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PubMed1987

Mortality among Australian conscripts of the Vietnam conflict era. II. Causes of death.

In a cohort of Australian national service conscripts, death rates from International Classification of Diseases, Eighth Revision (ICD-8) cause of death classes for 19,205 veterans of the Vietnam conflict were compared with those of 25,677 veterans who served only in Australia. Comprehensive, clinically reviewed cause of death data were collected and coded to a single ICD-8 three-digit cause of death code by the Australian Bureau of Statistics. Over 98% of the deaths among veterans were included in five classes of causes of death. These were neoplasms (14%), diseases of the circulatory system (7%), accidents, poisonings, and violence (external causes) (74%), and diseases of the digestive system and mental disorders (2% each). For the last two classes, chronic abuse of alcohol was a common factor in most deaths among Vietnam veterans. The death rates of Vietnam veterans were statistically significantly higher than those for other veterans for only two classes of causes of death: diseases of the digestive system and external causes. After adjustment for Army corps grouping, this excess was not statistically significant for external causes. There was no statistically significant difference in death rates from neoplasms, nor were deaths from specific neoplasms more frequent among the group that served in Vietnam. While this suggests that service in the Vietnam conflict has not increased death rates from neoplasms among servicemen, the follow-up period, ranging from 9-16 years, is shorter than the latency period for some neoplasms. The study findings provide a measure of support for claims by Australian Vietnam veterans of an increased incidence of stress-related disorders associated with service in the Vietnam conflict.

Adult↗
PubMed1990

Combat experience and postservice psychosocial status as predictors of suicide in Vietnam veterans.

The authors examined potential risk factors for suicide among 38 Vietnam veterans using 46 Vietnam veterans who died from motor vehicle accidents as a comparison group. The veterans were selected from Los Angeles County Medical Examiner's file (1977-1982). Data for these veterans were obtained from military service records, the coroner's reports, and the psychological autopsy conducted with the decedents' family members. No military service factor was associated with suicide. The characteristics of Vietnam veteran suicide cases were not substantially different from non-Vietnam veteran suicide cases with respect to known demographic risk factors. The psychological profile of Vietnam veteran suicide cases are also similar to non-Vietnam veteran suicide cases in most instances. Symptoms related to posttraumatic stress disorder were observed more frequently among suicide cases than accident cases. However, suicides were not associated with specific combat experiences or military occupation. The extent of combat experience in Vietnam per se as measured in this study is not a good predictor of suicide death.

Adult↗
PubMed1988

Proportionate mortality study of US Army and US Marine Corps veterans of the Vietnam War.

The patterns of mortality among 24,235 US Army and Marine Corps Vietnam veterans were compared with that of 26,685 non-Vietnam veterans using standardized proportional mortality ratios. The veterans were a random sample of deceased Vietnam-era veterans identified in a Veterans Administration computerized benefit file. Military service information was obtained from military personnel records, and cause of death information from death certificates. Statistically significant excess deaths were observed among Army Vietnam veterans for motor vehicle accidents, non-motor vehicle accidents, and accidental poisonings. Similar findings have been reported in other studies of Vietnam veterans. Suicides were not elevated among Vietnam veterans. The Marine Corps Vietnam veterans appeared to have an increased mortality from lung cancer and non-Hodgkin's lymphoma. Although exposure to several environmental factors may be speculated, this study did not investigate possible etiologic factors for these elevated malignancies.

Accidents↗
PubMed2000

Posttraumatic stress disorder among Hispanic Vietnam veterans.

