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Veterans and Agent Orange: Update 2004 (2005)
Board on Health Promotion and Disease Prevention (HPDP)

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Veterans and Agent Orange: Update 2004

APPENDIX A
Epidemiologic Tables for Chapter 4

In Tables A-1, A-2, and A-3, respectively, studies are grouped according to whether their subjects had occupational exposures, had environmental exposures, or were specifically veterans. The tables provide an overview of design aspects of those epidemiologic studies reviewed in this and earlier reports that presented results on more than one health outcome or that investigated populations that have been repeatedly studied. The summaries include the study’s design type, the numbers of subjects in the study and comparison populations, and a synopsis of how subjects were selected, how data were collected, what inclusion criteria were used, and how exposure was determined. Results were discussed in the appropriate health outcome chapter of the Veterans and Agent Orange document in which the publication was reviewed. The references for this section are at the end of Chapter 4.

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Veterans and Agent Orange: Update 2004 APPENDIX A Epidemiologic Tables for Chapter 4 In Tables A-1, A-2, and A-3, respectively, studies are grouped according to whether their subjects had occupational exposures, had environmental exposures, or were specifically veterans. The tables provide an overview of design aspects of those epidemiologic studies reviewed in this and earlier reports that presented results on more than one health outcome or that investigated populations that have been repeatedly studied. The summaries include the study’s design type, the numbers of subjects in the study and comparison populations, and a synopsis of how subjects were selected, how data were collected, what inclusion criteria were used, and how exposure was determined. Results were discussed in the appropriate health outcome chapter of the Veterans and Agent Orange document in which the publication was reviewed. The references for this section are at the end of Chapter 4.

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Veterans and Agent Orange: Update 2004 TABLE A-1 Epidemiologic Studies—Occupational Exposure Reference Study Design Description Study Group (N) Comparison Group (N)a PRODUCTION WORKERS NIOSH Studies Reviewed in Update 2002 Steenland et al., 2001 Cohort A study to reexamine and compare diabetes data from the NIOSH cohort and the United States Air Force Ranch Hands in order to reconcile differences between the two study methods and protocols 267 NIOSH workers 990 Ranch Hand subjects 227 NIOSH comparisons 1,275 Ranch Hand comparisons NIOSH Studies Reviewed in Update 2000 Calvert et al., 1999 Cohort Continuing follow-up of workers employed more than 15 years ago at two plants that manufactured substances contaminated with TCDD to evaluate associations between serum TCDD and serum glucose (diabetes), TSH, total T4, and T3 281 260 Steenland et al., 1999 Cohort Mortality study of workers at 12 industrial plants that produced chemicals contaminated with TCDD, using a job-exposure matrix to estimate TCDD exposure categories. Endpoints reported are all cancers, ischemic heart disease, and diabetes 5,132 (3,538 with exposure data divided into septiles of cumulative exposure; 608 with chloracne) —

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Veterans and Agent Orange: Update 2004 Calvert et al., 1998 Cohort Continuing follow-up of workers employed more than 15 years ago at two plants that manufactured substances contaminated with TCDD to evaluate the association between TCDD exposure and cardiovascular outcomes 281 260 Halperin et al., 1998 Cohort Continuing study of a cohort of TCDD-exposed workers at two plants that manufactured substances contaminated with TCDD to assess the association between serum TCDD and immunological outcome variables for eligible workers and matched neighborhood controls 259 243 NIOSH Studies Reviewed in Update 1998 Sweeney et al., 1996, 1997/1998 Cross-sectional Study of numerous noncancer end points for liver function, gastrointestinal disorders, chloracne, serum glucose, hormone and lipid levels, and diabetes in same group as Calvert et al. (1991) 281 260 Halperin et al., 1995 Cross-sectional Study of surrogates for cytochrome P450 induction in same group as Calvert et al. (1991) 281 260

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a NIOSH Studies Reviewed in Update 1996 Calvert et al., 1994 Cross-sectional Study of porphyria cutanea tarda in same group as Calvert et al. (1991) 281 260 Egeland et al., 1994 Cohort Study of total serum testosterone and gondadotropin levels in chemical production workers exposed to dioxin, in same group as Calvert et al. (1991) 248 231 NIOSH Studies Reviewed in VAO Sweeney et al., 1993 Cohort Peripheral neuropathy in same group as Calvert et al. (1991) 281 260 Alderfer et al., 1992 Cohort Assessment of psychological variables to determine depression in same group as Calvert et al. (1991) 281 260 Calvert et al., 1992 Cohort Assessment of liver and gastrointestinal systems in same group as Calvert et al. (1991) 281 260 Calvert et al., 1991 Cohort Study of workers employed at one of two plants manufacturing substances contaminated with TCDD at least 15 years prior to assessment of chronic bronchitis, COPD, ventilatory function, thorax, and lung abnormalities, compared to matched neighborhood controls 281 260

