A G E N T ORANGE:
VETERANS' C O M P L A I N T S C O N C E R N I N G E X P O S U R E
T O H E R B I C I D E S IN S O U T H VIETNAM
ISSUE BRIEF NUMBER IB80040
P a m e l a W.
Science Policy,Research Division
THE LIBRARY OF CONGRESS
CONGRESSIONAL RESEARCH SERVICE
MAJOR I S S U E S S Y S T E M
D A T E O R I G I N A T E D 09/06/79
D A T E U P D A T E D 06/25/82
FOR ADDITIONAL INFORMATION CALL 287-5700
From 1962 to 1971, the United States Air Force
(USAF) sprayed various
herbicide mixtures (chemicals that kill plants)
in South Vietnam.
purpose of the spraying was to defoliate jungle growth to deprive the
Communist forces o f ground cover, and to destroy enemy crops to restrict food
supplies. The most extensively used of these herbicide mixtures was known a s
Agent Orange, a 50:50 mix of two common herbicides called 2,4,5-T and 2,4-D
( 2 , 4 , 5 - t r i c h l o r o p h e n o x y a c e t i c acid and 2 , 4 - d i c h l o r o p h e n o x y a c e t i c acid).
third chemical present
in the mixture in small amounts was TCDD, a n
inevitable by-product of the manufacture of 2,4,5-T. This chemical, called
tetrachlorodibenzo-para-dioxin or simply "dioxin," i s highly toxic
laboratory animals when administered in its pure form.
toxicity values in humans have not been established, although Gosselin e t
al., in the 1976 edition of 9
TCDD in a class of chemicals for which the "probable lethal dose1' for humans
would be less than 5 mg/kg, o r about 7 drops for a 1 5 0 ~b (70 kg) person.
CRS has been unable to locate any report 0 6 a human death from exposure to
The human health
effect that has been most consistently
documented following exposure to small amounts of TCDD a s a contaminant i n
There i s other, less
other compounds is a skin condition known as chloracne.
consistent, evidence of damage to the liver and the nervous system in humans.
Extensive testing on laboratory animals has been done to determine possible
long-term effects of exposure to TCDD.
It can induce cancer i n some strains
of rats and mice (carcinogenicity) cause fetal death in several species
(teratogenicity), but has been found not to cause genetic changes i n
mammalian cells (mutagenicity). The American Medical Association's
on Scientific Affairs concluded that "there i s no scientific evidence that
2,4-0, 2,4,5-T or TCDD has caused reproductive difficulties o r hazards in the
Congressional intRrest was triggered by receipt of reports from Vietnam
veterans who believed they had been harmed by exposure to herbicides,
particularly Agent Orange. The 96th Congress held numerous hearings on the
use of herbicides in South Vietnam, and various initiatives to deal with the
problem were introduced. P.L. 96-151 was enacted to direct the Veterans
Administration (VA) to conduct a n epidemiological study on Vietnam veterans
to determine whether there may be adverse human health
with exposure to phenoxy herbicides and/or
This study and other
studies planned will help elicit answers to the scientific questions posed by
the Veterans Administration i n determining whether or not the veterans1
medical problems, allegedly due to exposure to Agent orange an&
herbicides used i n Vietnam, ar@ cornpensable.
Pollowing recommendations made
by the Interagency Work Group on Phensxy Herbicides
(now the Agent Orange
Working Group), legislation was introduced in the 97th Congress to expand the
scope of the V A 1 s epidemiological study of the health effects of Agent Orange
to include other factors related to military
service in Vietnam;
legislation also allows veterans with medically certifiable conditions that
might possibly have been caused by exposure to Agent Orange t o receive
medical care in VA facilities. The bill (H.R. 3499) was considered by the
House and Senate i n June 1981, put into final form in October, and signed by
3 , 1981.
Its title i s the Veterans1 Health Care,
the President Nov.
Training, and Small Business Loan Act of 1981 (P.L. 97-72).
BACKGROUND AND POLICY ANALYSIS
During the summer of 1969, the first reports of human birth defects
allegedly attributed to Agent Orange appeared in Vietnamese newspapers.
Based on these allegations and the results of a study sponsored by the
National Cancer Institute that showed that 2,4,5-T contaminated with TCDD
caused birth defects in laboratory animals, the USAF stopped spraying 2,4,5-T
in South Vietnam by early 1971.
Although the Department of Defense maintains that only a limited number of
U.S. military personnel can be positively identified a s having been exposed
to 2,4,5-T in South Vietnam (i.e., crews of aircraft that were used to spray
herbicides), it is theoretically possible that large numbers of both military
personnel (from the United States, South Vietnam, North Vietnam, Australia,
and New Zealand) and civilians (especially South Vietnamese peasants) were
exposed to 2,4,5-T through the USAF spraying program.
A growing number of
U.S. veterans who served in South Vietnam have begun to attribute the cause
of various chronic ailments which they are now experiencing
nervous disorders, cancers, and birth defects in their offspring) to exposure
to 2r4,5-T in South Vietnam, and many have filed claims with the VA for
compensation. The VA has not yet awarded compensation to veterans for any
claims related to 2,4,5-T exposure because of the lack of valid human data to
prove a cause and effect relationship between exposure to 2,4,5-T and/or TCDD
and specific health effects (except for chloracne).
The industrial production of 2,4,5-T always results i n some
contamination although TCDD levels can be reduced to about 0.01 parts per
Because it was not widely recognized
million (ppm) with current technology.
until the late 1960s that 2,4,5-T could contain hazardous amounts of TCDD,
manufacturers did not start reducing the level of TCDD in 2,4,5-T until the
USAF was already winding down its herbicide spraying program.
TCDD levels in the 2,4,5-T
containing herbtcide mixtures used in South
Vietnam were approximately 2 ppm i n Agent Orange
(which accounted for
approximately 96% of the 2,4,5-T used in South Vietnam),
ppm in Agent Purple, and 65.6 ppm i n Agents Pink and Green
Pink, and Green contained the remaining 2,4,5-T used in South Vietnam).
herbicides procured by the USAF were code named after the colored band that
was placed around each 55 gallon drum in order to identify the contents.]
Although TCDD is well established a s one of the most toxic chemicals known
for acute (short-term) effects, there i s no consensus in the scientific
community over the chronic (long-term) effects on humans of exposure to l o w
levels of TCDD (such a s those levels found in the herbicides used in South
low levels of TCDD and/or TCDD alone have caused various
tumors in mice and rats. A recently-released National Toxicology Program
bioassay of TCDD confirms these earlier reports that TCDD is carcinogenic in
some laboratory animals.
Thymic atrophy (without a corresponding loss in
immune function) and severe weight loss have been observed i n many species
after TCDD exposure.
