1 15 24 https://www.nal.usda.gov/exhibits/speccoll/files/original/6c990d636a544a4e4f4160da0d919994.pdf 6f3ba42969deef3d06f65df2958cf48b PDF Text Text Item ID Number °1835 Author Keller, Carl Corporate Author Report/Article Title Memorandum with several attachments: from Chairman, Science Panel, AOWG, to Members of the Science Panel, AOWG, with subject Meeting of the Science Panel, dated February 5, 1985. Journal/Book Tito Year 000 ° Month/Day Color H Number of Images 12 DOSCTipton Notes Avn ' ' L- Young filed this item under "Vietnam Veterans Twin Study." Memo gives notice of a science panel meeting scheduled for February 21, 1985 with the purpose of reviewing the VETS II protocol. Attachments include inquiries about the possiblity of a female Vietnam veterans study, and the minutes of the November 29,1984 meeting of the Science Panel of the Agent Orange Working Group. Wednesday, July 11, 2001 Page 1836 of 1870 �"r DEPARTMENT OF HEALTH & HUMAN SERVICES • Date Memorandum February 5, 1985 From Public Health Service National Institutes of Health Chairman, Science Panel, AOWG Subject Meeting of the Science Panel TO Members of the Science Panel, AOWG This is to announce that there will be a meeting of the Science Panel of the Agent Orange Working Group at 9:30 a.m., February 21, 1985, in room 729G of the Hubert Humphrey Building, Washington, D.C. The purpose of the meeting will be to review the protocol for the Veterans Administration Twin Study (VETS II). You will (or will have) receive(d) a copy of this protocol under seperate cover. I am enclosing some comments made by a special review group last summer for your information. Please bring your written comments to the meeting and we will summarize our review at that time. We have also received additional congressional correspondence concerning female Veterans' needs. It appears that we are now being requested to recommend what, if any, studies of the health of female Vietnam veterans should be done and to examine proposed studies in that light. I am enclosing appropriate materials and we will discuss this at our meeting. In addition, please find enclosed the minutes of our last meeting (November 29, 1984) for your approval. Carl Keller, Ph.D. �OW1AUN X. MmOM. WVOMWO. ITKOM TMumwND. SOUTH CAMX.INA ALAM CRANSTON. CAuraMM ftOeCRT T. STAf FOMO. VERMONT JCNNINCS lUNOOLPH. WIST VMOMIA MANX H. MUMOWMI. ALASKA (MM M. MATSUNAOA. HAWAII AMCN WCrtll. KNNtnVANM MNNW MCONCIM. AMMNA JCMMIAM OCNTON. ALAIAMA MOMI J. MffCHIU. MANN KUOYSOSCHWraMMNUOTA ANTHONY J. HHNCm CHW COUNSH/tTAW OMICTM JONATHAN H STIIMfMO. MIMOMTY CNItf COUNSO/ STAW OMCTOII A\\ ^.t.^_ * ClLj flff * ff JfeVUllVU • t^+-^*~.^. Pftfafpa 0WVf»VlAJ *^ * ~MtPllfif? 0WIUIV%> COMMITTEE ON VETERANS' AFFAIRS WASHINGTON, DC 20510 January 23, 1985 Honorable Charles Baker Chair Cabinet Council Agent Orange Working Group Department of Health and Human Services Humbert Humphrey Building, 614-G 200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Mr. Baker, I have long had a strong interest in the issue of how the Federal Government might conduct research to investigate the possible health effects in female Vietnam veterans of their exposure to Agent Orange. Enclosed is a copy of an October 16, 1984, letter to me on this subject from Dr. James 0. Mason, the Director of the Centers for Disease Control. It is my understanding that the draft protocol outline mentioned in Dr. Mason's letter is pending in the Agent Orange Working Group and may be considered during the Group's next meeting, which is scheduled to take place in early February. I believe that it is extremely important that research be undertaken on this issue, and I strongly urge that the Working Group undertake its review of the protocol outline as expeditiously as possible. It is my strong hope that the members of the Working Group will be able to report favorably on the possibility of a study of female Vietnam veterans, either by endorsing the protocol outline as developed by CDC or by suggesting whatever changes to the outline the members believe are needed in order for a study to go forward. Thank you for your attention to my views on this issue. I would appreciate hearing from you on this matter as soon as possible after the Working Group's February meeting. With best wishes, Sin Alah Cranston Ranking Minority Member Enclosure �CTER JUDICIARY APPROPRIATIONS VETERANS' AFFAIRS WASHINGTON. D.C. 20SIO January 4, 1985 The Honorable Margaret M. Heckler Secretary Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Secretary Heckler: I write regarding the government's epidemiological study on Agent Orange being conducted by the Centers for Disease Control (CDC). As a member of the Senate Veterans' Affairs Committee, I am very concerned that CDC's study fails to include women who served in Vietnam. Approximately 20,000 women served there as members of the military or as civilians employed by service organizations. Many of these women are now suffering from health problems that may be associated with Agent Orange. It is my sense that research is needed to assess the problems among women who were in Vietnam to avoid excluding them from Agent Orange compensation programs. I urge that this omission be rectified by the Health and Human Services Administration. Your consideration of this request is greatly appreciated. Sincerely, Arlen Specter AS:gfs _ *s •- TRACER �'DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Centers for Disease Control Memorandum Date 'December 20, 1984 From Director, Center for Environmental Health Subject Possible Study of Female Vietnam Veterans To Dr. Carl Keller Chair, AOWG Science Panel At the Agent Orange Working Group (AOWG) Meeting of December 4, 1984, Dr. Brandt requested that the Centers for Disease Control (CDC) and the AOWG Science Panel discuss what additional information the Science Panel would need to assess the scientific utility of a study of female Vietnam veterans. As you know, CDC assessed the feasibility of a study of women veterans and described the possible study approach in a protocol outline dated June 25, 1984, copy attached. In that document and in the attached memorandum to Dr. Brandt from Dr. James Mason, CDC Director, responding to the Science Panel's initial critique, of the protocol outline, CDC stated its belief that a comprehensive health assessment of female Vietnam veterans motivates the study, rather than any specific hypothesis. In addition, there are gender-specific issues that would not permit generalization of male data to the female veteran. CDC has also clearly stated that the proposed study is a "Vietnam Experience" study rather than an "Agent Orange" study, per se. By that, I mean we believe it will not be possible to estimate individual female veterans' opportunity for exposure by relating their unit's location to herbicide spraying missions. Like the "Vietnam Experience" study being conducted in males, the study of female veterans would compare the health of Vietnam veterans to comparable veterans who served elsewhere. Any of the exposures women veterans experienced in Vietnam, (e.g. stress of caring for a high volume of combat casualties, parasitic diseases, whatever Agent Orange may have been ubiquitous in the Vietnamese environment, etc.) might influence the health of Vietnam veterans compared to other female veterans. �Page 2 - Dr. Keller Given these two assumptions, that any health assessment of women Vietnam veterans should be as comprehensive as that in male Vietnam veterans, and that the study should look at all exposures in Vietnam, not exclusively at the opportunity for Agent Orange exposure, I believe that the study described in the protocol outline is appropriate. If the Science Panel can provide CDC with a list of specific hypotheses that will address the health concerns of female Vietnam veterans, I will request the resources to develop a protocol to study these hypotheses. I look forward to hearing from you in the near future. Please do not hesitate to contact me if you have any further questions. r, ~\": I Vernon N. Houk, M.D. Attachments �MOV T!) 19M Director Centers for Disease Control Possible Study of Female Vietnam Veterans Edward N. Brandt» Jr.» M.D. Chair Pro Tempore Cabinet Council Agent Orange Working Group Thank you for the opportunity to review and respond to the Agent Orange Working Croup Science Panel*• critique of th« protocol outline for a study of female Vietnam veterans. The Science Panel mentioned two Issues which they felt must be carefully considered before proceeding further with development of the study: 1) "the great potential for confounding exposures both during and after Vietnam to teratogenlc agents other than herbicides and their contaminants," and 2) "what a study of female veterans will contribute In the way of scientific Information which Is not already being obtained from the ongoing male studies." Cf»C shares the Science Panel's Interest In having a research plnn which addresses potentially confounding exposures* In this regard, it is important to consider the purpose of the study. As stated in the protocol outline, the proposed study is similar to the Vietnam Experience Study of men currently being conducted. All the exposures unique to the Vietnam environment, from parasitic diseases* to psychological stress, to waste anesthetic gases nay influence the health of the Vietnam veteran cohort. Agent Orange Is only one of many exposures Included In this experience. For analyses of the effects of Vietnam service in general, exposure to t-xcese waste anesthetic gases in field hospitals in Vietnam would not be a confounder of the association of Vietnam service with health outcomes. Rather, the anesthetic gases are but one of the many exposures that are part of the Vietnam Experience* On the other hand, for analyses focusing on specific exposures experienced in Vietnam, such as Agent Orange, waste anesthetic cfls exposure might be • confounder* Such analyses would be expected to control for operating room experience In Vietnam. Occupational exposures, Including waste anesthetic gases, experienced after military service might also be potential confounding factors since they could differ between the Vietnam and non-Vietnam female veterans. Again, these exposures would be considered in the analysis. To respond to the general concern about confounding, CDC would deal with potentially confounding factors in this study with the same approach used in the recent Birth Defects Study and the ongoing study of male veterans. �2 - Fdward K. Brandt, Jr., M.D. retailed Information would be gathered from personal Interviews and record revjf»we about potential conf minders, e.g., dorofirapltic, occupational, or other risk factor* for disease that might occur with differing frequencies among Vietnam and non-Vietnam veterans. In the analysis such factors would be controlled for, eliminating any actual confounding effect of th<:&e variables. The second concern of th« Science Panel related to the research questions urique to women thut would beflr'dreftsedin the proposed study. As fitatf^ above, the study is primarily designed to look at military service in Vietnam, in p.enrral, as the, «r.ain exposure of Interest, rather than estltiatee of /,pent Orcn^e exposure. Two caveats should be mentioned regarding the study of Apcnt Or/jT>£e exposure, per so, in relation to the health of feraale Vietnam veterans. First, because of the duties of t»oet women w^o served in Viet nan, thfir livelihood of erposure to Agent Orange may bo less than that of c-.ale Vletnan veterans. *o«t women who served In Vletnso ver*» stationed «t military horprtals cr headquarter units that were at some distance frora the heaviest <\f>fcnt Orange sprayings. Second, if, ns speculated by BOP.C scientists, A^cnt Ornpfle residues became ubiquitous throughout Vletnan, female Vietn*a- veteror.s way hav« been exposed throi^gh food supplies, drinking water, etc. 1'ofcovor, these types of expoBurcs could not be quantified by relating the prrotii.ity c.f the women'* units to the Ranch llnnd sprayinfc missions or other applications of A.r.«?nr. Throe ^road protipR of hoalth ontcoyfs would be studied In relattor to VJetvan norvicei reproductive outcone«, psychologic outcotaen, and gercral outconts for which T?otwsn may experience different risks than tnpn. ^productive outcomes would include fertility, spontaneous abortion*, con^enltol irnlforciarlono as well as dlRRawcc of fetr^lo reproductive Presnaney outcomes of the women are of pwrtJcular interest since maternal are more c.onnonly aesocfnted with adverfle effects than p«r«rn3l flseasps of reproductive organs nny be related to the Intiurnce of various stresses *nJ insults to the delJcate hypothalarjic-pitultrry-ovarlan ai:lp. Also of note in this repard, certain subclinical paraoitlc diseases, ns iralrria nnd acicbiasie, rsy becowc nanifewt during the f;trrt;n of outcoreo such as nnxlfty, dt-prrsslor, and font lYaur.atlc P rirord«r and hehrtvloral outcomes nuch no substance abuse and crininal activity r;ny crhihit different potternw In r.ole and frwnJc VlettJfln1 veterans. ^'Ith « .l»r^e proportion of acute care nnrses onon^ female Vietnam vetor.^nH, special c.o»>6 iteration would he given to possible ntr«sr.ft*l effects of curing frr a lorfc* volune of combat casualties. The psychosocial component of the fennle study is also crucial to the cowplete evaluation and interpretation of t heother clitics! data to he collected, specifically in the determination of outcwrs as a cause v«rnun on effect of plynlcal and Mochcrical (e.R. hepatitis, cirrhosis, memory c!lsorder&). f'enrrsl health outcooca would Include n vnrlety of conditions of concern to fenole vi«tnair. veterans* These outcomes are similar to those helnr. *ddr«BFct' IP tie ongoing study of trale veterans. An was the case 1n the study of p-alc v*»tcr«ns, there are few specific hypotheses based on previous scientific studies. CPC believer* that a comprehensive health Interview and physical exsii-« nation would he n?edcd f.o addrees the veterans' concerns thoroughly. �Page 3 - Edward N. Brandt, Jr., M.D» The Rtatifttlcal power of the propoeed atudy for Important health outconon would be good. Tha Interview phase of the study la designed to detect Increases of about twofold in the relative rieka for health outcomes occurrinr with the frequency of 0.3Z» while the examination phaae is designed to detect twofold incraaaea in conditions that occur with a frequency of 1*52 or greater (power * 0.95, Alpha * 0*05, J-tail). With that level of statistical power, moat conditions that ara of concern to women vho eerved in Vietnam will be adequately addressed. Only relatively email incraaaea in uncoeaon conditions would escape detection* The Intent of the atudy which CDC was aaked to propoaa la to address the health concama of female Vietnam veterans comprehensively and with sufficient atatiatlcal precision* That haa determined the study design and sample oize, rather than any single research hypothesis. The coat of doing this atudy la significant. A decision to do this resenrch, in a world of finite raeourc«a, aay aean that money for other activities may not be available. We ara neutrsl on doing the atudy* However, if a decision is made to proceed, wa ara confident that we can do a valid atudy, acceptable to the yetarana groups, if we are provided the necaaaary resources. We will he plen*«d to provide any further information you need. >**** Jamas ^rMaflon;"'V,f!#8fcP«H. Assistant Surgeon General cc: OD CEH CDC/W ES/PHS Tracer 85084; CDC ID D19247; CEH #B-59 10/19/84 CDC:CEH!CDD:AOP:PLayde:dd/doc �Minutes of the November 29, 1984 Meeting of the Science Panel of the Agent Orange Working Group The Science Panel of the AOWG met at 9:30 AM on November 29, 1984, in the offices of the United States Army and Joint Services Environmental Support Group (ESG) in room 210, Riddell Building, 1730 K Street, NW, Washington, D.C. Attendees were as indicated on the attached attendance sheet. The purpose of the meeting was to review in depth the procedures to be used by the ESG to assign an Exposure Opportunity Index to individual Vietnam veterans identified from other sources. Since the procedures had been developed during the CDC Birth Defects Study, individual records of Vietnam veteran participants in that study were available for review. Several individual records were selected to illustrate the information available and the method and steps used to assign an estimate of the likelihood of exposure to Agent Orange while in Vietnam. The method used in the CDC Birth Defects Study assigned a value from one to five to each veteran depending on the recorded proximity of his unit to an Agent Orange application while he was assigned to the unit. The value of the assigned index also took into account the particular job classification that the veteran had at the time. For example, a veteran whose job was either clerical, administrative or logistical would not be expected to be with his unit while on patrol away from the base, although he might be expected to serve guard duty on the base perimeter. If exposure consisted of a patrol approaching a Ranch Hand spray track, he would not be included, but if exposure consisted of base perimeter spraying, he could have been exposed. A score of five (highly likely to have been exposed) was assigned to all individuals in a unit which was known to have been within two kilometers within 72 hours of an Agent Orange application and who held military occupational specialties (job classifications) implying that they should have been with their assigned unit on such a mission. A score of five was also assigned to all veterans known to have handled Agent Orange, such as Ranch Handers or chemical personnel. A score of one (very unlikely to have been exposed) indicated that the veteran was assigned to a unit which was neither known nor expected to have been near an application site. Scores of two to four indicated a range of possibility from probably not exposed to probably exposed. Although the methods used to develop these procedures involved considerable subjective judgement on the part of the investigators, a description of the Vietnam experience contained in the records of veterans classified as "very unlikely to have been exposed" seems quite adequate to consider them as much less likely to have been exposed to Agent Orange than those classified as "highly likely to have been exposed". Members of the Science Panel unanimously agreed that the data and methods under consideration are adequate to classify many of the veterans into groups which were highly likely or very unlikely to have been exposed to Agent Orange while in Vietnam. Other methods for assigning intermediate values need to be completed and may best be adopted for specific studies where necessary. �Some of the implications of using the Exposure Opportunity Index as defined above were discussed as follows: 1) Some veterans cannot be classified because their records are not available or are incomplete. It is thought that this will be a small group if adequate search is undertaken. 