GULF WAR and HEALTH
VOLUME 2
Insecticides and Solvents
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
Support for this project was provided by the Department of Veterans Affairs. The views presented in this report are those of the Institute of Medicine Committee on Gulf War and Health: A Literature Review of Pesticides and Solvents and are not necessarily those of the funding agency.
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COMMITTEE ON GULF WAR AND HEALTH: LITERATURE REVIEW OF PESTICIDES AND SOLVENTS
JACK M.COLWILL (Chair), Professor Emeritus,
School of Medicine, University of Missouri-Columbia, Columbia, Missouri
SAMUEL J.POTOLICCHIO (Vice-Chair), Professor,
Department of Neurology, George Washington University Medical Center, Washington, DC
ANN ASCHENGRAU, Professor,
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
LORNE A.BECKER, Chairman,
Department of Family Medicine, State University of New York Upstate Medical University, Syracuse, New York
DEBORAH A.CORY-SLECHTA, Professor and Chair,
Department of Environmental Medicine, University of Rochester, Rochester, New York
WILLIAM E.DANIELL, Associate Professor,
Department of Environmental Health, School of Public Health and Community Medicine, University of Washington, Seattle, Washington
MARION F.EHRICH, Professor,
Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
MANNING FEINLEIB, Professor of Epidemiology,
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
ROBERT G.FELDMAN, Professor of Neurology,
Boston University School of Medicine, Boston, Massachusetts
MARK S.GOLDBERG, Associate Professor,
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
LYNN R.GOLDMAN, Professor,
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
ROSE H.GOLDMAN, Associate Professor of Medicine,
Harvard Medical School,
Associate Professor,
Department of Environmental Health, Harvard School of Public Health, Cambridge, Massachusetts
RONALD GOLDNER, Clinical Professor of Dermatology,
University of Maryland School of Medicine, Baltimore, Maryland
DAVID F.GOLDSMITH, Associate Research Professor,
George Washington University, Washington, DC
CYNTHIA HARRIS, Director and Associate Professor,
College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural and Mechanical University, Tallahassee, Florida
RUSS B.HAUSER, Assistant Professor,
Occupational Health Program, Harvard School of Public Health, Boston, Massachusetts
JANICE L.KIRSCH, Study Oncologist and Researcher,
Northern California Childhood Leukemia Project, University of California, Berkeley, California
ANTHONY L.KOMAROFF, Professor of Medicine,
Harvard Medical School, Cambridge, Massachusetts
MICHAEL L.LEFEVRE, Director of Clinical Services,
Department of Family and Community Medicine, School of Medicine, University of Missouri-Columbia, Columbia, Missouri
RICHARD MAYEUX, Gertrude H.Sergievsky Professor of Neurology,
Psychiatry and Public Health, Columbia University, New York, NY
STEPHEN A.MCCURDY, Associate Professor of Medicine,
University of California, Davis, California
SANDRA MOHR, Formerly with the National Jewish Medical and Research Center,
Division of Environmental and Occupational Health Sciences, Denver, Colorado
TOSHIO NARAHASHI, John Evans Professor of Pharmacology, Alfred Newton Richards Professor of Pharmacology,
Northwestern University, Chicago, Illinois
LEENA A.NYLANDER-FRENCH, Assistant Professor,
Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina
MICHAEL O’MALLEY, Staff Physician,
Employee Health Service, University of California, Davis, California
CHARLES POOLE, Associate Professor,
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
CARRIE A.REDLICH, Associate Professor,
Department of Medicine, Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut
JOSEPH V.RODRICKS, Principal,
Environ, Inc., Arlington, Virginia
KENNETH D.ROSENMAN, Professor,
Department of Medicine, Michigan State University, East Lansing, Michigan
MARY ANN SMITH, Assistant Professor,
School of Public Health, University of Texas-Houston Health Sciences Center, Houston, Texas
ANNE M.SWEENEY, Associate Professor,
School of Rural Public Health, Texas A&M University, Bryan, Texas
PATRICK R.M.THOMAS, Radiation Oncologist,
Bardmoor Cancer Center, Largo, Florida
WILLIAM M.VALENTINE, Associate Professor,
Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee
JOHN E.VENA, Professor,
Department of Social and Preventive Medicine,
Director,
Environmental and Society Institute, University of Buffalo, Buffalo, New York
LAURA STEWART WELCH, Director,
Occupational and Environmental Medicine, Washington Hospital Center, Washington, DC
CHRISTINA WOLFSON, Associate Professor,
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
TONGZHANG ZHENG, Associate Professor,
Division of Environmental Health Sciences, Yale University School of Public Health, New Haven, Connecticut
STAFF
CAROLYN E.FULCO, Senior Program Officer
CATHARYN T.LIVERMAN, Senior Program Officer
CARRIE I.SZLYK, Program Officer
MICHELLE CATLIN, Senior Program Officer
SANDRA AU, Research Associate (until May 2002)
SUSAN FOURT, Research Associate (until May 2002)
MICHAEL SCHNEIDER, Research Associate
JUDITH A.URBANCZYK, Research Associate
HOPE R.HARE, Research Assistant
A.WEZI MUNTHALI, Research Assistant
KAREN AUTREY, Senior Project Assistant (until February 2002)
JUDITH ESTEP, Senior Project Assistant (until December 2002)
ROSE MARIE MARTINEZ, Director,
Board on Health Promotion and Disease Prevention
CONSULTANTS
APPLIED EPIDEMIOLOGY, INC.,
Amherst, Massachusetts
MIRIAM DAVIS, Independent Medical Writer,
Silver Spring, Maryland
DIANE MUNDT,
Applied Epidemiology, Inc., Amherst, Massachusetts
MARY PAXTON, Independent Consultant,
Falls Church, Virginia
ELIZABETH TONKIN,
Vanderbilt University Medical Center
MARIE-FRANCE VALOIS,
McGill University, Montreal, Canada
LISA ZIMMERMAN,
Vanderbilt University Medical Center
EDITORS
NORMAN GROSSBLATT, NRC Senior Editor
KATE KELLY, Independent Editor
REVIEWERS
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following for their review of this report:
JAMES V.BRUCKNER, Professor, Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, GA
LUCIO G.COSTA, Professor of Environmental Health, Toxicology and Department of Environmental Health, University of Washington, Seattle, WA
BERNARD D.GOLDSTEIN, Dean, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
PHILIPPE GRANDJEAN, Adjunct Professor of Public Health, Department of Environmental Health, Boston University School of Public Health, Boston, MA
MATTHEW C.KEIFER, Director, Occupational and Environmental Medicine Program, Harborview Medical Center, University of Washington, Seattle, WA
ANDREW F.OLSHAN, Professor, Department of Epidemiology, University of North Carolina, Chapel Hill, Chapel Hill, NC
DAVID OZONOFF, Chair, Department of Environmental Health, Boston University School of Public Health, Boston, MA
THOMAS G.ROBINS, Professor, Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
PALMER W.TAYLOR, Sandra and Monroe Trout Chair and Professor, Department of Pharmacology, School of Medicine, University of California, San Diego, La Jolla, CA
DAVID J.TOLLERUD, Center for Environmental and Occupational Health, Hahnemann University, Philadelphia, PA
CURTIS TRAVIS, Quest Technologies, Knoxville, TN
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by DONALD R.MATTISON, Senior Adviser, National Institute of Child Health and Human Development and the Center for Research for Mothers and Children, who was appointed by the Institute of Medicine and HAROLD C.SOX, Annals of Internal Medicine, American College of Physicians-American Society of Internal Medicine, who was appointed by the Report Review Committee. They were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the author committee and the institution.
PREFACE
More than a decade has passed since the Gulf War. After the Iraqi invasion of Kuwait on August 2, 1990, about 700,000 US military personnel were deployed to the Persian Gulf. Air attacks against Iraqi forces began on January 2, 1991, and the ground war followed between February 24 and 28. Despite the short duration and the small number of immediate casualties, allied forces were exposed to the horrors of war and to many noxious substances. After the war, large numbers of veterans suffered from a variety of symptoms characterized in part by fatigue, headache, difficulties of cognition, and vague arthralgias. Studies of military personnel clearly demonstrate that the prevalence of those symptoms has been higher in those deployed to the Persian Gulf than in those not deployed.