In some species, acute exposure to TCDD can cause liver
damage. Birth defects such a s cleft palate and kidney abnormalities have
been reported in baby mice when the mothers were exposed during pregnancy.
National Toxicology Program animal study of male reproductive effects of
exposure to TCDD, however, has failed to reveal a statistically significant
increase in reproductive abnormalities in TCDD-exposed animals o r birth
defects in the TCDD-exposed male animals1 offspring. Although there is some
experimental evidence that TCDD may cause mutations (changes i n the c e l l l s
genetic material that may produce birth defects in as-yet-unconceived
offspring), these experiments have been few, they have been done mainly on
non-mammalian species o r in vitro (in test tubes), and they have basically
Some investigators feel that humans are less sensitive than animals to the
toxic effects of TCDD. There is wide variation of responses to TCDD among
different species, and the mechanisms of its toxicity and metabolism are not
understood. More work needs to be done to clarify whether human exposure to
TCDD can produce the same health effects with the same potency as those
observed in animal studies.
If a cause and effect relationship is to be scientifically established
between human exposure to a chemical and chronic health effects, a study
which meets the following minimum criteria must be conducted to prove that
a group of people (the "study groupw) must be
such a relationship exists:
identified that has already been exposed to the chemical under study
would help to know the level of exposure); this study group must be large
enough to detect chronic effects with statistical significance
(to find a n
effect that occurred in 1 out of 1 0 0 people, one would need to examine a t
least 100 people); a control group must be fOUnCl that ideally would differ
from the study group only by never having been exposed to the chemical under
study (thus, any differences in chronic health effects between the study and
control groups could be attributed Only to exposure to the chemical under
study); a n d , due to the long latency period for many chronic effects, the
study and control groups must be followed for as many years after exposure as
it takes for the chronic effects to show up
studies, subjects must be followed for a minimum of 1 0 to 20 years after
exposure to the suspect carcinogen).
These exacting criteria a r e not met by
most of the studies that have explored the relationship between human
exposure to TCDD and/or 2,4,5,-T and subsequent health effects.
chloracne has such a cause and effect relationship been well established.
Workers who have been exposed to TCDD and/or
2,4@5-T i n industrial
explosions or who have had other occupational exposure are frequently found
to have a skin condition known a s chloracne
which resembles normal acne
except that it is caused by chemical exposure.
Chloracne can appear from
weeks to months after initial exposure and while mild cases (blackheads) may
clear in a matter of months, severe cases (inflammatory lesions and scars)
may last up to 3 0 years after exposure has ceased.
While the severity of
chloracne is not thought to correlate precisely with the intensity or
2,4,5-TI chloracne i s associated so
duration of exposure to TCDD and/or
closely with exposure that some scientists argue that patients who have not
exhibited chloracne are unlikely to have suffered other toxic effects of TCDD
and/or 2,4,5-T exposure.
Studies of these exposed workers have also indicated a variety of other
health problems. For example, the United States Air Force Technical Report
on the Toxicology, Environmental Fate, and Human Risk of Herbicide Orange and
its Associated Dioxin (1978) listed a number of symptoms, signs, or disorders
that had been reported after occupational exposure to TCP
2,4,5-T's precursor), 2,4,5-TI or TCDD
As noted, these
studies, which reported symptoms associated with human exposure to dioxin,
were not conducted in such a way as to prove a cause-and-effect
between exposure to TCDD and/or 2,4,5-T and any of these effects, but they
may be indicative of such a relationship.
Several of the above studies have focused on investigating cancer rates
among exposed workers.
These studies do not show a clear cause/effect
relationship between carcinogenicity associated with exposure to TCDD and/or
2,4,5-T because very few exposed workers (with the exception of those in
Nitro, West Virginia) have been followed for more than ten years (the latency
period for most cancers being 1 5 to 4 0 years after exposure) and the results
have been equivocal.
However, they support a continuing suspicion and
indicate a need for further study.
When the scientific panel of the
Interagency Work Group on Phenoxy Herbicides reviewed five research papers by
European scientists, it concluded that despite the studiesf limitations, they
do "show a correlation between exposure to phenoxy acid herbicides and an.
increased risk of some forms of cancer."
A soft-tissue sarcoma study Bas
been proposed that will be conducted jointly by the Armed Forces Institute of
Pathology and the National Cancer Institute.
Studies that have been conducted in non-industrial settings have not been
able to prove a cause and effect relationship between exposure to TCDD and/or
2,4,5-T and specific health effects. The National Academy of Sciences
was directed by congress [P.L. 91-441, sec. 506(c)] to conduct a study on the
effects of herbicides in South Vietnam, including health effects.
study, as well as a t least three other similar studies that were conducted in
unable to find adequate data upon
South Vietnam during the early 1 9 7 0 ~were
which to reach any conclusions concerning a Causal effect between exposure to
herbicides and any health effects, including birth defects.
An explosion in a Hoffman-LaRoche chemical plant in Seveso, Italy in July
1976 caused thousands of people to be exposed to varying doses of TCDD as a
toxic cloud drifted across the Italian countryside in a cone-shaped pattern
about a mile long and half a mile wide.
Some 5400 people lived in the two
zones most directly affected, with an additional 40,000 people potentially
exposed. Animals began to die 2 to 3 days after the incident with over 1,100
animals killed by direct exposure to TCDD. Over 700 people were evacuated
from their homes.
Chloracne was reported in 187 people, mostly children, and
it tended to heal rapidly. Long-term human health effects of exposure to
Preliminary findings reported in
TCDD at Seveso are still being studied.
1979 by Hoffman-LaRoche revealed that SeVeSO residents had suffered liver
damage but that there was no permanent breakdown in liver function.
also reported that rates of spontaneous abortions, fetal malformations,
congenital defects, chromosome aberrations, reactions to infectious disease,
and morbidity and mortality were not affected by TCDD exposure. As reported
by the American Medical Association's Council on Scientific Affairs, "The
most recent progress report on the long-term epidemiologic survey of the
residents of the Seveso area emphasizes the preliminary nature of their
findings and reiterates the conclusions of prior investigators.
the skin, no organs or body functions were impaired.
No derangement of
gestation, no fetal lethality and loss, no gross malformations, no growth
retardation at term and no cytogenetic abnormalities have yet occurred."
Health effects of domestic use of 2,4,5-T have been
surveillance by various Government agencies for some years.
the Departments of Agriculture, Interior, and Health, Education and Welfare
jointly announced the suspension of cer$ain uses of 2,4,5-T following studies
indicating that it was a teratogen.
21, 1978, the Environmental
Protection Agency (EPA) issued a Rebuttable Presumption Against Registration
(RPAR) on 2,4,5-T, finding that the herbicide had exceeded
criteria and inviting comments from interested parties.
