VA Names Members of Gulf War Veterans Advisory Committee Secretary Peake to Hear Their Concerns, Issues
WASHINGTON (May 13, 2008) -- Veterans who served in the Southwest Asia
theater of operations during 1990-1991 will have their own special
advocates before Secretary of Veterans Affairs Dr. James B. Peake,
thanks to a new advisory committee Peake established to respond to
issues unique to them.
The 14-member, independent panel will advise the Secretary and the
Department of Veterans Affairs (VA) on the full range of health care and
benefits needs of those who served in the conflict.
"Gulf War veterans made an invaluable contribution to national security
and peace in a volatile region," Peake said. "This new panel will ensure
that VA benefits and programs adapt to the needs of these veterans, just
as our services have adapted for veterans of other conflicts."
Serving on the committee are Gulf War and other veterans, veterans
service organizations' representatives, medical experts, and the
survivors of Gulf War veterans. Members were selected to provide a
variety of perspectives, experiences and expertise.
The committee will be chaired by Charles Cragin, a retired Navy captain,
who has had several senior level positions within the federal
government, including Acting Under Secretary of Defense for Personnel
and Readiness and Chairman of VA's Board of Veterans Appeals.
In January 2002, the Department created an advisory committee to assist
VA's secretary on research into the medical problems of Gulf War
veterans. That older committee will retain responsibility for research
involving veterans of the 1990-1991 conflict in the Middle East.
This committee's first meeting will be held in mid-June in Washington,
D.C. It is expected to complete its work within 18 months. Committee
meetings will be open to the public.
A list of the members of VA's Gulf War Advisory Committee is attached.
Membership
VA Advisory Committee on Gulf War Veterans
* Charles Cragin, (Chair) of Raymond, Maine. Currently serves a
senior counselor for Maine Street Solutions, LLC.
* Martha Douthit of Ashburn, Va. Surviving spouse of Gulf War
Army veteran, member of the Gold Star Wives of America, currently an
international trade analyst with the U.S. Department of Commerce.
* Dr. Henry Falk of Atlanta. Retired rear admiral and former
Assistant U.S. Surgeon General. Currently director for the Coordinating
Center for Environmental Health and Injury Prevention with the Centers
for Disease Control and Prevention.
* Mark Garner of Lorton, Va. A retired Marine Corps chief warrant
officer-three and Gulf War veteran who served as a Nuclear, Biological,
and Chemical Defense Officer.
* Dr. Lynn Goldman of Chevy Chase, Md. Vice chair of the
Institute of Medicine Gulf War and Health Study; currently professor of
environmental health sciences at Johns Hopkins University.
* Dr. John Hart of Plano, Texas. Past president of the Society
for Behavioral and Cognitive Neurology, currently professor of neurology
and psychiatry at the University of Texas Southwestern Medical Center.
* William (Rusty) Jones of South Riding, Va. Retired Marine Corps
colonel, and veteran of Gulf War and Vietnam War.
* Kirt Love of Crawford, Texas. An Army veteran of the Gulf War,
currently serving as director of the Desert Storm Battle Registry.
* Daniel Ortiz of Whittier, Calif. An Army veteran of the Gulf
War, currently serving as department service director with the Veterans
of Foreign Wars.
* Daniel Pinedo of Oceanside, Calif. Marine Corps colonel
currently serving as the comptroller for First Marine Expeditionary
Force at Camp Pendleton, Calif.
* Thomas Plewes of Annandale, Va. A retired Army lieutenant
general and former chief of the Army Reserve. Currently a senior
program officer with National Academy of Sciences.
* Valerie Randall of Savage, Md. A retired Army sergeant first
class; currently with the Department of Homeland Security.
* Edward (Randy) Reese of Washington, D.C. An Army veteran of the
Gulf War; currently national service director for the Disabled American
Veterans.
* Steve Robertson of Fredericksburg, Va. A Gulf War veteran who
served both in the Air Force and Army National Guard. Currently
director of the national legislative commission for The American Legion.
