Agent Orange Use and Impact in Vietnam: A Review
Main Article Content
Abstract
Abstract
Physicians and other members of the medical community frequently are asked about “Agent Orange” and potentially “associated” health issues. The Vietnam War officially ended in 1975, but concerns over the legacy of Agent Orange linger to this day. Under the Agent Orange Act of 1991, the United States Department of Veterans Affairs (DVA) recognizes 14 diseases associated with alleged exposure to Agent Orange, its associated dioxin (TCDD) contaminant, and other tactical herbicides used in combat operations in Vietnam during the war. The medical community needs to understand why Agent Orange has become a national public health issue, and be prepared to respond to questions by veterans and the public. Although the Institute of Medicine (IOM) provided recommendations to DVA on the medical issues, they were directed by the Act to develop “statistical associations” for human diseases rather than to establish cause and effect relationships. No IOM report determined a consistent, coherent, and credible evidence of a causal connection between a disease and exposure to Agent Orange. The reality is that the current Agent Orange Policy is based on politics driven by public, media, veteran and congressional actions. Special evaluations and considerations must be given to the numerous health studies of our Vietnam Era veterans and what they have indicated. Perhaps we could have been fairer to all Vietnam veterans with a program of 'Vietnam experience' benefits rather than Agent Orange benefits. Greater efforts should have been made to study how societal pressures and politics have played a larger role than the efforts of the scientific and medical communities in providing health answers for our Vietnam veterans and the Vietnamese, all who now continue to suffer the lasting effects of war.
Article Details
How to Cite
YOUNG, Alvin L.; YOUNG, Kristian L..
Agent Orange Use and Impact in Vietnam: A Review.
Medical Research Archives, [S.l.], v. 5, n. 10, oct. 2017.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/1525>. Date accessed: 20 apr. 2024.
Keywords
Vietnam War, Agent Orange, Agent Orange Act of 1991, tactical herbicides, dioxin/TCDD, veteran health effects, environmental fate, Veterans Administration
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Larsen SR, Collins JL (1975): Vietnam Studies: Allied Participation in Vietnam. Department of The Army, Washington, DC, USA
2. Young AL (2009): Vietnam and the Agent Orange Controversy Revisited. Chapter 1, IN: Young AL, The History, Use, Disposition and Environmental Fate of Agent Orange. Springer Science +Business Media, LLC, New York NY, USA
3. Young AL, Cecil PF (2011): Agent Orange Exposure and Attributed Health Effects in Vietnam Veterans. July Supplement 2011, Mil Med 176 (7): 29-34
4. Sholdt LL (2008): Entomology with the US Marines in Vietnam – Some Lessons Learned. Proceedings of the DoD Symposium “Evolutions of Military Medical Entomology”, Annual Meeting of the Entomological Society of America, 16 November 2008
5. Schoof HF (1969): Research and Control Activities on Vector-borne Diseases in Southeast Asia. Reprint Number 479, Technical Development Laboratories, National Communicable Disease Center, Savannah, GA 31402
6. Fox RP (1979): Air Base Defense in the Republic of Vietnam 1961-1973. Office of Air Force History, United States Air Force, Washington, DC, USA
7. Westing AH (1976): Ecological Consequences of the Second Indochina War. Stockholm Peace Research Institute. Almquest & Wiksell International, Stockholm, Sweden
8. Young AL (2009): The Military Use of Tactical Herbicides in Vietnam. Chapter 3, IN: Young AL, The History, Use, Disposition and Environmental Fate of Agent Orange. Springer Science +Business Media, LLC, New York NY, USA
