HOUSE COMMITTEE ON Veterans AFFAIRS

 

PRESENTATION BY CHARLES W. KELLEY

December 6th 2005

 

ATTACHMENT 2

 

Evidence of facts and studies that show a direct link to Peripheral Neuropathy and Central Nervous System Damages from exposures to Agent Orange, Agent Blue, and Agent White toxic chemical exposures.

 

NEUROLOGICAL AND NEUROPSYCHIATRIC EFFECTS

 

In Attachment 1, I have documented many of the symptoms of peripheral neuropathy from toxic chemical exposures.

 

Many toxicologists believe that not only do these toxic chemical herbicides (plural) cause peripheral neuropathy (PN) but also central nervous system (CNS) issues.

 

What many government scientists do not take into account and totally disregard is Vietnam Veterans are a once in 100 years “environmental disaster victims.”  Considering that no prior toxic chemical accidents or even farmers, railroad workers, forestry workers, etc., who used these toxic chemicals had total control over the dose or application rate.  Veterans had no such control and were not only subjected to higher levels of TCDD formulas but dose or application rates at six to 25 times higher than what was recommended by the less than forthcoming chemical companies.  Including, that Veterans were exposed to not only TCDD as in a separate herbicide but the herbicide used in and around Vietnam Veterans was a combination of herbicides.  With additional forms of directed specific plant types of herbicides used, such as Agent Blue, also in their bodies at the very same time.

 

It should also be noted that in 1969 the United States “State Department” got involved in the controversy of the use of herbicides.  Their scientific conclusion was that Agent Orange posed little threat to humans but that Agent Blue was of major concern with its form of arsenic acid. (12) (13)

 

This description of our toxic chemical exposures matches no other toxic chemical hazard other than the possibility of the Love Canal, New York environmental disaster, which contained many of the same forms of toxic chemicals (plural) that Vietnam Veterans were exposed.  However, once again the dose rate for Vietnam Veterans is much higher than even in the Love Canal disaster. 

 

It is mind-boggling and heartless that while the government/DOD/VA lied to our nations warriors in 1982 that there was no TCDD impact.  The whole town of Times Beach, Missouri was bought up and civilians told to leave and not come back.(1) Told to leave and not come back for TCDD exposures in the infamous Christmas message only at an exposure rate of an “exponentially number amount less” than the Vietnam Veterans were exposed.  Yet, for the Nations Veterans the government/DOD/VA portrayed this TCDD exposure totally benign.  Not telling the Veterans, they more than likely would develop many medical issues from this DOD/government mistake. 

 

Big difference between the way the government treats its civilians versus the way the government treats its used up government assets since these used up government assets, the Veterans, are powerless; thanks to the congress to stop this government collaboration and conspiracy.     

 

Toxicologists state the CNS damage in the form of nervous system lesions or other issues precludes a PN involvement.(2) The EPA, in their 1992-1996 dioxin reassessments categorically stated that the brain may be particularly vulnerable to accumulating dioxin into its fat content.  Nervous system tissue itself, with its high lipid content, can also act as a repository for dioxin.  Dioxin accumulates in the body fat and once in the body, even at very minuscule amounts, interferes with cell development.(3)

 

It is also note worthy that the main toxic chemical in Agent White 2,4-D, is also noted for this seeking of a more lipid environment as a repository.

 

Dioxin exposure causes damage to the peripheral and central nervous systems.  The association between dioxin and damage to the nervous system is reflected in a finding by the Veterans' Advisory Committee on Environmental Hazards, which recommended that the VA compensate Vietnam veterans for peripheral neuropathies as “service related.”

 

Already discussed in the formal presentation are the VA’s constraints that were put on this “obvious toxic chemical caused disorder” to the point that no (zero) Veteran would qualify.

 

Effects on the central nervous system occur before gross pathological damage can be demonstrated in the peripheral nerves.  The neuropsychiatric and neuropsychological symptoms of central nervous include depression, anxiety, reduced cognitive function, poor coordination, etc. (2) 

 
One severe consequence of central nervous system damage by dioxin is higher rates of suicide (shown in dioxin-exposed Vietnam veterans, chemical production workers, and forestry workers).  Another severe consequence is excess deaths from accidents (also significantly elevated in dioxin-exposed chemical production workers and Vietnam veterans).  These accidents could be caused by neurological malfunction, or also represent disguised suicide to a certain extent.(2) 

 

Other effects on the central nervous system found in exposed Vietnam veterans and chemical production workers include depression, anxiety, loss of libido, and other neuropsychiatric and neuropsychological effects.  Effects on the central nervous system also have been demonstrated in a dose-related manner in Vietnam veterans and chemical production workers, providing firm epidemiological evidence that dioxin caused these effects.(2)

 
In addition, the same range of neuropsychiatric and neuropsychological effects seen in dioxin-exposed populations have been demonstrated for exposure to other neurotoxic substances, such as solvents.  This demonstrates a similar biological mechanism between the neuropsychiatric and neuropsychological effects caused by dioxin and other substances.(2)


Peripheral Nerve and Cerebrovascular Abnormalities

The following studies document clinically diagnosed neurological and cerebrovascular effects among several populations exposed to dioxin.(2)

 
 These gross abnormalities of the peripheral and central nervous system serve to indicate extreme endpoints of the effects of dioxin.  More subtle effects on the central nervous system occur before clinically demonstrable peripheral nerve damage.


Peripheral Nerve and Cerebrovascular Abnormalities

 

Government studies:

 

·         The Air Force Ranch Hand study in the scientific transcripts stated a found dioxin linear dose response to chronic polyneuropathy.

 

·         “Data showed a significant increase in the index of polyneuropathy.  Another run through the data showed it correlated significantly with dioxin.”(4)

·         “A significant and adverse relationship between peripheral neuropathy and dioxin body burden was found.”(5)

 

“The most severe neuropsychological consequence of dioxin exposure is excessive suicides, which has been demonstrated among exposed Vietnam Veterans, chemical production workers in the U.S. and European countries, forestry workers, and railroad workers.  Another severe consequence is the excessive death rate from accidents found among the dioxin-exposed chemical production workers and Vietnam Veterans, representing either motor neuron malfunction or suicide in disguise.

 

“In 1977, the Working Group of the International Agency for Research on Cancer (IARC) found that neurological and behavioral changes were among the most frequently reported effects in studies of exposures to 2,4,5-T (IARC, 1977a). 

 

IARC identified 6 out of 7 different populations occupationally exposed to chlorinated phenolic compounds where neuropsychological symptoms such as neurasthenic or depressive syndromes were established (IARC, 1977b).  IARC noted that PNS damage was also found in the same 6 dioxin-exposed populations, including polyneuropathies, lower extremity weakness, and sensorial impairments (sight, hearing, smell, taste). 