Tuesday, May 13, 2008
VA Names Members of Gulf War Veterans Advisory Committee Secretary Peake to Hear Their Concerns, Issues
AFGE LAUNCHES NATIONWIDE AD CAMPAIGN FOR FULL AND
AFGE LAUNCHES NATIONWIDE AD CAMPAIGN FOR FULL AND MANDATORY VA FUNDING
Union representing VA workers
is urging elected officials not to privatize VA healthcare.
Ads target Sen. McCain's "VA Card" promise.
For more about Sen. John McCain's "VA Card" promise that would dismantle the VA, click here...
http://www.vawatchdog.org/08/nf08/nfFEB08/nf021108-1.htm
For more about privatizing the VA, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=privatize+privatizing&op=or
For more about the AFGE, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=afge&op=and
Story here... http://www.prnewswire.com/cgi-bin/stories
.pl?ACCT=104&STORY=/www/story/05-12-2008/0004811441&EDATE=
Story below:
-------------------------
AFGE Launches Nationwide Ad Campaign Aimed at Funding the VA
Union Representing VA Workers Urge Elected Officials Not to Privatize Veterans' Health Care
WASHINGTON, /PRNewswire-USNewswire/ -- The American Federation of Government Employees today launched a nationwide radio ad campaign urging Congress to provide full, mandatory funding for the Department of Veterans' Affairs. In the ad, AFGE urges presidential candidate Sen. John McCain (R-Ariz.) to support full funding for the VA.
"As the nation's highest profile veteran and a ranking member of the Senate Armed Services Committee, Senator McCain now is in a position to do something that will have long range impact on the health care of his fellow veterans," said AFGE President John Gage. "AFGE strongly feels that recent proposals by Senator McCain are misguided," he added.
In February, Sen. McCain told press in New Hampshire that he plans to offer veterans vouchers to receive care at private for-profit healthcare facilities. That move, according to AFGE, would be tantamount to dismantling the current Veteran's Health Administration (VHA), which is widely regarded as the nation's foremost medical health care system.
The ad features veteran and AFGE member Phil Glover who expresses concerns about the McCain voucher plan calling it a means of privatizing veterans' health care and undermining the solvency of the VA. Referring the McCain's voucher plan, Glover says, "That would be the end of the VA -- the end of the promise and the start of a huge boondoggle for big corporations."
"While it has been argued that the VA has not been responsive to the growing needs of burgeoning veterans' population, many of the short falls can be directly attributed to a lack of funding," said J. David Cox, AFGE national secretary-treasurer who is also a former VA nurse. "Vouchers could cripple the system by diverting much needed funds away from veterans' health care. We urge all members of Congress to support full, mandatory funding for the VA. But, because of his political stature we are especially targeting Sen. McCain."
The radio ads start airing this week in North Carolina, New Mexico, Florida, Colorado, Minnesota, Virginia and Pennsylvania. For more information, go to http://www.fundtheva.com or http://www.afge.org.
AFGE is the largest federal employee union, representing 600,000 workers in the federal government and the government of the District of Columbia.
-------------------------
posted by Larry Scott
Founder and Editor
VA Watchdog dot Org
Monday, May 12, 2008
Ex-State officials allege corruption in Iraq
Ex-State officials allege corruption in Iraq
WASHINGTON (Map, News) - The Bush administration repeatedly ignored corruption at the highest levels within the Iraqi government and kept secret potentially embarrassing information so as not to undermine its relationship with Baghdad, according to two former State Department employees.
Arthur Brennan, who briefly served in Baghdad as head of the department's Office of Accountability and Transparency last year, and James Mattil, who worked as the chief of staff, told Senate Democrats on Monday that their office was understaffed and its warnings and recommendations ignored.
Brennan also alleges the State Department prevented a congressional aide visiting Baghdad from talking with staffers by insisting they were too busy. In reality, Brennan said, office members were watching movies at the embassy and on their computers. The staffers' workload had been cut dramatically because of Iraqi Prime Minister Nouri al-Maliki's "evisceration" of Iraq's top anti-corruption office, he said.
The State Department's policies "not only contradicted the anti-corruption mission but indirectly contributed to and has allowed corruption to fester at the highest levels of the Iraqi government," Brennan told the Senate Democratic Policy Committee.
