As a Victim of  Agent Orange ,  I've collected a lot of information on herbicides (AO/dioxin)... heard too many stories of the effects of herbicide (AO/dioxin) exposure... 

My efforts in the AO/dioxin issue are educational. The more information that is available in an easy term that all people can understand (not just scientists), the better off we are. Any normal person can make up there own mind about the hazardous effects of these chemicals.

Please understand that dioxin is still present as a contaminant in many products that are sold in stores today... although not in the concentration found in the herbicides used during the Vietnam War. However, continued exposure to these chemicals (and similar ones) increase the body burden of toxins.

Reading List

These (web) pages are presented to educate. If you wish to help in that education process, please feel free to distribute this information. If you have doubts as to the detrimental effects of the various agents used during the Vietnam War, you are encouraged to contact the survivors of cancers... widows of husbands who lingered in their very painful death... and, the children deprived of many things that we, as veterans, believed in... freedom, liberty, justice, the pursuit of happiness... the American dream.

Agent Orange Talking Paper #1 by Gary D. Moore... an outline of facts everyone should know about AO/dioxin.
National Academy of Science, 1996 Summary, Table 1-1 Disease list accepted by the VA for compensation
Notes on Herbicides Used During the Vietnam War by Gary D. Moore
Ranch Hand (USAF) Herbicide Totals (One (1) Column) USAF Operation herbicide spraying
Ranch Hand (USAF) Herbicide Totals (Two (2) Column) USAF Operation herbicide spraying
Re-evaluation of Dioxin - 1993 by Linda Birnbaum
Your Health and Dioxin (Agent Orange/Herbicide) Exposure by Gary D. Moore... tips from experience


Web Sites of Interest:

The American Legion

Association Birth Defects Children this is an organization that is NOT veteran, yet supports us... please support ABDC!
Austrialian Vietnam Veteran (G. McMahon)His reflection on Agent Orange, PTSD, etc.
Crow's Nest, The A veteran information site (e.g., VA Healthcare, POW-MIA, Honor Roll for Agent Orange Victims, etc.)
Department of Veteran Affairs (VA) Lots of information if you want to dig
Friends of the Vietnam Memorial
National Academy of Science - Veterans and Agent Orange: Update 1996 List of AO cancers.
New Jersey Agent Orange Commission Updates on the NJAOC
The Retired Officers Association A great organization for retired military officers
Son of a Vietnam Veteran A tribute to his father (and all Vietnam Vets) by a son, Lou Plummer
Sixties Journal Issues On-Line
US Army Home Page
Veteran News & Information Service
Vietnam Veterans of America (National)

12th Special Operations (USAF) defoliation mission in South Vietnam

123 Providers from the 12th Special Operations Squadron at Bien Hoa Air Base spray defoliant over the jungle in South Vietnam. This Squardon began spraying in 1962. (Ref: Mission Vietnam, Seventh Air Force, USAF)


USAF Ranch Hand Herb Tapes
Herbicide Amounts from August 1965

Grand Total: 8,165,491 gallons

South Vietnam Quadrants:

I Corp
II Corp
III Corp
IV Corp

Agent (Herbicide) Chart
Agent Orange Information

I Corps - 2,355,322

Location Orange White Blue Total Gallons
A Shau 53,550 2,550 6,128 62,228
An Hoa 6,500 1,800 11,250 19,550
Binh Hoa 8,220 0 1,600 9,820
Cam Lo 80,375 8,660 12,785 101,820
Camp Carrol 78,200 5,400 5,050 88,650
Camp Eagle 14,250 0 0 14,250
Camp Esso 53,410 5,600 0 64,510
Camp Evans 18,690 0 880 19,570
Camp Henderson 68,155 7,040 4,800 79,995
Chu Lai 12,170 4,150 1,598 17,918
Con Thien 84,700 12,460 10,925 108,085
Da Nang, China Beach 13,800 0 2,000 15,800
Dong Ha 54,385 5,060 9,935 69,380
Duc Pho, LZ Bronco 46,225 14,400 1,175 61,800
Firebase Jack 140,875 11,900 3,280 156,055
Firebase Rakkassan 150,145 23,900 2,510 176,555
Firebase West 15,405 3,690 18,480 37,575
Hill 63 20,500 3,200 0 23,700
Hill 69 11,620 4,150 1,598 17,368
Hoi An 17,520 3,000 13,950 34,470
Hue 41,395 0 5,070 46,465
Khe Sanh, Firebase Smith 43,705 3,040 4,300 51,045
LangCo Bridge 50,610 5,600 3,500 59,710
LZ Baldy 15,430 3,000 13,950 32,380
LZ Dogpatch, Hill 327 4,490 0 8,250 12,740
LZ Geronimo 22,535 14,000 468 37,003
LZ Jane, Firebase Barbara 91,150 6,750 3,700 101,600
LZ Langley, Firebase Shepard 72,105 7,040 4,800 83,945
LZ Profess, Hill 55 39,300 13,000 17,209 69,509
LZ Rockcrusher, Hill 85 47,800 0 0 47,800
LZ Rockpile 110,050 15,440 7,650 133,140
LZ Ross 15,405 6,720 18,508 40,633
LZ Sandra 118,780 20,210 24,755 163,745
LZ Snapper, Firebase Leather 11,350 0 3,000 14,350
Marble, Hill 59 15,405 6,720 18,508 40,633
Phu Bai 54,300 3,000 120 57,420
Phu Luc, LZ Tommahawk 78,250 4,000 0 82,250
Quang Nai 25,605 0 1,800 27,405
Quang Tri, LZ Nancy 68,000 2,750 3,700 74,450

II Corps - 1,054,406

Location Orange White Blue Total Gallons
An Khe, Camp Radcliff 37,810 6,400 5,610 49,820
An Lao, LZ Laramie 68,970 490 10,570 80,030
Ban Me Thuot 16,000 9,250 0 25,250
Ben Het 80,495 7,230 3,000 90,725
Bon Song, LZ Two Bits 80,643 630 6,000 87,273
Bre Nhi 6,600 0 0 6,600
Cam Ranh Bay 21,227 1,373 0 22,600
Camp Granite 59,310 2,075 5,390 66,775
Che Oreo 0 1,800 0 1,800
Da Lat 575 0 0 575
Dak To 49,460 600 34,800 84,860
Firebase Pony 43,490 0 3,800 47,290
Kontum 0 415 0 415
LZ Dog, LZ English 63,073 630 6,000 69,703
LZ Oasis No Data
LZ Putter, Firebase Bird 50,095 0 7,200 57,295
LZ Uplift 43,455 3,220 275 46,950
Nha Trang 6,950 325 0 7,275
Phan Rang 110 2,075 0 2,185
Phan Thiet 5,000 330 220 5,550
Plei Ho, SF Camp 15,300 1,260 110 16,670
Plei Jerang 98,220 51,235 1,800 151,255
Pleiku 1,210 11,640 1,950 14,800
Puh Cat, LZ Hammond 29,700 7,210 0 36,910
Qui Nhon 53,215 1,800 4,125 59,140
Song Cau 5,650 55 0 5,705
Tuy An 13,215 3,740 0 16,955
Tuy Hoa 29,565 4,485 0 34,050

III Corps - 4,086,229

Location Orange White Blue Total Gallons
An Loc 77,000 79,830 0 156,830
Ben Cat 87,250 83,640 20,105 190,995
Ben Hoa 35,045 124,525 3,950 163,520
Cholon 320 0 0 320
Cu Chi 59,150 67,540 14,105 140,795
Dau Tieng (Michelin) 32,370 45,800 3,800 81,770
Dien Duc, Firebase Elaine 66,850 25,800 0 92,350
Duc Hoa 750 0 0 750
Firebase Di An 6,000 0 1,595 7,595
Firebase Frenzel 13,445 57,560 900 71,905
Firebase Jewel, LZ Snuffy 219,550 146,010 7,300 372,860
Firebase Mace 34,280 23,350 730 58,360
Katum 299,420 239,395 20,000 558,815
Lai Khe 57,120 22,300 1,800 81,220
Loc Ninh 46,660 103,710 1,800 152,170
Long Binh, Firebase Concord 13,445 57,560 0 71,005
LZ Bearcat 17,840 75,470 0 93,310
LZ Fish Nook 44,000 23,800 0 67,800
LZ Schofield 38,640 17,210 7,800 63,650
Nha Be (Navy Base) 119,725 121,925 6,000 247,650
Nui Ba Den, Firebase Carolin 50,020 66,500 2,100 118,620
Phouc Vinh 484,383 146,576 12,810 643,769
Phu Chong 39,848 62,230 12,055 114,130
Phu Loi 79,000 83,430 0 162,430
Qua Viet 50,610 5,600 3,500 59,710
Quan Loi 44,190 34,300 0 78,490
Saigon No Data
Song Be 1,900 9,220 0 11,120
Tan Son Nhut 6,320 0 1,595 7,915
Tay Ninh 720 3,225 600 4,545
Trang Bang 32,365 39,560 6,000 77,925
Vo Dat, Firebase Nancy 14,180 29,100 0 43,280
Vung Tau 7,350 0 0 7,350
Xuan Loc 23,865 58,750 660 83,275

IV Corps - 669,534

Location Orange White Blue Total Gallons
Ben Luc 45,900 14,838 0 60,738
Ben Tre 24,800 24,750 0 49,550
Can Tho 15,160 13,915 11,685 40,760
Cao Lanh 1,875 2,935 830 5,640
Dong Tam 5,870 605 165 6,640
Firebase Grand Can(yon?) 0 1,540 0 1,540
Firebase Moore 9,820 0 0 9,820
Ham Long 3,275 1,620 0 4,895
Moc Hoa 12,400 6,590 0 18,990
My Tho 13,320 7,316 965 21,601
Nam Can 150,345 64,295 0 214,640
Phnom 0 184 0 184
Phu Quoc 19,000 0 0 19,000
Rach Gia 0 2,155 0 2,155
Seafloat 4,700 0 0 4,700
Soc Trang 3,410 2,391 1,280 7,081
Tan An 89,550 36,450 0 126,000
Tieu Con 8,700 0 0 8,700
Tra Vinh 9,885 8,000 0 17,885
Vinh Loi 30,010 0 0 30,010
Vinh Long 8,360 9,755 890 19,005

Note: This does NOT include US Army helicopter or ground applications, or any form of the insecticide programs by GVN, or the US military. The amount represents gallons within eight (8) kilometers of the area. Thus, each area is 9.6 miles in diameter.

Description TCDD (Dioxin) Amounts
Agent Orange 1.77 to 40 ppm
Agent Blue (Purple) 32.8 to 45 ppm
Agent Red (Pink) 65.6 ppm
Agent White (Green) 65.6 ppm
Silvex 1 to 70 ppm
2,4,5-T (Current) 0.1 ppm or less

Latest AO News

= N E W S B R I E F I N G
= WASHINGTON, D.C. 20301

DoD News Briefing
Dr. Joel Michalek, Air Force Health Study Principal Investigator
Wednesday, March 29, 2000 1:30 p.m.

ADM. QUIGLEY: Good afternoon, ladies and gentlemen.
We have with us this afternoon Dr. Joel Michalek. He is an Air Force surgeon and is the principal investigator for the Air Force health study on Operation Ranch Hand, and normally works out of Brooks Air Force Base in Texas. He'll be briefing the findings of the latest phase of this study.
Then when complete, we'll have executive summaries -- paper -- for you back on the table. And the entire study, much more lengthy, will be online, and we'll give you that URL.

Dr. Michalek? All yours.

Q: For the record: Once again we've gone through this issue of we have a complicated subject; we don't have the report before the briefing. It just seems a crazy way to do things. Just for the record.

ADM. QUIGLEY: Noted. We'll see what we can do.

Q: Why can't we have it now so we can look at it?

ADM. QUIGLEY: Because this seemed like a logical way to do it.

Q: Well, I mean, we could follow along while he points to certain thoughts. I mean, that's --

ADM. QUIGLEY: Well, he doesn't have briefing charts to go to page 7 of the study and follow it here as we go to paragraph 4. I mean, that just seems to be a cumbersome way to do it. Rather to have the subject-matter expert walk you through the findings in a relatively brief way, hitting what the professional thinks is the high points of the findings, and then allow you the opportunity to read the thing in depth when you've kind of had the issue framed more broadly by the leader of the effort.

Q: But the point is that we --

ADM. QUIGLEY: If you-all are unhappy with that process, I mean, let me take that. I mean --

Q: The point is we won't be able to question on it, not having seen it.
Q: Yeah. The problem is then we read the report, then we have a dozen more questions, we're back in our offices. Who do we call then?
Q: You get to tell us what you think is important rather than us getting a chance to read the report and -- (inaudible).
Q: And ask.

ADM. QUIGLEY: Yeah. You end up at the same point, Otto, at the end of the day, but it's a different order of doing things. Honestly, if you would prefer to have it the other way, I don't see why that would be a big deal.

Q: It would be real helpful.

ADM. QUIGLEY: We could give it out at such and such a time in the morning of the day, embargo it until the completion time of the brief if that would allow you to have a better, a more comprehensive understanding and ask more intelligent questions.

Q: Which is the way you normally do it because you know that that is the way that we prefer it so we can be not ignorant when we're briefed by a subject matter expert.

ADM. QUIGLEY: All right. We won't be able to do that today, but we'll take a whack at that the next go-round on one of these efforts. Okay?

DR. MICHALEK: Thank you, sir.
First of all, I need to tell you, sir, I'm not a surgeon, I'm a statistician. I'm sorry I didn't tell you that earlier.

Q: You're not a medical doctor?

DR. MICHALEK: No. I'm a Ph.D. statistician.

Q: And you're not in the military, are you?

DR. MICHALEK: I am a civilian. Federal civil servant, GS-15, with the United States Air Force, working at Air Force Research Lab, Brooks Air Force Base.

Well, I have some things to tell you. Good afternoon. My name is Dr. Joel Michalek. I am principal investigator of the Air Force health study on Agent Orange, also known as the "Ranch Hand" study.

I appreciate you coming here today, and I'll gladly take your questions after I -- following my prepared statement.

I am always pleased to have an opportunity to tell people about the study. Before I address the report, I want to emphasize that our first concern is for the veterans. I've been with the study since 1978, and I can tell you first-hand that we have spent countless hours with over 2,000 Vietnam veterans in physical examinations in San Diego and Houston. We developed close relations with them, and are dedicated to leaving no stone unturned to find a relation between Agent Orange exposure and adverse health effects.

