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Veterans and Agent Orange: Update 1998 (1999)
Institute of Medicine (IOM)

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Veterans and Agent Orange: Update 1998

Index

Note to the reader: This index contains entries for each of the three volumes of the Veterans and Agent Orange series released to date: Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (I), Veterans and Agent Orange: Update 1996 (II), and Veterans and Agent Orange: Update 1998 (III). Page numbers for the discussions of topics in specific volumes follow the roman numerals denoted above. Thus, for example, the entry ''Agent Blue, I: 27, 89-90, 93, 97, 100; III: 136, 137" first refers to material found on pages 27, 89-90, 93, 97, and 100 in Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam, then to material found on pages 136 and 137 of Veterans and Agent Orange: Update 1998.

A

Acquired immune deficiency syndrome. See AIDS/HIV

Acute lymphocytic leukemia (ALL). See Leukemia

Acute myeloid leukemia (AML). See Leukemia

ADA. See American Diabetes Association (ADA)

Adipose tissue

TCDD distribution, I: 130, 131, 168-169, 259, 269, 280

Aerial spraying, I: 3, 24; III: 135, 137, 139

military early research, I: 25-26; III: 28

records of, I: 84-85, 287

See also Herbicide application methods; Herbicides

AFHS. See Air Force Health Study (AFHS)

Aflatoxin, I: 453

Africa

sub-Saharan, II: 181; III: 282

Age and aging

acute lymphocytic leukemia incidence, data for selected age groups, III: 384

acute myeloid leukemia incidence, data for selected age groups, III : 384

bone cancer incidence, data for selected age groups, III: 302

brain cancer incidence, data for selected age groups. III: 356

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547

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Veterans and Agent Orange: Update 1998 Index Note to the reader: This index contains entries for each of the three volumes of the Veterans and Agent Orange series released to date: Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (I), Veterans and Agent Orange: Update 1996 (II), and Veterans and Agent Orange: Update 1998 (III). Page numbers for the discussions of topics in specific volumes follow the roman numerals denoted above. Thus, for example, the entry ''Agent Blue, I: 27, 89-90, 93, 97, 100; III: 136, 137" first refers to material found on pages 27, 89-90, 93, 97, and 100 in Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam, then to material found on pages 136 and 137 of Veterans and Agent Orange: Update 1998. A Acquired immune deficiency syndrome. See AIDS/HIV Acute lymphocytic leukemia (ALL). See Leukemia Acute myeloid leukemia (AML). See Leukemia ADA. See American Diabetes Association (ADA) Adipose tissue TCDD distribution, I: 130, 131, 168-169, 259, 269, 280 Aerial spraying, I: 3, 24; III: 135, 137, 139 military early research, I: 25-26; III: 28 records of, I: 84-85, 287 See also Herbicide application methods; Herbicides AFHS. See Air Force Health Study (AFHS) Aflatoxin, I: 453 Africa sub-Saharan, II: 181; III: 282 Age and aging acute lymphocytic leukemia incidence, data for selected age groups, III: 384 acute myeloid leukemia incidence, data for selected age groups, III : 384 bone cancer incidence, data for selected age groups, III: 302 brain cancer incidence, data for selected age groups. III: 356

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Veterans and Agent Orange: Update 1998 breast cancer incidence in US women, data for selected age groups, III: 324 cancer age-specific incidence, I: 436-438 chronic lymphocytic leukemia incidence, data for selected age groups, III: 384 chronic myeloid leukemia incidence, data for selected age groups, III : 384 diabetes prevalence, data by age, III: 492 epidemiologic studies, control of aging effects, II: 261-262; III: 409 female reproductive system cancer incidence, data by type, for selected age groups, III: 329, 330 gastrointestinal tract cancer incidence, data by type for selected age groups, III: 267 Hodgkin's disease incidence, data for selected age groups, III: 372 laryngeal cancer incidence, data for selected age groups, III: 292 latency and, II: 261-262, 273, 275; III: 409, 414-415, 425, 428, 430 leukemia incidence, data by type, for selected age groups, III: 384 liver/intrahepatic bile duct cancers incidence, data for selected age groups, III: 282 lung cancer incidence, data for selected age groups, III: 296 melanoma incidence, data for selected age groups, III: 313 multiple myeloma incidence, data for selected age groups, III: 377 nasal/nasopharyngeal cancer incidence, data for selected age groups, III: 289 non-Hodgkin's lymphoma age of onset, I: 436 non-Hodgkin's lymphoma incidence, data for selected age groups, III: 362 prostate cancer incidence, data for selected age groups, III: 334 renal cancers incidence, data for selected age groups, III: 352 soft-tissue sarcoma age of onset, I: 436 soft-tissue sarcoma incidence, data for selected age groups, III: 306 testicular cancer incidence, data for selected age groups, III: 343 urinary bladder cancer incidence, data for selected age groups, III: 347 See also Demographic data, Vietnam veterans Agent Blue, I: 27, 89-90, 93, 97, 100; III: 136, 137 volume used in Operation Ranch Hand, data. III: 136 Agent Green, I: 27, 90, 92, 114; III: 136, 137, 140, 146 volume used in Operation Ranch Hand, data, III: 136 Agent Orange, II: 308; III: 130, 159, 315, 344, 359, 389, 407, 444, 460, 462, 489, 491 Air Force research activities, II: 31-32; III: 28-29 birth defects association, II: 298, 300; III: 435 cancer latency issues, II: 260-276; III: 407-431 chemical composition, I: 27; II: 102 chloracne association, II: 317, 318; III: 479 congressional hearings, II: 27-28; III: 25 defoliant effectiveness, I: 90 Department of Veterans Affairs activities, II: 29-31, 153, 156-157; III: 27-28 Environmental Protection Agency research activities, II: 32; III: 29-30 exposure opportunity index (EOI), II: 290-291; III: 146-148 federal government action/research, I: 45-60; II: 27-32; III: 27-32 health effects of, concerns, I: 2; II: 19-23, 26-27; III: 19-20, 236, 237, 240, 242, 243 International Agency for Research on Cancer research activities, III: 30 legislation, I: 47-52; II: 28-29; III: 26-27 Orange II formulation, I: 90; III: 137 product liability litigation, I: 34-35 spontaneous abortion increased risk, II: 283 suspension of use, I: 92-93; II: 26 TCDD as contaminant of, I: 91, 114, 126-127; II: 102; III: 140 Vietnam amount used, I: 1, 27, 74, 90, 97-98, 106; II: 1, 26; III: 136 Vietnam military application, I: 1, 3, 27, 74, 84-85, 90, 92-93, 97-107, 543-545; II: 1, 26-27; III: 1, 25, 136-138, 140 Vietnam surplus disposal, I: 93-94 Vietnam veterans' concerns, I: 32-34; II: 26-27

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Veterans and Agent Orange: Update 1998 Vietnam veterans' increased disease risk, II: 22-23; III: 22-23, 272 volume used in Operation Ranch Hand, data, II: 136 See also Herbicides; Incineration, of Agent Orange Agent Orange, the Deadly Fog, I: 33 Agent Orange Act of 1991. See Public Law 102-4 Agent Orange Briefs, I: 56; II: 31; III: 28 Agent Orange Registry (AOR), I: 20, 53, 56, 729; II: 29, 31, 153, 228; III: 28, 344 See also Department of Veterans Affairs, U.S. (DVA) Agent Orange Review, I: 56; II: 31; III: 28 Agent Orange Scientific Task Force, I: 60-61 Agent Orange Study, I: 19, 57, 58-59, 63-64, 276-278; II: 102; III : 147, 148 Agent Orange Task Force, II: 24-26; III: 24-25, 148 See also Department of Veterans Affairs, U.S. (DVA) Agent Orange Validation Study, III: 240 Agent Orange Victims International, I: 34 Agent Orange Working Group, I: 19, 46, 58, 277, 743 research methodology, I: 728 Agent Pink, I: 27, 90, 92, 114; III: 136, 137, 140, 146 volume used in Operation Ranch Hand, data, III: 136 Agent Purple, I: 27, 89, 92, 114; III: 136, 140, 146 TCDD in, I: 126 volume used in Operation Ranch Hand, data, III: 136 Agent White, I: 27, 90, 92-93, 97, 115, 189; III: 136, 137 volume used in Operation Ranch Hand, data, III: 136 Agricultural/forestry workers brain tumors, I: 320, 523; II: 136 Canadian Farmer Cohort, II: 135-136 cancers, I: 13, 37, 320-323, 443, 447, 454; II: 133-137, 179 case-control studies, I: 326-341, 486-488; II: 118-122, 138-140; III: 185-195, 228-232 cohort studies, I: 318-323; II: 118-120, 135-137, 197-198; III: 178-185, 224-228 epidemiologic studies, I: 37, 318-323; II: 118-120, 135-137, 232-234, 238-239, 241-243; III: 178-195, 224-232, 284-285, 335, 364-365, 379-380, 387-388 female reproductive and breast cancers, I: 510-511 hepatobiliary cancer, I: 454; II: 183-184; III: 284-285 herbicide exposure assessment, I: 265-266; III: 154-157 Hodgkin's disease, I: 550-553; II: 135 Irish agricultural workers study, II: 136-137 kidney cancer, I: 515 leukemia, I: 332-335, 566-568; II: 136; III: 387-388 multiple myelomas, I: 11-12, 558-561; II: 138-139, 238-239, 241-243; III: 379-380 non-Hodgkin's lymphoma, I: 9, 256-257, 530-540; II: 138, 139, 232-234; III: 364-365 prostate cancer, I: 11, 518, 519, 575; II: 8-9; III: 335 reproductive outcomes, I: 510-511, 598 respiratory cancer, I: 11, 466; II: 197-198 soft-tissue sarcomas, I: 37, 326-328, 479-481, 486-488 sperm dysfunction, I: 632 suicide, I: 650 See also Forests; Professional herbicide/ pesticide applicators Agricultural herbicides, I: 24, 35, 39, 174-175, 181; II: 137-139 See also Herbicides Agriculture. See Agricultural/forestry workers; Food crops; Forests Ah receptor (AhR), I: 3, 123, 134; II: 3-4, 51-53, 54-56, 57-62; III: 54-58, 129 animal studies and, I: 114, 123; II: 3-4, 51-53, 54-56, 57-62, 92-93; III: 33, 34, 35, 54-58, 62-63, 67-69, 129 anti-estrogenicity and, II: 62; III: 67-69 biological consequences of activation, II: 57; III: 62 blood abnormalities, I: 125 cacodylic acid acute toxicity, I: 188 cacodylic acid carcinogenicity, I: 118, 119, 187 cacodylic acid chronic exposure, I: 188-189

