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Disposition of the Air Force Health Study (2006)

Chapter: Appendix C Epidemiological Studies of Vietnam Veterans Health

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Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

C
Epidemiologic Studies of Vietnam Veterans Health

Table C-1 provides an overview of design aspects of the epidemiologic studies related to Vietnam veterans’ health reviewed in the Institute of Medicine’s Veterans and Agent Orange report series (IOM, 1994, 1996, 1999, 2001, 2003, 2005). 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. The table was excerpted from Appendix A of the Veterans and Agent Orange: Update 2004 report. More information on these studies may be found in the reports referenced.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

TABLE C-1 Epidemiologic Studies of Vietnam Veterans

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

UNITED STATES STUDIES

AFHS Studies Reviewed in Update 2004

Akhtar et al., 2004

Cohort

Follow-up to Ketchum et al. (1999), comparing cancer incidence among Ranch Hands with Vietnam veterans who served in Southeast Asia but did not spray herbicides and with U.S. national cancer rates

1,189 net Ranch Hands for external analysis; 1,009 net Ranch Hands for internal analysis

1,776 net comparison subjects for external analysis; 1,429 net comparison subjects for internal analysis

Barrett et al., 2003

Cohort

Serum TCDD measurement and psychological functioning among Ranch Hand veterans

1,109

1,493

Michalek et al., 2003

Cohort

Correlation for TCDD elimination and Ranch Hands with diabetes

343

No comparison group

Pavuk et al., 2003

Cohort

Study to examine the relationship between serum TCDD and thyroid function in Ranch Hand veterans

1,009

1,429

AFHS Studies Reviewed in Update 2002

Barrett et al., 2001

Cohort

Based on tests of cognitive functioning in 1982 and dioxin concentrations measured in 1987 and 1992, analyzed association between serum dioxin levels and cognitive functioning

937 Ranch Hands

1,052 Ranch Hand comparisons

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Michalek et al., 2001a

Cohort

Based on physical examination through 1992 and medical records reviewed through March 1993, association between serum dioxin levels and hepatic abnormality

1,109 Ranch Hands

1,493 Ranch Hand comparisons

Michalek et al., 2001b

Cohort

Based on physical examination in 1982, 1985, 1987, 1992, and 1997, and medical records through 1997, association between serum dioxin and peripheral neuropathy

761 Ranch Hands

1,086 Ranch Hand comparisons

Michalek et al., 2001c

Cohort

Based on physical examination in 1982, 1985, 1987, and 1992, and medical records through 1997, association between serum dioxin and hematologic function

953 Ranch Hands

1,280 Ranch Hand comparisons

Steenland et al., 2001

Cohort

Reexamine and compare diabetes data from the NIOSH cohort and the United States Air Force (USAF) Ranch Hands in order to reconcile differences between the two study methods and protocols

267 NIOSH workers; 990 Ranch Hands

227 NIOSH comparisons 1,275 Ranch Hand comparisons

AFHS Studies Reviewed in Update 2000

AFHS, 2000

Cohort

266 health-related endpoints, including assessments of 10 clinical areas: general health, neoplasia, neurologic, psychologic, gastrointestinal, cardiovascular, hematologic, endocrine, immunologic, pulmonary

995

1,299

Longnecker and Michalek, 2000

Cohort

Based on physical examination and medical records review through 1992, association between serum dioxin and diabetes mellitus among comparison group (no Ranch Hands)

1,197

Ketchum et al., 1999

Cohort

Based on physical examination and medical records review through 1992, association between serum dioxin and cancer, skin cancer, cancer other than skin cancer

980 Ranch Hands

1,275 Ranch Hand comparisons

Michalek et al., 1999a

Cohort

Further elucidate relationship between dioxin and diabetes mellitus, effect of dioxin body burden on sex-hormone-binding globulin and insulin and fasting glucose

871 Ranch Hands

1,121 Ranch Hand comparisons

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

Michalek et al., 1999b

Cohort

Based on physical examinations in 1982, 1985, 1987, and 1992, immunologic response and exposure to dioxin among Ranch Hand and comparison cohorts

914 Ranch Hands 372 (lymphocyte counts conducted)

1,186 Ranch Hand comparisons 491 (lymphocyte counts conducted)

Burton et al., 1998

Cohort

Based on physical examination and medical record review through 1992, association between serum dioxin and occurrence and timing (relative to Southeast Asia service) of chloracne and acne

930 Ranch Hands

1,200 Ranch Hand comparisons

Michalek et al., 1998b

Cohort

Updates, all-cause and cause-specific post-service mortality (through 1993) among veterans of Operation Ranch Hand, using standardized mortality ratios

1,261 Ranch Hands

19,080 Ranch Hand comparisons

Michalek et al., 1998c

Cohort

Prospective study, exposure and long-term health, survival, reproductive outcome

1,208 veterans; 903 offspring

1,549 veterans; 1,254 offspring

Michalek et al., 1998d

Cohort

Third report in a series investigating dioxin body burden and preterm birth, intrauterine growth retardation, infant death among offspring of Ranch Hand veterans

859

1,223

AFHS Studies Reviewed in Update 1998

Michalek et al., 1998a

Cohort

Paternal serum dioxin levels and infant death among Ranch Hand offspring

859 children: 323 background exposure; 267 low exposure; 269 high exposure

1,223 children

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Henriksen et al., 1997

Cohort

Relationship between serum dioxin and glucose, insulin, and diabetes mellitus in Ranch Hands through 1992

989

1,276

AFHS, 1996; Michalek et al., 1998b

Cohort

Mortality update, Ranch Hands through the end of 1993 in the AFHS cohort (1983, 1984b, 1985, 1986, 1989, 1991a, 1995)

1,261

19,080

Henriksen et al., 1996

Cohort

Serum dioxin and reproductive hormones in Ranch Hands, 1982, 1985, 1987, and 1992

