1 15 106 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 https://www.nal.usda.gov/exhibits/speccoll/files/original/bc54fa583efffdef8051d9f49a71404e.pdf 208c08c339cf33fd3b1a079fcdbc1162 PDF Text Text ItomDNunber °1861 Author Bangert, Joseph V. Corporate Author Commonwealth of Massachusetts Agent Orange Progra RdDOrt/ArtldO TltlO Health Survey of Massachusetts Vietnam Veterans, Summary Journal/Book Title Year 1986 Month/Day June Color 0 Number of Images 12 Descrlpton Notes Wednesday, July 11, 2001 Page 1862 of 1870 �COMMONWEALTH OF MASSACHUSETTS AGENT ORANGE PROGRAM Office of the Commissioner of Veteran's Services 100 Cambridge Street Boston, MA 02202 "Health Survey of Massachusetts Vietnam Veterans" SUMMARY June, 1986 �FOREWORD The Commonwealth of Massachusetts Agent Orange Program, a program of the Office of the Commissioner of Veterans' Services, was provided funding by the 1983 Massachusetts Legislature for the purpose of conducting, "medical and scientific testing related to the possible health effects of Agent Orange on Massachusetts Vietnam Veterans." In January, 1984, the Agent Orange Program, Office of the Commissioner of Veterans' Services (OCVS) was implemented to survey programmatic, medical and scientific options. The Agent Orange Program instituted the Agent Orange Medical /Scientific Advisory Board to provide technical recommendations, oversight and review of proposals and implemented medical and scientific programs and studies. In January, 1985, the Massachusetts Agent Orange Program, in cooperation with the Massachusetts Department of Public Health published the "Mortality Among Massachusetts Vietnam Veterans, 1972-1983" written by Michael Kogan, M.A., and Richard Clapp, M.P.H., as the first step in the Commonwealth's attempt to find some answers to the complex questions surrounding the issue of Agent Orange. This mortality study provides a stable foundation for our continued ongoing efforts to provide scientific, technical, verifiable data regarding the effects of Agent Orange where none had been previously available. The Massachusetts Agent Orange Program's "Health Survey of Massachusetts Vietnam Veterans, 1986" is the second step in our program's continuing efforts to determine the needs of Massachusetts Vietnam Veterans and their families. This survey utilized the "American Legion," or "Stellman questionnaire," with minor modifications. The survey results, contained within, are the result of over 2,000 Massachusetts Vietnam Veterans and their families, and dependents who took the time out to complete a rather detailed and complex form. Only 1,500 of the 2,000 questionnaires were included in the Massachusetts survey as they were chosen on the completedness of the questionnaire, and those filled out by Massachusetts veterans who had not been in the Vietnam theatre were excluded. The analysis of the data collected by the Massachsuetts Agent Orange Program was compiled and analyzed by Mr. Frank J. Bove, M.S., an epidemiologist and PhD candidate with Harvard University School of Public Health. We are indebted to the hard work of this young scientist. The Massachusetts Agent Orange Program also acknowledges the leadership role of Governor Michael S. Dukakis of Massachusetts as well as that of Commissioner of Veterans' Services, John Halachis in their ongoing committment to this program and its importance for the more than 50,000 Massachusetts Vietnam Veterans. We also acknowledge the General Court of the Commonwealth of Massachusetts, and in particular to Senator Fran Doris, Representative Thomas Vallely and former Representative Tom Lynch who took the leadership in bringing the Massachusetts Agent Orange Program into being. We would be remiss if we did not acknowledge the pioneering role of Mr. Christopher Gregory, the former Director of the Agent Orange Program in getting the program on line. We shall continue first and foremost to aggressively and independently survey and test Massachusetts Vietnam Veterans who bore the brunt of battle and will never be forgotten. Jsefob/V. Bangert, Director Massachusetts Agent Orange Program r �SUMMARY Fifteen hundred Vietnam veterans in Massachusetts completed health questionnaires in January 1985. The respondents were those who filed a claim against the $180 million proposed out of court settlement reached by attorneys' representing the seven chemical manufacturers of Agent Orange and Vietnam veterans. Although not a random sample of the more than 50,000 Massachusetts Vietnam veterans, the findings indicate a considerable amount of illness among the respondents including tumors, neurobehavioral problems, reproductive difficulties and birth defects among their offspring. These findings are consistent with the observed symptoms and disease found among those exposed to 2,4-D, 2,4,5-T and 2,3,7,8-TCDD (Dioxin) in the workplace or the environment. INTRODUCTION Concern about the long-term effects of exposure to Agent Orange is widespread among Vietnam veterans in the U.S. and Australia, as well as among the citizens of Vietnam. In southern Vietnam, recent studies report a variety of persistent clinical problems including recurring bouts of headaches, depression and anxiety, asthenia, loss of libido, GI disorders and adverse reproductive outcomes. Studies of workers exposed to dioxin contaminated substances have found elevated rates of lymphomas and soft tissue sarcomas. Neurologic and liver effects have also been reported. Table 1 lists the findings of some of these occupational studies. Table 2 lists the findings of a Massachusetts Departments of Public Health and Veterans Services study of mortality among Vietnam veterans. This study found elevated rates of soft tissue sarcomas, kidney cancer, motor vehicle accidents and suicides. Table 3 lists findings from other studies of Vietnam veterans. This survey of the health of Massachusetts Vietnam veterans is part of an on-going research program that was sparked by the findings of previous studies as well as the concerns raised by veterans. The results of this survey are consistent with those in the studies mentioned above. METHODS AND SUBJECTS In January, 1985, The Massachusetts Agent Orange Program instituted a large-scale media campaign to alert Vietnam veterans �of the court-imposed deadline for filing a claim against the proposed $180 million settlement reached by attorneys for the seven manufacturers of Agent Orange and Vietnam veterans. About 2,000 veterans filed claims during a two day period at the state's Office of Veterans Services. The American Legion health questionnaire was distributed to those filing claims. In addition, some 300 questionnaires were mailed to veterans who phoned the Agent Orange Program requesting to participate in the health survey. Approximately 1800 questionnaires were returned to the Agent Orange Program, fifteen hundred of these were selected based on the criteria of completedness and actual service in Vietnam. Staff of the Agent Orange Program as well as trained volunteers, all of whom were Vietnam veterans, assisted respondents with any questions or difficulties they encountered with the questionnaire. Concerning the birth outcome data requested by the questionnaire, if the veterans were not sure of the information being asked, they were provided with a self-addressed envelope and permitted to take the questionnaire home to consult with their spouses. RESULTS Analysis of the questionnaire data was performed using DBASE III. Over a quarter of the respondents stated that they were diagnosed with tumors (cancerous, benign, fatty or other). Nine were diagnosed with Hodgkins Disease. Nearly 22% of the respondents indicated that one or more of their children had birth defects. Out of 1907 live births reported in the questionnaires, 462 (24%) had at least one birth defect and 160 had more than one defect. Thirty-seven spina bifida, other brain or spine defects were reported. Table 4 presents the data on other congenital malformations. Nearly one-third of the respondents indicated a decrease in libido and 22% reported fertility difficulties (see Table 4). Nearly two-thirds of the respondents indicated persistent problems with tiredness, over half reported persistent headaches and difficulties with memory or concentration, and almost half reported nervous disorders (see Table 5). Seventy-three percent of the respondents answered yes to the question: "Have you or your family ever noticed a personality change?". Eighty-two percent of the respondents claimed they regularly had at least one of the following problems: depression, violent rage, anxiety and irritability. Most had more than one problem. Two hundred and seventy-five respondents reported suffering from mental Illness or a breakdown. Symptoms of peripheral neuropathy in the lower or upper extremities were reported in over two-thirds of the veterans. Indications of asthenia were found in over half of the questionnaires (see Table 5). �Many respondents reported GI disorders. Over a third stated they had repeated nausea without flu or other sickness. Over 25% reported repeated bouts with diarrhea. One-third indicated that they regularly experienced loss of appetite and 20% reported weight loss. CONCLUSION We reemphasize that the questionnaires were not randomly distributed and were completed on a volunteer basis by a selfselected group of MA veterans. This means that we cannot base a valid, scientific study on the information contained in these questionnaires. However, the questionnaires clearly indicate considerable disease and suffering among a relatively young group of people (93% under age 45, 80% under age 40). The symptoms and disease found are consistent with findings from other studies of people exposed to dioxin, 2,4-D and 2,4,5-T. REFERENCES Ashe WF, Suskind RR (1949,1950)tReports on chloracne cases, Monsanto Chemical Co., Nitro, W.VA. Baader EW, Bauer AJ (1951):Industrial intoxication due to pentachlorophenol. Indus Med Surg 20:289-290. Barr MM (1982) :letter to editor. ANZ J. Psych. 