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Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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INDEX

A

Abortion, spontaneous, from exposure to fuels, 292–293

ACGIH. See American Conference of Governmental Industrial Hygienists

ACS. See American Cancer Society

Acute nonlymphocytic leukemia, from exposure to fuels, 290

Agency for Toxic Substances and Disease Registry (ATSDR), 29, 34, 41, 45, 49–50, 100, 348, 351, 355, 403

Agents

identification of, 21

specified in PL 105–368 and PL 105–277, 13

Air-pollution studies

ambient exposures, 89

and exposure to combustion products and cardiovascular disease, 280–281

and lung cancer, 88

Alberta Health Care Insurance Plan, 99

Ambient air-pollution studies, 89

and exposure to combustion products, 89–91

American Academy of Dermatology, 335

American Cancer Society (ACS), 60, 90, 92, 129, 138, 256

on the consequences of smoking, 6

CPS-II Study, 89, 129, 135, 138, 279–280, 282

American Conference of Governmental Industrial Hygienists (ACGIH), 29, 351, 358

American Heart Association, 278

American Thoracic Society (ATS), 252, 256

Epidemiological Standardization project, 256

Amoco Oil Company, 72, 74, 76, 94, 97–98

Amyloidosis, experimental studies of the toxicology of hydrazines in, 355

Animal models, 405–406

Argentina, studies from cited, 92

Arizona, studies from cited, 289

Arteriosclerotic heart disease, mortality from, and exposure to nitric acid, 388–389

Assessing the strength of the evidence, 22–25

bias, 24–25

biologic plausibility, 2–4, 16, 24

chance, 25

consistency of association, 4, 23

dose-response relationship, 4–5, 23

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

specificity of association, 4, 23–24

strength of evidence of an association, 4, 22–23

temporal relationship, 4, 23

Asthma, 240, 242

categories used to evaluate indoor pollutants related to, 25

conclusions about, 264–266

from exposure to fuels, 242, 244

key studies of, 265–266

“physician-diagnosed,” 246

ATS. See American Thoracic Society

ATSDR. See Agency for Toxic Substances and Disease Registry

Australia, studies from cited, 241, 243, 255, 257, 260, 320

B

Benzene, 6, 29, 102, 133

Bias, 24–25

in assessing the strength of the evidence, 24–25

confounding, 25

information bias, 24–25

reducing, 6, 22

selection bias, 24

Bioassays, chronic, 47

Biologic plausibility, in assessing the strength of the evidence, 3, 16, 24

Biological monitoring data, 26n

Biomass-fuel combustion, 261–262

population-based studies of, 261–262

Biomass studies, 262–264

Birth defects, 310–311

conclusions about, 311

in Gulf War Veterans, 288–290

Bladder cancer, 111–119

conclusions about, 118–119

and exposure to combustion products, 114–118

additional studies on cancers of the renal pelvis, 118

case-control studies, 115–118

cohort studies, 114–115

selected epidemiologic studies, 200–206

and exposure to fuels, 111–114

case-control studies, 111–114

selected epidemiologic studies, 198–200

Blinding, 406

Bolivia, studies from cited, 262, 268

Bosnia veterans, 257–258

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

Brain/CNS cancers

and exposure to combustion products, selected epidemiologic studies, 197

and exposure to fuels, selected epidemiologic studies, 195–196

Breast cancer

female, 101–102

male, 102–104

British Medical Research Council, 260, 262, 268

C

California, studies from cited, 73, 89, 92, 289, 301, 309, 310, 311

California Office of Statewide Health Planning and Development, 250

Cambridge Neuropsychological Test Automated Battery, 320

Canada, studies from cited, 69–70, 72, 75–77, 79–80, 86, 95, 97–101, 106, 108, 121–122, 124–126, 128–130, 133, 140, 259, 283, 295, 301, 308, 310, 361

Cancers, 16, 60–239, 413–454

bladder cancer, 111–119

brain/CNS cancers, 195–197

cancers of the nasal cavity and nasopharynx, 66–70

cancers of the oral cavity and oropharynx, 61–66

colon cancer, 74–76

developmental insults from, 359

esophageal cancer, 70–72

and exposure to hydrazines, toxicology of, 355

and exposure to nitric acid, toxicology of, 358–359

and exposure to uncombusted fuels, 35

female breast cancer, 101–102

female genital cancers (cervical, endometrial, uterine, and ovarian), 104–105

genotoxicity, 359

hepatic cancer. See Liver cancer

Hodgkin’s disease, 130–132

inadequate/insufficient evidence to determine whether an association exists, 8–9, 400–401

kidney cancer, 119–127

laryngeal cancer, 80–85

leukemias, 137–140

limited/suggestive evidence of an association, 7–8, 399

liver cancer, 78–79

lung cancer, 85–93

male breast cancer, 102–104

male genital cancers (prostatic and testicular), 105–107

malignant melanoma of the skin, 94–98

multiple myeloma, 132–137

myelodysplastic syndromes, 140–142

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

nervous system cancers, 107–110

non-Hodgkin’s lymphoma, 127–130

non-melanoma skin cancers, 98–101

ocular melanoma, 110–111

pancreatic cancer, 79–80

prostatic cancer. See Male genital cancers

rectal cancer, 76–78

stomach cancer, 72–74

summary of conclusions, 142–143

susceptibility to infection, 359

tables, 144–222

Cancers of the nasal cavity and nasopharynx, 66–70

conclusions about, 69–70

and exposure to combustion products, 67–69

case-control studies, 67–69

selected epidemiologic studies, 147–148

and exposure to fuels, 66–67

case-control studies, 67

selected epidemiologic studies, 147

Cancers of the oral cavity and oropharynx, 61–66

conclusions about, 65–66

and exposure to combustion products, 63–65

case-control studies, 63–65

selected epidemiologic studies, 145–146

and exposure to fuels, 62–63

case-control studies, 63

cohort studies, 62–63

selected epidemiologic studies, 144

Cancers of the renal pelvis, in bladder cancer, and exposure to combustion products, 118

Carbon monoxide and carbon dioxide

from combustion, 41–42

toxicity of, 48

Carcinogenicity, of various agents and categories used by other IOM committees, 15

Cardiovascular effects, 277–287

and exposure to combustion products, 278–284

and exposure to fuels, 278

and exposure to nitric acid, 384

and exposure to uncombusted fuels, experimental studies, 37

inadequate/insufficient evidence to determine whether an association exists, 10

Case-control studies, 408–409

of bladder cancer

and exposure to combustion products, 115–118

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

and exposure to fuels, 111–114

of cancers of the nasal cavity and nasopharynx

and exposure to combustion products, 67–69

and exposure to fuels, 67

of cancers of the oral cavity and oropharynx

and exposure to combustion products, 63–65

and exposure to fuels, 63

of colon cancer

and exposure to combustion products, 75–76

and exposure to fuels, 75

of esophageal cancer, and exposure to combustion products, 71

of female breast cancer, and exposure to combustion products, 102

of female genital cancers (cervical, endometrial, uterine, and ovarian), and exposure to combustion products, 105

