Veterans and Agent Orange: Herbicide Dioxin Exposure and Type 2 Diabetes PDF
Preview Veterans and Agent Orange: Herbicide Dioxin Exposure and Type 2 Diabetes
Veterans and Agent Orange Herbicide/Dioxin Exposure and Type2D iabetes g nekihndt ire Lac egnwee eetReodithtivitvemERmoC s eeert guet donsbnnntaoaeearpigeOxDAwEteB noitn eenvs oea dirennt Psoaoh iimtfDsoloiravPeiHD INSTITUTE OF MEDICINE L AYNMOEIDTSAASCNEARP Washington, D.C. NATIONAL ACADEMY PRESS ••2 101C onstitutionA venue,N .W. ••Wa shingtonD,2C 0 418 :ECITON ehT tcejorp taht si eht tcejbus fo siht troper saw devorppa yb ehtgninrevoG s r , eee lns b rsiwommdhalcahoe rcinrwr mearc udfflhoanfooatBeuoC nsoeoechiRttaN el haytnmoeidtaa c N,Afsoecn eeli hacytnSmo ei,dtgaanc NiAfr oedennaig neEhttsnI i- etut f.oenici deeh MTsrebmem fo e leebheittstn iormpomsfoecr eht trope rerewnesohc .ecnal aebtairporp pra odfrag ehrt idw nsaecnetepm olcaice prsie hrtof troppuS rof siht tcejorp saw dedivorp yb eht tnemtrapeD fo snareteVsriaffA . ehT eettim meonCici defetoMutit s enefhIsot o ehtrtrao pse irdnheittnes esrwpeiv w eoitveR eh te cgnneiddirvaEg eeRht kni Lne eewrtuesBopxE ot tneg AegnarO dnasetebaiD dna e gganidn uef h fteoso hytlirassec etn oenra n .yc 4-89170-903- 0.o Nkoo Bdradnat SlanoitanretnI lanoitiddA seipoc fo siht troper era elbaliava rof elas morf eht lanoitaNymedacA ,sserP 10 1n2oituti t,senuonCevA ,.W.N xoB ,58 2,notgnihsa W.C.D .55002 llaC)008( 2426-426 ro )202( 3133-433 ni( eht no tngantiihlsoapWo r,t)eamera ro tisiv ehts’PAN t aega pemoh .ude.pan.www t aelbaliav as itrope rsih tf otxe tllu fehT .ude.pan.www roF enrooimtam rtoufonbia eh tetutitsnIo f ,enic itdiesMiv eht MOI emoh egap:ta .ude.moi.www srthg ilr l.Asecnei c fSyomeda clAanoit aeN h yt0b0 0t2hgirypoC e .devres .acire m fAsoeta tdSeti neU h ntdietnirP ehT tnepres sah neeb a lobmys fo gnol ,ef i,lgnilaeh dn aegdelw ognnkomatsomla s elsrl n uaeodt cinlgngaun i icies.l nhyed ntrref i ododgtetreenhsotbeTicppheorrsdeaas e payt oyegbt o uelet nhifittoc sisndiIeM g ,afn teeimnc ivoeewlrrieoeafcrnrdcnGlaeh .nilr ennBiees ueMhciltaa te Shytb “Knowing is not enough; we must apply. Willing is not enough; we must do.” —Goethe INSTITUTE OF MEDICINE Shaping the Future for Health ehT lano iytmaeNdacA fosecneicS si a ,e tgan vi,ittraipufto erypptrneeoipnc-ofslesfo dehsiugnitsid sralohcs degagne ni cifitneics dna gnireenigne ,hcraeser detacided oteht ecnare hft oreucfne iy cgdsonlao ndhncaet ot rieht esu rof e h lt.aerrean fenlgoepwUeht etadn asam ayhmeda ceA h,t36 8 n1sisergn oeC h yt tb oidtetna rrgetra hec h ftyotirohtua taht seriuqer ti ot esivda eht lare dtenfemnrevog no cifitneics dna lacinh c.estrettam.rD .secnei c fSyomeda clAanoit aeN h fttonedise r spsitreb l .AeMcurB ehT gnireenig n fEyomeda clAanoitaN refehottr aerhhec td,n 4 ud6ne9ih1silba tssaew lanoi tyamNedacA fo ,secneicS sa a lneoliltaarzaipnag rfo ogn i.dsnraetesntiugone tIsi suomonotua ni sti noitartsinimda dna ni eht noitceles fo sti ,srebmem gnirahs htiweht lanoitaN ymedacA fo secneicS eht ytilibisnopser rof gnisivda eht laredef.tnemnrevog ehT lanoitaN ymedacA fo gnireenignE osla srosnops gnireenigne smargorp demiata gnite elmanoita n,sd eseenga rnuooictnaecude