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081-831-1047 (SL4) - Supervise the Implementation of Preventive Medicine Policies

Standards: Ensured soldiers applied PMMs, as appropriate, to protect against cold, heat, biting insects, diarrhea and dysentery, hearing loss, skin infections, sexually transmitted diseases (STD), acquired immunodeficiency syndrome (AIDS), and foot problems. Ensured soldiers practiced good oral hygiene and properly disposed of waste. Ensured that the Army tobacco use policies were applied.


Conditions: You are a leader in a unit performing a mission in a field environment. You are responsible to ensure personnel employ preventive medicine measures (PMMs) to protect themselves from disease and nonbattle injuries.

Standards: Ensured soldiers applied PMMs, as appropriate, to protect against cold, heat, biting insects, diarrhea and dysentery, hearing loss, skin infections, sexually transmitted diseases (STD), acquired immunodeficiency syndrome (AIDS), and foot problems. Ensured soldiers practiced good oral hygiene and properly disposed of waste. Ensured that the Army tobacco use policies were applied.

Performance Steps

1.   Ensure proper preventive medicine measures (PMM) are followed for protection against cold injuries.

a. Wear layers of loose clothing.

Note.  Minimize sweating.  When clothing becomes wet or dirty, it loses its ability to provide warmth.

(1)  Remove layers of clothing before doing strenuous work.

WARNING:Do not remove protective clothing in a chemical environment

(2)  Replace layers of clothing when your strenuous work is completed.

(3)  Launder clothing regularly.

b. Exercise to increase blood circulation.

(1)  Tighten and relax arm and leg muscles, fingers, and toes.

(2)  Use hands to massage and warm the face.

WARNING: Physical and mental weariness contribute to inactivity, reduced heat, and increased chance for cold injury

(3)  Refrain from smoking. Smoking decreases blood flow to the skin.

c. Change socks.

(1)  Put on dry socks during rest breaks to reduce the risk of frostbite and trench foot.

WARNING: Severe frostbite and trench foot can result in the loss of hands or feet

(2)  Put damp socks inside your shirt around your waist to dry.

d. Prevent dehydration.

(1)  Drink sufficient fluids (potable water, juices, and warm nonalcoholic beverages).

Note.  Drinking a sufficient amount of potable water in cold weather is as important as it is in hot weather.  In cold weather, you may not realize that your body is losing fluids and salt.  Sweat evaporates rapidly or is absorbed so completely by the layers of clothing that it is seldom visible on the skin.

(2)  Rest when possible.

e. Pair with a buddy.

(1)  Remind each other to do warming exercises often.

(2)  Watch for signs of cold injury such as frostbite, trench foot, and hypothermia.

2.   Ensure proper PMMs are followed for protection against heat injuries.

a. Drink sufficient amounts of water.

Note.  Your body needs a minimum amount of water for cooling, waste elimination, and metabolism. Any attempt to train the body to use less water can be harmful and may lead to heat injuries.

(1)  Use the fluid replacement policy for warm weather table as a guide (see tables 081-831-1047-1 and 081-831-1047-2).

Table 081-831-1047-1.  *Fluid Replacement Policy for Warm Weather
(Average Acclimated Soldier Wearing BDU, Hot Weather)


Easy Work

Moderate Work

Hard Work

Heat Category

WBGT Index, �F

Work/ Rest

Water Intake, Qt/Hr

Work/ Rest

Water Intake, Qt/Hr

Work/ Rest

Water Intake, Qt/Hr


78 - 81.9





40/20 min


2 (green)

82 - 84.9



50/10 min


30/30 min


3 (yellow)

85 - 87.9



40/20 min




4 (red)

88 - 89.9



30/30 min


20/40 min


5** (black)


50/10 min


20/40 min






CAUTION: Hourly Fluid Intake Should Not Exceed 1½ Quarts.  Daily Fluid Intake Should Not Exceed 12 Quarts.

*The work/rest times and fluid replacement volumes will sustain performance and hydration for at least 4 hours of work in the specified heat category.  Individual water needs will vary ± ¼ quart per hour.

*NL = no limit to work time per hour.  Rest means minimal physical activity (sitting or standing) and should be accomplished in shade if possible.

*Wearing body armor adds 5° F to WBGT Index.

Wearing ALL MOPP overgarments adds 10° F to WBGT Index.

**Suspend physical training and strenuous activity.  If an operational (nontraining) mission requires strenuous activity, enforce water intake to minimize expected heat injuries.