16: 88-89. » Barr MM (1983): Apparent progressive axonal dying back neuropathy in Vietnam veterans. Neuroscience Letters, Abstracts suppl. ll:s.29. Dugois P, et.al. (1956): Acne chlorlque au 2,4,5-T. Lyon Med 88:446-447. Erickson JD, et.al. (1984): Vietnam veterans1 risks for fathering babies with birth defects. JAMA 252:903-912. Goldman PJ (1973): Schwetst akute chlorakne, eine massenintoxikation durch 2,3,6,7-TCDD. Der Hautarzt 24:149-152. �Moses M, et.al. (1984): Health Status of workers with past exposure to 2,3,7,8-TCDD in the manufacture of 2,4,5-T: Comparison of findings with and without chloracne. Am J Ind Med 5:161-182. Pazderova-Vejlupkov J, et.al (1980): Chronic poisoning by 2,3,7,8-TCDD. Prac Lek 32::204-209. NIH Library Translation. Pazderova-Vejlupkov J, et.al (1981): The development and prognosis of chronic intoxication by TCDD in men. Arch Env Health 36:5-11. Poland AP, et.al. (1971): Health survey of workers in a 2,4-D and 2,4,5-T plant. Arch Env Health 22:316-327. Stellman S, Stellman J (1980): Health problems among 535 Vietnam veterans potentially exposed to toxic herbicides. Am J Epi 112:444 (abstract). Susklnd RR (1953): A clinical and environmental survey, Monsanto Chemical Co., Nitro, W.VA.. Report of the Kettering Laboratory, July. Suskind RR (1977): Chloracne and associated health problems in the manufacture of 2,4,5-T. Report to the NIEHS/IARC Joint Conference, Lyon, France. January. Telegina KA, Bikbulatova LJ (1970): Affection of the folllcular apparatus of the skin in workers employed in the production of the butyl ester of 2,4,5-T. Vestnik Derm Ven 44:35-39. �TABLE 1 REPORTED OCCUPATIONAL EXPOSURES TO DIOXIN-CONTAMINATED SUBSTANCES RESULTING IN HUMAN ILLNESS* Year,place & chemical(s) Type of exposure & number of cases Neurological effects Other effects References 1949 W.VA TCP, 2,4,5-T explosion 117 production 111 nervousness, irritability, insomnia, personality change,depression, headache,pain & weakness in lower extremities, per ipheral neuropathy fatigue, [Ashe & weight Suskind, loss, 1949, weakness, 1950; decreased Suskind, libido,im - 1953; Suskind, potence 1977] . 1949 Germany TCP production, industrial lab 17 pain & weakness,paresthesia,polyneuritis in lower extremities fatigue, decreased libido, impotence 1952 Germany TCP production 31 pain & weakness,paresthesia in lower extremities, memory & concentration deficits,sleep disturbances, apathy,dulled emotional response fatigue, [Susmyocardial kind, damage 1977] 1953 Germany TCP explosion 55 hearing impairment, peripheral neuropathy fatigue, [Golddrowsiness, man, myocardial 1973] damage 1956 France TCP production 17 peripheral neuropathy 1964 USSR TCP 2,4,5-T production 128 headache,memory loss, sleeplessness [Baader & Bauer, 1951] [Dugois, et.al., 1956] fatigue, [Telejoint pain gina & Bikbulatova, 1970] �TABLE 1 (continued) Year,place & chemical(s) Type of exposure & number of cases Neurological effects Other effects References 1965-68 Czechoslovakia TCP 2,4,5-T production 80 pain & weakfatigue, [Pazderoness in lower weight va-Vejlupkov, loss extremities/ somnolence, et.al., 1980; headache, insomnia,peri19811 pheral neuropathy, emotional & psychiatric disorders 1969 NJ TCP 2,4,5-T 2,4-D production 73 weakness in lower extremities,hypomania *adapted from Moses/et.al.,1984 [Poland, et.al. ' 1971] �TABLE 2 Standardized Proportional Mortality Ratios for Selected Causes of Death for Vietnam Veterans Compared with Either Non-Vietnam-Veterans or Non-Veteran Males ICO NO* CAUSE OF DcATH OBSERVES VIETNAM VETERAN DEATHS All Causes COMPARISON GROUP NON- VIETNAM VETERANS PMR 95% C.I. NON-VETERAN MALES PMR 95% C.I. 840 140-239 All Neoplasms 153-154 Colo-Rectal 162 Lung, Bronchus 171 Connective Tissue 9 880 189 Kidney 9 183 (96,348) 353 (191,651) 139 88 (75,103) 87 (74,102) 28 111 (77,160) 138 (96,199) • 129 95 (78,115) 112 (94,134) 8 113 (56,228) 85 (42,172) 98 (66,146) 102 (72,145) 25 (513,1510) 473 (262,855) 390-429 'Circulatory System 439-459 (except Cerebrovascular) 430-438 Cerebrovascular Disease 571 Cirrhosis of the Liver 29 94 (65,136) 90 (61,132) • E800-E999 All external causes 428 108 (98,119) H3 (103,124) E810-E825 Motor vehicle accidents 169 110 (95,127) 127 (106,152) E950-E958 Recorded suicides 102 93 (77,112) 118 (98,143) 799.9, Estimated suicides*1* E850-E869, E950-E958, 163 113 (96,132) 140 (120,163) 31 80 (56,114) 66 (46,94)' E980-E982 E960-E969 Homicides International Classification of Diseases, 9th Revision, code number. **See reference (6) for discussion of this category. Note that there were 13 deaths in the category 799.9. �TABLE 3 REPORTS ON THE HEALTH STATUS OF VIETNAM VETERANS Reference Exposed Health Effects Stellman & Vietnam Veterans 535 congenital malformations, GI disturbances,pain in joints,sleep and psychological disturbances Barr/1982; 1983 Vietnam Veterans Australia, 120 peripheral neuropathy, insomnia,depress ion, Irritability,lassitude, memory loss,headaches, attempted suicides Erickson, et.al. 1984 Vietnam Veterans 696 congenital malformations: spina bifida,cleft lip, impaired hearing,clubfoot Stellman, 1980 �TABLE 4 CONGENITAL MALFORMATIONS Total Number Birth Defect Prevalence * BDMP Incidence Rate * Spina Bifida,other brain or spine defects 37 195 18.4 clubfoot 24 126 24.5 cleft lip/palate 17 89 13.4 missing, deformed or extra toes/fingers 31 163 Down's Syndrome 11 58 7.9 hip abnormalities 21 111 27.0 heart defect 60 defect of the digestive system 35 hearing disorders 63 cerebral palsy 27.2** 6 other skeletal defects Condition requiring special education or care 46 122 * per 10,000 live births ** polydactyly and syndactyly OTHER REPRODUCTIVE PROBLEMS Problem Number % Loss of libido 487 32.4% Infertility 330 22.0% Infertility and saw physician 246 16.4% low birth weight children 162 8.1% (under 5.5 Ibs.) �10 TABLE 5 NEUROBEHAVIORAL DYSFUNCTION Problem Number % persistent tiredness (saw physician) 957 270 63.7% 18.0% persistent headaches (saw physician) 773 338 51.5% 22.5% nervous disorders (saw physician) 684 356 45.5% 23.7% difficulty with memory or concentration (saw physician) 786 165 52.3% 11.0% mental illness or breakdown (receiving some disability) 275 132 18.3% 8.8% 1233 1015 82.1% 67.6% 321 21.4% regularly depressed, get into a violent rage, anxious or irritable (more than one behavioral problem) Sensory symptoms of early stage peripheral neuropathy asthenia (need hands to rise from chair, can't climb stairs without holding onto railing, unable to do tasks requiring holding arms at shoulder level, difficulty grasping tools) 775 51.6% � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 069 Folder The folder containing the original item. 1861 Series The series number of the original item. Series III Subseries III Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Bangert, Joseph V. Description An account of the resource Corporate Author: Commonwealth of Massachusetts Agent Orange Program Date A point or period of time associated with an event in the lifecycle of the resource 1986-06-01 Title A name given to the resource Health Survey of Massachusetts Vietnam Veterans, Summary Subject The topic of the resource state-funded Vietnam veterans study mortality trends congenital birth defects industrial exposure ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/f0823836210e4e506c7d5e6b30024225.pdf f27b8237f2250a67fe96458923a3ecfc PDF Text Text Item D Number °2418 Author Bianco, Vanda Corporate Author ROPOrt/ArtlGto Tttta Typescript: Obstetric Monitoring in Brianza de Seveso From 1975to1981 Journal/Book Title Year 000 ° Month/Day Color ° Number of Images 30 Descrtoton Notes Friday, October 05, 2001 Page 2418 of 2422 �CBSTSTSIC MCNITGE32TG 121 3RIANZA DI 3SVZSG ?20H 1975 TO 13S1 Dr Vanda Bianco (researcil worker, University of Milan) Dr L. Meazza Prof. G. Senotti (Coordinator of C.P.2} (tlie Professor of Obstetric and Gynecolccica] holag^', University of Milan) �REPORT GIT OBSTETRIC MONITORING IN 3RIANZA DI SEVSSO Total monitored pregnancies (up to 16/5/83): 21 532 Methods of investigation The aim of this study since the beginning was to gather pregnancy data on a number as close as possible to 100% of the pregnancies of the women residing in the 11 communes. Since we were to study phenomena like the trend of the spontaneous abortion rate in small population samples, such as zones A and 3, the loss of even a few cases could have appreciably affected the rates. Cur study covers all the pregnancies concluded between January 1st 1975 and December 3-lst 1981. ported was checked The completeness of the cases, re- and missing cases recovered by means of: 1) a list of births in the eleven communes (thoroughly checked by Special office personnel as from the third quarter of 1976 but not for the previous quarters); 2) the reports of spontaneous abortion (sent by law to the provincial medical until autority) June 1973 and available from July i976. The search for reports of spontaneous abortion for the period January "975 June 1976 unfortunatelv Droved fruitless. In fact they were no longer to be found in the competent offices because their preservation after the normal statistical work-over and after the entry into fbrce of law 194 was thought to be pointless; 3) the recovery of clinical data from neighboring hospitals (Carate, Cantu, Garbagnate, Clinica Zucchi of Monza, Saronno) net included in the monitoring plan and from the largest hospitals in the city of Milan, attended by a significant percentage of the pregnant women of the 11 communes; 4) the A/D forms of all the hospitals in Lombardy. These forms are available from May-June 1 975: uo to end1976 they appear incomplete whereas from '77 to '81 the standard is de �available only in March. 