1 15 6 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 054 Folder The folder containing the original item. 1444 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Gough, Michael Source A related resource from which the described resource is derived Issues in Science and Technology Date A point or period of time associated with an event in the lifecycle of the resource 1987 Title A name given to the resource Environmental Epidemiology: Separating Politics and Science Subject The topic of the resource Agent Orange controversy AOWG CDC ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 055 Folder The folder containing the original item. 1451 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Gough, Michael Source A related resource from which the described resource is derived Environmental Science and Technology Date A point or period of time associated with an event in the lifecycle of the resource 1989 Title A name given to the resource Estimating Cancer Mortality: Epidemiological and Toxicological Methods Produce Similar Assessments Subject The topic of the resource EPA ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 172 Folder The folder containing the original item. 5100 Series The series number of the original item. Series VII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Gough, Michael Source A related resource from which the described resource is derived Nature Date A point or period of time associated with an event in the lifecycle of the resource December 12 1985 Title A name given to the resource Letter to the Editor: Dioxin Exposure at Monsanto Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 197 Folder The folder containing the original item. 5546 Series The series number of the original item. Series VIII Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Gough, Michael Title A name given to the resource The Political Assessment: A Congressional View ao_seriesVIII https://www.nal.usda.gov/exhibits/speccoll/files/original/ab95496c4c638a5bb49f9afdbf295521.pdf 26f4c9788c35e677e92b4f733907390f PDF Text Text Item ID Number °1498 Author Gough, Michael Corporate Author Report/Article TltlO Typescript: Chapter 9: The Political Assessment: A Congressional View Journal/Book Title 000 Year ° Month/Day Color n Number of Images 10 DOSCrlptOH Notes Tnis Tuesday, May 15, 2001 manuscript is a draft version of a chapter or section from the following book: Agent Orange and its Associated Dioxin: Assessment of a Controversy. Young, A. L. and G. M. Reggiani, eds. New York: Elsevier, 1988. This book is available in the NAL collection, call no.: RA1242 T44 A3. Page 1498 of 1514 �CHAPTER 9 "THE IMPORTANCE OF AGENT ORANGE AND DIOXIN WAS ACKNOWLEDGED WHEN THE HIGHEST LEVELS OF GOVERNMENT BECAME INVOLVED," THE POLITICAL ASSESSMENT: A CONGRESSIONAL VIEW MICHAEL GOUGII In December, 1979, Congress passed and President Carter signed Public Law 96-151, which instructed the Veterans Administration to carry out a study of possible long-term health effects resulting from exposure to dioxin-containing herbicides in Vietnam. This was not the first time that Congress had considered Agent Orange. Almost a decade earlier, in 1970, Senator Philip Hart; of Michigan held hearings about the possibility that spraying with Agent Orange was causing birth defects in Vietnam and that the use of the same herbicides could be harmful for the population of the United States. In response to those hearings, the Department of Health reduced the use of 2,4,5-T in the United States and the Department of Defense stopped Agent Orange spray missions in Vietnam. The law that was passed in 1979 mandating the Agent Orange study resulted from veterans testifying before Congress that Agent Orange had caused cancer, birth defects, and other health effects. It directed the Veterans Administration to study ground troops who had served in Vietnam to see if any long-term health effects in veterans or their families could be related to the use of Agent Orange. To prod the Veterans Administration along, Congress said that the protocol for the study had to be designed within 180 days or the Congress had to be told the reason why. 9: 1 �The OTA (Office of Technology Assessment), which is a technical support office of. Congress, was directed by law to review and approve the plans for the Veterans Administration study and to monitor the conduct of the resulting study. The bulk of my presentation is about OTA's role, but before going into that, I will discuss other major events in the Agent Orange issue. Some results are now available from the Ranch Hand study, the mortality and morbidity study of the Air Force personnel who flew the spray missions in Vietnam, which was well underway in 1979. The Air Force had responded early to Congressional inquiries and realized that they had an occupational health problem. They moved ahead on their own without the intense prodding Congress put on the Veterans Administration for the ground troop study. George Lathrop has dismissed those studies. Also in December, 1979, President Carter established the Agent Orange Working Group (AOWG), composed of Executive Branch agencies with programs that touched on possible effects on health of dioxin, Agent Orange, and herbicides. In February, 1980, the Office of Technology Assessment