2 15 34 https://www.nal.usda.gov/exhibits/speccoll/files/original/620294ad073fa0fd6c3f020e2931ca02.pdf 291037b038463232e61219356849404c PDF Text Text Item D Number °1968 Author Young, Alvin L. Corporate Author RBOOrt/APtiClB Title Lettcr to J. S. Coombs from Alvin L. Young. January 25, 1984 Journal/Book Title Year 000 ° Month/Day Color Number of knages 3 Young responds to Coombs's letter of January 13, 1984 (also included in item), discussing Young's support of the Australian Servicemen's Health Study protocol and his concern about the commitment of resources. See item 1969 for continuation of this line of correspondence. Monday. July 30. 2001 Pago 1968 of 1993 �EXECUTIVE OFFICE OF THE PRESIDENT OFFICE OF SCIENCE AND TECHNOLOGY POLICY WASHINGTON, D.C. 20506 January 25, 1984 Dear Mr. Coombs: I have reviewed your letter of January 13, 1984 requesting my signature on the attached document as affirmation that the Australian Servicemen's Health Study is "epidemiologically sound and feasible and that its performance is scientifically desirable." I fully appreciate your concern that the protocol is now finalized and that it is imperative for the study, if approved, be initiated immediately. My concern is not whether the protocol is epidemiologically sound (in my opinion it certainly is) nor whether its performance is scientifically desirable (in my opinion both of our nations will gain valuable information from this scientific study), rather my concern is with the word "feasible." The study is feasible only if the resources are committed. The commitment of resources to such a study is not one that should be made lightly. It will involve governmental priorities and political concerns. As an "outsider" I must not contribute to those deliberations. I endorse the scientific validity of the protocol and recognize the importance of conducting, in a timely manner, health studies of veterans who served in Vietnam. Sincerely, «r. //' , Alvin Lj Y~6ung Senior Policy Analyst for Life Sciences Mr. J. S. Coombs O.C. G.P.O. Box 4842 Sydney, N.S.W. 2001 Australia �ROYAL COMMISSION ON THE USE AND EFFECTS OF CHEMICAL AGENTS ON AUSTRALIAN PERSONNEL IN VIETNAM Commissioner: The Hon. Mr Justice Phillip Evatt DSC Secretary: Mr B.D. Meade G.P.O. Box 4842 Sydney. N.S.W. 2001 Telephone: (02) 239 6222 13 January, 1984 Dr. Alvin L. Young, Lt. C o l . , U . S . A . F . , PhD, Senior Policy Analyst for L i f e Sciences, Executive O f f i c e of the President, O f f i c e for Science and Technology Policy, WASHINGTON DC 20500 USA Dear Al, Notwithstanding the participation of all members of the Scientific Advisory Panel in the finalisation of the protocol our masters require the attached confirmation of the agreement reached which I included in a letter to the appropriate Minister. Accordingly I would be obliged if you would return the attached document as a matter of extreme urgency. Kind regards, J. S. Coombs Q.C. Attachment. �The Hon. Mr. Justice Phillip Evatt DSC LLB, Royal Commissioner, Royal Commission on the Use and Effects of Chemical Agents on Australian Personnel In Vietnam, G.P.O. Box 4842, SYDNEY. N.S.W. 2001 Dear Judge, We the undersigned, members of your Scientific Advisory Panel, hereby confirm that we took part in a review and critique of a protocol for Australian Servicemens Health Study leading to its consolidation into the protocol dated 22 December, 1983. We confirm our agreement that the study is epidemiologically sound and feasible and that its performance is scientifically desirable. Yours sincerely, Dr. Bruce Armstrong Dr. Tony McMichael MB, BS Dr. John Mathews B. Sc, MB, MD, MRACP, PhD, FRACP Dr. D. Riedel, M.Sc, PhD Dr. Alvin Young � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 076 Folder The folder containing the original item. 1968 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 J. S. Coombs from Alvin L. Young, January 25, 1984 Subject The topic of the resource international cooperation AVHS study protocol ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/7ef44819fdcfdc6bd1cae4bb29a33d7d.pdf a6e183bdf33a3d4afc78862f1c696fb2 PDF Text Text ftemU Number 0197 Author Young. Alvin L. ° Executive Office of the President, Office of Science and RBPOrt/ArtiClB Tlth Lettor to 6, 1984 Mrs. Pat Bragg from Alvin L. Young. February Journal/Book Title Year 000 ° Month/Day Color Number of Images 1 Letter discusses the telephone conversation that Bragg and Young had the previous week regarding the official visit of Mr. John Coombs and Dr. John Matthews from the Australian Royal Commission on the Use and Effects of Chemical Agents on Australian personnel in Vietnam. The mentioned attached itinerary is missing. See item 1966 for proposed itinerary for this visit. Monday. July 30. 2001 Page 1970 of 1993 �EXECUTIVE OFFICE OF THE PRESIDENT OFFICE OF SCIENCE AND TECHNOLOGY POLICY WASHINGTON. D C 20600 February 6, 1984 Dear Mrs./Bragg: This is to confirm our telephone conversation of last week informing you of the official visit of Mr. John Coombs and Dr. John Matthews from the Australian Royal Commission on the Use and Effects of Chemical Agents on Australian Personnel in Vietnam (itinerary attached). Dr. Matthews is the principal investigator of the Australian Serviceman's Health Study and Mortality Study. The two men will be in Washington for the release of the Air Force Health Study, February 24, 1984, and requested that arrangements be made with the Air Force for them to meet with the Air Force Principal Investigators. Mr. Coombs and Dr. Matthews have suggested either a late afternoon or an evening meeting on February 24, or a meeting on Saturday morning, February 25. Dr. Barclay Shepard, Veterans Administration, has offered to provide an office for the meeting. I would appreciate your assistance in coordinating the meeting between these two scientific teams. If you have any questions or if I can be of assistance, please contact me at 395-3125. Sincerely, to Alvin Young" LT COL USAF, Ph.D Senior Policy Analyst for Life Sciences Mrs. Pat Bragg HQ USAF/SGI Boiling, AFB, D.C. cc: 20332 Dr. Barclay Shepard � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 076 Folder The folder containing the original item. 1970 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. Description An account of the resource Corporate Author: Executive Office of the President, Office of Science and Technology Policy, Washington, D. C. Title A name given to the resource Letter to Mrs. Pat Bragg from Alvin L. Young, February 6, 1984 Subject The topic of the resource international cooperation Australia AVHS ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 034 Folder The folder containing the original item. 0695 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Hall, Peter Ben Selinger Source A related resource from which the described resource is derived Nature Date A point or period of time associated with an event in the lifecycle of the resource July 23 1981 Title A name given to the resource Letter to the Editor: Australian 2,4,5-T Subject The topic of the resource dioxin AVHS ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/807f43f1dde03857d586217d022f9014.pdf 935dede7f0dfdb3aa4ff367c2c6802c4 PDF Text Text Item D Number 01959 Author Young. Alvm L. Corporate Author RBpOPt/ArtiClB Titta Letter to The Honorable Mr. Justice Phillip Evatt from Alvin L. Young. January 26. 1984 Journal/Book Title Year 000 ° Month/Day Color Number of Images 1 DOSCrutOn NOteS Young endorses the scientific validity of the Australian Servicemen's Health Study protocol and recognizes the importance of conducting this study. See item 1968 for correspondence leading to this letter. Monday. July 30. 2001 Page 1969 of 1993 �EXECUTIVE OFFICE OF THE PRESIDENT Ol F ICE OP SCIFNCF AND TECHNOLOGY I'OL ICY January 26, 1984 Dear Judge, I endorse the scientific validity of the protocol for the Australian Servicemen's Health Study and recognize the importance of conducting, in a timely manner, health studies of veterans who served in Vietnam. Sincerely, Alvin L. Young Senior Policy Analyst for Life Sciences The Honorable Mr. Justice Phillip Evatt DSC LLB, Royal Commissioner, Royal Commission on the Use and Effects of Chemical Agents on Autstralian Personnel In Vietnam, G.P.O. Box 4842 SYDNEY. N.S.W. 2001 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 076 Folder The folder containing the original item. 1969 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, January 26, 1984 Subject The topic of the resource international cooperation AVHS study protocol ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 075 Folder The folder containing the original item. 1954 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 Shannon, Peter Date A point or period of time associated with an event in the lifecycle of the resource 1983-12-01 Title A name given to the resource Letter: from Peter Shannon to Alvin L. Young, 9 December 1983 Subject The topic of the resource AVHS Australia 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 The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 079 Folder The folder containing the original item. 2042 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 Coombs, J. S. Title A name given to the resource Letter: to Alvin L. Young from J. S. Coombs, 7 August 1984 Subject The topic of the resource veteran psychological health AVHS 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 The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 072 Folder The folder containing the original item. 1905 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/. Description An account of the resource Corporate Author: United Press International Date A point or period of time associated with an event in the lifecycle of the resource February 16 1982 Title A name given to the resource News Brief: Australia Scales Down Agent Orange Survey Subject The topic of the resource AVHS ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 027 Folder The folder containing the original item. 0409 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Nature Date A point or period of time associated with an event in the lifecycle of the resource April 10 1980 Title A name given to the resource News in Brief: US agency denies Agent Orange cover up; News in Brief: Australia orders Agent Orange inquiry Subject The topic of the resource VA AVHS government liability 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 The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 053 Folder The folder containing the original item. 1407 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 Program: 1985 Annual Summer Toxicology Forum, Aspen, Colorado, 15-19 July 1985 Subject The topic of the resource AVHS risk assessment dioxin ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 071 Folder The folder containing the original item. 1904 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 Jessop Description An account of the resource Corporate Author: Commonwealth of Australia, Senate, Standing Committee on Science and the Environment Date A point or period of time associated with an event in the lifecycle of the resource February 5 1982 Title A name given to the resource Reference: Pesticides Inquiry (Official Hansard Report), Melbourne, Friday, 5 February 1982. Subject The topic of the resource Australian Parliamentary hearings health effects veteran psychological health AVHS ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 071 Folder The folder containing the original item. 1903 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 Jessop Description An account of the resource Corporate Author: Commonwealth of Australia, Senate, Standing Committee on Science and the Environment Date A point or period of time associated with an event in the lifecycle of the resource February 4 1982 Title A name given to the resource Reference: Pesticides Inquiry (Official Hansard Report), Melbourne, Thursday, 4 February 1982. Subject The topic of the resource Australian Parliamentary hearings health effects dioxin AVHS ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 070 Folder The folder containing the original item. 1899 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 Jessop Description An account of the resource Corporate Author: Commonwealth of Australia, Senate, Standing Committee on Science and the Environment Date A point or period of time associated with an event in the lifecycle of the resource December 8 1981 Title A name given to the resource Reference: Pesticides Inquiry (Official Hansard Report), Tuesday, 8 December, 1981. Subject The topic of the resource Australian Parliamentary hearings health effects pesticide regulation AVHS ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 028 Folder The folder containing the original item. 0447 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Aldred, J. E. Description An account of the resource Corporate Author: Consultative Council on Congenital Abnormalities in the Yarram District Date A point or period of time associated with an event in the lifecycle of the resource September 26 1978 Title A name given to the resource Report of the Consultative Council on Congenital Abnormalities in the Yarram District Subject The topic of the resource AVHS congenital birth defects ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 036 Folder The folder containing the original item. 0786 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Jessop, D. S. Source A related resource from which the described resource is derived Senate Date A point or period of time associated with an event in the lifecycle of the resource November 25 1982 Title A name given to the resource Standing Committee on Science and the Environment: Report on Pesticides and the Health of Vietnam Veterans Subject The topic of the resource AVHS government liability ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/6e5160597f40b1e483a4fe74fb41335a.pdf 74ff90e8a94b18099e2ce8b0db4eb704 PDF Text Text Item ID Number 01885 Author Corporate Author RUpOrt/ArtiClB TltlB Submission to the Scientific Advisory Committee, Australian Veterans Herbicide Studies, 3rd Meeting to be held in Sydney 3 & 4th March 1981. Journal/Book Title Year 1981 Month/Day February 26 Color ! Number of Images 64 Descrlpton Notes Wednesday, July 18, 2001 Pago 1885 of 1908 �26th February, 1901 SUBMISSION TO THE! SCIENTIFIC ADVISORY COMMITTEE AUSTRALIAN VETERANS HERBICIDE STUDIES 3rd Meeting to be held in Sydne.y 3 & 4th March 1981 SECTIONS: 1. Pilot Study FJroposa3 . • 2. Progress Report on Exposure Lstiiuatiun * 3. Revised Plans ?.nd Estimates for ths Study �SECTION 1 ^ : ' " - . : ' • -. •• PILOT STUDY PROPOSAL Page 1. AUSTRALIAN VETERANS HERBICIDE STUDIES • . 