2) Many veterans, such as would fall in groups two to four of the CDC Birth Defects classification system, cannot be unambiguously assigned to highly likely or very unlikely exposed catagories. Several suggestions as to how to handle these were: a) Classify them as unknown and drop them from further analysis. This would have rendered approximately one half of the Vietnam veterans in the CDC Birth Defects Study as unclassifiable. b) Use five classes (as in the CDC Birth Defects Study) or one or more intermediate classes. This system, would retain larger numbers of classifiable study subjects, but may reduce the statistical power of a study due to missel ass ifications. c) Attempt to classify all veterans with available records into likely or unlikely exposed groups. This is also almost certainly going to increase missclassification and therefor reduce statistical power. 3) The index as currently developed is intended to be a measure of the likelyhood that any exposure took place and presents some problems during analysis since it is not a dose response statistic. Using the computer methods now available, there is the possibility for counting the number of encounters a given unit may have had and trying to estimate the intensity of exposure. There is some support for this since almost all of the encounters which a given unit has had may be recorded in the quarterly reports (at least in those units which have been specifically examined). 4) There is clearly an association between combat and Agent Orange exposure since combat operations are a major factor in determining opportunities for exposure at the individual as well as the unit level. This must be considered in the light of specific study needs e.g., it may not have been relevant for a Birth Defects Study, but may be important in a Mortality Study. 5) While the methods which have been developed do provide for an estimation of the number of opportunities for exposure, there has been no attempt to quantify the possible exposure amount. The index only assigns a value to the likelihood that a given veteran was within two kilometers within three days of an application of Agent Orange. Whether this constitutes an effective toxic dose cannot be determined from the records and is the subject of ongoing health effects research. In order to assist in the usefulness of these methods for future research, a subpanel was assigned the task of developing guidelines for the application of these alternative methods to specific studies. The meeting adjourned at 1:30 PM, November 29, 1984. �, A - 357/ or 4 CASH / st.* 6. A 0 e? -rr U.S. �Department of Medicine and Surgery Washington D.C. 20420 Veterans Administration JAN 3 0 1985 In Reply Refer To: 10A7 Dear Colleague: Enclosed is a copy of the latest version of the Vietnam Experience Twin Study Protocol. These are being distributed at the request of Dr. Carl Keller—he will be in touch with you in the near future to arrange a meeting to discuss his plans for reviewing the protocol. Sincerely, BARCLAY M. (BHEPARD ,* M. D. Director Agent Orange Projects Office Enclosure � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 068 Folder The folder containing the original item. 1835 Series The series number of the original item. Series III Subseries III 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 Keller, Carl Title A name given to the resource Memorandum with several attachments: from Chairman, Science Panel, AOWG, to Members of the Science Panel, AOWG, with subject Meeting of the Science Panel, dated February 5, 1985. Subject The topic of the resource Vietnam Experience Twin Study AOWG 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 080 Folder The folder containing the original item. 2075 Series The series number of the original item. Series III Subseries IV 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/. Date A point or period of time associated with an event in the lifecycle of the resource June 25 1986 Title A name given to the resource Letter: from W.F. Ginnivan to Dr. Al Young, 25 June 1986 regarding Veterans' Affairs memorandum about CDC study Subject The topic of the resource Australia CDC Birth Defects Study AOWG 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 064 Folder The folder containing the original item. 1730 Series The series number of the original item. Series III Subseries III 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 Keller, Carl Title A name given to the resource Memorandum (Draft): Possible Study of Female Vietnam Veterans, from Carl Keller to Edward N. Brandt, August 6, 1984 Subject The topic of the resource veteran health and hygiene study protocol AOWG 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 079 Folder The folder containing the original item. 2038 Series The series number of the original item. Series III Subseries IV 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 Donovan, John W. Title A name given to the resource Letter: to J. D. Erickson from John W. Donovan, June 27, 1984. Subject The topic of the resource AOWG Australian Royal Commission hearings CDC Birth Defects Study international cooperation ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/72b052afa308d2ef9586e3adc75a955f.pdf 63be1bd4bb5e2574fb4ae68f2848d9f1 PDF Text Text Item D Number °2034 Author Young, Alvin L. Corporate Author RBDOrt/ArtiCle Title Letter: to The Honorable Mr. Justice Phillip Evatt from Alvin L. Young, July 13, 1984 Journal/Book Title Year 000 ° Month/Day Color D Number of Images 1 DeSCrlptOn NOtBS Letter is updating Evatt on the Agent Orange activities in the United States, including several studies. Young also expresses his opinion that the Royal Commission must continue its work seeking a thorough assessment of the scientific data so that the most accurate picture and answers can be given to the veterans of both countries. Tuesday, August 07, 2001 Page 2034 of 2084 �EXECUTIVE C OFFICE OF SCIE ,/ - -- OtOGY POLICY WASH^UTON, D.C. 20506 July 13, 1984 Dear Judge: It has been a few months since our last communication. I believe it is important to bring you up-to-date on activities related to Agent Orange. Currently, efforts are underway through the auspices of the White House Agent Orange Working Group, to advance the Veterans Administrations Identical Twins Study (VETS) and the National Institute for Occupational Safety and Health's (NIOSH) Dioxin Registry and accompanying mortality and morbidity studies. In addition in mid-August the Center For Disease Control will release its completed Birth Defects Study. Although, much of the activity involving the Vietnam Veterans and Agent Orange appears, at least in the press, to center on the legal out-of-court settlement activities in New York, the Federal Government continues to press for scientific answers to the critical health questions posed by this issue. The dichotomy is that in the United States we may not get the opportunity to place before the public and the veteran and scientific communities a proper assessment of the scientific information. For that reason, I believe it is imperative that the Royal Commission continues to seek a very thorough assessment of the scientific data. It is only through a process of open and complete scientific dialogue that we can hope to provide answers to the very complicated situation that surrounds the men and women who so gallantly served in Vietnam. I hope that the proposed epidemiologic study, planned during my visit to Australia, can be conducted and the results viewed by your Commission. I feel that a trip to the United States to meet with the research and veteran communities should clearly be taken before the Commission completes its assessment. I will be pleased to assist in appropriate arrangements. Sincer Alvin L.l YoCTng, Ph.D. Senior Policy Analyst for Life Sciences The Honorable Mr. Justice Phillip Evatt, D.S.C. Royal Commissioner Royal Commission on the Use & Effects of Chemical Agents on Australian Personnel in Vietnam G.P.O. Box 4842 SYDNEY, N.S.W., 2001 , AUSTRALIA � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 079 Folder The folder containing the original item. 2034 Series The series number of the original item. Series III Subseries IV 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 Young, Alvin L. Title A name given to the resource Letter: to The Honorable Mr. Justice Phillip Evatt from Alvin L. Young, July 13, 1984 Subject The topic of the resource AOWG Vietnam Experience Twin Study NIOSH international cooperation 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 079 Folder The folder containing the original item. 2030 Series The series number of the original item. Series III Subseries IV 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 Donovan, John W. Title A name given to the resource Letter: to Barclay Shepard from John W. Donovan, 27 June 1984 Subject The topic of the resource AOWG international cooperation ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/4f904ee6bde921600602aec66129b9c8.pdf 2d917d2fec3f208acdd6536c4758daf5 PDF Text Text Item ID Number 01708 Author LeVois, Maurice E. Corporate Author RBPOrt/ArtlClB TltlO Typescript: [Update on study protocol], September 20, 1982 Journal/Book Title Year 000 ° Month/Day Color a Number of Images 3 Descriptor Notes Monday, June 11, 2001 Page 1709 of 1793 �1. On 5 March 1982, the AOWG Science Panel approved a 4 December 1981 DOD/AAQTF conceg<t. _jaaper on cohort selection. Scecifically, what the Science Panel approved was the genera1 jprinicj, ple of selecting battalion, and then company size, military units for exposrue analysis, assigning the company A/O exposure score to each member of that company. If an individual was reported absent on a day when his company received an exposure, that individual's exposure score would be reduced accordingly. This is a departure from the approach suggested by UCLA, in which individual subjects were to be drawn at random and exposure scores developed for each subject individually. 2. On 5 March 1982, the Science Panel states: "The Science Panel will oversee this cohort selection process." The 4 December 1981 DOD/AAOTF concept gaper was clearly not a scientifically rigorous methodological protocol. AOWG approval of that document should not have been construed as a signal to proceed with the actual selection of subjects without first developing a step-by-step protocol with the assistance of the Science Panel and othe qualified scientists. 3. On 10 June 1982, the VA submitted to the AOWG Science ' Panel a memorandum (attached) concerning AAOTF cohort selection activities. That memo alerted members of the �Science Panel to the fact that inappropriate and unapproved decisions concerning cohort composition, exposure criteria, and selection methods had been made independently by DOD/AAOTF. It was the VA's belief that, if the AAOTF proceeded to select subjects as they proposed, their efforts would produce unusable cohorts and no useful data on the feasibility of conducting the larger study. 4. Between 4 December 1981 and 10 June 1982, meetings were held on the topics of Agent Orange exposure and cohort selelction and some important progress occured. °It was generally agreed that a third cohort, roughly comparable to the two Vietnam cohorts could be assembled, if that were called for by the final study design. °A general AAOTP cohort data automation contract was developed by AAOTF. It should be noted that general functional capabilities, not specific data elements, were approved by the VA. °A Ranch Hand mission time/distance exposure matrix was developed. "Methods of equating the different modes of exposure were proposed. Work on this problem continues. "The AAOTF proceeded with work on an augmented "services" herbicide application record. This work also continues. The AAOTF was never asked by the AOWG or the VA to halt work on the documentation of herbicide use in Vietnam. This informiWon is essential to any cohort selelction process. �°On 8 April 1982, a letter was sent from VA Administrator Nimmo to Secretary Weinberger addressing the need for the support and cooperation of both agencies in this research effort, (attached) *J °0n 8 April 1982, a memo was sent by Secretary Scheiker to A Secretary Weinberger, (attached) That memo recommended that DOD assume responsibility for cohort selection in support of the VA study. "On 26 April 1982, Secretary Weinberger issued a tasking memo to the Secretaries of Army, Navy and Air Force authorizing full DOD support of this effort, (attached) "The AOWG Science Panel created a subcommittee to 1. develop an acceptable Agent Orange exposure index 2. develop a cohort selection protocol for the AAOTF. °On 8 September 1982, the Chairman of the Science Panel forwarded to DOD a draft protocol for cohort selection for DOD approval. 5. The AOWG and the VA can not provide the kind of continuous scientific supervision which is required for proper cohort selection. It has become clear that this important, complex and costly effort cannot be adequately supervised by a physiologist. The AAOTF should obtain the assistance of a qualified epidemiologist and/or biostatistician before proceeding with their cohort selection pilot work. � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 063 Folder The folder containing the original item. 1708 Series The series number of the original item. Series III Subseries III 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 LeVois, Maurice E. Title A name given to the resource Typescript: [Update on study protocol], September 20, 1982 Subject The topic of the resource Agent Orange Exposure Study AAOTF study criticism AOWG ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/db66bc9a47f71dfe987d292c6ebd0809.pdf c8096af243b6f4c551649b5f1b6005ae PDF Text Text °1703 Item ID Number Author Corporate Author Report/Article Title Typescript: White Paper: Status of VA Epidemiologic Study of Agent Orange, August 27, 1982 Journal/Book Title Year 000 ° Month/Day Color n Number of Imagoe 2 DeSCMptOn NOtOS "DM&S" typed next to date. Monday, June 11, 2001 Page 1704 of 1793 �DM&S 8/27/82 WHITE PAPER STATUS OF VA EPIDEMIODOGIC STUDY OF AGENT ORANGE The epidemiology protocol originally submitted to the VA by the U.C.L.A. School of Public Health on April 29, 1982, has now been reviewed by the VA Advisory Committee on Health-Related Effects of Herbicides, the White House established Agent Orange Working Group (AOWG) and the Office of Technology Assessment. All of these review groups have noted that further development of the research protocol is needed in certain areas. For example, each of the following topics has been mentioned by one or more of the protocol review groups as needing additional attention: a clear statement of specific hypotheses to be tested; the data reduction and analytic methods to be employed; the rationale for a third cohort; and more exact statistical power calculations associated with these refinements of the protocol. The protocol is currently being reviewed by a committee of the National Academy of Sciences (MAS). The VA has been advised that MAS is now in the final stages of this review process. It is expected that the report will be completed and forwarded to the Veterans Administration by the third week of September. Further refinement of the protocol is underway and should be completed during the month of October. Barring unforeseen complications, a contract for the conduct of a pilot study of approximately 900 veterans (or 300 per cohort) should be awarded in the January-February 1983 time frame. A critical component of the pilot study will be to evaluate the cohort selection procedures and the feasibility of developing cohorts for the full scale study which will be twenty times larger than the pilot study cohorts. This aspect of the protocol was not developed by U.C.L.A. and has become the focal point of recent activity by the VA, the Army Agent Orange Task Force (AAOTF) and the AOWG. The basic issue is whether the military records are sufficiently complete and detailed so as to provide a reliable indicator of �"likelihood of exposure" to herbicides. The present assessment of the records suggest that identifying the cohort with a high likelihood of exposure will be easier than identifying the cohort with low likelihood of exposure. The reason for this is that the present records of herbicide missions, the HERBS Tape, provide a reference point for estimating likelihood of exposure because tracking a company in an area known to have been sprayed with herbicides on a given day can be objectively determined by the records. When looking for units considered "not likely exposed" the record searchers can only assume selected units were not near herbicide targets; a subjective evaluation; thus, they cannot document the absence of exposure to herbicides. It is important therefore to note that misclassifying an individual as to likelihood of exposure can result in "diluting-out" any health effect that may be present and associated with exposure. The AOWG has appointed a subcommittee of its Science Panel to establish procedures for cohort selection for the epidemiology pilot study. The VA has brought in biostatistical consultants to work with this subcommittee and with the AAOTF. The subcommittee is now in the process of preparing its final report to the Science Panel. When this report is forwarded to the VA, a recommendation will be made by the Chief Medical Director to the Administrator as to whether the pilot study will focus only on Agent Orange or whether it will center on the total Vietnam experience with Agent Orange as a major emphasis. The pilot study itself is expected to be a major factor in the final decision to broaden or limit the scope of the full scale epidemiology study. That decision may not be made until the results of the pilot study are available in late 1984 or early 1985. 2. � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 063 Folder The folder containing the original item. 1703 Series The series number of the original item. Series III Subseries III 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 Typescript: White Paper: Status of VA Epidemiologic Study of Agent Orange, August 27, 1982 Subject The topic of the resource Agent Orange Exposure Study AOWG AAOTF study protocol ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/a0107319411c24ad329c9d98088573fa.pdf 820d6cf7d3fcdfe7926cdec1149874c5 PDF Text Text Item ID Number °1695 Author LeVois, Maurice E. Corporate Author Roport/Artldo Title Memorandum: Agent Orange Research Predecisional Memorandum, from Maurice E. LeVois to Administrator, July 29, 1982 Journal/Book TltlB Year 000 ° Month/Day Color r] Number of unages 2 Descriptor Notes Monday, June 11,2001 Page 1696 of 1793 �Veterans Administration Director, Agent Orange Research and Education Office (001E) July 29, 1982 Administrator Slll : " Agent Orange Research Prcdec is iona 1 Memorandum ].. The Ayent Orange epidemiology research protocol has been reviewed and approved, in general terms, by the White House Agent Orange Working Group (AOWG) Science Panel, the Congressional Office of Technology Assessment (OTA), and the VA Advisory Committee on HeaJth~Related Effects of Herbicides. Although some differences remain among the recommendations made by these committees, all three of these review groups support tte idea of including a third cohort to evaluate the effect of the "Vietnam experience" on the health of veterans. vi 2. The AOWG strongly endorses the three cohort research design as an effective means of evaluating the health effects of both the Vietnam experience and of exposure to Agent Orange. 3. The three cohort research design may have far reaching implications: a) A third cohort will increase the cost of the study by nearly 50%; b) A throe cohort study design will increase the total number of hypotheses to be tested and, therefore, will increase the probability of finding both real and chance effects; c) Specific risk factors or exposures will be impossible to identify in the "Vietnam experience" portion of the study. Flealtii problems found to be associated with Vietnam service niay require further research to identify causation and establish the relative increase in risk for each health problem; d) For the purpose of compensation, the assumption of exposure to a general health risk factor by anyone who served in Vietnam, without requiring documentation of a specific exposure, may include very large numbers of veterans. This also applies to the process of compensation based upon Agent. Orange results; *•) If common health problems are found to te weakly associated with Agent Orange or service in Vietnam (i.e. only a slight increase in relative risk) then the VA may want to consider an "attributed risk" formulation for compensating veterans. 4. It is your decision whether or not the VA will conduct a study of three or only of two cohorts, Public Taw 97-72 states that you "may" broaden the scop} of the study to look at the general health effects of service in Vietnam, You rrwy also limit the focus of the study to the Agent Orange issue. �'there are a nurnter o£ options available to you: a) Broaden the .scop:; of the study by including a third cohort as the AQWG recommends. This option appears to be consistent with the wishes of the veterans" service organizations and the Congress; b) Limit the scope of the study to the health effects of Agent Orange exposure and study only two cohorts. The U.C.L.A. authors of the research protocol recommend this option on scientific grounds, but do not present: a strong argument for their position; c) Proceed with plans for a pilot study contract based upon three cohorts. If the National Academy of Sciences (NAS) ^review group recommends against the three cohort design drop the third group and re-negotiate the pilot study contract; d) Proceed as in c) atovc. If NAS agrees that a three cohort study is appropriate, then the pilot study can be used to evaluate the feasibility of the three cohort design. Participation rates may be lowest for the third, non-Vietnam, cohort. If. fewer titan 70% of the potential subjects in that group participate in the pilot study, the third group may have to be dropped from the final design for statistical reasons; e) Ask the VA Advisory Committee on Health-Related Effects of Herbicides and the VA Policy Coordinating Committee (PCC) to consider the three cohort design issue and provide you with their independent recommendations. MAURICE E. r.EVOlS Director, Agent Orange Research and Education Office � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 063 Folder The folder containing the original item. 1695 Series The series number of the original item. Series III Subseries III 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 LeVois, Maurice E. Title A name given to the resource Memorandum: Agent Orange Research Predecisional Memorandum, from Maurice E. LeVois to Administrator, July 29, 1982 Subject The topic of the resource Agent Orange Exposure Study AOWG study criticism study protocol ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/99ce5314cd52c9e588a3a52f8c3ae102.pdf 89fec2c94c996592c00243a2d2b682c8 PDF Text Text Item ID Number 01694 Author F| nn Peter A y ' - Corporate Author Report/Article Titlfl Memorandum: VA Pilot Study Cohort Selection by the Army Agent Orange Task Force (AAOTF), from Peter A. Flynnto Chairman, White House Agent Orange Working Group, July 19, 1982 Journal/Book Title Year °00° Month/Day Color ' Number of Images 2 Descrlpton Notes Monday, June 11, 2001 Page 1695 of 1793 �JUL 1982 MEMORANDUM FOR CHAIRMAN, WHITE HOUSE AGENT ORANGE WORKING GROUP SOBJBCTj VA Pilot Study Cohort Selection by the Arny Agent Orange Ta»k Forc« (AAOTP) As you know, wh«n th« AOWG gave the VA the go~ah«ad to proceed with their pilot epideialo logical study, we in DoD coiaraitted ourselves to the AOWG to »e«tiny th«a January 1, 1903, date by which the VA estimated it would ne«d naraaa for the study. This date waa passed to the AAOYF and, as they had agreed in advance, they began to work immediately. That date was felt to be a reasonable on« with the programed personnel on board, in frtw K«antiB@, we had secured additional active duty personnel frota th<? Air Force, Navy and Marine Corps as we had said we would. The approach to the records u@«d by the AAOTF was basted on decisions of the Science Panel of th« AOWC and sora« announced asauraptions on our part whore there were no fira guidelineo. Discussions over the last month have made it apparent that there remain serious unresolved issues with regard to the 0CLA protocol in both its scop« and focus and in regard to ao£t« aspects of cohort selection. While the AAOT7 has been making excellent progress, th«re is now a substantial likelihood that the cohort selection process may not fully meet the VA's desires which ar« still being articulated by the VA. Accordingly, I have directed the AAOl'F to suspend its pilot study cohort selection activities until such ti»« as the aforementioned issues are resolved and the AAOTf can b« given clear and confirmed narching orders. We and th« AAOTF stand ready to assist those individuals and groups who are working with the protocol, particularly in those areas where thft records have a direct bearing on what is possible in tho way of data extraction. When definite new directions arcs aade available, we will, of course, immediately resua« the selection process for the pilot study. It is clear that the January 1, 1983, date can no longer be aet« A new date will have to be set depending on when we corasence work and the scope of the required records work. �As a matter of incidental interest, the AACTF lias briefed tm> National Academy of Science review personnel as requested by the VA. We continue to stand ready to be of all possible assistance with this important study. S16HIB P«t«r A, Plynn Captain, J1C, QSN Director for Professional Servicoo cc; Mr. R. Christian, AAOTF Dr. Vernon Houk, CDC, Science Panel Cbairwan Dr. Carl Keller, Research Panel Chairman HAFile/Reading/Chron/HRMChron COORDINATJOH; Plynn/dcs/16Jul82/0788d Dr. Bricker � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 063 Folder The folder containing the original item. 1694 Series The series number of the original item. Series III Subseries III 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 Flynn, Peter A. Title A name given to the resource Memorandum: VA Pilot Study Cohort Selection by the Army Agent Orange Task Force (AAOTF), from Peter A. Flynn to Chairman, White House Agent Orange Working Group, July 19, 1982 Subject The topic of the resource Agent Orange Exposure Study AOWG study criticism study protocol ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/cf559abc9397fcc381c86059207b4e20.pdf b55a20462fc1f2aeba9e56b7c99f5c16 PDF Text Text Item ID Number °1684 Author Spivey, Gary H. Corporate Author Roport/Artldo TltlO Review of the Draft Protocol for Epidemiological Studies of Agent Orange Journal/Book Title Year 000 ° Month/Day Color Number of Images D 22 Descriptor Notes Wednesday, June 06, 2001 Page 1685 of 1688 �SUBJECT: Review of the Draft Protocol for Epidetniological Studies of Agent Orange Submitted by Gary H. Spivey, M.D., MPH, Principal Investigator Rogert Detels, M.D., MS, Co-Principal Investigator Division of Epidemiology School of Public Health University of California Los Angeles, California Attached please find the individual comments of members of the Science Panel of the Agent Orange Working Group. Basically, every member expresed concern about the lack of details in the protocol to the point that it is not possible to constructively review the proposal. . The following paragraphs taken from comments submitted by individual members highlight these concerns: General Comments 1. "While we certainly appreciate Dr. Spivey1s concern that release of certain specifics of his anticipated protocol might induce bias in the eventual study, we cannot provide an effective analysis of a protocol without such information. We suggest that at least a small subcommittee of the Science Panel be supplied with all of the details of the protocol and that the report of this subcommittee be held in confidence and not be released to the general public. We believe that an informed evaluation is absolutely essential before any further action is undertaken to initiate any subsequent studies." 2. "The section on proposed outcome measures is particularly weak. The statement that an examination will be done because '...the veterans will expect a physical exam1 is inappropriate. The inclusion of special examinations for individuals with recognized disease unrelated to Agent Orange, for example, an examination of the eye backgrounds and peripheral pulses in subjects with a history of diabetes mellitus is of questionable value in such a protocol. At the same time the protocol ignores entirely the neurological examination, which both animal and human data suggest may be of importance. "Statements such as the one included on page 9 which opines that chloracna is a 'self-limiting skin condition' raise further questions about the authors' full understanding of the potential health effects of dioxins. Chloracne can be a severe skin condition that in some individuals is persistent for years even following discontinuation of exposure. The statement on page 18 that 'Chloracne is the only established health outcome associated with dioxiri exposure1 is not justified." .3... "It is clear that the current UCLA protocol is inadequate. Therefore, a study is yet to be designed and conducted. Overall, it is our opinion that two important factors must be present for the design and conduct of �a study. First, it is critical that adequate epidemiologic expertise be • available within the Group or Agency which assumes responsibility, and second, there must be continuous interface with and cooperation from the DOD and VA so that details of records and activities during the Vietnam War are accessible to the researchers. "Finally, any delay dependent upon further review of this UCLA protocol should be avoided due to its incomplete nature. Any further review should be postponed until an appropriate scientific protocol based upon a complete iteration of exposure data and veterans' data is available." 4. . "In summary, prior to any further attempts to design a study on Vietnam veterans, it is recommended that the Veterans Administration review the morbidity data they have collected thus far, that the Department of Defense establish information on exposure data and determine what the sizes of prospective cohorts might be, and that the Veterans Administration embark on a mortality study. Since any outside group is unfamiliar with the record keeping system of the military, it would be redundant, wasteful, and time-consuming to have outside groups do this preliminary work for the military." Specific Comments Exposure 1. "I am deeply troubled by this aspect of the report. On page 43, the authors correctly surmise, 'We have not identified a mechanism which would document actual exposure.1 Over the past year in our Committee, as well as the Agent Orange Working Group in the White House, we have wrestled, frankly unsuccessfully, with trying to establish some mechanism for documenting exposure. I recall clearly our meeting with the members of the National Academy of Sciences and their comments regarding any proposed epidemiological study on Agent Orange exposure in Vietnam. The take-home message was, 'If we cannot scientifically validate and document exposure, we cannot do a scientific epidemiological study.1 Although Spivey's approach suggests a mechanism by which we might overcome this problem, I suspect we are justifiably due some criticism for the grouping approach. I am now persuaded that we will never be able to do an epidemiology study on individual veterans per se, but must examine military units serving in specific spray areas. There is now some hope from recent DOD activities that we might be able to document some segments of the military population in Vietnam exposed to Agent Orange. Every effort then must be made to work closely with Mr. Christian and his associates in DOD in meticulously reviewing records and films to establish some case for exposure. I recommend we do not fund any additional feasibility studies until a thorough and comprehensive search and cataloging of available DOD records, films, and reports are completed." 2. "In conclusion, I atn not convinced that significant ground troop exposure to 2,4,5-T containing herbicide occurred as a result of aerial application. Other uses of the herbicide most likely represented a greater exposure. Additionally, the study must address the question of did the Vietnam �conflict participant incur a health decrement risk over and beyond that which was expected and secondly, if a risk was incurred, is it service connected? This protocol requires greater examination of the exposure criteria and further discussion and refinement." Use of Terminology "Definition of Antipersonnel gas: Riot agents such as GS and CN used in Vietnam were not antipersonnel gases since they do not kill or incapacitate for an extended period of time. Both CS and CN have been used throughout the world by civilian police to control riots of civilians and in prisons without causing fatalities. This improper definition should be corrected. "The substitution of 'riot control agents' in place of 'antipersonnel gases' is suggested." Conclusion The members of the Panel had many other specific comments and only some of their major concerns were quoted here, -ft—a-ppears that" the present proposal is inadequate and it is recommended that a course of action be developed that will not cause any further unnecessary delays in attempting to answer questions about health issues of Vietnam veterans. A specific protocol should be -"Allayed in which the size of the cohorts and their perceived exposures are characterized and which will serve as the basis for the studies. �>;&W>*&^i(&X^ **iic«S»S*v.^ A The major concern we have with this draft document is the lack of detail provided by the authors in describing the protocol itself. This lack of detail makes an informed critical review impossible. The investigators state that a detailed protocol is not provided due to their inability to examine all relevant military records on which the studies would be based and also because of potential bias they fear might result from premature public release of a detailed study design. The quality, scope, and availability of military records on Vietnam veterans in addition to the ability to locate individuals in a time - space frame in Vietnam have previously been major issues with regard to developing an epidemiologic protocol. In our view, an adequate protocol requires a clear and detailed evaluation of those military records that are available. While a preliminary feasibility study might be indicated to evaluate the procedure of establishing cohorts with differing exposure levels, a detailed and clear understanding of what records are available may make this unnecessary. A thorough evaluation of those records that exist, what the records contain, and how they might be used in establishing appropriate cohorts must be performed before any protocol can be properly reviewed. We also strongly disagree that the full protocol should be withheld due to potential bias. It is important that the full protocol receive adequate peer review due to the importance of the investigation. The publicity which currently surrounds the study has already influenced those individuals who will eventually be included. A full presentation of the protocol in our view would have little further adverse impact. To withhold pertinent details may cause far more harm by seriously damaging public confidence in the credibility and independence of the study. ... ,. ..--.. We do not agree that the "historical cohort study" should be limited to draftees and one term enlisted men. Excluding individuals with longer service will undoubtedly exclude some individuals with the greatest potential exposures. Inadequate detail is provided about cohort selection by the authors. Full and extensive discussion of the HERBS data, of the nature of troop movements through Vietnam, and the pattern of likely exposures are critical in evaluating the protocol. There is a fair amount of information offered on environmental persistence of agent orange, but no assessment of how the data affects presumed exposure to ground troops. The concept of establishing low to high exposure groups based on a "time - place - company exposure grid" is too vague as presented and it is not clear that the authors have a fundmental understanding of the core issues which need to be addressed in establishing such cohorts. The sections in the protocol>on potential confounding variables and control groups are both non-specific and short on detail. The section on proposed outcome measures is particularly weak. The physical examination in our view can be a significant factor in this study in determining ill health, since the potential end organ toxicity for a number of organ systems can be identified and specifically evaluated through a physical examination. The statement that an examination will be done because "...the veterans will expect a physical exam" is inappropriate. The inclusion of special examinations for individuals with recognized disease unrelated to agent orange, for example an examination of the eye grounds and peripheral pulses in subjects with a history of diabetes mellitus is of questionable value in such a protocol. At the same time the protocol ignores entirely the neurological examination, which both animal and human data suggest may be of importance. �Statements such as the one included on page 9 which opines that chloracne i is a "self-limiting skin condition" raise further questions about the authors' ! full understanding of the potential health effects of dioxins. Chloracne can I be a severe skin condition that in some individuals is persistent for years ] even following discontinuation of exposure. The statement on page 18 that "chloracne is the only established health outcome associated with dioxin exposure" ! . is not justified. The authors have devoted considerable effort to giving a review of basic epidemiologic principles and a superficial review of toxicity information. While this information may be of interest as introductory material, the critical task of-the contract was to establish a thorough, detailed, and scientifically "~"fc. defensible protocol. "•••;'s;»;;i'-h:'"ii'...; :::j;PK.::^::':^ :^.Ex2rr::;v::r^ ^^ It is our opinion that the current draft protocol is inadequate as presented and that a major effort will be required to develop the protocol to a point where further peer review can be meaningful. ;: We look forward to working with the Science Panel in responding to the VA on this important proposed study. ••" " " . . 