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Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

Index

A

Adipose tissue, TCDD distribution, 130, 131, 168-169, 259, 269, 280

Aerial spraying, 3, 24

early military research, 25-26

records of, 84-85, 287

Aflatoxin, 453

Agent Blue, 27, 89-90, 93, 97, 100

Agent Green, 27, 90, 92, 114

Agent Orange

amount used in Vietnam, 1, 27, 74, 90, 97-98, 106

chemical composition, 27

disposal of Vietnam surplus, 93-94

effectiveness as defoliant, 90

federal government action/research, 45-60

legislation, 47-52

military application in Vietnam, 1, 3, 27, 74, 84-85, 90, 92-93, 97-107, 543-545

Orange II formulation, 90

product liability litigation, 34-35

suspension of use, 92-93

TCDD as contaminant of, 91, 114, 126-127

Vietnam veterans' concerns, 32-34

See also Herbicides

Agent Orange, the Deadly Fog, 33

Agent Orange Act of 1991, 2, 7, 20, 21, 51, 572, 721, 728-730

Agent Orange Briefs, 56

Agent Orange Registry, 20, 53, 56, 729

Agent Orange Review, 56

Agent Orange Scientific Task Force, 60-61

Agent Orange Study, 19, 57, 58-59, 63-64, 276-278

Agent Orange Victims International, 34

Agent Orange Working Group, 19, 46, 58, 277, 743

research methodology, 728

Agent Pink, 27, 90, 92, 114

Agent Purple, 27, 89, 92, 114

TCDD in, 126

Agent White, 27, 90, 92-93, 97, 115, 189

Agricultural/forestry workers

brain tumors, 320, 523

cancers, 13, 37, 320-323, 443, 447, 454

case-control studies, 326-341, 486-488

cohort studies, 318-323

epidemiologic studies, 37, 318-323

exposure assessment, 265-266

female reproductive and breast cancers, 510-511

hepatobiliary cancer, 454

Hodgkin's disease, 550-553

kidney cancer, 515

leukemia, 332-335, 566-568

multiple myelomas, 11-12, 558-561

non-Hodgkin's lymphoma, 9, 256-257, 530-540

prostate cancer, 11, 518, 519, 575

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

reproductive outcomes, 510-511, 598

respiratory cancer, 11, 466

soft tissue sarcomas, 37, 326-328, 479-481, 486-488

sperm dysfunction, 632

suicide, 650

See also Professional pesticide/herbicide applicators

Agricultural herbicides, 24, 35, 39, 174-175, 181

Ah receptor

in animal studies, 114, 123

in nervous system, 161

in TCDD biologic plausibility, 3, 133-138, 452-453

in TCDD carcinogenicity, 118, 439

in TCDD hepatotoxicity, 151, 152, 457

in TCDD immunotoxicity, 122, 150

in TCDD reproductive toxicity, 123

in TCDD teratogenicity, 159-160

AIDS, 338, 527, 541, 695

Air Force, 81

Vietnam casualties, 83

See also Operation Ranch Hand;

Ranch Hand study

Alcohol consumption, 507

American Association for the Advancement of Science, 29, 92

Herbicide Assessment Commission, 30-31

American Cancer Society, 334

American Legion, 60, 278-279, 399, 601-602, 626, 633

δ-Aminolevulinic acid synthetase, 153-154

Amitrole, 323

Angina, 708

Animal studies

Ah receptor, 3, 123, 134

blood abnormalities, 125

cacodylic acid acute toxicity, 188

cacodylic acid carcinogenicity, 118, 119, 187

cacodylic acid chronic exposure, 188-189

cacodylic acid developmental toxicity, 189

cacodylic acid genotoxicity, 187-188

cacodylic acid pharmacokinetics, 186-187

cacodylic acid reproductive toxicity, 189

characteristics of, 111-114

2,4-D carcinogenicity, 118-119, 176-178

2,4-D chronic exposure, 179-180

2,4-D developmental toxicity, 124, 180-181

2,4-D genotoxicity, 178-179

2,4-D immunotoxicity, 122-123, 181

2,4-D pharmacokinetics, 175

2,4-D reproductive toxicity, 124, 180, 181

evidentiary role, 228

generalizability, 112, 113, 114, 118, 122-123, 160

hepatic abnormalities, 124-125, 688

male-mediated disorders, 593-594

nonhuman primates, 151

picloram in, 118, 119, 125, 190-192

2,4,5-T acute toxicity, 184

2,4,5-T carcinogenicity, 118, 119, 182-184

2,4,5-T chronic exposure, 184

2,4,5-T developmental/reproductive toxicity, 124, 185

2,4,5-T genotoxicity, 184

2,4,5-T immunotoxicity, 123

2,4,5-T pharmacokinetics, 182

TCDD carcinogenicity, 3, 116, 138-142

TCDD cardiovascular toxicity, 171

TCDD dermal toxicity, 173-174

TCDD developmental toxicity, 123-124, 156-157, 159-160

TCDD gastrointestinal toxicity, 169-170

TCDD hepatotoxicity, 124-125, 151-156

TCDD immunotoxicity, 119-122, 146-151

TCDD-induced wasting syndrome, 162-166

TCDD metabolic toxicity, 166-169

TCDD neurotoxicity, 160-166

TCDD pharmacokinetics, 127-133

TCDD reproductive toxicity, 123-124, 156-159

TCDD respiratory tract toxicity, 170

Arkansas, 373-374, 663

Armed Forces Institute of Pathology, 494

Army, U.S., 81, 280, 281, 702

Chemical Corps, 13, 15, 16-17, 94-95, 272, 273, 286, 394, 470, 571, 703-704, 705, 711, 722-725

Vietnam casualties, 83

Aryl hydrocarbon hydroxylase, 135, 153, 155-156, 170

Assembly of Life Sciences (ALS), 62, 63

Asthma, 708, 711, 713

Ataxia, 658

Atlanta Congenital Defects Program, 387

Australia, 61, 91, 340, 406, 418, 444, 470, 488-489, 537, 546, 614-615, 633, 702, 710

Autoimmune disease, 697-699

Autoimmunity, 693

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

B

B cell function, 147, 148

BASF, 312-313, 444, 530, 550, 558

Beck's Depression Inventory, 650, 651

Bias, methodological. See Methodological bias

Biochemical warfare, 29, 45

Biologic plausibility

Ah receptor-TCDD interaction, 3, 133-137, 439, 452-453

altered sperm parameters, 634

animal studies, 228

bone cancer, 474

brain tumors, 525

carcinogenicity, 116-118, 119, 146, 176-178, 182-184, 187, 190-191, 439, 451

childhood cancer, 630

chloracne, 678

circulatory disorders, 708

diabetes mellitus, 692

evidentiary role of, 111, 114, 223-224, 240-241, 434

female reproductive system cancers, 512

fetal/infant death, 624

genitourinary tract cancers, 521-522

genotoxicity, 178-179, 184, 187-188, 191

hepatobiliary cancer, 453-453, 457

Hodgkin's disease, 557

hyperlipidemia, 692

immunotoxicity, 122, 146-151, 181, 192, 699

infertility, 634

leukemia, 571

liver disorders, 691-692

low birthweight outcomes, 628

male-mediated reproductive outcomes, 593-595

motor/coordination dysfunction, 661

multiple myeloma, 12, 563

nasal/nasopharyngeal cancer, 460

neuropsychological disorders, 658

non-Hodgkin's lymphoma, 549

peripheral nervous system disorders, 666

porphyria cutanea tarda, 679, 682

renal toxicity, 179-180

reproductive outcomes, 123-124, 180-181, 185, 189, 192, 605, 618, 628

respiratory cancers, 472

respiratory disorders, 713

skin cancer, 503

soft tissue sarcoma, 500

See also TCDD biologic plausibility

Biological samples, 20-21, 729-730

Biomarkers

chloracne as, 4, 10, 172-173, 262, 401, 672-674

in exposure assessment, 259-262, 280-284

research recommendations, 17, 725

sperm parameters as, 631

Bionetics Research Laboratory, 30

Birth defects

definition, 605-606

environmental exposure studies, 608-609

epidemiology, 606

evaluation of epidemiologic data, 615-618

first reports of herbicide association, 1

herbicide association in, 13-14, 618

occupational exposure studies, 607-608

risk factors, 606-607

TCDD biologic plausibility in, 618

in Vietnam veterans' children, 609-615, 618

See also Reproductive disorders;

