Veterans and Agent Orange Update 2004 (2005) / Chapter Skim
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1 Introduction
1 Introduction
Pages 11-19
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From page 11... ...
conduct an independent, comprehensive review and evaluation of scientific and medical information regarding the health effects of exposure to herbicides used during military operations in Vietnam. The herbicides picloram and cacodylic acid were to be addressed, as well as the most well-known of the formulations, Agent Orange (a 50:50 mixture of the herbicides 2,4-dichlorophenoxyacetic acid [2,4-D]
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From page 12... ...
CHARGE TO THE COMMITTEE In accordance with PL 102-4, the committee was asked to "determine (to the extent that available scientific data permit meaningful determinations) " the following regarding associations between specific health outcomes and exposure to TCDD and other chemical compounds in herbicides: A)
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From page 13... ...
The committee regarded evidence from several small studies that have satisfactorily addressed bias and confounding and that show an association that is consistent in magnitude and direction as sufficient evidence of an association. The original committee found sufficient evidence of an association between exposure to herbicides and three cancers -- soft-tissue sarcoma, non-Hodgkin's lymphoma, and Hodgkin's disease -- and two other health outcomes, chloracne and porphyria cutanea tarda (PCT)
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From page 14... ...
Spina bifida in offspring of exposed individuals Inadequate or Insufficient Evidence to Determine Whether an Association Exists Hepatobiliary cancers Nasal or nasopharyngeal cancer Bone cancer Breast cancer Female reproductive cancers (cervix, uterus, and ovary) Urinary bladder cancer Renal cancer Testicular cancer Leukemia (other than CLL)
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From page 15... ...
The Update 1996 committee added three health outcomes to this list: PCT, acute and subacute transient peripheral neuropathy (henceforth called "early-onset transient peripheral neuropathy") , and spina bifida in children of veterans.
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From page 16... ...
After reconvening to reevaluate the previously reviewed and new literature regarding that illness, the Acute Myelogenous Leukemia report was produced; it reclassified AML in children from "limited or suggestive evidence of an association" to "inadequate evidence to determine whether an association exists." Inadequate or Insufficient Evidence to Determine Association By default, any health outcome considered falls into this category prior to accumulation of enough reliable scientific data to promote it to the categories of sufficient or limited-suggestive evidence of an association or to the category of suggestive evidence of no association. In this category, available studies may have inconsistent findings or are of insufficient quality or statistical power to support a conclusion regarding the presence or absence of an association.
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From page 17... ...
The committees that produced VAO and the updates found that body of evidence was sufficient for reaching conclusions about statistical associations between herbicide exposures and health outcomes, but that the lack of adequate data on Vietnam veterans themselves complicated consideration of the second part of the charge. Estimating the magnitude of risk of a particular health outcome among herbicide-exposed Vietnam veterans requires quantitative information about the dosetimeresponse relationship for each health outcome in humans, information on the extent of herbicide exposure among Vietnam veterans, and estimates of individual exposure.
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From page 18... ...
Chapter 4 provides an overview of populations repeatedly studied in an effort to understand the chemicals of interest in this report; it also gives design information on those epidemiologic studies new to this update that investigated those populations or that report multiple health outcomes. Chapter 5 addresses exposure assessment issues and the exposure assessments conducted in the studies of the major cohorts.
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From page 19... ...
Washing ton, DC: National Academy Press.
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