1. While we certainly appreciate Dr. Spivey's concern -that release of certain specifics of his anticipated protocol might induce bias in the eventual study, we can not provide an effective analysis of a protocol without such information. We do not support blind trust in the correctness of Dr. Spivey's deductions and selections. We suggest that at least a small subcommittee of the Science Panel be supplied with all of the details of the protocol and that the report of this subcommittee be held in confidence and not be released to the general public. We believe that an informed evaluation is absolutely essential before any further action is undertaken to initiate any subsequent studies. 2. The following comments are provided with references to paragraphs and stamped page*numbers at the bottom of each page: a. Pg. 007, Para. B, Method: HERBS data. This has already been defoliation missions with separate Veterans Administration has such a Calls for Computer mapping of accomplished for both cropland map overlays by year. The set of overlays. b. Pg. Oil, Last paragraph:' Our records show that all fixed wing missions using herbicides blue and white were not stopped until 31 October 197.1. The last helicopter mission with Herbicide Orange was recorded on 9 June 1970. All fixed wing defoliation missions with Orange ceased on 16 April 1970. The same paragraph neglects to mention that.herbicides were also sprayed along the sides of rivers, roads, and communication lines to prevent cover to the enemy. �c. Pg. 020, 1st Para.: For possibly highly exposed personnel he might also wish to include chemical unit personnel at battalion level charged with spraying base camp perimeters, riverine personnel who sprayed the edges of rivers, and other personnel involved in cleaning up herbicide spills after accidental releases. d. Pg. 040, Ques. 1 posed: The discussion here is extremely limited and does not mention the fact that many personnel both Orange and non-Orange exposed may have had prior exposures to TCDD through agricultural or home use during childhood and adolescence. There is no reason to believe that commercially available herbicides did not also contain TCDD. In fact, during the period when these young men were children the TCDD concentrations in such compounds may have been higher due ..to lack of perfection in the manufacturing process. We believe this should be looked into and also considered. If such is the case then an "unexposed" guaranteed population of young adult males of that period may be impossible to find. We are now researching the use of 2, 4, 5-T at posts and stations here in the United States and overseas. Because of the long latent period for carcinogenic effects, perhaps those persons claiming effects such as testicular cancer may be reaping exposures which took place while in childhood here in the United States and having nothing to do with Vietnam service. Similarly, prior exposures to other toxic environmental hazards may now be showing up as diseases in the Vietnam veteran population. No mention is made of possible other exposures to dioxin containing substances such as pentacholophenol wood preservatives and hexachlorophene used in surgical germicidal soaps. Thus unexposed Orange troops may have gained dioxin exposure from other sources. Likewise, a veteran who served in Vietnam say from 1967 to 1968 has had 12 years in which (depending upon his civilian work environment) he may have been exposed to several other toxic and hazardous compounds that are now producing disease symptoms and which have no relation to Herbicide Orange in any way. e. Pg. 041, Ques. 2, Other Exposure: Attachment 1 to these comments lists possible other exposures encountered by military members serving in Vietnam. It is by no means an exhaustive list. We agree that these additional sources of exposure to various substances and disease entities may be very important confounding factors in relation to sorting out primary effects caused by exposure to Herbicide Orange. f. Pg. 043, Ques. 5: Comparison to veterans who served in Korea and World War II may be exceptionally difficult since many if not most of the personnel records were destroyed in the St. Louis Records Center fire. g. Pg. 047, 1st line, 1st paragraph: Suggest substitution of "riot control agents" in place of "antipersonnel gases." �^ f ' & s ^ S f Q e S ^ & S ^ ^ ; h. Pg. 049, Para. E.I.: Why will the study be limited to draftees and one term enlisted men? Why not include young troop commander officers and senior enlisted personnel who were in the field? Follow-up physical examination records for career enlisted and officer personnel would probably be much more extensive and easily obtainable than from civilians who left the service at the end of one enlistment. i. Pg. 052, Para. 3, Estimation of Exposure: We see no reason to construct a second exposure index involving a long term environmental persistence as many.studies have been already directed at herbicide persistence, especially considering the high rrtobility of the troop populations while in Vietnam and decay studies of herbicides and TCDD such as Seveso. Also supporting this contention would be the long terra studies conducted at Englin^Air Force Base at the loading hardstands where there was exceptionally high concentrations of Herbicide Orange spilled and trapped in the ground. j j. Pg. 052, last para.: What is proposed in this last paraj graph and onthe following page can amount to millions of dollars ,;• of labor time to locate a defined population with respect to the : HERB tapes. The already accomplished Battalion studies conducted .1 by the Army and the Marine Corps have pointed out how laborious and time consuming such a massive effort would be. The major fallacy of such a study would be that the-major source of contamination and/or exposure to ground troops may not be from fixed wing Ranch Hand spraying. This is because of entrapment of the herbicide in triple layer tree canopys, rapid absorbtion of the herbicide into plant leaf tissue, vaporization of the spray above the jungle canopy, rapid decay of dioxin due to photo degradation (less than 6hr.half-life), and low or nonexistent volatility and very low solubility of dioxin in water. A probable source of much higher contamination would be from spraying of herbicides around the perimeters of camps and fire bases through the use of helicopters, truck mounted decontamination spray units, backpack hand sprayers, and Buffalo turbines. These types of perimeter spraying are very poorly documented at best and only a tiny fraction of all helicopter spray missions are documented in the HERBS tapes. Couple this lack of data as to amounts, type and dates of perimeter spraying with the already proven difficult task of placing troops with respect to physical location by each day of the year at a specific grid location and we have a very "iffy" situation at best. What the author advocates in no way seems to be a solution. Finally after 18 months neither the Science Panel nor anyone else has been able to establish just what constitutes an "Exposure" to Herbicide Orange. k. Pg. 053, Para. 4, Establishing Cohorts: In this discussion we assume the -author is referring to single or multiple exposures from Ranch Hand flights over or near the selected company. There are many problems to this method of counting on a company and its personnel being at a certain place at a certain time with respect to an overflight by Ranch Hand aircraft. To name a few, we have the following: �(1) In the case of Marine records the troops were carried on the Morning Reports (MR) as either Killed in Action (KIA), Wounded in Action (WIA), Missing in Action (MIA), present for duty, or transferred. Hence minor disabilities were not entered ' in the MR and consequently a Marine may have remained in base camp while his platoon was out on patrol. (2) Companies did not necessarily operate all together and stay together. Marine units very frequently operated in small 'patrols and platoon size units. Documentation as to their day-to-day locations are very poor. In one Marine battalion study for a .two month period only 4 exact unit locations could be determined for an operational area of 10km long along route 9 and width of 6.5km back from each side of this. road. We know that patrols roamed all over this area to protect the security of the .route from enemy ambushes but it is impossible to fix company, platoon, or squad locations during this time. (3) In the case of the 1st. Cav. units, platoons would , be detached from a company for a period of time and assigned to '• another infantry battalion far from the operating location of thie 1st. Cav. parent company. (4) In air mobile operations, it was not uncommon to have helicopters drop a platoon of men into a landing zone and then the platoon would go into a search mission through the jungle with no documentation as to their day-to-day location. Finally one or more days later the platoon would reassemble at the landing zone and be airlifted out. In the mean time the rest of the Company would be at the base camp or operating in other areas. (5) We have also found that there are errors in the morning reports regarding the duty status of individuals. It has been observed that as long as six months elapsed before a correction was made to pick-up or drop an individual. Similarly some people may have been detached from the units for short periods of time (several days) without this showing up in the Morning Report. We know of one case of an individual whose body was in the mortuary in Tan San Nhut and his unit was unknown for quite a while. When his unit was contacted they thought he was still with them until they made a detailed search. He was, of course, being carried on the Morning Report as present for duty although he had been dead for several days. We cannot trust the validity of these combat records in all cases. (6) There was also a very high thruput of.personnel in the Army battalions studied. For a battalion of about 971 persons over 2,300 personnel served for varing periods of time in the one year period which was studied. 1. Pg. 063, last para.: It seeins wise to mention that a preliminary review cost for pulling a record at the St. Louis Records Center and determining minimum locator information will be $5.17 per record. More detailed research could run the bill up and overall costs of a major search could be very very expensive. �m. Pg. 069, HERBS Tape Mapping: The National Academy of Sciences report "The Effects of Herbicides in South Vietnam" Part A, Summary''on page IV-104 shows just such a mapping as is desired to be accomplished. We understand that it took the computer at least 5 twelve hour runs to produce these maps. Why should they be done over as they were made directly_from the HERBS hard copy reports and should be available. This is a very costly process to duplicate. As may be seen from the referenced page, each spray track is shown on the map with the date of the mission, number of gallons sprayed and the type of herbicide. (Attachment 2 enclosed) ^ ~ -.;; ^sssssz?..*' n. Pg. 070, Major portion of page: This is an idealized approach and is not at all typical to many units operating over there, especially those which were air mobile, or to Marine . units. We determined this when we looked at the same Marine battalion that GAO had said was right under a spray track. In one of the battalion studies no detailed unit records were found for an entire six month period. ~ o. Pg. 089, 1st new para.: As mentioned earlier detailed personnel records for Korean veterans may not be available because of the St. Louis records center fire. We understand reconstruction (costly) of about 35% might be possible. One major factor has been overlooked in a possible comparison between Vietnam and Korean veterans and that is Korea was not in a jungle environment and units operated as units. Winter fighting was common in portions of the Korean war while Vietnam was in a jungle environment with many different types of disease exposures and small unit operations involving living off the land. Korea was not a s>. unpopular as Vietnam. p. Pg. 249, Definition of Antipersonnel gas: Riot agents such as CS and CN such as used in Vietnam were not antipersonnel gases since they do not kill or incapacitate for an extended j period of time. Both CS and CN have been used throughout the j world by civilian police to control riots of civilians and in i prisions without causing fatalities. This improper definition / should be corrected. ""' q. Pg. 249, Definition of Battalion: An idealized definition, not. necessarily true in Vietnam type combat operations. �As you requested, we have reviewed the "Draft Protocol for Epidemiologic Studies of Agent Orange", G.H. Spivey and R. Detels, U.C.L.A., submitted to the Veterans Administration (contract V101 ( 3 P-842). 9 ) It is our understanding'that the purpose of the contract was to procure an epidemiologic protocol outlining specific plans for the study of Vietnam Veterans exposed to Agent Orange. The protocol submitted, if it is a final product, does not fulfill this goal. It is diffuse and nonspecific and does not outline an approach particular to the problem being addressed. In fact, numerous epidemiologic approaches to the study of veterans, are outlined, as are numerous hypotheses which could be tested. Not included, however, is a clear discussion of benefits and drawbacks of various approaches, and a clear recommendation for a study addressing this issue. The authors of the protocol note a number of problems which they encountered including access to military data and the issue of bias if specific plans for a study of Veterans a_re publicly discussed. To these problems should be added the very limited time which the contractor had to fulfill the assignment. The question of scientific bias, however, should not continue to be a deterrant to the development and outline of specific plans for a study of the Vietnam Veterans. In fact, any protocol for such a stiidy should be specific and receive the widest review possible before a study is initiated. In response to Senator Cranston's letter, it is clear that the current UCLA protocol is inadequate. Therefore, a study is yet to be designed, and conducted. Overall, it is our opinion that two important factors must be present for the design and conduct of a study, regardless of what Group or Agency specifically carries out these tasks. First, it is critical that adequate epidemiologic expertise be available within the Group or Agency which assumes responsibility, and second, there must be continuous interface with and cooperation from the DOD and VA so that details of records and activities during the Vietnam War are accessible to the researchers. k ael?end<int " ° further review of this UCLA protocol P° should be avoided due to its incomplete nature. In uarHo.lar-P the National *ca<toay of Seizes should be P^tponed^t 1 « �This review represents my own personal assessment of the protocol and does not represent necessarily a. (Department jposition. Several fundamental comments are provided in the way of general criticism. More specific, perhaps less important, thoughts are then attached, Atch 1. a. Confidentiality of Protocol Design Since premature public disclosure could potentially jeopardize the validity of the study, it is agreed that certain specific details of the protocol design requires restricted public access. However, this scientific panel must obtain a more detailed discussion of the study design. The Veterans Administration must develop a mechanism which preserves the validity of the study while providing adequate scientific peer review. Functionally it would be preferable to have the detailed protocol made available .to this panel with a follow on discussion with Dr Sprivey and the other principal designers some weeks later. b. Definition of the Fundamental Question to Be Answered. The Vietnam veteran through some form of "collective wisdom" perceives himself to have suffered an abnormal, unexpected health decrement either in himself or his progeny following his participation in the Vietnam conflict. One cannot determine why this "collective wisdom" has singled out Agent Orange as the causative .factor. However, the "collective wisdom" of a group of persons occupationally exposed has often times proved correct. Subsequently,'the scientific community has then through rigorous examination determined the cause of the observed decrement. I have not come to a conclusion regarding Herbicide Orange, the "collective wisdom" of the veteran may prove to be correct on both counts i.e. health decrement and cause. However, close examination of the "occupational environment" of the Vietnam conflict does not easily reduce to a single factor of exposure but rather reveals a multiplicity of exposures which singularly or in combination could produce the decrements described. The fundamental question to be answered by the VA study is: . Did the Vietnam conflict participant incurr a health decrement risk over and beyond that which was expected and' secondly if a risk was incurred is it service connected? The Congress, perhaps naively, tried to address this question by directing the VA to conduct an epidemiology study. Approximately a year later the Congress had gathered additional information on the Vietnam experience. While not yet an act of Congress, the newly proposed legislation has enjoyed wide acceptance and support. . The so called broadening of the VA study to include other possible causitive factors was supported by