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Talk:Ozone therapy

Discovery of ozone
The article previously stated that Joseph Lloyd Martin discovered ozone. This is inconsistent with what I have found in other reputable references and what is stated in the Ozone article (i.e. that it was discovered by Christian Friedrich Schönbein). The reference for this (which was not properly linked is here http://www.homeoint.org/history/cleave/m/martinjl.htm) and does not state that he discovered ozone but that he had a patent for "for Ozonized Oxygen Gas and its compounds for inhalation in the treatment of disease as a hygienic agent, and compressing the same in water for internal or medicinal use". This is not the same as having discovered the gas, so I have removed this part of the sentence.--NHSavage (talk) 17:22, 13 July 2011 (UTC)

Bias
A neutral viewpoint would include much better balance, such as the following excerpt: "Despite a lack of direct support of O3 therapy, the current Food and Drug Administration regulations do not restrict the use of it in situations where it has proven its safety and effectiveness. Nonetheless, there has been support for its safety and effectiveness in multi-international studies."  As well as the following, from the same published review "Despite the presently compelling evidence, future studies should include more double-blind, randomized clinical trials with greater sample sizes, determination of longevity in benefits produced, as well as methods of measurements and analysis."  (Med Gas Res. 2017 Oct 17;7(3):212-219. doi: 10.4103/2045-9912.215752. eCollection 2017 Jul-Sep.)  — Preceding unsigned comment added by 65.129.201.220 (talk) 15:42, 26 July 2022 (UTC)

 * One might also be interested in posting the following diagram recently published by Harvard Medical School researchers, with Ozone gas (O3) at top center:  Medical Gas Therapy for Tissue, Organ, and CNS Protection: A Systematic Review of Effects, Mechanisms, and Challenges (PMID: 35243825 PMCID: PMC9069381 DOI: 10.1002/advs.202104136 Free PMC article 65.129.201.220 (talk) 15:59, 26 July 2022 (UTC)

Clearly this is a very biased article written by opponents. There is no suggestion of neutrality in the way it is written. It needs to be tagged. Abstrator (talk) 01:14, 24 December 2011 (UTC)
 * Not clear at all. --Ronz (talk) 17:02, 24 December 2011 (UTC)
 * Actually it is clearly not neutral. Please look at version https://secure.wikimedia.org/wikipedia/en/w/index.php?title=Ozone_therapy&oldid=453926959 and notice all the sections about: countries where the therapy is practised as regular medicine, methods of use, journals, etc. I'd go as far as accusing the user WLU of vandalism for the series of edits on 4 October. I'll tag the article as not neutral. Alecsescu (talk) 08:38, 29 December 2011 (UTC)
 * Please focus on content. If you want to make accusations of vandalism, take them somewhere else and provide plenty of evidence. Otherwise, such accusations are disruptive and incivil.
 * I agree that it is worth trying to salvage some information on its use if we can agree on the sources and don't confound WP:MEDRS issues with those of marketing and use. --Ronz (talk) 18:52, 29 December 2011 (UTC)
 * Hi, by no means I'm going to learn Wikipedia "bureaucracy" just to make a vandalism accusation on page that is of no interest to me. Click on the history link I gave; if that is not enough evidence of vandalism, then it's not vandalism. I know a reputable clinic doing ozone injections for disk herniation, claiming to show results and patients are indeed satisfied; it is not subsidised by the state, but it is a legal practice. Before WLU's edits, the article showed the view that this is a legal and established practice in some states, now it says "Some marketers of ozone generators make fantastic promotional claims [...]" (very encyclopedical...). I edited the article in the least biased way I could to represent facts as they are, and now you reverted again to WLU's view of the world. I have no idea what MEDRS is, and I won't edit the article again. — Preceding unsigned comment added by Alecsescu (talk • contribs) 11:01, 30 December 2011 (UTC)
 * It's not vandalism. Glad we're past that. --Ronz (talk) 17:26, 30 December 2011 (UTC)
 * I can't believe I'm being bullied on Wikipedia. You took out that fragment which was verifiably accurate, noticed my non-combat, and then you came back to make it clear that you're happy everything worked the way you forced it.Alecsescu (talk) 12:00, 21 January 2012 (UTC)
 * Please focus on content if you have any interest in changing consensus. --Ronz (talk) 17:33, 21 January 2012 (UTC)
 * Agreed, the bias in the language choice, article selection, expert selection (Ernst is an expert in nothing but asking others to prove negatives), if you would like a line by line content argument, I will gladly oblige. There are as many Pub Med articles that are pro Ozone as there are the select few that you have chosen.  To use quackwatch, Ernst, certain physicians who have written for quackwatch, etc. is the definition of using BIAS in an article.  The article needs to be flagged. 50.250.97.5 (talk) 19:12, 31 August 2023 (UTC)
 * I agree the article is biased, see WP:GOODBIAS. Some alt-med journals exist for the sole reason of bolstering quackery. QuackWatch and Ernst are WP:CITEd because of WP:PARITY, which is a content guideline. tgeorgescu (talk) 00:16, 1 September 2023 (UTC)
 * Ernst is an expert in nothing but asking others to prove negatives This is just random bullshit. --Hob Gadling (talk) 06:21, 1 September 2023 (UTC)

Dischome (talk) 20:45, 12 September 2013 (UTC)I've attended Ozone conferences in Europe, where they are very accepted. More and more they are being accepted in the US, primarily right now by sports doctors, who can't necessarily get reimbursed by insurance, but nevertheless use ozone therapy to get results that people will pay for. Eventually it will be common place in the US. Because ozone is a natural substance, pharmco will not endorse it as they cannot patent it. I don't have ozone facts immediately handy, but I am giving you the fact of my experience. I guess I am agreeing that the article is biased, as the practice of using ozone it used in many other countries successfully.
 * I've attended Ozone conferences in Europe, where they are very [well] accepted. By whom? By accredited medical professionals/associations? Please be more concise. --user:ASMB--
 * Because ozone is a natural substance, pharmco will not endorse it as they cannot patent it. Statement is dubious, salicylic acid is a natural constituent of willow tree bark and that didn't prevent Bayer patenting aspirin. --user:ASMB-- —Preceding undated comment added 17:33, 26 October 2013 (UTC)

This entry appears to be outdated and biased. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312702/ Ktjnwebb (talk) 03:06, 11 January 2019 (UTC)

Moved to talk
Seems to confuse health claims, use, and efficacy. Basically, there are the WP:MEDRS issues with health claims, vs WP:SOAP issues that might be addressed with rewording and better sources: --Ronz (talk) 18:41, 29 December 2011 (UTC)

Mainstream medicine uses
Ozone therapy is a well established alternative and complementary therapy in most mainland European countries where health authorities have tolerated its practice. The European Cooperation of Medical Ozone Societies, founded in 1972, publishes guidelines on medical indications and contraindications of ozone and hosts training seminars. In the early 1980s, a German survey and investigation into ozone therapy by the University Klinikum in Giessen and the Institute for Medical Statistics, published in the Empirical Medical Acts revealed over 5 million ozone treatments had been delivered to some 350,000 patients, by more than 1000 therapists, of this number about half were medical doctors. Although ozone is used in a complementary capacity by a significant number of doctors in Italy, Switzerland, Austria and Germany, it has still not gained popular support with mainstream industry policy makers in those countries, it is not covered by health insurance, nor is it part of the curriculum at most esteemed medical schools. Proposals to include ozone therapy in German health insurance schemes invoked hostile objections from pharmaceutical researchers who question its evidence base. Former Soviet Union Countries seem also to have had less difficulty in accepting ozone as a medicine.

Pseudoscience
Should this article be added to Category:Pseudoscience?  —Entropy (T/C) 17:19, 13 January 2012 (UTC)
 * Yes, as in modern medicine, ozone is not used, and the FDA treats it as a pseudoscience. ThePlatypusofDoom (talk) 21:21, 25 April 2016 (UTC)

Very little of this article is about the topic
Very little of this article is about Ozone therapy. If someone wants to read about chemical properties of ozone, we have the article for it. I will be deleting the material that is not about "Ozone therapy" and leave a link for ozone for those interested in its properties. ParkSehJik (talk) 04:12, 25 November 2012 (UTC)

MEDRS source British Medical Source removed and replaced by offtopic random statements about ozone
This edit was made removed WP:MEDRS British Medical Journal sourced content and replaced it with offtopic statements about ozone in the stratosphere and MEDRS violating claims. The edit summary was "Requires more than one paper to change things", which is not a policy or guideline. The edit appears to be vandalism and is being reverted o MEDRS grounds alone. ParkSehJik (talk) 06:22, 25 November 2012 (UTC)

Madrid declaration link
Hi,

I agree with Yobol that this is not a WP:MEDRS document, and as stated in the edit comment, I don't think a consensus statement by ozone therapy societies is important to a discussion about ozone therapy itself. The document contains some practice guidelines, but those guidelines are also unreferenced.

-- UseTheCommandLine (talk) 06:21, 4 December 2012 (UTC)

Hello. I am sorry if I have been a headache, I was just trying to help. I know many medical websites that ta`lk about ozone therapy, but they're all in Spanish, that's the reason that when I found the declaration I thought it could help improving the article. The next time I am going to edit this article or any other related to ozone therapy I will ask first discussing in the respective talk page. Sorry if my English is not good, it is not my first language. I hope that together we can improve this article. --Biol. Cons. (talk) 03:01, 10 December 2012 (UTC)

Discolysis article improvement
Hello. I found two metaanalysis of discolysis. Please discuss in the talk page.--Biol. Cons. (talk) 19:21, 15 December 2012 (UTC)

Is this a fringe theory
Is this theory "mainstream enough" that it can be called "alternative medicine" without being called a "fringe theory?"

If the answer is no, then Fringe theories should be added to the top of the article.

Since I'm on the fence here and I expect that there won't be universal agreement on whether the existing POV template is sufficient or if adding "fringe theories" improves the encyclopedia, I'm asking that this template not be added until after discussion has occurred.

Discuss. davidwr/ (talk)/(contribs)/(e-mail)  20:44, 11 June 2013 (UTC)

 * Agree that currently it's fringe. will add tag. -- [ UseTheCommandLine  ~/ talk  ]# ▄ 20:55, 12 September 2013 (UTC)

Safety
The following websites might help to contribute in “Safety” of ozone therapy.

 * Why Ozone Therapy?
 * Ozone Theraphy_Dentistry with a conscience

 * These are all pro-ozone therapy articles, which gives undue weight to fringe science. ThePlatypusofDoom (talk) 21:24, 25 April 2016 (UTC)

I've removed the following sentence from the lede:
 * At least 10 deaths have been related to ozone therapy or its lack of usefulness, in nine cases there had been investigation and in eight it was discovered that the practitioners had used false credentials.