EXAMINER.COM RELATED ARTICLES
Ex-officials: Bush admin. ignored Iraq corruption
Blackwater unlikely to face charges in Iraq shooting
Iraq: Sadr City cease-fire signed after weeks of fighting
Iran hard-liners come out against Iraqi-US deal
AP IMPACT: Number of disabled veterans rising The U.S. embassy "effort against corruption - including its new centerpiece, the now-defunct Office of Accountability and Transparency - was little more than 'window dressing,'" he added.
Deputy State Department spokesman Tom Casey said the administration takes the issue of corruption seriously and pointed to its recent appointment of Lawrence Benedict as coordinator for anti-corruption initiatives at the U.S. embassy in Baghdad.
Benedict's appointment "is another demonstration that we are working at very senior levels to help the Iraqis deal with this issue," Casey said. "Any assertion that we have not taken this issue seriously or given it the attention it deserves is simply untrue."
The Office of Accountability and Transparency, or "OAT" team, was intended to provide assistance and training to Iraq's anti-corruption agencies. It was dismantled last December, after it alleged in a draft report leaked to the media that al-Maliki's office had derailed or prevented investigations into Shiite-controlled agencies.
The draft report sparked hearings in Congress and prompted a showdown between Democrats and senior State Department officials on whether the public has a right to know the extent to which al-Maliki was involved in corruption cases.
Brennan charges the State Department never responded to his team's report, which was retroactively classified because agency officials said it could hurt bilateral relations with Iraq. Other recommendations by the group also were kept secret, including a negative assessment of Iraq's Joint Anti-Corruption Committee, Brennan said.
In July 2007, the OAT team concluded that the committee's only purpose was to provide a forum for complaints against Judge Radhi Hamza al-Radhi, a top anti-corruption official in Baghdad whom many U.S. officials have hailed as the most effective in exposing fraud and abuse.
But information later released by the embassy ignored the team's assessment and ultimately "failed to even mention what a disaster" the committee "really was," Brennan said.
Brennan said he approved the embassy report against his better judgment but later regretted it.
Mattil, who worked with Brennan, made similar allegations. Specifically, he said the U.S. "remained silent in the face of an unrelenting campaign" by senior Iraqi officials to subvert Baghdad's Commission on Public Integrity, which had been led by al-Radhi. Then, the U.S. turned its back on Iraqis who fled to the United States after being threatened for pursuing anti-corruption cases, he said.
"Since we have done so little (to undercut corruption), it's easy to see why the government of Iraq has not done more," said Mattil, who left the accountability office last October after having served for a year as its chief of staff. "We have demanded no better."
Brennan was appointed as OAT director last summer and arrived in Baghdad in July. He left only a few weeks later after his wife was diagnosed with cancer. He stepped down from his position in August.
Iraqi government officials could not be reached for comment.
Sen. Byron Dorgan, head of the Democratic Policy Committee, said the testimony was critical in light of upcoming legislation that would appropriate more than $170 billion for the wars in Iraq and Afghanistan. The Senate Appropriations Committee, of which Dorgan is a member, is expected to approve the legislation Thursday.
"It is a cruel irony if we are appropriating money next Thursday or did appropriate money last month or last year and that money ends up actually providing the resources for an insurgency in Iraq which ends up killing Americans," said Dorgan, D-N.D.
Pentagon presents biggest obstacle to Democrats' plan to boost college aid for veterans
Pentagon presents biggest obstacle to Democrats' plan to boost college aid for veterans
WASHINGTON: Veterans groups say it is time to expand college aid for former service members, and Democrats want to use an election year to do it. Their biggest obstacle? The Pentagon.
The Defense Department is lobbying against legislation proposed by Sen. Jim Webb, a Virginia Democrat, that would guarantee a full scholarship for service members to any in-state public university. According to defense officials, the plan would hurt its ability to retain service members because the new GI education bill would require only three years before the full benefit kicks in. The Defense Department wants the commitment to be extended to at least six years.
"We have no issue with the fact that Sen. Webb wishes to provide a more generous education benefit to troops," said Pentagon spokesman Geoff Morrell. "But we are certainly concerned that this would be eligible to them" so soon.
The Pentagon's opposition to Webb's bill underscores the difficulty the military has had in recruiting and retaining an all-volunteer force at a time when it is engaged in a war that is deeply unpopular with the American public.