1,045 participants (1982); 474 provided semen

1,224 participants (1982); 532 provided semen

AFHS Studies Reviewed in Update 1996

AFHS, 1995

Cohort

Mortality updates of Ranch Hands who sprayed herbicides in Vietnam, compared with USAF C-130 air and ground crew veterans in Southeast Asia who did not spray herbicides

1,261, original cohort

19,101, original cohort

Wolfe et al., 1995

Cohort

Paternal serum dioxin and reproductive outcomes of Ranch Hand veterans, compared with USAF veterans from Southeast Asia who did not spray herbicides

932

1,202

AFHS Studies Reviewed in VAO

AFHS, 1992

Cohort

Reproductive outcomes of AFHS participants

791

942

AFHS, 1984a, 1987, 1990, 1991b

Cohort

Baseline morbidity, follow-up examination results

1,208 baseline

1,668 baseline

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

AFHS, 1983, 1984b, 1985, 1986, 1989, 1991a

Cohort

Mortality updates, Ranch Hands who sprayed herbicides in Vietnam, compared with USAF C-130 air and ground crew veterans in Southeast Asia who did not spray herbicides

1,261 (original cohort)

19,101 (original cohort)

Michalek et al., 1990

Cohort

Mortality of Ranch Hands, compared with USAF C-130 air and ground crew veterans in Southeast Asia

1,261

19,101

Wolfe et al., 1990

Cohort

Health status of Ranch Hands at second follow-up, compared with USAF C-130 air and ground crew veterans in Southeast Asia

995

1,299

Centers for Disease Control and Prevention Studies Reviewed in VAO

Decoufle et al., 1992

Cohort

Association between self-reported health outcomes and perception of exposure to herbicides based on Vietnam Experience Study

7,924

7,364

O’Brien et al., 1991

Cohort

Interview report and mortality for NHL based on Vietnam Experience Study

8,170

7,564

CDC, 1990a

Case-control

Selected Cancers Study: population-based case-control study of all men born 1921–1953; cases diagnosed area covered by eight cancer registries, controls selected by random-digit dialing

1,157 NHL; 342 STS; 310 HD; 48 nasal carcinoma; 80 nasopharyngeal carcinoma; 130 primary liver cancer

1,776

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

CDC, 1990b

Case-control

Selected Cancers Study: population-based case-control study of all men born 1921–1953; cases diagnosed in area covered by eight cancer registries, controls selected by random-digit dialing for NHL

1,157

1,776

CDC, 1990c

Case-control

Selected Cancers Study: STS

342

1,776

CDC, 1990d

Case-control

Selected Cancers Study: HD, nasal cancer, nasopharyngeal cancer, primary liver cancer

310 HD; 48 nasal carcinoma; 80 nasopharyngeal carcinoma; 130 primary liver cancer

1,776

CDC, 1989b

Cohort

Vietnam Experience Study: random sample, U.S. Army enlisted men, 1965–1971

2,490

1,972

CDC, 1988a

Cohort

Vietnam Experience Study: random sample, U.S. Army enlisted men, 1965–1971, psychosocial outcomes

2,490

1,972

CDC, 1988b

Cohort

Vietnam Experience Study: physical health outcomes

2,490

1,972

CDC, 1988c

Cohort

Vietnam Experience Study: reproductive outcomes

12,788 children

11,910 children

CDC, 1987; Boyle et al., 1987

Cohort

Vietnam Experience Study: mortality

9,324

8,989

Erickson et al., 1984 a,b

Case-control

CDC birth defects study, children born in the Atlanta, Georgia, area 1968–1980, comparing paternal Vietnam experience and potential Agent Orange exposure for birth defects cases and normal controls

7,133

4,246

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

Department of Veterans Affairs Studies Reviewed in Update 2002

Kang et al., 2001

Cohort

Health of Army Chemical Corps Vietnam veterans, compared with 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 with contemporary veterans not deployed to Vietnam; odds ratios calculated for reproductive history and various birth defects

3,392 women; 1,665 women with indexed pregnancy

3,038 women; 1,912 women with indexed pregnancy

Kang et al., 2000b

Cohort

Gynecologic cancers among female Vietnam veterans, compared with veteran controls

484

5,946

Department of Veterans Affairs Studies Reviewed in Update 1998

Dalager and Kang, 1997

Cohort

Morbidity and mortality experience (1968–1987), Army Chemical Corps Vietnam veterans, compared with U.S. men; extension of Thomas and Kang (1990)

2,872

2,737

Mahan et al., 1997

Case-control

Lung cancer among Vietnam veterans (1983–1990)

329

269

111

McKinney et al., 1997

Cross-sectional

Tobacco use in veterans and nonveterans by 1987 NMES

15,000

Bullman and Kang, 1996

Cohort

Mortality 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

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Dalager et al., 1995b

Case-control

HD cases diagnosed 1969–1985 among Vietnam-era veterans

283

404

Watanabe and Kang, 1995

Cohort

Postservice mortality among Marine Vietnam veterans

10,716

9,346

Department of Veterans Affairs Studies Reviewed in Update 1996

Dalager et al., 1995a

Cohort

Update of Thomas et al. (1991) through Dec. 31, 1995

4,586

5,325

Bullman et al., 1994

Case-control

Association between testicular cancer and surrogate measures of exposure to Agent Orange in male Vietnam veterans

97

311

Department of Veterans Affairs Studies Reviewed in VAO

Bullman et al., 1991

Case-control

PTSD cases in Vietnam veterans, compared with Vietnam veterans without PTSD, for association with traumatic combat experience

374

373

Dalager et al., 1991

Case-control

NHL cases diagnosed 1969–1985 among Vietnam-era veterans, compared with cases of other malignancies among Vietnam-era veterans, for association with Vietnam service

201

358

Eisen et al., 1991

Cohort

Health effects in 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 female Vietnam veterans, compared with female non-Vietnam veterans and for each cohort compared with U.S. women