The cited webpage does not say what the sentence says: it lists a different number of cases, in none of which ozone therapy is established as the cause of death, and in most of which the underlying cancer or another therapy is clearly cause of death; it does not mention investigations or false credentials. Nor does the site appear to be a reliable source: it has a polemical tone and its information is very vague and supported by deadlinks. I have searched for the original supporting news articles without luck. It would be useful to have anecdotes of deaths from ozone therapy, if anyone can help locate some more reliable information. Fuzzypeg★ 23:46, 29 March 2020 (UTC)

Reversion of safety discussion
Both articles are included on pubmed. The journal is less mainstream, but the methodology and contentions are clear. Need further elaboration to justify removal. Ies (talk)
 * Please read WP:MEDRS and WP:FRINGE and don't try and force stuff in sourced to weak sources. You have been warned for edit-warring. Be aware this topic is subject to discretionary sanctions. Alexbrn (talk) 19:05, 25 April 2016 (UTC)
 * It is fine to contest the strength of the references, but you need to remember respond to talk page discussions before reverting edits without sufficient elaboration. Ies (talk)  19:07, 25 April 2016 (UTC)
 * Wikipedia editors follow WP:PAGs above all. You were edit warring against them. Alexbrn (talk) 19:09, 25 April 2016 (UTC)
 * Thanks for clarifying. My suggestion to you is to please try to remember Civility, and to respond to editors questions when reverting before starting something that could be perceived as an edit war. Ies (talk) 19:14, 25 April 2016 (UTC)
 * My advice to you is to get some basic understanding of Wikipedia's WP:PAGs before repeatedly trying to force novel content in. Maybe WP:BRD might help? Alexbrn (talk) 19:18, 25 April 2016 (UTC)
 * Ok thank you. Incidentally, if by "novel" you are trying to invoke WP:OR, this would not be correct in this instance, and I would request that you review the reference and editorial response if you have concerns. Regardless, as you appear to feel strongly about the issue, I will defer, as I do not think your decision negatively impacts the article. Ies (talk)  19:31, 25 April 2016 (UTC)
 * No, "novel" in respect of accepted knowledge. I have no "feelings" about this topic and it is inappropriate for you to try for that angle. Alexbrn (talk) 20:07, 25 April 2016 (UTC)
 * As this is fringe medicine, there is not much "accepted knowledge" about it. There is no angle, simply responding to your criticism. Thanks again. Ies (talk) 20:13, 25 April 2016 (UTC)

Fringe
FYI, I have initiated a discussion about this topic at WP:FT/N. Alexbrn (talk) 20:11, 25 April 2016 (UTC)
 * Much appreciated. Ies (talk) 20:17, 25 April 2016 (UTC)

Additional References

 * Ozone therapy: A clinical review
 * Mechanisms of Action Involved in Ozone Therapy
 * "The application of ozone therapy in all public hospitals is still being delayed by prejudice, no fundings, commercial competition by big Pharma and above all by the incomprehensible disinterest, if not plain obstruction, by Health Authorities such as the FDA in USA and the European Medical Association."
 * " As it has happened for other innovative medical approaches, thanks for the efforts of many expert physicians, ozone therapy will be eventually accepted by orthodox medicine." — Preceding unsigned comment added by 76.14.15.93 (talk) 19:30, 8 October 2016 (UTC)

 * Both of those quotes come from the second link, which was published in a well-known predatory open access journal with a history of faked peer-reviews, rushed publication of bad articles and other trust-eroding issues. The first link does not support the claims. Finally, as a rule of thumb, any source you come across that actually uses the term "big Pharma" in a serious, pejorative sense can be safely dismissed as unreliable. MjolnirPants   Tell me all about it.  17:36, 9 October 2016 (UTC)

Moved here
This does not appear to be pubmed indexed "This statement is opposed with the release of a peer-reviewed publication (2016), which performed a systematic review of controlled human trials of two major forms of systemic ozone therapies. Based on the Cochrane Library (1992) evidence classification system, as well as the Oxford Center for Evidence Based-Medicine (2009) criteria, systemic medical ozone therapy is establishing itself as evidence-based medicine. "

Doc James (talk · contribs · email) 03:00, 14 August 2016 (UTC)

Further sources
I suggest: BMJ Case Rep. 2013 Jan 31;2013. pii: bcr2012008249. doi: 10.1136/bcr-2012-008249. The use of ozone therapy in Buruli ulcer had an excellent outcome. Bertolotti A1, Izzo A, Grigolato PG, Iabichella ML. The British Medical Journal's (BMJ)impact factor (2014) is 16.3; it uses a comprehensive peer review process giving priority to articles that improve clinical decision-making in general medicine. BMJ Case Rep is owned by BMJ. BMJ is one the world top medical journals.
 * Not a reliable source. Alexbrn (talk) 15:59, 17 December 2016 (UTC)

 * May I ask why one of the world top medical journals is considered by you "not a reliable source"? — Preceding unsigned comment added by 151.20.233.113 (talk) 16:02, 17 December 2016 (UTC)
 * Please see WP:MEDRS and maybe WP:WHYMEDRS for further background. Alexbrn (talk) 16:04, 17 December 2016 (UTC)

Thank you very much--151.20.233.113 (talk) 16:07, 17 December 2016 (UTC)

Is this perhaps good? Spine is a top Journal and this is a Review of Literature Fort NM, Aichmair A, Miller AO, Girardi FP. L5-S1 Achromobacter Xylosoxidans Infection Secondary to Oxygen-Ozone Therapy for the Treatment of Lumbosacral Disc Herniation: A Case Report and Review of the Literature. Spine (Phila Pa 1976). 2013 Dec 30. [Epub ahead of print] --151.20.233.113 (talk) 16:16, 17 December 2016 (UTC)
 * Case reports are primary sources and so generally not allowed for health claims. The secondary component of primary sources (this promises a review) is sometimes allowed, but is often biased to colour the finding from the primary research. I cannot access the full text of this article so don't know what it says. Alexbrn (talk) 16:26, 17 December 2016 (UTC)

Thank you very much, I will try to search a systematic review in a top journal.--151.20.233.113 (talk) 16:30, 17 December 2016 (UTC)

I suggest following systematic reviews:

J Nat Sci Biol Med. 2011 Jan-Jun; 2(1): 66–70. doi: 10.4103/0976-9668.82319 Ozone therapy: A clinical review, authors A. M. Elvis and J. S. Ekta — Preceding unsigned comment added by 151.20.236.169 (talk) 15:50, 24 December 2016 (UTC)

GERMAN, I. J. S.; RODRIGUES, A. C.; ANDREO, J. C.; POMINI, K. T.; AHMED, F. J.; BUCHAIM, D. V.; ROSA JòNIOR, G. M.; GONALVES, J. B. O. & BUCHAIM, R. L. Ozone therapy in dentistry: A systematic review. Int. J. Odontostomat., 7(2):267-278, 2013.- 151.20.232.106 (talk) 02:48, 25 December 2016 (UTC)

Pain Physician. 2012 Mar-Apr;15(2):E115-29, Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials. Magalhaes FN1, Dotta L, Sasse A, Teixera MJ, Fonoff ET.--151.20.232.106 (talk) 02:51, 25 December 2016 (UTC)

Revista Dor Print version ISSN 1806-0013 Rev. dor vol.13 no.3 São Paulo July/Sept. 2012 http://dx.doi.org/10.1590/S1806-00132012000300012. Ozone therapy for lumbosciatic pain* José Oswaldo de Oliveira Junior; Gustavo Veloso Lages --151.20.232.106 (talk) 02:53, 25 December 2016 (UTC)

This Article is STILL biased and must be revised.
As previously stated many years ago, the language and tone of this article is very clearly anti-ozone therapy. Wikipedia should be a place of neutrality to allow readers to form their own opinions.

Please present the pro and cons side by side and let the reader decide his or her view.

Moreover, some the website sources used to promote the writer's skewed point of view are dangerously unqualified and smacks of yellow journalism.

Articles and writers such as this one should be outlawed from wikipedia. It is ridiculous that it has remained this way for so long.

— Preceding unsigned comment added by 47.142.153.211 (talk) 22:30, 5 July 2017 (UTC)
 * See WP:NPOV, particularly WP:GEVAL, & WP:FRINGE. Alexbrn (talk) 06:32, 6 July 2017 (UTC)
 * Seconded. Delta13C (talk) 10:33, 6 July 2017 (UTC)

Reference supports opposite claim
The only reference that is actually a clinical review published in a scientific journal is reference 2. It’s cited at the end of the introduction and invalidates every claim made in the introduction regarding ozone being dangerous, pseudoscientific, etc. I can’t even find a scientific journal article saying ozone isn’t effective. This is embarrassing. Chemacb (talk) 22:54, 13 March 2020 (UTC)