1983. Case records for cases probably relevant to our study, have been looked for and mainly found, bi± still missing from this report since it is worked on data elaborated by the computer up to May 16th, 1983. The follO7/i;ig data about each pregnancy are always known: mother's registry office data, date of last menstrual period, date of delivery or abortion and weight of the newborn . The date of conception can be established with good approximation by the date of the last menstrual period. The pregnancy data have been stored in the computer of the Special Office at Desio according to a program agreed in advance with the epidemiology group (figure 1). For the study of spontaneous abortions we have chosen the statistical method that relates the number of spontaneous abortions occurring in a given period to the number of conceptions for that period, in order to exclude any factors that might affect the number of conceptions. In fact the number of conceptions in the populations under study might have been affected in varying degree, contraception having been heavily promulgated at the beginning due to fear of damaging effects of TCDD on the concept embryo . Table 1 gives the total number of pregnancies monitored and the disaggregation by year of conception and by zone of residence of the cravida a**" the ^"me of cc'cclus1' 0*1 of ^~he ^rec^aif '""'•* ^S*T-- •* ~ oregnancies failed to 36 sssicr.ed to rhs zor.es due '"c iv"~c~'2l=~-— •--» ^ c ^ r> £ T- yi -a -^ at— • c •!— ^- r <~* - £ -• .-- s r P ••- 2 �The 1974 conception data are incomplete in that the numbers in the table refer only to the conceptions resulting in delivery or abortion on or after January 1st 1975. Similarly the 1981 data are incomplete because they include only the conceptions resulting in delivery or abortion by 31 December 1981 . 21 532 pregnancies were monitored (all pregnancies ending in voluntary abortion have been deliberately excluded) . This table shows that the total number of conceptions was steadily declining from 1975 to 1980 in line v/ith the national trend. 1975 only was cut of line as throughout the territory and in each individual zone the figures were lower than in 1977, probably due to the heavy contraception program in the area immediately after the accident, through 1977. in scnes A and B, after a low in 1976 the figure rose again in 1977 and 1973, probably by way of compensation. In 1979 and 1980 zones A and B came back into line v/ith the rest of the territory with a progressive fall in the conception rate similar to that for the whole of the Lcnbardy Region. This declining trend justifies the criterion chosen for the determination of the abortion rate. Table 2 gives the number of abortions and of conceptions by area according to tha decree of pollution and by quarter of ccncsptisr from the foxirth quarter cf 1974 to the first quarter of 1981 . Table 3 gives the related percentages. The tone A values are not studied individuallv because the small number of pregnancies to allow a. significant evaluation. From these tablas and from graph 1 there emerges a relativel" �stable trend ir. the nor. ABR zone (index of the reliability of the data), which fluctuates between 1G% and 13% with only two values definitely below the lower limit (9.37% in the 2nd quarter of 1976 and 9.37% in the 2nd quarter cf 1980) and two values above the upper limit (14.47% in the 4th quarter of 1976, the highest value found in the non A3P. zone, and 14.24% in the 4th quarter of 1977) . If we consider the rates for A + B , R and A+3+R exceeding the upper limit found in non A3R (14.47%), -~e note a concentration between the 3rd quarter of 1976 and the 4th quarter of 1978 (table 3A) . The peak - 33.33% - was reached in A-t-3 in the first quarter of 1977. This behavior is indicative of an acute .phenomenon adversely affecting the conceptions in A+3 and R(and A-fB+R) from the 3rd ouarter of 1976 and lasting throughout 1973. • Throughout the period preceding the accident and since the 1st quarter cf 1979 in zone R and in the whole of A+3-i-R there is no single rate exceeding the threshold of 14.47% (maximum value in the control zone). The situation in A+3 is different. Zven thcugh here too the peak concentration of values exceeding 14.47% is found in the period immediately after the accident, "re nonetheless find similar peaks in the preceding period (2nd quarter o£ •j. : IS.42%; 1st quarter of 1976: 22.22%) and after 1973 (1st quarter of 1379: 14.31%; 4th quarter 197?: 19.23%; 1st quarter l?3l: 15.33%) As the population sample is small, these may be thought to be fortuitous events. However, the next table (table 33) may suggest other hypotheses. This table highlights those quarterly rates for zones A+B, �exceeding the peak value of non A3R, exceed the rate for the non A32 zone for the same qtiarter. The follc^/ing points are of great interest: 1) higher rates in R and A+3---R than in non ABU are a practically constant finding right up to end-1373, after v/hich they occur only in the 4th quarter of 1979 and in the 3rd quarter of 1930; 2} in A-i-3 the rates -ere higher than in non A3R in 13 of the 26 quarters studied, 7/1 th a practically uniform distribution. It could be argued that A-r3 has a genetically more abortion-prone "lO^Q population or one chronically exposed to abortigenic factors that are expressed throughout the period under reviet/: in the period July 1976-March 1978 this population experienced an additional factor that.accentuated this predisposition to spontaneous abortion. Cr it may be argued that the factor responsible for the increase in spontaneous abortions in,- 2 (and in A-T-3+?.) in the period from the 3rd quarter of 1976 to the 4th quarter of 1973 w'as' operative in A-r3 previously as veil and that its action in that zone continued into 1979 and 193C. Another line of argument is that II and A-r-3-rZl "5/ere previously exposed to factors capable of increasing the rate of spontaneous abortions and that the sane factors ?/ere at tvcrlc on a greater scale, or nev; factors -rere s-.iperadded '?-ith a S3~ergic action, causing an even more striking increase in the period July 197-5December 1972 . Interestingly, as from January 1979 the rates for ~. (and A+3+lO "•/ere actually lor/er than in non A32. This datum rules o".t the possibility of a greater gei'.etic predisposition to spontaneous abortion for the inhabitants cf zone li. A rr.cre lilcelv h r '~oth- �:he preventive meas^•lres (removal, killing of animals, prohibition on cultivation, health and hygiene regulations, etc) and reclamation took effect by eliminating the environmental factors (TCDD ? Others ?) that were previously responsable for higher spontaneous abortion rates in this zone than in the control (non ABR) zone. Ail analysis of the population by maternal ace, parity, number of previous abortions elicited no significant differences in the various zones compared, as is appears from table 4. We have calculated the statistical significance of the differences found between the rates in the zones compared. To increase the statistical power of the analysis, we considered zones A, B and R globally and compared periods of four consecutive quarters, taking July "376 as the reference date. This enables us to look at the zones we are comparing for a year before the accident and for four years after (tables 5 and 6). The rates for the first period are identical in the zones compared. In the periods July 1376-June i377 and July 1977-June 1973 the rates for A+3-r3 were higher than in non A3?.. For the statistical comparison we used the Z test according to the formula: ?= ± 2 V od-o) n The differences for ?ercer.tage rate n = number of conceptions the periods July 1976-June 1977 and July 1 377-June 1S73 are statistically significant. The difference for the period July 1 37S-June 1380, in which A+2-i-R presents lower rates than ncn A33, (see diagram), is significant. At the request of the ISC (International Steering Committee^ we conducted a survey of gestaticnal are and birthweights (as possible indicators of to::icity) in the monitored tsrritory. Graph �2 shows exactly superposable gestational age curves for A+3+R and nor. A3H. Graphs 3 and 4 (gestational age by maternal age ar.d gestational age by parity) represent the trend of this phenomenon in the -/hole sample. Since there were no significant differences in respect of these factors in the cones compared, we saw no point in reproducing these graphs with a disaggregation by zone. The birthweicht study was conducted on a percentile basis. Graphs 5-11 give the curves for the 5th, 10th, 25th, 5Cth, 73th, 30th and 95th percentiles, comparing the global sample with A+3+R before and after 10 July 1976 and with non A3R before and after the same date. These graphs do not seem to reveal any important differences between the zones compared. The differences in the first and last weeks probably depend on the smallness of the sample for these weelcs. As these data are very recent, any opinion we can express now is very superficial. CCNCLuSlblTS In the eleven communes there is one area, namsly A+B-Kx, in which the abortion rate is higher than in the rest of the territory, the difference being statisticallv significant for the two years following the ICI-IZoA accident (July 1975-June 1975). In 1979 and 1 9SC the rates in A-r3-rIl "'•ere lower than in non A3?., significantly so in I960. In the period July 1975-June 1976 the rates in the two zones compared were identical. v."e have no direct toxicolocical or biological evidence on which to base an assertion that TCDD was responsible for the difference but the time co~'nci— de'^ce "rovld s~roncplT;t sv.ccest that i.t "*/as. Zone A-r3 considered separately >resen~3 almost consistently higher �spontaneous abortion rates tiian dees non A3?., v/ith a peak cf 33.22% in the 1st quarter of 1977. However, the phenomer.cn may be more apparent than real (apart from the period 1376/72) and related to the small number of cases, 'which results in a distribution of abortion cases in which higher percentage levels (talc en one by one) are likely to be more frequent. The scale of the phenomenon is cf sufficient interest to warrant further investigation, ^/hich is ncv under -;/ay. There are no sizable differences between the populations compared in regard to gestational age, birthweicht or the various pathological conditions of pregnancy other than spontaneous abortion. �Figure 1 PREGNANCY DATA I:T?UT CODE no. : individual number (registry office) maiden name, forename, husband's name place and date of birth. domicile, residence PREGNANCY STARTING DATE ORIGINAL FORM (last menstrual p e r i o d ) CASE SHEET RECOVERED FCRI-i -RE-PREGNANCY HISTORY: 1 ) malformations 2} hereditary diseases - thalassemia 3) hereditary diseases - other 4) hypertension o) nephropathy 6 ) other PREGNANCY CCU2SE : 1 ) E?H toxemia 2} hypertension ( 140-160) 3) hypertension (over 160) 4) nephropathy: cystopyelitis 5) nephropathy: other 6) other 7) RK isoimmunisation . 