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                    <text>Item ID Number

01336

Author

Smith, Pamela W.

Corporate Author

Science Policy Research Division, Library of Congress,

Report/Article TitlO Agent Orange: Veterans' Complaints Concerning
Exposure to Herbicides in South Vietnam, Issue Brief
Number IB80040

Journal/Book Title
Year

1982

Month/Day

APHI 20

Color

n

Number of Images
DeSOriptOU Notes

21

Date

originated: 09/06/79, Date Updated: 04/20/82.
Includes a table of military projects involving agents
orange, purple, pink, or green, with dates and
descriptions of projects. Also includes a table of the
signs, symptoms, and disorders reported after
occupational exposure to TCP, 2,4,5-T or TCDD. Item
gives an overview of background and policy analysis,
health effects, perseonnel exposure, veterans'
problems, Department of Defense efforts, health
studies, the Interagency Work Group and Agent Orange
Working Group, Congressional action, and legislation
and hearings

Thursday, May 03, 2001

Page 1336 of 1403

�AGENT ORANGE:

VETERANS' COMPLAINTS CONCERNING EXPOSURE
TO HERBICIDES IN SOUTH VIETNAM
ISSUE BRIEF NUMBER IB80040

AUTHOR:
Pamela W. Smith
Science Policy Research Division

THE LIBRARY OF CONGRESS
CONGRESSIONAL RESEARCH SERVICE
MAJOR ISSUES SYSTEM

DATE ORIGINATED 09/06/79
DATE UPDATED 04/20/82

FOR ADDITIONAL INFORMATION CALL 287-5700
0426

�CRS- 1

IB80040

UPDATE-04/20/82

ISSUE DEFINITION
From 1962 to 1971, the United States Air Force
(USAF) sprayed various
herbicide mixtures (chemicals that kill plants) in South Vietnam.
The
purpose of the spraying was to defoliate jungle growth to deprive the
Communist forces of ground cover, and to destroy enemy crops to restrict food
supplies. The most extensively used of these herbicide mixtures was known as
Agent Orange, a 50:50 mix of two common herbicides called 2,4,5-T and 2,4-D
(2,4,5-trichlorophenoxyacetic' acid and 2,4-dichlorophenoxyacetic acid).
A
third chemical present in the mixture in small amounts was TCDD, an
inevitable by-product of the manufacture of 2,4,5-T. This chemical, called
tetrachlorodibenzo-para-dioxin or simply "dioxin," is highly toxic
to
laboratory animals when administered in its pure form.
Acute
(short-term)
toxicity values in humans have not been established, although Gosselin et
al., in the 1976 edition of Clinical Toxicology of Commercial Products, puts
TCDD in a class of chemicals for which the "probable lethal dose" for humans
would be less than 5 mg/kg, or about 7 drops for a 150 Ib (70 kg) person.
CRS has been unable to locate any report of a human death from exposure to
pure TCDD.
The human health effect that has been most consistently
documented following exposure to small amounts of TCDD as a contaminant in
other compounds is a skin condition known as chloracne. There is other, less
consistent, evidence of damage to the liver and the nervous system in humans.
Extensive testing on laboratory animals has been done to determine possible
long-term effects of exposure to TCDD.
It can induce cancer in some strains
of rats and mice (carcinogenicity) , cause fetal death in several
species
(fetotoxicity)
and
birth
defects
in
developing
mouse
fetuses
(teratogenicity), but has been found not to cause genetic changes in
mammalian cells (mutagenicity). The American Medical Association's Council
on Scientific Affairs concluded that "there is no scientific evidence that
2,4-D, 2,4,5-T or TCDD has caused reproductive difficulties or hazards in the
human. "
Congressional interest was triggered by receipt of reports from Vietnam
veterans who believed they had been harmed by exposure to herbicides,
particularly Agent Orange. The 96th Congress held numerous hearings on the
use of herbicides in South Vietnam, and various initiatives to deal with the
problem were introduced. P.L. 96-151 was enacted to direct the Veterans
Administration (VA) to conduct an epidemiological study on Vietnam veterans
to determine whether there may be adverse human health effects
associated
with exposure to phenoxy herbicides and/or dioxin.
This study and other
studies planned will help elicit answers to the scientific questions posed by
the Veterans Administration in determining whether or not the veterans'
medical problems, allegedly due to exposure to Agent Orange and
associated
herbicides used in Vietnam, are compensable. Following recommendations made
by the Interagency Work Group on Phenoxy Herbicides
(now the Agent Orange
Working Group), legislation was introduced in the 97th Congress to expand the
scope of the VA's epidemiological study of the health effects of Agent Orange
to include other factors related to military
service in Vietnam.
The
legislation also allows veterans with medically certifiable conditions that
might possibly have been caused by exposure to Agent Orange to receive
medical care in VA facilities.
The bill (H.R. 3499) was considered by the
House and Senate in June 1981, put into final form in October, and signed by
the President Nov. 3, 1981.
Its title is the Veterans' Health Care,
Training, and -Small Business Loan Act of 1981 (P.L. 97-72).

�CRS- 2

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UPDATE-04/20/82

BACKGROUND AND POLICY ANALYSIS
History
During the summer of 1969,
the first reports of human birth defects
allegedly attributed to Agent Orange appeared in Vietnamese newspapers.
Based on these allegations and the results of a study sponsored by the
National Cancer Institute that showed that
2,4,5-T contaminated
with TCDD
caused birth defects in laboratory animals, the USAF stopped spraying 2,4,5-T
in South Vietnam by early 1971.
Although the Department of Defense maintains that only a limited number of
U.S. military personnel can be positively identified as having been exposed
to 2,4,5-T in South Vietnam (i.e., crews of aircraft that were used to spray
herbicides), it is theoretically possible that large numbers of both military
personnel (from the United States, South Vietnam, North Vietnam, Australia,
and New Zealand) and civilians (especially South Vietnamese peasants)
were
exposed to 2,4,5-T through the USAF spraying program. A growing number of
U.S. veterans who served in South Vietnam have begun to attribute the cause
of various chronic ailments which they are now experiencing
(especially
nervous disorders, cancers, and birth defects in their offspring) to exposure
to 2,4,5-T in South Vietnam, and many have filed claims with the VA for
compensation. The VA has not yet awarded compensation to veterans for any
claims related to 2,4,5-T exposure because of the lack of valid human data to
prove a cause and effect relationship between exposure to 2,4,5-T and/or TCDD
and specific health effects (except for chloracne).
TCDD Contamination
The industrial production "of 2,4,5-T always
results in some
TCDD
contamination although TCDD levels can be reduced to about 0.01
parts per
million (ppm) with current technology. Because it was not widely
recognized
until the late 1960s that 2,4,5-T could contain hazardous
amounts of TCDD,
manufacturers did not start reducing the level of TCDD in 2,4,5-T until the
USAF was already winding down its herbicide spraying program.
The average
TCDD levels in the 2,4,5-T - containing
herbicide mixtures used in South
Vietnam were approximately
2 ppm in Agent Orange
(which accounted for
approximately 96% of the 2,4,5-T used in South Vietnam), approximately
32.8
ppm in Agent Purple, and 65.6 ppm in Agents Pink and Green
(Agents Purple,
Pink, and Green contained the remaining 2,4,5-T used in South Vietnam).
The
herbicides procured by the USAF were code named after the colored band that
was placed around each 55 gallon drum in order to identify the contents.
/

