March 2000

 

AGENT ORANGE AND RELATED ISSUES

 

THE VIETNAM CONFLICT

• An estimated 3.1 million veterans served in the Southeast Asia Theater (Vietnam, Laos, Cambodia, flight crews based in Thailand, and sailors in the South China Sea).

• An estimated 2.6 million personnel served within the borders of South Vietnam and in adjacent waters.

 

AGENT ORANGE

Agent Orange was a herbicide used in Vietnam to defoliate trees and remove cover for the enemy.  Agent Orange spraying missions were flown in Vietnam between January 1965 and April 1970.  Shipped in orange-striped barrels, it was a reddish-brown liquid containing four herbicides:  2,4,5-trichlorophenoxyacetic acid (2,4,5-T), 2,4-dichlorophenoxyacetic acid (2,4-D), cacodylic acid and picloram.  The 2,4,5-T was contaminated in the manufacturing process with dioxin.  Several herbicides were sprayed in Vietnam at different times -- during different years as well as during different seasons because of the variety of vegetation and environmental conditions.

 

The history of herbicides for military use dates to World War II.  During the early part of the war, interest arose in chemicals that could be used for crop destruction. Two chemicals were developed as a result of those early efforts -- 2,4-D and 2,4,5-T. Although neither chemical was used in World War II, the value of their use in weed and brush programs was recognized, and both chemicals have been used widely throughout the world since the 1940s by farmers, foresters and homeowners.

 

VA SERVICES FOR VIETNAM VETERANS

 

      Free Medical Care:  VA has offered special access to health services and studies since 1978, when it initiated a medical surveillance program for Vietnam veterans with health concerns.  By 1981, VA offered priority medical care to Vietnam veterans with any health problems which may have resulted from Agent Orange exposure.  That program continues today.  

 

  Special Compensation for 10 Diseases:  As with other veteran, Vietnam veterans with disabilities incurred or aggravated by military service may receive monthly VA compensation.  As knowledge has grown from studies of Agent Orange, some diseases that may not have become evident in service have been recognized as service-connected.  Based on clinical research, the following diseases are now on VA's Agent Orange list:  chloracne, Hodgkin's disease, multiple myeloma, non-Hodgkin's lymphoma, porphyria cutanea tarda, respiratory cancers (lung, bronchus, larynx and trachea), soft-tissue sarcoma, acute and subacute peripheral neuropathy and prostate cancer.  In addition, monetary benefits, health care and vocational rehabilitation services are provided to Vietnam veterans' offspring with spina bifida, a congenital birth defect of the spine.  VA presumes that all military personnel who served in Vietnam and who have one of the listed diseases were exposed to Agent Orange.

 

VA RESPONSE TO CONCERNS ABOUT AGENT ORANGE

      • VA developed the Agent Orange Registry Examination Program in 1978 to identify Vietnam veterans concerned about Agent Orange exposure.  Nearly 300,000 Vietnam veterans have been provided examinations under the Registry program as of December 1999.  VA maintains a computerized registry of data from these examinations.  Registrants receive periodic updates on studies and policy.

      • VA's Advisory Committee on Health-Related Effects of Herbicides was established in 1979 to examine issues surrounding the possible health effects of herbicides on Vietnam veterans.  VA also established the Veterans' Advisory Committee on Environmental Hazards, consisting of non-VA experts in dioxin and radiation exposure as well as several lay members, to advise the Secretary on the results of Agent Orange-related research, and regulatory, administrative and legislative initiatives.  Since passage of a 1991 law (PL102-4), which directs VA to request that the National Academy of Sciences (NAS) review diseases associated with herbicide exposure, the committee's work has been superseded by the NAS review.

      • The NAS reviews and evaluates scientific literature about Agent Orange.  NAS reviewed more than 6,000 abstracts of scientific or medical articles and analyzed 230 epidemiological studies before its initial July 1993 report, which led to the inclusion of additional diseases on the list for presumptive service-connection.  The NAS review has been continuing, with acute and subacute peripheral neuropathy and prostate cancer added to VA's presumptive list after the NAS issued an updated report in March 1996.  Also based on that report's findings of new "limited or suggestive evidence" of an association between herbicides and spina bifida in the children of Vietnam veterans, VA proposed legislation to aid children of Vietnam veterans who suffer from that disorder, and established a reproductive outcomes research center to investigate potential environmental hazards of military service.  The latest NAS update, released in February 1999, contained no major changes in its classifications of diseases.  (The executive summary of that report is available on the Institute of Medicine's National Academy Press web site at http://books.nap.edu/html/update98/.)  The next major update is scheduled to be completed by the end of 2000.  

However, a separate VA study led Secretary of Veterans Affairs Togo D. West Jr. to call for legislation to benefit children who suffer from birth defects that may have been caused by their mothers' Vietnam service, not necessarily by herbicide exposure.  Secretary West also asked NAS to further review a study by the National Institute of Occupational Safety and Health of dioxin-exposed production workers at two U.S. plants that revealed elevated rates of diabetes among workers.  A decision whether to establish a presumption of service-connection for diabetes will be made once the additional review is completed, which is expected in May 2000.