Teratogenicity

Bladder cancer

epidemiologic studies, 515-517

herbicide association in, 12, 521, 576

histopathology, 513

incidence, 513

risk factors, 513-514

Vietnam veterans' risk, 513, 517, 522

Boehringer, 313

Bone cancer

in children, 628

epidemiology, 472-473

herbicide association in, 13, 473-474, 577

Vietnam veterans' risk, 473, 474

Brain tumors, 339

in agricultural workers, 320

clinical features, 522

2,4-D exposure and, 119, 176-177

epidemiology, 522-523

herbicide association in, 12, 525, 576

Vietnam veterans' risk, 525

Breast cancer

in agricultural workers, 510

environmental exposure studies, 511, 512

epidemiology, 505, 506-507

herbicide association in, 13

histopathology, 505-506

risk factors, 507

Vietnam veterans' risk, 505, 511

Bronchitis, 708, 711, 713

Bureau of Labor Statistics, 79, 80

n-Butyl esters, 27

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

C

Ca Mau peninsula, 100, 104

Cacodylic acid, 88-89

acute toxicity, 188

animal studies, 185-189

carcinogenicity, 118, 119, 187

chemical properties, 186

chemical structure, 111, 114

chronic exposure, 188-189

developmental toxicity, 124, 189

domestic use, 185-186

formulations in Vietnam, 186

genotoxicity, 119, 187-188

kidney toxicity, 125

metabolism, 115, 116

pharmacokinetics, 186-187

reproductive toxicity, 124, 189

California, 341

Camp Drum, New York, 25-26, 89

Canada, 11, 319-320, 323, 374-375, 443, 467-468, 537-539, 620, 650

Cancer

age-specific incidence, 436-438

in agriculture workers, 320-323, 443

biologic plausibility, 116-118, 119, 434

categories of herbicide association in, 572

in children, 14, 594-595, 628-631

clinical features, 433-436

environmental exposure epidemiologic studies, 444, 469

epidemiologic studies, 45, 317, 320-323, 325-326, 367, 383-384, 391-393, 443-445

epidemiology, 433, 435-438, 442, 525

evidence of no herbicide association in, 12-13, 576-577

expected incidence in Vietnam veterans, 439-440, 442, 452, 460-461, 473, 475, 501, 505, 513, 522, 526, 564

in herbicide/pesticide applicators, 320-321, 323, 325-326, 443, 447 , 466-468, 488, 491

insufficient evidence for determining herbicide association in, 13 -14, 577-578

latency effects in studies, 231-232, 434, 435, 436-438, 494, 495, 727

limited/suggestive evidence of herbicide association in, 10-12, 574-576

mortality studies, 442-445

multistage model, 142-143, 434, 439

occupational studies, 443-444

P450 induction to, 144-145, 170

phenoxy herbicide association in, 483

research priorities, 19, 727

research recommendations, 19, 727

risk assessment, 442-443, 578

sufficient evidence of herbicide association, 8-10, 572-574

TCDD animal studies, 138-142

TCDD genotoxicity, 143-144

TCDD in initiation/promotion, 116, 142-143, 434, 439

TCDD in P450 induction to, 144-145

Vietnam veterans' risk, 391-393, 401, 402-403, 405, 436-438, 444-445, 578

See also Carcinogen(s);

specific cancer;

specific cancer site

Carcinogen(s)

cacodylic acid as, 118, 119, 187

2,4-D as, 118-119, 176-178

herbicides as, 3

mechanism of action, 434

picloram as, 118, 119, 190-191

2,4,5-T as, 118, 119, 182-184

TCDD as, 3, 116-118, 434, 439

See also Cancer

Cardiovascular system

cardiomegaly, 703

circulatory disorders, 699-709

lipid abnormalities in, 688

TCDD in, 171

Case-control studies

agriculture/forestry workers, 326-341

evidentiary role of, 234-235, 727

exposure assessment for, 256-257, 727

Causality, statistical association vs., 7, 227, 239, 246

Centers for Disease Control, 19, 40-41, 51

Agent Orange action/research, 57-62, 63-64

Agent Orange Study, 276-278

birth defects research, 387-389, 609-612

exposure opportunity index, 274-276, 611-612

research methodology, 728

validation study, 59, 260-261, 281-284, 285, 387, 742-743

See also Selected Cancers Study;

Vietnam Experience Study

Central nervous system. See Neurologic disorders

Cerebrospinal Malformation Study, 610

Cerebrovascular disease, 702

stroke, 658, 659, 660

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

Cervical cancer, 13, 505, 509, 510, 512

Chemical production

Agent Orange product liability litigation, 34-35

hexachlorophene, 40

TCDD contamination in, 91, 126

See also Industrial accidents;

Production workers

Chemoreception

characteristics of, 133-134

dioxin-responsive enhancers in, 135-136

estrogen-mediated, 145

TCDD dose-response linearity, 137-138

in TCDD hepatotoxicity, 154-155

in TCDD-induced wasting syndrome, 164

See also Ah receptor

Children, cancer in, 14, 594-595, 628-631

China, 458

Chloracne, 39

animal studies, 173-174

in chemical production workers, 308, 310, 316

clinical features, 672-673

compensation for Vietnam veterans, 50, 51, 55, 56

diet and, 174

epidemiologic studies, 674-678

herbicide association in, 10, 678

in Seveso accident, 366-367

skin cancer and, 502

as TCDD biomarker, 4, 10, 28, 172-173, 262, 401, 672-674

Chlordane, 91

Chlorodibenzodioxins, 28

Chlorophenols, 9

Circulatory disorders

epidemiologic studies, 700-707

herbicide association in, 14, 708

research methodology, 699-700

Cleanup efforts

after Nitro accident, 38

Agent Orange disposal, 93-94

Seveso, Italy, 43-44, 367-368

Cleft lip/palate, 373-374, 375, 611, 612

Coast Guard, 81

Cognitive neuropsychiatric disorders

environmental studies, 651-653

herbicide association in, 657-658

occupational studies, 649-651

Vietnam veterans' risk, 653-656

Cohort studies

agriculture/forestry workers, 318-323

definition, 229

exposure assessment for, 254-256

methodology, 229-232

Colon cancer.

See also Gastrointestinal tract cancers

in agricultural workers, 328-329

herbicide association in, 12-13, 576-577

Colorectal cancer, 446

Vietnam veterans' risk, 447, 450, 451, 452

Compensation for veterans, 227

congressional legislation, 47, 50-51

Department of Veterans Affairs, 55-56

product liability litigation, 34-35

Confidence intervals, 244

Congress, U.S., 2, 31, 46-52

Corticosterone, TCDD and, 168, 171-172

Cytochrome P450. See P450

Czechoslovakia, 317, 649, 675, 688

D

2,4-D. See 2,4-Dichlorophenoxyacetic acid

Data sources

Agent Orange Registry, 20, 53, 56, 729

agricultural/forestry workers studies, 265-266, 318-341

animal studies, 111-114, 228

case reports, 235-236

CDC studies, 387-391

chemical production workers, 303-318

computerized data bases, 735-736

controlled epidemiologic studies, 228-237

death certificates, 236-237

Department of Veterans Affairs epidemiologic studies, 393-399

environmental exposure studies, 267-269, 372-375, 383-384

epidemiologic studies as, 737-738

exposure reconstruction model, 725-726

herbicide/pesticide applicators, 266-267, 323-326

HERBS tapes, 20, 62, 85, 96-98, 273-279, 287, 291, 602, 725

International Register of Workers Exposed to Phenoxy Herbicides and Their Contaminants, 313-314

mandated efforts, 20-21

military herbicide use in Vietnam, 84-85

non-military herbicide exposures, 4-5, 222-223, 241-242

organization of, 737

paper/pulp mill workers, 341, 364

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

presentations/reports to committee, 739-756

randomized controlled trials, 227-228

recommendations for future research, 287-289, 291, 722-725, 729-730

reproductive outcomes, 593-595

review of, 244-245

self-reports, 270-271

state government, 60

state-sponsored Vietnam veteran studies, 400-405, 495-496

stored biological samples as, 20-21, 729-730

TCDD production workers, 264-265

troop location, 273-279, 287

Vietnam casualties, 82-83

Vietnam veteran demographics, 79, 80-84

in Vietnam veteran exposure assessment, 270-287

Vietnam veteran reproductive outcomes, 601

Vietnamese civilian health outcomes, 371-372

women veterans, 83-84

See also Epidemiologic studies;

Military records

DDT, 87, 91

Death certificates, 236-237

Defoliants

Agent Orange as, 90

military applications, 25, 26

tactical role of, in Vietnam, 85

Vietnam herbicide mission maps, 99-100

Demographic data, Vietnam veterans, 79, 80-84

Denmark, 317, 443, 444, 454, 463, 477, 480, 509, 510, 537, 553, 565 , 567

Department of Agriculture, U.S., 35, 39, 443

Department of Defense, U.S., 17, 27, 29, 31, 78

herbicide spray mission records, 84-85

herbicide use precautions, 95

military records, 78, 724-725

Department of Veterans Affairs, U.S., 2, 8, 17, 18, 20, 50-51, 284

in Agent Orange controversy, 33, 53-54

Agent Orange Registry, 729

health care in, 54

military records, 78-79, 724-725

outreach activities, 56

recommendations for, 724-725, 726-730

research efforts, 54-55

veterans' advocacy groups and, 61

Vietnam veteran epidemiologic studies, 50, 393-399, 445, 469-470, 493-495, 543-547, 562

Depressive disorders, 650, 651

Desiccant herbicides, 88-89

Developmental disorders

cacodylic acid in, 189

2,4-D in, 180-181

neurological, 660

picloram in, 192

2,4,5-T in, 185

TCDD in, 123-124, 149, 156-157, 159-160, 185

See also Low birthweight

Diabetes mellitus, 683-685, 691, 692, 698

Diamond Shamrock Corporation, 34, 35

Diazinon, 91

Dibenzofurans, 126

2,4-Dichlorophenoxyacetic acid (2,4-D)

