
D-3. A warning sign, similar to the following, employees must immediately evacuate the area
must be affixed in a readily visible location at or and notify the fire department or rescue unit.
near entrances to the chlorination room: Fire department and rescue personnel will be
qualified to contain chlorine leaks or spills and
CAUTION are under a respiratory protection program
CHLORINE HAZARD AREA which includes regular training in respirator se-
UNAUTHORIZED PERSONS KEEP OUT lection, maintenance, inspection, cleaning, and
CAUSES BURNS, SEVERE EYE HAZARD evaluation.
MAY BE FATAL IF INHALED D-7. Leak repairs must be made by personnel
IN CASE OF EMERGENCY CALL trained in the use of and equipped with a self-
(Fire Department #) contained breathing apparatus (SCBA). It is rec-
DO NOT ENTER SPACE ommended that SCBA equipment (two sets) be
kept at a central location (i.e., fire station) so that
D-4. Where chlorine gas is used, one of the they can be used throughout the installation
most important items of safety equipment is a whenever the need arises. SCBA equipment
fail-safe type chlorine leak detector. The leak de- must be maintained per the respirator program.
tector must sound an alarm at an atmosphere See OPNAVINST 5100.23 series.
chlorine concentration of 1 ppm (3mg/m3). The D-8. The base safety officer or a qualified dus-
chlorine detector will be calibrated and main- trial hygienist (located at Naval hospitals, clinics
tained per the manufacturer’s instructions. Writ- commands and NAVE NPVNTMEDUS) will be
ten records of calibration and maintenance will consulted about the safe operation of chlorima-
be kept on file. tion facilities.

5-30 November 1990


MANUAL OF NAVAL PREVENTIVE MEDICINE

APPENDIX E
NAVY ENVIRONMENTAL AND
PREVENTIVE MEDICINE UNITS
UNIT GEOGRAPHICAL AREA OF ASSIGNMENT

Navy Environmental and Preventive 20° W longitude West to 100° W longitude,


Medicine Unit No. 2 including Iceland
Norfolk, Virginia 23511-6288
Commercial: (804) 444-7671
AUTOVON:564-7671

Navy Environmental and Preventive 100° W longitude West to 150° W longitude,


Medicine Unit No. 5 including all of Alaska
Naval Station, Box 143
San Diego, California 92136-5143
Commercial: (619) 556-7070
AUTOVON: 526-7070

Navy Environmental and Preventive 150º W longitude West to 70° E longitude,


Medicine Unit No. 6 except Alaska
Pearl Harbor, Hawaii 96860-5040
(Mail address: Box 112, Fleet Post Office
San Francisco 96610
Commercial: (808) 471-9505
AUTOVON: 430-0111 ask for 471-9505

U.S. Navy Environmental and Preventive 70° E longitude West to 20° W longitude,
Medicine Unit No. 7 except Iceland
Naples, Italy
(Mail address Fleet Post Office
New York 09521
Commercial: 9-011-39-81-724-4468/4469
AUTOVON: 450-3219

November 1990 5-31


APPENDIX F
TREATED WATER QUALITY
STANDARDS

Section 1. NATIONAL PRIMARY DRINKING WATER REGULATIONS


(NPDWR)

F-1. Contaminant Levels for Inorganic Chemicals


[ I
Contaminant MCLG MCL AL 2
m g / L1 mg/L mg/L
7 million
fibers/L
longer than 10
micrometers
Arsenic 0.05
1
Barium 2 2
Cadmium 0.005 0.005
Chromium 0.1 0.1
Copper 1.3
Lead o 0 . 0 1 54 I
Mercury 0.002 0.002
Nitrate (as N) 10 10
Nitrite (as N) 1 1 ’
Total Nitrate and 10 10
Nitrite (as N)
Selenium 0.05 0.05

I Fluoride 4 4
1 Maximum Contaminant Level Goal (MCLG). The maximum level of a
contaminant in drinking water at which no known or anticipated adverse
effect on the health of persons would occur, and which allows an
a d e q u a t e m a r g i n o f s a f e t y . Maximum contaminant level goals are
nonenforceable health goals.

2 Action Level (AL). Concentration of lead or copper in water that


determine, in some cases, whether a water system must install corrosion
control treatment, monitor source water, replace lead service lines, and
undertake a public education program.

3 The copper action level is exceeded if the concentration of copper


in more than 10 percent of tap water samples properly collected during
any monitoring period is greater than 1.3 mg/L (i.e., if the “90th
percentile” copper level is greater than 1.3 mg/L).

4 The lead action level is exceeded if the concentration of lead in


more than 10 percent of tap water samples properly collected during any
monitoring period is greater than 0.015 mg/L (i.e., if the “90th
percentile” lead level is greater than 0.015 mg/L).

Change 1
January 1993 5-33
CHAPTER 5. WATER SUPPLY ASHORE

F-4 . Turbidity. The MCL for month it is required to monitor.


turbidity is applicable to both 3. MCL violations must be
community water systems and reported to the State no later
noncommunity water systems using than the end of the next business
surface water sources in whole or day after the system learns of
in part. The MCL for turbidity the violation.
in drinking water measured at a 4. Monitoring Requirements
representative entry point(s) to for Total Coliforms:
the distribution system is: a. Each public water
1. One turbidity unit for system must sample according to a
monthly average (5 turbidity written sample siting plan.
units monthly may apply at State Plans are subject to State review
option) . and revision. The State must
2. Five turbidity units establish a process which ensures
(maximum) average for two the adequacy of the sample siting
consecutive days. plan for each system.
3. The requirements in this b. A system must
section apply to unfiltered collect a set of repeat samples
systems until 30 December 1991, for each total coliform-positive
unless the State has determined routine sample and have it
prior to that date, in writing, analyzed for total coliforms. At
that filtration is required. least one repeat sample must be
These requirements apply to from the same tap as the original
filtered systems until 29 June total Coliform-positive sample;
1993. The requirements apply to other repeat samples must be
unfiltered systems that the State collected from within five
has determined, in writing, must service connections of the
install filtration until 29 June original total coliform-positive
1993 or until filtration is sample. At least one must be
installed whichever is later. upstream and another downstream.
After the above dates, consult The system must collect all
the latest edition of 40 CFR 141. repeat samples within 24 hours of
being notified of the original
result, except where the State
F-5. Coliform Bacteria waives this requirement on a
case-by-case basis. If a total
1. The MCL for coliform coliform-positive sample is at
bacteria (also called total the end of the distribution
coliforms) is based on the system, or one service connection
presence or absence of coliforms away from the end of the
in a sample rather than on an distribution system, the State
estimate of coliform density. may waive the requirement to
a. The MCL for systems collect at least one repeat
analyzing at least 40 samples sample upstream of the original
each month is: No more than 5 sampling site.
percent of the monthly samples c. If total coliforms are
may be total coliform positive. detected in any repeat sample,
b. The MCL for systems the system must collect another
analyzing fewer than 40 set of repeat samples, as before,
samples/month is: No more than 1 unless the MCL has been violated
sample per month may be total and the system has notified the
coliform positive. State (in which case the State
2. A public water system must may reduce or eliminate the
demonstrate compliance with the requirement to take the remaining
MCL for total coliforms each samples) .

Change 1 January 1993


5-36
MANUAL OF NAVAL PREVENTIVE MEDICINE

d. If a system has only minimum monitoring requirements) .


one service connection, the State g . Monthly monitoring
has the discretion to allow the requirements are based on
system to collect the required p o p u l a t i o n s e r v e d . Tables 5-F1
set of samples at the same tap and 5-F2 summarize the routine
over a four-day period or to and repeat sampling requirements
collect a larger volume repeat for total coliforms.
sample(s) (e.g., a single 400ml
sample). TABLE 5-F1
e. If a system which Total Coliform Sampling
collects fewer than five Requirements
samples/month detects total According to Population Served
coliforms in any routine or
repeat sample (and the sample is Population Served Minimum
not invalidated by the State), it Number of
must collect a set of five Routine
routine samples the next month Samples per
the system provides water to the Month
public, except that the State may 25 to 1,000 1*
waive this requirement if (1) it 1,001 to 2,500 2
performs a site visit to evaluate 2,501 to 3,300 3
the contamination problem, or ( 2 ) 3,301 to 4,100 4
it has determined why the sample 4,101 to 4,900 5
was total coliform-positive and 4,901 to 5,800 6
(a) this finding is documented in 5,801 to 6,700 7
writing along with what action 6,701 to 7,600 8
the system has taken or will take 7,601 to 8,500 9
to correct this problem before 8,501 to 12,900 10
the end of the next month the 12,901 to 17,200 15
system serves water to the 17,201 to 21,500 20
public, (b) this document is 21,501 to 25,000 24
signed by the supervisor of the 25,001 to 33,000 30
State official who makes the 33,001 to 41,000 40
findings, (c) the documentation 41,001 to 50,000 50 **
is made available to EPA and the * For non-community water
public and (d) in certain cases systems see NPDWR.
(described in this rule), the ** For community water
system collects at least one systems serving greater than
additional sample. 50,000 see NPDWR.
f . Unfiltered surface
water systems and systems using
unfiltered ground water under the
direct influence of surface water
must analyze one coliform sample 5. Invalidation of Total
each day the turbidity of the Coliform Positive Samples
source exceeds one NTU (this a. Each total coliform-
positive sample counts in
sample counts toward the system’s compliance calculations, unless

Change 1
January 1993 5-37
CHAPTER 5. WATER SUPPLY ASHORE

b. a turbid culture in a. Total coliform


the absence of an acid reaction analyses are to be conducted
using the P-A; using the 10 tube MTF, the MF,
c. or confluent growth or The P-A or the MMO-MUG test. A
colony number that is "too system may also use the 5 tube
numerous to count” using the MF, MTF technique (using 20 ml sample
the sample is invalid (unless portions) of a single culture
total coliforms are determined, bottle containing the MTF medium,
in which case, the sample is as long as a 100 ml sample is
valid) and the system must, used in the analysis.
within 24 hours of being notified b. A 100 ml standard
of the results, collect another sample volume must be used in
sample from the same location as analyzing for total coliforms,
the original sample and have it regardless of the analytical ,
analyzed for total coliforms. In method used.
such case, EPA recommends using c. Fecal coliform
media less prone to interference analysis must be conducted using
from heterotrophic bacteria for methods described in 40 CFR
analyzing the replacement sample. 141.21 and Standard Methods.
The State may waive the 24-hour d. E. coli analysis must
time limit on a case-by-case be conducted using methods
basis. described in the Federal Register
10. Analytical Methodology of 8 Jan 91 (56 FR 642) and/or
Standard Methods.

F-6. The MCL for radiological contaminants are: *

Gross alpha particle activity including


radium 226 but excluding radon and uranium. . . .15 pCi/L
Combined radium-226 and radium-228 . . . . . . . . . . . ..5 pCi/L
Tritium. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,000 pCi/L
Strontium-90 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 pCi/L
* Screening indicators have been established for radiological
contaminants. Gross alpha present at less than or equal to 5 pCi/L, as
an indicator, eliminates the need to analyze for radium 226 and 228.
Gross beta present at less than or equal to 8 pCi./L, as an indicator,
eliminates the need to analyze for tritium and strontium-90.

F - 7 . Sodium and Corrosivity

No MCLS have been published; however, monitoring is required. See


Appendix G.

Change 1
5-39A January 1993
MANUAL OF NAVAL PREVENTIVE MEDICINE

Section II. NATIONAL SECONDARY DRINKING WATER REGULATIONS

F-8. The secondary M C LS a r e as follows:

Contaminant Level
Aluminum 0.05 to 0.2 mg/L
Chloride 250 mg/L
Color 15 color units
Copper 1.0 mg/L

Fluoride 2.0 mg/L


Foaming agents 0.5 mg/L
Iron 0.3 mg/L
Manganese 0.05 mg/L
Odor 3 threshold odor number

pH 6.5 to 8.5
Silver 0.1 mg/L
Sulfate 250 mg/L
Total Dissolved Solids (TDS) 500 mg/L
Zinc 5 mg/L

Note: The contaminants covered by this regulation are those that may
adversely affect the aesthetic quality of the drinking water. These
secondary levels represent reasonable goals for drinking water quality,
but are not federally enforceable. The individual States may establish
higher, lower or no levels for these contaminants. All Navy and Marine
Corps facilities must provide drinking water of the highest quality in
consonance with the NSDWR as well as the federally enforceable NPDWR.

Change 1
January 1993 5-39B
H—1 MANUAL OF NAVAL PREVENTIVE MEDICINE

APPENDIX G
NPDWR SURVEILLANCE
REQUIREMENTS
System Test Sampling interval

Community water Surface water Inorgmics annually


Organics every 3 years
Radiochemicals every 4 years
Turbidity daily
Coliform bacteria monthly*
Trihalomethanes quarterly**
Nitrates annually
Sodium annually
Corrosivity biannually
Ground water Inorganic every 3 years
Organics State option
Radiochemicals every 4 years
Turbidity State option
Coliform bacteria monthly*
Trihalomethanes quarterly**
Nitrates every 3 years
Sodium every 3 years
Corrosivity annually

Noncommunity water Surface water Inorganic State option


Organics State option
Radiochemicals State option
Turbidity daily
Coliform bacteria quarterly
Nitrates State option
Ground water Inorganic State option
Organics State option
Radiochemicals State option
Turbidity State option
Coliform bacteria one per quarter
Nitrates State option

*Number of samples dependent on number of people served bysystem.