Table 081-831-1047-2. Examples of Categories of Work

Easy Work

Moderate Work

Hard Work

  • Weapon maintenance.
  • Walking on hard surface at 2.5 mph, �  30-pound load.
  • Manual of arms.
  • Marksmanship training. Drill and ceremony.
  • Walking on loose sand at 2.5 mph, no load.
  • Walking on hard surface at 3.5 mph, ³ 40-pound load.
  • Calisthenics.
  • Patrolling.
  • Individual movement techniques, i.e. low crawl, high crawl.
  • Defensive position construction.
  • Field assaults.
  • Walking on loose sand at 2.5 mph with load.
  • Walking on hard surface at 3.5 mph,

(2)  Drink extra water before combat operations.

(3)  Maintain excess water in your system for strength and alertness.

(4)  Protect yourself from dehydration and heat injuries associated with wearing full chemical protective gear.

b. Rest whenever possible.

(1)  Take rest breaks in accordance with the heat condition table as the tactical situation permits.

(2)  Use rest breaks to drink water and to cool off.

c. Eat meals.

(1)  Eat regular meals daily to replace salt lost through heavy sweating.

(2)  Eat something at each meal, even if you are not hungry.

Note.  Usually, eating field rations or liberal salting of the garrison diet will provide enough salt.  Excess intake of salt should be avoided.

d. Protect yourself from exposure.

(1)  Wear uniform properly.

(2)  Provide shade whenever possible.

(3)  Use barrier creams and lotions.

3.   Ensure proper PMMs are followed for protection against biting insects.

a. Apply extended-duration repellent lotion-

Note.  Extended-duration repellent lotion is a preparation that can be used on the skin.

(1)  On exposed skin except the eyes, lips, and sensitive skin.

(2)  Two inches under edges of battle dress uniform (BDU).

(3)  Keep away from flame or excessive heat.

(4)  Wipe hands after application.

Note.  Repeat the above application every 6 hours during strenuous activity and soon after any activity that washes away the repellent (such as stream crossings).

Note.  Do not wear after-shave lotion or cologne in the field; they attract biting or stinging arthropods (insects).

b. Apply permethrin aerosol clothing repellent.

(1)  Use only on fabric.

(2)  Do not apply to skin.

(3)  Do not treat BDUs while being worn.

(4)  Treat outside of BDU, insect head net, and mosquito bed net.

(5)  Do not treat underwear or inside the cap.

(6)  Avoid breathing vapors.

(7)  Dry clothing (BDUs) thoroughly prior to wearing.

c. Wear uniform properly.

(1)  Tuck pant legs into boots, roll sleeves down, and close collar.

(2)  Wear uniform loosely.

(3)  Check clothing frequently.

(4)  Use buddy system to check areas of body not easily seen during self-examination.

d. Take malaria pills to protect against malaria parasites.  (Use in the manner prescribed for your unit.)

e. Clean and inspect yourself.

(1)  Wash yourself daily or as often as the tactical situation permits.

(2)  Use the buddy system to check each other for ticks and for arthropod bites.  (If ticks are found attached or if insect bites are found, seek medical attention.)

(3)  Use insecticide powder, cream, or shampoo when prescribed by medical personnel.

f.  Clean and inspect your clothing.

(1)  Wash your uniform to remove arthropods and their eggs.

(2)  Use available military laundry service or scrub your clothing yourself with soap and water.

g. Use your bed net when sleeping.

(1)  Suspend bed net above sleeping area.

(2)  Tuck edges of bed net under the sleeping pad or bag.

(3)  Treat the bed net with permethrin aerosol clothing repellent.

(4)  Spray interior space with resmethrin.

(5)  Avoid breathing vapors.

(6)  Do not use permethrin clothing repellent or resmethrin on skin.

4.   Ensure proper PMMs are followed for protection against diarrhea and dysentery.

a. Identify the indications of diarrhea and dysentery.

Note.  Diarrhea is an intestinal disorder characterized by abnormally frequent and watery bowel movements.

Note.  Dysentery is an infectious disease characterized by stomach pain and diarrhea with passage of mucus and blood.

b. Purify your drinking water if treated water is not available.

Note.  Before using iodine tablets, check them for physical change.  If they are old, they can lose their disinfecting ability.  Tablets that are not uniformly steel gray or that are stuck together or crumbled should not be used.