acute toxicity, 179

in Agent Orange, 27

in Agent White, 90

altered sperm parameters, 632

animal studies, 174-181

carcinogenicity, 118-119, 176-178, 439

chemical properties, 114, 175

chemical structure, 111, 114

chronic exposure, 179-180

development of, 24, 26, 35

developmental toxicity, 124, 180-181

domestic use, 174-175, 177-178

formulations, 175

genotoxicity, 119, 178-179

immunotoxicity, 122, 181

ingestion of, 653

kidney toxicity, 125

liver toxicity, 125

metabolism, 115, 116

military field tests, 26

in neuropsychiatric outcomes, 649, 650, 653

in non-Hodgkin's lymphoma, 256-257, 574

occupational exposure, 36, 37, 310-311, 321

pharmacokinetics, 175

reproductive toxicity, 124, 180-181, 597-598

role of, 88

teratogenic potential, 30, 92

therapeutic application, 659

See also Herbicides

Diet

breast cancer and, 507

in cancer risk, 442

chloracne and, 174

gastrointestinal cancers and, 446

Dinoxol, 91

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

Dioxin. See 2,3,7,8-Tetrachlorodibenzo-p-dioxin

Dioxin Registry, 36-37

Dioxin-responsive enhancers, 135-136

Diquat, 91

Domestic herbicide use

agricultural use, 24, 35, 39, 174-175, 181

2,4,-D, 174-175

pet cancers and, 119, 177-178

picloram, 189

2,4,5-T, 181-182

TCDD contamination in, 91

See also Agricultural/forestry workers

Dopaminergic system, 163-164, 165

Dose-response relationship

animal studies, 111-114, 118

2,4-D pharmacokinetics, 175

dermal application of TCDD, 128-129

evidentiary role of, 239-230, 252

fetal mortality in animals, 159

research recommendations, 19, 727

TCDD-chloracne, 673

in TCDD-exposed workers, 445

TCDD-immune system processes, 696

TCDD immunotoxicity, 122

TCDD threshold, 137-138

TCDD tissue distribution, 130

Dow Chemical Company, 34, 35, 307-312, 461-462, 529, 558, 598, 607, 620, 674

DVA. See Department of Veterans Affairs

Dystonia, 658

E

Electrical transformers, 364-365, 444, 626, 675

Emphysema, 708, 713

Encephalopathy, 649

Endocrine system, 150-151

Environmental exposures

accidental exposures, 364-365, 368-370

in agricultural areas, 372-375

Alsea, Oregon, 39, 42-43, 372-373, 598

birth defects and, 608-609

bladder cancer and, 516-517

brain tumors and, 523

as cancer risk factor, 442

cancer studies, 442, 444, 454-455, 469

chloracne and, 676-677

circulatory disorders and, 701-702

epidemiologic studies, 3, 301, 365-384, 469

evidentiary role of research on, 4-5, 222-223, 241-242

exposure assessment strategies, 262-263, 267-270

female reproductive system cancers and, 511

hepatobiliary cancers and, 454-455

immune modulation and, 693-694

leukemia and, 568-570

motor/coordination dysfunction and, 658-659

multiple myeloma and, 562

neonatal death and, 621

neuropsychiatric outcomes and, 651-653

non-Hodgkin's lymphoma and, 540-541

peripheral nervous system disorders and, 663-665

porphyria cutanea tarda and, 680-681

respiratory cancers and, 469

soft tissue sarcomas and, 491-492

spontaneous abortion and, 598-599

stillbirth and, 620

See also Missouri, Times Beach;

Seveso, Italy

Environmental Protection Agency, 39, 59-60, 93

in Alsea, Oregon, 42-43

TCDD cancer potency estimate, 138

in Times Beach, Missouri, 41

Enzyme induction

liver, 155-156

lung, 170

porphyria, 153-154

Epidemiologic studies

agricultural/forestry workers, 318-323, 326-341

altered sperm parameters, 632

autoimmunity, 697-698

birth defects, 607-618

bladder cancer, 515-517

bone cancer, 472-473

brain tumors, 523

cancer, 45, 59, 317, 320-323, 367, 383-384, 391-393, 401, 402-403, 435-445, 574

case-control studies, 326-341

chemical industry production workers, 303-318

childhood cancer, 628-630

chloracne, 674-678

circulatory disorders, 700-707

cleft lip/palate, 373-374, 375

cohort studies, 229-232

colon cancer, 12, 328-329, 576-577

congressionally mandated, 50

controlled observational, 228

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

cost of, 727

diabetes mellitus, 684-685

environmental exposures, 365-384

evaluation of, 300-301, 591-592, 737-738

evidentiary role of, 224-225, 228-237, 300, 305

exposure assessment for, 251-259

exposure reconstruction model and, 725, 726-728

female reproductive system/breast cancers, 508-511

gastrointestinal tract cancers, 446-447

gastrointestinal ulcers, 691

hepatic enzyme disorders, 686-688

hepatobiliary cancers, 453-455

herbicide/pesticide applicators, 323-326

Hodgkin's disease, 9, 329, 331, 335-336, 341, 384, 391, 393, 549-553, 549-556, 574

immune modulation, 693-696

infertility, 632-633

kidney cancer, 515

leukemia, 13, 332-333, 334-335, 564-571, 577-578

limitations, 4, 223

lipid abnormalities, 688-690

liver cancer, 13, 329, 391, 393

low birthweight, 626-627

meta-analysis, 225, 237-238, 242-243, 243, 244

motor/coordination dysfunction, 658-661

multiple myeloma, 11-12, 331, 334, 335, 336, 341, 557-563, 576

nasal/nasopharyngeal cancer, 459

neurological disorders, 365-366, 642-648

neuropsychiatric disorders, 649-657

non-Hodgkin's lymphoma, 9, 328, 329, 330, 331, 333-334, 335-338, 383, 384, 391-393, 401, 528-548, 573-574

NRC Commission on Life Sciences, 63

perinatal death, 620-624

peripheral nervous system disorders, 662-666

porphyria cutanea tarda, 680-682

proportionate mortality studies, 232-233

prostate cancer, 11, 518-519, 575-576

rare diseases in, 231, 499

recommendations, 15-20, 721-725, 731

reproductive outcomes, 41-42, 311-312, 321, 364-365, 368, 370, 371-375, 387-388, 389-390, 591-592

resolution in, 242-243

respiratory cancers, 10-11, 364, 461-472, 575

respiratory disease, 709-713

of Seveso population, 44-45, 365-368, 444, 454-455, 469, 491-492, 503, 511, 517, 523, 540, 568-570, 571, 598-599

skin cancer, 502-503

soft tissue sarcoma, 8, 311, 326-328, 329-330, 335-336, 337, 339-340, 384, 391, 393, 395-396, 401, 403, 476, 477-500, 572-573, 574

spontaneous abortion, 42, 336-337, 372-373, 405-406, 596-605

state-sponsored, 399-405, 495-496, 546

strength of evidence in assessment of, 238-241

TCDD biomarkers, 259-262

testicular cancer, 405, 519

in Times Beach, 368-370

Vietnam veterans in, 50, 57-59, 62-63, 384-418

Vietnamese in, 370-372, 599-601

See also Exposure assessment

Epidermal growth factor, 145, 154

Epstein-Barr virus, 528

Erbon, 309

Erythrocyte sedimentation, 696

Estrogen

hepatic binding, 154

receptor-mediated responses, 145

Ethoxyresorufin O-deethylase (EROD), 153, 155

Exposure assessment

biomarkers for, 17, 259-262, 280-284

for cancer studies, 436-439

for case-control studies, 256-257

CDC Agent Orange Study, 58

CDC exposure opportunity index, 274-276, 611-612

CDC validation study, 59, 260-261, 281-284, 387

for cohort studies, 254-256

current estimates, 284-287

difficulties in, 14-15, 222, 247-248, 284, 286-287

for environmental studies, 262-263, 267-270

evidentiary role of, 4, 15, 250-253

exposure-dose relationship, 252-253

ground spraying, 288-289

historic exposure reconstruction, 17-18, 19-20, 254, 255-256, 725-726, 728

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

individual differences, 261, 286

job exposure matrix, 259-262

limitations in existing data sources, 14-15, 290-291

misclassification bias in, 17, 257-259, 724

in non-military settings, 4-5, 15, 222-223, 241-242

for occupational studies, 262-267, 269-270

paper/pulp mill workers, 266-267

process perspective, 252-253

for Ranch Hand study, 386

research recommendations, 16-18, 287-290, 291, 721-722, 724-725

for risk assessment, 14-15, 247-248, 250, 578

self-reports, 270-271

serum TCDD in, 19, 20-21, 261, 282-285, 289, 290, 725, 742-743

Seveso accident, 267-268, 285, 598-599

state-sponsored studies, 400, 401-402, 403-404

Stellman's study, 278-279, 284

strategies for, 253-254

Times Beach case, 268, 368-369

Vietnam military records in, 271-280

Vietnam service as element of, 271, 284-287

Vietnam spray data, 273-279

Vietnam troop movement data in, 95-96, 273-279, 287

Vietnamese population, 269, 731

workshop on, 746-747

Exposure reconstruction model

data sources, 725-726

epidemiologic research and, 726-728

evaluation of, 18, 289-290, 726

recommendations, 15-16, 17-20, 287-290, 291, 721-722, 725-728

F

Federal government, in herbicide management/research, 45-60

Federation of American Scientists, 29

Finland, 324, 364, 383-384, 443, 444, 467, 492, 541, 561

Florida, 324, 467

Food crops, 89

Agent Orange in destruction of, 62, 90

as military target, 27, 31, 87, 97, 98-100, 106

Forest Service, U.S., 42

Forestry workers

See Agricultural/forestry workers

Forests

early defoliant field tests in, 26

2,4,5-T spraying, 42-43

in Vietnam, 31-32, 62, 90, 104

Fort Detrick, Maryland, 25

Fungicides, 91

G

Gastrointestinal disorders

cacodylic acid in, 188

TCDD in, 169-170

ulcers, 690-692

Gastrointestinal tract cancers

biologic plausibility, 451

epidemiology, 445-447

herbicide association in, 12, 447-451, 576-577

in Vietnam veterans, 446, 452

General Accounting Office, 52-53, 96

General Birth Defects Study, 610, 626

General Services Administration, 77

Genetic alteration

cacodylic acid in, 119, 187-188

cancer mechanism, 433-434

2,4-D in, 119, 178-179

male-mediated reproductive outcomes, 593-594

picloram in, 191

2,4,5-T in, 119, 184

TCDD in, 118, 142, 143-144, 439

Genetic factors

in Ah receptor-mediated events, 134

in cancer risk, 10

in porphyria cutanea tarda, 10, 679

Geneva Protocol, 45

Germany, 312-313, 326, 443, 477, 508-509, 530, 565, 675-676

Givaudan Company, 43

Glucocorticoid receptor, 154

Great Britain. See United Kingdom

Ground/perimeter spraying, 20, 24, 74, 85, 90, 91, 94-96, 100, 272 , 286, 287, 288-289

