Challenge to the President, Secretary of VETERANS AFFAIRS, THE CONGRESSIONAL leaders on the senate and

house veterans affairs committees,

all CONGRESSIONAL leaders,

and BOARD of VETERANS’ appeals

on toxic chemical associations to disabling chronic PERSISTENT PERIPHERAL NEUROPATHY (Polyneuropathy)

in our VIETNAM Veterans 

 

 

  

The united States campaigning “army of Vietnam” and their widows and orphans deserve

GOVERNMENT “deeds”
 
not “just words” from our government

 

ABSTRACT: Chronic Peripheral neuropathy associated with exposures to the dioxin, TCDD during wartime service by our VIETNAM Veterans. 

 

In order to determine the “validity” of the Secretary of the Department Affairs legal statements and the “validity” of the work of the National Academy of Science Institute of Medicine (NAS/IOM) regarding Chronic Debilitating Peripheral Neuropathy found in Vietnam Veterans a four-year data search was completed.

 

It was found during this search association to dioxin exposures and peripheral neuropathy was “statistically significant” and demonstrated “a proven increased risk of incidence with an Odds Ratio of at least OR =2.39.  P values of association were found at  < p - 0.050 and P values of significant differences at p - 0.0042.

 

In the governments “Gold Standard of Denial,” the Ranch Hand Study statistics were not available for obvious government denial reasons.  Evidence did find many associations in the scientific transcripts and statements by Dr. Michalek  "... we consistently found a statistically significant increased risk of all indices of Peripheral Neuropathy among Ranch Hand veterans.”

 

Additionally, during this study, it was found that government processes used in determining associations was not only non determinable as to qualification but what was found bordered on scientific misconduct and lack of intellectual freedom.

 

 

16 January 2007

 

To: Senators, Congresspersons, Government Decision Makers, and Congressional Staff Members

 

President George Bush

The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

 

Congressman Christopher Shays

Oversight Ranch Hand

1126 Longworth Building
Washington, DC 20515-0704

 

Congressman Bob Filner

Incoming Democratic Chairman

House Veterans Affairs Committee

U.S. House of Representatives

2428 Rayburn House Office Building

Washington, DC  20515

 

Senator Daniel Akaka

Incoming Democratic Chairmen

Senate Veterans Affairs Committee

Senate Office Building
Washington D.C. 20510 

 

For Congressman Buyer

CO Mr. Jeff Phillips

Communications Director

House Veterans Affairs Committee

U.S. House of Representatives

335 Cannon House Office Building

Washington, DC  20515

 

For Senator Craig 

CO Mr. Jeff Schade

Communications Director

Senate Veterans Affairs Committee

412 Russell
Senate Office Building
Washington D.C. 20510

 

Mr. Jim Nicholson

Secretary - Department of Veterans Affairs

810 Vermont Avenue, NW, Room 1000
Washington, D.C. 20420

 

Ms. Renee L. Szybala

Director

Compensation & Pension Service

VA Central Office

810 Vermont Avenue,

Washington, D.C. 20420

 

Mr. William McLemore

Deputy Assistant Secretary

Intergovernmental and International Affairs

Department of Veterans Affairs

810 Vermont Avenue N.W. Suite 915

Washington, DC 20420

 

Mr. Len Sistek

U.S. House of Representatives

Committee on Veterans Affairs

Oversight and Investigations

Room 333

Cannon House Office Building

Washington, DC  20515

 

Mr. Chris McNamee

U.S. House of Representatives

Committee on Veterans Affairs

Professional Staff Member

Subcommittee on Disability Assistance

337 Cannon HOB

Washington, DC 20515 

 

Mr. David Abbot

Staff Member

Compensation & Pension Service

VA Central Office

810 Vermont Avenue,

Washington, D.C. 20420

 

Congressman John Linder
1026 Longworth House Office Building
Washington, DC  20515-1007

 

Senator Saxby Chambliss

416 Russell Senate Office Building
Washington, DC 20510

 

Senator Johnny Isacson

Senate Office Building
Washington, DC 20510
 

 

Dr. Michelle Catlin, PhD

National Academy of Sciences
500 Fifth Street, NW

Washington, DC 20001

 

 

FROM:

Please respond to: 

Charles Kelley

2078 Eastwood Drive,

Snellville, GA 30078

SP5Kelley2nd94th@aol.com

Cell: 404-641-6477

 

Subject: The VERACITY and INTEGRITY of the government CONTROLLED and funded Ranch Hand study and the mortality and morbidity impacts to the Vietnam Veterans and their family via the tainted NAS/IOM and Department of Veterans Affairs decisions.

 

To Whom It May Concern:

 

This notice of disagreement and NEW evidentiary scientific and medical data submitted is for all Veterans of the Vietnam Era with diagnosed Chronic and Persistent Polyneuropathy.

 

 

{Toxic Chemical Issues and cumulative evidentiary data compiled by Charles Kelley –

“Veterans Agent Orange Lay Expert. 

 Author “Vietnam’s Rain Agents Orange, White, and Blue (Weapons of Mass Destruction)”}

 http://www.2ndbattalion94thartillery.com/book/bookorders.htm

 

Contents

 

Veterans' Statements

OVERVIEW

EVIDENCE

The government slippery slope

Summary

conclusions 

 

Veterans' Statements 

In toxicity comparison the entire town of Times Beach, Missouri was evacuated because of pooled stock at <2 parts per million.

Isomer Definition: A chemical species with the same number and types of atoms as another chemical species, but possessing different properties.

 

The Veterans' claims are denied by the DEPARTMENT OF VETERANS AFFAIRS because of “service connection” based on exposure to herbicides in RVN is not warranted for any conditions - other than those for which “VA has found” a positive association exists between the condition and such exposure. 

 

Veterans further state; the statements that deny chronic persistent polyneuropathy made by the Secretary of Veterans Affairs, VA scientists, and NAS/IOM scientists are baseless as they are not experts in either the immunological issues of toxic chemical (dioxin/furan toxic chemicals) nor the resulting many many dioxin created autoimmune forms of neuropathies (autoimmune neuropathy).

 

Veterans further state the evidence and facts that will be demonstrated and documented qualifies this disorder for inclusion for automatically associated presumptive disorders.

 

OVERVIEW

 

The BVA and the Secretary of the Department of Veterans Affairs is “inconsistent” in statements of fact of the requirements for the Veteran to prove his service connection including that many studies have shown association of neuropathies that meet the VA’s own requirements of such studies.  (See 38 C.F.R 1.17  “Evaluation of studies relating to health effects of dioxin and radiation exposures.”)

