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Determining Agent Orange Exposure
The case of the Vietnam veteran's exposure to dioxin through Agent Orange presents the most complex epidemiological problem ever imagined. The test is this: How do you determine, among 2.5 million Vietnam veterans, who was exposed to Agent Orange, to what degree and extent, and what if any, is the resultant harm of that exposure?
Parkinson's disease has now been added to the list of disorders produced by Agent Orange! See the current list of diseases and disorders!
Some of the difficulties encountered when confronting this problem include:
A new page will be added here in the near future describing HOW the Department of Veterans Affairs made the determination of the effects on Veterans. (Hint: It was not from studying VIETNAM VETERANS!)
- An estimated 2.5 million men and women served in Vietnam. During their tour or tours, they may have been highly mobile, moving about the countryside throughout an area as big as the state of California. Tracking a single individual for every day of their tour is extraordinarily difficult, tracking large numbers is almost impossible.
- How can exposure be quantified with precision? "Exposure" in epidemiology means the person had the "opportunity" for contact in some manner with the chemical. But what is contact? Does this mean direct contact, such as physically being sprayed with the products, or does it include more remote opportunities, such as contact through airborne particulates, or contact through the food and water chain?
- Degree of exposure: This is sometimes called the dose/response factor in science. In order to estimate the health effect of an exposure, it is useful (some say critical) to be able to estimate "how much" exposure a person may have had, in quantity, frequency, and duration as well as means of exposure.
- Effect: Science looks for "cause and effect" in determining health outcomes. If is extremely difficult to accurately state that a behavior or exposure causes an outcome. For example, it is widely accepted that cigarette smoking may cause lung cancer, but this does not account for those who smoke for years and never get cancer, nor those who never smoked and get the disease.
- Delay: Many diseases, including cancer, have extremely long latency periods. It is possible, therefore, for a person to be exposed to a toxin, and not have the effect of that exposure manifested for twenty years or more. During the years, however, a person may have been "insulted" with other additional exposures through the workplace or the environment. It becomes extremely difficult assessing and separating these "confounding" exposures when looking for the source of a disease.
Keeping these difficult criteria in mind, we shall next examine the efforts at studying the effect of Agent Orange exposure.
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The Fifteen Herbicides Used in Vietnam
- PURPLE: A formulation of 2,4,-D and 2,4,5,-T used between 1962 and 1964.
- GREEN: Contained 2,4,5-T and was used 1962-1964.
- PINK: Contained 2,4,5-T and was used 1962-1964.
- ORANGE: A formulation of 2,4,-D and 2,4,5-T used between 1965 and 1970.
- WHITE: A formulation of Picloram and 2,4,-D.
- BLUE: Contained cacodylic acid.
- ORANGE II: A formualtion of 2,4,-D and 2,4,5-T used in 1968 and 1969 (also sometimes referred to as "Super Orange")
- DINOXOL: A formulation of 2,4,-D and 2,4,,5-T. Small quantities were tested in Vietnam between 1962 and 1964.
- TRINOXOL: Contained 2,4,5-T. Small quantities tested in Vietnam 1962-1964.
Small quantities of all of the above were tested in Vietnam, 1962-1964.