of Hodgkin’s disease

and exposure to combustion products, 132

and exposure to fuels, 131

of kidney cancer

and exposure to combustion products, 124–127

and exposure to fuels, 121–124

of laryngeal cancer

and exposure to combustion products, 82–84

and exposure to fuels, 81–82

of leukemias, and exposure to combustion products, 138–139

of liver cancer

and exposure to combustion products, 78–79

and exposure to fuels, 78

of male breast cancer

and exposure to combustion products, 103

and exposure to fuels, 103

of male genital cancers (prostatic and testicular)

and exposure to combustion products, 106–107

and exposure to fuels, 106

of malignant melanoma of the skin

and exposure to combustion products, 96–97

and exposure to fuels, 95

of multiple myeloma

and exposure to combustion products, 135–136

and exposure to fuels, 134

of myelodysplastic syndromes

and exposure to combustion products, 141

and exposure to fuels, 140–141

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

of nervous system cancers

and exposure to combustion products, 109

and exposure to fuels, 109

of nitric acid exposure, 383–384

laryngeal cancer, 383

multiple myeloma, 384

of non-Hodgkin’s lymphoma

and exposure to combustion products, 129–130

and exposure to fuels, 128–129

of non-melanoma skin cancers

and exposure to combustion products, 100

and exposure to fuels, 99

of ocular melanoma, and exposure to combustion products, 110

of outdoor air pollution, 254–255

of pancreatic cancer, and exposure to combustion products, 80

of rectal cancer

and exposure to combustion products, 77–78

and exposure to fuels, 77

of sarcoidosis, and exposure to combustion products, 337–341

of stomach cancer

and exposure to combustion products, 73

and exposure to fuels, 72

tables of, 425–456

Case reports and case series, 409–410

Categories of association, 4–6, 25–27

inadequate/insufficient evidence to determine whether an association exists, 5, 8–10, 26, 142–143

limited/suggestive evidence

of an association, 5, 7–8, 26

of no association, 6, 11, 26–27

sufficient evidence of a causal association, 5, 7, 25, 142

sufficient evidence of an association, 5, 7, 26, 142

Causal relationships, evidence of, 3, 15–16

CDC. See Centers for Disease Control and Prevention

Centers for Disease Control and Prevention (CDC), 361–362

Central nervous system (CNS) cancers, 294–296

Cervical cancer. See Female genital cancers

Cervical intraepithelial neoplasia (CIN), 105

CFS. See Chronic fatigue syndrome

Chemical identity and selected physical and chemical properties

of combustion products, 41–42

gases, 41–42

particulate matter, 42

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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of hydrazine, 349–350

of nitric acid, 349–350

of selected uncombusted fuels, 30–31

Chemical Industry Institute of Toxicology (CIIT), 45

Chevron Corporation, 241

Childhood cancers, 293–296, 311–313

central nervous system cancers, 294–296

conclusions about, 313

leukemia, 293–294

China, studies from cited, 63–64, 66–67, 73, 90–94, 256–257, 294, 301, 308, 335

Chlamydia pneumoniae, 340–341

Chronic bioassays, 47

Chronic bronchitis, 240

conclusions about, 267–269

and exposure to fuels, 242, 245

key studies of, 268

Chronic fatigue syndrome (CFS), 361

Chronic obstructive pulmonary disease (COPD), conclusions about, 269–270

CIIT. See Chemical Industry Institute of Toxicology

CIN. See Cervical intraepithelial neoplasia

Civilian populations, epidemiology of MCS symptoms in, 326–327

CNS. See Central nervous system cancers

Cohort studies, 20, 407–408, 413

of bladder cancer, and exposure to combustion products, 114–115

of cancers of the oral cavity and oropharynx, and exposure to fuels, 62–63

of colon cancer, and exposure to fuels, 74–75

of esophageal cancer

and exposure to combustion products, 71

and exposure to fuels, 70

of exposure to hydrazine, 363–369

in Italian power plant cohort, 368–369

in UK hydrazine production cohort, 367–368

in US aerospace cohort, 363–367

of exposure to nitric acid, 381–383

in Italian chemical plant workers, 382

in nitric acid production cohort, 382–383

occupational studies, 381–383

in Pennsylvania sheet and tin mill, 381

in US mid western metal pickling cohort, 381–382

of female breast cancer, and exposure to fuels, 101

of female genital cancers (cervical, endometrial, uterine, and ovarian), and exposure to fuels, 104

of Hodgkin’s disease

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

and exposure to combustion products, 132

and exposure to fuels, 131

of kidney cancer

and exposure to combustion products, 124

and exposure to fuels, 120–121

of laryngeal cancer, and exposure to fuels, 81

of leukemias, and exposure to combustion products, 138

of male genital cancers (prostatic and testicular), and exposure to fuels, 106

of malignant melanoma of the skin

and exposure to combustion products, 96

and exposure to fuels, 94–95

of multiple myeloma, and exposure to fuels, 133–134

of nervous system cancers, and exposure to fuels, 108–109

of non-Hodgkin’s lymphoma

and exposure to combustion products, 129

and exposure to fuels, 128

of non-melanoma skin cancers, and exposure to fuels, 98–99

of pancreatic cancer, and exposure to fuels, 79

prospective and retrospective, 407

of rectal cancer, and exposure to fuels, 76–77

of stomach cancer

and exposure to combustion products, 73

and exposure to fuels, 72

tables of, 414–425

Colon cancer, 74–76

conclusions about, 76

and exposure to combustion products, 75–76

case-control studies, 75–76

selected epidemiologic studies, 153–154

and exposure to fuels, 74–75

case-control studies, 75

cohort studies, 74–75

selected epidemiologic studies, 152–153

Columbia, studies from cited, 263

Combustion products, 39–49

bladder cancer, and exposure to, 114–118

cancers of the nasal cavity and nasopharynx, and exposure to, 67–69

cancers of the oral cavity and oropharynx, and exposure to, 63–65

cardiovascular disease, and exposure to, 278–284

air-pollution studies, 280–281

conclusions about, 284

Gulf War Veteran studies, 279–280

occupational studies, 282–284

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

colon cancer, and exposure to, 75–76

esophageal cancer, and exposure to, 70–71

female breast cancer, and exposure to, 102

female genital cancers (cervical, endometrial, uterine, and ovarian), and exposure to, 105

hepatic cancer, and exposure to, 156

Hodgkin’s disease, and exposure to, 131–132

kidney cancer, and exposure to, 124–127

laryngeal cancer, and exposure to, 82–84

leukemias, and exposure to, 138–139

liver cancer, and exposure to, 78–79

lung cancer, and exposure to, 86–93

male breast cancer, and exposure to, 103

male genital cancers (prostatic and testicular), and exposure to, 106–107

malignant melanoma of the skin, and exposure to, 95–97

multiple myeloma, and exposure to, 135–136

myelodysplastic syndromes, and exposure to, 141

nervous system cancers, and exposure to, 109

neurologic outcomes, and exposure to, 321–325

non-Hodgkin’s lymphoma, and exposure to, 129–130

non-melanoma skin cancers, and exposure to, 99–100

ocular melanoma, and exposure to, 110

pancreatic cancer, and exposure to, 80

physical and chemical properties of, 41–42

potential exposures in the Gulf War, 40–41

prostatic cancer, and exposure to. See Male genital cancers

rectal cancer, and exposure to, 77–78

reproductive and developmental outcomes, and exposure to, 297–313

adverse pregnancy outcomes, 298–311

respiratory outcomes, and exposure to, 243–270

asthma, key studies of, 265–266

biomass-fuel combustion, 261–262

chronic bronchitis, key studies of, 268

conclusions, 264–269

exposure statistics, 251

Gulf War studies, 246–251

occupational studies, 259–261

other biomass studies, 262–264

outdoor air pollution, 252–258

stomach cancer, and exposure to, 72–73

toxicity studies of, 43–49

toxicokinetics of, 42–43

and uncombusted fuels, 28–59

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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Computed-tomographic (CT) scans, 323