4,582

5,324

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

Watanabe et al., 1991

Cohort

Mortality experience (1965–1984) in Army and Marine Corps Vietnam veterans, compared with: (1) branch-specific (Army and Marine) Vietnam-era veterans, (2) all Vietnam-era veterans combined, (3) the U.S. male population

24,145 Army 5,501 Marines

(1) 27,145 Army

4,505 Marines

(2) 32,422 combined Vietnam era

(3) U.S. male population

Bullman et al., 1990

Cohort

Mortality experience in Army I Corps Vietnam veterans, compared with Army Vietnam-era veterans

6,668 deaths

27,917 deaths

Farberow et al., 1990

Case-control

Psychological profiles, military factors associated with suicide and 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

Thomas and Kang, 1990

Cohort

Morbidity and mortality experience (1968–1987) in Army Chemical Corps Vietnam veterans compared with U.S. men

894

True et al., 1988

Cross-sectional

PTSD and Vietnam combat experience among Vietnam-era veterans

775

1,012

Breslin et al., 1988; Burt et al., 1987

Cohort

Mortality experience (1965–1982) in Army and Marine Corps Vietnam veterans, compared with Vietnam-era veterans who did not serve in Southeast Asia, standardized by age and race; nested NHL case-control study

24,235

26,685

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Kang et al., 1987

Case-control

STS cases (1975–1980) diagnosed at the Armed Forces Institute of Pathology (AFIP), compared with 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 (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

PTSD in association with traumatic combat experience among American Legion members serving in Southeast Asia (1961–1975)

2,858

Study group subdivided for internal comparison

Stellman et al., 1988a

Cohort

Physical health, reproductive outcomes among American Legion members who served in Southeast Asia (1961–1975), for association with combat and herbicide exposure

2,858

3,933

Stellman et al., 1988b

Cohort

Social, behavioral outcomes among American Legion members who served in Southeast Asia (1961–1975), 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 with 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) in male Michigan Vietnam veterans, compared with non-Vietnam veterans from Michigan

3,364 deaths

5,229 deaths

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

State Studies Reviewed in VAO

Fiedler and Gochfeld, 1992;

Kahn et al., 1992a,b,c

Cohort

New Jersey: outcomes in select group of herbicide-exposed Army, Marine, and Navy Vietnam veterans, compared with veterans self-reported as unexposed

10 Pointman I

55 Pointman II

17 Pointman I

15 Pointman II

Clapp et al., 1991

Case-control

Massachusetts: selected cancers identified (1982–1988) among Vietnam veterans, compared with Massachusetts Vietnam-era veterans with cancers of other sites

214

727

Deprez et al., 1991

Descriptive

Maine: Vietnam veterans, compared with atomic test veterans and general population, for health status and reproductive outcomes

249

113 atomic test veterans

Levy, 1988

Cross-sectional

Massachusetts: PTSD in chloracne as indicator of exposure to TCDD; control Vietnam veterans

62

5

Anderson et al., 1986a

Cohort

Wisconsin: mortality experience, veterans compared with nonveterans (Phase 1); mortality experience of Vietnam veterans and Vietnam-era veterans, compared with 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

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Anderson et al., 1986b

Cohort

Wisconsin: mortality experience in Vietnam-era veterans and Vietnam veterans, compared with U.S. men, Wisconsin men, Wisconsin nonveterans, and Wisconsin other veterans

122,238 Vietnam-era veterans; 43,398 Vietnam veterans

Goun and Kuller, 1986

Case-control

Pennsylvania: STS, NHL, selected rare cancer cases, compared with controls without cancer for Vietnam experience in men (1968–1983)

349

349 deceased

Holmes et al., 1986

Cohort

West Virginia: mortality experience (1968–1983) of veterans, Vietnam veterans, Vietnam-era veterans, compared with nonveterans; Vietnam veterans compared with Vietnam-era veterans

615 Vietnam veterans; 610 Vietnam-era veterans

Pollei et al., 1986

Cohort

New Mexico: chest radiographs of Agent Orange Registry Vietnam veterans, compared with radiographs of control USAF servicemen, for pulmonary and cardiovascular pathology

422

105

Kogan and Clapp, 1985, 1988

Cohort

Massachusetts: mortality experience (1972–1983) among white male Vietnam veterans, compared with non-Vietnam veterans and all other nonveteran white males in Massachusetts

840 deaths

2,515 deaths in Vietnam-era veterans

Lawrence et al., 1985

Cohort

New York: mortality experience in (1) Vietnam-era veterans, compared with nonveterans and (2) Vietnam veterans, compared with Vietnam-era veterans

(1) 4,558

(2) 555

17,936

941

Rellahan, 1985

Cohort

Hawaii: health outcomes in Vietnam-era (1962–1972) veterans residing in Hawaii, associated with Vietnam experience

232

186

Wendt, 1985

Descriptive

Iowa: health effects and potential exposure to Agent Orange among veterans who served in Southeast Asia

10,846

None

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

Greenwald et al., 1984

Case-control

New York: STS cases, compared with 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

Texas: preliminary (1) cytogenetic, (2) sperm, (3) immune response tests in Vietnam veterans, compared with controls

(1) 30;

(2) 32;

(3) 66

(1) 30;

(2) 32;

(3) 66

Other U.S. Veterans Studies Reviewed in VAO

Tarone et al., 1991

Case-control

Testicular cancer (18–42 years old) cases, January 1976–June 1981, compared with hospital controls, for association with Vietnam service

137

130

Aschengrau and Monson, 1990

Case-control

Cases with late adverse pregnancy outcomes compared with 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

Male twin pairs who served in Vietnam era (1965–1975), for association between Vietnam service and PTSD

2,092

2,092

Aschengrau and Monson, 1989

Case-control

Association between husband’s military service and spontaneous abortion at or by 27 weeks, compared with women delivering at 37 weeks