Health Effects —

Animal Data

Although TCDD is well established as one of the most toxic chemicals known
for acute (short-term) effects, there is no consensus in the
scientific
community over the -Chronic (long-term) effects on humans of exposure to low
levels of TCDD (such as those levels found in the herbicides used in South
Vietnam) .
Statistically

significant

animal

experiments

have

demonstrated

that

�CRS- 3

IB80040

UPDATE-04/20/82

2,4,5-T containing low levels of TCDD and/or TCDD alone have caused various
tumors in mice and rats. A recently-released National Toxicology Program
bioassay of TCDD confirms these earlier reports that TCDD is carcinogenic in
some laboratory animals. Thymic atrophy (without a corresponding loss in
immune function) and severe weight loss have been observed in many species
after TCDD exposure. In some species, acute exposure to TCDD can cause liver
damage. Birth defects such as cleft palate and kidney abnormalities have
been reported in baby mice when the mothers were exposed during pregnancy. A
National Toxicology Program animal study of male reproductive effects of
exposure to TCDD, however, has failed to reveal a statistically
significant
increase in reproductive abnormalities
in TCDD-exposed animals or birth
defects in the TCDD-exposed male animals' offspring. Although there is some
experimental evidence that TCDD may cause mutations (changes in the cell's
genetic material that may produce birth defects in as-yet-unconceived
offspring), these experiments have been few, they have been done mainly on
non-mammalian species or in vitro (in test tubes), and they have basically
been inconclusive.
Some investigators feel that humans are less sensitive than animals to the
toxic effects of TCDD. There is wide variation of" responses to TCDD among
different species, and the mechanisms of its toxicity and metabolism are not
understood. More work needs to be done to clarify whether human exposure to
TCDD can produce the same health effects with the same potency as those
observed in animal studies.
Health Effects. -- Human.TData.
If a cause and effect relationship is to be scientifically
established
between human exposure to a chemical and chronic health effects, a study
which meets the following minimum criteria must be conducted to prove that
such a relationship exists: a group of people (the "study group") must be
identified that has already been exposed to the chemical under study (it
would help to know the level of exposure); this study group must be large
enough to detect chronic effects with statistical significance
(to find an
effect that occurred in 1 out of 100 people, one would need to examine at
least 100 people); a control group must be found that ideally would differ
from the study group only by never having been exposed to the chemical under
study (thus, any differences in chronic health effects between the study and
control groups could be attributed only to exposure to the chemical under
study); and, due to the long latency period for many chronic effects, the
study and control groups must be followed for as many years after exposure as
it takes for the chronic effects to show up
(i.e., in
carcinogenicity
studies, subjects must be followed for a minimum of 10 to 20 years after
exposure to the suspect carcinogen). These exacting criteria are not met by
most of the studies that have explored the relationship
between human
exposure to TCDD and/or 2,4,5,-T and subsequent health effects.
Only for
chloracne has such a cause and effect relationship been well established.
Workers who have been exposed to TCDD and/or
2,4,5-T in industrial
explosions or who have had other occupational exposure are frequently found
to have a skin condition known as chloracne — which resembles normal acne
except that it is caused by chemical exposure.
Chloracne can appear from
weeks to months after initial exposure and while mild cases (blackheads)
may
clear in a matter of months, severe cases (inflammatory lesions and
scars)
may last up to 30 years after exposure has ceased.
While the severity of
chloracne is not thought to correlate precisely with the intensity or
duration of exposure to TCDD and/or
2,4,5-T, chloracne is associated
so

�CRS- 4

IB80040

UPDATE-04/2'0/82

closely with exposure that some scientists argue that patients who have not
exhibited chloracne are unlikely to have suffered other toxic effects of TCDD
and/or 2,4,5-T exposure.
Studies of these exposed workers have also indicated a variety of other
health problems. For example, the United States Air Force Technical Report
on the Toxicology, Environmental Fate, and Human Risk of Herbicide Orange and
its associated Dioxin (1978) listed a number of symptoms, signs, or disorders
that had been reported after occupational exposure to TCP
(trichlorophenol,
2,4,5-T's precursor), 2,4,5-T, or TCDD
(see Appendix).
As noted, these
studies, which reported symptoms associated with human exposure to dioxin,
were not conducted in such a way as to prove a cause-and-effect relationship
between exposure to TCDD and/or 2,4,5-T and any of these effects, but they
may be indicative of such a relationship.
Several of the above studies have focused on investigating
cancer
rates
among exposed workers. These studies do not show a clear
cause/effect
relationship between carcinogenicity associated with exposure to TCDD
and/or
2,4,5-T because very few exposed workers (with the exception
of those in
Nitro, West Virginia) have been followed for more than ten years (the latency
period for most cancers being 15 to 40 years after exposure) and the results
have been equivocal.
However, they support a continuing suspicion and
indicate a need for further study.
When the scientific
panel of the
Interagency Work Group on Phenoxy Herbicides reviewed five research papers by
European scientists, it concluded that despite the studies' limitations, they
do "show a correlation between exposure to phenoxy acid herbicides and an
increased risk of some forms of cancer." A soft-tissue "sarcoma study has
been proposed that will be conducted jointly by the Armed Forces Institute of
Pathology and the National Cancer Institute.
Studies that have been conducted in non-industrial settings have not been
able to prove a cause and effect relationship between exposure to TCDD and/or
2,4,5-T and specific health effects. The National Academy of Sciences
(NAS)
was directed by Congress P.L. 91-441, sec. 506 (c) to conduct a study on the
effects of herbicides in South Vietnam, including health effects.
This NAS
study, as well as at least three other similar studies that were conducted in
South Vietnam during the early 1970s, were unable to find adequate data upon
which to reach any conclusions concerning a causal effect between exposure to
herbicides and any health effects, including birth defects.
An explosion in a Hoffman-LaRoche chemical plant in Seveso, Italy in July
1976 caused thousands of people to be exposed to varying doses of TCDD as a
toxic cloud drifted across the Italian countryside in a cone-shaped pattern
about a mile long and half a mile wide. Some 5400 people lived in the two
zones most directly affected, with an additional
40,000 people
potentially
exposed. Animals began to die 2 to 3 days after the incident with over 1,100
animals killed by direct exposure to TCDD. Over 700 people were
evacuated
from their homes. Chloracne was reported in 187 people, mostly children, and
it tended to heal rapidly. Long-term human health effects of exposure to
TCDD at Seveso are still being studied.
Preliminary
findings reported in
1979 by Hoffman-LaRoche revealed that Seveso residents had suffered liver
damage but that there was no permanent breakdown
in liver function.
They
also reported that rates of spontaneous abortions, fetal malformations,
congenital defects, chromosome aberrations, reactions to infectious
disease,
and morbidity and mortality were not affected by TCDD exposure. As reported
by the American Medical Association's Council on Scientific
Affairs,
"The
most recent progress report on the long-term epidemiologic survey of the
residents of the Seveso area emphasizes the preliminary
nature of their

�. .