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Veterans and Agent Orange: Update 1998 cacodylic acid developmental toxicity, I: 189 cacodylic acid genotoxicity, I: 187-188 cacodylic acid mechanism of action, II: 50; III: 49-50 cacodyhc acid mechanism of toxicity, II: 50-51 cacodylic acid pharmacokinetics, I: 186-187 cacodylic acid renal toxicity, II: 50-51 cacodylic acid reproductive toxicity, I: 189 cacodylic acid toxicity summary, II: 50 cacodylic acid toxicokinetics, II: 50; III: 48 characteristics of, I: 111-114 combinatorial interactions, II: 57-58 DNA binding capability and transcription activation of. II: 56-57; III: 58-61 evidentiary role, I: 228 free radicals and, II: 60; III: 64-65 generalizability, I: 112, 113, 114, 118, 122-123, 160 growth/differentiation signaling. III: 62-63 growth factor and, II: 59 hepatic abnormalities. I: 124-125, 688 human health relevance of toxicology, III: 35-36 inconsistencies in, II: 57-62 ligand-independent activation, II: 58 male-mediated disorders, I: 593-594 multiple forms of, II: 57 nervous system and, I: 161 nonhuman primates, I: 151 picloram in, I: 118, 119, 125, 190-192; III: 51 protein kinases and, II: 60-62; III: 65-67 redox signaling, III: 64-65 signaling interactions, II: 59-62; III: 62-69 structural and functional aspects of, II: 54-56; III: 54-58 TCDD acute toxicity, II: 75-76 TCDD biologic plausibility and, I: 3, 133-138, 452-453 TCDD carcinogenicity and, I: 3, 116, 118, 138-142, 439; II: 3, 65-68 TCDD cardiovascular toxicity, I: 171; II: 76; III: 74-75 TCDD dermal toxicity, I: 173-174; II: 76 TCDD developmental toxicity, I: 123-124, 156-157, 159-160; II: 3, 71, 72-73; III: 92-105 TCDD disease outcomes, II: 3; III: 39-43, 71-105 TCDD endocrine effects. III: 83-84 TCDD gastrointestinal toxicity, I: 169-170 TCDD hepatotoxicity and, I: 124-125, 151-156, 457; II: 3-4, 73-75; III: 76-79 TCDD immunotoxicity, I: 119-122, 146-151; II: 3, 68-71; III: 85-92 TCDD-induced wasting syndrome, I: 162-166; II: 76-77; III: 80-83 TCDD lethality, III: 71-73 TCDD mechanism of action, II: 3, 54-65; III: 51-53, 54-58, 62-63, 67-69 TCDD mechanism of toxicity, II: 65-77 TCDD metabolic toxicity, I: 166-169 TCDD neurotoxicity, I: 160-166; II: 3, 75; III: 84-85 TCDD pharmacokinetics, I: 127-133 TCDD renal toxicity, II: 77; III: 75-76 TCDD reproductive toxicity, I: 123-124, 156-159; II: 3, 71-72; III: 92-105 TCDD respiratory tract toxicity, I: 170 TCDD teratogenicity and, I: 159-160 TCDD toxicity update summary, II: 51-53 TCDD toxicokinetics, II: 3, 53-54; III: 4-5, 33 toxicity, potential health risks and contributing factors, III: 106, 107, 108 transcriptional-independent responses, II: 58-59 AIDS/HIV, I: 338, 527, 541, 695; II: 326 Air Force. See U.S. Air Force Air Force Health Study (AFHS), I: 62-63, 260, 272, 622; II: 284, 293-295, 336; III: 23, 25, 29, 239, 438-439, 495, 505, 514 appropriation for, I: 51 autoimmune disease in, I: 698 basal/squamous cell skin cancer in, III: 318, 321, 322 baseline mortality studies, II: 151 birth defects in offspring, II: 286, 293-295; III: 436, 438, 439 bone cancer in, III: 303 cancer and latency in, III: 423, 424, 425, 427

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Veterans and Agent Orange: Update 1998 circulatory disease in, I: 703-705, 706; II: 336; III: 514, 517 data sources, I: 385-386; II: 150-151 diabetes mellitus in, I: 684; II: 330; III: 495, 498-500, 502 epidemiologic studies, II: 31, 32, 149, 150-152, 154-156, 293-295; III: 28-29, 206-207, 218, 237-240, 303, 309-310, 313-314, 318, 321 , 322, 339, 340, 385, 436, 438, 439, 446-447, 449, 452-453, 457-458 , 481, 486, 495, 498-500, 502, 505, 506, 507, 510, 513, 514, 517 exposure assessment in, I: 279-280, 281, 386; II: 4-5, 101, 103, 109; III: 6, 146-147, 157-158, 162 gastrointestinal ulcers in, I: 691; III: 510, 513 immune system disorders in, I: 696 infertility in, II: 280; III: 446-447, 449 lipid abnormalities in, I: 689; II: 333; III: 505, 506, 507 liver toxicity in, II: 332; III: 510, 513 low birthweight in, I: 626, 627; III: 457-458 melanoma in, III: 313-314 methodology, I: 230-231, 385-386, 445, 757-762 multiple myelomas in, I: 562; II: 244, 245 neurological disorders in, I: 659 non-Hodgkin's lymphoma in, I: 541 participants, I: 722-723; II: 150-152 perinatal death in offspring, III: 452-453 peripheral nervous system disorders in, I: 665 porphyria cutanea tarda in, I: 681-682; II: 321-322; III: 481 recommendations for, I: 16-17, 722-724; II: 23, 24 reproductive outcomes in, I: 601, 612-613, 632, 633, 727; II: 293-295; III: 436, 438, 439, 446-447, 449, 452-453, 457-458 respiratory cancers in, I: 469; II: 201 respiratory disorders in, I: 711-712; III: 486 role of, I: 53 skin cancers in, II: 209 skin disorders in, I: 678 soft-tissue sarcoma in, I: 492-493; III: 309-310 spina bifida in offspring, II: 9, 295-296; III: 7, 8, 9-10, 438 spontaneous abortions in, II: 283-284 status of, I: 53; II: 31-32 TCDD half-life estimates, I: 260-261; II: 104-105; III: 37, 50, 157-158 TCDD serum levels, I: 273, 281, 285, 656; II: 101, 103, 105, 109, 351, 356, 357; III: 146, 147 See also Operation Ranch Hand; U.S. Air Force; Vietnam veterans Alanine aminotransferase (ALT), II: 331, 332; III: 45, 509, 510 Alaskan natives Inuit, III: 50-51 See also Race/ethnicity Alberta, Canada, II: 135-136, 232, 242, 246; III: 234-235, 319-320 Alberta Cancer Registry, III: 235 Alberta Health Care Insurance Plan, III: 235 Alcohol consumption, I: 507 ALL. See Leukemia Allergies, II: 327, 329; III: 487-488 See also Immune system disorders Alsea, Oregon, I: 42-43, 372-373, 598 ALT. See Alanine aminotransferase (ALT) American Association for the Advancement of Science, I: 29, 92 Herbicide Assessment Commission, I: 30-31 American Cancer Society, I: 334; II: 177, 181, 189, 191, 204, 205, 209, 211, 217, 223, 228, 231, 239, 245; III: 267, 282, 289, 292, 295, 296, 302, 304, 312, 322, 324, 329, 334, 343, 347, 351, 356, 362, 371, 377, 383 Cancer Prevention Study, II: 239; III: 229 American College of Epidemiology, II: 25 American Diabetes Association (ADA), III: 492, 493, 502 American Industrial Hygiene Association, II: 25 American Journal of Epidemiology, II: 281 American Legion, I: 60, 278-279, 399, 601-602, 626, 633; II: 113, 157 Vietnam veterans' epidemiologic studies, III: 212-213, 243 American Public Health Association, II: 25 American Thoracic Society Epidemiology Standardization Questionnaire, II: 136

