Committee to Review the Evidence Regarding the Link Between Exposure to Agent Orange and Diabetes's Books

Veterans and Agent Orange

Herbicide/Dioxin Exposure and Type 2 Diabetes

By: Institute of Medicine,Division of Health Promotion and Disease Prevention,Committee to Review the Evidence Regarding the Link Between Exposure to Agent Orange and Diabetes

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Veterans and Agent Orange

Herbicide/Dioxin Exposure and Type 2 Diabetes

By: Institute of Medicine,Division of Health Promotion and Disease Prevention,Committee to Review the Evidence Regarding the Link Between Exposure to Agent Orange and Diabetes

In response to the concerns voiced by Vietnam veterans and their families, Congress called upon the National Academy of Sciences (NAS) to review the scientific evidence on the possible health effects of exposure to Agent Orange and other herbicides. This call resulted in the creation of the first NAS Institute of Medicine Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides in 1992. The committee published its initial findings in the 1994 report Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. This report is the result of a 1999 request from the Department of Veterans Affairs (DVA) under the aegis of the Veterans and Agent Orange research program. Specifically, DVA asked the committee to examine evidence regarding the association, if any, between Type 2 diabetes and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. Veterans and Agent Orange: Herbicide/Dioxin Exposure and Type 2 Diabetes reviews the scientific evidence regarding the association, if any, between Type 2 diabetes1 and exposure to dioxin2 and other chemical compounds in herbicides used in Vietnam. This report examines, to the extent that available data permitted meaningful determinations, (1) whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiologic methods used to detect the association; (2) the increased risk of the disease among those exposed to herbicides during Vietnam service; and (3) whether there is a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.

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National Academies Press

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ISBN 10

0309171490

ISBN 13

9780309171496

Veterans and Agent Orange

Update 1998

By: Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Second Biennial Update),Institute of Medicine

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Veterans and Agent Orange

Update 1998

By: Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Second Biennial Update),Institute of Medicine

Third in a series of six congressionally mandated studies occurring biennially, this book is an updated review and evaluation of the available scientific evidence regarding the statistical association between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposures. As part of the review, the committee convened a workshop at which issues surrounding the reanalysis and the combination of existing data on the health effects of herbicide and dioxin exposure were addressed. This book builds upon the information developed by the IOM committees responsible for the 1994 original report, Veterans and Agent Orange, and Veterans and Agent Orange: Update 1996, but will focus on scientific studies and other information developed since the release of these reports. The two previous volumes have noted that sufficient evidence exists to link soft tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne with exposure. The books also noted that there is "limited or suggestive" evidence to show an association with exposure and a neurological disorder in veterans and with the congenital birth defect spina bifida in veterans' children. 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.

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625

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National Academies Press

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ISBN 10

0309524687

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9780309524681

Veterans and Agent Orange

Update 2010

By: Institute of Medicine,Board on the Health of Select Populations,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Eighth Biennial Update)

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Veterans and Agent Orange

Update 2010

By: Institute of Medicine,Board on the Health of Select Populations,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Eighth Biennial Update)

Because of continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Congress passed the Agent Orange Act of 1991. The legislation directed the Secretary of Veterans Affairs (VA) to request the Institite of Medicine to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam to be followed by biennial updates. The 2010 update recommends further research of links between Vietnam service and specific health outcomes, most importantly COPD, tonsil cancer, melanoma, brain cancer, Alzheimer's disease, and paternally transmitted effects to offspring.

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836

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National Academies Press

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ISBN 10

0309214475

ISBN 13

9780309214476

Veterans and Agent Orange

Update 11 (2018)

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Eleventh Biennial Update)

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Veterans and Agent Orange

Update 11 (2018)

From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those 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 bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, 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), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academies of Sciences, Engineering, and Medicine was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 11 (2018) examines peer-reviewed scientific reports concerning associations between various health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published between September 30, 2014, and December 31, 2017, and integrates this information with the previously established evidence database.

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739

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National Academies Press

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ISBN 10

0309477166

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9780309477161

Improving the Presumptive Disability Decision-Making Process for Veterans

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans

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Improving the Presumptive Disability Decision-Making Process for Veterans

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans

The United States has long recognized and honored the service and sacrifices of its military and veterans. Veterans who have been injured by their service (whether their injury appears during service or afterwards) are owed appropriate health care and disability compensation. For some medical conditions that develop after military service, the scientific information needed to connect the health conditions to the circumstances of service may be incomplete. When information is incomplete, Congress or the Department of Veterans Affairs (VA) may need to make a "presumption" of service connection so that a group of veterans can be appropriately compensated. The missing information may be about the specific exposures of the veterans, or there may be incomplete scientific evidence as to whether an exposure during service causes the health condition of concern. For example, when the exposures of military personnel in Vietnam to Agent Orange could not be clearly documented, a presumption was established that all those who set foot on Vietnam soil were exposed to Agent Orange. The Institute of Medicine (IOM) Committee was charged with reviewing and describing how presumptions have been made in the past and, if needed, to make recommendations for an improved scientific framework that could be used in the future for determining if a presumption should be made. The Committee was asked to consider and describe the processes of all participants in the current presumptive disability decision-making process for veterans. The Committee was not asked to offer an opinion about past presumptive decisions or to suggest specific future presumptions. The Committee heard from a range of groups that figure into this decision-making process, including past and present staffers from Congress, the VA, the IOM, veterans service organizations, and individual veterans. The Department of Defense (DoD) briefed the Committee about its current activities and plans to better track the exposures and health conditions of military personnel. The Committee further documented the current process by developing case studies around exposures and health conditions for which presumptions had been made. Improving the Presumptive Disability Decision-Making Process for Veterans explains recommendations made by the committee general methods by which scientists, as well as government and other organizations, evaluate scientific evidence in order to determine if a specific exposure causes a health condition.