was invited to sit with the Agent Orange Working Group as an observer, and it became an active participant in this group. In August, 1981, President Reagan placed the Agent Orange Working Group into the Cabinet Council on Human Resources, elevating and enlarging the scope of the work group. The Agent Orange Working Group has had profound effects on Executive Branch efforts to try to better understand dioxin and Agent Orange. Among the several studies coordinated by the Agent Orange Working Group (ten major epidemiological studies scheduled for completion by 1990 and five ongoing health surveillance projects), one is complete. It is the 9: 2 �Birth Defects Study carried out by the Center for Disease Control. This study has two conclusions: the tfirst conclusion was that there is no association between service in Vietnam and birth defects. The second conclusion was th,a,t there may be an association between opportunities for exposure, to Agent Orange and a handful of birth defects, As soon a,s the results of that study were released, at least one bill was written in the Senate which was to provide compensation to all veterans who had fathered children with spina bifida, a. colleC" tion of tumors,and cleft lip with or without cleft palate, That legislation never left the Senator's office. The people who had clone the study at the Center for Disease Control, i.e., Dave Hricson and his colleagues, came to Congress. They talked to congressional staff in great detail about the structure of the study, its strengths and limits, and how to draw conclusions from its results. They also went to the American Legion, the Disabled American Veterans, the Vietnam Veterans of American, and other veterans organizations, where they explained the study and convinced those veterans that the connections that had been shown, although theoretically valid, woulcl not make a great deal of sense biologically. This was a great achievement for solid scientific exposition and convincing people not to be afraid and consequently do something foolish. Some scientists still argue about the meaning of those possible connections between exposure to Agent Orange and birth defects. The Birth Defects Study, like many of the other Agent Orange studies, was clone for political reasons. Politically, it has been examined and tried. The Congress looked at the conclusions and decided no harm had been associated with Agent Orange. So the CDC Birth Defects Study, from the point of view of politics, is over. The Congress will not reopen it. 9: 3 �It is Interesting to note in this context that in the Agent Orange lawsuit which was settled in the District Court of New York in May, 1985, Judge Weinstein also considered the CDC Birth Defects Study. He reached the same conclusion as Congress, deciding that the study results were not sufficient to sustain any association between Agent Orange and birth defects. Thus, in the judicial system also, the CDC Birth Defects Study has been weighed and found not to be convincing in demonstrating any association between Agent Orange exposure and b i. r th de f e c t s . These are events which are very important. It should be kept in mind that here we are not dealing with a purely scientific issue but with very sensitive and complicated political and social issues. The scientific conclusions, therefore, \vhile they are very important to us to understand whether or not: d.i.oxin and Agent Orange cause disease, still are less important to society than the decisions that are made in the courtrooms and in the Congressional Hearing Rooms. To come back to OTA, Congress wrote OTA into the Agent Orange study because of disagreement between the Senate and House Committees on Veterans' Affairs. Sensitive to veterans' complaints that the Veterans Administration was indifferent to their claims of harm from Agent Orange, the Senate wanted the study to be carried out by some other agency. The House Committee, on the other hand, had more faith in the Veterans Administration and acted to preserve Veterans Administration's responsibilities for research on veterans' health. The two committees compromised, giving responsibility for the study to the Veterans Administration and mandating that the Office of Technology Assessment make periodic reports to the committee, keeping Congress informed about progress or lack o f i t. 9: 4 �This was an entirely new role for the Office of Technology Assessment, and its constitutionality has been questioned. The question arose a month after Congress directed the Veterans Administration to do the Agent Orange study. At that time, Congress passed another law directing the National Institute for Occupational Safety and Health to do a study on dioxinexposed workers, and, again, Congress required that the Office of Technology Assessment review and approve the protocol and monitor the conduct of the study. President Carter vetoed that law on the basis that giving a congressional branch agency--the Office of Technology Assessment—veto authority over the execution of an Executive Branch study was a violation of separation of powers doctrine, Executive Branch lawyers concluded after examining the case that the bill was unconstitutional. Legislative Branch lawyers, however, concluded that it was constitutional. Neither branch has taken