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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 (NRC), whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. Ordinarily, the NRC appoints a committee of experts to produce a report, which then undergoes independent review according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. In the case of this report, the Medical Follow-up Agency’s (MFUA) general oversight body, the Committee on Epidemiology and Veterans’ Follow-up Studies, has provided overall guidance; the study, however, was conducted by MFUA staff and the report written by an MFUA staff officer. Although this report has been reviewed in accordance with established NRC procedures, it represents the views of its author and not the deliberations of an expert NRC committee.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education.

This project was supported by funds from the Department of Veterans Affairs under contract V101(93)P-1225.

Library of Congress 92-62023

ISBN 0-309-04791-9

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Copyright 1992 by the National Academy of Sciences. All rights reserved.

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.



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