this'scientific panel. �Dr Spivey has concluded that "the original Agent Orange question, # 1 page 30, addressed with suitable safeguards for confounding by other exposures and factors, would seem to be the most appropriate for this study". His discussion of this narrowly definded question leave's the impression that a true decrement may go unrecognized and that sequential study of other narrowly defined exposures may be necessary to determine the existence of a health risk. The Government and the veteran wants an answer to the broader question in terms of what diseases and health decrements are in excess of the norm and is the excess, if it exist, service connected. For the purpose of prevention of future disease the identification of the causative factor becomes useful. Dr Spivey's discussion of the broader question, fno. 4, page 33, implies that the discrimination of an effect would not be decernable. A properly .designed study could examine the existance of disease excess in both broad categories of impacted systems and specific disease end points. Identification of exposure factors could be examined by use of a regression matrix. The use of multivariate statistics may be ideal in this study design instance. Further, a group of reasonably informed individuals could develop a list of major independent variables (occupational and environmental exposures) which given present state of the art knowledge represent potential risks to human health singularly or in combination. c. Exposure Criteria The Spivey design if adopted would be largely dependent on an exposure which at this reading admittedly lacked definitive objective criteria. Sole reliance on the Herbs tape and troop headquarters location assumes that the aerial spraying of herbicide was the principal route of exposure to 2,4,5-T containing herbicides. This method functionally ignores the application of herbicide by means other than aircraft and helicopter. Additionally, it fails to observe the possible presence of other 2,4,5-T containing herbicides 'which may have been used by local commanders. The various agencies were free to procure these herbicides through the Federal supply system; the General Services Administration (GSA) regularly negotiated contracts with private companies. Only the tactical herbicides were controlled and even then local commanders obtained these herbicides probably by barter. A list of commerically available 2,4-D and 2,4,5-T herbicides is attached, Atch 2. It is not known how many of these were procured by the GSA. Attachment 3 lists some Federal Stock Numbers (FSN's) which were 2,4-D and 2,4,5-T containing herbicides other than Herbicide Orange. If Herbicide Orange is the causative factor for the health decrements claimed, the aerial application was not necessarily the significant route of exposure. While the quantities applied aerially were massive, the ground troop proximity was not sufficiently close to represent a significant exposure. A more likely exposure would have been 'the local application of herbicide to base perimeters and associated undesirable vegetation. Here some ground troops were immediately adjacent to the spray. This is not to say that in certain instances that the Ranch Hand aircraft application of herbicide to base perimeters didn't occur. There is reason to believe that base perimeter spraying by Ranch Hand did occur. �Lastly/ if the Herbs tapes are to be used to establish exposure then a consistent objective exposure model needs to be developed. Such a model must consider wind direction, altitude of dispersal, air temperature, particle size, volitility of the herbicide and the type of vegetation targeted. If ground troops were not directly below -the spray path, then the above parameters become important in determining what residual material may have been inhaled by personnel located some distance away from the spray path. Obviously the greater the distance the less the concentration of exposure. However, a simple plume dispersion model may not be appropriate since local vegetation would intercept the mist/vapors and incident radiation may degrade the level of TCDD. It is suggested that local weather information be used if available. Failing that, simplifying assumptions could be made using seasonal information. Development of this methodology may not prove definitive but would most likely describe reasonable bounds for exposure. d'. Proportionate mortality study This short term study proposed by Dr Spivey's group has merit. The proportionate mortality study should be undertaken even though the results may be less than definitive. ln conclusion, I am not convinced that significant ground troop exposure to 2,4,5-T containing herbicide occured as a result of !, aerial application. Other uses of the herbicide most likely represented a greater exposure. Additionally the exposure to other occupational and environmental factors present in Vietnam represent equivalent in greater risks of chronic disease. The study must address the question of did'the Vietnam conflict participant incurr a health decrement risk over and beyond that which was expected and secondly, if a risk was incurred, is it service connected? This protocol requires greater examination of the exposure criteria and the futher discussion and refinment of \question number four, page 33. 3 Attachments 1. Specific Comments 2. Formulations Containing 2,4,5-T �^ Specific Comments 1. Design of a Study Using Vietnam as the Exposure Criteria The concept of a factorial experimental design could be used to establish as independent variable matrix. This matrix could have incorporated within it the Agent Orange exposure as well as exposure to such factors as Dapsone, pentachlorophenol, other 2,4-D and 2,4,5-T herbicides, Malithion, illicit drugs, alcohol consumption, riot control agents, DEBT and smoking. Variables which are not quantitative or quantifiable could have digital descriptors applied as indicators of exposure. The dependent variable matrix could access categories of disease or specific disease end points. The independent matrix could then be used to predict disease outcome via miltivariate regression. If significant relationships were found, examination would be required to determine plausibility before causation could be assigned. The control group of non Vietnam veterans would have similiar independent and dependent matricies developed. A comparison of the two dependent matricies would examine the question of health decrement over and beyond what was expected. All persons in the study matrix would receive a study questionnaire and have their military and private medical records examined. A random number of personnel in the large matrix cells would be selected for physical examination. The objective physical examination findings would flesh out and validate the independent" and dependent matricies. Should significant health decrements be found in certain matrix cells, additional cell members would be physically examined to validate the initial findings. Mortality analysis of the full cohort would be undertaken. 2. Personnel to be studied While the greatest involvement of personnel did occur in the time period 1965-1972, the greatest concentration of TCDD in 2,4,5-T containing herbicides occurred prior to 1965. Any exposure criteria uniformly applied across the years of involvement would indicate that .early year personnel would have been exposed to greater levels of TCDD. Also, it would seen advantageous to include people who had multiple year exposure. Personnel who voluptered to go to Vietnam should be included in the study. If desired the differentiation of volunteer/ draftee and enlis.ted/officer personnel could be entered into the independent variable matrix. The illicit drug and alcohol habits of the four possible groups may have been different. �:£i:ji!iKVfcV^^ Note: The Marines had a policy of. no hard liquor while in Vietnam. It is unclear if this was for all Marines. 3. Cost of Study At ,the present time cost is not a consideration of study design. Only after the best possible scientific design has been established must a judgement be made to accept the anticipated cost. In this case it could seem cost acceptance becomes the ultimate burden of the Congress after the Veteran's Administration describes what can or cannot be done scientifically. 4. Assessing Herbicide Orange Exposure by Questionnaire This technique frequently used in an occupational setting is extremely risky in this case. Since the same aircraft sprayed White and Blue, the recollection of a study participant that a plane or helicopter "flew near or over him spraying something" will not establish exposure to Herbicide Orange. The additional observation that a camouflaged aircraft was used doesn't narrow the possibilities. The first Ranch Hand planes sent to Vietnam for defoliation had bright silvery skins. 5. Active Duty Deaths One should not assume that an active duty death occurring within one year was due to traumatic battle injury. Additionally, the fact o_f contributory cause may be important if the immune system were compromised. Lastly some deaths may have occurred as a result of disease only. �i^/w^.^&rtSi^i&fcC'rt.U.i.^yS^^ 67346 . 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Trinoxol ' Butoxyethanol ester 59.7# act. ing. 1*2.9$ a.e. k Ib/gal Trinoxol Super 6 Butoxyethanol ester 2h.3% a.e. 2 Ib/gal • 8 . $ act. ing. 15 58.5£ a.e. 6 Ib/gal 57.2£ act. ing. lil'.Qfc a.e. h Ib/gal . £8.3^ act. ing. ijl.9^5 a,e« h Ib/agl Weedone 2,li,?-T ,3?pcial Air Snray Formula Butoxyethanol ester £8.7^ act. ing. 1^2,2^ a.e. it Ib/gal Weedar 2,h,?-T Triethylamine salt Weedone 2,!t,^-T Butoxyethanol eater gjlt-D and 2,>-t,£-T mixtures Dinoxol Butoxyethanol-ester Emulsamine HK •' Alkylamine salts ./' ' '• Dinoxol Super 6 Butoxyethanol esters Emulsaverb 100 acid 't anune salt F^nulsavert 2h8 acid & amine salt 2,i;~D 3 . a.i. 21.75? a.e. 2 Ib/gal 1^ 2,U,5-T 30.2£ a.i. 21.735 a.e. 2 Ib/gal 2,U-D 2,^,5-T 3 . a.i, 16.93? a.e. 1.5 Ib/gal 1W '29.5^ a.i. 16.5^ a.e. 1.5 Ib/gal • 2,h-D 2,fc,5-T Ii3.?q' a.i. 29283 a.e. la.755 a.i. 29.8* a.e. 3 Ib/gal 3 Ib/gal' 2,U-D 2,U,5-T 21.255 a.i. ..11.9^ a.e. 21.255 a.i. 11.92&ra.e. 1 Ib/gal 1 Ib/gal 2,li-D 2,h,5-T 13.25C a.i. 6.1^ a.e. 19.3^ a.i. 12.255 a.e. ^Ib/gal 1 Ib/gal �, / '' •^V;V\ •',:l'c7;'.; ;^ ' •- :.^..^^i^^^'^'';^-''^^^^ :.'•'•....-•' ' ' . . • '••", . !•' •.': • ^ .V.-«/.' '• 3.' ~ *- " 1 Envertf-.DT Butoxyethanol ester G7347 _ 2,h-D 1-7.1% a.i. 2,U,5-T ' 17.03.a.i. 12.2$ a.e. 12.2g ae. lib/gal 1 Ib/gal j' Weedar Amine BK • Dimethylamine salt 2,ij-D Trimethylamine salt 2,U,5-T V/eedone BK 6k Butoxyethanol ester Weedone IBK Butoxyethanolester 2,/i-D 2,U,$~T 2,h-D 2,U,^rT 2k.5$ a.i. 2 . $ a.e. 2 Ib/gal 0[ 2 . a.i. 2 . $ a.e. 2 Ib/gal 8^ 01 19.7^ a.i. lh.2^ a.e. 1.33 Ib/gal' lil.^- a.i. 28.6^ a.e. 2,6? Ib/gal 31.1^ a.i. 21.1$ a.e. 2 Ib/gal 29.7^ a.i. 21.k% a.e. 2 Ib/gal Dow Chemical Co . , Midland^ ^ M i chiga n o 86ItO Esteron 2h? Concentrate Propylene glycol butyl ether ester 92.5'^ a.i. 60.2^ a.e'. Esteron 2l Propylene glycol butyl ether ester 69.2% a.i, U5>»0$ a.e. k Ib/gal Heddon Propylene glycol butyl ether ester 20.1$ a.i. 13.3$ a.e. 1 Ib/gal Veon Trimethylamine salt $6.1% a.i. 1 0 2 i.e. k Ib/gal :,$ Verton 2T Propylene glycol butyl ether ester 37.2$ a.i. 2lu2$ a.e. 2 Ib/gal 6 Ib/gal * V '' ' 2 > Ij-D and 2, Itf 5>-T mixtures Brush Killer LV 2-2 Isooctyl esters 3k.7% a.i. 23.03 a.e. 33-K a.i. 23.03 a.e. 2 Ib/gal 2 Ib/gal 6£.0$ a.i. 'k$,3% a.e, k Ib/gal Esteron Brush Killer Propylene glycol butyl either esters (PGBE) 2,h-D • 36.0'<a.i. 22.2^ a.e. 2,U,?-T 3U.1J6 a.i. 22.2% a.o. 2 Ib/gal 2 Ib/gal Brush Killer LV liT Isooctyl ester Tippon 2-2 PGBE esters 2,h~D 2,U,5~T 2,U,$-T 2,h-D 2,ii > £~T 36.3^ a.i. 3luW a.i. 22.1$ a.e. 22.k% a»e. 2 Ib/gal 2 Ib/gal �.. , ..;'•'• .;• i'Vii%'t'v'»'4'-$'*i'^'1:'1'1'' •;' V .'...,• . • ; '••j.j ,:**^>wfrn. !."..'--•'••• •> • — 3 — 67543 Veori Brugh Killer Dimethylamine . Trimethylamine 2,4-D 2-,4,5-T 24.3% a.i. 2.8.2% a.i. 20.2% a . e . 20.2% a.e. 2 Ib/gal 2 Ib/gal Verton CE (PGBE) 2,4-D ' 36.0% a.i. 2,4,5-T 34.17o a.i. 22.2% a . e . 22.2% a.e. 2 Ib/gal 2 Ib/gal 10.3% a.e. 41.3% a.e. 1 Ib/gal 4 Ib/gal TORDQN and 2,4,5-T Mixtures Tordon 155 Isooctylester Piclorara PGBE . 2,4,5-T 15.1% a.i. 63.4% a.i. Thompson-Ha yward 2.4.5-T BED-WEED- LV-6 2,4,5-T 64.0% a.i. 44.4% a.e;. 4 Ib/gal 2,4,5-T IsoocyCl. ester 83.5% a.i. 58.8% a.e. 6 Ib/gal 22".2% a . e . 22.2% a . e . 2 Ib/gal 2 Ib/gal DED-WEED LV-9 Isoocytl ester 2.,4-D__ and 2,4, 5-X mixture DED WEED LV-33 Isooctylester Isooctylester 2,4-D 2,4,5-T 33.5% a.i. 31.9% a . i . Transvaal Inc. , Jacks£nville, Arkansas 7207/? 2.4,5-T Brush-Rhap A-4T Triethylamine salt 2,4,5-T . 57.0% a.i. 40.8% a.e. 4 Ib/gal Brush-Rhap LV-4T Ethyl hexyl ester 2,4,5-T 65.3% a.i. 45.4% a.e. 4 Ib/gal Brush-Rhap LV-6T Ethyl hexyl ester 2,4j5-T 87.0% a.i. 60.4% a.e. 6 Ib/gal Brush-Rhap A-2D-2T Dimethyl amine salt Triethylamine salt 2,4-D 2,4,5-T 24.7% a.i. 28.67, a.i. 20.5% a.e. 20.5% a.e. 2 Ib/gal 2 Ib/gal Brush-Rhap LV-2D-2T Ethylhexyl ester Ethylhexyl .ester 2,4-D 2,4,5-T 34.7% a.i. - 23.0% a.e. 33.1% a.i. 23.0% a.e. 2 Ib/gal 2 Ib/gal �This document entitled "Draft Protocol for Epldemiological Studies of Agent Orange" was prepared under the direction of Dr. Gary II. Spivey, University of California, Los Angeles, California, Veterans Administration Contract V-101(.98)3P-842. It consists of three parts. The first 19 pages are primarily an introduction. The second 65 pages which are entitled "Research Methods and Proposed Protocol" primarily represent a discussion of the difficulties normally faced in epidemiology studies, and the rest of the document is a literature review covering about 141 pages. In addition, an outline of a proposed cursory physical examination is also attached. From the information provided in this draft, it is not possible to constructively criticize any proposed study since insufficient information is provided to determine how this study is to be conducted. Apparently the authors of this proposed protocol had a number of difficulties; among them, the inability to obtain exposure data partly because they did not have any security "clearance. Basically, the authors of this draft document recommend that cohorts be established for follow up, that they receive a basic physical examination, and that a questionnaire be administered. The proposal in the document on how to determine exposure appears rather cumbersome and will probably not be very rewarding. I, therefore, suggest that battalions be identified and that the basic exposure of these battalions be determined. The individual soldiers should then be assigned to their respective battalions. In addition, the amount of time each veteran spent in Viet Nam should be determined. It could then be established on a subsample how great the variation is for the amount of time that the different veterans actually spent within the battalion versus the' amount of time spent in Viet Nam. If it turns out that the amount of time per soldier spent away from his battalion in Viet Nam does not differ a great deal, it is unnecessary to check for the presence or absence of all soldiers in the morning report since the exposure for all of them will be roughly the same. It is recommended that this be determined by the Department of Defense under the supervision of the IIHS working..group and be reviewed by an outside advisory group. Since the sprayed Agent Orange is persistent in the environment, it is assumed that, in addition to the exposure to spraying missions, the soldiers had additional exposure while in sprayed areas. It is recommended that it be determined whether battalions who were sprayed on were also usually battalions that were in sprayed areas. In addition, all battalions that were exposed to aborted missions should be identified and their special additional exposure determined. �While the Department of Defense is determining exposure levels of Viet Nam veterans and identifying veterans who could be grouped into cohorts, it is recommended that the Veterans Administration review the morbidity data which have been collected in different Veterans Administration Hospitals from Viet Nam veterans to determine whether any obvious clustering of certain symptoms and signs can be identified, or any disease patterns which are out of the ordinary. Concurrently with these efforts, a prospective and retrospective mortality study should be .conducted. Approximately twenty people should be trained to locate death certificates of Viet Nam era veterans. Information about deaths of Viet Nam. era veterans will have to be obtained from different sources since particularly in the early part of the Viet Nam War, social security numbers were not used as serial numbers. However, by using a multifaceted approach, it should be possible to locate better than 95% of the death certificates within an eight-month's period. Once death certificates have been located, the Viet Nam veterans have to be separated from veterans who served in other areas during the same time period. In addition, all casualties can be separated before a retrospective mortality study is done. In addition to this retrospective mortality study, a prospective mortality study can also be initiated at the same time. A more detailed outline of this study will be provided later. . . Since the Veterans Administration and the Department of Defense are most . familiar with their own records and since this is merely a search for records, no obvious bias could be introduced into this part of the study or into the interpretation of the analysis of death certificates, particularly if the raw data are made available to a review group. There is, therefore, no reason why this should be done by a group outside of the military, particularly if outside help is solicited in areas where no internal expertise is available. It is stated on pciges 64 and 65 of the present draft document that from the Viet Nam era veterans during the period from 1965 to 1972, there are now 130,000 deaths and that approximately one-third (i.e., A3,000) of the soldiers are expected to be Viet Nam veterans. These numbers should be rechecked since there have been statements in the press that a total.of about 50,000 veterans were killed in action in Viet Nam. One would have to assume that there should be many more death certificates than 43,000. In summary, prior to any further attempts-to design a study on Viet Nam veterans, it is recommended that the Veterans Administration review the morbidity data they have collected thus far, that the Department of Defense establish detailed exposure data and determine what the sizes of prospective cohorts might be, and that the Veterans Administration embark on a mortality study. Since any outside group is unfamiliar with the record keeping system of the military, it would be redundant, wasteful, and time consuming to have