the case to court, and the issue is unresolved. The veto of the NIOSH bill was successful. President Carter's veto message also instructed the Administrator of the Veterans Administration to ignore the provisions of Public Law 96-151 which directed the Veterans Administration to submit the study plan to the Office of Technology Assessment for review. However, Senator Alan Cranston, at that time Chairman of the Senate Committee on Veterans' Affairs, wrote the Administrator that ignoring the provision would not be a wise course. He pointed out that Congress must provide funds for the Veterans Administration study and that funding depended, on the Office of Technology Assessment reviewing and approving the study plan. The Office of Technology Assessment was part of the process, and it has played an active role in Agent Orange issues ever since. 9: 5 �OTA assembled an Advisory Board to participate in its Agent Orange activities. The panel includes academics--epidemiologists and statisticians, a toxicologist, a neurologist, and a gynecologist. Then there are members who represent stakeholders. There are three representatives from chemical companies that made the Agent Orange components: Monsanto, Dow Chemical, and American Cyanamid. They are neatly balanced by representatives of the American Legion, the Disabled American Veterans, and the Vietnam Veterans of America. Despite the congressional requirement that a protocol be written in 180 days, the Veterans Administration did not produce one within that time. The Veterans Administration was sued by veterans' groups because of some of its procedures. There was a hearing before the General Accounting Office about the methods used by the Veterans Administration to contract for the protocol design. All of these events contributed to the protocol's being late. When the Office of Technology Assessment received the first draft of the protocol, we rejected it as inadequate. The basic plan of the protocol was to compare morbidity and mortality rates between two groups of veterans, one which had been exposed to Agent Orange and one which had not been. In response to OTA's and others' criticisms, the protocol was revised. The revision process just dragged along. It was not until September, 1982, two and a half years after Congress passed the law, that OTA approved the protocol. By that time the Agent Orange Working Group Science Panel had become convinced that it was really impossible to separate exposed from not- exposed veterans, and they were urging that a study be done to compare the health of veterans who had gone to Vietnam with the health of veterans who have not gone to to Vietnam, A study of that type would at least provide a 9: 6 �clue as to whether or not Vietnam veterans in general were suffering from ill effects as a result of that experience. The recommendation placed pressure on the Veterans Administration to do a "Vietnam Experience Study" even though the Administration was planning an Agent Orange study. Rather than making a decision between the two studies on its own, the Veterans Administration asked for another review of their protocol from the National Academy of Sciences. In September, 1982, all the delay came to a head because Congress had exhausted its patience. One hundred and: one representatives from the House of Representatives wrote a letter to the Veterans Administration requesting that the study be transferred from the Veterans Administration to some other agency. Dr. Vernon Monk of the Centers for Disease Control, in testifying before the House Veterans' Affairs Committee, said that the Centers for Disease Control was well placed to do the study. The Senate Veterans' Affairs Committee reaffirmed its previously held conviction that the responsibility for the study should be transferred somewhere else. The result was that the execution of the study was taken from the Veterans Administration and given to the Centers for Disease Control. The Centers for Disease Control finally resolved the controversy about whether to do an Agent Orange Study or a Vietnam Experience Study: they are doing both. The CDC studies are the largest, probably the most compjLicated, and the most expensive epidemiology studies ever conceived. They will cost at least $70 million, involve interviews of 30,000 veterans, and 10,000 physical examinations to be carried out at the Lovelace Clinic. The Vietnam Experience Study is relatively straightforward. Looking at the records easily establishes whether or not a veteran went to Vietnam. The two cohorts can thus 9: 7 �be easily assembled, with the men who went to Vietnam on one side and those who did not on the other; then their health can be examined. The Vietnam Experience Study is underway and on schedule. The same cannot be said about the Agent Orange Study,because it is much harder to say whether or not a veteran was exposed to Agent Orange. In January, 1985, the Centers for Disease Control sent the Office of Technology Assessment a summary of their efforts to resolve the exposure problem. At that time the Centers for Disease Control were able to identify the locations of battalions on the ground in Vietnam, A battalion is about 1,000 men, four maneuver companies and a headquarters company. The battalion that the Centers for Disease Control