OBJECTIVE: The purpose of this study was to examine posttraumatic stress disorder (PTSD) among Hispanics who served in the Vietnam War. METHOD: The authors conducted secondary data analyses of the National Vietnam Veterans Readjustment Study, a national epidemiologic study completed in 1988 of a representative sample of veterans who served during the Vietnam era (N=1,195). RESULTS: After adjustment for premilitary and military experiences, the authors found that Hispanic, particularly Puerto Rican, Vietnam veterans had significantly more severe PTSD symptoms and a higher probability of experiencing PTSD than nonminority veterans. However, they had no greater risk for other mental disorders, and their greater risk for PTSD was not explained by acculturation. Despite their more severe symptoms, Hispanic veterans, especially Puerto Rican veterans, showed no greater functional impairment than non-Hispanic white veterans. CONCLUSIONS: Hispanic Vietnam veterans, especially Puerto Rican Vietnam veterans, have a higher risk for PTSD and experience more severe PTSD symptoms than non-Hispanic white Vietnam veterans, and these differences are not explained by exposure to stressors or acculturation. This high level of symptoms was not accompanied by substantial reduction in functioning, suggesting that the observed differences in symptom reporting may reflect features of expressive style rather than different levels of illness.

Acculturation↗
PubMed1981

Current excessive drinking among Vietnam veterans: a comparison with other veterans and non-veterans.

Analysis of recent data collected in a 1977 U.S. national epidemiologic study of substance abuse revealed that Vietnam veterans (N=87) had substantially higher levels of alcohol consumption and binge drinking, than comparable groups of Vietnam "era" veterans with no Vietnam service (N=107), other veterans (N=483), and nonveterans (N=2,600). Vietnam veterans and Vietnam era veterans also had a somewhat higher level of drug abuse than expected for individuals from similar social backgrounds. Multiple Classification Analysis (MCA) was the technique used to adjust for demographic differences between these four groups. The results of these analyses reinforced previous research findings and substantiated the President's Commission on Mental Health, which speculated that alcohol abuse may become a special health problem among this population. Since evidence for "post-traumatic" or delayed stress among Vietnam veterans has been culminating, and some research has indicated a link between stress and increased alcohol consumption, it was suggested that the drinking pattern found among this Vietnam veteran sample may be a symptom of post-traumatic stress.

Adult↗
PubMed2002

Persistent organochlorine residues and their bioaccumulation profiles in resident and migratory birds from North Vietnam.

Concentrations of persistent organochlorines (OCs), such as polychlorinated biphenyls (PCBs), 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) and its metabolites (DDTs), hexachlorocyclohexane isomers (HCHs), hexachlorobenzene (HCB), and chlordane compounds (CHLs), were determined in whole-body homogenates of resident and migratory birds collected from the Red River estuary, North Vietnam, during March and October 1997. Contamination pattern was in the order of DDTs > PCBs > HCHs > CHLs > HCB in both resident and migratory birds. Residue concentrations, according to the feeding habit, showed little variability, which may reflect relatively similar trophic levels of the bird species analyzed. Resident birds accumulated greater concentrations of DDTs as compared to migrants. In contrast, HCH residues were greater in migratory species. Higher proportions of p,p'-DDT to total DDT concentrations were found in many species of residents and migrants, indicating recent exposure to technical DDT in northern Vietnam. Congener-specific PCB analysis showed the predominance of penta- and hexachlorobiphenyls in all the species analyzed. Estimation of hepatic microsomal enzyme activities suggested higher metabolic capacity for PCB congeners in shore birds from Vietnam as compared to higher-trophic predator birds and marine mammals. Comparison of OC residues in avian species in Asia-Pacific revealed that DDT residues in resident birds in North Vietnam are among the highest values reported for the countries surveyed, suggesting recent usage of DDT in Vietnam. Available data for birds, fish, and bivalves from the recent Asia-Pacific Mussel Watch Program suggested that Vietnam might be a potential source of DDT contamination in Asian developing countries. To our knowledge, this is the first study of the OC accumulation in avian species from Vietnam.

Animals↗
PubMed1990

The association of selected cancers with service in the US military in Vietnam. I. Non-Hodgkin's lymphoma. The Selected Cancers Cooperative Study Group.

