Blue Water Navy Vietnam Veterans and Agent Orange Exposure (2011) / Chapter Skim
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6 LONG-TERM ADVERSE HEALTH EFFECTS
6 LONG-TERM ADVERSE HEALTH EFFECTS
Pages 109-126
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From page 109... ...
A few of the studies include veterans who served in the Blue Water Navy in Vietnam, but most of the studies do not distinguish Navy veterans, let alone Blue Water Navy veterans, from other Vietnam-veteran populations. In compliance with the congressional legislation that mandated the biennial reports, the VAO committees have examined the available evidence of a positive association between Agent Orange and health outcomes from epidemiologic studies in which chance, bias, and confounding can be ruled out with reasonable confidence.
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From page 110... ...
For example, a well-conducted study that had strong findings in accord with less compelling results from studies of populations with similar exposures could constitute such evidence. There is limited or suggestive evidence of an association between exposure to the chemicals of interest and the following health outcomes: Laryngeal cancer, 1994, 1995 Cancer of the lung, bronchus, or trachea, 1994, 1995 Prostatic cancer, 1994, 1997 Multiple myeloma, 1994, 1995 AL amyloidosis, 2007, 2009 Early-onset transient peripheral neuropathy, 1996, 1997 Parkinson's disease (category change from Update 2006)
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From page 111... ...
, 2000, 2001 Spina bifida in offspring of exposed people, 1996, 1996 Inadequate or Insufficient Evidence to Determine an Association The available epidemiologic studies are of insufficient quality, consistency, or statistical power to permit a conclusion regarding the presence or absence of an association. For example, studies fail to control for confounding, have inadequate exposure assessment, or fail to address latency.
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From page 112... ...
Immune system disorders (immune suppression, allergy, and autoimmunity) Circulatory disorders (other than hypertension and ischemic heart disease)
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From page 113... ...
as a service-related condition in Vietnam veterans, including Blue Water Navy veterans, but does not link it to Agent Orange exposure, although the VA website on these diseases does (http://www.publichealth.va.gov/ exposures/diseases.asp)
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From page 114... ...
, the committee could not determine any dose-response relationships for health effects experienced by Blue Water Navy veterans. The committee attempted to determine whether adverse health outcomes among Blue Water Navy personnel were consistent with those associated with TCDD exposure in other Vietnam veterans and if their health effects occurred more or less frequently than those seen in other Vietnam veterans previously identified as exposed to TCDD.
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From page 115... ...
The incidence of one cancer linked to Agent Orange exposure, NHL,1 was found to be lower than that in the control population (RR 0.8, 95% CI 0.5–1.0) (Wilson et al., 2005a)
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From page 116... ...
This case–control study compared the incidence of testicular cancer in Vietnam veterans with different probable exposures to Agent Orange (Bullman et al., 1994)
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From page 117... ...
Centers for Disease Control and Prevention Selected Cancers Study For evaluating cancer risks in Blue Water Navy Vietnam veterans, the most informative study was the Selected Cancers Study conducted by the Centers for Disease Control and Prevention (CDC)
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From page 118... ...
The authors concluded that the roughly 50% increase in NHL risk in all Vietnam veterans was due to service in Vietnam in general rather than to specific characteristics of service and Agent Orange exposure. Similarly, for Hodgkin's disease, the highest risk was in I Corps, followed by the Blue Water Navy (OR 1.39, 95% CI 0.56–3.46)
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From page 119... ...
The number of veterans who had NHL was compared with the number of veterans who had diagnoses other than NHL. Exposure was determined on the basis of having served or not having served in Vietnam or on the basis of surrogates of Agent Orange exposure, including branch of service, combat-duty occupation, or corps.
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From page 120... ...
Results were not confounded by age, year of hospitalization, race, or education. Results do not support any association between NHL or Hodgkin's disease and surrogates of Agent Orange exposure in Vietnam veterans.
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From page 121... ...
The committee considered this population to be potentially relevant even though they were not Vietnam veterans. The results of the two studies are valuable because they provide background on the potential effects of occupational exposures in Navy personnel who were not in the Vietnam environment; that is, they examined potential occupational exposures other than herbicides.
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From page 122... ...
. To the committee's knowledge, no studies assessing TCDD in biological samples of Blue Water Navy veterans are available.
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From page 123... ...
In contrast, the CDC Selected Cancers Study found a significantly higher prevalence of NHL in Blue Water Navy Vietnam veterans. Finally, in a small study, testicular cancer was associated with service in the Navy (although the Blue Water Navy was not specified)
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From page 124... ...
However, they are the only studies that have identified this link. Overall, the committee concludes that because of the small number of studies and their limitations, there is no consistent evidence to suggest that Blue Water Navy Vietnam veterans were at higher or lower risk for cancer or other long-term health outcomes than shore-based veterans, Brown Water Navy veterans, or Vietnam veterans in other branches of service.
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From page 125... ...
2005. Did TCDD exposure or service in southeast Asia increase the risk of cancer in air force Vietnam veterans who did not spray Agent Orange?
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