201

1,119

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

AUSTRALIAN VETERANS STUDIES

Australian Studies Reviewed in Update 2000

AIHW, 1999

Cohort

Validation of the male veterans study (CDVA, 1998a) by medical documents, doctors’ certification, 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

Australian Studies Reviewed in Update 1998

Crane et al., 1997a

Cohort

Mortality experience (through 1994) of Australian veterans who served in Vietnam

59,036 men

484 women

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

Tasmanian Vietnam veterans, compared with neighborhood controls for adverse reproductive and childhood health outcomes

357

281

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Reference

Study Design

Description

Study Group (N)

Comparison Group (N)*

Fett et al., 1987a

Cohort

Mortality experience in Vietnam veterans, compared with Vietnam-era veterans through 1981

19,205

25,677

Fett et al., 1987b

Cohort

Cause-specific mortality experience in Vietnam veterans, compared with Vietnam veterans through 1981

19,205

25,677

Forcier et al., 1987

Cohort

Mortality in Vietnam veterans by job classification, location, time of service

19,205

Internal comparison

Donovan et al., 1983, 1984

Case-control

Congenital anomalies in children (1969–1979), compared with infants born without anomalies, for association with paternal Vietnam service

8,517

8,517

OTHER VIETNAM VETERANS’ STUDIES

Other New Vietnam Veterans’ Studies Reviewed in Update 2004

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

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Other Vietnam Veterans Studies Reviewed in Update 1998

Chinh et al., 1996

Cohort

Antinuclear antibodies and sperm autoantibodies among Vietnamese veterans who served 5–10 years in a “dioxin-sprayed zone”

25

63; 36

NOTE: Abbreviations: 2,4,5-T, 2,4,5-trichlorophenoxyacetic acid; AFHS, Air Force Health Study; CDC, Centers for Disease Control and Prevention; CDVA, Commonwealth Department of Veterans’ Affairs (Australia); HD, Hodgkin’s disease; MVA, motor vehicle accidents; NIOSH, National Institute for Occupational Safety and Health; NHL, non-Hodgkin’s lymphoma; NMES, National Medical Expenditure Survey; PTSD, post-traumatic stress disorder; SMR, standardized mortality ratio; STS, soft-tissue sarcoma; TCDD, 2,3,7,8-tetrachlorodibenzo-p-dioxin; Update 2004, Veterans and Agent Orange: Update 2004 (IOM, 2005); Update 2000, Veterans and Agent Orange: Update 2000 (IOM, 2001); Update 1998, Veterans and Agent Orange: Update 1998 (IOM, 1999); Update 1996, Veterans and Agent Orange: Update 1996 (IOM, 1996); USAF, United States Air Force; and VAO, Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (IOM, 1994).

*Comparison group based on a population (e.g., U.S. white males, country rates); details are given in the text for population sp ecifics.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

REFERENCES

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AFHS. 1984a. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Baseline Morbidity Study Results. Brooks AFB, TX: USAF School of Aerospace Medicine. NTIS AD-A138 340.

AFHS. 1984b. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update: 1984. Brooks AFB, TX: USAF School of Aerospace Medicine. NTIS-AD-A-162-687.

AFHS. 1985. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update: 1985. Brooks AFB, TX: USAF School of Aerospace Medicine. NTIS-AD-A-163-237.

AFHS. 1986. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update: 1986. Brooks AFB, TX: USAF School of Aerospace Medicine. USAFSAM-TR-86-43.

AFHS. 1987. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. First Follow-up Examination Results. Brooks AFB, TX: USAF School of Aerospace Medicine. USAFSAM-TR-87-27.

AFHS. 1989. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update: 1989. Brooks AFB, TX: USAF School of Aerospace Medicine. USAFSAM-TR-89-9.

AFHS. 1990. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Brooks AFB, TX: USAF School of Aerospace Medicine. USAFSAM-TR-90-2.

AFHS. 1991a. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update: 1991. Brooks AFB, TX: Armstrong Laboratory. AL-TR-1991-0132.

AFHS. 1991b. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Serum Dioxin Analysis of 1987 Examination Results. Brooks AFB, TX: USAF School of Aerospace Medicine. AL-TR-91-0009.

AFHS. 1992. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Reproductive Outcomes. Brooks AFB, TX: Armstrong Laboratory. AL–TR–1992–0090.

AFHS. 1995. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. 1992 Follow-up Examination Results. Brooks AFB, TX: Epidemiologic Research Division, Armstrong Laboratory. AL-TR-920107.

AFHS. 1996. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update 1996. Brooks AFB, TX: Epidemiologic Research Division, Armstrong Laboratory. AL/AO-TR-1996-0068.

AFHS. 2000. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. 1997 Follow-up Examination Results. Brooks AFB, TX: Human Systems Program Office. Armstrong Laboratory. AFRL-HE-BR-TR-2000-02.

AIHW (Australian Institute of Health and Welfare). 1999. Morbidity of Vietnam Veterans: A Study of the Health of Australia’s Vietnam Veteran Community: Volume 3: Validation Study. Canberra: AIHW.

Akhtar FZ, Garabrant DH, Ketchum NS, Michalek JE. 2004. Cancer in US Air Force veterans of the Vietnam war. Journal of Occupational and Environmental Medicine 46(2):123–136.

Anderson HA, Hanrahan LP, Jensen M, Laurin D, Yick WY, Wiegman P. 1986a. Wisconsin Vietnam Veteran Mortality Study: Proportionate Mortality Ratio Study Results. Madison, WI: Wisconsin Division of Health.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Anderson HA, Hanrahan LP, Jensen M, Laurin D, Yick WY, Wiegman P. 1986b. Wisconsin Vietnam Veteran Mortality Study: Final Report. Madison, WI: Wisconsin Division of Health.