The RPAR was based
on toxicological data from animal studies showing a correlation between
2,4,5-T exposure and cancer and birth defects.
One of the comments received
was from Alsea, Oregon, claiming that there was a high incidence of
miscarriage among area women following spraying of the local forests with
EPA investigated this claim and reported its conclusion that the
incidence of spontaneous abortion over a 6-year period in Alsea was higher
than the rates i n two other regions of Oregon that had lower rates of 2,4,5-T
Based on the combination of evidence from the animal studies and the
Alsea study, EPA announced the emergency suspension of the domestic use sf
2,4,5-T on forests, pastures, and rights-of-way on Feb. 28, 1979. The Alsea
study has been criticized on methodological grounds by various groups, and
its results are rejected by a number of writers.
cancellation of 2,4,5-T began in June 1979. On Mar. 24, 1981, EPA and Dow
Chemical requested a recess in the hearing to discuss the possiblity of
The recess has b@en
negotiating a settlement.
Herbicide Spraying i n Vietnam
Approximately 1 0 7 million pounds of herbicides were aerially disseminated
on 6 million acres o f South Vietnam (an area about the size of Connecticut)
from January 1 9 6 2 to February 1971. Approximately 276,000 gallons of Agents
Green, Pink, and Purple were sprayed in South Vietnam prior to 1965 when they
were replaced by Agent Orange.
Approximately 1 1 million gallons of Agent
making it the most widely used
Orange were then sprayed in South Vietnam
herbicide of the war.
Ninety percent of Agent Orange was sprayed on 2.9
million acres of inland forests and mangrove forests for defoliation, 8% was
sprayed on enemy crops for crop destruction, and the remaining 2% was sprayed
around base perimeters, cache sites, waterways, and communications lines.
The Air Force continued to operate its herbicide spraying program in South
Vietnam until the late 1960s when the National Cancer Institute released
results of an animal bioassay that showed 2,4,5-T to be tesatogenic and/or
fetotoxic i n rodents, and newspapers in South Vietnam
health problems among the rural popuPations who had been exposed
The Air Force first restricted the use of Agent Orange to areas
remote from populations in October of 1969, then stopped a11 airplane
spraying of Agent Orange in early 1 9 7 0 ' a n d all helicopter spraying of Agent
Orange by 1971.
All remaining herbicide stocks were gathered and stored a t
either Gulfport, Mississippi or Johnston Island in the Pacific until they
were incinerated at sea i n 1977.
The following table outlines major military projects
handling of Agents Orange, Purple, Pink, or Green in South Vietnam.
MILITARY PROJECTS INVOLVING AGENTS ORANGE, PURPLE, PINK, OR GREEN
Selection of herbicides, and development
and evaluation of defoliation techniques.
Aerial spraying of herbicides in South
Development and testing of aerial spray
Redrumming and movement of surplus
herbicide from South Vietnam to
Maintenance of herbicide inventory
and research on options for disposal.
Dedrumming of herbicide inventory and
at-sea incineration of Agent Orange.
Each of these projects involved some human exposure to the herbicide
2,4,5-T and its contaminant, TCDD. The difficulty lies i n
determining who may have been exposed and at what level.
P e r s o n n e l Exposed
The e a r l y t r i a l s t h a t w e r e c o n d u c t e d i n S o u t h V i e t n a m t o i m p r o v e a i r c r a f t
s p r a y s y s t e m s ( 1 9 6 0 t o e a r l y 1 9 6 2 ) w e r e c o n d u c t e d b y USAF p e r s o n n e l
t o t h e S p e c i a l A e r i a l S p r a y F l i g h t D i v i s i o n , L a n g l e y AFB, V a . (USAF p e r s o n n e l
engaged i n t h e h e r b i c i d e program d i d n o t r e c e i v e permanent change of
t h u s making i t more d i f f i c u l t t o
a s s i g n m e n t s t o South Vietnam u n t i l 1964
t r a c k p e r s o n n e l who may h a v e b e e n e x p o s e d t o h e r b i c i d e s ) .
During l a t e 1962
a n d e a r l y 1 9 6 3 , t h e C r o p s D i v i s i o n a t F o r t D e t r i c k a n d t h e USAF Armament
Laboratory a t Eglin A i r Force Base,
F l o r i d a were i n v o l v e d i n e f f o r t s t o
p r o v i d e i m p r o v e m e n t s i n s p r a y s y s t e m c o m p o n e n t s i n s u p p o r t o f O p e r a t i o n RANCH
Most o f t h e p e r s o n n e l i n v o l v e d i n t h e a c t u a l h a n d l i n g o f
h e r b i c i d e drums
a USAF f l i g h t m e c h a n i c o r c r e w c h i e f
r e s p o n s i b l e f o r e n s u r i n g t h a t t h e a i r c r a f t were p r o p e r l y l o a d e d a n d t h a t
s p r a y systems were f u n c t i o n a l .
Each h e r b i c i d e a i r c r e w C o n s i s t e d o f
and a c o p i l o t (both u s u a l l y o f f i c e r s )
and a f l i g h t mechanic/spray
operator (usually enlisted).
The a i r c r e w s were f r e q u e n t l y j o i n e d b y S o u t h
V i e t n a m e s e a n d U.S. o b s e r v e r s .
n o t e d i n a USAF r e p o r t ,
a i r c r a f t , i t was n o t uncommon t o h a v e h e r b i c i d e l e a k a g e f r o m a r o u n d t h e
n u m e r o u s h o s e c o n n e c t i o n s j o i n i n g t h e s p r a y t a n k a n d pumps w i t h t h e w i n g a n d
a f t s p r a y booms.
In hot weather, the odor of herbicide within t h e a i r c r a f t
was d e c i d e d l y n o t i c e a b l e . n
T h e USAF h a s d a t a o n 6 , 5 4 2 h e r b i c i d e s p r a y i n g m i s s i o n s
b e t w e e n A u g u s t 1 9 6 5 a n d F e b r u a r y 1 9 7 1 o n i t s "HERBSw c o m p u t e r t a p e .
d a t a w e r e c o m p i l e d on a m i s s i o n - b y - m i s s i o n basis f r o m r e p o r t s a n d f i l e s i n
v a r i o u s commands a n d o f f i c e s i n S o u t h V i e t n a m a n d t h e U n i t e d S t a t e s .