8) threatened abortion within week 23 9) threatened abortion after week 2Z 10) radiation up to end week 24 11) radiation after week 24 12) exanthematous infections before end week 15 13) exanthematous infections after week 15 • 14) other viral infectious diseases 15.) other infectious diseases 16) other diseases 17) drugs taken: steroid hormones 18) drugs taken: yasosuprina 19) drugs taken: other (excl. Ca and vitamins) * 20) Debendox taken * 21 ) Debendox not taken PREVIOUS PREGNANCIES duration in weeks �CUTCCM3 OF PREGNANCY commune of delivery or abortion date of delivery or abortion spontaneous abortion induced abortion normal delivery non surgical vaginal surgical abdominal b ir t;T!/e i gh t (s) * Datum stored only for gravidas residing in Seregno at the specific request of the USSL 62 operators. For the other gravidas the use of Debendox is included under item 13. �Table 1 Zone A 3 ?. N'or.A3?. Unas sign. 13" A 5 55 39 £l 2 . 149 197 5 11 97 503 2 .83 9 197 5 5 74 45 7 2 .578 2 3 .134 100 = 25 2 . 539 2 24 3.2 Year " 5T - 5 2 .520 3.5 53 ^ 197 3 ----- 11 105 454 2 . 33 1 2 . 308 1979 4 85 453 2 .19 T 4 2 . 73 4 1980 4 77 41Q 2 .14 9 * 2 .553 198 1 0 17 2- 50 - 3 42 521 3.450 17.439 24 21.532 Total Number - 48 of pregnancies observed by zone of residence and by year of conception and totals by zone and by year. �Table 2 3 c IV. 74 A ~ .i - C A C ? quarter 1 -7 14 143 52 73S 1 7 19 15 139 36 577 I 0 1 II C 4 34 19 152 59 709 "7 1 13 130 Ci 736 C i 2 ^ 2 1 22 91 717 I C 1 •7 14 i^ 152 A 124 52 399 II 0 3 3 22 15 131 75 672 III 0 0 C 19 103 35 516 1 i 10 23 4 17 117 100 691 589 T IV . 7 5 IV. 76 T 1 3 7 21 15 126 77 TT 0 1 6 29 20 133 33 645 I I I 22 17 141 79 695 650 1 3 IV. 77 0 0 3 2 28 17 126 94 I r; 1 1- 3 26 20 109 64 396 0 5 2 26 19 109 61 555 III 0 3 4 26 14 124 57 611 1 2 3 27 17 112 72 576 0 3 4 24 12 103 66 490 TT 0 0 3 21 9 107 61 304 III 0 1 4. 14 4 121 77 505 593 IV. 73 I 0 0 3 25 16 122 •j- A 0 0 2 14 7 53 550 II 1 3 2 19 5 105 37 47 475 III 0 0 0 22 15 1 15 62 549 10 1 69 554 IV. 79 IV . 30 0 1 3 22 1 1" Number of conceptions ending on spontaneous abortion (A) and total number of conceptions (C) by quarter and by zone of residence. �Table 3 QUARTER ZONE A— 3 ZONE •3 ZONE ZONE A— 3— x nor. .-. 3 ~. 5. 5 4/7-a 5 . 33 9 79 1/75 2/73 3/73 £/73 5 _ 00 13. 42 3. 59 7- 41 10. 79 1 1 . 73 12. CO 9. 21 10. 06 1 3 • 00 1 1 . 56 3. 94 1 2. 70 a . 73 1 1 . 01 1 2. 59 1/75 2/75 3/76 4/75 22 . 22 1 2 . 00 1 2. 1 G 1 2 . 21 1 3. ^5 i 3 . •; S 1 2. 1 3 1 0 . -1 1 31 1 9- 23 1 4. 53 15. 31 1 5 - 33 1 3- 30 1 4 .£L .1/77 2/77 3/77 i/77 33- 33 20. 00 1 5 .00 7. 14 1 1 . 90 1 5- 04. 12. 06 1 3. 49 i 5 . 33 15. 95 12. 65 12. 3 — 1 3- 07 12. 37 1/73 2/73 3/73 4/73 14. 31 5. 45 13. 79 1 3. 79 13. 35 1 7 . 43 1 1 . 29 1 5 . 13 17. 65 1 5 - 00 1 1 . 76 1-a. 39 10. 7- ' 10. 99 10. 97 1/79 2/79 3/79 i/79 * 4 dt 1 i. 29 5 . £T " 3 • 23 11.! t 3 . /*,- 11. 9. 37 3 • 63 : ~• i ^ 1 3 • il"T '. 2. - .-*T '2. T 1 2 . 35 "/ 0 t ii _ ^ • •* i 1 3. i ! 9. w J 1 1. * — 37 24 1 2. 32 1 i 2; 53 " 2 . ^3 £ " - ' ^ ." 3 5. 0 /' 5 . 90 -/ 0 '• - • 04 a _ ~- v • - .' - T= ~ . •" 5 o •? : . 36 3 . 25 7 _ 2^ ' 2 - 5- ?'- 3 J - -" �TABLE QUARTER 3a ZONE ZONE ZONE •--- 3—?. •3 .- — 3 ... ••---•,-:•:-•: 5 .33 1/75 2/75 3/75 4/75 5 .00 in -53 3 1 1 73 1 2 . 00 m 7 . 41 ~22l 12 .00 — o / -• <- 2/ / O 3/75 4/76 1/77 2/77 3/77 A/ 77 1/73 2/73 3/73 . 4/73 in "23] ' 1 *2 T • -J v B35SS ft? FTo" . QCj 7 .14 |TZ•~aTj 6 .45 13 .73 13 .79 5 .5 1 0 .06 1 3 .00 i : . 56 g . 34 10. 73 TT1] 1/75 • 3 .3 - 2 .70 3 . 73 4/7* 3. /^ •« 1 2. 10 1 2 .33 12. 21 1 FnrT=] "5^1 [T4T 11. 30 ZONE *— . — ^ r^o r. .-\ w .< - 2 .13 FT? . ?'| irf . ** '^ \ 9 .73 .1 1 .01 12 • 53 10 • 35 11 • w ' 1 3 . 30 nil !l£ FT" r\ /t] fTf 7T31 FT?~Q=1 12. 06 13. 49 12 .65 1 2 .34 EH53 EZ, g =j 10 i 6Ell FT . 53 10 .97 12 • 52 i i . 11 11 .35 ^ >* 3 • 37 . 55 ^ " 4, i ^ " i .10 1 2 • 73 n 7 ..4"3l 1 1 . 29 fTT _ r,rj 1 1 .75 13 .07 12 .37 1 1 .37 1 4. 24 ^4 i n .39 \ •™. 1/73 2/79 3/79 4/7? mi OZ 1 4 .29 6 . 57 p 9 7T!1 . 3. 41 •5 31 • * . 1- : - ~ ~J • . 25 . 53 9 . 53 •z . 3~ •' ,^- ' 4 .29 ~ . 57 7 13 £ . 90 3,' 30 4/ 3 0 - C - - ; J . 04 ; J . Ci 3 . 93 "] > . » w •» Q :/30 2/30 .64 • 47 ^ . ^w �TABLE 3b UARTER ZONE ZONE A- 3 ZONE ZONE A-3-?, 9.3 6.39 5 .5 - * 1/75 2/73 3/73 A/75 1/75 2/75 3/76 4/76 ^ _ CO 1 3. 42 10. 79 3. 69 7 • —1 22 . 1 1 1 2. 00 9. 21 10.06 1 3.00 11.56 3 . 94 12 .70 c .73 1 1 .01 1 2 .69 1 2.10 * 1 "* 2 •4 4 I i . T3 1 2 . QQ - 1 2 ^ 21 12.18 1 3 . 43 1.9..._ 2 1 1 4. "6.31 li ii 10 . 3 3 i i ^1 * 13 .30 14 .47 1/77 2/77 3/77 4/77 33.-- -3 3 20. 00 1 6 . 00 7. 14 1 1 . 90 15.33 13.95 12.65 12.34 1 3 .07 12 .37 1 1 • 37 14 .24 1/73 2/73 3/73 4/73 1 a. i l 6. 45 12 17.65 10 .74 10 • 99 10 • 97 12 .'52 1/ 7 9 2/79 2/79 4/79 * / 30 2/30 3/ 3-0 4 •' 3 0 • W ^ ^ B * 1 ^3 5 • 04 12. .PJL 1 3 • 49 13. 17. £1 1 1 ."29 15. i 5 3" n. 1 * 22 3 . -11 .•M^— • i j. C . * -i 1 5.00 11 .76 1 4.. 3? 11 .35 9-37 3-53 67 23 3 . T *r i 3 •^.» '-•"'? 29 5 . 57 7.36 ~ "" 6. 90 1 3 • 91 • " "^ij. 3 . ••3 1 13 .47 12 . 1 0 ; ^ • 73 • "i 2 . 3 3 ; -, 3 .i . '1.6 - ,5 tt _ 55 Q ~" * . i '^ . " ? . — v' " �TABLE 4a PERCENTAGE DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE A) BY MATERNAL AGE GROUP 20- 21-25 25-30 31-35 36-40 A-3-R 14,27 r.cn A3?. 10,50 Unassign. 46 , 15 35,74 35,71 23.07 29,93 31,53 30,75 12,90 14,50 0.00 5,94 5,13 0,00 TOTAL 35,"0 31,21 14,25 5.12 3) 11,23 46-50 50- 1,15 1,35 0,00 0,04 0,09 0, OO 0,00 0,00 0,00 1.31 0,03 0,GO BY NUMBER OF PREVIOUS PREGNANCIES 0 A*a-R . i Unassign . 50 ,31 54 , 55 75 ,92 24 ,8722 ,53 23 ,07 TOTAL 53 ,31 22 ,99 no n A3?. C) 41-45 2 9 ,00 3 3* 0 ,00 3 ,31 2 ,53 0,00 1,99 1 , 56 0,00 a ,53 2 ,32 1,72 a ,56 'BY NUMBER OF PREVIOUS ABORTIONS A-3-R non A3?. Unassign. TOTAL ' ' 92,50 92, 71. 92.30 5,39 5,59 7,59 1,23 1.15 O.CO 0,31 0,42 0,00 92,57 5,73 1,13 0,40 �TABLE 4b DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE AND BY AGE GROUP 20- 26-30 31-35 A-8-R 322 305 non ABR 35? 323T Unassign. 5 3 573 2302 4 291 1344 0 134 553 0 25 123 0 1 3 0 0 0 0 2253 3203 1 3 TOTAL 3331 1533 703 151 10 0 11471 1235 21-25 4036 36-40 41-45 46-50 50- TOTAL DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE AND BY NUMBER OF PREVIOUS PREGNANCIES 0 1 2 3 A^B-R 1360 non A3R 5350 Unassign. 10 351 2074 3 203 733 0 35 233 0 45 153 0 TOTAL 2533 931 324 193 732O 3^ TOTAL 2255 9203 13 • 11471 DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE AND BY NUMBER OF PREVIOUS ABORTIONS 0 A-3-R non ABR Unassign. TOTAL 1 2 2025 3333 12 133 324 1 23 107 0 10531 553 2-7 33 0 2255 3203 13 �TABLE 5 half year -5 —- — -. - - 41 49 I. 77 II. 77 40 I. 73 43 1 1 7^ 10 . 23 1 53 • -2 293 236 313 35 33 II. 75 395 352 42 I -: 12 . 13 3 1 5.02 15 . os IS 5 15 0 12 . 50 17 •: II. 73 ;_ 79 39 220 255 294 23 263 10. 55 II.7S 25 234 I.30 13 29 223 9. 15 7. 39 272 1C. 66 II.30 1". 53 1 ~! 13. 25 •_ 1 7 13 ,1 5 c 13 35 1-= 53 1 7 -• 13 1 . 3** *i 12 .36 13 07 14 . 15 1 2 .97 1234 13 55 12 .77 1 15 1 10 .36 1 1 37 11 594 « ji. Q 11 .1 3 -i .73 13 12 03 1036 11 13 12 .30 1C .62 11 . 77 Number of conceptions ending in abortion (A), total number of conceptions (C) and rate (£) by half year of conception and by residence zone. TABLE 6 nor. A3S period July 75-June 76 July; 76-June 77 July 77-June 78 "4 : 650 1 ii 9C 369 1 3- July 78-June 79 57 537 July 79-June 80 1A 312 .33 310 2724 11. 33 5 .32 1 c 40 34; 2S41 293 75 C6 13. 53 1 1 CO 2 03 266 2131 12. 20 3 . 39 264 2239 11. 79 1 Number of conceptions ending in spontaneous abortion (A), total number of conceptions (C) and rates ($) by one-year period before and after the ICMESA accident in zone A+B+R and in zone non ABR. �CALCULATION OF STATISTICAL SIGNIFICANCE - MODEL Comparison of spontaneous abortion rates in zone A+B+R and in zone non ABR in one-year periods before and after the ICMESA accident according to the Z test. period July 1975-June 1976: A+B+R rate non ABR rate= 11.38 period July 1976-June 1977 13.53 I 2 2541 confidence limits: 12.13 rate for A+B+R = 15.82 15.33 SIGNIFICANT period July 1977-June 1978 :i.S9 I 2 / 16.49 (100- 15.49) confidence limits: 10.41 _ rate for A+B+R = 16.49 13.37 SIGNIFICANT period July 19,78-June 1979 12.20 ± 2 . T12.G3 (130 - 12.03! 2131 confidence limits: rate for A+B+R 10.31 = 12.03 NON SIGNIFICANT period July 1979-June 1980 confidence limits: rate for A+B+R = 8.59 SIGNIFICANT �Graph 1 ABORTION RATES BY QUARTER IN ZONES non A+B+R, A + B + R , A+B, R ,\ • \ A nit-n 111 it \ I'-HJl) c i u; 1 1 ' I i • i • v 11)111 �Graph 2 DISTRIBUTION OF DELIVERIES BY GESTATIONAL AGE AND RESIDENCE ZONE SO 40 RESIDENCE ZONE i >> i i- 0( 0 0 _'ti 1'f) :i(V :)l 32"~3l""34 35 36 ""37 ~'3fl 30 40 42 43 44 45 46 gestational age �Graph 3 DISTRIBUTION OF DELIVERIES BY GESTIONAL AGE AND PARITY -10 PARITY 'J 0 20 Ml :> i on 01 ) 'JO :i ~32~"'Ji3~"~3~"35~ 36 37 38' 39 40 41 42 43 44 45 46 .^esrational age �Graph 4 nrSTHIMUTlON OF DELIVERIES BY GESTIONAL AGE AND MATERNAL AGE GROUP 1U M A T E R N A L AGE GROUP - 20 2 1 L'ii 2fi 30 — — . - 3 1 3t> 3 0 '10 (II g e s t a t i o n a l age ��Graph 7 :JJ.th 4-100 25th PERCENTILE '1000 '.11)00 IHOO ;MOO tola I 2200 — • — • - n o i i A i II[fl 2000 l i J t i II 11)00 lt>00 1200 . born up to 1/7/76 1001 .. born after 1/7/76 nooj4~3 44 45 46 " gestational age ��light Graph 9 1-100 75th PERCENTTLE •1200 'IOOO .mot A :i io :ioo 2-IO A,in - - no,, .<! . born up to 1/7/76 .. born a f t e r 1/7/76 ft 36 37 3fl 30 40 41 '\2 13 14 45 46 yestational age � 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. 095 Folder The folder containing the original item. 2418 Series The series number of the original item. Series IV 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 Bianco, Vanda L. Meazza G. Remotti Title A name given to the resource Typescript: Obstetric Monitoring in Brianza de Seveso From 1975 to 1981 Subject The topic of the resource congenital birth defects 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. 