Adding to the military's dilemma is the larger number of soldiers and Marines needed to fight the wars in Iraq and Afghanistan. Last year, the Pentagon recommended that the Army be increased by about 65,000 soldiers to a total of 547,000, and the Marines be increased by 27,000 to 202,000.
Today in Americas
McCain differs with Bush on climate changeConfronting questions, Obama assures Jews of his supportU.S. justices' conflicts halt apartheid appealThe difficulty in finding young people also can be attributed in part to low unemployment numbers in recent years. According to the nonpartisan Congressional Research Service, unemployment dropped from 6 percent in 2003 to 4.6 percent in 2007.
In recent months, the military has had to take creative steps to reach its desired troop numbers. A year ago, when Army recruiters did not meet their goal, the service announced new $20,000 (€13,000) bonuses for recruits and up to $40,000 (€26,000) if an enlistee signed up for at least four years.
The Army also has granted special exceptions to recruits with prior criminal records, medical problems or low-aptitude scores that would have otherwise disqualified them from service. Senior military officials defended the change in policy as justified because they say current restrictions were so stringent that many members in Congress would have been denied entrance to the ranks because of indiscretions from their youth.
Retention rates have been less troublesome in the military, with the Army and Marine Corps exceeding their goals by large margins in 2006 and staying strong in 2007. Studies have found that combat deployments can prompt service members to re-enlist, usually because of a sense of accomplishment.
Still, the Defense Department is worried that its retention numbers could fall as service members are asked to return repeatedly to Iraq and Afghanistan and they are given too much of an incentive to leave. One particular problem facing the military is its ability to hang on to seasoned combat veterans, including those in the elite forces, who are being lured to higher-paying jobs in the private sector.
Webb, a Vietnam veteran and critic of the Iraq war, counters that his legislation would be more effective in attracting new recruits and would offset any drop in the military's ranks.
"I can't think of a better way to broaden (the) propensity to serve than to offer a truly meaningful educational benefit, rather than simply taking that smaller demographic" of those already enlisted "and pound on it" with repeated combat tours, he said.
QTC has competition
QTC has competition
MES Solutions Awarded VA Contract to Administer C&P Exams for Veterans
HOUSTON, May 12 /PRNewswire/ -- MES Solutions announced today the award of the Department of Veterans Affairs contract to administer Compensation and Pension (C&P) disability examinations to veterans. The contract covers six VA Regional Offices: Indianapolis, Indiana, Des Moines, Iowa, St. Louis, Missouri, Lincoln, Nebraska, Cleveland, Ohio and Waco, Texas.
As the recognized national leader in the areas of workers' compensation, disability, and auto liability medical evaluations, MES Solutions brings over 30 years of medical evaluation experience to assist the Department of Veterans Affairs in processing Compensation and Pension Disability Examinations.
J. Patrick Cohan, President and COO of MES Solutions, stated, "As a veteran-owned company MES Solutions is honored to have been selected for this important project. We are committed to bringing our reputation of quality and timeliness to the disability evaluation process for the Department of Veterans Affairs and to our deserving service men and women."
ABOUT MES SOLUTIONS -- MES Solutions is a management service organization established in 1978 to provide legal, insurance, business, government and other entities direct access to multi-specialty examiners and reviewers with expertise in conducting independent medical evaluations, disability evaluations, peer review, and utilization management services. The first, oldest and largest organization of its type in the United States, MES Solutions is the only company accredited by the prestigious Utilization Review Accreditation Commission (URAC) for Independent Medical and Disability Evaluation services. For more information, visit http://www.messolutions.com .