provided as an example was spread out along a line of 40 kilometers. It was not possible to know where the 1,000 men actually were. Were 990 at the middle of the line or were they at one end? Were they spread out evenly along the entire line? No one knows. One way to decide that a battalion was exposed is to declare that any Agent Orange spray mission within a fixed distance caused exposure. In practice, AOWG and CDC have accepted that a spray mission at a distance of two kilometers'might result in exposure. Now consider an airplane spraying Agent Orange somewhere within two kilometers of the battalion spread out on the 40 kilometer line. It is very hard to say who of the battalion was exposed and who was not. Even assuming that exposure could be ascertained, it is impossible to know how much exposure took place. OTA was very critical of the plans to decide a battalion was exposed on the basis of such data. This criticism was expressed in periodic reports sent to the congressional committees. 9: 8 �Right: now, I think a majority o£ the OTA Advisory Board feels that the study on Agent Orange should not go on because of difficulties in deciding who was exposed and who was not. The panel has not voted on this issue, and I could be wrong, in my assessment, but I don't think so, If, after seeing more details about exposure, OTA decides the study is impossible, Congress could decide not to do the study. That would involve an act of courage on the part of the Congress because it has made a commitment that this study would be done. The Veterans' Affairs Committees of the Senate and of the House may face the dilemma, having promised the veterans to do the study, that they have changed their mind. I used to think that, no matter what the technical problems, the study would be done. I am no longer so certain. Congress has considered, over and over again, providing compensation to veterans who claim ill effects from Agent Orange exposure. At one time there was a list of over 20 diseases being considered as compensable. Congress finally passed a law which provides compensation for chloracne and porphyria cutanea tarda (PCT), if they occurred within one year after .leaving Vietnam, Although there are very few cases of either disease, the law was not a hollow gesture on the part of the Congress. They wanted to do something to compensate veterans who had been harmed, but, at the same time, they wanted to limit compensation to diseases that might be connected with Agent Orange, Subsequently, Congress directed the Veterans Administration to set up a special committee to review claims about diseases resulting from Agent Orange exposure. That committee will function only until the studies of the Centers for Disease Control arc complete, because at that moment we expect to have the answer to our questions. 9: 9 �Summing up, we can say that Congress is working out the Agent Orange controversy. In 1979, Congress refused to make a decision about whether or not Agent Orange had caused health, effects. Instead, Congress directed the Executive Branch to gather information for making a decision. By now, some results have come in. The Air Force's studies on Ranch Hand personnel provide no convincing evidence that Agent Orange has affected human health. The Birth Defects Study, performed by the Centers for Disease Control, also failed to provide convincing evidence of a connection between Agent Orange and human effects. Congress has directed the Veterans Administration to compensate two conditions which have been related to dioxin exposure should they appear in Vietnam veterans. The judge in the Agent Orange class action stated that the veterans had failed, to prove their case in court that Agent Orange was the cause of their illnesses. These points are convincing many people that, regardless of all the fears about Agent Orange and the toxicity which might reside in the dioxin molecule, exposure to Agent Orange, if it occurred, has not harmed the veterans. However, that is not yet the end of the Agent Orange controversy. Intellectually and emotionally the veterans might accept that they have not been able to prove that their diseases were caused by Agent Orange, but they can always contend that no one could prove the contrary. Probably, Agent Orange will pass away as a political issue. Some veterans will continue to contend they were harmed, but the decisions already made in Congress and in the courtroom will convince many people that no detectable harm was done. As more study results come in, if the results continue to show no health effects, they will reinforce the conclusions already made. 9: 10 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 056 Folder The folder containing the original item. 1498 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Gough, Michael Title A name given to the resource Typescript: Chapter 9: The Political Assessment: A Congressional View Subject The topic of the resource legislation AOWG CDC VA ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/efea74b6f6c3831bd84d51f6bbf6350a.pdf be306aac08bdf1b882955623c79078e4 PDF Text Text ItomDMier osoee Author D NDtScam|BI, Gough, Michael Corporate Author ROpOrt/ArtlClO TltlO Typescript: The CDC Epidemiologic Study of Vietnam Veterans Will Cost Much, Buy Little, and Canceling it Does not Leave Us Without Information, June 11, 1984 Journal/Book Title Year 000 ° Month/Day Color D Includes cover letter from Gough to Alvin L. Young, June 11, 1984. Friday, February 22, 2002 Page 5066 of 5115 �June 11. 