051 Folder The folder containing the original item. 1342 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Brunelle, Philip D. Source A related resource from which the described resource is derived Morning Union, Springfield, Massachusetts Date A point or period of time associated with an event in the lifecycle of the resource November 6 1982 Title A name given to the resource Clipping: Tufts Medical Team Tests Children in Check of Agent Orange Effects Subject The topic of the resource congenital birth defects 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. 094 Folder The folder containing the original item. 2379 Series The series number of the original item. Series IV 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 Bruzzi, Paolo Source A related resource from which the described resource is derived Accidental Exposure to Dioxins: Human Health Aspects Date A point or period of time associated with an event in the lifecycle of the resource 1983 Title A name given to the resource Birth Defects in the TCDD Polluted Area of Seveso: Results of a Four-Year Follow-Up Subject The topic of the resource congenital birth defects dioxin 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. 078 Folder The folder containing the original item. 2006 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 Constable, John D. Maureen C. Hatch Source A related resource from which the described resource is derived The New England Journal of Medicine Date A point or period of time associated with an event in the lifecycle of the resource March 8 1984 Title A name given to the resource Letter to the Editor: Agent Orange and Birth Defects (Continued) Subject The topic of the resource congenital birth defects dioxin human exposure 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. 031 Folder The folder containing the original item. 0559 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 Courtney, K. Diane Source A related resource from which the described resource is derived Archives of Environmental Contamination and Toxicology Date A point or period of time associated with an event in the lifecycle of the resource 1977 Title A name given to the resource Prenatal Effects of Herbicides: Evaluation by the Prenatal Development Index Subject The topic of the resource health effects animal testing congenital birth defects ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/24722c12f18a266338b77b1415f99208.pdf d011e5d300b3e4836b02672d137cdb32 PDF Text Text Item ID Number 00579 Author Cutting, Robert T. Corporate Author U. S. Department of Defense Report/Article TftlQ Congenital Malformations, Hydatidiform Moles, and Stillbirths in the Republic of Vietnam, 1960-1969 Journal/Book Title Year 197 MOUth/Dey December Color ° D Number of Images 34 DeSOriptOU NOtQS Alvin L. Young filed this item under the category "Human Exposure to Phenoxy Herbicides and TCDD" Tuesday, February 20, 2001 Page 579 of 680 ��CONGENITAL MALFORMATIONS //v HYDATIDIFORM MOLES AND STILLBIRTHS IN THE REPUBLIC OF VIETNAM 1960 -1969 Robert T. Cutting 1 Tran Huu Phuoc 2 Joseph M. Ballol Michael W. Benenson1 Charles H. Evans 3 D e c e m b e r 1970 1 US Army Medical Research Team (Walter Reed Army Institute of Research), Vietnam (Present address: Walter Reed Army Institute of Research, Wash., DC 20012) 2 Ministry of Health, Government of the Republic of Vietnam 3 0ffice of the Command Surgeon, Military Assistance Command, Vietnam For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 - Price 45 cents I) �SYNOPSIS-ABSTRACT A ten-year survey of the incidence of stillbirths, hydatidiform moles and congenital malformations was conducted in the Republic of Vietnam using records maintained at 22 hospitals. The study collected 480,087 livebirths, 16,166 stillbirths, 2,866 moles and 2,355 malformations of all types. The military use of herbicides is depicted and the data are sorted into two time periods, pre- or light-spraying years (1960-65) and heavyift&i,spraying years (1960-69). Comparing the earlier with the later period the stillbirth rate was 36.1 and 32.0, the mole rate was 6.6 and 5.6 and the malformation rate was 5.5 and 4.5 per 1000 livebirths. biased by data from population centers. The survey is �ACKNOWLEDGMENTS Dr. Trang Minh Tung - Minister of Health, Government of the Republic of Vietnam Dr. Dinh Xuan Minh -- Special Assistant to the Minister of Health Dr. Dang Quoc Phu -- Director, National Institutes of Public Health Dr. Trung Minh Cac — Vice General Director of Health, Ministry of Health Vo Liet Nu-- Chief, Records Section, Tu-Du Maternity Hospital BG Richard R. Taylor — Command Surgeon, Military Assistance Command, Vietnam Dr. Theodore R. Woodward — Professor of Medicine, University of Maryland, School of Medicine Col. Robert J. T. Joy - Deputy for Medical and Life Sciences, Office of Director of Defense Research and Engineering Maj. Herbert E. Segal - Division of Preventive Medicine, Walter Reed Army Institute of Research �CONTENTS Page Synopsis-Abstract » i Acknowledgments ii Introduction 1 Methods 3 Results 4 Discussion ° 5 Conclusions 7 Tables 9 Figure 1 Location of Hospitals Visited 25 Figure 2 Number of Livebirths Collected by Year, Republic of Vietnam 1960 - 1969 26 Figure 3 Countrywide Incidence of Stillbirths, Malformations and Moles per 1000 Livebirths per Year Figure 4 Acres Sprayed by Year, Republic of Vietnam, 1960-1969 References. „ 27 28 29 �INTRODUCTION In 1969 Bionetics Research Laboratories reported an increase incidence of developmental abnormalities in rats and mice born of mothers which had received 2, 4, 5-trichlorophenoxyacetic acid (2,4,5-T) during early pregnancy (1). Because herbicides* containing this compound had been used for military purposes in the Republic of Vietnam (RVN), concern was expressed about possible similar effects in humans. To determine whether such effects could be shown in humans, the Ministry of Health, RVN, (MOH) and the US Military Assistance Command, Vietnam (MACV) undertook a cooperative study of obstetrical records over the 10 year interval 1960 - 1969 in 22 hospitals. This report describes the incidence of recorded congenital malformations, stillbirths, and hydatidiform moles in RVN before (1960 - 1965) and after (1966 - 1969) large scale military use of herbicides. * A gent Orange, used in Vietnam defoliant operations, is composed of a 1:1 mixture of the n-butyl esters of 2,4-dichlorophenoxyacetic acid and 2,4,5-trichlorophenoxyacetic acid. ��METHODS Evaluations of Obstetrical Records and Survey Procedures. The initial efforts were directed to assess the availability and accuracy of obstetrical records in Vietnamese medical facilities, and to develop techniques for review and interpretation. A pilot study performed in seven provincial and district hospitals and one Saigon hospital (Tu-Du) revealed that Vietnamese obstetrical records were available and accurate, and developed reviewing techniques. The survey was then extended to other medical care facilities throughout the country. Hospital Ledger. In all but four hospitals, a Daily Summary Ledger, prepared by the chief midwives served as the primary source document. This contained 15-20 categories of information on each obstetrical or gynecologic patient. The following information was recorded: hospital admission number; patient's name, age, parity, and date of admission; presentation, time, and method of delivery; baby's sex, weight, and general condition at birth; placenta weight; estimate of blood loss; and name of person attending. A "remarks" column recorded such data as vacuum extraction, reversion, placenta delivery assistance, Caesarean section and indication, blood transfusion, uterine revision, maternal or infant complications with treatment and results, and, most germane to this study, congenital malformations. Some hospitals also included in the Ledger the patient's address and occupation, father's name and occupation, baby's name, date of discharge or departure prior to discharge, and whether patient paid for her care. The accuracy of the information in the Daily Summary Ledger in each hospital was tested by comparing it to the information in random samples of individual medical records. Several hundred such comparisons failed to reveal any discrepancies. No Daily Summary Ledger was kept at Hue, My Tho, or Tay Ninh; at these hospitals each individual obstetrical and gynecological record available was individually examined. Records System at Tu-Du A system of automatic data processing is used at Tu-Du Maternity Hospital in Saigon which was devised by a staff member trained in statistics in the United States and who has been chief of that medical records office for 12 years. The system uses manual coding of the information derived from the hospital records, transposition to punch cards and compilation. Eighteen malformation types are specified; these include all those commonly observed, the remainder are categorized as unspecified. �Criteria for Stillbirth, Malformation and Mole. Abortions were distinguished from stillbirths by recorded fetal weight. Stillbirth was defined as fetuses weighing 750gm. or more and without evidence of life after complete separation from the mother. Only a few weighed less than lOOOgm. In the rare case where fetal weight was not recorded, stillbirth was defined as a birth with a gestation period of twenty-four weeks or longer. Malformations were counted in both livebirths and stillbirths. Malformations associated with abortions were not counted. More than one malformation was occasionally recorded for a single infant and these malformations were counted individually. In no case were more than three malformations recorded for a single birth. Hydatidiform moles were counted only if delivered. Hospitals Surveyed The location of each hospital visited is shown in Figure 1. All are Ministry of Health public hospitals and are free to those who do not desire or cannot afford to pay. RESULTS A total of 499,119 birth events were counted. There were 480,087 livebirths, 16,166 stillbirths, and 2,866 hydatidiform moles. Table 1 shows the location and type of hospital by geographic area, the years for which data were available and the number of livebirths counted. A small number of birth events for the years 1959 and 1970 were collected and are included in Table 1 for completeness. If these data are excluded, there are 488,852 total birth events, which include 470,200 livebirths, 15,812 stillbirths and 2,840 hydatidiform moles during the 1960-69 