Website: http://www.messolutions.com/
Attention Vietnam Vets or other AO exposed vets
If you served in Vietnam, and have any illnesses related to Hypertension, file a claim, or reopen previous claim.. also evidence of an association between exposure to the
chemicals of interest and the following health outcomes:
Laryngeal cancer
Cancer of the lung, bronchus, or trachea
Prostate cancer
Multiple myeloma
AL amyloidosis (category change from Update 2004)
Early-onset transient peripheral neuropathy
Porphyria cutanea tarda
Hypertension (category change from Update 2004)
Type 2 diabetes (mellitus)
Spina bifida in offspring of exposed people
also see message I sent July 31, 2007
http://groups.yahoo.com/group/VeteranIssues/
[VeteranIssues] Agent Orange Exposure and Hypertension
Data Suggest a Possible Association Between
Agent Orange Exposure and Hypertension, But the Evidence Is Limited
WASHINGTON — A new report from the Institute of Medicine finds suggestive but limited evidence that exposure to Agent Orange and other herbicides used during the Vietnam War is associated with an increased chance of developing high blood pressure in some veterans. The report is the latest update in a congressionally mandated series by the IOM that reviews every two years the evidence about the health effects of these herbicides and the type of dioxin — TCDD — that contaminated some of them.
see: http://www.elpasotimes.com/ci_9207845 article
VA begins taking claims related to Agent Orange exposure
By Chris Roberts / El Paso Times
Article Launched: 05/09/2008 12:56:04 PM MDT
Veterans Affairs has started taking claims for hypertension related to Agent Orange exposure, but it will determine at a later date whether the claims will be honored as being military "service-related," according to service organizations who received notices from VA.
A letter from the Texas Veterans Commission to its county service officers indicates that the claims are expected to be approved. The claims won't be actively "worked" until the VA makes its decision.
Requests for comment made to local VA agencies were referred to Washington, D.C. However, after two days, the public affairs office in Washington, D.C., still had no comment.
If the claims are approved, it could mean as much as $300 a month for Bob Snow, a retired soldier who worked as a forward observer directing artillery fire in the Vietnamese jungles. Snow - who worked with special forces soldiers and Montagnards, a French name for the indigenous people of Vietnam's central highlands - operated in areas sprayed with Agent Orange, a defoliant that knocked down vegetation used as cover by the enemy.
Snow retired in 1982 and was diagnosed with hypertension by the VA in 1983. However, the condition was not considered service related and therefore his disability compensation was limited. If hypertension is connected to Agent Orange claims, it could mean as much as an extra $300 per month for Snow, which he said will relieve some of the pressure of the rising cost of living.
Jeri Elena Mark worked as a radar mechanic for Hawk missile systems at a base in Vietnam where she watched planes drop Agent Orange on vegetation surrounding the camp, which was being shelled. She had experienced high blood pressure, a symptom of hypertension, during her Army career, usually associated with flashbacks from her Vietnam service.
She retired in 1985, but her exposure is not considered combat-related, so she would get no increase in disability payments. However, her family would receive benefits after her death if the cause is related to hypertension.
Chris Roberts may be reached at chrisr@elpasotimes.com; 546-6136.
Full report released below
http://www.nap.edu/catalog.php?record_id=11906
http://www.nap.edu/catalog.php?record_id=11906#toc
Table of contents is above.... review for illnesses you have
Below is from Page 11, of the executive summary
TABLE S-1
Summary of Findings in Occupational, Environmental, and
Veterans Studies Regarding the Association Between Specific Health Outcomes
and Exposure to Herbicides
a
Sufficient Evidence of Association
Evidence is sufficient to conclude that there is a positive association. That is, a positive association
has been observed between exposure to herbicides and the outcome in studies in which chance,
bias, and confounding could be ruled out with reasonable confidence. For example, if several small
studies that are free of bias and confounding show an association that is consistent in magnitude
and direction, there could be sufficient evidence of an association. There is sufficient evidence of
an association between exposure to the chemicals of interest and the following health outcomes:
Soft-tissue sarcoma (including heart)
Non-Hodgkin’s lymphoma
Chronic lymphocytic leukemia (CLL)
Hodgkin’s disease
Chloracne
Limited or Suggestive Evidence of Association
Evidence suggests an association between exposure to herbicides and the outcome, but a
firm conclusion is limited because chance, bias, and confounding could not be ruled out with
confidence. For example, a well-conducted study with strong findings in accord with less
compelling results from studies of populations with similar exposures could constitute such
evidence. There is limited or suggestive evidence of an association between exposure to the
chemicals of interest and the following health outcomes:
Laryngeal cancer
Cancer of the lung, bronchus, or trachea
Prostate cancer
Multiple myeloma
AL amyloidosis (category change from
Update 2004)
Early-onset transient peripheral neuropathy
Porphyria cutanea tarda
Hypertension (category change from
Update 2004)
Type 2 diabetes (mellitus)
Spina bifida in offspring of exposed people
Inadequate or Insufficient Evidence to Determine Association
The available studies are of insufficient quality, consistency, or statistical power to permit a
conclusion regarding the presence or absence of an association. For example, studies fail to
control for confounding, have inadequate exposure assessment, or fail to address latency. There is
inadequate or insufficient evidence to determine whether an association exists between exposure to
the chemicals of interest and the following health outcomes
that were explicitly reviewed:
Cancers of the oral cavity (including lips and tongue), pharynx (including tonsils), or
nasal cavity (including ears and sinuses)
Cancers of the pleura, mediastinum, and other unspecified sites within the respiratory
system and intrathoracic organs
Esophageal cancer (category change from
Update 2004)
Stomach cancer (category change from
Update 2004)
continued
Copyright National Academy of Sciences. All rights reserved.