Growth factors

epidermal, 145, 154

TCDD induction of, 136-137

transforming, 145

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

H

Halogenated aromatic hydrocarbons, 125, 126, 151

in hepatic enzyme induction, 155

Hawaii, 60, 400, 603

Headaches, 650, 660

Health and Human Services, U.S., Department of, 57-59

Health outcomes

categories of evidence in assessing, 227-237

categories of herbicide association in, 5-8, 221, 223-225, 246-247

early herbicide research, 29-32, 35-36

early TCDD research, 28-29

in evaluating exposure reconstruction model, 289-290

evidence of no association of herbicides in, 12-13, 224, 247, 447-451, 503, 521, 525, 576-577

insufficient evidence for determining herbicide association in, 13-14, 19, 247, 457, 460, 473-474, 512, 521, 571, 577-578, 605, 618, 624, 627, 630, 634, 657, 666, 691, 699, 708, 713, 727

limited/suggestive evidence of herbicide association in, 10-12, 19 , 247, 472, 519-521, 563, 574-576, 727

research priorities, 19, 726-727

sufficient evidence of herbicide association in, 8-10, 246-247, 500 , 548, 556-557, 572-574, 678, 682

See also Epidemiologic studies;

specific disease

Healthy worker effect, 230

Hearing loss, 659-660

Helicopters, in herbicide delivery, 26, 86, 87, 93, 94

Hepatitis B infection, 453

Hepatitis C infection, 453

Hepatobiliary cancers

epidemiology, 452-455

evidence for herbicide association, 13, 577

Herbicides

action of, 88

agricultural role of, 24, 35, 39, 174-175, 181

banned from U.S. military use, 32, 45

carcinogenicity, 118-119

developmental toxicity, 124

early concerns about, 29-32, 35-36

evidence of no association in health outcomes, 12-13, 224, 247, 447-451, 503, 521, 525, 576-577

immunotoxicity, 122-123

insufficient evidence for determining association in health outcomes , 13-14, 19, 247, 457, 460, 473-474, 512, 521, 571, 577-578, 605, 618, 624, 627, 630, 634, 657, 666, 691, 699, 708, 713, 727

limited/suggestive evidence of association in health outcomes, 10-12, 19, 247, 472, 519-521, 563, 574-576, 727

military application in Vietnam, 1, 3, 24, 27, 74, 84-96, 98-107, 286

military research and development, 25-26

reproductive toxicity, 124

selective, 24, 88

settings for occupational exposure, 36-38

sufficient evidence of association in health outcomes, 8-10, 246-247, 500, 548, 556-557, 572-574, 678, 682

TCDD contamination of, 2, 3, 27, 91-92, 114, 126-127

types of, 88

See also Agent Orange;

2,4-Dichlorophenoxyacetic acid;

2,4,5-Trichlorophenoxyacetic

acid;

2,3,7,8-Tetrachlorodibenzo-p-dioxin

HERBS tapes, 20, 602, 725

contents, 96-97, 273

deficiencies, 97, 104-105

in exposure assessment, 273-279, 287, 291

source of, 62, 85, 96

Hercules, Inc., 35

Hexachlorophene, 40

Highway workers, 326

Historic exposure reconstruction, 17-18, 19-20, 254, 255-256, 725-726, 728

Hodgkin's disease

in agricultural/forestry workers, 328, 329, 331, 335-336, 341, 550-553

biologic plausibility of TCDD in, 557

in chemical industry workers, 549-550

in environmental exposure studies, 384

epidemiology, 526, 527-528

herbicide association in, 8, 9-10, 556-557, 574

histopathology, 526-527

research recommendations, 19, 727

in Vietnam veterans, 258, 526, 554-556

Hoffman-Taff, 40

Hormonal system

estrogen-mediated responses, 145, 154

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

in TCDD carcinogenesis, 116, 145

TCDD in, 156-159

in TCDD-induced wasting syndrome, 165

Hourglass spray system, 25

Hydatidiform mole, 30, 600-601

Hydrocephalus, 609, 611

Hypercholesterolemia, 690

Hyperlipidemia, 152-153, 688, 692

Hypertension, 705, 706, 707, 708

Hyperthyroidism, TCDD-induced, 168

Hypoglycemia, TCDD-induced, 166-168

Hypospadias, 609, 611

I

I Corps, 52, 96, 98, 394, 493-494, 542, 543, 546

mortality study, 233

II Corps, 542

III Corps, 59, 104, 276, 281-282, 542, 543

Immune system

autoimmunity, 697-699

cellular immunity, 147

2,4-D toxicity, 181

endocrine system and, 150-151

herbicide toxicity, 122-123

humoral immunity, 147-148

immune modulation in, 692-696, 698-699

macrophage function, 148

picloram toxicity, 192

research methodology, 692

suppression in, 693

TCDD toxicity, 119-122, 146-151, 338

Immunoglobulin antibodies, 693, 696, 697

Incineration, of Agent Orange, 93-94

Industrial accidents, 316-317

BASF, 312-313, 444, 530, 550, 558

Nitro, West Virginia, 38-39, 305-307, 597, 607, 686, 700

Industrie Chimiche Meda Societa Anonima, 43

Infertility, 631-634

Influenza, 713

Insecticides, 87-88, 91

Institute of Medicine, 2, 20, 57, 62-64, 742, 743-744

Insufficient evidence for determining herbicide association

in altered sperm parameters, 14, 634

basis for finding of, 13, 247, 577

in birth defects, 14, 605

in bone cancer, 13, 473-474, 577

cancer in children of Vietnam veterans, 14, 630

in circulatory disorders, 14, 708

in cognitive and neuropsychiatric disorders, 14, 657-658

in diabetes mellitus, 14, 691

in female reproductive system/breast cancers, 13, 14, 512, 577

in gastrointestinal tract ulcers, 14, 691

in genitourinary tract cancers, 13, 521, 577

in hepatic enzyme abnormalities, 14, 691

in hepatobiliary cancers, 13, 577

in immune system disorders, 14, 699

in infertility, 14, 634

in leukemia, 13, 571, 577-578

in lipid abnormalities, 14, 691

in liver cancer, 13, 457, 577

in low birthweight, 14, 627

in motor/coordination dysfunction, 14, 661

in nasal/nasopharyngeal cancer, 13, 460, 577

in neuropsychiatric outcomes, 14, 657, 666

in perinatal death, 14, 624

in peripheral nervous system disorders, 14, 666

in renal cancer, 13, 521, 577

research recommendations, 19, 727

in respiratory disorders, 14, 713

in spontaneous abortions, 14, 605

in testicular cancer, 13, 521, 577

Interagency Working Group on the Long-Term Health Effects of Phenoxyherbicides and Contaminants, 46

Interleukin-1, 148

International Agency for Research on Cancer (IARC), 8, 12-13, 246, 264-265, 270, 313-314, 478, 479, 499, 565, 573, 577, 731

International Register of Workers Exposed to Phenoxy Herbicides and Their Contaminants, 313-314

Intrauterine growth retardation, 625, 626

Iowa, 11, 37, 60, 318-319, 332, 333, 334-335, 374, 400, 447, 495, 534, 550, 560, 567, 603, 660, 677

Italy, 320-321, 338-340, 340-341, 384, 486-487, 492, 523, 537, 552 , 553, 561, 566, 632

See also Seveso, Italy

IV Corps, 81, 98, 542

J

Job exposure matrix, 256

Johnston Island, 93

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

K

Kansas, 9, 37, 335-336, 487, 490, 550

Kaposi's sarcoma, 338, 487, 695

Kidney cancer

in children, 628

epidemiologic studies, 515

epidemiology, 513, 514

herbicide association in, 13, 521, 577

histopathology, 513

risk factors, 514

Vietnam veterans' risk, 522

Kidneys, 2,4-D toxicity in, 125, 179-180

L

Laos, 106

Laryngeal cancer, 461, 470-471

See also Respiratory cancers

Latency effects in cancer studies, 231-232, 434, 435, 436-438, 494 , 495, 727

Lawn care products, 119, 177-178

Leather tanners, 486, 514

Legal issues

Agent Orange manufacturers' liability, 34-35

federal government liability, 34

South Korean Vietnam veterans, 62

in Times Beach, Missouri, 41

Legislation

Agent Orange Act of 1991, 2, 7, 20, 21, 51, 572, 721, 728-730

federal, 45-60

Public Law 91-441, 47, 63

Public Law 96-151, 50, 52, 57

Public Law 97-72, 50

Public Law 98-181, 51

Public Law 98-542, 50-51

Public Law 99-272, 50

Public Law 100-687, 51

Public Law 101-239, 51

Public Law 102-4, 2, 7, 20, 21, 51, 572, 721, 728-730

Vietnam veterans' compensation, 47, 50-51, 55-56

Leiomyosarcomas, 475

Leukemia

in agricultural workers, 13, 332-333, 334-335, 566-568

in children, 628

epidemiologic studies, 564-572

epidemiology, 564

herbicide association in, 13, 571, 577-578

in production workers, 564-566

in pulp/paper workers, 568

risk factors, 564

in Seveso, Italy, 13, 568-570, 571, 577

TCDD biologic plausibility in, 571

Vietnam veterans' risk, 564, 570, 571-572

Limited/suggestive evidence of herbicide association

basis for finding of, 10-12, 247, 574-575

in cancer, 10-12, 519-521, 574-576

in multiple myeloma, 10, 11-12, 563, 574, 576

in prostate cancer, 11, 519-521, 575-576

research recommendations, 19, 727

in respiratory cancers, 10-11, 472, 574, 575

Limited/suggestive evidence of no herbicide association

basis for finding of, 12-13, 224, 247, 576-577

in brain tumors, 12, 525, 576

in gastrointestinal tract cancers, 12-13, 447-451, 576-577

in skin cancer, 12, 503, 576

in urinary bladder cancer, 12, 521, 576

Lindane, 91

Lipid abnormalities, 688-690, 692

epidemiologic studies, 45

TCDD in, 152-153, 259-260

Liver cancer

in children, 628

epidemiologic studies, 453-455

herbicide association in, 13, 457, 577

picloram in, 190

research recommendations, 19, 727

risk factors, 453

in Seveso, Italy, studies, 454-455

TCDD in, 116, 138-139, 142, 143

in Vietnam veterans, 391, 393, 455, 457

See also Hepatobiliary cancers

Liver disorders

2,4-D in, 179

enzyme activity, 155-156, 685-687, 691-692

epidemiologic studies, 45

herbicides in, 125

lipid abnormalities, 688

picloram chronic toxicity, 191-192

in Seveso, Italy, studies, 367

TCDD in, 115, 124, 129-130, 151-156, 155, 165-166

Low birthweight

definition, 625

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

epidemiology, 625-626

herbicide association in, 14, 627-628

risk factors, 625-626

Low-density lipoprotein receptors, 154-155

Lung cancer

in agricultural/forestry workers, 466

cacodylic acid and, 187

2,4-D in, 177

herbicide association in, 472

in herbicide/pesticide applicators, 326, 466-468

in paper/pulp mill workers, 364, 468

in production workers, 461-466

in Seveso, Italy, studies, 469

in Vietnam veterans, 469-470, 472

See also Respiratory cancers

M

Maine, 60, 400, 603

Malathion, 87, 88, 91

Malignant lymphomas

2,4-D exposure and, 119, 177-178

See also Hodgkin's disease;

