Veterans and Agent Orange: Update 1996

In VAO, the committee found sufficient evidence of an association with herbicides and/or TCDD for five diseases: soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, chloracne, and porphyria cutanea tarda (in genetically susceptible individuals). The recent scientific literature continues to support the classification of the first four of these diseases in the category of sufficient evidence. Based on the recent literature, the committee has reclassified porphyria cutanea tarda into the category of limited/suggestive evidence, as described below. Based on the recent literature, there are no additional diseases that satisfy this category's criteria--that a positive association between herbicides and the outcome must be observed in studies in which chance, bias, and confounding can be ruled out with reasonable confidence. The committee regards evidence from several small studies that are free from bias and confounding, and that show an association that is consistent in magnitude and direction, as sufficient evidence for an association. The evidence that supports the committee's conclusions for the three cancers is detailed in Chapter 7 for chloracne in Chapter 11.