Evidence of safety and efficacy
An unreferenced statement mentioning "some evidence for its effectiveness in specific medical applications" was removed from the article's lead paragraph. It seems to me there is actually quite a bit of evidence, so I'm gathering what I can find here, in preparation to add something to that effect to the article. (I'll add these to the below list as I find them.) Some of these studies are not double blinded, randomized, controlled studies, and some are not published in ideal peer reviewed conditions. They do not constitute proof, and may be open to dispute, but they are "some evidence". Fuzzypeg★ 06:16, 27 April 2020 (UTC)
 * Ozone therapy found effective for pain relief in knee osteoarthritis:
 * https://onlinelibrary.wiley.com/doi/abs/10.1002/pmrj.12088 (Ozone therapy effective in pain relief for osteoarthritis of the knee: review article including 8 studies, 355 patients treated and 363 controls)
 * https://pesquisa.bvsalud.org/portal/resource/pt/mdl-30498370 (review article including 5 studies, 225 patients treated and 203 controls)
 * https://www.sciencedirect.com/science/article/abs/pii/S0965229918307337?via%3Dihub (2019 review article including 10 studies)
 * Ozone therapy effective for lumbar pain relief (few and poor-quality studies in support):
 * https://pesquisa.bvsalud.org/portal/resource/pt/mdl-31521383 (2019 review including 6 trials found ozone therapy more effective than steroids or placebo, with low confidence)
 * https://pesquisa.bvsalud.org/portal/resource/pt/mdl-30414366 (2018 review found few and poor-quality studies in support of lumbar pain relief. This review is useful in discussing minor but potentially serious complications)
 * Ozone therapy effective treatment for herniated discs in terms of pain, function and complication rate: https://www.jvir.org/article/S1051-0443(09)01668-6/fulltext (metaanalysis of 12 studies covering nearly 8000 patients)
 * Ozone therapy effective for treatment of chronic wounds (healing and wound closure): https://onlinelibrary.wiley.com/doi/abs/10.1111/iwj.12907 (2018 review of 9 studies, 453 patients)
 * Intralesional ozone injection effective against warts: https://www.ncbi.nlm.nih.gov/pubmed/31584525?dopt=Abstract
 * Ozone therapy effective against Hepatitis B:
 * https://ojs.uv.es/index.php/JO3T/article/view/11459/pdf (2018 study: 28 patients all had viral load and biological markers reduce to undetectable levels within 15 days)
 * https://www.ncbi.nlm.nih.gov/pubmed/19544653?dopt=Abstract (2008 Chinese-language study on 20 patients plus 22 control)
 * Ozone therapy effective for chronic Hepatitis C:
 * https://www.ncbi.nlm.nih.gov/pubmed/21417811?dopt=Abstract: 2011 preliminary study: symptoms improve and 25-45% of patients test negative for RNA in serum
 * https://www.ncbi.nlm.nih.gov/pubmed/21417811?dopt=Abstract 2009 Russian language study found ozone therapy more effective than standard treatments
 * https://www.tandfonline.com/doi/abs/10.1080/01919512.2012.720161 2012 Review of 3 prior studies, and preliminary results of combined ozone and interferon therapy. Patients treated with ozone therapy have a 40% relapse rate one year after treatment.
 * HIV: Ozone in conjunction with antiretroviral treatment:
 * https://ojs.uv.es/index.php/JO3T/article/view/11458/pdf: 2018. Participants were 32 patients already taking Lamivudine 150mg and Zidovudine 300mg daily, with high viral load, low CD4 and CD8 counts and adverse reactions to retrovirals. Viral load became undetectable after 1 month in all 32 patients; CD4 and CD8 cells substantially increased; all side effects of antiretroviral drugs disappeared or improved.
 * Herpes zoster: https://www.ncbi.nlm.nih.gov/pubmed/29559601?dopt=Abstract 2018 Chinese study comparing 30 patients treated with ozone therapy vs 30 patients treated with valacyclovir, mupirocin ointment and laser treatment: all the ozone group recovered (vs only 87% of control group), and did so faster and with less pain.
 * Multiple sclerosis: https://www.ncbi.nlm.nih.gov/pubmed/28623000?dopt=Abstract 2017 study: Ozone insufflation led to significantly increased antioxidant enzymes and cellular reduced glutathione; decreased oxidation damage; and decreased levels of pro-inflammatory cytokines TNFα and IL-1β. Stimulated CK2 expression and the Nrf2 pathway.

COVID-19 section
I'm aware that my edits may raise some questions. I personally have no idea whether ozone therapy is effective for COVID-19 or anything else, and am not affiliated with any ozone proponents; I am simply trying to map out significant evidence around this issue. I don't want to suppress reporting on this subject simply for fear of encouraging the uninformed to try unproven treatments – and WP is not censored. Nor do I want to uncritically promote this therapy by citing only poor, one-sided research. I feel the information in the article is notable (it has certainly made the Italian and Spanish news!), and I'd like to present it clearly, without hiding the limitations of the evidence, but also without descending into pejoratives, WP:OR, WP:WEASEL words or liberal sprinkling of adjectives such as "unproven", "discredited" into every second sentence as scare flags for the reader.

Oh, and it bugs me when people say there's "no evidence" of something, when what they mean is insufficient or inconclusive evidence. The American Cancer Society was misrepresented as saying there was "no credible scientific basis" for anti-cancer claims, when what they really said was that there were a number of trials showing interesting results but that no rigorous trials on humans have yet shown positive effect and hence it remains unproven.

I have (please note) also substantially improved the safety section, giving a lot more information on negative side-effects of the treatment (I had to translate a lot of German for this info, it took me ages). I may soon be able to add even more regarding negative effects. So I'm not editing with an agenda here, merely trying to achieve accuracy and a neutral point of view. Fuzzypeg★ 15:58, 27 April 2020 (UTC)

 * People with a vested interested in making positive claims around a treatment's success is not 'evidence.' Anyone can call up a newspaper and claim "XYZ," and that in and of itself does not constitute evidence. You're welcome to note these assorted ozone therapy clinics are making claims about positive outcomes related to some specific treatment, but without peer-reviewed empirical evidence to back up their claims, they shouldn't be treated factual. You're conveniently and purposefully leaving out important details (like the existence of simultaneous treat unrelated to ozone therapy which may have a more of an impact than the ozone treatment. CymHastings (talk) 19:48, 27 April 2020 (UTC)
 * Please assume good faith. I am not "purposely" leaving out information. Very happy for that to be clarified; it helps the article. I thought it was implied by stating that a number of patients were no longer intubated by end of treatment, and didn't really consider stating it more explicitly.
 * Many research articles are published with authors disclosing conflicts of interest: that doesn't prevent these articles being considered "evidence". Lack of peer review certainly decreases the reliability of evidence very substantially. These reports mostly constitute expert opinion without critical appraisal, which falls of a very low rung on the scale of medical evidence, but is still evidence. I note that the groups producing these reports are all attempting to begin randomized controlled studies and publish peer-reviewed papers, but to run controlled studies requires ethics approval, which has been difficult to obtain for some of them (though they have had approval to deliver treatment). This, for instance, looks ostensibly like a well-designed trial, but failed to obtain ethics approval. Perhaps the failure to deliver gold-standard research comes down to these researchers' "lack of rigour", as you have insinuated, or perhaps it comes down to institutional reluctance to consider alternate therapies. Who knows? I don't wish to present these reports as anything more than they are, but I also don't want to negatively misrepresent them or leap to conclusions about the competency of the people making them. Fuzzypeg★ 23:47, 27 April 2020 (UTC)
 * Hi again CymHastings. I prefer the language of the edits you've made this time (still not convinced about the words "claim" and "anecdotal", but won't bother arguing). I agree it's sensible to point out the lack of external validation. I'm dubious about this statement: "as of late April, no hospital outside of the ozone therapy community has enacted such treatments based on these recommendations". What does it mean to be "outside the ozone therapy community"? Not practicing ozone therapy? Then no hospital outside the community can or will ever practice the therapy, by definition. Or do you mean something else? In which case, what is your evidence regarding the 20+ hospitals offering this treatment in Italy, plus others in China, Portugal, Brazil, Romania and Turkey? This sounds very much like original research, and I think it needs clarifying, with supporting citation, or else removing. Fuzzypeg★ 00:00, 28 April 2020 (UTC)
 * It is very difficult for me to assume good faith when you post the statements of the clinicians as fact. Again, someone claiming something does not demonstrate fact. Further, you (and the clinicians for that matter) are attempting to demonstrate causation through proximity. Just because ozone therapy was applied and there was an improvement in condition does not mean the improvement was directly related to the treatment. By excluding from the statements additional information (from pre-existing conditions of the patients to the additional forms of treatment applied at the same time as the ozone therapy), the paraphrasings you list exclusively work to imply the ozone therapy caused the improvements. Baring the release of empirical evidence to support such, they are, by definition, claims. Further, ‘anecdotal’ exactly communicates that a limited number of claims without empirical evidence have been made. It’s an accurate use of the word. If and when any party produces confirmed physical evidence to show a causal link between the treatment and the outcome, I will more than happily yield to different phrasing. In the interim, you should clearly indicate that the clinicians are reporting whatever improvements they claim without using statements of fact. Again, anyone can report anything... and we should be mindful to list claims as such baring evidence to support said claims. A casual reading of your contributions would make the average viewer believe the patients actually had improvements; instead, clinicians reported improvements but failed to provide actual evidence in support of their reports. Are we to take the words of persons just because they called up a newspaper?
 * Several of the clinics you’ve listed or are cited are alternative medicine establishments and are not part of the mainstream public health community. While other centers may be using ozone therapy (as you listed off), none are necessarily doing so BECAUSE of the recommendations of Dr. Baeza at the Ibiza institution. I’m more than happy to be corrected (it wouldn’t be the first time).
 * I’m sorry if I come across as overly agressive. I’ve seen far too many uneducated people fall prey to claims by miracle workers, and given the popularity (and misuse) of Wikipedia as a source for truth for the masses, I fear for people who may interpret your contributions as a factual recounting of the events rather than just the reporting of events by parties with vested interests. We can’t assume everyone is thorough enough to click on the source links; we have to ensure the entries themselves clearly differentiate between reports of facts and actual facts. CymHastings (talk) 02:41, 28 April 2020 (UTC)
 * Please don't add any information about COVID-19 to this article yet. Have you heard about the Recentism idea before?  It can be very tempting for editors to rush forward, even though nothing's really known, to add something about the big news topic.  But it's better in these instances to remember that There is no deadline, and that if we wait, we can put truly solid information in.  I'd rather that we got this right, even if that means waiting months until proper medical review articles (NB:  not case studies, like "We tried this on these two patients, and they recovered") to get published.  WhatamIdoing (talk) 15:52, 28 April 2020 (UTC)
 * Thank-you. I read the WP:MEDRS that Alexbrn linked in his edit summary, and am much chastened. I may continue to add notes to the talk page, such as the five clinical trials I've found currently underway:
 * https://clinicaltrials.gov/ct2/show/NCT04366089 Started 2020-03-26, Rome. Randomized controlled, single-blind on outcomes assessor. ~152 participants. Treatment group receives systemic autohemotherapy with Ozone 30 mcg / ml 250ml 2 times / day for 7 days, plus standard of care. Control group receives standard of care. (Standard of care includes hydroxychloroquine and antibiotics.)
 * http://www.chictr.org.cn/showproj.aspx?proj=49947 Started 2020-02-22, Haihe Hospital, Tianjin. Non-random controlled. 15 mild ill and 15 severe or critical ill patients receive conventional treatment plus ozonated autohaemotherapy; 30 controls receive conventional treatment.
 * https://clinicaltrials.gov/ct2/show/NCT04359303 Starting April 2020, Valencia, Spain. Randomized controlled double-blind. ~50 participants. Treatment group receive WHO-recommended treatment plus autohaemotherapy: 200 mL at 40 mcg/mL of medical ozone / oxygen in 200 mL of patient’s blood. Controls receive WHO-recommended treatment.
 * https://clinicaltrials.gov/ct2/show/NCT04370223 Starting ~2020-05-04, Clinica Nuestra Señora del Rosario, Ibiza. Randomized controlled open-label. ~208 participants, all with COVID-19 pneumonia. Treatment group receive standard hospital treatment plus autohaemotherapy every 12 hours during 5 days (100-200ml of patient’s blood interacted with 200ml gas containing 40 μg/mL ozone). Controls receive standard hospital treatment.
 * https://www.irct.ir/trial/47149 Starting ~2020-04-23, Baqiyatallah University of Medical Sciences, Iran. Randomized, controlled, non-blinded. Target of 80 participants. Treatment group receive ozone major autohaemotherapy (100-200cc blood interacted with equal volume of 35μg/mL ozone; volume depending on severity) 1-2 times daily depending on severity of disease, plus conventional treatment. Controls receive conventional treatment.
 * But I understand WP guidelines on levels of medical evidence better now, and am in no hurry to add any more on this to the article proper.
 * CymHastings, I was not stating those reports as facts. If you reread my edits you should see liberal use of quotation-marks and words such as "stated", "reported". If you find it hard to assume good faith, please try harder. As I said, I won't bother arguing about the other language, though I still disagree. Fuzzypeg★ 06:39, 4 May 2020 (UTC)

Ozone therapy — OHT
Hello everyone,

An in-depth debate on this topic has been ongoing for several days now. To access its interactive content, simply click on → this hyperlink.

