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Pages 398-402

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From page 398... ... 398 A CONCLUSIONS FROM GULF WAR AND HEALTH VOLUMES 1 AND 2 Sufficient Evidence of a Causal Relationship Evidence is sufficient to conclude that there is a causal association between exposure to a specific agent and a specific health outcome in humans. The evidence is supported by experimental data and fulfills the guidelines for sufficient evidence of an association (below) Read the entire page →
From page 399... ... CONCLUSIONS FROM VOLUMES 1 AND 2 399 Limited/Suggestive Evidence of an Association Evidence is suggestive of an association between exposure to a specific agent and a specific health outcome, but the body of evidence is limited by the inability to rule out chance and bias, including confounding, with confidence. For example, at least one high-quality study reports a positive association that is sufficiently free of bias, including adequate control for confounding. Read the entire page →
From page 400... ... 400 GULF WAR AND HEALTH Inadequate/Insufficient Evidence to Determine Whether an Association Exists Evidence is of insufficient quantity, quality, or consistency to permit a conclusion regarding the existence of an association between exposure to a specific agent and a specific health outcome in humans. Cancers • Solvents and o oral, nasal, or laryngeal cancer o stomach, rectal, or pancreatic cancer o bone cancer o melanoma or nonmelanoma skin cancer o ovarian or uterine cancer o prostate cancer • Solvents other than trichloroethylene and cervical cancer • Solvents other than tetrachloroethylene and dry-cleaning solvents and o esophageal cancer o bladder cancer o lung cancer • Specific solvents other than benzene and o brain and other central nervous system cancers o non-Hodgkins lymphoma o acute and adult leukemia • Solvents other than trichloroethylene and mixtures of benzene, toluene, and xylene and colon cancer • Benzene and myelodysplastic syndromes • Insecticides and o lung cancer o pancreatic cancer o soft tissue sarcomas o prostate, testicular, or bladder cancers o kidney cancers o brain and other central nervous system cancers • Insecticides and solvents o Hodgkins disease o hepatobiliary cancers o multiple myeloma • Lindane and solvents and breast cancer • Parental preconception exposure to insecticides and childhood leukemias, brain and other central nervous system cancers, and non-Hodgkins lymphoma • Parental preconception exposure to solvents and neuroblastoma and childhood brain cancers Read the entire page →
From page 401... ... CONCLUSIONS FROM VOLUMES 1 AND 2 401 • Uranium and o lymphatic cancer o bone cancer Neurologic Effects • Insecticides and solvents and o peripheral neuropathy o Parkinsons disease o amyotrophic lateral sclerosis o Alzheimers disease • Solvents and o multiple sclerosis o a long-term reduction in color discrimination o long-term hearing loss o long-term reduction in olfactory function • Uranium and nervous system disease Reproductive Effects • Insecticides and solvents and male or female infertility after cessation of exposure • Parental preconception exposure to insecticides or solvents and o spontaneous abortion or other adverse pregnancy outcomes o congenital malformations • Uranium and reproductive or developmental dysfunction Other Health Effects • Insecticides and aplastic anemia • Solvents other than benzene and aplastic anemia • Insecticides and solvents and o irreversible cardiovascular outcomes o persistent respiratory symptoms or impairment after cessation of exposure • Solvents and o cirrhosis o alterations in liver function tests after cessation of exposure o chronic pancreatitis and other persistent gastrointestinal outcomes o the systemic rheumatic diseases: scleroderma, rheumatoid arthritis, undifferentiated connective tissue disorders, and systemic lupus erythematosus • Exposure to uranium and lung cancer at higher levels of cumulative exposure (>200 mSv or 25 cGy) • Uranium and o nonmalignant respiratory disease o gastrointestinal disease o immune-mediated disease o effects on hematological parameters o genotoxic effects o cardiovascular effects Read the entire page →
From page 402... ... 402 GULF WAR AND HEALTH o hepatic disease o dermal effects o ocular effects o musculoskeletal effects • Pyridostigmine bromide and long-term adverse health effects • Exposure to sarin at low doses insufficient to cause acute cholinergic signs and symptoms and subsequent long-term adverse health effects • Anthrax vaccination and long-term adverse health effects • Botulinum toxoid vaccination and long-term adverse health effects • Multiple vaccinations and long-term adverse health effects Limited/Suggestive Evidence of No Association Evidence is consistent in not showing a positive association between exposure to a specific agent and a specific health outcome after exposure of any magnitude. A conclusion of no association is inevitably limited to the conditions, magnitudes of exposure, and length of observation in the available studies. Read the entire page →

From page 398...