Aschengrau A, Monson RR. 1989. Paternal military service in Vietnam and risk of spontaneous abortion. Journal of Occupational Medicine 31:618–623.

Aschengrau A, Monson RR. 1990. Paternal military service in Vietnam and the risk of late adverse pregnancy outcomes. American Journal of Public Health 80:1218–1224.


Barrett DH, Morris RD, Akhtar FZ, Michalek JE. 2001. Serum dioxin and cognitive functioning among veterans of Operation Ranch Hand. Neurotoxicology 22:491–502.

Barrett DH, Morris RD, Jackson WG Jr, Stat M, Michalek JE. 2003. Serum dioxin and psychological functioning in US Air Force veterans of the Vietnam War. Military Medicine 168:153–159.

Boyle C, Decoufle P, Delaney RJ, DeStefano F, Flock ML, Hunter MI, Joesoef MR, Karon JM, Kirk ML, Layde PM, McGee DL, Moyer LA, Pollock DA, Rhodes P, Scally MJ, Worth RM. 1987. Postservice Mortality Among Vietnam Veterans. Atlanta: Centers for Disease Control and Prevention. CEH 86-0076.

Breslin P, Kang H, Lee Y, Burt V, Shepard BM. 1988. Proportionate mortality study of US Army and US Marine Corps veterans of the Vietnam War. Journal of Occupational Medicine 30:412–419.

Bullman TA, Kang HK. 1996. The risk of suicide among wounded Vietnam veterans. American Journal of Public Health 86(5):662–667.

Bullman TA, Kang HK, Watanabe KK. 1990. Proportionate mortality among US Army Vietnam veterans who served in Military Region I. American Journal of Epidemiology 132:670–674.

Bullman TA, Kang H, Thomas TL. 1991. Posttraumatic stress disorder among Vietnam veterans on the Agent Orange Registry: a case-control analysis. Annals of Epidemiology 1:505–512.

Bullman TA, Watanabe KK, Kang HK. 1994. Risk of testicular cancer associated with surrogate measures of Agent Orange exposure among Vietnam veterans on the Agent Orange Registry. Annals of Epidemiology 4:11–16.

Burt VL, Breslin PP, Kang HK, Lee Y. 1987. Non-Hodgkin’s lymphoma in Vietnam veterans. Washington, DC: Department of Medicine and Surgery, Veterans Administration.

Burton JE, Michalek JE, Rahe AJ. 1998. Serum dioxin, chloracne, and acne in veterans of Operation Ranch Hand. Archives of Environmental Health 53(3):199–204.


CDC (Centers for Disease Control). 1987. Postservice mortality among Vietnam veterans. Journal of the American Medical Association 257:790–795.

CDC. 1988a. Health status of Vietnam veterans. I. Psychosocial characteristics. Journal of the American Medical Association 259:2701–2707.

CDC. 1988b. Health status of Vietnam veterans. II. Physical health. Journal of the American Medical Association 259:2708–2714.

CDC. 1988c. Health status of Vietnam veterans. III. Reproductive outcomes and child health. Journal of the American Medical Association 259:2715–2717.

CDC. 1989. Health Status of Vietnam Veterans: Vietnam Experience Study. Vols. I–V, Supplements A–C. Atlanta: US Department of Health and Human Services.

CDC. 1990a. The Association of Selected Cancers with Service in the US Military in Vietnam: Final Report. Atlanta: US Department of Health and Human Services.

CDC. 1990b. The association of selected cancers with service in the US military in Vietnam. I. Non-Hodgkin’s lymphoma. Archives of Internal Medicine 150:2473–2483.

CDC. 1990c. The association of selected cancers with service in the US military in Vietnam. II. Soft-tissue and other sarcomas. Archives of Internal Medicine 150:2485–2492.

CDC. 1990d. The association of selected cancers with service in the US military in Vietnam. III. Hodgkin’s disease, nasal cancer, nasopharyngeal cancer, and primary liver cancer. Archives of Internal Medicine 150:2495–2505.

CDVA (Commonwealth Department of Veterans’ Affairs). 1998a. Morbidity of Vietnam Veterans: A Study of the Health of Australia’s Vietnam Veteran Community. Volume 1: Male Vietnam Veterans Survey and Community Comparison Outcomes. Canberra: Department of Veterans’ Affairs.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

CDVA. 1998b. Morbidity of Vietnam Veterans: A Study of the Health of Australia’s Vietnam Veteran Community. Volume 2: Female Vietnam Veterans Survey and Community Comparison Outcomes. Canberra: Department of Veterans’ Affairs.

Chinh TT, Phi PT, Thuy NT. 1996. Sperm auto-antibodies and antinuclear antigen antibodies in chronic dioxin-exposed veterans. Chemosphere 32(3):525–530.

Clapp RW. 1997. Update of cancer surveillance of veterans in Massachusetts, USA. International Journal of Epidemiology 26(3):679–681.

Clapp RW, Cupples LA, Colton T, Ozonoff DM. 1991. Cancer surveillance of veterans in Massachusetts, 1982–1988. International Journal of Epidemiology 20:7–12.

Crane PJ, Barnard DL, Horsley KW, Adena MA. 1997a. Mortality of Vietnam Veterans: The Veteran Cohort Study. A Report of the 1996 Retrospective Cohort Study of Australian Vietnam Veterans. Canberra: Department of Veterans’ Affairs.

Crane PJ, Barnard DL, Horsley KW, Adena MA. 1997b. Mortality of National Service Vietnam Veterans: A Report of the 1996 Retrospective Cohort Study of Australian Vietnam Veterans. Canberra: Department of Veterans’ Affairs.


Dalager NA, Kang HK. 1997. Mortality among Army Chemical Corps Vietnam veterans. American Journal of Industrial Medicine 31(6):719–726.

Dalager NA, Kang HK, Burt VL, Weatherbee L. 1991. Non-Hodgkin’s lymphoma among Vietnam veterans. Journal of Occupational Medicine 33:774–779.