 

In 1986, the IARC clearly restated it’s finding that dioxin had been found to be associated with peripheral neuropathies and personality changes (IARC, 1986). (2)

 

“The evidence from the 1990 Ranch Hand study (Thomas, et al., 1990) is particularly compelling in demonstrating CNS damage from Agent Orange exposure. (2)


“Significant psychological deficits were found among Ranch Hand veterans in several subscales in a battery of psychological tests.  In contrast, none of the typical dioxin-related psychological deficits were ever found in statistical excess among matched controls.  Ranch Hand Veterans experienced a statistically significant excess of great or disabling fatigue during the day, a condition found among many other populations exposed to dioxin. (2)

 

“Borderline statistically significant verified psychological disorders were found for the category "other neuroses.  A series of tests found a borderline statistically significant excess of Ranch Hands experienced depression, somatization, and the severity of psychological distress.  Antisocial and paranoid scores for the Ranch Hands were significantly higher, and the psychotic delusion score was marginally significantly higher for Ranch Hands. (2)

 
 “CNS effects, other than neuropsychological deficits, were also found among Ranch Hand veterans (Thomas, et al., 1990).  When Ranch Hand veterans or controls that had known past exposures to insecticides were excluded from one analysis (so that neurological findings could be attributed solely to Agent Orange), Ranch Hand veterans exhibited significantly elevated relative risk for cranial nerve dysfunction.  Analyses disclosed marginally more balance/Romberg sign (standing without swaying when eyes closed and feet together) and coordination abnormalities for Ranch Hand veterans. (2)

 

“The VA proposed exclusion of peripheral neuropathies that only become evident 10 or more years after service in Vietnam, on the assumption that such a neuropathy could not be associated with Agent Orange exposure, due to the long interval from exposure.  (2)

 

“This assumption contradicts the findings of the OTA, which found that neurological damage is not always detectable clinically, or noticeable by, the sufferer after exposure to a neurotoxic substance such as dioxin.  As time progresses or old age approaches, the rate of natural neuronal cell death accelerates, and the results of earlier neurological damage may first become evident, or unmasked (OTA, 1990).  The availability of alternate neuronal pathways is reduced, which were formerly responsible for compensating for earlier toxic damage.  The OTA specifically noted the importance of research showing the possibility that neurotoxic substances were important in Alzheimer's disease, the degenerative brain disease of old age.” (2)

 

These found Ranch Hand medical dioxin correlation facts “were not published” in their released publications.  One would wonder why?

 

One openly criticized fact is the cohort selection of the Ranch Hand study.  The Ranch Hand study used those MOS’s associated with loading, spraying, and overall handling of the toxic chemicals.  Yet, they were compared to other Vietnam Veterans that were supposedly never exposed.  How this was ascertained at the inception of the study is unknown since the methodology for measuring dioxin was not recognized until 1987, while the first physicals were given in 1982.  In using the dioxin method approved in 1987, the Ranch Hand made the decision to cut off at 10 parts per trillion (ppt).  Even though the studies at Emory University show a correlation to a 17% increase in cancer, any cancer, when going from 5 ppt to 10 ppt.(6)

 

Including the scientists could not correlate that this increase remained linear across the scale or did at some level become logarithmic or possibly a step linear progression.

 

Why this study did not use a cohort “not associated with Vietnam” in its correlation and statistical comparisons is a real question involving integrity of the study.  Like comparing a sick two-story building with the 1st and 2nd floors only and then say, “see we found no statistical increases between the two floors in any disorders.”  (Everyone in the building is sick and dying.)      

 

·         The Korean Agent Orange Impact studies in a totally blind honest study, unlike our own government’s studies, found dioxin related to peripheral neuropathy at a p-value of 0.039.  The study also found a p-value of difference between Vietnam Veterans and non-Vietnam Veterans a p-value of difference of 0.0042.  An odds ratio (OR) was found of 2.39.(7)

 

·         The Korean Agent Orange Impact studies also found cerebrovascular issues as follows:  Brain Atrophy except cerebellum a p-value of 0.0165, Brain Infarction a p-value of 0.0013.  In the spinal chord areas the study found Radiculopathy including herniated intervertebral disc a p-value of <0.0001, Radiculopathy a p-value of 0.0002 was found with an odds ratio (OR) of 3.98, Myelopathy a p-value of 0.0851, and in Spondylosis a p-value of 0.1311 was found.(7)

 

·         In a second Korean impact study evaluating the immune system the statement was made:  Based on the results of two epidemiological studies, Peripheral Nerve Disease is the most prevalent disease followed by Lung Cancer, Beurger’s Disease, Larynx Cancer, non-Hodgkin’s Lymphoma, and Chloracne associated with Agent Orange Exposures.  Based on the results of two epidemiological studies of probably associated with Agent Orange exposure, Hypertension was the most prevalent disease followed by Diabetes Mellitus, Seborrheic Dermatitis, Central Nervous Diseases, Liver Diseases, Cancer, Hyperlipidemia, Cerbrovascular Disease, Ischemic Heart Disease, and other skin disorders such as Chronic Urticaria and Psoriasis Vulgaris.(8)

 

·         In the second study, based on three cohorts, the conclusion was that military service in Vietnam and/or dioxin exposures may contribute toward alteration of IgG subclasses, T-cell subset activity, and qualitative characteristics of red blood cells.(8)              

 

Unlike our own government studies that refuse to statistically compare Vietnam Veterans and non-Vietnam Veterans, this study did compare “unlike Veterans” as well as had no default selection as to MOS, which limits the methods of exposure.

 

1973 and 1974 -  “Similar findings were reported by Jerasneh, et al (1973, 1974) in a factory in Czechoslovakia which in 1965-68 produced 76 cases of chloracne, 2 deaths from bronchogenic cancers.  Some workers had porphyria cutanea tarda, urophryimuria, abnormal liver tests, severe neurasthenia, depression syndrome, and peripheral neuropathy.”  (9)

 

  1975 -  “An accident in West Virginia affected 228 people.  Symptoms included chloracne, melanosis, muscular aches and pains, fatigue, nervousness, and intolerance to cold. (9)

 

In humans the IARC found that: a 23 year old farming student, who committed suicide, had 6 grams of 2,4-D in his body, acute congestion of all organs, severe degeneration of ganglion cells in his central nervous system, and three cases of peripheral neuropathy in humans sprayed with 2,4-D with initial symptoms of nausea, vomiting, diarrhea, swelling and aching of feet, legs with latency. (9)

 

In individual cases showed paresthesia in the extremities, pain in the legs, numbness and aching of fingers and toes, swelling in hand joints, and flaccid parapheresis.  Similar case reports in agriculture workers sprayed by 2,4-D, or workers associated with 2,4-D developed symptoms of somnolence, anorexia, gastralgia, increased salivation, a sweet taste in the mouth, a sensation of drunkenness, heaviness of the legs and hyperacusea, rapid fatigue, headache, loss of appetite, pains in the region of liver and stomach, weakness, vertigo, hypotension, bradycardia, dyspeptic symptoms, gastritis, liver dysfunction, changes in metabolic processes.  (9)

 

1977 - “The IARC International Agency for Research on Cancer reported in 1977 with respect to 2,4,5-T’s effects on humans that: workers exposed at a factory in the USSR had skin lesions, acne, liver impairment, and neurasthenic syndrome.”  (9)

 

1985 -  “The Hawaii Department of Health released an evaluation of the health of 418 Hawaii veterans of the Vietnam Era.  The veterans for this study group were selected at random from both Vietnam and non-Vietnam veterans currently living in Oahu, Hawaii, and matched according to health status prior to military service.  Veterans were sent questionnaires, followed up by letters and telephone calls, resulting in an 81% response rate.