To provide some background, the Air Force began planning the study in 1978 to address concerns of veterans and the public regarding the consequences of exposure to Agent Orange and its dioxin contaminant. In 1982, we held our first physical examination to evaluate the health and reproductive experiences of veterans of Operation Ranch Hand, the unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971.

The purpose of the study is to determine whether Ranch Hand veterans have experienced adverse health that can be attributed to their exposures. Ranch Hand veterans were exposed to herbicides through the loading, flight operations and maintenance of the aircraft and spray equipment. The study includes a comparison group of other Air Force veterans who flew in service C-130 aircraft in Southeast Asia from 1962 to 1971, the same period during which the Ranch Hand unit was active. These comparison veterans were not involved with spraying herbicides.

The 1,000 ranch hands and 1,300 comparisons participated in the physical examinations in 1982, 1985, 1987, 1992, and 1997. A final physical exam is scheduled for the year 2002. The data gathered during these exams is analyzed, evaluated and published in various reports and articles. Our work is peer-reviewed by leading experts in their fields at the Centers for Disease Control and Prevention, the National Institutes of Health, the National Academy of Sciences, as well as academic experts throughout the country and, indeed, the world. In addition, we work through an advisory committee of leading academic experts that also include members nominated by veterans organizations.

Today we are releasing our latest morbidity report summarizing the results of the 1997 physical examination of 2,300 Air Force veterans. Although previously reported in 1992, this report includes the strongest evidence to date that exposure to Agent Orange is associated with adult onset diabetes.

The 1997 result suggests that as dioxin levels increase, not only are the presence and severity of adult onset diabetes increased, but the time to onset of disease is decreased. A 47 percent increase in diabetes was seen in those veterans with the highest levels of dioxin. This is particularly strong evidence, since dioxin is that component of Agent Orange that has been linked to many health effects in laboratory animals.

Cardiovascular disease findings were mixed. As an overall group, the Ranch Hands have experienced a 26 percent increase in heart disease. But the risk was not increased in the Ranch Hands with high levels, high dioxin levels. Within the Ranch Hand group, the risk of cardiovascular abnormalities such as high blood pressure and the prevalence of prior heart attack indicated by electrocardiogram did tend to increase with dioxin levels. The mixed results mean that some indicators of disease increased with exposure and others did not. While the study indicates that adult onset diabetes and cardiovascular disease seem most likely related to herbicide exposure, biological processes relating herbicide exposure with these diseases have not yet been described. And until such processes are found, these statistical findings may not reflect cause and effect.

In recognition of the need for biological studies, the Air Force has funded research at two separate academic institutions to explain any biological relationship between dioxin and diabetes. We have launched a study of glucose, transporters and dioxin body burden in adipose tissue of Ranch Hand veterans and have just begun a study on insulin sensitivity and dioxin body burden. In regard to cardiovascular disease, we are consulting with cardiology experts to determine what new tests to be included in the next physical examination to clarify what we have already found in 1997.

At the end of 15 years' follow-up, we still have found no consistent evidence that the Ranch Hand veterans are experiencing an increased risk of cancer. The Ranch Hands as a group exhibit a 6 percent increase in the risk of cancer. However, differences by military occupation were inconsistent, and therefore not supportive of a relation between herbicide exposure and cancer.

For example, the Ranch Hand enlisted ground crew, the subgroup with the highest dioxin levels, and presumably the greatest herbicide exposure, are experiencing a 22 percent decreased risk of cancer.

Another finding of the study is a loss of sensation in the feet, which increased with dioxin levels.

Finally, several blood tests regarding liver function and lipids were slightly elevated and did tend to increase with dioxin level. However, these tests may be elevated for many reasons, are not a disease by themselves, and cannot be explained entirely by any other finding in the study.

The report recognizes two major limitations of the study.

First, the results should not be generalized to other populations, such as Vietnamese civilians or other DOD veteran populations, who may have been exposed in different ways and at different levels of herbicide. The Air Force cannot determine what effect herbicides or dioxin levels have, other than those found in the Ranch Hand group, or from other sources, such as contaminated food. Groups with higher exposures may well have effects not seen in this study.

Second, the size of the study makes it difficult to detect increases in rare diseases, and small increases in those rare diseases may not be detected. For example, liver cancer is very rare, and even a tenfold increase in disease may not be detected in the study.

In conclusion, diabetes and cardiovascular abnormalities represent the most important dioxin-related health effects seen in the Ranch Hand study. These two areas appear to have the greatest magnitude of effect in terms of quality of life and health care costs, and, from a public health perspective, demand the greatest attention. I can assure you will continue to devote ourselves to that end.

Finally, the National Academy of Sciences will review this report, along with many other studies of herbicide and dioxin exposure, to make a report to the secretary of the Department of Veterans' Affairs, to assist him in decisions related to compensation.

I'd like to direct you to our website, where we have posted this report and other

information about the study. Thank you. I'd be happy to answer any questions you may have. Q: Doctor, could you tell us, first of all, if cancer hasn't been shown to be linked to it, what are the nine diseases that are now linked to Agent Orange and dioxins?

DR. MICHALEK: Sir, first of all, there are some studies which associate cancers of all kinds with dioxin.

And those were found by aggregating the largest chemical-worker studies in the world together into a single study -- and that was published recently -- showing that all cancers combined, in very large studies of industrial workers, are found to be associated with dioxin exposure. That study and all studies of industrial workers are controversial because industrial chemical workers are exposed to thousands of other chemicals, besides dioxin.

The nine diseases that you just asked for, I do not have memorized. I have some of them, one being -- (inaudible) -- lymphoma, soft-tissue sarcoma, spina bifida in the children of Vietnam veterans, perhaps --

Q: Lung cancer.

DR. MICHALEK: -- lung cancer --

Q: Prostate cancer.

DR. MICHALEK: -- Prostate cancer, for example. I am sorry; I don't have the list memorized.

Q: But the veterans are being -- correct me if I am wrong -- veterans who do have, for instance, lung cancer and prostate cancer are being compensated currently for such illnesses, are they not?

DR. MICHALEK: Sir, I don't pay much attention to that because my job is to do the Ranch Hand Study. The issues of compensation are handled by the Department of Veterans Affairs.

Q: Do you expect in the years ahead, given how long it takes for cancers to develop -- I would think you would now be reaching the maturation stage, where you would begin to see statistically, an elevated incidence of cancer in this group, whether they were exposed to Agent Orange or not. Are you anticipating the next few years are critical to show you any potential statistical --

DR. MICHALEK: Absolutely because, as the prevalence of disease increase, our power to detect it increases. So the next few years are critical.

We are planning for this study to shut down in the year 2006. And unless we have been directed otherwise, that's going to happen. But in the next several years, the key indicators will be revealed, that you just described; in particular, more detailed analyses of cancer.

And, as an example, we published a paper, in 1999 in the American Journal of Epidemiology, summarizing the cancer data, as I have just described, up to, but not including, the main report, which we are releasing today.

In that article, we showed no relation between cancer of the kidney and bladder. More recently we received a phone call from a nurse in Florida suggesting that we look more carefully at renal cell carcinoma.

We did that and found a trend in renal cell carcinoma against dioxin, and that's being submitted to a journal as we speak.

So that data, although it's been made public -- is published --

Q: (Off mike) -- your group?

DR. MICHALEK: Yes, sir. From our group. So yes, the point being that as we near the end of the study and the prevalence increases, our ability to detect exposure effects increases, that's why it's so critical that the study be continued through its conclusion in the year 2006.


Q: You very carefully selected a control matched in age, matched in their military specialty, but -- so these were people who were operating, working around C-130s in Southeast Asia at this time?

DR. MICHALEK: Yes. They were chosen on purpose, because -- and by the way, the issue of the control group and who should be in the control group and what the numbers should be were all argued out in 1979, 1980, during peer review at protocol.

The issue of who should be in the control group was of central importance. Number one choice at the beginning was that we use Air Force veterans stationed in Europe who flew the same kind of aircraft that the Ranch Handers flew, but that idea was discarded because there weren't enough of them.

Q: But so --

DR. MICHALEK: So we chose these Vietnam veterans who were themselves in Vietnam but had no exposure to herbicides.

Q: That shoots -- I ask because I interviewed a veteran who had brain cancer that he attributed to -- and he had this sort of job in the Marine Corps, and he was exposed to the Agent Orange on the ground as he slept. Now, is this -- were these sort of exposures filtered out of the control group?

DR. MICHALEK: The control group itself has been measured for dioxin as well as the ranch handers have. They have dioxin levels in background range from zero to 10 parts per trillion. We have been able to characterize their exposure. Many of our controls believe that they were exposed to herbicides in Vietnam, just as many other Vietnam veterans do. All we know about our control group is, number one, they were Vietnam veterans, and number two, they were not Ranch Handers. And so they are, themselves, an important reference group, because they help us ask the question as to whether the Ranch Hand veterans are any different from any other Vietnam veteran. They will not -- this study will not answer the question as to whether the Ranch Hand veterans are different from veterans who didn't go to Vietnam at all. That study, by the way, was already launched by the CDC in what's called the Vietnam Experience Study. It was patterned after the Ranch Hand study and was stopped in 1989.

Q: But if you were to examine -- but the blood tests or other work on the control group show a lower -- lower dioxin levels, is that --

DR. MICHALEK: Yes. The controls have dioxin levels like all of us in this room that range really between zero and 10 parts per trillion.

We all have dioxin in our bodies because whenever you touch a piece of Formica or breathe smoke from burning trash or pick up a Styrofoam cup, you're getting a tiny bit of dioxin into your body. It's everywhere; we're constantly picking it up, and we're constantly releasing it. And us in this room have a steady-state condition in our bodies where our uptake is approximately equal to the elimination of dioxin.

So there is a background level in everyone of dioxin who lives in industrialized countries. We recognize that, and that's taken into account in our reports. In fact, in a recent published paper, we have shown that in the comparison group -- forget about the Ranch Handers -- just in the comparison group, we see trends relating diabetes and dioxin, just as we do in the Ranch Hand group.

Q: Was the relative risk link of the diabetes and cardiovascular disease, was that the same kind of relative risk increase that you saw in the other diseases that are on the list that are currently compensated for?

DR. MICHALEK: We are not able to study most of the other conditions that are on the list because those conditions are very rare, such as soft-tissue sarcoma. We expect to see -- I think we've seen maybe one case of soft-tissue sarcoma in the entire study. The point being, this study is just too small to study the other conditions that are being compensated for. Even spina bifida, which is being compensated for largely because of our data, is a very rare condition. We saw no cases among children born to the comparison group, and only three among children born to Ranch Hand veterans, but we saw a trend, and the trend was enough to convince the National Academy of Scientists to call the data "suggestive," and that led to compensation.

Q: I guess what I'm asking is the trend here with cardiovascular disease and with diabetes enough to -- do you think, in your opinion, considering past experience with other diseases, to get diabetes on the list of compensated diseases?

DR. MICHALEK: I really don't want to answer that, because if I do, that will just destroy my credibility.


Q: A related question. Are the things that are on the list, are they things where there is a biological process that has been established or are they just things where there is a statistical relationship?

DR. MICHALEK: I don't think a biological process has been established for any of these conditions. I think everything you're seeing on this list is the result of a statistical investigation. I have the list right here in front of me now.

However, the exception may be chloracne; there may be a biological process identified for chloracne. By the way, we have seen no chloracne in the Ranch Hand veterans, and that was published in 1995.

We went back to the medical records collected while the men were in Vietnam, and we studied those looking for any evidence of a condition similar to chloracne, which looks just like acne but which is spread on the face and torso. Found no evidence of chloracne.


Q: If the study is so small and you can't make any general comparisons, what's the value of this study?

DR. MICHALEK: It's not really that small. I mean, in terms of rare diseases, it's small, but in terms of common diseases, such as diabetes, it's not small. It's 1,000 exposed and 1,300 controls. We have a lot of statistical power to assess changes in continuously distributed variables such as blood pressure, lipids and liver enzymes; very little ability to study very rare diseases, very good ability to study common diseases, such as diabetes.

Q: You're saying there's no biological link yet between any of these diseases, including your most recent health initiative --

DR. MICHALEK: Diabetes.

Q: -- diabetes. Then you're not prepared to say that Ranch Hand experience relates -- causes these --

DR. MICHALEK: No, I'm not prepared to say that dioxin causes diabetes. I'm only telling you that people who have high dioxin levels are at a greater risk of diabetes. That's an association that I'm reporting to you, not causation.

Q: The limits, the size limits of the study, how does it affect detecting the links with these cancers that have been mentioned? Is it large enough to do that, or --

DR. MICHALEK: It's becoming less and less of an issue because as the men get older, the prevalence is increasing, as was just pointed out. We have good power, we have good ability to study all cancers combined, and pretty fair ability to study subsets of cancer, such as kidney and bladder. And our ability will increase over the next few years as more and more men have cancer.

Q: So the fact that you haven't detected --

DR. MICHALEK: Doesn't mean it's not there.

Q: -- a higher risk of cancer so far does not mean it's not there.

DR. MICHALEK: Exactly.

Q: Can you compare the incidence or the -- how does the result of the Ranch Hand studies or these Ranch Hand veterans compare with the general population?

DR. MICHALEK: Well, that hasn't been our emphasis because we're so concerned with protecting against bias. We do that with a carefully selected control group that's matched to these Ranch Handers on age and military occupation. Comparisons with the U.S. male population haven't been done, but they could be. But they just haven't been done.

Q Can you answer some of the critics of this program that say you did physicals in '97, it's been two and a half or three years, and you are only now coming out with some results like this?

DR. MICHALEK: Actually, I presented the diabetes results in 1991 at a conference in Stockholm, Sweden. It's published in the proceedings. Shortly afterward we began to write an article; it was published in 1995. We have known about the diabetes result since 1991. We have summarized those results in scientific literature.

We ourselves have been very concerned and critical of our own work, because it was an unexpected finding. The National Academy of Sciences has held workshops on diabetes and dioxin in which I have participated and presented data. Last year we answered a series of in-depth questions from the Institute of Medicine, National Academy of Sciences about our work relating dioxin and diabetes. We responded to those, and soon the National Academy will review the issue and present a decision on dioxin and diabetes. I am not aware of what they're going to say.