Sincerely, — euphonie breviary 20:50, 13 July 2020 (UTC)
 * Discussion archived at Wikipedia talk:WikiProject Medicine/Archive 138 Sandy Georgia (Talk)  05:19, 4 August 2020 (UTC)
 * Discussion archived at Wikipedia talk:WikiProject Medicine/Archive 138 Sandy Georgia (Talk)  05:19, 4 August 2020 (UTC)

Why is the empirical research supporting ozone missing? A simple google pulled up NIH data that supports the efficacy of ozone for health uses
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312702/ 69.94.200.170 (talk) 14:07, 25 September 2022 (UTC)

 * That is not "NIH data". That is an article from the "Journal of natural science, biology, and medicine" which happens to be included in PubMed Central. We have no reason to think that journal is reliable enough for writing about medical topics. It is not indexed in MEDLINE, for example. XOR'easter (talk) 17:37, 6 March 2023 (UTC)

 * There is no ozone therapy, there is ozone poisoning. Ozone is a poison. It is very good that there is ozone at high altitudes, but we would not like to breathe ozone. tgeorgescu (talk) 17:32, 24 March 2023 (UTC)

 * Also Aspirine is a poison, and a medicine. It depends on the dosage and way of administration. Ozone in microdosages 0-60 max 80 micrograms per ml O2) is a medicine, if used correctly by medical doctors, according to guidelines based on the principles of Evidence Based Medicine (EBM).
 * Inhalation of oxygen: Ozone being a very potent oxidant harms the lungs irritating the mucous membranes of the lungs to result in pulmonary oedema.
 * Oxygen during inhalation penetrates the capillaries of the alveoli and is not being stopped by the antioxidants at the epithelial surface. At the air-epithelium interface, the alveolar cells are constantly overlaid by a very thin (about 0.1 µm) film composed of water, salts and molecules such as surfactant and phospholipids, the so called Endothelial Lining Fluid (ELF).
 * Ozone, on the other hand, when inhaled, immediately reacts with biomolecules present in the ELF and is not transferred into the alveolar capillaries. As a result, ozone has a more powerful oxidative action, harms available substances that should protect the alveoli and causes lung oedema. It doesn't get a chance to enhance antioxidant mechanisms as when it comes into contact with blood, water or PUFA.
 * The conclusion here is in order to be safe Ozone needs to be administered in low dosages avoiding pulmonary inhalation, by different application methods via tissues that have sufficient antioxidants available, including blood.
 * Administration via different routes than inhalation can encompass immune system activation, vascular and haematological modulation and increase of anti-oxidant activity.
 * Mechanism of Action
 * Ozone can be administered either by intramuscular, intra- articular or intra-discal injections, by mixing it with autologous blood and transfusing it back, locally applying it to the skin with bagging and through vaginal or rectal insufflation. Not through inhalation.
 * When the ozone reaches the body cells there are two important reaction chains. Ozone will be reacting with the membrane phospholipids and thus produce the following products: Ozonides, Aldehydes, Peroxide, and Hydrogen peroxide. (Viebahn-Haensler)
 * Secondly these products will act as second messengers activating enzymes like Superoxide Dismutase (SOD) causing an increase in intra erythrocytic 2,3 DPG level, enhancement of general metabolism through improved oxygen delivery and upregulation of a number of antioxidant enzymes as well of haeme oxygenase 1 and Heat Shock Protein 70 (HSP-70).
 * Ozone’s antioxidant capacity.
 * Ozone is a potent oxidant. High dosages cause high oxidative stress and eventual inflammation and even damage to the tissue.
 * Low dosages, though, can activate antioxidant pathways. In other words, low dosage of Ozone activates the homeostasis mechanism in the body to prevent oxidation and damage of cells and structure.
 * Low concentration Ozone comes in contact with H2O and PUFA
 * In vitro and in vivo studies of the long-term antioxidant capacity of infiltration with O2-O3 gas mixture in the human body show that it binds immediately to water and cell membrane components like Poly Unsaturated Fatty Acids (PUFA).(Noel L.Smith et al)
 * Hydrogen Peroxide (OH-) and Lipidoxidation products are formed.
 * After contact with water (H2O), Hydrogen Peroxide is formed and after contact with the PUFA 	Lipid Ozonation products are formed.
 * This activates Nuclear Factor Erythroid 2 related Factor 2
 * The presence of hydrogen peroxide and the lipid ozonation products increase activation of the Nuclear Factor Erythroid 2-related Factor 2 (Nrf2).
 * Which results in the expression of Antioxidant Response Elements (ARE)
 * The activation of Nrf2 causes the expression of the so-called Antioxidant Response Elements (ARE) genes. ARE genes are normally associated with Kelch Like Ech Associated Proten-1 (KEAP-1). Now when mildly activated, they dissociate from KEAP-1 and transcription of Antioxidant Response Elements (ARE) driven genes can be induced.
 * These genes after being induced will produce antioxidant enzymes as Super Oxide Dismutase (SOD), Glutathione Peroxidase (GPx), Glutathione S-transferase (GST) Catalase (CAT) Heme Oxygenase-1 (HO-1) NADPH HSP-70 that will enhance antioxidant processes. .(Noel L.Smith et al) (citation see above)
 * The importance of this is that after the immediate oxidative effect, antioxidant mechanisms are stimulated and after repetitive stimulation the antioxidant mechanisms remain active at a higher grade. (Viebahn, Malatesta, Galié)
 * Vascular and haematological modulation
 * The presence of O3 causes an increase of efficiency of oxygen delivery to the cells. The mitochondrial respiratory chain is made more efficient.
 * Secondly low dose ozonised blood enhances blood circulation and oxygen delivery to ischemic tissues as a result of the concerted effect of NO and CO and an increase in intraerythrocytic 2,3 diphosphoglycerate (2,3 DPG). (Bocci)
 * Pathogen inactivation of bacteria fungi and viruses.
 * O2-O3 mixture is known in industry for its strong antibacterial, antifungal and antiviral action in disinfecting water, materials, and spaces. In ozone therapy nevertheless this effect
 * is mostly of use in direct application of O2-O3 mixture to
 * infected wounds,
 * rectal dysbiosis,
 * vaginal dysbiosis, after which the good bacterial flora has to be re-established with micro biotic supplements.
 * In the blood, in case of a sepsis (microbial infection of the blood) for example, as ozone binds too fast to water, available proteins and PUFA and because of the small dosage used, ozone will not be sufficient to act as an antipathogen. (Bocci)
 * Immune system activation
 * In the research of Galie et al, they provide scientific, histologic and biochemical evidence that treatment with a low concentration of ozone in cultured cells promotes nuclear translocation of Nrf2 at the chromatin sites of active transcription and increases the expression of antioxidant response element (ARE) driven genes.
 * Also, it is now proven that cytokines are directly stimulated by Ozone in fibroblasts and leucocytes. (Malatesta)
 * “Nrf2 is able to modulate inflammation through multiple mechanisms, such as the regulation of redox homeostasis and the suppression of pro-inflammatory genes. -- Inflammation increases local and systemic ROS level while ROS enhance inflammation. --The Nrf2-KEAP1 mediated ROS-homeostatic control can break this vicious cycle.” (Galié et al.)
 * This is a finding that is falling in place with the publication of Cuadrado in Nature Reviews, where ozone is not yet mentioned. Cuadrado states: “a functional NRF2–KEAP1 axis is essential for protection against a plethora of diseases that have oxidative stress and inflammation as underlying pathological features.
 * “(Cuadrado) (Lamberto Re)
 * Hermelyn Meinardi (talk) 17:36, 9 April 2023 (UTC)
 * The presence of O3 causes an increase of efficiency of oxygen delivery to the cells. The mitochondrial respiratory chain is made more efficient.
 * Secondly low dose ozonised blood enhances blood circulation and oxygen delivery to ischemic tissues as a result of the concerted effect of NO and CO and an increase in intraerythrocytic 2,3 diphosphoglycerate (2,3 DPG). (Bocci)
 * Pathogen inactivation of bacteria fungi and viruses.
 * O2-O3 mixture is known in industry for its strong antibacterial, antifungal and antiviral action in disinfecting water, materials, and spaces. In ozone therapy nevertheless this effect
 * is mostly of use in direct application of O2-O3 mixture to
 * infected wounds,
 * rectal dysbiosis,
 * vaginal dysbiosis, after which the good bacterial flora has to be re-established with micro biotic supplements.
 * In the blood, in case of a sepsis (microbial infection of the blood) for example, as ozone binds too fast to water, available proteins and PUFA and because of the small dosage used, ozone will not be sufficient to act as an antipathogen. (Bocci)
 * Immune system activation
 * In the research of Galie et al, they provide scientific, histologic and biochemical evidence that treatment with a low concentration of ozone in cultured cells promotes nuclear translocation of Nrf2 at the chromatin sites of active transcription and increases the expression of antioxidant response element (ARE) driven genes.
 * Also, it is now proven that cytokines are directly stimulated by Ozone in fibroblasts and leucocytes. (Malatesta)
 * “Nrf2 is able to modulate inflammation through multiple mechanisms, such as the regulation of redox homeostasis and the suppression of pro-inflammatory genes. -- Inflammation increases local and systemic ROS level while ROS enhance inflammation. --The Nrf2-KEAP1 mediated ROS-homeostatic control can break this vicious cycle.” (Galié et al.)
 * This is a finding that is falling in place with the publication of Cuadrado in Nature Reviews, where ozone is not yet mentioned. Cuadrado states: “a functional NRF2–KEAP1 axis is essential for protection against a plethora of diseases that have oxidative stress and inflammation as underlying pathological features.
 * “(Cuadrado) (Lamberto Re)
 * Hermelyn Meinardi (talk) 17:36, 9 April 2023 (UTC)
 * This is a finding that is falling in place with the publication of Cuadrado in Nature Reviews, where ozone is not yet mentioned. Cuadrado states: “a functional NRF2–KEAP1 axis is essential for protection against a plethora of diseases that have oxidative stress and inflammation as underlying pathological features.
 * “(Cuadrado) (Lamberto Re)
 * Hermelyn Meinardi (talk) 17:36, 9 April 2023 (UTC)
 * “(Cuadrado) (Lamberto Re)
 * Hermelyn Meinardi (talk) 17:36, 9 April 2023 (UTC)
 * Hermelyn Meinardi (talk) 17:36, 9 April 2023 (UTC)