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Veterans and Agent Orange: Update 2004 Fingerhut et al., 1991 Cohort Cancer mortality in male workers from 12 plants producing TCDD contaminated chemicals (1942–1984), compared to US population 5,172 — Monsanto Studies Reviewed in VAO Collins et al., 1993 Cohort Mortality of workers (through 1987) exposed and not exposed to dioxin between March 8, 1949, and November 22, 1949, as indicated by presence of chloracne, compared to local population mortality rates 122 with chloracne; 632 without chloracne — Moses et al., 1984 Cohort Study of health outcomes in Monsanto workers (1948–1969) with chloracne reported as a surrogate to 2,4,5-T exposure compared to health outcomes in workers without chloracne as surrogate for no exposure 117 109 Suskind and Hertzberg, 1984 Cohort Evaluation of health outcomes (1979) at clinical examination among workers exposed to 2,4,5-T (1948–1969) compared to nonexposed workers at same Monsanto plant 204 163

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Zack and Gaffey, 1983 Cohort Study of mortality experience of all white male workers (1955–1977) employed at a Monsanto plant through Dec. 31, 1977, compared to mortality rates of standardized US population 884 — Zack and Suskind, 1980 Cohort Evaluation of mortality experience among employees with chloracne exposed to TCP process accident in 1949 at Monsanto, compared to US male population standard 121 — New Dow Studies Bodner et al., 2003 Cohort Additional 10-year follow-up of cohort studied by Cook et al. (1986), through 1995; Dow cohort findings compared with IARC International Study and NIOSH Dioxin Registry. 2,187 — Dow Studies Reviewed in Update 2002 Burns et al., 2001 Cohort Study comparing mortality in a cohort of chemical workers who manufactured or formulated 2,4-D between 1945 and 1994 1,567 40,600 non-exposed chemical workers; US population Dow Studies Reviewed in Update 1998 Ramlow et al., 1996 Cohort Study of mortality in a cohort of workers exposed to pentachlorophenol (PCP) 770 36,804 non-exposed

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Veterans and Agent Orange: Update 2004 Dow Studies Reviewed in Update 1996 Bloemen et al., 1993 Cohort Additional years of follow-up of Bond et al. (1988) study cohort through 1986 878 36,804 non-exposed workers; US population Dow Studies Reviewed in VAO Bond et al., 1989a Cohort Study of incidence of chloracne among a cohort of workers potentially exposed to TCDD, and association with other risk factors 2,072 Internal comparison Bond et al., 1989b Cohort Extension of Ott et al. (1987) study through 1984 2,187 — Bond et al., 1988 Cohort Study of mortality (through 1982) among workers potentially exposed to 2,4-D (1945–1983) compared to US white males and all other male employees not exposed 878 36,804 employees not exposed; US white male population Bond et al., 1987 Cohort Extension of Cook et al. (1980) study, mortality through 1982 322 2,026 employees without chloracne; US white male population Cook et al., 1987; Ott et al., 1987 Cohort Expanded Cook et al. (1986) study an additional three years, through 1982 2,187 —

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Sobel et al., 1987 Case-control Study of STS among Dow chemical employees (1940–1979) compared to employees without STS for possible association with several chemical exposures 14 126 Cook et al., 1986 Cohort Mortality experience (1940–1979) of men manufacturing chlorinated phenols compared to US white men 2,189 — Bond et al., 1983 Cross-sectional Study of differences in workers potentially exposed and not exposed to TCDD during chemical production for (1) morbidity and (2) medical examination frequency between 1976 and 1978 (1) 183 (2) 114 (1) 732 (2) 456 Townsend et al., 1982 Cohort Study of adverse reproductive outcomes among wives of Dow chemical employees potentially exposed to TCDD (1939–1975) compared to reproductive outcomes among wives whose husbands were not exposed 370 345