Multiple myeloma;

Non-Hodgkin's lymphoma

Mangrove forests, 31, 62, 90, 104

Marine Corps, 81, 96, 280, 545, 702, 710

non-Hodgkin's lymphoma in, 542, 545, 546-547

Vietnam casualties, 83

Massachusetts, 60, 400-401, 405-406, 445, 470, 496, 602-603, 613, 620, 621, 622

Mast cells, 693

MC-1 spray system, 25

Medical Literature Analysis and Retrieval System, 735

Melanomas. See Skin cancer

Melatonin, in TCDD-induced wasting syndrome, 165

Meta-analysis, 243, 244

Methodological bias

analyzing stored biological samples, 20-21, 729-730

cancer studies, 436

controlling for, 33, 226-227, 234-235, 242-246

exposure assessment, 17, 257-259, 286-287, 291, 724

healthy worker effect, 230

proportionate mortality studies, 233

recall bias, 256, 601

reproductive outcomes studies, 591-592, 601

self-reports, 270-271

Methodology

Agent Orange Study, 58-59, 63-64

Agent Orange Working Group, 19, 728

Alsea investigation, 372-373, 598

American Legion Agent Orange study, 602

assessment of strength of evidence, 238-241

BASF study, 312-313

burden of proof approach, 226-227, 245

cancer studies, 435-440, 442-443, 445

case-control studies, 234-235, 256-257, 326-341

case reports, 235-236

categories of evidence, 227-237

categories of health outcome association, 5-8, 223-225, 246-247

CDC Birth Defects Study, 611-612

CDC epidemiologic studies, 19, 387-393, 498, 728

circulatory disease studies, 699-700, 705-706, 707

cohort studies, 229-232, 254-256, 318-323

confidence intervals, 244

controlled observational studies, 228

Department of Veterans Affairs studies, 393-399, 494-495

disease latency effects, 231-232, 434, 436-438, 494, 495, 727

dose-response relationship, 239-230, 252

Dow studies, 307-312

environmental exposure assessment, 262-263, 269-270

evaluation of epidemiologic studies, 300-301

evaluation of exposure reconstruction model, 18, 289-290, 726

expected cancer incidence, 439-440

exposure assessment strategies, 251-259, 270-287

immune system research, 692

indirect adjustment, 229

information management, 735-738

judgment in, 245-246

meta-analysis, 225, 237-238, 242-243

neurological assessment, 14, 641-642, 649

neuropsychiatric studies, 657

NIOSH studies, 303-305

Nitro, West Virginia, industrial accident studies, 305-307

NRC Commission on Life Sciences, 63

occupational exposure assessment, 262-264, 269-270

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

odds ratio determination, 234, 239

Office of Technology Assessment, 19, 728

paper/pulp mill worker studies, 341, 364

Ranch Hand study, 230-231, 385-386, 498, 757-762

relative risk assessment, 229, 239, 258

reproductive outcome studies, 591-592

respiratory disease studies, 708-709, 712-713

risk assessment, 225-226

sample size and disease frequency, 231, 242-243, 440, 499

Selected Cancers Study, 234-235, 498

self-reports, 270-271

soft tissue sarcoma studies, 482-490, 497-500

standardized mortality ratio, 229-230

statistical significance/power, 226-227, 243

TCDD biomarkers, 259-262

Times Beach studies, 368-370

type I error, 243

type II error, 243

See also Data sources;

Methodological bias;

Research needs;

Risk assessment methodology

Methods of herbicide application

early military research, 25-26

in Operation Ranch Hand, 85-87

in Vietnam, 1, 3, 24, 27, 74, 85-87, 94-96

2-Methyl-4-chlorophenoxyacetic acid, 700

6-Methyl-1,3,8-trichlorodibenzofuran, 153

Michigan, 374, 375, 383

Midwest Research Institute, 29-30

Military operations

aerial spraying of herbicides in Vietnam, 27, 85-91

banning of strategic herbicide use, 32, 45

disposal of surplus Agent Orange, 93-94

distribution of personnel in Vietnam, 81, 82

early herbicide research, 25-26

early objections to herbicide use in Vietnam, 29, 31-32

ground spraying of herbicides in Vietnam, 94-96

herbicide applications in Vietnam, 1, 3, 24, 27, 74, 84-96, 98-107, 286

precautions in herbicide use, 95

South Vietnam tactical zones, 98

U.S. involvement in Vietnam, 75-76, 84

Vietnam troop movements, 52-53, 96, 273-279, 287

See also Military records;

Operation Ranch Hand

Military records, 742-743

for exposure assessment, 271-280, 287-288

ground spraying of herbicides in Vietnam, 94, 95

of herbicide spray missions, 27, 62, 84-85, 104-106

HERBS tapes, 62, 96-98

recommendations for research, 17, 724-725

Vietnam casualties, 82-83

Vietnam veterans in, 75-80, 106

Minnesota, 37, 326, 332, 333, 468

Minnesota Multiphasic Personality Inventory, 641

Miscarriages. See Spontaneous abortion

Missouri, 621, 626, 664-665, 681

Times Beach, 40-42, 268, 368-370, 693-694

Mixed-function oxidase activity, 131, 155, 156

Monsanto Company, 34, 35, 38, 305-307, 444, 674, 700

Montagnards, 31, 371, 599

Mortality studies

cancer, 442-445

death certificate data, 236-237

methodology, 229-233, 435

standardized mortality ratio, 229-230

Motor coordination dysfunction

environmental studies, 658-659

herbicide association in, 661-662

occupational studies, 658

Vietnam veterans' risk, 662

Motor/sensory/coordination problems, 14, 658-662

MPTP, 661

Multiple myeloma, 331, 334, 335, 336, 341

in agricultural/forestry workers, 558-561

biologic plausibility of TCDD in, 563

epidemiologic studies, 331, 334, 335, 336, 341, 557-563

epidemiology, 526, 528

herbicide association in, 10, 11-12, 563, 574, 576

histopathology, 527

Vietnam veterans' risk, 563

Myocardial infarction, 708

N

Nasal/nasopharyngeal cancer

clinical description, 457-458

epidemiology, 458-459

herbicide association in, 13, 19, 460, 577

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

treatment, 458

Vietnam veterans' risk, 460

Nasal olfactory mucosa, 130

National Academy of Sciences (NAS), 2, 28-29, 31, 43, 47, 51, 55, 57

National Cancer Institute (NCI), 9, 30, 37, 439

National Institute for Occupational Safety and Health (NIOSH), 8, 12, 36-37, 260, 264, 270, 285, 303-305, 443, 478, 479, 499, 564, 573, 577, 650-651, 686, 731

National Institutes of Health, 92

National Library of Medicine, 735

National Personnel Records Center, 17, 77, 385, 724

National Research Council, 20, 62-64

National Toxicology Program, 139-141

National Veterans Legal Services Project, 60

National Vietnam Veterans Birth Defects/Learning Disabilities Registry and Data Base, 741-742

National Vietnam Veterans Readjustment Study, 79, 83, 655

Navy, 81, 280-281, 286

herbicide use in, 95

non-Hodgkin's lymphoma odds ratio in, 542

Vietnam casualties, 83

Nebraska, 9, 37, 332, 333-334, 535

Neonatal death. See Perinatal death

Netherlands, 316-317, 323, 325-326, 443, 464, 468, 477, 558

Neurasthenia, 649

Neurobehavioral toxicity,

2,4-D, 180

Neuroblastoma, 594

in children, 628

Neurologic disorders

assessment issues, 14, 641-642

childhood cancer, 628

classification of, 640

cognitive and neuropsychiatric effects, 649-658

compensation for Vietnam veterans, 55

2,4-D in, 179

epidemiologic studies, 44-45, 643-648

herbicide association in, 14, 657, 661, 666

motor/coordination dysfunction, 14, 658-662

in occupational studies, 649-651, 658, 662-663

peripheral nervous system disorders, 662-666

in Seveso, Italy, studies, 365-366, 523

TCDD in, 160-166

in Vietnam veterans' offspring, 609, 660

Vietnam veterans' risk, 658, 662, 666

New Hampshire, 341, 364

New Jersey, 656, 695

Agent Orange Commission, 60, 280-281, 401-402, 741

New Mexico, 60, 402

New York, 60, 364-365, 402-403, 444, 470, 495, 626

New Zealand, 329-331, 373, 486, 490, 535-536, 552, 560-561

Non-Hodgkin's lymphoma

age of onset, 436

in agricultural/forestry workers, 530-540

compensation for Vietnam veterans, 51, 55-56

2,4-D in, 256-257

environmental studies, 540-541

epidemiologic studies, 328, 329, 330, 331, 333-334, 335-338, 383, 384, 391-393, 401, 528-540, 573-574

epidemiology, 526, 527

herbicide association in, 8-10, 548, 573-574

histopathology, 526

in paper/pulp workers, 540

in production workers, 9, 529-530, 548

research recommendations, 19, 727

in Selected Cancers Study, 234-235

in Vietnam veterans, 9, 401, 526, 541-548, 549

Northeast Pharmaceutical and Chemical Corporation, 40

Null hypothesis, 225

O

Occupational exposure, 5, 303

cancer mortality, 443-444

as cancer risk factor, 442

epidemiologic studies, 303-365

exposure assessment strategies, 253-256, 258-259, 262-267, 269-270

pulp/paper workers, 37-38, 267, 341, 364, 443, 447, 454, 468, 516, 523, 540, 561-562, 568

research recommendations, 15-16, 731

vs. Vietnam veteran exposure, 4, 285, 290

See also Agricultural/forestry workers;

