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Veterans and Agent Orange PDF

1007 Pages·2015·5.24 MB·English
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THE NATIONAL ACADEMIES PRESS     This PDF is available at http://nap.edu/18395 SHARE Veterans and Agent Orange: Update 2012 DETAILS 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 FIND RELATED TITLES  Visit the National Academies Press at NAP.edu and login or register to get: – Access to free PDF downloads of thousands of scientific reports  – 10% off the price of print titles  – Email or social media notifications of new titles related to your interests – Special offers and discounts Distribution, posting, or copying of this PDF is strictly prohibited without written permission of the National Academies Press. (Request Permission) Unless otherwise indicated, all materials in this PDF are copyrighted by the National Academy of Sciences. Copyright © National Academy of Sciences. All rights reserved. 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 THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 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 International Standard Book Number-10: 0-309-28886-X Additional copies of this report are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334- 3313; http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www. iom.edu. Copyright 2014 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. 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 The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr. is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examina- tion of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the Na- tional Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council. www.national-academies.org 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 Copyright National Academy of Sciences. All rights reserved.

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Committee to Review the Health Effects in Vietnam Veterans of Exposure to . School of Nursing and Midwifery, Adelaide, South Australia Gastrointestinal and Digestive Diseases, Including Liver Toxicity, 906 a better understanding of the role of herbicide exposure in development of stroke,.
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