(1)  Fill your canteen with the cleanest, clearest water available.

(2)  Add iodine tablets.

(a)   Add two tablets to a one-quart canteen of water.

(b)   Double the amount of tablets if a two-quart canteen is used.

(3)  Replace the cap.

(4)  Wait five minutes for the tablets to dissolve.

(5)  Shake the canteen to mix the contents.

(6)  Disinfect the canteen cap threads.

(a)   Loosen the cap.

(b)   Tip the canteen over and squeeze to allow leakage around the canteen threads.

(c)   Turn the canteen right side up.

(d)   Tighten the cap.

(7)  Wait 30 additional minutes before drinking.

c. Obtain food and drink from an approved source.

(1)  Obtain food, drink, and ice only from medically approved sources.

Note.  Do not obtain food, drink, and ice from vendors unless they have been approved by medical personnel.

(2)  Obtain food from the dining facility when possible.

d. Wash your hands for at least 30 seconds-

(1)  After using the latrine.

(2)  Before touching eating utensils or food.

(3)  After eating.

(4)  After smoking.

e. Dispose of food waste properly.

(1)  Use covered container to keep out pests and to prevent breeding of flies.

(2)  Use plastic bags in the event you have dumpster-type receptacles and regular waste pick-up.

(3)  Bury in the event you are in the field and do not have waste pick-up or other disposal methods available.

Note.  Before burying any waste, obtain prior approval by contacting either the logistics or the preventive medicine section.

5.   Ensure proper PMMs are followed for protection against hearing loss.

a. Wear protective devices such as earplugs, ear canal caps, or earmuffs.

b. Wear vehicle headgear such as helicopter crew helmets and armored vehicle crew helmets.

c. Keep hearing protection devices clean to avoid ear infections.

d. Avoid noise and/or limit the time in noise hazardous areas.

6.   Ensure proper PMMs are followed to prevent skin infections.

a. Bathe frequently.  Take a full bath at least once every week.  If showers or baths are not available, use a washcloth daily to wash-

(1)  Your genital area.

(2)  Your armpits.

(3)  Your feet.

(4)  Other areas where you sweat or that become wet (between thighs or [for females] under breasts).

b. Keep skin dry.

(1)  Use foot powder on your feet (especially if you have had fungal infections in the past).

(2)  Use talcum powder in areas where wetness is a problem.  (Cornstarch may be used as a substitute for talcum powder.)

c. Change to clean clothing after a full bath.

(1)  Wear loose-fitting uniforms to allow for better ventilation and blood circulation.

(2)  Wear proper clothing.

Note.  Do not wear nylon or silk-type undergarments.  Cotton undergarments allow more evaporation of moisture.

d. Shave facial hair often enough to be clean shaven (males only) to allow a tight fit of the protective mask.

7.   Ensure proper PMMs are followed for care for the feet.

a. Before movement.

(1)  Wear the proper type of footgear, correctly fitted and broken in.

(2)  Wear clean socks that are free of holes or knotty darns.

(3)  Use foot powder and clean socks.

(4)  Treat and protect blisters, pressure spots, and infections before movement.

b. During movement.

(1)  Keep feet as dry as possible.

(2)  Change socks (if possible) for dry ones when they become damp or wet.

(3)  Dry socks by putting them inside your shirt around your waist.

(4)  Relieve tender pressure spots on the feet by adjusting gear.

(5)  Dust the feet with foot powder once or twice daily.

c. Inspect feet at rest periods.

(1)  Wash feet during the noon break if possible.

(2)  Raise feet while resting to help reduce congestion and swelling.

d. Take care of blisters.

(1)  Wash the blister and the surrounding area with soap and water.

(2)  Seek medical treatment for painful blisters or signs of infection such as redness, throbbing, and drainage.

8.   Ensure soldiers practice good oral hygiene.

a. Brush your teeth after every meal if possible.

b. Use dental floss at least once a day.

c. Rinse your mouth with potable water after brushing and flossing.

9.   Ensure soldiers are informed about protection against STD.

a. Use a prophylactic (condom).

Note.  Individuals should use a condom during sexual intercourse when there is a possibility of acquiring an infection.

b. Urinate immediately after intercourse.

c. Wash well with soap and water.

Note.  Females should not douche unless directed to do so by medical personnel.

10. Ensure soldiers are informed about protection against AIDS.

Note.  AIDS is contagious in the same way as STDs are contagious.  Infection can result from a sexual relationship with an infected person.  Sexual contact is not the only way to contract AIDS but is a major contributor.

a. Prevent sexual transmission-know your partner.