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813

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National Academies Press

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ISBN 10

030910730X

ISBN 13

9780309107303

Immunization Safety Review

Thimerosal-Containing Vaccines and Neurodevelopmental Disorders

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Immunization Safety Review Committee

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Immunization Safety Review

Thimerosal-Containing Vaccines and Neurodevelopmental Disorders

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Immunization Safety Review Committee

In this report, the Immunization Safety Review committee examines the hypothesis of whether or not the use of vaccines containing the preservative thimerosal can cause neurodevelopmental disorders (NDDs), specifically autism, attention deficit/hyperactivity disorder (ADHD), and speech or language delay.

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137

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National Academies Press

Published Date

ISBN 10

0309076366

ISBN 13

9780309076364

Disposition of the Air Force Health Study

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on the Disposition of the Air Force Health Study

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Disposition of the Air Force Health Study

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on the Disposition of the Air Force Health Study

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.

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277

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National Academies Press

Published Date

ISBN 10

0309100992

ISBN 13

9780309100991

Ethical and Scientific Issues in Studying the Safety of Approved Drugs

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Ethical and Scientific Issues in Studying the Safety of Approved Drugs

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Ethical and Scientific Issues in Studying the Safety of Approved Drugs

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Ethical and Scientific Issues in Studying the Safety of Approved Drugs

An estimated 48 percent of the population takes at least one prescription drug in a given month. Drugs provide great benefits to society by saving or improving lives. Many drugs are also associated with side effects or adverse events, some serious and some discovered only after the drug is on the market. The discovery of new adverse events in the postmarketing setting is part of the normal natural history of approved drugs, and timely identification and warning about drug risks are central to the mission of the Food and Drug Administration (FDA). Not all risks associated with a drug are known at the time of approval, because safety data are collected from studies that involve a relatively small number of human subjects during a relatively short period. Written in response to a request by the FDA, Ethical and Scientific Issues in Studying the Safety of Approved Drugs discusses ethical and informed consent issues in conducting studies in the postmarketing setting. It evaluates the strengths and weaknesses of various approaches to generate evidence about safety questions, and makes recommendations for appropriate followup studies and randomized clinical trials. The book provides guidance to the FDA on how it should factor in different kinds of evidence in its regulatory decisions. Ethical and Scientific Issues in Studying the Safety of Approved Drugs will be of interest to the pharmaceutical industry, patient advocates, researchers, and consumer groups.

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292

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National Academies Press

Published Date

ISBN 10

0309218136

ISBN 13

9780309218139

Contaminated Water Supplies at Camp Lejeune

Assessing Potential Health Effects

By: National Research Council,Division on Earth and Life Studies,Board on Environmental Studies and Toxicology,Committee on Contaminated Drinking Water at Camp Lejeune

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Contaminated Water Supplies at Camp Lejeune

Assessing Potential Health Effects

By: National Research Council,Division on Earth and Life Studies,Board on Environmental Studies and Toxicology,Committee on Contaminated Drinking Water at Camp Lejeune

In the early 1980s, two water-supply systems on the Marine Corps Base Camp Lejeune in North Carolina were found to be contaminated with the industrial solvents trichloroethylene (TCE) and perchloroethylene (PCE). The water systems were supplied by the Tarawa Terrace and Hadnot Point watertreatment plants, which served enlisted-family housing, barracks for unmarried service personnel, base administrative offices, schools, and recreational areas. The Hadnot Point water system also served the base hospital and an industrial area and supplied water to housing on the Holcomb Boulevard water system (full-time until 1972 and periodically thereafter). This book examines what is known about the contamination of the water supplies at Camp Lejeune and whether the contamination can be linked to any adverse health outcomes in former residents and workers at the base.

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338

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National Academies Press

Published Date

ISBN 10

0309136997

ISBN 13

9780309136990

Application of Toxicogenomics to Cross-Species Extrapolation

A Report of a Workshop

By: National Research Council,Division on Earth and Life Studies,Board on Life Sciences,Board on Environmental Studies and Toxicology,Committee on Emerging Issues and Data on Environmental Contaminants,Committee on Applications of Toxicogenomics to Cross-Species Extrapolation

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Application of Toxicogenomics to Cross-Species Extrapolation

A Report of a Workshop

Some of what we know about the health effects of exposure to chemicals from food, drugs, and the environment come from studies of occupational, inadvertent, or accident-related exposures. When there is not enough human data, scientists rely on animal data to assess risk from chemical exposure and make health and safety decisions. However, humans and animals can respond differently to chemicals, including the types of adverse effects experienced and the dosages at which they occur. Scientists in the field of toxicogenomics are using new technologies to study the effects of chemicals. For example, in response to a particular chemical exposure, they can study gene expression ("transcriptomics"), proteins ("proteomics") and metabolites ("metabolomics"), and they can also look at how individual and species differences in the underlying DNA sequence itself can result in different responses to the environment. Based on a workshop held in August 2004, this report explores how toxicogenomics could enhance scientists' ability to make connections between data from experimental animal studies and human health.

