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The Vietnam War was fought in a jungle environment that provided cover to the enemy and made battlefield observations difficult, so military strategists used herbicides to remove foliage along key roads and waterways, defoliate areas surrounding enemy bases and supply and communications routes, and improve visibility in heavily canopied forests. The last three decades have seen an ongoing debate about the effects of this military use of herbicides and the potential adverse long-term health effects on those who may have been exposed to these herbicides. In response to these concerns, the Air Force Health Study (AFHS) was created to investigate the potential relationship between the herbicides used and the health problems of those exposed. Disposition of the Air Force Health Study assesses the scientific merit of the AFHS operations and procedures, and makes recommendations for improvement.
The Air Force Health Study (AFHS) is a longitudinal, prospective epidemiologic study of more than 2,700 men followed for approximately 20 years. This cohort participated in up to six intensive physical examinations with high rates of compliance. In addition to a complete record of clinical measurements and observations collected at these exams, serum and other biological samples were obtained and preserved. Extensive questionnaires addressing health, lifestyle, and socioeconomic status were administered during each exam, and other information was obtained about the participants' employment, families and offspring, and potential sources of environmental exposures. While the study was completed in 2006, the extensive health data linked to several types of longitudinally collected biologic specimens - some 91,000 serum, whole blood, urine, semen, and adipose tissue specimens - remain a resource for additional research. The AFHS assets are exceptional in the sheer multitude and range of types of information available for each participant. The longitudinal nature of the AFHS - with its extended follow-up, high rates of retention, and repeat biological samples - provides a valuable opportunity for research beyond the original aims of the study. Currently, the Institute of Medicine is the custodian of these assets. The Air Force Health Study Assets Research Program outlines the feasibility and advisability of maintaining the biospecimens based on interest generated from the general scientific community and results of pilot projects and other research projects using the AFHS assets. According to this report, sustaining access to the AFHS biospecimens and data benefits the veterans community and the public at large, who will gain from the information derived from studies of the assets. . This report discusses the scientific value of the AFHS data and biospecimens and the lessons learned in managing access to the assets.
For almost four decades, controversy has surrounded the tactical use of herbicides in Southeast Asia by the United States military. Few environmental or occupational health issues have received the sustained international attention that has been focused on Agent Orange, the major tactical herbicide deployed in Southern Vietnam. With the opening and establishment of normal relations between the United States and the Socialist Republic of Vietnam in 1995, the time has come for a thorough re-examination of the military use of Agent Orange and other "tactical herbicides" in Southern Vietnam, and the subsequent actions that have been taking place since their use in Vietnam. The United States Department of Defense has had the major role in all military operations involving the use of tactical herbicides, including that of Agent Orange. This included the Department's purchase, shipment and tactical use of herbicides in Vietnam, its role in the disposition of Agent Orange after Vietnam, its role in conducting long-term epidemiological investigations of the men of Operation RANCH HAND, and its sponsorship of ecological and environmental fate studies. This book was commissioned by The Office of the Deputy Under Secretary of Defense (Installations and Environment) with the intent of providing documentation of the knowledge on the history, use, disposition and environmental fate of Agent Orange and its associated dioxin.
From 1972 to 1982, approximately 1,500-2,100 US Air Force Reserve personnel trained and worked on C-123 aircraft that had formerly been used to spray herbicides in Vietnam as part of Operation Ranch Hand. After becoming aware that some of the aircraft on which they had worked had previously served this purpose, some of these AF Reservists applied to the US Department of Veterans Affairs (VA) for compensatory coverage under the Agent Orange Act of 1991. The Act provides health care and disability coverage for health conditions that have been deemed presumptively service-related for herbicide exposure during the Vietnam War. The VA denied the applications on the basis that these veterans were ineligible because as non-Vietnam-era veterans or as Vietnam-era veterans without "boots on the ground" service in Vietnam, they were not covered. However, with the knowledge that some air and wipe samples taken between 1979 and 2009 from some of the C-123s used in Operation Ranch Hand showed the presence of agent orange residues, representatives of the C-123 Veterans Association began a concerted effort to reverse VA's position and obtain coverage. At the request of the VA, Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft evaluates whether or not service in these C-123s could have plausibly resulted in exposures detrimental to the health of these Air Force Reservists. The Institute of Medicine assembled an expert committee to address this question qualitatively, but in a scientific and evidence-based fashion. This report evaluates the reliability of the available information for establishing exposure and addresses and places in context whether any documented residues represent potentially harmful exposure by characterizing the amounts available and the degree to which absorption might be expected. Post-Vietnam Dioxin Exposure rejects the idea that the dioxin residues detected on interior surfaces of the C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure. Accordingly, this report states with confidence that the Air Force Reservists were exposed when working in the Operation Ranch Hand C-123s and so experienced some increase in their risk of a variety of adverse responses.
This report represents the results of the health assessment of the 1, 016 Ranch Hands and the 1,293 Comparisons who participated in the 1985 followup examination of the Air Force Health Study. The purpose of the study is to determine whether long-term health effects exist and can be attributed to occupational exposure to herbicides. The result show a subtle but consistent narrowing of medical differences between the two groups since the Baseline study in 1982; however, the Ranch Hands continue to manifest slightly more minor adverse health conditions than the Comparisons. Continued surveillance of these groups is indicated. The report concludes that there is not sufficient evidence to implicate a causal relationship between herbicide exposure and adverse health in the Ranch Hand group. Keywords: Health surveys; Epidemiologic investigation; Phenoxy herbicides; Herbicide orange; Dioxin; Air Force health study, Morbidity.
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.
Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases.