Veterans and Agent Orange

1007 Pages·2015·5.24 MB·English

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Veterans and Agent Orange: Update 2012
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1006 pages | 6 x 9 | HARDBACK
ISBN 978-0-309-28886-6 | DOI 10.17226/18395
AUTHORS
BUY THIS BOOK Committee to Review the Health Effects in Vietnam Veterans of Exposure to
Herbicides (Ninth Biennial Update); Board on the Health of Select Populations;
Institute of Medicine
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Veterans and Agent Orange: Update 2012
V
eterans
Agent
and
Orange
Update 2012
Committee to Review the Health Effects in
Vietnam Veterans of Exposure to Herbicides
(Ninth Biennial Update)
Board on the Health of Select Populations
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
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NOTICE: The project that is the subject of this report was approved by the Governing
Board of the National Research Council, whose members are drawn from the councils of
the National Academy of Sciences, the National Academy of Engineering, and the Institute
of Medicine. The members of the committee responsible for the report were chosen for
their special competences and with regard for appropriate balance.
This study was supported by Contract/Grant No. VA241-P-2024 between the National
Academy of Sciences and the US Department of Veterans Affairs. Any opinions, findings,
conclusions, or recommendations expressed in this publication are those of the author(s)
and do not necessarily reflect the views of the organizations or agencies that provided
support for the project.
International Standard Book Number-13: 978-0-309-28886-6
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Suggested citation: IOM (Institute of Medicine). 2014. Veterans and Agent Orange: Up-
date 2012. Washington, DC: The National Academies Press.
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
Advising the Nation. Improving Health.
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
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are chair and vice chair, respectively, of the National Research Council.
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Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
COMMITTEE TO REVIEW THE HEALTH EFFECTS
IN VIETNAM VETERANS OF EXPOSURE TO
HERBICIDES (NINTH BIENNIAL UPDATE)
MARY K. WALKER (Chair), Professor, Department of Pharmaceutical
Sciences, University of New Mexico, Albuquerque
REBECCA A. BETENSKY, Professor, Department of Biostatistics, Harvard
School of Public Health, Boston, Massachusetts
MICHAEL J. CARVAN III, Shaw Associate Professor, School of Freshwater
Sciences, University of Wisconsin–Milwaukee
SCOTT DAVIS, Professor and Chair, Department of Epidemiology, School of
Public Health, University of Washington, Seattle
NAIHUA DUAN, Professor, Department of Biostatistics, Columbia University
Medical Center, New York, New York
STEPHANIE M. ENGEL, Associate Professor, Department of Epidemiology,
Gillings School of Global Public Health, University of North Carolina at
Chapel Hill
JENNIFER R. GRANDIS, Professor and Vice Chair for Research,
Department of Otolaryngology and Pharmacology, University of
Pittsburgh, Pennsylvania
KARL KELSEY, Professor, Epidemiology and Pathology and Laboratory
Medicine, Brown University, Providence, Rhode Island
STEPHEN B. KRITCHEVSKY, Director, J. Paul Sticht Center on Aging,
Wake Forest University Baptist Medical Center, Winston-Salem,
North Carolina
JAMES R. OLSON, Professor, Department of Pharmacology and Toxicology,
School of Medicine and Biomedical Sciences, University at Buffalo, New
York
GAIL S. PRINS, Professor, Department of Urology, University of Illinois,
Chicago
HELEN H. SUH, Associate Professor, Department of Health Sciences, Bouve
School of Health Sciences, Northeastern University, Boston, Massachusetts
MARC WEISSKOPF, Associate Professor, Department of Environmental and
Occupational Epidemiology, Harvard School of Public Health, Boston,
Massachusetts
LORI A. WHITE, Associate Professor, Department of Biochemistry and
Microbiology, School of Environmental and Biological Sciences, Rutgers
University, New Brunswick, New Jersey
LUOPING ZHANG, Professor, School of Public Health, University of
Califorina, Berkeley
v
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
Study Staff
MARY BURR PAXTON, Study Director
JENNIFER A. COHEN, Program Officer
TIA S. CARTER, Senior Program Assistant (through March 2013)
ANDREA COHEN, Financial Associate