 

“Compared to veterans who did not serve in Vietnam, Vietnam veterans reported significantly more emotional problems including depression, rage, anxiety ("uptight"), or irritableness (PTSD).  A statistically significant greater number of Vietnam veterans reported neurological symptoms, including tiredness, headaches, nervous disorders, hearing loss, difficulty with memory or concentration, dizziness, faintness, fainting, and blurred vision.

 

“A statistically significant greater number of Vietnam veterans reported muscular and skeletal problems, possibly of neurological origin, including problems with joints of upper extremities (neck, arms, hands, etc.), difficulty climbing stairs or holding arms at shoulder level.”(2)

 

These Vietnam Veterans show the same typical symptoms that many Vietnam veterans demonstrate in what seems to be some sort of “toxic chemical syndrome, which includes a chronic and debilitating neuropathy condition.”

 

In 1987 - the Department of Neurological Sciences at the St. Lukes Medical Center in Chicago published findings on the neurological damage to 47 railroad workers.  These workers were responsible for cleaning up a 1979 spill of Monsanto's dioxin contaminated "OCP-Crude," a mixture of mono- to trichlorinated phenols.  Two of the 47 workers committed suicide.  Forty-three of the remaining 45 were diagnosed as having peripheral neuropathies.  (The excess rate of suicides in this group is more than obvious.) (2) 

 

1990 – The VA study of Army Chemical Corps units found excess deaths from nervous system disease.  As well as the excess deaths from Hodgkin's disease, leukemia, and brain cancer.  Deaths from nervous system diseases included two deaths (0.7 expected, SMR = 4.16) from amyotrophic lateral sclerosis and one from multiple sclerosis.  These three deaths represented a fourfold increase in mortality from diseases of nervous system, although this excess was not statistically significant.  The authors discussed the fact that although these diseases were of unknown origin, “recent epidemiological studies suggest a possible association between motor neuron disease and occupational exposure to organic solvents.”(2)

 

It must be pointed out that the Australians reported in their survey of over 44,000 Australian Vietnam Veterans that they expected to find two motor neuron disorders instead they found 128; with respect to MS they expected to find 19 instead they found 84.(10)

 

This was over a decade ago so what the increase in continued development is at present is not known.  *Motor Neuron disorder is the European term for our amyotrophic lateral sclerosis (ALS). 

 

Again, it must be pointed out that while the VA study did have cohorts that served in Vietnam as well as outside Vietnam the cohorts were the same in toxic chemical exposures.  The comparison group was also Army Chemical Corps workers that sprayed the toxic chemicals in the United States.  When asked why they did not use a toxic chemical clean comparison group as was recommended, the answer was.  The NAS/IOM “did not mandate” such a comparison group. (11)

Commonly, railroad workers exposed were found to have intermittent distal paresthesia (abnormal sensations in the extremities, such as burning, prickling, "pins and needles," etc.), often with distal sensory loss of a mild degree, decreased reflexes, and electrical evidence of slowed conduction in one or more nerve.  Thirty-five also manifested postural and terminal intention tremor that resembled benign essential tremor.  The tremors were still progressing in some workers at the time the study ended.

 
Twenty-four had irregular involuntary contractions of the muscles, writer's cramp and/or other action of the hands, not seen initially, becoming prominent only several years after exposure.  In all 24 of these individuals, the dystonic movements were associated with prolonged or continued muscle activity that invariably involved holding some object and moving that object in some way, e.g., writing, turning a screw driver, hammering, etc.(2)

 

It should be noted that the Ranch Hand transcripts also noted a found issue with Ranch Handers of difficulty in repetitive motions.  Including in the first draft a reported finding of Ranch Handers experiencing “degenerating neurological disorders.”  This was deleted from the published report because of statements that the “Exposure Index” was wrong.  This is another criticism of the Ranch Hand report and that is the use of this Exposure Index that can be changed or manipulated.  If that is the case then the study could just as well have said that the Ranch Handers were experiencing degenerating neurological disorders from eating too many Beer Nuts at the officer’s or NCO clubs.”

 

Prior to the development of the tremors, however, the railroad workers experienced a sense of fatigue and muscle aching.  In physical examinations during 1981, a total of 22 of the 45 had indications of some cognitive impairment, commonly involving attention and concentration, based on subtests of the Wechsler Memory Scales, and on slowed reaction times.

 
In an examination in November 1981, all 45 had scores on the Beck Depression Inventory indicating some degree of depression.

 
1989 - Dow Chemical Corporation performed an analysis in 1989 of two groups of employees who had been employed sometime between 1937 to 1980, who had been exposed to dioxins, finding elevated soft tissue sarcomas, prostate, and stomach cancer.  In addition, Dow found elevated deaths from vascular lesions of the central nervous system, although these excess were not statistically significant.


Seveso, Italy Residents in the 15-year mortality dioxin accident study found a “three-fold increase” in peripheral neuropathy. 

Missouri Residents Exposed to Dioxin-Contaminated Soils, CDC Study.  

 

In 1971, dioxin-contaminated oily wastes from 2,4,5-trichlorophenol and hexachlorophene production were mixed with waste oil and sprayed for dust control on roads in residential and recreational areas in eastern Missouri near St. Louis.  In 1986, the CDC published a study documenting the health effects in residents exposed to the dioxin-contaminated soils around the Quail Run Mobile Home Park in Gray Summit, Missouri.  The study subjects had lived in the area for at least six or more between 1971 to 1983, for an average of 2.8 years.  A range of statistically significant adverse clinical tests and reported symptoms were found in the 154 exposed persons several years after exposure when compared to controls, including neurological and immunological abnormalities, abnormal liver enzymes, excretion of uroporphyrin suggestive of porphyria cutanea tarda, and dermatologic disorders.

 

Statistically significant differences were found between the exposed persons and the controls for 2 of the 14 self-reported neurological symptoms, including numbness or "pins and needles" (28.6% vs 18.1%; p < 0.05), and persistent severe headaches (26.0% vs 14.2%; p< 0.05).  The statistical significance of these findings was found to persist when the CDC made adjustments for psychological stress (knowing you lived in a dioxin contaminated area), age, sex, and socioeconomic status.  The exposed group also reported a greater prevalence of tremors (9.1% vs 3.9%; p = 0.07) and chronic memory loss (8.4% vs 3.2%; p = 0.06), although these differences were only of borderline statistical significance.

 

It should be noted also that the Ranch Hand study found a direct linear dose response to short-term memory loss, which also correlated to the number of days of exposure.

 
In 1990, the CDC published a follow-up study of the 41 Quail Run residents.  Four of the exposed persons, upon medical examinations, were found to have abnormal pain sensation (pin prick) in the lower extremities.  Five were found to have abnormal reflexes.  These abnormalities were found almost two decades after exposure.

 

Central Nervous System Effects (Neuropsychological and Neuropsychiatric (2)


Central nervous system damage by dioxin (and other organic compounds such as solvents, discussed in a following section) occurs before any clinical diagnosis of peripheral nerve damage is possible.  The effects of dioxin on the central nervous system include poor coordination and neuropsychiatric effects (depression, anxiety, loss of libido, suicide, decreased mental functioning, poor coordination, accidents, etc.).  These central nervous system effects may be measured clinically by a range of memory, intelligence, coordination, and mental skill tests that require certain types of mental functioning.