Conclusions, 264–269

about asthma, 264–266

about birth defects, 311

about bladder cancer, 118–119

about cancers of the nasal cavity and nasopharynx, 69–70

about cancers of the oral cavity and oropharynx, 65–66

about childhood cancers, 313

about chronic bronchitis, 267–269

about chronic obstructive pulmonary disease, 269–270

about colon cancer, 76

about combustion products and cardiovascular disease, 284

about dermatologic outcomes, 336

about emphysema, 269

about esophageal cancer, 71–72

about female breast cancer, 102

about female genital cancers (cervical, endometrial, uterine, and ovarian), 105

from Gulf War and Health, Volumes 1 and 2, 17, 398–402

about Hodgkin’s disease, 132

about kidney cancer, 127

about laryngeal cancer, 84–85

about leukemias, 139–140

about liver cancer, 79

about low birthweight and intrauterine growth retardation, 310

about lung cancer, 93

about male breast cancer, 103–104

about male genital cancers (prostatic and testicular), 107

about malignant melanoma of the skin, 98

about multiple chemical sensitivity, 331

about multiple myeloma, 137

about myelodysplastic syndromes, 141–142

about nervous system cancers, 110

about neurobehavioral effects, 321, 324

about non-Hodgkin’s lymphoma, 130

about non-melanoma skin cancers, 100–101

about ocular melanoma, 111

about pancreatic cancer, 80

about peripheral neuropathy, 319

about posttraumatic stress disorder, 323

about rectal cancer, 78

about reproductive and developmental outcomes, 297

about respiratory outcomes, 242–243, 264, 269

about sarcoidosis, 341

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

about stomach cancer, 74

summary of, 142–143

Consistency of association, in assessing the strength of the evidence, 4, 23

Contact dermatitis, experimental studies of the toxicology of hydrazines in, 356

Controlled epidemiologic studies (observational), 406–410

case-control studies, 408–409

case reports and case series, 409–410

cohort studies, 407–408

cross-sectional studies, 409

information from death certificates, 410

Controlled trials, randomized, 20

in humans, 406

COPD. See Chronic obstructive pulmonary disease

Cross-sectional studies, 20, 409, 410

of hydrazine exposure, 369–370

Japanese hydrazine hydrate workers, 369–370

missile-propellant handlers at Vandenberg Air Force Base, California, 369

rocket-propellant workers in Danish Air Force, 369

of outdoor air pollution, 254–255

CT. See Computed-tomographic scans

Czech Republic, studies from cited, 302, 307, 309

D

Danish Air Force, rocket-propellant workers in, 369

Danish Cancer Registry, 134, 136, 311

Danish Gulf War Study, 361

Danish Supplemental Pension Fund, 134, 136

Death certificates, information from, 410

Denmark, studies from cited, 91, 103

Dermatologic outcomes, 331–336

absorption of fuels by Gulf War personnel, 28

conclusions about, 336

dermatitis, and fuel exposure, 333–334

experimental studies in exposure to uncombusted fuels, 39

inadequate/insufficient evidence to determine whether an association exists, 10

Determinants of disease, epidemiology dealing with, 20

Developmental insults, from exposure to nitric acid, 359

Developmental outcomes. See Reproductive and developmental outcomes

Diabetes mellitus, mortality from, and exposure to nitric acid, 389

Diagnostic and Statistical Manual of Mental Disorders-IV, 320

Diesel heater fumes

exposure to, 19

Disease induction, exposure preceding the onset of disease by the duration of, 23

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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Diseases

epidemiology dealing with determinants of, distribution of, and frequency of, 20

not specified in legislation, 18

DOD. See US Department of Defense

Dose-response relationship, in assessing the strength of the evidence, 4–5, 23

E

Ear nose and throat (ENT) conditions, 262

Ecologic studies, given less weight, 22

Ecuador, studies from cited, 292

EMBASE, 403

EMBCS. See European Merged Bladder Cancer Study

Emphysema, conclusions about, 269

Endometrial cancer. See Female genital cancers

ENT. See Ear nose and throat conditions

Environmental studies, 14

EPA. See US Environmental Protection Agency

Epidemiologic studies, 3, 16, 19–21, 290–291, 360–389, 405–412

of acute nonlymphocytic leukemia, 290

of bladder cancer

and exposure to combustion products, 200–206

and exposure to fuels, 198–200

of brain/CNS cancers

and exposure to combustion products, 197

and exposure to fuels, 195–196

of cancers of the nasal cavity and nasopharynx

and exposure to combustion products, 147–148

and exposure to fuels, 147

of cancers of the oral cavity and oropharynx

and exposure to combustion products, 145–146

and exposure to fuels, 144

of colon cancer

and exposure to combustion products, 153–154

and exposure to fuels, 152–153

controlled epidemiologic studies, 406–410

of esophageal cancer

and exposure to combustion products, 149

and exposure to fuels, 148

experimental studies, 405–406

of female breast cancer

and exposure to combustion products, 189

and exposure to fuels, 188–189

of female genital cancers (cervical, endometrial, uterine, and ovarian)

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

and exposure to combustion products, 192–193

and exposure to fuels, 191

of hepatic cancer

and exposure to combustion products, 156

and exposure to fuels, 156

of Hodgkin’s disease

and exposure to combustion products, 216

and exposure to fuels, 215–216

of hydrazine exposure, occupational studies, 362–370

of kidney cancer

and exposure to combustion products, 210–212

and exposure to fuels, 207–210

of laryngeal cancer

and exposure to combustion products, 159–163

and exposure to fuels, 158

of leukemias, 290

and exposure to combustion products, 220–221

of lung cancer

and exposure to combustion products, 164–184

and exposure to fuels, 163–164

of male breast cancer

and exposure to combustion products, 190–191

and exposure to fuels, 190

of MCS symptoms in veteran and civilian populations, 326–327

of melanoma skin cancer, and exposure to fuels, 184–185

of multiple myeloma

and exposure to combustion products, 218–220

and exposure to fuels, 216–218

of myelodysplastic syndromes

and exposure to combustion products, 222

and exposure to fuels, 221–222

nature of the Gulf War studies, 410–411

of neuroblastoma, 291

of nitric acid exposure, occupational studies, 371–384

of non-Hodgkin’s lymphoma

and exposure to combustion products, 214–215

and exposure to fuels, 212–213

of non-melanoma skin cancers

and exposure to combustion products, 187–188

and exposure to fuels, 187

of ocular melanoma, and exposure to combustion products, 197–198

of pancreatic cancer

and exposure to combustion products, 157–158

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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and exposure to fuels, 157

