"Provider" similar to the ones
used in Operation Ranch Hand
Photo: 15th webmaster
1962 and 1971, US military forces sprayed
millions of gallons of herbicides
over South Vietnam.
Orange accounted for much of the total sprayed."
Press Release - July 28, 1993 [REPORT]
DMZ Vets and Agent Orange [see
STUDY AT COLUMBIA
Orange Statistics - Statistical
were used by the U.S. during the Vietnam War to
defoliate the hiding places of the Viet Cong (VC)
guerillas and North Vietnamese Army (NVA) regulars.
most infamous herbicide used was called Agent Orange.
The steel drums in which the herbicide was transported
were color-coded with an orange stripe. Other
colors such as Blue, White, Purple and Pink, were used
to designate different herbicide formulations.
largest volume of herbicide was applied from the air
by C-123 "Provider" twin-engine aircraft.
This air spray program was code named Operation Ranch
were also used around the perimeters of fire bases to
keep the concertina wire clear of vegetation,
providing an open view for sentries on guard duty.
were also sprayed along river banks to reduce the
number of US casualties in the Brown Water Navy.
Ranch Hand statistics page
fly in close formation as they
spray defoliation chemicals on the jungle
to deprive the enemy of hiding places
the war, veterans began to experience health problems
that they attributed to herbicide exposure.
Finally, almost 20 years after the war ended, Congress
asked the Institute of Medicine (IOM) National Academy
of Sciences (NAS) to perform an in-depth study.
The length of time that had elapsed since the end of
the war certainly didn't help the committee.
July 28, 1993 the following Press Release was issued
by the Institute of Medicine, National Academy of
LINKS DISEASE TO HERBICIDES;
CALLS FOR NEW STUDIES OF EXPOSED
July 28, 1993
WASHINGTON - Evidence exists linking three cancers and two other
health problems with chemicals used in herbicides in the Vietnam
War, a committee of the Institute of Medicine (IOM) has
concluded. Those diseases are soft tissue sarcoma,
non-Hodgkin's lymphoma, and Hodgkin's disease, as well as skin
diseases chloracne and porphyria cutanea tarda (PCT). The
committee also concluded that new studies piecing together
different types of information could help determine how much the
risk of disease is increased in veterans who were exposed to
such herbicides as Agent Orange.
committee's report specifically focuses on Agent Orange and
other herbicides used in Vietnam, some of which contained
dioxin, and unintended byproduct of the manufacturing process.
"Over the years, extreme views have evolved on the
issue," said Harold Fallon, IOM committee chair and dean of
the School of Medicine at the University of Alabama, Birmingham.
"On one extreme is the view that Agent Orange has not led
to health problems. Our committee has determined through
an extensive review of the scientific literature that indeed,
there does appear to be a link between exposure to herbicides
and certain diseases."
of the evidence the committee reviewed about adverse health
effects came from studies of people who were exposed as a result
of their jobs or from industrial accidents. These types of
exposures often were at high levels and for long periods of
time. Getting a clear picture of the health risks for
Vietnam veterans is not so straightforward, the committee said,
because the levels of exposure were extremely wide ranging.
Indeed, while most veterans probably had lower exposure levels,
some may have experienced levels as high as that of occupational
or agricultural exposures. What is uncertain is how many
veterans may have been exposed to those higher levels and who
those individuals are.
"We simply do not know the degree of risk for Vietnam
veterans," said committee vice chair David Tollerud,
director of occupational and environmental medicine, University
of Pittsburgh Graduate School of Public Health. "We
do feel, however, that enough information exists to allow
studies to be done that would lead to a better understanding of
the risk that veterans face for contracting diseases related to
herbicide exposure in Vietnam."
committee examined more than 230 epidemiological studies in
detail on a range of health problems and their possible
association with herbicides. It found sufficient evidence of a
statistical association between exposure to herbicides or dioxin
and soft tissue sarcoma, non-Hodgkin's lymphoma, and Hodgkin's
disease. The committee also found sufficient evidence of an
association between herbicides or dioxin and chloracne and PCT.
