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. 027 Folder The folder containing the original item. 0383 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/. Description An account of the resource Corporate Author: Malformation Registry of the Special Department of Seveso Date A point or period of time associated with an event in the lifecycle of the resource June 20 1983 Title A name given to the resource Final Report of the Congenital Defects and Other Unfavorable Outcomes of Pregnancy Found in the Population of the Seveso Area Affected by TCDD Pollution on 10/7/76 Subject The topic of the resource civilian impact congenital birth defects dioxin ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 027 Folder The folder containing the original item. 0384 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/. Description An account of the resource Corporate Author: Pesticides Branch, Ministry of Agriculture, Fisheries and Food, Great Westminster House, London, England Date A point or period of time associated with an event in the lifecycle of the resource December 13 1982 Title A name given to the resource New Evidence Concerning the Safety of 2,4,5-T Subject The topic of the resource Great Britain soft tissue sarcoma dioxin 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. 027 Folder The folder containing the original item. 0385 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Pesticide Abstracts 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 Abstract: Dally, S. "Toxicite de la 'Dioxine'. [Toxicity of dioxin]"; Anonymous. "A Propos de l'accident de Seveso. [The Seveso Incident]"; Jaubert, A. "Le Poison de Seveso. {Poison of Seveso]" Subject The topic of the resource chloracne dioxin 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. 027 Folder The folder containing the original item. 0386 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/. Date A point or period of time associated with an event in the lifecycle of the resource 1978 Title A name given to the resource Typescript with attachments: Forest Spray - Miscarriage Investigation, Alsea, Oregon: Questionnaire Evaluation and Study Plan Subject The topic of the resource civilian impact herbicide poisoning questionnaire 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. 027 Folder The folder containing the original item. 0387 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Revue Scientifique Date A point or period of time associated with an event in the lifecycle of the resource 1945 Title A name given to the resource The Individual Variations of Experiments in Teratogenesis Subject The topic of the resource animal testing 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. 027 Folder The folder containing the original item. 0389 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Chemical and Engineering News Date A point or period of time associated with an event in the lifecycle of the resource April 16 1973 Title A name given to the resource Health Hazard of Dioxins Still Uncertain Subject The topic of the resource aquatic animals animal testing ecological impact 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. 027 Folder The folder containing the original item. 0390 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Chemical and Engineering News Date A point or period of time associated with an event in the lifecycle of the resource March 11 1974 Title A name given to the resource War Herbicide Report Stirs Controversy Subject The topic of the resource NAS ecological impact dioxin 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. 027 Folder The folder containing the original item. 0393 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Pesticide Abstracts Date A point or period of time associated with an event in the lifecycle of the resource 1976 Title A name given to the resource Abstract: Anonymous. A Propos de l'accident de Seveso. [The Seveso Incident.] Subject The topic of the resource Seveso dioxin 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. 027 Folder The folder containing the original item. 0398 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived International Environment Reporter: Current Report Date A point or period of time associated with an event in the lifecycle of the resource September 10 1978 Title A name given to the resource Italian Report on Causes of Seveso Called Balanced by Hoffman-Laroche Subject The topic of the resource congenital birth defects study criticism ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 027 Folder The folder containing the original item. 0403 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Environmental Science & Technology Date A point or period of time associated with an event in the lifecycle of the resource June 6 1979 Title A name given to the resource EPA Suspends the Major Uses of Two Herbicides Subject The topic of the resource dioxin Oregon herbicide regulation 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. 027 Folder The folder containing the original item. 0411 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived New Zealand Medical Journal Date A point or period of time associated with an event in the lifecycle of the resource April 23 1980 Title A name given to the resource Report to the Minister of Health of an investigation into allegations of an association between human congenital defects and 2,4,5-T spraying in and around Te Kuiti Subject The topic of the resource New Zealand congenital birth defects herbicide poisoning ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 027 Folder The folder containing the original item. 0414 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived Medical World News Date A point or period of time associated with an event in the lifecycle of the resource February 27 1970 Title A name given to the resource Defoliants, Deformities: What Risk? Subject The topic of the resource animal testing congenital birth defects herbicide regulation ao_seriesIII https://www.nal.usda.gov/exhibits/speccoll/files/original/83e9967701deb14815fe16c14594eaf9.pdf f2c521d5b52571c48677e07e9a93d151 PDF Text Text Item ID Number 00421 Author Anonymous Epidemiologic Studies Program, Human Effects Monitor! RODOrt/ArtiClO TltlO ReP°rt of Assessment of a Field Investigation of SixYear Spontaneous Abortion Rates in Three Oregon Areas in Relation to Forest 2,4,5-T Spray Practices Journal/Book Title Year 1979 Month/Day February 28 Color Number of Images OeSCriptOU Notes 104 Alvin L Youn 9 filed tnis itern under the category "Human Exposure to Phenoxy Herbicides and TCDD" Tuesday, February 06, 2001 Page 422 of 526 �RESORT OF ASSESSMEOT OF A FIELD OF SIX-YEAR SPOnaMEOUS ABORTION RATES IN THREE OREGON AREAS IN RELATION TO FOREST 2,4,5-T SPRAY PRACTICES Prepared by the Epidemiologic Studies Program^ Human Effects Monitoring Branch , Benefits and Field Studies Division, \JiOA February 28, 1979 �TABLE OF CONTENTS Page List of Tables ii List of Figures iv Chapter I Introduction II Purpose and Scope 1 6 III Methods 8 IV Results 37 V Summary and Conclusions 77 Appendix A Questionnaire: Oregon Miscarriage Investigation 80 B Labor Room Statistics, Jackson Memorial Hospital 99 �LIST OF TABLES Table 1. 2. 3. Page Selected Agricultural Statistics for Counties Including the Study, Control and/or Urban Areas 18 Zip Codes Corresponding to the Study, Urban, and Control Areas 20 Total Acres Treated and Pounds 2,4,5-T Used in Alsea Basin (1972-1977) 4. 22 Applications of 2,4,5-T by Day and Month in the Alsea Basin (1972-1977) 5. 6. 24 Annual Admissions and Births in Hospitals in Study Urban, and Control Areas , 30 Number of Hospitalized Spontaneous Abortion Cases for • Study, Urban, and Control Areas 7. 8. 9. 10. 33 Number of Hospitalized Spontaneous Abortion Cases for Study, Urban, and Control Areas, Accummulated by Month.. 39 Hospitalized Spontaneous Abortion Cases by Study, Urban, Control Area, and Age Group of Patient 40 Number and Percent of Spontaneous Abortions According to Length of Gestation in the Study, Urban and Control Areas 41 Total Number of Births by Months for the Study, Urban, and Control Areas 11. 42. Number of Births Corresponding to the Month of Spontaneous Abortions in the Study, Urban and Control Areas 43 11 �LIST OF TABLES Table 12. Page Monthly Spontaneous Abortion Index for the Study , Urban, and Control Areas ............................. 44 13 . Abortion Index by Period, Area, and Month...................47 14. Analysis of Variance of Abortion Index by Period, Area, and Month ..................................... 51 15. Parameters of the Model "Index « A + B Sin (2J t-D)" for the various areas.......................T...............57 16. Study Area Index Corrected for Phase Shifts Study minus Control — 1 month lag................................58 17. Study Area Index Corrected for Phase Shift, Study minus Urban --- 2 month lag....................... ..........59 18. Study Area Index Corrected for Phase Shifty Study minus (Urban plus Control)-'—2 month lag. . .................60 . 19. Number of Births per Month and Unweighted Abortion Index for the Study, Urban, and Control Areas ............... 64 20. Cross - Correlation of Corrected Study Area Index with Spray Data ....................................... 68 21. Pounds of 2,4,5-T Applied in the Alsea Basin and Abortion Index for the Study Area by Month and Period. 22. Cross-Correlation of Study Area Abortion Index with Spray Data ............................................. 70 23. Study and Urban Area Physician Interviews: Estimated Numbers of Spontaneous Abortions Treated Annually and Percentages Hospitalized................................... . 74 iii �LIST OF FIGURES Figure Number Page 1. Oregon 2. Study Area in Lane, Lincoln and Benton Counties of Oregon .......................................... 10 3. Land Cover in Lincoln, Benton, and Lane (Partial) Counties, Oregon ............................................. 11 4 . Control Area in Malheur County, Oregon ...................... 