of Prader-Willi syndrome, 291

of prostatic cancer

and exposure to combustion products, 194–195

and exposure to fuels, 193

of rectal cancer

and exposure to combustion products, 155–156

and exposure to fuels, 154–155

of reproductive outcomes from exposure to fuel, 290–291

of respiratory outcomes, and fuel exposure, 243–246

of Scud missile debris, exposure by Gulf War veterans to, 360–362

of stomach cancer

and exposure to combustion products, 151–152

and exposure to fuels, 150

types of, 17, 405–412

Epidemiological Standardization project, 256

Error, reducing common sources of, 6, 22

Esophageal cancer, 70–72

conclusions about, 71–72

and exposure to combustion products, 70–71

case-control studies, 71

cohort studies, 71

selected epidemiologic studies, 149

and exposure to fuels, 70

cohort studies, 70

selected epidemiologic studies, 148

and exposure to nitric acid, 387–388

Ethiopia, studies from cited, 335

European Merged Bladder Cancer Study (EMBCS), 113–114, 117–119

European Prospective Study into Cancer and Nutrition, 254

Evaluation of the literature, 3–4, 18–27

categories of association, 25–27

considerations in assessing the strength of the evidence, 22–25

epidemiologic studies, 20–21

identification of the literature, 19

inclusion criteria, 4, 21–22

Evidence

of a causal relationship, 3, 16

of a statistical association, 2, 15

Excerpta Medica database, 403

Experimental studies, 405–406

animal models, 405–406

of exposure to nitric acid, 357–358

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

randomized controlled trials in humans, 406

of the toxicology of hydrazines, 354–356

amyloidosis, 355

cancer, 355

contact dermatitis, 356

genotoxicity, 355

hepatic effects, 354

nervous system effects, 354

reproductive and developmental effects, 354–355

respiratory effects, 354

systemic lupus erythematosus, 355

of the toxicology of nitric acid, 357–358

residual effects of corrosive action and irritation, 357–358

of uncombusted fuels, 34–39

cancer, 35

cardiovascular effects, 37

dermal effects, 39

gastrointestinal effects, 37

hepatic effects, 36–37

immunologic effects, 37–38

neurologic effects, 35–36

renal effects, 38

reproductive and developmental effects, 38–39

respiratory effects, 36

Exposure.

See also Combustion products;

Fuels;

Hydrazines;

Nitric acid

to compounds in exhaust fumes, 92–93

to environmental or wartime hazards, 1

and exposure-free interval for reversible effects, 21–22

to preventive medicines or vaccines associated with Gulf War service, 1

to toxic agents, 1

Exposure intensity, 6, 10, 14

estimating, 26n, 247

Exposure limits, for uncombusted fuels, 29

Exxon Corporation, 121, 128, 131–133

F

FAB. See French-American-British system

Factor analysis, 411

Fatigue, reported by Gulf War Veterans, 14

Female breast cancer, 101–102

conclusions about, 102

and exposure to combustion products, 102

case-control studies, 102

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

selected epidemiologic studies, 189

and exposure to fuels, 101

cohort studies, 101

selected epidemiologic studies, 188–189

Female genital cancers (cervical, endometrial, uterine, and ovarian), 104–105

conclusions about, 105

and exposure to combustion products, 105

case-control studies, 105

selected epidemiologic studies, 192–193

and exposure to fuels, 104

cohort studies, 104

selected epidemiologic studies, 191

Finland, studies from cited, 64, 80, 100, 105, 125, 264

Finnish Cancer Registry, 100, 123

Forced vital capacity (FVC), 251, 259

France, studies from cited, 80, 83, 117, 127, 141, 254

French-American-British (FAB) system, 139–140

Frequency of disease, epidemiology dealing with, 20

Fuels, 12, 19.

See also Uncombusted fuels

bladder cancer, and exposure to, 111–114

cancers of the nasal cavity and nasopharynx, and exposure to, 66–67

cancers of the oral cavity and oropharynx, and exposure to, 62–63

and cardiovascular disease, 278

colon cancer, and exposure to, 74–75

dermatitis, and exposure to, 333–334

esophageal cancer, and exposure to, 70

female breast cancer, and exposure to, 101

female genital cancers (cervical, endometrial, uterine, and ovarian), and exposure to, 104

hepatic cancer, and exposure to. See Liver cancer

Hodgkin’s disease, and exposure to, 131

kidney cancer, and exposure to, 120–124

laryngeal cancer, and exposure to, 81–82

leukemias, and exposure to, 138

liver cancer, and exposure to, 78

lung cancer, and exposure to, 86

male breast cancer, and exposure to, 103

male genital cancers (prostatic and testicular), and exposure to, 106

malignant melanoma of the skin, and exposure to, 94–95

multiple myeloma, and exposure to, 133–134

myelodysplastic syndromes, and exposure to, 140–141

nervous system cancers, and exposure to, 108–109

neurologic outcomes, and exposure to, 318–321

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

non-Hodgkin’s lymphoma, and exposure to, 128–129

non-melanoma skin cancers, and exposure to, 98–99

ocular melanoma, and exposure to, 110

pancreatic cancer, and exposure to, 79

prostatic cancer, and exposure to. See Male genital cancer

rectal cancer, and exposure to, 76–77

reproductive and developmental outcomes, and exposure to, 290–297

childhood cancers, 293–296

conclusions about, 297

infertility, 291–292

selected epidemiologic studies, 290–291

spontaneous abortion, 292–293

respiratory outcomes, and exposure to, 241–243

asthma, 242, 244

chronic bronchitis and emphysema, 242, 245

conclusions about, 242–243

nonmalignant respiratory disease, 241–244

pneumonia and influenza, 245–246

selected epidemiologic studies, 243–246

stomach cancer, and exposure to, 72

toxicokinetics of, 34

FVC. See Forced vital capacity

G

Gases from combustion, 41–42, 45–48

carbon monoxide and carbon dioxide, 41–42, 48

hydrogen sulfide, 41, 45

nitrogen oxides, 41, 46–47

ozone, 47–48

physical and chemical properties, 41–42

sulfur oxides, 41, 45–46

toxicity studies of, 43–49

toxicokinetics of, 42–43

Gasoline sniffing, 36, 320–321

Gastrointestinal effects, experimental studies of exposure to uncombusted fuels, 37

Gene-Tox database, 359

General exposure, to engine exhaust, 91–92

General Health Questionnaire, 322

Genetic susceptibility

and exposure to nitric acid, 359

and hydrazine, 356

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

Genital cancers

female, 104–105

male, 105–107

Genotoxicity

experimental studies of the toxicology of hydrazines in, 355

from exposure to nitric acid, 359

Georgia, studies from cited, 289, 302

Germany, studies from cited, 64, 66, 81, 83–84, 91–92, 106, 113, 123, 125

Global Initiative for Chronic Obstructive Lung Disease (GOLD), 240, 269

GOLD. See Global Initiative for Chronic Obstructive Lung Disease

Greece, studies from cited, 90, 254

Gulf War and Health: Updated Literature Review of Sarin, 1

Gulf War and Health, Volume 1: Depleted Uranium, Pyridostigmine Bromine, Sarin, and Vaccines, 1, 12, 18

conclusions from, 398–402

Gulf War and Health, Volume 2: Insecticides and Solvents, 1, 12, 18, 29

conclusions from, 398–402

H

Harvard Six Cities Study, 90, 256, 280

Hawaii, studies from cited, 289

HCFA. See Health Care Financing Administration

HCs. See Hydrocarbons

Headaches, reported by Gulf War Veterans, 14

Health Care Financing Administration (HCFA), 82

“Healthy-worker” effect, 407–408

Hepatic cancer. See Liver cancer

and exposure to combustion products, selected epidemiologic studies, 156

and exposure to fuels, selected epidemiologic studies, 156

Hepatic effects, experimental studies

of exposure to uncombusted fuels, 36–37

of the toxicology of hydrazines in, 354

Herbicides used in Vietnam, categories used to evaluate, 25

High-quality studies, 5, 26

Hodgkin’s disease, 130–132

conclusions about, 132

and exposure to combustion products, 131–132

case-control studies, 132

cohort studies, 132

selected epidemiologic studies, 216

and exposure to fuels, 131

case-control studies, 131

cohort studies, 131

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

selected epidemiologic studies, 215–216

Human health outcomes, 6

summary of findings regarding the association between exposure to fuels,

combustion products, hydrazines, and nitric acid and specific health outcomes, 7–11