1 • 1.1 EJackground 1.2 Postulated effects of herbicides 2. AIMS AND OBJECTIVES OF THE PILOT STUDY 7 2.1 General Aims .2.2 Specific Objectives ' 3. RESEARCH PLAN ' _ " - • " A." METHODS OF DATA COLLECTION TO RE TESTED FOR THE FAMILY SURVEY 8 13 A.I Data collection methods to be tested A. 2 The questionnaire Zf."3" Data collection by Questionnaire - A.A Coding and data entry for Questionnaire • A.5 Medical history and examination 5. VALIDATION OF fCDICAL DATA '• • " . . ' . " 19 5.1 Overviev/ / 5.2 Methodology 5.3 Conditions to ba validated 5.A Service Medical Records 5.5 Non-Service Records 6. COKTIDIKTIALITY AM) PRIVACY ISSUES '"' 23 6.1 Confidentiality 6.2 Privccy 7. STATISTICAL AfiALYSIS G;r 1i!F. PILOT STUDY 25 8. ATrNDJCES 28 ' 8.3 SI rue I urc; of tht1 lnte::vicv//C?Jf->stionr!£iirc fi.? Structui-R of •:•'.? t-tjo'.ical Hirtory and Modical Examination of Adu3ts B.3 MedJcal Cxor:i.i.n::;.iur-; of Children �> • • -1- • . 1. AUSTRALIAN VETLMhS HERDiCIDC STUDIES I.I Kackground . ' . . . ' • In its report of its second meeting he.ld in Sydney 14th September, 1980 the Scientific Advisory Cormjittcc (SAC) considered a research protocol which set out the broad long-tern 'strategy proposed by the investigators from the Commonwealth Institute of Health. The Committee reported that it "considered these planned investigations to cover fairly completely the possibilities for epidorniological investigation in Australia of the effects of herbicide exposure in Vietnam during the Vietnam war". T!" . Committee identified measurement of exposure to herbicides and the comparability of Vietnam veterans and a proposed control group as two key issues which must be clarified before the scientific viability of the whole study could be assessed. The Committee also recommended expanded pilot studies to provide the data necessary for a fully informed choice of the best method within a spectrum ranging from a mailed self-administered questionnaire (SAQ) to interview and medical examination of all-veterans and their progeny. It was considered that as far as possible these preliminary investigations should be incorporated into a single pilot study to avoid the delays of a sequential approach. It was noted that there may be advantage to all concerned if the Committee were to review plans for the pilot study prior to their commencement. Work is currently proceeding according to a plan drawn up for the pilot survey. Due to limited resources in personnel end shortage of'time it has not been possibJe to provide completed documentation for all aspects of the pilot study. The present submission is a summary which has been prepared to meet a deadline. Further development, particularly of data collection instruments, is proceeding rapidly cr.ci more information could be-nade available to the Conndttee during its meeting, if so desired. A progress report on exposure estimation .is subr.iittex' in section 2 and revised plans and estimates for the investigation are submitted in section 3. �* • - 2 - . . . I'2 Posiulolnci effects of herbicides* The terms of reference as given by the Department of Veterans' Affairs to the now Commonweal th Institute of Health concerned the possible effects of contact v/ith or exposure to Agent Orange and subsequent disabilities in Australian veterans, or in complications of pregnancy in their spouses and the occurrence of congenital malformations in their offspring. Although the possible effects of Agent Orange remain the primary concern of the investigators, the possible effects of exposure to other herbicides such as Agent Blue (cacog'ylic acid) will also be actively sought in the investigation. Agent Orange consisted of a mixture of 2,4-D and 2,4,5,-T. The latter is contaminated during manufacture with TCOD (2,3,7,8-tetrachlorodibanzo-para-dioxin). The pharmaco-dynamics and toxicology of these chemicals has recently been reviewed by the Department of Health. 2,4-D may be absorbed from the gastrointestinal tract or by •inhalation. Little absorption occurs directly though the skin. Absorbed 2,4-D is quick] y excreted from the body, mostly in urine as the free acid. It does not accumulate in the body. There are many reports of consumption of •sublethal doses of 2,4-D without any apparent ill-effects. However, occupationally exposed workers have complained of rcn-specific symptoms such as excessive fatigue, epigastric pains, anorexia (loss of appetite), occasional upper respiratory tract symptoms and impaired taste sensitivity. Medical investigation has not implicated 2,4-D as the cause of all symptoms but did suggest indications of increased incidence of liver disc9.se among workers with chronic exposure to herbicides. Isolated cases of peripheral neuropathy and contact dermatitis following exposure to 2,4-D have been reported. 2,4, 5- T is readily ah; orbed from the gastrointestinal tract after incjGstion and probably aftcr_ inhalation. Skin absorption, however. is slight. Like 2,/t-D it is readily excreted and is not stored in the: body. .Stove rnetaoolism does occur in animz-.ls but the bulk is secreted unchanged in the urine, "iho oral dose required to produce symptoms in man is probably three to four grains. Medical exyrcination of workers engaged in the manufacture of 2,4,5-T has shown increased incidence of chloracne which could be attributed to the presence of TCDD as an impurity. It should be noteci that increased incidences of urinary por'phyria, chloracnc and nirrutisrii have been demonstrated in workers employed in n^nufc.cturing chlorinated phenols such an Z/ijS-trichlorophonol, the precursor of 2,4,5-T. Again, the responsible agent could be TCDf), and most reports do not distinguish its effect from possible: effects cf 7,4,5-T. 2,4,5-T has been shown to csuse toratogenic effects in animals which cannot be wholly attributed to the; presence of toxic impurities such r.s TCOE.). Who the v or not 2,4,5-T is carcinogenic cannot be deduced conclusively from results reported to date. 2,'i,5--T, like 2,4-D, does not- increase mutation rates nor stimulate mutc'C^nic responses in rats r.nd mice. Jt does, hov/ever, produce chromatic! a bnorma lilies, j.n vitro in cultured n-jiioi lyriipiujcylos and affect the cf).ccn.os;o!::«j!S onrj j.eproUuclivG Riec-lianisms of dioui-e si/j hamster bone narrow cells. It shcvjjd I: -2 r.Jclefl, however; that these effects may IKIVO been due to cellular toxicity lather than ^etTit.ic ol.tei Information in tl-.ir; section has been obtoinscl Riciniy from ur,[rjb}is!ii-cl doc%;.i:writi, preparcci tiy tf-o ii;:parLi".t:nt of Health, �•- . -3- • . ' TCDD was present in Agent Orange and Agent Purple used by U.S. military forces in South Vietnam. Kr.av/Jeclge of the toxic effects of TCDD in man comes mainly from medical assessment of occupation-ally exposed workers engaged, in the production of chlorinated phenols and their derivates. Limited data are available from known episodes of exposure of the general population. Table 1.1 lists known toxic effects attributed to TCDD in TABLE 1.1 TOXIC EFFECTS OF TCDD IN MAN Dermatologi ca1; Chloracne Porphyria cutanea tarda Hyperpigmentation and hirsutism Internal: , "~ ~ Psychifit3.\ic: Liver damage (mild fibrosis, fatty changes, haernofuscin deposition and parenchymai-cell degeneration) Raised serum hepatic enzyme levels Disorders of fat metabolism Disorders of carbohydrate metabolism Cardiovascular disorders Urinary tract disorders Rc'spiratory tract disorders Pancreatic disorders Polyneuropathies Sensory impairments (sight, hearing, . ' 'smell, taste) Neurasthenic or depressive syndromes Source: Horcberger, E. Reggi&ni, Ci. Sarnbreth, 3. and Wipf, U.K., ^J.CL.J^9.u;Pj_jJyil- ^2» 2273 (1979) Expos2cJ individuals may develop a variety of medical conditions with chloracne, n-?LirologicRl and behavioural changes, liver end fat metabolism disorders end signs of porphyria cutanea t&rda (a disorder of porphyrin metabolism) arr.ong the most frequently rej.iort»d toxic effects. Reports from Sweden have shown recently a statistically significant c'ssociation between human exposure to chlorc;:f;enoxy acids and chj orophcnols end increased incidence of certain soft, tissue sorccr-iata snci lymphomata. �Table 1.2 summarises the results of some toxicological experiments with TCOD in laboratory animals. TABLE 1.2 TCDD - EXPERIMENTAL TOX1CITY •A Dose LDtjQ for laboratory animals Systemic lesions (liver, blood, skin, etc) and clinical chemistry abnormal findings at chronic administration Embryotoxicity, foetotoxicity, postnatal growth retardation Reproduction, fertility Immunodeficiency (atrophy of lymphoid tissue) Enzyme induction Carcinogenicity Mutagerdcity (?) (0.6-ll5)ug/kg 0.1 ug/kg 0.25 ug/kg 0.01 ug/kg 0.1 ug/kg 1 ug/kg 0.1 ug/kg 2 ug/ml (1) Indicative-; values Note: lug = O.OOlmg Source: Homberejer, Regggiani, fi. Sambreth. J. and V/ipf, U.K., 22, 3273 (1979) Chronic toxicity of TCDD is most often manifested as hop::tic necrosis (death of liver cells) and thymic and lymphojd atrophy. The degree of hepatic involvement appears to be dose and species related. Suprossion of the thyniu-; and lyrnphoid tissue leads to decreased iraiune responses in mice, rats and guinea pigs. Acne of increasing severity v/as produced when AS'Creasing doses of TCOD were applied to 7?abbit's ears. A total close of 0.002 to 6.C03 mo/kg over a nine month period produced severe hstmotoJogical changes F.rsci death in rhesus monkeys, making these among the most TCOD-susceptible animals tested. TCOO is o potent teratogen which causes increased fetal mortality in animals. It pio^uces cleft palate snd kidney rbnormalities in mice at doses as low as 0.001 r.ig/ky whilst di?pres»s?ci fetal v/eight t-nd visoral Ic-sions, occur in rats ot O.CC05> to 0.003 nig/kg. Teratolcigical effects in rhcsuc- rnoniwys h&vs not bee;i demonstrated. Studies on the corcinorjenic potentifil of TCTJi) h.r.ve bc.-cn Jess conclusive. The potential r;iutacenicity of 1CDD in hun;ans has not bjen cttcr^inecl. reeding studies with i-ats tiavc not sh.own iT.utag3n.ic effucU-. but TCiJi) has b&en 5-.!N.o\vn to induce rnutagrnic changes in so.'i-;-: stjains of bscterici, in common with many other substances. �Cacodylic scid • . • When used as a herbicide cacodylic acid has the potential for absorption by inhalation and through the skin. No human data arc known to be available on its dermal absorption and very little is known about human pulmonary absorption of organic arsenicGls. Ingested seafood arsenic is apparently absorbed from the gastrointestinal tract. Whilst no data are available on the distribution of organic arsenic compounds in humans, studies with forestry workers exposed to cacodylic acid have demonstrated its rapid urinary clearance form the body. • Study of the biotransformation of cacodylic scid in living rats has shown that it is fairly stable i_n .vivo and is not converted to inorganic arsenic. Any in vivo transformation of cacodylic acid in other species is not clear. Little data are available on the chronic toxicity of cacodylic acid in humans. Toxic effects of these organic arsenicals used as drugs are mainly manifested in ths central nervous system and include encephalopathy and optic atrophy. Other less frequent side effect include dermatitis, liver damage and disturbances of the haemopoetic system. Cacodylic acid has been considered as a source of intcxication of domestic animals leading to symptoms similar to those produced by chronic ingestion of inorganic arsenic. Chronic feeaing of cacodylic acid to rats and beagle dcgs has produced..no significant effects on body weigh1;, food consumption, organ weights, urinslysis or haematoionical system. Organic arsenr'.cals have no known rnutagenic or teratogenic effects in man or animals and no conclusive evidence cf carcinogenic activity in laboratory animals is known. N'-j epidemic]ogical investigations r.re known to have: been conducted on the carcinogenicity of cacodylic acid or other organic arsenic compounds. There are only three reported studies of the toxic effects to humans of cacodylic acid end its salts in the recent literature. The most extensive documentation of Cc'coclylic acid tox.icity in humans is that of Peoples £t «J_. (I97i0. Tncse authors reviewed 3/i uncontroIJed cases of occupational exposure finioogst CaHfornian agricultural workers which occurred bc-twcen 197J5--7?. exposure cccurrod as a result of misuse, accident or equipment tfH.1function. Basically, cscodylic acid noted as a chemical irritant. Ir.gsstiun produced nausea, coJic vr;;;iiting and diarrhriee;. Application to ths fcye prc'Ciuceci ir.jjcj conjunctivitis whilst der.r.al application produced a contact dermatitis or an alJergic response, The worst ca.se was that of a spray-rig operator who received particularly heavy exposure by drenching of rhis cJothing and by splashing of he.rbio.icie so.luLicr, into his mouth. H J was hospitalised with "paralysis, irregular :rer.pir:-ition, nur-ibner-? anc! f^inti.r^g". Investigation revealed no orcpn dr.rriare a. ici recovery was spontaneous. F'ull rt-(,civory \.-)s always pvfrrpt in tfie yth;:r casc-s, anc! blood arsenic levels al'./ctys rcn:air:r;'d nonr^l. No chronic effects were reported. �[rir)rQ:inic Arsnnic Chronic exposure tc rnco'icir.al inorganic arsenics such as Fowlers' solution produces a characteristic syndrcr.se of tv/perpi client ntion followed by keratoses and, infrequently, dermal neoplasia. "this distinctive clinical syndrome has lead to general agreement that srsciiic can cause skin cancer. There have been numerous reports and several epitieraiclocjical studies of the incidence of cancer amongst workers occupational! y exposed to arsenic in nining and metallurgy, in the chemical industry end in agriculture. The cpidcmiological data are ccnsistcnt with but do not demonstrate a causal relationship between inorganic arsenic and cancer of the skin and respiratory tract. • There is nothing in the recent literature to suggest that cacodylic acid is degraded to inorganic arsenic _in vivo. Indeed there is ample evidence that such a process wculd be contrary to the established metabolic fate of arsenic compounds in r.i£rr.;nals. Halclicsin (Malelhion) Maidiosin is an organophosphorus insecticide of moderate mammalian toxicity. It is rapidly rr;staboliscc! to a variety of products and excreted laroc-'ly .in the urine. It is not cumulative in body tissues. Sublethai exposure can cause depression of plasma colincsterasc activity but this requires a high intake. Spontaneous recovery occurs after cessation of exposure. • " r* Other insecticides used in Vietnam include DDT. The chronic toxicity of DOT to fi.an has been thoroughly .investigated. Massive chronic exposure produces orJy a mild 3tiniu.lat.ian of tho rnicrosomal enzymes of the .liver. In this investigation the major postulated effects are those related to TCi'JD, since- this is the.- potentially ruost toxic contaminant in Agent Orange which comprised a very higi'i pioportiGn of'herbicide usad in Vietnam. �42. ' -- /.'-..•• AIMS AND OBJECTIVES OF THE PILOT STUDY 2.1 General Aims § . - . The purpose of the Pilot Study is to assist in planning the mainsurvey. It addresses rnethodcJonical issues related to study design including the comparability of Vietnam veterans snd the proposed control group and, methods of data collection. It is not expected to provide data on the effects of herbicide exposure in Vietnam but is expected to test methodology and provide a basis for logical decision as to the best and most acceptable methods 'if the conducting the main survey. .2.2 The specific objectives of the pilot stuoy are as follows: 2.2.1. Tojrihqs_e t2etween_sever£l methods of data cohloctien. The choice vail "be maae primarily on the response rate and quality of data, although the cost and duration of data collection will also be a consideration. 