14 5 . Land Cover in Malheur County, Oregon........................15 6 . Urban Area in Benton County, Oregon.........................17 7. Acres Sprayed with 2,4,5-T in Alsea Basin Accumulated by Respective Month, 1972-1977 .......... ........ 25 8. Pounds of 2,4,5-T Sprayed in Alsea Basin Accumulated by Respective Month, 1972-1977.............. ---- 26 9 . Hospitals in Study and Urban Areas..........................28 10 . Hospitals in Control Area................................'. . . 29 11. Plot of Monthly Spontaneous Abortion Index . for the Study, Urban, and Control Areas ..................... 45 12. Abortion Index for the Study Area by Month and Period.......................................... . 48 . 13. Abortion Index for the Control Area by Month and Period ............................................ 49 14. Abortion Index for the Urban Area by Month and Period ............................................. 50 15. Spontaneous Abortion Index, 1972-1977 For the Study Area and the Combined Control and Urban Areas ..................... 55 iv �LIST OF FIGURES Figure Number 16. Page Study and Control Areas: a) Combined Urban and Control Index; b) Study Area Index; c) Urban and Control Index Shifted Back Two Months 56 11. Predicted and Observed Points for the Study Area 61 18. Predicted and Observed Points for the Urban & Control Area 67 19. a) Study Area Abortion Index Corrected for Phase Shifted Urban Index b) Pounds of 2,4,5-T Sprayed by Month 65 Cross-Correlation of Study Area Abortion Index with Spray Pattern in Total Pounds 2,4,5-T applied by Month, 1972-1977 66 20. �Chapter I INTRODUCTION One of the widely used chlorophenoxy herbicides is the chemical 2,4,5-trichlorophenoxy acetic acid, commonly referred to as 2,4,5-T. A selective herbicide, 2,4,5-T is especially useful for brush control on rangeland, along right-of-ways, and in conifer forest habitats. The parent acid is formulated in a variety of emulsifiable esters and specific amine salts registered for use in both Canada and the United States. Many studies have been conducted to determine the fate of TCDD in the environment. Since TCDD is reportedly not mobile in soil, it is not considered to be a risk in ground water. TCDD does not accumulate in vegetation (1). In comparison with other pesticide products, the phenoxy herbicides are relatively non-toxic to mammals, and 2,4,5-T is classified as moderately toxic with an acute oral LD_ (rat) at 500 mg (acid basis) Ag (2). However, low levels of TCDD have been shown to have oncogenic effects in rodents and related effects in primates. Fetotoxicity and teratogenicity have been demonstrated at low levels, with the appearance of cleft palate and kidney anomalies in rats, mice, and hamsters. toxic effects in avian species have also been reported (1). Embryo- �In July, 1978, Staff of the EPA Office of Pesticide Programs (OPP) and Colorado State University epidemiologists met in Oregon with local and State health officials to begin an investigation into a group of women living in the vicinity of Alsea who claimed they had experienced miscarriages because of herbicide spraying in the course of forest management. The investigation was precipatated in late June, 1978, when EPA received a letter signed by eight women living in this area who had experienced 10 miscarriages since 1973. The women claimed to be surrounded by forest land which has been sprayed for years with herbicides known to contain dioxin. They also charted their dates of miscarriage and related dates the forest areas were sprayed. Each of the women was under a physician's care at the time of miscarriage, and neither the women nor their doctors could ascertain the reasons for abortion. The investigators met with four of the women to discuss the circumstances of their reported exposure and any possible relationship to their subsequent miscarriages. Following the visit by EPA and Colorado State University staff, an extensive health questionnaire (Appendix A) was designed jointly by OPP's Epidemiologic Studies Programs (ESP's) in Miami, Iowa, South Carolina and Colorado, in which detailed questions on self and family pregnancy and medical histories, environmental aspects, diet, occupational and household pesticide usage were included. During the first week of August, 1978, an epidemiologist from Colorado's ESP administered the questionnaire to nine women who had experienced 13 confirmed miscarriages from May, 1973 to March, 1978. �During late August and early September, the health questionnaire and related data (spray application, vital statistics, etc.) were evaluated independently by 10 experts in the fields of obstetrics, gynecology, epidemiology, biostatistics, reproductive endocrinology, and perinatal medicine. The consensus of the reviewers was that: 1. the spontaneous abortions did appear to follow a seasonal pattern (two of the reviewers noted the seasonal relationship but drew no conclusions); 2. Good Samaritan Hospital records for Benton County women for the years 1975-77 showed numerically higher rates of spontaneous abortions per live births during Jan,, Feb., Mar., and Oct., Nov., and Dec., of each year than during April through Sept. (these records were based on stillbirths of terms greater than 20 weeks). Conversely, 10 of the 13 miscar- riages reported by the Alsea participants occurred during the months of.April through September (1973-1978); 3. there was a high numerical incidence of March to June miscarriages (nine of 13) among the Alsea participants. However, there was concern that the reports might comprise a biased sample (albeit unintended) of all miscarriages that occurred within the area and years under investigation; �4. a causal relationship between forest herbicide spraying and reproductive wastage had not been demonstrated from the data presented. Opinions ranged from ". . .no evidence of a causal relationship . . ."to "I cannot support or refute a cause and effect relationship ..." Reviewers either stated or inferred that there was no real evidence of an epidemic based on the data presented. An analysis of the data by staff of OPP's Human Effects.Monitoring Branch (HEMB) identified: 1) the possibility of a relationship between time of spraying and conception and subsequent abortions among the Alsea women; and 2) the fact that, while State and county records of spontaneous abortions are given for terms of 20 weeks or greater, 12 of the 13 miscarriages experienced by the women in Alsea were for terms of less than 20 weeks. Based upon the comments of the reviewers and HEMB staff, OPP undertook to develop data on spontaneous abortions of 20 weeks duration or less in the Study area and in a comparable control population. o �The current study of 6-year spontaneous abortion rates in three Oregon areas was initiated by the Human Effects Monitoring Branch, Office of Pesticide Programs, in October of 1978. The study was accomplished under contract to the Epidemiologic Studies Program (ESP) projects in Colorado, Florida and Idaho. Scientists from the Colorado Project, under the direction of Dr. Eldon Savage, organized and conducted the field investigations, developed the data including the spontaneous abortion index, and prepared much of the report. Idaho project staff assisted in collection of hospital data in Malheur County. Statistical analysis and tie interpretative narrative were developed by Drs. Robert Duncan and Thomas Keefe of the Florida and Colorado projects, respectively. The following scientist were instrumental in the successful development and conduct of the study: Dr. Eldon P. Savage, Director, Colorado ESP, Colorado State University Colorado ESP Staff: Drs. Thomas Keefe, Robert Zimmerman and Richard Hayes; Messrs. William Wheeler, Lawrence Mounce and Jerry . Rench; Ms. Lois Cox and Ms. Barbara Stevens. Idaho ESP Staff (Dr. Charles Brokopp, Director): Ms. Jill Wyatt and Ms. Pamela Smith. Dr. Robert C. Duncan, Director, Florida ESP, School of Medicine, University of Miami. HEMB Staff: Drs. Jack Griffith and Charles Miller, Mr. Robert Heath and Ms. Mary Frankenberry. This report was organized and edited by: Jack Griffith, Ph.D. Robert Heath, M.S. Mary Frankenberry, B.A. �Chapter II PURPOSE AND SCOPE The purpose of this study was to assess the rates of spontaneous abortion occurring in a forested region of Oregon's Coastal Range, centered' about the Alsea basin, where 2,4,5-T has been commonly used in forest management/ and to compare those rates with rates occurring in a comparable control area. Specific objectives of the study were to test the following hypotheses: a. whether or not differences in spontaneous abortion rates exist between the study and control populations; b. whether or not seasonal variations in rates exist within the study and control populations; c. whether or not such variations, 'if they exist, can be associated with time and concentration of spray applications in the study area. The data are limited to in-patient records of women hospitalized for spontaneous abortions of less than 20 weeks term, based upon; a. the observation that 12 of the 13 miscarriages reported by the original nine participants were for terms of less than 20 weeks duration; �b. the assumption that a possible chemical effect would be most likely during the first trimester of pregnancy and could therefore be masked in abortion data spanning the entire nine months of term. �Chapter III METHODS The methods used in this study consisted of defining the study area, developing/confirming a 2»4,5-T use history in that area, researching U.S. Postal ZIP code boundaries, selecting a control area, defining an urban area, abstracting spontaneous abortion data from the hospitals in the three areas, interviewing area physicians, retrieving county birth data from Oregon computer tapes, and collecting various descriptive data ancillary to the study. Description of the Study Area The Study Area comprises approximately 1600 square miles of Oregon's forested Coastal Range (Figures 1 and 2). It was selected so as to be centered around the "Al'sea