As part of a series of investigations into the health of Vietnam veterans, we conducted a population-based, case-control study of non-Hodgkin's lymphoma between 1984 and 1988. All men born between 1929 and 1953 and diagnosed as having non-Hodgkin's lymphoma in an area covered by eight cancer registries were considered eligible. Control subjects were identified by random-digit dialing from these same regions and were frequency-matched to men with lymphoma by age. Analyses of 1157 men with pathologically confirmed lymphomas and 1776 control subjects showed that the risk of non-Hodgkin's lymphoma was approximately 50% higher among Vietnam veterans (odds ratio, 1.47; 95% confidence interval, 1.1 to 2.0) compared with men who did not serve in Vietnam. Vietnam veterans were also at higher risk relative to (1) men who had not served in the military, (2) other veterans, and (3) other veterans who served between 1964 and 1972. An analysis of the military histories of the 232 Vietnam veterans suggested that the relative risk (1) increased with length of service in Vietnam (P = .10), and (2) was higher among men in the sea-based Navy than among other veterans (P = .11). Little difference in risk, however, was noted according to dates of service, type of unit, military region, or any other characteristics that may have been associated with the use of Agent Orange. Although the cause remains uncertain, results of this study indicate that the risk of non-Hodgkin's lymphoma is higher among Vietnam veterans than among other men.

Adult↗
PubMed1990

The association of selected cancers with service in the US military in Vietnam. II. Soft-tissue and other sarcomas. The Selected Cancers Cooperative Study Group.

As part of a series of investigations into the health of Vietnam veterans, we conducted a population-based, case-control study of soft-tissue and other sarcomas between 1984 and 1988. All men born between 1929 and 1953 and diagnosed in an area covered by eight cancer registries were considered eligible. Controls were selected by random-digit dialing. Analyses of 342 men with pathologically confirmed sarcoma and 1776 controls showed that Vietnam veterans had a relative risk of 1.0 for sarcoma in comparison with men who did not serve in Vietnam (95% confidence interval, 0.6 to 1.6). Restriction of the analysis to the 254 men with soft-tissue sarcoma yielded a relative risk of 0.9 (95% confidence interval, 0.5 to 1.6). Several attributes of military service in Vietnam (eg, branch, duration of service, military region, and other characteristics that may have been associated with the use of Agent Orange) were examined, and none was associated with an increased risk for the development of sarcoma. Furthermore, no morphologic type of sarcoma was overrepresented among Vietnam veterans. Results were unchanged if Vietnam veterans were compared with (1) other veterans or (2) men who never served in the military. This study, which had 97% power to detect a relative risk of 2.0 for all sarcomas, provides no evidence that the risk for the development of soft-tissue or other sarcomas is increased among veterans 15 to 25 years following service in Vietnam.

Adult↗
PubMed1988

Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin levels in US Army Vietnam-era veterans. The Centers for Disease Control Veterans Health Studies.

This study investigates whether military records can be used to identify US Army Vietnam veterans who were likely to be exposed to the herbicide Agent Orange. Serum levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a toxic contaminant in Agent Orange, were obtained for 646 ground combat troops who served in heavily sprayed areas of Vietnam and for 97 veterans who did not serve in Vietnam. The distributions of current TCDD levels in Vietnam and non-Vietnam veterans were nearly identical (mean in each group, approximately equal to 4 parts per trillion [ppt]). Only two men (both Vietnam veterans) had clearly elevated levels (greater than 20 ppt). Levels of TCDD did not tend to increase with greater likelihood of exposure to Agent Orange, as estimated from either military records or self-reported exposure. This study is consistent with other studies and suggests that most US Army ground troops who served in Vietnam were not heavily exposed to TCDD, except perhaps men whose jobs involved handling herbicides.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1987

Soft tissue sarcoma and military service in Vietnam: a case-control study.