... 398 A CONCLUSIONS FROM GULF WAR AND HEALTH VOLUMES 1 AND 2 Sufficient Evidence of a Causal Relationship Evidence is sufficient to conclude that there is a causal association between exposure to a specific agent and a specific health outcome in humans. The evidence is supported by experimental data and fulfills the guidelines for sufficient evidence of an association (below)

Read the entire page →

From page 399...

... CONCLUSIONS FROM VOLUMES 1 AND 2 399 Limited/Suggestive Evidence of an Association Evidence is suggestive of an association between exposure to a specific agent and a specific health outcome, but the body of evidence is limited by the inability to rule out chance and bias, including confounding, with confidence. For example, at least one high-quality study reports a positive association that is sufficiently free of bias, including adequate control for confounding.

Read the entire page →

From page 400...

... 400 GULF WAR AND HEALTH Inadequate/Insufficient Evidence to Determine Whether an Association Exists Evidence is of insufficient quantity, quality, or consistency to permit a conclusion regarding the existence of an association between exposure to a specific agent and a specific health outcome in humans. Cancers • Solvents and o oral, nasal, or laryngeal cancer o stomach, rectal, or pancreatic cancer o bone cancer o melanoma or nonmelanoma skin cancer o ovarian or uterine cancer o prostate cancer • Solvents other than trichloroethylene and cervical cancer • Solvents other than tetrachloroethylene and dry-cleaning solvents and o esophageal cancer o bladder cancer o lung cancer • Specific solvents other than benzene and o brain and other central nervous system cancers o non-Hodgkins lymphoma o acute and adult leukemia • Solvents other than trichloroethylene and mixtures of benzene, toluene, and xylene and colon cancer • Benzene and myelodysplastic syndromes • Insecticides and o lung cancer o pancreatic cancer o soft tissue sarcomas o prostate, testicular, or bladder cancers o kidney cancers o brain and other central nervous system cancers • Insecticides and solvents o Hodgkins disease o hepatobiliary cancers o multiple myeloma • Lindane and solvents and breast cancer • Parental preconception exposure to insecticides and childhood leukemias, brain and other central nervous system cancers, and non-Hodgkins lymphoma • Parental preconception exposure to solvents and neuroblastoma and childhood brain cancers

Read the entire page →

From page 401...

... CONCLUSIONS FROM VOLUMES 1 AND 2 401 • Uranium and o lymphatic cancer o bone cancer Neurologic Effects • Insecticides and solvents and o peripheral neuropathy o Parkinsons disease o amyotrophic lateral sclerosis o Alzheimers disease • Solvents and o multiple sclerosis o a long-term reduction in color discrimination o long-term hearing loss o long-term reduction in olfactory function • Uranium and nervous system disease Reproductive Effects • Insecticides and solvents and male or female infertility after cessation of exposure • Parental preconception exposure to insecticides or solvents and o spontaneous abortion or other adverse pregnancy outcomes o congenital malformations • Uranium and reproductive or developmental dysfunction Other Health Effects • Insecticides and aplastic anemia • Solvents other than benzene and aplastic anemia • Insecticides and solvents and o irreversible cardiovascular outcomes o persistent respiratory symptoms or impairment after cessation of exposure • Solvents and o cirrhosis o alterations in liver function tests after cessation of exposure o chronic pancreatitis and other persistent gastrointestinal outcomes o the systemic rheumatic diseases: scleroderma, rheumatoid arthritis, undifferentiated connective tissue disorders, and systemic lupus erythematosus • Exposure to uranium and lung cancer at higher levels of cumulative exposure (>200 mSv or 25 cGy) • Uranium and o nonmalignant respiratory disease o gastrointestinal disease o immune-mediated disease o effects on hematological parameters o genotoxic effects o cardiovascular effects

Read the entire page →

From page 402...

... 402 GULF WAR AND HEALTH o hepatic disease o dermal effects o ocular effects o musculoskeletal effects • Pyridostigmine bromide and long-term adverse health effects • Exposure to sarin at low doses insufficient to cause acute cholinergic signs and symptoms and subsequent long-term adverse health effects • Anthrax vaccination and long-term adverse health effects • Botulinum toxoid vaccination and long-term adverse health effects • Multiple vaccinations and long-term adverse health effects Limited/Suggestive Evidence of No Association Evidence is consistent in not showing a positive association between exposure to a specific agent and a specific health outcome after exposure of any magnitude. A conclusion of no association is inevitably limited to the conditions, magnitudes of exposure, and length of observation in the available studies.

Read the entire page →

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