 * Not very helpful I'm afraid, and nobody will be making any changes to the article based on this TL;DR screed. Which, if any, of the refs you have wedged in meet our sourcing requirements WP:MEDRS? - Roxy the dog 20:04, 9 April 2023 (UTC)

 * was warned that her next edit to Ozone therapy will take her to WP:AE. tgeorgescu (talk) 20:27, 9 April 2023 (UTC)
 * OK, THanks t. - Roxy the dog 20:55, 9 April 2023 (UTC)
 * Could you please be more specific? Did you read any of the references? You seem only to react directly without reading. I studied a year at the university of Verona in Italy to grasp it. And I have no intentions to send lies into the world. I will go and check which of the refs I have wedged in, meet the sourcing requirements WP: MEDRS. That will take some time.
 * Therapeutic Indications
 * The following table 1 shows the therapeutic indications for ozone therapy.
 * The grade of evidence according to the standard of Evidence Based Medicine (EBM) are
 * A= Shown statistically relevant evidence in Systematic Reviews (SR) of Randomised Controlled Trials (RCT).
 * B =Systemic Reviews of Case Control (Individual or Cohort) studies.
 * C = Expert opinion without explicit critical appraisal or based on physiology bench research. ( OCEBM)
 * TABLE 1 THERAPEUTIC INDICATIONS (Burns, Smith 2017, Linee Guida e Buone Pratiche in Ossigeno Ozono terapia art. 6-L. 8 marzo 2017 n.24, Zambello, Bonetti et al)
 * SPINE
 * Grade of evidence EBM
 * Bulging disc of the cervical, dorsal and lumbar spine
 * A
 * Herniated disc of the cervical, dorsal and lumbar spine
 * A
 * Osteoarthritis of the cervical, dorsal and lumbar spine
 * A
 * Pain after back surgery FBSS of the cervical, dorsal and lumbar spine
 * B
 * Spinal canal Stenosis of the cervical, dorsal and lumbar spine
 * B
 * NERVE ENTRAPMENT SYNDROMES
 * Nerve Entrapment Syndrome (Carpal Tunnel Syndrome)
 * B
 * Ulnar Nerve Entrapment Syndrome (Guyon’s Canal Syndrome)
 * B
 * Ulnar Nerve Entrapment Syndrome (Cubital Canal Syndrome)
 * B
 * Posterior Tibial Nerve Entrapment Syndrome
 * B
 * (Medial Tarsal Tunnel Syndrome)
 * B
 * Sural Nerve Entrapment Syndrome
 * B
 * Deep Peroneal Nerve Entrapment Syndrome (Anterior Tarsal Tunnel Syndrome)
 * B
 * Superficial Peroneal Nerve Entrapment Syndrome
 * B
 * External popliteal sciatic nerve or common peroneal nerve entrapment syndrome
 * B
 * Entrapment syndrome of the lateral cutaneous nerve of the thigh  (Bernhardt-Roth Syndrome)
 * B
 * Interdigital nerve entrapment syndrome (Civinini-Morton neuroma)
 * B
 * ARTHROSIS AND SYNOVITIS
 * Trapeziometacarpal Arthrosis (Rizarthrosis)
 * B
 * Knee, Hip, Shoulder or Elbow Arthrosis (GRADE A for the knee (Raeissadat), GRADE B)
 * A/B
 * Knee, Hip, Shoulder or Elbow Synovitis
 * B
 * Retropatellar chondropathy
 * A
 * VARIOUS GENERALIZED DEGENERATIVE DISEASES
 * Therapeutic Indications GRADE C
 * Peripheral Vasculopathies
 * C
 * Dry maculopathy
 * C
 * Ulcers due to Vasculopathies
 * C
 * Pressure sores Decubitus
 * C
 * Diabetic foot ulcers (Anupunpisit) GRADE A
 * A
 * Herpes Simplex
 * C
 * Herpes Zoster
 * C
 * M.Dupuytren
 * Vascular Headaches
 * C
 * Multiple Sclerosis
 * C
 * ALS Amyotrophic Lateral Sclerosis
 * Parkinsons Disease
 * C
 * Fibromyalgia
 * C
 * Acne
 * C
 * Rheumatoid Arthritis
 * C
 * Ulcerative recto colitis
 * C
 * Bronchial Asthma
 * C
 * Allergies
 * C
 * Liver diseases
 * C Hermelyn Meinardi (talk) 20:53, 9 April 2023 (UTC)
 * Ulcerative recto colitis
 * C
 * Bronchial Asthma
 * C
 * Allergies
 * C
 * Liver diseases
 * C Hermelyn Meinardi (talk) 20:53, 9 April 2023 (UTC)

 * WP:MEDRS sets forth two conditions:
 * systematic reviews, and
 * indexed for MEDLINE.
 * While technically some systematic reviews which aren't indexed for MEDLINE could be accepted (if published in very reputable journals), in light of WP:ECREE it is not such a good idea.
 * Do mind that higher quality sources are allowed, specifically rendering the EBM consensus in sources published e.g. by AMA or WHO. tgeorgescu (talk) 21:48, 9 April 2023 (UTC)

title: Talk:Ozone therapy


text:
Terminal High Altitude Area Defense

Terminal High Altitude Area Defense (THAAD), formerly Theater High Altitude Area Defense, is an American anti-ballistic missile defense system designed to shoot down short, medium, and intermediate-range ballistic missiles in their terminal phase (descent or reentry) by intercepting with a hit-to-kill approach. THAAD was developed after the experience of Iraq's Scud missile attacks during the Gulf War in 1991. The THAAD interceptor carries no warhead, instead relying on its kinetic energy of impact to destroy the incoming missile.

Originally a United States Army program, THAAD has come under the umbrella of the Missile Defense Agency. The Navy has a similar program, the sea-based Aegis Ballistic Missile Defense System, which also has a land component ("Aegis Ashore"). THAAD was originally scheduled for deployment in 2012, but initial deployment took place in May 2008. THAAD has been deployed in the United Arab Emirates, Israel, Romania, and South Korea.

On 17 January 2022, THAAD made its first operational interception, of an incoming hostile medium-range ballistic missile in the UAE.

Development

The THAAD missile defense concept was proposed in 1987, with a formal request for proposals submitted to industry in 1991. The THAAD program benefited from results of previous missile defense efforts like High Endoatmospheric Defense Interceptor (HEDI) and the Kinetic Kill Vehicle Integrated Technology Experiment (KITE). In September 1992, the US Army selected Lockheed (now Lockheed Martin) as prime contractor for THAAD development. Prior to development of a physical prototype, the Aero-Optical Effect (AOE) software code was developed to validate the intended operational profile of Lockheed's proposed design. The first THAAD flight test occurred in April 1995, with all flight tests in the demonstration-validation (DEM-VAL) program phase occurring at White Sands Missile Range. The first six intercept attempts missed the target (Flights 4–9). The first successful intercepts were conducted on 10 June 1999 and 2 August 1999, against Hera missiles.

The vulnerability and lethality analyses of THAAD have been conducted by the U.S. Army Research Laboratory (ARL). The vulnerability assessment for the THAAD featured an evaluation of the effects of major electromagnetic elements. This included EM interference, EM radiation operations, EM radiation hazards, EM pulse, electrostatic discharge, and lightning effects on components of the THAAD system.

The ARL assessments were designed to determine the THAAD system's growth potential given its tactical design as well as provide survivability analysis against threats such as conventional weapons, chemical weapons, and electronic warfare countermeasures. The data collected from the analyses were used to develop trajectory models for targets and missile as well as target trajectories using infrared scene generation of infrared countermeasures (IRCMs).

The THAAD system is being designed, built, and integrated by Lockheed Martin Missiles and Fire Control acting as prime contractor. Key subcontractors include Raytheon, Boeing, Aerojet Rocketdyne, Honeywell, BAE Systems, Oshkosh Defense, and MiltonCAT.

Engineering and manufacturing
In June 2000, Lockheed won the Engineering and Manufacturing Development (EMD) contract to turn the design into a mobile tactical army fire unit. Flight tests of this system resumed with missile characterization and full system tests in 2006 at White Sands Missile Range, then moved to the Pacific Missile Range Facility. The Interceptor was led through development and initial production by Tory Bruno, who later became CEO of United Launch Alliance.

THAAD-ER
Lockheed is pushing for funding for the development of an extended-range (ER) version of the THAAD to counter maturing threats posed by hypersonic glide vehicles that adversaries may deploy, namely the Chinese WU-14, to penetrate the gap between low- and high-altitude missile defenses. The company performed static fire trials of a modified THAAD booster in 2006 and continued to fund the project until 2008. The current 14.5 in-diameter single-stage booster design would be expanded to a 21 in first stage for greater range with a second "kick stage" to close the distance to the target and provide improved velocity at burnout and more lateral movement during an engagement. Although the kill vehicle would not need redesign, the ground-based launcher would have only five missiles instead of eight. As of 2020, THAAD-ER is only an industry concept, but Lockheed believes that the Missile Defense Agency will show interest because of the weapons under development by potential adversaries. If funding for the THAAD-ER begins in 2020, a system could be produced by 2024 to provide an interim capability against a rudimentary hypersonic threat. The Pentagon is researching whether other technologies like directed energy weapons and railguns are better solutions for missile defense; these are expected to become available in the mid to late 2020s.

Production

Sometimes called Kinetic Kill technology, the THAAD missile destroys missiles by colliding with them, using hit-to-kill technology, like the MIM-104 Patriot PAC-3 (although the PAC-3 also contains a small explosive warhead). This is unlike the Patriot PAC-2 which carried only an explosive warhead detonated using a proximity fuze. Although the actual figures are classified, THAAD missiles have an estimated range of 125 miles (200 km), and can reach an altitude of 93 miles (150 km). A THAAD battery consists of at least six launcher vehicles, each equipped with eight missiles, with two mobile tactical operations centers (TOCs) and the AN/TPY-2 ground-based radar (GBR); the U.S. Army plans to field at least six THAAD batteries, at a purchase cost of US$800 million per battery. By September 2018 MDA plans to deliver 52 more interceptors to the Army. In June 2020 the Senate Armed Services Committee draft of the FY2021 DoD budget allocated funding for the eighth THAAD battery.

The THAAD missile is manufactured at a Lockheed Martin facility near Troy, Alabama. The facility performs final integration, assembly and testing of the THAAD missile. The THAAD Radar is an X-Band active electronically scanned array Radar developed and built by Raytheon at its Andover, Massachusetts Integrated Air Defense Facility. The THAAD radar and a variant developed as a forward sensor for ICBM missile defense, the Forward-Based X-Band – Transportable (FBX-T) radar, were assigned a common designator, AN/TPY-2, in late 2006/early 2007. The THAAD radar can interoperate with Aegis and Patriot systems, in a 3-layer antimissile defense.