A case-control study was conducted in men who were of draftable age during the Vietnam conflict to examine the association of soft tissue sarcomas (STSs) with military service in Vietnam as well as other host and environmental risk factors. A total of 217 STS cases selected from the Armed Forces Institute of Pathology were compared to 599 controls for Vietnam service, occupational and nonoccupational exposure to various chemicals, occupational history, medical history, and life-style (smoking, alcohol, coffee, etc.). Military service information was verified by a review of the patient's military personnel records. Other information was ascertained from a telephone interview with either subjects or their next of kin. Cases and controls were stratified on the basis of the hospital type (civilian, Veterans Administration, and military); the Mantel-Haenszel estimate of the odds ratio (OR), adjusted for the effects of the stratification variable, was calculated. Vietnam veterans in general did not have an increased risk of STS when compared to those men who had never been in Vietnam (OR, 0.85; 95% confidence interval, 0.54-1.36). Subgroups of Vietnam veterans who had higher estimated opportunities for Agent Orange exposure seemed to be at greater risk of STSs when their counterparts in Vietnam were taken as a reference group. However, this risk was not statistically significant.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1997

Sequence and phylogenetic analyses of HIV-1 infection in Vietnam: subtype E in commercial sex workers (CSW) and injection drug users (IDU).

More than 4,000 persons with human immunodeficiency virus type 1 (HIV-1) infection have been identified in Vietnam through sentinel surveillance since 1990, when the first case of HIV-1 infection was diagnosed in a young woman in Ho Chi Minh City. Currently, the estimated HIV-1 seroprevalences of 10% for injection drug users (IDU) and 3% for female commercial sex workers (CSW) in Vietnam are comparable to those observed in the same risk groups in Thailand five years ago. To clarify if concurrent epidemics with different HIV-1 subtypes (or clades) are occurring among different high-risk behavior groups in Vietnam, we conducted a genotypic analysis of HIV-1 by amplifying and sequencing a 325-nucleotide region spanning the principal neutralizing domain, or V3 loop, of the gp120-encoding env gene from genomic DNA extracted from dried, filter paper-blotted blood samples, collected in April/May and August/September 1995 from 8 HIV-1-seropositive CSW in Ho Chi Minh City, Can Tho and An Giang provinces and from 16 IDU in Ho Chi Minh City, Hanoi, Nha Trang and An Giang province. Sequence alignment and comparison with other HIV-1 subtypes indicated that the HIV-1 strains from CSW and IDU in Vietnam were genetically most similar to subtype E strains from Cambodia. The interstrain genetic variation among the Vietnam HIV-1 env sequences ranged from 0.3% to 9.0% (mean, 4.6%). Phylogenetic analysis verified that some of the Vietnam HIV-1 strains formed discrete clusters and were indistinguishable from other Southeast Asian strains. The demonstration of subtype E in both CSW and IDU in Vietnam contrasts sharply with the previously observed HIV-1 clade restriction in these high-risk behavior groups in nearby Thailand.

Adolescent↗
PubMed1990

The association of selected cancers with service in the US military in Vietnam. III. Hodgkin's disease, nasal cancer, nasopharyngeal cancer, and primary liver cancer. The Selected Cancers Cooperative Study Group.

As part of a series of investigations into the health of Vietnam veterans, we conducted case-control studies involving 310 men with Hodgkin's disease, 48 with nasal carcinoma, 80 with nasopharyngeal carcinoma, 130 with primary liver cancer, and 1776 controls between 1984 and 1988. All men born between 1929 and 1953 and diagnosed in an area covered by eight cancer registries were considered eligible as cases; controls were recruited by random-digit dialing. Whereas the study had excellent power (96%) to detect a twofold increase in risk for Hodgkin's disease among Vietnam veterans, its ability to detect a similarly elevated risk in the other cancers was limited, ranging from 38% (nasal carcinoma) to 75% (primary liver cancer). Analyses showed that risks among Vietnam veterans relative to other men were 1.1 (Hodgkin's disease), 0.7 (nasal carcinoma), 0.5 (nasopharyngeal carcinoma), and 1.2 (primary liver cancer). None of these relative risks was significantly different from 1.0. Similar results were obtained if Vietnam veterans were compared with (1) other veterans or (2) men who never served in the military. An examination of several attributes of military service in Vietnam (eg, branch, duration of service, and other characteristics that may have been associated with the use of Agent Orange) failed to identify any groups of veterans who were at increased risk for Hodgkin's disease. Small numbers limited further analyses of nasal, nasopharyngeal, and liver cancer. These results provide no evidence that, 15 to 25 years following service in Vietnam, the risk of these malignant neoplasms is higher among veterans.

