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081-831-1053 (SL1) - Practice Individual Preventive Medicine Countermeasures

Standards: Applied preventive medicine countermeasures to protect, as appropriate, against cold, heat, biting insects, diarrhea and dysentery, hearing loss, skin infections, sexually transmitted diseases (STD), acquired immunodeficiency syndrome (AIDS), and foot problems. Practiced oral hygiene, proper disposal of waste, and Army tobacco use rules.

Conditions: You are a soldier deployed to a unit in the field. 
Necessary equipment and materials
will vary depending on physical environment
and climate: water, food, uniforms,
replacement clothing, barrier creams and
lotions, standard military skin
extended-duration repellent lotion,
permethrin aerosol clothing repellent, d-phenothrin
aerosol area spray, malaria pills, soap,
mosquito bednet, iodine tablets, canteen,
covered container, plastic bags, earplugs,
foot powder, talcum powder, razor,
toothbrush, dental floss, and an entrenching
tool.

Standards:
Applied preventive medicine countermeasures
to protect, as appropriate, against cold,
heat, biting insects, diarrhea and
dysentery, hearing loss, skin infections,
sexually transmitted diseases (STD),
acquired immunodeficiency syndrome (AIDS),
and foot problems. 
Practiced oral hygiene, proper
disposal of waste, and Army tobacco use
rules.

 

Performance
Steps

1.   Apply proper preventive medicine measures (PMMs)
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.

(3) 
Refrain from smoking
because it restricts blood flow to
the skin.

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

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
the shirt 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.   Apply proper PMMs 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) 
Hourly fluid intake
should not exceed 1 ½ quarts of
water every hour. Daily fluid
intake should not exceed 12
quarts. 
If your urine is dark
yellow, you are not drinking
enough water.

(2) 
Fluid intake needs will
vary depending on type of work and
temperature (see table 081-831-1053-1
and figure 081-831-1053-1).

 

 

 

Table 081-831-1053-1.
*Fluid Replacement Policy for Warm
Weather
*(Average acclimated soldier wearing
BDU, Hot Weather)

Heat
Category

WBGT
Index
°
F

Easy
Work

Moderate
Work

Hard
Work

Work/
Rest

Water
intake
Qt/hr

Work
Rest

Water
Intake, Qt/hr

Work
Rest

Water
Intake, Qt/hr

1*

78
– 81.9

NL

½

NL

¾

40/20
min

¾

2
(green)

82
– 84.9

NL

½

50/10
min

¾

30/30
min

1

3 
(yellow)

85
– 87.9

NL

¾

40/20
min

¾

30/30
min

1

4
(red)

88
– 89.9

NL

¾

30/30
min

¾

20/40
min

1

5**
(black)

>90

50/10
min

1

20/40
min

1

10/50
min

1

Caution

Hourly fluid intake
should not exceed 1 ½ quarts. Daily
fluid intake should not exceed 12
quarts.

*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 quarts 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 degrees
Fahrenheit to WBGT Index.

*Wearing
all MOPP overgarments adds 10 degrees
Fahrenheit 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.

 

 

 

 

 

 

 

 

 

  

 

*Examples of
Categories of Work

Easy
Work

Moderate
Work

Hard
Work

Weapon
maintenance

Walking
on hard surface at 2.5 mph,
 
30-lb 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,
< 40-lb load.

Calisthenics

Patrolling.

Individual
movement techniques, such as
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,
³
40-lb load.



Figure
081-831-1053-1.
Examples of work categories

 



(3) 
Drink extra water
before combat operations.

(4) 
Maintain excess water
in your system for strength and
alertness.

(5) 
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.   Apply proper PMMs for protection against arthropod
(insect) bites and arthropod-borne
diseases.

a.
Apply extended-duration
arthropod repellent lotion.

Note.  Extended-duration
arthropod repellent lotion can be used
on the skin.

(1) 
Apply lotion on exposed skin except the eyes, lips, and sensitive skin.

(2) 
Spread lotion two inches under edges of battle dress uniform (BDU).

(3) 
Keep the lotion away
from flame or excessive heat.

(4) 
Wipe hands after
application.

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

b.
Apply permethrin clothing
repellent. 
Use either the IDAA kit (most
effective) or the aerosol
formulation.