First units equipped (FUE)
On 28 May 2008, the U.S. Army activated Alpha Battery, 4th Air Defense Artillery Regiment (A-4), 11th Air Defense Artillery Brigade at Fort Bliss, Texas. Battery A-4 is part of the 32nd Army Air & Missile Defense Command. At the time, the battery had 24 THAAD interceptors, three THAAD launchers based on the M1120 HEMTT Load Handling System, a THAAD Fire Control and a THAAD radar. Full fielding began in 2009. On 16 October 2009, the U.S. Army and the Missile Defense Agency activated the second Terminal High Altitude Area Defense Battery, Alpha Battery, 2nd Air Defense Artillery Regiment (A-2), at Fort Bliss.

On 15 August 2012, Lockheed received a $150 million contract from the Missile Defense Agency (MDA) to produce THAAD Weapon System launchers and fire control and communications equipment for the U.S. Army. The contract included 12 launchers, two fire control and communications units, and support equipment. The contract provided six launchers for THAAD Battery 5 and an additional three launchers each to Batteries 1 and 2. These deliveries will bring all batteries to the standard six launcher configuration.

General missile defense plans
In May 2017, the Pentagon proposed spending $7.9 billion in its FY 2018 budget on missile defense which includes THAAD interceptors and Patriot interceptors, along with $1.5 billion for Ground-based Midcourse Defense (GMD) against intercontinental ballistic missiles.

Israel
In March 2019, Bravo Battery, 2nd Air Defense Artillery Regiment (B-2 THAAD), 11th Air Defense Artillery Brigade was deployed at Nevatim Airbase during a joint US-Israeli drill, after which it was to be moved to an undisclosed location in the Negev desert in southern Israel. The X-Band radar system, which is part of the THAAD system, has been deployed at Nevatim since 2008.

In 2012, the U.S. AN/TPY-2 early missile warning radar station on Mt. Keren in the Negev desert was the only active foreign military installation in Israel.

Romania
In 2019, while the Aegis Ashore at NSF Deveselu was being upgraded, B Battery, 62nd Air Defense Artillery Regiment (B-62 THAAD), was emplaced in NSF Deveselu, Romania during the interim.

South Korea

On 17 October 2013, the South Korean military asked the Pentagon to provide information on the THAAD system concerning prices and capabilities as part of efforts to strengthen defenses against North Korean ballistic missiles. However, South Korean Park Geun-hye administration decided it will develop its own indigenous long-range surface-to-air missile instead of buying the THAAD. South Korean Defense Ministry officials previously requested information on the THAAD, as well as other missile interceptors like the Israeli Arrow 3, with the intention of researching systems for domestic technology development rather than for purchase. Officials did however state that American deployment of the THAAD system would help in countering North Korean missile threats. In May 2014, the Pentagon revealed it was studying sites to base THAAD batteries in South Korea.

The deployment was opposed by China and Russia. In February 2016, Chinese Foreign Minister Wang Yi said that having THAAD in South Korea would "shatter the regional strategic balance" and that the system exceeded South Korea's need. In 2017 a Chinese military official said that the deployment had a negative influence on "bilateral military ties and mutual trust" with the United States. Western experts say that the range of THAAD's radar and interceptors should not pose a threat to China and the U.S. has had similar capabilities in Taiwan and Japan for years. Chinese officials believe that its location in South Korea would allow THAAD's radar to detect Chinese missile launches from behind during their boost phase and differentiate between decoys and warheads, sharing information with the rest of the U.S.-led network. This would erode China's nuclear deterrence, which has a much smaller stockpile compared to the United States and Russia. Missile tests in China usually pointed away from Korea, but that trajectory may also need to be reversed in order to minimize detection by THAAD. Chinese officials asked South Korea to downgrade the radar of the missile defence system, but no adjustments were made.

In July 2016, American and South Korean military officials announced the deployment of THAAD system in the country following ballistic missile and nuclear tests by North Korea. Each THAAD unit consists of six truck-mounted launchers, 48 interceptors, a fire control and communications unit, and an AN/TPY-2 radar. Seongju County in North Gyeongsang Province was chosen as a THAAD site, partly because it is out of range of North Korean rocket artillery along the DMZ. This sparked protests from Seongju County residents, who feared that radiation emitted by the AN/TPY-2 radar would impact their health, and damage the region's famed oriental melon crop. On 30 September 2016, the U.S. and South Korea announced that THAAD would be relocated to Lotte Skyhill Seongju Country Club, farther from the town's main residential areas and higher in elevation, to alleviate concerns.

On 6 March 2017, two THAAD launcher trucks arrived by air transport at Osan Air Base South Korea, for a deployment. Earlier that day, North Korea had launched 4 missiles. A Reuters article stated that with the THAAD defense system, a North Korean missile barrage would still pose a threat to South Korea, while an article in the International Journal of Space Politics & Policy said that South Korean forces already possess Patriot systems for point defense and Aegis destroyers capable of stopping ballistic missiles that may come from the north, in a three-layer antimissile defense for South Korea. On 16 March 2017, a THAAD radar arrived in South Korea. The THAAD system is kept at Osan Air Base until the site where the system is due to be deployed is prepared, with an expected ready date of June 2017. Osan Air Base has blast-hardened command posts with 3 levels of blast doors.

By 25 April 2017, six trailers carrying the THAAD radar, interceptor launchers, communications, and support equipment entered the Seongju site. On 30 April 2017, it was reported that South Korea would bear the cost of the land and facilities for THAAD, while the US will pay for operating it. On 2 May 2017, Moon Sang-gyun, with the South Korean Defense Ministry, and Col. Robert Manning III, a spokesman for the U.S. military, announced that the THAAD system in Seongju is operational and "has the ability to intercept North Korean missiles and defend South Korea." It was reported that the system will not reach its full operational potential until later this year when additional elements of the system are onsite. On 7 June 2017 President Moon Jae-in suspended further THAAD deployment pending a review, after discovering four addition launchers had entered South Korea without the defense ministry informing him. The 35th Air Defense Artillery Brigade (United States) has integrated THAAD into its layered defense on the Korean Peninsula, denoted Combined Task Force Defender, composed of both US and ROK personnel.

Even in the face of a North Korean ICBM test on 4 July 2017, which newly threatens Alaska, a Kodiak, Alaska-based THAAD interceptor test (FTT-18) against a simulated attack by an Intermediate Range Ballistic Missile had long been planned. FTT-18 was successfully completed by Battery A-2 THAAD (Battery A, 2nd Air Defense Artillery Regiment, Terminal High Altitude Area Defense) of the 11th Air Defense Artillery Brigade (United States) on 11 July 2017. The soldiers used the procedures of an actual combat scenario and were not aware of the IRBM's launch time.

Also in 2017 another Kodiak launch of a THAAD interceptor was scheduled between 7:30 PM and 1:30 AM on Saturday 29 July, Sunday 30 July, or Monday 31 July, at alternative times, in preparation for a possible ICBM test by North Korea. On 28 July 2017 North Korea launched a test ICBM capable of reaching Los Angeles. In response, President Moon Jae-in called for deployment of the four remaining THAAD launchers which were put on hold when he came to power. Lee Jong-kul, of South Korean President Moon Jae-in's Democratic Party of Korea states "The nuclear and missile capabilities of North Korea…have been upgraded to pose serious threats; the international cooperation system to keep the North in check has been nullified...", citing tensions over the U.S. deployment of the Terminal High Altitude Area Defense anti-missile system in South Korea. The Atlantic Council, in the June 2017 memorandum "Eliminating the Growing Threat Posed by North Korean Nuclear Weapons" to President Trump, recommends a checklist of actions, including the following declarations to North Korea.
 * No use of WMDs, or it will result in a unified Korea under Seoul after the North's assured destruction.
 * No export of nuclear equipment or fissile material; it will be intercepted, and the US will respond.
 * No missile or missile test aimed at ROK (South Korea), Japan, or the US; it can then be shot down or pre-empted.

On 30 July 2017, a Kodiak-sited THAAD interceptor shot down an MRBM which launched over the Pacific Ocean, the 15th successful test; the Missile Defense Agency (MDA) director emphasized the data collection from the intercept, which enhances the modelling and scenario simulation capabilities of the MDA. John Schilling estimates the current accuracy of the North's Hwasong-14 as poor at the mooted ranges which threaten US cities (which would require more testing  to prove its accuracy).

On 11 August 2017, The New York Times reviewed the anti-missile options that are available to counter a planned salvo of four Hwasong-12 missiles, were they to be launched in mid-August 2017 from the North, and aimed to land just outside the territorial waters of Guam, a distance of 2100 mi, flying at altitudes exceeding 60 mi, in a flight of 1065 seconds (18 minutes). These options for the missile defense of South Korea include "sea-based, Patriots and THAAD" according to General John E. Hyten, commander of U.S. Strategic Command.

On 2 September 2017, the North Korean news agency KCNA released a photograph of an elongated payload, intended to fit in the warhead of one of its missiles. On 3 September 2017 both Japan's Foreign Ministry and the South Korean Joint Chiefs announced the detection of a magnitude 6.3 seismic event, centered near Punggye-ri, which is North Korea's underground nuclear test site. Japan's Foreign Ministry has concluded that the event was the North's sixth nuclear test. Choe Sang-hun of the New York Times reports that the test was a major embarrassment for China's Paramount leader Xi Jinping, who was hosting a BRICS summit (Brazil, Russia, India, China, and South Africa) in Xiamen, China. Cheng Xiaohe, an expert on North Korea at China's Renmin University, said the timing of the test appears to be deliberate. China's Foreign Ministry urged the North to "stop taking wrong actions", and agreed that further UN actions are needed to resolve the impending crisis. By creating a thermonuclear-capable payload for at least one of its missiles, the North has created a need for THAAD, which is capable of intercepting ICBM threats at the lower altitudes and ranges estimated for a Hwasong-14 ICBM subjected to the load of a heavier warhead needed to carry a thermonuclear weapon.

On 4 September 2017, BBC analyst Jonathan Marcus predicted a flood of several million refugees at the border of North Korea and China, were the North to be destroyed. China has positioned only two brigades at the border. Marcus points out that China and Russia have proposed the de-nuclearization of Korea and the replacement of the armistice with a peace treaty.

On 25 October 2017, Battery D, 2nd Air Defense Artillery Regiment, Terminal High Altitude Area Defense, reflagged with the 35th Air Defense Artillery Brigade in preparation for a permanent change of station to South Korea. In the interim before THAAD D-2's permanent transfer to South Korea with their families, THAAD Battery A-4 will deploy to South Korea.

The South Korean decision to deploy THAAD to protect itself against North Korea caused backlash and retaliation measures from China.

On 30 October 2017, South Korea and China agreed to normalize relations, which had rifted due to THAAD deployment.