Central nervous system effects will occur at lower exposures to dioxin than will result in any peripheral nerve damage that can be demonstrated clinically (such as by nerve condition test).  The most severe consequences of central nervous system damage by dioxin is an excess of suicides, resulting from an underlying depression state, as well as fatal accidents arising from coordination dysfunction.  The high rate of psychosocial problems experienced by Vietnam veterans thus appears to be related in part to dioxin exposure, and not solely to some unique stress from service in Vietnam.

 
Harvard Study of Vietnam Veterans with Organic Psychological Disorders. 

In 1988, the Department of Psychiatry, Harvard Medical School published a study of the psychological disorders of Vietnam veterans heavily exposed to Agent Orange.  The presence of chloracne (a skin condition resembling acne, persisting several decades after exposure) was used to indicate past heavy exposures to Agent Orange.  A total of 1957 Vietnam veterans in the Boston area were contacted.  Of these, 42 veterans reported a condition possibly indicative of chloracne.  Six were confirmed to have current mild cases of chloracne.

 

Twenty-five control subjects, also Vietnam veterans, were selected at random.  These controls were confirmed as not having chloracne, scars possibly indicative of chloracne, or recollection of any condition resembling chloracne.  In order to account for the effect of combat stress, all of the control subjects were chosen to equal or exceed the combat experience of the exposed subjects.  Reports of combat experience in all study participants were verified independently. 

Common tests for central nervous system function include the following: Dotting tests require the placement, as rapidly as possible, of dots on either side of two parallel lines.  Trail making tests require the subject to join numbered objects with a pencil mark.  Visual Search tests require visual searching of a pattern for similarities.  Digit Symbol tests require the subject to substitute symbols for the numbers 1-9 as rapidly as possible.  The Grooved Pegboard test require the placement of 25 keys into shaped holes, etc.

 
A neuropsychological battery of tests sensitive to the effects of brain dysfunction was administered to the chloracne and control groups, as well as standardized interview to determine whether they experienced the symptoms of posttraumatic stress disorder (PTSD) in the last 6 months.  The testers and interviewers were blind to the chloracne diagnosis of the veterans.


The exposed group scored significantly lower (indicating greater deficits) than the control group on six of the nine neuropsychological tests for brain dysfunction, and highly significantly lower on four of these tests (p < 0.01.)    

 

The exposed subjects had significantly higher scores than did control subjects on the measures for PTSD.  All of the exposed subjects met the diagnostic criteria for PTSD and the three associated features (depression, anxiety, and aggression).  In contrast, in the control subjects, the PTSD rate was only 20%, and the rate for the three
associated features was only 8%.

 
The author of the study concluded that the statistical evidence for organic psychological deficits in the exposed subjects is very strong, based on the neuropsychological battery of tests, as well as on the difference in the rate of PTSD and the associated features of depression, anxiety, and aggression.  There were enough significant correlations between the PTSD and neuropsychological measures to make it unlikely that this degree of association could occur by chance.

 
Significant exposure to Agent Orange, as measured by the presence of chloracne, appeared to increase the prevalence of PTSD.  The probability of finding six PTSD cases in six veterans in the exposed group, based on the prevalence of PTSD in the controls (5 out of 25), was only 0.000064 (p= 0.000064).  The level of combat experience was found not to be a likely explanation of the differences in PTSD scores, since two of the exposed subjects experienced only light combat, while all of the controls experienced heavy combat.  Furthermore, the type of anxiety described by the exposed Vietnam veterans, on a subjective basis, differed substantially from the less exposed Vietnam veterans.

 
Veterans' Affairs Study of Chemical Corps Veterans


The 1990 study by the Department of Veterans Affairs (VA) on Vietnam veterans who had served in the Army Chemical Corps found an excessive hospitalization rate for mental disorders.  These mental disorder diagnosis were accompanied by other findings of excess brain cancer, nervous system disease, and neurologically- based excess accidental
 

Out of approximately 1000 men serving in the Chemical Corps, 894 were located for the study. During the study period from 1978 to 1988, 136 out of the 894 Chemical Corps veterans were treated as inpatients in the VA medical system.  Mental disorders were the most common primary diagnosis among the 136 patients.  The VA provided no statistical analysis of these findings.


Air Force 1990 and 1991 Ranch Hand Reports

 
The February 1990 Air Force Ranch Hand follow-up morbidity report found a greater frequency of central nervous system deficits in some test categories for Ranch Hand veterans compared to controls.  When Ranch Hand veterans or controls that had known past exposures to insecticides were excluded from the analysis (so that any neurological findings could be attributed solely to Agent Orange), Ranch Hand veterans exhibited a significantly elevated relative risk for a measure of cranial nerve function.  Analysis disclosed marginally more balance/Romberg sign (standing without swaying when eyes closed and feet together) and coordination abnormalities for Ranch Hand veterans.


The Air Force study released in March 1991 correlated the physical health findings from the 1990 Ranch Hand study with “serum dioxin levels.”  Dioxin levels were found to be significantly associated with poor coordination and deficits in a central nervous system index.

 

Psychosocial Characteristics

 
The CDC also has established increased occurrences of depression and anxiety in Vietnam veterans.  In the 1988 Psychosocial Characteristics part of the Vietnam Experience Study (VES), the CDC found that among Vietnam veterans, certain psychological problems were significantly more prevalent, including depression (4.5% vs. 2.3%; odds ratio = 2.0; 95% C.I. = 1.3 - 1.8) and generalized anxiety (4.9% vs. 3.2%; odds ratio = 2.0; 95% C.I. = 1.1 - 2.1).  About 15% of Vietnam Veterans experienced combat-related posttraumatic stress disorder at some time during their military service.  Depression and anxiety were not restricted to the group of veterans having posttraumatic stress disorder.

 
Central Nervous System Effects (Neuropsychological/psychiatric (2)
 

In 1988, the American Legion-Columbia University Vietnam Veteran Study examined the health and reproductive outcome of Vietnam veterans in relation to past exposures to Agent Orange.  The study was conducted by Dr. Jeanne Stellman, Professor of Public Health at Columbia, and Dr. Steven Stellman, the Assistant Vice President for Epidemiology at the American Cancer Society.  An Agent Orange exposure estimation methodology was developed based on the Department of Defence spray mission data and troop movement files development by the U.S. Army and Joint Services and Environmental Support Group.

 

Agent Orange exposure status was scored for 2087 men who served in Southeast Asia, categorized as low (0 -0.097) for 947 men, medium (0.098 - 0.308) for 583 men, and high (0.308 -9.9) for 557 men.  The Vietnam veterans responding to the questionnaire did not know their exposure status ranking.  A group of 102 Vietnam veterans who had handled Agent Orange directly were placed in a separate category.

 
A health "symptom complex" scale was developed that could indicate neurological effects from Agent Orange exposure, which included reports of either feeling faint, fatigue, or aches.  Compared to veterans of the same era who did not serve in Vietnam, a statistically significant greater number Vietnam veterans overall were found to report these symptoms (p < 0.001).  For veterans who were herbicide handlers, when compared to other Vietnam veterans, there were also significantly higher reports of these symptoms (p < 0.001 - 0.05).


