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APPENDIX C Epidemiologic Tables for Chapter 4
APPENDIX C Epidemiologic Tables for Chapter 4
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The citations for the articles in this appendix can be found in the reference list at the end of Chapter 4. Contents of TABLE C-1 Epidemiologic Studies -- Occupational Exposure Page PRODUCTION WORKERS 718 NIOSH Studies, 718 Monsanto Studies, 721 Dow Studies, 721 BASF Studies, 723 IARC Studies, 724 Studies from Other Chemical Plants, 728 AGRICULTURAL–FOREST PRODUCTS 729 Studies from the Agricultural Health Study, 729 717
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(n) a PRODUCTION WORKERS NIOSH Studies Reviewed in Update 2006 Lawson Cohort Follow-on of NIOSH cross- 176 workers 217 referent wives et al., 2004 sectional medical study wives with 513 with 604 births (Sweeny et al., 1989, 1993)
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diabetes, smoking-related cancer, and all other cancers Calvert Cohort Follow-up of workers 281 260 et al., 1998 employed more than 15 years before at 2 plants that manufactured TCDD contaminated materials; to evaluate association between TCDD exposure and cardiovascular outcomes Halperin Cohort Follow-up of a cohort of 259 243 et al., 1998 TCDD-exposed workers at 2 plants that manufactured TCDD-contaminated materials; to assess association between serum TCDD and immunologic outcome variables for eligible workers and matched neighborhood controls NIOSH Studies Reviewed in Update 1998 Sweeney Cross- Non-cancer endpoints 281 260 et al., 1996, sectional for liver function, 1997/1998 gastrointestinal disorders, chloracne, serum glucose, hormone, lipid concentrations, diabetes in the group studied by Calvert et al.
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(1991) NIOSH Studies Reviewed in VAO Sweeney Cohort Peripheral neuropathy in 281 260 et al., 1993 group studied by Calvert et al.
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31, 1977, compared with mortality of standardized US population Zack and Cohort Mortality experience 121 -- Suskind, among employees with 1980 chloracne exposed to TCP process accident in 1949 at Monsanto, compared with US male population standard Dow Studies in Update 2004 Bodner Cohort Additional 10-year follow- 2,187 -- et al., 2003 up of cohort studied by Cook et al.
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(n) a Dow Studies Reviewed in Update 2002 Burns et al., Cohort Mortality in chemical 1,567 US population; 2001 workers who manufactured 40,600 non-exposed or formulated 2,4-D, chemical workers 1945–1994 Dow Studies Reviewed in Update 1998 Ramlow Cohort Mortality in PCP-exposed 770 US population et al., 1996 workers 36,804 non-exposed workers Dow Studies Reviewed in Update 1996 Bloeman Cohort Follow-up of cohort studied 878 US population; et al., 1993 by Bond et al.
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from TCDD exposure, compared with mortality experience of US white men Ott et al., Cohort Mortality experience 204 -- 1980 among workers exposed to 2,4,5-T in manufacturing (1950–1971) , compared with mortality experience of US white men BASF Studies Reviewed in Update 2000 Zober et al., Cohort Review and summary of 154 surviving None 1997 (1953 previous BASF studies of (as of 1989)
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(n) a BASF Studies Reviewed in Update 1998 Ott and Cohort Cancer incidence and 243 -- Zober, 1996 mortality experience (through 1992)
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of 1,189 -- Janys, 1997 German workers exposed to TCDD and other contaminants in herbicide and insecticide production; SMR and Cox regression model IARC Studies Reviewed in Update 1998 Kogevinas Cohort Mortality (through 1992) 26,615 total -- et al., 1997 of workers engaged in (21,863 production or application exposed; 4,160 of phenoxy herbicides and probably composed of (1)
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Flesch- Cohort Cancer and circulatory 1,189 2,528 gas workers Janys et al., system mortality among 1995 chemical plant workers in Hamburg, Germany, exposed to herbicides contaminated with PCDD/F IARC Studies Reviewed in Update 1996 Kogevinas Case– Nested studies of the 11 cases, STS; 5 controls per case et al., 1995 control relationship between STS 32 cases, NHL and NHL and occupational exposures in the IARC cohort Kogevinas Cohort Cancer incidence and 701 -- et al., 1993 mortality experience of female workers in 7 countries, potentially exposed to chlorophenoxy herbicides, chlorophenols, and dioxin, compared with national death rates and cancer incidence rates Lynge, 1993 Cohort Cancer incidence in the 3,390 men; -- group studied by Lynge 1,071 women (1985) ; follow-up extended through 1987 Kogevinas Cohort STS and malignant 14,439 (13,482 3,951 non-exposed et al., 1992 lymphoma mortality in exposed, employees an international cohort of 416 probably production workers and exposed, 541 herbicide sprayers (group unknown studied by Saracci et al., exposure)
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(n) a IARC Studies Reviewed in VAO Bueno de Cohort Mortality experience of 2,310 -- Mesquita production workers exposed et al., 1993 to phenoxy herbicides and chlorophenols in the Netherlands, compared with national rates Coggon Cohort Mortality experience 1,104, Factory -- et al., 1991 among 4 cohorts of workers A; 271, potentially exposed (1963– Factory B; 1985)
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(n) a Studies from Other Chemical Plants Reviewed in Update 2000 Hryhorczuk Cohort Morbidity (chloracne, 366 303 et al., 1998 prophyria, general health status)
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(n) a Thomas, Cohort Mortality experience 1,412 -- 1987 as of Jan.