CRS- 5

IB80040

UPDATE-04/20/82

findings and reiterates the conclusions of prior investigators.
Except for
the skin, no organs or body functions were impaired.
No derangement of
gestation, no fetal lethality and loss, no gross malformations-, no growth
retardation at term and no cytogenetic abnormalities have yet occurred."
Health effects of domestic use of 2,4,5-T have been
kept
under
surveillance by various Government agencies for some years.
In April
1970,
the Departments of Agriculture, Interior, and Health, Education and Welfare
jointly announced the suspension of certain uses of 2,4,5-T following studies
indicating that it was a teratogen.
On Apr. 21, 1978,
the Environmental
Protection Agency (EPA) issued a Rebuttable Presumption Against
Registration
(RPAR) on 2,4,5-T, finding that the herbicide had exceeded certain
risk
criteria and inviting comments from interested parties. The RPAR was based
on toxicological data from animal
studies showing a correlation between
2,4,5-T exposure and cancer and birth defects. One of the comments received
was from Alsea, Oregon, claiming
that there was a high incidence of
miscarriage among area women following spraying of the local forests with
2,4,5-T. EPA investigated this claim and reported its conclusion that the
incidence of spontaneous abortion over a 6-year period in Alsea was higher
than the rates in two other regions of Oregon that had lower rates of 2,4,5-T
usage. Based on the combination of evidence from the animal studies and the
Alsea study, EPA announced the emergency suspension of the domestic use of
2,4,5-T on forests, pastures, and rights-of-way on Feb. 28, 1979.
The Alsea
study has been criticized on methodological grounds by various groups, and
its results are rejected by a number of writers.
EPA hearings
on
cancellation of 2,4,5-T began in June 1979.
On Mar. 24, 1981,
EPA and Dow
Chemical requested a recess in the hearing to discuss the possiblity of
negotiating a settlement.
The recess has been
extended
while
the
negotiations continue.
Herbicide Spraying in Vietnam
Approximately 107 million pounds of herbicides were aerially disseminated
on 6 million acres of South Vietnam (an area about the size of Connecticut)
from January 1962 to February 1971.
Approximately 276,000 gallons of Agents
Green, Pink, and Purple were sprayed in South Vietnam prior to 1965 when they
were replaced by Agent Orange. Approximately 11 million
gallo.ns of Agent
Orange were then sprayed in South Vietnam — making it the most widely used
herbicide of the war. Ninety percent of Agent Orange was sprayed on 2.9
million acres of inland forests and mangrove forests for defoliation, 8% was
sprayed on enemy crops for crop destruction, and the remaining 2% was sprayed
around base perimeters, cache sites, waterways, and communications lines.
The Air Force continued to operate its herbicide spraying program in South
Vietnam until the late 1960s when the National Cancer
Institute
released
results of an animal bioassay that showed 2,4,5-T to be teratogenic
and/or
fetotoxic in rodents, and newspapers in South Vietnam started reporting
health problems among the rural populations who had been exposed to such
herbicides. The Air Force first restricted the use of Agent Orange to areas
remote from populations
in October of 1969,
then stopped all airplane
spraying of Agent Orange in early 1970 and all helicopter spraying of Agent
Orange by 1971.
All remaining herbicide stocks were gathered and stored at
either Gulfport, Mississippi or Johnston Island in the Pacific until they
were incinerated at sea in 1977.
The following
table outlines
major military projects involving
handling of Agents Orange, Purple, Pink, or Green in South Vietnam.

the

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MILITARY PROJECTS INVOLVING AGENTS ORANGE, PURPLE, PINK, OR GREEN
PROJECT

DATES

DESCRIPTION

AGILE

1960-68

Selection of herbicides., and development
and evaluation of defoliation techniques.

RANCH HAND

1962-71

Aerial spraying of herbicides in South
Vietnam.

Various USAF
Projects

1962-70

'Development and testing of aerial spray
equipment.

PACER IVY

1971

Air Force
Logistics
Command Project

1972-77

PACER HO

1977

Redrumming and movement of surplus
herbicide from South Vietnam to
Johnston Island.
Maintenance of herbicide inventory
and research on options for disposal.
Dedrumming of herbicide inventory and
at-sea incineration of Agent Orange.

Each of these projects involved some human exposure to the herbicide
2,4,5-T and its contaminant, TCDD. The difficulty lies in
determining who may have been exposed and at what level.

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Personnel Exposed
The early trials that were conducted in South Vietnam to improve aircraft
spray systems (1960 to early 1962) were conducted by USAF personnel assigned
to the Special Aerial Spray Flight Division, Langley AFB, Va. (USAF personnel
engaged in the herbicide program did not receive permanent change of station
assignments to South Vietnam until 1964 -- thus making it more difficult to
track personnel who may have been exposed to herbicides). During late
1962
and early 1963, the Crops Division at Fort Detrick and the USAF Armament
Laboratory at Eglin Air Force Base, Florida were involved in efforts to
provide improvements in spray system components in support of Operation RANCH
HAND.
Most of the personnel involved in the actual handling of herbicide drums
were Vietnamese.
However, a USAF flight mechanic or crew chief was
responsible for ensuring that the aircraft were properly loaded and that the
spray systems were functional. Each herbicide aircrew consisted of a pilot
and a copilot (both usually
officers) and a flight mechanic/spray unit
operator (usually enlisted). The aircrews were frequently joined by South
Vietnamese and U.S. observers. As noted in a USAF report, "within the
aircraft, it was not uncommon to have herbicide leakage from around the
numerous hose connections joining the spray tank and pumps with the wing and
aft spray booms. In hot weather, the odor of herbicide within the aircraft
was decidedly noticeable."
The USAF has data on 6,542 herbicide spraying missions that took place
between August 1965 and February 1971 on its "HERBS" computer tape.
These
data were compiled on a mission-by-mission basis from reports and files in
various commands and offices in South Vietnam and the United States.
The
HERBS tape contains the following data for each mission:
date; mission
number; location; province and UTM coordinates; type of herbicide (basically,
Agents Orange, White, or Blue); quantity of herbicide; area covered; purpose
of mission (defoliation, crop destruction, etc.); and type of aircraft (plane
or helicopter). The NAS used the HERBS tape in its evaluation of the effects
of herbicides on South Vietnam. After evaluating the HERBS data, the NAS
concluded that the HERBS tape accounted for approximately 86% of all
herbicide operations in South Vietnam and that "despite certain
recognized
deficiencies," the HERBS tape is "a reliable source for an assessment of the
major part of the herbicide operation in South Vietnam" and "is the best and
in fact the only available comprehensive computation of the major part of the
herbicide operations conducted in the Vietnam war."
When the DOD suspended all use of 2,4,5-T in South Vietnam, the USAF was
left with an inventory of 2.22 million gallons of unused Agent Orange
(1.37
million gallons which had been shipped to South Vietnam and 0.85
million
gallons which were waiting to be shipped at the Naval Construction Battalion
Center at Gulfport, Mississippi). In April 1972, the 1.37 million gallons of
Agent Orange were moved from South Vietnam to Johnston Island in the Pacific
Ocean for storage. The total amount of TCDD in the remaining Agent Orange
stock was approximately 44.1
pounds.
Problems began to arise in both
locations as drums reportedly began to leak and the USAF expressed concern
over further leakage problems that could occur if a tornado hit the
Mississippi site or if a typhoon hit the Pacific site.
After exploring a
number of options, the USAF decided to dispose of the Agent Orange by burning
it at high temperatures at sea on the Dutch incinerator
ship named the
"Vulcanus." The Agent Orange was drained from the drums at each site and