basin", an area of approximately 400 square miles. The Study area includes the western half of Benton County, northwestern Lane County and all but the northern and northwestern reaches of Lincoln County. It is bounded on the west by approximately 70 miles of the Pacific Coast entending from.Lincoln City southward to Florence, and extends inland for distances ranging from 10 to 35 miles. (Exact boundaries conform to U.S. Postal ZIP boundaries.) The Study area includes all but the northern and southern reaches of the Siuslaw National Forest. Interspaced throughout one numerous commercially owned and Bureau of Land Management forested acreages (Figure 3). Mountain elevations of approximately 1,000 feet are not uncommon? peak elevation is slightly more than 4,000 feet. �Figure 1. O IO OREGON 20 30 SO 60 �Figure 2. Study Ar ea in Lane, Lincoln and Benton Counties of Oregon ci^^±^rt^±^±i^^^ STUDY AREA _3_0 SCALE in �3. Land Cover in Lincoln. Bento, and Lane (p.rtl.1, Co.nt.es O.e.on FOREST CROP &/or RANGE �Drainage is primarily westward; principal rivers include the Siletz, Alsea, Yaquina and the Siuslaw. Eastern fringes of the area drain eastward into the Willamette Valley. Maximum runoff is reached generally during the winter months as the result of storms off the Pacific occurring usually as rain. There is little snow accumulation. The Study area is predominantly rural. The four hospitals in the area are located in the four largest towns: Newport (pop. 5,200); Lincoln City (4,200); Toledo (2,800); and Florence (2,250). Each of these hospitals was utilized in the study. With the exception of Philomath (1,700), all other towns/villages have populations of less than 1,000. Alsea has a population of 400 (1970 census). All of the nine women who participated in the first phase of the investigation resided, at the time of pregnancy, in rural residences located within 12 miles of Alsea. All but one of the women resided in the Alsea River watershed; the ninth resided southwest of Philomath in the Corvallis watershed. Description of the Control Area After careful review and consultation with staff of the Oregon State Health Department, the Control area was selected in Malheur County, Oregon. Selection was based on the following criteria: 1. The area had little or no use of 2,4,5-T. •?- The area is primarily rural, as is the Study area. �3. Physician practices and hospital facilities were expected to be similar to those in the Study area. 4. The area bore topographic similarities to the study area, being of similar elevation and, although not mountainous, having rugged terrain (escarpments, rolling hills, arroyos, canyons). The Control area comprises four contiguous postal ZIP code zones in the northeastern part of Mal,heur County (See Figure 4). The area covers approximately 1,000 square miles and is bounded on the east and northeast by the Snake River, which there forms the Oregon-Idaho boundary. Several creeks drain the area eastward into the Snake River. Approximately 90 percent of the area is classified as rangeland, sagebrush being the dominant vegetation. Cropland accounts for a small but important percentage of the area along stream and river courses. Twenty-one percent of the land in the county is in private ownership, 75 percent is Federal and the remainder (5%) is State, county, or local governments. (See Figure 5) The two hospitals in the Control area are located in the two largest towns: Ontario (pop. 8,200) and Nyssa (pop. 2,900). Both hospitals were utilized in the survey. The area also includes the town of Vale (1,850) and the villages of Harper and Cairo (pop. less than 250). 13 �Figure 4. Control Area in Malheur County Oregon / _1^1_Jj»1^1_f«1i •*1_jiVjjVllj's_|1 COf4TROL AREAL ...._, ,._30Mil«» SCALE | �Figure 5. Land Cover in Malh'eur County Oregon FOREST CROP &/or RANGE 15 �Personnel from the Malheur County Cooperative Extension Agent's office had no specific figures to report on pesticide use in the county; however, it was stated that there is very/ very little use of 2,4,5-T in the county, particularly in the cultivated areas. Personnel from the area office of the BUM, which has the responsibility for management of public land within Malheur County, reported that 2,4,5-T has not been applied on BLM lands in the county since 1972 by either BLM or ranchers with grazing permits. Additionally, BLM personnel stated that no pesticides of any kind had been applied to BLM grazing land since 1968. A sagebrush control program used 2,4-D but not 2,4,5-T in Malheur County. • Description of the Urban Area The Urban area is comprised of the two connecting Postal ZIP zones that encompass the cities of Corvallis and Albany, Oregon. Both sites are located in the agricultural non-forested Willamette Valley. The Corvallis ZIP zone is contiguous with the east-central boundary of the Study area and the Albany zone connects the Corvallis zone at its northeast corner (see Figure 6). The populations of Corvallis and Albany are over 37,000 and 21,000 (1970 census). 16 �Urban Area in Benton County, Oregon Figure 6, URBAN AREA 30 U l l « » SCALE 17 �TABLE 1 Selected Agricultural Statistics for Counties Including the Study, Control and/or Urban Areas Oregon, 1972 - 1977 County and Area Lincoln Study Malheur Control Lane Study Benton Study & Urban 1,357 258 1,840 575 Land in Farms, Acres 1,360,195 47,390 270,587 129,034 Approximate Land Area, Acres 6,309,760 631,104 2,913,280 427,520 21.6 7.5 9.3 30.2 5 38 158 58 1,278 208,726 553,042 457,813 935 59 900 301 23,040,163 495,703 11,780,769 5,317,112 991 214 1,152 423 20,063,573 1,028,121 9,319,416 2,667,955 All Farms, Number .Percent in Farms Forest Production, Number of Farms Forest Production, Dollars Crops, Number of Farms Crops, Collars Livestock, Number of Farms Livestock, Dollars U.S. Bureau of the Census, Census of Agriculture, 1969 \fol. 1 area Report Part 41. Oregon Section 2. County Data. U.S. Government Printing Office, Washington, D.C. 1972. 18 �Women in both cities use Good Samaritan Hospital in Oorvallis for gynecological and/or obstetrical care, as do various women throughout the Study area. All spontaneous abortion records for terms of less than 20 weeks were obtained from the Hospital, first, to derive additional data for the Study area.- and, second, to permit comparison of seasonal spontaneous abortion patterns and frequencies in an unsprayed urban area adjacent, to the Study area. The abortion data for the Urban area are considered to be of limited utility in this study because of an apparent tendency for firsttrimester abortions to be frequently handled in urban clinical facilities of a type that do not exist in the Rural Study and Control areas. The .data are useful, however, in providing a measure of monthly and seasonal trends on patterns in abortion frequencies. Research of zit* Code Boundaries To facilitate an identification of the boundaries of the Study area, ZIP code maps were developed with the cooperation of personnel in local post offices. The boundaries of the Study area, which coincide with the zip code delivery routes, remained unchanged during the study time frame of 1972-1977 (See Table 2). 19 �TABLE 2 ZIP Codes Corresponding to the Study, Urban, and Control Areas Oregon, 1972 - 1977 Area Zip Codes Urban 97321, 97330 Control 97906, 97913, 97914, 97918 Study 97324, 97357, 97369, 97388, 97439, 20 97326, 97365, 97370, 97390, 97453, 97341, 97366, 97376, 97391, 97480, 97343 97367 97380 97394 97498 �Spray Data In the study of the Alsea are.5? wonen, spray data on the use of 2,^,5-7 were collected and plotter- for the immediate area referred to as the "Alsea Basin". This ir.forrv-tior. was supplied '•// the following major organizations that used the chemical: USFS-Ciuslaw National Forest; USDI-Bureau of Land Management, Alsea Resources Area; Willamette Incustries, Inc., Pilonath, Oregon; and Starker Forest, Philomath, Oregon. The supplier" data consisted of the elate(s) of application, rate of application, formulation, :: ur.be r of acres treated, arV th.e location of the treated land. The locations of the sprayed areas were plotted to quarter-section on township maps. In this manner the perimeter of the "Alsea Basin" could then be defined as one covering approximately 40C square miles or 255,000 acres. During the o-year period fron 1S7P-1977, a total of 71"! acres was treated with 9916 pounds of 2,4,^-T. Tlie poundage and acreage varied fron year to year (TsMe 3). Tf^.e areas treated during this period represent approximately 3% of the total acreage within the "Also?. Basin". * As mentioned previously, the predominant feature of the study area is the forested Coastal Range. Since the Coastal Range extends from north ern California into Washington, it was considered necessary to ect.-.hlio', that: 1) topography and vegetation are similar throughout Oregon; and 2) forest management practices in the Alsea basin are representative of the 21 �Table 3 Total Acres Treated and Pounds 2,4,5-T Used in Alsea Basin Oregon, 1972-1977 Year Acres Treated Treatment Total 2,4,5-T (Ibs.) 1972 88 0.5 Ib/A 98 219 63 1.0 Ib/A 2.0 Ibs/A 44 98 438 189 769 3.0 Ibs/A 468 1973 444 25 469 1 Ib/A 2 Ibs/A 444 50 494 1974 207 80 287 1 Ib/A 207 240 447 1975 223 239 90 552 3 Ibs/A 1 Ib/A 2 Ibs/A 3 Ibs/A 223 478 270 971 1976 1256 2 Ibs/A 2512 1977 444 90 534 2 Ibs/A 3 Ibs/A 888 270 Total 3,566 1158 6,351 �entire forested area. Personal communications with representatives of the U.S. Forest Service and commercial tree farm operators substantiated that the ecological characteristics of the Coastal Range were consistent in the Oregon Coastal Range and that the chemical, 2,4,5-T, is used as a camion forest management tool in this region. The herbicide 2,4,5-T is applied almost exclusively by helicopter at an average rate of two pounds per acre for control of undesirable vegetation such as red alder, vine iraple, salmonberry, and Thimbleberry. Certain weather factors such as wind and precipitation dictate time of application, but in general the compound is used in the spring (March, April, or May) with a second application made, if needed, in middle to late summer (July and/or August). These seasonal usage patterns are shown in Table 4 and Figures 7 and 8. To avoid contamination of water sources prior to 1978, the general application policy was to avoid spraying near homes and provide for a single swath of 30 to 60 feet on each side of any major stream. In September, 1978, the Oregon Forest Practices Act provided extended guidelines. These guidelines required that no spraying was to be made within 500 feet of an inhabited residence nor within 200 feet on either side of a Class A stream. Class A streams are defined as major streams with fish and/or ones that are used for domestic water supplies. Thus, the data from the Alsea basin illustrate a pattern which may be considered as representative of the Study area. In general, greater amounts of the chemical were applied during the spring than �Table 4 Applications of 2,4,5-T by Day and Month in the Alsea Basin Oregon, 1972-1977 •Year Dates Total Days Acres treatment Amount Applied (Ibs 1972 March 17, 20, 31 April 4 3 1 1 4 9 148 296 121 48 151 468 no 144 219 769 5 1 6 444 25 469 444 50 494 3 1 1 1 6" 180 27 48 32 287 180 27 144 96 447 July 31 August 1, 19, 23, ? 