Dalager NA, Kang HK, Thomas TL. 1995a. Cancer mortality patterns among women who served in the military: the Vietnam experience. Journal of Occupational and Environmental Medicine 37:298–305.

Dalager NA, Kang HK, Burt VL, Weatherbee L. 1995b. Hodgkin’s disease and Vietnam service. Annals of Epidemiology 5(5):400–406.

Decoufle P, Holmgreen P, Boyle CA, Stroup NE. 1992. Self-reported health status of Vietnam veterans in relation to perceived exposure to herbicides and combat. American Journal of Epidemiology 135:312–323.

Deprez RD, Carvette ME, Agger MS. 1991. The Health and Medical Status of Maine Veterans: A Report to the Bureau of Veterans Services, Commission of Vietnam and Atomic Veterans. Portland, ME: Public Health Resource Group.

Donovan JW, Adena MA, Rose G, Battistutta D. 1983. Case-Control Study of Congenital Anomalies and Vietnam Service: Birth Defects Study. Report to the Minister for Veterans’ Affairs. Canberra: Australian Government Publishing Service.

Donovan JW, MacLennan R, Adena M. 1984. Vietnam service and the risk of congenital anomalies: a case-control study. Medical Journal of Australia 140:394–397.


Eisen S, Goldberg J, True WR, Henderson WG. 1991. A co-twin control study of the effects of the Vietnam War on the self-reported physical health of veterans. American Journal of Epidemiology 134:49–58.

Erickson JD, Mulinare J, McClain PW, Fitch TG, James LM, McClearn AB, Adams MJ Jr. 1984a. Vietnam Veterans’ Risks for Fathering Babies with Birth Defects. Atlanta: Centers for Disease Control.

Erickson JD, Mulinare J, McClain PW, Fitch TG, James LM, McClearn AB, Adams MJ Jr. 1984b. Vietnam veterans’ risks for fathering babies with birth defects. Journal of the American Medical Association 252:903–912.


Farberow NL, Kang H, Bullman T. 1990. Combat experience and postservice psychosocial status as predictors of suicide in Vietnam veterans. Journal of Nervous and Mental Disease 178:32–37.

Fett MJ, Adena MA, Cobbin DM, Dunn M. 1987a. Mortality among Australian conscripts of the Vietnam conflict era. I. Death from all causes. American Journal of Epidemiology 126:869–877.

Fett MJ, Nairn JR, Cobbin DM, Adena MA. 1987b. Mortality among Australian conscripts of the Vietnam conflict era. II. Causes of death. American Journal of Epidemiology 125:878–884.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Fiedler N, Gochfeld M. 1992. Neurobehavioral Correlates of Herbicide Exposure in Vietnam Veterans. New Jersey Agent Orange Commission.

Field B, Kerr C. 1988. Reproductive behaviour and consistent patterns of abnormality in offspring of Vietnam veterans. Journal of Medical Genetics 25:819–826.

Forcier L, Hudson HM, Cobbin DM, Jones MP, Adena MA, Fett MJ. 1987. Mortality of Australian veterans of the Vietnam conflict and the period and location of their Vietnam service. Military Medicine 152:9–15.


Goldberg J, True WR, Eisen SA, Henderson WG. 1990. A twin study of the effects of the Vietnam war on posttraumatic stress disorder. Journal of the American Medical Association 263:1227–1232.

Goun BD, Kuller LH. 1986. Final Report: A Case-Control Mortality Study on the Association of Soft Tissue Sarcomas, Non-Hodgkin’s Lymphomas, and Other Selected Cancers and Vietnam Military Service in Pennsylvania Males. Pittsburgh, PA: University of Pittsburgh.

Greenwald P, Kovasznay B, Collins DN, Therriault G. 1984. Sarcomas of soft tissues after Vietnam service. Journal of the National Cancer Institute 73:1107–1109.


Henriksen GL, Michalek JE, Swaby JA, Rahe AJ. 1996. Serum dioxin, testosterone, and gonadotropins in veterans of Operation Ranch Hand. Epidemiology 7(4):352–357.

Henriksen GL, Ketchum NS, Michalek JE, Swaby JA. 1997. Serum dioxin and diabetes mellitus in veterans of Operation Ranch Hand. Epidemiology 8(3):252–258.

Holmes AP, Bailey C, Baron RC, Bosanac E, Brough J, Conroy C, Haddy L. 1986. West Virginia Department of Health Vietnam-Era Veterans Mortality Study, Preliminary Report. Charleston, WV: West Virginia Health Department.


IOM (Institute of Medicine). 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: National Academy Press.

IOM. 1996. Veterans and Agent Orange: Update 1996. Washington, DC: National Academy Press.

IOM. 1999. Veterans and Agent Orange: Update 1998. Washington, DC: National Academy Press.

IOM. 2001. Veterans and Agent Orange: Update 2000. Washington, DC: National Academy Press.

IOM. 2003. Veterans and Agent Orange: Update 2002. Washington, DC: The National Academies Press.

IOM. 2005. Veterans and Agent Orange: Update 2004. Washington, DC. The National Academies Press.


Kahn PC, Gochfeld M, Lewis WW. 1992a. Dibenzodioxin and Dibenzofuran Congener Levels in Four Groups of Vietnam Veterans Who Did Not Handle Agent Orange. New Jersey Agent Orange Commission.

Kahn PC, Gochfeld M, Lewis WW. 1992b. Immune Status and Herbicide Exposure in the New Jersey Pointman I Project. New Jersey Agent Orange Commission.

Kahn PC, Gochfeld M, Lewis WW. 1992c. Semen Analysis in Vietnam Veterans with Respect to Presumed Herbicide Exposure. New Jersey Agent Orange Commission.