 

The VA/board mandates positive association on exposures to “herbicides" plural).  Then mandates the Veteran prove “dioxin, TCCD” (singular) associations.

 

Veterans disagree with the VA and/or Board that all such medical associations in claims in wartime service in a toxic chemicals (plural) environment must be addressed/associated to the one single by-product of the manufacturing process of (2, 4, 5 trichlorophenoxyacetic acid; 545.4 Kg/m3) {2,4, 5-T} producing the dioxin, TCDD with that being impure Dioxin (2, 3, 7, 8-tetrachlorodibenzo-p- Dioxin) {2,4,5-T}. 

 

Veterans state that the dioxin, TCDD is a “single toxicant” of a “single component” that made up the SINGLE Herbicide with the nomenclature of “Agent Orange.”  

 

Board and its members need to be cognizant and knowledgeable to the scientific facts there is no such thing as “a dioxin.”  There are over 200 dioxins that are part of a family of “co-planer” toxicants, which includes dibenzofurans and polychlorinated biphenyls (PCB’s) and are rarely found alone, if at all, with just a single dioxin isomer.

 

Facts are - that in science and toxicology the most carcinogenic of all the dioxins, dibenzofurans, and polychlorinated biphenyls (PCB’s) IS (2, 3, 7, 8-tetrachlorodibenzo-p- Dioxin) {2,4,5-T} found in Agent Orange. 

 

Science compares the carcinogenic severity of other dioxins, dibenzofurans, and polychlorinated biphenyls (PCB’s) to the dioxin, TCDD that “IS” quantified and qualified as the worst.  The key words are “carcinogenic severity of other carcinogens in this family of toxic chemicals.”  Therefore, it is logical the Veteran would not only be exposed to the single toxicant of one component but many toxicants of the many components that made up the “Herbicides” (plural).

 

Veterans are in disagreement with the present acute and subacute transient peripheral neuropathy conclusions by the Department of Veterans Affairs as well as the NAS/IOM contracted by the same government agency the Veteran is now seeking disability compensation from on the issues of Peripheral Neuropathy and those issues normally associated with this nerve disorder.

 

Present Department of Veterans Affairs and government contracted Institute of Medicine (IOM) position on Peripheral Neuropathy is government biased and scientifically flawed.

 

EVIDENCE

 

It is imperative that those Congresspersons/Senators/Government decision makers know and understand the history of this nerve disorder, its associations to toxic chemicals, and the wide variety of opinions and biases against the nations Veterans when VA using the power it has in 38 C.F.R paragraph 1.17.  This 38 C.F.R. allows the Secretary to provide “guidelines for establishment of service connection” then minimize the effects and costs of this disorder and make many baseless, presumptuous, and erroneous decisions.

 

On May 23, 1991, the Veterans' Advisory Committee on Environmental Hazards (VACEH) considered the relationship between exposure to dioxin and the development of this condition.  The Committee concluded that there is a "significant statistical association" between “peripheral neuropathy” and exposure to dioxin.  The Committee qualified this opinion, stating that the association could be said to exist in the absence of exposure to chemical substances known to cause this disorder.  Committee members indicated that other risk factors that must be considered are age and whether the individual suffers from other known causes of peripheral neuropathy such as diabetes, alcoholism, or Guillain-Barre syndrome.  The Committee also advised that the disorder must become manifest within “ten years” of the last known dioxin exposure.

 

The VACEH’s statements confirm a found significant statistical association between “peripheral neuropathy” and exposure to dioxins.

 

The VACEH committee, in restating the medically obvious to even the 1st year medical student, stated that associations to other disorders such as alcoholism, Guillain-Barre, or diabetes also may cause peripheral neuropathy.  This statement no matter how medically inept and not even germane to the subject of  the stated found associations directly to Peripheral Neuropathy and dioxin exposures cannot be used as a qualifying statement against the Veterans. 

We now know with the state of medicine and science as it is now that exposures to dioxin does in fact create antibody problems as well as cytokine problems that direct autoimmunity in many different ways and levels.  To say this disorder could not produce what is called autoimmune neuropathy would be not only spurious at best but very unscientific (See Evidence Section Immune system).

 

We now have diabetes associated to the exposures as an automatic inclusive government compensated disability disorder.  The state of the scientific evidence (See Evidence Section Immune system) now has concluded that it is at least as likely as not the Guillain-Barr syndrome or similar immune system damages should also be included as a form of peripheral nervous system damages as an autoimmune disorder.

 

The VACEH clearly stated as part of their function (supposedly on behalf of the Veterans) the found "significant statistical association" between “peripheral neuropathy” and exposure to dioxin.  Then qualified that with a non-proven and non-justified ten year time limit.

 

To qualify the development time of any disorder associated to dioxins, including peripheral neuropathy, then one must understand not only the valid medical etiology (pathology) of how dioxin creates the found statistical association of Peripheral Neuropathy.  In addition, all the pathological roads must be identified as in many cases there is more than one pathological pathway of causations.   In addition, the discussion must now turn to threshold or ingestion rate in order to quantify a time limit.  In addition, the discussion of form of ingestion must be considered.  Different forms of Ingestions have different rates of body absorption.  None of these are known today much less in 1991.  Therefore, unless these VACEH scientists wrote on scrolls and walked on water the qualifying and the other inept statements other than the found statistical association to Peripheral Neuropathy and dioxin is nothing more than VA/government scientific misconduct.

  

It is impossible to know when the last dioxin exposures occurred in the Vietnam Veteran no matter where he/she resided after the war.  It is well known that most of the world’s population including the United States is exposed to some level of dioxins and/or dioxin like isomers.  Especially industrialized nations that continue to pollute the environment.

 

The questions have always been; what types of harm do these ingestions cause, what form of ingestions are at risk, what rate of ingestions are at risk, or what cumulative body threshold over time is required to cause some form of damage to organs and/or body operating systems.

 

The Environmental Protection Agency (EPA) in its reassessments of dioxins clearly stated that dioxin ingestions must be thought of as “cumulative lead ingestions.”  Having many subclinical long-term effects before the damage is discovered or manifestations began. 

 

These medical conditions must be considered and described as related to degenerating conditions suffered later in life which VA and NAS/IOM with no evidence to the contrary continually deny.