This executive summary plus thousands more available at http://www.nap.edu
Veterans and Agent Orange: Update 2006
http://books.nap.edu/catalog/11906.html
12
VETERANS AND AGENT ORANGE: UPDATE 2006
Colorectal cancer (including small intestine and anus) (category change from
Update
2004
)
Hepatobiliary cancers (liver, gallbladder, and bile ducts)
Pancreatic cancer (category change from
Update 2004)
Bone and joint cancer
* Melanoma
Non-melanoma skin cancer (basal cell and squamous cell)
* Breast cancer
Cancers of reproductive organs (cervix, uterus, ovary, testes, and penis; excluding
prostate)
Urinary bladder cancer
Renal cancer
Cancers of brain and nervous system (including eye) (category change from
Update
2004
)
Endocrine cancers (thyroid, thymus, and other endocrine)
Leukemia (other than CLL)
Cancers at other and unspecified sites
Infertility
Spontaneous abortion (other than for paternal exposure to TCDD, which appears not to
be associated)
b
Neonatal or infant death and stillbirth in offspring of exposed people
Low birth weight in offspring of exposed people
Birth defects (other than spina bifida) in offspring of exposed people
Childhood cancer (including acute myelogenous leukemia) in offspring of exposed
people
Neurobehavioral disorders (cognitive and neuropsychiatric)
Movement disorders, including Parkinson’s disease and amyotrophic lateral sclerosis
(ALS)
Chronic peripheral nervous system disorders
Respiratory disorders
Gastrointestinal, metabolic, and digestive disorders (changes in liver enzymes, lipid
abnormalities, and ulcers)
Immune system disorders (immune suppression, allergy, and autoimmunity)
* Ischemic heart disease
Circulatory disorders (other than hypertension and perhaps ischemic heart disease)
Endometriosis
Effects on thyroid homeostasis
This committee used a classification that spans the full array of cancers. However, reviews for
nonmalignant conditions were conducted only if they were found to have been the subjects of
epidemiologic investigation or at the request of the Department of Veterans Affairs.
By default, any
health outcome on which no epidemiologic information has been found falls into this category.
Limited or Suggestive Evidence of
No Association
Several adequate studies, which cover the full range of human exposure, are consistent in not
showing a positive association between any magnitude of exposure to the herbicides of interest and
the outcome. A conclusion of “no association” is inevitably limited to the conditions, exposures,
and length of observation covered by the available studies.
In addition, the possibility of a very
small increase in risk at the exposure studied can never be excluded.
There is limited or suggestive
TABLE S-1
Continued
Copyright National Academy of Sciences. All rights reserved.
This executive summary plus thousands more available at http://www.nap.edu
Veterans and Agent Orange: Update 2006
http://books.nap.edu/catalog/11906.html
SUMMARY
13
For the first time, a VAO committee found itself deadlocked with respect to
classifying the evidence for several health outcomes. The committee could not
reach consensus about the strength of the evidence concerning association of
herbicide exposure with three health outcomes: two cancers, breast cancer and
melanoma, and the specific cardiovascular condition, ischemic heart disease. In
each case, the debate was whether there was now enough evidence to move the
condition from “inadequate or insufficient evidence to determine association” to
“limited or suggestive evidence of association.”