**For systems serving greater than 10,000 population. For those systems
serving populations less than 10,000 monitoring is at state discretion.

APPENDIX H
REFERENCES
H-1. NAVY Instructions 5. NAVMEDCOM 6240.1 Series, Standards for
1. OPNAVINST 5090.1, Environmental and Potable Water.
Natural Resources Protection Manual. H-2. NAVAL FACILITIES ENGINEERING
2. OPNAVINST 5100.23 Series, Navy Occu- COMMAND MANUALS
pational Safety and Health (NAVOSH) Program. 1. NAVFAC DM-5.7, Water Supply Systems.
3. NAVFACINST 11330.11. Backflow rre- 2. NAVFAC MO-210, Operation and Mainte-
venters, Reduced Pressure Principle Type. - nance of Water Supply Systems.
4. NAVSUPINST 5100.24 Series, Calcium H-3. NAVAL ENERGY AND ENVIRON-
Hypochlorite.

November 1990 5-37


H—1 MANUAL OF NAVAL PREVENTIVE MEDICINE

APPENDIX G
NPDWR SURVEILLANCE
REQUIREMENTS
System Test Sampling interval

Community water Surface water Inorgmics annually


Organics every 3 years
Radiochemicals every 4 years
Turbidity daily
Coliform bacteria monthly*
Trihalomethanes quarterly**
Nitrates annually
Sodium annually
Corrosivity biannually
Ground water Inorganic every 3 years
Organics State option
Radiochemicals every 4 years
Turbidity State option
Coliform bacteria monthly*
Trihalomethanes quarterly**
Nitrates every 3 years
Sodium every 3 years
Corrosivity annually

Noncommunity water Surface water Inorganic State option


Organics State option
Radiochemicals State option
Turbidity daily
Coliform bacteria quarterly
Nitrates State option
Ground water Inorganic State option
Organics State option
Radiochemicals State option
Turbidity State option
Coliform bacteria one per quarter
Nitrates State option

*Number of samples dependent on number of people served bysystem.


**For systems serving greater than 10,000 population. For those systems
serving populations less than 10,000 monitoring is at state discretion.

APPENDIX H
REFERENCES
H-1. NAVY Instructions 5. NAVMEDCOM 6240.1 Series, Standards for
1. OPNAVINST 5090.1, Environmental and Potable Water.
Natural Resources Protection Manual. H-2. NAVAL FACILITIES ENGINEERING
2. OPNAVINST 5100.23 Series, Navy Occu- COMMAND MANUALS
pational Safety and Health (NAVOSH) Program. 1. NAVFAC DM-5.7, Water Supply Systems.
3. NAVFACINST 11330.11. Backflow rre- 2. NAVFAC MO-210, Operation and Mainte-
venters, Reduced Pressure Principle Type. - nance of Water Supply Systems.
4. NAVSUPINST 5100.24 Series, Calcium H-3. NAVAL ENERGY AND ENVIRON-
Hypochlorite.

November 1990 5-37


CHAPTER 5. WATER SUPPLY ASHORE

MENTAL SUPPORT ACTIVITY No. C-601-68.


1. NEESA 1-038 Water Management Con- 6. American Water Works Association,
tingency Planning. Standard for Inspecting and Repairing Steel
H-4. NAVAL SEA SYSTEMS COMMAND Water Tanks, Stand Pipes, Reservoirs, and Ele-
MANUAL vated Tanks, for Water Storage, AWWA D101-53
1. NAVSEA S6470-AA-SAF-010, Gas Free (R1979).
Engineering. 7. American National Standards Institute
H-5. DEPARTMENT OF THE ARMY PUBLI- (ANSI) Z117.1-1977, American Safety Require-
CATIONS ments for Working in Tanks and other Confined
1. TB MED 576, Sanitary Control and Sur- Spaces.
veillance of Water Supplies at Fixed Installa- 8. National Academy of Sciences, D-inking
tions. Water and Health, Volumes 1 (1977),2 (1980) Na-
2. TM5-700, Field Water Supply. tional Academy of Sciences, 201 Constitution
H-6. PUBLIC LAW Public Law 93-523, Safe Avenue, Washington, DC.
Drinking Water Act. 9. Ehlers, V., and E. Steel, Municipal and
H-7. CODE OF FEDERAL REGULATIONS Rural Sanitation, 6th edition, McGraw-Hill Book
1. Title 29, Code of Federal Regulations Company, Incorporated, 1965.
(CFR), Part 1910 OSHA Safety and Health Stan- 10. Salvato, J.A., Environmental Engineer-
dards. ing and Sanitation, 3rd edition, John Wiley and
2. Title 40, Code of Federal Regulations Sons, 1982.
(CFR), Part 141, National Primary Drinking 11. Freedman, B., Sanitarian’s Handbook,
Water Regulations, as amended. Theory and Administrative Practice for Envi-
3. Title 40, Code of Federal Regulations ronmental Health, 4th edition, Peerless Publish-
(CFR), Part 143, National Secondary Drinking ing Company, 1977.
Water Regulations. 12. White, G. C., Handbook of Chlorination,
H-8. MISCELLANEOUS 2nd edition, Van Nostrand Reinhold Company,
1. U.S. Environmental Protection Agency, 1986.
Water Supply Division. Cross-Connection Con- 13. APHA-AWWA-WPCF, Standard Meth-
trol Manual, EPA-570/9-89-007. ods for the Examination of Water and Wastewa-
2. U.S. Environmental Protection Agency, ter, 16th edition, American Public Health Asso-
Municipal Environmental Research Laboratory, ciation.
Treatment Techniques for Controlling Trihalom- 14. U.S. Environmental Protection Agency
ethanes in Drinking Water, EPA-600/2-81-156. Manual EPA-430/9-74-007, The Manual of Indi-
3. American Water Works Association, vidual Water Supply Systems.
Emergency Planning for Water Utility Manage- 15. U.S. Environmental Protection Agency
ment, AWWA manual M19. Manual, EPA-670/9-75-006, Handbook for Evalu-
4. American Water Works Association, ating Water Bacteriological Laborites.
Standardfor Deep Wells AWWA No. A100-66. 16. DHHS (NIOSH) Publication No. 81-123,
5. American Water Works Association, NIOSH-OSHA Occupational Health Guidelines
Standard for Disinfection Water Mains. AWWA for Chemical Hazards.

5-38 November 1990


l-1 MANUAL OF NAVAL PREVENTIVE MEDICINE

APPENDIX I
MICROBIOLOGICAL SAMPLING
TECHNIQUE FOR DRINKING

Sample Size: For most purposes, a 100 to 120 ml chlorine residual present in the drinking water
sample will suffice. Prior coordination with the sample. Consult the current edition of Standard
testing agency is recommended. Methods for the Examination of Water and Was-
Type Container: A sterile, clean container with a tewater for preparation of this chemical. DO NOT
screw cap will be used in microbiological sam- RINSE OR FLUSH THE SAMPLES CON-
pling. EPA approved water sampling bags con- TAINER PRIOR TO COLLECTING THE
taining sodium thiosulfate may also be used. SAMPLES AS THE SODIUM THIOSULFATE
WILL BE WASHED OUT!
PROCEDURE I-5. In the case of individual potable water
samples sent to the laboratory by courier, the
I-1. Open the cold water tap and allow the wa- elapsed time between collection and examination
ter to flow freely for several minutes to ensure will not exceed 6 hours. (The exception to this 6-
drawing water directly from the mains. Deter- hour rule is for samples mailed from distant in-
mine the chlorine residual and pH, and record the stallations; these samples may be held for up to
value. 30 hours.) Samples will be refrigerated to 4° C
Note: Samples must not be collected from fau- during shipment. The time and temperature of
cets with aerators, swivel or add-on devices un- storage of all samples will be recorded and must
less these devices are removed before running be considered in the interpretation of data.
the water in this step. I-6. Flaming water taps before collecting po-
I-2. Reduce the flow to produce a small stream table water samples is not necessary if reason-
of water. Carefully remove the cap or stopper of able care is exercised in the choice of sampling
the sample bottle by grasping the outside of the tap (clean, free of attachments, and in good re-
cap. Do not touch any surfaces which the sample pair) and if the water is allowed to flow at a uni-
will contact. Hold the cap in the hand. Fill the form rate before sampling. Alterations in the
bottle to within one-half inch of the bottom of the valve setting to change the flow rate during col-
neck and replace the cap. lection could affect the sample quality. Superfi-
I-3. Complete, the information required on DD cially passing a flame from a match or an alcohol-
Form 686 (Fluoride Bacteriological Examination soaked cotton applicator over the tap a few times
of Water) identifying the sample as to exact may have a psychological effect on observers, but
source, time of collection, chlorine residual, spe- it will not have a lethal effect on attached bacte-
cial circumstances if any, and the address to ria. The application of intense heat may damage
which the report will be forwarded. Identify the the valve-washer seating or create a fire hazard
sample bottle and the data card by the same to combustible materials next to the tap. If suc-
number. cessive samples from the same tap continue to
I-4. Sodium thiosulfate should be added to the show coliforms, the tap maybe disinfected with a
sample container before collection of the sample. hypochlorite solution to reduce external contami-
This chemical stops the bactericidal action of the nation as the source of these organisms.

November 1990 5-39


CHAPTER 5. WATER SUPPLY ASHORE
-.\

APPENDIX J
REMEDIAL ACTIONS TO BE
TAKEN IN EVENT
CONTAMINATED WATER
SAMPLES ARE FOUND
Conditions Possible Cause Recommendations
I. No known sanitary defects, health The contaminated samples a. Collect repeat samples promptly.
hazards, or inadents of a gastrointes- might indicate a localised situ- b. Expedite shipment of samples so that a
tinal disease. ation within the piping of the prompt report may be obtained &om the labo-
building where the sample was ratory.
coUected, or a faulty sampiiig c. Make an immediate investigation to determine
technique. if any unusual conditions have occurred, such
as repairs to the water mains, faucets, or pip
ing within the building, or in the vicinity of the
sampling point.
d. Test for chlorine at various outlets to ensure
the proper dosage.
e. If the foregoing investigation shows the need,
flush the portion of the system by opening out-
lets, until a proper chlorine residual is re-
corded; carry out localised chlorination if
needed.
f. Resample following paragraph 5-20.3.e.
& If examination shows that conditions defined
in paragraph 2 below exist, then the remedid
actions recommended in that paragraph must
be followed.
2. occurrence of a major disaster, such Self evident. a. Immediate rejection of water supply system
as the inundation of the source, and institution of an emergency treatment
breakdown in treatment plant units, program. Treat all drinking water and water
gross contamination of the system used for culinary purposes.
through a cress-connection, failure of b. After the necessary repairs have been com-
an underwater crossing, damage pleted, super-chlorinate and flush the entire
from an earthquake, etc. system.
c. Collect samples from representative points
throughout the system until negative micro-
biological results are obtained on at least two
consecutive sets of standard samples collected
on different days.
d. Remove restrictions on the use of water.
3. Occurrence of an outbreak of one of Contamination of the water a. Carry out recommendations under Condition 1
the so-called waterborne diseases. system at the source, in with special emphasis on the investigation of
reservoirs, treatment plant the source, reservoirs, treatment processes,
facilities, or distribution system and distribution system.
and not generally obvious at the b. Increase the chlorine dosage and residual in
onset of the outbreak. the system.
c If the conditions contributing to the contami-
nation are found to be serious, such as a direct
contamination with sewage, reject the supply
and institute emergency treatment until the
condition is corrected.