 

Therefore, the government/VA stance on any “time limit” to manifestations of any disorder is totally without merit or scientific precedence regarding an unknown toxic chemical or a group of unknown toxic chemicals that can have a cumulative effect not only in body accumulation but damages that occur because of constant duration of exposures.

 

Congresspersons/Senators/Government decision makers must know or become aware that these dioxins and dioxin like furans remain in the body attached to more lipid cells (fat) and only degrade in toxicity at a rate of seven to ten years of half-life.  It should also be noted that our central nervous system cells are about 70% - 80% lipids (fat) and the rest is protein.   

 

In dioxins reassessment reports, EPA identified 18 major U.S. Dioxin Sources.  It might be well for the Congresspersons/Senators/Government decision makers to make note that one of the identified sources of major dioxin contamination was the toxic chemical 2,4, -D.  Those that are familiar with the Vietnam Veterans Toxic Chemical Legacy may recall that 2,4-D was not only used as a separate herbicide with the nomenclature Agent White but also used as a 50/50 mixture within the herbicide with the nomenclature Agent Orange.

 

Clearly pointing out that the most widely used dioxins containing herbicide chemical was Agent White and not Agent Orange.  Agent White was the code name for a mixture of an approximate ratio of 4:1 of 2, 4-D (2, 4-dichlorophenoxyacetic acid; 239.7 kg/m3) and Picloram (4-amino-3, 5, 6-trichloropicolinic acid; 64.7 kg/m3), used from 1965 to 1971.

 

The toxic chemical 2,4-D is also noted for attachment to more lipid cells as a repository.

 

Further stated by the Veteran the Herbicide with the nomenclature Agent White (2,4-D) also had other dioxin isomers as well as closely related furans, which was also used separately, and as a 50/50 mixture with Agent Orange.

 

Dr. Daniel Teitelbaum, MD.; one of the world’s foremost toxicology experts in 1989 in a letter to Admiral Zumwalt during the 1989 Herbicide assessments stated: (X)

 

{In the context of evaluating Agent Orange but as documented after reviewing Dow Chemicals own documentation, his concern also was for Agent White (2,4-D):}

 

{Agent White was the code name for a mixture of an approximate ratio of 4:1 of 2, 4-D (2, 4-dichlorophenoxyacetic acid; 239.7 kg/m3) and Picloram (4-amino-3, 5, 6-trichloropicolinic acid; 64.7 kg/m3).} 

 

“What I do think...may bear on the Agent Orange issue, is the fact that in review of Dow’s 2,4-D documentation I found that there are significant concentrations of potentially carcinogenic materials present in 2,4-D which have never been made known to the EPA, FDA, or to any other agency.  Thus, in addition to the problem of the TCDD which, more likely than not, was present in the 2,4,5-T component of Agent Orange, the finding of other dioxins and closely related furans and xanthones in the 2,4-D formulation….”

 

Picloram is a conveniently Dow proprietary chemical formula that contained not only nitrosamines but also a form of benzene toxic chemical known as hexachlorobenzene.  Which would almost guarantee this formula would have other dioxins and dioxin like isomers.

 

For example:

 

Any of the hexachlorodibenzofuran isomers

Any of the hexachlorodibenzo-p-dioxin isomers

Any of the tetrachlorodibenzofuran isomers

Any of the tetrachlorodibenzofuran –p-dioxin

Any of the pentachlorodibenzofuran isomers

Any of the pentachlorodibenzo – p-dioxin isomers

 

It should be noted here, as you have seen on TV the lawyer commercials, the benzene family of toxic chemicals are also noted for causing blood disorders, including leukemia’s.

 

One can readily see that the government mandated to a “cause and effect” of the one dioxin isomer, TCDD to one medical disorder or a group of medical disorders from mixed dioxin compound isomers or dioxin like isomers in the form of furans and/or polychlorinated biphenyls (PCB’s) is outside the realm and ability of science as we know it at this present time and has mandated “undue hardship on the Veterans of this nation” that served in the government created toxic chemicals (plural) environment.

 

VA and U.S. Government, studies have solely concentrated on the worst dioxin that being 2, 3, 7, 8-tetrachlorodibenzo-p- Dioxin found in 2, 4, 5-T or Agent Orange.  Clearly, there are other dioxins, xanthones, and closely related dioxin like furan isomers that have never been looked at, identified, nor even a VA/government concern for over 40 years.

 

It is further stated by the Veteran the Herbicide with the nomenclature Agent Blue cacodylic acid (dimethyl arsenic acid) symptoms include:  (X)

 

Acute exposure may lead to: 

 Chronic exposure may lead to: 

Carcinogenicity has not been tested adequately, but it should be noted that other inorganic arsenic compounds have been found associated with liver, lung, skin, and “stomach cancers.”

 

While not in the dioxins family Agent Blue cacodylic acid (dimethyl arsenic acid) certainly has toxic chemical properties according to our own US EPA.  (X)

 

In 1969 when the US State Department got involved in analyzing and minimizing the effects that were being seen in our Vietnam Veterans.  The US State Department clearly indicated in a report by ______ that Agent Orange was of very little concern.  However, Agent Blue with its arsenic acid base “was a real concern.” (X)

 

These toxic chemical effects and possible outcomes cannot be just government ignored because Agent Blue was not as widely used as Agent White or Agent Orange.  There were very few areas of Vietnam where only Agent White and Agent Orange were used and not Agent Blue.    

        

Congresspersons/Senators/Government decision makers must recognize this clear difference between Vietnam Veterans and other increased risks of working with these isomers, and the normal genotype population.  The Vietnam Veteran in general is not going to meet the normal genotype population in background exposure levels.  Not only in dioxin isomers but also exposures to other toxic chemicals at the exact same time.

 

A study published in Industrial Health on Dioxin; Exposure-Response Analysis and Risk Assessment the following statements were made.  (X)

 

Abstract:

 

…In 1997, dioxin was found to be a human carcinogen by the International Agency for Research on Cancer (IARC), based on four other studies of industrial workers exposed to high levels.  Recently there has been interest in estimating human cancer risk at “low-level environmental exposures.”  Here we review quantitative exposure – response analysis and risk assessment for low level environmental levels…  In the US the background risk of cancer death by 75 is 12%, so doubling the background levels of dioxin exposure risk to somewhere between 12.1 and 13.0%.  Our results agree broadly with results from a German cohort, which is the only other cohort for which a quantitative risk assessment has been conducted. (X)

 

This study also found that “all cancer sites” were elevated not just the ones the government/VA has reluctantly stated are associated.  Additional statements were made that dioxins may be the first manmade “all site” cancer-producing carcinogen.  In addition, those cohort individuals that were exposed to pentachlorophenol (PCP) were excluded from this study. (X)

 

Pentachlorophenol is also a major product of the metabolism of hexachlorobenzene in mammals.