Veterans, Congress, the Department of Defense (DOD), and the Department of Veterans Affairs (VA) all have been deeply concerned about the etiology of the symptoms that were so prevalent among Gulf War veterans. As a result of requests by Congress, the Institute of Medicine (IOM) has embarked on a series of studies to review the health effects of many of the biologic, chemical, and environmental agents to which veterans may have been exposed. Our committee was charged in the second study to review the literature on the long-term human health effects of insecticides and solvents thought to have been used in the Gulf War.
Because of the large volume of literature on those compounds, IOM appointed a 37-member committee, one of the largest committees in its history. Our committee is composed of epidemiologists, toxicologists, industrial hygienists, and physicians with expertise in a number of relevant fields, including occupational medicine, neurology, dermatology, oncology, family medicine, and internal medicine.
The task of this committee was to identify for review the literature that focused on the insecticides and solvents to which Gulf War veterans may have been exposed. DOD, VA, RAND researchers, and Gulf War veterans provided information about the agents used.
The committee addressed the full scope of health effects that are potentially associated with insecticides and solvents, not just the veterans’ symptoms. It focused on human studies of long-term effects that might follow exposure to those agents, inasmuch as veterans’ symptoms have continued long after the war. The primary literature reviewed was epidemiologic studies of various occupational groups; when available, studies of Gulf War veterans were included in the committee’s analysis. Experimental data and toxicologic studies provided information about the acute and long-term effects of insecticides and solvents on humans and animals and about plausible biologic mechanisms of adverse health outcomes.
The committee placed its conclusions in categories of strength of evidence. Similar categories were used in Volume 1 of Gulf War and Health and in numerous other IOM studies.
Given the varied expertise and judgment within the committee, members occasionally differed in their interpretation of findings. In some instances committee members, even after careful deliberation, could not reach consensus on the category of association for a particular conclusion. In those instances, the committee presents no conclusion but discusses both points of view in the chapter and notes where additional research might be needed to draw more definitive conclusions.
Although the committee found associations between exposure to insecticides or solvents and some diseases and symptoms in some occupational groups, it was faced with a paucity of data regarding exposure for veterans. Therefore, it could not extrapolate from findings in published studies to the likelihood that veterans’ illnesses are related to exposure to insecticides or solvents.
Despite the many challenges faced by the committee as it reviewed the epidemiologic literature, it arrived at numerous conclusions regarding associations. We hope that our review will be helpful not only for veterans but also for other groups interested in the long-term health outcomes of exposure to insecticides and solvents.
Jack M.Colwill, M.D., Chair
ACKNOWLEDGMENTS
The committee wishes to express its appreciation to the many people who contributed to this study by sharing their experience and providing their expertise. A number of Gulf War veterans presented information on the use of pesticides and solvents during the Gulf War. Speakers at the committee’s May 2001 meeting included Venus Hammack, Desert Storm Battle Registry; Patrick Eddington, National Gulf War Resource Center; Kirt Love, Desert Storm Battle Registry; Denise Nichols, National Vietnam and Gulf War Veterans Coalition; Ed Bryan, Persian Gulf Era Veterans, Massachusetts; and David Johnson, University of Oklahoma Health Sciences Center. In addition, the committee appreciates the information received from many other Gulf War veterans and their family members. The committee acknowledges the efforts of Department of Defense and Department of Veterans Affairs staff who provided background materials. The committee benefited greatly from the scientific expertise provided by reviewers and colleagues consulted in the course of the study including Neil Miller, Patricia Stewart, and David Zee. The committee values the contributions made by a number of individual consultants including—Miriam Davis, Diane Mundt, Mary Paxton, Elizabeth Tonkin, Marie-France Valois, and Lisa Zimmerman, and the assistance of Applied Epidemiology, Inc., of Amherst, Massachusetts. The committee also appreciates the support of the sponsor, the Department of Veterans Affairs.