Q: So why release the information now? I mean, what's different today about what you knew in '91 and/or '95?

Q: You released it 10 years ago. Why are you doing it (today ?) ?

DR. MICHALEK: The data has actually already been released. It was released in 1991, it was released in 1994, and it's being released again today, the point being that the issue of diabetes and dioxin is very difficult to study. Scientists are very critical of these data, the reason being, number one, this is an unexpected finding; number two, dioxin is related to body fat, and diabetes are related to body fat. So many scientists think, well, because we find a relation between dioxin and diabetes, well, you must not be controlling well enough for body fat. And so the skeptic would say, Oh, there's really nothing to this, you just haven't done a proper statistical control. Well, in the intervening years we've analyzed the data many, many different ways, and we responded to many different questions about the data. And as we do that, the credibility of the result is increased to the point that our advisory committee has written a letter to Secretary Shalala announcing his finding and recommending several million dollars' worth of additional research to relate diabetes and dioxin, and ourselves have launched two independent studies of dioxin and diabetes, one at the University of California Davis, looking at the cellular level relating dioxin and glucose transport in fat cells from fat samples taken from our study studies. Separately, we're sending 30 Ranch Hand veterans and 30 matched controls to the VA Medical Center in Little Rock to undergo insulin sensitivity testing to relate that to their dioxin body burdens.

So as we speak, I am announcing an association which itself is being carefully studied to determine whether this is real or not. In other words, is there really a biological reason why dioxin and diabetes should be related? The answer is, we don't know at this point, but we're trying to find out.

Q: So is this a re- or a new analysis of old data, or is this just a reiteration of previous analyses?

DR. MICHALEK: No, sir. This is another analysis on the same men. Remember, these men have been taking physical exams every five years. It was in 1992 that we saw a result for the first time, because at that time -- actually, earlier than that, 1991 -- we were able for the first time to relate their health to their actual body measurement of dioxin. That's when we saw the diabetes for the first time. They came back for another physical in 1992, and we did more extensive testing on diabetes, thinking that maybe we just hadn't done the right measurements. Well, the finding was maintained. We still saw a dioxin trend in 1992 and we published that.

Then they came back again in '97. We did repeated testing on dioxin and diabetes, and the finding was upheld once again. So you're seeing the repeated measures on the same men. It was saying in-depth measurements of diabetes, following advice from our advisory committee. In other words, as these men come back and as the result is replicated in the same group, the strength of the finding has increased to the point that our committee has recommended to Donna Shalala that additional funding be allocated to the study.


Q: And at the same time, as you were saying, you've screened out the associate between body fat and diabetes to make sure that that's not a factor --

DR. MICHALEK: Exactly. We have expertise applied to this study from all over the United States. Statisticians at the Mayo Clinic, at Harvard University, at Hopkins, at the National Academy of Sciences, looking at this data in every way possible to try to address the issue you just described. The point is that the finding has remained, no matter how we choose to adjust the data, for body fat.

Q: Have you increased the percentage of people who appear to be having the onset, or is the percentage roughly the same as it was 10 years ago?

DR. MICHALEK: Of course, the percentage of the -- the prevalence of diabetes is increasing as the men get older and as they get heavier. One of the primary risk factors for diabetes is body fat. As they age, they get heavier and their risk of diabetes increases. There are other findings that are related to diabetes and dioxin that are tied into the picture, such as peripheral neuropathy. In the same report that we're releasing today, you will see an association between peripheral neuropathy and dioxin. Now, peripheral neuropathy is one of the sequelae of adult onset diabetes.

Q: That's vision? Is that what that is?

DR. MICHALEK: It's the loss of sensation in the limbs, especially in the feet.

Q: Oh, that's right.

Q: A couple of quick questions. When did the Shalala letter go out?

DR. MICHALEK: It was dated March 7th, from Secretary Shalala's office to Dr. Clint Olden, chief of NIEHS [National Institute of Environmental Health Sciences] in Research Triangle Park.

Q: So she sent the letter?

DR. MICHALEK: It was sent from her office. It didn't have her signature.

Q: And it was sent to the Research Triangle Park to --

DR. MICHALEK: Clint Olden (ph), director of NIEHS, which is a part of NIH.

Q: And, I'm sorry, I was under the impression that you all sent her a letter asking for more money.

DR. MICHALEK: No. The chairman of our advisory committee -- that was Dr. Robert Harrison, University of Rochester, Department of Medicine -- he's the chief of our advisory committee, which is an independently administered advisory group of academic experts, which is actually administered by HHS.

Q: You said a 40 percent -- is that a 47 percent increase in diabetes? What is the actual number of the 1,000?

DR. MICHALEK: I don't know the number offhand. The prevalence of diabetes is relatively high, even in control groups. It's about 17 percent of our controls are diabetic.

Q: In your control group?

DR. MICHALEK: And the individuals with high dioxin levels it's probably over 20 percent diabetic.

Q: What would it be for the general population?

DR. MICHALEK: That's a frustrating issue, because generally people do not have good data on diabetes. Diabetes is not well documented. Studies that purport to show a relation between exposures and diabetes using death certificates for example are not well conducted, because diabetes doesn't show up on death certificates, like heart disease does. Diabetes is difficult to study. It is a condition that is primarily detected through elevated blood sugar, and most people don't have routinely done blood sugar measurements. And so we probably have the best data in the world on diabetes in adult males. So that this study is not only a landmark from the point of view of dioxins; it's probably a landmark from the point of view of diabetes.

Q: How much higher are the levels of dioxins in the Ranch Hand group than the control group?

DR. MICHALEK: The control group dioxin levels range from about zero to 10 parts per trillion. Parts per trillion is 10 to the minus 12. CDC actually measures to 10 to the minus 15, which is parts per quadrillion, and reports to a part per trillion. A part per trillion is approximately equivalent to one second in 32,000 years, or it's equivalent of one dime in a stack of dimes from here to the sun. That's one part per trillion. You and I in this room have between [zero and] 10 parts per trillion. Ranch Hand veterans have up to 600 parts per trillion today. We think that in Vietnam they had up to 3,000 parts per trillion when you extrapolate that, using our best estimate of the elimination rate.

To give you a benchmark, if you look at the population exposed to dioxin in an industrial accident in Italy in 1974, in Seveso, where civilians were exposed to a factory explosion that occurred at a chemical plant, those exposures range up to 30 to 40 thousand parts per trillion. Q: Let me double-check something. So that when you talk about the relative risk being 47 percent higher in that ranch hands, your base first is the control group?

DR. MICHALEK: Right. So I see, say, a 50 percent increase. If the percentage in the control group is 10 percent, that means the percentage of the Ranch Hand group is 15 percent, if I am talking about a 50 percent increase.

Q: When you said it was --

DR. MICHALEK: So approximately a 50 percent increase. So if the percentage in the control group is 20 percent, then the percentage in the Ranch Hand group is 30 percent.

Q: You said the percentage in actual numbers was 17 percent?

DR. MICHALEK: Is roughly 17 percent in the control group.

Q: And in the Ranch Hand group it is?

DR. MICHALEK: In that highest exposed category would be, well, 50 percent greater than 17 -- would be about 22 percent, 23 percent, somewhere in there.

Q: And how big is the total Ranch Hand group? I know it's 1,000 in your sample that you studied --

DR. MICHALEK: Well, actually there were 1,261 Ranch Handers that ever existed.

Q: (Off mike)?

DR. MICHALEK: Well, 22 were killed in action, 50 died before the first physical, and about 1,000 showing up for physical examinations.

Q: Have you looked at those mortality rates, the 50 that died before the first physical?

DR. MICHALEK: Yes. We do a mortality study every few years. That's published in -- the last one published in American Journal of Epidemiology 1999. And, by the way, you can find all these papers if you go to MEDLINE and just type in my name, and they will all come up.

The overall mortality experienced for the two groups is nearly identical. However, if you look at the subgroup of enlisted veterans, enlisted, non-flying enlisted, that we believe are the most heavily exposed, you will see a 50 percent increase in deaths due to cardiovascular disease. That gives us a signal that perhaps cardiovascular disease is related to dioxin, because we saw those deaths. The caveat on the mortality study is that we don't have access to dioxin levels like we do in the physical exam data. And all of those limitations are described in the main report. The main report, by the way, is about 3,000 pages.

Since the study began, we have published about 20,000 pages of reports. All of them are available through the National Technical Information Service. But very soon all of them will be available on CD-ROM and through our Web page. To get to our Web page -- it has a long complicated address, but I'll tell you the easy way. You go to On the opening screen you click on Air Force Research Laboratory, which is where I work. There's many icons on the opening screen. Click on Air Force Research Laboratory. On the next screen, click on Air Force Health Study. And you have to do that in one following stream -- click on Air Force Health Study, and then it will come up.

Q: (Off mike)?

DR. MICHALEK: Yes, the full detailed Web address is there [in the news release]. It's quite long.


Q: I've got a really dumb question. That is: Did you (inaudible) people who were involved in the airplanes, running the airplanes, flying the airplanes, loading the airplanes and all that stuff? I would think the people who were on the ground in walking through the jungle, places where you would spray, they would probably be a lot more exposed to this. Am I wrong?

DR. MICHALEK: Yes, sir, that is a concern. Actually the CDC in 1986 visited our facilities to copy our protocol and launch a study of Army troops exactly as you described, who had from their measurements high exposure opportunity in Vietnam on the ground. It was called the Vietnam experience study. It was published in 1988 and '89 by the CDC. The study was stopped in 1989-1990 because CDC measured dioxin body burden in those men. They found no increases. They found a distribution in their exposed group that was the same as our control group, and their control group was the same as our controls -- in other words, they are all background levels. That caused the CDC to decide to stop the study. And it was at that point the CDC allocated some of their remaining funds to us so that we could measure dioxin body burdens in the Ranch Hand veterans. And we began to collaborate with CDC in 1985 and '86 to measure dioxin for the first time in serum. And since then CDC has been doing these measurements in the Ranch Hand comparison veterans. So the study you describe has been done, but it was stopped.

Q: Are you aware of any studies that have been done or are being prepared to look at dioxin levels in Vietnamese civilians? Who -- if American veterans were exposed for 12 months or 13 months -- these people are exposed for decades -- if there was an effect, you would expect it to show up there.

DR. MICHALEK: Exactly. My focus of course is the Ranch Hand study, and now you are talking about policy decisions way above my head. Certainly --

Q: I am just wondering if you are aware of any such studies.

DR. MICHALEK: I am aware of some talk about the possibility of doing studies in Vietnam, and you could probably find out more about that than I can.

Q: Finally, I just want to make this accurate -- dumb question I guess again. The statistical link between diabetes and cardiovascular disease in the Ranch Hand group, is it just as strong a trend as in any of these other diseases? Why can't you answer that?

DR. MICHALEK: Okay, I'm sorry I didn't clarify that. In terms of association, it's probably as strong or stronger than any association that has ever been found between dioxin and any disease. And the reason is that diabetes is so prevalent, so common, and there are so many ways to measure it. Not only do you measure disease onset and the occurrence of disease, you can measure diabetes by means of various kinds of measurements of glucose and sugars in the blood.

Don't have all those degrees of freedom, all those abilities with cancer.

Thank you.




The Story of Agent Orange

U.S. Veteran Dispatch Staff Report
November 1990 Issue

It is the war that will not end. It is the war that continues to stalk and claim its victims decades after the last shots were fired. It is the war of rainbow herbicides, Agents Orange, Blue, White, Purple, Green and Pink.

This never-ending legacy of the war in Vietnam has created among many veterans and their families deep feelings of mistrust of the U.S. government for its lack of honesty in studying the effects of the rainbow herbicides, particularly Agent Orange, and its conscious effort to cover up information and rig test results with which it does not agree.




On August 2, 1990, two veteran's groups filed suit in U.S. District Court in Washington, D.C., charging that federal scientists canceled an Agent Orange study mandated by Congress in 1979 because of pressure from the White House.

The four year, $43 million study was canceled, according to the Centers for Disease Control (CDC) in Atlanta, because it could not accurately determine which veterans were exposed to the herbicide used to destroy vegetation in Vietnam.

The American Legion, Vietnam Veterans of America and other veteran's groups are charging a massive government cover-up on the issue of herbicide exposure because of the hundreds of millions of dollars in health care and disability claims that would have to be paid.

The results of the scientific studies are rigged, claim many veterans, to exonerate the government which conducted the spraying and the chemical companies which produced the herbicides. Until there is a true study of the effects of Agent Orange, say the veterans - a study devoid of government interference and political considerations, the war of the rainbow herbicides will go on.

Charges of a White House cover-up have been substantiated by a report from the House Government Operations Committee. That report, released August 9, 1990, charges that officials in the Reagan administration purposely "controlled and obstructed" a federal Agent Orange study in 1987 because it did not want to admit government liability in cases involving the toxic herbicides.

Government and industry cover-ups on Agent Orange are nothing new, though. They have been going on since before the herbicide was introduced in the jungles of Vietnam in the early 1960s.




Agent Orange had its genesis as a defoliant in an obscure laboratory at the University of Chicago during World War II. Working on experimental plant growth at the time, Professor E.J. Kraus, chairman of the school's botany department, discovered that he could regulate the growth of plants through the infusion of various hormones. Among the discoveries he made was that certain broadleaf vegetation could be killed by causing the plants to experience sudden, uncontrolled growth. It was similar to giving the plants cancer by introducing specific chemicals. In some instances, deterioration of the vegetation was noticed within 24-48 hours of the introduction of the chemicals.

Kraus found that heavy doses of the chemical 2,4-dichlorophenoxyacetic acid (2,4-D) could induce these growth spurts. Thinking this discovery might be of some use in the war effort, Kraus contacted the War Department. Army scientists tested the plant hormones but found no use for them before the end of the war.

Civilian scientists, however, found Kraus' plant hormones to be of use in everyday life after the war. Chemical sprays that included 2,4-D were put on the market for use in controlling weeds in yards, along roads and railroad rights of way.




The Army continued to experiment with 2,4-D during the 1950s and late in the decade found a potent combination of chemicals which quickly found its way into the Army's chemical arsenal.