5-40 November 1990


Bureau of
Medicine and Surgery NAVMED P-5010-6 (Rev. 7-2005)
Washington, DC 20372-5300 0510-LP-103-9057

Manual of Naval Preventive Medicine

Chapter 6

WATER SUPPLY AFLOAT

DISTRIBUTION STATEMENT "A"

This publication supersedes NAVMED P-5010-6 of 1990 S/N 0510-LP-206-6300


CHAPTER 6
WATER SUPPLY AFLOAT

CONTENTS

Section I. Introduction Page

Article 6-1. Scope...........................................................................................6-1


6-2. Responsibilities ...........................................................................6-1
6-3. Shipboard Potable Water ............................................................6-2
6-4. Potable Water Usage Requirement .............................................6-3

Section II. Receipt and Transfer


Article 6-5. Receipt and Transfer of Potable Water.......................................6-5
6-6. Approved Sources.......................................................................6-5
6-7. Sources of Doubtful Quality ...................................................... 6-6
6-8. Care of Shipboard Potable Water Hoses and Equipment ...........6-6
6-9. Connection Procedures ...............................................................6-6

Section III. Storage and Distribution


Article 6-10. Potable Water Production ...........................................................6-7
6-11. Potable Water Tanks ...................................................................6-8
6-12. Vents and/or Overflow Lines......................................................6-8
6-13. Manholes.....................................................................................6-8
6-14. Measurement of Water Level......................................................6-9
6-15. Filling Lines ................................................................................6-9
6-16. Potable Water Piping ..................................................................6-9
6-17. Repairs ......................................................................................6-10
6-18. Potable Water Tank Coatings ...................................................6-10
6-19. Labeling and Color-Coding ......................................................6-10
6-20. Potable Water Hose Storage Lockers .......................................6-10

Section IV. Disinfection


Article 6-21. Disinfection of Potable Water Supplies....................................6-11
6-22. Disinfection of Potable Water Tanks and Systems...................6-15
6-23. Disinfection of Potable Water Hoses, Tapes, and Rods ...........6-16
6-24. Emergency Disinfection of Water for Drinking and
Cooking Purposes ...............................................................6-16
6-25. Chlorine Dosage Calculator......................................................6-16
6-26. Required Halogen Residuals.....................................................6-18

Section V. Potable Water, Submarine/Yard Craft


Article 6-27. Submarines................................................................................6-19
6-28. Yard Craft .................................................................................6-19
CONTENTS
(Continued)

Section VI. Cargo Water


Article 6-29. Emergency Use of Potable Water Tanks for Ballast ................6-21
6-30. Handling of Cargo Water..........................................................6-21
6-31. Temporary Water Tanks ...........................................................6-22

Section VII. Emergency Water Supplies


Article 6-32. Battle Dressing Stations............................................................6-25
6-33. Emergency Potable Water, 5-Gallon Containers ......................6-25
6-34. Can and Bottle Drinking Water ................................................6-26

Section VIII. Evaluation of Taste and Odor Problems


Article 6-35. General Evaluation of Taste and Odor Problems .....................6-27
6-36. Causes of Taste and Odor in Potable Water .............................6-27
6-37. Indicators of Taste and Odor Problems ....................................6-28
6-38. Initial Evaluation of Taste and Odor Problems.........................6-28
6-39. Control Measures for Taste and Odor Problems.......................6-30
6-40. Request for Outside Assistance ................................................6-30

Section IX. Cross-Connections


Article 6-41. General Cross-Connections ......................................................6-33
6-42. Cross-Connection Definitions...................................................6-33
6-43. Improper Piping Installation .....................................................6-34
6-44. Medical Department Cross-Connection Surveillance...............6-34

Section X. Manufacture and Handling of Ice


Article 6-45. Manufacture of Ice....................................................................6-37
6-46. Special Precautions for Handling of Ice ...................................6-37
6-47. Cleaning and Disinfecting Ice Machines ..................................6-37
6-48. Bacteriological Quality of Ice ..................................................6-38

Section XI. Water Testing Requirements and Procedures


Article 6-49. Scope.........................................................................................6-39
6-50. Temperature and pH Testing ....................................................6-39
6-51. Salinity (Chloride Content).......................................................6-40
6-52. Halogen Residual (Chlorine/Bromine) .....................................6-40
6-53. Bacteriological Collection and Testing.....................................6-44
6-54. Potable Water Log ....................................................................6-45

Section XII. Sample Water Sanitation Bill


Article 6-55. Sample Water Sanitation Bill....................................................6-47

Section XIII. References and Appendices


Article 6-56. References.................................................................................6-49
6-57. Appendices................................................................................6-51

ii
CHAPTER 6
WATER SUPPLY AFLOAT

TABLES Page

Table 6-1. Potable Water Transfer Procedures for Ship-to-Shore and Ship-to-Ship ...........6-6

Table 6-2. Methods for Disinfection of Potable Water Tanks ..........................................6-15

Table 6-3. Chlorine Dosage Calculator for 5% Liquid Sodium Hypochlorite


(Unscented) .......................................................................................................6-17

Table 6-4. Chlorine Dosage Calculator for 10% Liquid Sodium Hypochlorite
(Unscented) .......................................................................................................6-17

Table 6-5. Chlorine Dosage Calculator for 65-70% Powder Calcium Hypochlorite.........6-18

Table 6-6. Required Halogen Residuals.............................................................................6-18

Table 6-7. Bulk Ice-Making Machine Cleaning/Disinfection Instructions........................6-37

Table 6-8. Ice Dispensing Machine Cleaning/Disinfection Instructions ...........................6-38

Table 6-9. Routine Testing Procedure Summary ...............................................................6-41

LIST OF APPENDICES

Appendix A. Abbreviations ...................................................................................................6-51

Appendix B. Definitions.........................................................................................................6-52

Appendix C. Water Sampling Technique...............................................................................6-53

Appendix D. Sample Potable Water Sanitation Bill...............................................................6-53

iii
MANUAL OF NAVAL PREVENTIVE MEDICINE

THIS PAGE INTENTIONALLY LEFT BLANK

iv
6-1 CHAPTER 6. WATER SUPPLY AFLOAT 6-2

SECTION I. INTRODUCTION
Article Subject Page

6-1 Scope ..............................................................................................................................6-1


6-2 Responsibilities ..............................................................................................................6-1
6-3 Shipboard Potable Water................................................................................................6-2
6-4 Potable Water Usage Requirement ................................................................................6-3

6-1. Scope

a. This chapter provides information for c. Chief, BUMED is responsible for


safe and proper potable water handling proced- establishing and promulgating health standards
ures for United States Naval Ships (USNS). for water quality afloat. BUMED will
Applicable potable water quality standards are set promulgate appropriate instructions, notices, or
forth in current Office of the Chief of Naval other publications to reflect afloat water quality
Operations (OPNAV), Bureau of Medicine and requirements. Additionally, BUMED will set
Surgery (BUMED), and Military Sealift forth shipboard requirements for medical
Command (MSC) instructions. The basic surveillance of potable water systems.
principles outlined in the following sections will
help prevent water-borne disease outbreaks. The d. Area, fleet, and subordinate commanders
use of trademark names in this publication does are responsible for issuing the necessary imple-
not imply endorsement by the Department of menting directives to ensure that adequate water
Navy (DON), but is intended only to assist in sanitation standards are provided and enforced in
identifying specific products. each ship within the command.

b. All personnel concerned with loading, e. The commanding officer, master, or other
treatment, storage, distribution, and medical applicable responsible party of each ship is
surveillance of potable water should be familiar responsible for promulgating a water sanitation
with current applicable naval instructions and bill to ensure that procedures for receipt, transfer,
directives, which supplement this chapter. treatment, storage, distribution, and surveillance
are provided and followed.
6-2. Responsibilities
f. The engineering department of the ship
a. The Naval Sea Systems Command is responsible to the commanding officer or
(NAVSEASYSCOM) is responsible for the master for implementing the requirements of the
design, construction, and maintenance of the NAVSEASYSCOM. This responsibility
shipboard potable water systems, including includes the supply and treatment of potable
treatment facilities and processes to assure that water and for the system components that
safe drinking water is available at all times. receive, store, distribute, produce, and treat
potable water. The engineering officer shall
b. The Naval Facilities Engineering ensure that all ship-to-shore connections are
Command (NAVFACENGCOM) is responsible made only by authorized shore personnel, when
for promulgating instructions for ship-to-shore available, or in their absence, ship personnel
potable water connections and for providing who are properly supervised by authorized shore
potable water from an approved source when the personnel; and that all connections required for
ship is berthed at a naval facility. ship-to-ship potable water transfer are made by
personnel trained in handling potable water.

25 Jul 2005 6-1


6-2 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-3

The engineering officer is responsible for the source waters, can vaporize and mix with the
chloride and hydrogen ion (pH) testing of the water vapor during the distillation process,
ship’s potable water. The engineering depart- carrying over into the condensate chamber and
ment shall ensure minimum halogen residuals distillate reservoir.
are maintained at a potable water tank before
placing the tank on-line to the potable water c. Distilled water tends to be mineral free
distribution system. and can be highly corrosive to metal piping and
storage tanks. The leaching of lead and copper
g. The medical department representative from plumbing fixtures and service lines and any
(MDR) is responsible for conducting a medical other sources in contact with potable water
surveillance program of the potable water (lead-based paint) is of special concern. Opera-
system including collection of samples for tional checks of shipboard water plants afloat,
coliform bacteria testing as prescribed and daily inspection, and approval of watering points
halogen residuals from the distribution system. ashore are only a part of the precautions
The MDR shall notify the commanding officer necessary to assure a safe water supply. Many
or master of any discrepancies observed in the points of possible contamination exist within the
potable water distribution system. ship and may contribute to waterborne disease
outbreaks. Therefore, regardless of the source of
6-3. Shipboard Potable Water the water, there must be vigilant surveillance to
assure adequate protection from subsequent
a. Shipboard potable water primarily contamination.
comes from approved ashore sources and ships
water production plants which include distilla- d. Potable Water Sources for Naval Ships:
tion plants or reverse osmosis (RO) plants.
Present water plants aboard naval ships are (1) Distillation, RO, or other NAVSEA
designed to make the ship as self-sufficient as approved water production technology.
possible. Generally, ship water treatment plants
are capable of producing potable water from (2) Shore-to-ship delivery from an
bacteriologically contaminated seawater, approved source.
provided the specific procedures set forth in
Chapters 531 and 533 of the Naval Ships Tech- (3) Shore-to-ship delivery from an
nical Manual (NSTM) are followed. In addition, unapproved source (when approved source does
potable water must be adequately disinfected to not exist), refer to Article 6-7.
maintain the required halogen residual level in
the potable water tanks and distribution system. (4) Ship-to-ship.

b. Avoid making water while operating in e. Potable water is used aboard ship for
harbors or from polluted seawater. Seawater drinking, cooking, laundry, medical, personal
shall be assumed polluted when ships are hygiene, and other purposes.
operated in close formation. While making pot-
able water, care must be taken not to strip fuel f. Health concerns regarding potable water
waste tanks or empty bilges forward of the salt- quality may include physical, chemical, and
water intakes. Source water in harbors or ship bacteriological parameters. Direct chemical
navigation lanes is likely to be contaminated by additives to potable water systems afloat should
fuel/oil slicks or other pollutant sources. be tested/certified by the product manufacturer
Volatile Organic Chemicals (VOCs), which in accordance with National Sanitation
have a lower boiling point than water and which Foundation International Standard known as
could be present in contaminated unapproved NSF/ANSI Standard 60: Drinking Water
Treatment Chemicals – Health Effects.

6-2 25 Jul 2005


6-3 CHAPTER 6. WATER SUPPLY AFLOAT 6-4

Likewise, indirect chemical additives to potable 6-4. Potable Water Usage Requirement
water systems afloat should be tested/certified
by the product manufacturer in accordance with a. Proper indoctrination of the crew and
NSF/ANSI Standard 61: Drinking Water System attention to leaks and waste should limit potable
Components – Health Effects. Manufacturers water consumption to reasonable amounts.
should meet other applicable NSF/ANSI potable Water hours may at times become necessary on
water public health standards as indicated. some ships and this may adversely impact
personal hygiene practices. This is particularly
g. Use of seawater in food services spaces applicable to troop-carrying ships loaded beyond
including sculleries is prohibited and seawater their water-producing capacity. Personnel may
outlets in these spaces must be removed. The keep clean and live under sanitary conditions,
dangers of cross connections and of using even with a limited water supply. If unusual
polluted overboard water cannot be overempha- conditions require drastic restrictions in the use
sized. Cross connections between the potable of potable water, the allowances should not be
water and seawater of other systems are not less than 2 gallons per man per day to be used
permitted. Exception: specific garbage grinders, for drinking and cooking purposes. In hot
which use seawater flush and have been environments it is necessary to provide
approved by BUMED for use in designated sufficient drinking water quantity to prevent heat
sculleries. Installation of salt water flush casualties.
garbage grinders precludes storage of clean
dishware or other items in the scullery because b. For new ship constructions, 50 gallons
of concerns for aerosol contamination. per day per man is specified by NAVSEA for
design considerations. This encompasses a
h. Seawater is used aboard ships such as in broad spectrum of potable water uses including
the fire mains, decontamination, and for marine drinking water, galley and scullery, personal
sanitation devices (MSDs) flushing. Since hygiene, and laundry.
conservation of potable water is a constant
requirement, it is impractical to provide potable
water for all purposes.

25 Jul 2005 6-3


6-4 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-4

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6-4 25 Jul 2005


6-5 CHAPTER 6. WATER SUPPLY AFLOAT 6-6

SECTION II. RECEIPT AND TRANSFER


Article Subject Page

6-5 Receipt and Transfer of Potable Water ..........................................................................6-5


6-6 Approved Sources ..........................................................................................................6-5
6-7 Sources of Doubtful Quality ..........................................................................................6-6
6-8 Care of Shipboard Potable Water Hoses and Equipment...............................................6-6
6-9 Connection Procedures...................................................................................................6-6

6-5. Receipt and Transfer of Potable Water 6-6. Approved Sources. Potable water may be
received from approved shore facilities or other
a. When receiving or transferring potable vessels. The following are approved potable
water via approved sources, proper procedures water sources:
must be followed to prevent contamination.
a. Environmental Protection Agency
(1) A free available chlorine (FAC), (EPA) (State and territory) approved public
chloramines (total chlorine), or total bromine water systems.
residual as applicable shall be completed prior to
the initial transfer of water. b. Approved U.S. military sources including
establishments under the cognizance of the
(2) If water taken aboard the ship does British Royal Navy, Canadian Forces, and the
not have the required halogen residual, the ship Royal Australian Navy. These sources are
must boost halogen residual, or have shore subject to termination or modification. See the
facility boost halogen residual in source water to current American-British-Canadian-Australian
obtain the proper residual. Naval Quadripartite Standardization Agreement
Program, ABCA NAVSTAG 23, Quality Stand-
(3) When potable water from the trans- ards for Potable Water. Under certain emergency
ferring source contains the proper halogen or wartime situations, shore water sources may be
residual, no further treatment is required. under the cognizance of Quadripartite Standardi-
zation Agreement 245, Edition 2, of the
b. Potable water connections between American-British-Canadian-Australian Armies
shore and ships must be made or supervised by Standardization Program, Minimum Require-
authorized shore station personnel. In the event ments for Water Potability (Short and Long Term
shore personnel are unavailable, properly trained Use) or the NATO Standardization Agreement,
ship personnel will complete this responsibility. STANAG 2136, Minimum Requirements of
The individual making the potable water hose Water Potability for Short Term Issue.
connections shall ensure hoses are not connected
to a non-potable system. Engineering will notify c. OCONUS water source information
the MDR prior to making potable water hose may be obtained from U.S. military representa-
connections. The MDR shall determine if the tives ashore or Navy Environmental Preventive
correct halogen residual is present in the source Medicine Units (NAVENPVNTMEDUs) having
water and if it is not, he or she must notify the area responsibility.
engineering department representative.
d. Bottled water must be obtained from
c. Potable water hoses shall not be sub- DOD approved sources.
merged in harbor water.