1973 May 5,6,10,13,14 August 15 T974 April 26, 27, 29 May 4 July 29 August 2 1975 April 9, 16 May 25, 27, 29 July 31 August 20 2 3 1 1_ 7 239 • 202 16 95 552 478 282 16 195 971 1976 April 5-10 May 6 5 1_ 2512 35 6 1256 35 1291 2547 4 534 1158 . 1977 March 12-15, 19 �Figure 7. Acres Sprayed with 2,4,5-T in ATsea Basin Accumulated by Respective Month, 1972 through 1977 3 U x n »S 2-4 25 �Figure 8. . . Pounds* of 2,4,5-T Sprayed in AT sea Basin Accumulated by Respective Month, 1972 through 1977. 1 x 3 3 1 - ' J ' F ' M ' A ' M T 71 J ' A ' S MONTH *Active ingredient » 0 ' N ' D' �during the summer treatments. Additionally, the spray program is not a month-long operation. Usually it spans only a few days' time. The duration of 'the spraying depends on the number of acres to be treated and on the weather conditions. Selection of Hospitals and Abstraction of Spontaneous Abortion Data Spontaneous abortion data were abstracted from all five hospitals located in the Study and Urban areas (See Figure 9) and from the two hospitals located in the Control area (See Figure 10). These hospitals were viewed as the primary source of health care delivery for the respective areas. The seven Oregon hospitals contacted are located in Corvallis, Lincoln City, Newport, Toledo, Florence, Nyssa, and Ontario. Those hospitals and the number of admissions and live births that each recorded in 1975 are found in Table 5. All field work was completed during November and December, 1978. Most of the hospitals were reluctant to participate in a record search with non-hospital personnel because of patient confidentiality. Three hospitals pjrmitted a complete record search by field epidemiologists, while at the other four hospitals the data were abstracted by hospital personnel. Patients' names and addresses, excepting ZIP codes, were not recorded. For each of the spontaneous abortions the following information was provided or abstracted: H-ICDA diagnosis code, age of patient, date of 27 �Hospitals in Study and Urban Areas Figure 9. Lincoln/ City INCOLN COUNTY Toledo Newport/ x/Corvallis BENTON COUNTY / LANE COUNTY Florencejx 28 �Figure '10. / Hospitals in Control Area i Ontario Nyssa / MALHEUR COUNTY �TABLE 5 Annual Admissions and Births in Hospitals in Study, Urban, and Control Areas Oregon 1972.- 1977 Hospital location Hospital Name Urban Area Study Area Admissions 1975 Births 1975 Good Samaritan Corvallis 7589 986 Western Lane Florence 802 87 North Lincoln Lincoln City 1367 77 Pacific Communities Newport 1159 48 New Lincoln Control Area City Ibledo 875 103 Malheur Memorial Nyssa 710 110 Holy Rosary Ontario 4097 474 3U �spontaneous abortion, gestation period, and ZIP code of patient's residence. Only records of spontaneous abortions that occurred from 1972 through 1977 were sought. This time period coincided with the temporal miscarriage pattern of the nine original Alsea women. From 1972 to 1977, two ICDA texts were used by the hospitals. In 1973 H-ICDA was published and spontaneous abortions were listed by the codes 643.0, 643.1, 643.2, and 643.9. The 643.9 code includes any spontaneous abortions not listed as induced or spontaneous. Prior to 1973, hospitals used the 8th revision of ICDA. Spontaneous abortions were coded as 643.0, 643.1, 643.2, and 643.9. The code number 644- was also used for 1972, since this code approximated ft-ICDA code number 643.9. Physician Interviews A list of private physicians who practice at each of the five hospitals in the Study and the Urban areas was compiled from information provided by the hospitals and by local health officials. From the list, 30% of the physicians were randomly selected for interview. Ebwever, since physicans tended to practice in groups, doctors not randomly selected were also interviewed whenever available. In the Study area 19 of 27 (70%) of the physicians—all general practitioners—were contacted. In Corvallis all eight of the obstetricians/gynecologists were interviewed as well as 20% (five) of the general practitioners and 10% (two) of the internists. �When possible, interviews were carried out in the doctor's office. Each physician was asked to estimate the number of spontaneous abortion cases of terms less than 20 weeks that he or she had treated per year during the 1972 to 1977 time period. Each was also asked to estimate the percentage of those cases which had been hospitalized. Because of similarities in medical facilities and rural population distribution in the Control and the Study areas, physician practices were assumed to be similar in the two areas. Therefore, it was decided not to conduct physician interviews in the Control area. Data Preparation The data on spontaneous abortions of less than 20 weeks from the seven study hospitals were edited, coded, keypunched, and computer edited. The number of monthly hospitalized spontaneous abortions during 19721977 were tabulated for each of the three areas. These data were also tabulated and cross-tabulated according to the several variables of interest. For example, the data on hospitalized spontaneous abortions were cross-tabulated according to area (Study, Urban, and Control) and gestation period (less than 4 weeks, 5-8 weeks, 9-13 weeks, 14-17 weeks, and 17-20 weeks). Birth certificate data for 1972 through 1977 were obtained in the form 32 �of computer tapes from the Vital Statistics Section of the Oregon State Health Department. These computer tapes were used to obtain the number of births per month in the Study, Urban, and Control areas for 1972-1977. The Spontaneous.Abortion Index; In order to make comparisons among areas and among the months of the year, especially within areas, the data on spontaneous abortions need to take into account the number of births in the three areas during each of the twelve months. The index described below is basically the ratio of the number of hospitalized spontaneous abortions to the number of births corresponding to the spontaneous abortions, based on the residence ZIP Code of the women contributing to each event. Thus, the ratio is not a true rate but rather an index of the hospitalized spontaneous abortion experience of the women residing in the three areas. In order to describe the spontaneous abortion index, the following notation is required: Y. • = the number of hospitalized spontaneous abortions in the area (i * 1,2,3. . ) in the j . month (j » 1,2,..., 12) during 1972-1977; X- = the number of births in the i— area and in the j month during 1972-1977. �An index that has been used in similar studies is simply the ratio Y /5f ij ij. The inherent problem with such an index is that the .numerator involves women of one conception period whereas the denominator involves women of a different non-overlapping conception period. The spontaneous abortion index developed here is Z-• = Yji/C.:-: where C^• is a five-month moving-average of the X^.'s which have been appropriately shifted. In particular, C^= where the weights (W , . . W ) represent the proportions of ., abortions of varying gestation. In the above definition of C.^/ the second subscript on the number of births is taken modulo 12; for example, j+3+k = 13 refers to January births. The rationale for the use of GJJ rather than X^ • is that a woman who has a spontaneous abortion in month j could have delivered between month j+4 and month j+8, depending on her length of gestation. In averaging the number of births in the five months between month j+4 and month j+8, one could use a simple average (i.e., W^ = W2 = . . = W5 = .20). Instead, . a weighted average of the number of births was applied with estimated weights given by the proportions of abortions for the five gestation periods. Index values were calculated, by month and area, for the aggregated six-year data and for the two three-year periods 1972-1974 and 1975- 1977. 34 �Statisticial Procedures Statistical evaluation of the data is based on the following analyses; 1. Analysis of variance of the abortion index by area and month, deriving a residual error term by dividing the data into two 3-year periods. 2. Frequency table analyses, by chi-square, to test monthly variation in the cumulated number of spontaneous abortions analyzed as simple frequencies and as expected monthly frequencies of spontaneous abortions calculated from the frequencies of corresponding live births. 3. Tests of cyclic trends including: (a) A power-spectrum analysis of the abortion index over months to test for cyclic trends in the monthly data. (b) Adjustment of the abortion index data to account for phase differences between the Study area and the Control and Urban areas. (c) Fit of a sine-wave model to the abortion index data. (d) Cyclic analysis of the raw abortion data (unadjusted for births). 