 

Chronic toxicity: Much research on PCP has been performed with poorly characterized technical material, and the chronic toxicity observed may depend in large measure on the proportion of chlorodibenzo-p-dioxins present in the mixture [69].  In a 90-day feeding trial in rats, 30 mg/kg/day produced depressed red blood cell and hemoglobin levels as well as liver degeneration, and even lower doses resulted in irregular blood chemistry and enzyme levels, along with increased liver and kidney weights [69,71].  Pure PCP, and technical PCP without dioxin contamination, produced only slight enlargement of livers and kidneys [69].  Purified PCP also did not produce toxic effects such as liver damage and immune system alterations, which had previously been reported for the technical product [69,71].  In humans, the most common exposure to PCP is inhalation in the workplace.  Abdominal pain, nausea, fever, and respiratory irritation, as well as eye, skin, and throat irritation, may result from such exposure [70], while very high levels may cause obstruction of the circulatory system in the lungs and cause heart failure [70].  Survivors of toxic exposures may suffer permanent visual and central nervous system damage [70].  Persons regularly exposed to PCP tend to tolerate higher levels of PCP vapors than persons having little contact with these vapors [70,71].

 

While cancer is not the subject of the Veterans denial, cancer risk does play a part in the rebuttal of denial.  It is clinically impossible to have a cancer causing toxicant that can only produce cancer and not autoimmune derivates of a cancer such as Peripheral Neuropathy.  This will be shown in the dysregulation of B and T cells in the immune system found associated and the variances found in the cytokines of the immune system.  (See Evidence Section)  Many subclinical autoimmune disorders are associated with peripheral neuropathies.

 

Veteran will also demonstrate the association to many such immune disorders that will cause many forms of neuropathy.  Including Veterans evidence will show that EPA and NAS now agree – “The NAS committee agreed with EPA's conclusion that dioxins are probably toxic to the human immune system,….”

 

Congresspersons/Senators/Government decision makers must remember that dioxins create at least three immune system damages in Immunotoxicology and combination of damages that the outcomes are multiple in outcomes and severity.

 

Dioxin created:

Some immunotoxicologists argue that one molecule of a carcinogenic agent, like dioxin in the right place and at the right time can create a multitude of outcomes and severity in immune system damages.

 

This study also found that while smoking and asbestos cause cancer at many sites “but not all.”  The fact that the Ah receptor occurs in all parts of the body may be the reason for TCDD not being limited to only a few cancer sites but “all cancer sites.”  In addition, SMR for all cancers = 1.46; digestive system cancers = 1.41 (which are still denied by the government/VA); respiratory cancers = 1.67.  Not a lot of variance; yet, Veterans are still denied at present.

 

Congresspersons/Senators/Government decision makers must learn from this study that when graphed as to which fit the parts per trillion in years scenario.  The logarithmic and piece-wise linear graph fit the analysis.  This is the important part for those not familiar; a threshold model did not fit the analysis suggesting there was “no threshold of exposure level below, which there were no (zero) cancer risks.” (X)

 

Once again, this study as in the Ranch Hand study was mainly for those exposed by dermal exposures, which is the most benign of all the exposures.  Skin does not absorb the toxicants very well; yet, the lungs and gastrointestinal system readily absorb dioxins.  In other words, this study as well as the Ranch Hand study would be the best-case analysis not the worst-case analysis.  Including that many disorders found as increased were not brought forward for NAS/IOM review because the did not meet the dioxin linear mandate.  This is additional scientific misconduct on the part of our government.  No scientific conclusion has been established that in all dioxin associated disorders a linear correlation even exists.  Contrary to this government/VA/NAS-IOM mandate some studies have demonstrated the fact of a non-linear response.   

 

The Environmental Protection Agency (EPA) as recently as 2005 stated general exposure levels in its dioxin reassessments, which began in 1992. (X)  While the mid-90’s levels of exposures is about half of what it was in the 1980’s it is still at 25 parts per trillion Toxic Equivalent (TEQ) lipid.  The Vietnam Veteran was at his/her most vulnerable for additional cumulative damages in the 1980’s at approximately 55 parts per trillion Toxic Equivalent (TEQ) lipids.  So even on long-term damages, there can be no time limit from initial massive multiple toxic chemical exposures resulting from the Veterans wartime service in the parts per trillion range or the parts per million ranges.  Chronic exposures resulting in constant/continuous exposures must be considered; not some “initial estimated dose” of one toxic chemical isomer of many toxic chemical isomers involved experienced during only the time spent in Vietnam. 

 

Vietnam Veterans are outside this generic qualification of background exposures.  As anyone can see it might be the additional 20 or 30 years of dioxins accumulation that is the causation dose or reaches the cumulative body threshold.  However, if not for Service in Vietnam in a toxic chemicals (plural) environment that increased his or her increased baseline at an early age then the mortality and disability manifestations caused by the dioxin, TCDD may not have taken place or had any effect on early mortality or early disability the Veteran now develops.      

 

It was known that Peripheral Neuropathies and Chronic Fatigue Syndrome (the old medical term of Neurasthenic syndrome) were associated to toxic chemical pesticide and herbicide exposures as far back as the late 1940’s.  (See Evidence Section)

 

An announcement on 3 December 2006: 

 

What are the possible health effects of Dioxin exposures?

 

At high enough levels, dioxins can cause cancer in humans.  They can also damage the nervous system, weaken the immune system, and alter menstrual cycles.

 

Dioxins have caused cardiovascular and respiratory problems, skin disease, birth defects, and other conditions in laboratory animals.

 

(X) SOURCES: National Institute of Environmental Health Sciences, federal Agency for Toxic Substances and Disease Registry

 

In addition, recently a new medical finding located in dorsal root ganglionitis (inflammation in the spinal cord) - recently discovered in a two-week autopsy, with the cause of death listed as Chronic Fatigue Syndrome.  This becomes a “clear physical manifestation” of the disorder in the Central Nervous System.