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Cohort AHS -- serum TCDD and 567 815 2004 insulin sensitivity in Air Force veterans exposure to herbicides Studies from US Agricultural Health Study (AHS) Reviewed in Update 2004 Flower Prospective Parental pesticide application 150 -- et al., 2004 cohort and cancer risk in offspring of pesticide applicators in AHS cohort Alavanja Prospective Correlation between 55,332 -- et al., 2003 cohort pesticide exposure (including 2,4-D and 2,4,5-T)
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Reviewed in Update 2000 Alavanja Cohort Analysis of self-reported 35,879 None et al., 1998 health care visits resulting from pesticide use by Iowa and North Carolina pesticide applicators Studies of Other Agricultural Workers Reviewed in Update 2006 United Farm Workers Mills and Nested California United Farm 128 breast 640 cancer free Yang, 2005 case– Workers evaluated effects of cancer cases control specific pesticides including 2,4,D on breast cancer Mills et al., Nested California United Farm 131 2005 case– Workers evaluated effects control of specific pesticides including 2,4,D on lymphohematopoeitic cancers (LHC) Lee et al., Case– Population-based 170 stomach; 502 2004a control agricultural pesticide use and 137 esophagus adenocarcinoma of stomach or esophagus Torchio Cohort Men licensed to use 23,401 2,683 et al., 1994 agricultural pesticides in Piedmont area of Italy Reif et al., Case– Men with occupation 134 1989 control indicated entered into New Zealand Cancer Registry 1980–1984 (brain or CNS cancers)
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2004 Control Study evaluated effects of rural herbicide exposure (arsenicals, phenoxys) on male farmers Chiu et al., Nested Examined the association 973 2,853 2004 case– between agricultural control pesticide use and familial cancer with NHL Lee et al., Nested NHL among asthmatics who 2004b case– reported previous pesticide control exposure Studies of Other Agricultural Workers Reviewed in Update 2002 Arbuckle Cohort Spontaneous abortions in 2,110 women; None et al., 2001 couples living on full-time, 3,936 family-run farms in Ontario, pregnancies Canada Masley Cross- Targeted survey of 548 None et al., 2000 sectional households in an agriculture- households; survey based rural area of 1,407 Saskatchewan, Canada individuals Curtis et al., Cohort Time to pregnancy in couples 2,012 None 1999 living on full-time, family- pregnancies run farms in Ontario, Canada Savitz et al., Cohort Male pesticide exposure 1,898 couples; None 1997 and pregnancy outcome for 3,984 full-time, family-run farms in pregnancies Ontario, Canada Studies of Other Agricultural Workers Reviewed in Update 2000 Arbuckle Cohort Spontaneous abortions in 2,110 women; None et al., 1999 couples living on full-time, 3,936 family-run farms in Ontario, pregnancies Canada Studies of Other Agricultural Workers Reviewed in Update 1998 Gambini Cohort Cancer mortality (1957– 958 -- et al., 1997 1992)
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(n) a Faustini Cohort Immune system components 10 Internal comparison et al., 1996 and function among farmers who mixed and applied commercial formulations containing 2,4-D and MCPA Studies of Other Agricultural Workers Reviewed in Update 1996 Dean, 1994 Cohort Brain and hematopoietic Population size -- cancer mortality in unclear agricultural workers, compared with non agricultural workers in Ireland (1971–1987)
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to incidence expected among the general population Morrison Cohort Mortality experience, male 155,547 -- et al., 1992 farmers 35 years or older (1971–1987) , compared with Canadian prairie province rates Ronco et al., Cohort Cancer incidence (1970– None given None given 1992 1980)
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in Saskatchewan, Canada, compared with age- and period-specific mortality rates expected for Saskatchewan men Corrao Cohort Cancer incidence among 642 18,839 et al., 1989 male farmers licensed (1970– 1974) to use pesticides, compared with number expected among licensed non-users Wiklund Cohort Malignant lymphoma 354,620 1,725,845 et al., 1988a incidence among agricultural and forestry workers in Sweden, compared with the general population of men; 1960 census Wiklund Cohort STS incidence among 354,620 1,725,845 and Holm, agricultural and forestry 1986 workers in Sweden, compared with the general population of men; 1960 census Wiklund, Cohort Cancer incidence (diagnosed 19,490 -- 1983 1961–1973)
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(n) a Studies of Forestry Workers Reviewed in Update 2002 Thörn et al., Cohort Mortality and cancer 261 243 2000 incidence in Swedish lumberjacks exposed to phenoxy herbicides Studies of Forestry Workers Reviewed in VAO Green, 1991 Cohort Mortality experience, male 1,222 -- forestry workers (1950– 1982)
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Studies of Herbicide–Pesticide Applicators Reviewed in Update 1996 Asp et al., Cohort Mortality and cancer 1,909 -- 1994 morbidity experience of male chlorophenoxy herbicide applicators (cohort studied by Riihimaki et al., 1982, 1983) in Finland (1955–1971)