decade under consideration. Figure 2 shows the number of livebirths collected by year. Hospitals outside the Capital contributed the largest portion of the progressive increase in number of livebirths. Only a few hospitals had records for the entire decade. There is a relative lack of data for the first half of the decade. Before 1969, hospital records were kept for varying periods of time. Since 1969, MOH has required records maintenance for a minimum of five years. The incidence of abnormal birth events by geographic area is shown in Table 2, and includes 1959 and 1970 data. All rates are expressed as per 1000 livebirths. Wide variations in some hospitals' annual incidence of all birth events were observed, and in some hospitals the rates were unrealistically low. Except in the smallest hospitals, variation in rates was usually greater between hospitals than the year-to-year variation within hospitals. Excluding the small district hospitals, stillbirth rates varied from 8.7 at Long Dien (4,214 livebirths over 7 years) to 62.7.at Qui Nhon (6,303 livebirths over 4 years). Hydatidiform mole rates varied from 1.4 at Tan An (24,596 livebirths �'over"» years) 10 ib'i'iTai'""Can ivno (16,066HVfeeinttgtfVerCU years). Maltormation rates varied from 1.1 at Tan An to 7.4 at Hue (5,271 livebirths over 2.3 years). Table 3 presents annual birth abnormality rates for the years 1959 - 1970. If 1959 and 1970 data are excluded, the rates for the decade are: stillbirth - 33.6, moles -6.0, and malformations - 4.9. Figure 3 depicts the decline in the countrywide stillbirth rate, and the stable mole and malformation rates. The rates of stillbirths, moles and malformations for the four geographic areas are compared in Table 4. Congenital Malformations. Table 5 presents the 2,355 congenital malformations by type collected from all hospitals. Only obvious congenital malformations were recorded. Forty percent of all malformations were not specified by type in the Ledger nor in the individual medical records of the patients. Anencephaly, cleft lip/palate, clubfoot and hydrocephaly accounted for over 80% of all specified malformations. Congenital heart disease was not recorded nor were there autopsy reports on those infants who were dead at birth or died shortly thereafter. The hospital records do not distinguish between harelip and cleft palate, the general term "bee de lievre" being used for both malformations. Unusual deformities, such as those associated with thalidomide, were not reported. Individual Hospital Data Tables 9 through 29 present the birth defect data for each individual hospital surveyed. Herbicide Usage in Vietnam. Figure 4 shows the number of acres sprayed by year in Vietnam during the decade (3). Prior to 1966 there was comparatively little use of herbicides. Since 1966, more than 800,000 acres were sprayed annually. The birth defect data were grouped into pro- and light-spraying years (1960 - 1965) and heavy-spraying years (1966 - 1969). In Table 6 the data for these two periods are compared. The data for the years 1959 and 1970 are not included in this Table. DISCUSSION This study does not directly test a relationship between herbicides and birth abnormalities. Such an assessment would require prospective studies with examination of one population before and after exposure, or examination of two comparable populations with only one exposed to herbicides. Information about the precise dose of herbicide to which pregnant women were exposed and the week of pregnancy would be required. Careful examination and follow-up appraisal of all livebirths would be necessary to detect �tne presence ot inapparent maitorniauons. Ail stillborn ana luiant ueatns wouia require post-mortem examination. The dose of herbicide could then be related to embryological development of malformations. It is obviously impossible to carry out such a study. This study has several biases. The first is that nearly all the information was derived from population centers and larger hospitals. In the six district hospitals visited (Tables 1 and 2) there were only 9857 livebirths with 86 stillbirths (a rate of 8.7), 3 moles (a rate of 0.3) and 14 malformations (a rate of 1.4). The two Saigon maternity hospitals contributed 59% of the data. The second bias is the absence of data from private medical sources. There are several private hospitals in Saigon with large obstetrical departments and excellent standards of practice. Many other cities have private hospitals. All cities had several private "cliniques" usually directed by a single physician. Wealthier Vietnamese often attend these private hospitals, and the birth defect rates in this population might differ from those obtained in this survey. This is suggested by data from the Da Lat province hospital which has two classes of patients. One class, presumably wealthier, pays for obstetrical care. Both classes are served by the same obstetrical personnel and the same labor and delivery rooms. The only difference is assignment to different areas of the hospital for the post-partum period. The hospital maintains the records separately and the information was so collected and analyzed in this study (Tables 1, 2, 20, and 21). The paying class had lower stillbirth, mole and malformation rates. The third bias is that the data are restricted almost exclusively to ethnic Vietnamese. There are a half million Chinese living in the Saigon/Cholon area and they use the six private Chinese hospitals in the area, none of which were surveyed. Montagnards as a rule do not enter district or province hospitals, but deliver at home. Untoward events limited the availability of data at some hospitals. These include a mortar round exploding in the record room at My Tho in 1968, a flood in the record room at Qui Nhon in 1965, the loss of 1961 and 1962 Hung Vuong records which were borrowed for a medical school project, administrative disposition of record files, before 1965 at Can Tho and Ban Me Thout and before 1967 at Pleiku and Tay Ninh, and finally the 1968 Tet Offensive when several hospitals became battlegrounds and some records were destroyed. During the earlier part of the decade, some hospitals reported very few birth defects and hospital personnel frankly admitted incomplete reporting during those years. Most of the directors of the hospitals visited had been appointed within the past few years, and improvement in records keeping coincident with their assignment resulted in more complete reporting during the latter part of the decade. This has caused comparatively higher reported rates for recent years and in some hospitals the data suggest an upward trend when one actually may not exist; i.e., at Baria,Nha Trang, and Ban Me Thuot. Changes in local obstetrical referral practices influence rates in specific hospitals. For example, those district hospitals near province hospitals began to refer problem cases to the province hospital when doctors with obstetrical training were assigned. Referral practice has been influenced by gradual improvement in roads, public trans- �portation, and security. The referral system accounts for the higher abnormality rates in province hospitals. This influence is also noted in the Capital area. For example, Tan An and Bien Hoa refer many problem and mole patients to the Tu-Du hospital in Saigon. Rates are influenced by other factors. A study of moles begun in the Nha Trang hospital in 1968 resulted in a striking increase in the mole rate, probably due to more complete reporting and to the referral of a larger number of patients with suspected moles from surrounding districts. The feasibility of relating the birth data collected to the quantity of herbicide sprayed by province by year was studied. Initially it seemed possible that abnormal birth event rates might be correlated to the amount of herbicide sprayed. The records for each aerial spray mission, including map coordinates of the area covered and the type and quantity of herbicide used, were made available by MACV. However, it was not possible to determine what proportion of any province's total yearly birth events are included in this survey. Neither the MOH Maternal and Child Health Program nor the birth registry system collect complete data. RVN officials estimate that currently only 70% of all births are reported to MOH and only 50% are reported as registered to the National Institute of Statistics. Our inability to obtain a consistent sample of birth events by province precluded meaningful correlation between spray and birth event data. Comparisons of birth event data between countries are difficult because of variations in reporting procedures and differences in definitions of the various events. The incidence of stillbirths, moles, and malformations from studies in large Asian populations (4-13) is shown in Tables 7 and 8. The data from this study fall within the ranges reported by other workers. CONCLUSIONS Medical records at Vietnamese medical facilities were found to be sufficiently complete and accurate to compile birth events data for the decade of the sixties. Except in the Saigon area, there was frequent under-reporting of abnormal birth events particularly in the first part of the decade, resulting in unrealistically low rates in some hospitals for that earlier period. This survey collected information on 480,087 livebirths, 16,166 stillbirths, 2,866 moles and 2,355 congenital malformations of all types from medical records maintained at 22 hospitals representing the Coastal, Interior, Capital and Delta geographic regions. There was a decline in the countrywide stillbirth rate and stable mole and malformation rates during the decade, weighted by the Saigon experience which contributed 59% of the data. Meaningful correlation of any province's annual abnormal birth events to quantitative herbicide data was precluded by our inconsistent sampling of birth data. �Sorting the data into two time periods, before (1966-65) and after (1966-69) the large scale military use of herbicides, failed to show any influence of herbicides. Rather, a downward trend was observed in all categories of abnormal birth events. In comparing the earlier with the later period the countrywide stillbirth