1984 Dear M , This is the paper that I mentioned to you. As we discussed on the phone, I am a l i t t l e uncom-fortabl e attempting to scuttle the CDC study so long as OTA is mandated a role in it, but I don't think that we w i l l gain enough -from the study to justify doing it. I also have some pride of authorship about the paper. H you or anyone else -finds it convincing or use-ful , I'd l i k e someday to get credit for it, but that's not uppermost on my mind, Please -feel free to duplicate the paper as you want. If you have any suggestions for additions or corrections to it, please call me Sincerely, michael gough 6404 e. halbert rd., bethesda, rnd. 20817 �The CDC Epiderniologic Study of Vietnam Veterans W i l l Cost Much, Buy L i t t l e , and Cancelling It Does Not Leave Us Without In-formation In December 1979, Congress passed Public Law 96-151 d i r e c t i n g the Veterans Administration (VA) to study possible long-term health effects in Vietnam veterans exposed to dioxin-containing herbicides. Now, four and a half years later, the responsibility for the study has been transferred to the Centers for Disease Control (CDC), and work has begun on a study that is expected to produce its first results in about three years and to cost $70,000,000 and perhaps much more. The CDC study is to examine three possibilities! (1) that exposure to d i o x i n present in Agent Orange is associated w i t h adverse health effects among Vietnam veterans, <2> that service in Vietnam is associated with adverse health effects, and (3) that an elevated risk of developing certain cancers is associated w i t h service in Vietnam and/or exposure to Agent Orange. The first p o s s i b i l i t y w i l l be examined by comparing the health status of three cohorts (groups): combat soldiers l i k e l y to have been exposed to Agent Orange, combat soldiers not l i k e l y to have been exposed, and soldiers of any sort who were not l i k e l y to have been exposed. The second p o s s i b i l i t y w i l l be examined by comparing the health of a cohort of Vietnam veterans w i t h the health of veterans of service in other areas. Each cohort w i l l consist of 6,000 men; all cohort members w i l l answer a detailed questionnaire, and 2,000 of each cohort w i l l undergo a detailed medical and phychological examination. By any measure, the CDC study w i l l be among the largest cohort studies ever undertaken. The third p o s s i b i l i t y w i l l be examined by a case-control study. "Cases," men who have the types of tumors being studied, w i l l be i d e n t i f i e d from cancer registries. The P. 1 6/11/84 �frequency of Vietnam service among that group w i l l be compared to the frequency among a group of "controls," men who l i v e in the same geographical areas but who do not have the cancers. M i l i t a r y records w i l l be used to estimate veterans' exposure to Agent Orange. Comparison of the levels of d i o x i n exposure in Vietnam to levels of exposure in other situations convinces many (certainly most, and perhaps almost a l l ) experts f a m i l i a r w i t h dioxin's effects that the CDC study w i l l find no health detriment associated with Agent Orange. Some veterans, however, claim that the wartime nature of their exposures in Vietnam accentuated the effects of d i o x i n , and that p o s s i b i l i t y is the strongest argument for doing the CDC study. Nevertheless, veterans have not developed chloracne, a disease associated with r e l a t i v e l y h i g h d i o x i n exposure. There were no cases of chloracne among Ranch Handers, the veterans who were exposed to the highest levels of d i o x i n , and only one possible case among the veterans who have enrolled in the VA's Agent Orange registry. Therefore, the conditions in Vietnam were not sufficient to cause the one v i s i b l e manifestation of d i o x i n exposure. Veterans correctly point out that there is a p o s s i b i l i t y that exposures to d i o x i n at levels too low to cause chloracne might cause cancer or other effects. There is no denying that argument on s c i e n t i f i c grounds; it could be. However, there is now no convincing evidence for health effects other than chloracne and some l i v e r and biochemical abnormalities that have been seen in exposed chemical workers. Those symptoms did not appear in chemical workers who were employed in non-contaminated areas of plants. It is reasonable to think that those workers were exposed to levels of d i o x i n too low to cause chloracne, but s t i l l much greater than P. 2 6/11/84 �levels most people are exposed to. Neither populations o-f workers who developed chloracne nor others probably exposed to lesser levels o-f d i o x i n have suffered -from unusually high rates o-f cancer or reproductive health effects. These observations argue against manifestation of any health effects other than chloracne and the symptoms seen in chemical workers and against manifestation of any other diseases in the absence of chloracne. (The last statement is not make in ignorance of the higher than