Monsanto 2,4,5-T Production Workers.

In an independent 1984 study of workers at Monsanto's Nitro, West Virginia 2,4,5-T manufacturing plant, workers who had exhibited chloracne (a criteria for exposure) had statistically significant (p < 0.025) higher prevalence of reported symptoms of muscle pain, insomnia, as well as reported sexual dysfunction and decreased libido.  A study published in the same year by Monsanto Corporation also found statistically significant increased incidences for three neurological/psychological syndromes.  For nervousness/anxiety/depression, the rate ratio for all exposed workers compared to "unexposed" workers at the same plant was 1.3, which increased to 2.9 for the subgroup of exposed workers over the age of 50.  For decreased libido, the rate was higher among exposed workers (rate ratio = 2.28).  For impotence, the rate was higher among exposed compared to unexposed workers (rate ratio = 2.35).

 
Missouri Residents Exposed to Dioxin-Contaminated Soils, CDC Study. 
 

The 1986 CDC study documenting the health effects in residents exposed to the dioxin-contaminated soils around the Quail Run Mobile Home Park in Gray Summit, Missouri found psycho neurological and neuropsychiatric abnormalities.  A statistically significant difference between the exposed and non-exposed group was found for the vocabulary subset of the Wechsler Adult Intelligence Scale.  The exposed group was found to have statistically significant higher (more abnormal) scores on the tension/anxiety and anger/hostility scales.  In addition, the scores of the exposed group were higher for the depression/dejection and fatigue/inertia scales, although these differences were not statistically significant.  The exposed group also consistently took longer to complete and made more errors in the Trail Making tests.

 
Earlier Studies Establishing Neuropsychiatric Abnormalities from Exposures to Dioxin


Earlier studies have also established a casual link between occupational exposures to dioxin and psychological abnormalities.  In a 1981 study of dioxin-exposed residents in Seveso, Italy, there was a nearly threefold higher incidence of peripheral neuropathy in those subjects exhibiting signs of dioxin exposure, such as chloracne or abnormal serum hepatic enzymes.  In one study of workers at a U.S. 2,4-D and 2,4,5-T manufacturing plant, workers with the most severe chloracne scored significantly higher on the manic scale of the Minnesota Multiphasic Personality Inventory (MMPI) than those workers who had less severe acne (p< 0.05). 
 

A study of three laboratory scientists who had transient minimal exposure to dioxin found them to have personality changes and other neurological disturbances, as well as chloracne in two of the scientists. 

A study published in 1981 showed markedly higher rates of both nerve damage and psychiatric problems in Czechoslovakian 2,4,5-T production workers.  This study is important in showing the central nervous system involvement, manifesting as neuropsychiatric disorders, when peripheral nervous system damage was diagnosed.  Sixty four percent of the 55 workers were found to have psychiatric changes, severe neurotic symptoms and signs with disorders of the vegetative nervous system.  Eleven percent exhibited neurasthenia syndromes with depressive components.  Fourteen percent exhibited pseudo neurasthenia syndromes where there was arteriosclerosis of the central nervous system.

 
Although, the authors of the study for comparison provided no controls or standard incidences of these abnormalities for the general population, the relative rates were obviously and strikingly elevated.  In 1968 and 1969, 80 out of 400 2,4,5-T production workers became ill, and 55 were admitted into the Department of Occupational Diseases University in Prague.  Out of the 55 workers, 23 percent were found to have neurological effects at the time of the onset of illness, with 31 percent currently.  These neuropathies predominantly consisted of peripheral neuron lesions in the lower extremities (peripheral neuropathy), verified by electromyography.  Seven percent had encephalopathy (atherosclerosis of the cerebral arteries) at the time of onset of illness, with 9 percent suffering from this disorder after 10 years.  In some patients, symptoms became more severe during the 3 to 4 year period after the initial illness, and illness persisted in all of
the patients at the time of the publication of the study. 


 Suicides Associated with Dioxin Exposures (2)


Studies on several populations exposed to dioxin and phenoxyacetic acid herbicides have demonstrated statistically significant increased risks of suicide.  The fact that elevated suicide rates were found in forestry workers as well as in chemical production workers, argues against the excess suicides among Vietnam veterans being attributable solely to
psychological disorders unrelated to dioxin exposures (such as combat related posttraumatic stress disorder).

 
Furthermore, a significant fraction of the excessive rates of accidental deaths among Vietnam veterans and dioxin-exposed chemical production workers, are probably due to suicide.  This is because a corner's report does not indicate suicide for a death certificate unless the victim clearly indicated intent to commit suicide, or the evidence clearly indicates suicide.  Suicides may be intentionally disguised as fatal accidents, drug overdose, and single driver accidents.

 
Massachusetts Vietnam Veterans

 
A 1988 study by the Massachusetts Department of Public Health found elevated estimated suicide deaths in Vietnam veterans compared to either non-Vietnam veterans (standardized mortality odds ratio (MOR) =1.46; 95% C.I. = 0.89 - 2.37) or non-veteran male controls (MOR) = 1.73; 95% C.I. = 1.22 - 2.44).


New York State Vietnam Veterans

 
In 1985, the New York State Department of Health, in conjunction with the VA and NCI, published a study of causes of death among New York State (excluding New York City) Vietnam veterans between 1965-1967 and 1970-1980.  Both non-veterans and non-Vietnam veterans were used as controls.  Statistically significant excess suicides were observed for Vietnam veterans compared to non-veterans (adjusted Mortality Odds Ratio [MOR] = 1.62, C.I. = 1.44 - 1.82).  Excess suicides were also observed when Vietnam veterans were compared to veterans who did not serve in Vietnam (MOR = 1.24, C.I. = 0.88 - 1.75), although this excess failed to reach statistical significance.


Vietnam Army Veterans, CDC Postservice Mortality Study

 
In 1987, the CDC published findings of the causes of death in 9324 U.S. Army veterans who served in Vietnam, compared to 8989 non-Vietnam veterans.  Excess mortality in Vietnam veterans occurred mainly in the first five years after discharge from active duty (rate ratio = 1.45; 95% C.I. = 1.08 - 1.96).  The CDC found that Vietnam veterans (as a whole group, without controlling for the most heavily exposed) had increased risks for dying from suicide within five years post discharge (rate ratio = 1.72; 95% C.I. = 0.72 - 3.88).  In addition, it was found that Vietnam service had a greater effect on mortality for those who were discharged before 1970, compared to those discharged during 1970 or later (p = 0.05).  The elevated death rate for discharge before 1970 corresponds to the fact that Agent Orange spraying reached a peak in 1969, tapering off in 1970, and eventually was stopped completely in 1971.


Wisconsin Department of Health Vietnam Veteran Study


The 1986 Wisconsin Department of Health study found significantly elevated deaths from
suicide among Wisconsin Vietnam veteran compared to non-veterans (civilians) (SMR = 1.18; p < 0.05).  Elevated rates were also found when Vietnam veterans were compared to other veterans who had not served in Vietnam (SMR = 1.14), although in this comparison the difference failed to reach statistical significance.

