Blue Water Navy Vietnam Veterans and Agent Orange Exposure (2011) / Chapter Skim
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SUMMARY
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, prostate cancer, Hodgkin's disease, respiratory cancers, ischemic heart disease, and soft-tissue sarcoma. Before 1997, Vietnam veterans were eligible for a presumption of exposure if "during active military, naval, or air service, they had served in the Republic of Vietnam" unless there was evidence that they had not been exposed to Agent Orange.
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Blue Water Navy Vietnam veterans along with other Vietnam veterans have become concerned about their potential exposure to the TCDD contaminant present in Agent Orange. Recent publications, such as that of an Australian study of potential TCDD enrichment of potable water aboard Royal Australian Navy ships as a result of the waterdistillation process, have prompted additional concerns regarding exposure of Blue Water Navy veterans to TCDD.
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Conceptual Approach The committee considered that the most appropriate approach for assessing the risks of long-term adverse health effects would be a riskassessment framework. The framework begins with identifying the sources of Agent Orange and its TCDD contaminant and potential receptors (in this case, ground troops and Brown Water Navy and Blue Water Navy populations)
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Rather, it focused its literature searches and other efforts on identifying epidemiologic studies of health effects seen in Vietnam veterans that included Navy personnel as a specific population and studies that divided Navy personnel into those who may have served in the Blue Water Navy, in the Brown Water Navy, or onshore. Information Sources Many data sources and methods were identified and pursued by the committee, including published peer-reviewed literature, models for assessing the environmental concentrations of Agent Orange and TCDD, anecdotal information from veterans and other interested parties on veteran experiences during the war and afterwards, and such other information sources as written and published accounts of the war (including memoirs)
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The committee held three open sessions to collect veterans' input. At the first two sessions, held in Washington, DC, the committee heard from the VA, several veterans service organizations (for example, the Blue Water Navy Vietnam Veterans Association)
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That presumption -- a mechanism of disability compensation that the VA has used in other contexts -- allows veterans to receive disability compensation and treatment for a medical condition without having to provide proof that the condition was "incurred in or aggravated by" their military service. The VA denies Blue Water Navy Vietnam veterans presumptions of service connections for herbicide-related conditions unless a veteran was aboard a ship at the time of docking in Vietnam or, if shore docking did not occur, the evidence shows that the ship operated in Vietnam's close coastal waters for extended periods, members of the crew went ashore, or smaller vessels went ashore regularly from the ship with supplies or personnel.
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Vietnam veterans who served on the ground and on the inland waterways of Vietnam are eligible for compensation for their Agent Orange–associated medical problems regardless of the time they spent in Vietnam and the potential for their exposure to Agent Orange during the war. SELECTED CHEMICALS USED DURING THE VIETNAM WAR By far the most widely used herbicide in Vietnam was Agent Orange, followed by Agent White; other tactical herbicides that were used during the war include Agent Blue, Agent Purple, Agent Pink, and Agent Green.
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FATE AND TRANSPORT OF AGENT ORANGE AND TCDD IN THE VIETNAMESE ENVIRONMENT Potential exposure of Blue Water Navy personnel to Agent Orange and its contaminant TCDD is related to the fate of these chemicals in the Vietnamese environment. The committee considered using a mathematical model to estimate likely TCDD concentrations based on Agent Orange inputs to the environment.
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The committee concluded that Agent Orange and TCDD would have entered waterways from riverbank spraying (although this was a small fraction of the total Agent Orange applied in Vietnam) or as runoff from soil, particularly in the Mekong delta area that was heavily sprayed and that experienced frequent flooding.
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It should be noted that ground troops and Brown and Blue Water Navy personnel also included an unknown fraction of personnel who were remote from spraying operations and possibly had no opportunity for exposure. The committee identified several plausible exposure pathways and routes of exposure to Agent Orange–associated TCDD in the three populations.
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The issue of distillation of marine water is important because of the finding by the committee that prepared the 2008 VAO update that Blue Water Navy veterans could have been exposed to TCDD via contaminated potable water. The Australian Department of Veterans Affairs determined that Royal Australian Navy personnel who served offshore were exposed to Agent Orange–associated TCDD in Vietnam because the distillation systems aboard the ships were thought to be able to concentrate TCDD in source water into the potable water during the evaporative process.
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Overall, the committee concludes that because of the small number of studies and their limitations, there is no consistent evidence to suggest that Blue Water Navy Vietnam veterans were at higher or lower risk for cancer or other long-term adverse health effects associated with Agent Orange exposure than shore-based veterans, Brown Water Navy veterans, or Vietnam veterans in other branches of service. CONCLUSIONS Since the 1970s, IOM committees and other groups have attempted to reconstruct Vietnam veterans' potential exposure to Agent Orange and
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Therefore, the committee evaluated the plausibility of exposure of the three populations to Agent Orange and TCDD via various mechanisms and routes. The committee recognized that considerable variability exists in the potential for TCDD exposure by Blue Water Navy personnel, ground troops, and Brown Water Navy personnel.
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The committee's judgment is that exposure of Blue Water Navy Vietnam veterans to Agent Orange–associated TCDD cannot reasonably be determined.
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