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(n) a Garry et al., Cross- Health outcomes resulting 719 None 1994 sectional from exposure in male pesticide applicators in Minnesota Studies of Herbicide–Pesticide Applicators Reviewed in VAO Swaen Cohort Cancer mortality experience 1,341 -- et al., 1992 (through 1987)
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Barthel, Cohort Cancer incidence (1948– 1,658 -- 1981 1972) in male agricultural production workers, compared with expected population incidence rates Smith et al., Cohort Differences in adverse 459 422 1981 reproductive outcomes in chemical applicators (1973– 1979)
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(n) a PAPER AND PULP WORKERS Paper and Pulp Studies Reviewed in Update 2006 McLean Cohort IARC pulp and paper 27 never et al., 2006 workers exposure to exposed; 16 nonvolatile organochlorine ever exposed compounds Paper and Pulp Studies Reviewed in Update 2000 Schildt Case– Histopathologically verified 410 410 et al., 1999 control oral-cancer cases, matched control subjects; mailed exposure questionnaire on lifetime occupational history, oral cancer risk factors, pesticide use, smoking, SES, place of residence Rix et al., Cohort Cancer incidence in blue- 14,788 (14,362 -- 1998 collar workers at 3 Danish identified for paper mills, compared follow-up)
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(n) a Robinson Cohort Mortality experience through 3,572 -- et al., 1986 March 1977, white male workers employed in 5 paper and pulp mills, compared with expected number of deaths in US population CASE–CONTROL STUDIES Case–Control Studies Reviewed in Update 2006 De Roos Nest case– AHS limited to female 135 675 et al., 2005a control participants to determine association of 2,4-D and rheumatoid arthritis De Roos Case– Investigation of PCBs and 100 100 et al., 2005b control other organchlorines and risk of NHL Hartge Case– Estimate the effects of 1,057 1,321 et al., 2005 control residential herbicide exposure on NHL risk.
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during gestation at residence based on application of GIS approach to pesticides data from CPUR Tango et al., Case– Examined multiple 2004 control pregnancy outcomes in Japan -- infant deaths from congenital defects Magnani Case– Mortality study that et al., 1987 control examined five cancer -- esophageal, pancreatic, cutaneous melanoma, kidney, and brain in deceased male residents Case–Control Studies Reviewed in Update 2000 Ekström Case– All new cases of 565 1,164 et al., 1999 control histologically confirmed gastric adenocarcinoma in 2 areas in Sweden; age- and sex-matched control group randomly selected by computerized population register
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(n) a Hardell and Case– Male cases, 25 years or older, 404 741 Eriksson, control with histopathologically 1999 confirmed NHL during 1987–1990 in northern and central-Sweden; age-matched controls from National Population Registry García Case– Match-paired study of 261 261 et al., 1998 control congenital malformations or defects in an agricultural region of Spain Case–Control Studies Reviewed in Update 1998 Blatter Case– Multicenter Dutch study of 222 764 et al., 1997 control paternal occupation and risk of spina bifida in offspring (1980–1992)
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(n) a Case–Control Studies Reviewed in Update 1996 Hardell Case– Association between 105 335 et al., 1994 control occupational exposures, parameters related to NHL in white men in Sweden Mellemgaad Case– Cases of renal-cell carcinoma 365 396 et al., 1994 control (20–79 years)
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(n) a Case–Control Studies Reviewed in VAO Cantor Case– NHL (population-based)
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(1987) , 1989 association with phenoxy herbicides in farmworkers Alavanja PMR USDA extension agents 1,495 -- et al., 1988 Analysis, mortality experience nested (1970–1979)
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patients with other neurologic diseases, for association with chemical exposures in farming Olsson and Case– NHL (1978–1981) in 167 50, same area; Brandt, control Swedish men, compared with 80, other parts of 1988 2 groups of men without Sweden NHL for association with occupational exposures including phenoxy acids Hardell Case– Kaposi's sarcoma in AIDS 50 50 et al., 1987 control patients (23–53 years)
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in four SEER areas, compared with population control subjects, for risk factors associated with the disease, including farm use of herbicides Pearce Case– Male multiple myeloma 76 315 et al., 1986a control cases diagnosed 1971–1981 in New Zealand, compared with control subjects with other cancers, for potential association with phenoxy herbicides and chlorophenols Pearce Case– NHL cases (ICD-9 202) in 83 168 other cancer; et al., 1986b control men diagnosed 1977–1981 in 228 general New Zealand, compared with population control group sample with other cancers and population sample, for association with occupational exposure to phenoxy herbicides and chlorophenols Smith and Case– Update of Smith et al.
