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VA TO REVIEW NAS REPORT ON AGENT ORANGE EXPOSURE

Author: Not Specified
Publication: Not Specified
Document Dated: July 1, 1996
Date Posted: January 27, 1997


Washington, DC, March 14, 1996 -- The Department of Veterans Affairs (VA) is announcing it will conduct an indepth review of a recent report issued by the National Academy of Sciences (NAS) on the health effects of exposure to Agent Orange and other herbicides.

Reviewing the latest scientific studies, NAS found that there is new limited or suggestive evidence to show an association with acute and subacute peripheral neuropathy (a neurological disorder) in Vietnam veterans, and spina bifida (a congenital abnormality) in their children.

Secretary of Veterans Affairs Jesse Brown said: "I am deeply concerned about the suggestion that the children of Vietnam veterans may be at higher risk for spina bifida. I have instructed VA's Veterans Health Administration to move quickly to provide a thorough evaluation of this issue. I want to ensure that studies are conducted so that we can provide answers that will address the concerns of Vietnam veterans and their families."

Brown said that, in response to the report, VA will vigorously pursue research on the reproductive health of Vietnam veterans. He has ordered a task force, in consultation with veterans organizations and other interested parties, to conduct the review and make recommendations to him within 90 days.

The decisions follow today's release of a follow-up to NAS's first report, issued in July 1993, which found that sufficient evidence exists of an association between herbicide exposure and soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, chloracne and porphyria cutanea tarda. VA announced at that time that Hodgkin's disease and porphyria cutanea tarda (a liver disorder) would be added to the department's list of diseases for disability compensation purposes. VA had previously recognized soft-tissue sarcoma, non-Hodgkin's lymphoma and chloracne as being associated with herbicide exposure and Vietnam service, and had been paying compensation to Vietnam veterans for these conditions.

Also at that time, Brown ordered a VA task force to review the evidence for the diseases for which NAS found only limited or suggestive evidence of an association with herbicides of the kinds used in Vietnam: respiratory cancers (lung, larynx and trachea), prostate cancer and multiple myeloma (a cancer involving the bone marrow). As a result of the task force review, conducted in consultation with veterans groups and other interested parties, Brown announced in September 1993 that Vietnam veterans suffering from respiratory cancers and multiple myeloma would be awarded disability compensation based on presumed exposure to Agent Orange and other herbicides.

In 1995, NAS established a new 16-member committee to reexamine earlier scientific studies and review newly published ones on the association between diseases and exposure to dioxin and other herbicides.

VA had requested that the committee focus special attention on prostate cancer, peripheral neuropathy, hepatobiliary cancer and nasopharyngeal cancer, but there was no change in category for these conditions.

In its latest report, the committee concluded that porphyria cutanea tarda should be moved from the category of sufficient evidence of association to that of limited/suggestive evidence of an association. Brown has determined that, despite the change in category, there is no basis to change the compensation regulation. "VA will continue to compensate Vietnam veterans with this condition, based on their Vietnam service and presumed exposure to herbicides," said Brown.

The committee also moved skin cancer from the category of limited/suggestive evidence of no association to inadequate/insufficient evidence to determine whether an association exists.

Two additional conditions were placed in the category of limited/suggestive evidence of an association: acute and subacute peripheral neuropathy, and spina bifida in offspring. In this category, according to NAS, the evidence is suggestive of an association between herbicides and outcome but is limited because chance, bias and confounding could not be ruled out with confidence. At least one high quality study shows a positive association, but the results of other studies are inconsistent.

VA is in the process of establishing the task force to review the evidence NAS used to arrive at its conclusions. In addition, VA will pursue research on birth defects among children of Vietnam veterans and reproductive health effects of Vietnam service.

Specifically, VA is conducting the Vietnam Women Veterans Reproductive Health Study and will be contributing funds for the NAS National Research Council's project on reproductive toxicology.

VA also will consult with reproductive epidemiologists to explore all other avenues for studies on the associations between herbicides and birth defects, particularly neural tube defects.

Vietnam veterans who believe they have health problems that may be related to their exposure to Agent Orange while serving in Vietnam should contact the nearest VA medical center or regional office. VA's nationwide toll-free number is 1-800-827-1000.


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