2.2.2. Cotnparability of Veteran jand Coritro.l Groups The pilot study will obtain data on comparability additional to that available a priori from existing records. 2.2.3. TesJ_o/_Prcced_ur8S_ toJ-'e_uspd As far eis possible the procedures to be used in the family survey will be .tested during the pilot study. The greatest eipphssis will be on data collection and analysis related to the specific objectives of the pilot study. �3. RESEARCH PLAN 3.1. Vietnam Veterans nnci Contro^ Grouos 1. About 40,000 male army personnel served in Vietnam. About 11,000 male personnel served in the Army during the period of the Vietnam War but were not sent to Vietnam. It has been decided to restrict the study at this stags to male Arrny personnel for the following reasons: (a) To avoid the introduction of possible confounding factors. This means the veteran and control groups should be as homogeneous as possible. The minimal medical standards of en cry into the three Forces were not the same. The Army had a far larger contingent of National Servicemen than either the Navy or Air Force and the usual Service experiences (e.g. diet, living conditions, combat conditions) of members of each Force were presumably quite different. It was therefore decided to drew the veteran and control groups from within a single Force. (b) The possible herbicide effects could be very Final 1. As large as possible a sample of veterans and controls should be considered so as to maximise the chances of detecting such effects. The Army was the largest Force and also contained the highest number of potentially exposed individuals. It was therefore preferred to the Navy or Air Force. (c) There are only a few hundred potentially exposed female Army personnel. Btcause of marriage and the subsequent change of surname it would be difficult to contact these individuals. rurVh-.Tii'ore, even if all could be contacted a few hundred is toe few for the lively detection of the types of effects to bo. considered ir- the family survey. It was decided to District the , study, at. least in;u.a!ly; to nisle servicemen. Australian involvement in Vietnam ceased at the r;nd of 1972. It was decided that only nale servicemen who enlisted pre-1573 and who served -in the Army at some period during the Vietr.cm War years would be included in the study. Of this group those who went to Vietnam will be known as the V grou.o, those who did not v.-ill be known as the C group. Before undertaking & statistics! analysis of the possible effect cf herbicide exposure, it is necessary to compare the V and C groups. Significant differences bstw&en the group? should IK-. noted and, whsre possible, corrected for in the final analysis, "So date it hus been possible1 to compare the V and C groups on the basis of ac:a at en] is twin I:, tirns spont in Avir.y and f,'atiorinl/i<egujar service.-. The two groups jn:e str.ilcliccilly significantly different (p 0.01) with lecipect to each of these three variables. Figure 1 illustrates the results. - The (.'ifferencn in the age at on.liii.ment' dJrlriL-u lions. of the V rind C groups (fig 3.J (a)) is dun to the-: feet that, although there are none of the C group in the GL" ':>•'• category, their; o.rc: 417 of the V group in this category. In the othe/: /i age at f;nl}.:;rnK:nt catec;o?-ios abivjl 85"; fa 12 in the V cjvoufj and ]55c ;'o t!:e C QLOUO. Tho effects of c-ijo v.v:: '.•.icll--doc:uf'ientf.sd Jn tha cpide.-niolc-jici-J l::tc.rati.ri?: ?.p.d it i-i'iajld bo j:c«3'jiblc to adjust for thi.:; �Figure 3.1 (b) shows that, for the V group there is a higher percentage of Regular servicemen than of National servicemen. Exactly the opposite is true of the C group. It is not so obvious how one should adjust for this difference between the groups. This matter needs close attention. The psychological scores in the entrance medical exam could • be of assistance in this regard as could further information to be obtained via the pilot study questionnaires. Figure 3.1 (c) shows that the V group is different from the C groups in so far as a much larger proportion of the former remained in the Army for more than six years (this being the shortest optional sign on period for a Regular serviceman). This difference is probably largely attributable to the fact that more of the V group were Regular servicemen making a career of the Army. However other effects could also be operating and the data to be collected from the pilot study should be studied closely with regard to this difference. •The results of the pilot study will be needed before the question of comparability csn be addressed more fully. This will give information on other variables such as ethnicity, socio-economic status, rural/urban living, together with a self-assessment of the reason for not going to Vietnam. It is planned that Army medical records of the entrance physical examination will be used to give medical and psychological status at the time of enlistment. 3.3 fission of the Pilot Study Twenty three Sydney metrcpolitpn electorates h^vn been selected. Six hundred individuals are; to be drawn from these electorates, 300 frcm the V group r.nd 300 from the C group. Three different interview modes (self-administered (SA), telephone (T) and face-to face (fF)) are to be assessed. One'hundred individuals; from both the V and C groups will be interviewed under each method. Figure 3.2 illustrates the egc at enlistment, length of service and Rcgulcr/Mc-tional service profiles of the V and C subgroups in the selector! Sydney electorates. Those should be compared with the Austrcilia-wjoe profiles illustrates in figure 3.1. It ic clear that, at leai-t on the basis of these; three variables, the chosen Sydney electorates are representative of the whole of Australia for V and C groups. Since; age at enlistment, length of service end Regular/National service rtetus have been slicv;n to be important variables, it was decided to strsi'.ify v<t.sn selecting trie pilot survey sample. To ensure that there are a i-ufrlcionl nur-.ihsr of individuals in each stratum, some of the ck;t'?! have b:,an cropped. Subject to the coritrainls in-posed by the overall numbers ?;v?liable in the ehosc-r, Sydney electorates in each stratum, the: design tio.s been chosen to be as "balan^d" as possible with respect to th'j V ar.rj C groups. Table. 3.1 below FI-.CWS the i'.umbers to be. sampled from each s'-rfiliuTi �-10- Mjmber of Veterans and Controls to be selected at random from each stratum by service status ?.nd time in the Army. Service Time in Status Army Vietnam (V) non-Vietnam (C) Age at enlistment Ago at enlistment LE 20 GT 20 Regular GT 2 yr. Army , 38 38 ' 42 National GT 2 yr. 37 Service LE 2 yr. GT 20 43* 42 LE 2 yr. LE 20 MARGINAL TOTAL * 40* 16* 25* 14* 2* 37 41 48 89 150 150 150 150 the maximum possible number so far indentified as resident in the Sydney study area. �-II -- tiirinjii -(*)'-••...Qfi^l.^^JLhLS.1.''. ._ . .........i_..i_..,. ,,..j ...,.. ..—(...., ...... . . ... . ___ .,...... r; . - -, , , . _ . . - . . - . . _,~.t . —i.-., »_ i.-l. . - fe I -L . : : • [ - i • , . •. „ _ . . .:. . , . .:. - > _• .,--.- _J ...J -j. -:-!..-., i » , . -.1- -!•-••• - t -J i- :- . h • i ,- .-I.-.-.-, ..,. ._.,. , . . r . , -1 -i -1 ..!. ',..; iori^ ."2..iZlLL:irj./:lJJliJjJ\!JJ : ccx^vc.u':".;'.:"". - -rrTi.. j"::!"..! ."!".!"• j.:r.i"j":.":"."'.:' • L • !. :..._. .._----.,.-?- 1j -.-|- J -,--•;••, T • ••? -i: • • • : • i i i i • -_ - » ---- - ........ \: / . l - : ——^ — _;.•:!•:;: -*- . -J -, —--~ ;.: .'_;.: J.j ^ '|: VjTiT-L::VTj:;: "!:•:;:.:. ." i '_ i ;. 1 1 _ _1 _ _ . .......... ... .._ i : ••; | '|~jj;"7". "• '! , ~~" j T ", "\ ~\ ';"": '•"!"~ {"'"! • " ; 1 '•""";"""•" 1 r::::!.;.rp";'.ri"::"; i.CMi:..,": ::".!"!":"!-.!.!- --..:-" "• ' : !! T: - i :' v • " '• - i - ' V . .. ^ . . v ^ f ^__'"* ...^ . _ . " . . - L i . .^:" : „ „ . „ . . ' . .•::::.U:::L-••.::;.!:;.; ..,... ! —v1 . Figure 3.1 I'VofiJca by (a) a^o, (l>) RCI-VJCG .'.-.tc.tui- and (c) '}.C:!;£'r.h of * service: for Lho total population oT the V and C croups .if. /'.'U-;l.;v.O.:i.f-.. �:r.l.1:|:i:hv.rJT!j ri '..Li-!.:, .i. ...:_.i-U ..-l T. . _ ^,_,__ ...j ... :l::j:!'4jj.:r.i.r - r r"! f-rri ; ; ! i ' • . \ • i ' • • i i i i ! • i " • ' i j r i i / I — . f . ... :-;_.. ^ ;..., J. -:-i-.-r ;.---.:.,-.. -.-;-;-; ;- -} -j-| ;- |- I -i -; ^-f tX;l- ;- |^ ^ ^-- -^» ^^ jr . - • r <; .........j r..^,.,,T. ..._„.....!..-r-;-.- -,.r-u-._.... ,....._L :-:-.--;-V;-•'•••---~-I^^~^-. .... .,..„,.,.. ,\--: — - : r,-J .--.-*r - • - : - • > - [ T - i - j - t - t - • ; -I"| "i -il'i"; " r-:" 1 : . ". . -^ . . _ . "i"! ! . i-,. a---.-., i'l'l , . 1 I I I I ! I :n:j i-jfl: :::Ll:L run h-i-r iir!"j!liii!;j4--r-'J-l-i^ i!"^".?-t"".!"irii '_''" :~*~\ | ;---;--|"'-:--;--;—--|-;-^--;^-f-|-i -j j • . _ /|a,\ . '. . (N«.i,0"*l A ;.._..:..: J_:_:.!..:."'..Li.j_i.|.i'.l4.'-;....._j..,_f .... :.; i • / - ., A.»«tYic«•/•.,_: - ui.i.:..:. .1 !.;.j..J-..:.r ... .1 :..:_] . ..-.{.:.: -:--:-} . - i - i - i - i | - : J ...i^lJ/lL^^.-^rdji^CfO.^^^^};,.^1;?;^ dihi:$?!H:fc; 3.? I •onioi- by (a) r.-^o, (b) service status rind (c) for vhe iilj.cn v.o be i--:i;rij)J.od d n the Tilot Si-udy. of :?cr ice �V' '•! *v ' - . • -5"?-*••>- 4. METHODS OF DATA COLLECTION ID .BE TESTED FOR THE: FAMILY SURVEY * ! Data Collection Methods to be Tested • Four different methods of data collection arc to be tested in the pilot study giving a total of five different data sets for analysis. They are: 1. 2. 3. 4. 5. Self-administered questionnaire Telephone interview Face-to-face interview Telephone interview and medical exaTiination Face-to-face interview and medical examination. The saTie questionnaire will be used for methods 1, 2 and 3. Differing additional instructions, standard probes and explanatory remarks will be issued for the questionnaire for each of methods 2 and 3. The questionnstire is dividad- into two- booklets - ons for the male, the other for his wife. The one questionnaire also serves veterans and controls. The areas of the questionnaire not applicable to controls are clearly designated. The mailing initiating the self-administered questionnaire, telephone interview and face-to-fcce interview will take place on the sense day. A mailing house v/ill be used for the pilot study as this will b'e necessary in any type of family survey. 4.1 1. * ™ ' ~~f-admini.—stored Questionnaire Sel — •--•---•--••-----— - ------ ' — •---"• '-----' " 1 3 The two questionnaires, two postage paid return addressed envelopes and tv.'O questionnaire cor.ifi-.er it slips will be mailed together with an individually addressed covering letter. A reminder letter, together with another set of questionnaires, ccmrnant slips and return envelopes will, be sent ?s-/y_ weeks later to non-responclers. Ten days later, again, continued non-respbnders will be contacted by telephone reminder call and a door-knrck reminder will be made about 12 days after that. There will be no deviation from the self -administered approach. Neither telephonists nor door-knock interviewers may conduct the' interview.. The door knocker may take delivery of the questionnaire. 4.1 2. Te_le3hone i An individually addressed letter will be mailed to each veteran together w:.th two slips (on which fie and his wife will suggest the lest tirr.ss and telephone numbers at v.-hic:i they can be contacted) and two postage paid addressed return envelopes. Telephone interviewing will take place or. t!io re turn slips are receiver] . ton-resporidfjrs v/ill be contacted by r.,«cns of a printout provided by Telecom or by consulting telephone directories. Thone v/itl-iout teleph.o;«?s v/ill be door-knockeci and inter viev.'C-c' f2co-to-i'ace. v . 4.1 3. ^ ^ A .. J: ° I inter views "r.cb£.! Initial contact will be by neans of on iridiv.iiii..all.y yr'drossed Ir.tter t-xplainicg the stu'Jy r.nci ttiat an ir.tcrvir:v;er will cnll ov uclt'plv.'.no to rnnko times. To:: thn inter views. Tlss trap, and wife will bo inl.c^-viev.-c;ci at l.ir:-er. find places convordc.'nt to tier;;. �' ft ' -14- In all three methods an attempt will be made to get non-responders to complete' a mini-questionnaire including brief health entails and the reason for non-response. 4.1 4. TelephonG: interview plus_rcqdical exafnination On completion of the telephone interview, the interviewer will offer, to a prs-se3acted sample, the medical examination. Family preference for location and time will be noted. 4.1 5. race-to-fcicc interview plus medical examination On completion of the face-to-face interview the interviewer v/ill offer to a pre-selected sample the medical examination. Again the family preference for location and time will be noted. Appointments for the examination will be finalised from the Study office. The entire fieldwork period from the mailing date to cut-off is two calendar months. 4.2 The broad objectives of the questionnaire are: • . To collect all data that may be relevant. Areas to he covered are exposure to herbicides, serviceman's medical disorders, familybirth defects, female reproductive histories, possible confounding factors, comparability of veterans and controls: . To collect valid data. ' . Upgrade personal details for continued subject surveillance. . Ease of management and administration.' -. To facilitate easy entry into computer snd the subsequent editing. , To collect relevant data to categorise individuals for each disorder. . To attract and hold the interest of the subject. II. 1has been possible to design or,;- ciuostionnairc, which contains the items c'eivnrtf necessary to achieve these objectives, that cjin successfully be both self- t'.rid interviev-'er-ac^dnistcrcd. The use of the standard GuosUomriJrc-! r.lso ailor/s Tor f-xac.-t statisriceil anofiysis of the; quality of clatti between rr.cthc'Js o.'id rerr.ovos a vc:ri?i/iQ rram the f.swosn'.cnt of resp rates. ]nc.!ivicinal items have t'C-yn disigrjcci to cr-ver one v? more of the ncj (.icLti areas: �^ . . .. . • . . . • . . .. -15' general demographic socioeconomic comparabiJity of veterans arid controls confounding factors 3ong-terrr. surveillance of the veteran exposure to herbicides medical status of veteran reproduction in women birth defects in children. • . / '' . - ; Available literature and experience suggested that the male subjects would not adequately answer questions on reproduction in their wives, birth defects Jn their children nor be able to give the names and addresses of attending doctors or hospitals. It was, therefore, decided to provide one questionnaire for the man and a shorter separate questionnaire for his wife , to provide details of her reproductive history and any birth defects in her • • children (details of the structure of the questionnaire are appended in 10. 