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Improving the Presumptive Disability Decision-Making Process for Veterans (2008)
Board on Military and Veterans Health (BMVH)

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. "Appendix H: IOM's Statements of Task and Conclusions for Agent Orange and Gulf War Reports." Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press, 2008.

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Improving the Presumptive Disability Decision-Making Process for Veterans

estimates of statistical association, risk, and biological plausibility. For each disease, determine, to the extent that available data permitted meaningful determinations:

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

  2. The increased risk of the disease among those exposed to herbicides during Vietnam service; and

  3. Whether there is a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.

The committee was also asked to address the following specific areas of concern as requested by the Department of Veterans Affairs (VA):

  • The relationship between exposure to herbicides and the development of acute and subacute peripheral neuropathy;

  • The relationship between exposure to herbicides and the development of prostate cancer, hepatobiliary cancer, and nasopharyngeal cancer; and

  • The relationship between the length of time since first exposed and the possible risk of cancer development.

1999. Veterans and Agent Orange: Update 1998

Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Second Biannual Update)

Statement of Task:

Conduct a second review and evaluation of the newly published scientific evidence regarding associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. For each disease, determine, to the extent that available data permitted meaningful determinations:

  1. Whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiologic methods used to detect the association;

  2. The increased risk of the disease among those exposed to herbicides during Vietnam service; and

  3. Whether there is a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.

The committee also addressed the following specific areas of interest as identified by VA:

  • The relationship between exposure to herbicides and the subsequent development of diabetes;

  • The issue of the latency between exposure to herbicides and development of adverse health outcomes;

  • The classification of chondrosarcomas of the skull;

Page
571
Front Matter (R1-R32)
General Summary (1-6)
Summary (7-26)
1 Introduction (27-35)
2 A Brief History of Presumptive Disability Decisions for Veterans (36-51)
3 The Presumptive Disability Decision-Making Process (52-69)
4 Legislative Background on Presumptions (70-82)
5 Case Studies Summary Chapter (83-135)
6 Establishing an Evidence-Based Framework (136-149)
7 Scientific Evidence for Causation in the Population (150-174)
8 Synthesizing the Evidence for Causation (175-197)
9 Applying Population-Based Results to Individuals: From Observational Studies to Personal Compensation (198-236)
10 Health and Exposure Data Infrastructure to Improve the Scientific Basis of Presumptions (237-297)
11 Governmental Classification and Secrecy (298-308)
12 The Way Forward (309-328)
13 Recommendations (329-338)
Appendix A: Statement of the Veterans' Disability Benefits Commission to the Institute of Medicine's Committee on the Presumptive Disability Decision-Making Process, May 31, 2006 (339-343)
Appendix B: Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans Open Session Meeting Agendas (344-348)
Appendix C: Glossary (349-408)
Title Page (409-409)
Appendix D: Historical Background (410-423)
Appendix E: Arguments Favoring and Opposing Presumptions (424-433)
Appendix F: Tables: Summary of Presumptive Disability Decision-Making Legislative History (434-565)
Appendix G: VA's White Paper on the Presumptive Disability Decision-Making Process (566-569)
Appendix H: IOM's Statements of Task and Conclusions for Agent Orange and Gulf War Reports (570-591)
Appendix I: Case Studies (592-709)
Appendix J: Causation and Statistical Causal Methods (710-719)
Appendix K: Sources of Health and Exposure Data for Veterans (720-763)
Appendix L: Additional Classification and Secrecy Information (764-773)
Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff (774-781)