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Veterans and Agent Orange: Update 1998 d-Aminolevulinic acid synthetase, I: 153-154 Amitrole, I: 323 AML. See Leukemia Angina, I: 708 See also Circulatory disorders Animal studies; III: 394-396, 524 2,4-D carcinogenicity, I: 118-119, 176-178; II: 48; III: 47, 396 2,4-D chronic exposure, I: 179-180 2,4-D developmental toxicity, I: 124, 180-181; III: 46 2,4-D disease outcomes and mechanisms of toxicity, II: 48-49; III: 38-39, 44-47 2,4-D genotoxicity, I: 178-179 2,4-D immunotoxicity, I: 122-123, 181; III: 46, 423 2,4-D lethality, III: 44-45 2,4-D mechanism of action, II: 47-48; III: 44 2,4-D mechanism of toxicity, II: 48-49 2,4-D neurotoxicity, II: 48; III: 45-46, 473 2,4-D pharmacokinetics, I: 175 2,4-D reproductive toxicity, I: 124, 180, 181; III: 46 2,4-D toxicity profile update summary, II: 46 2,4-D toxicokinetics, II: 46-47; III: 43-44 2,4,5-T acute toxicity, I: 184 2,4,5-T carcinogenicity, I: 118, 119, 182-184; III: 396 2,4,5-T chronic exposure, I: 184 2,4,5-T developmental/reproductive toxicity, I: 124, 185; II: 49-50 2,4,5-T genotoxicity, I: 184 2,4,5-T immunotoxicity, I: 123 2,4,5-T mechanism of action, III: 47-48 2,4,5-T mechanism of toxicity, II: 49-50 2,4,5-T pharmacokinetics, I: 182 2,4,5-T toxicity profile update summary, II: 49 2,4,5-T toxicokinetics, II: 49; III: 47 Anthropometry. See Body weight AOR. See Agent Orange Registry (AOR) Apoptosis TCDD and, II: 3, 67 Arctic Inuit natives, III: 50-51 Argentina, III: 224 Arkansas, I: 373-374, 663; III: 234 Armed Forces Institute of Pathology, I: 494 Army Chemical Corps. See U.S. Army Chemical Corps Army Reserve Personnel Center, II: 152 Army. See U.S. Army ARNT, II: 4, 45, 55, 56, 57, 58, 66; III: 38, 54-58, 63 Arsenic respiratory cancer and latency, II: 268; III: 420 Aryl hydrocarbon hydroxylase, I: 135, 153, 155-156, 170 Aryl hydrocarbon receptor (AhR). See Ah receptor (AhR) Asbestos respiratory cancer and latency, II: 268; III: 420 Asia, III: 471 Asian Americans, II: 188 See also Race/ethnicity Aspartate aminotransferase (AST), II: 331, 333; III: 45, 509 Assembly of Life Sciences (ALS), I: 62, 63 Association of Birth Defect Children, II: 292 AST. See Aspartate aminotransferase (AST) Asthma, I: 708, 711, 713 See also Respiratory disorders Ataxia, I: 658 See also Motor/coordination dysfunction; Neurobehavioral toxicity Atlanta Congenital Defects Program, I: 387 Atlanta, Georgia, II: 241, 296; III: 229 CDC Birth Defects Study, II: 9; III: 438 Atlantic Ocean, III: 108 Australia, I: 61, 91, 340, 406, 418, 444, 470, 488-489, 537, 546, 614-615, 633, 702, 710; II: 113, 132, 149, 160, 202, 293; III: 216-217, 218, 237, 244-245 Air Force veterans, III: 244 Army veterans, III: 244, 245 Australian National Service Vietnam veterans, III: 273, 286 Bureau of Statistics Health Interview Survey, 1989-1990, III: 245, 485, 511, 517 Department of Defense, III: 244, 245 Department of Veterans Affairs, III: 244, 245 Electoral Commission rolls, III: 245 Health Insurance Medicare, III: 245 herbicide use by forces, III: 137-138 lung cancer mortality in Vietnam veterans, III: 424

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Veterans and Agent Orange: Update 1998 National Death Index, III: 245 Navy veterans, III: 244 Victorian Cancer Registry, III: 232 Vietnam veterans epidemiologic studies, III: 9, 273, 285-286, 290, 294, 295, 298, 299, 303, 310, 311, 314, 315, 327, 329, 339, 340,343, 346, 349, 353, 355, 359, 365, 380, 389, 469, 486, 489, 500,506, 512-513, 517 See also Tasmania Autoimmune disease, I: 697-699 See also Immune system disorders; Systemic autoimmune disease; Systemic lupus erythematosus Autoimmunity, I: 693, 697-699; II: 7, 21, 327, 329; III: 487-488 See also Immune system disorders B Baltic Sea, II: 329; III: 108, 236, 272, 285, 358, 484, 515 Basal/squamous cell skin cancer biologic plausibility, III: 322 epidemiologic studies, III: 317-322, 323 herbicide environmental exposure and, III: 323 herbicide occupational exposure and, III: 321, 323 herbicides association with, III: 317-322, 323 incidence, III: 319-320 mortality studies, III: 319, 321 scientific literature update, III: 319-320 Vietnam veterans and, III: 323 See also Melanoma; Skin cancer BASF, I: 312-313, 444, 530, 550, 558; II: 130-131, 238, 318-319, 325, 330-331, 332-333, 334, 336; III: 153, 154, 174, 221-222, 269-270, 273, 297, 349, 484, 495, 506, 511 Aktiengesellschaft, III: 221 Dioxin Investigation Programme, II: 131 Occupational Safety and Employee Protection Department, II: 131 Basic helix-loop-helix (BHLH), II: 54, 55, 56 Bayer, III: 154 B cell function, I: 147, 148 Beck's Depression Inventory, I: 650, 651 Benefits. See Compensation, veterans BHLH. See Basic helix-loop-helix (BHLH) Bias, methodological. See Methodological bias Binghamton, New York, III: 234 Biochemical warfare, I: 29, 45 Biologic plausibility, II: 88, 92; III: 2, 124, 128 Ah receptor-TCDD interaction, I: 3, 133-137, 439, 452-453; III: 129 altered sperm parameters, I: 634; III: 451 animal studies, I: 228; II: 176; III: 460-462, 474-475 basal/squamous cell skin cancer, III: 322 birth defects, II: 298; III: 444 bladder cancer, III: 351 bone cancer, I: 474; III: 304 brain tumors, I: 525; III: 362 breast cancer, II: 217; III: 327, 329 carcinogenicity, I: 116-118, 119, 146, 176-178, 182-184, 187, 190-191, 439, 451; II: 176; III: 394-397 childhood cancer, I: 630; II: 300 chloracne, I: 678; II: 320-321; III: 480 circulatory disorders, I: 708; III: 518 diabetes mellitus, I: 692; II: 335; III: 502-503 evidentiary role of, I: 111, 114, 223-224, 240-241, 434; II: 88, 92, 176; III: 23 female reproductive system cancers, I: 512; III: 334 fetal/neonatal/infant death, I: 624; III: 453 gastrointestinal tract cancers, III: 281-282 gastrointestinal ulcers, III: 513-514 genitourinary tract cancers, I: 521-522 genotoxicity, I: 178-179, 184, 187-188, 191 hepatobiliary cancer, I: 452-457; III: 286, 288 Hodgkin's disease, I: 557; III: 377 hyperlipidemia, I: 692 immunotoxicity, I: 122, 146-151, 181, 192, 699; III: 491 infertility, I: 634; II: 282; III: 451 laryngeal cancer, III: 295 leukemia, I: 571; III: 390 liver disorders, I: 691-692; II: 335; III: 513-514 low-birthweight outcomes, I: 628; III: 458 lung cancer, III: 302 male-mediated reproductive outcomes, I: 593-595; III: 451 melanoma, III: 317 motor/coordination dysfunction, I: 661; III: 475 multiple myeloma, I: 12, 563; III: 383

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Veterans and Agent Orange: Update 1998 nasal/nasopharyngeal cancer, I: 460; III: 292 neurobehavioral disorders, II: 314; III: 474-475 neuropsychological disorders, I: 658 non-Hodgkin's lymphoma, I: 549; III: 366 peripheral nervous system disorders, I: 666 porphyria cutanea tarda, I: 679, 682; II: 323; III: 482 prostate cancer, III: 343 renal cancers, III: 356 renal toxicity, I: 179-180 reproductive outcomes, I: 123-124, 180-181, 185, 189, 192, 605, 618, 628; II: 300-301; III: 458, 460-462 respiratory cancers, I: 472 respiratory disorders, I: 713; III: 486 skin cancer, I: 503 soft-tissue sarcoma, I: 500; III: 311 testicular cancer, III: 347 See also TCDD biologic plausibility Biological samples, I: 20-21, 729-730 Biomarkers chloracne as, I: 4, 10, 172-173, 262, 401, 672-674; II: 318 exposure assessment and, I: 259-262, 280-284; II: 101-104; III: 146-147 research recommendations, I: 17, 725; II: 25 sperm parameters as, I: 631 Bionetics Research Laboratory, I: 30 Birth defects biologic plausibility, III: 444 definition of, I: 605-606; II: 286; III: 435 epidemiologic studies, II: 140, 286-296; III: 436, 437-438, 443 epidemiology, I: 606; II: 286; III: 435-436 evaluation of epidemiologic data, I: 615-618 herbicide association first reports, I: 1 herbicide association in, I: 13-14, 618; II: 7, 11, 20, 286-296; III: 436-444 herbicide environmental exposure studies, I: 608-609; II: 140, 287-288, 297; III: 437 herbicide occupational exposure studies, I: 607-608; II: 286-287, 297; III: 437 Ranch Hand participants' children and, II: 293-296; III: 436, 438, 439 risk factors of, I: 606-607; II: 298; III: 444 scientific literature update, III: 437, 439-443 Seveso, Italy, study, II: 287; III: 436 summary, II: 295-296 TCDD biologic plausibility in, I: 618; II: 298; III: 460-461 Vietnam veterans' children and, I: 609-615, 618; II: 288-296, 297, 298; III: 435, 436, 437-438 See also Cleft lip/palate; Neural tube disorders; Reproductive disorders; Spina bifida; Teratogenicity Birth Defects Study, II: 9, 290-291, 296; III: 147, 436, 438, 439 See also Centers for Disease Control and Prevention (CDC) Births. See Birth defects; Low birthweight; Perinatal death; Preterm delivery (PTD) Bladder cancer biologic plausibility, III: 351 epidemiologic studies, I: 515-517; II: 225-227; III: 347-351 epidemiology; II: 223; III: 347 herbicide association in, I: 12, 521, 576; II: 7, 12, 21, 225-227, 250; III: 3, 10, 21, 132, 347-351 herbicide environmental exposure and, III: 349, 350-351 herbicide occupational exposure and, III: 348, 350 histopathology, I: 513 incidence, I: 513 incidence, data by age/gender/race, for selected age groups, III: 347 risk factors, I: 513-514 scientific literature update, II: 226-227; III: 348-349 Vietnam veterans' risk, I: 513, 517, 522; II: 223, 226; III: 349, 351 See also Genitourinary cancers Body mass index (BMI), II: 281; III: 499, 502 Body weight loss of and TCDD, II: 3 Boehringer-Ingelheim, I: 313; III: 153-154 Bone cancer biologic plausibility, III: 304 children and, I: 628 chondrosarcomas of the skull, III: 2, 10, 266, 304 epidemiologic studies, III: 303-305 epidemiology, I: 472-473; II: 204; III: 302