1). .1 ' The internal design of the questionnaire has considered: number of questions. On3y those needed to gain necessary data have been included. No areas of interest are omitted. Question design. The qj.-estions are simply worried; easily understood; not open to interpretation; allow for and cover all possibJe answers to each question. Length. The questionnaire is of reasonable length with no unnecessary areas. The order of questions is logical and tactful. "fte subject's task is straightforward, simple and ronains constant for closed questions. .:, The instructions and explanations to the subject or interview&r are adequate and clear, friendly and occur es frequently as necessary. * Coding provisions arc clear and -nccurnte and alJow for spc-edy operation. ton-ceded questions provide well-designed space for writinrj opon--en.cbd answers --.rid the coding plan provides for the ultimate coding . Th'-! skip instructions follow one? system only. As both vritco'c-ris and controls arc using the s?.;*ie questionnaire c.l^ar ciofirsitioM has been provided whore questions aro not relevant for centre] s. Coriipr.jTitij lity . Vihei'O possible r.nd i-pproprJat.e the questionnaire provides for Comparability with othoi relevant studies. �-16- • fS 4.3 Data Jpol lgj2Uon_ f 'or jjuesti onna ire 4.3.1 Interviews Standard explanations, probes and extra question leads will be written into the questionnaires used for both telephone and face-to-face interviews. A questionnaire manual, specific interviewing manual and a coding manual will be issued. 4.3.2 Interviewers . • • . The telephone interviewing, face-to-face interviewing, telephone . reminder and door-knock reminder burden of the pilot study is to be contracted to an interviewing consultancy. Only firms capable of undertaking the family survey will be considered. The consultant will bs required to provide female interviewers of the highest stanoard and experience. Close field supervision will be mandatory to ensure correct interviewing techniques, quality control of data and standard approach. In addition information will be provided by the consultant on fundamental comparability matters such as time taken for interview, number of calls (telephone, in person) to achieve interview, rapport, relative costs. times .of day and week contacts were established, fc'ach respondent, will be eskod to complete the subject's comment sheet, which was mailed with the questionnaire, to gain direct information from each subject about his OY: her feelings about the questionnaire and the study in general. After each telephone and face-to-face interview the respondent will be asked these questions also, further feedback about the pilot study, the questionnaire and the data collection method will be gained in debriefing sessions with interviewers and their supervisors. t\ . /! Coding _s_ncj_ Jjs t a J'n tr y for .Ousst Jcnna .Ire 4./S.1 Coo'i ncj Where the possible range of answsrs to a question can be anticipated, the question is pre-coded. Whore tables of responses occur, the coding scheme is prc-plsnnad. Alphabetical punching will be used where coding :!& impossible and where absolute accuracy of recording is needed e.g. names a open dat of coded answers is required. Tha subject will tick pve-codod boxes or y.-rite answers in full. i-sse cofnpletea1 schso'uics will bs editec1 ard poftcoded by study staff. -._\c';:"'1: o- f ;:cri_ interv.k:v.|s The interviewer will automatically code t'Eicf1. reply except Ir.o^c ing p-jstcudii-g which vail La done in the office. TMe L;;!fir,t;t".-ip.-iiri; layout iu fJcr-ignc-c! so tint thin can bs rvvia �Medical The medical examination is being developed in order to examine 200 families, 100 of whom will be controls and 100 will be veterans. 100 of the families have been interviewed by telephone end 100 face to face. The medical examination is planned to be the sama in essentials in the pilot study as any medical examination that rcay be conducted in the main survey of families. /4.5.I. .Objectives . The objectives of the medical examination in the pilot study are: 1. To compare the methods of data collection i.e. to determine if medical examination contributes to the quality of the data. 2. To help validate information obtained at interview. 3. To screen subjects for • • • (i) Specific conditions - in the past or present, that could be related to herbicides. (ii) Present state of health. (iii) Indications of chronic disease that may or may not be related to herbicide effect. A. To look for observable birth defects in the offspring of subjects. 4.5.2. Ths conditions presently regarded by Veterans as related to herbicide exposuie include: '. ' i Skin dir.ecr.r; » paiticu.lfjr.ly chloraene; Altered Behaviour e.g. violent niaocJ swings; Neurological sy.T.ptor.is su;h as nj^bnviss ana tingling of extremities; 'Various cjastro-int^stinal disturbances. , ! Many of these complaints are subjective and difficult to measure. With this in mind the proposed bodies. 1 t-"xar,iin;-ition v.'ill not be primarily ciir.ea.se oriented but rather sy::iptu."; oriented. It v/ill involve a d:-:t.yi.lcd Medical I Li story in order to determine if the outcomes of interest exist, but in the context of post and present health, PiTsoriyl, fciin?.Jy jsrd cccupational histories as vzll as a pl'iysi examination v/ilh specie. I sifiph-ayis on t^rotet to-c?as will bz jncluded. A series of psyches lo-j.icr. 1 ti'-r.ts j n ccTinion u:;e on.- p3r:nnc:d in an effort to elucidate the particularly difficult area oT bc'Ivjv.i.otJT.T,! change. �4.5.3 Facility ' • _ It ir> proposed that the medical examinations should take place at a centrally located public Hospital or other facility. A team of two physicians, one paediatrician, 2 nurses and a clerk should be able to handle A families in the examination period which is estimated to be 3-4 hours. The location should have laboratory, equipment, waiting room and interviewing room facilities. The Medical history and physical examination will be performed by separate physicians, while psychological tests will be supervised by nurses. . . . �" '-19- •' . tt 5. - 5.1 VALIDATION OF MEDICAL. DATA Overview ^ * "" • .' • N ' ff ' Medical record validation is planned to run concurrently with the checking, editing and coding as well as input cf the data.. It is • important that the validation and input phases are co-ordinated and that an even balance of work is maintained. Medical record validation will be 'performed by the medical record administrator (Ms. Keitha Jones) appointed to the project, with the assistance of a second medical record administrator. 5.2 Methodology Upon receipt of information from 600 Pilot Study survey questionnaires, information will be checked, edited, coded and input by key punch operators. Computer lists of all YES responses to medical questions will be generated, pjovidinr] the subject has completed the section on health care facility treatment/type of facility/address of facility/approximate date of treatment. Listings will be by subject name v/ith groupings by health care facility to be approached. Computer validation checklists will be generated for each subject, containing the following information; SUBJECT'S NAML7ADDRESS/DOB/CUESTION NUMBER (YES RESPONSE) NAME OF HEALTH CARE FACILITY. KsLhodoloyy of validation of Hospital Medical Records will be as follows: ed ValjLcintion Format •. i 1. 2. 3. 4. Condition investigated Condition not investigated Condition investigated but not-validated Condition investigated/condition confinr.ed and accounted for by known disease factors 5. Condition investicjatcci/conciitjon confirmed but not accounted for by known disease factors Lists of medical records to be viewed vill be; sent to esch hospital medic.!!, record Fd:n.unstratcr/|-or>pitfil administration with a photoco-.y of the subject's signed consent to release information. The subject's oricjinal consent forn will be retained v/iLhi.n the Her'jicicie Study offices, Each valiaation checklist v.-iJJ be coded by ths M . R . A . using the Int.c?.national C3assif.1 cation of Discr.fcas Sth. f\evJ£ion V.'.H.O. r.i> each conJition is validated. Viilidator's irdtir-ls nrid clclc of vr«.Ucation wi.ll also to eritcvecj. . �-205.3. £onditjonsjto_bc_ va3.iidatcd \ The following target organs/systems/conditions v.'ill be assigned specific disease codes, using I.C.D.9 for the purpose of validation. Broad 1.C.D.9 groupings will be used for preliminary statistical analysis. TARGET ORG AN/SYSTjFM/CONDI TION ICO GROUPING ICD SPECIFIC COOES Demiatological • Nsoplastic Hepatic Haemopoetic Immunological (Endocrir e/Me tabol i c/Nu tr i t) Cardiovascular Renal Reproductive - Male (Incl. Sexual) - Female Neurological 680 - 709 140 - 239 570 ~ 573 280 - 289 to be decided 240 - 279 390 - 459 580 - 599 • 600-608 (D.S.M. Ill) (ICO 9-300-316)? 630 - 676 610-629 320 - 389 Medical record validation will also include chocking hospital medical records for: Reported deaths of offsprings ) Reported neoplasms of offsprings ) VETERANS & CONTROL Reported Birth defects of offspring) Reported birth defects, reported deaths/reported neoplasms of offspring will be coded using JCC 9 aftc-.r medical record validation. �5 /J - Service M3d.lcal Records (covering the period of Vietnam Conflict) Army health services medical records are storeri in Melbourne (separately from the Central Army Records Office) and vail be viewed in order to determine: 1.1 Type of medical data available Number of mecljcal examinations performed Content of each medical examination Methods of question batteries/scoring used by the Army medical personnel Methods of determining medical status on entry into the army Determine who will retrieve/select 600 index cards and pre-code the information 1.2 It is proposed that the statistician and medical record administrator view and select these records for the Pilot Study 1.3 These records are stored via the last tv/o digits of the Army service number (6 or 7 digit number depending on type of enlistment). 5.5 N'qn-Service Records 5.5.1 Valicjat1on j.isj_ rig rb so ita 1 Records 5.5.1.1 in all subj ects Identification sheet/reported final diagnoses Hospital discharge summary/concurrent final diagnoses - copy retained by M.R.A. Operation charts - Various treatment charts Physician's notes (past/present history of illness to be validated) Nurses notes Consultation charts . . . Laboratory cherts/biochemistry - Abnormal rerults/x-ray/cat scans/nuclear nsdicine/special radiolog.i cal procedures Cancer registration notification and subsequent fornis .Hospital discharge reports (rases where no discharge summary is .available) ., �5.5.1.2. ^Additional sources for birth j nf onMtion nnd_bir_th_ 9^ Obstetrical charts/delivery charts Newborn (reported birth defects) charts 5.5.2 . • ' - Validation v/i. tfy General Practi t ipnsr Records The methodology will be as for hospital medical records, refer 5.2.1 with computer validation checklists, and standard contract letter (comptuer generated) requesting validation of reported yes responses to target organ conditions. The £[U_a.li_ty of_J^ta_obtG.incb_le from G.P. records is at nr_cfinnt;__an facTor._ l_ b_ ~ r r e " . o n V t x i storage iJs "well as 're IrToval we triads _ Ij> .alsojjin i'^ino\sTi_facu.or. The R.A.c.G.F. P.b.M.R. system has been Tritreauced~tC) rJany G.P"" surgeries in N.S.W. and in these cases retrieval of recent medical information should present no problems. 5.5.3. Vaiidation - - ' - - - The methodology will be as for Hospital/G.P. records and presents the sane problems of retrieval systems. Quality of data available is also an unknown factor. 5. 5. i\ ffiljdjatj.on using cithej^fedicajl ^Record Sources "... 1. Death certificates 2. Post mortem reports 3. Coroners Court Medicn.1 Records may be used for reported deaths by ir.ScTis of misadventure. These reports do not appc-;ar to be" sent to hospital medical record departments as a matter of course. /u Health Statistics Bureau 5. Perinatal Statistics Unit Commoriwea.Hh Institute of Health Sydney University - Or. Paul Lancaster. ;/ 6. Maternal and Child Health Division of Health Coniaiicsicm - Dr. . (GratUn-Smith) . • .7. Community Health Centres D. Mco'i'oank for 1975 is an unbiased although limited source of JFifonT.^tion (as a foll--bT'c!< validstion instivr.-.?nt ) . Kocovds are hold hy t!io Cc:.Y.ionwi?ciJih j>pGrt[:,ant of Health, i\\v.i could possibly be i.;s<;Ci as a va.Udat j.on fo? refiorte-c! riiar;nosr;i-> 01 as an i ncopendont source of dc:t? on ouvcer;:2. This is biing ifivcstignlf-a furth.ev. ~lhs major p/o^le-ri Et present appears to be retrieve:], of identifying :.rifonaatio;i. . �6. CONFIDENTIALITY AND PRIVACY ISSULS 6-1 Confidentiality ' \ • ' .. , • Much of the information being sought is sensitive and personal, and some may be relevant should the veteran make a future medical claim. In order to reduce non-compliance, it is essential that in format ion collected from subjects should be used only for the purposes of the investigation, and that this can be absolutely guaranteed. A unique confidential survey number v/ill be assigned to each subject and only this number wiJl be used to identify data. A separate f le vail be kept of names, service number and this confidential survey number. The investigation should be required to refuse access to individual data to any other government department or organisation. A means to ensure this is currently being investigated, one possibility being that members of the study team should have the status of Census Officers. • •• • 6.2 Privacy Medical record administrators constantly face the problem of balancing the desire for personal privacy against the need for public/research information. In many situations a great deal of personal discretion is used, since legal precedent is practically non-existent.. 6.2.1 New Sputl'i V.'n I cs privacy Corr<mij._tce_ The New South Wales Privacy Ccrrmittee was established under the Privacy Act, 1975 (N.S.W.) as a direct result of Professor W.L. Morrison's Report cri the Law of privacy (1973). The 13 robbers of the Privacy Committee have four main functions; namely - Research (to research and develop a general policy towards privacy), Complaints, Public Education, and Law Reform. •^. 6.2.2 Heal th Corr^ission _oj*__ Ngw South Wales The Health Commission of N.S.W. refers any requests for research involving difficult confidentiality issues to the N.S.W. Privacy Committee, and is usually guided by that Commit lee's decision, before allowing the researcher access to Hospital Medical Records. i The Health Cnraiission of New South Wales has also distribute:! a Circular No. 80/106, issued 31 st March 1900, to all Hospitals and Corwunity Health Centres. . . . _ . . J d °f this circular states "No information concern.! no a patient cff'cTicnr'is to be supplied to another person without the written consent of the patient or client. This written consent must be preserved in the case notes". The client must be ]'Nr GRMfD of the purposes of th? lj;-iiy requci'-lincj hir> confidential information, and must be Icyully capable of giving conse:-it. This consent must be fjccly given, arid cover what is required. Section 8.3 fAfites "Information should not b:.: supplied for ror;'X:?::!i v/ithout consc;n'L"o"fThe p'sticnl. or conbultal.icn \;i th the.1 eppropriatt; t'ics;;.ii;aj or rocjicr.n.l r.ut! ;ori ty . Attention is r'j'i'Wii vo lh:; guiciijliivji; for acccrcs vo dav.n p;:oa;ced by tn>? Privacy Commit toe". �,-./, J,^ •. . 