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Exposure to Agent Orange

About Agent Orange

The Question

Angel Orange

Pathogenesis

Epidemiology

Is Angel Orange dangerous?

 


The Question: "I am a 55-year-old male who served in Vietnam as a Medical Specialist in the Field. Since my discharge in 1972 I have noticed various things that seem to be going wrong. As I look back over my medical lab tests I see Very High RBC and WBC in my Urine examination. I always have had a burning in my bladder and I am always extremely hot body temp. wise, now when I wake up I feel like I have allot of pressure on the back of my Head and I have excruciating Neck pain continently? I have been diagnosed as having been exposed to Agent Orange "

Dr. Keti:
March 10, 2003


About the Agent Orange
Agent Orange, is a herbicide, a defoliant which was used by U.S. forces during the Vietnam War to expose enemy guerrilla forces in forested areas. Agent Orange was shipped in orange-striped barrels and it is a reddish-brown liquid containing four chemicals: 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), 2,4-dichlorophenoxyacetic acid (2,4-D), cacodylic acid and picloram. The 2,4,5-T was contaminated in the manufacturing process with dioxin. (2,4)

Organic herbicides began to be produced with dinitrophenol compounds in 1932. A breakthrough occurred in the 1940s with 2,4-D (2,4-dichlorophenoxyacetic acid), a compound similar to plant hormones, which destroys plants by interfering with their normal metabolism.(2)
Loss of foliage, flower and fruit occurred within two to three weeks after spraying. Not all of the trees died and a large percentage of those surviving trees were permanently damaged. Dioxin has an environmental half-life of about three years or more and has shown up in the food chain. (9)

Pathogenesis
Agent Orange contains varying amounts of dioxin. Dioxins are also created unintentionally during the manufacture of Chlorine containing products like the Polychlorinated biphenyls (PCBs) oils used in the utility transformers.

Dioxin has an environmental half-life of about three years or from several hours to 7 years on the surface of plants; beneath the soil surface it's half-life can be 10 years or more. (9)

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Epidemiology
Exposure to this defoliant has been linked with acne, non-Hodgkin's lymphoma, Hodgkin's disease, and soft-tissue sarcoma.

Many soldiers were exposed to Agent Orange in the Vietnam War. Afflicted veterans brought a class-action suit against manufacturers of Agent Orange, which was settled out of court by the establishment of a fund to compensate them and their families for any disabilities.
According to the Vietnam Experience Study, Vietnam veterans reported current and past health problems more frequently than did non-Vietnam veterans. Vietnam veterans also reported more health problems among their children, including more birth defects, and more problems with impaired fertility.(3)

In the late 70’s the Department of Veterans Administration began responding to the concerns of Vietnam veterans about the long-term effects of the Agent Orange And began a broad program that encompassed clinical evaluation, epidemiological studies and literature review.
The Department of Veterans Affairs has established computerized Agent Orange registry of over 300,000 records (Sept 2001) of veterans who had military service in Vietnam from 1962 – 1975, of whom over 186,000 had records of signs and symptoms relating to the Agent Orange; records prior to 1982 were unavailable due to lack of data entry coding at the time.


From surveying the current literature, it appears that although there are tests that measure the level of dioxin in blood and fat body, these tests are not routinely performed. Although dioxin is toxic to some animals, only two clinical effects were repeatedly observed in humans in cases of dioxin’s environmental pollution. These are the transient hepatic effects and cloracne. (9)

Although the metabolic pathway of dioxin in humans has not been established, it is well known in animals. The metabolites are excreted through urine and the unabsorbed ones are removed through feces. Dioxins distribute through body and accumulate in body fats. Data with regards to peripheral neurological effects of dioxin on humans are inconsistent and so far no direct link has been established.

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Agent Orange and its Linkage to Some Conditions
The National Academy of Sciences ( NAS) identifies four distinct categories of diseases/conditions that are associated with exposure to Agent Orange.

In their report “Veterans and Agent Orange 2000 Update”(ref. 10) they find little or no association between the AGENT ORANGE and the brain and gastrointestinal tumors.
Other conditions are totally excluded from that association such as congenital (birth defects), common conditions with clearly defined clinical pathway (appendicitis, hernia), pre-existing conditions before the military service, trauma and other disabling conditions caused by injury, and conditions that have identified causal agent (e.g. tuberculosis).
A new (Healthcare) law was enacted in 1996, and has several provisions that affect the hospital and medical delivery by the Department of Veterans Affairs (VA), but the law is not implemented retroactively.(5) For more info refer to this article: Vietnam Veterans and Exposure to Agent Orange

According to the findings of the Institute of Medicine of the National Academy of Sciences, (NAS IOM) and the reports published in 94, 96, 98 there is either sufficient evidence of an association between AGENT ORANGE, and the following conditions, grouped under category 1:
Soft Tissue Sarcoma, Non-Hodgkin's lymphoma, Hodgkin's lymphoma and, Cloracne; or limited/suggestive evidence (category 2) of an association with the following conditions:
Porphyria Cutanea Tarda, Cloracne, Prostate Cancer, Multiple Myeloma, and Spina Bifida. (1, 6, 5)

According to a new report from the Institute of Medicine (IOM) of the National Academies a re-evaluation of evidence now supports an association between exposure to herbicides used during the Vietnam War and the development of a specific form of leukemia in veterans. The same goes for Diabetes. (5, 8)


Because hematuria (increased Red Blood Count in urine), increased WBC (white blood count) in urine and the other symptoms that you are experiencing may be the result of a serious problem, you should consult a doctor for further test analysis and evaluation.

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References and Links

Pictures of Porfirya Cutanea Tarda

CDC-Agent Orange Validation Study (2)

Vietnam Veterans and Exposure to Agent Orange(3)

Agent Orange by L. Vancil (4)

National Academies Press (5)

CDC- article(6)

National Academies of Science (7)

VA - More info on Agent Orange (8)

NA Press-Dioxin Toxicity(9)

  Study Publications:

The DCD Vietnam Experience Study. Health status of Vietnam veterans: I. Psychosocial characteristics. Journal of the American Medical Association 1988;259:2701-2707.

The CDC Vietnam Experience Study. Health status of Vietnam veterans: II. Physical health. Journal of the American Medical Association 1988;259:2708-2714.

The CDC Vietnam Experience Study. Health status of Vietnam veterans: III. Reproductive outcomes and child health. Journal of the American Medical Association 1988;259:2715-2719.