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Epidemiologic Studies of Veterans’ Symptoms and General Health Status |
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B CONCLUSIONS AND RECOMMENDATIONS: GULF WAR AND HEALTH, VOLUME 1 |
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TABLES
TABLE 5.1 |
Selected Epidemiologic Studies—Pancreatic Cancer and Exposure to Insecticides |
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TABLE 5.2 |
Selected Epidemiologic Studies—Hepatobiliary Cancers and Exposure to Insecticides |
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TABLE 5.3 |
Selected Epidemiologic Studies—Lung Cancer and Exposure to Insecticides |
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TABLE 5.4 |
Selected Epidemiologic Studies—Soft Tissue Sarcomas and Exposure to Insecticides |
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TABLE 5.5 |
Selected Epidemiologic Studies—Skin Cancers and Exposure to Insecticides |
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TABLE 5.6 |
Selected Epidemiologic Studies—Breast Cancer and Exposure to Insecticides |
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TABLE 5.7 |
Selected Epidemiologic Studies—Urologic Cancers and Exposure to Insecticides |
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TABLE 5.8 |
Selected Epidemiologic Studies—Brain and Other CNS Tumors and Exposure to Insecticides |
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TABLE 5.9 |
Selected Epidemiologic Studies—Non-Hodgkin’s Lymphoma and Exposure to Insecticides |
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TABLE 5.10 |
Selected Epidemiologic Studies—Hodgkin’s Disease and Exposure to Insecticides |
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TABLE 5.11 |
Selected Epidemiologic Studies—Multiple Myeloma and Exposure to Insecticides |
TABLE 5.12 |
Selected Epidemiologic Studies—Adult Leukemia and Exposure to Insecticides |
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TABLE 5.13 |
Selected Epidemiologic Studies—Childhood Leukemia and Exposure to Insecticides |
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TABLE 5.14 |
Selected Epidemiologic Studies—Other Childhood Cancers and Exposure to Insecticides |
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TABLE 6.1 |
Description of Cohort Studies Related to Exposure to Organic Solvents |
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TABLE 6.2 |
Description of Case-Control Studies of Oral, Nasal, and Laryngeal Cancer and Exposure to Organic Solvents |
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TABLE 6.3 |
Selected Epidemiologic Studies—Oral Cancer and Exposure to Organic Solvents |
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TABLE 6.4 |
Selected Epidemiologic Studies—Nasal Cancer and Exposure to Organic Solvents |
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TABLE 6.5 |
Selected Epidemiologic Studies—Laryngeal Cancer and Exposure to Organic Solvents |
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TABLE 6.6 |
Description of Case-Control Studies of Gastrointestinal Tract Tumors and Exposure to Organic Solvents |
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TABLE 6.7 |
Selected Epidemiologic Studies—Esophageal Cancer and Exposure to Organic Solvents |
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TABLE 6.8 |
Selected Epidemiologic Studies—Stomach Cancer and Exposure to Organic Solvents |
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TABLE 6.9 |
Selected Epidemiologic Studies—Colon Cancer and Exposure to Organic Solvents |
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TABLE 6.10 |
Selected Epidemiologic Studies—Rectal Cancer and Exposure to Organic Solvents |
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TABLE 6.11 |
Selected Epidemiologic Studies—Pancreatic Cancer and Exposure to Organic Solvents |
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TABLE 6.12 |
Description of Case-Control Studies of Liver Cancer and Exposure to Organic Solvents |
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TABLE 6.13 |
Selected Epidemiologic Studies—Hepatobiliary Cancers and Exposure to Organic Solvents |
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TABLE 6.14 |
Description of Case-Control Studies of Lung Cancer and Exposure to Organic Solvents |
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TABLE 6.15 |
Selected Epidemiologic Studies—Lung Cancer and Exposure to Organic Solvents |
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TABLE 6.16 |
Selected Epidemiologic Studies—Bone Cancer and Exposure to Organic Solvents |
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TABLE 6.17 |
Description of Case-Control Studies of Melanoma Skin Cancers and Exposure to Organic Solvents |
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TABLE 6.18 |
Selected Epidemiologic Studies—Melanoma Skin Cancers and Exposure to Organic Solvents |
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TABLE 6.19 |
Selected Epidemiologic Studies—Nonmelanoma Skin Cancers and Exposure to Organic Solvents |
