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El. knyga: Veterans and Agent Orange: Update 1998

  • Formatas: 624 pages
  • Išleidimo metai: 22-Dec-1999
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309524681
  • Formatas: 624 pages
  • Išleidimo metai: 22-Dec-1999
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309524681

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Third in a series of six congressionally mandated studies occurring biennially, this book is an updated review and evaluation of the available scientific evidence regarding the statistical association between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposures. As part of the review, the committee convened a workshop at which issues surrounding the reanalysis and the combination of existing data on the health effects of herbicide and dioxin exposure were addressed.



This book builds upon the information developed by the IOM committees responsible for the 1994 original report, Veterans and Agent Orange, and Veterans and Agent Orange: Update 1996, but will focus on scientific studies and other information developed since the release of these reports. The two previous volumes have noted that sufficient evidence exists to link soft tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne with exposure. The books also noted that there is "limited or suggestive" evidence to show an association with exposure and a neurological disorder in veterans and with the congenital birth defect spina bifida in veterans' children. This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans organizations, researchers, and health professionals.

Table of Contents



Front Matter 1 Executive Summary 2 Veterans and Agent Orange: Previous IOM Reports 3 Toxicology 4 Methodologic Considerations in Evaluating the Evidence 5 Exposure Assessment 6 Epidemiologic Studies 7 Cancer 8 Latency and Cancer Risk 9 Reproductive Effects 10 Neurobehavioral Disorders 11 Other Health Effects Appendix A: Information Gathering Appendix B: ICD-9 Codes for Cancer Outcomes Appendix C: Committee and Staff Biographies Index
Executive Summary
1(17)
Veterans and Agent Orange: Previous Iom Reports
17(15)
Background
17(6)
Impact of the Reports
23(2)
Federal Government's Response to Concerns over the Military Use of Herbicides in Vietnam
25(7)
Toxicology
32(92)
Summary
32(4)
VAO and Update 1996 Overview
36(1)
Update of the Scientific Literature---Overview
36(7)
Toxicity Profile Updates
43(65)
Issues in Evaluating the Evidence
108(16)
Methodologic Considerations in Evaluating The Evidence
124(11)
Questions to Be Addressed
124(4)
Issues in Evaluating the Evidence
128(4)
Summary of the Evidence
132(3)
Exposure Assessment
135(34)
Military Use of Herbicides in Vietnam
135(6)
Occupational and Environmental Exposures to Herbicides and Dioxin
141(1)
Exposure Assessment for Epidemiology
142(4)
Exposure Assessment in Studies of Vietnam Veternas
146(4)
Exposure Assessment in Occupational and Environmental Studies
150(7)
Review of the Scientific Literature
157(12)
Epidemiologic Studies
169(96)
Occupational Studies
219(13)
Environmental Studies
232(4)
Vietnam Veterans Studies
236(29)
Cancer
265(142)
Introduction
265(2)
Gastrointestinal Tract Tumors
267(15)
Hepatobiliary Cancers
282(6)
Nasal/Nasopharyngeal Cancer
288(4)
Laryngeal Cancer
292(3)
Lung Cancer
295(7)
Bone Cancer
302(2)
Soft-Tissue Sarcomas
304(7)
Skin Cancers
311(2)
Melanoma
313(4)
Basal and Squamous Cell (Nonmelanoma) Skin Cancer
317(5)
Breast Cancer
322(7)
Cancers of the Female Reproductive System
329(5)
Prostate Cancer
334(9)
Testicular Cancer
343(4)
Urinary Bladder Cancer
347(4)
Renal Cancer
351(5)
Brain Tumors
356(6)
Non-Hodgkin's Lymphoma
362(9)
Hodgkin's Disease
371(6)
Multiple Myeloma
377(6)
Leukemia
383(7)
Summary
390(17)
Latency and Cancer Risk
407(27)
Analysis of Latency in Epidemiologic Studies
408(4)
Four Questions Addressed by the Committee
412(4)
Review of the Scientific Literature
416(2)
Respiratory Cancer
418(8)
Prostate Cancer
426(2)
Non-Hodgkin's Lymphoma
428(2)
Relevance of Latency in Assessing the Effect of Herbicides on Cancer Risk in Vietnam Veterans
430(4)
Reproductive Effects
434(32)
Introduction
434(1)
Birth Defects
435(9)
Fertility
444(7)
Stillbirth, Neonatal Death, and Infant Death
451(3)
Low Birthweight and Preterm Birth
454(4)
Conclusions for Reproductive Effects
458(8)
Neurobehavioral Disorders
466(12)
Background
466(2)
Cognitive and Neuropsychiatric Effects
468(1)
Motor/Coordination Dysfunction
469(1)
Chronic Persistent Peripheral Neuropathy
470(3)
Acute and Subacute Transient Peripheral Neuropathy
473(1)
Conclusions for Neurobehavioral Disorders
473(5)
Other Health Effects
478(53)
Introduction
478(1)
Chlorance
478(2)
Porphyria Cutanea Tarda
480(2)
Respiratory Disorders
482(5)
Immune System Disorders
487(4)
Diabetes
491(12)
Lipid and Lipoprotein Disorders
503(5)
Gastrointestinal and Digestive Disease, Including Liver Toxicity
508(6)
Circulatory Disorders
514(4)
Summary
518(13)
APPENDIXES 531(16)
A Information Gathering
533(4)
B ICD.9 Codes for Cancer Outcomes
537(3)
C Committee and Staff Biographies
540(7)
Index 547


Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Second Biennial Update), Institute of Medicine