Production workers;

Professional

pesticide/herbicide applicators

Odds ratio, 224, 234

Office of Technology Assessment, 19, 50, 52, 57, 728

Ohio, 336, 550

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

Operation Ranch Hand, 3, 4, 15, 16-17, 24, 74

application techniques, 25, 85-86, 87-88

disposal of surplus herbicide, 93-94

herbicide formulations, 88-91

number of military personnel in, 94, 273

objectives, 85

operations data, 86, 87, 92, 106-107

start of, 84, 85

suspension of, 27, 31, 32, 92-93

targeting procedures, 86

See also Ranch Hand study

Oregon, 336-337, 341

Alsea, 42-43, 372-373, 598

Ovarian cancer, 338-339, 506, 510-511

herbicide association in, 13, 512

See also Reproductive system cancers, women

P

P450, 130, 144-145, 170, 709

PACER HO, 93

Pancreatic cancer. See Gastrointestinal tract cancers

Paper/pulp industry workers

cancers in, 443, 454, 468, 516, 523, 540, 568

chemical exposures in, 37-38, 267

epidemiologic studies, 38, 341, 364

Parkinsonism, 661

PCT. See Porphyria cutanea tarda

Pennsylvania, 60, 403, 562

Perimeter spraying. See Ground/perimeter spraying

Perinatal death

definitions, 618-619

descriptive epidemiology, 619-620

epidemiological studies, 620-624

herbicide association in, 14, 624

risk factors, 619-620

TCDD biologic plausibility in, 624

Peripheral nervous system disorders, 55, 662-666

environmental studies, 663-665

herbicide association with, 666

occupational studies, 662-663

Vietnam veterans' risk, 666

Pharmacokinetics

cacodylic acid, 186-187

2,4-D, 175

picloram, 190

2,4,5-T, 182

TCDD, 127-133, 260-261, 284

TCDD-induced wasting syndrome, 162-166

Phenoxy herbicides, 8, 9, 10, 11, 27

action of, 27

See also Herbicides

Phenoxyenolpyruvate carboxykinase, 172

Phenoxypropionic acids, 327

Phytar 560-G, 89

Picloram, 88, 90, 91

acute toxicity, 191

animal studies, 189-192

carcinogenicity, 118, 119, 190-191

chemical properties, 189

chemical structure, 111, 114-115

chronic exposure, 191-192

developmental/reproductive toxicity, 192

domestic use, 189

genotoxicity, 191

immunotoxicity, 122-123, 192

liver toxicity, 125

metabolism, 115, 116

pharmacokinetics, 190

Pleurisy, 711, 713

Pneumoconiosis, 713

Pneumonia, 710, 713

Pointman Project, 60, 280, 401-402, 656

Polychlorinated dibenzodioxins, 126, 327

Polymorphonuclear neutrophils, 148

Porphyria, 153-154

Porphyria cutanea tarda

clinical features, 679

compensation for Vietnam veterans, 50, 55

epidemiologic studies, 680-682

herbicide association in, 10, 682

Vietnam veterans' risk, 682-683

Posttraumatic stress disorder, 397-398, 653-656, 658

Production workers

bladder cancer, 513-517

brain cancer, 523

cancer mortality, 443-444

chloracne, 674-676

circulatory disorders, 700-701

diabetes mellitus, 684

epidemiologic studies, 36-37, 303-318

exposure assessment, 264-265

female reproductive/breast cancer, 508-510

gastrointestinal tract cancers, 447

gastrointestinal ulcers, 691

hepatic enzyme dysfunction, 686, 687

hepatobiliary cancers, 453-454, 455

Hodgkin's disease, 9

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

immune system disorders, 697-698

leukemia, 564-566, 570-571

lipid abnormalities, 688-689

multiple myeloma, 557-578

nasal/nasopharyngeal cancers, 458, 459

neurologic/neuropsychiatric disorders, 649, 650-651, 662-663

non-Hodgkin's lymphoma, 9, 529-530, 548

porphyria cutanea tarda, 680

prostate cancer, 518

renal cancer, 515

reproductive outcomes, 596-598, 607, 620, 621

respiratory cancer, 10, 461-466, 471

respiratory disorders, 709-710

skin cancer, 502

soft tissue sarcoma, 8, 477-479, 499

testicular cancer, 519

See also Industrial accidents

Professional pesticide/herbicide applicators

cancer in, 320-321, 323, 325-326, 443, 447, 466-468, 488, 491

epidemiologic studies, 323-326, 447, 466-468

exposure assessment, 266-267

reproductive outcomes, 324-325

Prolactin, 165

Proportionate mortality ratio, 232-233

Prostate cancer

epidemiologic studies, 518-519

epidemiology, 513, 514-515

herbicide association in, 10, 11, 519-521, 575-576

histopathology, 513

research recommendations, 19, 727

Vietnam veterans' risk, 11, 518, 519, 522

Psychiatric disorders

assessment for, 641

epidemiological studies, 649-657

herbicide association in, 14, 657

posttraumatic stress disorder, 397-398, 653-656, 658

Public concern, 1, 2, 23-24, 29-32, 35-36, 39

federal government response to, 45-60

Public Law 91-441, 47, 62

Public Law 96-151, 50, 52, 57

Public Law 97-72, 50

Public Law 98-181, 51

Public Law 98-542, 50-51

Public Law 99-272, 50

Public Law 100-687, 51

Public Law 101-239, 51

Public Law 102-4, 2, 7, 20, 21, 51, 572, 721, 728-730

Pulmonary system

disorders in Vietnam veterans, 402

TCDD absorption, 129

See also Respiratory cancers;

Respiratory disorders

Q

Quail Run mobile home park, 268, 369-370, 455, 665, 681, 687, 694

R

Race/ethnicity, Vietnam veterans, 81, 82, 83, 84

Radiation exposure, 564, 595

Railroad workers, 323-324, 467, 486, 649-650, 658

Ranch Hand study, 62-63, 260, 272, 622

appropriation for, 51

autoimmune disease in, 698

circulatory disease in, 703-705, 706

data sources, 385-386

diabetes mellitus in, 684

exposure assessment in, 279-280, 281, 386

gastrointestinal ulcers in, 691

immune system disorders in, 696

lipid abnormalities in, 689

low birthweight in, 626, 627

methodology, 230-231, 385-386, 445, 757-762

multiple myelomas in, 562

neurological disorders in, 659

non-Hodgkin's lymphoma in, 541

participants, 722-723

peripheral nervous system disorders in, 665

porphyria cutanea tarda in, 681-682

recommendations for, 16-17, 722-724

reproductive outcomes in, 601, 612-613, 632, 633, 727

respiratory cancers in, 469

respiratory disorders in, 711-712

role of, 53

serum TCDD levels in, 656

skin disorders in, 678

soft tissue sarcoma in, 492-493

status of, 53

TCDD half-life estimates, 260-261

TCDD serum levels, 273, 281, 285

See also Operation Ranch Hand

Rectal cancer. See Gastrointestinal tract cancers

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

Relative risk, 224, 229, 230, 239, 258

Reproductive disorders

altered sperm parameters, 631, 632, 633-634

animal studies, 123-124

cacodylic acid in, 189

2,4-D in, 180-181

female reproductive system cancers, 13, 14, 505-512, 577

herbicide association in, 13-14, 605, 634

infertility, 631, 632-634

male-mediated, 593-595

methodological approach to study of, 591-592

occupational risk factors, 594-595

picloram in, 192

in Ranch Hand study, 758-762

research recommendations, 727

2,4,5-T in, 185

TCDD in, 123-124, 156-159

See also Birth defects;

Low birthweight;

Perinatal death;