6.?..'!>. Action^.bcinn_t_fike_n ": -24- . - Letters explaining the aims, recjirerr.ents and Methodology of the Veterans Herbicide Study will be sent to both the Privacy Convnitteo of N.S.W. and the Health Commission of M.S.W., and if required, discussions v/ill be organised between members of the herbicide Study Group and the Privacy Committee. Prof. L. Davidson v/ill be writing tc the Department of Veterans' Affairs in Canberra to address the question of confidentiality of a national level. At no time will medical records of any kinci be viewed by a member of the Veterans Herbicide Study without the express informed consent of Veterans/Controls/Wives etc. Production of the patient's signed consent will accompany all requests for medical record validation. Confidentiality and privacy of questionnaires will be maintained at all times within the offices of the Herbicide Study Group. �-25- • 7. 7.1 STATISTICAL ANALYSIS OF TIE PILOT STUDY Response Rates . > - Three types of response rates are of interest: (a) overall response i.e. v/hethcr any questions answered (? agreement to participate) * C-*) ^I^IJl^Lj^SSD^L i'G> now many ar>d which questions were answered • • - -1satisfactorily. (This is an aspect of data quality) (c) nj3dic_al_examination response i.e. hov/ many of the respondents agree •. . " to and attend a medical examination Ths rates (a) and (c) will be assessed as follows for each of the three interview modes: 100 -Vietnam veterans (V) and 100 non-Vietnam controls (C) Stratified random sample of 50 from each of V and C groups These are the 'selected individuals' Questionnaire to all 200-> Response rate (a) If 'selected individual, responds to questionnaire ascs/tain willingness to participate in nodical exmsmination On3y fcir T and FT modes,- ascertain av.tfjr.clance rate at medical exa'njnation e.sonso �tt ' • -26- . • ' ••' "' ' Sierniatycki* has found that the three interview modes yielded response rates of (a) SA - 70.3% (b) T - 73.5% (c) » FF - 84.1% Similar results are expected in our study and will be presented as follows: Interview Mode Pecentarje overall response Within respondents % positive response •' to medical SA T -Within respondents % attendance at medical (estimate only) KF The estimate of the % attendance at medical for the SA mode will be calculated on the basis of the observed mean attendance rate among those in the T and TF modes who gave a positive response. Only an estimate is to be calculated for the SA mode because of the time requirements for the pilot survey. Al] response rates will be calculated usinrj appropriately weighted values from each stratum. The rate (b) will be used to identify sensitive areas of the questionnaire whose wording should be reconsidered and to alert the statistician to tests whose power may be seriously affected by the presence of missing values. Power studies will have to be conducted in the light of the (b) response rates. All three response rates will be used as estimates of the figures to b& expected in ths main survey power calculations associated with the various hypotheses to be tested can then be made using these estimates. ". There are two important aspects here: (a) .the problem of non-response.1 on specific questions should bo' addressed. This has two obvious implications (i) can the question bs changed so as to increase response rate? (ii) \vhat is the effect on the power of the tts.ts to lie carried out ), say, estimates of the missing vnlu-is? ( ) 0. Sic;niatycki. A cornporison of n.ail, telephone and home .interview * strategics for household feaHh surveys AJi'H 69: 23B-M5, 1^75. �W ' • -27- ' (b) The problem of bias i.e. false reporting of nodical status. There are several ways in which one can try to detect this and determine hew often it occurs in different typos of individuals: • (i) use of medical records librarian to check on diagnosed illnesses (ii) use Army entrance medical examination data if feasible on some reported illnesses (iii) use incidence of medical disorders thought to be unrelated to herbicide exposure to "flag" over-reporting (iv) look at correlations between the battery scorer, on the questionnaire and on the medical. Low correlation could indicate false reporting and/or an inconsistent form of scoring in these two modes. 7.3 Comparability ' •. The issue of comparability of the V and C groups lias several aspects: (a)tfs'dicalrecords of the; entrancefcxaniwill be available on all 600 individuals. In addition, agu at enlistment, length of service and Regular/National service status are already known for each individual. (b) Additional information will only be available from respondents. It is there fore necessary to determine whether the respondent (R) c-nd non-respondent (fW) sections of the V and C subgroups sampled ore comparable. This will be done via (i) entrance medical exa<n records, age of enlistment, length of service. Rsgu 1 fir/National service status, place of residence (ii) a mini-questionnaire to Ws. This will ask for education, occupation and any chronic radical problems in self or family. • If the R and MR sections of the sample of 600 are comparable on the. basis of (i) &nd (ii) in both th2 V and C groups, no adjustment is necessary. If nnt, the differences should bs ascertained and taken into account when preparing pcv-ver calculations for the main study onci devising .possible statistical, analyses. •' (c) The R sections of tho V and C su!. groups will be compared via additional inf conation on the questionnaire e.g. nationality, income, education, occupation, ru::;.. I/urban r;tatus. (d) Within the: V subgroups of respondents it will also ht> necessary to compare ttiosr-; v;!ic went, into the; fr'.old with those v.'iio stayed on the bases. If it is founri th-:;t groups arc not comparable:, the rli f f crciv.cs should be ascortn\r-.o.n r.nrl thsir known i :i fu.oL-i in ti-.e areas of intriri-;;!: siioi .'Id br: su.'J i.o.'i oj.oscOy. Wl^vrevor povr:.bJo. t-n appj-nf)rJolo adjusl'i^nt sliould be iixjo.-i.o'-it^o in the: CM'irJoir-.. �U - • 8. • -28- . APPENDICES ' ' ' 8-1 Structure of A • - MALr QUEST IpKMIRE (For Pilot Study) 1.. Personnel information. 2. General information 2.1 Nature of study itself 2.2 Subjects participation 2.2.1. Importance 2.2.2. Voluntary • • . '. 2.2.3. Confidential 2.3 Contacts for further information. 3. Instructions. 3.1 How to fill in the questionnaire 3.2 V/hat to do with completed questionnaire 3.2.1. Where; to send it 3.2.2. Date to send it by 3.3 Contacts for help in filling in questionnaire A. Subject identification A.I Todays date A.2 ' Surname A.3 Given names " A.A Address in full A.5 Mono phone number A.6 Work phone number A.7 Confidential survey number , . - ' . . • . ' 5. Demoqraphics 5.1 'Dole of birth • 5.2 Type of place where lived while growing up 5.3 Years of schooling 5.4 Tertiary qualifications 5.5 Kaeiai origins .: ' ^ . • • ..-. 6. Occupational and Exposure History 6.1 Gencial job history • 6.1.3. Prior to go: no defence services 6.1.2 V.'hilo in defence services 6.1.3. After leaving defence services 6.2 Job contact with specific chemicals and substanc-es ' 6.4 Details of defence service 6. <';,.! Da to of enlistr.-.f.int 6.A.2 Ital'e of clisehriiVjt; 6.-'i.3 Status within service f - - t* \ t- i +• ' '• ' :' ' 6.5.1 L'Crto'ls of service 6.5.2 Details of cf;i.::iiicul exposures 6.5.2. .1 Sprayifn;, riie!.rlcMls 6.5.2.2 Mixino, carryinrj or locrJirg chi:mi.CQls 6.5.2.3 Clctrniri:; or rqi.'iin'nci equipmsnt used to carry • �6.5.2. 4 . In area while it was being sprayed by aircraft • 6.5.2.3 In area while it was being sprayed from vehicle, boat or backpack 6.5.2.6 In area where vegetation was dead and dying 6.6 Leisure time exposure to specific chemicals and substances 7. Medical history 7.1 Height ' ' . 7.2 Weight ' 7.3 Self-rating of heal.h 7.3.1 Physical health 7.3.2 Mental health 7.4 Specific medical conditions requiring validation 7.4.1 Derrnatologic 7.4.2 Neoplastic ' 7.4.3 Hepatic 7.4.4 HaeiTiOpoietic 7.4.5 Immunologic : ' • . ' ' 7.4.6 Cardiac 7.4.7 Endocrine conditions • 7.4.8 Urinary/kidney conditions " """ 7.4.9 Reproductive ' . 7.4.10 Neurologic 7.4.11 Psychological 8. History of smoking, alcohol and marijuana use 8.1 Sn-oking tii story 8.1.1 Now/ever 8.1.2 Stopped/started 8.1.3 Quantity 8.2. Alcohol Consumption 8.2.1 Now/ever 8.2.2 Stopped/started '. . 8.2.3 Quantity 8.3. Marijuana use 8.3.1 Lver 8.3.2 Quantity 9. s Marital history ' "' 9J Current, marital status . 9.2 Number of marriages 9.3 Number of relationships lasting more than 6 months .. ' 10. ljj-egrr;incy outcome 10.3 ftecord of all live births 3.0.2 Record of all occasions on which tried for n period of at least a year to conceive n child but were not ab.le lo c.io so 10.3 Record of all prrcjriTiric.ies not ending in a Live birth 10. /: i'.c-cc-icl of oil children horn with birth defects 10.5 Kf^-erd of nil ci'iildren di£;(jnosea as bejiio cancer 11. f't-STcp'Jons of hijsbindr. or ex-hutbcinds health 13.1 Pliysicr.1 health �. •• , - . • 12. Closing statment 12.1 : * -30- . . . Thanks 12.2 Reminder about what to do with questionnaire B. FEMALE QUESTIONNAIRE 1. Personnel information2. 3. General information 2.1 Nature of study itself 2.2 Subjects participation 2.2.1 Importance 2.2.2 Voluntary * 2.2.3 Confidential 2.3 Contacts for further information .' Instructions 3.1 How to fill in the questionnaire 3.2 What to do with completed questionnaire 3.2.1 Where to send it - 3.2.2 Date to send it by 3.3 Contacts for help in filling in questionnaire A. Subject identification 4.1 Todays date A.2 Surname A. 3 Given n&r;:es A.i\ Address in. full A.5 Home phone number A. 6 Work phono number . 5. Demoqraphics 5.1 "Date of birth 5.2 Years of schooling 5.3 Tertiary qualifications 5.A Racial origins 6. Occupations! History 6.1 General job history 7. Medical history 7.1 Height 7.2 height 8. History of smoking and alcohol consumption 8.1 Srr.old.ng KLstory 6.1.1 tow/ever 8.1.2 Stoppod/stnrted 8.1.3 Clientity " . 8.2 Alcohol consumption 8.2.1 Now/ever 8.2.2 Sloppy/started 8.2.3 Qjcntily �& ' -31- 9. Marital history 9.1 Current marital status 10. Pregnancy outcome 10.1 Record of all live births including children who have since died 10.2 Record of all occasions on which tried for a period of at least a year to conceive a child but were r.ut able to do so 10.3 Record of all pregnancies net ending in a live birth 10./i Record of all children born with birth defects 10.5 Record of all children diagnosed as having cancer 11. Perceptions of husbands or ex-husbands health 11.1 Physical health 11.2 Mental health 12. Closing statement' . " .- 12.1 Thanks 12.2 Reminder about what to do with questionnaire �-32•2 ' tniclurc of the M i e r i i a l r l i s ^ o r ^ a P d t e r J i c a l Examination of Adu3 t s It is proposed to examine 200 subjects and their children. The time of the medical examination will be approximately 3 to 4 hours. It is proposed to examine the veterans children at the same time generally in the company of their mother. PROGRAMME The proposed medical examination will be in six parts :Administration, medical history, laboratory data collection, physical examination, psychological tests, examination of offspring. SCOPE AND CONTENT OF THE MEDICAL EXAMINATION • 1. ADMINISTRATION - 10 minutes. During administration identification details and age etc. will be collected 2. MEDICAL HISTORY - A5 minutes. Performed by Physician No. 1. The system review v/i31 be a standard medical history with more or less emphasis on outcomes of interest. 3. LABORATORY DATA - 15 minutes. Vcne puncture to be performed by a nurse. Laboratory data to provit!?. haernato.logy and biochemical information. - Provision to be made for serum storage at -70-' C. The nurse will also record vital statistics e.g. height, weight and supervise spirometry. 4. PHYSICAL. EXAMINATION -• 60 minutes. Performed by Physician No. 2. (i) General examination major systems. (ii) Skin examination with photography if necessary. % " . •(iii) tourological examination. • (iv) [-.'Xcittination of target organs e.g. liver, spleen, 3'yrcph glands and testes. 5. PSYDDLCGICAL TESTS -• 60 minutes. Proposed Psycho] coir;:-:! ttsts are the Corne.l] Index (C.I..) end the M.innesot'i! ;>j]tiplujs;ic Personality Inventory (f..Mpj). Two olhc:i indices tl>:>.t may be suitable are K:inn corisidarrd - tho Onr.t? tv^siJonnaire and the !5ock Octpressic.i :nvc i ritory. A re-run of the Army's pjycholorjical tests prior to ent:y into i'ho servicos is being coroicirred. iics'i tests iiifiy be yr^inisVcrc-'Ci by <; nurse. �-336. OFFSPRING •' - ' • - . ' . - examination to be performed by a Paediatrician. (i)• General physical examination. (ii) Birth defects. . 8.3 Medical Examination of Children '., -. •' ' .. •• As previously stated it is intended that the children of veterans be examined by a Paediatrician at the same time as the subjects are being examined. Resources are being planned on the basis of examining approximately 400 children. .. The medical examination of the children will have as its objectives: 1. An estimate of present state of health. 2. Recording of any observable birth defects 2.. _ _ validation of any reported birth defects or medical conditions. A provisional list of birth defects has been compiled based en tht birth defects to be included in a case-control study of the effect of service in Vietnam to be conducted by the Center for Disease Control, Atlanta, USA. A parent of the children will be asked about the listed birth defects and confirmation will bs sought cither with evidence of surgical correction or at physical examination. Where the terminology is general and a positive response is obtained, specification and confirmation will be obtained via hospital and doctor nodical records. �d . -34- 6.3.1. List of Birth Defects . SPINA BIFIDA AND/OR HYDROCEFKALUS MICROCEPHALUS • NEUROFI6ROMOTOSIS . -' ' ' ' < ' "' ANOPHTHALMOS MICROPHTHALMOS • . ' BUPHTHALMOS CONGENITAL CATARACT . . ' COLOBOMA ANOf/iALY OF TIE EAR - IMPAIRING HEARING KIART CONDITIONS CONGENITAL CYSTIC DISEASE OF ANY ORGAN ANOMALIES OF THE GASTRO INTESTINAL TRACT CLEFT LIP AND/OR PALATE HYPGSPADIUS EPIDSPADIUS . ' . ANOMALIES OF THE URINARY TRACT ' ANOMALIES OF THE FEMALE GENITAL TRACT CLUB FOOT REDUCTION DLTOrWITIES OF THE LIMBS CHONDRODYSTRCHIY OSTEO GttlESIS IMPERFECT A HEREDITARY OEDEMA OF THE'LEGS SPECIFIC ANOMALIES OF HAIR SPECIFIC ANOMALIES OF NAILS ANOI-IALIES OF TH: ENDOCRIK:: SYSTEM ;/ SITUS INVERSUS DOWNS SYNDROME DI AF'HfViG 1ATIC HH^I A CONGENITAL NEOPLASf-! ' - CYOTOMEGALO VIRUS - HERPES SIMPLEX SYPilYLIS ' ' - �SECTION 2 DRfiFT REPORT -:.26/02/81 HERBICIDE EXPOSURE IN VIETNAM CONSIDERATIONS JOHN ROGERS �1. INTRODUCTION - 1 t 2. HERBICIDES USED BY US FORCES 1 3. HERBICIDES USED BY AUSTRALIAN FORCES 4 4. NON HERBICIDE EXPOSURE 5 . 