expected rate of stomach cancer in one exposed occupational population or the reported excess of soft tissue sarcomas in another exposed population. However, those specific suggestions of associations are better investigated in a case-control study such as described below.) The possible results of the Vietnam service study are more uncertain; there may be significant effects on health. Nevertheless, the power of the study to detect excess health deteriments is s u f f i c i e n t l y l i m i t e d that it w i l l provide l i t t l e information for making decisions about compensating i n d i v i d u a l veterans who claim adverse health effects. The cohort studies have a good chance of detecting any 2-fold increases in diseases that occur w i t h a normal frequency of 0.5 to 2.0 percent. In males of the age of Vietnam veterans, the only diseases that occur that frequently are common a l l e r g i e s and m i l d respiratory infections. The likelihood of detecting rarer diseases is smaller. Unfortunately, the absence of f i n d i n g any effects cannot be presented as a f i n d i n g that there is no effect. Instead, the study w i l l only be able to say that Agent Orange-exposed veterans or Vietnam veterans are not experiencing particular diseases at rates two or more times those seen in other veterans. P. 3 d/li/84 �The case-control study of some cancers, according to CDC, has a 95 percent chance of detecting a two-fold increase in soft-tissue sarcomas if the excess is present. According to at least one review of the CDC study plan, the study w i l l be unable to detect an increase smaller than four or five-fold. In any case, the study w i l l be unable to detect excesses smaller than two fold; neither w i l l i t be able to rule them out even if there is no excess. Nevertheless, the case-control study has the v i r t u e of testing a hypothesis—that d i o x i n causes specific cancers. Although other (National Cancer Institute) studies are examining the same question, they are concentrated in non-industrial areas of the country and have less chance of examining the possible effects of industrial exposures to d i o x i n . Therefore, the case-control study might go ahead as an effort to settle outstanding questions about soft tissue sarcomas and lymphomas. As the recently negotiated settlement of the veterans-' case against the chemical companies showed, science is not necessary to make policy judgements <or tradeoffs). Although some spokesmen for the veterans c l a i m that the companies settled because the companies knew that they were at fault, other interpretations are possible. Had the n i n e cases representing the veterans'' class action gone to t r i a l , the veterans would probably have won some, the companies some. The losers in both cases would have appealed. The cases could have wound on across the years and been resolved who knows when. By settling, the companies e l i m i n a t e d uncertainties about future l i t i g a t i o n and l i a b i l i t i e s . Each company's stock rose on Wall Street the day the suit was settled. Furthermore, the settlement stipulates that no causal l i n k was shown between herbicides and the veterans' illnesses. P. A 6/11/84 �A 1983 court case in Nova Scotia did consider what is known about dioxin's health effects in a dispute between timber companies and citizens of nearby areas. The judge who heard the case decided for the companies, saying that the citizens had not shown that spraying w i t h dioxin-containing herbicides would result in a risk to human health. Either ignoring s c i e n t i f i c information or making use of what is a v a i l a b l e , it is possible to make policy about d i o x i n s at the present time. Given that the CDC study is l i k e l y to find no adverse health effects but be unable to show that some small elevated risk does not exist, it w i l l not materially assist pol i cyrnak ing or making compensation decisions. The p o s s i b i l i t y that there might be "something really there," that there are now-undetected disasterous health effects among veterans, makes it d i f f i c u l t to consider c a n c e l l i n g the CDC study. In fact, there is l i t t l e risk of missing something that is really there. The CDC study of b i r t h defects (results expected in mid-summer) w i l l provide much more information about possible birth defects than w i l l the cohort studies. The Air Force Ranch Hand study is underway and w i l l continue for 20 years w i t h p e r i o d i c reports on the morbidity and mortality of those men. If excess adverse health effects appear in the Ranch Handers, veterans of the ground forces in Vietnam could be examined for that particular condition or the appearance of the disease in the Ranch Handers could be taken as presumptive evidence that other veterans are suffering the same diseases. P. 5 6/11/84 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 170 Folder The folder containing the original item. 5066 Series The series number of the original item. Series VII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Gough, Michael Title A name given to the resource Typescript: The CDC Epidemiologic Study of Vietnam Veterans Will Cost Much, Buy Little, and Canceling it Does not Leave Us Without Information, June 11, 1984