Turkey
According to U.S. officials the AN/TPY-2 radar was deployed at Turkey's Kürecik Air Force base. The radar was activated in January 2012.

United Arab Emirates
The United Arab Emirates (UAE) signed a deal to purchase the missile defense system on 25 December 2011. The United Arab Emirates (UAE) graduated its first two THAAD unit classes at Fort Bliss in 2015 and 2016. Its first live-fire exercises with Patriot missiles took place in 2014.

On 17 January 2022, THAAD made its first real-world intercept against an incoming Houthi ballistic missile in the UAE.

Hawaii
In June 2009, the United States deployed a THAAD unit to Hawaii, along with the SBX sea-based radar, to defend against a possible North Korean launch targeting the archipelago.

Guam
In April 2013, the United States declared that Alpha Battery, 4th Air Defense Artillery Regiment (A-4), would be deployed to Guam to defend against a possible North Korean IRBM attack targeting the island. In March 2014, Alpha Battery, 2nd ADA RGT (A-2), did a change of responsibility with A-4 and took over the Defense of Guam Mission. After a successful 12-month deployment by A-4, Delta 2 (D-2) took its place for a 12-month deployment. In 2018-2019 Echo Battery, 3rd ADA Regiment (E-3) deployed to Guam.

Wake Island

On 1 November 2015, a THAAD system was a key component of Campaign Fierce Sentry Flight Test Operational-02 Event 2 (FTO-02 E2), a complex $230 million missile defense system test event conducted at Wake Island and the surrounding ocean areas. The objective was to test the ability of the Aegis Ballistic Missile Defense and THAAD Weapon Systems to defeat a raid of three near-simultaneous air and missile targets, consisting of one medium-range ballistic missile, one short-range ballistic missile and one cruise missile target. During the test, a THAAD system on Wake Island detected and destroyed a short-range target simulating a short-range ballistic missile that was launched by parachute ejected from a C-17 transport plane. At the same time, the THAAD system and the USS John Paul Jones guided missile destroyer both launched missiles to intercept a medium-range ballistic missile, launched by parachute from a second C-17.

Europe and the Middle East
By March 2016, Army Space and Missile Defense Command was considering THAAD deployments to Europe with EUCOM and the Middle East with CENTCOM.

Japan
In November 2015, Japanese Defense Minister Gen Nakatani said he would consider the U.S. deploying the THAAD in Japan to counter the threat of North Korean ballistic missiles. By October 2016, Japan was considering procuring either THAAD or Aegis Ashore to add a new missile defense layer. In May 2017 it was reported that Japan government officials now favor the Aegis Ashore system as it comes with a wider coverage area, which would mean fewer units needed to protect Japan, and it is also cheaper.

At the Center for a New American Security 2017 conference, citing publicly available sources and simulations of strikes against US bases in Asia, two Navy Fellows, Commanders Shugart and Gonzalez, USN noted that two more Patriot batteries, two more Aegis ships, and five more THAAD batteries would counter China's published SRBM (short-range) and MRBM (medium-range) capabilities against Japan.

Russia has opposed the missile acquisitions and fears that the US will have access to the management of Aegis Ashore missile defense complexes after their deployment in Japan. "We do not know of any cases anywhere in the world when the United States deployed its weapons and transferred control over them to the country in whose territory it all happened. I very much doubt that they will make an exception and in this case," concluded the Russian Foreign Minister.

In 2020, Japan suspended plans to acquire the Aegis Ashore system; the Japanese government claimed that they were concerned about environmental issues caused by the system dropping spent boosters. Local citizens of the areas chosen to place the system also protested the acquisition, claiming that such placement would guarantee strikes on their homes during wartime. The Japanese government has since not made it clear whether or not they will re-evaluate purchasing THAAD systems.

Oman
On 27 May 2013, Oman announced a deal for the acquisition of the THAAD air defense system. However, a sale has not been announced.

Saudi Arabia
On 6 October 2017, the US reached a deal to provide Saudi Arabia with THAAD in a deal worth $15 billion. Seven fire units each with a Raytheon AN/TPY-2 radar, two mobile tactical stations (with two spares for a total of 16), and six launchers (with two spares for a total of 44), 360 interceptor missiles.

Taiwan
In 2017, a Hong Kong–based media report claimed that THAAD could be deployed in Taiwan to intercept People's Republic of China missiles. However, Taiwan's Foreign Minister, David Lee, has said he is unaware of any talks with the US about possible deployment. Local military experts have said that it was neither necessary, nor affordable for Taiwan to deploy THAAD because China is threatening Taiwan with short-range missiles, whereas THAAD is designed to shoot down medium and long-range missiles. The Minister of National Defense, Feng Shih-kuan, said in March 2017 that he was firmly opposed to the deployment of a THAAD system in Taiwan although comments made by Feng's deputy minister Cheng De-mei during a Foreign Affairs and National Defense Committee Q&A session that was held in April 2017 in which he said that Taiwan did not need a THAAD system in the short term because its US-made phased-array radar system at Hsinchu County’s Leshan base was on par with the THAAD system in terms of detection capability was described as "in slight contrast with Minister of National Defense Feng Shih-kuan’s last month." It was reported that Freddy Lim urged the ministry during the same Q&A session "to procure whatever is necessary to ensure the nation’s defense capabilities, which could not be compromised due to China’s pressure." Taiwan's existing early warning system, built by the manufacturer of the THAAD radar, can serve to counter China's missile launches.

Operators
🇸🇦 Saudi Arabia

🇺🇸

The US has 7 batteries of THAAD, which will expand to 8 batteries in the future.
 * United States Army
 * A Battery, 2nd Air Defense Artillery Regiment (A-2 ADA)
 * B Battery, 2nd Air Defense Artillery Regiment (B-2 ADA)
 * D Battery, 2nd Air Defense Artillery Regiment (D-2 ADA)
 * E Battery, 3rd Air Defense Artillery Regiment (E-3 ADA)
 * A Battery, 4th Air Defense Artillery Regiment (A-4 ADA)
 * B Battery, 62nd Air Defense Artillery Regiment (B-62 ADA)
 * E Battery, 62nd Air Defense Artillery Regiment (E-62 ADA)

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Terminal High Altitude Area Defense


text:
Constitutive equation

In physics and engineering, a constitutive equation or constitutive relation is a relation between two or more physical quantities (especially kinetic quantities as related to kinematic quantities) that is specific to a material or substance or field, and approximates its response to external stimuli, usually as applied fields or forces. They are combined with other equations governing physical laws to solve physical problems; for example in fluid mechanics the flow of a fluid in a pipe, in solid state physics the response of a crystal to an electric field, or in structural analysis, the connection between applied stresses or loads to strains or deformations.

Some constitutive equations are simply phenomenological; others are derived from first principles. A common approximate constitutive equation frequently is expressed as a simple proportionality using a parameter taken to be a property of the material, such as electrical conductivity or a spring constant. However, it is often necessary to account for the directional dependence of the material, and the scalar parameter is generalized to a tensor. Constitutive relations are also modified to account for the rate of response of materials and their non-linear behavior. See the article Linear response function.

Mechanical properties of matter
The first constitutive equation (constitutive law) was developed by Robert Hooke and is known as Hooke's law. It deals with the case of linear elastic materials. Following this discovery, this type of equation, often called a "stress-strain relation" in this example, but also called a "constitutive assumption" or an "equation of state" was commonly used. Walter Noll advanced the use of constitutive equations, clarifying their classification and the role of invariance requirements, constraints, and definitions of terms like "material", "isotropic", "aeolotropic", etc. The class of "constitutive relations" of the form stress rate = f (velocity gradient, stress, density) was the subject of Walter Noll's dissertation in 1954 under Clifford Truesdell.

In modern condensed matter physics, the constitutive equation plays a major role. See Linear constitutive equations and Nonlinear correlation functions.

Friction
Friction is a complicated phenomenon. Macroscopically, the friction force F between the interface of two materials can be modelled as proportional to the reaction force R at a point of contact between two interfaces through a dimensionless coefficient of friction μf, which depends on the pair of materials:

 * $$F = \mu_\text{f} R. $$

This can be applied to static friction (friction preventing two stationary objects from slipping on their own), kinetic friction (friction between two objects scraping/sliding past each other), or rolling (frictional force which prevents slipping but causes a torque to exert on a round object).

Stress and strain
The stress-strain constitutive relation for linear materials is commonly known as Hooke's law. In its simplest form, the law defines the spring constant (or elasticity constant) k in a scalar equation, stating the tensile/compressive force is proportional to the extended (or contracted) displacement x:

 * $$F_i=-k x_i $$

meaning the material responds linearly. Equivalently, in terms of the stress σ, Young's modulus E, and strain ε (dimensionless):

 * $$\sigma = E \, \varepsilon $$

In general, forces which deform solids can be normal to a surface of the material (normal forces), or tangential (shear forces), this can be described mathematically using the stress tensor:

 * $$\sigma_{ij} = C_{ijkl} \, \varepsilon_{kl} \, \rightleftharpoons \, \varepsilon_{ij} = S_{ijkl} \, \sigma_{kl} $$

where C is the elasticity tensor and S is the compliance tensor.

Solid-state deformations
Several classes of deformations in elastic materials are the following:
 * Plastic: The applied force induces non-recoverable deformations in the material when the stress (or elastic strain) reaches a critical magnitude, called the yield point.
 * Elastic: The material recovers its initial shape after deformation.
 * Viscoelastic: If the time-dependent resistive contributions are large, and cannot be neglected. Rubbers and plastics have this property, and certainly do not satisfy Hooke's law. In fact, elastic hysteresis occurs.
 * Anelastic: If the material is close to elastic, but the applied force induces additional time-dependent resistive forces (i.e. depend on rate of change of extension/compression, in addition to the extension/compression). Metals and ceramics have this characteristic, but it is usually negligible, although not so much when heating due to friction occurs (such as vibrations or shear stresses in machines).
 * Hyperelastic: The applied force induces displacements in the material following a strain energy density function.

Collisions
The relative speed of separation vseparation of an object A after a collision with another object B is related to the relative speed of approach vapproach by the coefficient of restitution, defined by Newton's experimental impact law:

 * $$ e = \frac{|\mathbf{v}|_\text{separation}}{| \mathbf{v}|_\text{approach}} $$

which depends on the materials A and B are made from, since the collision involves interactions at the surfaces of A and B. Usually 0 ≤ e ≤ 1, in which e = 1 for completely elastic collisions, and e = 0 for completely inelastic collisions. It is possible for e ≥ 1 to occur – for superelastic (or explosive) collisions.

Deformation of fluids
The drag equation gives the drag force D on an object of cross-section area A moving through a fluid of density ρ at velocity v (relative to the fluid)

 * $$D=\frac{1}{2}c_d \rho A v^2 $$

where the drag coefficient (dimensionless) cd depends on the geometry of the object and the drag forces at the interface between the fluid and object.