Humans, randomized controlled trials in, 406

Hydrazines, 348–356

chemical identity and selected physical and chemical properties of, 349–351

experimental studies, 354–356

genetic susceptibility, 356

interactions, 356

occupational studies of, 362–370

recommended exposure limits for, 352–353

toxicokinetics, 351–353

Hydrocarbons (HCs), 120–121, 133, 135

Hydrogen sulfide

from combustion, 41

respiratory diseases, from outdoor air pollution, 258

toxicity of, 45

Hypertensive heart disease, mortality from, and exposure to nitric acid, 389

I

IARC. See International Agency for Research on Cancer

ICD. See International Classification of Disease codes

Iceland, studies from cited, 91

Identification

of class or agent, 21

of the relevant literature, 19

Idiopathic environmental intolerance. See Multiple chemical sensitivity

IES. See Impact of Events Scale

IHD. See Ischemic-heart-disease

Immunologic effects, experimental studies in exposure to uncombusted fuels, 37–38

Impact of Events Scale (IES), 322

Imperial Oil Limited, 70, 74–76, 79, 86, 93, 95, 98, 101, 104, 106, 108, 121, 128, 130–131, 133

Inadequate/insufficient evidence to determine whether an association exists, 5, 8–10, 26, 142–143, 400–402

cancers, 8–9, 400–401

cardiovascular effects, 10

conclusions from Gulf War and Health, Volumes 1 and 2, 400–402

dermal effects, 10

neurologic effects, 10, 401

other health effects, 10, 401–402

reproductive effects, 9–10, 401

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

respiratory effects, 10

Inclusion criteria for literature used, 4, 21–22

exposure assessment, and exposure-free interval for reversible effects, 21–22

identification of class or agent, 21

methodological rigor, 21

specificity of outcome, 21

support studies, 22

Increased risk in Gulf War Veterans, determining, 2–3, 15–16

India, studies from cited, 261, 263, 384

Individual susceptibility, to uncombusted fuels and combustion products, 49–50

Indoor air pollution, from combustion of fuels, 88

Indoor pollutants related to asthma, categories used to evaluate, 25

Infection, susceptibility to, from exposure to nitric acid, 359

Infertility, from exposure to fuels, 291–292

Influenza, from exposure to fuels, 245–246

Information

bias in, 24–25

from death certificates, 410

Inhalation of fuels, by Gulf War personnel, 28

Inhibited red fuming nitric acid (IRFNA), 347–348

Institute of Medicine (IOM), 1–2, 12, 14–15, 288

previous studies by, 5–6, 15, 25, 141, 288

Institute of Oncology (Poland), 383

Interactions

with hydrazine, 356

with nitric acid, 359

with uncombusted fuels and combustion products, 50

International Agency for Research on Cancer (IARC), 2, 15, 20, 29, 61, 82, 100, 348, 351, 357, 359, 385, 403

International Classification of Disease

seventh revision (ICD-7), 381

eighth revision (ICD-8), 133

ninth revision (ICD-9), 10, 61–64, 68, 70, 74, 76, 78–79, 83, 85, 94, 101–102, 104–105, 110–111, 119, 127–128, 130, 132, 137–138, 246, 251, 280, 283

Clinical Modification, 279

tenth revision (ICD-10), 326

International Classification of Disease (ICD) codes, 22, 24, 277, 281, 324, 363

International Renal-Cell Cancer Study (IRCCS), 118, 123, 125

International Standard Classification of Occupation and Industry (ISCOI), 68, 125–126

Intrauterine growth retardation, 6, 302–310

IOM. See Institute of Medicine

Iowa, studies from cited, 113, 115, 128–129, 289, 328, 336

Iowa Farm Family Health and Hazard Survey, 336

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

Iowa Persian Gulf Study Group, 411

IRCCS. See International Renal-Cell Cancer Study

IRFNA. See Inhibited red fuming nitric acid

Ischemic-heart-disease (IHD), 368, 371

ISCOI. See International Standard Classification of Occupation and Industry

Israel, studies from cited, 332

Italian chemical plant workers, cohort studies of nitric acid exposure, 382

Italian power plant cohort, 368–369

Italy, studies from cited, 65, 70, 72–73, 90–91, 101–102, 107, 109, 113, 116, 128, 130–132, 136, 139, 368, 382