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Veterans and Agent Orange: Update 1998 herbicide association in, I: 13, 473-474, 577; II: 6, 11, 20, 204-205, 249-250; III: 7, 10, 303-305 herbicide environmental exposure and, III: 303, 305 herbicide occupational exposure and, III: 303, 305 incidence of, data by gender/race, for selected age groups, III: 302 scientific literature update, II: 204-205; III: 303 Vietnam veterans' risk, I: 473, 474; II: 204 Vietnam veterans studies, III: 303, 305 Boston Hospital for Women, II: 291-292 Brain tumors, I: 339 2,4-D exposure and, I: 119, 176-177 agricultural workers and, I: 320; II: 136 biologic plausibility, III: 362 clinical features, I: 522 epidemiologic studies, II: 136, 229-230; III: 356-361 epidemiology, I: 522-523; II: 228-229; III: 356 herbicide association in, I: 12, 525, 576; II: 7, 12, 21, 229-230, 250; III: 8, 12, 21, 356-362 herbicide environmental exposure and, III: 358, 361 herbicide occupational exposure and, III: 357-358, 360 incidence, data by gender/race, for selected age groups, III: 356 scientific literature update, II: 229-230; III: 357-359 Vietnam veterans' risk, I: 525; II: 228-229, 230 Vietnam veterans studies, III: 358-359, 361 Breast cancer agricultural workers and, I: 510 biologic plausibility, II: 217; III: 327, 329 epidemiologic studies, II: 214-216, 217; III: 324-328 epidemiology, I: 505, 506-507; II: 213-214; III: 322, 324 herbicide association in, I: 13; II: 6, 11, 12, 20, 89, 213-217, 249-250; III: 7, 10, 324-329 herbicide environmental exposure studies, I: 511, 512; III: 328 herbicide occupational exposure studies, II: 214-216; III: 324-326, 328 histopathology, I: 505-506 incidence in US women, data by race, for selected age groups, III: 324 risk, estimated, II: 218 risk factors, I: 507 scientific literature update, III: 326-327 Vietnam veterans' risk, I: 505, 511, 213, 216-217; III: 329 Vietnam veterans studies, III: 326, 328 See also Reproductive system cancers, women British Columbia, Canada, III: 10, 227-228, 338, 439-440, 447-448, 449, 452, 453, 457 Cancer Incidence File, III: 227 Death File, III: 227 Division of Vital Statistics, III: 452, 457 Health Surveillance Registry, III: 227, 439 Bronchitis, I: 708, 711, 713 See also Respiratory disorders Bronchus cancer. See Lung cancer Brown, Jesse, II: 24; III: 24, 25 Bureau of Labor Statistics, I: 79, 80 Bureau of the Census, III: 231 n-Butyl esters, I: 27 C Cacodylic acid, I: 88-89; II: 4; III: 5, 19, 32, 135, 136, 137, 218 acute toxicity, I: 188 animal studies, I: 185-189; II: 50-51; III: 34, 38, 48, 49-50, 396 carcinogenicity, I: 118, 119, 187; II: 40; III: 396 chemical properties/structure, I: 111, 114, 186; II: 38; III: 32 chronic exposure, I: 188-189 developmental toxicity, I: 124, 189 dimethylarsenic radical formation and, II: 4 disease outcomes, III: 34, 50 domestic use, I: 185-186 genotoxicity, I: 119, 187-188 kidney toxicity, I: 125; II: 42 mechanism of action, II: 50; III: 38, 49-50 mechanisms of toxicity, II: 50-51 metabolism, I: 115, 116

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Veterans and Agent Orange: Update 1998 pharmacokinetics, I: 186-187 renal toxicity, II: 50-51 reproductive toxicity, I: 124, 189; II: 42 toxicity update summary, II: 50 toxicokinetics, II: 50; III: 32-33, 48 Vietnam formulations, I: 186 volume used in Operation Ranch Hand, data, III: 136 Calcium homeostasis of and 2,4,5-T, II: 4 California, I: 341; III: 232 See also Irvine, California Ca Mau peninsula, Vietnam, I: 100, 104 Camp Dram, New York, I: 25-26, 89 Canada, I: 11, 319-320, 323, 374-375, 443, 467-468, 537-539, 620, 650; II: 8, 132, 135-136, 140, 219-220, 243, 248; III: 226, 232,303, 309, 335, 344, 348, 353 Census of Agriculture, 1971, II: 135 Census of Population, 1971, II: 135 Central Farm Register, 1971, II: 135 Central Farm Register, 1981, II: 135 Mortality Data Base, II: 135; III: 227 Mortality Study of Canadian Male Farm Operators, II: 135-136; III: 224 Saskatchewan Cancer Foundation, II: 139 Saskatchewan Hospital Services Plan, II: 139 Statistics Canada, III: 227 See also Alberta, Canada; British Columbia, Canada; Manitoba, Canada; New Brunswick, Canada; Ontario, Canada; Saskatchewan, Canada Cancer age-specific incidence, I: 436-438 agricultural workers and, I: 320-323, 443; II: 136, 137-138 biologic plausibility, I: 116-118, 119, 434; II: 176; III: 394-397 children and, I: 14, 594-595, 628-631 clinical features, I: 433-436 epidemiologic studies, I: 45, 317, 320-323, 325-326, 367, 383-384, 391-393, 443-445; II: 133-138, 147-148 epidemiology, I: 433, 435-438, 442, 525; II: 175; III: 265-266 herbicide association, insufficient evidence for determining, I: 13-14, 577-578; II: 249-250; III: 393 herbicide association, limited/suggestive evidence of, I: 10-12, 574-576; II: 247-249; III: 393 herbicide association, no evidence of, I: 12-13, 576-577; II: 250; III: 393-394 herbicide association, sufficient evidence of, I: 8-10, 572-574; II: 175, 176, 247; III: 390, 392 herbicide environmental exposure epidemiologic studies, I: 444, 469; II: 147-148 herbicide exposure measures, H: 175, 176; III: 265-266 herbicide occupational exposure studies, I: 443-444; II: 133, 134 herbicide/pesticide applicators and, I: 320-321, 323, 325-326, 443, 447, 466-468, 488, 491; II: 137-138 herbicides, categories of association in, I: 572 mortality studies, I: 442-445; II: 133, 134, 136, 137, 263; III: 410-411, 421, 422, 423, 424, 426, 427, 429 multistage model, I: 142-143, 434, 439 P450 induction to, I: 144-145, 170 phenoxy herbicide association in, I: 483; III: 422, 423, 429 research priorities, I: 19, 727 research recommendations, I: 19, 727 risk assessment, I: 442-443, 578; II: 251, 276; III: 430-431 site groupings for ICD-9 cancer codes, III: 537-539 TCDD animal studies, I: 138-142; II: 176; III: 394, 396 TCDD genotoxicity, I: 143-144 TCDD in initiation/promotion, I: 116, 142-143, 434, 439 TCDD in P450 induction to, I: 144-145 Vietnam civilians, II: 148 Vietnam veterans, expected incidence, I: 439-440, 442, 452, 460-461, 473, 475, 501, 505, 513, 522, 526, 564; II: 176-177; III: 266-267 Vietnam veterans' risk, I: 391-393, 401, 402-403, 405, 436-438, 444-445, 578; II: 251, 276; III: 397, 430-431 See also Latency effects in cancer studies; specific cancers; specific cancer sites Carcinogen(s) 2,4-D as, I: 118-119, 176-178; II: 40, 48; III: 47, 396