9. Young AL (2009): A History of the Development and Procurement of Tactical Herbicides. Chapter 2, IN: Young AL, The History, Use, Disposition and Environmental Fate of Agent Orange. Springer Science +Business Media, LLC, New York NY, USA
10. Bovey RW, Young AL (1980): The Science of 2,4,5-T and Associated Phenoxy Herbicides. John Wiley & Sons. A Wiley-Interscience Publication. New York
11. Young AL, Young KL (2013): Investigations into Allegations Concerning 2,4,5-T Herbicide. Agent Orange Investigative Report Series, No. 6. Compensation Service, Department of Veterans Affairs, 810 Vermont Ave, NW, Washington DC 20420. Contract: VA-101-12-C-0006
12. IOM (1994 – 2014): Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Institute of Medicine, National Academies of Science, Washington DC, USA
13. Lavy TL (1987): Human Exposure to Phenoxy Herbicides. VA Monograph, May 1975. Department of Medicine and Surgery, Central Office, Department of Veterans Affairs, Washington DC 20420
14. Kearney PC, Kaufman DD (1975): Herbicides: Chemistry, Degradation, and Mode of Action. Two Volumes, Marcel Dekker, Inc., New York, NY, USA
15. Hood, RD (1985): Cacodylic Acid: Agricultural Uses, Biologic Effects, and Environmental Fate. VA Monograph, December 1985. Department of Medicine and Surgery, Central Office, Department of Veterans Affairs, Washington, DC 20420, USA
16. Young AL (2004): TCDD Biomonitoring and Exposure to Agent Orange: Still the Gold Standard. Environ Sci Pollut Res 11 (3): 143-146
17. Young AL, Van Houten WJ, Andrews WB (2008): 2nd Agent Orange and Dioxin Remediation Workshop. Environ Sci Pollut Res 15 (2): 113-118
18. Young AL, Giesy JP, Jones PD, Newton M (2004): Environmental Fate and Bioavailabilty of Agent Orange and Its Associated TCDD During the Vietnam War. Environ Sci Pollut Res 11 (6): 359-370
19. Young AL, Cecil PF, Guilmartin JF (2004): Assessing Possible Exposures of Ground Troops to Agent Orange During the Vietnam War: The Use of Contemporary Military Records. Environ Sci Pollut Res 11 (6): 349-358
20. Cecil PF (1986): Herbicidal Warfare: The RANCH HAND Project in Vietnam. Praeger Special Studies, Praeger Scientific, New York NY, USA
21. Cecil PF, Young AL (2008): Operation FLYSWATTER: A War Within a War. Environ Sci Pollut Res 15 (1): 3-7
22. Crummett WB (2002): Decades of Dioxin: Limelight on a Molecule. Xlibris Corporation, USA
23. Baughman R, Meselson M (1973): An analytical method for detecting TCDD (dioxin): levels of TCDD in samples from Vietnam. EHP 5:27-35
24. Tenenbaum D (1996): Focus Article: The Value of Vietnam. EHP 104 (12): 104-112
25. Schecter, A., Le, C.D., Thuy, L.T.B., Hoang, T.Q., Dinh, Q.M., Hoang, D.C., Pham, H.P., Schecter A, Tong HY, Monson SJ, Gross ML, Raisanen S, Karhunen T, Osterlund EK, Constable JD, Cau HD, Dai LC, Quynh HT, Lang TD, Phuong NTN, Phiet PH, Vu D (1990): Human Adipose Tissue Dioxin and Dibenzofuran Levels and “Dioxin Toxic Equivalents” in Patients From the North and South of Vietnam. Chemosphere 20 (7-9): 943-950
26. Schecter A, Dai LC, Thuy LBT, Quynh HT, Minh DQ, Cau HD, Phiet PH, Phouong NTN, Constable JD, Baughman R, Papke O, Furst P, Raisanen S (1995): Agent Orange and the Vietnamese: The Persistence of Elevated Dioxin Levels in Human Tissues. Am J Public Health 85 (4): 516-532
27. Kang HK, Watanabe KK, Breen J, Remmers J, Conomos MG, Stanley J, FlickerM (1991): Dioxins and Dibenzofurans in Adipose Tissue of US Vietnam Veterans and Controls. Am J Public Health 81 (3): 344-349
28. Pham DT, Nguyen HM, Boivin TG, Zajacova A, Huzurbazar SV, Bergman HL (2015): Predictors for dioxin accumulation in residents living in Da Nang and Bien Hoa, Vietnam, many years after Agent Orange use. Chemosphere 118: 277-283.