5. SUMMARY OF POSSIBLE CHEMICAL EXPOSURES IN VIETNAM 5 6. MODELLING EXPOSURE 6 7. DATA 8. . . . 6 AERIAL SPRAYING - a) Spray drift ' " 8 i) "Deterministic" model. Conclusions ' 8 10 t ii) "Statistical" model Comments 9. RECOMMENDATIONS 10. REFERENCES APPENDIX I 11 11 -• ' ' .7 13 - - '' -. 14 ' . Comments on Recofiimondations . 19 i. APPENDIX II Additional references required APPENDIX III "Statistical" model 20 - . 23 �Research on 2,4-0, 2,4,5-T and related herbicides began during World War II, and had at that time a clearly military connotation. However, herbicides were not used for military purposes in World War II. The first, small-scale military use of herbicides was in the 1950's in the Malayan "emergency". In tha early 1960's the possibility of tactical use of herbicides was given considerable impetus. A number of herbicictas were evaluated, in various combinations, for their phytoxic effectiveness in South Vietnam. In South Vietnam, the first military herbicide operations were carried out in early 1962, and were phased out in 1971. After a relatively slow buildup from 1962 to 1965, the operations increased rapidly to a peax in 1967, declined, but only slightly, in 1968 and 1969, and dropped sharply in 1970. According to information from US Department of Defence, the last herbicide spraying by fixed-wing aircraft was flown on January 7, 1971. After this, herbicide operations were limited to spraying around perimeters of the fire bases, on enemy cache sites, and along land and water communication routes, and v/ere all carried out by'helicopter or on the ground. The last helicopter operation under U.S. control was flown on Cctooer 31, 1971. Herbicides used by US forces The herbicidal "Agents" used for military purposes in South Vietnam were identified by cods names referring to the color of bands painted on the containers of the chemicals. These of interest to thisstudy are the Agents: Orange, White & Blue. Agent Orange is a 50:50 mixture of the n-butyl esters of 2,4-0 ([2,A-ciichloroprTenoxy]acetic acid) and 2,4,5~T ([2,4,5-trichloropnenoxyjacetic acid). Each gallon of Orange contained t\ ID of 2,4-0 and 4.6 Ib of 2.5,5-T en an acid ectjivalent___ _ basis.3 Orange was tne agent used most extensively in uris Vietnam war" until its use was terminated on April 15, 1970 because of the concerns of its possible teratogsnicity and its concaminati.cn with the highly toxic TCDO (2,J5,7,8-tetrachlorodioerizo-para-dioxin). /\g_cnt Wnite is a mixture containing 2 Ib of 2,4-0 and'6.54 Ib of piclordm"(4-amino-3,5,6-trichloropicolinic acid) per gallon on an acid equivalent basis, (or 4:1 on a molar basis). It is a formulated product containing 2,4-0 and picloram as the triisopropsnolamine salts, with tne addition of surfactants and water. *This introduction is based on material in reference a (17). Acid equivalent is the weight of the acid form of the chemical, this is used oecause the weights of various ester or amine formulations vary. Expression in terms of acid equivalents provides a uniform basis for comparison of different formulations �Avjgnt Bluj3 was formulated as the sodium salt of cacocJylic acid (hydroxycrirp.nlnylarsine oxide). It contained a minimum of'21 percent sodium cacciiylate v/ith additional free cacoclylic .-jcid for a total dimetnylarsinic acid equivalent of not less tran 26 percent on a weight basis, or 3.1 Ib of cacodylic acid and about 1.7 Ib arsenic per gallon, v/ith 5 percent surfactant and 0.5 percent antifoam agent. All agents were intended for use at a rate of 3 gal./acre (28 litres per hectare), except that in the earlier operations and on rare occasions thereafter, only half of this dose was used. The homicides were applied oy US forces fixed-wing aircacft (UC-123), helicopter (UH-1), from trucks, from river boats, and from backpacks. South Vietnamese forces may have also oeen involved disseminating the herbicides Orange, White & Blue by these methods. Both aircraft types were outfitted with special spraying equipment, consisting essentially of a container for the herbicide and a spray boom witn nozzles. The container of tne UC-123 spray system had a nominal capacity of 1000 gal. -and the plans normally flew at 150 ft. (45 m) with a delivery speed of 130 to 140 knots. The "spray-on" time of 3 1/2 to 4 minutes permitted approximately 950 gallons of herbicid-j to be distributed at the rate of 28 litre/hectare over a path of 14 km length. During the peak of activity (1968--1969) approximately 30 C-123/UC-124 aircraft were employed. However, r'nany other squadrons of C-123 aircraft were used routinely throughout South Vietnam in transport operations (4). Tne capacity of the UH-1 spray system container was 2GO gal. but the helicopter could carry only 100 gal. d'js to weight limitations. Spraying by fixed-wing aircraft accounted for the greater majority of the nerbicide used in the Vietnam war, at least into the later part of 1970 from which time on helicopter herbicide operations increased and gradually became predominant, until they became the only aerial means of heroicide delivery. (17) The amount of herbicide used by year is listed in table 1 (17) and the estimates of quantities of herbicide component total usage is given in table 2 (66). Tne region that received the greatest concentration of herbicides was the Rung-Sac Special Region south of Saigon and adjoining Pnouc Tuy province (where tns Australians were posted). This level is reflected in the quantities used in military region III which included the Rung-Sat Special Region (taole 3). Trie correspondence of spray missions in military region III and ins positions of Australian soldiers has yet to be determined - and the numbers involved is suoject only to conjecture. �Tablc 1 Application of^.. War_by Year (17) 1962July 1965 Millions of Aug-fec 1965 1966 1967 ._ 1968 Orange NAa .37 White NAa 0 Blue NAa 0 Total' 1.27 ' .37 1.64 3.17 1969 _ _ 1970 Total 2.22 3.25 .57 .0 0 11.22 .53 1.33 .2.13 1.02 .22 .01 5.24 .02 .38 .28 .26 .13 .00 1.12 4.83 4.63 4.53 .97 .01 18.85 2.19 a Not available TABLE 2. Estimated quantities of herbicicios ijr-.ci TCDD ciiggeminaterj in _ Soutn Vieinc.:,\ frc.~'. January ic^i2^(^ru^ry_I97i_ (6i) Chemical Pounds 2,4-D 55,940,150" 2,4, 5-T 44,232,600 363 F3icloram Cacodylic Acid Total of Herbicides 3,041,800 ,3,543,710 106,763,260 Tne mean TCOD concentration in Herbicide; Orsngn was estimated at 1.93 ppm. v• �TA3L£ !> y.^Jj?LrbJj:lc^^ . ' A : ' '' Herbicide Expenditure (gallons) Orange White Blue Combat Tactical Zones CTZ I 2,250,000 363,000 . 298,000 CTZ II 2,519,000 729,000 473,000 e 5,309,000 3,719,000 294,000 1,227,000 435; ooo J#,p_00 5,2/16,000 1,127,000 * CTZ III (includes Saigon) CTZ IV Subtotals J,227,00 Grand total * Source: HERBS tape (65) Herb,icides strai ion f orces Australian troops may have also ooen exposed to herbicides sprayed for perimeter vegetation control around the Australian camps. The cnemicals used were on the whole obtained commercially from within Australia and included GRAXX3XONE (paraquat) REGLCNE (diquat), TOROON 50D (piclora;n/2,4-D) and HYVAR (oranacil). Tne annual usage in Vietnam -in -the years 1960 to 1971 was of the order of ( ) 6: 9,000 liters of diquat 1,600 liters of TORDON 500 4,000 kg bromacil .• •' Cofn.T.encing November 1967 a field investigation was conducted under scientific supervision to establish the metnodology for disseminating tnese herbicides. Suossquent to toxic effects b:>ing found in operators -breakdown of mucous membranes, nose oleed-5, ulceration of lips and conjunctivitis - the use of DM50* was discontinued and strict procedures for handling were recommended (31). In addition the Department of Defense "accords a fairly high degree of probability" that the Australia Task Force procurrcd and used 1,000 gallons of Agent Blue (cacodylic acid) obtained from local sources ( ) 6. * DM50 is a chemical which accelerates the uptake of herbicide into plants, and unfortunately has tlu same-effect for hu-r.ans. �-5- Non Herbicide Exposures • •• . .• Further to th3 heroicides diss-^rnnunated by the U.S. forces, the Australian troops may have co;na in contact with Ma.lati~i:'.on sprayed from specially prepared C--123 planes or "uug-biras". • The Malathion was selected for malarial mosquito control on advice frcin the World Health Organization. Unlike the hsroicidcs which were sprayed in "remote" areas the Malathion was sprayed "indiscriminately" over populated areas, "even whole to,-;ns" (A.L. Young, private conuiunication). These aircraft routinely sprayed insecticide adjacent to military and civilian installations, as well as in areas where military operations were in progress or about to commence (4) Medical treatments are also of interest, in particular (1) antimalarial drugs including the experimental drug Dapsone which was used oetween 1969 and 1970and withdrawn after adverse side effects and (2) innoculations for Plague which too had adverse side effects but remained in use. Summary of possible^ j^hj^nica 1 exposures in ^i.".tnam. Thus the chemicals which are of interest to the Australian Veterans Herbicide study are: 1. Agents used by U.S. forces (a) Orange '(b) White . . . (c) Blue . (d) Malathion; ;"•"" . .. . . 2. "Agents" used by Australian forces (a) Grammoxone , / (b) Reglone (c) llyvar [(d) Agent Blue] (e) Insecticides; 3. Australian Medical Treatments '"V- (a) Antimalarials (b) Plague innor.ulations. *" " i �• Modjjllincj exposure -6- . The object of the Veterans l-brbici.de Gtuay is to explore the causal effects of hcrbicirJe exposure in Vietnam with regard to possible adverse health outcome in Australian Vietnam Veterans. The hypothesis that a certain herbicide (or even combinations of chemicals) could cause the undesirable health effect can only be demonstrated by being consistent with the current knowledge of the chemical(s) biological action. Secondly to validate the supposition a dose-response relationship must bo shown i.e. TTe health effect should increase with increasing exposure. Any attempt to determine the 'dose1 or exposure of military personnel must be predicted on events that occurred at least ten years ago. Since there was no sampling program associated with the handing or dissemination of the heroicides in South Vietnam, a . quantitative determination of exposure in terms of actual dose can only be suoject to speculation (/'O. • However, it is still possible to determine "relative" exposure levels. For tne "Agents" of greatest concern, namely Orange, White and Blue, it is true to say that exposure did not include all Australian servicemen. Moreover, within the military population at risk, the range in magnitude of exposure must have been great. The range is so great that it is plausible that the possible errors in predicting this "relative" exposure may be less than the range itself. Data To predict exposure levels with certainty it is necessary to have a minimum of verifiable data available. To demonstrate a possiole causal or 'legal' connection requires a higher standard of documented information. Exposure to Malathion is a case which amplifies this point. No documented information regarding the "indiscriminate:" spraying of this substance is available. It may be possible to show relationship between otner highly correlated confounding factors, such as corneat duty or season and presumed Mslathion exposure. .Witnout supplementary documentary evidence it is impossible to separate the effects of the selection criteria from the exposure. A correlation between such "Malathion exposure" and health effects would ue insufficient to prove the causal nature of exposure. There is no way that such an effect could DC ascribed to the exposure to Malatnion alone. To obtain a presumed exposure level for Agents Orange, White and Blue the follo.vjng sources of data are available: 1. The so called "HERBS" computer tapes which document the herbicide sprayinfj missions of United States fixed wing aircraft, [approximately 8CK of total heruioido dissrainated by �-7- Unitcd States and South Vietnam forces is documented on these tapes]. The information on tape includes: Start co-ordinates, finish co-ordinate, gallons of agent and type of agent. The spraying from helicopters is omitted - as is record of aerial spraying before 1965. 2. The Australian army has supplied the locations of approximately 70% of Australian Units [based on commander diary information]. This is the so called "CM)11 data. Vital co-ordinate information is currently incomplete, but should be able to bs obtained. 3. A comprehensive survey of all Army personnel in South Vietnam to be conducted by this study will include questions .to fill in information gaps i.e. Report possible exposure to helicopter spray missions; unit postings (which are not included in "CARD" data); subjective information on exposure to handling herbicides, spraying from backpacks, trucks and boats, to aerial spraying and to.areas that were recently sprayed. Questions allowing the assessment of the internal consistency of the soJrces of information are to be included. 4. Survey questions will include checks for accidental and occupational exposure to phenoxy herbicides, arsenicals, asbestos and other Detrimental environmental agents outside the potential exposure in Vietnam. Aerial Sgrayjnc[ ' • • ' The exposure to the aerial application to these agents may be separated logically into four areas: a. Spj?ay_drift and concentrations in "jungle"* from aerial application. This concerns the fate of spray from the time the spray leaves the plane until spray particles impact on the jungle foliage, tree trunks and ground and to the herbicide distribution within the jungle ecosystem. •b< J^LF.