FREDERICK (RICK) ERDTMANN, Director, Board on the Health of Select
Populations
NORMAN GROSSBLATT, Senior Editor
vi
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
Reviewers
This report has been reviewed in draft form by individuals chosen for their
diverse perspectives and technical expertise, in accordance with procedures ap-
proved by the National Research Council’s Report Review Committee. The pur-
pose of the independent review is to provide candid and critical comments that
will assist the institution in making its published report as sound as possible and
to ensure that the report meets institutional standards of objectivity, evidence, and
responsiveness to the study charge. The review comments and draft manuscript
remain confidential to protect the integrity of the deliberative process. We thank
the following for their review of the report:
Linda S. Birnbaum, National Institute of Environmental Health Sciences
Margit L. Bleecker, Center for Occupational and Environmental Neurology
Kim Boekelheide, Brown University
Norman E. Breslow, University of Washington
James Brophy, McGill University
David L. Eaton, University of Washington
Edward Elton George, Massachusetts General Hospital
Elaine S. Jaffe, National Cancer Institute
David W. Kennedy, University of Pennsylvania Health System
Kevin Kip, University of South Florida, College of Nursing
Roderick J.A. Little, University of Michigan
John Meeker, University of Michigan School of Public Health
Murray A. Mittleman, Harvard School of Public Health
Rosemary Polomano, University of Pennsylvania School of Nursing
vii
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
viii REVIEWERS
Noel R. Rose, Johns Hopkins University School of Medicine
Hugh H. Tilson, University of North Carolina at Chapel Hill
Although the reviewers listed above have provided many constructive com-
ments and suggestions, they were not asked to endorse the conclusions or recom-
mendations, nor did they see the final draft of the report before its release. The
review of the report was overseen by Kristine M. Gebbie, Flinders University
School of Nursing and Midwifery, Adelaide, South Australia. Appointed by the
Institute of Medicine, she was responsible for making certain that an independent
examination of the report was carried out in accordance with institutional pro-
cedures and that all review comments were carefully considered. Responsibility
for the final content of this report rests entirely with the authoring committee and
the institution.
Copyright National Academy of Sciences. All rights reserved.
Veterans and Agent Orange: Update 2012
Preface
This update focuses on the relevant scientific studies published from October
1, 2010, through September 30, 2012, that is, after the literature considered in Up-
date 2010. To accomplish the review, the Institute of Medicine (IOM) established
a committee of 15 members representing a wide array of expertise to evaluate
the newest scientific evidence and to consider it in light of the studies reviewed
in Veterans and Agent Orange (VAO), Update 1996, Update 1998, Update 2000,
Update 2002, Update 2004, Update 2006, Update 2008, and Update 2010. A
link to the experience and expertise of previous committees was provided by
recruiting eight members from committees responsible for earlier updates. All
committee members were selected because they are experts in their fields, have
no conflicts of interest with regard to the matter under study, and have taken no
public positions concerning the potential health effects of herbicides in Vietnam
veterans or related aspects of herbicide or 2,3,7,8-tetrachlorodibenzo-p-dioxin
(TCDD) exposure. Biographic sketches of committee members and staff appear
in Appendix D.
In this second decade of evaluation, the committee sought the most accurate
information and advice from the widest possible array of knowledgeable sources
for consideration. To be consistent with National Academies’ procedures, the
committee met in a series of closed sessions in which members could freely
examine, characterize, and weigh the strengths and limitations of the evidence.
The committee also convened five open meetings—in September, November, and
December 2012 and in January and March 2013—to provide an opportunity for
veterans and veterans service organizations, researchers, policy makers, and other
interested parties to present their concerns, review their research, and exchange
information directly with committee members. The oral presentations and written
ix
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