Army scientists found that by mixing 2,4-D and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) and spraying it on plants, there would be an almost immediate negative effect on the foliage. What they didn't realize, or chose to ignore, was that 2,4,5-T contained dioxin, a useless by-product of herbicide production. It would be twenty more years until concern was raised about dioxin, a chemical the Environmental Protection Agency (EPA) would later call "one of the most perplexing and potentially dangerous" known to man.

According to the Encyclopedia Britannica, "The toxicity of dioxin renders it capable of killing some species of newborn mammals and fish at levels of five parts per trillion (or one ounce in six million tons). Less than two millionths of an ounce will kill a mouse. Its toxic properties are enhanced by the fact that it can pass into the body through all major routes of entry, including the skin (by direct contact), the lungs (by inhaling dust, fumes or vapors), or through the mouth. Entry through any of these routes contributes to the total body burden. Dioxin is so toxic, according to the encyclopedia, because of this: "Contained in cell membranes are protein molecules, called receptors, that normally function to move substances into the cell. Dioxin avidly binds to these receptors and, as a result, is rapidly transported into the cytoplasm and nucleus of the cell, where it causes changes in cellular procession."

After minimal experimentation in 1961, a variety of chemical agents was shipped to Vietnam to aid in anti-guerilla efforts. The chemicals were to be used to destroy food sources and eliminate foliage that concealed enemy troop movements.




The various chemicals were labeled by color-coded stripes on the barrels, an arsenal of herbicides known by the colors of the rainbow, including Agent Blue (which contained arsenic), Agent White, Agent Purple, and the lethal combination of 2,4-D and 2,4,5-T, Agent Orange.

On January 13, 1962, three U.S. Air Force C-123s left Tan Son Nhut airfield to begin Operation Hades (later called Operation Ranch Hand), the defoliation of portions of South Vietnam's heavily forested countryside in which Viet Cong guerrillas could easily hide. By September, 1962, the spraying program had intensified, despite an early lack of success, as U.S. officials targeted the Ca Mau Peninsula, a scene of heavy communist activity. Ranch Hand aircraft sprayed more than 9,000 acres of mangrove forests there, defoliating approximately 95 percent of the targeted area. That mission was deemed a success and full approval was given for continuation of Operation Ranch Hand as the U.S. stepped up its involvement in Vietnam.




Over the next nine years, an estimated 12 million gallons of Agent Orange were sprayed throughout Vietnam. The U.S. military command in Vietnam insisted publicly the defoliation program was militarily successful and had little adverse impact on the economy of the villagers who came into contact with it.

Although the herbicides were widely used in the United States, they usually were heavily diluted with water or oil. In Vietnam, military applications were sprayed at the rate of three gallons per acre and contained approximately 12 pounds of 2,4-D and 13.8 pounds of 2,3,5-T.

The military sprayed herbicides in Vietnam six to 25 times the rate suggested by the manufacturer.

In 1962, 15,000 gallons of herbicide were sprayed throughout Vietnam. The following year that amount nearly quadrupled, as 59,000 gallons of chemicals were poured into the forests and streams. The amounts increased significantly after that: 175,000 gallons in 1964, 621,000 gallons in 1965 and 2.28 million gallons in 1966.

The pilots who flew these missions became so proficient at their jobs that it would take only a few minutes after reaching their target areas to dump their 1,000-gallon loads before turning for home. Flying over portions of South Vietnam, Laos and Cambodia that had been sprayed, the pilots could see the effects of their work. Many of them adopted a grim fatalism about the job. Over the door of the ready room for Ranch Hand pilots at Tan Son Nhut Airport near Saigon hung this sign: "Only You Can Prevent Forests."




Unknown to the tens of thousands of American soldiers and Vietnamese civilians who were living, eating and bathing in a virtual omnipresent mist of the rainbow herbicides, the makers of these chemicals were well aware of their long-term toxic effects, but sought to suppress the information from the government and the public, fearing negative backlash.

Of particular concern to the chemical companies was Agent Orange, which contained dioxin. Publicly, the chemical companies said dioxin occurred naturally in the environment and was not harmful to humans.

Privately, they knew otherwise.

A February 22, 1965 Dow Chemical Corporation internal memorandum provided a summary of a meeting in which 13 executives discussed the potential hazards of dioxin in 2,4,5-T. Following that meeting, Dow officials decided to meet with other makers of the chemical and formulate a stance on Agent Orange and dioxin.

In March 1965, Dow official V.K. Rowe convened a meeting of executives of Monsanto, Hooker Chemical, which operated the Love Canal dump, Diamond Alkali, the forerunner of Diamond-Shamrock, and the Hercules Powder Co., which later became Hercules, Inc.

According to documents uncovered only years later, the purpose of this meeting was "to discuss the toxicological problems caused by the presence of certain highly toxic impurities" in samples of 2,4,5-T. The primary "highly toxic impurity" was 2,3,7,8 TCDD, one of 75 dioxin compounds.



Three months later, Rowe sent a memo to Ross Mulholland, a manager with Dow in Canada, informing him that dioxin "is exceptionally toxic, it has a tremendous potential for producing chloracne (a skin disorder similar to acne) and systemic injury." Rowe ordered Mulholland in a postscript to the letter that "Under no circumstances may this letter be reproduced, shown or sent to anyone outside of Dow." Among those in attendance at one of the meetings of chemical company officials was John Frawley, a toxicologist for Hercules, Inc. In an internal memorandum for Hercules officials, Frawley wrote in 1965 that Dow was concerned the government might learn of a Dow study showing that dioxin caused severe liver damage in rabbits. Dow was concerned, according to Frawley, that "the whole industry will suffer." Frawley said he came away from the meeting with the feeling that "Dow was extremely frightened that this situation might explode" and lead to government restrictions.

The concern over dioxins was kept quiet and largely out of the public view. The U.S. government and the chemical companies presented a united front on the issue of defoliation, claiming it was militarily necessary to deprive the Viet Cong of hiding places and food sources and that it caused no adverse economic or health effects to those who came into contact with the rainbow herbicides, particularly Agent Orange.




But, scientists involved in Operation Ranch Hand and documents uncovered recently in the National Archives present a somewhat different picture. There are strong indications that not only were military officials aware as early as 1967 of the limited effectiveness of chemical defoliation, they knew of potential long-term health risks of frequent spraying and sought to keep that information from the public by managing news reports.

Dr. James Clary was an Air Force scientist in Vietnam who helped write the history of Operation Ranch Hand. Clary says the Air Force knew Agent Orange was far more hazardous to the health of humans than anyone would admit at the time.

"When we (military scientists) initiated the herbicide program in the 1960s," Clary wrote in a 1988 letter to a member of Congress investigating Agent Orange, "we were aware of the potential for damage due to dioxin contamination in the herbicide. We were even aware that the `military' formulation had a higher dioxin concentration than the `civilian' version, due to the lower cost and speed of manufacture. However, because the material was to be used on the `enemy,' none of us were overly concerned. We never considered a scenario in which our own personnel would become contaminated with the herbicide. And, if we had, we would have expected our own government to give assistance to veterans so contaminated."




Aware of the concern over the use of herbicides in Vietnam, particularly the use of Agent Orange, the U.S. Military Assistance Command, Vietnam (MACV), attempted to put the proper public relations spin on information concerning Operation Ranch Hand by announcing a "revision" in its policy on the use of herbicides.

It was not so much a revision of the policy as it was an appearance of a revision of the policy as it was an appearance of revision, as is evident in a memorandum signed by Gen. R.W. Komer, deputy to Gen. William Westmoreland for civil operations and RD support (CORDS).

"The purpose of this exercise would be to meet criticisms of excessive use of defoliants by clarifying that they will no longer be used in large areas, while in reality not restricting our use of defoliants (since they are not now normally used in this area anyway). In addition, there would be an escape clause . . . which would permit the use of defoliants even in the prohibited area provided that a strong case could be made to MACV/JGS.

"Appearing to restrict the use of defoliants in this manner would (a) help meet US and Vietnamese criticism of these operations; (b) increase peasant confidence so that they would grow more rice; (c) be of psywar (psychological warfare) value by suggesting that large areas were sufficiently pacified by now that large scale defoliants use was no longer necessary."

But the idea that the spraying of herbicides could be confined to a limited area as suggested in this memo was known to be futile as early as 1962.




One of the first defoliation efforts of Operation Ranch Hand was near a rubber plantation in January, 1962.

According to an unsigned U.S. Army memorandum dated January 24, 1966, titled "Use of Herbicides in Vietnam," studies showed that within a week of spraying, the trees in the plantation "showed considerable leaf fall."

"The injury to the young rubber trees occurred even though the plantation was located some 500 yards away and upwind of the target at the time of the spray delivery."

The memo went on to say that "vapors of the chemical were strong enough in concentration to cause this injury to the rubber." These vapors, "appear to come from `mist drift' or from vaporization either in the atmosphere or after the spray has settled on the vegetation."

The issue of "mist drift" continued to plague the defoliation program. How far would it drift? How fast? Wind speed and direction were of major concerns in answering these questions. Yet, there were other questions, many of which could not be answered.

What happened in humid weather?

How quickly did the chemicals diffuse in the atmosphere or were they carried into the clouds and dropped dozens of miles away? How long would the rainbow herbicides linger in the air or on the ground once they were sprayed?

A November 8, 1967 memorandum from Eugene M. Locke, deputy U.S. ambassador in Saigon, once again addressed the problem of "mist drift" and "significant damage" to rubber plantations from spraying earlier in the year.

According to Locke, "the herbicide damage resulted from a navigational error; some trees in another plantation had been defoliated deliberately in order to enhance the security of a U.S. military camp. The bulk of the herbicide damage must be attributed, however, to the drift of herbicide through the atmosphere. This drift occurs (a) after the spray is released from the aircraft and before it reaches the ground, and/or (b) when herbicide that has already reached the ground vaporizes during the heat of the day, is carried aloft, then moved by surface winds and eventually deposited elsewhere.

"There is a lack of agreement within the Mission regarding the distances over which the two kinds of drift can occur. When properly released (as required at 150 feet above the target, with winds of no more than 10 mph blowing away from nearby plantations) herbicide spray should fall with reasonable accuracy upon its intended target. The range of drift of vaporized herbicide, however, has not been scientifically established at the present time. In recognition of this phenomenon and to minimize it, current procedures require that missions may be flown only during inversion conditions, i.e., when the temperature on the land and in the atmosphere produces downward currents of air. Estimates within the Mission of vaporized herbicide drift range from only negligible drift to distances of up to 10 kilometers and more."

Ten kilometers and more. More than six miles. In essence, troops operating more than six miles from defoliation operations could find themselves, their water and their food doused with chemical agents, including dioxin-laced Agent Orange. And they wouldn't even know it.

More than four months later, on March 23, 1968, Gen. A.R. Brownfield, then Army Chief of Staff, sent a message to all senior U.S. advisors in the four Corps Tactical Zones (CTZ) of Vietnam.

Brownfield ordered that "helicopter spray operations will not be conducted when ground temperatures are greater that 85 (degrees) Fahrenheit and wind speed in excess of 10 mph."

But the concern was not for any troops operating in the areas of spraying, as was evident in the memo, but for the rubber plantations. The message ordered that "a buffer distance of at least two (2) kilometers from active rubber plantation must be maintained." No such considerations were given for the troops operating in the area.




One of the U.S. government's worst planned and executed efforts to use herbicides was a secret operation known as "Project Pink Rose."

According to a recently declassified report on "Project Pink Rose," the operation had its genesis in September 1965 when the Joint Chiefs of Staff received a recommendation from the Commander in Chief Pacific "to develop a capability to destroy by fire large areas of forest and jungle growth in Southeast Asia."

On March 11, 1966, a test operation known as "Hot Tip" was documented at Chu Pong mountain near Pleiku when 15 B-52s dropped incendiaries on a defoliated area. According to the declassified memo, "results were inconclusive but sufficient fire did develop to indicate that this technique might be operationally functional."

What neither the government nor the chemical companies told anyone was that burning dioxins significantly increases the toxicity of the dioxins. So, not only was the government introducing cancer causing chemicals into the war, it was increasing their toxicity by burning them.


Nevertheless, "Project Pink Rose" continued.


In November, 1966, three free strike target areas were selected: one in War Zone D and two in War Zone C. Each target was a box seven kilometers square. The target areas were double and triple canopy jungle. The areas were heavily prepped with defoliants, the government dumping 255,000 gallons on the test sites.

The three sites were bombed individually, one on January 18, 1967, another January 28, 1967 and the last on April 4, 1967. According to the memo, "the order and dates of strikes were changed to properly phase Pink Rose operations with concurrent ground operations."

Which means that U.S. and Vietnamese troops were living and fighting in these test sites on which 255,000 gallons of cancer causing defoliants had been dumped.

The results of "Project Pink Rose" were less than favorable.

According to the memo, "The Pink Rose technique is ineffective as a means of removing the forest crown canopy."

The conclusion: "Further testing of the Pink Rose technique in South Vietnam under the existing concept be terminated."




In addition to the planned dumps of herbicides, accidental and intentional dumps of defoliants over populated areas and into the water supplies was not unusual, according to government documents.

A memorandum for the record dated October 31, 1967, and signed by Col. W.T. Moseley, chief of MACV's Chemical Operations Division, reported an emergency dump of herbicide far from the intended target.

At approximately 1120 hours, October 29, 1967, aircraft #576 made an emergency dump of herbicide in Long Khanh Province due to failure of one engine and loss of power in the other. Approximately 1,000 gallons of herbicide WHITE were dumped from an altitude of 2,500 feet.

No mention was made of wind speed or direction, but chemicals dropped from that height had the potential to drift a long way.

Another memorandum for the record, this one dated January 8, 1968 and signed by Col. John Moran, chief Chemical Operations Division of MACV, also reported an emergency dump of herbicide, this time into a major river near Saigon.

"At approximately 1015 hours, January 6, 1968, aircraft #633 made an emergency dump over the Dong Nai River approximately 15 kilometers east of Saigon when the aircraft experienced severe engine vibration and loss of power. Approximately 1,000 gallons of herbicide ORANGE were dumped from an altitude of 3,500 feet."



The chemical companies continued to insist that the herbicides in general, and Agent Orange in particular, had no adverse effects on humans. This despite Dow's concerns about human exposure to Agent Orange expressed internally in 1965 but hidden from the government. And this despite evidence at the plants producing Agent Orange that workers exposed to it suffered unusual health problems.