 

This new finding seems to confirm what many scientists have been saying for decades now regarding toxic chemical Peripheral Nervous System (PNS) issues and that is before any PNS issues manifest a Central Nervous System (CNS) subclinical event/causation has taken place and precedes any PNS manifestations.

 

While there seems to be, a running battle between psychiatrists and medical doctors as to the cause of this disorder.  It seems there is a medical physiological  issue associated to our toxic chemical exposures in our damaged immune systems that create this nerve damage or inflammation as well as the chronic fatigue issues found in 1984 of degenerating neurological issues by our own governments studies of those that sprayed the toxic chemicals. (X)

 

The “Government Bias” has always been that toxic chemical etiolgy must be found directly to an antigenic response by the body to the toxicant that caused the peripheral neuropathy.  This is also a flawed assumption.  Flawed by the assumptions that exposure to multiple toxic chemicals event would force the body to a direct response to the dioxin, TCDD, or any other toxicant.  With a half-life in the body of a decade or longer thereby demanding the exposures to the various toxic chemicals must be considered as simultaneous or parallel multiple exposures as opposed to a serial single toxicant exposure. This clearly demonstrates that any time limit put on a Veteran for diagnoses is a false conclusion by the government/VA/NAS-IOM in any disorder. 

 

Dioxin exposures create many systemic body damages such as in the immune system that will not meet some mandated International Classification of Diseases (ICD) but rather an undefined toxic chemicals (plural) syndrome of organ and/or body system damages in neurological, endocrine, hematological, immunological, gastrological, cardiovascular, urology, or any combination of each.  Each one separately can be the cause of chronic and persistent neuropathies of many types and varieties and even combination of different neuropathies (autonomic, sensory, motor).

 

The Veterans' Advisory Committee on Environmental Hazards did not qualify the association to “acute or subacute transient peripheral neuropathy” but clearly stated "significant statistical association" between peripheral neuropathy and exposure to dioxin did exist as early as 1991 clearly meeting the requirements in 38 C.F.R. 1.17.

 

While the Veterans' Advisory Committee on Environmental Hazards did put a flawed time limit of 10 years on the manifestation of the nerve damages, it did not indicate any time of resolution of the disorder.  Primarily because of the conditions in which the nerve damage is being caused by is more than likely not going to be curable such as in autoimmune peripheral neuropathy or even some of the smoldering cancer conditions or undiagnosed toxic chemical caused cancers.  Thus, this also eliminated the slow progression of the real disorders and long-term development from being compensated or service connected.

 

This particular disorder has an even more obvious government/VA bias and undue hardship on the Veteran in that our government put a time limit on not only the manifestation to one year but also the damage to the nerve myelin matter would repair itself within two years after removal from the toxic chemicals or resolve itself.

 

While that may be true for the Department of Defense testing program on Vietnam Veterans in the use of Dapsone for the harsh type of malaria that was found in Vietnam.  It is not true of dioxin associated Peripheral Neuropathies.  Dapsone is noted for causing peripheral neuropathy and hematological disorders directly as in a direct antigenic response to the chemicals in Dapsone (a leprosy treatment medication).  This is especially true in hematological issues, which is the most common adverse effect and is seen in patients with or without G6PD deficiency.  {Glucose 6-phosphate dehydrogenase (G6PD) deficiency is an enzyme deficiency of the red blood cells.  G6PD deficiency leads to an abnormal rupture (breakage) of the red blood cells called hemolytic anemia (abnormally low red blood cell count)}.  Almost all patients demonstrate the inter-related changes of a loss of 1-2 g of hemoglobin, an increase in the reticulocytes (2-12%), a shortened red cell life span and a rise in methemoglobin.  G6PD deficient patients have greater responses.

 

Once a medical diagnosis is reached that, the patient is having these difficulties with red blood cells or Peripheral Neuropathy and muscle weakness the recommend medical treatment is to remove the patient from the Dapsone.  Normally Recovery on withdrawal is “usually substantially complete.”  The mechanism of recovery is reported by axonal regeneration.

 

In addition to the warnings and adverse effects reported above, additional adverse reactions include: nausea, vomiting, abdominal pains, pancreatitis, vertigo, blurred vision, tinnitus, insomnia, fever, headache, psychosis, photo toxicity, pulmonary eosinophilia, tachycardia, albuminuria, the nephrotic syndrome, hypoalbuminemia without proteinuria, renal papillary necrosis, male infertility, drug-induced Lupus erythematosus, and an infectious mononucleosis-like syndrome.  In general, with the exception of the complications of severe anoxia from over dosage (retinal and optic nerve damage, etc.) these adverse reactions have regressed off drug.

 

This is an example of how the one year or ten year rule would fit the diagnosed VA scenario and even the scenario that in most cases the medical issues caused by the direct taking of the Dapsone (a direct antigenic response) should resolve in most patients, once removed.  This would also fit the scenario of a poisons such a snake bite, or ingesting a poisonous plant, or even an untreated tick bite.

 

This scenario does not fit the secondary Ah receptor toxic chemical damages done by the dioxin, TCDD or many toxicants of similar dioxin like isomer properties the Veteran was exposed.

 

Our own Environmental Protection Agency has clearly stated as well as other studies that dioxins in and by themselves do not cause an antigenic body response such as a poisonous plant, spider, snake, or even some types of tick bite.  Once again, the taking of Dapsone may produce an antigenic response.  In these examples once the toxicant is eliminated by the body, which varies in time and methodology the body damage is then over, and the body as stated will repair itself "to some level."

 

Common and medical scientific sense mandates that there can be no antigenic response for the dioxins since the dioxins are in the body 40 years after the exposures.  This would also mandate that since there is no antigenic response there could be no time limit of resolution.  This would also mandate that only a C & P for the damages or the doctor’s opinion with diagnostics that the damages being done are getting better or resolving.  That is not up to VA or the IOM for the individual veteran. 

 

This would have to conclude that somehow our government/VA/NAS-IOM has magically defined the following: 

Therefore, someone somewhere has determined that direct contact with the dioxin, TCDD at some level will create some level of “direct peripheral nerve damage only” that does not involve a central nervous system involvement or any cell DNA or mitochondria cell DNA modifications and they know how it does it and what the ingestion rate must be and/or the total body threshold is; regardless of method of ingestions.

 

Congresspersons/Senators/Government decision makers, Veteran finds the VA decisions on peripheral neuropathy disorder to be only transient and resolution of disorder baseless, presumptuous, and erroneous and not scientific as it applies to the toxicants in question. 