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transferred to the Vulcanus. The empty drums were then rinsed with diesel
fuel and crushed. The rinse fluid was combined with the Agent Orange for
incineration at sea. A total of 15,480 drums of Agent Orange were processed
at the Mississippi site between May 24, 1977, and June 10, 1977, by
approximately 110 USAF officers/technicians from the five Air Logistics
Centers of the Air Force Logistics Command (located at Kelly AFB Texas;
Hill
AFB, Utah; Warner Robbins AFB, Georgia; Tinker AFB, Oklahoma; and McCellan
AFB, California). A total of 24,795 drums of Agent Orange were processed at
the Johnston Island site between July 27, 1977,
and Aug. 23,
1977.
Approximately 100 civilian employees hired by a contractor
performed the
dedrumming process. At both the Johnston Island and Mississippi
sites,
workers were provided with daily changes of work clothes and some with
protective clothing. The Agent Orange was incinerated at sea in the period
from July to September 1977.
Results of industrial hygiene studies conducted
at the time of the disposal operation by the U.S. Air Force
(Gulfport)
and
the Battelle Memorial Institute
(Johnston
Island) revealed no immediate
adverse health effects among the personnel involved in the operation.
Department of Defense, Efforts
The USAF has stated that it can now identify 1,264
servicemen who were
directly exposed to Agent Orange as they handled herbicide., containers and
flew spraying missions in South Vietnam.
The Air Force has initiated a
health effects study of Air Force personnel involved in operation
"Ranch
Hand," who sprayed Agent Orange in Vietnam. The Department of Defense
(DOD)
believes that these individuals had at least 1000
ti-mes more exposure .to
Agent Orange than the average ground troops. The epidemiological study will
try to determine whether a causal relationship
can be established
between
exposure to the 2,4-D/2,4,5-T mixture and long-term health effects. Although
the study was originally scheduled to begin in October 1979, peer review of
its protocols forced delays.
The University of Texas School
of Public
Health, the U.S. Air Force Scientific Advisory Board and the Armed Forces
Epidemiological Board reviewed the
study
protocols
and
recommended
modifications. Then the Air Force asked the National
Academy of Sciences
(NAS) to review the protocols.
On May 6, 1980,
the NAS
announced
recommendations that the scope and duration of the study be expanded to
increase the likelihood of obtaining definitive data.
NAS also expressed
concern about the public perception of credibility
and impartiality
of a
study conducted internally by the Air Force. The Interagency Work Group's
Scientific Panel, however, has recommended that the study, as designed by the
Air Force, be conducted because, despite its limitations,
it provides "a
focus as to the type of health effects that may possibly
occur in other
(ground troop) personnel."
The Ranch Hand study is proceeding in several phases and will continue for
20 years.
The first phase consists
of a detailed
medical
history
questionnaire, which has been administered to the Ranch Handers in their
homes by trained interviewers from Louis Harris and Associates.
A carefully
matched control group, selected from military records held by the Air Force,
has also been interviewed.
The first data from the questionnaire
should be
available by mid-summer 1982.
Also underway is the second phase of the
study, a 3-day series of physical examinations, including a battery of
psychological tests, which will be given to both the study group and the
controls. The contractor for this phase is Kelsey-Seabold of Houston.
The
exams are scheduled to be completed by September 1982,
with
preliminary
findings available 2 to 3 months later. Follow-up exams will be conducted at
1, 3, 5, 10, and 20 years. A mortality analysis on the Ranch Hand group is

�,

, ,

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in progress at the Air Force School of Aerospace Medicine, with data
anticipated around August 1982, and a mortality tracking program will be
continued throughout the study. Information on the health status of the
veterans, as shown by the questionnaires and the physical examinations, will
provide data for a morbidity analysis.
Many of the veterans who have filed claims with the VA for compensation
for health effects caused by exposure to TCDD in South Vietnam did not hold
jobs that caused direct exposure to 2,4,5-T. They claim that their exposure
occurred indirectly either by being sprayed with overhead planes
(although
substances other than herbicides were also sprayed from planes) or by being
exposed to 2,4,5-T in the environment.
According to the DOD, military
personnel did not usually enter areas sprayed with Agent Orange until 4 to 6
weeks after treatment.
However, a recent General
Accounting
Office
investigation concluded that a large number of Marines in the I Corps section
of Vietnam from 1966-1969 were in, or close to, areas sprayed with Agent
Orange on both the day of spraying and within 4 weeks afterward.
Some Army
units were also close to Agent Orange spraying.
The Department of Defense has recently made progress in identifying ground
troops that may have been exposed to Agent Orange. Two Army and one Marine
battalion - 31st Engineer Battalion, 2050 troops; 1st Squadron, 9th Calvary
(Air Mobil), 2300 troops and 3rd Battalion, 1st Marines, have been identified
as being in areas of Agent Orange operations.
Exact numbers, locations, and
identities of individuals who may have been sprayed are impossible to
determine.
Veterans' Problems and Veterans^ .Administration E_f_fO'rts
The first reports of veterans' concerns over health effects of exposure to
2,4,5-T began to appear in late 1977 and early 1978, following media coverage
of several veterans' claims.
Veterans have associated a number of illnesses
with exposure to 2,4,5-T, including skin conditions, fatague, nervousness,
numbness in extremities, vision and/or hearing impairments, birth d'efects in
offspring, reduced libido, miscarriages, impotency, respiratory problems,
gastro-intestinal tract disturbances, and various cancers, as well as a
variety of other illnesses.
As of Apr. 1, 1982, the VA had received 13064 claims for damage reportedly
related to in-service exposure to herbicides? 2986 claims have been made due
only to exposure to the herbicides and not for any specific condition; 10078
claims have been filed for specific conditions related to herbicide exposure,
but 3469 of these have not had the diagnosis con-firmed by medical
authority.
Of the 6609 claims with a confirmed diagnosis, 923 (13.7%) have been allowed
for reasons other than Agent Orange exposures and 5686
(86.3%) have been
denied. Approximately 93% or 858 of the total 923 claims allowed were for
service-connected skin conditions, and the remaining 7% or 65 claims were
allowed for cancer, psychiatric and neurological
conditions, and various
other miscellaneous disabilities. The 5686 claims denied fall into the
following categories (many claims have more than one claimed diagnosis): 3055
for various skin conditions; 2335 for nervousness, headache, or fatigue; 886
for paralysis
or numbness; 751 for gastro-intestinal
or genito-urinary
conditions; 399 for various malignancies; 356 for impaired sexual activity;
394 for eye, ear, nose, and throat conditions; 274 for lung conditions; 227
for cardiovascular conditions; and 137 for miscellaneous conditions. The VA
has not awarded compensation for the claims of chronic illnesses
related to
Agent Orange exposure because of the lack of valid human data to prove a