rate was 36.1 and 32.0, the mole rate was 6.6 and 5.6, and the malformation rate was 5.5 and 4.5. These rates are within the ranges reported for other Asian populations. A natural variation was observed in the incidence of abnormal birth events as recorded during the decade. This variation was frequently of a greater magnitude between hospitals than the year-to-year variation within hospitals. The effect of any single variable (i.e., herbicides) cannot be demonstrated unless it changes this natural variation and is not masked by other variables. Such a change was not found in this survey. Vietnam Herbicides Malformations Moles Stillbirths , �TABLE 1. LOCATION AND TYPE OF HOSPITALS SURVEYED, YEARS OF DATA AVAILABILITY, AND NUMBER OF LIVEBIRTHS COUNTED TYPE* YEARS** D P P P D P P D 1962-70 1960-70 1964-70 1966-69 1966-70 1967-69 1968-70 1967-70 4,375 13,543 15,789 6,190 1,190 13,061 5,271 3,553 P P P P P 1967-69 1968-70 1966-70 1960-70 1960-70 6,947 2,488 5,808 4,658 10,860 C C C(P) 1960-69 1959-69 1961-69 182,450 99,600 40,099 D P P P P HOSPITAL 1969-70 1965-69 1969 1964-70 1961-69 740 16,056 3,922 18,891 24,596 Coastal Plain Long Dien Baria Nha Trang Qui Nhon Tuy Phuoc Da Nang Hue Hue Districts (3) LIVEBIRTHS Interior Tay Ninh Pleiku Ban Me Thuot j Da Lat (Paying) Da Lat (Nonpaying) Capital Tu-Du Maternity Hospital Hung Vuong Maternity Hospital Bien Hoa Delta Cai Rang Can Tho My Tho Kien Hoa Tan An TOTAL *D » District, P = Province, C = Capital ** Data for 1970 restricted to the first 3-4 months 480,087 �TABLE 2. HOSPITAL INCIDENCE OP BIRTH ABNORMALITIES BY GEOGRAPHIC AREA Stillbirths Rate* Moles Malformations Coastal Plain Long Dien Baria Nha Trang Qui Nhon Tuy Phuoc Da Nang Hue Hue Districts (3) 8.7 26.2 47.0 62, 14, 42, 48, 4.7 0.8 4.3 6.8 0.3 1.8 2.7 2.9 4.0 0.8 2.8 7.4 1.1 Interior Tay Ninh Pleiku Ban Me Thuot Da Lat (Paying) Da Lat (Nonpaying) 37.9 27.7 43.6 20.0 51.0 6.3 2.4 2.1 1.1 5.6 1.4 0.8 0.9 1.7 6.3 Capital Tu-Du Hung Vuong Bien Hoa 34.8 32.3 21.8 9.2 4.1 1.1 7.1 5.0 2.4 18.9 54.4 43.8 30.3 22.9 1.8 15.8 10.4 1.7 1.4 1.8 6.4 4.6 1.2 1.1 33.7 6.0 4.9 0 1.9 6.3 3.2 Delta Cai Rang Can Tho My Tho Kien Hoa Tan An COUNTRYWIDE *per 1000 livebirths 10 �TABLE 3. Year INCIDENCE OF STILLBIRTHS, HYDATIDIFORM MOLES AND CONGENITAL MALFORMATIONS, BY YEAR Livebirths Stillbirths WT. Rate* No. Moles Rlfte* Malformations No7 Rate* 3,258 25,106 24,355 21,326 33,060 39,009 46,821 53,013 69,844 73,188 84,478 6,629 TOTAL 125 1,022 919 744 1,153 1,381 1,632 1,839 2,159 2,288 2,675 229 38.3 40.7 37.7 34.9 34.9 35.4 34.8 34.7 30.9 31.3 31.2 34.5 9 186 164 134 207 249 318 323 359 381 519 ' 17 2.8 7.4 6.7 6.3 6.3 6.4 6.8 6.1 5.9 5.2 6.1 2.6 11 184 121 148 187 210 202 320 276 334 341 17 3.4 7.3 5.0 6.9 5.6 5.4 4.3 6.0 3.9 4.6 4.0 2.6 480,087 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 16,166 33.7 2,866 6.0 2,355 4.9 *per 1000 livebirths TABLE 4. Area COMPARISON OF STILLBIRTHS, MOLES AND MALFORMATIONS BY GEOGRAPHIC AREA Livebirths Stillbirths Ro~IRate* Moles No; Malformations NoT Rate* Capital Coastal Interior Delta 322,149 62,972 30,761 64,205 10,368 2,371 1,232 2,195 32.5 38.6 40.0 34.3 2,134 240 128 364 6.6 3.8 4.2 5.7 1,900 192 93 170 5.8 3.0 3.0 2.6 TOTAL 480,087 16,126 33.7 2,866 6.0 2,355 4.9 *per 1000 livebirths 11 �TABLE 5. TYPE, NUMBER, DISTRIBUTION, AND RATE OF CONGENITAL MALFORMATIONS OBSERVED IN 480,087 LIVEBIRTHS Type Not specified Anencephaly Cleft lip/palate Hydrocephaly Clubfoot Ventre batracien** Monster Umbilical Achondroplasia Polydactyly Abnormal genitalia Spina bifida Evisceration Hermaphrodite Imperforate anus Tumor Ascites Siamese twins Malformation of legs Large abdomen Malformation of hands Microcephaly Syndactyly Others (specified) TOTAL Number Percent of Total 935 525 452 136 39.7 22.3 19.2 5.8 3.5 3.2 1.8 0.5 0.6 0.3 0.3 0 0 0 0 0.2 0.2 0 .1 0 .1 0 .1 0 .1 0 .1 0 .1 0.6 81 76 42 11 13 8 8 8 7 6 6 5 4 3 3 3 3 3 2 15 100.0 2,355 *per 1000 livebirths **Enlarged abdomen with or without ascites 12 Rate* 1.95 1.09 0.94 0.28 0.17 0.16 0.09 0.02 0.03 0.02 0.02 0.02 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.03 4.91 �TABLE 6. COMPARISON OF BIRTH EVENTS DATA IN LIGHT-SPRAYING TO HEAVY-SPRAYING YEARS, COUNTRYWIDE AND BY GEOGRAPHIC AREAS Light^Spraying (1960-65)f Heavy-Spraying (1966-69) N o T R a t e N o . R a t e * Countrywide Livebirths Stillbirths Moles Malformations 189,677 6,851 1,258 1,052 36.1 6.6 5.5 280,523 8,961 1,582 1,271 32.0 5.6 4.5 Coastal Plain Livebirths Stillbirths Moles Malformations 12,580 366 20 27 29.1 1.6 2.1 47,347 1,892 211 148 40.0 4.4 3.1 Interior Livebirths Stillbirths Moles Malformations 7,052 360 39 34 51.0 5.5 4.8 21,619 794 85 54 36.7 3.9 2.5 Capital Livebirths Stillbirths Moles Malformations 151,726 5,641 1,141 965 37.2 7.5 6.4 167,165 4,602 984 924 27.5 5.9 5.5 18,319 484 58 26 26.4 3.2 1.4 44,392 1,673 302 145 37.4 6.8 3.3 Delta Livebirths Stillbirths Moles Malformations *per 1000 livebirths 13 �TABLE 7. COMPARISON OF STILLBIRTH, MALFORMATION, AND ANENCEPHALY RATES AMONG ASIAN POPULATIONS Period No. Births Stillbirth Rate* Hsu Stevenson 1951-53 1961-64 32,176 9,872 13.8 11.5 0.56 1.3 Sanghvi Kolah Stevenson (Bombay) Stevenson (Calcutta) 1946-55 1960-63 1961-64 76,763 29,553 39,498 25.9 43.7 14.0 8.6 0.8 0.9 1.5 1961-64 19,191 46.2 3.0 0.3 Indonesia Suharjono 1962-67 15,018 - 5.7 1.0 Japan Neel 1948-54 64,569 - 10.2 0.6 Malaysia Stevenson 1961-64 15,937 25.2 10.4 1.0 Philippines Jongco Abad-Vasquez Stevenson 1962-63 1961-63 1961-64 46,025 28,663 29,669 15.0 20.6 5.6 12.8 8.4 G.8 0.6 0.5 Singapore Stevenson 1961-64 39,683 12.3 8.6 0.5 Taiwan Wei 1955-62 14,834 - 8.7 1.2 Thailand Siriraj Hosp. 1966 14,332 - 47.8** 0.4 Vietnam Cutting 1960-65 1966-69 180,884 249,779 36.1 32.0 5.5 4.5 1.1 1.0 Country Hong Kong India Author *per 1000 livebirths **A11 malformations, major and minor Malformation Rate* Anencephaly Rate* �TABLE 8. COMPARISON OF HYDATIDIFORM MOLE RATES AMONG ASIAN POPULATIONS Author Rate** Hong Kong King* 1.8 Japan Hasegawa* 4.3 Philippines Acosta-Sison* 5.9 Taiwan Wei* 8.0 Vietnam Cutting 1960-65 1966-69 6.6 5.6 Country *as reported by Marquez-Montes, et al. **per 1000 livebirths TABLE 9. LONG DIEN DISTRICT HOSPITAL Stillbirths Rate Year Livebirths No. 1962 1963 1964 1965 1966 1967 1968 1969 1970 701 101 298 747 656 601 610 508 153 1 1 3 10 8 6 3 3 3 1.4 9.9 10.0 13.4 12.2 10.0 4.9 5.9 19.6 38 8.7 TOTAL (1/3) 4,375 *A11 rates are expressed per 1000 livebirths 15 Moles 0 0 0 0 0 0 0 0 0 Malformations Rate* NoT 2 0 0 2 1 1 2 0 0 2.8 2.7 1.5 1.7 3.3 1.8 �TABLE 10. BARIA PROVINCIAL HOSPITAL Stillbirths Rate Year Livebirths No. 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 588 1,368 1,353 1,303 1,169 1,334 1,444 1,659 1,391 1,562 372 27 38 32 27 39 41 36 32 32 41 11 13,543 356 (1/3) TOTAL TABLE 11. Year Livebirths 1964 1965 1966 1967 1968 1969 1970 1,507 2,111 2,113 2,767 3,168 3,615 TOTAL (1/4) Moles No. Malformations No. Rate 3 2 9 3 6 1 0.8 0.8 2.2 1.3 5.4 2.2 3.8 2.7 3 4 3 1 6 3 3 2 5 4 2 5.1 2.9 2.2 0.8 5.1 2.2 2.0 1.2 3.6 2.5 5.4 26 1.9 36 2.7 0 0 0 46 28 24 21 34 31 25 19 23 26 30 1 1 26.2 NHA TRANG PROVINCIAL HOSPITAL Stillbirths Rate No. 508 61 86 132 149 146 146 22 40 41 62 50 46 37 43 15,789 742 47.0 No. Moles Rate Malformations No. Rate 5 10 4 12 22 41 6 16 1.9 4.3 6.9 11.3 11.8 1 2 14 5 8 10 6 100 6.3 46 3.2 4.7 0.7 0.9 6.7 1.8 2.5 2.8 11.8 2.9 �TABLE 12. Livebirths QUI NHON PROVINCIAL HOSPITAL Stillbirths No. Rate 0 7 6 7 1,178 1,491 1,772 1,749 60 79 133 116 51 52 75 62 6,190 TOTAL 388 62.7 TABLE 13 . Livebirths 1966 1967 1968 1969 1970 Moles No . R~ate 4.7 3.4 4.0 20 3.2 Year 1967 1968 1969 TOTAL 3.4 TUY PHUOC DISTRICT HOSPITAL Stillbirths No . Rate Moles No. R~ate 7 15 21 11 15 1 0 0 0 0 3.7 14.3 1 Malformations Rate No7 0.8 272 260 331 260 67 2 4 7 3 1 1,190 17 TABLE 14. TOTAL (1/3) 21 0 0 1 0 0 DA NANG PROVINCIAL HOSPITAL 0.8 Malformations Rate RoT Stillbirths No. Rate Moles No. R~ate 4,620 4,347 4,094 174 198 185 38 46 45 16 19 21 3.5 4.4 5.1 13 14 10 13,061 557 42.7 56 4.3 37 Livebirths 17 3.0 2.8 3.2 2.4 �TABLE 15. Year Livebirths HUE PROVINCIAL HOSPITAL Stillbirths No. Rate Moles No. Rate Malformations No. Rate 1968 1969 1970 (1/3) 1,156 2,837 1,278 51 132 73 44 46 57 14 12.1 20 2 7.0 1.6 9 21 9 7.8 7.4 7.0 TOTAL 5,271 256 48.5 36 6.8 39 7.4 TABLE 16. Year Livebirths HUE DISTRICT HOSPITALS Stillbirths Rate NoT Cua-Huo 1969 1970 (1/3) 560 178 Thanh-Noi 1969 1970 (1/3) 174 212 Tay-Loc 1967 1968 1969 1970 (1/3) 783 694 675 277 6 2 4 3 7.6 2.8 5.9 10.8 3,553 17 4.7 Moles No. R~ate TOTAL 2 0 3.5 1.7 Malformations NoT Rate 1 0 1.7 0 0 18 1.2 1.4 1.5 0.3 1.1 �TABLE 17. TAY NINH PROVINCIAL HOSPITAL Livebirths NoT Stillbirths Rate Moles No. Rate 1967(3/4) 1968 1969 1,818 2,563 2,566 55 109 99 30 43 39 8 17 19 4.4 6.6 7.4 TOTAL 6,947 263 37.9 44 6.3 Year TABLE 18. Year Livebirths Malformations No. Rate 2.2 1.2 1.2 10 1.4 PLEIKU PROVINCIAL HOSPITAL Stillbirths N < T R a t e 1968 1969 1970 (1/4) 840 1,304 344 20 36 13 24 28 38 TOTAL 2,488 69 27.7 19 Moles No"Rate 4 2 0 4.7 1.5 2.4 Malformations No. Rate 2 0 0 2.3 0.8 �TABLE 19, BAN ME THUOT PROVINCIAL HOSPITAL Stillbirths Rate Livebirths No. 1966 1967 1968 1969 1970 (1/3) 1,201 1,417 1,227 1,292 671 56 57 43 60 37 TOTAL 5,808 253 Year TABLE 20. Year 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 (1/2) TOTAL 0 0 0 9 3 47 40 35 46 55 43.6 Stillbirths Rate No. 236 221 232 259 760 5 3 3 3 18 4,658 Malformations Rate No. 6.9 4.5 3.9 12 2.1 0.9 DA LAT PROVINCIAL HOSPITAL - PAYING Livebirths 276 624 679 947 424 Moles No. Rate 21 14 13 12 24 (data missing from 10 36 15 24 12 18 12 13 12 28 93 20.0 20 Moles W. R~ate No. 2.6 1 0 0 0 2 hospital) 0 1 1.6 1 1.5 1 1.1 0 0 1 0 3 1 1.1 Malformations Rate 4.2 2.6 _ 1.6 3.2 2.4 1.7 �TABLE 21. Year 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 (1/2) TOTAL DA LAT PROVINCIAL HOSPITAL - NONPAYING Livebirths Stillbirths Rate No. 1,376 651 10,860 TABLE 22. 12 5 4 5 5 6 7 5 3 8 1 17.1 6.3 4.7 5.1 5.3 5.6 6.4 4.4 2.4 5.8 1.5 2 5 8 9 5 2 8 3 11 11 4 2.8 6.3 9.4 9.1 5.3 1.9 7.3 2.6 8.7 8.0 6.1 51.0 554 943 1,067 1,092 1.136 1,261 61 5.6 68 6.3 TU-DU MATERNITY HOSPITAL, SAIGON Stillbirths Rate Year Livebirths No. 