HERBS t a p e c o n t a i n s t h e f o l l o w i n g
data f o r each mission:
n u m b e r ; l o c a t i o n ; p r o v i n c e a n d UTM c o o r d i n a t e s ; t y p e o f h e r b i c i d e ( b a s i c a l l y ,
Agents Orange, White, o r Blue); q u a n t i t y of h e r b i c i d e ; a r e a covered;
of mission ( d e f o l i a t i o n , crop d e s t r u c t i o n , e t c . ) ; and t y p e of a i r c r a f t (plane
T h e NAS u s e d t h e HERBS t a p e i n i t s e v a l u a t i o n o f t h e e f f e c t s
of h e r b i c i d e s on S o u t h Vietnam.
A f t e r e v a l u a t i n g t h e HERBS d a t a ,
t h e NAS
concluded t h a t
t h e HERBS t a p e a c c o u n t e d f o r a p p r o x i m a t e l y 8 6 % o f
h e r b i c i d e o p e r a t i o n s i n South Vietnam and t h a t
"despite certain recognized
d e f i c i e n c i e s , " t h e HERBS t a p e i s " a r e l i a b l e s o u r c e f o r a n a s s e s s m e n t o f
major p a r t of t h e h e r b i c i d e o p e r a t i o n i n S o u t h Vietnam" a n d " i s t h e best a n d
i n f a c t t h e only a v a i l a b l e comprehensive computation of t h e major p a r t of t h e
h e r b i c i d e o p e r a t i o n s conducted i n t h e Vietnam war."
When t h e D O D s u s p e n d e d a l l u s e o f 2 , 4 , 5 - T i n S o u t h V i e t n a m , t h e USAF was
l e f t w i t h a n i n v e n t o r y o f 2.22 m i l l i o n g a l l o n s o f u n u s e d Agent Orange
m i l l i o n g a l l o n s which had been s h i p p e d t o S o u t h Vietnam a n d 0.85
g a l l o n s w h i c h were w a i t i n g t o b e s h i p p e d a t t h e N a v a l C o n s t r u c t i o n B a t t a l i o n
Center a t Gulfport, Mississippi).
I n A p r i l 1972, t h e 1.37 m i l l i o n g a l l o n s of
A g e n t O r a n g e w e r e moved f r o m S o u t h V i e t n a m t o J o h n s t o n I s l a n d i n t h e P a c i f i c
Ocean f o r s t o r a g e .
T h e t o t a l a m o u n t o f TCDD i n t h e r e m a i n i n g A g e n t O r a n g e
s t o c k was a p p r o x i m a t e l y 44.1
Problems began t o a r i s e i n both
l o c a t i o n s a s d r u m s r e p o r t e d l y b e g a n t o l e a k a n d t h e USAF e x p r e s s e d c o n c e r n
over f u r t h e r leakage problems t h a t could occur i f
a tornado h i t
~ i s s i s s i p p is i t e o r i f a t y p h o o n h i t t h e P a c i f i c s i t e .
After exploring a
n u m b e r o f o p t i o n s , t h e USAF d e c i d e d t o d i s p o s e o f t h e A g e n t O r a n g e b y b u r n i n g
i t a t high temperatures a t s e a on t h e
D u t c h i n c i n e r a t o r s h i p named t h e
f l V u l c a n u s . w The A g e n t O r a n g e was d r a i n e d f r o m t h e d r u m s a t e a c h s i t e a n d
transferred to the Vulcanus.
The empty drums were then rinsed with diesel
fuel and crushed.
The rinse fluid was combined with the Agent Orange for
incineration at sea. A total of 15,480 drums of Agent Orange were processed
at the Mississippi
site between May 24, 1977, and June 1 0 , 1977, by
from the five Air Logistics
approximately 1 1 0 USAF officers/technicians
Centers of the Air Force Logistics Command (located at Kelly AFB Texas; Hill
AFB, Utah; Warner Robbins AFB, Georgia; Tinker AFB, Oklahoma; and McCellan
A total of 24,795 drums of Agent Orange were processed
the Johnston Island site between July 27, 1977, and Aug.
Approximately 100 civilian employees hired by a contractor performed the
At both the Johnston Island and Mississippi sites,
workers were provided with daily changes of work
clothes and some with
The Agent Orange was incinerated at sea in the period
from July to September 1977. Results of industrial hygiene studies conducted
at the time of the disposal operation by the U.S. Air Force
the Battelle Memorial
(Johnston Island) revealed no immediate
adverse health effects among the personnel involved in the operation.
Department of Defense Efforts
The USAF has stated that i t can now identify 1,264 servicemen who were
directly exposed to Agent Orange as they handlea herbicide
flew spraying missions in South Vietnam.
The Air Force has initiated a
health effects study of Air Force personnel involved in operation "Ranch
Hand," who sprayea Agent Orange in Vietnam.
The Department of Defense
believes that these individuals had at least 1000 times more exposure to
Agent Orange than the average ground troops.
The epidemiological study will
try to determine whether a causal relationship can be established between
exposure to the 2,4-D/2,4,5-T mixture and long-term health effects.
the study was originally scheduled to begin in October 1979, peer review of
its protocols forced delays.
The University of Texas School of Public
Health, the U.S. Air Force Scientific Advisory Board and the Armed Forces
Epidemiological Board reviewed the
Then the Air Force asked the National Academy
(NAS) to review the protocols.
On May 6, 1980, the N A S
recommendations that the scope and duration of the study be expanded to
increase the likelihood of obtaining definitive data.
NAS also expressed
concern about the public perception of credibility and impartiality of a
study conducted internally by the Air Force. The Interagency Work
Scientific Panel, however, has recommended that the study, a s designed by the
Air Force, be conducted because, despite its limitations, it provides "a
focus as to the type of health effects that may possibly occur in other
(ground troop) personnel."
The Ranch Hand study is proceeding in several phases and will continue for
The first phase consists of a detailed
questionnaire, which has been administered to the Ranch Handers in their
homes by trained interviewers from Louis Harris and Associates.
matched control group, selected from military records held by the Air Force,
has also been interviewed.
The first data from the questionnaire should be
available by mid-summer 1982. Also underway is the second phase of the
study, a 3-day series of physical examinations, including a battery
psychological tests, which Will be given to both the study group and the
The contractor for this phase is Kelsey-Sea.bold of Houston.
exams are scheduled to be completed by September 1982, with preliminary
findings available 2 to 3 months later. Follow-up exams will be conductea at
A mortality analysis on the Ranch Hand group is
1 , 3, 5, 1 0 , and 2 0 years.
in progress at the Air Force School of Aerospace Medicine, with data
anticipated around August 1982, and a mortality
tracking program will be
continued throughout the study. Information on the health status of the
veterans, as shown by the questionnaires and the physical examinations, will
provide data for a morbidity analysis.