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Veterans and Agent Orange: Update 1998 2,4,5-T as, I: 118, 119, 182-184; II: 40; III: 396 cacodylic acid as, I: 118, 119, 187; II: 40; III: 396 herbicides as, I: 3, 40; II: 273, 275; III: 426, 428, 430 mechanism of action, I: 434 picloram as, I: 118, 119, 190-191; II: 40; III: 396 TCDD as, I: 3, 116-118, 434, 439; II: 3, 39-40, 65-68; III: 394, 396 See also Cancer Cardiovascular system disorders cardiomegaly, I: 703 circulatory disorders, I: 699-709 lipid abnormalities in, I: 688 TCDD in, I: 171; II: 76; III: 74-75 See also Circulatory disorders; Myocardial infarction Case-control studies agricultural/forestry workers, I: 326-341; II: 138-140; III: 185-195, 228-232 evidentiary role of, I: 234-235, 727; II: 94-95, 178, 179, 180, 188; III: 130 herbicide environmental exposure, II: 144-146, 148-149, 184, 186, 190, 193, 241; III: 201-204 herbicide exposure assessment for, I: 256-257, 727 herbicide occupational exposure, II: 122-127, 138-140, 183, 184, 186, 188, 190, 193, 200, 222, 240; III: 173, 175, 185-196 paper/pulp workers, II: 126-127, 200 Vietnam veterans, II: 155-157, 159-160, 187, 223; III: 208-217 Causality statistical association vs., I: 7, 227, 239, 246; II: 5, 19, 97, 247; III: 6, 20, 132-133, 390 CDC. See Centers for Disease Control (CDC); Centers for Disease Control and Prevention (CDC) CDDs. See Chlorinated dibenzo-p-dioxins (CDDs) Cell-mediated immunity (CMI) TCDD and, II: 69-70 Cell proliferation TCDD and, II: 3, 67 Cellular retinoic acid binding protein, type II (CRABP-II), II: 73 Census Bureau. See Bureau of the Census Centers for Disease Control (CDC), I: 19, 40-41, 51; III: 363, 517 Agent Orange action/research, I: 57-62, 63-64; II: 28; III: 25 Agent Orange Study, I: 276-278; II: 102 birth defects research, I: 387-389, 609-612; II: 289 exposure opportunity index, I: 274-276, 611-612; II: 290-291; III: 147-148 research methodology, I: 728 validation study, I: 59, 260-261, 281-284, 285, 387, 742-743; II: 103, 104; III: 240 See also Cerebrospinal Malformation (CSM) Study; General Birth Defects Study (GBDS); Selected Cancers Study; Vietnam Experience Study (VES) Centers for Disease Control and Prevention (CDC), II: 9 epidemiologic studies, II: 113, 155-156; III: 26, 207-209, 218, 240 TCDD half-life investigation, II: 104-105 See also Birth Defects Study; Vietnam Experience Study (VES) Central nervous system (CNS). See Cognitive/ neuropsychiatric disorders; Motor/ coordination dysfunction; Neurologic disorders Cerebrospinal Malformation (CSM) Study, I: 610; II: 289-290 Cerebrovascular disease, I: 702 stroke, I: 658, 659, 660 Cervical cancer, I: 13, 505, 509, 510, 512; II: 6; III: 329, 330, 332 Chemical production. See Herbicides; Industrial accidents; Production workers Chemicals and chemical industry Agent Orange product liability litigation, I: 34-35 CDD contamination in production, I: 91, 126 hexachlorophene production, I: 40; II: 128 production workers exposure studies, I: 303-318; II: 114-118, 128-135, 171-175, 182-183, 191, 193-197, 206-207, 232, 237-238, 273-274, 275; : 170-178, 218, 219-224, 284, 363-364, 378-379, 386-387, 420, 423, 426, 429 See also Herbicides; Industrial accidents

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Veterans and Agent Orange: Update 1998 interactions, significant, III: 69-71 intracellular communication of, II: 3, 67-68 latency issues, II: 13-14, 269, 270, 272; III: 420, 421, 423, 424, 425, 426, 429, 431 lethality, III: 71-73 leukemia association, II: 246; III: 386-388, 390 lipid abnormalities and, I: 688-690; II: 333-334; III: 505, 506,507 liver toxicity, I: 115-116, 124, 138-139, 142, 143, 151-156, 165-166; II: 42, 331-333; III: 509 lung cancer and, III: 297-298, 299, 421, 423 mechanism of action, animal studies, II: 3, 54-65; III: 54-58, 62-63, 67-69 mechanisms of toxicity, II: 65-77 metabolism, I: 115-116, 131-133, 155 multiple myeloma association, II: 237-238, 243, 244; III: 378-380, 383 nasal/nasopharyngeal cancer and, I: 460 neuropsychiatric outcomes and, I: 649-650, 651-652, 656, 657-658; II: 308 neurotoxicity, I: 160-166, 642; II: 3, 75; III: 84-85, 469, 470-471 non-Ah-mediated toxicity, I: 138 non-Hodgkin's lymphoma and, I: 8, 9, 528-529, 574; II: 5, 6, 231-234; III: 364, 429 occupational exposure, I: 36-39, 262-267, 269-270, 303; II: 108-109, 113-140, 178-179, 190, 191-200, 219-220, 222, 232-234, 237-238; III: 153, 154, 155, 219, 220, 221-222, 223, 224, 284-285, 293, 296-297, 303 opioid antagonist capacity, I: 164 oral administration, I: 128 perinatal death association, II: 285-286 peripheral neuropathy and, II: 310-311, 314; III: 470-471 pharmacokinetics, I: 127-133, 160, 259-261, 284 porphyria cutanea tarda and, II: 5, 6, 321-323; III: 481-482 potential health risk estimating, II: 63-65; III: 105-108 production of, I: 28, 114 prostate cancer association, II: 220-223, 273, 274, 275; III: 336-337, 425, 426 protein kinases and, II: 60-62; III: 65-67 Qsar model approach, III: 106 Ranch Hand study, II: 109; III: 50, 146-147 renal cancer association, II: 225; III: 353 renal toxicity, II: 77; III: 75-76 reproductive toxicity, I: 123-124, 156-159, 368, 371-372, 597, 599, 605; II: 3, 41-42, 71-72; III: 92-105, 446, 449 respiratory cancers and, II: 13-14, 189-203, 269, 270, 272 respiratory disorders and, I: 170, 472, 709-710, 712-714; III: 484 sensitivity interspecies and interindividual differences, II: 63-64; III: 108 skin cancer and, I: 141, 142-143, 502-503; II: 209-211; III: 313-316, 317, 319, 320, 322 soft-tissue sarcoma and, I: 477, 478, 490, 498-500; II: 5, 6, 205-208; III: 307, 308 solubility, I: 114, 115-116, 127 teratogenicity, I: 28-29, 30, 31, 123, 159-160, 185, 368, 370, 372; III: 461 testicular cancer association, II: 228; III: 346 tissue specificity, II: 64 toxic equivalency factors approach, II: 63; III: 106, 158, 159 toxic equivalent concentration approach, III: 107 toxicity, factors influencing, II: 63-65; III: 105-108 toxicity profile, III: 50-108 toxicity update summary, II: 51-53 toxicokinetics, animal studies, II: 3, 53-54; III: 4-5, 48 Vietnam amount used, I: 27, 106; II: 26 Vietnamese civilians' exposure, II: 108-109, 148; III: 156-157 Vietnam military exposure, I: 17, 26, 149-161; II: 21, 22, 181, 185, 187, 190, 201-202, 204, 205, 208, 209, 211, 212, 226, 276, 308; III: 146, 147, 237, 239, 240, 430-431 Vietnam veterans' compensation, II: 28-29; III: 26-27 wasting syndrome, I: 160-161, 162-166; II: 76-77; III: 80-83 See also Herbicides; Serum levels, TCDD; TCDD biologic plausibility

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Veterans and Agent Orange: Update 1998 12-O-Tetradexanoylphorbol-13-acetate (TPA), II: 76 TCDD, I: 129-131, 259 Texas, I: 60, 403-404, 696; III: 243 TGF. See Transforming growth factor-α; Transforming growth factor-β. T-H Agricultural & Nutrition Company, I: 35 Thailand, I: 26, 90 Thompson Chemicals Corporation, I: 35 Thyroid TCDD effects, I: 168-169 thyroiditis, I: 697, 698 Times Beach, Missouri, I: 40-42, 268, 368-370, 693-694; II: 113, 144, 184; III: 200-201, 234, 283 Tissue distribution TNF. See Tumor necrosis factor (TNF) Tobacco exposure and use, I: 11, 223, 442, 461, 463; II: 190-191, 197; III: 299 perinatal mortality and, I: 619-620 respiratory cancer and latency, II: 268; III: 418 Tollerud, David, III: 25 Topography, I: 25 Toxic equivalency factors (TEFs), II: 45, 52, 63; III: 37, 105, 106, 108 Toxic equivalent concentration (TEC), III: 105, 107 Toxicity 2,4-D profile update, II: 46-49; III: 43-47 2,4,5-T profile update, II: 49-50; III: 47-48 cacodylic acid profile update, II: 50-51; III: 48-50 contributing factors, III: 105-108 definition, II: 35 health risk estimation, III: 105-108 picloram profile update, II: 51; III: 50 TCDD profile update, II: 51-77; III: 50-108 Toxicokinetics, III: 32-36 2,4-D, II: 46-47; III: 32-33, 43-44 2,4,5-T, II: 49; III: 47 cacodylic acid, II: 50; III: 32-33, 48 definition, II: 35 literature update, II: 36; III: 36-37 previous reports summary, II: 38-39 TCDD, II: 53-54; III: 33, 53-53, 161 Toxicology 2,4-D profile update, II: 46-49; III: 43-47 2,4,5-T profile update, II: 49-50; III: 47-48 cacodylic acid profile update, II: 50-51; III: 48-50 disease outcomes, II: 37, 48-49, 50-151, 65-77; III: 33-35, 38-43, 44-47, 48, 50, 71-105 earlier reports summary, II: 37-42; III: 36 evaluation issues, III: 108-110 human health relevance, III: 35-36 literature update, II: 43-45; III: 36-43 mechanisms of toxic action, II: 36, 47-48, 50, 54-65; III: 33, 38, 44, 47-48, 49-50, 53-71 picloram profile update, II: 51; III: 50 studies evaluation, III: 128-129 summary, II: 35-37; III: 3-5, 32-36 TCDD profile update, II: 51-77; III: 50-108 toxicity profiles update, II: 45-77; III: 45-108 TPA. See 12-O-Tetradecanoylphorbol-13-acetate (TPA) Trail-Making Test, II: 308 Transforming growth factor-α, I: 145; II: 59, 74 Transforming growth factor-β, II: 59 2,4,5-Trichlorophenol (TCP), I: 28; II: 319; III: 152, 153, 219, 220, 223, 515 2,4,5-Trichlorophenoxyacetic acid (2,4,5-T); II: 4, 18; III: 5, 19, 218, 219, 220, 223, 224, 226, 234 acute toxicity, I: 184 Agent Orange and, I: 27; II: 26 animal studies, I: 181-185; II: 49-50; III: 47-48, 396, 462 birth defects and, II: 287; III: 462 calcium homeostasis and, II: 4 carcinogenicity, I: 37, 118, 119, 182-184; II: 40; III: 396 chemical properties, I: 114, 182; II: 38; III: 32 chemical structure, I: 111, 114 chloracne and, I: 36 chronic exposure, I: 184 circulatory disorders and, I: 700-701 development of, I: 24, 26, 35, 181; III: 135, 136, 137, 138, 140 developmental toxicity, I: 185; II: 42, 49-50 disease outcomes, III: 48 domestic use, I: 181 environmental exposure events, I: 42-43 genotoxicity, I: 119, 184