dna ,hcraeser dna sezingocer ehtroirepus ymfe odl aat cn nmAo fe a ieodf.i .thi lAl.satssulrrNeiWiDe rWespn tifngoenmeeveihca .gnireenignE ehT enicide Mf oetutitsnI sec ny emfieo cdlSa ac dn A0eo n 7hiyie9stbh1iatlNb astaswe o teruc esesehctiv r fe tosssnnreo eniebistmm sa eeneifmifronoporoi prtepahpntaimaxe fo ycilop sretta mgniniatrep ot eht htlaeh fo eht .cilbup ehT etutitsnI stca rednu ehtr e - re tolrtaaenhboci ss se yecym rn besf gelndtoyniaea itocnvco icSoiAtelighittbaiNsnops na resivda ot eht laredef tnemnrevog ,dna nopu sti nwo ,evitaitini ot yfitnedi seussifo etfuot it tnfeseohndtI i e sh nset.iireIhp nS..nnreoDKita c,duhndcaera e,s eelrraaccidem .enicideM ehT li chncuro aCleasneoRitaN dys e mez le c iyadfnnsnb naoeiaaeociwghiAcrttSoaN 6191 ot etaicossa eht daorb ytinummoc fo ecneics dna ygolonhcet htiw ehts’ymedacA sesoprup fo gnirehtr uefgdelwonk dna gnisivda eht larede f.tnemn rgenviongoitcnuFni ecnadrocca htiw lareneg seicil odpenimreted yb eht ,ymedacA eht licnuoC sahemoceb eht lapicnirp gnitarepo ycnega fo htob eht lanoitaN ymedacA fo secneicS dna ehtN a - lan oyimtedacA gfnoireeni gnn iEgn isdeicviovrrpes ot ,ethntemnr eevhotg ,cilbupdna e hctifitne i .cdgssnneaiirteiennu imegmhnoTec licnuoC dseire tyslitnniimodja ybhtob . ee s.e n cmtrts idu arDue .c nrfdieti.Mi .aBonlbimfrdeAalltelDehiAsduMtWnaWIcA .licnu ohCcraes elRanoit aeN h ft,oylevitceps e,rnamria hecc idv nnaamria hecra KN IEL HGTNIDRAG EERCNEDI VEE HWTEIV E ORETETTIMMOC SETEBA IDD NEAGNA RTONE G OAETRUSOP XNEEEWTEB divaD ,durelloT ,DM HPM ( riahC ,) 1,2,3 rosseforP fo cilbuP htlaeH dnadeM i- enic dna ,rotceriD retneC rof latnemnorivnE dna lanoitapuccO,htlaeH htl aceiHl blfuooPo hyctSisrev ilneUxerD leahciM ,ffonimA,DM 2,3 ,rosseforP tnemtrapeD fo ,ygolorueN ytisrevinUfo enici dlfeooMo h,coScsicn a nrataFiaSnrofilaC ,D h,PS H, MD,Mnamdo onGevetS 3 t o nfceonmOtr a,preoDsse feotraPicossA l- enicide Mf oloohc Sytisrevin Usnikpo Hsnho J,scitsitatsoi Bf onoisivi D,ygo treboR ,kcirreH ,DhP,HIC 3 rerutceL no lairtsudnI ,eneigyH tnemtrapeDfo htl aceiHl blfuooPo hdcrSav r,ahHtl aleaHtnemnorivnE ,otto,iDc hcaPivPr-IztreH 3 t,enrteoamsits,creyoafgs poosferlAoDPoimedipE ll ilHepa htaCanilor ahCtr ofyNotisrevinU divaD ,leoH,DhP 3 dehsiugn iyttsiisDrevi n,UrosseforP lacideM ytisrevinUfo aniloraC htuoS werdnA ,nahslO,DhP 1,2,3 etaicossA ,rosseforP tnemtrapeD fo,ygoloimedipE ll ilHepa htaCanilor ahCtr ofyNotisrevinU ,Dh P,D M,rez OdrawoH 3 ygoloc nnrOoi /sadfyahnegECai ohflCo oethatmeH ,n oriottcceeSriD fo eht rec n,arCetneC d nraossefor Pf o,eniciedveiMnU r - amoh a ylftkoiOs hten n,esKomaR,DhP 2, 3 , rtonsesmetfroarpPe Df oygoloisy hdPnaocamrahP l- enici dyerManire tefegoVel lyotCisrev i Mns&UaA x,eyTgo leo N,esoR ,DM,DhP 3,2 ,r otsnseemftorraPpeD fo ryagloulcoeilbooMrcdinMa ,ygolonummI snhoJ snikpoH ytisrevinU loohcS fo eneigyH dnacilbuP Health ,hCBB M,nietsnebu RruhtrA i atn ni,uStonMedi s eeecrviPiVtu c ndeanxeaED enici dlfeooMohcS , D,Mnre tlSeahciM fnooisiv i,Dfei hd Cn,aenicid eftMonemtrap e,DrosseforP nrtaeaSt neecCne ihctSl aseaH xyfetoTisrev i,nyUgoloimed ilpaEcinilC oinotnA nasuS ,eiksoW ,DhP,HIC 3 etaicossA ,rosseforP tnemtrapeD fo kroWvnE i- lle wstotaLtesuhcas