35 �(e) Examination of birth data from Miami, Florida (Jackson Memorial Hospital, 1976-77) for cyclic behavior. (f) A test for cyclic trends after recalculating the abortion index by raw numbers of births as the denominator rather than the five-month moving average. 4. Cross-correlation analyses between Study area abortion indices and spray patterns. (a) Cross-correlation analyses, parametric and non-parmetric, between the Study area abortion index and the monthly spray pattern of 2,4,5-T in pounds sprayed per month. (b) Cross-correlation analysis with the monthly spray pattern after adjusting the abortion index data for differences in cyclic trends. (c) Cross-correlation analyses of Study area abortion index and spray patterns for the periods 1972-74 and 1975-77. 5. Evaluation of physician interview data. 3G �Chapter IV RESULTS The annual numbers of hospitalized spontaneous abortion cases in the three areas appear in Table 6. There was a total of 477 cases: 188 in the Study area, 109 in the Control area and 180 in the Urban. Table 7 depicts these cases accumulated by month of the year for the 1972 to 1977 time period. The same cases are also represented according to the age of the patient in Table 8. Table 9 presents, for each area, the cases by weeks-of-term categories for those cases (456) for which term was known. As mentioned previously, the number of births in these three areas needs to be taken into account in any comparisons made among the areas with respect to the number of spontaneous abortions. Table 10 presents the number of births per calendar month for the Study, Urban and Control areas; the five-month moving average of the number of births corresponding to the month of spontaneous abortion is given in Table 11 for each area, where the weights were obtained from the tabulation of spontaneous abortions according to length of gestation (Table 9). Table 12 presents the monthly spontaneous abortion index for each of the three areas in the study; the monthly spontaneous abortion index for these areas is also displayed graphically in Figure 11. An obvious feature of this graph is the elevated index of the Study area for the month of June. 37 �TABLE 6 Number of Hospitalized Spontaneous Abortion Cases for Study, Urban, and Control Areas Oregon, 1972 - 1977 Study Area Urban Area 1972 37 44 9 1973 34 40 19 1974 23 38 27 1975 31 19 27 1976 33 20 8 1977 30 19 19 188 180 109 Year Tbtal 38 Control Area �TABLE 7 Number of Hospitalized Spontaneous Abortion Cases for Study, Urban, and Control Areas, Accumulated by Month Oregon, 1972 - 1977 Month Study Area Urban Area January 10 25 12 February 17 17 4 March 18 15 7 April 11 16 14 May 16 17 9 24 15 6 July 20 5 7 August 17 11 10 17 ' 11 June September . 9 Control Area October 15 19 7 November 16 7 8 December 15 16 14 188 180 109 Tbtal 39 �TABLE 8 Hospitalized Spontaneous Abortion Cases by Study, Urban, Control Area, and Age Group of Patient Oregon, 1972 - 1977 Age Group Study Area -Percent Urban Area 10-14 3 1.6 0 0 0 0 15-19 38 20.2 12 6.7 14 12.8 20-24 69 36.7 68 37.8 38 34.9 25-29 44 23.4 62 34.4 24 22.0 30-34 18 9.6 26 14.4 21 19.3 35-39 9 4.8 7 3.9 9 8.3 40-44 6 3.2 5 2.8 3 2.8 45-49 _!_ 0.5 0 Total 188 100.0 180 ' Percent 0__ 10.0 Control Area Percent 0 0_ 109 100.1 �TABLE 9 Number and Percent of Spontaneous Abortions According to length of Gestation in the Study, Urban, and Control Areas Oregon, 1972 - 1977 Gestation Period 1. 18 - 20 weeks Study Area Urban Area 8 12 (4.6%) 2. ' 14 -17 weeks (6.7%) 24 15 '(13.8%) 3. 10 - 13 weeks 68 (39.1%) 4. 5 - 9 weeks (46.1%) 60 (33.3%) 12 (6.9%) Obtal 83 62 (35.6%) 5, 4 weeks or less (8.3%) 10 Control Area 7 (6.8%) 14 (13.7%) 48 (47.1%) 28 (27.5%) 5 Cverall 27 (5.9%) 53 (11.6%) 199 (43.6%) 150 (32.9%) 27 (5.6%) (4.9%) (5.9%) 180 102 456 174 41 �TABLE 10 total Number of Births by Months for the Study, Urban/ and Control Areas Oregon 1972 - 1977 Study Area Urban Area Control Area January 194 338 124 February 188 353 124 March 202 34.4 126 April 189 335 131 May 201 357 155 June 228 378 145 July 203 315 156 August 212 351 131 September 204 342 154 October 170 .343 136 November 172 337 155 December 181 327 129 2344 4120 1666 Six-Year Total �TABLE 11 Number of Births Corresponding to the Month of Spontaneous Abortions in the Study, Urban, and Control Areas Oregon, 1972 - 1977 Month Study Area Urban Area Control Area January 208.8 338.3 146.3 February 206.8 345.0 142.6 March 191.8 341.5 April 177.8 340.4 143.6 May 177.9 334.8 142.3 June 184.0 334.3 130.5 July 189.7 342.0 126.5 August 193.0 345.7 125.4 Septeinber 195.6 342.5 129.0 October 196.7 346.9 138.7 November 208.7 358.1 147.3 December 213.4 350.7 148.1 Total 2344 4120 1666 Based on five-month moving average. 43 ' 145.6 �TABLE 12 Monthly Spontaneous Abortion Index for the Study, Urban, and Control Areas Oregon, 1972 - 1977 Month Study Area Urban Area Control Area Average January 48.1 73.9 82.0 68.0 February 82.2 49.3 28.1 53.2 March 93.8 43.9 48.1 61.9 April 61.9 47.0 97.5 68.8 May 89.9 50.8 63.2 68.0 June 130.4 44.9 46.0 73.8 July 105.4 14.6 55.3 58.4 August 88.1 31.8 79.8 66.6 September 46.0 49.6 85.3 60.3 October 76.2 54.8 50.5 60.5 November 76.7 19.6 54.3 50.2 December 70.3 45.6 94.5 70.1 Average 80.8 43.8 65.4 63.3 IV The spontaneous abortion index is defined as the ratio of the number of hospitalized spontaneous abortions to the corresponding number of live births based on a five-month moving average, and is expressed as abortions/1,000 births. �Figure 11. Plot of Monthly Spontaneous Abortion Index for the Study, Urban, and Control areas Oregon, 1972-1977 •—.STUDY A R E A M I M I M I M URBAN AREA •r^^^pror-,CONTROL A R E A i I r i j | -j — |j p— p J F M A M A O J J S N �Statistical Analyses In order to arrange the data in such a way that proper error terms for hypothesis tests could be calculated and to see whether seasonal spontaneous abortion patterns were consistent over time, -the data were gathered into two 3-year periods as shown in Table 13. The plots of these data are shown in Figures 12, 13, and 14. From the graphical representations it is seen that the time (seasonal) patterns within each area are remarkably similar for the two periods. The analysis of variance appropriate for the data in Table 13 is given in Table 14. Although the three-year time periods could have been viewed as a blocking factor, it was decided to test the various interaction terms for possible significance. Clearly, the only significant variation is among the three areas. The mean values for the three areas are: Study area = 80.8; Urban area = 43.8; and Control area = 65.4 (see Table 12). By the New Duncan's Multiple Range Test, all three means are significantly different from each other (p<.05, two tailed). From Table 13 and Figure 14 it is seen that there is a decrease in the overall Abortion Index for the Urban area during Period II. Analysis showed that this decrease is significant (p<.0002). The mean AC, �TABLE 13 Abortion Index "by Period, Area, and Month Oregon, 1972-1977 PERIOD I PERIOD II (1972 - 3 - 4) (1975 - 6 - 7) Study Area Urban. Area Control Area January 48 95 68 48 53 96 February 77 58 28 87 41 28 March 94 59 14 94 29 82 April 45 76 84 79 18 111 May 112 54 84 67 48 42 June 98 72 46 163 18 46 July 95 29 63 116 0 47 August 76 52 96 104 12 64 September 61 76 140 31 23 31 October 71 63 29 81 46 72 November 105 22 68 48 17 41 December 84 57 95 56 34 95 Average 80.5 59.4 67.9 81.2 28.3 62.9 Study Area Urban Area Hospitalized spontaneous abortions/1,000 live births adjusted for gestational age distribution of observed abortions. Ihe computed monthly births.for the six-year interval were divided equally between the two periods,, 47 Control Area �Figure 12 Abortion Index for the Study Area By Month and Period 180 160 140 120 X O) "O c O 100 O 80 60 40 20 0 kt-Hfi* tS&y-***-- fni-m m^t F •lK&*f>W*r.i* U t a < | H f / 4 M I & £ * * ' » 4rmWt*-«BWM-h*MCM M M J J Month A 0 N D �Figure 13 Abortion Index for the Control Area By Month and Period 140 120 X O) 100 TO c 4J 80 O 60 40 20 • M «•*» •»*»|f*r-*«"'-I*^--**i-«V—W(vl.J.»»» J F M •••viftL.,,i fMIVI* ***•»*« if* I'#lr**of»*Jtr*v M J Month Irtfc-rfwi^uwf^Htn^rtm-ijh*.1,* J A l.|>M<»t*««1M.Rf 0 N ,.2, �Figure 14 Abortion Index for the Urban Area By Month and Period X 01 -a N Month D �TABLE 14 Analysis of Variance of'Abortion Index by Period, Area, and Month (See liable 13} Source of Variation Degrees of Freedom Sum of Squares Mean Square F-Ratio Periods 1 2,485.13 2,485.13 4.10 Areas 2 16,475.53 8,237.76 13.58* Months 1.1 3,377.82 307.07 <1 Periods x Areas- 2 3,498.08 1,749.04 2.88 Periods x Months 11 7,74.9.38 704.49 1.16 Areas x Months 22 25,156.81 1,143.49 1.89 Non-additivity 1 0.34 0.34 21 12,738.58 606.60 Residual p<.0002 51 <1 �abortion index of the Urban area for Period I is 59.4. When this is oonpared to the six-year mean for the Study area (80.8) and that for the Control area (65.4) using the New Duncan's Multiple Range Test it is found that both the Urban area and the Control area differ from the Study area (p<.05, two tailed), but not from each other. This seems a more conservative analysis since the reason for the precipitous decrease of the abortion index during Period II is presently unknown. Figure 12 is noteworthy for two reasons. First, there is striking similarity in the patterns, especially the "shoulders" on the curves following the peaks for each period. Second, the peak for the second period corresponding to a greatly increased pesticide usage is higher than that for the first period. Frequency Table Analyses Uniform Hypothesis^ Since the adjusted numbers of births used for the denominators in calculating indices appear sensibly flat (see Table 11) monthly variations in the cumulated number of spontaneous abortions were analyzed as simple frequencies (see Table 7). Under the hypothesis that monthly accumulated spontaneous abortions were uniformly distributed throughout the year, chi^square analyses were performed for each area. The urban area showed a significant variation among months due to a high number of spontaneous abortions in December