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Veterans and Agent Orange: Update 1998 half-life of, II: 4 infertility and, II: 280-282 liver toxicity, I: 125; II: 42; III: 524 mechanisms of action, III: 33, 38, 47-48 mechanisms of toxicity, II: 49-50 metabolism, I: 115, 116 military applications, I: 26, 88; II: 26 neurobehavioral toxicity, III: 475 pharmacokinetics, I: 182 porphyria cutanea tarda and, II: 322 reproductive toxicity, I: 185; II: 42; III: 462 respiratory disorders and, I: 709 suspension of use, I: 1, 39, 42-43, 92, 181-182 TCDD contamination of, I: 2, 3, 27, 91, 114, 126, 182; III: 140 teratogenicity, I: 30, 92, 373-374 toxicity profile update summary, II: 49 toxicokinetics, II: 49; III: 47 volume used in Operation Ranch Hand, data, III: 136 See also Herbicides; 2,3,7,8-Tetrachlorodibenzo-p-dioxin Triglyceride levels, I: 688-689; III: 520-521 Trinoxol, I: 91; III: 137 Tuberculosis, I: 711 See also Respiratory disorders Tumor necrosis factor (TNF), I: 148; II: 59, 60; III: 87, 88 Twin studies, I: 398-399, 406, 703, 711 U UDP glucuronyl transferase (UGT1), II: 74; III: 37, 52 Uerdingen, Germany, III: 154 UGT1. See UDP glucuronyl transferase (UGT1) Ulcers, gastrointestinal, I: 690-692 epidemiologic studies, II: 334; III: 510-513 epidemiology, II: 334; III: 508-509 herbicide exposure association with, II: 334; III: 510-514 herbicide occupational exposure and, III: 510-512 scientific literature update, II: 334; III: 510-513 Vietnam veterans and, III: 512-513 See also Metabolic and digestive disorders Umea, Sweden, III: 228, 229 Uniroyal Inc., I: 35 United Kingdom, I: 315-316, 340, 382, 444, 462-463, 464, 477,479, 537, 565, 595, 689; II: 194, 196, 269; III: 223, 224, 420 England National Cancer Register, III: 232 herbicide exposure assessment, III: 151 See also Yorkshire, England United Nations, I: 45 United Paperworkers International Union, III: 232 Update 1996. See Veterans and Agent Orange: Update 1996 Uppsala, Sweden, III: 228 Urinary bladder cancer. See Bladder cancer Uroporphyrinogen decarboxylase (UROD), II: 321; III: 480, 481 U.S. Air Force, I: 81,113; III: 29, 138, 218, 237, 239, 339, 513, 517 Armstrong Laboratory, Population Research Branch, III: 29 Baseline Morbidity Report, II: 32 Baseline Mortality Report, 1982, II: 31 Follow-Up Examination Results, 1985, 1987, 1992, II: 32 Human Resources Laboratory records, II: 150, 152; III: 237 Military Personnel Center records, II: 151; III: 238 Mortality Updates, 1984, 1985, 1986, 1989, 1999, II: 32 Reproductive Outcomes, II: 32 Serum Dioxin Level Follow-Up Examination Results, II: 32 TCDD half-life investigations, II: 104-105 Vietnam casualties, I: 83 women veterans mortality studies, II: 152-153 See also Air Force Health Study (AFHS); Operation Ranch Hand U.S. Army, I: 81, 280, 281, 702; II: 140, 185 Army Chemical Corps Vietnam Veterans Health Study proposal, II: 24 Environmental Support Group (ESG), II: 152 Vietnam casualties, I: 83 Vietnam veterans studies, II: 201, 226, 244; III: 240, 241, 283, 294, 298, 313, 315, 318, 338, 339, 344, 346, 348, 365, 373, 380, 485, 512, 517

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Veterans and Agent Orange: Update 1998 women veterans mortality studies, II: 152-153, 201 See also U.S. Special Forces U.S. Army Chemical Corps, I: 13, 15, 16-17, 94-95, 272, 273, 286, 394, 470, 571, 703-704, 705, 711, 722-725; II: 5, 23, 24, 101, 103, 104, 201-202, 245; III: 6, 23, 138-139, 146-147, 241, 272, 298, 309, 314, 344, 358-359, 385, 389, 485, 512, 517 U.S. Coast Guard, I: 81 U.S. Congress, I: 2, 31, 46-52; III: 25-28, 237, 240 See also Congressional hearings; Legislation USDA. See Department of Agriculture, U.S. (USDA) U.S. Marine Corps, I: 81, 96, 280, 545, 702, 710; II: 185, 201, 226, 244; III: 140 non-Hodgkin's lymphoma in, I: 542, 545, 546-547 Vietnam casualties, I: 83 Vietnam veterans studies, III: 241, 242, 283, 294, 298, 309, 313, 315, 338, 339, 346, 348, 365, 373, 380, 485, 489, 512, 517 women veterans mortality studies, II: 152-153 U.S. Military Assistance Command, III: 138 U.S. Navy, I: 81, 280-281, 286; II: 185, 228; III: 339, 344 herbicide use in, I: 95; II: 104; III: 135, 139, 140 non-Hodgkin's lymphoma odds ratio in, I: 542 Vietnam casualties, I: 83 women veterans mortality studies, II: 152-153 U.S. Special Forces, I: 286; II: 103-104; III: 138 USSR, I: 317; III: 224 See also Russia Utah, I: 560; II: 241 Uterine cancer, I: 506; III: 329, 333 herbicide association evidence, I: 13; II: 6, 211, 213; III: 333 See also Reproductive system cancers, women V VAO. See Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (VAO) Verona, Missouri, II: 128-129; III: 219, 220 Very-low-density lipoprotein (VLDL) receptors, II: 333; III: 503 VES. See Vietnam Experience Study (VES) Veterans. See Foreign veterans; Vietnam veterans; Women veterans Veterans Administration. See Department of Veterans Affairs, U.S. (DVA) Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (VAO), II: 1, 2, 5, 8, 10, 11, 12, 35, 45, 63, 65, 71, 89, 90, 91, 96, 97, 99, I 01, 102, 104, 107, 112, 132, 176, 179, 180, 181, 187, 190, 196, 207, 209, 210, 214, 218, 225, 228, 232, 236, 237, 246, 247, 249, 250, 266, 271, 278, 279, 286, 293, 296, 300, 305, 312, 323, 328, 357; III: 1, 2, 3, 5, 12, 32, 43, 85, 124, 125, 126, 132, 150, 157, 169, 220, 221, 223, 286, 303, 311, 320, 359, 389, 390, 416, 434, 435, 519, 522 background, II: 17-19; III: 17-23 basal/squamous cell skin cancer studies summary, III: 317-318, 321, 323 birth defects studies summary, III: 436-439 bladder cancer studies summary, II: 225-226; III: 347-348, 350-351 bone cancer studies summary, II: 204; III: 302, 305 brain tumor studies summary, II: 229; III: 356-357, 360, 361 breast cancer studies summary, III: 324-326, 328 childhood cancer studies summary, II: 299 chloracne studies summary, II: 318; III: 479-480 chronic persistent peripheral neuropathy studies summary, II: 310 circulatory disorders studies summary, II: 335-336; III: 514 cognitive and neuropsychiatric disorders studies summary, II: 307; III: 468-469

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Veterans and Agent Orange: Update 1998 congressional hearings on Agent Orange, II: 27-28; III: 25 Department of Veterans Affairs Task Force, II: 4-26; III: 24-25 diabetes mellitus studies summary, II: 330; III: 496-497 federal government response to concerns over military use of herbicides in Vietnam, II: 27-32; III: 25-30 female reproductive cancers studies summary, II: 211-212; III: 330-331, 332, 333 gastrointestinal tract tumors studies summary, II: 177-178; III: 268, 274-281 gastrointestinal ulcers studies summary, II: 334; III: 510 health outcomes conclusions, II: 19-23; III: 19-20 hepatobiliary cancers studies summary, III: 282-283, 287-288 herbicide environmental exposure studies, II: 142-143, 144, 145-146; III: 197-202, 203-205, 275, 277, 279, 281, 283, 288, 291, 301, 316, 323, 328, 336, 342, 345, 350-351, 354, 369, 382, 392, 437, 454, 455, 456, 459, 479, 520 herbicide occupational exposure studies, II: 114, 115-116, 117-118, 119-120, 121-126; III: 170-174, 176-178, 180-182, 183-185, 188-196, 274-275, 276-277, 278-279, 280, 282-283, 286, 291, 294, 300-301, 305, 310, 312, 316, 317, 321, 323, 324-326, 328, 332, 333, 335-336, 345, 350, 354, 360, 367-369, 374-376, 381-382, 391-392, 454, 455, 456, 459, 496, 520 Hodgkin's disease studies summary, II: 235; III: 372, 374-375, 376 immune system disorders, studies summary, II: 327; III: 488-489 impact of report, II: 24-26; III: 23-25 infertility studies summary, II: 280; III: 445-446, 450 laryngeal cancer studies summary, III: 293, 294 legislation on Agent Orange, II: 28-29; III: 26-27 leukemia studies summary, II: 245; III: 385-386, 391-392 lipid abnormalities studies summary, II: 333; III: 504, 520, 521 liver toxicity studies summary, II: 332; III: 510 low-birthweight studies summary, III: 456-457, 459 lung cancer studies summary, III: 296, 300-301 melanoma studies summary, III: 313-314, 316, 317 metabolic and digestive disorders, studies summary, II: 330, 332, 333, 334 motor/coordination dysfunction studies summary, II: 309; III: 469-470 multiple myeloma studies summary, III: 377-378, 381-382 nasal/nasopharyngeal cancer studies summary, III: 290, 291 non-Hodgkin's lymphoma studies summary, II: 231-232; III: 362-363, 367-369, 370-371 perinatal death studies summary, II: 285; III: 451, 454, 455, 456 peripheral neuropathy studies summary, III: 470-471, 473 porphyria cutanea tarda studies summary, II: 321-322; III: 481-482 prostate cancer studies summary, III: 335-336, 341, 342 renal cancer studies summary, II: 224; III: 352-353, 354, 355 research recommendations, II: 23-24; III: 23 respiratory disorders studies summary, II: 324-325; III: 483 skin cancer studies summary, III: 312 soft-tissue sarcomas studies summary, II: 205-206; III: 306-308 spontaneous abortion studies summary, II: 283 summary of, II: 37-42 testicular cancer studies summary, III: 343-344, 345-346 toxicology, overview, III: 36 Vietnam herbicides use by military, II: 26-27 Vietnam veterans' exposure studies, II: 154, 156-157, 158-159; III: 207-209, 210-217, 275, 278, 279, 281, 283, 288, 291, 305, 310, 312, 316, 317,