25 Jul 2005 6-5


6-7 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-9

6-7. Sources of Doubtful Quality. All water b. Shipboard potable water risers shall be at
supplied by public or private systems not listed least 18 inches above the deck and turned down,
in Article 6-6 should be considered of doubtful except when risers are located within the ship,
quality. When doubt exists as to the quality of such as in submarines. Potable water riser must be
water, the MDR, or a responsible officer must properly labeled and fitted with a cap and keeper
investigate the source and examine the water as chain. Potable water riser valve or valve handles
thoroughly as possible with the means available; must be properly color coded in accordance with
he or she must then advise the commanding NSTM Chapter 505. Riser hose connections shall
officer or master relative to necessary proced- be disinfected prior to connection.
ures, safeguards, and disinfection. In instances
where the ship must receive water of doubtful c. Potable water tank sounding tubes will be
quality, disinfection will be accomplished in equipped with screw caps attached to keeper
accordance with Article 6-21. chains. Screw caps will be secured with a lock.
On those ships with sounding rods, the rod should
6-8. Care of Shipboard Potable Water Hoses remain in the tube at all times. Potable water
and Equipment sounding tapes must be sanitized prior to each use
and shall only be used for potable water tank
a. Potable water hoses shall not be used volume measurements.
for any other purpose. They must be properly
labeled, stored, and protected from sources of 6-9. Connection Procedures. Table 6-1 provides
contamination at all times. They must be guidelines for connection procedures covering
examined routinely and removed from use when ship-to-shore and ship-to-ship transfer of potable
cracks develop in the lining or leaks occur. water. Modification of these procedures may be
Disinfection procedures for potable water hoses necessary or required due to ship configuration or
are found in Articles 6-9 and 6-23. operating conditions.

Table 6-1. Potable Water Transfer Procedures for Ship-to-Shore and Ship-to-Ship*

Ship-to-Shore Ship-to-Ship
Remove shore cap and flush pier side potable water outlet for Both ships disinfect their respective potable water riser
15-30 seconds. Immerse outlet and rinse fitting in solution connections. The leading potable water hose shall have the
containing 100-ppm FAC (free available chlorine) for at least hose cap in place during the high-line procedure.
2 minutes. Flush water to waste for 15-30 seconds.

Deliver a clean disinfected potable water hose to the outlet When the receiving ship secures the potable water hose, the
just before the connection is made (potable water hoses cap is removed and the hose coupling is disinfected.
should be provided by the shore facility). Remove hose caps
or uncouple hose ends and disinfect if not previously
disinfected. Connect hose to pier side outlet and flush.

Disinfect shipboard riser connections with 100-ppm FAC The supplying ship connects its end and flushes the hose.
solution. Connect hose to the potable water shipboard riser
and deliver potable water. Other FDA listed food contact
surface disinfectants such as iodine may be used if approved
by the MDR.

When the transfer is completed, secure the shore water When the transfer is completed, the receiving ship removes
source; remove the ship connection, then the shore connec- the potable water hose and replaces the caps on the receiving
tion. Thoroughly flush the potable water outlet and recap. connection and the potable water hose.

Drain the potable water hose thoroughly and properly store in The supplying ship then retrieves, couples or caps, and
the potable water hose storage locker. properly stores the potable water hose.

*Tables read top to bottom, not left to right.

6-6 25 Jul 2005


6-10 CHAPTER 6. WATER SUPPLY AFLOAT 6-10

SECTION III. STORAGE AND DISTRIBUTION


Article Subject Page

6-10 Potable Water Production .............................................................................................. 6-7


6-11 Potable Water Tanks...................................................................................................... 6-8
6-12 Vents and/or Overflow Lines......................................................................................... 6-8
6-13 Manholes ....................................................................................................................... 6-8
6-14 Measurement of Water Level ........................................................................................ 6-9
6-15 Filling Lines................................................................................................................... 6-9
6-16 Potable Water Piping ..................................................................................................... 6-9
6-17 Repairs ......................................................................................................................... 6-10
6-18 Potable Water Tank Coatings ...................................................................................... 6-10
6-19 Labeling and Color-Coding ......................................................................................... 6-10
6-20 Potable Water Hose Storage Lockers .......................................................................... 6-10

6-10. Potable Water Production centrifugal separator and cartridge filters that
remove suspended particles as small as 1 micron
a. Types of Water Production Plants in some cases. Triple pass RO plants used for
submarines do not have a separator but are fitted
(1) Distillation plants. Installed on with cartridge filters nominally rated at 3 micron
naval vessels are three general types, depend- to remove suspended particles. The RO water
ing on the source of heat used to evaporate treatment technology in lieu of distillation will
seawater. likely be the technology of choice for fresh water
production for new construction ships. A brief
(a) Steam distilling plants are discussion of RO treatment is below.
operated by steam supplied directly or indirectly
from a power plant or auxiliary boiler. They are (a) Through a high-pressure pump,
subdivided into two groups, submerged type the filtered water is then boosted up in pressure to
and flash type. These subdivisions differ as much as 1000 psi where it is introduced into
mainly in the pressure in the heating elements the RO pressure vessels that contain circularly
and evaporator shell. wrapped polyamide thin film RO membranes. A
portion of the filtered water, typically 20-25
(b) Waste heat distilling plants are percent, permeates through the membrane to
submerged tube type and use heat derived from become fresh water. The remaining brine, which
diesel engine jacket water. does not pass through the RO membrane, is dis-
charged from the RO unit as waste.
(c) Vapor compression type distill-
ing plants require primarily only electrical (b) Although the RO membrane is
energy for operations; however, additional heat theoretically capable of removing all viruses and
exchangers that use waste heat (exhaust gas or bacteria from the source water under optimal
cooling water) may be installed. operating conditions, membrane fouling does
occur and can compromise the integrity of the
(2) Reverse osmosis (RO). Single and membranes. Reverse osmosis is not solely relied
triple pass RO plants are another type of upon for accomplishing pathogen removal in
shipboard water production technology. RO single pass RO plants thus additional disinfection
consists of a pre-filtration section that typically such as chlorination or bromination is required.
includes, in surface ships, a coarse strainer, a

25 Jul 2005 6-7


6-10 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-13

(c) In triple pass RO plants addi- storage spaces. These potential sources of
tional disinfection requirement is waived contamination make it necessary to devote
because it is assumed that the redundancy of careful attention to maintaining the quality of
three membranes, connected in series, would water stored in skin tanks, particularly those
accomplish adequate removal of pathogenic located in inner bottoms.
organisms. Triple pass RO water quality is
comparable to distilled water and often may be b. Potable water tanks should not be filled
better. with ballast water unless absolutely necessary for
the survival of the ship. When non-potable liquid
b. NSTM Chapter 533, Potable Water (water) is introduced into potable water tanks, all
Systems (1995), and NSTM Chapter 531, tanks, lines, fittings, and pumps must be discon-
Desalination, Volume 3 Reverse Osmosis nected from the potable water system, plugged or
Desalination Plants (1999), RO treated water capped, and not reconnected until adequately
from a single pass RO unit ranges in purity from cleaned, flushed, disinfected, and tested as
350 to 500 ppm Total Dissolved Solids (TDS), applicable in accordance with Article 6-22.
while distilled water purity is on the order of Cross connections between potable and non-
1 to 2 ppm TDS and a third pass RO unit can potable water must be prevented for force health
produce water with less than 1.0 ppm TDS. protection.
Low TDS distilled water and multi pass RO
water can be more corrosive to plumbing and 6-12. Vents and/or Overflow Lines. Vents
storage tanks than single pass RO water. In and/or overflow lines provided on potable water
addition, water high in dissolved gasses (e.g., tanks will be located to reduce the possibility of
carbon dioxide and oxygen), after multiple contamination. The openings must be screened
passes through RO membranes, can also be with 18-mesh or finer non-corrosive metal wire.
corrosive. They must not terminate in food service, medical,
toilet, or other spaces where contamination or
c. Although potable water production/ odors may be transmitted to the water, nor in any
treatment is an engineering responsibility, the space where electrical or electronic equipment is
MDR must be cognizant of the process to ade- located. In no instance will potable water tanks
quately provide surveillance and recommenda- vent outside the ship.
tions.
6-13. Manholes. The construction and location
6-11. Potable Water Tanks of manholes should minimize the possibility of
contamination. If a manhole is located on the
a. The construction and location of pot- side of the tank, flush-type construction is accept-
able water tanks should prevent contamination able. If located on the top (including the deck, if
of the water. For full utilization of space, the deck forms the top of the tank), a coaming or
potable water is stored on most ships in inner curb rising at least one-half inch above the top of
bottom tanks, other skin tanks, and peak tanks. the tank must be provided and the manhole cover
The ship bottom, which serves as the outer shell must extend to the outer edge of the curb or
of the inner bottom tanks, is subjected to maxi- flange. The cover must have an intact gasket and
mum external pressure from water that may be a device for securing it in place. Normally, man-
heavily polluted, and is vulnerable to leakage. holes not exposed to the weather decks are fitted
The plating over the inner bottom tanks often with the flush-type manhole cover or the raised,
serves as the deck in machinery spaces. Inner bolted-plate cover. The latter is preferable for
bottom and other skin tanks may have common potable water tanks.
bulkheads with ballast tanks, fuel tanks, or other

6-8 25 Jul 2005


6-14 CHAPTER 6. WATER SUPPLY AFLOAT 6-16

6-14. Measurement of Water Level 6-16. Potable Water Piping

a. There are several methods for measure- a. Special attention must be given to potable
ment of water volume in tanks including auto- water piping located in the bilge area, particularly
matic level gauges, petcocks, and sounding the piping on the suction side of the potable water
tubes. Many ships have more than one system. pumps where leakage could result in contamina-
On those ships with sounding rods, when not in tion. This piping should be hydrostatically tested
actual use, the rod should remain in the sound- in accordance with the preventive maintenance
ing tube at all times. On those ships using steel system, and kept in sound material condition.
tapes, the tapes must be sanitized prior to each
use, stored in a sanitary manner, and used only b. Shipboard design specifications stipulate
for potable water measurements in accordance potable water piping through non-potable tanks
with Article 6-23. and piping non-potable liquid through potable
water tanks must have the pipe surrounded by
b. Soaking the entire tape apparatus in sloped self-draining pipe tunnel.
a solution of 100-ppm FAC (free available
chlorine) solution for 2 minutes may be used to c. Ensure adequate air gap or approved
sanitize potable water sounding tapes. Another backflow prevention device is provided between
method, which can be used, involves wiping the the potable water outlet and a non-potable water
tape with clean gauze soaked in an approved system, fixture, or machine. Article 6-42 pro-
disinfectant solution such as food service vides more information on cross connection
contact surface disinfectant in accordance with control.
Article 6-23, such as iodine (Wescodyne)
disinfectant or alcohol swab. d. All potable water pumps should be air-
tight and free from cross connections. Non-
6-15. Filling Lines potable water should never be used for priming
pumps or maintaining packing gland seals. Pumps
a. Potable water lines/piping must never that have been dismantled for repair must be
be cross connected to any non-potable piping or disinfected after reassembly prior to being
system. Where a common line is used to load returned to service.
and distribute potable water to non-potable
tanks, the delivery to the non-potable tanks must e. To avoid scald injuries, the temperature
be through an air gap or approved and appro- setting for the hot water heaters serving habit-
priate backflow prevention device. Filling lines ability space showers and lavatories must be set
that have common piping arrangement for not to exceed 120°F at the water tap. Hot water
directing potable water from an approved source heaters serving other areas such as the galley
to non-potable water systems by means of (Gaylord Hoods), laundry, etc., are set at
valves or interchangeable pipe fittings are not appropriately higher temperatures.
acceptable.
f. Point of use potable water treatment devices
b. Filling connections (hose valves) must such as charcoal impregnated or other filter equip-
be clearly labeled and color-coded in accord- ment use are generally not recommended. Only
ance with NSTM Chapter 505. They will be NSF certified point of use devices shall be used.
secured with screw caps attached with keeper These devices remove required trace halogen resid-
chains in accordance with Article 6-8. ual from the potable water and defeat the purpose
of residual halogen protection. In addition, charcoal
c. Filling connection hose valves must have filtration devices can promote bacterial growth,
the potable water receiving connection at least 18 especially when not used on a daily basis or when
inches above the deck and turned down to protect not changed at proper intervals. Point of use water
it from contamination following Article 6-8. treatment devices shall be used and maintained in
accordance with the manufacturer’s directions.
25 Jul 2005 6-9
6-17 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-20

