Veterans and Agent Orange: Update 2002
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In previous updates on the health risk to veterans posed by exposure to Agent Orange and other chemicals used in Vietnam, all forms of leukemia were considered collectively when examining research on links between exposure to herbicides and the risk for cancer. The combined evidence was found to be inadequate or insufficient to determine whether any association exists between leukemia and exposure to the herbicides or contaminants in them. However, a recent re-examination of the evidence revealed sufficient evidence of an association between exposure to herbicides sprayed during the Vietnam War and the risk for development of a specific form of leukemia - chronic lymphocytic leukemia CLL - in veterans.
Although classified as a form of leukemia, CLL shares many traits with Hodgkin's disease and non-Hodgkin's lymphoma, both of which previously have found to be positively associated with herbicide exposure.
Agent Orange Act Was Supposed to Help Vietnam Veterans—But Many Still Don't Qualify
NAS noted that a study of 47 exposed people in Florida involved a small survey of a problematic sample, making the data difficult to interpret. Finally, the committee noted that a study of an exposed population in Taiwan found no association between hypertension and being in the exposed population. When the analysis was restricted to persons having chloracne a skin condition associated with herbicide exposure , the study found an increased incidence of hypertension in women, but not in men, making the findings difficult to interpret. Relatively few of the positive findings were statistically significant and the findings overall are limited by the inconsistency of the results, the lack of controls, and other methodological concerns.
The inconsistent findings within and across the studies limit the ability to draw any conclusions regarding dose-response relationship.
Agent Orange Update
Viewing the new studies published since in relation to the previously reviewed evidence, VA has determined that the evidence overall does not establish a positive association between herbicide exposure and hypertension. Therefore, a presumption of service connection is not warranted. NAS, in Update , categorized certain other health outcomes as having inadequate or insufficient evidence to determine whether an association with herbicide exposure exists.
This category is defined to mean that the available studies are of insufficient quality, consistency, or statistical power to permit a conclusion regarding the presence or absence of an association with herbicide exposure. After considering the NAS report, the Secretary has determined that presumptions of service connection are not warranted for any of the diseases listed above.
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As noted above, VA has previously explained, in a series of Federal Register notices, its analysis of prior NAS reports concerning these diseases. The additional evidence and analysis addressed in Update with respect to these conditions is summarized below. In Update , NAS identified no additional studies relevant to the possible association between herbicide exposure and cancers of the pleura, mediastinum, and other unspecified sites within the respiratory system and intrathoracic organs; esophageal cancer; bone and joint cancer; cancers of the male reproductive organs other than prostate cancer , endocrine cancer, movement disorders including ALS but excluding Parkinson's disease ; endometriosis; effects on thyroid homeostasis; and certain reproductive effects.
Accordingly, the NAS's conclusions regarding those conditions were unchanged from Update In Update , NAS found that the relevant new studies it identified did not include any statistically significant findings of association between herbicide exposure and the following diseases: oral, nasal, and pharyngeal cancers; colorectal cancer; hepatobiliary cancer, melanoma, non-melanoma skin cancer; cancers of the female reproductive organs; urinary bladder cancer; renal cancer; chronic peripheral nervous system disorders; gastrointestinal, metabolic, and digestive disorders including changes in liver enzymes, lipid abnormalities, and ulcers ; and endometriosis.
Accordingly, NAS found that the additional evidence generally did not support an association between herbicide exposure and those health outcomes.
With respect to several other health outcomes, NAS in Update found that, although the new studies included some statistically significant positive findings, those findings did not warrant a change in the conclusion that the evidence overall is inadequate or insufficient to determine whether the health outcome is associated with herbicide exposure, as explained below. NAS discussed two new studies regarding stomach cancer.
Download a PDF of "Veterans and Agent Orange" by the Institute of Medicine for free. Public Law , the Agent Orange Act of , was enacted on February 6, That legislation, codified as 38 USC Sec. , directed the secretary of.
One of the studies found no increased mortality from stomach cancer in the exposed population. The other study found a statistically significant increased risk of stomach cancer among farm workers who used pesticides. NAS noted that this study was consistent with findings of a previously-reviewed occupational study finding evidence of an association between exposure to phenoxy herbicides but not other types of herbicides and stomach cancer. Agricultural Health Study—had provided no evidence suggestive of an association between herbicide exposure and stomach cancers.
Accordingly, NAS in Update concluded that the overall evidence does not support an association between exposure to the herbicides of interest and stomach cancer. NAS discussed two new studies regarding pancreatic cancer. One of the studies found no increased mortality from pancreatic cancer in the exposed population. The other study found a statistically significant increase in pancreatic cancer among deployed U.
NAS noted that a previously reviewed study also found evidence of an increased risk of pancreatic cancer in deployed Australian Vietnam veterans. NAS noted that no increase in risk has been detected to date in U. It further noted that the Vietnam veteran studies were limited due to lack of control for smoking and lack of supportive evidence from occupational or environmental studies.