(1) 
Apply permethrin
according to the product label.

(2) 
Use only on fabric.

(3) 
Do not apply to skin.

(4) 
Do not treat BDUs while
being worn.

(5) 
Treat outside of BDU,
insect headnet, and mosquito
bednet.

(6) 
Do not treat underwear
or inside the cap.

(7) 
Avoid breathing vapors.

(8) 
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. 
Wash yourself daily or as
often as the tactical situation
permits.

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 and yourself with soap
and water.

g.
Use your bednet when
sleeping.

(1) 
Suspend bednet above
sleeping area.

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

(3) 
Treat the bednet with
permethrin aerosol clothing
repellent.

(4) 
Spray interior space
with d-phenothrin aerosol spray
insecticide.

(5) 
Avoid breathing vapors.

(6) 
Do not use permethrin
clothing repellent or d-phenothrin
aerosol spray insecticide on skin.

4.   Apply proper PMMs for protection against
water-borne and food-borne diseases.

a.
Identify the indications
of diarrhea and dysentery.

(1) 
Diarrhea is an
intestinal disorder characterized
by abnormally frequent and watery
bowel movements.

(2) 
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 medical personnel have
approved them.

(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) 
Place it in a covered
container to keep pests out and to
prevent breeding of flies.

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

(3) 
Bury waste if 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.   Apply proper PMMs 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.   Apply proper PMMs 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) 
Genital area.

(2) 
Armpits.

(3) 
Feet.

(4) 
Other areas where you
sweat or which 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.   Apply proper PMMs for care of the feet.

a.
Before movement.

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

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

(3) 
Use foot powder.

(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 under 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.   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.   Protect against sexually transmitted diseases
(STDs).

a.
Use a condom (rubber).

Note.  Individuals
should use a condom during vaginal,
anal, or oral sex when there is a
possibility of acquiring an infection.

b.
Avoid high-risk sexual
behaviors.

(1) 
Having more than one
sexual partner.

(2) 
Changing sex partners
frequently.

(3) 
Having sex with casual
partners, prostitutes, or their
clients.

(4) 
Sexual practices such
as anal sex.

c.
Control alcohol intake
(it affects your ability to use safe
sex practices).

10. Protect against human immunodeficiency virus (HIV), the virus
that causes AIDS.

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

a.
Prevent sexual
transmission-know your partner. 
Avoid having sex with persons
who might be infected with HIV. 
At highest risk are those who
have more than one sex partner, or
who have unprotected sex with casual
partners, prostitutes or their
clients, partners who are HIV
infected, or who share needles with
others,

b.
Prevent transmission
through shared needles or
syringes-do not use injected,
nonprescribed drugs.

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

11. Apply proper PMMs 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 1-3 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 the Army’s tobacco use policies.

a.
Effects of tobacco use.

(1) 
Long term health costs.

(2) 
Diseases/conditions
related to tobacco use.

(3) 
Effects on health of
nonsmokers.

(4) 
Use of smokeless
tobacco.

b.
Effects on soldiers’
performance and health.

(1) 
Increases number of
sick call visits.

(2) 
Decreases readiness.

(3) 
Decreases night vision.

(4) 
Decreases hand-eye
coordination.

(5) 
Decreases stamina.

(6) 
Increases cold weather
injuries.

(7) 
Increases overall
number of injuries.

(8) 
Leads to addiction.

c.
Army tobacco policies in
accordance with AR 600-63.

d.
Available resources for
tobacco use cessation.

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 preventive medicine
countermeasures 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 apply the appropriate preventive medicine
countermeasures. 
The soldier will respond to
appropriate performance measures.

Performance
Measures

GO

NO
GO

1.   Protected against cold.

2.   Protected against heat.

3.   Protected against arthropod bites and
arthropod-borne diseases.

4.   Protected against water-borne and food-borne
diseases.

5.   Protected against hearing loss.

6.   Prevented skin infections.

7.   Provided care for the feet.

8.   Practiced good oral hygiene.

9.   Protected against sexually transmitted diseases.

10. Protected against AIDS.

11. Disposed of waste properly.

12. Identified the Army’s policies of tobacco use.

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.

References

 

Required

Related

 

 

AR
600-63

 

 

FM
21-10

 

 

FM
4-25.11