Kang HK, Weatherbee L, Breslin PP, Lee Y, Shepard BM. 1986. Soft tissue sarcomas and military service in Vietnam: a case comparison group analysis of hospital patients. Journal of Occupational Medicine 28:1215–1218.

Kang HK, Enzinger FM, Breslin P, Feil M, Lee Y, Shepard B. 1987. Soft tissue sarcoma and military service in Vietnam: a case-control study. Journal of the National Cancer Institute 79:693–699 [published erratum appears in Journal of the National Cancer Institute 79:1173].

Kang HK, Mahan CM, Lee KY, Magee CA, Mather SH, Matanoski G. 2000a. Pregnancy outcomes among US women Vietnam veterans. American Journal Industrial Medicine 38(4):447–454.

Kang HK, Mahan CM, Lee KY, Magee CA, Selvin S. 2000b. Prevalence of gynecologic cancers among female Vietnam veterans. Journal of Occupational and Environmental Medicine 42:1121–1127.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Kang HK, Dalager NA, Needham LL, Patterson DG, Matanoski GM, Kanchanaraksa S, Lees PSJ. 2001. US Army Chemical Corps Vietnam veterans health study: preliminary results. Chemosphere 43:943–949.

Ketchum NS, Michalek JE, Burton JE. 1999. Serum dioxin and cancer in veterans of Operation Ranch Hand. American Journal of Epidemiology 149(7):630–639.

Kim H-A, Kim E-M, Park Y-C, Yu J-Y, Hong S-K, Jeon S-H, Park K-L, Hur S-J, Heo Y. 2003. Immunotoxicological effects of Agent Orange exposure to the Vietnam War Korean veterans. Industrial Health 41:158–166.

Kim J-S, Lim H-S, Cho S-I, Cheong H-K, Lim M-K. 2003. Impact of Agent Orange Exposure among Korean Vietnam Veterans. Industrial Health 41:149–157.

Kogan MD, Clapp RW. 1985. Mortality Among Vietnam Veterans in Massachusetts, 1972–1983. Boston: MA. Massachusetts Office of the Commissioner of Veterans Services, Agent Orange Program.

Kogan MD, Clapp RW. 1988. Soft tissue sarcoma mortality among Vietnam veterans in Massachusetts, 1972–1983. International Journal of Epidemiology 17:39–43.


Lawrence CE, Reilly AA, Quickenton P, Greenwald P, Page WF, Kuntz AJ. 1985. Mortality patterns of New York State Vietnam veterans. American Journal of Public Health 75:277–279.

Levy CJ. 1988. Agent Orange exposure and posttraumatic stress disorder. Journal of Nervous and Mental Disorders 176:242–245.

Longnecker MP, Michalek JE. 2000. Serum dioxin level in relation to diabetes mellitus among Air Force veterans with background levels of exposure. Epidemiology 11(1):44–48.


Mahan CM, Bullman TA, Kang HK, Selvin S. 1997. A case–control study of lung cancer among Vietnam veterans. Journal of Occupational and Environmental Medicine 39(8):740–747.

McKinney WP, McIntire DD, Carmody TJ, Joseph A. 1997. Comparing the smoking behavior of veterans and nonveterans. Public Health Reports 112(3):212–217.

Michalek JE, Wolfe WH, Miner JC. 1990. Health status of Air Force veterans occupationally exposed to herbicides in Vietnam. II. Mortality. Journal of the American Medical Association 264:1832–1836.

Michalek JE, Rahe AJ, Boyle CA. 1998a. Paternal dioxin, preterm birth, intrauterine growth retardation, and infant death. Epidemiology 9(2):161–167.

Michalek JE, Ketchum NS, Akhtar FZ. 1998b. Postservice mortality of US Air Force veterans occupationally exposed to herbicides in Vietnam: 15-year follow-up. American Journal of Epidemiology 148(8):786–792.

Michalek JE, Rahe AJ, Boyle CA. 1998c. Paternal dioxin and the sex of children fathered by veterans of Operation Ranch Hand (2). Epidemiology 9(4):474–475.

Michalek JE, Albanese RA, Wolfe WH. 1998d. Paternal dioxin, preterm birth, intrauterine growth retardation, and infant death. Epidemiology 9(2):161–167.

Michalek JE, Akhtar FZ, Kiel JL. 1999a. Serum dioxin, insulin, fasting glucose, and sex hormone-binding globulin in veterans of Operation Ranch Hand. Journal of Clinical Endocrinology and Metabolism 84(5):1540–1543.

Michalek JE, Ketchum NS, Check IJ. 1999b. Serum dioxin and immunologic response in veterans of Operation Ranch Hand. American Journal of Epidemiology 149(11):1038–1046.

Michalek JE, Ketchum N, Longnecker MP. 2001a. Serum dioxin and hepatic abnormalities in veterans of Operation Ranch Hand. Annals of Epidemiology 11(5):304–311.

Michalek JE, Akhtar FZ, Arezzo JC, Garabrant DH, Albers JW. 2001b. Serum dioxin and peripheral neuropathy in veterans of Operation Ranch Hand. Neurotoxicology 22:479–490.

Michalek JE, Akhtar FZ, Longnecker MP, Burton JE. 2001c. Relation of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) level to hematological examination results in veterans of Operation Ranch Hand. Archives of Environmental Health 56(5):396–405.

Michalek JE, Ketchum NS, Tripathi RC. 2003. Diabetes mellitus and 2,3,7,8-tetrachlorodibenzo-p-dioxin elimination in veterans of Operation Ranch Hand. Journal of Toxicology and Environmental Health, Part A, 66:211–221.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Mo HJ, Park HJ, Kim JH, Lee JY, Cho BK. 2002. A study about the skin and general disease patterns of the Vietnam veterans exposed to dioxin. Korean Journal of Dermatology 40(6):634–638.


Newell GR. 1984. Development and Preliminary Results of Pilot Clinical Studies. Report of the Agent Orange Advisory Committee to the Texas Department of Health. University of Texas System Cancer Center.