J

Japan, studies from cited, 255

Japanese hydrazine hydrate workers, 369–370

K

Kaiser Permanente Medical Care Program, 92

Kashmir, studies from cited, 263

Kidney cancer, 119–127

conclusions about, 127

and exposure to combustion products, 124–127

case-control studies, 124–127

cohort studies, 124

selected epidemiologic studies, 210–212

and exposure to fuels, 120–124

case-control studies, 121–124

cohort studies, 120–121

selected epidemiologic studies, 207–210

Kuwait, oil-fires in, 40, 43, 93, 269, 322

L

Laryngeal cancer, 80–85

conclusions about, 84–85

and exposure to combustion products, 82–84

case-control studies, 82–84

selected epidemiologic studies, 159–163

and exposure to fuels, 81–82

case-control studies, 81–82

cohort study, 81

selected epidemiologic studies, 158

and exposure to nitric acid, 387

case-control studies, 383

Latency periods, 60, 410

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

LBW. See Low birthweight

Legislation, 1, 12, 18, 21

agents specified in PL 105–368 and PL 105–277, 13

diseases or illnesses not specified, 18

Leukemias, 137–140, 293–294

conclusions about, 139–140

and exposure to combustion products, 138–139

case-control studies, 138–139

cohort studies, 138

nested case-control studies, 138

selected epidemiologic studies, 220–221

and exposure to fuels, 138, 290

Limited/suggestive evidence

of an association, 5, 7–8, 26, 399

cancers, 7–8, 399

conclusions from Gulf War and Health, Volumes 1 and 2, 399

neurologic effects, 399

other health effects, 399

reproductive effects, 8

respiratory effects, 8

of no association, 6, 11, 26–27, 402

conclusions from Gulf War and Health, Volumes 1 and 2, 402

Literature

evaluation of, 3–4

identification of, 3–4, 18–27

peer-reviewed published, 19

Liver cancer, 78–79

conclusions about, 79

and exposure to combustion products, 78–79

case-control studies, 79

and exposure to fuels, 78

case-control studies, 78

Lombardy Cancer Registry for Varese Province, 368

Louisiana, studies from cited, 121, 128, 131, 133, 279–280, 360

Low birthweight (LBW), 6, 302–310

conclusions about, 310

and exposure to combustion products, 303–306

Lung cancer, 85–93

conclusions about, 93

and exposure to combustion products, 6, 86–93

and ambient air pollution from combustion of fuels, 89

ambient air-pollution studies, 89–91

and indoor air pollution from combustion of fuels, 88

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

occupational exposure to engine exhaust, 91–93

and occupations with exposure to combustion products, 87

selected epidemiologic studies, 164–184

and exposure to fuels, 86

selected epidemiologic studies, 163–164

and exposure to nitric acid, 386–387

Lupus. See Systemic lupus erythematosus

Lymphomas. See Non-Hodgkin’s lymphoma

Lymphopoietic cancer, and exposure to nitric acid, 388

M

Malaysia, studies from cited, 67–68

Male breast cancer, 102–104

conclusions about, 103–104

and exposure to combustion products, 103

case-control studies, 103

selected epidemiologic studies, 190–191

and exposure to fuels, 103

case-control studies, 103

selected epidemiologic studies, 190

Male genital cancers (prostatic and testicular), 105–107

conclusions about, 107

and exposure to combustion products, 106–107

case-control studies, 106–107

and exposure to fuels, 106

case-control studies, 106

cohort studies, 106

Malignant melanoma skin cancer, 94–98.

See also Non-melanoma skin cancers

conclusions about, 98

and exposure to combustion products, 95–97

case-control studies, 96–97

cohort studies, 96

selected epidemiologic studies, 185–187

and exposure to fuels, 94–95

case-control studies, 95

cohort studies, 94–95

selected epidemiologic studies, 184–185

Mantel-Haenzel test, 141

Maryland, studies from cited, 134

Massachusetts, studies from cited, 279–280, 360

MCS. See Multiple chemical sensitivity

MDFs. See Middle-distillate fuels

MDSs. See Myelodysplastic syndromes

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

MEDLINE, 403

Melanomas.

See also Malignant melanoma skin cancer;

Ocular melanoma

Mexico, studies from cited, 262

Michigan, studies from cited, 91, 112

Middle-distillate fuels (MDFs), 35, 37

Minnesota, studies from cited, 121, 126, 128

Missile-propellant handlers, at Vandenberg Air Force Base, California, 369

Mississippi, studies from cited, 288

Missouri, studies from cited, 43–44, 126

Mixtures of combustion products, toxicity studies of, 43–44

Mortality studies

of combustion products and respiratory outcomes, 259–260

of outdoor air pollution, 255–256

Multiple chemical sensitivity (MCS), 325–331, 361

background, 326–327

common triggers and original causes reported by people with, 331

conclusions about, 331

epidemiology of symptoms in veteran and civilian populations, 326–327

evaluation of the evidence and inclusion criteria, 327–328

Gulf War studies, 328–329

hypotheses about etiology, 327

prevalence of symptoms in Gulf War and US population-based samples, 326–327

studies in non-Gulf War Veteran populations, 329–331

Multiple myeloma, 132–137

conclusions about, 137

and exposure to combustion products, 135–136

case-control studies, 135–136

nested case-control studies, 135

selected epidemiologic studies, 218–220

and exposure to fuels, 133–134

case-control studies, 134

cohort studies, 133–134

selected epidemiologic studies, 216–218

and exposure to nitric acid, 388

case-control studies of, 384

Mutagenicity, 35

Myelodysplastic syndromes (MDSs), 140–142

conclusions about, 141–142

and exposure to combustion products, 141

case-control studies, 141

selected epidemiologic studies, 222

and exposure to fuels, 140–141

case-control studies, 140–141

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

selected epidemiologic studies, 221–222

Myelomas, multiple. See Multiple melanoma

N

Naphtha, 29

NAS. See National Academy of Sciences

Nasal cavity and nasopharynx, cancers of, 66–70

conclusions about, 69–70

and exposure to combustion products, 67–69

case-control studies, 67–69

selected epidemiologic studies, 147–148

and exposure to fuels, 66–67

case-control studies, 67

selected epidemiologic studies, 147

Nasopharyngeal carcinoma (NPC), 66–68

National Academy of Sciences (NAS), 1, 12

National Bladder Cancer Study (NBCS), 112–113, 115, 118

National Cancer Institute (NCI), 74, 112

National Cancer Survey database, 75, 77

National Enhanced Cancer Surveillance System (NECSS), 126, 129

National Family Health Survey (India), 261

National Guard units, 288, 360

National Health Interview Survey, 336

National Institute for Occupational Safety and Health (NIOSH), 29, 348, 356–357, 381

National Library of Medicine (NLM), 403–404

National Occupational Hazard Survey, 75, 77

National Oceanic and Atmospheric Administration (NOAA), 247, 251, 279

National Prader-Willi Syndrome Association, 296

National Priorities List, 336

National Research Council (NRC), 29, 34–39, 46, 48, 347–348, 351, 355–356, 369

National Taiwan University Hospital, 335

National Toxicology Program (NTP), 47

NBCS. See National Bladder Cancer Study

NCI. See National Cancer Institute

NECSS. See National Enhanced Cancer Surveillance System

Nepal, studies from cited, 262

Nervous system cancers, 107–110

conclusions about, 110

and exposure to combustion products, 109

case-control studies, 109

and exposure to fuels, 108–109

case-control studies, 109

cohort studies, 108–109

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

Nervous system effects, experimental studies of the toxicology of hydrazines in, 354

Nested case-control studies

in leukemias, and exposure to combustion products, 138

in multiple myeloma, and exposure to combustion products, 135

The Netherlands, studies from cited, 89–90, 92, 97, 114, 256, 280–281

The Netherlands Cohort Study on Diet and Cancer, 114, 256, 280–281

Neuroblastoma, and exposure to fuels, 291

Neurologic outcomes, 317–325

conclusions about, 319, 321, 323–325

and exposure to combustion products, 321–325

neurobehavioral effects, 323–324

neurologic diseases, 324–325

posttraumatic stress disorder, 322–323

and exposure to uncombusted fuels, 318–321

experimental studies in, 35–36

peripheral neuropathy, 319

neurobehavioral effects, 320–321

inadequate/insufficient evidence to determine whether an association exists, 10, 401

limited/suggestive evidence of an association, 399

New Caledonia, studies from cited, 91

New Jersey, studies from cited, 78, 112, 121

New York, studies from cited, 65, 73, 84, 90, 96, 102, 129, 132, 138, 257, 283, 295, 340

New Zealand, studies from cited, 127, 258, 310, 324

New Zealand Cancer Registry, 127

NHL. See Non-Hodgkin’s lymphoma

NHLBI, 253

NIOSH. See National Institute for Occupational Safety and Health

Nitric acid, 356–359

and cancer, 358–359

chemical identity and selected physical and chemical properties of, 349–350

experimental studies of, 357–358

and genetic susceptibility, 359

interactions, 359

occupational studies of exposure to, 371–384

recommended exposure limits for, 352–353

red fuming, 16, 347, 348, 356

residual effects of corrosive action and irritation, 357–358

toxicokinetics of, 356–357

white fuming, 356

Nitrogen oxides

from combustion, 41

toxicity of, 46–47

NLM. See National Library of Medicine

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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No-observed-effect level (NOEL), 358