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cause and effect relationship between exposure to a 2,4,5-T/2,4-D mixture
and/or TCDD and specific chronic health effects. Previously, the difficulty
of determining which veterans' were or were not exposed to Agent Orange was
also a factor in denying compensation, but more recently the VA has conceded
exposure for all veterans who were in Vietnam.
The VA is maintaining a registry of all Vietnam veterans who have come to
VA hospitals and health care facilities expressing concern about possible
herbicide-related health problems. Each such veteran, whether experiencing
any health problems or not, is given a physical examination; currently, some
2700-2800 exams are being conducted each month. Data from all the exams is
being computerized into a central Agent Orange Registry in addition to the
individual records being maintained at the local VA facilities.
As of Mar.
25, 1982, 81,670 veterans had received the initial exam, and about 61,000 of
the records had been coded into the computer. Information from the registry
is being analyzed to determine if the veterans have an increased rate of any
particular diseases.
Thus far, nothing unusual or unexpected has turned up.
Treatment of any health problems uncovered by the exams is handled under
normal VA procedures regarding service-connection, ability to pay for medical
care, etc., with the exception that special guidelines have been issued for
the handling of conditions possibly related to Agent orange.
In the Federal
Register of Dec. 2, 1981,
pursuant to Public Law 97-72, the VA issued
guidelines for use by its physicians to "assist them in making determinations
in individual cases as to whether a disability
may have been caused" by
exposure to Agent Orange. Even though treatment may be given for some
conditions, the VA specified that "In accordance with congressional intent, a
determination to furnish care under this authority does not establish that
the condition for which medical care is provided is service-connected" for
purposes of compensation or vocational rehabilitation eligibility.
Three additional VA activities on Agent Orange include participation
in
the tissue registry, the Chloracne Task Force, and investigations into TCDD
residues in body fat tissue of veterans. When VA facilities perform surgery
or autopsies on Vietnam veterans, tissue samples are taken and sent to the
Armed Forces Institute of Pathology where a special tissue registry is being
maintained. Examination of approximately 800 specimens has so far shown no
significant clustering of tumors or other particular
disease features. The
Chloracne Task Force was established in response to a congressional request
to sift out those cases of skin conditions that either resemble or are truly
Chloracne. Those veterans whose medical records show a definite possibility
of Chloracne will be invited to come to non-VA clinics for re-examination
by
dermatologists who have an expert knowledge of the disease.
The VA has
conducted a study to determine if TCDD can be detected in the body fat
tissues of Vietnam veterans at any higher levels than in veterans who were
not in Vietnam. Dioxin in body fat is measured in parts per trillion, levels
which are at the technological limits of available
detection methods.
The
test requires surgical removal of tissue from the abdomen and chemical
analysis of the sample on
gas
chromatography/high
resolution
mass
spectrometry instruments. The results of the study were inconclusive, and
the VA has decided that the reliability of the procedure is not sufficient to
warran-t its use in attempting to verify dioxin exposure.
An additional
problem is that dioxin contamination
is so ubiquitous (from domestic
herbicide use and from its formation in municipal incinerators) that it may
likely be found in everyone's fat tissue.
As mandated in P.L. 96-151, the Veterans' Affairs Amendments, the VA is
currently preparing to perform an epidemiological study of Vietnam veterans
exposed to Agent Orange. Although the study's protocol has been developed

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UPDATE-04/20/82

and validated by an independent group, the VA will perform the testing and
collect the data, with oversight by a non-VA
scientific
committee.
Procurement of an independent contractor for the study's protocol was delayed
for 14 months by a protest filed by the National Veterans Law Center
(NVLC) .
The NVLC alleged that not only was the .VA violating procurement law, but also
the study as currently contemplated did not comply with the requirements of
P.L. 96-151. On Feb. 2, 1981, the General Accounting Office concluded its
investigation and denied the NVLC protest. On May 5, 1981, the VA announced
the awarding of a contract to the University of California at Los Angeles
(UCLA) School of Public Health for the design of the epidemiological study.
UCLA submitted its first draft of the protocol to the VA in August 1981;
it
was peer-reviewed by the VA Advisory Committee on Health-Related
Effects of
Herbicides, by the Office of Technology Assessment, and by the Science
Panel
of the Agent Orange Working Group. All the review groups judged the draft
protocol to be inadequate and not in compliance with the contract. UCLA has
since modified the protocol, expanding on problem areas and incorporating the
suggestions of the review groups; its final submission to the VA is due April
29, 1982.
As with the Ranch Hand study, this epidemiological study will have
two main parts:
a questionnaire on health status and
medical
and
occupational history, and a physical exam with laboratory workup. The study
group will be 18,000 veterans, divided into 3 cohorts of 6000 each.
Two of
the cohorts will have had Vietnam service, and will be distinguished as
having a high or a low likelihood of herbicide exposure.
The third cohort
will be veterans with non-Vietnam military service.
Inclusion of the third
group will generate data about the health effects of Vietnam service in
addition to the information expected about herbicide-related health
effects.
The study will commence with a pilot project to field test its procedures.and
the questionnaire.
P.L. 96-151 also mandated the VA to conduct a comprehensive review and
scientific analysis of the worldwide literature on Agent Orange and other
phenoxy herbicides. JRB Associates prepared the review under contract, and
the VA published the 2-volume study in October 1981.
The VA is now preparing
to contract for an update to the literature review, to reflect new reports
and data -that have appeared.
The Interagency Work Group on Phenoxy Herbicides and Contaminants,
established in December 1979,
recommended that the Centers for Disease
Control (CDC) perform a case-control study to see if there is an increased
incidence of specific malformations in children of Vietnam veterans.
The
population to be studied is a group of 7500 children who have birth defects
and who are registered in CDC's Birth Defects Program (in operation since the
late 1960s). Information on the families of these children, gained by
extensive interviews and questionnaires, will be compared with that for 300
normal controls. The data will be analyzed to see what risk factors in the
parents' lives, including military service in Vietnam, may be related to
increased incidence of malformations in their children.
CDC has completed a
pilot study on a representative sample of the two groups to test the
questionnaire and the procedures for finding the families.
The main study
will be started in late April 1982, and a preliminary report on the issue of
Vietnam service is expected in the fall of 1983.
Detailed analysis of the
data on all risk factors will take several years to complete.
On Sept. 22, 1980, the Work Group held its first public meeting to discuss
problems and proposals related to exposure to herbicides. On Jan. 19,
1981,
the Secretary of Health and Human Services established the "Advisory
Committee on Special Studies Relating to the Possible Long-Term Health
Effects of Phenoxy Herbicides and Contaminants" to advise the Secretary and