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 12,350 11,294 11,482 12,795 17,099 18,747 19,429 23,776 26,675 28,803 535 519 517 500 637 705 691 626 699 829 182,450 6,258 TOTAL Malformations Rate No. 72 72 48 66 38 73 51 42 46 35 25 51 57 41 65 36 78 56 48 58 48 16 704 793 852 985 Moles Rate No. 43 46 45 39 37 38 36 26 26 29 34.8 21 Moles NcTKate Malformations No. Rate 145 140 122 139 182 195 189 187 188 196 12 12 11 12 11 10 9.7 7.9 7.0 6.8 138 87 123 125 142 115 166 125 138 144 11 7.7 11 9.8 8.3 6.1 8.5 5.3 5.2 4.9 1,683 9.2 1,303 7.1 �TABLE 23. HUNG VUONG MATERNITY HOSPITAL, SAIGON Stillbirths Rate Livebirths No. 1959* 1960 1961** 1962** 1963 1964 1965 1966 1967 1968 1969 3,258 11,228 4,608 238 11,088 8,693 10,665 11,349 13,667 12,257 12,549 125 404 133 6 412 366 360 366 397 308 342 TOTAL 99,600 Year 3,219 Moles Rate No. Malformations Rate No. 41 37 29 25 37 43 34 32 29 25 27 9 29 16 0 46 44 52 50 64 38 59 2.8 2.8 3.5 4.2 5.1 4.9 4.4 4.7 3.1 4.7 11 40 14 2 43 40 57 79 78 72 63 3.4 3.6 3.0 8.4 3.9 4.6 5.3 7.0 5.7 6.0 5.0 32.3 07 4.1 499 5.0 * Opened September 1959. ** Records borrowed and lost for this period. TABLE 24. BIEN HOA PROVINCIAL HOSPITAL Stillbirths Rate Moles NoT" Rate Year Livebirths No. 1961 1962 1963 1964 1965 1966 1967 1968 1969 4,166 5,058 142 108 112 96 89 84 88 91 81 34 25 26 22 21 21 19 19 16 1 6 11 5 8 1 1 7 4 40,099 891 21.8 44 TOTAL 4,344 4,331 4,371 4,227 4,056 4,735 4,811 Malformations No. Rate 0.2 1.4 2.5 1.1 1.9 0.2 0.2 1.5 0.8 11 7 5 8 8 12 12 21 14 2.6 1.6 1.2 1.8 1.9 3.0 2.5 4.4 2.8 1.1 98 2.4 �TABLE 25. CAI RANG DISTRICT HOSPITAL Livebirths Year 1969 1970 Stillbirths Rate No. Moles Rate No. Malformations Rate No. TOTAL 551 189 11 3 20 16 1 0 1.8 - 1 0 1.8 - 740 (1/3) 14 18.9 1 1.3 1 1.3 TABLE 26. CAN THO PROVINCIAL HOSPITAL 1965 1966 1967 1968 1969 TOTAL Stillbirths Rate Livebirths Year' (1/2) No. 1,769 3,650 3,697 3,498 3,442 93 163 224 210 183 53 47 60 60 53 16,056 873 54.4 Moles Rate No. 34 55 37 54 74 254 19 15 10 15 22 15.8 Malformations Rate No. 5 25 20 32 20 2.8 6.8 5.4 9.1 5.8 102 6.4 TABLE 27. MY THO PROVINCIAL HOSPITAL Stillbirths Rate Livebirths No. 3,922 172 43.8 23 Moles No. Rate 41 10.4 Malformations Rate No. 18 4.6 �TABLE 28. KIEN HOA PROVINCIAL HOSPITAL Year 1964 1965 1966 1967 1968 1969 1970 TOTAL Livebirths (1/3) Stillbirths Rate No. Moles No. Rate Malformations No. Rate 1,793 3,079 3,269 3,564 2,680 3,201 1,305 66 75 110 108 90 89 35 37 24 34 30 34 28 27 1 3 10 6 3 6 4 0.6 0.9 3.1 1.7 1.1 1.9 3.1 3 6 5 4 3 3 2 1.7 1.9 1.5 1.1 1.1 0.9 1.5 18,891 573 30.3 33 1.7 23 1.2 TABLE 29. TAN AN PROVINCIAL HOSPITAL Stillbirths Rate Year Livebirths No. 1961 1962 1963 1964 1965 1966 1967 1968 1969 1,905 2,124 2,198 2,376 3,075 3,028 3,229 3,228 3,433 27 36 33 59 95 65 91 76 81 24,596 563 TOTAL Moles No. Rate Malformations Rate No. 14 17 15 28 31 21 29 23 23 1.0 0.9 2.3 1.7 2.3 1.3 1.8 0.6 0.9 3 4 3 2 6 4 2 2 1.4 1.8 1.3 0.6 2.0 1.2 0.6 0.6 22.9 24 2 2 5 4 7 4 6 2 .3 35 1.4 26 1.1 �HUE DA NANG TUY PHUOC QUI NHON NHA TRANG DALAT BIEN HOA SAIGON LONG DIEN TAN AN MYTHO KIENHOA LOCATION OF HOSPITALS VISITED 25 Figure 1 �NUMBER OF LIVE BIRTHS COLLECTED, BY YEAR REPUBLIC OF VIETNAM, I960 - 1969 80 CAPITAL AREA 70 OUTSIDE CAPITAL AREA 60 o o 3 50 m 40 UJ 30 20 10 I960 61 62 i n. ii 63 64 65 66 67 68 69 YEAR 26 Figure 2 �COUNTRYWIDE INCIDENCE OF STILLBIRTHS,MALFORMATIONS, AND MOLES PER 1000 LIVE BIRTHS PER YEAR 1960-1969 • - STILLBIRTH x - MALFORMATION o - MOLE CC §40 \ O o O UJ 35 z UJ Q O ^ 30 10 I960 61 62 63 64 65 66 YEAR 27 67 68 69 70 Figure 3 �ACRES SPRAYED BY YEAR, REPUBLIC OF VIE I NAM 1960-1969 O O O 0~ O O O UJ o: a. <r o 0 I960 61 62 63 64 65 66 67 68 69 YEAR 28 Figure 4 �REFERENCES 1. Bionetics Research Laboratories: Evaluation of the Teratogenic Activity of Selected Pesticides and Industrial Chemicals in Mice and Rats. Vol. Ill, 1969 2. U. S. Department of the Army, Training Circular. TC-3-16. Employment of Riot Control Agents, Flame, Smoke, Antiplant Agents, and Personnel Detectors in Counterguerrilla Operations, April 1969 3. U. S. Congress. House. Committee on Science and Astronautics. Report to the Subcommittee on Science, Research and Development. Prepared by the Science Policy Research Division, Legislative References Service, Library of Congress (Committee Print) Serial F. Aug 8, 1969. 91st Cong. 1st Sess. US Govt. Printing Office, 1969. p. 15 4. Penrose AC: Genetics of Anencephaly. J Ment Del Res 1:4-15, 1957 5. Stevenson AC, Johnson HA, Stewart MIP, Golding DR: Congenital Malformations: A Report of a Study of Series of Consecutive Births in 24 Centers. Bull WHO 34:Suppl 9, 1966 6. Kolah PJ, Master PA, Sanghvi LD: Congenital Malformation and Perinatal Mortality in Bombay. Ame J Obstet Gynec 97:400-406, 1967 7. Suharjono, Sunoto, Sudijonto, Sugiono M, Sutedjo: The incidence of Congenital Malformation in the Dr Tjiptomangunkusumo General Hospital, Jakarta, 1962-1967. Paediatrica Indonesians 9:9-12, 1969 8. Neel JV; A Study of Major Congenital Defects in Japanese Infants. Amer J Hum Genetics 10:398-445, 1958 9. Jonco AP, Carlos FC, Fernadez EV: Congenital Anomalies in Filipinos. J Philippine Med Assn 41:57-60, 1965 10. Abad-VasquezL, Pascual-Poblete E, Jonco A: Congenital Malformation in the Newborn. J Philippine Afed Assn 41:294-303, 1965 11. Wei PY, Chen YP: Congenital Malformations, Especially Anencephalus, in Taiwan. Amer J Obstet Gynec 91:870-876, 1965 12. Annual Report, Siriraj Hospital, Bangkok, Thailand, 1966 13. Marquez-Montes H, de la Vega GA, Robles M, Bolio-Cicero A: Epidemiology and Pathology of Hydatidiform Mole in the General Hospital of Mexico. Amer J Obstet Gynec 85:856-864, 1963 29 GPO 903.233 � 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. 031 Folder The folder containing the original item. 0579 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 Cutting, Robert T. Tran Huu Phuoc Joseph M. Ballo Michael W. Benenson Charles H. Evans Description An account of the resource Corporate Author: U. S. Department of Defense Date A point or period of time associated with an event in the lifecycle of the resource 1970-12-01 Title A name given to the resource Congenital Malformations, Hydatidiform Moles, and Stillbirths in the Republic of Vietnam, 1960-1969 Subject The topic of the resource health effects human exposure 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. 032 Folder The folder containing the original item. 0604 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 Donovan, J. W. M. A. Adena G. Rose D. Battisutta Date A point or period of time associated with an event in the lifecycle of the resource 1983 Title A name given to the resource Case-Control Study of Congenital Anomalies and Vietnam Service (Birth Defects Study): Report to the Minister for Veterans' Affairs, January 1983 Subject The topic of the resource 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. 078 Folder The folder containing the original item. 2014 Series The series number of the original item. Series III Subseries IV Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Donovan, John W. Robert MacLennan Michael Adena Source A related resource from which the described resource is derived The Medical Journal of Australia Date A point or period of time associated with an event in the lifecycle of the resource March 31 1984 Title A name given to the resource Vietnam Service and the Risk of Congenital Anomalies: A Case-Control Study Subject The topic of the resource 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. 056 Folder The folder containing the original item. 1511 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Durham, William F. Clara H. Williams Source A related resource from which the described resource is derived Annual Review of Entomology Date A point or period of time associated with an event in the lifecycle of the resource 1972 Title A name given to the resource Mutagenic, Teratogenic and Carcinogenic Properties of Pesticides Subject The topic of the resource pesticide toxicology chromosomal aberrations congenital birth defects animal testing 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. 033 Folder The folder containing the original item. 0620 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 Dwyer, James H. Date A point or period of time associated with an event in the lifecycle of the resource August 1 1982 Title A name given to the resource Summary of Proceedings of a Conference on Herbicide Exposure and Reproductive Epidemiology in Viet Nam held April 10, 1982 at the Department of Medical Genetics, Mount Sinai School of Medicine Subject The topic of the resource congenital birth defects health effects human exposure Southeast Asia ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 055 Folder The folder containing the original item. 1470 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Epstein, Samuel S. Title A name given to the resource Teratological Hazards Due to Phenoxy Herbicides and Dioxin Contaminants Subject The topic of the resource congenital birth defects herbicide toxicology EPA ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 056 Folder The folder containing the original item. 1506 Series The series number of the original item. Series III Subseries II Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Epstein, Samuel S. Source A related resource from which the described resource is derived Environment Date A point or period of time associated with an event in the lifecycle of the resource July / August July/August 1970 Title A name given to the resource A Family Likeness Subject The topic of the resource dioxin herbicide regulation herbicide toxicology 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. 033 Folder The folder containing the original item. 0630 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 Erickson, J. David Joseph Mulinare Philip W. McClain Terry G. Fitch Levy M. James Anne B. McClearn Myron J. Adams, Jr. Source A related resource from which the described resource is derived Journal of the American Medical Association Date A point or period of time associated with an event in the lifecycle of the resource August 17 1984 Title A name given to the resource Vietnam Veterans' Risks for Fathering Babies With Birth Defects Subject The topic of the resource human exposure dioxin congenital birth defects ao_seriesIII