 

 

On July 1, 1991, Secretary of Veterans Affairs Derwinski announced that VA will propose rules granting service-connected disability status to certain veterans with peripheral neuropathy.  Proposed rule implementing the Secretary's decision was published for public comment in the Federal Register in January 1992.  (See 57 Fed. Reg. 2236, January 21, 1992).  It was anticipated that the final rule would be published in 1993.  However, in July 1993, when the National Academy of Sciences (NAS) released its comprehensive report, entitled Veterans and Agent Orange - Health Effects of Herbicides Used in Vietnam, peripheral neuropathy was not included in the category "sufficient evidence of an association" or even "limited/suggestive evidence of an association."  Rather, the NAS reviewers concluded that there is "inadequate or insufficient evidence to determine whether an association exists between exposure to herbicides (2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram) and disorders of the peripheral nervous system."  The NAS report added, "Although many case reports suggest that an acute or subacute peripheral neuropathy can develop with exposure to TCDD and related chemicals, reports with comparison groups do not offer clear evidence that TCDD exposure is associated with chronic peripheral neuropathy.  The most rigorously conducted studies argue against a relationship between TCDD or herbicides and chronic neuropathy."

 

Acute is used to mean immediate effect; as opposed to chronic that means an effect not appearing immediately.

 

VA asked the NAS, in its follow-up report, to consider the relationship between exposure to herbicides and the subsequent development of the acute and subacute effects of peripheral neuropathy (as compared to the chronic effects, which were focused on in the initial report).

 

In January 1994, VA published a notice in the Federal Register that Secretary Brown has determined that a presumption of service connection based on exposure to herbicides used in Vietnam is not warranted for a long list of conditions identified in the NAS report.  Peripheral neuropathy was included in this list.  (See 59 Fed. Reg. 341, January 4, 1994).

 

What did the NAS 1996 update conclude about peripheral neuropathy?

 

When the NAS reviewers separately reviewed chronic persistent peripheral neuropathy and acute and subacute transient peripheral neuropathy, they found that there was still inadequate or insufficient evidence to determine whether an association exists between exposure to herbicides and chronic persistent peripheral neuropathy.  On the other hand, they reported that there is some evidence to suggest, “neuropathy of acute or subacute onset may be associated with herbicide exposure.”  They included acute and subacute transient peripheral neuropathy among those conditions they placed in their second category “limited/suggestive evidence of an association.”  (Chronic persistent peripheral neuropathy remained in category three, “inadequate/insufficient evidence to determine whether an association exists.”)

 

What was VA’s response to the NAS 1996 finding about acute and subacute transient peripheral neuropathy?

 

After careful review of the report, Secretary Brown decided that VA should add acute and subacute peripheral neuropathy (when manifested within one year of exposure) to the list of conditions recognized for presumption of service connection for Vietnam veterans based on exposure to herbicides.  President Clinton announced this, along with other, decisions, at the White House, on May 28, 1996.  The proposed rule was published for public comment in the Federal Register in August 1996.  (See 61 Fed. Reg. 41368, August 8, 1996).  The final rule was published in the Federal Register in November 1996.  (See 61 Fed. Reg. 57587, November 7, 1996).

 

What did subsequent NAS updates conclude about peripheral neuropathy?

 

With regard to chronic persistent peripheral neuropathy, the 1998 report stated, “No new information has appeared in the intervening two years that alters this (the 1996) conclusion.”

 

With regard to acute and subacute transient peripheral neuropathy, the 1998 update reported, “The committee is aware of no new publications that bear on this issue.  If TCDD were associated with the development of transient acute and subacute peripheral neuropathy, the disorder would become evident shortly after exposure.  The committee knows of no evidence that new cases developing long after service in Vietnam are associated with herbicide exposure.” 

 

In update 2000:  For chronic persistent peripheral neuropathy, there is only inadequate or insufficient evidence to determine whether an association exists between exposure to dioxin or the herbicides studied in this report.  NAS found that there was limited/suggestive evidence of an association between exposure to the herbicides considered in this report and acute or subacute transient peripheral neuropathy.  The evidence regarding association was drawn from occupation and other studies in which subjects were exposed to a variety of herbicides and herbicides components.  Information available to NAS continued to support this conclusion.

 

Congresspersons/Senators/Government decision makers you should remember the statements made above by VA and NAS/IOM and the statements originally made by the committee that decided our fate from 1979 to 1991 (VACEH) and their findings that there is a "significant statistical association" between “peripheral neuropathy” and exposure to dioxin shown in the Evidence Section. Then as you go through the Veterans evidence bear in mind what other studies have found - even in the government exoneration tool the Ranch Hand study.  I think you will agree that in order for NAS/IOM to make the above statements that a large bias seems to be evident in the scientific world of those that are contracted and controlled by our government.

 

Veterans will clearly show the neurological condition, chronic polyneuropathy, is associated to exposures to dioxins as well as the associated Chronic Fatigue Syndrome (formerly diagnosed as Neurasthenic Syndrome) as a stand alone disorder and should be “automatically associated” for all Vietnam Veterans with that diagnosis that served in geographical Vietnam as well as those Veterans that were exposed around the world to the same “government created toxic chemical formulas and doses.”

 

The Chronic Fatigue Issues that go with this nerve disorder also found in exposure victims even in our own government studies that “is just as likely as not” associated to Central Nervous System damage associated with Chronic Fatigue Immune Dysfunction Syndrome, or sometimes called Myalgic Encephalopathy. 

  

A recent new finding seems to confirm what many scientists have been saying for decades now regarding PNS issues and that is before any PNS issues manifest a CNS subclinical event/causation has taken place and precedes any PNS manifestations.

 

This seems to be located in dorsal root ganglionitis (inflammation in the spinal cord) - recently discovered in a two-week autopsy, with the cause of death listed as Chronic Fatigue Syndrome.  This becomes a “clear physical manifestation” of the neurological disorder.

 

“Evidence reveals that Dow Chemical, a manufacturer of Agent Orange was aware as early as 1964 that TCDD was a byproduct of the manufacturing process.  According to Dow’s then medical director, Dr. Benjamin Holder, extreme exposure to dioxins could result in "general organ toxicity" as well as "psychopathological" and "other systemic" problems.”  (19)

 

{Psychopathological - The manifestation of mental or behavioral disorders.

 

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

 

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. 

