Gulf War and Health Volume 2: Insecticides and Solvents (2003) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-9
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) Pyridostigmine bromide Nerve agents and precursor compounds: sarin and tabun Synthetic chemical compounds: mustard agents, volatile organic compounds, hydrazine, red fuming nitric acid, and solvents Environmental particles and pollutants: hydrogen sulfide, oil-f~re byproducts, diesel heater fumes, and sand microparticles ' The committee searched and examined the literature on the insecticide propoxur.
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. After reviewing IOM's Guy War and Health, Volume 1, the secretary of veterans affairs determined that there was no basis to establish a presumption of a connection between Gulf War exposure to sane, pyr~dostigmine bromide, depleted uranium, or anthrax or botulinum toxoid vaccine and various health outcomes.
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Accordingly, committee members read each study and considered its relevance and quality. The committee classified the evidence of association between exposure to a specific agent and a specific health outcome into five previously established categories, as set forth below.
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For example, several high-quality studies report consistent positive associations, and the studies are sufficiently ffee of bias, including adequate control for confounding. Limited/Suggestive Evidence of an Association Evidence Tom available studies suggests an association between exposure to a specific agent and a specific health outcome in human studies, but the body of evidence is limited by the inability to rule out chance and bias, including confounding, with confidence.
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Limited/Suggestive Evidence of No Association Evidence from well-conducted studies is consistent in not showing a positive association between exposure to a specific agent and a specific health outcome after exposure of any magnitude. A conclusion of no association is inevitably limited to the conditions, magnitudes of exposure, and length of observation in the available studies.
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Consensus Not Reached on Category of Association Tetrachloroethylene and dry-cleaning solvents and esophageal cancer Trichloroethylene and colon cancer Mixtures of benzene, toluene, and xylene and colon cancer Tetrachloroethylene and dry-cleaning solvents and lung cancer Trichloroethylene and cervical cancer Solvents and kidney cancer. Benzene and solvents and brain and other central nervous system cancers Parental preconception exposure to solvents and childhood leukemia Organophosphorous insecticide exposure without OP poisoning and long-term neurobehavioral effects (that is, abnormal results on neurobehavioral test batteries and symptom findings)
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and allergic contact dermatitis LIMITED/SUGGESTIVE EVIDENCE OF ANASSOCIATION Tetrachioroethylene and dry-cleaning solvents and bladder cancer Solvents and bladder cancer Tetrachioroethylene and dry-cleaning solvents and kidney cancer Organophosphorous insecticides and non-Hodgkin's lymphoma Carbamates and non-Hodgkin's lymphoma Benzene and non-Hodgkin's {ymphoma Solvents and multiple myeloma Organophosphorous insecticides and adult leukemia Solvents and adult leukemia Solvents and myelodysplastic syndromes Neurologic Effects: 7 Organophosphorous insecticide exposure with OF poisoning and long-term neurobehavioral effects (that is, abnormal results on neurobehavioral test batteries and symptom findings) Solvents and neurobehavioral effects (that is, abnormal results on neurobehavioral test batteries and symptom findings)
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8 Cancers: GULF WAR AND HEALTH INADEQUATE/INSUFFICIENTEVIDENCE TO DETERMINE WHETHER ANASSOCIATION EXISTS: Solvents and oral, nasal, or laryngeal cancer Insecticides and pancreatic cancer Solvents other than tetrachioroethylene and dry-cleaning solvents and esophageal cancer Solvents and stomach, rectal, or pancreatic cancer Solvents other than trichIoroethylene and mixtures of benzene, toluene, and xylene and colon cancer Insecticides and solvents and hepatobiliary cancers Insecticides and Jung cancer Solvents other than tetrachioroethylene and dry-cleaning solvents and lung cancer Solvents and bone cancer Solvents and melanoma or nonmelanoma skin cancer Insecticides and sonic tissue sarcomas Lindane and solvents and breast cancer Solvents other than trichioroethylene and cervical cancer · Solvents and ovarian or uterine cancer · Solvents and prostate cancer Insecticides and prostate, testicular, bladder, or kidney cancers Specific solvents other than tetrachioroethylene and dry-cleaning solvents and bladder cancer Specific solvents other than tetrachioroethylene and dry-cleaning solvents and kidney cancer Insecticides and brain and other central nervous system cancers Specific solvents other than benzene and brain and other central nervous system cancers Specific solvents other than benzene and non-Hodgkin's lymphoma Insecticides and solvents and Hodgkin's disease Insecticides and specific solvents and multiple myeloma Specific solvents other than benzene and acute and adult leukemia Benzene and myelodysplastic syndromes · Parental preconception exposure to insecticides and childhood leukemias, brain and other central nervous system cancers, and non-Hodgkin's lymphoma Parental preconception exposure to solvents and neuroblastoma and childhood brain cancers Neurologic Effects: · Insecticides and solvents and peripheral neuropathy Insecticides and solvents and Parkinson's disease Insecticides and solvents and amyotrophic lateral sclerosis
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EXECUTIVE SUMMARY Insecticides and solvents and Alzheimer's disease Solvents and multiple sclerosis Solvents and a long-term reduction in color discrimination Solvents and long-term hearing loss Solvents and long-term reduction in olfactory function Reproductive Effects: 9 Insecticides and solvents and male or female infertility after cessation of exposure Parental preconception exposure to insecticides or solvents and spontaneous abortion or other adverse pregnancy outcomes Parental preconception exposure to insecticides or solvents and congenital malformations Other Health Elects: · No findings Insecticides and aplastic anemia Solvents other than benzene and aplastic anemia · Insecticides and solvents and irreversible cardiovascular outcomes Insecticides and solvents and persistent respiratory symptoms or impairment after cessation of exposure Solvents and cirrhosis · Solvents and alterations in liver function tests after cessation of exposure Solvents and chronic pancreatitis and other persistent gastrointestinal outcomes Solvents and the systemic rheumatic diseases: scleroderma, rheumatoid arthritis, undifferentiated connective tissue disorders, and systemic lupus erythematosus LIMITED/SUGGESTI VE E VIDENCE OF NO ASSO CIA TION
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