Veterans and Agent Orange Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans (2002) / Chapter Skim
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Pages 4-10
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From page 4... ...
The NAS was instructed to conduct a comprehensive review of the evidence that had become available since the previous IOM committee report and to reassess its determinations and estimates of statistical association, risk, and biological plausibility. On completion of VAO, successor committees were formed that produced Veterans and Agent Orange: Update 1996 (hereafter, Update 1996)
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From page 5... ...
The committee was not asked to and did not make judgments regarding specific cases in which individual Vietnam veterans have claimed injury from herbicide exposure. Rather, the study provides scientific information for the Secretary of Veterans Affairs to consider as the DVA exercises its responsibilities to Vietnam veterans.
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From page 6... ...
In addition, the possibility of a very small elevation in risk at the levels of exposure studied can never be excluded. Methodologic Considerations in Evaluating the Evidence Questions Addressed The committee was charged with the task of summarizing the strength of the scientific evidence concerning the association between herbicide exposure during Vietnam service and acute myelogenous leukemia in the children of those who
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From page 7... ...
the increased risk of the disease associated with exposure to herbicides during service in the Republic of Vietnam during the Vietnam era; and 3. whether there exists a plausible biologic mechanism or other evidence of a causal relationship between herbicide exposure and the disease.
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From page 8... ...
When exposure levels among Vietnam veterans have not been adequately determined, which has been the case in most studies, this question is very difficult to answer. The committees have found the available evidence sufficient for drawing conclusions about the association between herbicide exposure and a number of health outcomes.
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From page 9... ...
The likelihood that a given chemical exposure-health outcome relationship reflects a true association in humans is addressed in the context of: research regarding the mechanism of interaction between the chemical and biological systems; evidence in animal studies; evidence of an association between exposure and health outcome occurrence in humans; and/or evidence that a given outcome is associated with occupational or environmental chemical exposures. It must be recognized, however, that a lack of data in support of a plausible biologic mechanism does not rule out the possibility that a causal relationship does exist.
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From page 10... ...
A separate effort by another Institute of Medicine committee is facilitating the development and evaluation of models of herbicide exposure for use in studies of Vietnam veterans. That committee authored and disseminated a Request for Proposals for exposure assessment research in 1997 (IOM, 1997)
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