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)