The Diamond Alkali Co. in Newark, New Jersey, was one of the major producers of Agent Orange for the government. Spurred by Pentagon officials to make their production schedules to "help the war effort," patriotic employees at Diamond Alkali eagerly sought to fill their quotas.

But some of Diamond Alkali's employees began suffering what were described as "painful and disfiguring" skin diseases, according to the doctor who treated more than 50 of the employees in the early and mid 1960s.

"They (the employees) were aware of what was going on," said Dr. Roger Brodkin, head of dermatology at the University of Medicine and Dentistry of New Jersey.

"No one worried much about the skin disease because everyone was determined to make production schedules."

Brodkin said he alerted state health officials of the problem, but got little response.

"They came out, all of them, said Brodkin. "They looked around and they said, `Ah hah,' and left. Nothing was done."

Brodkin later discovered that many of Diamond Alkali's employees involved in the manufacture of Agent Orange were suffering a variety of ailments.

"We discovered that not only were these people getting skin disease, but they were also showing some indication of liver damage," he said.

It was not until 1983 that the state of New Jersey got around to testing the soil around the plant. It found hazardous levels of dioxin.

New Jersey Gov. Thomas Kean urged residents living within 300 yards of the plant to move.

It was not until 1968 that scientists began raising some concerns about the use of the rainbow herbicides in Vietnam.




Part of their concern came following a November 1967 study by Yale University botany Professor Arthur Galston. Galston did some experiments with Agent Orange and other herbicides to determine whether they were dangerous to humans and animals. Galston was unable to come to any definite conclusions on Agent Orange, but advised that continued use of it might "be harmful" and have unforeseen consequences.

The American Association for the Advancement of Science (AAAS) in the summer of 1968 sent a letter to the Secretaries of State and Defense urging a study to determine the ecological effects of herbicide spraying in Vietnam.

That letter prompted a cable from Secretary of State Dean Rusk to the U.S. Embassy in Saigon. The cable, dated August 26, 1968, sought additional information but informed embassy officials of the tactic State was going to take in its reply to the AAAS.

"The Department of State's proposed reply notes that the limited investigations of the ecological problem which have been conducted by agencies of the USG thus far have failed to reveal serious ecological disturbances, but acknowledges that the long-term effect of herbicides can be determined definitively only by long-term studies."

Rusk suggested releasing "certain non-sensitive" portions of a study on the ecological effects of herbicide spraying in Vietnam done earlier that year by Dr. Fred H. Tschirley, then assistant chief of the Corps Protection Research Branch, Corps Research Division of the U.S. Department of Agriculture in Beltsville, Maryland. Tschirley went to Vietnam under the auspices of the State Department early in 1968 and returned with exactly the report the U.S. government and the chemical companies wanted.

Tschirley foresaw no long-term ecological impact on Vietnam as a result of the herbicide spraying. In addition, in his report of April 1968, later reprinted in part in the February 21, 1969 issue of Science magazine, Tschirley exonerated the chemical companies.

"The herbicides used in Vietnam are only moderately toxic to warm-blooded animals," Tschirley wrote. "None deserves a lengthy discussion except for Agent Blue (cacodylic acid), which contains arsenic."

This despite evidence within the chemical companies that dioxin, the most toxic ingredient in Agent Orange, was responsible for health problems in laboratory animals and workers at the plants that produced the chemical.

"There is no evidence," Tschirley wrote, "to suggest that the herbicides used in Vietnam will cause toxicity problems for man or animals."

Rusk urged Tschirley's report be made public. In his cable to Saigon, he wrote: "Its publication would not only help avoid some awkwardness for Tschirley, but would provide us with valuable documentation to demonstrate that the USG is taking a responsible approach to the herbicide program and that independent investigation has substantiated the Midwest Institute's findings that there have been no serious adverse ecological consequences."

What Rusk did not mention was that Tschirley's report had been heavily edited, in essence changing its findings.




While the debate over the danger of Agent Orange and dioxin heated up in scientific circles, the U.S. Air Force continued flying defoliation sorties. And the troops on the ground continued to live in the chemical mist of the rainbow herbicides. They slept with it, drank it in their water, ate it in their food and breathed it when it dropped out of the air in a fine, white pungent mist.

Some of the troops in Vietnam used the empty Agent Orange drums for barbecue pits. Others stored watermelons and potatoes in them. Still others rigged the residue laden drums for showers.

Former Marine Danny Gene Jordan remembers sitting on Hill 549 near Khe Sanh in the spring of 1968, waiting for night and cooking his C-rations. Jordan had been in country just a few weeks and was still learning his way around, so he wasn't sure why the five C-123s approaching his unit would be flying so low and in formation.

"They're defoliating," one of his buddies told him.

Then came the mist, like clouds floating out of the back of the C-123s, soaking the men, their clothes and their food. For the next two weeks, the men of Jordan's unit suffered nausea and diarrhea. Jordan returned from Vietnam with an unusual amount of dioxin in his system. More than 15 years later, he still had 50 parts per trillion, considered abnormally high. He also had two sons born with deformed arms and hands.

The spraying continued unabated in 1968, even though, according to military records, it apparently was having minimal effects on the enemy. A series of memorandums uncovered in the National Archives and now declassified indicate that defoliation killed a lot of plants, but had little real effect on military operations.




As early as 1967 it had become clear that herbicide spraying was having few of the desired effects. According to an undated and unsigned USMACV memorandum, Rand Corporation studies in October 1967, concluded "that the crops destruction effort may well be counterproductive."

According to the memo, "The peasant, who is the target of our long range pacification objectives, bears the brunt of the crop destruction effort and does not like it."

Col. John Moran, chief of the Chemical Operations Division of MACV, wrote a memorandum dated October 3, 1968, and titled "Advantages and Disadvantages of the Use of Herbicides in Vietnam" that provides some key insights into the defoliation program.

"The effect of defoliation on the enemy, in itself, is of little military value," Moran wrote. "Its military potential is realized only when it is channeled into selected targets and combined with combat power to restrain the enemy from using an area or pay the cost in men and material from accurately delivered firepower."

Disadvantages of defoliation were more numerous, according to the memorandum.

"The herbicide program carries with it the potential for causing serious adverse impacts in the economic, social and psychological fields," Moran wrote.

Ecologically, according to the memorandum, "Semideciduous forests, especially in War Zone C and D, have been severely affected. The regeneration of these forests could be seriously retarded by repeated applications of herbicide."

An unsigned, undated memorandum written sometime late in 1968 provided even more details about the negative impact of defoliation.

Regarding the effect of VC/NVA combat and infiltration capability, the memo reported that "Very few PWs who have infiltrated even mention the effects of US herbicide operations. Some state that they have seen areas where the vegetation has been killed, but do not mention any infiltration problems caused by the defoliation. There are indications that US herbicide operations have had a negligible effect on NVA infiltration and combat operations."

The psychological effects of defoliation, according to the memorandum, were twofold; they either hardened the resolve of the VC/NVA or angered the Vietnamese farmers whose crops were destroyed.

"Some enemy soldiers may become more dedicated to the elimination of those who `ravage the countryside.' In addition, Allied herbicide operations may provide good material for enemy propaganda efforts aimed at fermenting an anti-US/GVN (Government of Vietnam) attitude among the population."


The reaction of the civilians affected by herbicide spraying is even more noticeable according to the memo.

"The obvious reaction of the peasant whose labors have been destroyed is one of bitterness and hatred. He will frequently direct this hatred toward both the US/GVN, for accomplishing the destruction, and the VC/NVA, for bringing it about. If he has previously leaned toward the VC, he is likely to side with them completely after the crop destruction. He is aided in making this decision by the incessant propaganda of the VC cadre who decry the `barbarous crimes perpetrated by the Americans and their lackeys.'"

So, while Operation Ranch Hand provided no long or short term military benefits, it also provided neither long nor short term psychological benefits. If anything, it embittered the civilian population of Vietnam and drove it closer to the Viet Cong and NVA. And no one yet was sure what eventually would be the effect on the health of those exposed to the chemicals. Operation Ranch Hand was shown by late 1968 to be a bankrupt strategy, one devoid of good sense, good planning or good intentions.




Meanwhile, the military continued to learn just how toxic Agent Orange could be. On October 23, 1969, an urgent message was sent from Fort Detrick, Maryland, to MACV concerning cleaning of drums containing herbicides. The message provided detailed instructions on how to clean the drums and warned that it was particularly important to clean Agent Orange drums.

"Using the (Agent) Orange drums for storing petroleum products without thoroughly cleaning of them can result in creation of an orange aerosol when the contaminated petroleum products are consumed in internal combustion engines. The Orange aerosol thus generated can be most devastating to vegetation in the vicinity of engines. Some critics claim that some of the damage to vegetation along Saigon streets can be attributed to this source. White and Blue residues are less of a problem in this regard since they are not volatile."

Not only was Agent Orange being sprayed from aircraft, but it was unwittingly being sprayed out of the exhausts of trucks, jeeps and gasoline generators.

In March 1969, Lt. Col. Jim Corey, deputy chief of CORDS in I Corps reported to his boss, R.M. Urquhart, unusual defoliation in Da Nang.

"A large number of beautiful shade trees along the streets in the city of Da Nang are dead or dying," Corey wrote. "This damage appears to be entirely a result of defoliation chemicals."

There was no evidence of insect or fungus damage to the vegetation, according to the memo.

"In every instance of tree and garden plot damage," Corey wrote, "empty defoliant barrels are either present in the area or have been transported along the route of the damage."

The use of herbicides was not confined to the jungles. It was widely used to suppress vegetation around the perimeters of military bases and, in many instances, the interiors of those bases.



Nevertheless, the use of Agent Orange throughout Vietnam was widespread through much of 1969. Then, late in the year a study done by Bionetics Research Laboratories showed that dioxin caused deaths and stillbirths in laboratory animals. The tests revealed that as little as two parts of dioxin per trillion in the bloodstream was sufficient to cause deaths and abnormal births. And some GIs were returning home from Vietnam with 50 parts per trillion, and more, in their bloodstream.


When the report was released by the Food and Drug Administration, the White House, on October 29, 1969, ordered a partial curtailment of the use of Agent Orange in Vietnam.


On November 4, 1969, a message went out from Joint Chiefs of Staff to Commander in Chief Pacific (CINCPAC) and MACV.


"A report prepared for the National Institute of Health presents evidence that 2,4,5-T can cause malformation of offspring and stillbirths in mice, when given in relatively high doses. This material is present in the defoliant (Agent) Orange.


"Pending decision by the appropriate department on whether this herbicide can remain on the domestic market, defoliation missions in South Vietnam using Orange should be targeted only for areas remote from population. Normal use of White or Blue herbicides can continue, but large scale substitution of Blue for Orange will not be permitted."




Despite the order, some troops continued to use Agent Orange when they ran out of the other rainbow herbicides. Finally, in early 1971, the U.S. Surgeon General prohibited the use of Agent Orange for home use because of possible harmful effects on humans and on June 30, 1971, all United States defoliation operations in Vietnam were brought to an end.




As soldiers who had served in Vietnam attempted to settle back into civilian life following their tours, some of them began to develop unusual health problems. There were skin and liver diseases and what seemed to be an abnormal number of cancers to soft tissue organs such as the lungs and stomach. There also seemed to be an unusually high number of birth defects among children born to Vietnam veterans who had been exposed to Agent Orange. Some veterans experienced wild mood swings, while others developed a painful skin rash known as chloracne. Many of these veterans were found to have high levels of dioxin in their blood, but scientists and the U.S. government insisted there was no link between their illnesses and Agent Orange.

In the mid 1970s, there was renewed interest in dioxin and its effects on human health following an industrial accident in Seveso, Italy, in which dioxin was released into the air, causing animal deaths and human sickness.




Then, in 1979, the Environmental Protection Agency banned the use of Agent Orange in the United States when a large number of stillbirths were reported among mothers in Oregon, where the chemical had been heavily used.

While veterans clamored for help from the Veterans Administration, the government responded either slowly, or not at all. In 1979, a National Veterans Task Force on Agent Orange was formed and legislation finally was passed by Congress at the urging of Rep. Tom Daschle (D-SD), a Vietnam veteran who became a U.S. Senator, to commission a large scale epidemiological study of veterans who had been exposed to the herbicide.

That proved to be only the beginning of the battle over Agent Orange.

Over the next four years, the VA examined an estimated 200,000 veterans for medical problems they claimed stemmed from Agent Orange and other herbicides used in Vietnam. But many of those examined were dissatisfied with their examinations. They claimed the exams were done poorly and often in haste by unqualified medical personnel. Many veterans also claimed that the VA seemed to have a mind set to ignore or debunk Agent Orange connected disability complaints.





Fed up with what they perceived as government inaction on the Agent Orange issue, veterans filed a class action lawsuit in 1982 against the chemical companies that had made Agent Orange. Among the companies named were Dow Chemical Co. of Midland, Michigan; Monsanto Co. of St. Louis, Missouri; Diamond Shamrock Corp. of Dallas, Texas; Hercules Inc. of Wilmington, Delaware; Uniroyal Inc. of Middlebury, Connecticut; Thompson Chemical Corp. of Newark, New Jersey and the T.H. Agriculture and Nutrition Co. of Kansas City, Missouri.

By the early 1980s, some of the chemical companies' dirty little secrets about dioxin were beginning to leak out.




Times Beach was an idyllic little community of about 2,200 residents in the rolling farmlands of eastern Missouri 20 miles southwest of St. Louis. It was an ideal place to live and raise children, with plenty of open spaces, two story wood frame houses, quiet streets and none of the pollution, poverty or crime of the inner city.

Or so it seemed.

Unknown to the residents of Times Beach, for several years in the mid 1970s, dioxin laced oil had been sprayed on the town's roads to keep down the dust. Times Beach was one of 28 eastern Missouri communities where the spraying had been done. But none of the others had the levels of dioxin contamination of Times Beach, parts of which had dioxin levels of 33,000 parts per billion, or 33,000 times more toxic than the EPA's level of acceptance.

The contamination was so bad that the government decided the only way to save the town's residents from further damage from dioxin was to buy them out and move them out.

In early 1983, the U.S. government spent $33 million buying the 801 homes and businesses in Times Beach and relocating its 2,200 residents. The entire town was fenced in and guards were brought in to keep out the curious. "Caution, Hazardous Waste Site, Dioxin Contamination," read the signs leading into Times Beach.