 

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

 

Gold Standard Government study Ranch Hand 

Other studies of Vietnam Veterans

 

 

Seveso, Italy

In all these studies they were decades after exposures and nothing had resolved itself as the VA and NAS/IOM have unscientifically and with great bias have mandated will happen within two years of removing ones self from the exposures.

The list of found associations to peripheral nerve damage and dioxin or dioxin like isomers goes on and on in medical history back to the late 1940's.  It would be redundant to include those in this Veterans challenge.  However if those Senators, Congresspersons, Government decision makers, and Congressional Staff Members decide to at least look at a path to justice for the nations government created disabled veterans then these accounts and facts can certainly be presented as a separate paper.  Just ask!

 

Veterans will give one more example:

 

In a dioxin like train spill, 49 Monsanto workers were sent in to clean up the spill.  Within 12 years, 45 of the workers had raging peripheral neuropathy and two workers had committed suicide.  It is unknown what happen to the other two. (X)

 

How can the VA/NAS-IOM continue to deny such found relationships by the governments own gold standard study and many other studies?  Simply put - congress has given the Government entities such as VA and NAS/IOM that much "corrupt power" over Veterans and the mandated yearly budget control, including the questionable use of the Board of Veterans Appeals.

 

 “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).  (X)

 

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).v (X)

 

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).  (X)

 

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)

 

Veterans need not know the etiology of such manifestations as to why they are becoming neurological disabled from dioxin exposures.

 

Peripheral Neuropathy by the best scientific minds in our nation go ischemic in about 33% of the cases.  Veterans cannot even get this noted medical diagnostic doubt from our government so called friendly agencies.

 

Peripheral Neuropathic disorders have many many causations associated to include:

 

Of course most know of the insulin issues associated with a diabetic involvement.

 

It should be noted here that in the only honest testing and evaluation done in the "Veterans Opinion" of Vietnam Veterans and dioxin levels the p-value found on "neuropathy and diabetes" in Veterans was only remarkable to 0.2157.  This is hardly significant in any scientific value.  Yet, this same study found both diabetes and peripheral neuropathy significant at p<0.5 with respective odds ratios of OR = 2.69 and OR = 2.39. (X)

 

The four levels of exposures did not show a significant trend in linear effect with the possibilty of a slight trend in diabetes involvement. Absent the tolerance values assigned this may be an accumulation of tolerances error.

 

These findings "were significant" after adjusting for potential confounders in:

age

smoking

alcohol

body mass index

education

martial status

health insurance

 

How much more do the government caused disabled Veterans of this nation need to prove in order to be compensated in disability for a disorder that has been proven and proven and then re-proven to be associated with the dioxin exposures.

 

What is it that the VA and the NAS/IOM need besides some honesty and integrity?

 

Immune system mediation of Peripheral Neuropathy

 

Immune system mediated, even subclinical immune system mediation can create neuropathic states. 

 

The Ranch Hand gold standard found increases in IgA antibodies as well as increase in Natural Killer cells associated. (X)

 

The aforementioned honest second Korean study reported not only found issues in increased IgA but also IgE as well as a disturbance in  in Ig1 - Ig4 subclass antibody homeostasis (well being) levels.  (X)

 

This study also found issues in the quality of blood in number of cells, reduced hemoglobin, and reduced hematocrit. (X)

 

This study also found disturbances in cytokines that direct immune systems creating a confused immune system as to what type of response is required or in some cases rather than one response both are created by the confused immune system. (X)

 

Th1 cells drive the type-1 pathway (“cellular immunity”) to fight viruses and other intracellular pathogens, eliminate cancerous cells, and stimulate delayed-type hypersensitivity (DTH) skin reactions.

 

Th2 cells drive the type-2 pathway (“humoral immunity”) and up-regulate antibody production to fight extracellular organisms: type 2 dominance is credited with tolerance of xenografts and of the fetus during pregnancy.

 

Disturbances found were in:

 

Interlukin 4 and 10

Interferon gamma

Tumor Necrosis Factor alpha

The Interlukin 4 and Interferon gamma ratio was found significantly elevated.

 

The government's own EPA recently stated that they also found cytokine dysregulaton issues with dioxin exposures.

 

The key here for Senators, Congresspersons, Government decision makers, and Congressional Staff Members is the one study found and stated that Military Service in Vietnam and/or Agent Orange Exposures disturbs immune-homeostasis resulting in dysregulation of B and T cell activities.

 

Disturbance in the immune homeostasis and the dysregulaton of B and T cell activities can certainly be concluded "is as likely as not" the reason for the VA and the NAS/IOM finally admitting to the cancers we Veterans have on our infamous Agent Orange Hit Parade as herbicide exposure associated.

 

To conclude, that this found and identified disturbance can only create "a cancer condition" is not only totally biased against the Vietnam Veterans but also would be scientific misconduct on the part of the VA and the NAS/IOM.  There are many many autoimmune disorders associated to mediated immune system problems to include the found dysregulaton in B and T cell activities in exposures to dioxins.

 

Just one of which would be peripheral nerve damages.  More on the other issues Vietnam Veterans have been saying for 40 years now below and how this causation can be the cause of many of our issues of government created death and disability.

 

This issue of immune system dysregulation found that certainly could be considered also associated to the neuropathy damage causation is the cardiovascular issues found significant.

 

Vasculopathy demonstrated a liner suggestion across the four levels of exposures while peripheral vasculopathy did not find this slope.  Vasculopathy was found as p-value of difference at 0.0002 while Peripheral Vasculopathy was not significant to <0.050 but remarkable to 0.0628.  Certainly within the realm of tolerances considering the amount of regression analysis. (X)

 

How do these apply to the Vietnam Veterans wide spread Peripheral Neuropathy with or without diabetes and the known and identified damaged immune system?

 

Immune Mediated Autonomic Neuropathies (Roy Freeman, MD)
 

Autonomic nerve fibers are affected in most generalized peripheral neuropathies. While this involvement is often mild or subclinical, there are a group of peripheral neuropathies in which the small or un-myelinated fibers are selectively or prominently targeted. While most generalized peripheral polyneuropathies are accompanied by clinical or subclinical autonomic dysfunction, there are a group of peripheral neuropathies in which the small or un-myelinated fibers are selectively targeted. In these neuropathies, autonomic dysfunction is the primary manifestation. A constellation of signs and symptoms occur from impairment of cardiovascular, gastrointestinal, urogenital, thermoregulatory, sudomotor and pupillomotor autonomic function. (XX)

 

The author of this submittal and challenge for all Veterans, Charles Kelley, has challenged "many times" those in government power that with the known prevalence of peripheral neuropathy found associated not only to dioxin exposures but the massive amount found in our Vietnam Veterans of especially what is called painful axonal sensory peripheral neuropathy that to conclude Vietnam Veterans diagnosed would had no autonomic nerve damages done would be scientific hypocrisy by the VA and the NAS/IOM which still continues to this day.  As you can see from the abstract of Dr. Freedman's article an entire constellation of signs and symptoms occur from impairment of cardiovascular, gastrointestinal, urogenital, thermoregulatory, sudomotor and pupillomotor autonomic function.