NOAA. See National Oceanic and Atmospheric Administration

NOEL. See No-observed-effect level

Non-cancer health outcomes, and exposure to nitric acid, 384, 388–390

arteriosclerotic heart disease (mortality), 388–389

cardiovascular effects, 384

diabetes mellitus (mortality), 389

hypertensive heart disease (mortality), 389

respiratory effects, 384

vascular lesions of CNS (mortality), 389

Non-Hodgkin’s lymphoma (NHL), 127–130

conclusions about, 130

and exposure to combustion products, 129–130

case-control studies, 129–130

cohort studies, 129

selected epidemiologic studies, 214–215

and exposure to fuels, 128–129

case-control studies, 128–129

cohort studies, 128

selected epidemiologic studies, 212–213

Non-melanoma skin cancers, 98–101

conclusions about, 100–101

and exposure to combustion products, 99–100

case-control studies, 100

selected epidemiologic studies, 187–188

and exposure to fuels, 98–99

case-control studies, 99

cohort studies, 98–99

selected epidemiologic studies, 187

Nonmalignant respiratory disease, and exposure to fuels, 241, 244

Normative Aging Study, 284

Norway, studies from cited, 89–90, 260, 382–383

Norwegian Cancer Registry, 383

NPC. See Nasopharyngeal carcinoma

NRC. See National Research Council

NTP. See National Toxicology Program

O

Observational studies, 406–410

case-control studies, 408–409

case reports and case series, 409–410

cohort studies, 407–408

cross-sectional studies, 409

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

types of epidemiologic studies, 406–410

Occupational Safety and Health Administration (OSHA), 29, 351, 356

Occupational studies, 2, 14–15, 16, 87

of exposure to combustion products, 91–93

and cardiovascular disease, 282–284

and respiratory outcomes, 259–261

of exposure to engine exhaust, 91–93

estimated exposure to compounds in exhaust fumes, 92–93

general exposure to exhaust, 91–92

Gulf War Veteran study, 93

of hydrazine exposure, 362–371

cohort studies, 363–369

conclusions from, 371

cross-sectional studies, 369–370

health outcomes, 372–374

of nitric acid exposure, 371, 375–385

case-control studies, 383–384

cohort studies, 381–383

conclusions from, 385

health outcomes and exposure to nitric acid, 386–390

Occupations, with exposure to combustion products, 87

Ocular melanoma, 110–111

conclusions about, 111

and exposure to combustion products, 110

case-control studies, 110

selected epidemiologic studies, 197–198

and exposure to fuels, 110

Odds ratios (ORs), 20, 22, 63

Oil-well fire by-products

exposure to, 14, 19, 28, 40, 43, 93, 267, 269

Gulf War studies of smoke, 248–249

Oklahoma, studies from cited, 122, 126

Oral cavity and oropharynx, cancers of, 61–66

conclusions about, 69–70

and exposure to combustion products, 67–69

case-control studies, 67–69

selected epidemiologic studies, 147–148

and exposure to fuels, 66–67

case-control studies, 67

selected epidemiologic studies, 147

Oregon, studies from cited, 362

Oropharynx, cancers of, 61–66

conclusions about, 69–70

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

and exposure to combustion products, 67–69

case-control studies, 67–69

selected epidemiologic studies, 147–148

and exposure to fuels, 66–67

case-control studies, 67

selected epidemiologic studies, 147

ORs. See Odds ratios

OSHA. See Occupational Safety and Health Administration

Outdoor air pollution, 252–258

cross-sectional or case-control studies, 254–255

hydrogen sulfide and respiratory diseases, 258

mortality studies, 255–256

prospective studies, 252–254

support studies, 256–258

Ovarian cancer. See Female genital cancers

Ozone, toxicity of, 47–48

P

PAHs. See Polycyclic aromatic hydrocarbons

Pancreatic cancer, 79–80

conclusions about, 80

and exposure to combustion products, 80

case-control studies, 80

selected epidemiologic studies, 157–158

and exposure to fuels, 79

cohort studies, 79

selected epidemiologic studies, 157

Particulate matter (PM) from combustion, 39, 40, 42–43, 48–50, 90

physical and chemical properties of, 42

toxicity studies of, 48–49

toxicokinetics of, 42–43

PEL. See Permissible exposure limit

Pennsylvania, studies from cited, 381–382, 384

Pennsylvania sheet and tin mill cohorts, cohort studies of nitric acid exposure, 381

Peripheral neuropathy

conclusions about, 319

from exposure to fuels, 319

Permissible exposure limit (PEL), 356

Persian Gulf region, 2, 347

Persian Gulf War Veterans Act (PL 105–277), 1, 12–13

Physical and chemical properties

of combustion products, 41–42

gases, 41–42

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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participate matter, 42

of uncombusted fuels, 29

PL 105–368 and PL 105–277, agents specified in, 13

PM. See Participate matter from combustion

PMRs. See Proportional morbidity ratios

Pneumonia, from exposure to fuels, 245–246

Poland, studies from cited, 90, 99, 383

Polycyclic aromatic hydrocarbons (PAHs), 39–40, 42–43, 49, 61, 63–66, 71, 80, 82–83, 85, 91–93, 97, 99–103, 105–107, 114–116, 117–119, 123, 125–126, 141, 307, 309, 312, 368, 370

Population-based studies, of biomass-fuel combustion, 261–262

Posttraumatic stress disorder (PTSD), 280, 321–323, 360–361

conclusions about, 323

from exposure to combustion products, 322–323

Prader-Willi syndrome (PWS), 296–297

from exposure to fuels, 291

Preterm births, 6, 298–302

and combustion-product exposure, 299–300

Primary studies, 21

ProCite database, 403

Profile of Mood States, 323

Proportional morbidity ratios (PMRs), 250

Prospective studies

design of, 406–407

of outdoor air pollution, 252–254

Prostatic cancer, 193–195.

See also Male genital cancers

and exposure to combustion products, selected epidemiologic studies, 194–195

and exposure to fuels, selected epidemiologic studies, 193

PTSD. See Posttraumatic stress disorder

PubMed, 404

PWS. See Prader-Willi syndrome

R

Randomized controlled trials, 20, 406

in humans, 406

RCCs. See Renal-cell carcinomas

Recommended exposure limits

for exposure to hydrazine, 352–353

for exposure to nitric acid, 352–353

for fuels, 32–33

Rectal cancer, 76–78

conclusions about, 78

and exposure to combustion products, 77–78

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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case-control studies, 77–78

selected epidemiologic studies, 155–156

and exposure to fuels, 76–77

case-control studies, 77

cohort studies, 76–77

selected epidemiologic studies, 154–155

Red fuming nitric acid (RFNA), 348, 356, 358–360

inhibited, 14, 347–348

Relative risk, 22

Renal-cell carcinomas (RCCs). See Kidney cancer

Renal effects, and exposure to uncombusted fuels, experimental studies of, 38

Reproductive and developmental outcomes, 288–313

and combustion products, 297–313

experimental studies

in exposure to uncombusted fuels, 38–39

of the toxicology of hydrazines in, 354–355

and fuels, 290–297

inadequate/insufficient evidence to determine whether an association exists, 9–10, 401