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Veterans and Agent Orange: Update 2004 Cook et al., 1980 Cohort Mortality experience (through 1978) of male workers involved in a chloracne incident (1964) from TCDD exposure, compared to mortality experience of US white men 61 — Ott et al., 1980 Cohort Mortality experience among workers exposed to 2,4,5-T in manufacturing (1950–1971) compared to mortality experience of US white men 204 — BASF Studies Reviewed in Update 2000 Zober et al., 1997 Cohort (1953 accident) Cross-sectional (1988 cohort) Review and summary of previous BASF studies of morbidity and mortality in workers exposed to TCDD after BASF accidents in 1953 and 1988 154 surviving (as of 1989) members of 1953 accident cohort 42 exposed (1988) extruder personnel No comparison group BASF Studies Reviewed in Update 1998 Ott and Zober, 1996 Cohort Cancer incidence and mortality experience (through 1992) of workers exposed to TCDD after the BASF accident, during reactor cleanup, maintenance, or demolition (based on the cohort of Zober et al., 1990) 243 — BASF Studies Reviewed in Update 1996 Zober et al., 1994 Cohort Morbidity experience in the same group as Zober et al. (1990) 158 161

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a BASF Studies Reviewed in VAO Zober et al., 1990 Cohort Mortality experience of workers exposed to TCDD (1954–1987) at BASF plant compared to population of Federal Republic of Germany (FRG) 247 — Thiess et al., 1982 Cohort Study of mortality experience among BASF employees potentially exposed to TCDD during Nov. 17, 1953, accident compared to population and other workers not exposed 74 180,000 (town); 1.8 million (district); 60.5 million (FRG); two groups of 74 each from other cohort studies IARC Studies Reviewed in Update 2000 Neuberger et al., 1999 Austrian chloracne cohort Morbidity up to 1993 of exposed chemical workers assessed by health insurance data and health examination, laboratory measures, and interviews with participating survivors and controls 159, including 50 who participated in examination Two control groups comparable to the 50 participants—numbers not given Hooiveld et al., 1998 Cohort Mortality (through 1991), using SMRs, of workers at one Dutch factory assessed in relation to work and exposure history; SMR and relative risk analyses 562 (serum samples for 50); 140 males at accident 567

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Veterans and Agent Orange: Update 2004 Jäger et al., 1998 Cohort Preliminary data from Neuberger et al. (1999; English abstract only) 159 in original cohort; 56 screened; 49 full data Matched nonexposed controls Neuberger et al., 1998 Cohort of exposed cases Preliminary data from Neuberger et al. (1999) 50 Age- and sex-matched controls; number not given Vena et al., 1998 Cohort International study (36 cohorts from 12 countries) of workers producing or spraying phenoxy acid herbicides and chlorophenols, categorized into one of three TCDD or higher chlorinated dioxin categories. Noncancer mortality (1939–1992) was analyzed by standardized mortality rate comparisons and by Poisson multiple regression 21,863 No comparison group Flesch-Janys, 1997 Cohort Mortality (1952–1984) study of German workers exposed to TCDD and other contaminants in the production of herbicides and insecticides. SMRs and Cox regression models were calculated 1,189 —

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Department of Veterans Affairs (VA) Studies Reviewed in Update 2002 Kang et al., 2001 Cohort Study evaluating the health of Army Chemical Corps Vietnam veterans compared to Army Chemical Corps veterans who did not serve in Vietnam 2,872 2,737 Kang et al., 2000a Cohort Self-report pregnancy outcomes for female Vietnam veterans compared to contemporary female veterans not deployed to Vietnam. Odds ratios were calculated for reproductive history and various birth defects 3,392 women; 1,665 women with an indexed pregnancy 3,038 women; 1,912 women with an indexed pregnancy Kang et al., 2000b Cohort Study of gynecologic cancers among female Vietnam veterans compared to femae veteran controls 484 5,946 Department of Veterans Affairs (VA) Studies Reviewed in Update 1998 Dalager and Kang, 1997 Cohort Morbidity and mortality experience (1968–1987) of Army Chemical Corps Vietnam veterans compared to US men; extension of Thomas and Kang (1990) 2,872 2,737 Mahan et al., 1997 Case-control Study of lung cancer among Vietnam veterans (1983–1990) 329 269 men hospitalized without cancer; 111 patients with colon cancer