29. Manh HD et al (2015): Levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans in breast milk samples from three dioxin-contaminated hotspots of Vietnam. Sci Total Environ 511: 416-422
30. Jones KC, Bennett BG (1989): Human exposure to environmental polychlorinated dibenzo-p-dioxins and dibenzofurans: an exposure commitment assessment for 2,3,7,8-TCDD. Sci Total Environ 78: 99-116
31. Environmental Protection Agency (1984-updated June 2015): Dioxin Publications as Reports, Articles and Archive Materials. US Environmental Protection Agency, Washington DC, USA. http://www.cfpub.epa.gov/ncea/dioxin/publication.cfm
32. CDC (1988): Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels in US Army Vietnam-Era Veterans. JAMA 260 (9): 1249-1254
33. Buffler PA, Ginevan ME, Mandel, JS, Watkins DK (2011): The Air Force Health Study: An Epidemiologic Retrospective. Ann Epidemiol 21: 673-687
34. Kang HK, Dalager NA, Needham LL, Patterson DG, Jr., Lees PSJ, Yates K, Matanoski GM (2006): Health Status of Army Chemical Corps Vietnam Veterans Who Sprayed Defoliants in Vietnam. Am J Indust Med 49: 875-884
35. Catlin Boehmer TK, Flanders WD, McGeehin MA, Boyle C, Barrett DH (2004): Postservice Mortality in Vietnam Veterans: A 30-Year Follow-up. Arch Intern Med 164: 1908-1916
36. Clarke PM, Gregory R, Salomon JA (2015): Long-term Disability Associated with War-related Experience Among Vietnam Veterans, Retrospective Cohort Study. Med Care 53 (5): 401-408
37. VHA Directive 1302 (Updated Dec 7, 2016): Agent Orange Registry Program. Veterans Health Administration, Department of Veterans Affairs, Washington DC, USA
38. Krishnamurthy P, Hazratjee, Opris D, Agrawal S, Markert R (2016): Is Exposure to Agent Orange a Risk Factor for Hepatocellular Cancer? – A Single-Center Retrospective Study in the US Veteran. J Gastrointest Oncol 7 (3): 426-432
39. Patterson AT, Kaffenberger BH, Keller RA, Elston DM (2015): Skin Disease Associated with Agent Orange and Other Organochlorine Exposures. J Am Dermatol 74 (1): 143-173
40. Gough M (1991): Human Health Effects: What the Data Indicate. Sci Total Environ 104 (1-2): 129-158
41. Bond GG, Bodner KM, Cook RR (1989): Phenoxy Herbicides and Cancers: Insufficient Epidemiologic Evidence for a Causal Relationship. Fund Appl Toxicol 12 (1): 172-188
42. Boffetta P, Mundt KA, Adami, H-O, Cole, P, Mandel JS (2011): TCDD and Cancer: A Critical Review of Epidemiologic Studies. Crit Rev Toxicol 41 (7): 622-636
43. CDC (1990): The Association of Selected Cancers with Service in the US Military in Vietnam: Final Report. Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta GA, USA
44. CDC (1988): Health Status of Vietnam Veterans, III. Reproductive Outcomes and Child Health. JAMA 259 (18): 2715-2719
45. Panangala SV, Shedd DT (2014): Veterans Exposed to Agent Orange: Legislative History, Litigation, and Current Issues. CRS Report 7-5700, Congressional Research Service, United States Congress, Washington DC, USA
46. Wade N (1980): Mythopoiesis. Protest TIBS, June 1980, p VIII
47. Samet JM, McMichael GH, Wilcox AJ (2010): The Use of Epidemiological Evidence in the Compensation Veterans. Ann Epidemiol 20: 421-427
48. Brown M (2011): Science Versus Policy in Establishing Equitable Disability Compensation Policy. July Supplement 2011, Mil Med 176 (7): 35-40
49. DVA (2017): Vietnam Era Health Retrospective Observational Study (VE-HEROeS), Department of Veterans Affairs, Washington DC, USA
2. Young AL (2009): Vietnam and the Agent Orange Controversy Revisited. Chapter 1, IN: Young AL, The History, Use, Disposition and Environmental Fate of Agent Orange. Springer Science +Business Media, LLC, New York NY, USA
3. Young AL, Cecil PF (2011): Agent Orange Exposure and Attributed Health Effects in Vietnam Veterans. July Supplement 2011, Mil Med 176 (7): 29-34
4. Sholdt LL (2008): Entomology with the US Marines in Vietnam – Some Lessons Learned. Proceedings of the DoD Symposium “Evolutions of Military Medical Entomology”, Annual Meeting of the Entomological Society of America, 16 November 2008
5. Schoof HF (1969): Research and Control Activities on Vector-borne Diseases in Southeast Asia. Reprint Number 479, Technical Development Laboratories, National Communicable Disease Center, Savannah, GA 31402