Chloracne is a specific acne-like skin disorder; PCT is a liver
disorder characterized by thinning and blistering of the skin.
category of sufficient evidence represented the strongest link
the committee made between adverse health effects and exposure
to herbicides, including Agent Orange or dioxin.
U.S. Department of Veterans Affairs currently compensates
Vietnam veterans for non-Hodgkin's lymphoma, soft tissue
sarcoma, and chloracne.
link between herbicides or dioxin and other adverse health
effects the committee studied fell into three remaining
Limited or Suggestive Evidence. The committee found limited or
suggestive evidence of an association between exposure to
herbicides of the kind used in Vietnam and three other cancers:
respiratory cancers, prostate cancer, and multiple myeloma.
Inadequate Evidence. The scientific data for most cancers and
other diseases, such as adverse neurological and reproductive
effects, were inadequate or insufficient to determine whether an
association exists, the report says (see attached list).
Association. For a small group of cancers, the committee found
that a sufficient number and variety of well-designed studies
exist to conclude that there is limited or suggestive evidence
of no association between these cancers and the herbicides or
dioxin. This group includes skin cancer, gastrointestinal tumors
(colon, rectal, stomach, and pancreatic), bladder cancer, and
MEASURES OF EXPOSURE NEEDED
reviewing the literature, the committee found that exposure
assessment was the weakest element in most epidemiological
studies of veterans. While some studies show a link between
adverse health effects and herbicides or dioxin, there are few
data indicating which individuals may have received high
exposures during service in Vietnam.
evidence about exposure during the war suggests that Vietnam
veterans as a group had substantially lower exposure to
herbicides and dioxins than the subjects in many occupational
studies, the committee said. Veterans who were participants in
Operation Ranch Hand -- the extensive spraying of some 19
million gallons of herbicide over 3.6 million acres of South
Vietnam from airplanes -- are an exception to this pattern,
however, because of their direct involvement in the spraying
committee also said that, among the approximately 3 million
Vietnam veterans, there may be some former ground troops not
directly involved in the spraying who were exposed to herbicides
at levels associated with adverse health effects.
committee emphasized that it may be possible to develop better
exposure measures for Vietnam veterans by relying on "less
formal" sources of historical information than have been
used in the past. Previous studies have relied primarily on the
carefully recorded information on aerial spraying in Operation
Ranch Hand and on blood tests for dioxin, but these measures may
not reflect the full range of exposures of Vietnam veterans to
committee urged that a non-government organization be
commissioned to develop and test new methods of evaluating
herbicide exposure in Vietnam veterans. These new methods would
draw on historical reconstructions and include information on
the spraying that occurred around base camps and other areas
which could have led to higher human exposures, the committee
said. Important information could be gained from historical
records of ground and perimeter spraying, herbicide shipments to
various military bases, and knowledge of the type of terrain and
foliage typical of the locations sprayed and the military
mission of the troops located there. These new methods of
measuring exposure should be evaluated by an independent,
non-government scientific panel.
prove to be valid, a new series of epidemiological studies of
veterans should be undertaken to assess the degree to which
veterans may be at risk of cancer and other disease as a result
of exposure, the committee said.
urged continued follow-up of the Ranch Hand veterans and its
comparison group, and recommended that members of the Army
Chemical Corps also be studied for adverse health effects from
exposure. Studies should be done by an independent agency,
noting that such an independent body could do much to 'satisfy
the public's concern about impartiality and scientific
addition, the committee recommended that -- for the purpose of
facilitating the collection of data for new studies -- the U.S.
Department of Defense identify in its computerized index of
military service records which veterans served in Vietnam.
Currently, this index does not indicate whether an individual
served in the Vietnam War. "Lack of an indicator of Vietnam
service complicates every epidemiologic study of veterans . . .
and leads to methodologic inconsistencies."