6-17. Repairs 6-19. Labeling and Color-Coding

a. In the event of a break or compromise a. Potable water sounding tubes will be


in the potable water system, or a potable water clearly labeled with an identification plate. The
tank is entered for any reason, all involved sounding tube cap will be color-coded dark blue.
tanks, parts, and lines must be cleaned, flushed, On ships using steel tapes for sounding potable
and disinfected prior to returning the system to water tanks, the tape handle must be color-coded
use. The MDR must be notified of the break or dark blue, labeled, or otherwise identified
entry and the disinfection procedure accomp- “POTABLE WATER USE ONLY."
lished by the engineering department.
b. Valves for receiving or supplying potable
b. For potable water piping repairs water must be conspicuously designated by a
including flanged joints, only sealants and warning plate bearing the inscription “POTABLE
lubricants certified to NSF/ANSI Standard 61 WATER ONLY" in ¼ inch high letters.
shall be used. Confirmation concerning
authorized sealants and lubricants may be c. Potable water hoses must be labeled
obtained by contacting NAVSEASYSCOM. “POTABLE WATER ONLY" with 1-inch high
letters approximately every 10 feet and the end
6-18. Potable Water Tank Coatings couplings painted dark blue in accordance with
NSTM Chapter 505.
a. Only potable water tank coatings that
are listed within NSTM Chapter 631 and d. Potable water piping passing through any
NSF/ANSI Standard 61 are approved for use. given space must be appropriately labeled to
Taste and odor problems with water quality are indicate the type of service and with an arrow
often associated with improper application and indicating the direction of the flow.
curing procedures. Paint thickness, the touch-
up material, ventilation, temperature, humidity, 6-20. Potable Water Hose Storage Lockers.
curing time, etc., are important application Potable water hose storage lockers must be
factors that can contribute to taste and odor identified and labeled "POTABLE WATER
complaints. Taste and odor are further discussed HOSE." When not in use, potable water hoses
in Section VIII. must be coupled or capped and stored in
designated lockers. The lockers must be vermin
b. The shipyard or contractor may wish to proof, locked, and be elevated at least 18 inches
complete potable water taste/odor testing, after off the deck when located on weather decks and
construction or repair of potable water tanks. sponsons. Printed instructions outlining step-by-
Water taste complaints are not uncommon from step methods for disinfection of potable water
ships which have undergone recent potable hoses and risers must be posted in a conspicuous
water tank painting. location inside the hose storage locker in
accordance with Article 6-55, Sample Water
Sanitation Bill.

6-10 25 Jul 2005


6-21 CHAPTER 6. WATER SUPPLY AFLOAT 6-21

SECTION IV. DISINFECTION


Article Subject Page

6-21 Disinfection of Potable Water Supplies....................................................................... 6-11


6-22 Disinfection of Potable Water Tanks and Systems...................................................... 6-15
6-23 Disinfection of Potable Water Hoses, Tapes, and Rods .............................................. 6-16
6-24 Emergency Disinfection of Water for Drinking and Cooking Purposes ..................... 6-16
6-25 Chlorine Dosage Calculator......................................................................................... 6-16
6-26 Required Halogen Residuals........................................................................................ 6-18

6-21. Disinfection of Potable Water Supplies or TBR after 30 minutes contact time measured at
the potable water tank. The amount of chlorine or
a. General bromine required to produce a FAC or TBR of not
less than 0.2 ppm after 30 minutes can vary widely
(1) Disinfection of water is required because of halogen demand, water temperature,
to ensure the destruction of pathogenic organ- and other factors. Again, these chemical reactions
isms. Maintenance of a halogen residual is the may impact water palatability.
usual method of guarding against contamination
or accidents that may occur during the produc- (3) Halogen types. Chlorine and
tion, handling, storage, and distribution of potable bromine are approved methods for disinfecting
water. The absence of a Free Available Chlorine shipboard potable water. Mechanical methods of
(FAC) or total bromine residual (TBR) in the treatment are preferable to chlorine batch treat-
ship's potable water may indicate contamination. ment procedures. Batch chlorination procedures
The presence of a halogen residual provides a are less reliable, require greater time and effort,
safety factor but does not correct unsanitary and are generally less effective. Many municipal
practices or conditions. FAC residual water sources use chloramine for disinfection
concentrations as high as 1.0 ppm at the tap which needs to be considered when doing halogen
usually do not cause objection-able tastes and testing pier side. Chlorine or bromine can be
odors, but where certain organic substances are added to chloramine treated municipal water.
present, very small concentrations of combined
chlorine or bromine can produce undesirable (a) Chlorine
tastes or odors. These undesirable tastes and
odors do not affect the safety (potability) of water 1. Chlorine is available for
but may impact palatability (taste) of water, thus shipboard use as calcium hypochlorite (HTH
discourage water consumption. While the 65-70% available chlorine), 6-ounce bottle, a
National Primary Drinking Water Standards are granular solid or sodium hypochlorite in varying
not applicable for shipboard potable water strengths, as a liquid. Common household bleach
systems, EPA has established a maximum (unscented) is a 5.25% solution of sodium hypo-
contaminant level (MCL) for all disinfectants at chlorite. HTH is most frequently used because of
4 ppm. its relatively long shelf life and reduced storage
space requirements. However, it should be noted
(2) All water has some halogen that HTH presents a potential personnel and fire
demand which is the amount of chlorine or hazard due to its corrosiveness and chemically
bromine used through reaction with substances active nature. This material is classified as
present in the water. Shipboard water is hazardous and requires special storage pre-
disinfected by the addition of sufficient chlorine cautions and shall be handled and stowed in
or bromine to produce not less than 0.2 ppm FAC accordance with NSTM, Chapter 670.

25 Jul 2005 6-11


6-21 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-21

Contact between HTH and oxidizable material 4. All lockers, bins, and
may result in spontaneous combustion (fire). enclosures containing HTH must be labeled with
HTH should be obtained in 6-ounce containers red letters on a white background, (HAZARD-
and stored in a cool, dry, well-ventilated place OUS MATERIAL, CALCIUM HYPOCHLO-
where there is no danger of contact with oxidiz- RITE).
able materials. Calcium or sodium hypochlorite
will lose strength gradually with age and more 5. Electrolytic disinfectant
rapidly when opened or stored in hot spaces or generator (EDG) uses brine electrolysis chemical
sunlight. process to produce a sodium hypochlorite solu-
tion (FAC) for injection. Chemical additives,
2. The ready use stock of including salt shall be certified to NSF/ANSI
6-ounce HTH bottles issued to the engineering Standard 60.
department must be stowed in a locked box
mounted on a bulkhead, preferably in the depart- (b) Bromine. Bromine is pro-
ment office space. Under no circumstances is the vided by a bromine impregnated resin cartridge,
box to be installed in a machinery space, flam- which is classified as slightly corrosive and
mable liquids storeroom, paint locker, berthing requires proper handling and storage procedures.
space, storeroom, or in the oil and water test Bromine cartridges must be stored in a clean, dry,
laboratory areas. A metal box, such as a first aid ventilated storeroom. Bromine storage lockers
locker, is recommended for this purpose. Vent require a hazardous warning plate described, in
holes (such as three 1/4 inch holes) shall be NSTM Chapter 533, Figure 6. Bromine cart-
drilled in the bottom of the box to allow release ridges have a shelf life of 2 years from the date of
of any chlorine products. No more than a 7-day manufacture. Cartridges exceeding the shelf life
supply shall be maintained in ready use stock at can still be used, but chemical disinfection
any time. efficiency may be reduced.

3. Storeroom stocks of b. Mechanical Methods of Disinfection


HTH must be stowed in labeled, ventilated
lockers or bins. The lockers or bins must be (1) Naval vessels use several types
located in an area where the maximum tempera- of chlorinator installations. Chlorinators may be
ture will not exceed 100°F (37.8°C) under installed in the distilling plant, distillate line, and
normal operating conditions and is not subject the shore fill line. The chlorinator may also serve
to condensation or water accumulation. The area both the distillate line and the shore fill line.
must not be adjacent to a magazine and the
lockers or bins must be located at least 5 feet (a) The distillate line is generally
from any heat source or surface, which may provided with an electric, motor-driven
exceed 140°F (60°C). They must not be located chlorinator. These chlorinators will have controls,
in an area used for stowage of paints, oils, grease, which energize the chlorinator in conjunction with
or other combustible organic materials. No more the distillate pump motor and water flow past the
than forty-eight 6-ounce bottles shall be stowed chlorinator.
in any individual locker or bin. Issue will be
made only to personnel designated by the MDR (b) The shore fill line is generally
or engineering officer. provided with a hydraulically actuated chlorinator
or an electrical motor driven chlorinator. The
hydraulically actuated unit injects hypochlorite
solution into the water system in proportion to the
flow of water through a meter.

6-12 25 Jul 2005


6-21 CHAPTER 6. WATER SUPPLY AFLOAT 6-21

(c) The distillate line and the fill After a pre-calculated period of time, the timing
line may be served by a fill line chlorinator unit device terminates the bromine feed into the
if the distilling plant is large enough to permit water. Recirculation of water continues for an
sufficient flow through the unit. This type of additional pre-calculated time period to complete
installation is generally provided with a an even dispersion of bromine through the tank.
hydraulically actuated or an electric motor- These time period calculations are based on
driven chlorinator. individual tank volume and temperature of the
water. This recirculation unit is also preset to
(2) Bromine treatment installations deliver 0.7 ppm bromine to the water being
use two types of brominators. One type is recirculated. A sampling tap is present to test the
used on the discharge line and the other is used bromine residual after recirculation; if the desired
to recirculate water in the potable water tanks level of bromine has not been achieved through
during treatment. the initial recirculation process, the timer may be
reset and the water recirculated until the desired
(a) The in-line (proportioning) level of TBR is achieved; however, efforts to
brominator is used when the desalination unit is achieve bromine levels at the 2.0 or higher ppm
online and making water. Multiple vendors level may not be practical due to the length of
manufacture these devices. Dependent on time required. It may be more convenient to use
design, the unit is either provided with a set of batch chlorination procedures to rapidly raise the
orifices that gauges a predetermine proportion levels of chlorine in the water supply, particularly
of flow through a bromine cartridge or via a in the event of contamination or necessity to
throttle valve design which controls flow. In achieve higher chlorine levels.
line brominator units contain an orifice preset to
deliver 0.7 ppm bromine to the water during (3) The batch chlorination method of
normal operating procedures and an orifice to disinfection may be used if mechanical methods
deliver 2.0 ppm bromine to the water when an for treatment are not available. However, this is
increase in total bromine is required as detailed considered the least desirable method of disinfect-
in Article 6-21a(3)(b). The throttle valve design ing a potable water tank because it may result in
also allows for adjustment of bromine feed. over-chlorination due to the inability to properly
Bromine is washed from the cartridge into the mix the water and hypochlorite solution. The
bypassed water stream. One in-line brominator proper dosage of chemical must be determined for
is required for each water plant. the volume of water to be disinfected. Article 6-25
provides guidance for determining the chlorine
(b) The recirculation brominator dosage. When 65-70% strength HTH is used, the
unit is designed to boost bromine residual for calculated amount is dissolved in a non-glass
water in a potable water tank. Treatment is container of warm water (80°F to 100°F) and the
accomplished by the recirculation of potable suspended matter is allowed to settle out. Only the
water from a potable water tank through the clear fluid (supernatant) is introduced into the
brominator and back to the same tank. This sounding tube when the tank is about 1/4 full, add
treatment offers diversity in recirculation and 1 gallon of potable water to flush the sounding
bromination of water received from external tube. Under no circumstances should chlorination
water sources as well as providing capability to be attempted by adding the solution to the bromina-
boost bromine levels from ship produced water tor cartridge container. The remaining sediment is
when necessary. As the water in a selected tank discarded as waste. Sufficient mixing of chlorine
is recirculated, a portion of the recirculated and water usually will be obtained by the stirring
water is automatically proportioned to flow action of the incoming water as the tank is being
through the bromine cartridge. A timing device filled. The motion of the ship will make a small
to achieve the required bromine feed into the contribution to mixing, and additional mixing may
selected tank limits flow through the cartridge.

