January 2003

Agent Orange And Related Issues

 

The Vietnam Conflict

An estimated 2.6 million personnel served within the borders of South Vietnam and in adjacent waters.

 

Agent Orange

Agent Orange was a herbicide used in Vietnam to defoliate trees and remove cover for the enemy.Agent Orange spraying missions were flown in Vietnam between January 1965 and April 1970.Shipped in orange-striped barrels, it was a reddish-brown liquid containing four chemicals:2,4,5-trichlorophenoxyacetic acid (2,4,5-T), 2,4-dichlorophenoxyacetic acid (2,4-D), cacodylic acid and picloram.The 2,4,5-T was contaminated in the manufacturing process with dioxin.Several herbicides were sprayed in Vietnam at different times�during different years as well as during different seasons because of the variety of vegetation and environmental conditions.

 

The history of herbicides for military use dates to World War II.During the early part of the war, interest arose in chemicals that could be used for crop destruction. Two chemicals were developed as a result of those early efforts -- 2,4-D and 2,4,5-T. Although neither chemical was used in World War II, the value of their use in weed and brush programs was recognized, and both chemicals have been used widely throughout the world since the 1940s by farmers, foresters and homeowners.

 

Medical Services For Vietnam Veterans

VA has offered special access to health services and studies since 1978, when it initiated a medical surveillance program for Vietnam veterans with health concerns.By 1981, VA offered priority medical care to Vietnam veterans with any health problems which may have resulted from Agent Orange exposure.That program continues today.

 

Special Compensation for Disease

As with other veterans, Vietnam veterans with disabilities incurred or aggravated by military service may receive monthly VA compensation.As knowledge has grown from studies of Agent Orange, some diseases that may not have become evident in service have been recognized as service-connected.Based on clinical research, the following diseases are now on VA�s Agent Orange list:chloracne, Hodgkin�s disease, multiple myeloma, non-Hodgkin�s lymphoma, porphyria cutanea tarda, respiratory cancers (lung, bronchus, larynx and trachea), soft-tissue sarcoma, acute and subacute peripheral neuropathy, prostate and adult-onset diabetes.

 

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In addition, monetary benefits, health care and vocational rehabilitation services are provided to Vietnam veterans� offspring with spina bifida, a congenital birth defect of the spine.VA presumes that all military personnel who served in Vietnam and who have one of the listed diseases were exposed to Agent Orange.

 

VA Response To Concerns About Agent Orange

VA developed the Agent Orange Registry Examination Program in 1978 to identify Vietnam veterans concerned about Agent Orange exposure.Nearly 300,000 Vietnam veterans have been provided examinations under the Registry program as of December 1999.VA maintains a computerized registry of data from these examinations.Registrants receive periodic updates on Agent Orange studies and VA policy.

 

VA�s Advisory Committee on Health-Related Effects of Herbicides was established in 1979 to examine issues surrounding the possible health effects of herbicides on Vietnam veterans.VA also established the Veterans� Advisory Committee on Environmental Hazards, consisting of non-VA experts in dioxin and radiation exposure as well as several lay members, to advise the Secretary on the results of Agent Orange-related research, and regulatory, administrative and legislative initiatives.Since passage of a 1991 law (PL102-4), which directs VA to request that the National Academy of Sciences (NAS) review diseases associated with herbicide exposure, the committee�s work has been superseded by the NAS review.

 

The NAS reviews and evaluates scientific literature about Agent Orange.NAS reviewed more than 6,000 abstracts of scientific or medical articles and analyzed 230 epidemiological studies before its initial July 1993 report, which led to the inclusion of additional diseases on the list for presumptive service-connection.The NAS review has been continuing, with acute and subacute peripheral neuropathy and prostate cancer added to VA�s presumptive list after the NAS issued an updated report in March 1996.Also based on that report�s findings of new �limited or suggestive evidence� of an association between herbicides and spina bifida in the children of Vietnam veterans, VA proposed legislation to aid children of Vietnam veterans who suffer from that disorder, and established a reproductive outcomes research center to investigate potential environmental hazards of military service.An NAS update, released in February 1999, contained no major changes in its classifications of diseases.

 

In April 2000, VA asked NAS to broaden an ongoing study to include the results of the military�s latest report on Agent Orange, which found a high rate of adult-onset diabetes among Vietnam veterans who participated in spraying operations.

 

In October 2000, NAS issued a report that found �limited / suggestive evidence� of a link between adult-onset (Type 2) diabetes and herbicides used in Vietnam, including Agent Orange.The IOM report concluded that other traditional risk factors for diabetes � heredity, weight and sedentary lifestyle � far outweigh the risks of Agent Orange.

 

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Still, based upon that NAS report, VA Secretary Anthony Principi announced he was directing the addition of Type 2 diabetes to the list of presumptive conditions associated with herbicide exposure.Rules permitting eligible veterans to apply for and receive compensation for adult-onset (Type 2) diabetes went into effect July 9, 2001.VA officials estimate that more than 178,000 veterans might qualify for disability compensation under the new rules within five years.

 

On Jan. 23, 2003, IOM issued a report citing "sufficient evidence of an association between exposure to herbicides" during the Vietnam War and chronic lymphocytic leukemia (CLL).That same day, Secretary Principi announced that he was directing VA officials to draft regulations adding CLL to the list of presumptive conditions associated with herbicide exposure.

 

 

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