What had been a comfortable little community became a ghost town. It remains a ghost town today because of dioxin contamination.

So, while the government was paying off the residents of Times Beach because of dioxin contamination, it continued to deny that Vietnam veterans who had been exposed to Agent Orange and its dioxin were at risk.




While the government was busily buying up Times Beach and evacuating its residents, the American Medical Association was coming under attack from environmental health specialists for its stance on dioxin. In its June 1983 convention, the AMA adopted a resolution calling for a public information campaign on dioxin to "prevent irrational reaction and unjustified public fright."

"The news media have made dioxin the focus of a witch hunt by disseminating rumors, hearsay and unconfirmed, unscientific reports," the resolution read, in part.

That position was overwhelmingly supported by President Ronald Reagan in a speech at the AMA convention, calling the resolution "a positive step toward a more reasonable public debate" on the issue.

But Dr. Samuel Epstein, professor of occupational and environmental medicine at the University of Illinois Medical Center in Chicago, called the AMA "incompetent and ignorant" for its stance on dioxin.

"The AMA's contribution in this area is a profound disservice and consistent with their established record of extreme conservatism and lack of information and demonstrated lack of concern for preventive medicine," said Epstein.

And Dr. Paul Wiesner, an assistant director of the CDC said that "Evidence is increasing that there is an association with a rare form of tumor called soft tissue sarcoma after occupational exposure (to dioxin)."




By 1983, the results of studies of Agent Orange and dioxin exposure began to trickle in. They were, for the most part, contradictory and confusing. A series of studies conducted between 1974 and 1983 by Dr. Lennart Hardell, the so called Swedish studies, showed a link between exposure to Agent Orange and soft tissue sarcomas and non-Hodgkin's lymphoma. And in July 1983, the Department of Health and Human Services (HHS) released a report citing "an association" between dioxin exposure and incidence of soft tissue sarcoma.

"The early warning sign has gone up," said Dr. Edward Brandt, Jr., assistant secretary of the HHS.

This was also the year of the Times Beach buy out and growing nationwide concern over dioxin. Few people knew what it was and only Vietnam veterans and researchers knew what it could do to the human body.

In December 1983, the EPA announced a nationwide plan to clean up more than 200 dioxin contaminated sites, including 50 plants where 2,4,5-T had been manufactured. The cost of the cleanup was put at $250 million and was expected to take four years.

But barely two months later, in February, 1984, the U.S. Air Force released the first part of a three part study on Operation Ranch Hand pilots and crewmen. It concluded that the 1,269 pilots and crewmen involved in the herbicide spraying program in Vietnam suffered no higher death or serious illness rates than the general population.

But to Vietnam veterans, studying aircrews who had handled drums of Agent Orange, and not the soldiers exposed to it, was like testing the crew of the Enola Gay for the effects of radiation, not the survivors of Hiroshima.

Said Maj. Gen. Murphy Chesney, deputy Air Force Surgeon General: "Do I worry as a physician because we used it? The answer is no. I say war is hell, you've got to win it. Agent Orange was a war agent. It was used to protect our ground troops. It saved millions of lives possibly, thousands, anyway, in Vietnam."

MACV memorandums written during the war did not support Chesney's claims that Agent Orange saved lives, but no one questioned him on his conclusions because those documents were still classified.

The VA, meanwhile, continued to dismiss veterans health complaints if they dealt with exposure to Agent Orange.

"A lot of veterans are scared because of early news reports of physical damage, while some among any large number of people are going to have health problems such as a matter of routine natural incidence," said Dr. Barclay Shepard, director of Agent Orange Studies for the VA. "Put that together with disillusionment over the Vietnam War and anger with the government and there is little wonder that many veterans truly believe that they have in some way been hurt. But the evidence has not supported a cause and effect relationship."



Then on May 7, 1984, came the news that the Agent Orange lawsuit, filed two years earlier, had been settled. Prodded by U.S. District Judge Jack B. Weinstein, attorneys for the veterans and the chemical companies reached an agreement at 4 a.m. the morning the case was to go to trial. At that time, 15,000 veterans and their relatives were involved in the suit, but about 250,000 subsequently filed claims.

Under the terms of the settlement, the Vietnam veterans who claimed exposure to Agent Orange would receive $180 million from the chemical companies. But those companies did not have to accept blame for any injuries that occurred as a result of Agent Orange. The U.S. government was not a party to the litigation.

"Thus resolution is a compassionate, expedient and productive means of meeting the needs of the people involved," said David Buzzelli, vice president of government and public affairs for Dow Chemical.

Veterans at first were ecstatic.

"This is a defeat for the chemical companies. We brought them down to their knees and we got an open admission of guilt," said Rod Rinker of Atlanta, one of the veterans who claimed Agent Orange exposure.

Not so, said the chemical companies.

"When you look at the overwhelming scientific evidence, Agent Orange is not a reasonable or likely cause of the ill health effects experienced by the veterans," said R.W. Charlton, another Dow spokesman.

Despite the release earlier of the results of the Operation Ranch Hand study, 1984 seemed to be a year in which the Vietnam veteran's complaints about Agent Orange and the health problems it caused were being taken seriously. The federal court decision boosted the morale of the Agent Orange claimants. Then Congress chimed in.

In late 1984, Congress passed Public Law 98-542, designed to provide compensation for soft tissue sarcoma and required the VA to establish standards for general Agent Orange and atomic radiation compensation.

It seemed as if the veterans were winning. But every time a veteran went to the VA seeking compensation for Agent Orange related problems, he was turned away.

"Since 1984, Public Law 98-542 has been virtually ignored," said South Dakota Sen. Tom Daschle. "In spite of the intent of Congress, in spite of the efforts of everyone involved in the writing of that law, in spite of our promises to veterans at that time that at long last, after all these years, they would be given the benefit of the doubt, not one veteran in this country has been compensated for any disease other than chloracne."

Agent Orange sufferers tried on several occasions to sue the government for its role in use of the herbicide, but their suits were routinely dismissed because of what has come to be known as the Feres Doctrine. In 1950, the Supreme Court ruled in a case involving the death of a military man that the government is not responsible for deaths, injuries or other losses related to military service.

Meanwhile, the reality of the settlement reached in the lawsuit with the seven chemical companies began to settle in. The lawyers involved wanted $40 million off the top for their fees. They had decided in a secret agreement prior to the May 1984 settlement that they would receive a 300 percent return on any investment in time and effort they had made. Many veterans charged that this secret fee agreement by the plaintiff's management committee precluded any incentive for the committee to represent the veterans in the suit. Judge Weinstein decided to give the lawyers $9.2 million.

It became readily apparent that $180 million just wasn't enough to take care of the Agent Orange claimants and their families, which had reached more than 200,000 by then. A master plan to divide the settlement noted that the settlement "is simply not large enough." The plan suggested taking $130 million for a settlement to provide cash payments to eligible veterans or the families of deceased members. Maximum cash payments of $12,800 to the most qualified claimants, or about 17,000 veterans and their survivors, was suggested. The master plan also suggested using $52 million to fund a "class assistance foundation" earmarked for benefit programs.




Results of Agent Orange tests continued to be mixed. The results varied greatly, depending on who was doing the testing.

In December, 1985, the Air Force released the third of its Operation Ranch Hand studies. It confirmed the other two: that there was no evidence that Agent Orange had any adverse affects on those who handled it during the war.

"At this time, there is no evidence of increased mortality as a result of herbicide exposure among individuals who performed the Ranch Hand spray operation in Southeast Asia," the Air Force concluded.

But in April, 1986, the CDC released a report that showed that the residents of a mobile home park near St. Louis were suffering from liver and immune system damage as a result of their exposure to dioxin laced chemicals.

According to the study, the 154 residents of Quail Run Mobile Home Park in Gray Summit, Missouri, near Times Beach southwest of St. Louis, showed depressed liver function and deficiencies in their immune systems. The dirt roads in the mobile home park had been sprayed in 1971 with dioxin laced oil to keep down the dust.

While the CDC seemed concerned about Missouri residents exposed to dioxin laced chemicals, it did not demonstrate the same concern for Vietnam veterans exposed to dioxin contaminated herbicides. In fact, information began to surface in 1986 that the CDC not only was dragging its feet on Agent Orange studies, it was deliberately ignoring information to which it had access in order to come up with results that would be favorable to the government.

In the summer of 1986, the House Veterans Affairs Subcommittee on Hospitals and Health Care held hearings to assess the progress of the CDC study of Agent Orange, mandated seven years earlier. Testimony from witnesses from the Office of Technology Assessment (OTA) shocked and angered members of the committee, according to Sen. Tom Daschle.

"OTA reported that the Centers for Disease Control had changed the protocol for the study without authorization," said Daschle. "OTA also reported at that particular hearing that petty arguments at CDC were interfering with the study's progress and that progress had virtually come to a standstill."

After seven years of study, the CDC had made no progress on one of the most important and highly publicized issues of the war in Vietnam.

In charge of the CDC study was Dr. Vernon Houk, director of the agency's Center for Environmental Health and Injury Control. The White House's Agent Orange Working Group was supposed to supervise the CDC study while the Pentagon's Environmental Support Group was charged with providing the CDC with records of Agent Orange spraying and troop deployment.

Houk's CDC team complained throughout the study that those records were too spotty to make a scientific study of the effects of Agent Orange on soldiers.

Not so, said the Pentagon. Richard Christian, head of the Pentagon's Environmental Support Group, testified before Congress in mid 1986 that the records of troop movements and spraying were more than adequate for a scientific study.

Christian's testimony was bolstered by two other sources. Retired Army Maj. Gen. John Murray had been asked by Defense Secretary Casper Weinberger in early 1986 to undertake a study to determine if Pentagon records were adequate for purposes of the study. After four months, Murray also determined that the records for a comprehensive study of Agent Orange were more than adequate.

In addition, the Institute of Medicine, an arm of the National Academy of Sciences, had used outside consultants to study reports of troop deployment and Agent Orange spraying to determine if they were sufficient for CDC purposes. Its conclusion: the Pentagon had the necessary records. The Institute of Medicine also was highly critical of the CDC research methods, charging that it excluded from its study the veterans most likely to have been exposed to Agent Orange.




Despite information from three sources that there were adequate records available for a comprehen sive CDC study on Agent Orange, the White House and CDC sought to cover it up.

First, the Institute of Medicine's study was never turned over to the White House. Then, Murray decided that as a non-scientist, he was in no position to challenge the objections of CDC's Houk and deferred to his judgement on the matter of records. Then, according to Daschle, the Pentagon came down hard on Christian for criticizing the CDC.

"DOD officials altered his follow-up testimony before it was sent to the Hill, deleting his information challenging CDC's claims," said Daschle.

By mid 1986, the White House had set the wheels in motion to cancel the CDC's Agent Orange study.

There were other indications that the Reagan administration had no real interest in studies of Agent Orange or dioxin. In late 1986, the House Energy and Commerce Committee learned that the White House's Office of Management and Budget (OMB) was trying to stop all dioxin research, claiming that enough research had been done.

Despite efforts to shut down research and cover up results of studies not favorable to the government or chemical companies, evidence continued to flow in showing a definite statistical link between cancers and exposure to Agent Orange and dioxin:

- A 1986 study by the National Cancer Institute of Kansas revealed that farmers exposed to 2,4-D, an ingredient of Agent Orange, had six times more non-Hodgkin's lymphomas than farmers not exposed.

- A VA study released in 1987 showed that Marines who served in areas of Vietnam that had been heavily sprayed with Agent Orange had a 110 percent higher rate of non-Hodgkin's lymphomas. The study also showed these Marines had a 58 percent higher rate of lung cancers.

- A 1987 study in the state of Washington showed veterans who had been exposed to Agent Orange had significant increases in soft tissue sarcomas and non-Hodgkin's lymphomas.

- A 1987 VA study showed veterans who were most likely exposed to Agent Orange had eight times more soft tissue sarcoma than other veterans.

Meanwhile, the CDC had been taking blood samples of 646 Vietnam veterans, selected on the basis of probable exposure to Agent Orange, to test the level of dioxin in their blood. Other scientists were highly critical of this method of testing, but the CDC moved on.

Then, in September 1987, the CDC exonerated Agent Orange, claiming once again there were not sufficient records available to make the necessary tests.

"We cannot find a sufficiently large number of people who have been exposed to do a scientifically valid study of exposure to Agent Orange," said Houk.

"We looked at three different kinds of exposure: short-term, long-term and exposure from being in an area of Vietnam where the herbicide was used. In none of these groups was there any difference in the level of Agent Orange in the blood."

Houk recommended that the Agent Orange study be canceled. The White House agreed, and shortly after that the CDC's $43 million Agent Orange study came to an end with a not guilty verdict for Agent Orange.




But again, there was more information available that was never presented. The Institute of Medicine in the weeks before the CDC released its results of blood tests wrote a stinging rebuke of the CDC's tests methods. It said that none of the CDC's conclusions was supported by scientific data. The CDC refused to turn this report over to the White House.

"Either it was a politically rigged operation or it was a monumentally bungled operation," said Rep. Ted Weiss (D-NY), chairman of the Government Operations Human Resources and Intergovernmental Relations Subcommittee.

Other information began turning up that there were concerted efforts by various agencies of the government to conceal records and information about the effects of Agent Orange.

Daschle learned that there were major discrepancies between a January 1984 draft of the Air Force's Operation Ranch Hand study and the February 1984 report. According to Daschle, the draft showed there were twice as many birth defects among the children of Ranch Hand participants. "The draft also reported that the Ranch Handers were less well than the controls by a ratio of 5 to 1," said Daschle.

But these results were deleted from the final Ranch Hand report, which said there had been no adverse effects from exposure to Agent Orange.

"The Air Force deleted these findings from the final report at the suggestion of a Ranch Hand Advisory Committee set up by the White House Agent Orange Working Group," said Daschle.

Air Force scientists involved in the study said they were pressured by non-scientists within the Air Force and the White House to change the results and delete critical information for the final report. Daschle says he has even obtained two versions of the minutes of the meeting in which that pressure was applied. One confirms what the scientists told him. Another set deletes that information.

"What happened there was a fraud perpetrated by people whose names we still do not know," said Daschle.

Part of the fraud appears to have been perpetrated by the Monsanto Corp., which produces a number of chemicals containing dioxin. Monsanto knowingly rigged test results of employees who had been exposed to dioxin to make the effects of it appear far less than it actually was, according to a February 23, 1990 Environmental Protection Agency memorandum.