6. Fox RP (1979): Air Base Defense in the Republic of Vietnam 1961-1973. Office of Air Force History, United States Air Force, Washington, DC, USA
7. Westing AH (1976): Ecological Consequences of the Second Indochina War. Stockholm Peace Research Institute. Almquest & Wiksell International, Stockholm, Sweden
8. Young AL (2009): The Military Use of Tactical Herbicides in Vietnam. Chapter 3, IN: Young AL, The History, Use, Disposition and Environmental Fate of Agent Orange. Springer Science +Business Media, LLC, New York NY, USA
9. Young AL (2009): A History of the Development and Procurement of Tactical Herbicides. Chapter 2, IN: Young AL, The History, Use, Disposition and Environmental Fate of Agent Orange. Springer Science +Business Media, LLC, New York NY, USA
10. Bovey RW, Young AL (1980): The Science of 2,4,5-T and Associated Phenoxy Herbicides. John Wiley & Sons. A Wiley-Interscience Publication. New York
11. Young AL, Young KL (2013): Investigations into Allegations Concerning 2,4,5-T Herbicide. Agent Orange Investigative Report Series, No. 6. Compensation Service, Department of Veterans Affairs, 810 Vermont Ave, NW, Washington DC 20420. Contract: VA-101-12-C-0006
12. IOM (1994 – 2014): Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Institute of Medicine, National Academies of Science, Washington DC, USA
13. Lavy TL (1987): Human Exposure to Phenoxy Herbicides. VA Monograph, May 1975. Department of Medicine and Surgery, Central Office, Department of Veterans Affairs, Washington DC 20420
14. Kearney PC, Kaufman DD (1975): Herbicides: Chemistry, Degradation, and Mode of Action. Two Volumes, Marcel Dekker, Inc., New York, NY, USA
15. Hood, RD (1985): Cacodylic Acid: Agricultural Uses, Biologic Effects, and Environmental Fate. VA Monograph, December 1985. Department of Medicine and Surgery, Central Office, Department of Veterans Affairs, Washington, DC 20420, USA
16. Young AL (2004): TCDD Biomonitoring and Exposure to Agent Orange: Still the Gold Standard. Environ Sci Pollut Res 11 (3): 143-146
17. Young AL, Van Houten WJ, Andrews WB (2008): 2nd Agent Orange and Dioxin Remediation Workshop. Environ Sci Pollut Res 15 (2): 113-118
18. Young AL, Giesy JP, Jones PD, Newton M (2004): Environmental Fate and Bioavailabilty of Agent Orange and Its Associated TCDD During the Vietnam War. Environ Sci Pollut Res 11 (6): 359-370
19. Young AL, Cecil PF, Guilmartin JF (2004): Assessing Possible Exposures of Ground Troops to Agent Orange During the Vietnam War: The Use of Contemporary Military Records. Environ Sci Pollut Res 11 (6): 349-358
20. Cecil PF (1986): Herbicidal Warfare: The RANCH HAND Project in Vietnam. Praeger Special Studies, Praeger Scientific, New York NY, USA
21. Cecil PF, Young AL (2008): Operation FLYSWATTER: A War Within a War. Environ Sci Pollut Res 15 (1): 3-7
22. Crummett WB (2002): Decades of Dioxin: Limelight on a Molecule. Xlibris Corporation, USA
23. Baughman R, Meselson M (1973): An analytical method for detecting TCDD (dioxin): levels of TCDD in samples from Vietnam. EHP 5:27-35
24. Tenenbaum D (1996): Focus Article: The Value of Vietnam. EHP 104 (12): 104-112
25. Schecter, A., Le, C.D., Thuy, L.T.B., Hoang, T.Q., Dinh, Q.M., Hoang, D.C., Pham, H.P., Schecter A, Tong HY, Monson SJ, Gross ML, Raisanen S, Karhunen T, Osterlund EK, Constable JD, Cau HD, Dai LC, Quynh HT, Lang TD, Phuong NTN, Phiet PH, Vu D (1990): Human Adipose Tissue Dioxin and Dibenzofuran Levels and “Dioxin Toxic Equivalents” in Patients From the North and South of Vietnam. Chemosphere 20 (7-9): 943-950
26. Schecter A, Dai LC, Thuy LBT, Quynh HT, Minh DQ, Cau HD, Phiet PH, Phouong NTN, Constable JD, Baughman R, Papke O, Furst P, Raisanen S (1995): Agent Orange and the Vietnamese: The Persistence of Elevated Dioxin Levels in Human Tissues. Am J Public Health 85 (4): 516-532
27. Kang HK, Watanabe KK, Breen J, Remmers J, Conomos MG, Stanley J, FlickerM (1991): Dioxins and Dibenzofurans in Adipose Tissue of US Vietnam Veterans and Controls. Am J Public Health 81 (3): 344-349
28. Pham DT, Nguyen HM, Boivin TG, Zajacova A, Huzurbazar SV, Bergman HL (2015): Predictors for dioxin accumulation in residents living in Da Nang and Bien Hoa, Vietnam, many years after Agent Orange use. Chemosphere 118: 277-283.
