Veterans and Agent Orange Update 2004 (2005) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-10
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From page 1... ...
to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. The Secretary was also to ask that NAS conduct updates at least every 2 years for 10 years from the date of the first report to review newly available literature and draw conclusions from the overall evidence.
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From page 2... ...
" the following regarding associations between specific health outcomes and exposure to TCDD and other chemical compounds in herbicides: A) 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; B)
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From page 3... ...
To obtain all information potentially relevant to the evaluation of health effects related to herbicide exposure, the present committee, in addition to reviewing studies of Vietnam veterans, reviewed studies of other groups potentially exposed to the constituents of the herbicides used in Vietnam (2,4-D, 2,4,5-T, TCDD, cacodylic acid, and picloram)
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From page 4... ...
Since Update 2002, a study of Korean Vietnam veterans developed an exposure index based on duration of service, troop location relative to herbicide spraying, and individual activity data from questionnaires. The investigators attempted to validate this exposure index with serum blood levels of TCDD, but samples were pooled within presumed exposure categories and only a narrow
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From page 5... ...
Cancer incidence and mortality were compared between the Ranch Hand cohort and the Air Force control cohort of Vietnam veterans; an excess incidence of melanoma was observed in some subgroups of the Ranch Hand Air Force veterans, but analyses did not establish this outcome in the entire cohort, and an increase in the incidence of, but not mortality from, prostate cancer was observed. A pilot case-control study of prostate cancer among Vietnam-era veterans found an elevated, but non-significant increase associated with reported Agent Orange exposure.
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From page 6... ...
Although the committee carefully reviewed the available literature on peripheral neuropathy, neither the new report nor the previous epidemiologic literature convincingly indicates an association between exposure and persistent neuropathy in veterans who do not have diabetes. Peripheral neuropathy is seen secondary to diabetes, for which an association with the compounds of interest has been noted.
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From page 7... ...
COMMITTEE'S CONCLUSIONS Health Outcomes The present committee weighed the strengths and limitations of the epidemiologic evidence reviewed in this report and in previous Veterans and Agent Orange reports. Its conclusions were drawn from the new evidence in the context of the entire body of literature.
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From page 8... ...
There is limited or suggestive evidence of an association between exposure to herbicides and the following health outcomes: Respiratory cancer (lung and bronchus, larynx, and trachea) Prostate cancer Multiple myeloma Early-onset transient peripheral neuropathyb Porphyria cutanea tarda Type 2 diabetes (mellitis)
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From page 9... ...
Circulatory disorders AL amyloidosis Endometriosis Effects on thyroid homeostasis Limited or Suggestive Evidence of No Association Several adequate studies, covering the full range of levels of exposure that human beings are known to encounter, are consistent in not showing a positive association between any magnitude of exposure to herbicides and the outcome. A conclusion of "no association" is inevitably limited to the conditions, exposure, and length of observation covered by the available studies.
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From page 10... ...
Anecdotal evidence and studies published in non-English-language journals suggest an array of longterm health effects that could potentially be related to the chemicals used by US troops in Vietnam. Although the explicit purpose of the newly established exposure database was to determine exposures of US service personnel who spent time in Vietnam, the possibility of using it to identify study populations among Vietnamese residents should be considered.
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