outside groups do this preliminary work for the military. �\ As requested at our last Advisory Committee meeting on Health Related Effects of Herbicides, I have reviewed the Draft Protocol submitted by Dr. Gary H. Spivey and Dr. Roger Detels of the Division of Epidemiology, School of Public Health, University of California, Los Angeles, California. I have read the report, but I am not professionally qualified to comment on many of the medical and epideraiological aspects of the Draft Protocol. It is my understanding that the Department of Health and Human Services (HHS) will provide sufficient epidemiological expertise to comment on those segments of the report. Dr. Spivey does make a good case, however, for the historical cohort design in his proposed epidemiological protocol. I am qualified to comment on two issues in the report, i.e., (1) Review "of Environmental Behavior of Agent Orange, and (2) Exposure. ExperimentalStudies The section dealing with environmental studies is understandably brief and should be so for a report: of th'is nature. The authors have done an acceptable job of reviewing the major environmental issues. However, since the magnitude of the literature is substantial, they have only treated it in a superficial manner. Its major problem is that it presents a non-critical evaluation of the literature. Consequently, it presents selected references without really commenting on the relevance of such data to the proposed epidemiological study. There are numerous typos in this section that should be corrected in the next typing. Exposure . ^ I am deeply troubled by this aspect of the report. On page 43, the authors correctly surmi.se, "We have not identified a mechanism which would document actual exposure." Over the past year in our Committee, as well as the Agent Orange Working Group in the White House, wo. have wrestled, frankly unsuccessfully, with trying to establish some mechanism for documenting exposure. I recall clearly our meeting with the members of the National Academy of Sciences and their comments regarding any proposed epidemiological study on Agent Orange exposure, in Vietnam. Th2 take-home message was, "If we can not scientifically validate and docur.cnt exposure, we csn not do a scientific epidemiological study." Although Spivey'a approach .suggests a mechanism by which we might overcome this problem, I suspect we are justifiably due some criticism for the grouping approach. I am now pursuaded that we will never be able to do an epidemiology study on individual veterans per se, but must examine military units serving in specific spray areas. There is now some hope from recent DOD activities that we might be able to document some segments : of the military population in Vietnam exposed to Agent Orange. Every effort then must be m'ade to work closely with Mr. Christian and his associates in DOD in meticulously reviewing records and films to establish some case for exposure. ; �I believe Dr. Spivey and his associates hav.e made a start on identifying the kind of epidemiology study needed and the information necessary to begin the • project. I am not impressed, however,, that"we liave a working program that could be used for the basis of funding a large epidemiological study mandated by Congress. We have a long way to go, and a major problem is the quality of the record of documented exposures that can be elicited from the DOD Record I Center. I recommend we do not fund any additional feasibility studies until a I thorough and comprehensive search and cataloging of available DOD records, films, | and reports is completed. <v I . H As a concise detailed protocol this document is clearly only a preliminary outline, primarily, as the authors stress repeatedly, because they have yet to be able to assess the data sources on which the studies will depend. As a result, the document consists mostly of extensive reviews of various aspects of the Agent Orange/dioxin'issue, its history, and public reaction. It also presents much material describing epidemiologic prinKJ^les and techniques. The latter is well written, clear and concises a good statement of principles and issues underlying the choice of cohort study approach. Considering the lack of access as yet to data sources, the proposal as presented seems quite reasonable: a retrospective cohort study, preceded by some feasibility work and several preliminary studies using existing overall veteran mortality/morbidity data. The cohort study itself would be a massive effort, the details of which cannot be fleshed out until the investigators examine first-hand the materials they will need to use. Until they get to that point, however, one cannot expect them to produce a protocol document of the sort we were able to construct for our birth defects/veterans study (given the fact that data sources and methodology were all at hand and familiar to us). Unfortunately, from our experiences with the "Smoky" cohort followup, I would be pessimistic that the investigators will have easy and prompt access to data or that tracing cohort members will go smoothly. � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 062 Folder The folder containing the original item. 1684 Series The series number of the original item. Series III Subseries III 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 Spivey, Gary H. Rogert Detels Title A name given to the resource Review of the Draft Protocol for Epidemiological Studies of Agent Orange Subject The topic of the resource Agent Orange Exposure Study ground troops exposure cohort study AOWG ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/e2a19ad1809ce041b16c99bf86949283.pdf 0af61b6b7190abb3653f576f9f511025 PDF Text Text Item ID Number 01572 Author Corporate Author Ronort/ArtlGlB Title Letter: [from Alvin L. Young] to Michele Flicker, [May 14, P 1985] Journal/Book Title Year 000 ° Month/Day Color ^ Number of Imagos 1 Descripton Notes Wednesday, June 06, 2001 Page 1673 of 1688 �DR. MICHELE FLICKER VAMC 4801 LINWOOD BLVD KANSAS CITY,MO 64128 DEAR MICHELE Thank you for sending the data from Rappe's paper. I hope that his present-ation and that of Hardell was worth while. I talked with Dr Houk today (Hay 14) about contributing at Eayreuth on both Risk Assessment and Status of CDC Studies on Agent Orange/Dioxin. We had the opportunity to discuss the VAX EPA ADIPOSE TISSUE STUDY- Without a doubt he feels that he can contribute and support the study,, Count on him to furnish standards and quality control assistance., Thus? I believe that ono the AOWG approves the protocol? it will be time to ask all three agencies for the financial resources to conduct the study. Please keep me informed of your progress on the protocol and if you can draftup cost estimates to complete the task it wouId be worth having them» Best wishes., Sincerely � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 061 Folder The folder containing the original item. 1672 Series The series number of the original item. Series III Subseries III 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 Letter: [from Alvin L. Young] to Michele Flicker, [May 14, 1985] Subject The topic of the resource VA/EPA TCDD Assay AOWG study protocol ao_seriesIII 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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/761d73c7ad39934f348b08c7815bf5ea.pdf dda590d55280c0870050037ce27d186d PDF Text Text Item ID Number 01469 Author Corporate Author Report/Article Title Journal/Book Title Year 0000 Month/Day Color '—' Number of Images 32 DOSCriptOD NOtOS Includes "Agent Orange Controversy: Is Agent Orange Responsible for Health problems Reported Among Vietnam Veterans?", OSTP Issue 1981-1988; Agenda for the Domestic policy Council Agent Orange Working Group at DHHS; "Air Force Health Study: Study Overview and Update," Air Force Systems Command; three articles, "Agent Orange: An American Tragedy", Joe Cole, The Stars and Stripes National Tribune, November 14,1988, "Legion Testimony Attacks CDC Study of Agent Orange", The Missouri Veterans News, "The Declassified War", Anthony L. Kimery, Veteran, November/December, 1988; correspondence from Congress to Donald M. Newman, Chairman, Agent Orange Working Group, November 22,1988; memorandum from National Vietnam Veterans Coalition, November 1988, No. 48, "Agent Orange: Pending New Legislation" Tuesday, May 15, 2001 Page 1469 of 1514 �OSTP ISSUE 1981-1988 AGENT ORANGE CONTROVERSY Is Agent Orange Responsible For Health Problems Reported Among Vietnam Veterans? �BACKGROUND From 1965 to 1970, USAF Applied in Tactical Operations in South Vietnam, & 42 Million Liters of Agent Orange. 2.5 Million Military Personnel From the U.S., Australia, New Zealand and South Korea Served One-Year Tours During the Same Period. BACKGROUND (Cont'd) �Beginning in 1978 Many Veterans Of That Era Reported Medical Problems That They Believed Stemmed From Exposure To Agent Orange During Their *» Military Assignment. Complaints Have Ranged From Tingling In the Extremities To Skin Disfigurement And Rare Forms Of Cancer. Some Veterans Have Fathered Children With Birth Defects. �DPC AGENT ORANGE WORKING GROUP (AOWG) o 1981 President Reagan Established the AOWG. <5> - Chaired By Under Secretary Of HHS - Serves As Overall Coordinator, Clearinghouse, And Evaluator Of The Federal Research Efforts o Policy Group - HHS, DOD, VA, OMB, OPD and OSTP o Science Panel - CDC, NIOSH, NIEHS, NCI, Air Force, OSHA, EPA, USDA, DOS, & OTA �STATUS OF AOWG ACTIVITIES o • In The Past 7 Years, AOVVG Provided Oversight To 10 Major Health Studies And 5 Major Health Surveillance Programs. • ' • • ' ' . o • * Federal Agencies Have Expended $200 M On Human, ToxicologicJAnd Environmental Studies. o i" CDC/Air Force Developed State-Of-The-Art Methods For Detecting And Verifying • • . - . - • . : • • i Exposure. o Serum Dioxin Studies Completed On Ground Troops. �Serum Dioxin Analyses Underway For Cohorts In Air Force Health Study (The Men Who Served in AF Defoliation Program In SEA And Their Matched Controls). �FINDINGS To Date, No Major Health Effects (Mortality, Cancer Or Birth Defects In Children) Can Be » Associated With Agent Orange Exposure in Vietnam. �RECOMMENDATIONS Retain DPC Agent Orange Working Group Retain HHS As Chair Within 18 Months, CDC Rare Cancer Study And Air Force Health Study Will Be Completed. Publish Findings, Brief Congress Close-Out AOWG �** » s < DEPARTMENT OF HEALTH & HUMAN SERVICES office of the Secretary \ *0 Washington, D.C. 20201 AGENDA FOR THE DOMESTIC POLICY COUNCIL AGENT ORANGE WORKING GROUP December 6, 1988 - 2:00-3:00 P.M. Welcome and Introductions Report from DOD Chairman Don Newman Admiral Edward Blasser ,DAS/Defense A presentation by Major-General James Sanders, Air Force Deputy Surgeon-General and the USAF Health Study (Ranch Hand) team. Report from Chairman Science Panel Remarks from the Veterans Administration Dr. Vernon Houk Don Ivers Other business from Members Chairman Don Newman Closing remarks Chairman Don Newman �DECEMBER 1988 BRIEFER: COL WILLIAM H. WOLFE EK-RT-i; -.1 �SERUM DIOXIN STUDIES ASSAY DEVELOPED AT CDC TO DETECT DIOXIN IN SERUM AT PARTS PER TRILLON LEVEL JOINT USAF/CDC EFFORTS: HALF-LIFE STUDIES (7.1 YEARS) ASSAY OF AFHS PARTICIPANTS PRETEST OF 200 DEMONSTRATED ASSAY VALIDITY RANCH HAND MEAN = 48.0 PPT COMPARISON MEAN = 4.8 PPT EXPANDED STUDY OF 2010 PARTICIPANTS TO BE COMPLETED IN 1989 FUNDED BY HQ AFSC WITH REIMBURSEMENT FROM EXCESS VA^ FUNDS (S.11) / j DETAILS OF TRANSFER BEING ARRANGED FUNDS TO COVER COST OF ASSAYS AND ANALYSIS J EK-RT-12-11 881122 �STATUS TO DATE SERUM DIOXIN VALUES IN AFHS PERSONNEL GROUP "NUMBER MEAN RANCH HAND 283 35.0 COMPARISON 246 4.8 RANGE 1.6 - 313 0 - 84 1 6 ~313 RANCH HAND ENLISTED GROUND 184 46 3 ' ' OTHER OCCUPATIONAL STRATA ARE TOO SPARSE FOR ANALYSIS AT THIS TIME J SAM/LS-10-11 881122 �AIR FORCE HEALTH STUDY 250 -r SERUM DIOXIN RESULTS 200-- COMPARISONS 150- - RANCH HANDS NUMBER OF PARTICIPANTS 100:, 50-- •llllil 0-9 10-19 20-49 50-99 SERUM TCDD LEVEL (ppt) 100-199 200 or ^ more �SCHEDULE OF REPORTS REPORT PUBLICATION DATE 1989 MORTALITY UPDATE COMPARISON COHORT EXPANDED (N=19, 101) WINTER 1988/1989 BIRTH DEFECT REANALYSIS BASED ON FULLY VERIFIED DATA SUMMER/FALL 1989 THIRD MORBIDITY REPORT FALL/WINTER 1989 SAM/LS-10-4 881122 �FUTURE PLANS 1989 COMPLETE SERUM DIOXIN ASSAYS 1990 ANALYZE SERUM DIOXIN DATA AND PUBLISH REPORT 1991 PREPARE FOR AWARD OF CONTRACT FOR THIRD FOLLOWUP EXAMINATIONS 1992 CONDUCT PHYSICAL EXAMINATIONS 1993 ANALYZE DATA 1994 PUBLISH REPORT SAM/LS-10-13 881122 �AFHS ADVISORY COMMITTEE ISSUES SCIENCE PANEL OF THE AOWG STRONGLY SUPPORTS KEEPING THE CURRENT ARRANGEMENT WITHIN DHHS USAF PRINCIPAL INVESTIGATORS STRONGLY FAVOR CURRENT STRUCTURE ANY ACTION BY USAF OR DOD TO MANAGE THE COMMITTE OR SELECT ITS MEMBERS WILL GENERATE CHARGES OF INTERFERENCE OR CONFLICT OF INTEREST INTENSE CONGRESSIONAL INTEREST EMPHASIZES NEED TO MAINTAIN SCIENTIFIC INDEPENDENCE SAM/LS-10-10 881122 �AFHS ADVISORY COMMITTEE RECOMMENDATIONS RENEW CHARTER OF THE ADVISORY COMMITTEE RETAIN RESPONSIBILITY FOR THE COMMITTEE WITHIN DHHS SELECT MEMBERS AFTER REQUESTING NOMINEES FROM VETERANS GROUPS SELECT CHAIRMAN FROM CIVILIANS CURRENTLY SERVING DR LEONARD KURLAND DR RICHARD MONSON SAM/LS-10-14 881122 �ADIPOSE TISSUE TCDD LEVELS IN EXPOSED PERSONS MISSOURI 1986 0 - 100 PPT EXPANDED HORSE ARENA RESIDENTIAL WASTE HAULING TCP PRODUCTION 20 50 150 250 350 450 550 PARTS PER TRILLION (PPT) 650 750 60 100 �SENT BY.'Xerox Telecopier 7020 ;12- 5-58 ; 8-52AM 4044884531^ 2024723519I« 3 VIETNAM VETERANS (646 MEN) 1 MAN •4. < •*. < fc * NON-VIETNAM VETERANS (97 MEN) too • 0 • 0 70 BO • 0 40 • 0 BO 10 0 RANCH HAND GROUND CREW (147 MEN) A. • 1 MAN COMPARISON GROUND CREW (49 MEN) TCDD (PARTS PER TRILLION) �30000 1 27821 27032 DC QC LU Q. 20000 ' CO hQC LU > LU _J Q O O 10000 - BACKGROUND REFERENCE RANGE (< 20 PPT) NO NO (.13) (.16) ND NO (.17) (.59) 137 PERSONS FROM UNEXPOSED AREA (ZONE S) PERSONS FROM EXPOSED AREA (ZONE A) WITH NO CHLORACNE PERSONS FROM EXPOSED AREA (ZONE A) WITH CHLORACNE �to CO CM OJ O CM P P 30O-1 i CO CO GOMPANY 25O- TRUCKERS PRODUCTION 20016OCM If* 100 CO u> I ro I CSl o CM o o. o o 50- c cc c c o o o o o o o o o o 01 DA/S EMPLOYED IN PRODUCTION X o o> X *?• �CO 04 100 90 IX CD O-J 80 z LU CO 10 CO CO O DC 70 60 so 40 RANCH HAND GROUND CREW (147 MEN) 30 ^ - 1 MAN 20 10 O 01 CO ro oo I to COMPARISON GROUND CREW (49 MEN) CM CD O O X O o> >: >- TCDD (PARTS PER TRILLION) �"To C*r» For Him Who Stull *n 6an>« Th» Sctti* And . Fo> Ht* Wtahm And Ml. OrphtnAbrthMn Lincoln .7 THE STARS AND STRIPES-THE NATIONAL TRIBUNE 14 NOVEMBER 1988 Agent Orange: An American Tragedy In May 1983 officials of the Center for Disease Control (CDC) recommend evacuation of the Quail Run Mobile Home Park near Times Beach, Missouri, after EPA. officials find dioxin contamination in excess of four times that of the town of Times Beach (1,100 ppb.). More than 90 percent of the town of Times Beach, located approximately 25 miles southwest of SL Louis, Mo., was found to be contaminated with more than 100 ppb. of dioxin, according to a January 1983 report CDC officials warned the more than 3,000 residents to stay away because of health hazards. Police were stopping the residents from removing personal belongings out of fear of spreading the contaminants to other areas. Flooding of the Meramec River may have further contaminated vast areas of southern Missouri, Russell Bliss, owner of Russell Bliss By Joe Cole Drain Oil Service, has been identified as the source of much of the contaminated waste oils which were sprayed on over 100 sites in southern Missouri, including Times Beach. The town of Times Beach paid Bliss $4,800 for two applications of the contaminated waste oils in 1971 and 1972. The federal government has since paid a reported 34.5 million dollars for the purchase of Times Beach, as pan of the EPA Super-fund hazardous waste site clean-up program. Last April 1988, Mr. Brian Manza, a disabled Vietnam veteran, visited the Times Beach site, only to be turned away by EPA officials, wearing "moon suits" as Brian described them. Theentireareawas fenced and posted as an extremely hazardous waste site. Brian's concerns are obvious to Vietnam veterans who were exposed to toxic chemicals in Vietnam. Millions of gallons of Agent Orange, contaminated with dioxin were sprayed over vast areas of Vietnam. If two spray missions using less than 5,000 gallons of contaminated oil could do this to a town in Missouri, what could millions of gallons of oil-based herbicides contaminated with dioxin at thousands of times the level found in Times Beach do to a country called Vietnam? In 1986, the Centers for Disease Control conducted blood serum studies of Vietnam veterans, as a possible method of identifying those veterans who may have been exposed to toxic chemicals while serving in the Vietnam War. Their findings indicated that Vietnam veterans' levels of dioxin in blood were similar to those samples of persons who had not served in Vietnam. Since the non-ex- posed comparison group was selected from the Times Beach and Southern Missouri area, one can only speculate as to the meaning of the studies results. Southern Missouri is no better nor worse than Vietnam. Last 7 July 1988, the Department of Defense declassified documents which revealed that the Defense Department-had purchased a chemical plant at NVeldon Springs, Missouri, which was to produce 8 million gallons of Agent Orange per year by late 1969, over and above the entire domestically produced product, which was currently being used for defoliation in Vietnam. Declassified USMACV reports indicate herbicide use in Vietnam during 1967 through 1969 was 11.9 million gallons per year. V/eldon Springs, Missouri is located approximately 25 miles west of SL Louis.