In 2001, VA requested that IOM convene a committee to conduct an interim review of acute myelogenous leukemia (AML). Its review of the literature, including literature available since its review for Update 2000, is published in Veterans and Agent Orange: Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans (hereafter, Acute Myelogenous Leukemia; IOM, 2002).

In conducting their work, the committees responsible for those reports operated independently of VA and other government agencies. They were not asked to and did not make judgments regarding specific cases in which individual Vietnam veterans have claimed injury from herbicide exposure. The reports are intended to provide scientific information for the secretary of veterans affairs to consider as VA exercises its responsibilities to Vietnam veterans.

CHARGE TO THE COMMITTEE

In accordance with PL 102-4, the committee was asked “to determine (to the extent that available data permit meaningful determinations)” the following regarding associations between specific health outcomes and exposure to TCDD and other chemical compounds in herbicides:

A) whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association;

B) the increased risk of the disease among those exposed to herbicides during service in the Republic of Vietnam during the Vietnam era; and

C) whether there exists a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.

Details of how the committee approached its charge and the methods it used in reaching its conclusions are discussed in Chapter 2.

CONCLUSIONS OF PREVIOUS VETERANS AND AGENT ORANGE REPORTS

Health Outcome Conclusions

VAO, Update 1996, Update 1998, Update 2000, Type 2 Diabetes, and Acute Myelogenous Leukemia provide detailed reviews of the scientific studies evaluated by the committees and their implications for cancer, reproductive and developmental effects, neurobehavioral disorders, and other health effects.

The original committee addressed the statutory mandate to determine whether there is a statistical association between a given health effect and herbicide use by assigning each of the health outcomes under study to one of four categories on the



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