As mandated by PL 102-4, the distinctions among categories are based on
statistical association, not on causality. The committee was directed to review the
scientific data, not to recommend VA policy; therefore, conclusions reported in
Table S-1 are not intended to imply or suggest policy decisions. The conclusions
are related to associations between exposure and outcomes in human populations,
not to the likelihood that any individual’s health problem is associated with or
caused by the herbicides in question.
Risk in Vietnam Veterans
There have been numerous health studies of Vietnam veterans, but most have
been hampered by relatively poor measures of exposure to herbicides or TCDD
and by other methodologic problems. In light of those problems, many conclusions
regarding associations between exposure to the chemicals of interest and
disease have been based on studies of people exposed in various occupational
and environmental settings rather than on studies of Vietnam veterans, although
studies of health consequences in the maturing veterans themselves have now
begun to generate more informative findings. The committee believes that there
is sufficient evidence to reach general or qualitative conclusions about associa-
TABLE S-1
Continued
evidence of
no association between exposure to the herbicides of interest and the following health
outcomes:
Spontaneous abortion and paternal exposure to TCDD
b
a
Herbicides indicates the following chemicals of interest: 2,4-dichlorophenoxyacetic acid (2,4-D),
2,4,5-trichlorophenoxyacetic acid (2,4,5-T) and its contaminant 2,3,7,8-tetrachlorodibenzo-
p-dioxin
(TCDD, or dioxin), cacodylic acid, and picloram. The evidence regarding association was drawn from
occupational, environmental, and veteran studies in which people were exposed to the herbicides used
in Vietnam, to their components, or to their contaminants.
b
This conclusion appropriately constrained by specific chemical and exposed parent was drawn in
Update 2002
but was not carried into the summary table.
* The committee was unable to reach consensus as to whether these endpoints had
Limited or
Suggestive Evidence of Association
or had Inadequate or Insufficient Evidence to Determine
Association
, and so these were left in the lower category.
Copyright National Academy of Sciences. All rights reserved.
This executive summary plus thousands more available at http://www.nap.edu
Veterans and Agent Orange: Update 2006
http://books.nap.edu/catalog/11906.html
14
VETERANS AND AGENT ORANGE: UPDATE 2006
tions between herbicide exposure and health outcomes, but the lack of adequate
exposure data on Vietnam veterans themselves makes it difficult to estimate the
degree of increased risk of disease in Vietnam veterans, as a group or individually.
Without information on the extent of herbicide exposure among Vietnam veterans
and quantitative information about the dose–time–response relationship for
each health outcome in humans, estimation of the risks experienced by veterans
exposed to the compounds of interest during the Vietnam War is not possible.
Because of those limitations, only general assertions can be made about risks
to Vietnam veterans, depending on which category of association has been attributed
to a given health outcome. If there were “limited or suggestive evidence
of
no association” between herbicide exposure and a health outcome, the evidence
would suggest no increased risk of the outcome among Vietnam veterans
attributable to exposure to the compounds of interest (at least for the conditions,
exposures, and lengths of observation covered by the studies reviewed). The only
health outcome remaining in this category is spontaneous abortion with respect to
paternal exposure specifically to TCDD. Even qualitative estimates are not possible
when there is “inadequate or insufficient” evidence of an association. For
outcomes categorized as having “sufficient” or “limited or suggestive” evidence
of an association with herbicide exposure, the lack of exposure information on
Vietnam veterans prevents calculation of precise risk estimates.
The requisite information to assign risk estimates continues to be absent despite
concerted efforts to model the exposure of the troops in Vietnam, to measure
the serum TCDD concentrations of individual veterans, and to model the dynamics
of retention and clearance of TCDD in the human body. Accordingly, this
committee has deleted the repetitious statements about the inability to calculate
risk for Vietnam veterans that had appeared with each health outcome in prior
updates. In place of those repeated statements, the committee states a general
conclusion that, at least for the present, it is not possible to derive quantitative
estimates of any increased risks of various adverse health effects that Vietnam
veterans may have experienced in association with exposure to the herbicides
sprayed in Vietnam.
