Consent Form to Serve as Test Subject in a Joint Naval Medical Research Institute - Lawrence Livermore Laboratory Study

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PROJECT TITLE: .Tracer gas Kinetic Studies f o r Decompression Table Design 11. I do hereby give my consent t o serve as a test subject in a joint Naval . tledical Research Institute - Lawrence Livermore Laboratory study. w i l l involve my twice breathing a m5xture of oxygen and radioactive nitrogen, argon, andfor krypton vhile sitting in front of a radiation detection device. ., I understand that the study i s designed t o measure how fast Inert gas enters and leaves parts of t h e human body. safer diver decmpression schedules. Ialso understand that this study will provide no direct benefit to me. This information is needed t o develop I have been informed that this study i o voluntary and that I may withdrau from it at any time. investigators vi11 answer any other questions I may have. My questions have been ansuered and I h o v that the I have been informed that the only disc m fort that I should expect vi11 follow from up t o 2 hours of breathing through a mouthpiece and of remaining harmful gas such as ozone o r nitrogen dioxide. receive a radiation dose from the study. is vith in the ranges used i n medical procedures and less than the dose currently allowed by law for people vho vork with radioactive materials. X have been told that there is still a very small risk of disease such as cancer o r leukemia from this amount of radiation. I understand that there is a emall risk of breathing a chemically . I have been igormed that this dose I have been told that the study vi11 adhere to the intent of the Privacy PRIVACY ACT MATERIAL REMOVED

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PROJECT TITLE: .Tracer gas Kinetic Studies for Decompression Table Design 11. I do hereby give my consent t o serve as h test subject in a joint Naval . The studyMedical Research Institute - Lawredce Livermore Laboratory study. w i l l Involve my twice breathing a mixture of oxygen and radioactive nitrogen, argon, and/or krypton while sl ttt ng In front of a radiation detection device. I understand that the study is designed t o measure how fast inert gas enters and leaves pzrts of the human body. safer diver deconpression schedules. I also understand that this study vill provide no direct benefit to me. This information is needed t o develop I have been informed that this study l e voIuntarg and that I my withdraw from itat any time. investigators will answer any other questions I may have. My questions have been answered and I know that the I have been informed that the only discomfort that I should expect vill follow from up t o 2 hours o f breathing through a mouthpiece and of remaining .harmful gas such as ozone or nitrogen dioxide. receive a radiation dose from the study.. is within the ranges used i n medfcal procedures and less than the dose currently alloved by law for people who work with radioactive materials. I have been told that there i s still a very small risk of diseage such a s cancer or leukemia from this amount of radiation. I understand that there is a mall risk of breathing a chemically Ialso understand that I will I have been Qlorraed that this dose. I I have been told that the study will adhere to the intent of' the Privacy PRIVACY ACT MATERIAL REMOVED