title: A NATO guide for assessing deployability for military personnel with chronic medical conditions: medical fitness for expeditionary missions, Task Group 174, Human Factors, and Medicine Panel.
abstract: BACKGROUND
  Each time a deployed military member has an exacerbation of a pre-existing chronic disease there is a potential risk to mission success, individual health, and the safety of the unit. Currently, North Atlantic Treaty Organization (NATO) member nations employ different approaches to assessing an individual's medical fitness for deployment.
  
  
  OBJECTIVE
  To set the minimum medical standards for NATO deployments.
  
  
  METHODS
  A seven nation task group met periodically from 2008 to 2012 to develop guidelines for frontline military physicians to assess medical fitness for deployment.
  
  
  RESULTS
  A medical deployment guide for 31 specific diseases/conditions using a rational, standardized and algorithmic approach based on a red-yellow-green risk stratification.
  
  
  CONCLUSIONS
  If adopted as a NATO policy, this guide could then be kept up-to-date through a process that allows nations to track individuals with known chronic disease who were deployed into a theater of operations, allowing the guide to become increasingly evidence-based, and also more accurate in quantifying the risk of exacerbation based on individual and disease characteristics, as well as the nature and length of the deployment.
authors.affiliation: Canadian Forces Health Services, 42 Health Services Medical Clinic, Building A-47, Canadian Forces Base Gagetown, PO Box 17000, Station Forces Oromocto, New Brunswick EOG 2PO, Canada.
authors.forename: Randy
authors.initials: R
authors.lastname: Russell
authors.affiliation: Royal Air Force Medical Board, Henlow Bedfordshire, SG16 6DN, United Kingdom.
authors.forename: Alastair
authors.initials: A
authors.lastname: Reid
authors.affiliation: Center for Medical Evaluation (CME), Queen Astrid Military Hospital, Brussels, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Borgers
authors.affiliation: Surgeon General's Office Royal Dutch Army, Kromhoutkazerne, Herculeslaan 1, 3584 AB Utrecht, The Netherlands.
authors.forename: Henry
authors.initials: H
authors.lastname: Wassink
authors.affiliation: Bundeswehr Medical Service Headquarters, Andernacherstr. 100, D-56070, Koblenz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Grove
authors.affiliation: Division of Epidemiology and Biostatistics, Department of Preventive Medicine and Biometrics, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814.
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
mesh_terms: D000465:Algorithms; D002908:Chronic Disease; D018450:Disease Progression; D005101:Expeditions; D006801:Humans; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel; D018570:Risk Assessment; D012307:Risk Factors