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Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft (2015)

Chapter: Appendix A: Public Agendas from Committee Meetings

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Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
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Appendix A

Public Agendas from Committee Meetings

FIRST PUBLIC MEETING

May 15, 2014
Keck Building, Room 106
500 Fifth Street, NW
Washington, DC 20001

1:00 p.m. Welcome; Goals and Conduct of the Public Meeting; Introduction of
  Committee Members
  Robert Herrick, Committee Chair
1:05 p.m. Charge to the Committee
  Loren Erickson, US Department of Veterans Affairs (VA)
1:25 p.m. Major Wesley T. Carter (retired), Chair, C-123 Veterans Association
1:45 p.m. Other Comments, as Requested by Attendees, and Discussion
2:00 p.m. Close Public Session

SECOND PUBLIC MEETING/WORKSHOP*

June 16, 2014
Keck Building, Room 100
500 Fifth Street, NW
Washington, DC 20001

 

Welcome, Goals, Conduct of Meeting, Introduction of Committee Members

8:30 a.m. Robert Herrick, Committee Chair
 
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
Panel 1: Post-Vietnam Handling and Use of the C-123s
8:45 a.m. Wesley Carter, C-123 Veterans Association
8:50 a.m. Alvin L. Young, A.L. Young Consulting, Inc.
8:55 a.m. Comments and Questions from Committee Members
Panel 2: Collection and Analysis of Samples
9:45 a.m. Peter Lurker, Germantown Consultants, LLC
9:50 a.m. Peter C. Kahn, AESOP, Rutgers University
9:55 a.m. Thomas E. McKone, University of California, Berkeley
10:00 a.m. Comments and Questions from Committee Members
10:45 a.m. BREAK
Panel 3: Exposure Modeling with Existing Data
11:00 a.m. Thomas H. Sinks, Deputy Director of NCEH, ATSDR
11:05 a.m. Jeanne M. Stellman, Columbia University
11:10 a.m. Patrick Finley, Sandia National Laboratories
11:15 a.m. Jeffrey H. Driver, RiskScience.net
11:20 a.m. Comments and Questions from Committee Members
12:15 p.m. LUNCH
Interpretations of Resulting Exposure Estimates and General Discussion
1:00 p.m. Comments and Questions from Attendees (Make request to staff for a 5-minute slot before lunch)
1:15 p.m. Additional Comments and Questions from Committee Members
1:30 p.m. General Discussion
2:30 p.m. Adjourn Open Session

_____________

*Invited meeting participants were asked to make presentations to the committee in response to the following questions:

Post-Vietnam Handling and Use of the C-123s

  • What were the methods of cleaning, painting, etc., performed on the C-123s that had sprayed herbicides before they were provided to the Air Force Reserve? How and with what?
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
  • While they were being used by the Air Force (AF) Reservists? Particularly for “Patches”? How frequently were the aircraft cleaned? How and with what?
  • What was the usual duration of crew members being inside the C-123s (both in flight and on the ground such as training exercises)? Please include preparation time for a flight, flight time and unloading time. And, what would be a plausible range of time (in hours or parts of an hour) spent in/on the planes? On a single weekend? Over the summer weeks?
  • Was any food consumed during a flight, and if so what type and how often?
  • What type of activities (on the ground and in the air) were crew members involved in while using the C-123s? (e.g., activities that might result in contact with surfaces, generate dust, exposure to new areas, clean surfaces)—Please estimate the duration of each activity.
  • How were the reservists assigned to the airplanes? (e.g., always flying the same planes? Or different assignments made each time? etc.)
  • What protective clothing (e.g., gloves, shirts, pants) were worn by pilots, other flight crew, and maintenance personnel when in an aircraft? Did this change seasonally? What facilities were available for cleaning hands within the aircraft?