°_nrO°nt£LOLa!LG. in JunQle 3nc' hence likely sources of contamination. Addresses .the following areas: i) volatalisation and revolatalisation ii) pnotodeconiposition and biodegredation of herbicide components • iii) redistribution of herbicide components within the jungle environment e.g. after leaf fall iv) Bioaccumulation "jungle" is used to indicate all possible tynes of vegetation such as forest, savanna, mangrove, swamp and cultivated land. �• -8t ^ • . c. Exposure ^nodes; i.e. exposure via dermal, alimentary and pulmonary routes including relative absorption values and likely sources of contamination via eacli route. d. Exposure categories i.e. use current data in the scientific literature to choose a_ priori meaningful exposure level categorisations. a) Spray drift There are two models which are proposed for spray drift calculation. They are not of necessity mutually exclusive and are as follows: i) J!te_teiininj.stic^ model of spray fate. "The generalised model format is for a mass continuity equation that in principle provides a complete description of the trajectory and properties of an aerosol or heavy particulate cloud, from the time of cloud stabilization to the collection by downwind surfaces. The terms included in the generalised model must therefore specify the direction and rate of downwind cloud travel, the alongwind crosswind snd vertical cloud dimensions of travel time and distance, the distribution of material within the cloud as a function of time and distance., and loss of material through gravitational settling, impaction or deposition on vegetation or other surfaces." (19) Ine model snculd also provide for the. effects of variations in chemical and physical properties of the material contained in the spray cloud e.g. the volatility of components; the mode of release and source emission time; and in meteorological, micro-meteorological, terrain and vegetative factors. Spray "drift" is used interchangab.lv to describe two distinct processes. Trie first type of "drift" refers to the variation of the actual flightpath to the "HERDS" data and the second to the .spreading of the spray cloud due to physical and meteorological conditions. The former could conceivably be tens of kilometres while the latter should be 1 kilometre at most. Although it has been stressed that the pilots were able to lay spray swaths accurately and that drift "just did not occur" (A.L. Young private communication), [Herbicide]" mission commanders stated that drift was a common problem and could extend frcv.i 1 to ?. kilometers. Ons "Rancn Hand" commander said in several cases drift could be up to 10 k:n. (These .instances were mountainous regions usually occupied by enemy forces) (18). r To reliably estimate the spray fate requires the following information. 1) Jl^UyJ__fJ^Y,.:path. The "IERRS" tapes give: the positions of flighupaLn""cn;ipaj"rits. SJncc all trie 1'jxed wiivj mission �preparation included aerial reconrmsanoe it :n<ay bs assumed that the endpoints or at leas'; the startpoint was relinbJy achieved. However it has been stated that the actual flightpath may have deviated markedly from a straight line (A.L. Young private communications) with terrain being a major factor. Furthermore, if a mission involved clearing jungle along a river bank or road, the straight line approximation would be grossly in error*. 2) Sp_L?iy_.-PJ:lliy£.icl sizs,_o'iRt.ribution is a critical factor in determining drift potential "revolatilisat Ion arid particularly fate within the jungle canopy -- drops smaller than ISQuci would .pose a problem. If the spray is volatile, i.e. Orange, the larger droplets can vapouriss to these dimensions, exaggerating the problem. The droplet size is highly dependent on viscosity, nozzle geometry, spray system pressure and aircraft speed. Incomplete data on particle size distribution is included in Table 4. . k TABLE 4 Spray characteristics of C-12'.5 Modular Internal Spray Systern_._TflTTs'pray m'aterlai'uhkriov/n'j" Aircraft speed Aircraft altitude Tank volume Spray time Particle size: (percentage by volume) 100J 1.9% . 100-500U 76.2% 500 130 Knots 150 ft (45 m) 1,000 gal (4,500 1) 3.5-4 min • 21.995 87% impacted within 1 min 13K drifted or volatilized Mean particle volume * • 0.61ul The committee on Effects of Herbicides in Vietnam (17) found several instances where defoliation missions were more than 8km from the nominated path. �The problem of volatility would also affect the water soluble Agents Blue and White which were sprayed in a concentrated form. Experience in agriculture has shown that it is possible for the water to vapouriss from spray particles leaving a dust of the concentrate which impacts with extreme unreliability (70). The effect varies inversely with droplet size. The water solubility of these Agents mean that they have a vastly different environmental fate if it rained within 6 hours of application. Il^rpjnme^ejrolp^Y.. The "deposition and/or drift of a spray cloud is hlgnly dependant on the locajL_ meterological conditions. Such factor as terrain, jungle surface and tiros of day dictate local v/ind direction, thermals and inversions which are impressed upon the larger scale weather patterns. Fortunately jungle provides micrometerological patterns which are stable over large areas so reliable predictions are possible given the factors of terrain, jungle surface, time of day and weather. A factor which interacts considerably with micro-meteorological factors to produce drift is aircraft spray height - it must be stressed that, although highly dedicated, the US pilots were operating undsr combat conditions, in many cases over difficult terrain so that the value of 150ft (45m) must be treated as a nominal altitude only. Conclusions . - The overwhelming problem yet to be faced is that of the validity of this model. Agricultural experience (70) has shown the inadequacies, even disasters, of models of spray behaviour in well controlled situations. The variety of specialised models available and the controversy over their validity (0), (9), (19), (70), (71) illustrates the potential problems. Furthermore the available models concern the application of dilute solutions (of ths order of 1 in 100) applied over an even crop surface by single lignt plane from an altitude of 3 meters •versus the situation in Vietnam where a concentrated solution was applied over a rougn jungle surface by a formation of cargo planes, flying at a nominal 45 meters. The utility of such models to the Vietnam situation could only be classed as fortuitous. In addition volatile esters "were requested [and used] in order to achieve more uniform coverage withj.n_ a forest csnopy"(66). Thus the volatilisation from puri:ic.U>s~~wiv.hin the sp ay cloud and from herbicide on leaf surfaces must, be included in any model of spray fate and/or exposure. It is obvious that there are many problems to be addressed before the deterministic mocisl would be a viable preposition. Validity could only be assessed by a careful re-enactment of the Vietnamese spraying operations under a variety of operational and wea tt if r cone1 i ti ons. �-11ii) Statistical Model The requirements of the "deterministic" rncdsl for hard data may not be fulfilled from the distance of time so it is suggested that a simpler "statistical" model of spray fate be used. It will be assumed that the planes started from the "HERBS" startpoint and headed in the direction of the endpoint. The variance of the probability distribution function of the actual fligntpath is assumed to increase with increasing distance from the startpoint. The "actual" endpoint is distributed at a mean distance of 14 km from the startpoint. The percolation and vertical distribution of spray within the jungle is more complex. The "deterministic" model would be of great benefit in calculating this distribution. The most satisfactory method would be to assign various fractions of the spray cloud to the sections of interest in the jungle ecosystem i.e. soil and lower canopy. 'The spray swath distribution function is derived assuming the flightpath is known. The major factor affecting variance of this distribution function being the number of aircraft and the terrain. The position of the troops will be treated as a two dimensional gaussian distribution centered on the "CARD" data co-ordinate. The variance will include such factors as co-ordinate accuracy and whether the troops were on patrol. The time effect is included in a simple exponential model of herbicide component decay choosing appropriate decay rates from the scientific literature. The effect of vegetation cover protection and exposure modes is included as a multiplicative factor. Considering ths simplifications so far, it is proposed that a simple cumulative model of exposure be used, giving relative exposure days as an output. (For the full mathematical treatment see Appendix III.) Comments The relativity of unrelated modes of exposure poses scientific problems which will take at least 6 man months to treat. References (!>), (22), (26), (40), (41), (42), (50), (_58) and experience in Australia with council workers spraying 2,4,5-T coupled with U.S. Air Force documents (currently requested) concerning calibration and spray simulation will enaole a reasonable connection to be obtained. The latter documents will also provide a more accurate basis for the numerical values proposed in Appendix III. The work of Isensec (35) tins shown that bioaccumulation .(1000-6000 x accumulation) of dioxin contained in contaminated silt is possible by aouatic organisms. Considering the volu.v.s of Agent Orange (the source of dioxin) which was distributed over the Rung Sat �-12fishing region it is dioxir, contamination highly cpcculntjvs. health effects it is significant fraction highly probable that seafood was a source of - the relative amounts and significance is For the purposes of regression analysis on hoped that this background exposure is' no a of the total exposure. �-1J5- ftecojr[fiy ndnt i otis_ 1. Run modified "HOPPS:I program using simple assumptions to estimate size of exposed group. 2. Maintain liason with Australian and U.S. experts in the fields of Pesticides. 3. Continue collecting relevant articles from World literature. . • 4. Develop models for (a) Spray drift (b) Environmental fate of herbicides (c) Exposure modes (d) Exposure categories. 5. That the models of drift and environmental fate be tested using • simulants to assess likely validity of theoretical predictions of drift and foliage penetration under conditions similar to those in South Vietnam. / 6. The proposed models should be subject to extensive scientific peer review �-14- 1. Comments by Dow Cftem j.cal Company on oresqntati.cn JTttr!<2_by_ D,r. _T.D. Sterling Royal COTnissiori~ - Herbieldejs~and PesTicicias 1973 2. Report of ths _ Consul tatlve Council^ onjconqonital abnormalities in j:hs Yarram District Oept. of Primary Industry" Canberra 1978 ~ Principles and Methods for jevaluat Ing the _tox ic i ty_qf_ chsm icals. ! Environmental Health Criteria' 6 TiHO 1978" " " " • Part 4. Criteria for Cstsrmlninn,_E_xpjJsu_re_ Leysjs^M-l.i.H taiQL^_rs5nr}? 1_ to^jjloxin and j-ieraicida drangs during t^e'vTet'nam War TcJra'Yt) USAF " ~ 5. Advisory Committes on Pesticides Further _Rov .lev/ of the Sa.rety For use In ths U.K. of the Herbicide 2,/t,3,-T "- 1980 6. Pcstlcidos used in Vistnafn Host 11 i t i e s and t_hg 1 r u se . in _ Agriculture : Ccnparitivg Study (draff) Environmental Health ' Dept. Health) 1980 7. Anon Report^ qn^ the Asrial uss(_of_ Phenoxy Horb-lcides Department of Food and Agricufuffe California 19"78 6. Bache D . H . , Saye r W . 3 . D . Transport of Aerial Spray, I.__A mode 1 of Aerial Dispersion Agric. Meterol. 15 pp 257-271 1975 » 9. Bache D.H., Uk S. Transport of Aeria 1 Soray , n_.___ Igsnsp^or t jvithin a crop canopy Agric. Meterol. 15 pp"3Vl-377 1975~ 10. Barnes J.M. 11. Bartleson F.D., Harrison D.D., Morgan J.D. Field Studies of wildlife exposed to TCDD contaminated .Soils AFATL-TR-75-49 "1975 . _ Assessing Hazards...Fro_m low doses of toxic subs cancels Br. teci. "Bul." 31 op I95-2CO 1975 * 12. Baur J.R. , Bovey R.W., McCall H.G. Thermal and Ultraviolet loss of Herbicides Arch. Environ. Contam. Toxicol 1 p'p 239 -"302 "1973 '13. Bbhm H.H. , Muller H. Model Studies on the Accumulation^ _p_f ferbicides LJ Microalgae NaturwissensnaYten 63 p296 1976 14. Bovey R.W. , Young A.L. The Science of 2, A, 5, -T and Assqciatsd Phenoxy Herbicides Wiley I960" 15. Byast T.H., Hance R.J. pj^gr^djrti^njpJL^^ Soils _lncupated_ in tjng Ll^oo^s 'cory_ - 197? 16. Cocucci S. e al AbDrotinn_jridjrrr.nsJ.oj;a^i_o_n_jDj^_.t^^ ^ 17. '*'•* PP;*y2"-'tS4 1979 Committee on the Effects of Herbicides in Vietnam The__E_ffects_gif l'!?rJi-iP^.es_-ir] A°'^^_/J ' ^ l . . J ~ Summary and Conclusions "National clL^^l Academy of Sciences �-15Comptroller General L!Lj> i_£rcyn_cj__Trc:qps In _Squch Vlelna'n v/ere_in areas sprayed with Hgrbicide rj'vanrfj' U."5~ iJelTcral /\ccbjntin"g'"orrTce l~979 "" 19. Cramer H.E., Boyle D.G. llj£jiicnLn£^ particle; behavlcijr - - 20. Crosby D.G. Conquering thg Monster — T^e_Phgtpohemicaj[_ Past rue tign^of ^l°J!P.cl-i9£iP_5. 1'^itn MaficnafMeeting oT Arr.erican CheinicaT'SoH'ety 1977 "(See Kcport on Aerial use . . . ) 21. Crosby D.G. , Wong A. S. ^ ~ " " ~ ' 19/7 22. Phar M.M., Tandon J.S. , Sircar K. P. ^sorpUon_ejTd_Dccretionjof 2 > A,.'j-TrJ L chlqroo(ienoxy Ac st. ic_ Acid^in Map "Arch ."frit r'PharTikYcody'n . 210 pp 230-255 "1974" 23. Dodge J.M. 24. Donaldson T.W., Irvine F.N. 2j_A, 5-T Res iducs in Dlackbsrry_Fj.'iji t Asian v/sed Science Society Corif. r979"~ 25. Farwell S.O., Robinson E., Powell W.J. , Adams D.F. Survey of airbourns 2, A-D in South Central Wash i ngton J. Air. Pollut. Con cam. '26 pp 22A~-3"i5 1976 26. Feldman R.J., Haibach H.L. PgLrc^tenpous^onstrabion of ^sornu^Postj.cides and Herbicides in Man Tox. Appl. Pnarm". 28"pp 125-132" 1974 27. Gsbefugi I., Baumann R., Korte F. ^^c^j^^sr^^j^cr^j^jj^^ • jiJCOD) unter simulierten Ur^^^ltbediTp^j'sn Naturiwissehs'ci : ialf"tibn~64 pp 486-487 1977 . 28. Gehring P.J. e_t al_ The Fatc_qf 2.4,5-T Following Oral Ad.T.inistratiofi to Man Tox. Appl. Pnarm. 26 p'p 352-"36l 1973 " """" ~ -- -- Trig Phenoxy Hgrblcidss - A Sum:nary - 1977 7th 29.. Hance R.J. Herbicide pgrsistence and breakdown in soil in the long term Proc. Assoc. Ap"p"r~Biol.~ - 30. Hiles R.A. and Bruce R.D. ZjJiLJbL^A^JlL0^ elimination _in the rat: First Trdgfr"6'f'"zc'r~o_ n'fdpv?" CoVtneuT'l'oxicol. 14 pp 599~ 600 " 1976 31. Holt E.S. (Major) ^Rsoort_of_the spraying oif J tJ rbic_l_des at_ J.st_ ArA.U~.FiVG" RopoiT "2/68 "1963" " " • 32. Hook J.B., Cardona R. Osborn J.L., Bailie M.D. The Renal _Hand.li.na of Cosmst. Toxicol. 14 pp 19-23" "1976" 33. I ARC Monographs Vol. I ARC Lyon 1973 2 34. 1ARC Monographs Vol. 15 Some' inorgcinic f.nd £rnono^J.alic_cp;i:f:ioi.ind_s ...... " ..... " .................... ~~ ..... """ Somq_ Fu^^ntsM-fi^JJ^ �-1635. -I ARC Monographs Vol. 23 Borne Mstals and Metallic Compounds IARC Lyon 1980 " 36. Isensee A.R. Bioaccumulation of 2,3,7,8 (TCDD) in 'Chlorinated Pnenoxy Acids and their D~ioxins'~~Ramel (edT~ 19/8 37. Isensee A.R., Jones G.F.. /V3sprDtioj}^ajid_Tjraj}sj^c_a^gn_o^f Rggt_ and Foliage^Applied ^^-Dichloroohe^nqi^ 2.71 - bTch j qrod i o'^n^p'-pj:dioxln . and 2,3,7,8 TCDD J. AgrTTood" Cnem. 19 pp f2J.O-f2i4 1971 " 38. Kimbrough R.D. (eu) Halogenated Biphenyls,, Kaphthalenes, pj.benzgdioxj.ris and related products Elsevier North" riofland "J980 39. Kirkwood R.D. Plant target areas and methods of attacking them Application of Pesticioes 2 Cranfield i960 40. Aerial Kolmodin-Hedrnan B, Erne K and Akerblcm M. flielo^/\Dp_lic_ation_ of pj-ienoxy • •herbicides in Field Worker Exposure during Pesticide Application ~eo TordoTr 1979 Al. Lavy T.L. Measuroment of 2? A, 5£T exposure of^forest workers Forest Produces" A'ssociaton 1978 National A2. Leng M.L. ReaHstic Evaluat3.on of J-brcan Exposure jTrgni^aopj ^-^^j 2,4,5-1 sprays Dow" CneiiTical Co.Tipa"ny " 1973 43. McNulty W.P. Toxicity 0/2.3,7,8 - Tetrachlorodibsnzo-n-:dioxin for Rr^S'JS Monkeys: Brief Rdporu Bull. Environ. Contain" l"ox~r8~pp""l08""-109 1977 44. " Nash R.G., E3eall M.L. Fatc_of_Si IVRX,,^!^. ,_ip_ _and ?-12i2jQj TCODJn_a ' mlcroagroecosystem chamosr A3S~PAP AM. Cl-EM "socTl"75 p$T"TsT78 " ' 45. Nash R.G., Bsall M.L. Distribution of Silycx, 2,A,-D and TCDi) toplipd •• to Turf in _Chafnbers and Field P'fots J.~Agric. cFicm. 