syfatoMisrev i,ntUnemnor ffatS reltu B. AdivaD rotce ryidD u,tS ,srewo BsemaJ tnatsi shscAraeseR ,ne hr.oeACfinneJ tnatsi shscAraeseR esoR eiraM ,zenitraM ,rotceriD noisiviD fo htlaeH noitomorP dnaesaesiD noitneverP 1 r oeflbisnops eerettimm oe c hfrtoebmeM egna rtOne gd AnsanareteV .)4991( ro felbisnopse reet2timmo ceh tf orebmeM .6991 etadpU :egnarO tnegA dna snareteV ro felbisnopse reet3timmo ceh tf orebmeM .8991 etadpU :egnarO tnegA dna snareteV v ,notta rnteSelhtaK no itn ooh im tfso,loir)avP9ei9HD91– 7r9o9t 1cg(enriitDcA noitne veesraP edsniaD nospmo h .TaDnnoD and ,sniksaG atiR stnatsi snsoAisi viD ,niwdooG assileM etaico slsaAicna niF stnatl ufsfnaotCS ,lu anhaTsuS enici defetoMutit s,nrIeci ftfcOej orroPineS ,noll ieocPnerolF rot itdcEartnoC iv ecaferP nI esnopser ot eht snrecnoc deciov yb mantei Vsnaretev dna rieht,seilimaf ssergnoC dellac nopu eht lanoitaN ymedacA fo secneicS )SAN( ot weivereht cifitneics ecnedive no eht elbissop htlaeh stceffe fo erusopxe ot tnegAegnarO cs iedld n bi r awucde,aPieh4L(btt- rco2y ea0rnhn1aoeu r ,b.6e)F 1s9i9h1lTlac detlus enri enhotitae rfco eht tsrif eStAuNtit s fneeoIentitciimd meooMtCR e - se des.nirn2ic u a9 isosf r9mbtt oowe1a rchp etnneetxeietiHflEhvVefatiEeVH ehT eettimmoc dehsilbup sti laitini sgnidnif ni eht 4991 troper snareteVdna mante i nVdie ssUedicibr e fHsotcef fhEtla e:Hegna rtOnegA . cilbuP waL 4-201 osla deksat eht SAN ot tcudnoc lainneib setadputaht dluow weiver ylwen dehsilbup cifitneics erutaretil gnidrager lacitsitatsicossa a - sn oniete wht teslbeameohct udo nearusopx eot nixoid dna r elhatcoimehcoc m - sdnuop ni eseht .sedicibreh ehT stluser fo eht tsrif owt fo eseht stroffeerew dehsil bnuip sn ae: drtetne6agnat9dnee9pagV1UrAO dna etadpU8991 .kroW e hnto 00 0e2tadpU .y arwed nyultnese r sptirop er sihT troper si eht tluser fo a 9991 tseuqer morf e httnemtrape DfosnareteV sriaf f)AAVD( rednu eht sigea fo eht snareteV dna tnegAegnarO hcraeserrp o - .marg AVD deks a eethuttit sfenonIicid eoMt lrleahcteg o etaettim mootcoc n - tcud a desucof weiver fo eht cifitneics ecnedive gnidrager eno fo ehtlacidem snoi tdiedsnsoecrdda ni eht troper seires ni ecnavda fo eht txen deludehcseib n - lain .troper ,yllacificepS AVD deksa eht eettimmoc ot enimaxe ecnediver e - gnidrag ,enhotitaico sfsia ,yna neewteb epyT 2 setebaid dna erusopxe otnixoid .mante i nVdie ssuedicibr e nhsidnuopm olcacime hrceh tdona divaD .A reltu Bdevres sa eht ydu trsotcerid rof siht tcejorp dnasevresed t g i en .dd eir t elett ooreruhtf efsogcotiaehlpdwmrkTeaeemdihrl oltwocotnkca iiv iiiv ECAFERP tnellec xkerow fo MOI ffat ssrebme msemaJ srewoB dna refin n,enJehoCdna osl aer asknah T.trope rsih tn okro wre hro fluah Tnasu So tsknah tlaicep s adnetxe ecnero l;Ftcejo rep hrt osfecnan ief hdteldn aoh h,wniwdo oaGsssil e oMdtednetxe ; d,nsletalaat rsli tcouuirtauhoSkon ddwFste nnildoodle lceedolcihixvwoeoPrp l ahdi ge r tuseeo,roihhtno rvttiopohr dtehtelegrw pen;uaisshdecE hiecMsraabes n od in;tasaecsialhb pudpna a nnnoosDpmo hdTna a t,isRniks aoGhdwedivorp .tcejorp eht ot troppus evitartsinimda ehT eettimmoc osla detifeneb morf eht ecnatsissa fo lareves stsitneicsdna srehcr ayoelhssweuro rtenneelg rieht emit