NAS found that the overall evidence remained insufficient or inadequate to determine whether an association exists.
NAS discussed four new studies concerning breast cancer. Three of the studies, including a Vietnam veteran study, found no increased risk of breast cancer in exposed populations. One study found an increased risk of breast cancer associated with self-reported use of household pesticides. NAS concluded that the new evidence tended to weigh against an association and that the one positive study was limited by potential recall bias and the lack of information regarding specific exposures.
NAS discussed four new studies regarding cancers of the brain and nervous system including the eye. It found that the new studies were consistent in finding no association between herbicide exposure and the development of gliomas the most common type of brain cancer. NAS noted that one of the new studies provided evidence of a possible relationship between herbicide exposure and meningiomas a type of nervous system cancer in women, but that the lack of identification of specific chemicals of interest makes interpretation of that result uncertain.
NAS concluded that the overall evidence remained inadequate or insufficient to determine whether and association exists. NAS discussed three new studies addressing whether all forms of leukemia are associated with herbicide exposure. One of the studies found no evidence of an association between herbicide exposure and leukemias, while the other two found evidence of such an association.
However, NAS found that one of the positive studies was limited by concern over possible misclassification of causes of death for the few people whose deaths were attributed to forms of leukemia other than those already considered to be associated with herbicide exposure i.
Viewing the new evidence in relation to the previously reviewed evidence, NAS found that the overall evidence was inadequate or insufficient to determine whether an association exists. NAS's finding that the evidence does not establish an association between herbicide exposure and all forms of leukemia does not affect its independent finding that there is sufficient evidence of a causal association between herbicide exposure and specific forms of leukemia i.
Start Printed Page NAS discussed three new studies regarding neurobehavioral effects. Two of the studies found an increased reporting of neurobehavioral symptoms with self-reported pesticide exposure, but no associations specific to herbicide exposure. The third study found an increased incidence of abnormalities on neurobehavioral testing among persons chronically exposed to herbicides, but NAS found this study limited by the small sample size, the lack of information on methodology, and the possibility that many other environmental and age-related factors may have affected the results.
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Further, the data do not clearly relate the increased symptoms or abnormal test results to specific neurobehavioral diseases or diagnoses. NAS concluded that the overall evidence remained inadequate or insufficient to detect an association. NAS noted that several previously reviewed studies failed to support the hypothesis that herbicide exposure is associated with respiratory mortality from non-cancer diseases.
In Update , NAS identified one new study showing increased respiratory mortality, but determined that no conclusions could be drawn from the study due to lack of specificity regarding the health outcomes and due to other methodological concerns. NAS concluded that most prevalence studies found no association between herbicide exposure and COPD, and the two that did find evidence of such association were limited by methodological concerns. NAS discussed two new studies regarding immune system disorders. One study found no evidence of immune system disorders in persons highly exposed to dioxin.
The other study found an increase in self-reported arthritis thought to be an autoimmune disorder among exposed women, but not men. NAS concluded that the positive finding was unsupported by experimental evidence and that the overall evidence remained inadequate or insufficient to determine whether an association exists. NAS identified one study finding evidence of an increased risk of mortality from rheumatic heart disease in an exposed population, but concluded that the basis for the observed association was unclear and that the data were limited by the lack of control for significant confounders and other methodological concerns.
NAS found that the overall evidence was inadequate or insufficient to determine whether herbicide exposure is associated with any circulatory disorders other than ischemic heart disease or hypertension. The Secretary testified that he was asking his staff at the VA to review current policy and our bipartisan letter today asks him to make clear whether he has received a report and whether the VA plans to change its policy.
It is long past time to right this wrong. Congressman David G. The legislation introduced into the th Congress is the fourth iteration as the bill was also introduced in the th, th, and th Congresses. Courtney has been a co-sponsor of the legislation each time it has been introduced.
Unfortunately, the Department of Veterans Affairs VA does not include blue water Navy veterans under this term because they served in the territorial waters off the coast of Vietnam, and not on the ground or in inland waterways. After a recent federal court decision ordering the VA to reevaluate its definition of inland waterways, the VA reaffirmed that the term only includes service in fresh water rivers, streams, canals, and similar waterways.
It does not include veterans who served on ships offshore but were exposed to the agent when polluted seawater was brought onboard for a number of purposes including bathing and cleaning of the vessel.
Skip to main content. Navy personnel to high levels of the toxic chemical. Social Justice. All backorders will be released at the final established price. Read more Read less.
The full text of the letter is below as well as available online. Despite this, the Department of Veterans Affairs continues to deny claims from Blue Water Navy Veterans, creating significant hardship for these brave Americans. During the Vietnam War, approximately twenty million gallons of Agent Orange were sprayed over the Republic of Vietnam, contaminating the land, rivers, harbors, and territorial seas.