and low numbers in July and November. The other two areas did 52 �not show significant variation among months/ but in the Study area the month of June had a significant contribution to the overall chi-square value. Further, in each area, various months showed large contributions to the overall chi-square. Expected Frequencies Based on Live Births; When the expected monthly frequencies of spontaneous abortions were calculated from the frequencies of corresponding live births from Table 11, the chi-square analyses were virtually the same as when based on the actual number of spontaneous abortions. Cyclic Trends Spectral Analysis! The Analyses of Variance and the chi-square analyses, together with a close study of Figure 11, strongly suggested the possibility of cyclic trends in the data. Power-spectrum analysis of the abortion index over months showed that for each area there was only one cycle of significance and it had a period of about four months in each area. Adjustment For Cyclic Trends: The importance of indentifying cyclic trends is two-fold. First, their presence might have some biological meaning relevant to this study. Second, a month-to-month comparison between the Study area and the Control areas should take into account phase differences which might be related to fertility patterns; or some other as-yet-unknown phenomenona. �The need for this type of adjustment is shown in Figure 15. Since the Study area and the combined Urban and Control areas seem to be almost exactly 180° out of phase, any month-by-month differences could be falsely amplified. Clearly, if the Control data are shifted back in time as shown in Figure 16, monthly differences could possibly reflect excess abortions in the Study area if they exist. Ihe Sine Wave Model; Since the power-spectrum analysis identified only one frequency for each set of data, it was decided to fit the simplest cyclic model: Index = A -f B Sin (,££ t - D) where t is in months. Table 15 shows quite clearly that this model adequately represents the data in the Urban and Control areas. Because of the peak in the Study area data around June and July, the model does not fit the Study area as well. Hie phase difference between the Study and the Urban and Control areas is on the order of two months. Tables 16, 17, and 18 show the Study area data adjusted for the Control and the Urban area and for both areas combined. Figures 17 and 18 show the sine wave models fitted to the abortion index data for the Study area and the Control and Urban Areas. 54 �FIGURE~15f SPONTANEOUS ABORTION INDEX, 1972 - 77 FOR THE STUDY AREA AND THE *" ' ' COMBINED CONTROL AND URBAN AREAS. (1404- STUDY AREA ao- - URBAN AND CONTROL | no, fioo'< ui C, 80, llo M 1 i I J F M L__ A L M 1 J Month J A S O N D �FIGURE 16: STUDY AND CONTROL AREAS: (a) COMBINED URBAN AND CONTROL INDEX, <b) STUDY AREA INDEX, (c) URBAN AND CONTROL INDEX SHIFTED BACK TWO MONTHS (i) CONTROL AND URBAN AREA 70 g so 40 tI 30 - I I I N M M 140 (b) STUDY AREA 120 *hoo 60 40 M M N J (e) URBAN AND CONTROL AREA WITH 2-MONTH PHASE SHIFT 80 70 X ui O ~ \ » 60 40 90 M M J J O N J -F �TABLE 15 Parameters of the Model "Index = A + B Sin (? t - D)" Ftor the Various Areas Control Urban + Control Study Urban A (Mean) 83.1 43.4 65.5 56.0 B (Amplitude) 15.6 15.2 24.7 15.6 T (Period in Months) 3.6 4.1 4.1 4.0 D (Phase Shift in Months) 1.1 3.1 2.2 2.8 Adequacy of the Model (Correlation) 0.49 0.78* ^* 0.05<p<.06 p<.001 57 .92** .84** �TABLE 16 Study Area Index Corrected for Phase Shifts Study minus Control —- 1 month lag Study Control Difference 48.1 (J) 28.1 (F) 20.0 82.2 (F) 48.1 (M) 34.1 93.8 (M) 97.5 (A) -3.7 61.9 (A) 63.2 (M) -1.3 89.9 (M) 46.0 (J) 43.9 130.4 (J) 55.3 (J) 75.1 105.4 (J) 79.8 (A) 25.6 88.1 (A) 85.3 (S) 2.8 46.0 (S) 50.5 (0) -4.5 76.2 (0) 54.3 (N) 21.9 76.7 (N) 94.5 (D) -17.8 70.3 (D) 82.0 (J) -11.7 �TABLE 17 Study Area Index Corrected for Phase Shift Study minus Urban — 2 month lag Study Urban Difference 48.1 (J) 43.9 (M) 4.2 82.2 (F) 47.0 (A) 35.2 93.8 (M) 50.8 (M) 43.0 61.9 (A) 44.9 (J) 17.0 89.9 (M) 14.6 (J) 75.3 130.4 (J) 31.8 (A) 98.6 105.4 (J) 49.6 (S) 55.8 88.1 (A) 54.8 (0) 33.3 46.0 (S) 19.6 (N) 26.4 76.2 (0) 45.6 (D) 30.6 76.7 (N) 73.9 (J) 2.8 70.3 (D) 49.3 (F) 21.0 59 �TABLE 18 Study Area Index Corrected for Phase Shift Study minus (Urban plus Control) — 2 month lag Difference Study Urban + Control 48.1 (J) 46.0 (M) 2.1 82.2 (F) 72.3 (A) 9.9 93.8 (M) 57.0 (M) 36.8 61.9 (A) 45.5 (J) 16.4 89.9 (M) 35.0 (J) 54.9 130.4 (J) 55.8 (A) 74.6 105.4 (J) 67.5 (S) 37.9 88.1 (A) 52.7 (0) 35.4 46.0 (S) 37.0 (N) 9.0 76.2 (0) 70.1 (D) 6.1 76.7 (N) 78.0 (J) -1.3 70.3 (D) 58.3 (F) 12.0 60 �STUDY AREA 130 H 120 110 Sine Wave Model 100 90 80 70 60 60 M M J Month N �FIGURE 18 PREDICTED AND OBSERVED POINTS ihOR THE URBAN + CONTr^ Ji. AREAS 80 - Urban + Control Areas 76 70 - 65 60 er» 55 50 45 40 35 I I M I I M N �Cyclic Analysis of the Numbers of Abortions; The raw numbers of abortions showed the same time behavior as did the indices. In order to find some rationale for cyclic variation in spontaneous abortions, a physician board-certified in obstetrics and gynecology was consulted. He was aware that births might show some high frequency cyclic behavior superimposed on a yearly cycle. The data for 1976-77 for Jackson Memorial Hospital in Miami, Florida are shown in Appendix B. A plot of these data suggests cycles of two-months duration. Plots of the Oregon birth data in this report suggest cycles of two-to-three-months duration. Clearly, these patterns need investigation since they might be viewed as "noise" in the data and thus obscure important relationships. Simple Number of Births as the Denominator for the Abortion Index; In order to see if any unanticipated algebraic relationships involved in computing the denominator for the index could be causing a problem, the raw numbers of births were used to compute abortion indices. The results of the analyses did not change from the above. Table 19 shows the distribution of births by month and the computed indices. Cross-Correlation Between Study Area Abortion Indices and Spray Pattern Cross-Correlation Analysis; A cross-correlation was computed between the abortion index for the Study area and the monthly pattern of spraying 2,4,5-T in pounds sprayed by month. 63 This �TABLE 19 Number of Births per Month and Unweighted Abortion Index for the Study, Urban, and Control Areas Oregon 1972 - 1977 Month Study Area Urban .Area January 194 51.5 338 74.0 124 96.8 February 188 90.5 353 48.1 124 32.3 March 202 89.1 344 43.6 126 55.6 April 189 58.2 335 47.8 131 100.9 May 201 79.6 357 47.6 155 58.1 June 228 105.3 378 39.7 145 41.4 July 203 98.5 315 15.9 156 44.9 August 212 80.2 351 31.3 131 76.3 September 204 44.1 342 49.7 154 71.4 October 170 88.2 343 55.4 136 51.5 November 172 93.0 337 20.8 155 51.6 December 181 82.9 327 48.9 129 108.5 2344 80.1 4120 43.6 1666 65.8 Total/Average 64 Control Area �FIGURE 19 (a) STUDY AREA ABORTION INDEX CORRfcCfED FOR PHASE-SHIFTED URBAN INDEX; (b) POUNDS OF 2,45-T SPRAYED BY MONTH (a) 100 —i CORRECTED INDEX • / 50 \ • M •p • •• te \ m us 0 — 4 2.4,5 - T (POUNDS) X 1,000 -I 3 . 2 1 0 .J I J F M A M i J i S i O I N D �FIGURE 20 CROSS-CORRELATION OF STUDY AREA ABORTION INDEX WITH SPRAY PATTERN IN TOTAL POUNDS OF 2,4,5-T APPLIED BY MONTH. 1972-77. .8 .7. 0.72 ** 0.61 .6 .5 .4- z o H .3 UJ CC CC O u o cc u .1 o.io o.io 0 -.1 - -0.09 -.2 -.3 -.5- i f I iI 4 3 2 1 0 Month* Shift in Spray Data �analysis showed that the abortion index for the Study area was significantly correlated (p<.01) with the spray pattern after a lag of two (r=.70) to three (r=.76) months (see Figure 20). To avoid problems with a non-normal distribution of the spray data, a Spearman rank correlation corrected for ties was computed. The twomonth lag was not quite significant (r=.46), but the three-month lag was (r=0.58, p<.05). Cross-Correlation Between the Adjusted Study Area Index and the Spray Pattern Removal of the Cyclic Trend: The differences shown in Tables 16, 17, and 18 now appear to be free of cyclic trends. This is shown in Figure 19. Thus, the adjusted indices over time can be related to the spray pattern over tijne in a straight-forward way. This is a more conservative approach than to use the unadjusted differences between the Study area and the Control or Urban areas when correlating with the spray pattern,, Cross-correlation of Spray Pattern with Adjusted Abortion Index; From Figure 19 it appears that the peak in the corrected abortion index for the Study area follows the peak in the spray pattern by two to three months. This is borne out in Table 20 which shows significant correlations (p<.01) after two months. 