(1)  Avoid having sex with multiple partners.

(2)  Avoid having sex with persons who might be carriers of the AIDS virus (high-risk groups include homosexual and bisexual persons and intravenous drug users).

b. Prevent transmission through shared needles or syringes-do not inject illicit drugs.

Note.  There is presently no cure for AIDS and no vaccine to prevent AIDS.

11. Ensure proper PMMs are followed for disposal of waste.

a. For human waste-

(1)  Use unit latrine.

(2)  Use cat-hole latrine.

(a)   Use only on the march.

(b)   Cover immediately after use.

(3)  Use a straddle trench for 1 to 3 day bivouac.

b. For other waste-

(1)  Bury-less than one week in the field.

(2)  Incinerate-longer than one week in the field.

12. Apply Army tobacco use policies.

a. Long term and immediate adverse effects of tobacco use.

(1)  Leading preventable cause underlying death in the United States is tobacco use.

(2)  Heart disease, cancer, emphysema, stroke.

b. Tobacco use in the military.

(1)  Decreases readiness, night vision, hand-eye coordination, and stamina.

(2)  Increases cold weather injuries and number of injuries.

(3)  Leads to addiction.

c. Army tobacco use policy.

(1)  AR 600-63.

(2)  Smoking is not permitted in DA-space except in designated areas.

(3)  Healthy People 2000 priorities-

(a)   Reduce military smokers to 20 percent.

(b)   Reduce smokeless tobacco use to 4 percent for age groups between 12 and 24.

d. Sources to help soldiers become tobacco-free.

(1)  Medical professionals.

(2)  Local preventive medicine service.

(3)  American Cancer Society.

(4)  Nicotine gum, nicotine patches.

(5)  Family and unit support.

13. Identify division PM section missions to support field forces.

a. Identify breakdowns in PMM (individual and leader/unit).

b. Inform commanders on specific measures to repair the breakdowns.

c. Provide technical assistance for training the unit FSTs.

d. Monitor training of individual and unit PMM.

e. Perform limited sanitation and vector control work.

14. Identify corps-level PM missions to support field forces.

a. Corps PM detachments.

(1)  Provide PM support to deployed forces in the corps/COMMZ in a direct support role or a general support role.

(2)  Transport organic personnel and equipment with logistical support from a unit in the geographic area.

(3)  Perform area and aerial spraying missions, medical detachment, PM (ENTO) only.

b. Armored cavalry regiment (ACR).  Provide the same type of support to the regiment as the division PM section provides to the division.

c. Separate brigades (separate infantry brigade [SIB] and heavy separate brigade [HSB]).  Provide the same type of support to the SIB/HSB that the division PM section provides to the division.

d. Civil affairs (CA) units.  Provide support for displaced persons, refugees, and evacuees.  Re-establish essential public health services.

Evaluation Preparation:

Setup: Evaluate this task during a field training exercise (FTX) or during a normal training session. If the evaluation is conducted during an FTX, the environmental and physical conditions at the FTX will be used as the scenario for which PMM policies are implemented. If the evaluation is done during a normal training session, create the scenario to include environmental and physical conditions.

Brief Soldier: Tell the soldier he will be evaluated on his ability to supervise/ensure appropriate preventive medicine policies are followed. The soldier will respond to appropriate performance measures.

Performance Measures



1.   Ensured soldiers protected against cold.



2.   Ensured soldiers protected against heat.



3.   Ensured soldiers protected against biting insects.



4.   Ensured soldiers protected against diarrhea and dysentery.



5.   Ensured soldiers protected against hearing loss.



6.   Ensured soldiers protected against skin infections.



7.   Ensured soldiers provided care for the feet.



8.   Ensured soldiers practiced good oral hygiene.



9.   Ensured soldiers understood PMM to protect against sexually transmitted diseases.



10. Ensured soldiers understood PMM to protect against AIDS.



11. Ensured soldiers disposed of waste properly.



12. Applied the Army's policies on tobacco use.



13. Identified division and corps level PMs and their mission.



Evaluation Guidance: Score the soldier GO if all performance measures are passed. Score the soldier NO GO if any performance measure is failed. If the soldier scores NO GO, show what was done wrong and how to do it correctly.







AR 40-5



AR 600-63



FM 4-25.11



FM 21-10