Many of the veterans who have filed claims with the VA for compensation
for health effects caused by exposure to TCDD in South Vietnam did not hold
jobs that caused direct exposure to 2,4,5-T. They claim that their exposure
occurred indirectly either by being s ~ r a y e dwith overhead planes
substances other than herbicides were also sprayed from planes) or by being
exposed to 2,4,5-T in the environment.
According to the DOD, military
personnel did not usually enter areas sprayed with Agent Orange until 4 to 6
weeks after treatment.
However, a recent General
investigation concluded that a large number of Marines in the I Corps section
of Vietnam from 1966-1969 were in, or close to, areas sprayed with Agent
Orange on both the day of spraying and within 4 weeks afterward.
units were also close to Agent Orange spraying.
The Department of Defense has recently made progress in identifying ground
troops that may have been exposed to Agent Orange. Two Army and one Marine
31st Engineer Battalion, 2050 troops; 1st Squadron, 9th Calvary
(Air Mobil), 2300 troops and 3rd Battalion, 1st Marines, have been identified
as being in areas of Agent Orange operations. Exact numbers, locations, and
identities of individuals who may have been sprayed are impossible to
Veterans' Problems and Veterans Administration Efforts
The.first reports of veterans' concerns over health effects of exposure to
2,4,5-T began to appear in late 1977 and early 1978, following media coverage
of several veterans' claims. Veterans have associated a number of illnesses
with exposure to 2,4,5-T, including skin conditions, fatague, nervousness,
numbness in extremities, vision and/or hearing impairments, birth defects in
offspring, reduced libido, miscarriages, impotency, respiratory problems,
gastro-intestinal tract disturbances, and various cancers, as well as a
variety of other illnesses.
As of Apr. 1 , 1982, the VA had received 13064 claims for damage reportedly
related to in-service exposure to herbicides; 2986 claims have been made due
only to exposure to the herbicides and not for any specific condition; 10078
claims have been filed for specific conditions related to herbicide exposure,
but 3469 of these have not had the diagnosis confirmed by medical authority.
Of the 6609 claims with a confirmed diagnosis, 923 (13.7%) have been allowed
for reasons other than Agent Orange exposures and 5686 (86.3%)
Approximately 93% or 858 of the total 923 claims allowed were for
service-connected skin conditions, and the remaining 7% or 6 5 claims were
allowed for cancer, psychiatric and neurological conditions, and various
other miscellaneous disabilities.
The 5686 claims denied fall into the
following categories (many claims have more than one claimed diagnosis): 3055
for various skin conditions; 2335 for nervousness, headache, or fatigue; 886
for paralysis or numbness; 751 for gastro-intestinal or genito-urinary
conditions; 399 for various malignancies; 356 for impaired sexual activity;
394 for eye, ear, nose, and throat conditions; 274 for lung conditions; 227
for cardiovascular conditions; and 137 for miscellaneous conditions. The VA
has not awarded compensation for the claims of chronic illnesses related to
Agent Orange exposure because of the lack of valid human data to prove a
cause and effect relationship between exposure to a 2,4,5-T/2,4-D
and/or TCDD and specific chronic health effects.
Previously, the difficulty
of determining which veterans were or were not exposed to Agent Orange was
also a factor in denying compensation, but more recently the VA has conceded
exposure for all veterans who were in Vietnam.
The VA is maintaining a registry of all Vietnam veterans who have come to
V A hospitals and health care facilities expressing concern about possible
herbicide-related health problems.
Each such veteran, whether experiencing
any health problems or not, is given a physical examination; currently, some
2700-2800 exams a r e being conducted each month.
Data from all the exams is
being computerized into a central Agent Orange Registry in addition to the
individual records being maintained a t the local VA facilities.
As of Mas.
25, 1982, 81,670 veterans had received the initial exam, and about 61,000 of
the records had been coded into the computer.
Information from the registry
is being analyzed to determine if the veterans have a n increased rate of any
Thus far, nothing unusual or unexpected has turned up.
Treatment of any health problems uncovered by the exams i s handled under
normal VA procedures regarding service-connection, ability to pay for medical
care, etc., with the exception that special guidelines have been issued for
the handling of conditions possibly related to Agent Orange.
In the Federal
Register of Dec. 2, 1981, pursuant to Public Law 97-72, the VA issued
guidelines for use by its physicians to "assist them in making determinations
in individual cases a s to whether a disability may have been causedw by
exposure to Agent Orange.
Even though treatment may be given for some
conditions, the VA specified that "In accordance with congressional intent, a
determination to furnish care under this authority does not establish that
the condition for which medical care is provided is service-conneetec3"
purposes of compensation or vocational rehabilitation eligibility.
Three additional VA activities on Agent Orange include participation
the tissue registry, the Chloracne Task Force, and investigations into TCDD
residues in body fat tissue of veterans.
When V A facilities perform
or autopsies on Vietnam veterans, tissue samples are taken and sent to the
Armed Forces Institute of Pathology where a special tissue registry i s being
Examination of approximately 800 specimens has so far shown no
significant clustering of tumors or other particular
Chloracne Task Force was established in response to a congressional request
to sift out those cases of skin conditions that either resemble or are truly
Those veterans whose medical records show a definite possibility
of chloracne will be invited to come to non-VA clinics for re-examination
dermatologists who have an expert knowledge of the disease.
The VA has
conducted a study to determine if TCDD can be detected in the body f a t
tissues of Vietnam veterans a t any higher levels than in veterans who were
not in Vietnam.
Dioxin in body fat is measured in parts per trillion, levels
which are at the technological limits of available detection methods.
test requires surgical removal of tissue from the abdomen and chemical
analysis sf the sample ow
spectrometry instruments. The results of the study were inconclusive, and
the VA has decided that the reliability of the procedure is not sufficient to
warrant its use i n attempting to verify dioxin exposure.
is that dioxin contamination is so ubiquitous
herbicide use and from its formation in municipal incinerators) that it may
likely be found in everyone's fat tissue.
As mandated i n P.L. 96-151, the Veterans' Affairs Amendments, the VA
currently preparing to perform a n epidemiological study of Vietnam veterans
exposed to Agent Orange.
Although the study's protocol has been developed
and validated by an independent group, the VA will perform
the testing and
collect the data, with oversight by a non-VA
Procurement of a n independent contractor for the study's protocol was delayed
for 14 months by a protest filed by the National Veterans L a w Center
The NVLC alleged that not only was the V A violating procurement law, but also
the study a s currently contemplated did not comply with the requirements of
On Feb. 2, 1981, the General Accounting
Office concluded its
investigation and denied the NVLC protest.
O n Kay 5 , 1981, the VA announced
the awarding of a contract to the University of California a t Los Angeles
(UCLA) School of Public Health for the design of the epidemiological study.