* �THE MISSOURI VETERANS NEWS PAGES Legion Testimony Attacks CDC Study of Agent Orange WASHINGTON (ALNS) • smaller than the size of New — The government has Jersey during the war. "It is "fallen short of its responsi- absurd that the CDC says bility" to compensate vic- that it cannot find enough tims of Agent Orange expo- people to study," Sommer sure, an American Legion said. He told the members spokesman has told a House that the CDC developed a subcommittee. study that was "destined to The statement submitted fail." by John Sommer, director of Basic research flaws were the Legion's Veterans Af- committed by the CDC, . fairs and Rehabilitation Di- Sommer said. Among the er1 vision, expressed serious rors made were what he concern for the govern- called "cardinal sins of ment's lack of responsibility epidemiology." First, the in recognizing any problems CDC research diluted the efassociated with dioxin expo- fects of Agent Orange exposure. Sommer criticized the sure by including in the Centers for Disease Control study group every person in for its mishandling of re- Vietnam. For example, search data, and for its about Lin every 5 men who interpretation of the data the served in Vietnam actually CpC researchers did gather. served in combat. The CDC Sommer pointed out that "generalized" exposure to the CDC study of Agent Agent Orange across the enOrange exposure was so tire service population in limited by the restrictions Vietnam, so that the 20 per upon just what veterans cent likely to be exposed would be included that an was diluted by the other 80 accurate picture of these per cent of the non-exposed veterans was not developed. men. Veterans eliminated from To further weaken the the group which the agency . CDC's study, the veterans looked at were those who who were not included in the served more than one tour in . study took away the "statisVietnam, those who served tical power" of the potential In a particular unit for fewer dioxin victims. "A knowthan 180 days, those who ledgeable epidemiologist were above the rank of E-S, would try to optimize the those who transferred from chance of observing an one unit to another during effect by including, rather their tour, and any veteran than excluding, the veterans who served any number of who are most likely to have days before or after the pro- suffered from exposures in posed study window (Janu- question," Sommer said. ' ary, 1967-December, 1968). Sommer also alleged that The U. S. sprayed more the CDC would minimize any .. flndlng^wWcnf^niuld^tte^ ffAgefir'Orange'16nvafci;area ^ Vietnam service to health •" ' ' ' ' ' ' problems. Levels of combat were not analyzed, nor were other studies which showed that levels of combat had a great deal to do with health problems of Vietnam veterans looked at. "It seems that every time the CDC came up with a positive finding, it was interpreted to be either negative or wrong," Sommer told the committee. The CDC also failed to avail itself of the compre; hensive computer analysis .of Vietnam service and •where troops were during different periods. He said that the data, developed by the U.S. Army and Joint Services Environmental Support Group, is one of the most carefully developed and extensive records of any environmental exposure to be found anywhere. He chastised the CDC for opting for a simplistic approach, rather than using this vital and readily available tool Despite Congressional mandates calling on the Veterans Administration to pay a certain amount for certain diseases, not one Agent Orange claim has yet to be paid. The VA also denied a presumption for certain problems to be related to dioxin exposure, denying even more veterans the right to collect disability compensation. Sommer's testimony also endorsed a legislative initiative which would exclude payments made to veterans and their survivors under the Agent Orange liability settlement In 1984 from being counted as income when determining eligibility for or entitlement to a veteran's or survivor's pension or a veteran's medical care under means test provisions. He also called for the bill to be extended beyond VA programs, to include any. based government ass tance program. • �Declassified War Documents Disclose A/O Use Counterproductive And Ineffective By Anthony L. Kimery I has been nearly 20 yean since the last orangetripcd, 55-gallon drum of Agent Orange was prayed on the green canopy of Southeast Asia. Since that time, the debate about its use and lethal side effects has appeared steadily throughout what are now yellowing pages of newsprint, scientific journals, congressional hearings, and scholarly attempts to relate ' 'the history of its use. abuse, and deadly, devastating consequences. Yet, after all that, there is still another story to be told. It is the story about the internal policies, politics, and decision-making regarding the use of chemical defoliants in Southeast Asia. The story is based on reams of newly declassified military records that -were recently released by the Army for ' storage at'the National Records and Archives Center near Washington. DC. This reporter spent weeks examining these records, most of which were declassified for the first time since being turned over to the National Archives. The documents show that America's use of defoliants in South Vietnam—a program that would be expanded to include Laos and Cambodia in direct violation of MACV directives governing the use of herbicides—was a holly debated and often strongly contested concept among military and political planners, strategists, and analysts. Agent Orange and its chemical cousin. Agent White, were first introduced to South Vietnam in 1962, albeit in limited quantities. According to the documents turned over by the Army to the National Archives, the defoliants were earmarked for three broad purposes. First, they offered a means to destroy crops and therefore deny foodstuffs to the burgeoning Vietcong movement in the coumryside';"second, they offered a means to dampen infiltration by providing observation corridors to South Vietmunete aerial spotters; and third, they offered support for allied operations—by clearing out landing zones and firebases. Between its introduction in 1962 and the end of the program in the early I970's, the U.S. government dumped 20 to 40 million gallons of the chemical on Southeast Asia, according to the documents. Exact figures are hard to come by, in apparent reflection of the willy-nilly planning of the U.S. program. While actual day-to-day chemical operations were under the titular control of the South Vietnamese government, it's clear the U.S. initialed and monitored the program's effectiveness. Contrary to popular belief, the most healed debates about the use of defoliants were not over the dangers they posed to human health, but over whether the principal reasons for their being used were justified. The Archives' records indicate that the military has long been aware that the saturation of South Vietnam widi herbicides was actually causing more problems than it was solving. The declassified records show that the horrific aftermath of Ranch Hand should have been avoided on the grounds that the program was counterproductive with respect to the objectives it hoped to achieve. Yet it was allowed to continue. The documents also indicate that within just a few years of their introduction to Vietnam, and continuing through the early I970's, there was overwhelming evidence that the use of defoliants was not hindering the VC by depriving them of foodstuffs. A study conducted on the use of herbicides between 1%) and June 1967, for instance, found that there had been nd effects of any significance from the use of the herbicides. The study concluded that their use was instead causing damage with respect to winning the hearts and minds of the Vietnamese. This report, and many others, clearly pointed to the negligible benefits of the further use of defoliants. A major policy review was convened in 1968 which, while conceding that the risks of using the defoliants did not outweigh the benefits, concluded that defoliation efforts should be intensified. As a result of this study, a clause was built into subsequent directives for using herbicides to permit their use in heavily populated areas, "in those cases of extreme military necessity." More important stilt, the military documents show that economic considerations brought about by the government's murd-million-dollar commitment to bringing on-line a government-run Agent Orange production plant was an important factor in escalating defoliation efforts. I n late 1967, prior to the broad-based policy review on the use of defoliants in South Vietnam, the American military command in South Vietnam prepared a memorandum containing harsh language about the "disadvantages" of using herbicides. "The herbicide program carries with it the potential for causing serious adverse impacts on the economic, social, and psychological .fields." the report concluded. Nevertheless, the proponents of Agent Orange within MACV continued to push for expanded use of Agent Orange and other herbicides. Consequently, the debate about their use continued to be rigorously fought in Saigon, despite doubts about the herbicides' actual effectiveness. Probably no better illustration of the conflict within the military over the use of herbicides is a July 1967 MACV memorandum setting forth new criteria for defoliant use. "Crop destruction should continue to be the highest priority for the use of herbicides." (he memorandum states. It adds, "there has never been a question as to the effectiveness of crop destruction." This conclusion, however, is in glaring contrast to what militarily contracted studies and intelligence reports were showing. A RAND Corporation report concluded in October 1967 that the VC required only three percent of the total food consumed in the country, that the crop-destruction operations were not in any major sense denying food to the VC, and that Vietnamese peasants, the target of long-range pacification objectives, bore (he brunt of the crop-destruction efforts, and they held the U.S. and the Government of Sourh Vietnam (GVN) responsible. As of July 31, 1968. the VCand North Vietnamese Army (NVA) had a daily food requirement of about 215 short ions, according to the documents. About 58 percent, or 124 short tons, could be internally procured in South Vietnam. Of that, "only a small portion is produced by the enemy in areas subject to herbicide operations," a MACV report concluded. This report added that "food shortages are reported in captured documents, but they are temporary in nature and are often the result of distribution problems. The enemy usually meets the minimum food requirements of his military forces." Numerous internal MACV reports, memorandums, and intelligence briefs support these conclusions. A 1968 MACV report on the RAND and other studies states, "reported food shortages have been the result of Allied sweep operations, not of herbicide operations.'' This had already been spelled out earlier, in a December 1967 field report to MACV, which states, "this headquarters does not have empirical data on the effects of herbicide operations on VC/NVA food stocks, nor is there evidence that enemy combat operations have been cancelled because of food shortages resulting from crop destruction. Such food shortages as Continued on next page Above: Three Air Force C-I.Ws spray Orange in the A Shau. Right: A USAF airman operates spray equipment during defoliation mission NOVEMBnR/OECF.MRF.R |0«» �are known (o exist among the VC arc the results of a many-faceted program to deny resources to the enemy." The report went on to stale that "the effort and cost of employing crop destruction is insignificant in comparison to (he troop effort required to control and secure an equivalent area of rice." (n a 1968 MACV evaluation of crop-destruction programs which followed the final 1%8 herbicide policy review, Col. John Moran, chief of the Chemical Operations Division, slated (hat "herbicide crop destruction is only one aspect of a comprehensive fooddenial program." Moran went on to stale that deprivation of food is due more to "Allied sweep operations" and only "occasionally to herbicide operations." The 196)1 MACV evaluation also emphasizes, as did the contracted private studies, (hat "very few POWs who have infiltrated ever mention the efforts of U.S. herbicide operations. Some stale (hat they have seen areas where vegetation has been killed but do not mention any infiltration problems caused by (he defoliation. There are indications that U.S. herbicide operations have had a negligible effect on NVA infiltration and combat operations." Yet, while this report says, "herbicide operations . . . appear to cause temporary food shortages in the area defoliated, but have little lasting effect on the VONVA food supply." it nevertheless states, "the CINCPAC Scientific Advisory Group concludes, without qualification, (hat the crop-destruction program is an essential and effective part of the total effort in South Vietnam." If there was ever any doubt about the ineffectiveness of U.S. defoliation operations, however, they were put firmly to rest in a MACV briefing paper dated December 1967. "Within the context of what has been studied, it would appear the crop-destruction effort may well be counterproductive. The VC continue to feed themselves, while the peasant bears the brunt_of the deprivation and doesn't like it." In other words, the U.S. policy of spraying Agent Orange over wide areas of South Vietnam in order to deny the VC and NVA the use of cover and food resources was not only not working and unnecessary, it was actually harming the American war effort. ile it was agreed by military planners in Saigon that the use of herbicides was sucT T cessful in denying the enemy cover, there is abundant evidence that defoliants did not significantly deprive the Vietcong access to food stores. One of the most damning condemnations of the use of herbicides found in the National Archives came in a November 20. 1968. letter from Robert II. Marian, USAID assistant director for economic planning and policy and embassy counselor for economic affaire to U.S. ambassador Ellsworth Bunker. Marian protested the expanding use of defoliants in Quang Due and Phu Bon Provinces. "I feel compelled to nonconcur in both proposals," Harlan wrote. "Although crop destruction operations may have had some successes, we suspect their effectiveness in hampering enemy military operations may have been exaggerated. The Report of the Herbicide Policy Review Committee, itself, on Page 17 pointed out, 'herbicide crop destruction is only one aspect of the efforts to deny foodstuffs to the VONVA. The enemy relies on commercial purchases, imports, taxation, requisition, and confiscation for some 90 percent of his food requirement.' " The negligible contribution!! of herbicide operations were equally evident with respect to the effect that herbicide operations were having on the Vietnamese population. In the early !960's. a herbicide evaluation report noted, "the chief sufferer from crop-destruction operations is the local worker." Such findings con- At right: USAF sprayers in stables in South Vietnam; they called for thousands of gallons. Below: Loading White on an Irotjuois prior to defoliation mission. U.S. dispatched special chemical teams VETERAN tinued (o mount through the balance of the 1960's and up until (he 1968 policy review. The same inconsistencies found in the debate about the effectiveness of denying food to the VONVA were just as replete in the debate over the psychological effects (he defoliants were supposed to bring. One MACV report. Advantages and Disadvantages of the Use of Herhicides in Vietnam, states, "the herbicide program dues not loom large as a public-opinion issue at the present lime." At the same lime, a MACCORDS evaluation report was staling that "the herbicide program is one of the most widely known programs" among the population, and it "is a natural topic of interest with people whose livelihood is in the land." "The principal effect on pacification is the animosity the peasant feels initially towards the U.S. for being responsible for the damage," the MAC-CORDS evaluation says, "and then toward the GVN for its failure to rectify the situation. There is nothing that can be done beforehand lo head off the alienation the peasant develops when his crops are destroyed." The MACCORDS report then summarizes the inadequacy of South Vietnam government efforts to compensate antiVC peasants for the inadvertent loss of their crops. "The present system is completely unsatisfactory from the point of view of rectifying the economic damage and its psychological impact by demonstrating lo the peasant the concern of the government for his welfare," (he report states. "The slowness and unfairness of this system usually result in further alienation of the peasant. He is left to his own devices to find the means with which to replant his crop, if there is enough time left in the growing season, or lo find some other means of supporting his family. Even if his claim were approved, the time lapse between submission and payment and the fact that it represents only a fraction of the actual damage, have the result of leaving the peasant in the hole and bearing the responsibility for an act he was helpless to prevent. As long as the present system remains, the pacification program is going lo suffer unpredictable .setbacks which h is at present unable to alleviate wnh-^ny—' effectiveness . . . The net effect is to alienate him further from his government. The report's conclusion seems to indicate that the spraying of Agent Orange was having more than just a slight impact on VC and NVA resources—it was actually turning pro-government peasants into antigovernment guerrillas. Col. Moran's report corroborates the MAC-CORDS evaluation. "The vast majority of (he enemy's daily food requirement is procured through taxation of the people and purchases from the local markets," Moran wrote. "While the enemy's production capability has been reduced, his procurement efforts have enabled him to sustain his forces. The taxes levied on the people arc in the form of food, money, and services. Through these measure!!, the enemy has been able (o. procure enough food from outside his areas to nearly offset his production losses. "The obvious reaction of the peasant whose labors have been destroyed is one of bitterness and haired. He will frequently direct this hatred toward the U.SXJVN for accomplishing the destruction. If he has previously leaned toward the VC, he is likely to side with them completely after the crop destruction. "Captured documents and interrogation reports indicate that the detrimental effects of herbicide operations far outweigh the beneficial effects." Moran concludes. "Civilians living in VONVA-conlrolled areas, whose crops are destroyed by herbicide operations, have no recourse but lo face famine and possible starvation as a result of Allied destruction of their crops." The declassified documents clearly present a picture which shows that the U.S.'s defoliation program nullified pacification efforts by alienating the Vietnamese from not only the U.S.. but from their own government as well. By the time the defoliation operations were stopped, the damage was irreparable. The documents also show that in other areas, the U.S. defoliation campaign was counterproductive to the U.S. war effort. The records show, for instance, that the destruction of valuable resources, such as harvestable limber and rubber trees, was far greater than was reported or admitted by the U.S. during (he war. �s public concerns over the use of herbicides intensified, the need for a policy was quickly L recognized and embarked upon by (he U.S. It is clear from (he minutes of those meetings (hat the intent was to allay fears by not only continuing defoliation efforts, hut by expanding them. The first meeting on this subject took place on January 17, 1968. under (he