�CRS- 12

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UPDATE-0'4/20/82

the Chair of the Interagency Work Group on Herbicides concerning the Advisory
Committee's oversight of the conduct of the Ranch Hand Study being conducted
by the Air Force. In its seventh report to the White House, the Work Group's
Scientific Panel concluded that:
While it is difficult to accept logically that a
single causative factor -- Herbicide Orange -- could be
responsible for such a diverse set of health effects as
alleged by Vietnam veteran claims to the VA , there is no
definitive evidence that permits selective exclusion of
some of these illnesses. Further, it is possible that
some of these health effects are occurring as a consequence
of Vietnam^ service but not due to exposure to Herbicide
Orange. The Science Panel is not aware of any data that
suggest a modification of its previous recommendation that
the •focus of a study of Vietnam veterans should be
broadened to consider Vietnam service as the exposure
factor rather than focus solely on Herbicide Orange
exposure.... The Science Panel is in receipt of data
which indicate that there is at best a remote chance of
accurate identification of specific ground troops who were
exposed to Herbicide Orange.... The Panel is therefore of
the opinion that design of a scientifically valid Herbicide
Orange study of ground troops may not be possible. If
the focus of a study of Vietnam veterans is broadened to
consider Vietnam service as the exposure factor, a study
of ground troops is necessary and a scientifically valid
study can be designed.
On July 17, 1981,
the Interagency Work Group was renamed and its
membership expanded. Now called the Agent Orange Working Group, it is part
of the Cabinet Council on Human Resources.
The Department of Health and
Human Services is the lead agency.
Because the VA currently recognizes only chloracne as a human health
effect that can be proven to be caused by exposure to 2,4,5-T, veterans may
have difficulty being compensated for even those effects for which there is
strong animal evidence (i.e., cancer and birth defects caused in utero which
are those birth defects that cannot be caused by the father and require the
mother and fetus to be exposed during the actual pregnancy).
Veterans who
claim compensation for health effects which are not supported by strong
animal data (i.e., mutations -- which could cause genetic defects in the
father's sperm that would affect children conceived after exposure) may have
an even tougher case to argue.
The veteran's question then becomes: How much evidence is required to
prove the right to compensation?
On whom does the burden of proof lie
(the
veteran or the VA)? .If more evidence is needed, who will generate it? And
finally, what constitutes fair treatment of veterans while the necessary data
are being gathered?
Congressional Action of the 96th Congress
The 96th Congress responded to the problems of establishing
a cause and
effect relationship between veterans' exposure to herbicides in South Vietnam
and the various health problems they are now experiencing by holding hearings
and enacting legislation.

�CRS- 13

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The Subcommittee on Oversight and Investigations, of the House Committee on
Interstate and Foreign Commerce held hearings on June 24 and 25, 1979,
to
hear testimony from veterans who allegedly have been affected by herbicide
exposure and from the Veterans Administration regarding its efforts to
unequivocally determine the relationship between herbicide exposure and
health effects. The Subcommittee on Medical Benefits and Facilities of the
House Committee on Veterans' Affairs held two sets of hearings on the hazards
associated with TCDD, veterans' complaints of health effects associated
with
Agent Orange exposure, and Veterans Administration's efforts to resolve the
Agent Orange problem.
The Senate Veterans' Affairs Committee also held hearings to
Agent Orange problem.

examine

the

As a step to gain access to records to locate veterans who may have been
exposed to herbicides in-service,
Title V of H.R.
2282, the Veterans'
Disability Compensation and Survivors' Benefits Amendments of 1979,
requires
the Director of the National Institute for Occupational
Safety and Health,
upon request by the VA (or other appropriate agency) to request the current
mailing address from the Internal Revenue Service of persons whom the VA
certifies may have been exposed to occupational
hazards.
H.R.
2282 was
passed in lieu of its companion bill, S. 689, and became Public Law 96-128 on
Nov. 28, 1979.
Title III of H.R. 3892, the Veterans' Affairs amendments, directs the
Veterans Administration to conduct an epidemiological study of the long-term
health effects on individuals from exposure to dioxins in Vietnam, upon the
Office of Technology Assessment's
(OTA) approval of its protocol.
Its
companion bill, S. 1039, was incorporated in H.R. 3892 as an amendment, and
the measure was enacted by Congress and signed by the President on Dec. 20,
1979 (P.L. 96-151) .
If enacted, S. 2096 would have directed the Secretary
of Health,
Education, and Welfare (now, Health and Human Services)
to undertake an
epidemiological study to determine the long-term adverse human health effects
associated with exposure to dioxins produced during the manufacture of
phenoxy herbicides. This bill proposed to investigate the long-term health
effects of exposure to dioxins, in general, not just to Agent Orange.
As
similarly incorporated in H.R. 3892, S. 2096 would have required that the
study's protocol be approved by the Congressional Office of Technology
Assessment. This bill was presented to the President on Dec. 21, 1979,
and
vetoed by him on Jan. 2, 1980.
President Carter vetoed the bill because the
White House counsel believed that such a procedure violated the separation of
power between the legislative branch and the executive branch.
He did not
feel that the Department of Health and Human Services' study protocol
should
be subject to approval by a congressional agency.
Title X of H.R. 5288, the Veterans' Rehabilitation Program and Veterans'
Educational Assistance Program would have directed the Secretary
of Health
and Human Services to conduct a study of veterans and other groups exposed to
the herbicide known as "Agent Orange" to determine if there may be adverse
health effects associated with such exposure. Like H.R. 3892 (P.L.
96-151)
and S. 2096, the bill called for OTA approval of the study's protocol.
The
bill also would have required the Secretary of Health and Human Services to
coordinate its efforts with other studies in the Federal Government.
During
the debate on S. 1188,
its companion bill, the
Disabled
Veterans'
Rehabilitation Act, the Senate adopted an amendment offered by Senator