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Veterans and Agent Orange: Update 2004 McKinney et al., 1997 Cross-sectional Study of the smoking behavior of veterans and nonveterans using the 1987 National Medical Expenditure Survey (NMES) 15,000 — Bullman and Kang, 1996 Cohort Mortality study of veterans with nonlethal (combat and noncombat) wounds sustained during the Vietnam war 34,534 — Watanabe and Kang, 1996 Cohort Mortality experience (1965–1988) of Army and Marine Corps Vietnam veterans; extension of Breslin et al. (1988) and Watanabe et al. (1991) 33,833 36,797 Dalager et al., 1995b Case-control Cases of HD-diagnosed 1969–1985 among Vietnam era veterans 283 404 Watanabe and Kang, 1995 Cohort Postservice mortality among Marine Vietnam veterans 10,716 9,346 VA Studies Reviewed in Update 1996 Dalager et al., 1995a Cohort Update of Thomas et al. (1991) through December 31, 1995 4,586 5,325 Bullman et al., 1994 Case-control Study of the association between testicular cancer and surrogate measures of exposure to Agent Orange in male Vietnam veterans 97 311 VA Studies Reviewed in VAO Bullman et al., 1991 Case-control PTSD cases in Vietnam veterans compared to Vietnam veterans without PTSD for association with traumatic combat experience 374 373

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Dalager et al., 1991 Case-control Cases of NHL diagnosed 1969–1985 among Vietnam-era veterans compared to cases of other malignancies among Vietnam-era veterans for association with Vietnam service 201 358 Eisen et al., 1991 Cohort Health effects of male monozygotic twins serving in the armed forces during Vietnam era (1965–1975) 2,260 2,260 Thomas et al., 1991 Cohort Mortality experience (1973–1987) among women Vietnam veterans compared to women non-Vietnam veterans and for each cohort compared to US women 4,582 5,324 Watanabe et al., 1991 Cohort Mortality experience (1965–1984) of Army and Marine Corps Vietnam veterans compared to: (1) branch-specific (Army and Marine) Vietnam-era veterans; (2) all Vietnam-era veterans combined; (3) the US male population 24,145 Army, 5,501 Marines (1) 27,145 Army, 4,505 Marines (2) 32,422 STET/OIC (3) US male population Bullman et al., 1990 Cohort Mortality experience of Army I Corps Vietnam veterans compared to Army Vietnam-era veterans 6,668 deaths 27,917 deaths Farberow et al., 1990 Case-control Psychological profiles and military factors associated with suicide and motor vehicle accident (MVA) fatalities in Los Angeles County Vietnam-era veterans (1977–1982) 22 Vietnam suicides; 19 Vietnam-era suicides 21 Vietnam MVA; 20 Vietnam-era MVA

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Veterans and Agent Orange: Update 2004 Thomas and Kang, 1990 Cohort Morbidity and mortality experience (1968–1987) of Army Chemical Corps Vietnam veterans compared to US men 894 — True et al., 1988 Cross-sectional PTSD and Vietnam combat experience evaluated among Vietnam-era veterans 775 1,012 Breslin et al., 1988 Burt et al., 1987 Cohort Mortality experience (1965–1982) of Army and Marine Corps Vietnam veterans, compared to Vietnam-era veterans who did not serve in Southeast Asia standardized by age and race; nested case-control study of NHL 24,235 26,685 Kang et al., 1987 Case-control STS cases (1975–1980) diagnosed at the Armed Forces Institute of Pathology, compared to controls identified from patient logs of referring pathologists or their departments for association with Vietnam service and likelihood of Agent Orange exposure 217 599 Kang et al., 1986 Case-control STS cases (1969–1983) in Vietnam-era veterans for association with branch of Vietnam service as a surrogate for Agent Orange exposure 234 13,496 American Legion Studies Reviewed in VAO Snow et al., 1988 Cohort Assessment of PTSD in association with traumatic combat experience among American Legionnaires serving in Southeast Asia (1961–1975) 2,858 Study group subdivided for internal comparison

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Stellman SD et al., 1988 Cohort Assessment of physical health and reproductive outcomes among American Legionnaires who served in Southeast Asia (1961–1975) for association with combat and herbicide exposure 2,858 3,933 Stellman JM et al., 1988 Cohort Assessment of social and behavioral outcomes among American Legionnaires who served in Southeast Asia (1961–1975) for association with combat and herbicide exposure 2,858 3,933 State Studies Reviewed in Update 1998 Clapp, 1997 Case-control Selected cancers identified (1988–1993) among Massachusetts Vietnam veterans, compared to Massachusetts Vietnam-era veterans with cancers of other sites; update of Clapp et al. (1991) 245 999 State Studies Reviewed in Update 1996 Visintainer et al., 1995 Cohort Mortality experience (1965–1971) among male Michigan Vietnam veterans, compared to non-Vietnam veterans from Michigan 3,364 deaths 5,229 deaths State Studies Reviewed in VAO Fiedler and Gochfeld, 1992; Kahn et al., 1992a,b,c Cohort New Jersey study of outcomes in select group of herbicide-exposed Army, Marine, and Navy Vietnam veterans, compared to veterans self-reported as unexposed 10 Pointman I 55 Pointman II 17 Pointman I 15 Pointman II