25 Jul 2005 6-13


6-21 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-21

be obtained by recirculation. If the chlorine c. Halogen Requirements


solution must be introduced into a full tank,
recirculation through a pump is the only way to (1) Halogen residual of 0.2 ppm through-
achieve adequate mixing. If pumps are used out the distribution system should be maintained.
which are not an integral part of the potable water However, due to halogen demand and other
system, they must be disinfected as described in factors it is recognized that this requirement is
Article 6-22. Thirty minutes or more after the sometimes not achievable in certain sections of
tank is filled or mixing is completed; the water the ship, such as the highest 0-levels on large
should be sampled and tested for a FAC residual. platform ships, where constant usage/flow of
If there are no sampling petcocks on the tank, a potable water is reduced. In the absence of
potable water outlet in the distribution system bacteriological contaminants, this lack of
nearest the tank may be used for sampling measurable (trace) residual in the less used
purposes. If the FAC residual is less than outlets should not be a matter of concern, but
required, additional chlorine must be added and requires close bacteriological monitoring.
mixed into the water, after the required contact
time, the FAC residual must be determined again. (2) Water without a halogen residual
A convenient figure to remember is that 1-ounce received from approved sources or water
of full strength HTH added to 5,000 gallons of produced on board must be chlorinated or
water is the approximate dose for 1.0 ppm initial brominated to provide at least 0.2 ppm halogen
chlorine concentration. (Note: The amount of residual (FAC/TBR) at the end of a 30-minute
active chlorine in 65-70% HTH is reduced contact time (CT) in the potable water tanks.
rapidly by exposure to air; therefore, all the
contents should be used as soon as possible after (3) Chloramines in lieu of chlorine are
opening the container.) This rule of "thumb" used in many municipal public water systems to
(1-ounce per 5,000 gallons) becomes a tool in reduce disinfection by-products. To determine
calculating dosages for “batch chlorination” and disinfectant residual for systems which use
is suggested as a starting point only; the required chloramines measure the total chlorine residual in
amount will depend on temperature, pH, and the lieu of FAC. At least 2.0 ppm total chlorine
chlorine demand of the water. In no instance residual should be present in the municipal water
should the manhole cover be removed to batch source at the pier riser.
chlorinate a tank. Sounding tubes, air vents, or
other methods should be used to introduce the (4) Water received from an unapproved
chlorine into the tank. source, a source of doubtful quality, or an area
where amebiasis or infectious hepatitis is
(4) Chlorination or bromination pro- endemic, must be chlorinated or brominated to
cedures are not adequate until the required provide at least a 2.0 ppm halogen residual
FAC/TBR is obtained after the allotted contact (FAC/TBR) at the potable water tanks at the end
time at the potable water tanks. Required of a 30-minute contact time. In these instances, if
halogen residuals are listed in Article 6-26. the ship's brominator cannot achieve a TBR of
2.0 ppm, the water must be chlorinated by the
(5) Ships with bromine systems may “batch method” to obtain not less than 2.0 ppm
add bromine to water that has been previously FAC at the potable water tank after 30-minute
chlorinated without any harmful effect. contact time. After 2.0 ppm halogen is main-
tained for 30 minutes in the potable water tank,
the water is considered safe for use.

6-14 25 Jul 2005


6-22 CHAPTER 6. WATER SUPPLY AFLOAT 6-22

6-22. Disinfection of Potable Water Tanks with Table 6-2. Mechanical cleaning and
and Systems chemical disinfection must be accomplished
under the following conditions:
a. Mechanical cleaning of tanks includes
all measures necessary to clean tanks of foreign (1) Tanks of new ships or tanks which
materials, rust, and other substances that are have been repaired.
present within the tanks.
(2) Where sludge or rust accumulation
b. There are two types of disinfection seriously impairs the quality of water.
procedures:
(3) Tanks that have been loaded with
(1) Mechanical cleaning with chemical non-potable, ballast water.
disinfection.
d. Chemical disinfection is required when
(2) Chemical disinfection. the following conditions exist:

c. Mechanical cleaning and chemical (1) Tanks in which there is continued


disinfection will be accomplished when the bacteriological evidence of contamination after
condition of a tank has deteriorated to the point normal disinfecting procedures.
where the chlorine demand has increased
significantly and bacteriological test results (2) Pipelines, valves, pump, etc., that
indicate the tank water quality is unacceptable. have been dismantled, repaired, or replaced.
After any tank has been mechanically cleaned, it
will be chemically disinfected in accordance (3) Tanks which have been entered.

Table 6-2. Methods for Disinfection of Potable Water Tanks*


(Reference: ANSI/AWWA** Standard C652-02)

METHOD 1 METHOD 2 METHOD 3


Fill tank to over flow level Spray/apply directly 200 ppm FAC to all Fill 5% of tank volume with 50 ppm
tank surfaces FAC solution

Add chlorine to achieve 10 ppm FAC Flush inlet/outlet pipes with 10 ppm Hold solution for 6 hours
throughout the tank FAC

Hold this solution for 24 hours Disinfected surfaces shall remain in Add potable water to chlorine solution to
contact with chlorine solution for a fill tank; hold this water for 24 hours
minimum of 30 minutes

Drain tank Refill tank with potable water with Drain tank
required halogen residual level

Refill tank with potable water with Refill tank with potable water with
required halogen residual level required halogen residual level

Perform bacteriological testing of potable water

Upon satisfactory bacteriological testing and asthetic quality water may be delivered to the system

* Table reads from top to bottom, not left to right. ** American Water Works Association (AWWA).

25 Jul 2005 6-15


6-25 CHAPTER 6. WATER SUPPLY AFLOAT 6-25

c. The standard 2 ½ inch water hose has a of a hose for disinfecting purposes. Volumes for
volume of 0.25 gallons per foot of hose. This other size hoses may be found in the NAVMED
figure may be used in determining the volume P-5010-5, Water Supply Ashore.

Table 6-3. Chlorine Dosage Calculator for 5% Liquid Sodium Hypochlorite (Unscented)
Tsp = teaspoon Tbsp = tablespoon 3 Tsp = 1 Tbsp 2 Tbsp = 1 Oz Qt = quart Gal = Gallon
QUANTITY PPM PPM PPM PPM PPM PPM
(GAL.) 1 5 25 50 100 200
50,000 1 Gal. 5 Gal. 25 Gal. 50 Gal. 100 Gal. 200 Gal.
25,000 2 Qt. 10 Qt. 50 Qt. 25 Gal. 50 Gal. 100 Gal.
10,000 26 Oz. 1 Gal. 5 Gal. 10 Gal. 20 Gal. 40 Gal.
5,000 13 Oz. 2 Qt. 10 Qt. 5 Gal. 10 Gal. 20 Gal.
2,000 6 Oz. 26 Oz. 1 Gal. 2 Gal. 4 Gal. 8 Gal.
1,000 3 Oz. 13 Oz. 2 Qt. 1 Gal. 2 Gal. 4 Gal.
500 2 Oz. 7 Oz. 1 Qt. 2 Qt. 1 Gal. 2 Gal.
200 1 Tbsp. 3 Oz. 13 Oz. 26 Oz. 52 Oz. 103 Oz.
100 2 Tsp. 2 Oz. 7 Oz. 13 Oz. 26 Oz. 52 Oz.
50 1 Tsp. 1 Oz. 4 Oz. 7 Oz. 13 Oz. 26 Oz.
25 1 Tbsp. 2 Oz. 4 Oz. 7 Oz. 13 Oz.
10 1 Oz. 3 Tsp. 3 Oz. 6 Oz.
5 1 Tsp. 5 Tsp. 2 Oz. 3 Oz.

Table 6-4. Chlorine Dosage Calculator for 10% Liquid Sodium Hypochlorite (Unscented)

QUANTITY PPM PPM PPM PPM PPM PPM


(GAL.) 1 5 25 50 100 200
50,000 2 Qt. 10 Qt. 50 Qt. 25 Gal. 50 Gal. 100 Gal.
25,000 1 Qt. 5 Qt. 25 Qt. 50 Qt. 25 Gal. 50 Gal.
10,000 13 Oz. 2 Qt. 10 Qt. 5 Gal. 10 Gal. 20 Gal.
5,000 7 Oz. 1 Qt. 5 Qt. 10 Qt. 5 Gal. 10 Gal.
2,000 3 Oz. 13 Oz. 2 Qt. 1 Gal. 2 Gal. 4 Gal.
1,000 1.5 Oz. 7 Oz. 1 Qt. 2 Qt. 1 Gal. 2 Gal.
500 1 Oz. 4 Oz. 1 pt. 1 Qt. 2 Qt. 1 Gal.
200 2 Tsp. 2 Oz. 7 Oz. 13 Oz. 26 Oz. 55 Oz.
100 1 Tsp. 1 Oz. 4 Oz. 7 Oz. 13 Oz. 26 Oz.
50 0.5 Oz. 2 Oz. 4 Oz. 7 Oz. 13 Oz.
25 2 Tsp. 1 Oz. 2 Oz. 4 Oz. 7 Oz.
10 1 Tsp. 2 Oz. 3 Oz.
5 1 Oz. 2 Oz.

25 Jul 2005 6-17


6-25 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-26

Table 6-5. Chlorine Dosage Calculator for 65-70% Powder Calcium Hypochlorite

Weight: 16 Oz. = 1 lb.


QUANTITY PPM PPM PPM PPM PPM PPM
(GAL.) 1 5 25 50 100 200
50,000 10 Oz. 3 lb. 15 lb. 30 lb. 59 lb. 9 Oz. 119 lb. 4 Oz.
25,000 5 Oz. 24 Oz. 7.5 lb. 15 lb. 29 lb.12 Oz. 59.5 lb.
10,000 2 Oz. 10 Oz. 3 lb. 6 lb. 12 lb. 23 lb. 13Oz.
5,000 1 Oz. 5 Oz. 1.5 lb. 3 lb. 6 lb. 11 lb. 15 Oz.
2,000 2 Oz. 10 Oz. 19 Oz. 2 lb. 7 Oz. 4 lb.13 Oz.
1,000 1 Oz. 5 Oz. 10 Oz. 20 Oz. 2 lb. 7 Oz.
500 3 Oz. 5 Oz. 10 Oz. 19 Oz.
200 1 Oz. 2 Oz. 4 Oz. 8 Oz.
100 1 Oz. 2 Oz. 4 Oz.
50 1 Oz. 2 Oz.
25 1 Oz.

6-26. Required Halogen Residuals

Table 6-6. Required Halogen Residuals

Chlorination Dosage
And Contact Time Bromination Dosage
Treatment Required Requirements (FAC) Requirements (TBR)

Water in potable water 0.2 ppm 0.2 ppm


distribution system Note: trace allowed in far ends of Note: trace allowed in far ends of
distribution (pipng) system for large distribution (piping) system for large
water distribution systems such as distribution systems such as found in
found in an aircraft carrier. an aircraft carrier.

Water from unapproved source 2.0 ppm Not applicable


(emergency-use) at point of consumption

Disinfecting tanks and system See Table 6-3 Not applicable

Disinfecting hoses, couplings, 100 ppm Not applicable


and water connections with 2 min. contact time
prior to connection
to potable water system.

6-18 25 Jul 2005


6-27 CHAPTER 6. WATER SUPPLY AFLOAT 6-28

SECTION V. POTABLE WATER, SUBMARINE/YARD CRAFT


Article Subject Page

6-27 Submarines .................................................................................................................. 6-19


6-28 Yard Craft .................................................................................................................... 6-19

6-27. Submarines e. Each bottle of HTH shall be inspected


prior to deployment or at least every 3 months.
a. Submarines are generally exempted from Bottles with deteriorated seals must be discarded
routinely halogenating potable water. However, and replaced.
some submarines have been retrofitted with an in-
line brominator unit. If bacteriological testing f. Bacteriological examination of potable
indicates positive coliform bacteria then the water shall be performed weekly on a minimum
potable water supply shall be treated with either of four samples representative of the distribution
calcium hypochlorite (65-70%) or bromine until a system. Any EPA approved method for bacterio-
residual of 0.2 ppm FAC or TBR as applicable is logical testing may be used. Either Colilert® or
obtained with a minimum 30 minutes contact Colisure ® Tests are generally used for simplicity
time. Halogen residual must be maintained until considerations. The results of all testing will be
repeat bacteriological testing indicates water is reported as "presence" or "absence."
safe. When using calcium hypochlorite (HTH),
the submarine atmosphere must be monitored for (1) Submarines alongside a tender may
chlorine gas. If the gas exceeds safe limits, the establish a schedule for weekly testing of potable
emergency procedures described in the Atmos- water samples by the tender while in port. But in
pheric Control Manual must be followed. all cases, weekly testing will be accomplished
while at sea or in port.
b. Cleaning and disinfecting tanks are
outlined in Article 6-22. (2) Daily halogen residuals will be per-
formed and recorded while in port using a shore
c. In accordance with COMSUBLANT/ water supply.
COMSUBPAC 6000.2 series, the following
minimum storage quantity of HTH will be (3) The MDR shall maintain a potable
carried on board submarines of the Force: water log including water source, date, bacterio-
logical testing, any disinfection procedure used,
(1) SSN - 9 six oz. bottles. and halogen readings.

(2) SSBN – 12 six oz. bottles. g. Color-coding, labeling, disinfection, and


storage of potable water hoses are covered under
d. The individual bottles of HTH must be Section III, Articles 6-19 and 6-20 and Section
sealed in plastic bags and stored only in a medical IV, Article 6-21 of this chapter.
instrument box, plastic rigid, size 9½ x 9 x 7
inches, NSN 6545-00131-6992. The case must 6-28. Yard Craft
be painted white and labeled: "HAZARDOUS
MATERIAL, CALCIUM HYPOCHLORITE" in a. Yard craft has been defined to include
red letters. The case must be vented at the bottom barges, tugs, and other vessels capable of
and be stored in any area away from engineering independent movement within the harbor, but not
spaces. routine ocean-going travel. These vessels usually
have no water producing capability; potable

25 Jul 2005 6-19


6-28 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-28

water is transferred from a shore facility. Most c. The PSO and the local MDR shall
yard craft are equipped with a potable water develop and implement a system for collection
storage tank and a limited distribution system. and examination of water samples for each
Disinfection of the water is not necessary when group of yard craft. Water samples for
water is transferred from an approved potable bacteriological analysis must be collected from
water source. Most problems associated with each craft water tank and distribution system on
contamination of water aboard yard craft are a weekly basis. In the event of bacteriological
usually the result of improper transfer procedures. contamination of the water supply, the MDR
shall investigate the source of contamination
b. Daily testing for halogen residual is not and provide recommendations regarding
usually performed due to the lack of personnel correction and disinfection. It may be necessary
and equipment. The MDR shall maintain close for the MDR to supervise disinfection
contact with the port services officer (PSO) and operations.
will provide surveillance procedures to ensure a
safe water supply.