 
Australian Veterans Health Service Study

 
The Australian Veterans Health Services published a mortality study comparing 19,205 Australian Vietnam veterans with 25,677 non-Vietnam veterans who served only in Australia.  For the period from 1983 to 1985, death rates from suicide were significantly elevated (odds ratio = 1.5; 95% C.I. = 1.0 - 2.4).


Canadian Forestry Workers

 
215. In 1991, the Ontario electrical utility company published a mortality study of 1222 men employed by the company between 1950 through 1982 for at least 6 months, who were exposed to phenoxyacetic acid
herbicides.  Herbicides were used to clear the right-of-way for power lines.  Most forestry workers were exposed to herbicides on a weekly basis throughout the year, and no protective clothing was worn in the 1950s and 1960s. The most commonly used herbicides were 2,4-D and 2,4,5-T (2,4,5-T up until March 1979).

 
Statistically significant elevated suicide rates were found among these forestry workers (SMR = 2.10; p = 0.04). One suicide death was preceded by a progressively disabling neurological disease (exact neurological diagnosis not provided in the study).

 
Boehringer 2,4,5-T Workers

The 1990 preliminary report on workers at the Boehringer 2,4,5-T plant in Germany found statistically significant excesses of suicide.  Twenty-one suicides were found for the period between 1952 to the present (SMR = 3.62; 95% C.I. = 2.18 - 5.66).


BASF 2,4,5-T Production Workers


218. The 1989 follow-up mortality study of BASF of its own workers exposed to a 2,4,5-T production accident in 1953 revealed statistically significant excesses of suicide, as well as the excess cancer deaths.  Among a group of 69 workers who had worked in the 2,4,5-T production area at the time of the accident, 2 had committed suicide within 9 years of exposure (0.22 expected; SMR = 9.09; 90% C.I. = 1.62 - 28.61; p one-sided < 0.05). Another group of 84 workers was engaged in the clean-up and demolition of the 2,4,5-T production area, who also experienced an excesses of suicides.  Within 19 years of their first exposure to dioxin, 3 in this group had committed suicide (SMR = 9.84; 90% C.I. = 2.68 - 25.44; p one-sided < 0.05).


 Fatal Accidents Associated with Dioxin Exposures (2)

 
Several studies have demonstrated higher rates of deaths from accidents (including motor vehicle accidents) for Vietnam veterans and other groups exposed to dioxin.  The higher rates of accidents found among chemical production workers exposed to dioxin is of particular relevance, since the excesses cannot be explained away by posttraumatic stress disorder or other post-Vietnam readjustment problems.  The excessive death rate from accidental causes among Vietnam veterans therefore appears to be due to dioxin exposure, and not due solely to unique psychological stress related to service in Vietnam.

 
Various dioxin-exposed populations, including Vietnam veterans, have demonstrated coordination problems, motor nerve abnormalities, etc., all of which could lead to fatal accidents.  Accidental deaths by vehicles, non-vehicular accidental deaths, and accidental poisonings (including drug overdoses) are either a consequence of organic neurological dysfunction from dioxin exposure, or suicide in disguise, also a consequence of central nervous system damage from dioxin exposure.

 

Veterans' Affairs Study of Chemical Corps Veterans

 
In the 1990, VA study of Army Chemical Corps veterans found statistically significant excess deaths were found for motor vehicle accidents among Vietnam veterans (SMR = 2.00; 95% C.I. = did not include 1) as well as from other accidents (SMR = 1.18).  Chemical Corps units were responsible for mixing and application of herbicides, as well as riot control substances and burning agents.  These probable neurologically based excess deaths from accidents
were accompanied by other findings in the same study of excess nervous system disease, brain cancer, and mental disorders which required hospitalization.

 
New York State Study of Vietnam Veterans

In 1985, the New York State Department of Health, in conjunction with the VA and NCI, published a study of the causes of death between 1965-1967 and 1970-1980 among New York State (excluding New York City) Vietnam veterans.  Non-motor vehicular injuries of transport were the highest cause of death in Vietnam veterans compared to non-Vietnam veterans (adjusted Mortality Odds Ratio [MOR] = 2.18; 95% C.I. = 1.19 - 3.99), followed by other accidents and burns (MOR = 1.37; 95% C.I. = 0.95 - 1.98).  Accidental poisoning deaths (potential disguised suicides) were also significantly elevated among Vietnam veterans compared to non-Vietnam veterans (MOR = 1.48; 95% C.I. = 1.21 - 1.82).


Fatal Accidents Associated with Dioxin Exposures Vietnam Army Veterans, CDC Postservice Mortality Study

In 1987, the CDC published findings of the causes of death among 9324 U.S. Army veterans who served in Vietnam, compared to 8989 non-Vietnam veterans. <199> The CDC found that Vietnam veterans had significantly higher mortality from motor vehicle accidents (rate ratio = 1.48; p = 0.03) compared to non-Vietnam veterans. This excess was most pronounced in the first five years after discharge from active duty (rate ratio = 1.93; 95% C.I. = 1.16 - 3.22; p = 0.01).

 
Vietnam service appeared to have a greater effect on mortality from motor vehicle accidents for those who were discharged before 1970, compared to those discharged during 1970 or later (p - 0.05).  This elevated risk of those discharged before 1970 corresponds to the fact that Agent Orange spraying reached a peak in 1969, and eventually was stopped in 1971.

 

Moreover, the list of studies and findings goes on and on regarding this impact of toxic chemical exposures from wartime service in Vietnam.


 Neuropsychiatric/Neuropsychological Disorders from Other similar Toxicants (2)


The studies summarized below illustrate the biological similarity between the central nervous system damage caused by dioxin and that found for other neurotoxic chemicals.  Central nervous system damage caused by neurotoxicants includes long-term organic psychological and psychiatric disorders, such as anxiety, depression, as well as impairments in motor speed, learning and memory, and mental flexibility. Several studies have shown that exposures to neurotoxic solvents have resulted in neuropsychiatric and neuropsychological profiles similar to the posttraumatic stress disorder suffered by World War II prisoners of war.

 
All chemicals which cause peripheral nerve damage also have been shown, when adequately tested, to cause central nervous system damage.

 
The total nervous system, not just the peripheral nerves, is subject to attack and damage by lipophilic ("fat loving") compounds.  Nervous system tissue, with its high lipid content, acts as a repository for organic solvents, or the extremely lipophilic compound, dioxin.

 
Exposure of the nervous system to toxic substances is through the bloodstream.  As a result, involvement is not limited to the peripheral nervous system tissue in the arms and legs.  Nerves in the brain, spinal cord, etc. are similarly effected.  Furthermore, neuropsychiatric and neuropsychological dysfunction from exposure to organic compounds is apparent prior to any overt peripheral nerve damage detectable by nerve conduction tests.


The studies described below show that the neuropsychiatric and neuropsychological effects of solvents persist years after exposure, and in many cases worsen.  Yet, solvents would be expected to persist in the fatty nervous system tissue a much shorter time than dioxin.