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, compared with women without ovarian cancer, for association with herbicide use Hardell Case– Primary liver cancer 98 200 et al., 1984 control diagnosed 1974–1981 in men (25–80) , residing in northern Sweden, compared with population-based control subjects, for association with occupational exposure to phenoxyacetic acid and chlorophenols continued
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, compared with subjects without cancer, for association with occupational exposures, including phenoxy herbicides Burmeister Case– Multiple myeloma, NHL, 550 multiple 1,100; et al., 1983 control prostate, stomach cancer myeloma mortality (1964–1978) in 1,101 NHL; 2,202; white men 30 years or older, compared with mortality 4,827 prostate; 9,654; from other causes, for 1,812 stomach 3,624 association with farming practices, including herbicide use, in Iowa Hardell and Case– HD diagnosed (1974–1978)
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in men (25–85) in northern Sweden, compared with population-based controls, for association with occupational exposure to phenoxyacetic acid and continued chlorophenols
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in 1979 northern Sweden, compared with population-based controls, for association with occupational exposure to phenoxyacetic acid and chlorophenols ABBREVIATIONS: 2,4-D, 2,4-dichlorophenoxyacetic acid; 2,4,5-T, 2,4,5-trichlorophenoxyacetic acid; AHS, Agricultural Health Study; CDC, Centers for Disease Control and Prevention; CLL, chronic lymphocytic leukemia; COPD, chronic obstructive pulmonary disease; FRG, Federal Republic of Germany; HD, Hodgkin's disease; IARC, International Agency for Research on Cancer; ICD, International Classification of Diseases; MCPA, methyl-4 chlorophenoxyacetic acid; NIOSH, National Institute for Occupational Safety and Health; NHL, non-Hodgkin's lymphoma; PCDD, polychlorinated dibenzodioxin; PCDF, polychlorinated dibenzofurons; PD, Parkinson's disease; PCP, pentachlorophenol; PCT, porphyria cutanea tarda; PMR, proportionate mortality ratio; SEER, Surveillance, Epidemiology, and End Results program of National Cancer Institute; SES, socioeconomic status; SIR, standardized incidence ratio; SMR, standardized mortality ratio; STS, soft-tissue sarcoma; TCDD, 2,3,7,8-tetrachlorodibenzo-p-dioxin; TCP, 2,4,5-trichlorophenol; TSH, thyroid-stimulating hormone; T3, triiodothryonine; T4, thyroxine; USDA, US Department of Agriculture; Update 2006, Veterans and Agent Orange: Update 2006 (IOM, 2007) ; Update 2004, Veterans and Agent Orange: Update 2004 (IOM, 2005)
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a Seveso Studies Reviewed in Update 2006 Baccarelli et al., Population Investigate health status of 101 chloracne 211 control 2005 based chloracne cases, TCDD- cases chloracne exposure relationship, and factors modifying TCDD toxicity Eskenazi et al., Population Seveso Women's Health Study 616 None 2005 based examining the relationship of TCDD (serum dioxin) and age at menopause Landi et al., 2005 Population Effects of CYP1A1, 62 59 based CYP1B1 variant genotypes and haplotypes on mRNA expression and EROD activity in lymphocytes Warner et al., Population Examined the age of 282 2004 based menarche in SWHS women who were premenarcheal at the time of the explosion Seveso Studies Reviewed in Update 2004 Baccarelli et al., Population mRNA concentrations, AhR, 62 59 2004 based ARNT, CYP1A1, CYP1B1 genes, and EROD activity in peripheral blood lymphocytes in a Seveso, Italy cohort Eskenazi et al., Cohort Relationship between serum 899 None 2004 TCDD concentration and age at exposure in SWHS participants Eskenazi et al., Cohort Association between maternal 888 None 2003a serum TCDD and birth outcome SWHS participants Landi et al., 2003 Population Effect of TCDD-mediated 62 59 based alterations in AhR-dependent pathway in Seveso Zone A and B residents Baccarelli et al., Population Immunologic effects in 62 59 2002 based Seveso residents, compared with previous published results continued
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a Eskenazi et al., Cohort Association between 381 None 2002a menstrual cycle characteristics and serum TCDD in SWHS participants Eskenazi et al., Cohort Association between 601 None 2002b endometriosis and serum TCDD concentration in SWHS participants Seveso Studies Reviewed in Update 2002 Warner et al., Cohort Association between 15 981 2002 individual serum TCDD and breast cancer risk in SWHS participants Seveso Studies Reviewed in Update 2000 Bertazzi et al., Cohort Mortality (through 1996) of 804, Zone A; 232,745 2001 residents in 3 exposure zones 5,941, Zone B; 38,624, Zone R Pesatori et al., Cohort Mortality (through 1991)
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a Pesatori et al., Cohort Cancer incidence in Seveso ~20,000 167,391 1993 residents (1–19) in first postaccident decade, compared with age-matched residents of neighboring non exposed areas Seveso Studies Reviewed in VAO Bertazzi et al., Cohort Mortality for exposed children 306, Zone A; 95,339 1992 (1976–1986)