67 �TABLE 20 Cross - Correlation of Corrected Study Area Index with Spray Data lag (months) 1 2 3 -.07 0.46 0.88* 0.42 -0.04 Study vs. Control -0.22 0.35 0.84* 0.33 -0,23 Study vs. Urban + Control 0.10 0.48 0.81* 0.42 0.11 Study vs. Urban JK.01 68 �TABLE 21 Pounds of 2,4,5-T Applied in the Alsea Basin and Abortion Index For the Study Area by Month and Period Oregon, 1972-1977 PERIOD I PERIOD II (1972 - 3 - 4) Abortion Index (1975 - 6-7) Pounds 2,4,5-T Abortion Index Pounds 2,4,5-T January 48 0 48 0 February 77 0 87 0 March 94 296 94 1158 April 45 290 79 2990 May 112 471 67 317 June 98 0 163 0 July 95 288 116 16 August 76 365 104 195 September 61 0 31 0 October 71 0 81 0 November 105 0 48 0 December 84 0 56 0 69 �TABLE 22 Cross-Correlation of Study Area Abortion Index with Spray Data Lag (months) 0 1 2 3 4 Period I 0.19 -0.06 0.27 0.31 Period II 0.32 -0.24 0.31 0.66 Spearman .Rank Correlation corrected for ties 0.01 <p<0.05 70 ** 0.00 0.00 �Abortion Index/Spray Pattern Cross-<torrelation Analyses for Periods I and II Table 21 shows the pounds of 2,4,5-T used by month and the abortion index by month for Periods I and II (1972-74 and 1975-77). Crosscorrelation analyses were conpleted between the abortion indices for each period and the respective monthly patterns of spraying 2,4,5-T in pounds sprayed by month in the "Msea Basin." Since the spray data are clearly not approximately normally distributed, a Spearman Rank Correlation corrected for ties was done to find the cross-correlation between spray patterns and the abortion index in the Study Area. The results are shown in Table 22. These correlations show the same pattern as those for the six-year aggregate of data (see Table 20), although the correlation does not reach significance for the Period I data. Physician Interviews Table 23 liscs the physicians' estimates of the number of spontaneous abortion cases of terms less than 20 weeks treated per year (1972-77) and the percentage that were hospitalized. Of the 19 doctors contacted at the four hospitals in the Study area, four refused to provide estimates and four indicated they did not handle such cases. The remaining 11 physicians provided positive 71 �.responses on number of cases handled and/or percentage hospitalized. Assuming that the four who refused to respond do handle such cases, 79% (15 of 19) of the physicians contacted have treated spontaneous abortions during the study period. From the physician interviews, it is estimated that approximately 70% of the spontaneous abortion cases are hospitalized among those treated by physicians practicing at one of the Study area's four hospitals. Ihe percentage is calculated by weighting the individual hospitalized percentage estimates by the respective number of cases treated by each responding physician. It is concluded, therefore, that the abortion data presented for the Study area are, indeed, representative of that area. It is further assumed that because of the aforementioned medical/population similarities between the Study and the Control areas, a similar representative percentage of spontaneous abortions are hospitalized in the Control area. The percentage of spontaneous abortion cases hospitalized in the Urban area is estimated to be approximately 30%. (Ihe estimate is adjusted for general practitioners not selected for interview). Ihe percentage is clearly less than that for the Study area, apparently due to those cases treated at the clinic and medical center facilities not available in the Study area. The data are considered to be reflective 72 �of seasonal spontaneous abortion patterns; however, Urban area index values are undoubtedly biased downward relative to those for the Study and Control areas. 73 �TABLE 23 Study and Urban Area Physician Interviews: Estimated Numbers of Spontaneous Abortions Treated Annually and Percentages Hospitalized, 1972 - 1977 Annual Mean Number of Spontaneous Abortion Cases, Percent 1972 - 1977 Hospitalized Type of Patients A GP * B GP 0 GP 0 D2 GP 10.0 E3 Pacific Communities Newporte, OR (9 Physicians) Contacted Physician C1 Hospital GP 0 75-80 — 95 — Western Lane Hospital Florence, OR (6 Physicians) F G GP H 1.5 GP GP I 20-30 Uhknown 6 GP, Surgery 25 1.5 95 ** New Lincoln Hospital Toledo, OR (4 Physicians) GP 15 75 K GP 7.1 50 L GP * M GP 0 N GP 0.3 74 — 100 �TABLE 23 (Continued) Annual Mean Number of Spontaneous Abortion Cases, Percent 1972 - 1977 Hospitalized North Lincoln Hospital Lincoln City, OR (8 Physicians) Type of Patients O GP 5.0 80 P GP 5.0 80 Q Hospital Contacted Physician GP * GP * GP * R S — — — Good Samaritan Hospital Corvallis, OR T GP 5.0 80 U5 GP 1 50 V6 GP 3.9 30 w GP * X — Internist 0 Y OB/GYN 50.0 — 10 z OB/GYN 50.0 10 AA OB/GYN 50.0 10 BB OB/GYN 50.0 10 CC Internist 0 DD GP 11 75 — 0 �TABLE 23 (Continued) Hospital Contacted Physician Type of Patients Annual Mean Number of Spontaneous Percent Abortion Cases, 1972 - 1977 Hospitalized EE OB/GYN 50.0 FF OB/GYN 0 GG OB/GYN 50.0 10 KH Good Samaritan Hospital Gorvallis, OR (continued) OB/GYN 50.0 10 Refused to release data. ^•Physician C has practiced in the community since January 1978. 2 Physician D has practiced in the community since 1975. ^Physician E has practiced in the community since 1977. Physician J has practiced in the community since 1976. ^Physician U has not taken any obstetric cases in past three years. Physician V has practiced for 14 months. 10 �Chapter V SUMMARY AND CONCLUSIONS the objectives of the study were to test the following hypotheses: (a) whether or not differences in spontaneous abortion rates between the study and control population; (b) whether or not seasonal variations in rates exist within the study and control populations; (c) whether or not such variations, if they exist, can be associated with time and concentration of spray applications in the Study area. The statistical einalyses of the spontaneous abortion and spray data presented herein to test these hypotheses have demonstrated that: 1. The 1972-77 abortion rate index for the Study area is significantly higher than those for either the Control or the Urban area. 2. There is a statistically significant seasonal cycle in the abortion index in each of the areas with a period of about 4 months. In particular/ there is an outstanding peak in �3. There is a statistically significant cross-correlation j between the Study area spontaneous abortion index and spray patterns in terms of pounds applied by months in the Alsea basin, 1972-77, after a lag time of 2 or 3 months. The results based on the six-year aggregate of abortion and spray data are confirmed and enhanced by the analysis of the two 3-year aggregates. The cyclic time patterns are consistent over time periods; the Study area shows an elevated abortion index over the Control and the Urban areas; and there is a peak in the abortion index which correlates positively with the spray pattern in the Alsea basin after a lag time of 2 to 3 months. For all its complexity, however, this analysis is a correlational analysis, and correlation does not necessarily mean causation. 78 S^ �REFERENCES 1. Rebuttable Presumption Against Registration and Continued Registration of Pesticide Products Containing 2,4,5-T. Environmental Protection Agency, Office of Pesticide Programs, Washington, D.C., Federal Register [6560-01] Vol. 43, No. 78 Friday, April 21, 1978. 2. Farm Chemicals Handbook - 1978. R. L. Meister, Jr. (ed.), Meister Publ. Co., Willoughby, Ohio, pp. 250-251, 1978. 79 �80 APPENDIX A QUESTIONNAIRE: Oregon Miscarriage Investigation NAME DATE ADDRESS Prior addresses: COUNTY STATE CITY COUNTY ccuNTr STATE to 19 From 19__ to 19 STATE CITY to 19 From 19 ^YY From 19 Family Physician: NAME ADDRESS ] Date of Last Complete Physicial Examination PHONE �I'RKCNANCY DATA 1'lease list all pregnancies — If more than 5, ntUl pages. If the answer to any question Is "yes" please specify time in weeks of gestation and describe fully. PKECNANCIES 1st 2nd 3rd 4th 5th Month_uml_year of conception Residence during pregnancy: (City, County, State) Indicate live births (give date) (I) Full Term ___ I'remalire S t i l l births/Spontaneous °" Induced abortions ([•ive date) Weeks of gestation ., 02.) Any hi rili defects, mental -deficiency, or other eongun 11 a 1 J mpa1rment ? (Answer No, Yes_ (describe) «ir unknown) oo �PREGNANCY DATA CONTINUED PREGNANCIES 1st 2nd 3rd Ath 5th For HvebJrths, did you experience spotting during pregnancy? For inlHcnrrlageH and jjtl 1 ll»i rl liJi, was there a long period of illness find spotting, or was miscarriage sudden? Weight change during proRiiuncy (Ib). Hid your doctor tell you that your weight gain WUH excesKive? Old your doctor indicate that you had high blood pressure during pregnancy? Did your doctor Indicate that you had kidney In fuel lun during pregnancy? (Weeks of I'rsl at Ion) a 00 to �PREGNANCY DATA CONTINUED PREGNANCIES 1st 2nd 3rd Ath 5th Did lie prescribe any iHtiiitr.u tions for weight control, high blood pressure, or kidney Infections? If yes pleaae specify mod i en t Ions. Did you have any respiratory Infections during pregnancy? i^mH.kji J*_L ^ejitat Ion) Did you use any of the following medicat Ion prior to or during pregnancy? If yes, Indicate how often. 1. Orn.l contraceptives 2. Hormone H 3. Antlnauseants Ant Ih istamines A. 5. AiULL'LljL 0. 7. 8. 0. 10. A n I I b l o t Irs (Specify) SJ ji£ p I ng^ ,P_n_1_s_ V] _tanij n s Traiu|u( L i z u r s (specify) Other medications (spec i f y) to �PREHNANCY 1>ATA CONTINUED PRECNANCIES 1st 2nd 3rd 4th 5th Hit! you use any of the following prior to or during pregnance? (Specify kind, amounts, frequency and when) J. Tobacco 2. Alcohol j. Marijuana 4. "Drill's" (coccaine, I.SD, etc.) Did you suffer any physical Jujuries during pregnancy? (If yea, .show kind, weeks of pregnancy, was physicians <:;\fi". required.) Were you X-rayed during pregnancy? (If yes, '-lLLy- LYIM1 and how often) oo .u �PREGNANCY DATA CONTINUED PREGNANCIES 1st 2nd 3rd 4th 5th What household chemicals (paints, garment cleaners, solvents, pesticides) were yon exposed to prior to or during pregnancy? (Specify J2nil how often) MUM your pregnancy confirmed by a physician if an early ml jU'nrr I age? Was your ml.scarrlage by a physician? oo in �86 PREGNANCY OUTCOME OF SISTERS For each of your sisters, please list pregnancy outcomes. Total number of pregnancies City of Residence 1. 2. 3. 4. 5. 6. Present Age Full term Premature Spontan. Induced Abortions Abortions �87 MEDICAL HISTORY A. SUBJECT'S: Have you had any of the following diseases or disorders in you lifetime? NO 1. Measles: Regular German 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. Infectious heptatitis Pneumonia, other respiratory infections Allergies (asthma, hay fever, drug reactions) Blood disorders, anemia Heart disease High blood pressure Kidney disease; cystic nephritis, etc. Diabetes Thyroid disorders Stomach disorders, ulcer Small bowel disorders, ileitis Large bowel disorders, colitis Nervous system disease, central, peripheral Epilepsy Muscle system disorders, paralysis Skeletal (bone) disorders Skin disease V.D. Congenital defects Mental illness Other (Please List) YES If yes, when/how long? �88 MEDICAL HISTORY (CONTINUED) B. Subject's hospitallzations, excluding pregnancies: APPROXIMATE DATE PLACE LENGTH Or STAY REASON C. MENSTRUAL INFORMATION: 1. Are your menstrual periods regular? No, „ Yes. 2. Would you characterize your menstrual period as (check one): a. Probably light b. Probably average c. Probably heavy D. SUBJECT'S FAMILY !