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UPDATE-04/20/82

Cranston to expand the study on health effects of exposure to Agent Orange to
include other factors related to service in Vietnam. The Senate also adopted
an amendment offered by Senator
Heinz requiring the VA to promulgate
regulations regarding guidelines to resolve veterans' disability claims based
on exposure to Agent Orange.
The ' amendments were striken by the House
because they were considered to be "non-germane" to the primary focus of the
bill.
S. 1872 (the Vietnam Veterans' Act); H.R.
6050 (the Vietnam Veterans'
Act); H.R. 6377 (the Vietnam Era Veterans Agent Orange Act); each would have
established a presumption of service-connected disability for health
effects
in Vietnam veterans (and birth defects in their children) exposed to Agent
Orange. H.R. 8238 (Independent Agent Orange Study) would have directed the
Veterans Administrator to request the National Academy of Sciences to conduct
a study on veterans exposed to Agent Orange.
H.R. 8300 would have expanded
the scope of the Agent Orange study currently being coordinated by the VA and
would have established deadlines for promulgating regulations related to
Agent Orange exposure claims. These bills received no action.
LEGISLATION
P.L. 97-72, H.R. 3499
Veterans' Health Care, Training and Small Business Loan Act of
1981.
Amends title 38, U.S. Code, to extend the Vietnam-era veterans'
readjustment
counseling program, to provide medical care for Vietnam veterans exposed to
herbicide defoliants (including Agent Orange), to recover the cost of certain
health care provided by the VA, and authorizes the VA to expand the scope of
its epidemiological study on the health effects of Agent Orange, and other
purposes. Introduced May 7, 1981;
referred to Committee on Veterans'
Affairs. Committee consideration and mark-up session held May 12.
Reported
to House (amended) by Committee on Veterans' Affairs (H.Rept. 97-79) May 19.
Passed House (amended) June 2, 1981.
Received in the Senate June 3.
Senate
struck all after the Enacting Clause and substituted the language of S. 921,
June 16. Passed Senate in lieu of S. 921 with amendments, June 16,
1981.
House concurred in Senate amendments with amendments Oct.
2, 1981.
Senate
agreed to House amendments Oct. 16, 1981.
Signed into law Nov. 3, 1981.
H.R.

523

(Roe)

Amends Title 38, U.S. Code, to waive the 1-year limitation on claims for
compensation from the Veterans Administration for disabilities
and diseases
incurred in or aggravated by military service in the case of claims by
veterans who served in Southeast Asia during the Vietnam era for compensation
for disabilities resulting from exposure to the phenoxy herbicides known as
Agent Orange or other phenoxy herbicides.
Introduced Jan. 5, 1981;
referred
to Committee on Veterans' Affairs.
H.R. 1173

(Montgomery, by request)

Amends section 307 of P.L. 96-151, by assigning
the responsibility
of
designating a protocol for, and conducting an epidemiological
study of,
veterans who were exposed to Agent Orange, to an independent
scientific
agency. Introduced Jan. 22, 1981;
referred to Committee on Veterans'
Affairs.
H.R. 1962

(Oilman)

�-

. ,

CRS- 15

IB80040

UPDATE-04/20/82

Amends the Veterans Health Programs Extension and Improvement Act of
1979
to require the Veterans Administration and the National Academy of Sciences
to enter into an agreement under which the Academy will
conduct an
epidemiological study of veterans exposed to Agent Orange.
Introduced Feb.
19, 1981; referred to Committee on Veterans' Affairs.
H.R. 2157

(Mottl)

Expands the scope of a study required to be conducted by the Administrator
of Veterans' Affairs concerning the effect on humans of exposure to the
chemical known as Agent Orange.
Introduced Feb. 25, 1981:
referred to
Committee on Veterans' Affairs.
VA requested Executive comment Mar. 2, 1981.
Referred to Subcommittee on Hospitals and Health Care Apr. 28. Hearings held
Apr. 30. Subcommittee consideration and mark-up session held.
Clean
bill
forwarded to full committee.
H.R. 2297

(Downey)

Amends Title 38, United States Code, to waive the 1-year limitation
on
claims for compensation from the Veterans Administration for disabilities and
disease incurred in or aggravated by military service in the case of claims
by veterans who served in Southeast Asia
during the Vietnam era for
compensation for disabilities
resulting from exposure to the
phenoxy
herbicides known as "Agent Orange" or other phenoxy herbicides.
Introduced
Mar. 4, 1981; referred to Committee on Veterans' Affairs.
H.R. 2493

(Daschle)

Amends Title 38, United States Code, to provide a presumption of service
connection for the occurrence of certain
diseases in veterans who were
exposed to herbicides in Southeast Asia during the Vietnam era.
Introduced
Mar. 12, 1981; referred to Committee on Veterans' Affairs.
H.R. 2953 (Daschle)
Entitles veterans exposed to Agent Orange
during the Vietnam era to
specified medical benefits.
Extends the period during which veterans of such
era may initially request psychological
readjustment counseling.
Extends
specified educational assistance without delimiting periods for vocational
training for specified veterans determined to be in need of such
assistance.
Introduced Apr. 1, 1981;
referred to Committee on Veterans' Affairs.
Referred to Subcommittee on Hospitals and Health Care Apr. 28. Hearings held
Apr. 28. Subcommittee consideration and mark-up session held Apr. 30, 1981.
H.R. 3163

(Railsback)

Requires the Secretary of Health and Human Services to arrange for an
independent epidemiological
study of persons
exposed to Agent Orange.
Introduced Apr. 8, 1981;
referred to Committee on Energy and Commerce.
Referred to Subcommittee on Health and the Environment Apr. 9, 1981.
S. 636 (Cranston et al.)
Entitles the United States to recover the costs of certain
medical
care
and services furnished to a veteran for a non-service-connected
disability
when disability is covered by another form of insurance
or compensation.
Permits the expansion of the scope of the epidemiological
and literature

�CRS- 16

IB80040

UPDATE-04/20/82

study of the long term adverse health effects of exposure to Agent Orange
during the Vietnamese conflict to include the effects of other factors.
Introduced Mar. 5, 1981; referred to Committee on Veterans' Affairs.
S. 689 (Heinz)

Amends section 307 of the Veterans Health Programs Extension
and
Improvement Act of 1979 to require the promulgation of regulations containing
guidelines for resolving claims for veterans benefits based on exposure, to
Agent Orange, and for other purposes. Introduced Mar. 12, 1981; referred to
Committee on Veterans' Affairs.
Hearings held Apr. 30, 1981.
S. 921

(Simpson)

Extends the authority of the Administrator
of Veterans' Affairs to
contract for hospital care or medical services in Puerto Rico and the Virgin
Islands without reference to patient loads or incidence of provision of
medical services for veterans treated by the Veterans' Administration in the
contiguous 48 States. Introduced "Apr. 8, 1981;
referred to Committee on
Veterans' Affairs.
Reported with amendment May 15, 1981
(S.Rept.
97-89);
H.R. 3499 passed in lieu (see P.L. 97-72 above) June 16, 1981.
S. 1345 &lt;Heinz)
Authorizes the Administrator of the Veterans' Administration to provide
hospital or nursing home care to a veteran for treatment of a condition
associated with exposure to Agent Orange during service in Vietnam.
Extends
the Vietnam-era veterans' readjustment counseling program.
Directs the
Administrator to expand the scope of the epidemiological study of long term
adverse health effects of other factors involved in such service. Introduced
June 8, 1981; referred to Committee on Veterans' Affairs.
S. 1953

(Specter)

Amends title 38, United States Code to provide a presumption of service
connection for the occurrence of certain diseases
in veterans who were
exposed to phenoxy herbicides while serving in Southeast Asia during the
Vietnam era.
Introduced Dec. 15, 1981; referred to Committee on Veterans
Affairs.
HEARINGS
U.S.