densaitrep xoet pleh eeveitgtimmoc strhegb i mr s,ea ensml ndieusoiucevsiiostprirop acfpo, hdycelrswaaeeensleerr ro rewsna seireuq gninrecnoc rieht .krow laicepS sknaht era dednetxe ot.srD yerffoeG trevlaC lanoitaN( etutitsnI rof lanoitapuccO ytefaS dna ,)htlaeH nyliraM tuhregniF lanoitaN( etutitsnI rof lanoitapuccO ytefaS dna,)htlaeH pilihP nreK ytisrevinU( fo sasnakrA rof lacideM ,)secneicS einnoBruelFaL ehT( egroeG notgnihsa WytisrevinU loohcS fo cilbuP htlaeH dna htlaeHreS v - ,)seci wehttaM rekcengnoL lanoitaN( etutitsnI rof latnemnorivnE ytefaSdna ,)htlaeH leoJ kelahciM riA( ecroF hcraeseR ,yrotarobaL skoorB riAecroF ,)esaB dna leahc ioMtotS ehT( enygotrtiogs enrlGieohvosihancWUS focilbuP rhetSl adhentHalaeH v .)seci sihT troper sah neeb deweiver ni tfard mrof yb slaudiv indensiohc rofrieht esrevid sevitcepsrep dna lacinhcet ,esitrepxe ni ecnadrocca htiw serudecorpa p - devorp yb eht s’ Ct.Rr eNowepeteit Rvie emheRmTsooCpru pfo sinhetpedni d - tn eweiver si o ted idviodrnpa c d lnsaatcniet mitmraochct ll itwsiss aehttitsni u - noit ni gnikam eht dehsilbup troper sa dnuos sa elbissop dna ot erusne tahteht ss e,n ee ,cvsyn i dtedslridnnaa viaondrivp onotestiafcer tterosusjpttbeeioretmsni ot eht yduts .egrahc ehT weiver stnemmoc dna tfard tpircsunam niamerfnoc i- laitned ot tcetorp eh tytirgetni fo eevhit t.asrseebciolrepd eW hsiw ot knahteht gsnliawuodlilvoi fdrnoif n oriiteahptici tnriap eht weiver fo siht :troper nhoJ.C ,raliaB ehT ytisrevinU fo ;ogacihC leinaD .W ,retsoF ytisrevinU fosaxeT nretsew hltaucoiSdeM retneC ta ;salla DenitsirK .M ,eibbe GaibmuloCevinU r - ;ytis arabraB .C ,nesn ayHtisrevinU fo dnalyraM ta ;eromitlaB luaP .D,yellotS ytisrevinU fo dnalyraM ta ;eromitlaB ahtraM ,nahguaV lanoitaN ,traeH,gnuL dna doolB ;etutitsnI .M dlanoD ,notrohW .M dlanoD ,notrohW .cnI elihWeht slaudividni detsil evoba evah dediv oervpitcurts nsotcnemmoc dna,snoitseggus ti t syut midle izerb iboitsfsaanhh otpepmhse te lrtanneitfn ofco s ithrtosptesrer .noitutit s e ndheinteattim mgonciroh t euhh attyilweritne du rdeilvlaoDT riahC Contents YRAM MEUVSITUCEXE ................................ ................................ .............. 1 NOITCUDORTNI ................................ ................................ ........................... 4 ,dn4uorgkcaB ,5krowema rdF nnaoitazinagrO ,6ecnedi ve Ehgtnitaula vnsEinoitaredisn ocCigolodohteM , sna9oiiBtacilbuP ,t9nemsse sesrAusopxE etrusop x fEyodu tcSigoloimedi peE h otdtetal esReussI d nsaedicibr eoH ,0s1ete be ap2iyDT ECNEDIV ECIGOLOIMEDIP EF OSEIRAMMUS ................................ ...... 11 1 1,stroho ClanoitapuccO ,2s2tro hnoaCre tmeaVnteiV ,3s3tro hloaCtnemnorivnE SISEHTNYS ................................ ................................ ................................ ..... 35 SNOISULCNOC ................................ ................................ .............................. 36 6,3seidu tcSigoloimedi pneEicnedi vfhEotgnertS kdseisRaercnI 7,3snaret emVante igVno msAeteba ifDo ,y8t3ilibis ucailgPoloiB SECNEREFER ................................ ................................ ................................ 38 ix
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