• Did subject*s_father, or father's brother(s) or sister(s) suffer from any congenital defect? ,.L No, Yes, Not sure. If yes, please list: Father His brother(s) His sister(s) Bid subject's mother, or mother's brother(s) or sister(s) suffer from any congenital defect? No, Yes, Not sure. If yes, please list: Mother Her brother(s) Her sister(s) • �89 MEDICAL HISTORY (CONTINUED-) - Mother's pregnancies: Total number How many were full term How many miscarriages , ? ? If known, during which week(s) of pregnancy 4. Did any of subject's brothers suffer from any congenital defect? No, ___ Yes, Not sure. If yes, list type of defect: 5. Major illnesses or diseases of brothers: 6. Did any of subject's sisters suffer from any congenital defect? No, Yes, No sure. If yes, list type of defect: __ 7. Major illnesses or diseases of sisters: �ENVIRONMENTAL ASPECTS PREGNANCIES 1st How m:iny miles la (was) your residence or place of work from the nearest area sprayed wil.li herbicides during each pregnancy? t.o«ihi you ever smell the chemical at the time Jt was applied to the Forest? (If yes, specify during wh^ch pregnancies.) What IB (was) the source of your water supply? ^VI» t you ever aware of a. iu the taste of your water during or soon after herbicide. •MM'! ll'ilt: l()_u'' Were your garden & flowers, trees, shrubs ever damaged when herhicide \j.\u applied lo I lit- forest? 2nd 3rd 4th 5th �F.NV1 RONMENTAI. ASPECTS CONTINUED PREGNANCIES , _ . . . . _ . _ _ - . _ , . . _..., r ~ 2nd 1st 3rd 4th — — ••• ~ " •• 5th hiring _ No, rise etc.) ever been tested for pesticide residues? hen s? 1 By whom (list) lere they may he obtained No, Yes, Not sure, vo �92 FOOD SUPPLY AND DIET A. What percentage of your meat and poultry products are raised locally? %, B. What percentage of your fruits and vegetables are raised locally? %. C. Does your milk come from local cows? Some(%). No, D. Do you have a home garden? Yes. No, Yes, E. Do you eat game taken from local forest areas that have been treated with herbicides? No, Yes. Kind? Approximate number of meals per year . �93 HOUSEHOLD PESTICIDE USAGE 1. Has a commercial applicator treated your residence for pests within the past five (5) years? _ Yes, _ No, _ Unknown. 2. Has your residence ever been treated for termites? __ No, _ Unknown. rr Yes, 3. Within the past five (5) years has your household used no-pest strips? _ Yes, _ No, _ Unknown. 4. Within the past five (5) years has your household used any of the following pesticides on pets? Insecticide Collar _ Yes, _ No, _ NA Insecticide Shampoo _ Yes, _ No, _ NA Insecticide Powder _ Yes, _ No, _ NA Other . __ ; __ 5. Within the past five (5) years have you used moth balls, crystals, flakes, or aerosols? _ Yes, _ No, _ Unknown. 6. Within the past five (5) years have pesticides been used in the: House _ Yes, No. Garden _ Yes ,_ No, _ NA. Yard _ Yes, __ No, _ NA.. 7. Are any pesticides stored on the premises? _ ,_ n _ Unknown. Yes, __ No,, 3. Within the past five (5) years have you used any disinfectants? _ Yes, _ No, _ Unknown. �94 02H.G1S 10K S3EIO 1KZJ3SVE KD'dC;Z >1DY£ C3HS 33VHVO 1 i I IP** 03 S ', app-psad STU3 st i •TPB.IC aq3 uo aj»M*1 i UZH10 G2E ^ZM01£ g K3CKVD 31ffY13D3^i 3SBC sq3 UT: pssn (•OMB i uFq3 Z 3 U ^ C) CHYA NWYT sfq3 SBU sastn 30VEVO sad aq3 uo ejeq^i asnoH isasfmaad aq3 uo pajoss X^suaaano BIB appjassd STUS 10 saouno XUBTU «.OH T pasn p-jouasnoq jnoX 30 aaqnam XUB ao aABq apTOT3S9d STU3 io Eaouno Xusc WOK i-thot- SJB s-[osoaav) icuoz pT^os anos ao pTnbT~[ UT appT^sed s-pq i si ainbn p-jo SO.A 8T>- ailED • P'[o SAA sT<-iinoY "asnio 31VK3£ - OV3H GlOHHSnOH 3TVK - OV3H QlOHHSnOH stq3 jpasn ou_fi TV13H3KKOO t: o C? W «H »-4 ^J C . *- o c •uwouVj 57 aaqnnu 3"j3sad pasn-uou jfB go saireu ©q3 pue saBaX aAfg 3sed aq3 pioqasnoq aqs Xq pasn sap^o -T3sad TJB 30 saniBU aac 3Bu/i PESTTCtDE NAME w e. _ — 1 — —i _ i — — 1 — — — — — — — — — . — i ii — i — i 1 — — —• — — — i __ *•• ••* _ — — — — — — — — — — — — - * — •W . MOT — *•" _ — - — — E - — — — **** — •*• — — — - — — — — — — ••" — MM — — — — — — — — — — — _ — — — — V ^~s H O L/*' C^ 1 i i i 1 — - K s ; ! — KOOS nniin «3K1C-K3E01I2 htws ^sQ!wr:-:ISEDIIX |a3yc)1S IOK j,aat:TE3uo: T EUlSTJO S3f OK ;T tpaaoss app sad siq3 sj S3i CIHOIS IOX i,A*avL pu'E spoi aapun OK paao3s apppsad STqs si S31 3KOX • 'HiKIO i SlSa 5 K3EC1IED 01 SilKIl-iJO YZHY SGNTn HSVfi ^apTOT3sac r XSVK S"j:q3 2n-isn uaqw ua^B3 T S3AOTD 5 SUO-pn^Oaid JO SdA3 3^Uf. S100E ^sqsubc 21 3SEC aq3 uf pasn • sj^a/ i _ i __ ^™* — — — — — — — — — — — — ™* — — �95 OCCUPATIONAL HISTORY OF SUBJECT Please list any employment: Employer (location) Describe Type of Business Job Title Beginning and ending Dates Do you launder your husband 1 s work clothes with family wash? Yes No OCCUPATIONAL HISTORY OF HUSBAND Employer (location) 1. 2. 3. 4. 5. 6. Describe Type of Business Job Title Beginning and ending Dates �96 THESE QUESTIONS REFER TO HUSBAND'S OCCUPATION: Was This Job Was Protective Considered Equipment, or Dangerous Clothing Available (1) Did He Inhale Did Chemical Solvents Chemical Solvents Oils,, Dusts, etc. Get Dust or Other Fumes? on His Skin/Clothes? Yes No If .yes, why? Yes No If yes, what was it? Yes No If yes, list if known: (2) Yes Yes Yes. No No If yes, "what No If yes, list if known: •If yes, why? was it? Yes No If yes~n 1st if known: Yes No If yesTl ist if known: (3) Yes Yes . No Yes No If yes, what No If yes" list if known: Yes No If yes, 1 1st if known: was it? Yes No If yes"7 list if known: Yes No If yes, 1 ist if known: Yes No If yes, what was it? Yes No If yes, list if known: Yes No If yes, 1 ist if known: If yes, why? was it? (4) Yes Yes No If yes, why? No If yes, what (5) Yes ' No If yes, why? �97 THESE QUESTIONS REFER TO HUSBAND'S OCCUPATION CONTINUED: Was This Job Was Protective Considered Equipment or Dangerous Clothing Available (6) Yes No If yes, why? Yes No If yes, what was it? Did He Inhale Did Chemical Solvents Chemical Solvents Oils, Dusts, etc. Get Dust or Other Fumes? on His Skin/Clothes? Yes Yes No ~ ~ If yes, list if known: No " ~ " If yes, list if known: 1. Did your husband serve in Vietnam? service. Yes, No, Months of 2. If ves, was he directly involved with spraying of Agent Orange ___ Yes. No, 3. Was he otherwise exposed to Agent Orange during his military activities? None; Some; Often. 4. Has your husband ever had a sperm examination? If yes, were abnormalities suspected? 5. Has your husband ever had V.D.? No knowledge. 6. Has your husband ever used marijuana? No know!edge. No, No, No, Yes. Yes (specify), No, Yes, 7. Has your husband ever used "drugs" such as coccaine, LOS, etc? No, Yes, No knowledge. Yes. �EDUCATIONAL BACKGROUND Did you graduate from high school? No, Yes, Class of 19_ If not, what was the highest grade completed? Did you graduate from college? degree's and year's If not, did you attend college? No, . No, __i . Yes, Yes, Did your husband graduate from high school? Class of 19 . Years. No, Yes, If not, what was the highest grade he completed? . Did your husband graduate from college? No, List degree1 s and year' s Yes, . If not, di'd your husband attend college? No, Yes, Years, �LA » 0 R ROOK S T A T I S T I C S Jtdutaa Kescrial Sbspitzl APPENDIX B 1977-1S7S CC liLl 76 77*76 WOV. DSC. 5S4 352 570 461 563 491 (•40 Z* 503 I -. MSL I m I i* t* nft * (471 t I IS73 I f?c 4.74. I I ! eat I I 1531 1 5 2 4 47 76-' 7-7 S SS?T. wVt I go .<tc 7i •13 65 il jLiveSirt'-s 76-77 1 l 29 Staff is -1 3C •7 i= • ; iS5£ 1515 it s s 1 52= 1570 = 1 i ...2_2 U45 L22 L 1?_ i 13 I ;~" I 4=2 i 514C ii:« I ; Private I I 1423 21 I 1425 |4S5 I 4 4 C 134? 1472 3 1273 1 3 7 = 1257 US! I1C5 1125 2 I 94 I 67 I1C1 I 1 C 2 I I 12 .14 K=J U42 I 1529 90 I 95 e I I £2 jiCC i £5 I 9£ I 72 I 65 I rC I 95 95 i 95 I £5 I 52 I t 5 I 10 S i Staff :ulti Pr*cr.ar.cias 7£-77 4 9 | ! 12 I 6:, I 9C I I " 66 t 51 3 I ! I I 12 i -i 1.6. I I I 71 I 63 j 43 i 4 I I I | 42 2 S I ' I /o- 77-?? I IT ! *3C4 I 24 U3S / o— /• Stiff 77-7S I 19 1270 1422 121" 24 1545 Staff i3=2 I 39C I 13 HC2 I 77 I5C7 | 464 I I i'4i£ i 4 7 5 I 1470 Staff I t | 54 j 73 *fi J L i ( j 1" I ! 62 1123 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 027 Folder The folder containing the original item. 0421 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/. Description An account of the resource Corporate Author: Epidemiologic Studies Program, Human Effects Monitoring Branch, Benefits and Field Studies Division, Environmental Protection Agency (EPA), Washington, D.C. Date A point or period of time associated with an event in the lifecycle of the resource February 28 1979 Title A name given to the resource Report of Assessment of a Field Investigation of Six-Year Spontaneous Abortion Rates in Three Oregon Areas in Relation to Forest 2,4,5-T Spray Practices Subject The topic of the resource dioxin congenital birth defects civilian impact herbicide application ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 028 Folder The folder containing the original item. 0431 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Source A related resource from which the described resource is derived The Lancet Date A point or period of time associated with an event in the lifecycle of the resource October 3 1981 Title A name given to the resource Seveso After Five Years Subject The topic of the resource chloracne congenital birth defects civilian impact ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 028 Folder The folder containing the original item. 0447 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Aldred, J. E. Description An account of the resource Corporate Author: Consultative Council on Congenital Abnormalities in the Yarram District Date A point or period of time associated with an event in the lifecycle of the resource September 26 1978 Title A name given to the resource Report of the Consultative Council on Congenital Abnormalities in the Yarram District Subject The topic of the resource AVHS congenital birth defects ao_seriesIII