Collection and Analysis of Samples

  • What would be the effect of environmental factors (e.g., sunlight, heat, etc.) on 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) degradation? Are there other factors that might affect degradation? What would be the extent of difference on residues on the planes’ interiors and exteriors?
  • What is the nature of TCDD’s physicochemical properties? How would they influence human exposures from herbicide residues on the aircrafts’ interiors? How would they influence the content of samples obtained over an extended period of time? Should these physicochemical properties be considered when interpreting the sampling results?
  • What environmental factors or activities in the C-123 could have affected the stability of TCDD in the interior of a plane?
  • How might TCDD in the surface residues be transferred to dust? What conditions might promote or decrease that process?
  • What solvents were used in gathering surface wipes in each period of sampling? Are there any implications for the comparability of the samples? • What do you think would constitute representative sample(s) for estimating the TCDD exposure of the C-123 Reservists, and why? What combination of available sampling data comes closest to this standard?
  • Do you have any opinions or thoughts as to why the 1994 and 1995 samples from “Patches” are so different?
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
  • Under what conditions were the air samples collected (plane on ground with or without door open; plane in flight)?

Modeling with Existing Data

  • What is the plausible range of values that could be used as inputs for each of the parameters in the various models?
  • The specific values quoted for Model 1 in Lurker’s abstract of 0.92 and 5.4 pg/kg-birthweight (BW)-day for the flight crew and maintainers differ from the results the committee obtained (3.0 for 60 kg and 2.5 for 70 kg BW) from equation 2 and using 42 days/year from Table 4 and 250 days/ year. Please go through the calculations for the Model 1 results given in the paper given that we were unable to reproduce it from the input parameters given in Table 4 using equation 2.
  • When modeling ingestion, what would you consider the most appropriate estimate and the plausible range for:
    • – hand to mouth frequency and
    • – transfer of TCDD from hand to mouth (for eating food, such as a sandwich, on a flight)?
  • How do the assumptions governing TCDD ingestion applied in Lurker et al. (2014) compare with those used in the National Research Council (1988) approach to establishing reentry criteria after polychlorinated biphenyl (PCB) transformer fires? What is the impact on resulting estimates?
  • Please explain how the physicochemical properties of TCDD would, or would not, make the application of Model 3 by Lurker et al. (2014) appropriate.

Interpretations of Resulting Exposure Estimates

  • What are your opinions of the applicability of various existing health guidelines for TCDD for the case of the AF Reservists who served on C-123s that had previously been used to spray herbicides in Vietnam?
  • What existing guidelines would be most appropriate for application to this situation?
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
Page 87
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
Page 88
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
Page 89
Suggested Citation:"Appendix A: Public Agendas from Committee Meetings." Institute of Medicine. 2015. Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Washington, DC: The National Academies Press. doi: 10.17226/18848.
×
Page 90
Next: Appendix B: History and Sampling of C-123s in the United States After Spraying Herbicides in Vietnam »
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From 1972 to 1982, approximately 1,500-2,100 US Air Force Reserve personnel trained and worked on C-123 aircraft that had formerly been used to spray herbicides in Vietnam as part of Operation Ranch Hand. After becoming aware that some of the aircraft on which they had worked had previously served this purpose, some of these AF Reservists applied to the US Department of Veterans Affairs (VA) for compensatory coverage under the Agent Orange Act of 1991. The Act provides health care and disability coverage for health conditions that have been deemed presumptively service-related for herbicide exposure during the Vietnam War. The VA denied the applications on the basis that these veterans were ineligible because as non-Vietnam-era veterans or as Vietnam-era veterans without "boots on the ground" service in Vietnam, they were not covered. However, with the knowledge that some air and wipe samples taken between 1979 and 2009 from some of the C-123s used in Operation Ranch Hand showed the presence of agent orange residues, representatives of the C-123 Veterans Association began a concerted effort to reverse VA's position and obtain coverage.

At the request of the VA, Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft evaluates whether or not service in these C-123s could have plausibly resulted in exposures detrimental to the health of these Air Force Reservists. The Institute of Medicine assembled an expert committee to address this question qualitatively, but in a scientific and evidence-based fashion. This report evaluates the reliability of the available information for establishing exposure and addresses and places in context whether any documented residues represent potentially harmful exposure by characterizing the amounts available and the degree to which absorption might be expected. Post-Vietnam Dioxin Exposure rejects the idea that the dioxin residues detected on interior surfaces of the C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure. Accordingly, this report states with confidence that the Air Force Reservists were exposed when working in the Operation Ranch Hand C-123s and so experienced some increase in their risk of a variety of adverse responses.

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