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Veterans and Agent Orange:: Length of Presumptive Period for Association Between Exposure and Respiratory Cancer
     

Veterans and Agent Orange:: Length of Presumptive Period for Association Between Exposure and Respiratory Cancer

by Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides
 

From 1962 to 1971, US military forces sprayed herbicides over Vietnam to strip the thick jungle canopy that helped conceal opposition forces, to destroy crops that enemy forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D),

Overview

From 1962 to 1971, US military forces sprayed herbicides over Vietnam to strip the thick jungle canopy that helped conceal opposition forces, to destroy crops that enemy forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the majority of the herbicides sprayed. Agent Orange was a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, one form of dioxin) was an unintended contaminant from the production of 2,4,5-T and was present in Agent Orange and some other formulations sprayed in Vietnam.

In 1991, because of continuing uncertainty about the long-term health effects on Vietnam veterans of the herbicides sprayed, Congress passed Public Law 102-4, the Agent Orange Act of 1991. In response to the request from the VA, IOM extended the service of the Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides that was responsible for Update 2002 to address the question of presumptive period and respiratory cancer. The charge to the committee was to undertake a review and evaluation of the evidence regarding the period between cessation of exposure to herbicides used in Vietnam and their contaminants (2,4-D, 2,4,5-T and its contaminant TCDD, cacodylic acid, and picloram) and the occurrence of respiratory cancer.

Editorial Reviews

Doody's Review Service
Reviewer: J. Thomas Pierce, MBBS PhD(Navy Environmental Health Center)
Description: The Institute of Medicine (IOM) appointed a committee to review health effects in Vietnam veterans exposed to herbicides. Their charge specifically examines the length of the presumptive period for association between exposure and respiratory cancer. This small volume follows the 1994 book, Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam, and its biennial updates published through 2002.
Purpose: Specifically, this book examines the length of the presumptive period for association between exposure and respiratory cancers. The committee's charge was limited in the sense of "limited/suggestive" evidence of an association between at least one chemical, that being 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and development of respiratory cancers.
Audience: This 56-page treatise will likely be referenced by claims examiners, legal staffs, and others involved in the administrative process relative to Vietnam veterans.
Features: This book is organized into four primary chapters, the introduction, evaluation of latent and presumptive periods, epidemiologic studies and conclusions. There is also an executive summary section. The book includes a hypothetical construct describing the time courses for exposure and manifestation of disease as well as a model showing how time-related factors are connected.
Assessment: The authors have been somewhat selective in limiting toxicology to merely "toxicokinetic and mechanistic data related to TCDD." While they may have performed calculations to describe critical serum or fat concentrations of TCDD, sample calculations or findings are not included. I was also disappointed that they did not choose to discuss any toxicodynamic data. Their exclusion of discussion of cell-mediated immunosuppressive properties for TCDD (estimated as long as 20 years) is similarly puzzling to me. However, in fairness, the book is probably adequate given the limitations imposed upon the committee's work.
3 Stars from Doody

Product Details

ISBN-13:
9780309091886
Publisher:
National Academies Press
Publication date:
04/02/2004
Pages:
74
Product dimensions:
6.00(w) x 9.00(h) x (d)

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