28 pp ~5"i4^623 J'980 46. Office of the President Report_on_ ^Jl^T A report of the panel on Herbicides of the -President 's'Scie'rice Advisory Committee. C.M. McLeod Chairman. Office of Science and Technology 47. Poland A., Glover E. , Kende A,S. SterpqopecJ.fic_,_ . of 2, ^i 7j 8 - 1 e t r ach 1 o roc! i ben ?. o -r^-c'l J c"x ih_ J5£jj(T>a Qc'M:o\Jal "" " ?." IB 6l Cnem 2M "pp 4936~494"6 "1976 48. Poland A., Kende A. ^JJ^.S-leJij'ajphl^orcciibjijn^ cpnt: cmi j r.ant and m J l c u I V P "f'^'J- TTOG" "35 p p ~ 49. Poland A., Kendo A. 50. Ramsey J.C., Lavy T.L. and Bra'jn IV.H. 51. F^pgiyni G. EstJnintion of thc_l_CDD tpxic_ppU5nt,:lnl in " ~ ' ~ C c n i L~" S'c,c'.~ ~ioxjf.:ol "[i''t-"i"iii"i7"" " " ~ " TlTe_Gc>nct}c_Exprorision_of AHM ActivJ.t'y:_ ryidRnc^ _ j n fYaTrpsZibn'sTv'r:''jn]"c"ii ~ "" " T.97'7 "........." E_x_nosurc of For r. s i: " Wo jJke r s_ t.g ' ~ ' " ' " �-17- 52. Rose J.Q. ej: al_ The £ate_ pXJ?^ _ _ following single .ar.J"repeatwT Or'al_"Do5es~"to JtiiVT<at~"~Tox. AppTr"f3harm. ' 36 pp"209-226""T976" 53. Schultz D.P., Harman P.O. Residues of 2./i,-D in Pcr.d Waters, Mud, and Iis!lJ.2Zl Pest- Mon - J - 9 PP 173-179 1974 ~ ~" 54. Simpson G.R. Aerial Spraying - S a f e Use of PesUoidgs on Cotton Crops Health Commission of N.S".-W. 1979 " ." ' ". 55. • 56. Sirons G.J., Frank R.F., Dell R.M. PicLojran^Rsjsid^^ Macdonal^^Cjrtj/jr Freejway Right qf Way^ BGl~i EnVir6rr."c"bn'ta"?Tf.~ Tox. 18 pp 526-533 1977"' Stevens T.S., DiPastiuals L.C., Farmer J.D. Acu^c_IJiha_latJLO^Tcx_i£(y_ooy__ ' .1 Herb icicles, .CscocfylTc "Acid and" . _ _ Disodiuir. Mathanoarsbnic'^cicl Bull. Environ. ContarnrTox. 2Jrpp'"Jo?i-311 ••a— - -• ••HI •• — I • • I* .-».•-.<•••-*—..—J»^. . J.. II I •— i . I I 1979 57. Stewart W. A Retrospective Study of Agnnt_0^ange_jnnjj Vietnam Veterans (Draft)~ US" Veterans7\3sbciation 1979 58. Tordoir W.F., Van Heemstra (ed) T. Field_ Workgr Expos-jre duri Pesticide Application Elsevier Nortn Holland 1930 59. Torstensson N.T.L. Dearedaticn__o_f 2,/t-D nnd MCPA in Soils of low pH Env. Qual. Safe. (SuppT3" pp" 262-5" 1975 60. Walsh I..M. et al Occurrence anci Distrihuti^on _of ^.rcenic in__Soils and Plants EnvirotiT lteaitfrpers.""l? pp 67-71 1977 61. Ward C.T., Matsumura F. Fate of 2,3,78 (TCDD) in a Model Aquatic _Envirpnrnent Arch. Environ. Con cam. Tox. "7 p~p 349-357 1978 62. Wauchope R.D., McWhorter C.G. Arsenic Residues int Sjjyb Simulated MS_M_A_ Spray Drift Bull. EnvTrdni" " Con tan. "fox.' 17 p"p r65"-167 1977" 63. V/eakley B.S. How dangerous is sodium cacodylate? J. Micros. 249-251 1977 64. Woolson L'.A. Rate <^J\rsj?nicn]js_jjiJ}^ Environ. Health Pefs. 19 pp"73~81. 1977 65. Young A. L. Use of Herbicides in South , Vietnam JLggl^gT^ Educational Conference on Heruiciae Ora'nya, Silve'r Springs Maryland 1.900 66. Young A . L . , Calcagni J.A., Thalken C.E., Tremblay J.W. ln;?_J.oxA^ mnn ris< of 67. Young A.I.., Thalken C.E., Arnold E.L., Cupello 3.M. , Cockerharn L.G., S...?j ?.J.i 8"JTCDCO. jLJlJyi\q.J:nxiro[i^cnt j_Sj^™^ ~ ' " ~ " " " 109 pp �-1868. Young A . L . , Wolfs W.M. Cr^r^ia J[o_^_e^ujTj0tinr; ^?P°stjr?_]:c!V(l!-^. 0?> miHtary_persopnol._to Dipx Jri" ~c:7icl_horb Vb Lc!?. JJrsnif :-j JjuHn'q j'^_ Viecr':o:,i tfa: ~ Position ^er'l^nluUxf by USlJOO* to L.6 VACC'i2"Cec"~i979 69. Zepp R.G. , Wolfe N . L . , Baughman fi.L., Gordon J.A. ^hemipnl^ anf[ Riotochsmica 1_ Alts r a t i o _n_f _ 2,A-D Esters in theAc]uatic J Southeast &Tv."~Res7"Lat3. U.S". 1975 70. Casimir M., Watt J.W. Ac'rial Snrny Apnl icat.ion _ Agaihist Insects .Pests AG Bulletin. Department of Agriculture NSW 079" 71. Cran field Institute of Technology College of Aeronautics. Aerial Application of Pesticides. Vol. I-II, Short Course, 1900. �-19- 2. (a) Mr James Watt, Research & Development Officer (Gayer Australia), 666-9041 - field trials/aerial spraying .(mathematical models/literature) (b) Mr Jack Snelson, Pesticides Co-ordinato.v for Commonwealth Department of Primary Industry (062) 72-3933 - most complete source of world literature concerning pesticides available in Australia tc (c) Mr Brad brett, Australian Veterinary Chemical Association (AVCA), Uth Floor, 60 York Street (290-0700) - good source of literature - excellent contacts in private and public sectors (d) Or - "Dick" Albanez statistics theoretical models of spray drift exposure (of Ranch Hand personnel). 3. (a) Jack Snelson is an excellent source (b) C.I.H. library is most helpful in obtaining material once the reference is found (c) Commonwealth Health library, Canberra has access to the Dialog database which includes Chemical Abstracts and Science Citation Tndgx_. Tne latter is line" most" useful source for D-) obtaining complete list of "material published by a given author in given years (ii) obtaining complete list of all books/articles which cite a given work. Relevant authors are: Alan Poland D.G. Crosby G. Rcggiani H.E. Cramer - enzyme induction heroicide degredation Seveso/dioxin long term effects. Spray drift (d) The Medlars/Mcdline database has already been searched and printouts are filed. (This database is limited because it excludes articles without a direct medical context.) (e) Obtain as much in formation as possible concerning American experiences with thsir surveys via Dick Albanez and Bill Wolfe - especially information much Al Young may have, and the report by Steven Mocks dealing with the herbicide spray mission simulations cone in Florida by USAF. �-20- References yet to he obtained .. ^ Anonymous , 197/4 . D JJinoci tion_ o_f _n.ranga_ torJiici dc_oy _ino.inoration . Final Environ^2nlarjvtaIe;nenE'r "OepartmenF'of the Air Fo'rce, Washington, D.C. 737 p. Bethel, J.S., Turnbull, K.J., Briggs, D. and Florcs, J. , 1975. l^iJay^r^o£_yie^nain fore5_ts_. American Forests, : 26-30, 36-61." Brown , • 3 . W . , 1 962 . Vegetation?*.! spray tests in Jpu.tlTj/jjBtna^. U.S. Army Chemical Corps [Biological Laboratories, Fort Oe'trick, Frederick, Maryland. 11? p. Available from the Defense Documentation Center, Defense Logistics Agency, Cameron Station, Alexandria, Virginia, DOC Number PD 476961. Carrier, J.M., 1974. Jh?_J^^yjl'lJ^il^hJcid^_jn^^nG and Mickey's Informants in South Vietnam. The Effects of" Herbicides Ln South Vietnam. Part B. Working Papers. National Academy of Science, Washington, D.C. 15 p. Coates, 3.H. , Sharpe, L.M. and Pollack, H. , 1962. The present sJ^tH %_° L.9.nILr DAc.aJL Jlci?i.E2LL-9.!L.v.L195i.? t L9n__i n__r els tic n 60 _m i 1 it a ry nseds'. Tecnnical Mo'tes 62-68. """Institute ToT Dsfen'ss Analyses', " Departmsnt of Defense, Wasnington, D.C. 30 p. Craig, D.A. , 1975. i-MJLtJJ?JLkApA^ Historical Report. San Antonio Air LcglstTcs Center, Oirectcfate of Energy Management, Kelly AFB, Texas. 58 p. Darrow, R.A., 1973. fpLi.?3G_(^na_ract^r|^ics__ c u ; ^ Sci. Soc. Am. "Aostrf 66, pp. 29-30. Wsed -. Darrow, R.A. , Irish, K.R. and Minarik, C.E., 1969. H?rbicidss_ Used Technical Report SAOQ-TR-69-11078. ^ Directorate of Air Force Aerospace Fuels, Kelly AFB, Texas. 60 p. . •' / Darrow, R.A., Truchclut, G.B. and Bartlett, C.M. , 1966. OCON1JS defoliation test: program. Technical Report 79. Crops DeparLTnenYJ"7~BioIc"gicar"Sciences Laboratory, U.S. Army Biological Center, Fort Patrick, Frederick, Maryland. 216 p. _ Basj3_G3G;ji:own, N:;_w~Brunsw jck,_ Canada. ' TechnicarTi'e.'iiorandum " 141. "D^paftmenT oP"Li>2 ~Ar>,y~, "FortDstrick, Frederick, Maryland. Demaree, K.D. and Creager, R.A., J968. ~ Fee, D.C. , Hughss, B.M., Taylor, M.L., Tiernan, T.O. and Hill, C.E., 1975. Analy,l^C3l__MGJ^hod_ql_ony__fqr .Hj_rj)i£idQ__Ora:Tgo. Vol. I . I DeterrMin'ation of UiTgin o"i"u5AV" 'i'toc'ks ~ locnnical Report ARL-75--0110. Aerospace Research Laboratories, Wright-Patterson AFB, Ohio. 30 p. �-21Grover R.J. Relative Volocj t ies of ester &_arninc t ,2,4-D KccdTSci . "24 f 26-28"" ^ ™ Grover R.3. , Maybank J. and Yoshida K. 1972 Droplet and vapour d r i f t from uu ty 1 e s ce rjr.nd d irne thy_l am incjva 1 tn o f ~2 , 4-0 Weed" Sci 20: 320-324 Harrigan, E.T., 1970. Calibration Test of tha UC-12:5:</A/A63Y-1 Snray_ Sy_s_tenni. Technical Repoi7Lr"ATJTC-lTf-7~u"J6. Arnia'TidhC'Developir.en'if and Test Center, Eglin AFB, Florida. 160 p. Hughes, B.M., Fee, D.C. , Taylor, M . L . , Tiernan, T.O., Hill, C.F. and Wu, R.L.C. , 1975. Analytical Msthodplogy^^ for jj^rplcirJe^ " " Vol. I. Determination oi" Giemical Co.T.positicn". technical" Report A.RL-75--0110. Aerospace Research Laboratories, Wright-Patterson AFB, Ohio. 357 p. Hurt t , W . and Darrow , R . A . , 1968 . Biolpgical_ ef Feet iveness o F_Stul 1 §i£LuAlJDl^.^f!SS.' Technical Kepoft"ArATL-TR"68-l22". "Mr Force" ArfnamdhV Laboratory, Eglin AFB, Florida. 31 p. Irish, K.R. , Darrow, R.A. snd Minarik, C.E., 1969. Inrormation tnanunl - . - ion ontroI in SoutheGs t Asia . Mic I . Pubi ic . 33. Department of the Army, Fort De trick, Frederick, Maryland. 71 p. Kearney, P.C. , V.'oolson, E.A. , Isensee & Hslling, C.S., 1973. JeJ,rGc!^jr£dJjDj2!^^ Dpccn u_am i nn t ion . Environ. Health Perspect. Exp. fssue No. 5, pp". "273-277. Klein, R.E. and Harrigan, E.T., 1969. Comparison/Test of Defoliants. Technical Report ADTC-TR-69-30, Vol. I. " Armament "Development and Test Center, Eglin AFB, Florida. 356 p. McConnell, A.F. , 1970. Mission: RANCH HAND. Air University Review, 21 ( ) 89-94. 2: Newton , , M . , 1 975 . E£i\^oj]^_s£t aj_imoact_ _q f _ " A ^ D . . . reforestation _tests JJ2J!'c-Ll;££r!Jrlrc^O' 'A'eed Sci. Soc. ATI., 'Ao'sTrT' 1 Vi7"52 p. Tschi rley , F . H. , 1 968 . Response __p_f _t.r onicQ_l _,and_ .SMbj: r£p_ij^a l__woody_ £la_nts_J;o crie."Tncal t"reat-;.iqnts. ~ t«searcn Report D^-f3-67. AgricukuFaTTtoseafcn Service's, U.S. Department of Agriculture, Washington, D.C. 197 p. Westing, A.H., 1976. ^3ogi£al_j:cn_s£gjo^ Jtndcjchina War. SlbckhoJiri InterniVtTonai Peace Research InstituceT"""Alrngrist and Wiksel Interr.ation, Stockholm, Sweden. 119 p. �-22- Statistical model To be "tabled at meeting. �SECTION 3 • . Revised Pjjins and Estimates for the Study During January 1931, three sets of plans for the study were prepared in conjunction with Professor MacLennan, Dr. Byth and Ms. Rose. These plans (copies of which are attached) addressed the Investigation Programme at three levels: Overall Strategic Plan 1 Year Plan (1981) Plan for the Pilot Survey (to June 1981) Since these plans were prepared, more detailed ones have been compiled in each of the main disciplinary areas of the study. We are currently monitoring progress agajnst these plans on a weekly basis. We look forward to the opportunity to give a presentation of the current plan and on progress. �IXSTITU-TE: OF HEALTH PROJECT PLAN 193T I Apii! RESEARCH PROGRAMME: ASPECT OF INVESTIGATION 1932 Oc'ob* July January "Ajsr.t Orange* Scientific In J Year Mcsf'cr Plon 1933 j October ! April Jonuory. April July October January Maintain nomot and oddf*ii«« 3a*a «n mortality and iMiotui of v«i«funt oid control* i , . I .I »-.«.n at1f f.nd.^op* U . Swb-iiflkJcn | J I .- J P«inll«d cmolyi 1 * of nior'ulilw „, .„ QPC>m|..> '?rt' P-'olUd Irian fof f i '• onf.*»r«n family turvcltloifi •"-" I I D«1ul'«d ona'yili of blflti <?•'•£•« a'ld reproduction Main l r«.peil F.««n|naiion of vamp'm of •«l*cl»d * i t ] W. 3. T^c .'*n?*S o' *ha o:* iniorvtfwi ' '' ' - - no.'n i^rvey <^np«nc/* on f/i* me * A MAJOR EVENTS CoTplciion i Analysis o? Vcioron Mortality of Pilot Survey I PrtfarrA by! 1.', . .i . Approvrd by: • • Preliminary Findings for Main Survey j Cennmvnti: Main Survey Report J �CC-J.W-JMVEAi.7K INSTITUTE 0? HEAS.TH RESEARCH PROGRAMME: PROJECT PLAN ts:vj =!S:YY or svc^er "Agent Oror-ijc" Scientific lnv«tiso^on ASPECT OF MVESTICATiOSi Master Plan for 1981 1981 Jc-iJory February April McrcS Juno May July- August Sentcrfibor October November December PROJECT I Uc*lon : j / t f * t t S w ^ ' a i ' - ' l / a * Arf^y N«f, a, Lnnir»'» ^ • f O * - . i » ' «v*!i . wi fig '1»i.-i ln..» ^ | ! anj Sla'jl of V.i.rno, m<< Con'iol.l CARO, £!<KI»r«l till, lmi»l;r.ill«i, Wo'or Nullify, »or S.r.lt. Horn.., R«gli-ir of | '! I PI011 V.i.funi ««: C«.»r«li't001 .oc..^..,. ! I j • S." AJ Cnncfue* Publicity *:'*»iiMifi»« ta> •M.,UI|S St,,iU( J • T«'«|>'.on« 1 i i t n f v ' « w f?00', t onrf ivv'op Main Su'fn/ S"u*»ay ii»<*f*f! CO')) L*.. I j j ! 1 i{nrf't« o*i<J R«i'in* CifVffioill'al**, •] PtJtm'orri .1C. ! " a.rtMl, AdJ.tienol P*rio<in«t No..!.J P*«por» S'oi:»'lewl T > « r i for in* Mo'n Surv ' I 0«i» Mor.Q.j«ni«iii r In Ofdri of J" Priority . ; Secruit Core Teem ! • •* Piio: Survey Personnel ' V f ^01". ',.1 Pilot Survey Storied Pilo! Survey Completed F'*sared bv: Recruit Main Su'vey Personnel Apurovso by: 0,.:*. Main Survey Slnrtea Survcillene* A . Long Term . Surveillance Started Comm*p.f«: ?r,lr , . �r . ' „ , . . jjr-^xg- 7*2; S^"*"*;) j fTiiA^iL.'W L'XSVjRSiTY Or SYDNEY 1 ! i ! Jcv.,o,.31 i 2j i 9J ! 16| p si * Lw i r t AM t KJJ r^^ PI iw i ii | 1 23| February 2G i i i ^ e..',.i. I 10 J ' 17 3 27 t |l P.I.I f~* " ! '..l .., * I I " : 1 »'»-»..<,.,!• i 1 ! • ' "Vli.*, •?•. j ; T 1 ;• Sit.,,'o'J 26 j Pi"«0t Surv«r R»p«rl of Flna.nn. and f_> 3 10 24 ! 17| t 31 ' ] 1 *• i<. SRC p.ft..w.l..r *l P,^...r.t ' °l.(in. -..M U ^nr -^ \Pf'r'iduf*"*** * ** Oooc Knot'. T S.A.Q. L ** 1 J;- -•. L^^—= 1 ' LH'*-« j ' " " !•! "':r.-_, |! ."".r.^r.. 'Jf .'.'.eei «i ..' =3 U; ~" A J 1 i . - — j —1 ' 1 Tj M.JI.ol £.„,„„„„„.. V JF^.I... (.00) ^ .- " . I ••;.'..,;,..„. • ,,.-.-. 14' ; • !-*: """• UV = C ! u 3 ^ Inh.nution I . S ', -E.po.^. ' . . ... ^ i £ A i I1 SAP ;. ' , • : • ' • : ' : ! i ; ' : •: • Cw.Ticnc? Pilot Su'vey Visit . i • . . ' | ' ' ' ; ! . ' . i ' • ' . : ^ 19 4 «*r i . ii) ""•", r".,,h,0...-.l*i TP'OCC v..,!v, 12 ••'. j •Oe-.Oi.'d.-.lQf . p ^ " • =J 1 U."., j j C 'H j '•*• A.t.l.nn' 1 J MAJ33 HVCSTS 5 2? jW,ii. »f Pi!.» &*»•» L •; ! • ^:;'V'v^.,V^'n ==r~. ! i 221 i • St! - A<imi«j>!rrcd Cut Jtiennoire L • '°'M S , i 15 July , ' i £;:'';!?'""•"•"* j .';^"."c.'™i j j June Ounilty o r In'ormation , - "—' via '*• Mnltlna —t > i 8 Pilot Survoy j ^ ^ . . 1 - , 1 24 May *• * ' ** > Ctili.'.ici '..Ic.'vUwl Did . . | "i...-,. I ' | .. ' , | —-j rf-.! •>< '•"'"«' . -- • r~ni.«". ' : !:j?,..|_ i !-••- i 20 I !->f»fVi«.v*ft priori* £. " < ~ , ^-.. . ! 13) April - r-| •j'slr"1 v ., i ! 6| "Ajcnt Oranja" Scientific Ir.vfittiga!;^ ASPECT OF INVESTIGATION: - ..-run "™~r°""""-r£rl ^--•"-• I i Telephone interviews — il ~ . i a:.:' ::..... H -n 1 27 RESEARCH PROGRAMME: * Face — to - Face Interviews i A.. *, i ir " 1 A^S i**L.iAs^ 1 , 11. i R.,I.»& . .. . - ^-%^ ri March 20 13j j >MO"f» i 1 ' • P^dby, . A,p, '; , . • ' ' . ' , ; • ; . i . . . • ^ > • Non-v»(»roni, at Con fro) t ' A , Con-.plcte . Pi!ct . Survey ... • • ' i Submission to Scientific Review Ccrr.mitteo ..... • .''.:• • • ' • ' : ; . . • 1 ' i i \ 1 C 1J ' . • � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 070 Folder The folder containing the original item. 1885 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 February 26 1981 Title A name given to the resource Submission to the Scientific Advisory Committee, Australian Veterans Herbicide Studies, 3rd Meeting to be held in Sydney 3 & 4th March 1981. Subject The topic of the resource AVHS study protocol ao_seriesIII