Adult↗
PubMed1984

Factor-analytic support for DSM-III's post-traumatic stress disorder for Vietnam veterans.

Found substantial support for DSM-III's criteria for Post-Traumatic Stress using 405 Vietnam combat veterans. The results also suggested that some additional symptoms such as depression and anger be included as major signs, especially when one is dealing with Vietnam veterans. A comparison of symptom intensity was made between Vietnam veterans and non-Vietnam veterans. The results of the second study showed that Vietnam veterans attested to experiencing significantly greater intensities of DSM-III criteria behaviors than did non-Vietnam veterans. However, no significant differences were found for symptoms related to depression.

Combat Disorders↗
PubMed2002

MMPI-2 profiles of Gulf and Vietnam combat veterans with chronic posttraumatic stress disorder.

The current study examined service era differences in a sample of 172 Gulf and Vietnam outpatient veterans with combat-related posttraumatic stress disorder (PTSD). Participants completed the MMPI-2 and several additional self-report measures of symptom severity (PTSD, depression, anxiety, hostility, and health complaints). Results indicated that MMPI-2 profiles differed significantly according to service era with Vietnam veterans scoring higher on scales 2, 8, and 0 and lower on scale 9 than did Gulf veterans. Examination of group means derived from parametric analysis of MMPI-2 data suggested a mean two-point code type of 2-8/8-2 for Vietnam veterans and 1-8/8-1 for Gulf veterans. In contrast, when the data were examined using descriptive techniques based on frequency counts of individual MMPI-2 profiles, the most frequently occurring two-point codetype was 7-8/8-7 for Vietnam veterans, and 6-8/8-6 for Gulf veterans. In addition, Gulf veterans reported a greater number of total health complaints than Vietnam veterans, whereas Vietnam veterans reported a greater number of physician-diagnosed physical conditions. Potential advantages of incorporating descriptive approaches versus parametric methods when examining profile data are also presented.

Adult↗
PubMed2006

Magnitude of arsenic pollution in the Mekong and Red River Deltas--Cambodia and Vietnam.

Large alluvial deltas of the Mekong River in southern Vietnam and Cambodia and the Red River in northern Vietnam have groundwaters that are exploited for drinking water by private tube-wells, which are of increasing demand since the mid-1990s. This paper presents an overview of groundwater arsenic pollution in the Mekong delta: arsenic concentrations ranged from 1-1610 microg/L in Cambodia (average 217 microg/L) and 1-845 microg/L in southern Vietnam (average 39 microg/L), respectively. It also evaluates the situation in Red River delta where groundwater arsenic concentrations vary from 1-3050 microg/L (average 159 microg/L). In addition to rural areas, the drinking water supply of the city of Hanoi has elevated arsenic concentrations. The sediments of 12-40 m deep cores from the Red River delta contain arsenic levels of 2-33 microg/g (average 7 microg/g, dry weight) and show a remarkable correlation with sediment-bound iron. In all three areas, the groundwater arsenic pollution seem to be of natural origin and caused by reductive dissolution of arsenic-bearing iron phases buried in aquifers. The population at risk of chronic arsenic poisoning is estimated to be 10 million in the Red River delta and 0.5-1 million in the Mekong delta. A subset of hair samples collected in Vietnam and Cambodia from residents drinking groundwater with arsenic levels >50 microg/L have a significantly higher arsenic content than control groups (<50 microg/L). Few cases of arsenic related health problems are recognized in the study areas compared to Bangladesh and West Bengal. This difference probably relates to arsenic contaminated tube-well water only being used substantially over the past 7 to 10 years in Vietnam and Cambodia. Because symptoms of chronic arsenic poisoning usually take more than 10 years to develop, the number of future arsenic related ailments in Cambodia and Vietnam is likely to increase. Early mitigation measures should be a high priority.

Arsenic↗
PubMed1992

Chronic liver injury in phenoxy herbicide-exposed Vietnam veterans.