chairmanship of David Carpenter, political officer at the U.S. embassy. In a memorandum for the record distributed (he following day by Col. Morin. he stresses thai Carpenter "emphasized that if (here should be a leak of this information to the press, (he embassy would receive m a n y inquiries which would be d i f f i c u l t to respond to." Not only was the embassy keeping the true intent and purpose of the policy review from the press, it was also keeping it secret from the GVN. "Mr. Carpenter cautioned the members of the committee that there should he no release of the purpose and actions of the committee (o the Republic of Vietnam," Moran wrote. ' 'There may be a need to call on officials of the Republic of Vietnam for certain data; however, such contacts should be limited to (he specific subject area involved without divulging any information of the policy review. He further requested that contacts with the Vietnamese government concerning these matters be conducted with his office." Such secrecy contrasted with the U.S.'s repeated assertion (hat herbicide operations were strictly under the control of (he GVN. with (he U.S. providing only support and logistic roles. This was again reiterated at a September 20.l%8. background briefing for the press in Saigon following the policy review. The answers provided to questions raised by the press during the briefing glaringly contradict information about the negligible effects of the defoliation programs. A memorandum to the secretary of stale from Ambassador Bunker, drafted the week before the press briefing, establishes that the press, public, and even l*eft: Dr. James flrwn inspects results tif defoliant sprayin/t. Below: Ranch hands inspert chemical Murage tank onboard U.S. aircraft In secret briefing papers prepared during late 1967, imum use of Orange." at a time when the Department of Defense was purling Another memorandum emphasizes the nerd to use into motion an Agent Orange expansion program, it is ' 'Orange in lieu of White (o avoid further procurement evident that orders for Agent Orange had consistently of White.'' Contracts for Agent Orange were having (o far exceeded both the ability and capability for using be "terminated at msts in excess of 1.5 million dolthis herbicide, which had caused an enormous lars." with "ultimate" contract terminations costing surplus—a surplus that was only going to get worse ihe government $19.1 million—a reflection of the US with a new multi-million dollar, government-run government's inability lo draw-down the Agent Agent Orange production plant soon to come on-line as Orange surplus. a result of the expansion program. ' 'Considerable dollar savings may he expected from One of the conclusions of these briefing papers, acceptable and maximum use of Orange." another which helped to prepare the way for the pending policy memorandum stales. "Forestalling potential future review, was that "MACV could be embarrassed if criticism of herbicide procurements should result if [the) plant expansion is carried out, and the pro- Orange can be employed to a greater extent*... regrammed herbicide cannot be used." quest review of requirements for both Orange and A report prepared by USAF Col. H.F. Greenhow, White herbicides and recommendations concerning Material Division, put the economic reasons for un- possible means to increase substitution of Orange for precedented increase in the use of Agent Orange vivid- While." ly in focus: "In view of the large inventory on hand, Memorandum after memorandum reiterates Ihe sur(he huge investment in production capability, and the plus problem. "White is being consumed at higher future low cost of Orange, it is imperative from an than forecast rates and is in short supply, while Orange economic point of view (hat Orange be used to the is heavily overstocked." one report notes. "Every maximum extent possible and that White be used only effort must be made lo schedule herbicide operations in when there is a compelling operational requirement." such a manner that White will not be used in lieu of Greenhow stressed that "the MACV staff computing Orange." another report says. requirements need to be more accurate in (heir com"Considerations argue strongly for use of Orange, putations and project their requirements into the future which is overstocked." wrote Army deputy assistant and realize die dollar impact caused by changes in chief of staff. MACV. Brigadier General John G. requirements." Wheelock. 111. By the time Greenhow prepared his report, howevFinally, on April 14. 1969, the U.S. embassy suser, MACVs "overstatement of requirements" had pended its policy requiring the use of Agent Orange on caused "excess quantities (of Agent Orange) having certain restricted defoliation targets, such as rubber been purchased." resulting in an 18-month supply on plantations and other valuable natural resources, and hand in (he system, with an additional eight million allowed the "use of Orange herbicide on all defoliation gallons per year to begin being produced in December targets." adding, "for economic reasons, the use of 1969 by the government's facility. Orange is preferred." The pressure was on. Twenty-eight million gallons had been committed for the completion of this plant, located at Weklon Springs. Missouri, as a result of the . hen concerns about the dangers dioxin deputy secretary of defense having, on erroneous information, ordered an Agent Orange expansion proposed to human health began to explode gram on July 31, 1967, an order that came at a time seven months later, in late 1969. there was when MACV was well aware that the use of Agent still little attention paid to Ihe ramifications of the allOrange was far less than it was forecasting, or had the out effort to deplete Agent Orange stockpiles. A memcapability to use. It was also at a time when the MACV orandum from the deputy secretary of defense to the the GVN. were being deliberately deceived about the secret briefing papers were pointing out that chairman of (he Joint Chiefs of Staff sent lo CINCPAC "MACV could be embarrassed if plant expansion is carried concludes that "large-scale substitution for Orange consequences of herbicide operations. will not be permitted." "We would prefer not to draw attention, even by out. and the programmed herbicide cannot be teed." By early 1969. the problem with the surplus of Despite (he fact that the memorandum points out implication, to the serious shortcomings (he |policy| review revealed in (he aspects of (he |hertncide| pro- Agent Orange was embarrassingly out of hand. Com- (even at this early lime) that the National Institutes of grams." Bunker said. munications traffic during this time period was frenetic Health had presented evidence that 2.4.5-T "can cause Among the shortcomings (hat were being concealed with requests and discussions about reducing the sur- malformation of offsprings and stillbirths in mice, was the growing concern over the economics of too plus of Agent Orange. Asa result. Agent Orange began when given in relatively high doses." and that "this much Agent Orange having been procured. By (his to be used for every defoliation purpose. The use of all material is present in defoliant Orange." Ihe largetime, "the entire commercial production of Orange other herbicides was brought to an abrupt halt, while a scale, and apparently counterproductive, spraying of (had been | diverted from domestic use to military re- number of policies governing the use of defoliants the chemical went forward. .quirements in Southeast Asia." were relaxed in order to deplete (he Agent Orange Within a few years, though, (he outrage over using Throughout the late I960'], beginning in 1967. surplus. chemical defoliants had grown so intense, both back Since "Agent Orange stocks were in long supply, home and in (he world community, that Ihe U.S. was military records declassified for the Veteran began to reflect that (here were pressing economic reasons and costly contract terminations were involved," one forced lo cancel its defoliation operations. But. by that favoring (he apparent unjustified reason (o increase the memorandum states in communications used in the time, following a decade of having negligently satuse of defoliants, especially Agent Orange, which had decision to halt the use of other defoliants, the termina- urated Southeast Asia with the chemical, the damage wrongly been ordered in vast quantities because of a tion of the use of other herbicides "should result in had already been done by a program, Ihe objectives of considerable dollar savings from acceptance and max- which all along were not being achieved." domestic shortage. W NOVF.MBF.R/DF.CEMBKR I 17 �Congreste of tfje ®mteb JB.C. 20510 November 22, 1988 Honorable Donald M. Newman Chairman Agent Orange Working Group 200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Don, As Chairmen and Ranking Minority Members of the House and Senate Veterans' Affairs Committees, we are writing to request that the Agent Orange Working Group review and provide comments on five studies recently published in "Environmental Research." (A copy of the journal is enclosed.) The studies examine the health effects of herbicide exposure and service in Vietnam based on questionnaires completed by American Legion members. We would appreciate your comments with respect to the scientific methods used, the validity of the statistical analyses, and the strength of the studies' findings. As always, we appreciate your continuing cooperation and support. We look forward to your response. With warm regards, Cordially, ^-»-A^ruc<i G.V. (Sonny) Montgomery Chairman ' <j y i f 1 ans't'on Chairman Solomon nority Member Frank H. Murkowski Ranking Minority Member Senate Committee on Veterans' Affairs ,„/,„/„ BZ AOW e<? Q3A House/Committee on Vete/ans1 Affairs �NATIONAL VIETNAM VETERANS COALITION 1000 Thomas Jefferson St.. Sixlh Floor Washington. D.C. 20007 (202) 338 NVVC J. IVmu* Hnrrh. Jr. November 1988 . No. 48 AGENT ORANGE Pending New Legislation The omnibus veterans benefits legislation following new provisions on Agent Orange: contains the (T)his agreement (i.e. the bill) would extend, from September 30, 1989 to December 31, 1990, the authority to provide basic VA health-care services for veterans' disabilities if it is found that the veteran, during active duty, may have been exposed in Vietnam to any toxic substance in a herbicide or defoliant. . . . (T)he agreement also includes a provision that states that amounts received as part of the settlement of the agent orange product liability litigation will not be considered as income for purposes of any of the needs-based programs administer by the VA, including nonservice-connected VA pension. (T)he proposed amendments would require the VA to conduct an outreach program to Vietnam veterans oriented to notifying them of health risks, if any, resulting from exposure to herbicides in - 13 - �Vietnam, as information on such health risks becomes known. In order to facilitate such an outreach effort, the bill would require the VA to take reasonable actions to organize and update the information contained in the VA's agent orange registry, particularly the addresses of veterans listed in the registry. (Remarks by Rep. G.V. (Sonny) Montgomery, Congressional Record, Oct. 19, 1988, H10353.) The committee report accompanying the legislation includes the following comments: Section 1203 of the bill treats Agent Orange payments "as reimbursement for prior unreimbursed medical expenses." (Id., H10338, 10555) (Ed. Note: The bill, however, does not make a similar exception for Social Security disability pensions or food stamp eligibility.) . . . . > After February 28, 1989, not less than one-third of the total number of members of the Ranch Hand Advisory Committee shall be individuals selected by the Secretary of Health and Human Services from among scientists who are recommended by veterans' organizations . . . . (Id., H10334, H10339) The House . . . rejected a Senate bill that, for the first time, would award disability benefits to veterans exposed to Agenent Orange during the Vietnam War [i.e., for soft tissue sarcoma, no-Hodgkins lymphoma] (Rep. Sonny) Montgomery said further studies were needed to prove a connection between various diseases and Agent Organge. (Philadelphia Inquierer, Oct. 20, 1988) "Sprayed and Betrayed" - Round II More newly declassified documents emerge from the National Archives: The State Department was involved in policy-making re spraying operations. "On 14 April 1969, the U.S. Embassy suspended its policy requiring the use of WHITE herbicide on certain restricted defoliation targets and will now allow use of ORANGE herbicide in all defoliation targets. For economic reasons, tfie use of ORANGE is preferred . . . . We respectfully request that you assure WHITE stocks are kept available for use should the policy be deinstituted." (Memorandum for Col. Tran Dinh Tho from Col. Harold C. Kerne (?) , Jr., "Use of Defoliants ORANGE and WHITE (V), 17 April 1969). LTC John A. Sullivan, CONVSNACV notes in a memo to CINCPAC "Ambassador Sullivan's approval has been requested for the use of CS in those areas of Laos approved for spray operations. ("Use of Riot Control Agent CS," undated) MIAs. During the week ending 4 Feb. 67, the following defoliation missions were flown in Laos with C-123 aircraft: - 14 - �31 Jan 3 sorties . . . Acft 611 lost to ground fire. 5 KIA (Ed. Note: the five men are now on the MIA list) (Memorandum from Maj. Philip L. Boster, COMUSMACV to NMCC, "Herbicide Report (V)," undated. Access Number (?) 0380818) The Empty Drums. The New Jersey Agent Orange Commission interprets other reports: • "It seems that as far as the US Government was concerned, "empty" Agent Orange drums were the property of the,, ARVN, and they could dispose of then anyway they chose. The problem was the drums weren't really empty, and each contained about 2.2 gallons of Agent Orange that was not pumped o,ut. The ARVN, in their constant quest to turn an extra buck, sold the drums to anyone who wanted them, generally civilians for about $2 each. The creative Vietnamese civilians used them for all sorts of things, spilling the residual Agent Orange all over the place and seriously damaging plants and shade trees throughout the city of Danang. The defoliant was even killing the civilians' vegetable gardens. Since we were using about 1000 gallns per day of herbicide out of Danang at the time, about 20 "empty" drums of Agent Orange were hitting the streets of Danang every day!! to compound this lunacy even more, it seems that the Vietnamese Navy compound purchased some of the drums to store gasoline for their generators. The result is that they ended up fogging their entire compound through the generator exhaust with Agent Orange, effectively killing all vegetation in sight!! "The report recommended that the practice of allowing the ARVN to sell the drums be discontinued, but we're not sure that ever happened. It also should be mentioned that Agent Orange was also stored at Bien Hoa, Phu Cat, Nha Trang, and in Saigon and was presumably disposed in the same manner." (NJAOC, Agent Orange Update, Oct. 1988) Miscellaneous 1. From studying the injuries among the tens of thousands of Kurdish refugees, the doctors believe the Iraquis are using a mixture of herbicide and a form of tear gas known as CS to drive the Kurds from their mountain villages. (Edmonton Journal, (?) Sept. 21, 1988) 2. (Vietnam veteran Ron Heiman) was 38 years died in January of this year . . . . The doctor put of death, on his death certificate, the type of killed him, and added that it was a direct result of poisoning. This is the first time such a statement an official record. old when he as the cause cancer that Agent Orange appeared in Well, the Death Certificate on file at the County Medical examiner's office has been changed! Any reference to Agent - 15 - �Orange has been removed from the official files! letter from George L. Claxton, Oct. 19, 1988) (Attachment to 3. Was the morbidity of women Vietnam-era veterans affected by assignment in Vietnam? . . . (N)o remarkable differences (between a control group of 720 U.S.-based Vietnam-era veterans and a study group of 28 Vietnam veterans) are seen in the percentage of those who had an acute illness, GYN condition or miscarriage. However, three interesting differences are observed. First, a higher percentage of those who were assigned in Vietnam have chronic conditions and disabilities, and they have more of them. Second, a higher percentage have been told they have cancer. Third, although a smaller percentage of Vietnam-assigned women ever had a baby, a higher percentage of those who did have children born with defects and/or die before their first birthday. (Le Donne, Trends in Morbidity and Use of Health Services by Women Veterans of Vietnam, Navy Medicine. May-June 1988, p. 24) 4. What's Evidence?, by Joe Cole (Mahess Productions, Inc. states: "blows the lid off") Send $15.00 to Joe Cole, 6806 36th Ave., S.E., Olympia, Washington 98503 5. As part of a budget austerity program in Massachusetts, the state's funding of its prestigious Agent Orange Commission has been reportedly "substantially reduced." 6. The Washington (Me) Sunrise Memorial; Made of two large, rugged stones, standing like the tattered pages of an open boo, the memorial carries three messages: one for those who are still missing in action or prisoners of war; one for all the men and women who served in Southeast Asia; and one for the veterans who have died, and the veterans and their families who continue to suffer, from medical and psychological problems associated with exposure to the chemical defoliants, such as Agent Orange, used in the war. (Bangor Daily News, Oct. 24, 1 9 8 8 ) ( E d . N o t e : This is claimed to be the first memorial in the country to honor Agent Orange victims . J •-14 - � 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 1469 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/. Title A name given to the resource Includes "Agent Orange Controversy: Is Agent Orange Responsible for Health problems Reported Among Vietnam Veterans?", OSTP Issue 1981-1988; Agenda for the Domestic policy Council Agent Orange Working Group at DHHS; "Air Force Health Study: Study Overvie Subject The topic of the resource AOWG DHHS Air Force Health Study Agent Orange Controversy 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 <p style="margin-top: -1em; line-height: 1.2em;">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.</p> <p>For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a></p> 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. 1460 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/. Title A name given to the resource Typescript: Scientific Issues and Agent Orange Exposure Subject The topic of the resource dioxin health effects AOWG health studies ao_seriesIII