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Veterans and Agent Orange: Update 2004 Clapp et al., 1991 Case-control Selected cancers identified (1982–1988) among Massachusetts Vietnam veterans, compared to Massachusetts Vietnam-era veterans with cancers of other sites 214 727 Deprez et al., 1991 Descriptive Study of Maine Vietnam veterans compared to atomic test veterans and general population for health status and reproductive outcomes 249 113 atomic test veterans Levy, 1988 Cross-sectional Study of PTSD in chloracne as indicator of TCDD-exposed and control Vietnam veterans in Massachusetts 6 25 Anderson et al., 1986a Cohort Mortality experience of Wisconsin veterans compared to nonveterans (Phase 1); mortality experience of Wisconsin Vietnam veterans and Vietnam-era veterans compared to nonveterans and other veterans (Phase 2) 110,815 white male veteran deaths; 2,494 white male Vietnam-era veteran deaths; 923 white male Vietnam veteran deaths 342,654 white male non-veteran deaths 109,225 white male other veteran deaths Anderson et al., 1986b Cohort Mortality experience of Wisconsin Vietnam-era veterans and Vietnam veterans compared to US men, Wisconsin men, Wisconsin nonveterans, and Wisconsin other veterans 122,238 Vietnam-era veterans 43,398 Vietnam veterans — Goun and Kuller, 1986 Case-control Cases of STS, NHL, and selected rare cancers compared to controls without cancer for Vietnam experience in Pennsylvania men (1968–1983) 349 349 deceased

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Holmes et al., 1986 Cohort Mortality experience (1968–1983) of West Virginia veterans, Vietnam veterans, and Vietnam-era veterans compared to nonveterans; Vietnam veterans compared to Vietnam-era veterans 615 Vietnam veterans 610 Vietnam-era veterans — Pollei et al., 1986 Cohort Study of chest radiographs of New Mexico Agent Orange Registry Vietnam veterans compared to radiographs of control Air Force servicemen for pulmonary and cardiovascular pathology 422 105 Kogan and Clapp, 1985, 1988 Cohort Mortality experience (1972–1983) among white male Massachusetts Vietnam veterans, compared to non-Vietnam veterans and to all other nonveteran white males in Massachusetts 840 deaths 2,515 deaths of Vietnam-era veterans Lawrence et al., 1985 Cohort Mortality experience of New York State (1) Vietnam-era veterans compared to nonveterans and (2) Vietnam veterans compared to Vietnam-era veterans (1) 4,558 (2) 555 17,936 941 Rellahan, 1985 Cohort Study of health outcomes in Vietnam-era (1962–1972) veterans residing in Hawaii associated with Vietnam experience 232 186

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Veterans and Agent Orange: Update 2004 Wendt, 1985 Descriptive Descriptive findings of health effects and potential exposure to Agent Orange among Iowa veterans who served in Southeast Asia 10,846 None Greenwald et al., 1984 Case-control Cases of STS in New York State compared to controls without cancer for Vietnam service and herbicide exposure including Agent Orange, dioxin, or 2,4,5-T 281 281 live controls 130 deceased controls Newell, 1984 Cross-sectional Preliminary (1) cytogenetic, (2) sperm, and (3) immune response tests in Texas Vietnam veterans compared to controls (1) 30 (2) 32 (3) 66 30 32 66 Other US Veteran Studies Reviewed in VAO Tarone et al., 1991 Case-control Study of cases between January 1976 and June 1981 with testicular cancer (18–42 years old) compared to hospital controls for association with Vietnam service 137 130 Aschengrau and Monson, 1990 Case-control Study of cases with late adverse pregnancy outcomes compared to normal control births for association with paternal Vietnam service (1977–1980) 857 congenital anomalies 61 stillbirths 48 neonatal deaths 998 Goldberg et al., 1990 Cohort Study of male twin pairs who served in Vietnam era (1965–1975) for association between Vietnam service and PTSD 2,092 2,092

