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Executive Summary
Pages 1-11

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From page 1...
... 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 venous chemical components of those herbicides, inclucling TODD. The secretary was also to ask that NAS conduct updates at least every 2 years for 10 years Tom the date of the first report to review newly available literature and draw conclusions from the overall evidence.
From page 2...
... " the following regarding associations b etween specific health outcomes and exposure to TCDD and other chemical compounds in herbicides: "A) whether a statistical association with herbicide exposure exists, taking into account the strength ofthe scientific evidence and the appropriateness ofthe statistical and epidem~olog~cal methods used to detect the association; B)
From page 3...
... The committee recognized that an absolute conclusion about the absence of association may never be attained, because, as is generally the case in science, studies of health outcomes after herbicide exposure are not capable of demonstrating that a purported effect is impossible. THE COMMITTEE'S EVALUATION Toxicology Data Since Update 2000, many expenmental studies have been published on the herbicides used in Vietnam or their contaminant TCDD.
From page 4...
... This section briefly summarizes the relevant epidemiologic studies published on those health outcomes since Update 2000. Cancer Three major epidemiologic studies have been published since Update 2000 that look at cancer outcomes: a study of residents of Chapaevsk, a Russian industrial community with documented contamination by TCDD and other chemicals; an update of a cohort of Dow Chemical Company workers; and a study of Swedish lumberjacks exposed to pesticicles.
From page 5...
... , which looked at Cnunitiv~ Lafferty on nennle involved in the aenal spraying of Agent Orange (the Ranch Hands) has been published, as has a study of cognitive effects on Czech workers exposed to TCDD during the production of 2,4,5-T.
From page 6...
... Because of the available data and the etiology of chronic lymphocytic leukemia, the present committee made conclusions for that leukemia separately. On the basis of all the evidence reviewed, the committee concluded that there is sufficient evidence of an association between exposure to at least one of the chemicals of interest (2,4-D, 2,4,5-T or its contaminant TCDD, picloram, or cacodylic acid)
From page 7...
... There is inadequate or insufficient evidence to determine whether an association exists between exposure to herbicides and the following health outcomes: Hepatobiliary cancers Nasal or nasopharyngeal cancer Bone cancer Breast cancer Female reproductive cancer (cervical, uterine, and ovarian) Urinary bladder cancer Renal cancer Testicular cancer Leukemia (other than CLL)
From page 8...
... The committee believes that there i s s uff~cient e vidence t o r each g Feral c Inclusions about a ssociations between herbicide exposure and the health outcomes, but the lack of adequate data on Vietnam veterans themselves makes it difficult to reach conclusions about increased risk of disease among Vietnam veterans. The lack of data on Vietnam veterans, the large uncertainties about the magnitude of potential risk posed by exposure to herbicides in epidemiologic studies, the inadequate control for other important risk factors in many epidemiologic studies, and the uncertainty about the nature and magnitude of exposure to herbicides in Vietnam add up to the unavailability of the information that would be necessary to measure the risk to people exposed to herbicides during service in Vietnam during the Vietnam conflict.
From page 9...
... could also provide information on diseases of aging. The AFHS is an epidemiologic study whose purpose is to determine whether exposure to the herbicides used in Vietnam might be responsible for any adverse health conditions observed in a cohort of Air Force personnel responsible for conducting aerial spray missions (the Ranch Hands)
From page 10...
... That assessment should provide more accurate and precise data on the potential exposure of individuals to herbicides sprayed in Vietnam, and the data could be used in epidemiologic studies to increase their power to detect health effects associated with exposure to the herbicides in Vietnam. ~ light of the anticipated availability of this database, it is even more important to continue research into the health effects of the herbicides in Vietnam veterans themselves, making use of this potentially valuable tool.
From page 11...
... That effort resulted in the report Veterans and Agent Orange: Herbicide/D`oxin Exposure and Type 2 Diabetes (hereafter referred to as Type 2 Diabetes; TOM, 20001. ~ 2001, VA requested that lOM convene a committee to conduct an interim review of acute myelogenous leukemia (AML)


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