Veterans' Hospital and Pittsburgh School of Medicine Study of Solvent

In 1989, a Pennsylvania Veterans' Hospital and the University of Pittsburgh School of Medicine published findings on the similarity of neuropsychiatric disorders in men occupationally exposed to solvents and former World War II prisoners of war.  Twenty-two men who had a history of exposure to mixed solvents, but who had no documented neurologic or psychiatric disorders or a history of alcohol intake exceeding one or two drinks per day, were tested using the Minnesota Multiphasic Personality Inventory (MMPI) to measure psychiatric symptoms.  Findings were compared to the MMPI profiles for World War II former prisoners of war. 
 

Results from the clinical scales found that for 90% of the solvent exposed men, two or more of the ten MMPI scales were elevated (more than 2 standard deviations above the norm) indicating a consistent pattern of solvent-induced neuropsychiatric symptoms. Sixteen of the 22 exposed workers had significant clinical neuropsychiatric elevations, and only one worker had all scores in the normal range.  The solvent exposed men were found to have neuropsychological profiles that were quite similar to those found in a group of former World War II prisoners of war.  The authors had found that half of the former prisoners met the full criteria of posttraumatic stress disorder.  The MMPI pattern found for the solvent exposed men was strikingly similar to that seen in other persons who have experienced severe wartime trauma (posttraumatic stress disorder).  Individuals with the MMPI scores observed among the World War II prisoners of war and solvent exposed men were described as having an unusual degree of concern for their physical well-being, being anxious, depressed, having difficulty concentrating, and being likely to report feelings of unreality and disturbances in thinking.

 
Suicidal Tendencies from Carbon Disulfide Exposure


Carbon disulfide, a volatile liquid used in the production of viscose rayon and cellophane, has been recognized since 1982 for causing psychiatric symptoms through central nervous system damage.  Suicidal tendencies, memory deficits, delusions, hallucinations, acute mania, depression, fatigue, and apathy are recognized neuropsychiatric symptoms.  Damage to the peripheral nerves (neuropathies) also result from carbon disulfide exposure.

 
Hospital Study of Workers Five Years after Solvent Exposure


In 1990, a collaborative study by six Swedish hospitals evaluated the lasting central nervous system effects of solvents.  A group of 46 men exhibited central nervous system disorders from solvent exposure at least 5 years after exposure had ceased.  These symptoms included reduced activity levels in everyday life, leisure activities, and education or training, as well as neuropsychiatric symptoms.  These men exhibit significant increased memory disturbances, difficulty in concentration, fatigue, lack of initiative, and mood effects such as irritation and depression.  This group of men also continued to have significantly lower performance levels in visuospatial ability (Block Design), perceptual speed (Digit Symbol, Same Numbers, Dots), memory, and psychomotor speed (Cylinders).  Most subjects had no improvement over the 5 years, and several showed signs of deterioration.

 
University of Pittsburgh School of Medicine Study, Dose-response Relationships for Neuropsychological Changes in Solvent Exposed Workers

The Department of Psychiatry, University of Pittsburgh School of Medicine published another study in 1990 establishing dose-response relationships for past exposure to solvents and the neuropsychological and neuropsychiatric effects of these exposures (personality changes resembling posttraumatic stress disorder).  Workers exposed to organic solvents were compared to age and education matched blue-collar workers with no history of exposure. 


The exposed workers exhibited significant clinical elevations for 4 of 10 scales of the MMPI, a pattern that indicates the presence of concern over ones health, anxiety, depression, poor concentration, and disturbances in thinking.  This pattern was fairly stable for all workers; 70% had elevated scores on 3 of the 4 clinically elevated scores.  Length of exposure to solvents was significantly correlated with clinical elevations in scores 2, 3, and 8. 


In addition, exposed workers performed significantly more poorly on four of the five cognitive text subgroups, including learning and memory measures, with the largest differences seen on tests for recall and verbal learning, visuospatial skills, psychomotor speed, and manual dexterity.

 
Oregon Health Sciences University Study of Painters

 
Oregon Health Sciences University published a study in 1986 evaluating personality profiles of 15 painters exposed to solvents.  The painters self-reported significantly more symptoms of chronic cough, headache, dizziness, sleep disturbance, decreased coordination, abnormal taste or smell, personality changes, and decreased memory than controls (p < 0.0001 - 0.05).  Upon testing, painters as a group demonstrated clinically significant elevations on MMPI scales measuring increased worry about physical health, depression, hysteria, anxiety, and schizoid tendencies.  Psychiatric evaluations found devastating impacts on the family and work life of the painters due to memory loss and personality changes.  Evidence of a possible or probable intellectual potential deterioration was found in five painters (33%), as determined by scores on subtests that are often sensitive to organic nerve damage (i.e., Digit Span, Arithmetic, Block Design and Digit Symbol subtests) compared to scores on subtests more resilient to such damage (i.e., Information, Vocabulary, and Similarities).  On the measure of hand strength, a significantly larger proportion of painters compared to controls scored low.  The painter group also scored lower on simple motor speed and strength and visuomotor coordination, as well as having problems with the test for cognitive-visuomotor coordination.  The painters had difficulty with auditory perceptual sensitivity tests, new learning and memory tests, and attention concentration/tracking tests.  The painter group scored at normal levels on the intelligence test sub scores of vocabulary and comprehension, but below expected on the full-scale IQ score.  After 1 year, 7 of the original 15 painter were evaluated again at another clinic, after there had been no additional solvent exposure.  Four of the painters continued to manifest cognitive impairment, and one was regarded as unusually mentally slow.  Abbreviated neuropsychological tests again showed impairment of visual-spatial perception, regulatory function, short-term memory, abstraction ability, and motor skills. Nerve conduction tests showed 6 of the 7 to have two to seven abnormal test results each, demonstrating the correlation between peripheral nerve damage and central nerve damage.

 
University of Oslo Study of Workers Exposed to Carbon Disulfide


In 1990, the National Hospital, University of Oslo, Sweden published an evaluation of 24 men exposed to carbon disulfide in a rayon factory.  Clinical neurological examination demonstrated abnormalities in 15. Six had more major neurological deficits, including facial palsy, reduced tempo or coordination, asymmetric reflexes or positive Romberg's test (inability to stand without swaying when eyes closed).  Thirteen had cerebral atrophy.  Nerve conduction tests were abnormal in 6.  The most common self-reported complaints of the workers were decreased memory, irritability, tiredness, and sleep disturbances.  Neuropsychological tests showed impairment in 14, including psychomotor retardation (slow performance on Trail Making Part B and Digit Symbol), and visuoconstructive difficulties (weak results on Block Design).  Decreased memory was found in 6.  Coordination difficulties were also common, resulting in poor results on steadiness and pegboard tests. 

London School of Hygiene Study of Paint Solvent Exposures

 
The London School of Hygiene published findings on a group of 44 men employed in a dockyard as painters, who were exposed to a range of solvents.  No evidence was found of impaired nerve conduction in the
ulnar or median nerves (indications of peripheral neuropathy), and few clinical signs of overt neurological damage were apparent.  Nevertheless, neuropsychological symptoms were found among the painters.  A highly significant excess of symptoms was found among those exposed to paint solvents, with poorer performance on the Reading, Trail Making, Visual Search, Grooved Pegboard and Block Design tests.  The painters overall reaction time was slower, and they recalled fewer items in the memory test.  This study reinforces again the fact that significant
central nervous system impairment occurs before peripheral nerve damages can be detected.