The memorandum was written by Dr. Cate Jenkins, a chemist in the Waste Characterization Branch, Characterization and Assessment Division of the EPA to Dr. Raymond C. Loehr, chairman of EPA's Science Advisory Board Executive Committee.

Jenkins writes that a key epidemiological study leading to the conclusion that there was no definitive data on human health effects of dioxins was based on examination of medical records of Monsanto employees from a 1949 explosion. That study "found no statistically significant excess cancer deaths," according to Jenkins.

"This study by Monsanto apparently has now been shown to be a fraud," Jenkins wrote.


"This study on behalf of Monsanto is described, where it is alleged that the record demonstrated a deliberate course of conduct by Monsanto through `altered' research to prove to the world that the only health consequences of dioxins was the relatively harmless, reversible condition of chloracne."

Since this study was altered, Jenkins surmises, "It could be that other studies on exposed populations are similarly flawed and subject to fraud." The study in question was done of employees at a Nitro, West Virginia Monsanto plant following an explosion in 1949 in which a number of them were exposed to dioxins. The study, performed by two Monsanto employees, concluded that the death rate of exposed workers was the same as the death rate of unexposed workers.



However, later investigation revealed that the authors of the study omitted five deaths from the exposed group and took four workers who had been exposed and put them in the unexposed group. This decreased the death rate in the exposed group and increased the death rate in the unexposed group. The exposed group actually had 18 cancer deaths as a result of the exposure, not the nine deaths reported in the study. And there were a total of 28 cancers in the exposed group, compared to only two cancers in the unexposed group.

This type fraud appears to have been perpetrated regularly in connection with Agent Orange research, yet Congress continues to rely on this flawed research when it considers legislation that would benefit the victims of Agent Orange and the other rainbow herbicides.




Efforts to get comprehensive Agent Orange legislation through Congress to right the wrongs of the cover-ups have been unsuccessful largely through the efforts of one man: Rep. Sonny Montgomery of Mississippi, chairman of the House Veterans Affairs Committee, who claimed to be the friend and champion of veterans in Congress - in fact had virtually single-handedly bottled up Agent Orange legislation.

The CDC, meanwhile, continues to perpetrate the scientifically flawed myth that Agent Orange and dioxin posed no health threats to Vietnam veterans.

In a study released March 29, 1990, the CDC admitted that Vietnam veterans face a higher risk of non-Hodgkin's lymphoma, but denied that it was a result of exposure to Agent Orange. It said the studies showed that Vietnam veterans do not have higher rats of soft tissue sarcomas, Hodgkin's disease, nasal cancer, nasopharyngeal cancer and liver cancer.




One of the more bizarre aspects of this report from the CDC was the claim that those veterans who suffered most from non-Hodgkin's lymphoma had served on Navy ships off the coast of Vietnam. It said that those who had served in III Corps, which had some of the heaviest Agent Orange spraying of the war, seemed to be at lower risk.

"There is no risk in this study associated with (dioxin) exposure," said Dr. Daniel Hoffman of the CDC. Veterans groups were appalled by the findings.

"The conclusion seems to fly in the face of other scientific studies, which indicates there is a connection between Agent Orange and cancer, birth defects and other disorders. It makes it sound like Agent Orange is like orange juice, healthy for you instead of harmful," said John Hanson, a spokesman for the American Legion.




The House Committee in its August 1990 report also found that the 1987 Agent Orange study canceled by CDC was done so at the behest of the White House. Its report was a stinging rebuke to the White House and the CDC. The report offered these conclusions:

"A. The CDC Agent Orange exposure study should not have been canceled because it did not document that exposure of veterans to the herbicide could not be assessed, nor did CDC explore alternative methods of determining the exposure.

"B. The original protocol for the CDC Agent Orange study was changed to the point that it was unlikely for the heaviest exposed soldiers to be identified.

"C. The blood serum analysis, which was used as proof by CDC that an Agent Orange exposure study could not be conducted, was based on erroneous assumptions and a flawed analysis.

"D. The White House compromised the independence of the CDC and undermined the study by controlling crucial decisions and guiding the course of research at the same time it had secretly taken a legal position to resist demands to compensate victims of Agent Orange exposure and industrial accidents.

"E. The Federal Government has suppressed or minimized findings of ill health effects among Vietnam veterans that could be linked to Agent Orange exposure."

An indepth reading of the report reveals even more sordid details of how the CDC and the White House stacked the deck on Agent Orange.

According to the report, "The CDC study was changed from its original format so that it would have been unlikely for the soldiers who received the heaviest exposure to the herbicide to be identified. CDC accomplished this by unjustifiably discrediting the military records provided to it by the Department of Defense's Environmental Study Group (ESG)."



The rebuke of the White House and its Agent Orange Working Group (AOWG) was even more revealing of the manner in which Agent Orange studies have been manipulated by political and economic concerns, not concerns about human lives.

"The original mandate to focus the White House panel on the effects of all herbicides was abruptly altered by the Reagan White House," according to the report. "By focusing the work of AOWG on Agent Orange only, the administration laid the groundwork for manipulating the study to the point of uselessness.

"A possible reason that the White House chose this path is revealed in confidential documents prepared by attorneys in OMB. The White House was deeply concerned that the Federal Government would be placed in the position of paying compensation to veterans suffering diseases related to Agent Orange and, moreover, feared that providing help to Vietnam veterans would set the precedent of having the U.S. compensate civilian victims of toxic contaminant exposure, too."




Despite the CDC's continuing recalcitrance on the issue of Agent Orange exposure, there have been other, more enlightened voices heard.

Secretary of Veterans Affairs Edward Derwinski is one of them. After hearing of the CDC's latest study, he ordered the VA to pay compensation to all veterans suffering from non-Hodgkin's lymphoma, a ruling which could mean as much as $23 million to the 1,600 non-Hodgkin's lymphoma sufferers or their widows and children.

Derwinski also decided not to challenge a California court's finding that the VA was applying too strict a standard to determine whether Agent Orange harmed Vietnam veterans. Derwinski ordered the VA to abide by legislation passed in 1984 to give veterans the benefit of the doubt on health claims.

"Overall, we're doing things a lot different here now," said Derwinski. "We're making decisions without sweeping things under the rug. We're not procrastinating. We're also shaking up a few people and sweeping away a few cobwebs."

Another of the more enlightened voices is that of retired Adm. Elmo Zumwalt Jr., who ordered certain areas of Vietnam to be sprayed with Agent Orange.

Zumwalt's son, Elmo Zumwalt III, served in the Navy in Vietnam and was exposed to the herbicide. Elmo Zumwalt III died in 1988 at the age of 42 from Hodgkin's diseases and lymphoma. Father and son believed that exposure to Agent Orange caused the cancers.

"I definitely believe my son would have had an additional 20 years of life had we not used it," said the elder Zumwalt.

Adm. Zumwalt has become a crusader on the issue of Agent Orange, charging that the government "intentionally manipulated or withheld compelling information on the adverse health effects" associated with exposure to Agent Orange.

"The flawed scientific studies and manipulated conclusions are not only unduly denying justice to Vietnam veterans suffering from exposure to Agent Orange," said Zumwalt, "they are now standing in the way of a full disclosure to the American people of the likely health effects of exposure to toxic dioxins."

Daschle is another of the enlightened voices, calling not only for true, scientific studies of Agent Orange free from political interference, but investigations of the cover-ups by the White House and the CDC that enabled them to perpetrate the myth that Agent Orange is not harmful to human health.

"Can you blame veterans for wondering what is going on?" asked Daschle. "Can you blame their families who continue to watch all of this unfold, and not share their sense of frustration, their sense of indignation at the conflicting comments, the duplicity, the obfuscation that occurs time and time again when government officials at the highest level are being called upon to inform the public, but they cover up information instead?"




But as the government continues to drag its feet, more veterans and their children continue to suffer the effects of Agent Orange.

Time is on the side of the government. The longer it waits, the longer it procrastinates, the more the problems of Agent Orange exposure is diminished by the deaths of those who suffered from exposure to it. Their names could be added to the black granite wall of the Vietnam memorial, casualties of the rainbow herbicides that followed them home from the war.



- Agent Orange: 2,4-D and 2,4,5-T; used between January 1965 and April 1970.
- Agent Orange II (Super Orange): 2,4-D and 2,4,5-T; used in 1968 and 1969.
- Agent Purple: 2,4-D and 2,4,5-T; used between January 1962 and 1964.
- Agent Pink: 2,4,5-T; used between 1962 and 1964.
- Agent Green: 2,4,5-T; used between 1962 and 1964.
- Agent White: Picloram and 2,4-D.
- Agent Blue: contained cacodylic acid (arsenic).
- Dinoxol: 2,4-D and 2,4,5-T; used between 1962 and 1964.
- Trinoxol: 2,4,5-T; used between 1962 and 1964.
- Diquat: Used between 1962 and 1964.
- Bromacil: Used between 1962 and 1964.
- Tandex: Used between 1962 and 1964.
- Monuron: Used between 1962 and 1964.
- Diuron: Used between 1962 and 1964.
- Dalapon: Used between 1962 and 1964.



Morbidity of Australian Vietnam Veterans

51,753 questionnaires were posted to 49,944 male Vietnam veterans, 278 female Vietnam veterans and 1,531 widows/divorced/separated partners. 86% of those to whom questionnaires were posted responded. 79% completed a questionnaire.

Condition Reported Percentage Expected
Vietnam Veterans
Hearing or ear problems 22030 55 10161
Haemorrhoids 11070 28 2107
Panic attacks 12068 30
Migrane 6887 17 489-4668
Anxiety disorders 16388 41 12478
Depression 17960 45 14249
Alcohol & drug abuse 14411 36
Insomnia & sleep disturbance 20642 52 20931
Impotence 7908 20 20930
Gastric reflux 12202 30
Ulcer 3089
- Stomach 4732 12
- Duodenal 3114 8
Cirrhosis of the liver 1132 3 41-1207
PTSD 12504 31 3059
High blood pressure 13790 34 7335-12992
Allergies 8415 21 9094
Asthma 3803 10 2689
Cancer 10000 25
Melanoma 2686 7 380
Skin cancer 6936 17
Cancer of head & neck 859 2
Leukemis 64 <1 26
Non-Hodgkin's lymphoma 137 <1 48
Soft tissue sarcoma 398 1 27
Cancer of the Colon 405 1 117
Male breast cancer 51 <1 3
Cancer of testis 151 <1 110
Cancer of eye 96 <1 11
Lung cancer 120 <1 65
Prostate cancer 428 1 147
Prostate disease (non-Ca) 2970 7 9141
Diabetes 2391 6 1780
Hepatitis 1603 4
Malaria 3294 8 907-1100
Strongyloides 636 2
Motor Neurone Disease 128 <1 2
Multiple sclerosis 84 <1 19
Ischaemic heart disease 5965 15 3236
Dermatitis 7530 19 1013
Eczema 2567 6
Acne/Rosacea 1076 3
Psoriasis 3179 8 473-1288
Tinea 8172 20

Veterans' Partners:

Stress 40
Anxiety disorders 34
Depression 30
Insomnia/sleep disturbance 23
Migrane 15
High Bblood pressure 11
Alcohol/drug overuse 8
Stillbirths 2149 5
Miscarriages 8614 22
Terminations 2010 5

Veterans' Children:

Uncorrectable sight problems 2376 8 4690-4962
Hearing/ear problems 3068 10 23488
Spina bifida 353 1 33
Anencephaly 47 <1 16
Down's syndrome 138 <1 92
Tracheoesophageal fistula 111 <1 23
Cleft lip or palette 273 1 64
Absent body parts 350 1 34
Other abnormality 4009 13 888
Leukemia 75 <1 57
Wilm's tumor 42 <1 7
Tumour nervous system 105 <1 48
Other cancers 730 103 per 10000 297-369
Other illness death 841 2 805
Suicide 231 1 75
Accident death 836 2 365
Psychiatric (diagnosed) 4410 11
Anxiety disorders (diagnosed) 6712 16
This summary has been prepared by Veterans' Independent Consultation Group Inc., from information contained in: Morbidity of Vietnam Veterans: A Study of the Health of Australia's Vietnam Veterans Community, Volume 1, Survey and Community Comparison Outco




Relationship with Agent Orange & Diabetes

VETERANS RESOURCES NETWORK (04/02/2000) Below is information from Trevor Hunt, the National Secretary of the Vietnam Veterans Association of Australia. It concerns the fact that the Australian Government allows compensation for Diabetes Mellitus as a result of Agent Orange exposure. See item "8" and "5.r" The medical reports and research on this issue would be helpful, if I get my hands on any, I will post them. While this relates to the Australian Government, it can be one more piece of helpful information to gain the "benefit of reasonable Doubt" when filing your VA claim. You will of course need your own Doctor's statement that you have Diabetes Mellitus and that it is related to your Agent Orange exposure while in Vietnam. Also present any reports and journal findings, that support your contention. Argue the Benefit of Doubt as provided by law. If anyone wins based on the benefit of doubt, contact me with your claim docket number at the Board of Veterans Appeals, or Veterans Court, and I will broadcast the case.


