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  • Formatas: 622 pages
  • Išleidimo metai: 13-Nov-2001
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309171014

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Veterans and Agent Orange: Update 2000 examines the state of the scientific evidence regarding associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. It is the fourth in a series of comprehensive reviews of epidemiologic and toxicologic studies of the agents used as defoliants during the Vietnam War. Over forty health outcomes in veterans and their children are addressed.



Among the report's conclusions is that there is sufficient evidence of a link between exposure and the development of soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne in veterans. Additionally, it found that scientific studies offer "limited or suggestive" evidence of an association with other diseases in veteransincluding Type 2 diabetes, respiratory cancers, prostate cancer, multiple myeloma and some forms of transient peripheral neuropathyas well as the congenital birth defect spina bifida in veterans' children.



Table of Contents



Front Matter 1 Executive Summary 2 Veterans and Agent Orange: Previous IOM Reports 3 Toxicology 4 Methodological Considerations in Evaluating the Evidence 5 Exposure Assessment 6 Epidemiologic Studies 7 Cancer 8 Reproductive Effects 9 Neurobehavioral Disorders 10 Other Health Effects Appendix A: Summary of Workshop Appendix B: ICD-9 Codes for Cancer Outcomes Appendix C: Committee and Staff Biographies Index
Executive Summary
1(14)
Organization and Framework
2(1)
Toxicology Summary
3(2)
Exposure Assessment
5(1)
Conclusions About Health Outcomes
5(7)
Increased Risk of Disease Among Vietnam Veterans
12(1)
Observations and Research Recommendations
13(2)
Veterans and Agent Orange: Previous IOM Reports
15(7)
Background
15(2)
Conclusions About Health Outcomes
17(3)
Increased Risk of Disease Among Vietnam Veterans
20(1)
Existance of a Plausible Biologic Mechanism or Other Evidence of a Casual Relationship
20(1)
Research Recommendations
21(1)
Toxicology
22(81)
Lay Summary
23(4)
Overview of the Scientific Literature in Update 2000
27(6)
Toxicity Profile Updates
33(52)
Issues in Evaluating the Evidence
85(18)
Methodolgical Considerations in Evaluating the Evidence
103(7)
Questions to be Addressed
103(3)
Issues in Evaluating the Evidence
106(4)
Exposure Assessment
110(22)
Occupational and Environmental Exposures to Herbicides and Dioxin
110(7)
Military use of Herbicides in Vietnam
117(5)
Exposure Assessment in Studies of Vietnam Veterans
122(10)
Epidemiologic Studies
132(116)
Occupational Studies
134(13)
Environmental Studies
147(3)
Vietnam Veteran Studies
150(10)
Observations and Research Recommendations
160(88)
Cancer
248(151)
Gastrointestinal Tract Tumors
250(17)
Hepatobiliary Cancers
267(6)
Nasal and Nasopharyngeal Cancer
273(4)
Laryngeal Cancer
277(4)
Lung Cancer
281(6)
Bone Cancer
287(4)
Soft-Tissue Sarcomas
291(8)
Skin Cancers-All Types
299(3)
Skin Cancer-Melanoma
302(6)
Skin Cancer-Basal and Squamous Cell (Nonmelanoma)
308(6)
Breast Cancer
314(6)
Cancers of the Female Reproductive System
320(6)
Prostate Cancer
326(9)
Testicular Cancer
335(4)
Urinary Bladder Cancer
339(6)
Renal Cancer
345(5)
Brain Tumors
350(5)
Non-Hodgkin's Lymphoma
355(9)
Hodgkin's Disease
364(7)
Multiple Myeloma
371(6)
Leukemia
377(6)
Summary
383(16)
Reproductive Effects
399(41)
Introduction
399(1)
Birth Defects
400(5)
Fertility
405(4)
Spontaneous Abortion
409(3)
Stillbirth, Neonatal Death, and Infant Death
412(1)
Low Birthweight and Preterm Birth
413(4)
Childhood Cancers
417(12)
Sex Ratio
429(2)
Summary
431(9)
Neurobehavioral Disorders
440(23)
Introduction
440(1)
Cognitive and Neuropsychiatric Effects
441(2)
Motor/Coordination Dysfunction
443(11)
Chronic Persistent Peripheral Neuropathy
454(3)
Acute and Subacute Transient Peripheral Neuropathy
457(1)
Conclusions for Neurobehaviorial Disorders
457(6)
Other Health Effects
463(70)
Introduction
463(1)
Chloracne
463(3)
Porphyria Cutanea Tarda
466(2)
Respiratory Disorders
468(7)
Immune System Disorders
475(6)
Diabetes
481(11)
Lipid and Lipoprotein Disorders
492(6)
Gastrointestinal and Digestive Disease, Including Liver Toxicity
498(7)
Circulatory Disorders
505(6)
Amyloidosis
511(2)
Summary
513(10)
APPENDIXES
A Summary of Workshop
523(1)
B ICD-9 Codes for Cancer Outcomes
524(3)
C Committee and Staff Biographies
527(6)
Index 533
Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Third Biennial Update), Division of Health Promotion and Disease Prevention