 
Neuropsychological Dysfunction in Twins Exposed to Solvents


In a 1991 study, 21 pairs of identical twins were evaluated for differences in subtle central nervous system dysfunction, where only one had past occupational exposure to solvents.  The solvent exposed twin performed significantly more poorly on cognitive tests, although being similar in education level as their siblings.  Exposed twins had significantly lower performances in associative learning tests, and Digit Span and Block Design tests.  Solvent exposure also was marginally associated with control of hand movements.

 

Moreover, the list of studies and findings goes on and on regarding this impact of toxic chemical exposures from wartime service in Vietnam.

 

Summary

 

In summary one would wonder how the VA or Congress could totally ignore the data I have provided which is a small portion of what could be provided.

 

Of course, it is all about politics, protecting the White House coffers, and money the congress would rather spend elsewhere to ensure reelections.

 

If a few Veterans such as myself and a few highly dedicated other Veterans can find this data, then we need a total overhaul of the VA and its leaders that are directed by White House after White House while the Congress sits idly by; turning a deaf ear and blind eye to what has to be considered United States Government collusion with the chemical companies.

 

 

REFERENCES:

 

(1) 1982 - Times Beach, MO, families received a letter on December 23, 1982, what is now called “The Christmas Message.”  “If you are in town it is advisable for you to leave and if your are out of town, do not go back.”  The whole town of Times Beach, MO was evacuated at 2 ppb (parts per billion).  Pooled stocks would have an estimated average TCDD concentration of 1.9 ppm.

 

(2)  Lawsuit in the United States District Court for the Eastern District of New York, Ivy versus Shamrock Chemicals Company, Affidavit of Cate Jenkins, PH.D. 

 

(3) Re-Evaluation of Dioxin - A Presentation by Dr. Linda Birnbaum, Director Environmental Toxicology Division U.S. Environmental Protection Agency (EPA) To the 102nd Meeting of the Great Lakes Water Quality Board, Chicago, Illinois July 15, 1993.

 

(4) October 14-15, 1999 Ranch Hand Advisory Committee Meeting, transcripts from

 

(5) October 19-20, 2000 Ranch Hand Advisory Committee Meeting, transcripts from day one

 

(6) Dioxin:  Exposure-Response Analysis and Risk Assessment, published in Industrial Health 2003, 41, 175-180.

 

(7) Impact of Agent Orange Exposure among Korean Vietnam Veterans, published in Industrial Health 2003, 41, 149-157.

 

(8) Immunotoxicological Effects of Agent Orange Exposure to the Vietnam War Korean Veterans, published in Industrial Health 2003, 41, 158-166.

 

((9) Department of Veterans Affairs Report “Classified Confidential Status 1, not for Publication and Release to the General Public.”  A report regarding adverse health affects from exposure to Agent Orange; Dated May 5 1990.

 

(10)  Morbidity of Australian Vietnam Veterans regarding 49,944 male Vietnam Veterans and 278 female Vietnam Veterans along with 1531 widows/divorced/separated partners.

 

 (11) March of 2000, House of Representatives, Subcommittee on National Security, Veterans Affairs, and International Relations, Committee on Government Reform, Washington, DC, ;Oversight review of the Ranch Hand Study.

 

(12) The Story of Agent Orange as reported in the U.S. Veteran Dispatch Staff Report November 1990 Issue.

 

(13) Recognition and Management of Pesticide Poisoning, 5th edition, U.S. EPA, Chapter 14.

 

(14) Developmental Neurotoxicity of Dioxin and Its Related Compounds, published in Industrial Health, 2003, 41, 215-230

 

 

Definitions:

 

From the South Korean study on CNS and PNS damages:

 

Significant difference found between Vietnam and non-Vietnam veterans in the following areas:

 

Peripheral Neuropathy = .0042

Radiculopathy (including herniation of the nucleolus pulposus) = .0001

Radiculopathy = .0002

 Radiculopathy -Doctors use the term radiculopathy to specifically describe pain, and other symptoms like numbness, tingling, and weakness in your arms or legs that are caused by a problem with your nerve roots.  The nerve roots are branches of the spinal cord that carry signals to the rest of the body at each level along the spine.  This term comes from a combination of the Latin word "radix," which means the roots of a tree, and the Latin word "pathos," which means a disease.  This disease is often caused by direct pressure from a herniated disc or degenerative changes in the lumbar spine that cause irritation and inflammation of the nerve roots.  Radiculopathy usually creates a pattern of pain and numbness that is felt in your arms or your legs in the area of skin supplied the by sensory fibers of the nerve root, and weakness in the muscles that are also supplied by the same nerve root.  The number of roots that are involved can vary, from one to several, and it can affect both sides of the body at the same time.

 

Herniation of the nucleolus pulposus = .0028

Brain atrophy except cerebellum (closely associated with physical disability and clinical course in MS patients) = .0165

 

Brain infarction = .0013

 

Brain infarction - Ischemic brain infarction is qualitative stage of acute cerebral ischemia, when reversible cells injure transfers into stable morphological defect (pan-necrosis) through hemodynamics failure and various complex metabolic events triggered by energetic deficit.  Vascular disease causes metabolic and hemodynamic changes in brain and they make the brain ready to develop eventual morphological defect following acute ischemic attack.  Acute ischemic attack triggers pathologic biochemical events in all CNS compartments that cause changes of neurons as well as astroglyal proliferation (astrocytosis) and activation of microglia in unison with neurotrophins withdrawal.  Based on morphological criteria ultimate brain infarction is formed by two distinct mechanisms of necrosis and apoptosis. 

Contemporary scientific ideas about ischemic stroke pathogenesis have made it possible to create schemes of a biochemical cascade of ischemic consistent events what is of value to searching for therapeutic approaches.

One of these schemes consists of following stages (Grotta, 1995).

 

Each stage could be possible target for therapeutics.  The earlier ischemic cascade can be interrupted, the better therapeutic effect is expected.

 

(Is it not interesting in Stage 7 it discuses the blood brain-barrier disruption since we now know that 2,4,5-T and 2,4-D are known to cross the blood brain protein barrier? (14)  Given the facts found in (14) if the toxic chemical 2,4,5-T is that catastrophic to the developing brain with its neurotoxicity, it certainly cannot be that good for the developed brain. 

 

Spondylosis = 0.1311 (Degeneration of the spine and neck bones) (None found in the comparison group).

 

Myelopathy = 0.0851 Myelopathy (The process that leads to compression of the spinal cord, also called arthritis and cervical spondylosis).  (Cervical, thoracic, and/or lumbar regions of the spine affecting the intervertebral discs and facet joints).

 

Vascular necrosis = 0.1270 (Disease resulting from the temporary or permanent loss of the blood supply to the bones).  (None found in the comparison group).

Peripheral Vasculopathy = 0.0628 (Includes Burger’s disease, Raynauds syndrome, and other vasculopathy).

 

Parkinson’s disease = 0.1830  (None found in the comparison group).

 

Sleep disorder = 0.1813 (None found in the comparison group).

 

Charles Kelley

DMZ Veteran 67-68

SP5Kelley2nd94th@aol.com