USE IN VIETNAM
1962 and 1971, U.S. military forces sprayed millions of gallons
of herbicides over South Vietnam. Agent Orange accounted for
much of the total sprayed.
scientific report in 1969 concluded that one of the primary
chemicals used in Agent Orange could cause birth defects in
laboratory animals, use of the herbicide was suspended. All
U.S.-authorized herbicide use in Vietnam was halted in 1971. As
the decade wore on, concern about possible long-term health
consequences of Agent Orange and other herbicides heightened,
fueled in part by reports from Vietnam veterans that they had
developed cancer or fathered handicapped children. Some veterans
attributed these health problems to wartime exposure to
then, thousands of scientific studies have been conducted. Faced
with lingering uncertainty, Congress asked the National Academy
of Sciences' Institute of Medicine to conduct a comprehensive
review of available scientific information regarding the health
effects of exposure to Agent Orange and other herbicides used in
Vietnam. The report is the product of the IOM committee's work,
begun in 1992.
study was sponsored by the U.S. Department of Veterans Affairs.
Institute of Medicine is a private, non-profit organization that
provides health policy advice under a congressional charter
granted to the National Academy of Sciences.
1-1 Summary of Findings in Occupational, Environmental, and
Veterans Studies Regarding the Association Between Specific
Health Problems and Exposure to Herbicides
Evidence of an Association
is sufficient to conclude that there is a positive
association. That is, a positive association has been observed
between herbicides and the outcome in studies in which chance,
bias, and confounding could be ruled out with reasonable
confidence. For example, if several small studies that are
free from bias and confounding show an association that is
consistent in magnitude and direction, there may be sufficient
evidence for an association. There is sufficient evidence of
an association between exposure to herbicides and the
following health outcomes:
cutanea tarda (in genetically susceptible individuals)
Evidence of an Association
is suggestive of an association between herbicides and the
outcome but is limited because chance, bias, and confounding
could not be ruled out with confidence. For example, at least
one high-quality study shows a positive association, but the
results of other studies are inconsistent. There is
limited/suggestive evidence of an association between exposure
to herbicides and the following health outcomes:
cancers (lung, larynx, trachea)
Evidence to Determine Whether an Association Exists
available studies are of insufficient quality, consistency, or
statistical power to permit a conclusion regarding the
presence or absence of an association. For example, studies
fail to control for confounding, have inadequate exposure
assessment, or fail to address latency. There is inadequate or
insufficient evidence to determine whether an association
exists between exposure to herbicides and the following health
reproductive cancers (breast, cervical, uterine, ovarian)
death and stillbirths
cancer in offspring
sperm parameters and infertility
Evidence to Determine Whether an Association Exists
and neuropsychiatric disorders
nervous system disorders
and digestive disorders (diabetes, changes in liver
enzymes, lipid abnormalities, ulcers)
system disorders (immune modulation and autoimmunity)
Evidence of No Association
adequate studies, covering the full range of levels of
exposure that human beings are known to encounter, are
mutually consistent in not showing a positive association
between exposure to herbicides and the outcome at any level of
exposure. A conclusion of 'no association' is inevitably
limited to the conditions, level of exposure, and length of
observation covered by the available studies. In addition,
the possibility of a very small elevation in risk at the
levels of exposure studied can never be excluded. There
is limited/suggestive evidence of no association
between exposure to herbicides and the following health
tumors (stomach cancer, pancreatic cancer, colon cancer,
'Herbicides' refers to the major herbicides used in Vietnam:
2,4-D (2,4-dichlorophenoxyacetic acid); 2,4,5-T
(2,4,5-tricbIorophenoxyacetic acid) and its contaminant TCDD
(2,3,7,8-tetrachlorodibenzo-p-dioxin); cacodylic acid;
and picloram. The evidence regarding association is drawn from
occupational and other studies in which subjects were exposed to
a variety of herbicides and herbicide components.
is a table containing Agent Orange Briefs also
called Fact Sheets
Orange Briefs (Fact Sheets) are
in the form of Word Documents
ORANGE BRIEFS (FACT SHEETS)