6-20 25 Jul 2005


6-29 CHAPTER 6. WATER SUPPLY AFLOAT 6-30

SECTION VI. CARGO WATER


Article Subject Page

6-29 Emergency Use of Potable Water Tanks for Ballast ................................................... 6-21
6-30 Handling of Cargo Water............................................................................................. 6-21
6-31 Temporary Water Tanks .............................................................................................. 6-22

6-29. Emergency Use of Potable Water (c) Results of bacteriologic testing.


Tanks for Ballast
(d) Above information shall be
a. Potable water tanks and pipelines which provided to the receiving ship prior to transfer.
will be filled with any non-potable liquid for
ballast or other emergency purposes must be (4) Water vessels shall deliver potable
disconnected and sealed off at the tanks. It shall water to receiving ships with a halogen residual of
not be reconnected until the contaminated tank, at least 0.2 ppm when the source is an approved
piping, and fittings have been properly cleaned watering point. If the halogen residual is below
and disinfected. 0.2 ppm, sufficient chlorine or bromine shall be
added to by the receiving ship to boost halogen
b. Water placed in these tanks must not be residual to 0.2 ppm with a 30-minute contact time
used for drinking or cooking purposes until it has at the potable water tank.
been adequately cleaned/disinfected and a
bacteriological analysis confirms water is safe (5) Water received from an unapproved
for human consumption. If bacteriological tests source must be halogenated to provide at least 2.0
are positive, the disinfection process must be ppm residual with a 30-minute contact time at the
repeated until such time as bacteriological analysis potable water tank.
is negative prior to the system being placed in ser-
vice. Chemical testing of water may be also b. Receipt of Cargo or Transferred Water
necessary to ensure water is safe for human con-
sumption if there is concern for chemical (1) The MDR of the receiving ship shall
contamination. test the halogen residual of water to ensure mini-
mum halogen residual of 0.2 ppm is present.
6-30. Handling of Cargo Water
(2) If the water does not contain a halogen
a. Water Ships, Barges, and Yard Craft residual of at least 0.2 ppm, it will be necessary for
the engineering department to treat the water in the
(1) Water must be taken from approved receiving tanks prior to piping to the distribution
watering sources as specified in Article 6-6. system.

(2) The water must be transferred in a (3) If the water is from an unapproved or
manner that prevents contamination in accord- questionable source, the MDR shall conduct bac-
ance with Article 6-9. teriological testing of the water prior to and after
adequate disinfection to 2.0 ppm in the distribution
(3) Vessels transporting potable water system to ensure bacteriological quality.
must maintain records of the following:
(4) The MDR shall ensure that appro-
(a) Source of water (indicate priate entries are documented in the potable water
whether or not from an approved source). log regarding source, halogen residual, bacterio-
logical testing, and recommendations.
(b) Daily halogen residual.
25 Jul 2005 6-21
6-31 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-31

6-31. Temporary Water Tanks. In emergency (b) Remove all scaling and rust.
situations to convert tanks commonly used for
other liquids for transporting potable water, the (c) Pumps shall be dismantled and
following considerations should be taken into cleaned with potable water and approved additive.
account for temporary storage and transfer of Remove and replace all gaskets. The replacement
potable water: gaskets shall be of material approved for use with
potable water system NSF/ANSI Standard 61.
a. Tank Selections and Preparation
(d) All lines shall be flushed with
(1) Paint coating of tanks for transport potable water and approved additive as referenced
shall be listed with NSF/ANSI Standard 61 for above.
potable water tanks and NSTM, Chapter 631.
(e) Obtain a diagram of the pumping
(2) When the tanks are cleaned and all and distribution system, and complete the follow-
surfaces are viewable, they must be inspected ing procedures:
by designated engineering personnel. The
following conditions should be considered: 1. Identify all parts of the system
to be used for potable water handling, and color
(a) Well-adhered coating. code for identification. The color code for potable
water systems is dark blue, as outlined in NSTM,
(b) Total dry-film thickness. Chapter 505, Piping Systems.

(c) Excessive rust. 2. Using blank flanges or caps,


blank off all piping, which is not to be used for
(d) Completeness of coatings. potable water transfer. Separation by valve
closure is not considered adequate safeguard
(e) Blistering and peeling. against cross connections.

(f) Water-tight integrity, especially 3. Identify water collection


inner-bottom tanks. points on each tank for testing purposes. Identify
chlorine introduction points for each tank.
(g) Any other potable water
degrading conditions. (f) Complete tank cleaning and
repair.
(3) Following the results of the inspection
of all tanks, the appropriate Type Commander (g) A final inspection should be
should decide on the approval or disapproval of conducted to assure that all repairs and cleaning
these tanks for transporting and storage of potable have been adequately accomplished.
water. If final approval is granted, necessary
repairs, maintenance, and cleaning identified (h) Disinfect tanks and related piping
during the inspection should be instituted. A in accordance with Article 6-22. Force ventilate
thorough cleaning of all tank surfaces, piping, the tanks for 8 hours to air dry.
pumps, etc., will be necessary using the following
guidelines: (i) Vents to all potable water tanks
must be screened with 18-mesh or finer non-
(a) Using high-pressure spray, clean corrosive wire and must not terminate in spaces
all tank surfaces with potable water. When where contamination may be transmitted to the
cleaning chemicals are used, they shall be listed water.
in NSF/ANSI Standard 60 as approved additives.

6-22 25 Jul 2005


6-31 CHAPTER 6. WATER SUPPLY AFLOAT 6-31

b. Transfer of Water for Use

(1) Water transferred from the ship for (3) Properly trained shipboard personnel
human consumption will contain 2.0 ppm FAC. shall monitor the procedures used for transfer of
potable water from the ship. Hoses previously
(2) Water transferred from the ship for used for fuel or other liquids shall not be used
human consumption will be absent of total and for the transfer of potable water. Only hoses
fecal coliform bacteria. A bacteriological approved for contact with potable water shall be
analysis must be conducted no later than 1-week used for transferring potable water.
prior to transfer.

25 Jul 2005 6-23


6-31 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-31

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6-24 25 Jul 2005


6-32 CHAPTER 6. WATER SUPPLY AFLOAT 6-33

SECTION VII. EMERGENCY WATER SUPPLIES


Article Subject Page

6-32 Battle Dressing Stations............................................................................................... 6-25


6-33 Emergency Potable Water, 5-Gallon Containers......................................................... 6-25
6-34 Can and Bottle Drinking Water ................................................................................... 6-26

6-32. Battle Dressing Stations (1) The initial step consists of careful
examination of the containers to ensure the con-
a. Ships are equipped with built-in potable tainers have not been used for any purpose other
water storage tanks in battle dressing stations to than the storage of potable water. Each container
provide an emergency potable water source. The shall have the word “POTABLE WATER” either
tanks are designed for gravity flow and are embossed or painted on the exterior surface in
isolated from the main potable water system. A letters at least 1-inch high.
piping diagram shall be provided for each tank
with appropriate instructions for filling and (2) Each container will then be physically
emptying. inspected for the following conditions:

b. Follow all Maintenance Requirement Card (a) Evidence of rust or corrosion,


(MRC) procedures. Once a quarter all emergency either interior or exterior.
potable water storage tanks must be drained and
refilled with potable water containing a minimum (b) Evidence of open seams or
trace halogen residual. breaks in the surface.

6-33. Emergency Potable Water, 5-Gallon (c) Interior coating of metal con-
Containers tainer not uniform, cracked, pitted, or peeled
away.
a. Some small ships store emergency potable
water supplies in 5-gallon potable water approved (d) Any evidence of dirt, grit,
containers due to the lack of an emergency tank in organic matter, or other substance embedded in
the battle dressing stations. These containers may the interior surface of the container.
be filled with water produced on board or from
approved shore facilities. This storage is accept- (e) Carefully inspect the cap to
able provided the containers have been properly ensure that it seats properly.
cleaned and disinfected prior to filling.
(f) Inspect the gasket to ensure that
b. Only approved 5-gallon potable water it is properly fitted and not deteriorated. If
containers shall be used for the storage of potable deterioration of the gasket is evident, it must be
water. Under no circumstances will 5-gallon replaced prior to use.
containers previously used for gasoline or other
petroleum products be used as emergency potable (g) Inspect the locking lever to
water containers aboard ship. ensure that it works properly by engaging the
seat or lock ring cam lugs.
c. Examination of water containers prior to
disinfection and filling. (h) Inspect the carrying handles to
ensure that they are properly attached and in
good repair.

25 Jul 2005 6-25


6-33 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-34

d. Manual washing is accomplished with g. Each can shall be labeled with date of
warm water (110-125° F), the recommended filling and source of the potable water.
amount of approved food service dishwashing
detergent, and a suitable long-handled, slender h. The 5-gallon containers shall be stored in
brush. (General-purpose detergent shall not be a clean dry place in the immediate vicinity of
used to clean emergency water containers anticipated use (battle dressing station without
because it may cause adverse health effects.) emergency potable water tanks).
Thorough rinsing with potable water is
necessary after cleaning. i. These containers shall be emptied,
flushed, and refilled with potable water contain-
e. All interior surfaces shall be disinfected ing a trace FAC or TBR (preferably 0.2 ppm or
by exposure to a chemical disinfectant solution greater) quarterly.
for at least 2 minutes. Approved chemical
disinfectants for these containers include: j. Halogen residual and bacteriological
calcium and sodium hypochlorite. Refer to tests are not required.
Article 6-25 for guidance in chlorine dosage
calculation. 6-34. Can and Bottle Drinking Water. If
canned drinking water is stored for emergency
f. Potable water used for filling emergency use in boats, rafts, battle stations, battle dressing
containers must contain a trace FAC or TBR stations, or storerooms it must be inspected in
(preferably 0.2 ppm or greater). accordance with PMS requirements. Bottle water
shall be procured only from DOD approved
sources.

6-26 25 Jul 2005


6-35 CHAPTER 6. WATER SUPPLY AFLOAT 6-36

SECTION VIII. EVALUATION OF TASTE AND ODOR PROBLEMS


Article Subject Page

6-35 General Evaluation of Taste and Odor Problems ........................................................ 6-27


6-36 Causes of Taste and Odor in Potable Water ................................................................ 6-27
6-37 Indicators of Taste and Odor Problems ....................................................................... 6-28
6-38 Initial Evaluation of Taste and Odor Problems ........................................................... 6-28
6-39 Control Measures for Taste and Odor Problems ......................................................... 6-30
6-40 Request for Outside Assistance ................................................................................... 6-30

6-35. General Evaluation of Taste and Odor (3) Leaks in non-potable piping through
Problems. A ship is a mobile vessel and must water tanks.
rely on a variety of water sources: shore, barge,
other ships, etc. There is a variety of shipboard (4) Improper disposal of chemicals or
piping systems, which, if not isolated, may be a liquids through potable water-sounding tubes.
source of unsafe cross connections to the potable
water system. The uniqueness of the shipboard (5) Potable water hoses used for non-
environment, the complexity of piping systems, potable liquids.
and multiple sources of water may individually,
or in combination, be a factor in the source of f. Excessive storage time of water in tanks.
taste and odor problems aboard ship. Taste and
odor problems are primarily aesthetic, but are g. Shipboard water production from con-
causes for concern aboard ship due to the taminated raw water source.
negative effect in the morale of personnel. Most
individuals are extremely sensitive to taste and h. Inadequate disinfection procedures
odor. Aboard ship, there are no water treatment resulting in development of chlorine by products.
processes to easily control taste and odor
problems that may develop. Water produced by i. Transfer of water from shore facilities or
the ship water plant is good quality and is the barges, which have taste and odor problems.
least likely source of problems.
j. Potable water tanks used for non-potable
6-36. Causes of Taste and Odor in Potable water liquids.
Water
k. Deteriorated, improperly applied (cured/
a. The following conditions or situations vented) tank coatings.
have been identified as causes of potable water
contamination resulting in severe taste and odor l. Shipboard water treatment plants pro-
problems aboard ship. Taste and odors potable ducing potable water while stripping fuel tanks,
water problems may be related to below factors: pumping oily bilges overboard forward of the
distilling plant feed pumps suction or when in
(1) Cross connections with non-potable close proximity to other ships.
systems.

(2) Leaks in common bulkheads between


potable water tanks and fuel tanks, ballast tanks,
bilges, and wastewater tanks.