limited/suggestive evidence of an association, 8

studies of birth defects in Gulf War Veterans, 288–290

Respiratory cancer, and exposure to nitric acid, 386

Respiratory outcomes, 240–270

and combustion products, 243–270

and exposure to fuel, 241–243

and exposure to nitric acid, 384

and exposure to uncombusted fuels, experimental studies, 36

and the toxicology of hydrazines, experimental studies, 354

Retrospective design, of studies, 407

Reversible effects, exposure-free interval for, 21–22

RFNA. See Red fuming nitric acid

Rhode Island, studies from cited, 340

Risks of illness among Gulf War Veterans

determining increased, 2–3, 15–16

human or animal populations exposed to an agent, 2, 15–16

Rocket-propellant workers, in Danish Air Force, 369

Roswell Park Memorial Institute, 65, 73, 84, 96, 129, 132, 138

S

Sarcoidosis, 337–341

conclusions about, 341

and exposure to combustion products, case-control studies of, 338–339

Saudi Arabia, studies from cited, 263

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

Scientific evidence, strength of, 1–2

SCLC. See Small cell lung cancer

Scud missiles

debris from, 14, 347, 357, 360–362, 385

propellant components of, 7, 347

SDA. See Seventh-Day Adventist Study

Searching the literature, 403–404

SEER. See Surveillance, Epidemiology, and End Results registry

Selection bias, 24

Self-reported symptoms, 410

Seventh-Day Adventist (SDA) Study, 89–90, 252, 264, 280

Short-term exposure limit (STEL), 356

SIRs. See Standardized incidence ratios

Six Cities Study, 90, 256, 280

Skin burns, 347

Skin cancers. See Dermatologic outcomes;

Malignant melanoma skin cancer;

Nonmelanoma skin cancers

Small cell lung cancer (SCLC), 85

Smoking consequences, 6, 367

maternal, 298, 309

Social Security Administration, 381

South Carolina, studies from cited, 337

South Korea, studies from cited, 302, 307, 323

Spain, studies from cited, 80–83, 113

Specificity

of association, in assessing the strength of the evidence, 4, 23–24

of outcome, 21

Spontaneous abortion, from exposure to fuels, 292–293

Standard Industrial Classification of Economic Activities, 311.

See also International Standard Classification of Occupation and Industry

Standard Occupational Classification, 311

Standardized incidence ratios (SIRs), 63, 71, 73, 281

State Health Registry of Iowa, 113, 129

Statistical association

evidence of, 2, 15

stability of, 5n

Statistical significance, measures of, 22

Statistics Canada, 301

STEL. See Short-term exposure limit

Stomach cancer, 72–74

conclusions about, 74

and exposure to combustion products, 72–73

case-control studies, 73

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
×

cohort studies, 73

selected epidemiologic studies, 151–152

and exposure to fuels, 72

case-control studies, 72

cohort studies, 72

selected epidemiologic studies, 150

Strength of evidence of an association, 4, 22–23

Study designs, 20

cohort or case-control studies, 20

cross-sectional studies, 20

randomized controlled trials, 20

Sulfur oxides

from combustion, 41

toxicity of, 45–46

Surveillance, Epidemiology, and End Results (SEER) registry, 81, 134–135, 137, 384

Susceptibility

to infection, from exposure to nitric acid, 359

to uncombusted fuels and combustion products, individual, 49–50

Sweden, studies from cited, 63–66, 71, 73, 77, 90–92, 97–98, 113–114, 124, 128, 130–131, 137, 139, 257, 261, 310, 383

Swedish Cancer Environmental Registry, 96–97, 113–114, 116, 124, 381

Switzerland, studies from cited, 91

Systemic lupus erythematosus, experimental studies of the toxicology of hydrazines in, 355

T

Tables of cancer studies related to exposure to fuels and combustion products, 144–222, 413–456

case-control studies, 425–456

cohort studies, 414–425

Taiwan, studies from cited, 91, 335

Temporal relationships, in assessing the strength of the evidence, 23

Testicular cancer. See Male genital cancers

Texaco, 101, 104, 106, 108

Texas, studies from cited, 82–84, 86, 93, 121

Toluene, 28–29, 34

Toxicity studies of combustion products, 43–49

gases, 45–48

mixtures of combustion products, 43–44

particulate matter, 48–49

Toxicokinetics

of combustion products, 42–43

of exposure to nitric acid, 356–357

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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of fuels, 29

of hydrazine, 351–353

of uncombusted fuels, 34

Toxicologic Assessment of Jet Propulsion Fuel, 8, 34

Toxicology, 16–17, 348–359

of hydrazines, 348–356

of nitric acid, 356–359

recommended exposure limits, 352–353

ToxNet, 404

Gene-Tox database, 359

Tucson Veterans Affairs Medical Center, 329

U

UDMH. See Unsymmetrical dimethylhydrazine

UK hydrazine production cohort, 367–368

Uncombusted fuels, 28–39

and combustion products, 28–59

experimental studies, 34–39

exposure limits, 29

physical and chemical properties of selected fuels, 29–31

recommended exposure limits for fuels, 32–33

toxicokinetics, 34

United Kingdom, studies from cited, 283, 289, 311, 367

United Kingdom Childhood Cancer Study, 311

University Hospital of Lille, 140

Unsymmetrical dimethylhydrazine (UDMH), 347–348, 351–352, 354–355, 360, 369–370

Uruguay, studies from cited, 81, 83

US, studies from cited. See individual states

US aerospace cohort, 363–367

US Army

Environmental Health Agency, 40

Environmental Hygiene Agency, 321

US Department of Agriculture, Forest Service, 261

US Department of Defense (DOD), 246–247, 250–251, 279, 290, 410

military treatment facilities, 93

US Department of Veterans Affairs (VA), 7, 19, 250, 289, 409

US Environmental Protection Agency (EPA), 40, 46, 336, 351

National Priorities List, 336

US Forest Service, 261

US mid western metal pickling cohort, cohort studies of nitric acid exposure, 381–382

US Surgeon General, 20

Utah, studies from cited, 112, 134

Uterine cancer. See Female genital cancers

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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V

VA. See US Department of Veterans Affairs

Vaccine safety, categories used to evaluate, 25

Validity of studies, 3, 6, 20

Vandenberg Air Force Base, California, missile-propellant handlers at, 369

Vascular lesions of CNS, mortality from, and exposure to nitric acid, 389

Veteran populations, epidemiology of MCS symptoms in, 326–327

Veterans Programs Enhancement Act (PL 105–277), 1, 12–13

Vietnam War, 322

categories used to evaluate herbicides used in, 25

VOCs. See volatile organic compounds

Volatile organic compounds (VOCs), 39

W

Washington, studies from cited, 69, 81, 84, 362

WFNA. See White fuming nitric acid

White fuming nitric acid (WFNA), 356, 358–359

WHO. See World Health Organization

World Health Organization (WHO), 46–47, 60, 140

Global Initiative for Chronic Obstructive Lung Disease, 240

X

Xylenes, 29, 34

Suggested Citation:"Index." Institute of Medicine. 2005. Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants. Washington, DC: The National Academies Press. doi: 10.17226/11180.
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The third in a series of congressionally mandated reports on Gulf War veterans’ health, this volume evaluates the long-term, human health effects associated with exposure to selected environmental agents, pollutants, and synthetic chemical compounds believed to have been present during the Gulf War. The committee specifically evaluated the literature on hydrogen sulfide, combustion products, hydrazine and red fuming nitric acid. Both the epidemiologic and toxicologic literature were reviewed.

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