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a Ideo et al., 1985 Cross- Enzyme activity among 117 adults 127 adults sectional residents of Seveso Zone B and an uncontaminated community Tenchini et al., Cross- Cytogenetic analysis, maternal 19 16 1983 sectional and fetal tissue among Seveso exposed, compared with control sample Ideo et al., 1982 Cross- Hepatic enzymes in exposed 16, Zone A; 51, 60 Bristo sectional children, compared with Zone B Assizio normal 26 Cannero Caramaschi Cohort Chloracne among Seveso 146 182 et al., 1981 children, compared with children with no chloracne, association with other health outcomes between chloracne and no chloracne groups Filippini et al., Cohort Prevalence of peripheral 308 305 1981 neuropathy on 2 screening examinations in Seveso residents, compared with residents of non-exposed areas Bisanti et al., Descriptive Selected health outcomes in 730, Zone A; None 1980 residents of Zone A, B, R 4,737, Zone B; 31,800, Zone R Boeri et al., 1978 Cohort Neurologic disorders in 470, Zone A 152, Zone R exposed residents on July 10, 1976, compared with residents of non-exposed areas Times Beach/Quail Run Studies Reviewed in VAO Evans et al., Cross- Retesting for skin delayed- 28 15 1988 sectional type hypersensitivity among non-responders in earlier test (Stehr et al., 1986) Stockbauer et al., Cohort Adverse reproductive 402 births 804 births 1988 outcomes (1972–1982)
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in men living in Vietnam, compared with other hospitalized patients, for association with a range of exposures, including herbicides Studies in Vietnamese Reviewed in VAO Dai et al., 1990 Cohort Infant mortality (1966–1986) 5,609 3,306 in 2 South Vietnam villages exposed to Agent Orange spraying, compared with infant mortality in an unsprayed area Phuong et al., Case– Birth defects, hydatidiform 15 birth 104 1989a control mole, compared with normal defects; 50 134 births (1982)
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a Phuong et al., Cohort Reproductive anomalies 7,327 births 6,690 births 1989b among births to women (May 1982–June 1982) living in heavily sprayed areas with herbicides in southern Vietnam, compared with births among women from Ho Chi Minh City Constable and Review Summaries, reproductive Hatch, 1985 outcomes among Vietnamese populations, including 9 unpublished studies Other Environmental Studies Reviewed in Update 2006 Chen et al., 2006 Investigated the prevalence of hypertension in Taiwanese residents near municipal waste incinerators for a least 5 years Lee C-C et al., Cohort From prior survey identified 85 subjects (52 33 2006 residence near Taiwan from exposure)
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a Pahwa et al., Case– HD, multiple myeloma, STS 316 HD cases 1,056 2006 control diagnosed 1991–1994 in men 342 multiple 19 years of age living in six myeloma cases Canadian provinces, exposed 357 STS cases to phenoxy herbicides and other pesticides Vermeir et al., Cross- Flemish Environmental and 2005 sectional Health Study on neuro behavior and dioxin-like compounds Wang et al., 2005 Cross- Thyroid function in newborns 118 sectional with exposure to PCBs Other Environmental Studies Reviewed in Update 2004 Fierens et al., Population- Association between serum 194 63 2003 based, dioxin, prevalence of diabetes, cross- endometriosis in several sectional Belgian towns Fukuda et al., Ecologic Correlation between 426 164 2003 cohort incinerator dioxin emissions municipalities municipalities and mortality in 803 Japanese with plants without plants municipalities Other Environmental Studies Reviewed in Update 2002 Revazova et al., Cohort Cytogenetic effects in women 15 possibly 30 non2001 exposed to different amounts exposed exposed but of dioxin while living in workers; living close to Chapaevsk, Russia plant Revich et al., Cohort Dioxin exposures in Children Samara 2001 Chapaevsk, Russia, and and adults in region and all various health outcomes in Chapaevsk, of Russia children and adults Russia Other Environmental Studies Reviewed in Update 2000 Schreinemachers, Cross- Cancer mortality rates in 4 -- -- 2000 sectional northern wheat-producing states using wheat acreage per county as surrogate for exposure continued
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a Other Environmental Studies Reviewed in Update 1998 Gallagher et al., Case– Community-based study of 226 BCC; 180 406 1996 control primary BCC and primary SCC SCC in Alberta, Canada Lovik et al., Cohort Immune system parameters 24 10 1996 in hobby fishermen in the Frierfjord, southeastern Norway Masala et al., Case– Multicenter study, NHL, HD, 421 HD; Internal 1996 control multiple myeloma, AML by 1,822 NHL; comparison region in Italy 325 multiple by region myeloma; 263 AML Waterhouse PMR NHL, HD, CLL in rural 42 men; 32 4 controls per et al., 1996 analysis, Michigan women case nested case– control Svensson et al., Cohort Mortality and cancer 2,896 East 8,477 West 1995 incidence experience in 2 coast coast cohorts of Swedish fishermen Weisglas- Cohort Immunologic effects of pre- 105 breast-fed 102 bottle-fed Kuperus et al., and postnatal PCB or TCDD 1995 exposure in 207 Dutch infants from birth to 18 months Wolf and Cross- Effects of inhalation 221 189 Karmaus, 1995 sectional exposure to TCDD and related compounds in wood preservatives on cell-mediated immunity in German day care center employees Other Environmental Studies Reviewed in Update 1996 Butterfield et al., Case– Possible environmental risk 63 68 1993 control factors associated with young onset PD Peper et al., 1993 Descriptive Environmental exposure 19 None in Germany to dioxins and furans, potential association with adverse neuropsychological effects