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Veterans and Agent Orange: Update 1998 323, 326, 328, 336, 342, 345-346, 351, 355, 370-371, 376, 382, 437-438, 450, 454, 455, 456, 459, 497, 521 Vietnam veterans' increased disease risk, II: 22-23; III: 22-23 Veterans and Agent Orange: Update 1996, III: 1, 2, 3, 6, 8, 10, 32, 37, 43, 44, 50, 85, 106, 109, 125, 126, 132, 150, 157, 159, 169, 220, 221, 222, 223, 266, 286, 295, 298, 303, 309, 311, 319, 320, 339, 349, 359, 389, 390, 416, 417-418, 424, 426, 428, 434, 435, 444, 458, 519, 522, 533 background, III: 17-23 basal/squamous cell skin cancer studies summary, III: 317-318, 321, 323 birth defects studies summary, III: 436-439 bladder cancer studies summary, III: 347-348, 350 bone cancer studies summary, III: 302, 305 brain tumor studies summary, III: 356-357, 360, 361 breast cancer studies summary, III: 324-326, 327, 328 chloracne studies summary, III: 479-480 circulatory disorders studies summary, III: 514 cognitive/neuropsychiatric disorders studies summary, III: 468-469 congressional hearings on Agent Orange, III: 25 Department of Veterans Affairs Task Force, III: 24-25 diabetes mellitus studies summary, III: 496 federal government response to concerns over military use of herbicides in Vietnam, III: 25-30 female reproductive system cancers studies summary, III: 330-331, 332, 333 gastrointestinal tract tumors studies summary, III: 268, 274-281 gastrointestinal ulcers studies summary, III: 510 health outcomes conclusions, III: 19-20 hepatobiliary cancers studies summary, III: 282-283, 287-288 herbicide environmental exposure studies, III: 197, 201, 203, 275, 277, 279, 283, 288, 323, 328, 336, 342, 345, 354, 369, 375, 382, 392 herbicide occupational exposure studies, III: 170, 172, 174, 175-176, 179, 183, 186-187, 274, 276, 278, 280, 282-283, 286, 291, 294, 300, 305, 316, 317, 321, 324-326, 328, 332, 333, 335-336, 345, 350, 354, 360, 367, 374, 381, 391, 496 Hodgkin's disease studies summary, III: 373, 374, 375, 376 impact of report, III: 23-25 infertility studies summary, III: 445-446 laryngeal cancer studies summary, III: 293, 294 legislation on Agent Orange, III: 26-27 leukemia studies summary, III: 385-386, 391, 392 lipid abnormalities studies summary, III: 504 liver disorders studies summary, III: 510 low-birthweight studies summary, III: 456-457 lung cancer studies summary, III: 296, 298, 300 melanoma studies summary, III: 313-314, 316, 317 motor/coordination dysfunction studies summary, III: 469-470 multiple myeloma studies summary, III: 377-378, 381, 382 nasal/nasopharyngeal cancer studies summary, III: 290, 291 non-Hodgkin's lymphoma studies summary, III: 362-363, 367, 369, 370 perinatal death studies summary, III: 451 peripheral neuropathy studies summary, III: 470-471, 473 porphyria cutanea tarda studies summary, III: 481-482 prostate cancer studies summary, III: 335-336, 341, 342 renal cancers studies summary, III: 352-353, 354, 355 research recommendations, III: 23 respiratory disorders studies summary, III: 483 soft-tissue sarcoma studies summary, III: 306-308

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Veterans and Agent Orange: Update 1998 testicular cancer studies summary, III: 343-344, 345 toxicology, overview, III: 36 Vietnam veterans' exposure studies, III: 206-207, 210, 213, 277, 281, 283, 326, 328, 333, 336, 342, 345, 355, 370, 376, 392 Vietnam veterans' increased disease risk, III: 22-23 Veterans' benefits. See Compensation, veterans Veterans' compensation. See Compensation, veterans Veterans' Dioxin and Radiation Exposure Compensation Standards Act of 1984. See Public Law 98-542 Veterans' Health Care Eligibility Reform Act of 1996. See Public Law 104-262 Veterans' Health Care, Training, and Small Business Loan Act of 1981. See Public Law 97-72 Veterans' Health Programs Extension and Improvement Act of 1979, III: 240 Vietnam, III: 533 herbicide latency issues, methodology, II: 13; III: 12-14 herbicide targeting in, I: 99-106 herbicide use in, concerns about, I: 29-32, 45; II: 1, 2, 4, 11, 17, 18, 26; III: 1, 2, 5, 12, 13, 17, 18, 25 research in, I: 30-31 troop movements in, I: 52-53, 96, 287 U.S. casualties in, I: 82-83 U.S. involvement, I: 75-76, 84 U.S. military herbicide use in, I: 1, 3, 24, 27, 84-85, 89-93, 94-96, 98-107, 286; II: 17, 18, 26, 27-32; III: 135-142 See also Ca Mau peninsula, Vietnam; Con Thieu province, Vietnam; Hanoi, Vietnam; Ho Chi Mirth City, Vietnam; Khe Sanh-Thonh Son Lam area; Mekong Delta; Rung Sat Special Zone; Vietnamese Vietnam Experience Study (VES), III: 26, 240, 512 birth defects in offspring, II: 288, 289, 290; III: 436, 438, 439, 445 cancer mortality in, I: 444-445 childhood cancer in, I: 629; II: 300 chloracne in, I: 677 circulatory disorders in, I: 702 exposure assessment use, II: 101; III: 146 hepatobiliary cancers, II: 185; III: 283 Hodgkin's disease in, I: 556 immune system disorders in, I: 696 infertility in, II: 280 liver cancer in, I: 455 low birthweight outcomes in, I: 626 lung cancer in, I: 469 methodology, I: 57-58, 281, 284, 389-391 multiple myeloma, II: 244 neonatal death in, I: 622 neurologic/neuropsychiatric outcomes in, I: 656 non-Hodgkin's lymphoma in, I: 542-543 origins, I: 50 reproductive outcomes in, I: 601, 609, 610-611, 626, 632 respiratory cancer in, II: 201 respiratory disorders in, I: 710-711 spina bifida in offspring, II: 9 Vietnam Veterans Agent Orange Health Study, I: 741 Vietnam veterans, I: 1; II: 2 acute and subacute transient peripheral neuropathy, II: 313; III: 473 advocacy groups, I: 60-61 Air Force research activities, II: 31-32; III: 28-29 altered sperm parameters in, I: 632, 634; III: 445, 446, 450 Australian, I: 61, 91, 406, 418, 444, 470, 496-497, 546, 614-615, 633, 702, 710; II: 113, 149, 160, 202, 293; III: 9, 216-217, 218, 237, 244-245, 273, 285-286, 290, 294, 295, 298, 299, 303, 310, 311, 314, 315, 327, 329, 339, 340, 343, 346, 349, 353, 355, 359, 365, 380, 389, 413, 424, 425, 469, 486, 486, 489, 500, 506, 512-513, 517 autoimmune disease in, I: 698, 699 basal/squamous cell skin cancer in, III: 323 birth defects in children of, I: 609-615, 618; II: 288-296, 298, 300; III: 435, 436, 437-438 bladder cancer in, I: 517; II: 223-224; III: 349, 351 bone cancer in, I: 473, 474-475; II: 204; III: 303, 305 brain tumors in, I: 522, 523, 525; III: 358-359, 361 breast cancer in, II: 213, 217, 218; III: 326, 328, 329