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TABLE 6.20 |
Description of Case-Control Studies of Breast Cancer and Exposure to Organic Solvents |
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TABLE 6.21 |
Selected Epidemiologic Studies—Breast Cancer and Exposure to Organic Solvents |
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TABLE 6.22 |
Selected Epidemiologic Studies—Cervical Cancer and Exposure to Organic Solvents |
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TABLE 6.23 |
Selected Epidemiologic Studies—Ovarian Cancer and Exposure to Organic Solvents |
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TABLE 6.24 |
Selected Epidemiologic Studies—Uterine and Endometrial Cancer and Exposure to Organic Solvents |
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TABLE 6.25 |
Description of Case-Control Study of Prostate Cancer and Exposure to Organic Solvents |
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TABLE 6.26 |
Selected Epidemiologic Studies—Prostate Cancer and Exposure to Organic Solvents |
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TABLE 6.27 |
Description of Case-Control Studies of Bladder Cancer and Exposure to Organic Solvents |
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TABLE 6.28 |
Selected Epidemiologic Studies—Bladder Cancer and Exposure to Organic Solvents |
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TABLE 6.29 |
Description of Case-Control Studies of Kidney Cancer and Exposure to Organic Solvents |
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TABLE 6.30 |
Selected Epidemiologic Studies—Kidney Cancer and Exposure to Organic Solvents |
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TABLE 6.31 |
Description of Case-Control Studies of Brain and Central Nervous System Cancers and Exposure to Organic Solvents |
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TABLE 6.32 |
Selected Epidemiologic Studies—Brain and Central Nervous System Tumors and Exposure to Organic Solvents |
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TABLE 6.33 |
Description of Case-Control Studies of Non-Hodgkin’s Lymphoma and Exposure to Organic Solvents |
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TABLE 6.34 |
Selected Epidemiologic Studies—Non-Hodgkin’s Lymphoma and Exposure to Organic Solvents |
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TABLE 6.35 |
Description of Case-Control Studies of Hodgkin’s Disease and Exposure to Organic Solvents |
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TABLE 6.36 |
Selected Epidemiologic Studies—Hodgkin’s Disease and Exposure to Organic Solvents |
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TABLE 6.37 |
Description of Case-Control Studies of Multiple Myeloma and Exposure to Organic Solvents |
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TABLE 6.38 |
Selected Epidemiologic Studies—Multiple Myeloma and Exposures to Organic Solvents |
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TABLE 6.39 |
Description of Case-Control Studies of Leukemia and Exposure to Organic Solvents |
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TABLE 6.40 |
Selected Epidemiologic Studies—Adult Leukemia and Exposure to Organic Solvents |
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TABLE 6.41 |
Selected Epidemiologic Studies—Acute Leukemia and Exposure to Organic Solvents |
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TABLE 6.42 |
Selected Epidemiologic Studies—Chronic Leukemia and Exposure to Organic Solvents |
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TABLE 6.43 |
Selected Epidemiologic Studies—Lymphatic Leukemia and Exposure to Organic Solvents |
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TABLE 6.44 |
Selected Epidemiologic Studies—Hairy Cell Leukemia and Exposure to Organic Solvents |
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TABLE 6.45 |
Description of Case-Control Studies of Myelodysplastic Syndromes and Exposure to Organic Solvents |
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TABLE 6.46 |
Selected Epidemiologic Studies—Myelodysplastic Syndromes and Exposure to Organic Solvents |
TABLE 6.47 |
Description of Case-Control Studies of Childhood Cancer and Exposure to Organic Solvents |
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TABLE 6.48 |
Selected Epidemiologic Studies—Childhood Leukemia and Exposure to Organic Solvents |
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TABLE 6.49 |
Selected Epidemiologic Studies—Childhood Neuroblastoma and Exposure to Organic Solvents |
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TABLE 6.50 |
Selected Epidemiologic Studies—Childhood Brain Cancers and Exposure to Organic Solvents |
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TABLE 7.1 |
Gulf War Studies and Peripheral Neuropathy |
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TABLE 7.2 |
Peripheral Neuropathy and Organophosphorous Insecticide Exposures |
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TABLE 7.3 |