O’Brien TR, Decoufle P, Boyle CA. 1991. Non-Hodgkin’s lymphoma in a cohort of Vietnam veterans. American Journal of Public Health 81:758–760.

O’Toole BI, Marshall RP, Grayson DA, Schureck RJ, Dobson M, French M, Pulvertaft B, Meldrum L, Bolton J, Vennard J. 1996a. The Australian Vietnam Veterans Health Study: I. Study design and response bias. International Journal of Epidemiology 25(2):307–318.

O’Toole BI, Marshall RP, Grayson DA, Schureck RJ, Dobson M, French M, Pulvertaft B, Meldrum L, Bolton J, Vennard J. 1996b. The Australian Vietnam Veterans Health Study: II. Self-reported health of veterans compared with the Australian population. International Journal of Epidemiology 25(2):319–330.

O’Toole BI, Marshall RP, Grayson DA, Schureck RJ, Dobson M, French M, Pulvertaft B, Meldrum L, Bolton J, Vennard J. 1996c. The Australian Vietnam Veterans Health Study: III. Psychological health of Australian Vietnam veterans and its relationship to combat. International Journal of Epidemiology 25(2):331–340.


Pavuk M, Schecter AJ, Akhtar FZ, Michalek JE. 2003. Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) levels and thyroid function in Air Force veterans of the Vietnam War. Annals of Epidemiology 13(5):335–343.

Pollei S, Mettler FA Jr, Kelsey CA, Walters MR, White RE. 1986. Follow-up chest radiographs in Vietnam veterans: are they useful? Radiology 161:101–102.


Rellahan WL. 1985. Aspects of the Health of Hawaii’s Vietnam-Era Veterans. Honolulu, HI: Hawaii State Department of Health, Research, and Statistics Office.


Snow BR, Stellman JM, Stellman SD, Sommer JF. 1988. Post-traumatic stress disorder among American Legionnaires in relation to combat experience in Vietnam: associated and contributing factors. Environmental Research 47:175–192.

Steenland K, Calvert G, Ketchum N, Michalek J. 2001. Dioxin and diabetes mellitus: an analysis of the combined NIOSH and Ranch Hand data. Occupational and Environmental Medicine 58:641–648.

Stellman JM, Stellman SD, Sommer JF. 1988a. Social and behavioral consequences of the Vietnam experience among American Legionnaires. Environmental Research 47:129–149.

Stellman SD, Stellman JM, Sommer JF Jr. 1988b. Health and reproductive outcomes among American Legionnaires in relation to combat and herbicide exposure in Vietnam. Environmental Research 47:150–174.


Tarone RE, Hayes HM, Hoover RN, Rosenthal JF, Brown LM, Pottern LM, Javadpour N, O’Connell KJ, Stutzman RE. 1991. Service in Vietnam and risk of testicular cancer. Journal of the National Cancer Institute 83:1497–1499.

Thomas TL, Kang HK. 1990. Mortality and morbidity among Army Chemical Corps Vietnam veterans: a preliminary report. American Journal of Industrial Medicine 18:665–673.

Thomas TL, Kang H, Dalager N. 1991. Mortality among women Vietnam veterans, 1973–1987. American Journal of Epidemiology 134:973–980.

True WR, Goldberg J, Eisen SA. 1988. Stress symptomatology among Vietnam veterans. Analysis of the Veterans Administration Survey of Veterans II. American Journal of Epidemiology 128:85–92.


Visintainer PF, Barone M, McGee H, Peterson EL. 1995. Proportionate mortality study of Vietnam-era veterans of Michigan. Journal of Occupational and Environmental Medicine 37(4): 423–428.


Watanabe KK, Kang HK. 1995. Military service in Vietnam and the risk of death from trauma and selected cancers. Annals of Epidemiology 5(5):407–412.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×

Watanabe KK, Kang HK. 1996. Mortality patterns among Vietnam veterans: a 24-year retrospective analysis. Journal of Occupational and Environmental Medicine 38(3):272–278.

Watanabe KK, Kang HK, Thomas TL. 1991. Mortality among Vietnam veterans: with methodological considerations. Journal of Occupational Medicine 33:780–785.

Wendt AS. 1985. Iowa Agent Orange Survey of Vietnam Veterans. Iowa State Department of Health.

Wolfe WH, Michalek JE, Miner JC, Rahe A, Silva J, Thomas WF, Grubbs WD, Lustik MB, Karrison TG, Roegner RH, Williams DE. 1990. Health status of Air Force veterans occupationally exposed to herbicides in Vietnam. I. Physical health. Journal of the American Medical Association 264:1824–1831.

Wolfe WH, Michalek JE, Miner JC, Rahe AJ, Moore CA, Needham LL, Patterson DG. 1995. Paternal serum dioxin and reproductive outcomes among veterans of Operation Ranch Hand. Epidemiology 6(1):17–22.

Suggested Citation:"Appendix C Epidemiological Studies of Vietnam Veterans Health." Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press. doi: 10.17226/11590.
×
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Next: Appendix D Calculation of Expected Number of Deaths in the US Air Force Ranch Hand Morbidity Study Cohort over the Next 10 Years »
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The Vietnam War was fought in a jungle environment that provided cover to the enemy and made battlefield observations difficult, so military strategists used herbicides to remove foliage along key roads and waterways, defoliate areas surrounding enemy bases and supply and communications routes, and improve visibility in heavily canopied forests. The last three decades have seen an ongoing debate about the effects of this military use of herbicides and the potential adverse long-term health effects on those who may have been exposed to these herbicides.

In response to these concerns, the Air Force Health Study (AFHS) was created to investigate the potential relationship between the herbicides used and the health problems of those exposed. Disposition of the Air Force Health Study assesses the scientific merit of the AFHS operations and procedures, and makes recommendations for improvement.

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