Congress.
House. Committee on Interstate and Foreign
Commerce. Subcommittee on Oversight and Investigations.
Agent Orange: exposure of Vietnam veterans.
Hearing, 96th Congress,
2d session. Sept. 25, 1980.
249 p.
Involuntary exposure to Agent Orange and other toxic
spraying. Hearings, 96th Congress,
1st session. June 26 and 27, 1979.
256 p.

U.S.

Congress. House. Committee on Veterans' Affairs. Ad Hoc
Subcommittee.
Status of Vietnam veterans in the Bay area.
Hearing, 96th Congress, 2d session. Apr. 10, 1980.
64 p.

U.S.

Congress.
House. Committee on Veterans' Affairs.
Subcommittee on Hospitals and Health Care.

�%

.. ,

CRS- 17

IB80040

UPDATE-04/20/82

Legislation to improve medical programs administered by
the Veterans Administration (H.R. 2157, H.R. 2953, and H.R. 2999).
Hearings, 97th Congress, 1st session. Apr. 28, 1981.
54 p.
U.S.

Congress. House. Committee on Veterans' Affairs.
.Subcommittee on Medical Facilities and Benefits. Herbicide
"Agent Orange". Hearing, 95th Congress, 2d session. Oct. 11,
1978.
62 p.
Oversight hearing to receive testimony on Agent Orange.
Hearing, 96th Congress, 2d session. Feb. 25, 1980.
121 p.

----- Oversight hearing to receive testimony on Agent Orange.
Hearing, 96th Congress, 2d session. July 22, 1980.
459 p.
--—•- Scientific community report on Agent Orange. Hearing, 96th
Congress, 2d session. Sept. 16, 1980.
145 p.
U.S.

Congress. House. Committee on Veterans' Affairs.
Subcommittee on Oversight and Investigations. Current
status of Agent Orange studies. Hearing, 97th
Congress, 1st session. May 6, 1981.
385 p.

U.S.

Congress.
Senate.
Committee on Veterans' Affairs. Agent
Orange update and appendix: Agent Orange activities (part II).
Hearing, 96th Congress, 2d session. Sept. 10, 1980.
1368 p.
Oversight on issues related to Agent Orange and other
herbicides. Hearing, 97th Congress, 1st session. Nov. 18,
1981.
(not yet printed)
• VA health resources and program extensions and appendix:
Agent Orange activities.
Hearing, 96th Congress, 1st session,
on S. 741 and S. 196.
Apr. 10,. 1979.
462 p.
• Veterans' Programs Extension and Improvement Act of 1981.
Hearing, 97th Congress, 1st session, on S. 26 (titles
II and III, only), S. 380, S. 458, S. 636, S. 689, S. 872, S. 914,
S. 921, and related bills. Apr. 30, 1981.
685 p.
• Vietnam veterans' readjustment. Hearings, 96th Congress, 2d
session.
Feb. 21, Mar. 4, and May 21, 1980.
Part 2.
595-2082 p.

ADDITIONAL REFERENCE SOURCES
American Medical Association.
Council on Scientific
Affairs.
Health effects of "Agent Orange" and
dioxin contaminants (Executive Summary).
1981.
6 p.
Behrens, Richard, et al. Comments from CAST (Council on
Agricultural Science and Technology): Dioxin.
1978,
9 p.
Bucfc, Craig. The Death of a nation.
Aug. 28, 1978:
49-50, 52-55.

New west, v. 3,

�CRS-18

IB80040

UPDATE-04/20/82

Cookson, Clive. "Emergency" ban on 2,4,5-T herbicide
in U.S. Nature, v. 278, Mar. 8, 1979:
10'8-110.
Davis, Donald E. et al. Comments from CAST (Council
on Agricultural Science and Technology): Agent
orange. 1978.
5 p.
Galston, Arthur W. Herbicides: a mixed blessing.
v. 29, February 1979:
85-90.

Bioscience,

International Agency for Research on Cancer.
IARC monographs on
the evaluation of the carcinogenic risk of chemicals to
man: 2,5,5-T, vol. 15, August 1977.
JRB Associates.
Review of literature on herbicides,
including phenoxy herbicides and associated
dioxins. Washington, Veterans Administration,
1981.
2v.
Laporte, Joan-Ramon. Multinationals and health: reflections on
the Seveso catastrophe.
International journal of health
services, v. 8, no. 4, 1978:
619-632.
National Research Council. The effects of herbicides in South
Vietnam: Part A. Summary and conclusions. Washington,
National Academy of Sciences, 1974.
AD-774-749.
398 p.
Peterson, Jeannie. Seveso:
1978:
232-239.

the event.

Ambio, v. 7, no. 5-6,

Reggiani, G. Localized contamination with TCDD - Seveso, Missouri, and
other areas. In: Halogenated biphenyls, terphenyls,
naphthalenes, dibenzodioxins and related products, ed. Renate
D. Kimbrough. Amsterdam, New York, Oxford, Elsevier/North-Holland
Biomedical Press, 1980.
Severe, Richard. Seveso: lessons from an escape.
June 17, 1978:
101-102, 104-106, 108.
U.S.

Economist, v. 2.67,

General Accounting Office. Health effects of exposure to
herbicide orange in South Vietnam should be resolved,
Apr. 6, 1979.
CED-79-22.
U.S. ground troops in South Vietnam were in areas sprayed
with herbicide orange. Nov. 16, 1979.
FPCD-80-23.

Young, Alvin et al. The toxicology, environmental fate and human
risk of herbicide orange and its associated dioxin. The
Surgeon General, U.S. Air Force, Washington, D.C.
October 1978.
Walsh, John. Seveso: the questions persist where dioxin created a
wasteland. Science, v. 197, Sept. 9, 1977:
1064-1067.
Whiteside, Thomas.

Defoliation.

New York, Ballantine,

•- The pendulum and the toxic cloud.

New Haven, Yale

1970.

�, ..

k

CRS-19

IB80040

University Press, 1979.
Zimmerman, David R. Agent Orange: Vietnam's lingering
poison. American health, v. 1, no. 1, Mar./Apr.
1982: 68-72.

UPDATE-04/20/82

�Signs, Symptoms, and Disorders Reported After Occupational Exposure to TCP, 2,4,5-T or TCDD
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27

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Zelikov and Danilov (88)
Total number of cases
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a

Number entries in table reflect the number of cases in which sign, symptom or disorder was
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c
Numbers do not include cases represented by "+" and totals may represent some double counting
due to the overlap to studies by Jirasek et al. and Pazderova et al.
SOURCE:

Young, Alvin et al. The Toxicology, Environmental Fate, and Human Risk of Herbicide
Orange and Its Associated Dioxin, p. VI-14. (Numbers in parentheses identify sources
in Young's bibliography.)

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