Reports of hepatotoxic injury in Vietnam veterans exposed to phenoxy herbicides (mainly, 2,4-D and 2,4,5-T) initiated a retrospective cohort study of veterans self-reporting exposure to Agent Orange (AO) while serving in Vietnam from 1962 to 1971. Historical, medical, and laboratory information was obtained in a subcohort of 100 randomly selected veterans from a pool of 350 registrants. An occupational work exposure ranking system was designed to estimate individual exposure to phenoxy herbicide and its contaminant, dioxin (TCDD). Job classifications were determined by military job codes. Military application of the herbicides used in Vietnam were derived from the National Research Council Report based on the Herbs tapes. Health examination included tests of body systems affected by TCDD and similar agents, e.g., hemopoietic system, cholesterol/lipid metabolism, hepatic function, and skin lesions. Skin rash was utilized as a marker disease, since no case of true chloracne was found among the cohort. The cohort was divided into those with (R) and without (NR) a reported rash during or after the Vietnam tour. The R group had higher frequency (31%) of abnormal liver studies of all types than the NR group (18%). Of the 14 Vietnam veterans with persistent serum transaminase elevations, 86% reported a rash. Abnormal liver functions correlated with herbicide exposure index in both groups, but was more prominent in the R group. Study of the exposure index components showed that the liver abnormalities were related to the months of exposure and not to job classification or exposure rank. Viral hepatitis and alcoholism among both groups accounted for the association between liver abnormalities and cumulative exposure to AO. These data provide strong supportive evidence that chronic liver abnormalities among Vietnam veterans applying to the AO Registry are mainly due to viral or alcoholic causality and not to herbicides and their TCDD contaminant.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed2001

Twenty-five year mortality of US servicemen deployed in Vietnam: predictive utility of early drug use.

Large numbers of young men were exposed to high-quality opiates for a relatively short time period during military service in Vietnam. This study examined the relationships of opiate and other drug abuse before, during, and shortly after their time of service in Vietnam with the subsequent 25-year mortality among the cohort of 1227 US Army enlisted returnees and their matched civilians previously studied in 1972 and 1974. Composite factor scores of a variety of drug use measures and other individual behavioral measures were selected separately for three time periods around service in Vietnam from over 120 measures associated with mortality. Results of path analytic models applied to selected significant measures showed that both in-Vietnam and post-Vietnam drug use factors were large and significant predictors of mortality, controlling for pre-service drug use, continuity to later drug use, and demographic and other behavioral measures. The magnitude of the direct effect of drug use on mortality was larger than those of the covariates that were entered in the path analyses, except age. Notwithstanding the high remission rate from opiate addiction, drug use in Vietnam had considerable predictive utility for premature death in this cohort. In light of the re-emergence of increased heroin use since the mid-1990s, the findings point to the importance of early intervention of drug use and comorbid problems for today's youth now initiating heroin use.

Adult↗
PubMed1990

Excess of seminomas observed in Vietnam service U.S. military working dogs.

During the Vietnam War, US military working dogs served with their companion dog handlers in close proximity, sharing common exposures to war-related activity, many zoonotic infectious agents, chemical pesticides, phenoxy herbicides, and extensive use of therapeutic drugs. To gain insight into the effects of the Vietnam experience, we investigated the occurrence of neoplasms in military working dogs based on standard necropsy examination by the Armed Forces Institute of Pathology. We observed that these dogs experienced significant elevated risks for testicular seminoma and, independently, testicular dysfunction. Experimental evidence shows testicular dysfunction and impaired spermatogenesis in laboratory animals exposed to phenoxy herbicides, dioxin, or tetracycline, and antibiotic used extensively in military working dogs in Vietnam. Because an unexplained significant decrease in sperm quality in Vietnam veterans has been observed by the Centers for Disease Control, further research is warranted if we are to clarify military service in Vietnam as a risk factor for testicular dysfunction. The testis should be made a priority site in the study of Vietnam experience-related cancers.

Animals↗