For a Newtonian fluid of viscosity μ, the shear stress τ is linearly related to the strain rate (transverse flow velocity gradient) ∂u/∂y (units s−1). In a uniform shear flow:

 * $$\tau = \mu \frac{\partial u}{\partial y},$$

with u(y) the variation of the flow velocity u in the cross-flow (transverse) direction y. In general, for a Newtonian fluid, the relationship between the elements τij of the shear stress tensor and the deformation of the fluid is given by

 * $$\tau_{ij} = 2 \mu \left( e_{ij} - \frac13 \Delta \delta_{ij} \right)$$ with  $$e_{ij}=\frac12 \left( \frac {\partial v_i}{\partial x_j} + \frac {\partial v_j}{\partial x_i} \right)$$  and  $$\Delta = \sum_k e_{kk} = \text{div}\; \mathbf{v},$$

where vi are the components of the flow velocity vector in the corresponding xi coordinate directions, eij are the components of the strain rate tensor, Δ is the volumetric strain rate (or dilatation rate) and δij is the Kronecker delta.

The ideal gas law is a constitutive relation in the sense the pressure p and volume V are related to the temperature T, via the number of moles n of gas:

 * $$pV = nRT$$

where R is the gas constant (J⋅K−1⋅mol−1).

Constitutive equations in electromagnetism and related areas
In both classical and quantum physics, the precise dynamics of a system form a set of coupled differential equations, which are almost always too complicated to be solved exactly, even at the level of statistical mechanics. In the context of electromagnetism, this remark applies to not only the dynamics of free charges and currents (which enter Maxwell's equations directly), but also the dynamics of bound charges and currents (which enter Maxwell's equations through the constitutive relations). As a result, various approximation schemes are typically used.

For example, in real materials, complex transport equations must be solved to determine the time and spatial response of charges, for example, the Boltzmann equation or the Fokker–Planck equation or the Navier–Stokes equations. For example, see magnetohydrodynamics, fluid dynamics, electrohydrodynamics, superconductivity, plasma modeling. An entire physical apparatus for dealing with these matters has developed. See for example, linear response theory, Green–Kubo relations and Green's function (many-body theory).

These complex theories provide detailed formulas for the constitutive relations describing the electrical response of various materials, such as permittivities, permeabilities, conductivities and so forth.

It is necessary to specify the relations between displacement field D and E, and the magnetic H-field H and B, before doing calculations in electromagnetism (i.e. applying Maxwell's macroscopic equations). These equations specify the response of bound charge and current to the applied fields and are called constitutive relations.

Determining the constitutive relationship between the auxiliary fields D and H and the E and B fields starts with the definition of the auxiliary fields themselves:
 * $$\begin{align}

\mathbf{D}(\mathbf{r}, t) &= \varepsilon_0 \mathbf{E}(\mathbf{r}, t) + \mathbf{P}(\mathbf{r}, t) \\ \mathbf{H}(\mathbf{r}, t) &= \frac{1}{\mu_0} \mathbf{B}(\mathbf{r}, t) - \mathbf{M}(\mathbf{r}, t), \end{align}$$

where P is the polarization field and M is the magnetization field which are defined in terms of microscopic bound charges and bound current respectively. Before getting to how to calculate M and P it is useful to examine the following special cases.

Without magnetic or dielectric materials
In the absence of magnetic or dielectric materials, the constitutive relations are simple:

 * $$\mathbf{D} = \varepsilon_0\mathbf{E} ,\quad \mathbf{H} = \mathbf{B}/\mu_0$$

where ε0 and μ0 are two universal constants, called the permittivity of free space and permeability of free space, respectively.

Isotropic linear materials
In an (isotropic ) linear material, where P is proportional to E, and M is proportional to B, the constitutive relations are also straightforward. In terms of the polarization P and the magnetization M they are:

 * $$\mathbf{P} = \varepsilon_0\chi_e\mathbf{E} ,\quad \mathbf{M} = \chi_m\mathbf{H},$$

where χe and χm are the electric and magnetic susceptibilities of a given material respectively. In terms of D and H the constitutive relations are:

 * $$\mathbf{D} = \varepsilon\mathbf{E} ,\quad \mathbf{H} = \mathbf{B}/\mu,$$

where ε and μ are constants (which depend on the material), called the permittivity and permeability, respectively, of the material. These are related to the susceptibilities by:

 * $$\varepsilon/\varepsilon_0 = \varepsilon_r = \chi_e + 1 ,\quad \mu / \mu_0 = \mu_r = \chi_m + 1$$

General case
For real-world materials, the constitutive relations are not linear, except approximately. Calculating the constitutive relations from first principles involves determining how P and M are created from a given E and B. These relations may be empirical (based directly upon measurements), or theoretical (based upon statistical mechanics, transport theory or other tools of condensed matter physics). The detail employed may be macroscopic or microscopic, depending upon the level necessary to the problem under scrutiny.

In general, the constitutive relations can usually still be written:
 * $$\mathbf{D} = \varepsilon\mathbf{E} ,\quad \mathbf{H} = \mu^{-1}\mathbf{B}$$

but ε and μ are not, in general, simple constants, but rather functions of E, B, position and time, and tensorial in nature. Examples are:

• Dispersion and absorption where ε and μ are functions of frequency. (Causality does not permit materials to be nondispersive; see, for example, Kramers–Kronig relations.) Neither do the fields need to be in phase, which leads to ε and μ being complex. This also leads to absorption.

• Nonlinearity where ε and μ are functions of E and B.

• Anisotropy (such as birefringence or dichroism) which occurs when ε and μ are second-rank tensors, $D_i = \sum_j \varepsilon_{ij} E_j ,\quad B_i = \sum_j \mu_{ij} H_j.$

• Dependence of P and M on E and B at other locations and times. This could be due to spatial inhomogeneity; for example in a domained structure, heterostructure or a liquid crystal, or most commonly in the situation where there are simply multiple materials occupying different regions of space. Or it could be due to a time varying medium or due to hysteresis. In such cases P and M can be calculated as: $\begin{align} \mathbf{P}(\mathbf{r}, t) &= \varepsilon_0 \int {\rm d}^3 \mathbf{r}'{\rm d}t'\; \hat{\chi}_e \left(\mathbf{r}, \mathbf{r}', t, t'; \mathbf{E}\right)\, \mathbf{E}\left(\mathbf{r}', t'\right) \\ \mathbf{M}(\mathbf{r}, t) &= \frac{1}{\mu_0} \int {\rm d}^3 \mathbf{r}'{\rm d}t' \; \hat{\chi}_m \left(\mathbf{r}, \mathbf{r}', t, t'; \mathbf{B}\right)\, \mathbf{B}\left(\mathbf{r}', t'\right), \end{align}$ in which the permittivity and permeability functions are replaced by integrals over the more general electric and magnetic susceptibilities. In homogeneous materials, dependence on other locations is known as spatial dispersion.

As a variation of these examples, in general materials are bianisotropic where D and B depend on both E and H, through the additional coupling constants ξ and ζ:
 * $$\mathbf{D}=\varepsilon \mathbf{E} + \xi \mathbf{H} \,,\quad \mathbf{B} = \mu \mathbf{H} + \zeta \mathbf{E}.$$

In practice, some materials properties have a negligible impact in particular circumstances, permitting neglect of small effects. For example: optical nonlinearities can be neglected for low field strengths; material dispersion is unimportant when frequency is limited to a narrow bandwidth; material absorption can be neglected for wavelengths for which a material is transparent; and metals with finite conductivity often are approximated at microwave or longer wavelengths as perfect metals with infinite conductivity (forming hard barriers with zero skin depth of field penetration).

Some man-made materials such as metamaterials and photonic crystals are designed to have customized permittivity and permeability.

Calculation of constitutive relations
The theoretical calculation of a material's constitutive equations is a common, important, and sometimes difficult task in theoretical condensed-matter physics and materials science. In general, the constitutive equations are theoretically determined by calculating how a molecule responds to the local fields through the Lorentz force. Other forces may need to be modeled as well such as lattice vibrations in crystals or bond forces. Including all of the forces leads to changes in the molecule which are used to calculate P and M as a function of the local fields.

The local fields differ from the applied fields due to the fields produced by the polarization and magnetization of nearby material; an effect which also needs to be modeled. Further, real materials are not continuous media; the local fields of real materials vary wildly on the atomic scale. The fields need to be averaged over a suitable volume to form a continuum approximation.

These continuum approximations often require some type of quantum mechanical analysis such as quantum field theory as applied to condensed matter physics. See, for example, density functional theory, Green–Kubo relations and Green's function.

A different set of homogenization methods (evolving from a tradition in treating materials such as conglomerates and laminates) are based upon approximation of an inhomogeneous material by a homogeneous effective medium (valid for excitations with wavelengths much larger than the scale of the inhomogeneity).

The theoretical modeling of the continuum-approximation properties of many real materials often rely upon experimental measurement as well. For example, ε of an insulator at low frequencies can be measured by making it into a parallel-plate capacitor, and ε at optical-light frequencies is often measured by ellipsometry.

Thermoelectric and electromagnetic properties of matter
These constitutive equations are often used in crystallography, a field of solid-state physics.

Refractive index
The (absolute) refractive index of a medium n (dimensionless) is an inherently important property of geometric and physical optics defined as the ratio of the luminal speed in vacuum c0 to that in the medium c:

 * $$ n = \frac{c_0}{c} = \sqrt{\frac{\varepsilon \mu}{\varepsilon_0 \mu_0}} = \sqrt{\varepsilon_r \mu_r} $$

where ε is the permittivity and εr the relative permittivity of the medium, likewise μ is the permeability and μr are the relative permeability of the medium. The vacuum permittivity is ε0 and vacuum permeability is μ0. In general, n (also εr) are complex numbers.

The relative refractive index is defined as the ratio of the two refractive indices. Absolute is for one material, relative applies to every possible pair of interfaces;

 * $$ n_{AB} = \frac{n_A}{n_B} $$

Speed of light in matter
As a consequence of the definition, the speed of light in matter is

 * $$c = \frac{1}{\sqrt{\varepsilon \mu}}$$

for special case of vacuum; ε = ε0 and μ = μ0,

 * $$c_0 = \frac{1}{\sqrt{\varepsilon_0\mu_0}}$$

Piezooptic effect
The piezooptic effect relates the stresses in solids σ to the dielectric impermeability a, which are coupled by a fourth-rank tensor called the piezooptic coefficient Π (units K−1):

 * $$a_{ij} = \Pi_{ijpq}\sigma_{pq} $$

Definitive laws
There are several laws which describe the transport of matter, or properties of it, in an almost identical way. In every case, in words they read:

 * Flux (density) is proportional to a gradient, the constant of proportionality is the characteristic of the material.

In general the constant must be replaced by a 2nd rank tensor, to account for directional dependences of the material.

title: Constitutive equation