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Aschengrau and Monson, 1989 Case-control Association between husband’s military service and women having spontaneous abortion at or by 27 weeks compared to women delivering at 37 weeks 201 1,119 AUSTRALIAN STUDIES Australian Studies Reviewed in Update 2000 AIHW, 1999 Cohort Validation of the male veterans study (CDVA, 1998a) using medical documents, doctors’ certification and records on a disease or death registry 6,842 — CDVA, 1998a Cohort Self-reported data on male members of the Australian Defence Force and the Citizen Military Force who landed in Vietnam or entered Vietnamese water. Questions on physical (including reproductive history) and mental health, and that of their partner(s) and children 49,944 mailed; 39,955 responded — CDVA, 1998b Cohort Self-reported data on female members of the Australian Defence Force and the Citizen Military Force who landed in Vietnam or entered Vietnamese water. Questions on physical (including reproductive history) and mental health, and that of their partner(s) and children 278 mailed 225 responded —

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Veterans and Agent Orange: Update 2004 Australian Studies Reviewed in Update 1998 Crane et al., 1997a Cohort Mortality experience (through 1994) of Australian veterans who served in Vietnam 59,036 males 484 females — Crane et al., 1997b Cohort Mortality experience (through 1994) of Australian national servicemen who served in Vietnam 18,949 24,646 O’Toole et al., 1996a,b,c Cross-sectional Survey of self-reported health status (1989–1990) of Australian Army Vietnam veterans 641 — Australian Studies Reviewed in VAO Field and Kerr, 1988 Cohort Study of Tasmanian Vietnam veterans compared to neighborhood controls for adverse reproductive and childhood health outcomes 357 281 Fett et al., 1987a Cohort Australian study of mortality experience of Vietnam veterans compared to Vietnam-era veterans through 1981 19,205 25,677 Fett et al., 1987b Cohort Australian study of cause-specific mortality experience of Vietnam veterans compared to Vietnam-era veterans through 1981 19,205 25,677 Forcier et al., 1987 Cohort Australian study of mortality in Vietnam veterans by job classification, location, and time of service 19,205 Internal comparison

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Veterans and Agent Orange: Update 2004 Reference Study Design Description Study Group (N) Comparison Group (N)a Donovan et al., 1983, 1984 Case-control Australian study of cases of congenital anomalies in children born (1969–1979), compared to infants born without anomalies for association with paternal Vietnam service 8,517 8,517 OTHER VIETNAM-VETERANS’ STUDIES Other New Vietnam-Veterans’ Studies Kim H-A et al., 2003 Cohort Immunotoxicologic effects of Agent Orange exposure on Korean Vietnam veterans 51 (24 Veterans–patient; 27 veterans–normal) 36 Kim J-S et al., 2003 Cross–sectional Agent Orange exposure and Korean Vietnam veterans 1,224 154 Mo et al., 2002 Cohort Skin and general disease patterns among Korean Vietnam veterans 332 None Other Vietnam Veterans Studies Reviewed in Update 1998 Chinh et al., 1996 Cohort Study of antinuclear antibodies and sperm autoantibodies among Vietnamese veterans who served 5–10 years in a “dioxin-sprayed zone” 25 63 age-matched controls; 36 additional male controls a The dash (—) indicates the comparison group is based on a population (e.g., US white males, country rates), with details given in the text for specifics of the actual population. ABBREVIATIONS: 2,4,5-T, 2,4,5-trichlorophenoxyacetic; AFHS, Air Force Health Study; CDC, Centers for Disease Control and Prevention; CDVA, Commonwealth Department of Veterans’ Affairs; HD, Hodgkin’s disease; MVA, mother vehicle accidents; NIOSH, National Institute for Occupational Safety and Health; NHL, non-Hodgkin’s lymphoma; NMES; National Medical Expenditure Survey; PTSD, posttraumatic stress disorder; SMR, standardized mortality ratio; STS, soft-tissue sarcoma; TCDD, 2,3,7,8-tetrachlorodibenzo-p-dioxin; Update 2000, Veterans and Agent Orange: Update 2000 (IOM, 2001); Update 1998, Veterans and Agent Orange: Update 1998 (IOM, 1998); Update 1996, Veterans and Agent Orange: Update 1996 (IOM, 1996); and VAO, Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (IOM, 1994).

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