25 Jul 2005 6-27


6-37 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-38

6-37. Indicators of Taste and Odor Problems The halogen demand in any water supply will vary
with respect to the amount of interfering or neut-
a. The MDR is responsible for surveillance ralizing substances present, which will reduce the
of the potable water system. Usually this function initial supply of chlorine or bromine added to the
is accomplished through determination of chlorine water. This is a complex problem, which can be
or bromine residuals from representative areas of summarized for medical surveillance purposes as
the ship on a daily basis and bacteriological testing follows: if the proper amount of chlorine or
of the potable water on a weekly schedule. This bromine has been added to the potable water tanks
testing, as well as complaints from the crew, can and no halogen residual is present or it dissipates
be very helpful in identifying and locating the in the distribution system, this is indicative that
source of the taste and odor problems. some substance has used or neutralized the halo-
gen in the system. The lack of ability to maintain
(1) Crew Complaints. Initial complaints a halogen residual in the tanks or the potable water
from the crew can provide important data, particu- system indicates that the chlorine or bromine is
larly if the complaints are associated to a specific reacting with some substance, which may be the
location and related to a specific time pattern. All source of the taste and odor problem. The causes
of these factors can be compared to a particular of taste and odor problems are quite varied; how-
tank in use, the disinfection processes for the tank, ever, a systematic approach may lead the resolu-
and the piping system associated with the tank. tion, or at least provide initial data for more
Each item of information is important when experienced investigators.
investigating taste and odor complaints.
6-38. Initial Evaluation of Taste and Odor
(2) Bacteriological Testing. If the cause Problems. The following statements and
or source of the taste and odor problem is a result questions represent an investigative approach to
of organic growth (biofilm) in the tanks, the stand- taste and odor complaints. The evaluation of
ard shipboard bacteriological test (Colilert®) is these items by MDR may result in identification
not useful in identifying taste and odor-causing of the source of the problem. If not, a great deal
bacteria. The bacteriological testing method of initial evaluation has been conducted and will
performed by MDR is designed solely to identify provide a baseline of information for personnel
the presence or absence of coliform bacteria, from Navy Environmental and Preventive
which is the indicator organism for bacteriological Medicine Units (NAVENPVNTMEDUs) or
drinking water quality. Therefore, bacteriological other organizations tasked to assist.
testing of the ship water supply may be consis-
tently negative, but the source of taste and odor
problems could still be the result of growth of a. When was the problem first noticed or
other microorganisms in the tanks and distribution initial complaints received? This date and time
system. may be related to a particular tank, a section of the
piping system or repairs and maintenance
(3) Halogen Residuals (FAC/TBR). associated with the system.
Maintenance of halogen residual is directly
affected by the microbiological and chemical b. What is the source of the water?
quality of the water. Loss of halogen residual
may be an indicator of contamination or biofilm (1) Shore (direct pressure).
buildup in tanks or piping.
(2) Ship’s tanks filled with shore water.
b. Chlorine or bromine, react with virtually
any substance in water and through this process, (3) Mixture of water remaining in ship's
may be neutralized. The use of the disinfectant in tanks and shore water.
a water supply is referred to as “halogen demand.”
(4) Barged water.

6-28 25 Jul 2005


6-38 CHAPTER 6. WATER SUPPLY AFLOAT 6-38

(5) Another ship. picture can be developed. Compare this data with
the source of the water and tanks, which were
(6) Produced by ship's water plant. on-line at the time. Perhaps a pattern will develop
associated with a particular source of water or an
c. Does the water have a characteristic taste individual tank.
or odor? It is sometimes possible to determine the
source of a water problem through a characteristic i. Identify potable water tanks with common
taste or odor. bulkheads to fuel, ballast, other tanks, or bilges. A
potable water tank with a common bulkhead to
d. Is the problem isolated to one section of bilges or other tanks containing fuel or ballast and
the ship, or does it occur throughout the ship? If small leaks could be a persistent source of taste
the problem is limited to a particular section of and odor problems. Identification of these tanks
the ship, the investigation should be oriented to or associated non-potable liquids, which may
occurrences affecting the piping system or contaminate the potable water system, must not be
tank supplying that section of the ship. Cross- overlooked as the source of that problem.
connections, repair or maintenance of the piping
systems, sounding tubes, and a particular tank are j. Identify any non-potable piping, which
possible sources of the problem. has been permanently installed through potable
water tanks. Any piping through potable water
e. Is the problem continuous or does it occur tanks should be enclosed in self-draining pipe
only while a particular tank is on-line? If the pro- tunnels to avoid contamination of the water
blem appears to be cyclic, compare the record of system. In many instances, evaluation of this
complaints and the particular tank(s), which are piping can only be accomplished upon entrance
supplying water to different sections of the ship. to the tanks, but MDR should be aware of the
Ongoing halogen residual testing may indicate location and existence of this type of piping.
increased halogen demand in the tank or particular
sections of the piping system. k. Review potable water disinfection pro-
cedures to ensure that engineering personnel
f. Can halogen residuals (FAC/TBR) be follow proper procedures. The engineering
maintained in the potable water tank? Engineering department is responsible for potable water
halogen testing at the potable water tanks may treatment. The MDR shall have a basic under-
indicate increased halogen demand due to con- standing of the system and review the procedures
taminants. for disinfecting to ensure that the proper amounts
of halogens are being added to achieve the pre-
g. Has the ship experienced similar taste scribed halogen residuals in the distribution
and odor problems in the past? Discussion with system.
engineering personnel may provide information
associated with a similar problem in the past. l. Identify any repair or maintenance opera-
tions conducted on the potable water distribution
h. Review the potable water log to identify system, which could have contributed to the taste
fluctuations, which may be occurring in the and odor problem. There are numerous points in
potable water distribution system. This is easily the potable water system, which can become a
accomplished by plotting a simple graph with source of contamination through either cross-
halogen residual levels on the vertical axis and connections or as a result of repair or maintenance
days on the horizontal axis. If this data can be procedures. The operations should be reviewed
plotted for the past 3 months, an accurate and correlated to the location within the system,
for possible sources of contamination.

25 Jul 2005 6-29


6-38 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-40

m. Has medical water quality surveillance b. Increased residuals have been and are still
been maintained for the potable water tanks while being used as a control measure for taste and odor
the ship is at the pier on direct service? Water in municipal water supplies ashore. The elevated
remaining in potable water tanks is ignored when chlorine residuals often satisfy the halogen de-
the ship is tied up to the pier. Consequently, the mand that may be present in the tanks or piping
water sits for long periods of time and may system. Therefore, ships that have not been able
become stagnant and provide a source for taste to identify a source of the taste and odor, should
and odor problems immediately upon resumption add sufficient chlorine to provide a dosage of 5.0
of tank usage. ppm in the potable water tanks, with the intent of
providing 2.0-ppm free residual chlorine in the
n. Are potable water tanks evaluated through water distribution system. This procedure may
halogen testing or bacteriological analysis prior to satisfy the halogen demand in the tanks or system
filling the tanks with shore water? If the tanks are and resolve taste and odor problems of a tempo-
filled with water from a shore source and mixed rary nature.
with water, which has remained in the tanks for
extended periods of time, taste and odor problems c. Steam application has been successfully
may occur. It is recommended that the water in used in treatment of taste and odor problems
the tank be evaluated for adequate halogen associated with improperly applied potable water
residual and bacteriological analysis prior to tank coatings. Ship personnel with outside assist-
filling with shore water. ance from NAVSEASYSCOM can accomplish the
actual steam application procedure. The use of
o. Identify the type of paint coating, date, steam application to identify uncured coatings
and location of application for each potable water should not be accomplished without prior approval
tank. An improperly cured or applied potable of NAVSEASYSCOM. Prior to use of steam
water tank coating may be the source of a application to any potable water tank, it is
temporary or permanent taste and odor problem. necessary to have at least some idea as to the
Usually the evaluation of the tank coating is not a success of the operation. This may be readily
function which can easily be conducted by ship- accomplished by boiling some of the bad tasting
board personnel. A temporary taste problem water for approximately 1 minute. If the taste and
following application of new tank coatings is not odor have been resolved through heating the
unusual, but should resolve following usage of the water, there is a reasonable measure of success
tanks. In contrast, lack of ability to maintain implied in the use of steam treatment of the tanks.
halogen residuals in the tanks accompanied by If the taste and odor have not been eliminated
persistent taste and odor problems may be directly through boiling of the water, steam treatment will
related to an improperly applied or uncured tank most likely be unsuccessful.
coating.
6-40. Request for Outside Assistance
6-39. Control Measures for Taste and Odor
Problems a. If the evaluation procedures outlined in
Article 6-36 have been conducted and no source
a. As previously indicated, mechanical can be determined for the taste and odor problem,
processes for the control of taste and odor are it is recommended that the area NAVENPVNT-
quite limited aboard ship. Identification and MEDU be contacted via the type command
elimination of the source of the taste and odor is medical officer for technical assistance. Medical
an important quality of life issue and may be a and appropriate engineering personnel should be
significant health concern. If the ship is at sea prepared to discuss the evaluation of specific
and the system must be used, increasing the items outlined in Article 6-38.
residual chlorine levels can be used to aid in the
control of taste and odor problems.

6-30 25 Jul 2005


6-40 CHAPTER 6. WATER SUPPLY AFLOAT 6-40

b. NAVENPVNTMEDU personnel will pro- resolution of the taste and odor problem. If the
vide consultative assistance for shipboard taste and problem cannot be resolved, or is suspected to
odor problem upon request. If the NAVENPVNT- involve tank coatings, a summary of investigative
MEDU personnel cannot provide onboard assist- results will be provided to the ship with a
ance due to geographical location, the preventive recommendation to notify NAVSEASYSCOM,
medicine assistant (PMA) from the nearest naval Washington DC, via the chain of command. The
hospital may be requested to provide onboard NAVSEA chain of command includes the applic-
assistance in reviewing the problem. able Naval Sea Support Center (NAVSEACEN) or
In-Service Engineering Agent (ISEA). NAVEN-
c. Following a thorough review of the situa- PVNTMEDU personnel will assist engineering
tion, the NAVENPVNTMEDU personnel will personnel or NAVSEASYSCOM representatives
provide appropriate recommendations for in the evaluation and testing of tank coatings
aboard the ship.

25 Jul 2005 6-31


6-40 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-40

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6-32 25 Jul 2005


6-44 CHAPTER 6. WATER SUPPLY AFLOAT 6-44

(1) NSF approved tracer dyes are to be used (2) The area NAVENPVNTMEDU can
in potable water systems. Fluorescein sodium provide additional information concerning safe
USP™ and Rhodamine WT™ are EPA-approved use of tracer dyes. Standard sea marker dye is
dyes and must be used as labeled. not approved for use in potable water systems.

25 Jul 2005 6-35


6-44 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-44

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6-36 25 Jul 2005


6-45 CHAPTER 6. WATER SUPPLY AFLOAT 6-47

SECTION X. MANUFACTURE AND HANDLING OF ICE


Article Subject Page

6-45 Manufacture of Ice....................................................................................................... 6-37


6-46 Special Precautions for Handling of Ice ...................................................................... 6-37
6-47 Cleaning and Disinfecting Ice Machines ..................................................................... 6-37
6-48 Bacteriological Quality of Ice...................................................................................... 6-38

6-45. Manufacture of Ice. This is accomplished (3) The ice machine drain from the ice
aboard ships with ice cube machines or icemakers storage compartment shall be provided with an
in most instances. A few small pantries, galleys, air gap between the ice storage compartment and
general messes and very small ships still maintain the deck drain.
ice cube trays for the manufacture of ice. Ice to
be used for food or drink and for chilling food (4) Ice shall be removed from the storage
must be from a potable water source. Regardless hop by the use of an ice scoop. The ice scoop
of the end use, all ice must be handled in a sani- shall be stored inside the machine on a bracket
tary manner and afforded the same protection as above the maximum ice level or outside the ice
water. storage compartment with the handle up in a free
draining metal bracket. The design of some ice
6-46. Special Precautions for Handling machines precludes proper storage of the ice scoop
of Ice inside the machine.

a. Due to the vulnerability of ice to (5) The ice scoop is considered to be


contamination, special precautions regarding food service equipment and, shall be washed,
handling and storage are necessary. rinsed, and sanitized at least daily as described in
NAVMED P-5010-1, Food Safety. For this
(1) All ice shall be prepared from reason the permanent installation of ice scoops
potable water. with chains or other permanent attachments is not
permitted.
(2) Ice machines shall be plumbed
properly to eliminate the possibility of cross- 6-47. Cleaning and Disinfecting Ice Machines.
connections and back-siphonage. Cleaning and disinfection procedures for ice cube
machine hops and flaking devices are detailed in
Tables 6-7 and 6-8.

Table 6-7. Bulk Ice-Making Machine Cleaning/Disinfection Instructions

STEP PROCEDURES

1. Turn off motor. Empty, defrost, and clean. Make certain overflow pipes carry off water used
for defrosting.

2. Wash all parts, including ice storage bin. Use a plastic bristle brush to scrub inside and outside of bins with mild
detergent solution.
3. Rinse. Rinse with water containing at least 50 ppm chlorine to preclude bad odors
and the accumulation of film deposits from detergents. Water drain should
be clear and free to allow proper rinse.

4. Check Water Control. Clean to prevent clogging of holes of water flow control.

25 Jul 2005 6-37


6-48 MANUAL OF NAVAL PREVENTIVE MEDICINE 6-48

Table 6-8. Ice Dispensing Machine Cleaning/Disinfection Instructions


(cleaning instruments without unit disassembly)

STEP PROCEDURES

1. Shut off water. Pour 1 qt. cleaning solution slowly into water reservoir.

2. Place a container below ice chute in bin and start ice Ice will be formed from cleaning solution. Discard ice. Shut
machine.