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a Other Environmental Studies Reviewed in VAO Lampi et al., Nested Cancer incidence in Finland 56 colon 688 1992 case– community residents exposed cancer; 40 control/ to chlorophenol-contaminated bladder cancer; Cohort water and food (1987) , 8 STS; 7 HD; compared with residents of 23 NHL; 43 other communities; several leukemia cancers, compared with population controls, for association with potential risk factors, including food and water consumption Vineis et al., Ecological Presentation rates (1985– 63 HD; 253 No non1991 1988)
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US EPA, 1979 Ecological Spontaneous abortion (1972– 2,344 births 1,666 births, design 1977) in herbicide-sprayed nonsprayed areas around Alsea, Oregon area; 4,120 compared with spontaneous Births, urban abortion in nonsprayed areas area ABBREVIATIONS: 2,4,5-T, 2,4,5-trichlorophenoxyacetic acid; AhR, aryl hydrocarbon receptor; AML, acute myelogenous leukemia; ARNT, arylhydrocarbon receptor nuclear transporter; BCC, basal-cell carcinoma; CYP1A1, cytochrome p450 1A1; CYP1B1, cytochrome P450 1B1; EROD, 7-ethoxyresorufun-O-deethylase; HD, Hodgkin's disease; NHL, non-Hodgkin's lymphoma; PCB, polychlorinated biphenyl; PD, Parkinson's disease; SCC, squamous-cell carcinoma; SWHS, Seveso Women's Health Study; STS, soft-tissue sarcoma; TCDD, 2,3,7,8-tetrachlorodibenzo-p-dioxin; Update 2006, Veterans and Agent Orange: Update 2006 (IOM, 2007)
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on Ranch Hand Veterans Reviewed in Update 2006 Pavuk Cohort Focus on prostate cancer using 59 81 et al., 2006 information on serum TCDD and years of service in Southeast Asia (SEA) AFHS, Air Force Health Study -- 2002 2005 exam cycle Ranch Hand veterans Ketchum Cohort Ranch Hand mortality analysis 1,262 Ranch 19,078 and summarizing current all-cause and Hand veterans comparison Michalek, cause-specific post-service mortality veterans 2005 rates for veterans sprayed between 1962 to 1971 Pavuk Cohort Examine cancer incidence in 1,482 No et al., 2005 Air Force veterans who served comparison in Southeast Asia and who were group not occupationally exposed to herbicides Kern et al., Cohort Observe whether insulin sensitivity ?
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(1999) , 1,189 net Ranch 1,776 net et al., 2004 comparing cancer incidence among Hands for comparison Ranch Hands with Vietnam veterans external analysis; subjects who served in Southeast Asia but 1,009 net Ranch for external did not spray herbicides and with Hands for analysis; US national cancer rates internal analysis 1,429 net comparison subjects for internal analysis Barrett Cohort Serum TCDD measurement and 1,109 1,493 et al., 2003 psychological functioning among Ranch Hand veterans Michalek Cohort Correlation for TCDD elimination 343 No et al., 2003 and Ranch Hands with diabetes comparison group Pavuk Cohort Study to examine the relationship 1,009 1,429 et al., 2003 between serum TCDD and thyroid function in Ranch Hand veterans Barrett Cohort Based on tests of cognitive 937 Ranch Hand 1,052 et al., 2001 functioning in 1982 and dioxin Ranch Hand concentrations measured in 1987 comparisons and 1992, analyzed association between serum dioxin levels and cognitive functioning Michalek Cohort Based on physical examination 1,109 Ranch 1,493 et al., through 1992 and medical records Hand Ranch Hand 2001a reviewed through March 1993, comparisons association between serum dioxin levels and hepatic abnormality Michalek Cohort Based on physical examination in 761 Ranch Hand 1,086 et al., 1982, 1985, 1987, 1992, and 1997 Ranch Hand 2001b and medical records through 1997, comparisons association between serum dioxin and peripheral neuropathy Michalek Cohort Based on physical examination in 953 Ranch Hand 1,280 et al., 1982, 1985, 1987, and 1992 and Ranch Hand 2001c medical records through 1997, comparisons association between serum dioxin and hematologic function
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a Steenland Cohort Re-examine and compare diabetes 267 NIOSH 227 NIOSH et al., 2001 data from the NIOSH cohort and workers; comparisons the United States Air Force Ranch 990 Ranch 1,275 in order to reconcile differences Hands Ranch Hand between the two study methods and comparisons protocols. Reports from AFHS Reviewed in Update 2000 AFHS, Cohort 266 Health-related endpoints, 995 1,299 2000 including assessments of 10 clinical areas: general health, neoplasia, neurologic, psychological, gastrointestinal, cardiovascular, hematologic, endocrine, immunologic, pulmonary Longnecker Cohort Based on physical examination and -- 1,197 and medical records review through Michalek, 1992, association between serum 2000 dioxin and diabetes mellitus among comparison group (no Ranch Hands)