UCLA submitted its first draft of the protocol to the VA in August 1981; it
was peer-reviewed by the VA Advisory Committee on Health-Related
Herbicides, by the Office of Technology Assessment, and by the Science Panel
of the Agent Orange Working Group. All the review groups judged the draft
protocol to be inadequate and not in compliance with the contract.
since modified the protocol, expanding o n problem areas and incorporating the
suggestions of the review groups; its final submission to the VA is due April
29, 1982. As with the Ranch Hand study, this epidemiological study will have
two main parts:
a questionnaire on health status and
occupational history, and a physical exam with laboratory workup.
group will be 18,000 veterans, divided into 3 cohorts of 6000 each.
the cohorts will have had Vietnam
service, and will be distinguished as
T h e third cohort
having a high or a low likelihood of herbicide exposure.
will be veterans with non-Vietnam military service.
Inclusion of the third
group will generate data about the health effects of Vietnam
addition to the information expected about herbicide-related health
The study will commence with a pilot project to field test its procedures and
P.L. 96-151 also mandated the VA to conduct a comprehensive review and
scientific analysis of the worldwide literature on Agent Orange and other
JRB Associates prepared the review under contract, and
the VA published the 2-volume study in October 1981.
The VA i s now preparing
to contract for an update to the literature review, to reflect new reports
and data that have appeared.
The Interagency Work Group on Phenoxy Herbicides and Contaminants,
established i n December 1979, recommended that the Centers for Disease
Control (CDC) perform a case-control study to see if there is a n increased
incidence of specific malformations in children of Vietnam veterans.
population to be studied is a group of 7500 children who have birth defects
and who are registered in CDC's Birth Defects Program (in operation since the
Information on the families of these children, gained by
extensive interviews and questionnaires, will be compared with that for 300
The data will be analyzed to see what risk factors i n the
parentsg lives, including military service in Vietnam, may be related
increased incidence of malformations in their children.
CDC has completed a
pilot study o n a representative sample of the two groups to test the
questionnaire and the procedures for finding the families.
will be started in late April 1982, and a preliminary report on the issue of
Vietnam service is expected in the fall of 1983. Detailed analysis of the
data on all risk factors will take several years to complete.
On Sept. 22, 1980, the Work Group held its first public meeting to discuss
problems and proposals related t o exposure to herbicides.
On Jan. 1 9 , 1981,
the Secretary of Health and Human Services established the "Advisory
Committee on Special Studies Relating t o the Possible Long-Term Health
Effects of Phenoxy Herbicides and Contaminantsw to advise the Secretary and
the Chair of the Interagency Work Group on Herbicides concerning the Advisory
Committee's oversight of the conduct of the Ranch Hand Study being conducted
by the Air Force.
In its seventh report to the White House, the Work Group's
Scientific Panel concluded that:
While i t is difficult to accept logically that a
single causative factor -- Herbicide Orange
responsible for such a diverse set of health effects [as
alleged by Vietnam veteran claims to the VA], there is no
definitive evidence that permits selective exclusion of
some of these illnesses. Further, it is possible that
some of these health effects are occurring as a consequence
of Vietnam service but not due to exposure to Herbicide
Orange. The Science Panel is not aware of any data that
suggest a modification of its previous recommendation that
the focus of a study of Vietnam veterans should be
broadened to consider Vietnam service as the exposure
factor rather than focus solely on Herbicide Orange
The Science Panei is in receipt of data
which indicate that there is a t best a remote chance of
accurate identification of specific ground troops who were
exposed to Hetbicide Orange....
The Panel is therefore of
the opinion that design of a scientifically valid Herbicide
Orange study of ground troops may not be possible.
the focus of a study o f Vietnam veterans is broadened to
consider Vietnam service as the exposure factor, a study
of ground troops is necessary and a scientifically valid
study can be designed.
On July 1 7 , 1981, the Interagency Work Group was renamed and its
Now called the Agent Orange Working Group, it is part
of the Cabinet Council on Human Resources.
The Department of Health and
Human Services is the lead agency.
Because the VA currently recognizes only chloracne as a human health
effect that can be proven to be caused by exposure to 2,4,5-T, veterans mag
have difficulty being compensated for even those effects for which there i s
strong animal evidence (i.e., cancer and birth defects caused in utero which
are those birth defects that cannot be caused by the father and require the
mother and fetus to be exposed during the actual pregnancy).
claim compensation f o r health effects which are not supported by strong
which could cause genetic defects in the
animal data (i.e., mutations
father's sperm that would affect children conceived after exposure) may have
a n even tougher case to argue.
The veteran's question then becomes:
How much evidence is required to
prove the right to compensation? On whom does the burden of proof lie
veteran or the VA)?
If more eviaence is needed, who will generate it? And
finally, what constitutes fair treatment of veterans while the necessary data
are being gathered?
Congressional Action of the 96th Congress
The 96th Congress responded to the problems of establishing a cause and
effect relationship between veterans' exposure to herbicides in South Vietnam
and the various health problems they are now experiencing by holding hearings
and enacting legislation.
The Subcommittee on Oversight and Investigations of the House Committee on
Interstate and Foreign Commerce held hearings on June 24 and 25, 1979, to
hear testimony from veterans who allegedly have been affected by herbicide
exposure and from the Veterans Administration regarding its efforts to
unequivocally determine the relationship between herbicide exposure and
health effects. The Subcommittee on Medical Benefits and Facilities of the
House Committee on Veterans' Affairs held two sets of hearings on the hazards
associated with TCDD, veterans' complaints of health effects associated with
Agent Orange exposure, and Veterans Administration's efforts to resolve the
Agent Orange problem.
The Senate Veterans' Affairs Committee also held hearings to
Agent Orange problem.
As a step to gain access to records to locate veterans who may have been
2282, the Veterans'
exposed to herbicides in-service, Title V of H.R.
Disability Compensation and Survivors' Benefits Amendments of 1979, requires
the Director of the National Institute for Occupational Safety and Health,
upon request by the V A (or other appropriate agency) to request the current
mailing address from the Internal Revenue Service of persons whom the VA
certifies may have been exposed to occupational hazards.
passed in lieu of its companion bill, S. 689, and became Public Law 96-128 on
Nov. 28, 1979.
Title I11 of H.R. 3892, the Veterans' Affairs amendments, directs the
Veterans Administration to conduct an epidemiological study of the long-term
health effects on individuals from exposure to dioxins in Vietnam, upon the
Office of Technology ~ s s e s s m e n t ' s (OTA) approval of its protocol.
companion bill, S. 1039, was incorporated in H.R. 3892 as an amendment, and
the measure was enacted by Congress and signed by the President .on Dec. 20,
1979 (P.L. 96-151).
