Anencephaly: agent orange implications?
A case of anencephaly is presented and the question of its association with Dioxin ("agent orange") is raised.
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A case of anencephaly is presented and the question of its association with Dioxin ("agent orange") is raised.
Some of the readjustment problems of Vietnam veterans have been attributed to posttraumatic stress disorder (PTSD). This case-control study compared demographic and military characteristics of 374 Vietnam veterans who had PTSD with 373 healthy Vietnam veterans. Veterans were chosen from the Agent Orange Registry, a Department of Veterans Affairs computerized database of approximately 200,000 Vietnam veterans who volunteered for a physical examination. Case patients and control subjects were frequently-matched by age, year of Registry examination, and race. Crude odds ratios (OR) were used to evaluate the risk of PTSD associated with certain characteristics of Vietnam service, as there was no apparent confounding by other military factors. Being wounded in Vietnam (OR, 2.33; 95% confidence interval (CI), 1.49-3.65) and having a combat job in Vietnam (OR, 1.54; 95% CI, 1.15-2.06) were the only risk factors for PTSD. Those who had noncombat jobs but were wounded had the highest risk of PTSD (OR, 3.56; 95% CI, 1.26-10.06).
Since the late 1970s several epidemiological studies have appeared linking exposure to phenoxy herbicides or chlorophenols to some malignant tumors. Most of these compounds are contaminated with dioxins and dibenzofurans; for example, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a contaminant of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), a component of Agent Orange which was sprayed in Vietnam during the war. The results of some of the epidemiological studies on cancer risks associated with exposure to these compounds have been manipulated and misinterpreted, particularly by the Australian Royal Commission on the Use and Effects of Chemical Agents on Australian Personnel in Vietnam. Furthermore, a book on Australian war history entitled Medicine at War, commissioned by the Federal Government, reiterates several of these misinterpretations, despite available contrary evaluations from Australian and U.S. authorities. These remarkable and confusing circumstances in the scientific process are considered also in the light of the recent classification of TCDD as carcinogenic to humans, Group 1, by a Working Group at the International Agency for Research on Cancer in Lyon, France.
This article discusses the use of sprayed herbicides during the Vietnam conflict and the health problems exhibited by the veterans exposed to these chemicals. A short history of health problems attributed to herbicide exposure is given. Experimental research on the effects of dioxin, a byproduct in the manufacture of some herbicides, is limited to laboratory animals. In every instance the tested animal exhibited some ill effects following exposure. The research has shown that the lethal dose varies according to animal species and that the effects of dioxin exposure are cumulative. Reasons are given for the lack of research on the effects of human exposure. Numerous physical and psychological signs and symptoms attributed to agent orange exposure are listed. The stresses on the veteran with these health problems are discussed. The nurse practitioner may be the first health care professional to see these patients. Specific interventions are suggested for the nurse to incorporate into practice.
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The Evatt Royal Commission Report on the Use and Effects of Chemical Agents on Australian Personnel in Vietnam has authoritatively rejected the substantive claims that were made by the Vietnam Veterans' Association of Australia about the adverse effects of exposure to phenoxy herbicides in Vietnam on the health of Vietnam veterans and their families. The Commission concluded that Vietnam veterans were not exposed to toxic levels of chemicals in Vietnam; that they are not at any increased risk of fathering children with birth defects, or contracting cancer; and that, although they have slightly higher rates of psychiatric disorder, heart disease, alcoholism and alcohol-related disease, these effects are unconnected with exposure to chemicals in Vietnam. The reasons for these findings deserve to be given the widest possible publicity. Only by doing so is there any prospect of dissolving the misapprehension that Vietnam veterans have been poisoned by herbicides.
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