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a Michalek Cohort Updates, all-cause and cause- 1,261 Ranch 19,080 et al., specific post-service mortality Hand Ranch Hand 1998b (through 1993) among veterans comparisons of Operation Ranch Hand, using standardized mortality ratios Michalek Cohort Prospective study, exposure 1,208 veterans; 1,549 et al., and long-term health, survival, 903 offspring veterans; 1998c reproductive outcome 1,254 offspring Michalek Cohort Third report in a series investigating 859 1,223 et al., dioxin body burden and preterm 1998d birth, intrauterine growth retardation, infant death among offspring of Ranch Hand veterans Reports from AFHS Reviewed in Update 1998 Michalek Cohort Paternal serum dioxin levels and 859 children: 1,223 et al., infant death among Ranch Hand 323 background children 1998a offspring exposure; 267 low exposure; 269 high exposure Henriksen Cohort Relationship between serum dioxin 989 1,276 et al., 1997 and glucose, insulin, and diabetes mellitus in Ranch Hands through 1992 AFHS, Cohort Mortality update, Ranch Hands 1,261 19,080 1996 through the end of 1993 in the Michalek AFHS cohort (1983, 1984b, 1985, et al., 1986, 1989, 1991a, 1995)
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1985, 1986, air and ground crew veterans in 1989, Southeast Asia who did not spray 1991a herbicides Michalek Cohort Mortality of Ranch Hands, 1,261 19,101 et al., 1990 compared with Air Force C-130 air and ground crew veterans in Southeast Asia Wolfe Cohort Health status of Ranch Hands at 995 1,299 et al., 1990 second follow-up, compared with Air Force C-130 air and ground crew veterans in Southeast Asia CDC Studies Reviewed in Update 2006 Boehmer Cohort Vietnam Experience Study -- post- 18,313 et al., 2004 service mortality CDC Studies Reviewed in VAO Decoufle Cohort Association between self-reported 7,924 7,364 et al., 1992 health outcomes and perception of exposure to herbicides based on Vietnam Experience Study O'Brien Cohort Interview report and mortality for 8,170 7,564 et al., 1991 NHL based on Vietnam Experience Study continued
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From page 768... ...
a CDC, Case– Selected Cancers Study: population- 1,157 NHL; 1,776 1990a control based case–control study of all men 342 STS; 310 born 1921–1953; cases diagnosed HD; 48 nasal area covered by 8 cancer registries, carcinoma; 80 controls selected by random-digit nasopharyngeal dialing carcinoma; 130 primary liver cancer CDC, Case– Selected Cancers Study: population- 1,157 1,776 1990b control based case–control study of all men born 1921–1953; cases diagnosed in area covered by 8 cancer registries, controls selected by random-digit dialing for NHL CDC, Case– Selected Cancers Study: STS 342 1,776 1990c control CDC, Case– Selected Cancers Study: HD, nasal 310 HD; 48 nasal 1,776 1990d control cancer, nasopharyngeal cancer, carcinoma; 80 primary liver cancer nasopharyngeal carcinoma; 130 primary liver cancer CDC, Cohort Vietnam Experience Study: random 2,490 1,972 1989b sample, US Army enlisted men, 1965–1971 CDC, Cohort Vietnam Experience Study: random 2,490 1,972 1988a sample, US Army enlisted men, 1965–1971, psychosocial outcomes CDC, Cohort Vietnam Experience Study: physical 2,490 1,972 1988b health outcomes CDC, Cohort Vietnam Experience Study: 12,788 children 11,910 1988c reproductive outcomes children CDC, 1987; Cohort Vietnam Experience Study: 9,324 8,989 Boyle mortality et al., 1987 Erickson Case– CDC birth defects study, children 7,133 4,246 et al., 1984 control born in the Atlanta, Georgia, area a,b 1968–1980, comparing paternal Vietnam experience and potential Agent Orange exposure for birth defects cases and normal controls
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From page 769... ...
a Department of Veterans Affairs Studies Reviewed in Update 2006 Kang et al., Cohort Army Chemical Corp; serum 1,499 1,428 2006 TCDD, Vietnam veterans {sprayers vs. not sprayers} vs not Vietnam vet Department of Veterans Affairs Studies Reviewed in Update 2002 Kang et al., Cohort Health of Army Chemical Corps 2,872 2,737 2001 Vietnam veterans, compared with Army Chemical Corps veterans who did not serve in Vietnam Kang et al., Cohort Self-report pregnancy outcomes for 3,392 women; 3,038 2000a female Vietnam veterans, compared 1,665 women women; with contemporary veterans not with indexed 1,912 deployed to Vietnam; odds ratios pregnancy women with calculated for reproductive history indexed and various birth defects pregnancy Kang et al., Cohort Gynecologic cancers among female 484 5,946 2000b Vietnam veterans, compared with veteran controls Department of Veterans Affairs Studies Reviewed in Update 1998 Dalager Cohort Morbidity and mortality experience 2,872 2,737 and Kang, (1968–1987)
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From page 770... ...