If enacted, S. 2096 would have directed the Secretary of Health,
Education, and Welfare (now, Health and Human Services) to undertake an
epidemiological study to determine the long-term adverse human health effects
associated with exposure to dioxins produced during the manufacture of
phenoxy herbicides. This bill proposed to investigate the long-term health
effects of exposure to dioxins, in general, not just to Agent Orange.
similarly incorporated in H.R. 3892, S. 2096 would have required that the
study's protocol be approved by the Congressional Office of Technology
This bill was presented to the President on Dec. 21, 1979, and
vetoed by him on Jan. 2, 1980. President Carter vetoed the bill because the
White House counsel believed that such a procedure violated the separation of
power between the legislative branch and the executive branch.
He did not
feel that the Department of Health and Human Services' study protocol should
be subject to approval by a congressional agency.
Title X of H.R. 5288, the Veterans' Rehabilitation Program and Veterans'
Educational Assistance Program would have directed the Secretary of Health
and Human Services to conduct a study of veterans and other groups exposed to
the herbicide known a s "Agent Orangen to determine if there may be adverse
health effects associated with such exposure.
Like H.R. 3892 (P.L.
and S. 2096, the bill called for OTA approval of the study's protocol.
bill also would have required the Secretary of Health and Human Services to
coordinate its efforts with other studies in the Federal Government.
the debate on S. 1188, its companion bill, the
Rehabilitation Act, the Senate adopted an amendment offered by Senator
Cranston to expand the study on health effects of exposure to Agent Orange t o
include other factors related to service in Vietnam.
The Senate also adopted
a n amendment offered by Senator Heinz requiring the VA to promulgat@
regulations regarding guidelines to resolve veterans' disability claims based
on exposure to Agent Orange.
The amendments were striken by the ~ o u s e
because they were considered to be "non-germane" to the primary focus of the
S. 1872 (the Vietnam Veterans' Act);
6050 (the Vietnam Veterans'
Act); H.R. 6 3 7 7 (the Vietnam Era Veterans Agent Orange Act); each would have
established a presumption of service-connected disability for health effects
i n Vietnam veterans (and birth defects i n their children) exposed to Agent
Orange. H.R. 8 2 3 8 (Independent Agent Orange Study) would have directed the
Veterans Administrator to request the National Academy of Sciences to conduct
a study o n veterans exposed to Agent Orange. H.R. 8300 would have expanded
the scope of the Agent Orange study currently being coordinated by the VA and
would have established deadlines for promulgating regulations related to
Agent Orange exposure claims. These bills received n o action.
Veterans' Health Care, Training and Small Business Loan Act of 1981.
Amends title 38, U.S. Code, to extend the Vietnam-era veterans' readjustment
counseling program, to provide medical care for Vietnam veterans exposed to
herbicide defoliants (including Agent Orange), to recover the cost of certain
health care provided by the VA, and authorizes the VA to expand the scope of
its epidemiological study on the health effects of Agent Orange, and other
Introduced May 7, 1981; referred to Committee on Veterans1
Committee consideration and mark-up session held May 12.
to House (amended) by Committee on Veterans' Affairs (H.Rept. 97-79) May 19.
Passed House (amended) June 2 , 1981. Received in the Senate June 3.
struck all after the Enacting Clause and substituted the language of S. 9 2 1 ,
June 16. Passed Senate in lieu of S. 9 2 1 with amendments, June 1 6 , $981.
House concurred i n Senate amendments with amendments Oct.
agreed to House amendments Oct. 1 6 , 1981. Signed into law Nov. 3 , 1981.
Amends Title 3 8 , U.S. Code, to waive the 1-year limitation on claims for
compensation from the Veterans Administration for disabilities and diseases
incurred in or aggravated by military service in the case of claims by
veterans who served i n Southeast Asia during the Vietnam era for compensation
for disabilities resulting from exposure to the phenoxy herbicides known a s
Agent Orange or other phenoxy herbicides.
Introduced Jan. 5 , 1981; referred
to Committee on Veterans1 Affairs.
1173 (Montgomery, by request)
Amends section 307 of P.L. 96-151, by assigning the responsibility of
designating a protocol for, and conducting a n epidemiological study o f ,
veterans who were exposed to Agent Orange, to an independent scientific
22, 1981; referred to Committee o n Veterans'
1 9 6 2 (Gilman)
Amends the Veterans Health Programs Extension and Improvement Act of 1979
to require the Veterans Administration and the National Academy of Sciences
to enter into an agreement under which the Academy Will conduct a n
epidemiological study of veterans exposed to Agent Orange.
1 9 , 1981; referred to Committee on Veterans' Affairs.
Expands the scope of a study required to be conducted by the Administrator
of Veterans' Affairs concerning the effect on humans of exposure to the
chemical known as Agent Orange.
Introduced Feb. 2 5 , 1981:
Committee on Veterans' Affairs.
VA requested Executive comment Mar. 2 , 1981.
Referred to Subcommittee on Hospitals and Health Care Apr. 28. Hearings held
Apr. 30. Subcommittee consideration and mark-up session held.
forwarded to full committee.
H.R. 2297 (Downey)
Amends Title 38, United States Code, to waive the 1-year limitation o n
claims for compensation from the Veterans Administration for disabilities and
disease incurred in o r aggravated by military service in the case of claims
by veterans who served in Southeast Asia during the Vietnam era for
compensation for disabilities resulting from exposure to the
herbicides known a s "Agent Orange" or other phenoxy herbicides.
Mar. 4 , 1981; referred to Committee on Veterans' Affairs.
Amends Title 38, United States Code, to provide a presumption of service
connection for the occurrence of certain diseases in veterans who were
exposed to herbicides i n Southeast Asia during the Vietnam era.
Mar. 1 2 , 1981; referred to Committee on Veterans' Affairs.
Entitles veterans exposed to Agent Orange during the Vietnam era to
specified medical benefits.
Extends the period during Which veterans of such
era may initially request psychological readjustment counseling.
specified educational assistance without delimiting periods for vocational
training for specified veterans determined to be in need of such assistance.
I , 1981; referred to Committee on Veterans' Affairs.
Referred to Subcommittee on Hospitals and Health Care Apr. 28. Hearings held
Subcommittee consideration and mark-up session held Apr. 30, 1981.
Requires the Secretary of Health and Human Services to arrange for a n
independent epidemiological study of persons exposed to Agent Orange.
Introduced Apr. 8, 1981; referred to Committee o n Energy and Commerce.
Referred to Subcommittee on Health and the Environment Apr.
S. 636 (Cranston et al.)
EntitLes the United States to recover the costs of certain medical care
and services furnished to a veteran for a non-service-connected
when disability is covered by another form o f insurance or compensation.