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National Academies Press

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ISBN 10

0309181682

ISBN 13

9780309181686

Applications of Toxicogenomic Technologies to Predictive Toxicology and Risk Assessment

By: National Research Council,Division on Earth and Life Studies,Board on Life Sciences,Board on Environmental Studies and Toxicology,Committee on Applications of Toxicogenomic Technologies to Predictive Toxicology

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Applications of Toxicogenomic Technologies to Predictive Toxicology and Risk Assessment

The new field of toxicogenomics presents a potentially powerful set of tools to better understand the health effects of exposures to toxicants in the environment. At the request of the National Institute of Environmental Health Sciences, the National Research Council assembled a committee to identify the benefits of toxicogenomics, the challenges to achieving them, and potential approaches to overcoming such challenges. The report concludes that realizing the potential of toxicogenomics to improve public health decisions will require a concerted effort to generate data, make use of existing data, and study data in new waysâ€"an effort requiring funding, interagency coordination, and data management strategies.

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300

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National Academies Press

Published Date

ISBN 10

0309178894

ISBN 13

9780309178891

Veterans and Agent Orange

Update 11 (2018)

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Veterans and Agent Orange

Update 11 (2018)

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739

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ISBN 10

0309477166

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9780309477161

Veterans and Agent Orange

Update 2004

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Fifth Biennial Update)

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Veterans and Agent Orange

Update 2004

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Fifth Biennial Update)

Sixth in a series of congressionally mandated studies, this book is an updated review and evaluation of the available evidence regarding the statistical assoication between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposure. This book builds upon the information contained in the earlier books in the series: Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (1994) Veterans and Agent Orange: Update 1996 Veterans and Agent Orange: Update 1998 Veterans and Agent Orange: Update 2000 Veterans and Agent Orange: Update 2002 Veterans and Agent Orange: Herbicides and Dioxin Exposure and Type 2 Diabetes (2000) Veterans and Agent Orange: Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans (2002) Veterans and Agent Orange: Update 2004 focuses primarily on scientific studies and other information developed since the release of these earlier books. The previous volumes have noted that sufficient evidence exists to link chronic lymphocytic leukemia, soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne with exposure. The books also noted that there is "limited or suggestive" evidence of an association between exposure and respiratory cancers, prostate cancer, multiple myeloma, the metabolic disorder porphyria cutanea tarda, early-onset transient peripheral neuropathies, Type 2 diabetes, and the congenital birth defect spinal bifida in veterans' children. 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.

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681

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National Academies Press

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ISBN 10

0309095980

ISBN 13

9780309095983

Veterans and Agent Orange

Update 2000

By: Institute of Medicine,Division of Health Promotion and Disease Prevention,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Third Biennial Update)

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Veterans and Agent Orange

Update 2000

By: Institute of Medicine,Division of Health Promotion and Disease Prevention,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Third Biennial Update)

Veterans and Agent Orange: Update 2000 examines the state of the scientific evidence regarding associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. It is the fourth in a series of comprehensive reviews of epidemiologic and toxicologic studies of the agents used as defoliants during the Vietnam War. Over forty health outcomes in veterans and their children are addressed. Among the report's conclusions is that there is sufficient evidence of a link between exposure and the development of soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne in veterans. Additionally, it found that scientific studies offer "limited or suggestive" evidence of an association with other diseases in veteransâ€"including Type 2 diabetes, respiratory cancers, prostate cancer, multiple myeloma and some forms of transient peripheral neuropathyâ€"as well as the congenital birth defect spina bifida in veterans' children.

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623

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National Academies Press

Published Date

ISBN 10

0309075521

ISBN 13

9780309075527

Veterans and Agent Orange

Update 1998

By: Institute of Medicine,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Second Biennial Update)

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Veterans and Agent Orange

Update 1998

By: Institute of Medicine,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Second Biennial Update)

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625

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National Academies Press

Published Date

ISBN 10

0309063264

ISBN 13

9780309063265

Veterans and Agent Orange

Update 2014

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on the Health of Select Populations,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Tenth Biennial Update)

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Veterans and Agent Orange

Update 2014

From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those 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 bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, 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), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 2014 is a cumulative report of the series thus far.

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1115

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National Academies Press

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ISBN 10

0309380669

ISBN 13

9780309380669

Veterans and Agent Orange

Update 2002

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Fourth Biennial Update)

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Veterans and Agent Orange

Update 2002

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Fourth Biennial Update)

This book updates and evaluates the available scientific evidence regarding statistical associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam, focusing on new scientific studies and literature.

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