Attached is the info as used by the Australian Government to accept Diabetes as war related Regards Geoff Trevor-Hunt OAM National Secretary Vietnam Veterans Association of Australia Instrument No.82 of 1999 Revocation and Determination of Statement of Principles concerning DIABETES MELLITUS ICD-10-AM CODES: E10, E11, E12, E13, E14 Veterans' Entitlements Act 1986 1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans' Entitlements Act 1986 (the Act): (a) revokes Instrument No.46 of 1999; and (b) determines in its place the following Statement of Principles. Kind of injury, disease or death 2. (a) This Statement of Principles is about diabetes mellitus and death from diabetes mellitus. (b) For the purposes of this Statement of Principles, "diabetes mellitus" means an endocrine disease characterised by: (i) a fasting venous plasma glucose concentration equal to or greater than 7.8 millimoles per litre on at least two separate occasions; or (ii) a venous plasma glucose concentration equal to or greater than 11.1 millimoles per litre both within two hours and at two hours after ingestion of 75 grams of glucose, attracting ICD-10-AM code E10, E11, E12, E13 or E14. Basis for determining the factors 3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that diabetes mellitus and death from diabetes mellitus can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces. Factors that must be related to service 4. Subject to clause 6, at least one of the factors set out in clause 5 must be related to any relevant service rendered by the person. Factors 5. The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting diabetes mellitus or death from diabetes mellitus with the circumstances of a person's relevant service are: (a) in relation to type 1 diabetes mellitus, being infected with rubella virus or Coxsackie B virus before the clinical onset of diabetes mellitus; or (b) in relation to type 2 diabetes mellitus, being obese for a period of at least ten years before the clinical onset of diabetes mellitus; or (c) in relation to type 2 diabetes mellitus, smoking at least 10 pack years of cigarettes or the equivalent thereof in other tobacco products, before the clinical onset of diabetes mellitus, and where smoking has ceased, the clinical onset has occurred within 10 years of cessation; or (d) suffering from gestational diabetes before the clinical onset of diabetes mellitus; or (e) suffering from acute pancreatitis or chronic pancreatitis before the clinical onset of diabetes mellitus; or (f) suffering from pancreatic cancer before the clinical onset of diabetes mellitus; or (g) undergoing surgery to the pancreas before the clinical onset of diabetes mellitus; or (h) suffering from cystic fibrosis before the clinical onset of diabetes mellitus; or (j) suffering from haemochromatosis before the clinical onset of diabetes mellitus; or (k) suffering from Cushing's syndrome before the clinical onset of diabetes mellitus; or (m) suffering from acromegaly before the clinical onset of diabetes mellitus; or (n) suffering from phaeochromocytoma before the clinical onset of diabetes mellitus; or (o) having been treated with pentamidine within the two years immediately before the clinical onset of diabetes mellitus; or (p) being treated with a drug reported to have caused hyperglycaemia, for a condition for which the drug cannot be ceased or substituted, at the time of the clinical onset of diabetes mellitus; or (q) being treated with immunosuppressive drugs, for organ transplantation, at the time of the clinical onset of diabetes mellitus; or (r) undertaking work involving hand decanting or spraying of 2,3,7,8-TCDD contaminated herbicides; or undertaking work involving filling, cleaning and maintenance of spray equipment used to apply 2,3,7,8-TCDD contaminated herbicides on more days than not, during a period of at least six months before the clinical onset of diabetes mellitus; or (s) the presence of a serum 2,3,7,8-TCDD level of at least 5 ppt at the time of the clinical onset of diabetes mellitus; or (t) in relation to type 1 diabetes mellitus, being infected with rubella virus or Coxsackie B virus before the clinical worsening of diabetes mellitus; or (u) in relation to type 2 diabetes mellitus, being obese for a period of at least ten years before the clinical worsening of diabetes mellitus; or (v) in relation to type 2 diabetes mellitus, smoking at least 10 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of diabetes mellitus, and where smoking has ceased, the clinical worsening has occurred within 10 years of cessation; or (w) being pregnant before the clinical worsening of diabetes mellitus; or (x) suffering from acute pancreatitis or chronic pancreatitis before the clinical worsening of diabetes mellitus; or (y) suffering from pancreatic cancer before the clinical worsening of diabetes mellitus; or (z) undergoing surgery to the pancreas before the clinical worsening of diabetes mellitus; or (za) suffering from cystic fibrosis before the clinical worsening of diabetes mellitus; or (zb) suffering from haemochromatosis before the clinical worsening of diabetes mellitus; or (zc) suffering from Cushing's syndrome before the clinical worsening of diabetes mellitus; or (zd) suffering from acromegaly before the clinical worsening of diabetes mellitus; or (ze) suffering from phaeochromocytoma before the clinical worsening of diabetes mellitus; or (zf) having been treated with pentamidine within the two years immediately before the clinical worsening of diabetes mellitus; or (zg) being treated with a drug reported to have caused hyperglycaemia, for a condition for which the drug cannot be ceased or substituted , at the time of the clinical worsening of diabetes mellitus; or (zh) being treated with immunosuppressive drugs, for organ transplantation, at the time of the clinical worsening of diabetes mellitus; or (zj) inability to obtain appropriate clinical management for diabetes mellitus. Factors that apply only to material contribution or aggravation 6. Paragraphs 5(t) to 5(zj) apply only to material contribution to, or aggravation of, diabetes mellitus where the person's diabetes mellitus was suffered or contracted before or during (but not arising out of) the person's relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70 (5A)(d) of the Act refers. Inclusion of Statements of Principles 7. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles. Other definitions 8. For the purposes of this Statement of Principles: "2,3,7,8-TCDD contaminated herbicides" means Agent Orange and other herbicides containing 2,4,5- trichlorophenoxyacetic acid alone or in combination; "acromegaly" means a chronic disease of adults due to hypersecretion of the pituitary growth hormone and characterised by enlargement of many parts of the skeleton e specially the distal portions, the nose, ears, jaws, fingers and toes; "acute pancreatitis" means an acute inflammatory condition due to auto-digestion of pancreatic tissue by its own enzymes, typically presenting with abdominal pain, and usually associated with raised levels of pancreatic enzymes in blood or urine; "being obese" means an increase in body weight by way of fat accumulation beyond an arbitrary limit, and due to a cause specified in the Repatriation Medical Authority's Statement about the causes of "being obese" signed by the Chairman of the Authority on 16 August 1996. The measurement used to define "being obese" is the Body Mass Index (BMI). The BMI = W/H2 and where: W is the person's weight in kilograms and H is the person's height in metres. "Being obese" is considered to be present when the BMI is 30 or greater. This definition excludes weight gain not resulting from fat deposition such as gross oedema, peritoneal or pleural effusion, or muscle hypertrophy. "Being obese" develops when energy intake is in excess of expenditure for a sustained period of time. For a factor to be included as a cause of "being obese" it must have resulted in a significant weight gain, of the order of a 20% increase in baseline weight, and in association with a BMI of 30 or greater; "chronic pancreatitis" means a continuing inflammatory disease of the pancreas characterised by irreversible morphological change that is typically associated with pain or permanent impairment of exocrine (steatorrhoea) and endocrine (diabetes mellitus) function or both; "Coxsackie B virus" means one of a heterogeneous group of viruses of the genus Enterovirus, that in humans has a tendency to affect the meninges and occasionally the cerebrum, but which can cause a wide spectrum of clinical illness; "Cushing's syndrome" means a condition due to the increased production of glucocorticoids in the adrenal gland, or increased blood levels of glucocorticoids from exogenous therapeutic administration of glococorticoids or adrenocorticotropic hormone (ACTH); "cystic fibrosis" means a generalised, autosomal recessive disorder, in which there is widespread dysfunction of the exocrine glands, characterised by signs of chronic pulmonary disease, pancreatic deficiency, abnormally high levels of electrolytes in the sweat, and occasionally by biliary cirrhosis; "death from diabetes mellitus" in relation to a person includes death from a terminal event or condition that was contributed to by the person's diabetes mellitus; "gestational diabetes" means carbohydrate intolerance of variable severity with onset or first recognition during pregnancy; "haemochromatosis" means a genetic disorder of iron storage in which an inappropriate increase in intestinal iron absorption results in the deposition of excessive quantities of iron in parenchymal cells, with eventual tissue damage and functional impairment of the organs involved, especially the liver, pancreas, heart and pituitary; "ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), effective date of 1 July 1998, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86451 340 3; "immunosuppressive drugs" means drugs or agents capable of suppressing immune responses; "pack years of cigarettes or the equivalent thereof, in other tobacco products" means a calculation of consumption where one pack year of cigarettes equals twenty tailor made cigarettes (being the "standard" cigarette pack contents) per day for a period of one calendar year, or 7 300 cigarettes. One tailor made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight. One pack year of tailor made cigarettes equates to 7 300 cigarettes, or 7.3kg of smoking tobacco by weight. Tobacco products means either cigarettes, pipe tobacco or cigars smoked, alone or in any combination; "pancreatic cancer" means a malignant neoplasm of the cells of the pancreas; "phaeochromocytoma" means a neoplasm of chromaffin tissue usually located in the adrenal medulla or sympathetic ganglion, which produces, stores and secretes catecholamines; "ppt" means parts per trillion; "relevant service" means: (a) operational service; or (b) peacekeeping service; or (c) hazardous service; "reported to have caused hyperglycaemia" means a drug reported to have caused hyperglycaemia in the published peer-reviewed medical literature; "rubella virus" means a member of the Togavirus family which causes rubella (German measles); "serum 2,3,7,8-TCDD" means 2,3,7,8-tetrachlorodibenzo-para- dioxin as measured from an appropriately derived blood sample; "terminal event" means the proximate or ultimate cause of death and includes: a) pneumonia; b) respiratory failure; c) cardiac arrest; d) circulatory failure; or e) cessation of brain function; "type 1 diabetes mellitus" means insulin dependent diabetes mellitus. Insulin dependence is not equivalent to insulin therapy. Rather, it means that the patient is at risk of ketoacidosis in the absence of insulin; "type 2 diabetes mellitus" means non-insulin dependent diabetes mellitus. Note: The National Diabetes Group Classification is detailed in the table: CLASS CLINICALCHARACTERISTICS DIAGNOSTICCRITERIA insulin dependent diabetes mellitus(IDDM, type 1) Ketosis prone; dependent on insulin for survival; usual onset in youth; absolute insulin deficiency; anti- islet cell antibodies often present at diagnosis unequivocal elevation of blood glucose with polyuria, polydipsia, weight loss and weakness non-insulin dependent diabetes mellitus (NIDDM, type 2) Ketosis resistant, usual onset after 40 years of age; majority obese; insulin resistance often present with inadequate insulin secretion same criteria for IDDM blood glucose levels as per definition of diabetes mellitus Application 9. This Instrument applies to all matters to which section 120A of the Act applies. Dated this Twenty-eighth day of October 1999 The Common Seal of the ) Repatriation Medical Authority ) was affixed to this instrument ) in the presence of: ) KEN DONALD CHAIRMAN Health: The agency says exposure to the chemical comes from the foods Americans eat. Levels in the atmosphere have declined during last two decades.


EPA Report Declares Dioxin a Cancer-Causing Agent


 The agency says exposure to the chemical comes from the foods Americans eat. Levels in the atmosphere have declined during last two decades.


--The long-expected government announcement Monday that the chemical dioxin causes cancer--and that the risk is greater than originally believed--has set off a new debate: what to do about it? 

The Environmental Protection Agency declared for the first time Monday that dioxin is a carcinogen, and said that the vast majority of exposure to the chemical comes from the food Americans eat--a connection that likely will prompt further concerns about the safety of the U.S. food supply. Dioxin comes from both natural and industrial sources, primarily waste incineration and the production of plastics and paper pulp. It can contaminate soil and water and enter the food supply from fish in tainted water and animals that eat plants containing the chemical. It accumulates in the fat of fish and animals and has been associated with several human lymphomas and lung cancer. It also can be passed through the breast milk of nursing mothers. In its report, the EPA said the chemical "can alter the fundamental growth and development of cells," leading to cancer and reproductive problems in animals "and potentially in people." The EPA report, a draft that will undergo further scientific review before being released in final form this fall, also sought to reassure Americans by stressing that dioxin levels in the atmosphere have declined substantially during the last two decades, the result of regulatory and other actions that have reduced dioxin emissions. 

The agency said that, based on a more complete understanding of dioxin toxicity, "the risks to people may be somewhat higher than previously believed, even though actual exposure seems to be declining among the general population." The conclusions about the chemical's cancer-causing properties came as no surprise. Dioxin has long been associated with cancer and other health consequences, such as birth defects. Dioxin first came to widespread public attention as a contaminant in the herbicide Agent Orange--used by American forces during the Vietnam War to defoliate enemy hiding places--after Vietnam veterans began complaining of a range of health problems, from skin rashes to cancer and birth defects in their offspring. Also, in 1983, the EPA essentially demolished the entire town of Times Beach, Mo., after substantial dioxin contamination was discovered on city streets.

 A fact sheet issued by the Public Health Service, the Agriculture Department and the EPA emphasized that the agencies have been monitoring dioxin levels in food for many years and will continue to do so. Furthermore, it said, Americans should follow the U.S. dietary guidelines which, among other things, urge a reduction in fat consumption. It also said that it was safe to continue to breast feed, saying that "dioxin has been in breast milk for many years and breast-fed infants show no increase in the number of cases of childhood cancer." It also declared that the U.S. food supply is "among the safest and most nutritious in the world," adding: "Food will never be without some risk and we are constantly working to reduce those risks." The EPA report issued no new dietary recommendations. But it did draw a direct link between fatty foods and dioxin residues, prompting criticism from both environmental and industry groups. "A lot of people eat a fatty diet, and EPA is insinuating that Americans should cut back on fat," said Monica Rhode, an official with the Falls Church, Va.-based Center for Health, Environment and Justice, a grass-roots environmental group founded in the wake of the Love Canal toxic dump crisis. "This should not be about a fat-free diet for Americans but a dioxin-free diet for polluters." And at least one restaurant industry group complained that the publicity almost certainly would provoke a consumer backlash in dining out. "The EPA says that dioxin is found in beef, fish and poultry--all the wonderful things that Americans like to eat--and that our members are in business to sell," said Scott Wexler, of the Empire State Restaurant Assn., which represents 5,000 restaurant and tavern owners in New York state. "Americans are very health-conscious and our members are very fearful that, if Americans react the same way that Europeans reacted, it would cause serious economic strife for American restaurant owners," he said. A year ago, several European countries--including Belgium, Germany, France and the Netherlands--took a series of actions after reports that dioxin had contaminated the food supply through tainted animal feed. Belgium banned chickens and egg-based foods from hundreds of farms and took butter off store shelves, while French agriculture officials stopped chicken production on dozens of French farms. 

The New York restaurant group has filed a lawsuit in federal district court here seeking to block the release of the final report "based on the fact that they haven't proven the case that the potential risk of dioxin is outweighed by the economic damage it would cause," Wexler said. Meanwhile, dozens of environmental groups sent a letter to President Clinton and Vice President Al Gore Monday urging the administration to further regulate industrial sources of dioxin pollution. But Kip Howlett, executive director of the Arlington, Va.-based Chlorine Chemistry Council, said the industry has cooperated with EPA actions in the past to reduce levels of dioxin, "and will continue to do so," adding: "We do not have a public health crisis or emergency here."


  Current VA AO compensation regs.

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