Spontaneous

abortion

Reproductive system cancers, women

epidemiologic studies, 508-512

epidemiology, 505, 506-508

herbicide association in, 13, 14, 512, 577

histopathology, 506

Vietnam veterans' risk, 512

Research needs

biomarkers, 17, 725

cost of, 727

exposure assessment, 4, 15, 16-17, 287-290, 291, 721-722, 724-728

health outcome priorities, 19, 726-727

Hodgkin's disease, 19, 727

mandated serum testing, 21, 730

military records, 17, 724-725

motor/coordination dysfunction, 660-661

neurobehavioral functioning, 657

occupational exposure data, 731

recommendations, 15-21, 721-731

research management, 16, 17-18, 723-724, 726

risk assessment, 731

Vietnamese population studies, 731

Respiratory cancers

in agricultural/forestry workers, 466

compensation for Vietnam veterans, 55

epidemiologic studies, 461-472

epidemiology, 460-461

herbicide association in, 10-11, 19, 574-575

in paper/pulp workers, 468-469

in production workers, 461-466

risk factors, 461

in Seveso outcomes, 469

Vietnam veterans' risk, 460-461, 469-470, 472

Respiratory disorders

herbicide association in, 14, 713

in paper/pulp mill workers, 341, 364

in production workers, 709-710

research methodology, 708-709, 712-713

TCDD in, 170, 472, 709-710, 712, 713-714

Vietnam veterans' risk, 713-714

Risk assessment for Vietnam veterans, 5, 221, 246

birth defects, 618

bone cancer, 474-475

cancer, 440, 442-443, 578

cancer in offspring, 630-631

chloracne, 678-679

circulatory disorders, 708

diabetes mellitus, 692

female reproductive system cancers, 512

fetal/infant death, 625

gastrointestinal cancers, 452

genitourinary tract cancers, 522

hepatic enzyme disorders, 692

hepatobiliary cancers, 457

Hodgkin's disease, 557

immune system disorders, 699

leukemia, 571-572

lipid abnormalities, 692

low birthweight outcomes, 628

motor/coordination dysfunction, 662

multiple myeloma, 563

nasal/nasopharyngeal, 460

neuropsychiatric outcomes, 658

non-Hodgkin's lymphoma, 549

peripheral nervous system disorders, 666

porphyria cutanea tarda, 682-683

reproductive outcomes, 634

respiratory cancer, 472

respiratory disorders, 713-714

skin cancer, 505

soft tissue sarcoma, 500

spontaneous abortion, 605

Risk assessment methodology, 5, 221, 246

EPA dioxin research, 59-60

predisposing factors, 731

relative risk determination, 224, 229, 258

standardized mortality ratio in, 229-230

strength of association in, 239

terminology, 224

Rung Sat Special Zone, 100, 104, 105, 106

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

S

Seasonal factors

in herbicide distribution, 26, 87

Selected Cancers Study

goals, 59, 387, 391

Hodgkin's disease in, 554-556

liver cancer in, 455

methodology, 57, 234-235, 243, 258, 391-393, 440, 527

nasal/nasopharyngeal cancer, 459

non-Hodgkin's lymphoma in, 9, 541-543, 573

soft tissue sarcoma in, 493, 498

Selective herbicides, 24, 88

Self-Report Symptom Inventory, 641

Serotonergic system, 166

Serum levels, TCDD

in CDC validation study, 281-284

mandated testing, 728, 729

measurement technique, 260

pharmacokinetics, 259-261

recommendations, 20-21

significance of, 4, 19, 261, 284-285, 289, 290, 725, 742-743

Services HERBS tapes, 97-98

Seveso, Italy

accidental contamination in, 43

bladder cancer, 517

brain tumors, 523

cancer mortality, 444

chloracne, 267, 676-677

circulatory disorders, 701-702

epidemiologic studies, 44-45, 63, 365-368

exposure assessment, 267-268, 285, 598-599

female reproductive cancers, 511

gastrointestinal ulcers, 691

hepatic enzyme disorders, 686-687

immune modulation, 695

leukemia, 13, 569-570, 571

lipid abnormalities, 689

liver cancer, 454-455

liver disorders, 367

lung cancer, 469

mortality studies, 652

multiple myeloma, 562

neuropsychiatric outcomes, 651-652

non-Hodgkin's lymphoma, 540-541

peripheral nervous system disorders, 663-664

porphyria cutanea tarda, 680-681

prostate cancer, 11

reproductive outcomes, 598-599

respiratory outcomes, 710

response to accident, 43-44

skin cancer, 503

soft tissue sarcoma, 491-492

Silvex, 309, 324

Skin cancer

animal studies, 141, 142-143

biologic plausibility for TCDD, 503

clinical features, 501, 502

epidemiologic studies, 502-503

epidemiology, 501-502

herbicide association in, 12, 576

TCDD in, 141, 142-143, 502-503

Skin sensitivity

to 2,4-D, 181

to picloram, 192

to TCDD, 172-174

See also Chloracne;

Porphyria cutanea tarda

Sleep disorders, 650

Soft tissue sarcoma, 311, 314

age of onset, 436

in agricultural/forestry workers, 322, 326-328, 329-330, 335-336, 337, 339-340

biologic plausibility of TCDD in, 500

case-control studies, 481-491

in children, 628

clinical features, 475, 476

in cohort studies, 231, 243

compensation for Vietnam veterans, 51, 55, 56

environmental exposure studies, 375, 383, 384

epidemiologic studies, 231, 476, 477-500

epidemiology, 475

herbicide association in, 8, 9-10, 500, 572-573

in pesticide applicators, 491

in production workers, 8, 477-479, 499

research recommendations, 19, 727

risk factors, 10, 477

in Vietnam veterans, 395-396, 401, 475, 492-498, 500

Somatostatin, 168, 169

South Korea, 61-62

Special Forces, 286

Sperm parameter disorders, 631, 632, 633-634

Spina bifida, 609, 611, 612

Spontaneous abortion, 592

in agricultural/forestry workers, 336-337

in Alsea, Oregon, case, 42-43, 372-373, 598

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

definition, 595-596

environmental exposure and, 598-599

epidemiologic data, quality of, 603-605

herbicide association in, 14, 605

maternal risk factors, 596

occupational exposure and, 596-598

risk factors, 594

in Vietnam veterans' wives, 405-406, 601-603

in Vietnamese civilians, 599-601

Standardized mortality ratio, role of, 229-230

State governments, 60

Vietnam veteran epidemiologic studies by, 399-405, 495-496

See also specific state

Stillbirth. See Perinatal death

Stomach

cancer, 446, 447

TCDD effects in, 169

See also Gastrointestinal tract cancers

Stroke risk, in herbicide exposure, 658, 659, 660

Substance use, 655

Sufficient evidence of herbicide association

basis for finding of, 8-10, 246-247, 572

in cancer, 8-10, 572-574

in chloracne, 10, 678

in Hodgkin's disease, 8, 9-10, 556-557, 573-574

in non-Hodgkin's lymphoma, 8-9, 10, 548, 573-574

in porphyria cutanea tarda, 10, 682

in soft tissue sarcoma, 8, 9-10, 500

Suicide, 398, 650, 655-656

Surveillance, Epidemiology, and End Result program, 336, 439-440, 506

Sweden, 8, 9, 13, 37, 322-323, 326-329, 375, 443, 444, 447, 467, 479, 480, 481, 482-486, 490, 510, 528-529, 530-533, 539, 548, 551-553, 561, 572-573

Systemic autoimmune disease, 697-699

Systemic lupus erythematosus, 697

T

2,4,5-T. See 2,4,5-Trichlorophenoxyacetic acid

T cell function, 147-148, 151

in autoimmunity, 697

in immune modulation, 694, 695

in Vietnam veterans, 698

T-H Agricultural & Nutrition Company, 35

Tannery workers, 486, 514

Tasmania, 418, 603

TCDD. See 2,3,7,8-Tetrachlorodibenzo-p-dioxin

TCDD biologic plausibility

Ah receptor in, 133-138

animal carcinogenicity studies, 138-146, 439

in brain tumors, 525

carcinogenesis, 116-118, 434, 439

cardiovascular toxicity, 171

in childhood cancer, 630

in chloracne, 172-174, 678

in fetal/infant death, 624

gastrointestinal toxicity, 169-170, 451

in genitourinary tract cancers, 521-522

in hepatobiliary cancers, 457

in Hodgkin's disease, 557

in immune system disorders, 122, 146-151, 699

in leukemia, 571

in motor dysfunction, 661

in multiple myeloma, 563

in nasal/nasopharyngeal cancer, 460

in neurological disorders, 160-166

in non-Hodgkin's lymphoma, 549

in porphyria cutanea tarda, 682

in reproductive disorders, 123-124, 156-159, 605, 618, 634

respiratory toxicity, 170

in skin cancer, 503

in soft tissue sarcoma, 500

Teratogenicity, 57, 62, 606-607

cacodylic acid, 189

2,4-D, 180-181

picloram, 192

2,4,5-T, 185, 373-374

TCDD, 28, 30, 123, 159-160, 185, 368, 370, 372

viral potential, 607

See also Birth defects

Testicular cancer, 405

epidemiologic studies, 519

epidemiology, 515

herbicide association in, 13, 521

histopathology, 513

Vietnam veterans' risk, 519, 522

Testosterone, 123, 157-158

Tetrachlorobenzene, 28

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD)

Ah receptor interaction, 3, 114, 118, 122, 123, 133-138, 150, 151, 152, 159-160, 439, 452-453, 457