31, 1995 1995a Bullman Case– Association between testicular 97 311 et al., 1994 control cancer and surrogate measures of exposure to Agent Orange in male Vietnam veterans Department of Veterans Affairs Studies Reviewed in VAO Bullman Case– PTSD cases in Vietnam veterans, 374 373 et al., 1991 control compared with Vietnam veterans without PTSD, for association with traumatic combat experience Dalager Case– NHL cases diagnosed 1969–1985 201 358 et al., 1991 control among Vietnam-era veterans, compared with cases of other malignancies among Vietnam era veterans, for association with Vietnam service Eisen et al., Cohort Health effects in male monozygotic 2,260 2,260 1991 twins serving in the armed forces during Vietnam era (1965–1975) Thomas Cohort Mortality experience (1973–1987)
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From page 771... ...
in Army Chemical 1990 Corps Vietnam veterans compared with US men True et al., Cross- PTSD and Vietnam combat 775 1,012 1988 sectional experience among Vietnam-era veterans Breslin Cohort Mortality experience (1965–1982) 24,235 26,685 et al., 1988 in Army and Marine Corps Vietnam Burt et al., veterans, compared with Vietnam1987 era veterans who did not serve in Southeast Asia, standardized by age and race; nested NHL case–control study Kang et al., Case– STS cases (1975–1980)
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From page 772... ...
among Massachusetts Vietnam veterans, compared with Massachusetts Vietnam-era veterans with cancers of other sites; update of Clapp et al., 1991 State Studies Reviewed in Update 1996 Visintainer Cohort Mortality experience (1965–1971) 3,364 deaths 5,229 deaths et al., 1995 in male Michigan Vietnam veterans, compared with non-Vietnam veterans from Michigan
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From page 773... ...
a State Studies Reviewed in VAO Fiedler and Cohort New Jersey: outcomes in select 10 Pointman I 17 Pointman Gochfeld, group of herbicide-exposed 55 Pointman II I 1992 Army, Marine, and Navy Vietnam 15 Pointman Kahn et al., veterans, compared with veterans II 1992a,b,c self-reported as unexposed Clapp Case– Massachusetts: selected cancers 214 727 et al., 1991 control identified (1982–1988) among Vietnam veterans, compared with Massachusetts Vietnam-era veterans with cancers of other sites Deprez Descriptive Maine: Vietnam veterans, compared 249 113 Atomic et al., 1991 with atomic test veterans and test veterans general population, for health status and reproductive outcomes Levy, 1988 Cross- Massachusetts: PTSD in chloracne 6 25 sectional as indicator of exposure to TCDD; control Vietnam veterans Anderson Cohort Wisconsin: mortality experience, 110,815 white 342,654 et al., veterans compared with non- male veteran white male 1986a veterans (Phase 1)
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From page 774... ...
a Pollei et al., Cohort New Mexico: chest radiographs 422 105 1986 of Agent Orange Registry Vietnam veterans, compared with radiographs of control Air Force servicemen, for pulmonary and cardiovascular pathology Kogan Cohort Massachusetts: mortality experience 840 Deaths 2,515 deaths and Clapp, (1972–1983) among white male in Vietnam1985, 1988 Vietnam veterans, compared with era veterans non-Vietnam veterans and all other non-veteran white men in Massachusetts Lawrence Cohort New York: mortality experience in (1)
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From page 775... ...
, for association between Vietnam service and PTSD Aschengrau Case– Association between husband's 201 1,119 and control military service and spontaneous Monson, abortion at or by 27 weeks, 1989 compared with women delivering at 37 weeks STUDIES OF AUSTRALIAN VIETNAM VETERANS Studies of Australian Vietnam Veterans Reviewed in Update 2006 ADVA, Cohort Cancer incidence from 1982 to 59,179 total; 2005a 2000 among Australian male Army, 41,084 (Army) ; Navy, and Air Force veterans who 13,538 (Navy)
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From page 776... ...
of Australian Army 1996a,b,c Vietnam veterans Studies of Australian Vietnam Veterans Reviewed in VAO Field and Cohort Tasmanian Vietnam veterans, 357 281 Kerr, 1988 compared with neighborhood controls for adverse reproductive and childhood health outcomes Fett et al., Cohort Mortality experience in Vietnam 19,205 25,677 1987a veterans, compared with Vietnam era veterans through 1981
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From page 777... ...
a Fett et al., Cohort Cause-specific mortality experience 19,205 25,677 1987b in Vietnam veterans, compared with Vietnam-era veterans through 1981 Forcier Cohort Mortality in Vietnam veterans by 19,205 Internal et al., 1987 job classification, location, time of comparison service Donovan Case– Congenital anomalies in children 8,517 8,517 et al., 1983, control (1969–1979) , compared with 1984 infants born without anomalies, for association with paternal Vietnam service STUDIES OF VIETNAM VETERANS FROM OTHER COUNTRIES Other Vietnam-Veteran studies Reviewed in Update 2004 Kim H-A Cohort Immunotoxicologic effects of 51 (24 veterans– 36 et al., 2003 Agent Orange exposure on Korean patient; 27 Vietnam veterans veterans–normal)
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