Permits the expansion of the scope of the epidemiological and literature
study of the long term adverse health effects of exposure to Agent Orange
during the Vietnamese conflict to include the effects of other factors.
Introduced Mar. 5, 1981; referred to Committee on Veteransq Affairs.
S. 689 (Heinz)
Amends section 307 of the Veterans Health Programs Extension
Improvement Act of 1979 to require the promulgation of regulations containing
guidelines for resolving claims for veterans benefits based on exposure to
Agent Orange, and for other purposes.
Introduced Mar. 1 2 , 1981; referred to
Committee o n Veterans1 Affairs.
Hearings held Apr. 30, 1981.
S. 9 2 1 (simpson)
Extends the authority of the Administrator of Veteransq Affairs to
contract for hospital care or medical services in Puerto Rico and the Virgin
Islands without reference to patient loads or incidence of provision of
medical services for veterans treated by the Veteransq Administration in the
contiguous 4 8 States.
Introduced Apr. 8 , 1981; referred to Committee o n
Veterans1 Affairs. Reported with amendment May 15, 1981 (S.Rept.
H.R. 3499 passed in lieu (see P.E.
97-72 above) June 1 6 , 1981.
S. 1345 (Heinz)
Authorizes the Administrator of the Veterans1 Administration to provide
hospital or nursing home care to a veteran for treatment of a condition
associated with exposure to Agent Orange during service in Vietnam.
veterans1 readjustment counseling program.
Administrator to expand the scope of the epidemiological study of long term
adverse health effects of other factors involved in such service.
June 8, 1981; referred to Committee on Veterans1 Affairs.
Amends title 38, United States Code to provide a presumption of service
connection for the occurrence of certain diseases in veterans who were
exposed to phenoxy herbicides while serving in Southeast Asia during the
Introduced Dec. 15, 1981; referred to Committee on Veterans
Congress. House. Committee on Interstate and Foreign
Subcommittee on Oversight and Investigations.
Agent Orange: exposure of Vietnam veterans. Hearing, 96th Congress,
26 session. Sept. 25, 1980. 249 p.
Involuntary exposure to Agent Orange and other toxic
spraying. Hearings, 96th Congress,
1st session. June 26 and 2 7 , 1979. 256 p.
Congress. House. Committee on Veterans1 Affairs.
Status of Vietnam veterans in the Bay area.
Hearing, 96th Congress, 2d session. Apr. 10, 1980. 64 p.
Committee on Veterans1 Affairs.
Subcommittee on Hospitals and Health Care.
Legislation to improve medical programs administered by
the Veterans Administration (H.R. 2157, H.R. 2953, and H.R. 2999).
Hearings, 97th Congress, 1st session. Apr. 28, 1981. 5 4 p.
Committee on Veterans1 Affairs.
Subcommittee on Medical Facilities and Benefits. Herbicide
"Agent Orangen. Hearing, 95th Congress, 2d session. Oct. 1 1 ,
1978. 6 2 p.
Oversight hearing to receive testimony on Agent Orange.
Hearing, 96th Congress, 2d session.
Feb. 25, 1980. 121 p.
Oversight hearing to receive testimony on Agent Orange.
Hearing, 96th Congress, 2d session. July 22, 1980. 459 p.
Scientific community report on Agent Orange.
Congress, 26 session. Sept. 16, 1980. 145 p.
Congress. House. Committee on Veteransf Affairs.
Subcommittee on Oversight and Investigations. Current
status of Agent Orange studies. Hearing, 97th
Congress, 1st session. May 6 , 1981. 385 p.
Congress. Senate. Committee on Veterans1 Affairs.
Orange update and appendix: Agent Orange activities (part 11).
Hearing, 96th Congress, 26 session. Sept. 10, 1980. 1368 p.
Oversight on issues related to Agent Orange and other
herbicides. Hearing, 97th Congress, 1st session. Nov. 18,
(not yet printed)
VA health resources and program extensions and appendix:
Agent Orange activities. Hearing, 96th Congress, 1st session,
on S. 741 and S. 196. Apr. 10, 1979. 462 p.
Veterans' Programs Extension and Improvement Act of 1981.
Hearing, 97th Congress, 1st session, on S. 26 (titles
I1 and 111, only), S. 380, S. 458, S. 636, S. 689, S. 872, S. 914,
S. 921, and related bills.
Apr. 30, 1981. 685 p.
Vietnam veterans1 readjustment. Hearings, 96th Congress, 2d
session. Feb. 21, Mar. 4 , and May 21, 1980. Part 2.
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American Medical Association.
Council on Scientific
Health effects of HAgent Orangeg1and
dioxin contaminants (Executive Summary)
Behrens, Richard, et al. Comments from CAST (Council on
Agricultural Science and Technology):
9 PBuck, Craig. The Death of a nation.
AUg. 28, 1978: 49-50, 52-55.
New west, v. 3 ,
"Emergencygvban on 2,4,5-T herbicide
Nature, v - 278, Mar. 8 , 1979:
Davis, Donald E. et al. Comments from CAST (Council
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1978. 5 p.
a mixed blessing..
Galston, Arthur W.
v. 29, February 1979: 85-90.
International Agency for Research on Cancer.
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2,5,5-TI vol. 15, August 1977.
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the SeVes0 catastrophe.
International journal of health
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The effects of herbicides in South
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Peterson, Jeannie. Seveso:
7, no. 5-6,
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Reggiani, G. Localized contamination with TCDD
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Nov. 16, 1979. FPCD-80-23.
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Z i m m e r m a n , D a v i d R.
A g e n t Orange: V i e t n a m ' s l i n g e r i n g
A m e r i c a n h e a l t h , v. 1, no. I, M a r . / ~ p r .
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Baader and Bauer (6)
Bauer , e t a l
Bleiberg e t a l .
Poland e t a l . (62)
Dugois e t a l .
Kimmig and Schulz
J i rasek e t a l .
J i rasek e.t a1
Pazderova e t a l .
Miura e t a l .
Ter Beek e t a l . (79)
Ze 1 i kov and Dan i l o v (88)
T o t a l number o f cases
r e ~ otedC
a ~ u m b e re n t r i e s i n t a b l e r e f l e c t the number o f cases i n which s i g n , symptom o r d i s o r d e r was
b+ = Sign, symptom o r d i s o r d e r r e p o r t e d b u t number o f cases n o t given.
do n o t i n c l u d e cases represented by "+I1
and t o t a l s may represent some double counting
due t o the o v e r l a p t o s t u d i e s by J i r a s e k e t a l . and Pazderova e t a l .
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(Numbers in parentheses identify sources
Orange and Its Associated Dioxin, p. VI-14.
in Young's bibliography.)