29. Manh HD et al (2015): Levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans in breast milk samples from three dioxin-contaminated hotspots of Vietnam. Sci Total Environ 511: 416-422
30. Jones KC, Bennett BG (1989): Human exposure to environmental polychlorinated dibenzo-p-dioxins and dibenzofurans: an exposure commitment assessment for 2,3,7,8-TCDD. Sci Total Environ 78: 99-116
31. Environmental Protection Agency (1984-updated June 2015): Dioxin Publications as Reports, Articles and Archive Materials. US Environmental Protection Agency, Washington DC, USA. http://www.cfpub.epa.gov/ncea/dioxin/publication.cfm
32. CDC (1988): Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels in US Army Vietnam-Era Veterans. JAMA 260 (9): 1249-1254
33. Buffler PA, Ginevan ME, Mandel, JS, Watkins DK (2011): The Air Force Health Study: An Epidemiologic Retrospective. Ann Epidemiol 21: 673-687
34. Kang HK, Dalager NA, Needham LL, Patterson DG, Jr., Lees PSJ, Yates K, Matanoski GM (2006): Health Status of Army Chemical Corps Vietnam Veterans Who Sprayed Defoliants in Vietnam. Am J Indust Med 49: 875-884
35. Catlin Boehmer TK, Flanders WD, McGeehin MA, Boyle C, Barrett DH (2004): Postservice Mortality in Vietnam Veterans: A 30-Year Follow-up. Arch Intern Med 164: 1908-1916
36. Clarke PM, Gregory R, Salomon JA (2015): Long-term Disability Associated with War-related Experience Among Vietnam Veterans, Retrospective Cohort Study. Med Care 53 (5): 401-408
37. VHA Directive 1302 (Updated Dec 7, 2016): Agent Orange Registry Program. Veterans Health Administration, Department of Veterans Affairs, Washington DC, USA
38. Krishnamurthy P, Hazratjee, Opris D, Agrawal S, Markert R (2016): Is Exposure to Agent Orange a Risk Factor for Hepatocellular Cancer? – A Single-Center Retrospective Study in the US Veteran. J Gastrointest Oncol 7 (3): 426-432
39. Patterson AT, Kaffenberger BH, Keller RA, Elston DM (2015): Skin Disease Associated with Agent Orange and Other Organochlorine Exposures. J Am Dermatol 74 (1): 143-173
40. Gough M (1991): Human Health Effects: What the Data Indicate. Sci Total Environ 104 (1-2): 129-158
41. Bond GG, Bodner KM, Cook RR (1989): Phenoxy Herbicides and Cancers: Insufficient Epidemiologic Evidence for a Causal Relationship. Fund Appl Toxicol 12 (1): 172-188
42. Boffetta P, Mundt KA, Adami, H-O, Cole, P, Mandel JS (2011): TCDD and Cancer: A Critical Review of Epidemiologic Studies. Crit Rev Toxicol 41 (7): 622-636
43. CDC (1990): The Association of Selected Cancers with Service in the US Military in Vietnam: Final Report. Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta GA, USA
44. CDC (1988): Health Status of Vietnam Veterans, III. Reproductive Outcomes and Child Health. JAMA 259 (18): 2715-2719
45. Panangala SV, Shedd DT (2014): Veterans Exposed to Agent Orange: Legislative History, Litigation, and Current Issues. CRS Report 7-5700, Congressional Research Service, United States Congress, Washington DC, USA
46. Wade N (1980): Mythopoiesis. Protest TIBS, June 1980, p VIII
47. Samet JM, McMichael GH, Wilcox AJ (2010): The Use of Epidemiological Evidence in the Compensation Veterans. Ann Epidemiol 20: 421-427
48. Brown M (2011): Science Versus Policy in Establishing Equitable Disability Compensation Policy. July Supplement 2011, Mil Med 176 (7): 35-40
49. DVA (2017): Vietnam Era Health Retrospective Observational Study (VE-HEROeS), Department of Veterans Affairs, Washington DC, USA