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Veterans and Agent Orange: Update 1998 cancer expected incidence, I: 439-440, 442, 446, 452, 461, 501, 505, 513, 522, 526, 564; II: 176-177; III: 266-267, 430-431 cancer in children of, I: 629, 630-631; II: 299 cancer mortality, I: 444-445 cancer studies, I: 391-393, 401, 402-403, 405, 436-438; II: 176-177; III: 266-267, 430-431 chloracne in, I: 677-679; II: 317, 318, 321; III: 479-480 chronic persistent peripheral neuropathy in, II: 311 circulatory disorders in, I: 702-705; II: 336; III: 516-518 class action suit, I: 34-35 cognitive/neuropsychiatric disorders in, II: 318; III: 469 compensation for, I: 34-35, 47, 50-51, 55-56; II: 28-29, 30-31; III: 26-27, 28 congressional responses to concerns of, I: 46-52; II: 27-29; III: 25-28 defining, I: 78 demographics, I: 79, 80-84 developmental toxicity, II: 72 diabetes mellitus in, I: 684, 685, 698; II: 330; III: 495, 497, 498, 500, 502 disabilities discharges, I: 32 disease increased risk for, I: 14-15, 221, 225-226, 247-248, 578; II: 14, 22-23, 88, 89, 91, 218, 223, 251, 276, 298, 300-301, 314, 321, 323; III: 14-15, 22-23, 124, 127-128, 329, 334, 343, 397, 430-431, 444, 462, 475-476, 491, 503, 507-508, 525 distribution by branch of service, I: 81 Environmental Protection Agency research activities, II: 32; III: 29-30 epidemiologic studies, I: 50, 57-59, 62-63, 384-418; II: 3, 6-7, 28, 113, 149-161; III: 26, 206-217, 236-245, 272-273, 275, 277-278 , 279, 281, 283, 285-286, 288, 290, 291, 294-295, 298, 301, 303, 305, 309-310, 312, 316, 317, 323, 326, 328, 333, 336, 338, 339, 340 , 342, 343-344, 345-346, 349, 351, 353, 355, 358-359, 361, 363, 365, 370-371, 372, 373, 376, 380, 382, 385, 386, 389, 392, 435, 436, 437-438, 445, 446, 450, 454, 455, 456, 457, 459, 467, 468, 469, 470, 473, 479, 480, 481, 482, 485-486, 489, 491, 495, 497, 498, 500, 502, 505-506, 512-513, 516-518, 521 federal government activities/research on military use of herbicides, II: 27-32; III: 25-30 female reproductive system cancers in, I: 505, 511-512, 577; II: 211, 212; III: 333 gastrointestinal tract cancers in, I: 446; II: 177, 180-181 gastrointestinal ulcers in, I: 691, 692; III: 512-513 genitourinary tract cancers in, I: 513, 518, 522; II: 223-224; III: 272-273, 275, 277-278, 279, 281 health care of, II: 28, 29; III: 26, 27 health concerns of, I: 1, 32-34, 46-47; II: 17-24, 26-27; III: 17-30 hepatic enzyme disorders in, I: 687 hepatobiliary cancers in, I: 455, 457; II: 181, 185, 187; III: 283, 285-286, 288 herbicide exposure assessment issues, II: 4-5, 14, 17-24, 26-27; III: 2, 5-6, 142, 143, 146-150 herbicide exposure assessment strategies for, I: 270-284; II: 99-109; III: 144-145 Hodgkin's disease in, I: 526, 554-556, 557; II: 235, 236; III: 372, 373, 376 immune modulation in, I: 695-696, 699; III: 489, 491 infertility, I: 632, 633, 634; II: 280; III: 445, 446, 450 International Agency for Research on Cancer research activities, III: 30 laryngeal cancer in, III: 294-295 latency relevance for assessing herbicides' effect on cancer risk in, II: 276; III: 12-13, 430-431 legislation concerning herbicide exposure and health of, II: 28-29; III: 26-27 leukemia in, I: 13, 564, 570, 571-572; II: 245, 246; III: 385, 386, 389, 392 lipid abnormalities in, I: 689, 692; II: 333; III: 505-506, 521 liver toxicity in, II: 332; III: 512-513 low-birthweight outcomes for, I: 626, 628; III: 457, 459 lung cancer in, III: 298, 301 melanoma in, III: 316, 317

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Veterans and Agent Orange: Update 1998 military experiences, I: 75, 82, 272, 286, 399 motor/coordination dysfunction in, I: 659-660, 662; II: 309, 310; III: 469, 470 multiple myeloma in, I: 526, 562, 563; II: 244; III: 380, 382 nasal/nasopharyngeal cancer in, I: 459, 460; II: 189; III: 290, 291 National Personnel Records Center listing, I: 17 neural tube defects in offspring, numbers, II: 297 neurobehavioral disorders in, II: 305, 308, 309, 310, 311, 313, 314; III: 467, 468 neuropsychiatric outcomes, I: 653-656, 658; II: 308; III: 469 non-Hodgkin's lymphoma in, I: 526, 541-548, 549; II: 234; III: 363, 365, 370-371 number of, I: 3, 4, 74, 75-80 outreach activities; II: 31; III: 28 Parkinson's disease in, II: 309-310 perinatal deaths in offspring, II: 285; III: 454, 455, 456 peripheral nervous system disorders in, I: 665, 666; II: 311, 313; III: 473, 475 porphyria cutanea tarda in, I: 681, 682-683; II: 321-322, 323; III: 481, 482 prostate cancer in, I: 513, 518, 519, 522; II: 9, 217-218, 221, 223; III: 336, 338, 339, 340, 342 records-based exposure assessment, I: 271-280 records identification, II: 24-25 renal cancers in, III: 352, 353, 355 reproductive outcomes, I: 405-406, 418, 601-603, 609-615, 618, 620-622, 625; II: 71, 278, 300-301; III: 435, 436, 437-438, 445, 446, 450, 454, 455, 456, 457, 459 research recommendations, II: 23-25; III: 23 respiratory cancers in, I: 469-470, 472; II: 190, 201-202, 203 respiratory disorders in, I: 710-712, 713-714; III: 485-486 risk assessment for, I: 14-15, 221, 225-226, 247-248, 578; II: 14, 22-23, 89, 91, 251, 276, 298, 300-301, 314, 321, 323, 349-357; III: 14-15, 22-23, 124, 127-128, 430-431 serum testing, I: 20-21 skin cancer in, I: 501, 505; II: 209; III: 312 soft-tissue sarcoma in, I: 475, 492-498, 500; II: 205, 208; III: 309-310 South Korea, I: 61-62 spina bifida in offspring, II: 9-10, 296, 298, 301; III: 7, 8, 9-10, 21, 24-25, 437-438 spontaneous abortions in, I: 601-603, 605; II: 283 state-sponsored studies of, II: 152-153, 158-159, 161, 202, 292; III: 213-215, 243-244 suicide incidence, I: 655-656 testicular cancer in, II: 153; III: 343-344, 345-346 twin studies, I: 398-399, 406, 703, 711 Vietnamese veterans, Vietnamese studies of, III: 245 women, I: 50, 83-84; II: 152-153, 180, 181, 190, 201, 204, 205, 209, 211, 212, 213, 216-217, 218, 223, 226, 228, 229, 23 I, 245, 278, 280; III: 326-329, 333, 434-435 See also Air Force Health Study (AFHS); Compensation, veterans; Demographic data, Vietnam veterans; Operation Ranch Hand; Risk assessment, Vietnam veterans Vietnam Veterans of America, I: 60 Vietnamese birth defects and herbicide exposure, II: 287-288 cancer in, II: 148; III: 283 epiderniologic studies, I: 599-601; II: 113, 144-145, 148, 184, 287-288; III: 202-202, 234, 283 herbicide environmental exposure, II: 144-145, 148, 287-288; III: 283 herbicide exposure assessment, I: 269, 370-372; II: 4-5, 108-109; III: 156-157 herbicide exposure indices development, II: 107-108 reproductive outcomes, I: 599-601, 608-609 research recommendations, I: 731 scientists in, studies of Vietnamese veterans, III: 245

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Veterans and Agent Orange: Update 1998 Viral infection immune system response, I: 692-693 TCDD-enhanced susceptibility, I: 149 teratogenic potential, I: 607 See also Immune system disorders Vitamin A, I: 174 VLDL. See Very-low-density lipoprotein (VLDL) receptors W Wales. See United Kingdom War Research Service, I: 25 Washington State, I: 336-338, 341, 487-488, 535; II: 149, 241; III: 229, 230, 232, 234 Wasting syndrome TCDD-induced, I: 162-166; II: 76-77; III: 80-83 Wechsler Adult Intelligence Scales, I: 641 West Germany, II: 328-329; III: 223, 337, 379, 387, 483, 506, 511, 515 West Virginia, I: 60, 404, 470, 496, 546, 621, 662-663, 686, 689, 700; II: 202; III: 243 See also Nitro, West Virginia Western Europe, II: 268; III: 510 Wilm's tumor, I: 594 See also Children, cancer in; Kidney cancer Wisconsin, I: 37, 60, 336, 404-405, 445, 455, 470, 496, 517, 523, 534, 546, 556, 560, 702, 710; II: 185, 202, 226, 229, 239, 241; III : 229, 243, 283, 313, 348 Women. See Breast cancer; Cervical cancer; Demographic data, Vietnam veterans; Gender; Ovarian cancer; Reproductive disorders; Reproductive system cancers, women; Uterine cancer Women veterans, I: 79; II: 30 breast cancer estimated risk, II: 218; III: 329 breast cancer expected incidence, I: 440, 461, 501, 505, 513, 522, 526, 564; II: 213 breast cancer in, II: 213, 216-217; III: 322, 324-328, 329 circulatory disease in, I: 702 epidemiologic studies, I: 50, 81, II: 28, 152-153, 180, 181, 190, 201, 204, 205, 209, 211, 212, 213-217, 218, 219-223, 226, 228, 229, 231, 245, 278, 280; III: 324-328, 333 mortality studies, I: 394-395, 470, 545; II: 152-153, 180, 201 reproductive outcomes, III: 434-435 reproductive system cancers m, II: 211, 212; III: 333 research recommendations, I: 728 statistics. I: 83-84 See also Reproductive system cancers, women Women Veterans Health Programs Act of 1992. See Public Law 102-585 World Health Organization, II: 282; III: 30, 454, 492 Mortality Data Bank, I: 314; II: 132; III: 223, 378, 484-485, 512, 516 World War II; I: 25, 32, 82; II: 150, 268; III: 237, 420 X Xenobiotic responsive elements (XREs), II: 56, 57, 58, 71; III: 66 , 67, 104 Y Yorkshire, England, III: 234

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Representative terms from entire chapter:

vietnam veterans