amount used in Vietnam, 27, 106

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

animal studies, 111-114, 138-142, 477

as antiestrogen, 512

autoimmunity and, 697-699

bioavailability, 128-129

biomarkers, 4, 17, 259-262, 725

in body temperature regulation, 169

carcinogenicity, 28-29, 116-118, 138-146, 439, 451

cardiovascular toxicity, 171

categorization as dioxin, 23n, 125

cell proliferation capability of, 145

chemical properties, 28, 114, 127

chemical structure, 125-126

chloracne and, 4, 10, 28, 172-173, 262

circulatory disorders and, 701-708

concerns about, 1, 2, 23-24, 28-32, 35-36

corticosteroids and, 168, 171-172

cytochrome P4501A2 and, 130, 144-145, 170, 709

developmental toxicity, 123-124, 149, 156-157, 159-160, 185

diabetes mellitus and, 683

distribution in brain, 160-161

dose-response relationships, 111-114, 122, 128-129, 130, 137-138, 445, 673, 696

environmental exposure assessment, 262-263, 267-270

environmental persistence, 288

estrogen-mediation of carcinogenesis, 144-145

excretion, 132-133

in fatty acid biosynthesis, 168-169

in female reproductive system/breast cancers, 512

gastrointestinal toxicity, 169-170, 447-452, 690-692

genotoxicity, 118, 143-144

half-life, 129, 260-261

hepatic enzyme disorders and, 155-156, 685-688, 691-692

in hepatobiliary cancers, 457

as herbicide contaminant, 2, 3, 27, 91-92, 114, 126-127

in hexachlorophene manufacture, 40

in hypoglycemia, 166-168

in immune modulation, 694-696

immunotoxicity, 119-122, 146-151, 338, 477

in inflammatory responses, 148

in lipid abnormalities, 688-690

liver toxicity, 115-116, 124, 138-139, 142, 143, 151-156, 165-166

metabolism, 115-116, 131-133, 155

in nasal/nasopharyngeal cancer, 460

in neuropsychiatric outcomes, 649-650, 651-652, 656, 657-658, 658

neurotoxicity, 160-166, 642

non-Ah-mediated toxicity, 138

in non-Hodgkin's lymphoma, 8, 9, 528-529, 574

occupational exposure, 36-39, 262-267, 269-270, 303

as opioid antagonist, 164

oral administration, 128

pharmacokinetics, 127-133, 160, 259-261, 284

production of, 28, 114

as promoter of carcinogenesis, 116, 142-143, 434, 439

reproductive toxicity, 123-124, 156-159, 368, 371-372, 597, 599, 605

in respiratory disorders, 170, 472, 709-710, 712-714

serum levels, 4, 19, 21, 261, 281-285, 289, 290, 725, 728, 729, 742-743

skin cancer and, 141, 142-143, 502-503

in soft tissue sarcoma, 477, 478, 490, 498-500

solubility, 114, 115-116, 127

sources of exposure, 127

teratogenicity, 28-29, 30, 31, 123, 159-160, 185, 368, 370, 372

wasting syndrome, 160-161, 162-166

See also Herbicides

Texas, 60, 403-404, 696

Thailand, 26, 90

Thompson Chemicals Corporation, 35

Thyroid

TCDD effects, 168-169

thyroiditis, 697, 698

Times Beach. See Missouri, Times Beach

Tissue distribution, TCDD, 129-131, 259

Tobacco exposure, 11, 223, 442, 461, 463

in perinatal mortality, 619-620

Topography, 25

Tordon101, 90

Transforming growth factor-α 145

2,4,5-Trichlorophenol, 28

2,4,5-Trichlorophenoxyacetic acid (2,4,5-T)

acute toxicity, 184

in Agent Orange, 27

animal studies, 181-185

carcinogenicity, 37, 118, 119, 182-184

chemical properties, 114, 182

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

chemical structure, 111, 114

chloracne and, 36

chronic exposure, 184

circulatory disorders and, 700-701

development of, 24, 26, 35, 181

developmental toxicity, 185

domestic use, 181

environmental exposure events, 42-43

genotoxicity, 119, 184

liver toxicity, 125

metabolism, 115, 116

military applications, 26, 88

pharmacokinetics, 182

reproductive toxicity, 185

respiratory disorders and, 709

suspension of, 1, 39, 42-43, 92, 181-182

TCDD contamination of, 2, 3, 27, 91, 114, 126, 182

teratogenicity, 30, 92, 373-374

See also Herbicides;

2,3,7,8-Tetrachlorodibenzo-p-dioxin

Triglyceride levels, 688-689

Trinoxol, 91

Tuberculosis, 711

Tumor necrosis factor, 148

Twin studies, 398-399, 406, 703, 711

U

Ulcers, gastrointestinal, 690-692

Uniroyal Inc., 35

United Kingdom, 315-316, 340, 382, 444, 462-463, 464, 477, 479, 537 , 565, 595, 689

United Nations, 45

USSR, 317

Utah, 560

Uterine cancer, 506

evidence for herbicide association, 13

See also Reproductive system cancers, women

V

Veterans Administration. See Department of Veterans Affairs

Veterans' Dioxin and Radiation Exposure Compensation Standards Act , 50

Vietnam

Con Thieu province, 96

concerns about herbicide use in, 29-32, 45

herbicide targeting in, 99-106

Khe Sanh-Thonh Son Lam area, 96

research in, 30-31

troop movements in, 52-53, 96, 287

U.S. casualties in, 82-83

U.S. involvement, 75-76, 84

U.S. military herbicide use in, 1, 3, 24, 27, 84-85, 89-93, 94-96, 98-107, 286

Vietnam Experience Study

cancer mortality in, 444-445

childhood cancer in, 629

chloracne in, 677

circulatory disorders in, 702

Hodgkin's disease in, 556

immune system disorders in, 696

liver cancer in, 455

low birthweight outcomes in, 626

lung cancer in, 469

methodology, 57-58, 281, 284, 389-391

neonatal death in, 622

neurologic/neuropsychiatric outcomes in, 656

non-Hodgkin's lymphoma in, 542-543

origins, 50

reproductive outcomes in, 601, 609, 610-611, 626, 632

respiratory disorders in, 710-711

Vietnam Veteran Agent Orange Health Study, 741

Vietnam veterans, 1

advocacy groups, 60-61

altered sperm parameters in, 632, 634

Australian, 61, 91, 406, 418, 444, 470, 496-497, 546, 614-615, 633 , 702, 710

autoimmune disease in, 698, 699

birth defects in children of, 609-615, 618

bladder cancer in, 517

bone cancer in, 473, 474-475

brain tumors in, 522, 523, 525

cancer in children of, 629, 630-631

cancer mortality, 444-445

cancer studies, 391-393, 401, 402-403, 405, 436-438

chloracne in, 677-679

circulatory disorders in, 702-705

class action suit, 34-35

compensation for, 34-35, 47, 50-51, 55-56

congressional responses to concerns of, 46-52

defining, 78

demographics, 79, 80-84

diabetes mellitus in, 684-685, 698

discharges for disabilities, 32

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
×

distribution by branch of service, 81

epidemiologic studies, 50, 57-59, 62-63, 384-418

expected cancer incidence, 439-440, 442, 446, 452, 461, 501, 505, 513, 522, 526, 564

exposure assessment strategies for, 270-284

female reproductive system cancers in, 505, 511-512, 577

gastrointestinal tract cancers in, 446

gastrointestinal ulcers in, 691, 692

genitourinary tract cancers in, 513, 518, 522

health concerns of, 1, 32-34, 46-47

hepatic enzyme disorders in, 687

hepatobiliary cancers in, 455, 457

Hodgkin's disease in, 526, 554-556, 557

immune modulation in, 695-696, 699

infertility, 632, 633, 634

leukemia in, 13, 564, 570, 571-572

lipid abnormalities in, 689, 692

low birthweight outcomes for, 626, 628

military experiences, 75, 82, 272, 286, 399

motor/coordination dysfunction in, 659-660, 662

multiple myeloma in, 526, 562, 563

nasal/nasopharyngeal cancer in, 459, 460

in National Personnel Records Center, 17

neuropsychiatric outcomes, 653-656, 658

non-Hodgkin's lymphoma in, 526, 541-548, 549

number of, 3, 4, 74, 75-80

peripheral nervous system disorders in, 665, 666

porphyria cutanea tarda in, 681, 682-683

prostate cancer in, 513, 518, 519, 522

records-based exposure assessment, 271-280

reproductive outcomes, 405-406, 418, 601-603, 609-615, 618, 620-622, 625

respiratory cancers in, 469-470, 472

respiratory disorders in, 710-712, 713-714

risk assessment for, 14-15, 221, 225-226, 247-248, 578

serum testing, 20-21

skin cancer in, 501, 505

soft tissue sarcoma in, 475, 492-498, 500

South Korean, 61-62

spontaneous abortions in, 601-603, 605

suicide incidence, 655-656

twin studies, 398-399, 406, 703, 711

women, 50, 83-84

Vietnam Veterans of America, 60

Vietnamese

epidemiologic studies, 599-601

exposure assessment, 269, 370-372

reproductive outcomes, 599-601, 608-609

research recommendations, 731

Viral infection

immune system response, 692-693

TCDD-enhanced susceptibility, 149

teratogenic potential, 607

Vitamin A, 174

W

War Research Service, 25

Washington state, 336-338, 341, 487-488, 535

Wasting syndrome, TCDD-induced, 162-166

Wechsler Adult Intelligence Scales, 641

West Virginia, 60, 404, 470, 496, 546, 621, 662-663, 686, 689, 700

Nitro accident, 38-39, 305-307, 597, 607, 686, 700

Wilm's tumor, 594

Wisconsin, 37, 60, 336, 404-405, 445, 455, 470, 496, 517, 523, 534 , 546, 556, 560, 702, 710

Women veterans, 79

circulatory disease in, 702

epidemiologic studies, 50, 81

expected cancer incidence, 440, 461, 501, 505, 513, 522, 526, 564

mortality studies, 394-395, 470, 545

research recommendations, 728

statistics, 83-84

See also Reproductive system cancers, women

World Health Organization

Mortality Data Bank, 314

World War II, 25, 32, 82

Suggested Citation:"Index." Institute of Medicine. 1994. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: The National Academies Press. doi: 10.17226/2141.
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Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam Get This Book
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Have U.S. military personnel experienced health problems from being exposed to Agent Orange, its dioxin contaminants, and other herbicides used in Vietnam? This definitive volume summarizes the strength of the evidence associating exposure during Vietnam service with cancer and other health effects and presents conclusions from an expert panel.

Veterans and Agent Orange provides a historical review of the issue, examines studies of populations, in addition to Vietnam veterans, environmentally and occupationally exposed to herbicides and dioxin, and discusses problems in study methodology. The core of the book presents

  • What is known about the toxicology of the herbicides used in greatest quantities in Vietnam.
  • What is known about assessing exposure to herbicides and dioxin.
  • What can be determined from the wide range of epidemiological studies conducted by different authorities.
  • What is known about the relationship between exposure to herbicides and dioxin, and cancer, reproductive effects, neurobehavioral disorders, and other health effects.

The book describes research areas of continuing concern and offers recommendations for further research on the health effects of Agent Orange exposure among Vietnam veterans.

This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans organizations, researchers, and health professionals.

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