Peripheral Neuropathy and Solvent Exposure |
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TABLE 7.4 |
Gulf War Studies and Neurobehavioral Effects |
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TABLE 7.5 |
Neurobehavioral Effects with History of Past OP Poisoning |
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TABLE 7.6 |
Neurobehavioral Effects Without Past History of OP Poisoning |
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TABLE 7.7 |
Neurobehavioral Effects and Solvent Exposure |
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TABLE 7.8 |
Case-Control Studies of Parkinson’s Disease and Insecticide Exposure |
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TABLE 7.9 |
Parkinson’s Disease and Solvent Exposure |
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TABLE 7.10 |
Amyotrophic Lateral Sclerosis (Motor Neuron Disease) and Solvents |
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TABLE 7.11 |
Multiple Sclerosis and Solvent Exposure |
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TABLE 7.12 |
Alzheimer’s Disease and Solvent Exposure |
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TABLE 8.1 |
Selected Epidemiologic Studies: Sperm and Semen Parameters and Exposure to Carbaryl |
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TABLE 8.2 |
Selected Epidemiologic Studies: Time-to-Pregnancy and Exposure to Insecticides |
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TABLE 8.3 |
Selected Epidemiologic Studies: Time-to-Pregnancy and Exposure to Organic Solvents |
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TABLE 8.4 |
Selected Epidemiologic Studies: Spontaneous Abortion and Paternal Exposure to Organic Solvents |
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TABLE 8.5 |
Selected Epidemiologic Studies: Congenital Malformations and Exposure to Insecticides |
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TABLE 8.6 |
Selected Epidemiologic Studies: Congenital Malformations and Exposure to Organic Solvents |
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TABLE 9.1 |
Selected Epidemiologic Studies: Aplastic Anemia and Exposure to Insecticides |
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TABLE 9.2 |
Selected Epidemiologic Studies: Aplastic Anemia and Exposure to Organic Solvents |
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TABLE 9.3 |
Selected Epidemiologic Studies: Hepatic Steatosis and Exposure to Organic Solvents |
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TABLE 9.4 |
Selected Epidemiologic Studies: Renal Disease and Exposure to Organic Solvents |
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TABLE 9.5 |
Selected Epidemiologic Studies: Systemic Rheumatic Diseases and Exposure to Organic Solvents |
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TABLE A.1 |
Demographic Characteristics of US Gulf War Troops |
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TABLE A.2 |
Most Frequent Symptoms and Diagnoses 53,835 Participants in VA Registry (1992–1997) |
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TABLE A.3 |
Major Studies of Gulf War Veterans’ Symptoms and Syndromes |
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TABLE A.4 |
Results of the Iowa Study |
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TABLE A.5 |
Results of the VA Study |
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TABLE A.6 |
VA Study Percent Distribution of Self-Reported Exposures (n=11,441) |
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TABLE C.1 |
Bibliographic Databases |
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TABLE C.2 |
Factual Databases |
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TABLE E.1 |
Relative Risks for Lung Cancer |
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TABLE F.1 |
Neurobehavioral Tests |
FIGURES
FIGURE 3.1 |
Structures of organophosphorous insecticides used in Gulf War |
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FIGURE 3.2 |
Structure of carbaryl |
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FIGURE 3.3 |
Structures of a) pyrethrin I, b) permethrin, and c) d-phenothrin |
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FIGURE 3.4 |
Structure of lindane |
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FIGURE 3.5 |
Structure of DEET |
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FIGURE 4.1 |
Structure of a) benzene, b) toluene, and c) xylenes |
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FIGURE.4.2 |
Metabolic pathways of chloroform biotransformation |
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FIGURE 4.3 |
Structure of various alcohols |
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FIGURE 4.4 |
Structure of various glycols |
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FIGURE 4.5 |
Structure of glycol ethers and their metabolites |
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FIGURE 4.6 |
Structure of various esters |
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FIGURE 4.7 |
Basic structure of ketones |