 

This becomes even more germane when one looks at the actual findings in dioxin studies supplemented by what was found in Vietnam Veterans in all of of our allies that served the toxic chemicals (plural) environment.

 

Gastrointestinal issues (normally diagnosed as IBS), the cardiovascular issues, the breathing rate issues, the COPD issue from minor > sleep apnea, kidney diseases, sexual dysfunction, etc.

 

The latest finding is more fuel to the fire that is raging among our scientific community in that does dioxin exposures directly cause a diabetic condition.

 

The latest study and testing may just conclude that what later studies verified and our Veterans have been correct all along.  In that the peripheral nerve damage (by default autonomic sensory nerve damages must be included) was occurring first.  That the dioxin caused immune mediated nerve damage may even be the reason for (in our Vietnam Veterans case) the increases in insulin sensitivity and "especially insulin resistance."

 

Therefore, the "scientific purist" may be exactly correct in stating that diabetes is not a direct result of dioxin exposures but rather the secondary effect of the dioxin damaged immune system and the mediated sensory nerve damage created in the endocrine system.

 

The inevitable scientific and logic question of:  Which came first - The Chicken or the Egg?

 

To the disabled or dying Vietnam Veteran and their family with no support from the government for created medical issues - it matters not!

 

Tom Blackwell, National Post

Published: Friday, December 15, 2006

 

In a discovery that has stunned even those behind it, scientists at a Toronto hospital say they have proof the body's nervous system helps trigger diabetes, opening the door to a potential near-cure of the disease that affects millions of Canadians.

 

Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas.

 

"I couldn't believe it," said Dr. Michael Salter, a pain expert at the Hospital for Sick Children and one of the scientists.

 

"Mice with diabetes suddenly didn't have diabetes any more."

 

The researchers caution they have yet to confirm their findings in people, but say they expect results from human studies within a year or so.  Any treatment that may emerge to help at least some patients would likely be years away from hitting the market.

 

But the excitement of the team from Sick Kids, whose work is being published today in the journal Cell, is almost palpable.

 

"I've never seen anything like it," said Dr. Hans Michael Dosch, an immunologist at the hospital and a leader of the studies.  "In my career, this is unique."

 

Their conclusions upset conventional wisdom that Type 1 diabetes, the most serious form of the illness that typically first appears in childhood, was solely caused by autoimmune responses -- the body's immune system turning on itself.

 

They also conclude that there are far more similarities than previously thought between Type 1 and Type 2 diabetes, and that nerves likely play a role in other chronic inflammatory conditions, such as asthma and Crohn's disease.

 

The "paradigm-changing" study opens "a novel, exciting door to address one of the diseases with large societal impact," said Dr. Christian Stohler, a leading U.S. pain specialist and dean of dentistry at the University of Maryland, who has reviewed the work.

 

"The treatment and diagnosis of neuropathic diseases is poised to take a dramatic leap forward because of the impressive research."

 

About two million Canadians suffer from diabetes, 10% of them with Type 1, contributing to 41,000 deaths a year.

 

Insulin replacement therapy is the only treatment of Type 1, and cannot prevent many of the side effects, from heart attacks to kidney failure.

 

In Type 1 diabetes, the pancreas does not produce enough insulin to shift glucose into the cells that need it.  In Type 2 diabetes, the insulin that is produced is not used effectively -- something called insulin resistance -- also resulting in poor absorption of glucose.

 

The problems stem partly from inflammation -- and eventual death -- of insulin-producing islet cells in the pancreas.

 

Dr. Dosch had concluded in a 1999 paper that there were surprising similarities between diabetes and multiple sclerosis, a central nervous system disease.  His interest was also piqued by the presence around the insulin-producing islets of an "enormous" number of nerves, pain neurons primarily used to signal the brain that tissue has been damaged.

 

Suspecting a link between the nerves and diabetes, he and Dr. Salter used an old experimental trick -- injecting capsaicin, the active ingredient in hot chili peppers, to kill the pancreatic sensory nerves in mice that had an equivalent of Type 1 diabetes.

 

"Then we had the biggest shock of our lives," Dr. Dosch said.  Almost immediately, the islets began producing insulin normally "It was a shock?  Really out of left field, because nothing in the literature was saying anything about this."

 

It turns out the nerves secrete neuropeptides that are instrumental in the proper functioning of the islets.  Further study by the team, which also involved the University of Calgary and the Jackson Laboratory in Maine, found that the nerves in diabetic mice were releasing too little of the neuropeptides, resulting in a "vicious cycle" of stress on the islets.

 

So next, they injected the neuropeptide "substance P" in the pancreases of diabetic mice, a demanding task given the tiny size of the rodent organs.  The results were dramatic.

 

The islet inflammation cleared up and the diabetes was gone.  Some have remained in that state for as long as four months, with just one injection.

 

They also discovered that their treatments curbed the insulin resistance that is the hallmark of Type 2 diabetes, and that insulin resistance is a major factor in Type 1 diabetes, suggesting the two illnesses are quite similar.

 

(This is of primary importance to the Nations Veterans - insulin resistance that is the hallmark of Type 2 diabetes was curbed.}

 

While pain scientists have been receptive to the research, immunologists have voiced skepticism at the idea of the nervous system playing such a major role in the disease.  Editors of Cell put the Toronto researchers through vigorous review to prove the validity of their conclusions, though an editorial in the publication gives a positive review of the work.

 

"It will no doubt cause a great deal of consternation," said Dr. Salter about his paper.

 

The researchers are now setting out to confirm that the connection between sensory nerves and diabetes holds true in humans.  If it does, they will see if their treatments have the same effects on people as they did on mice.

 

Nothing is for sure, but "there is a great deal of promise," Dr. Salter said.

 

 

The restated facts above of "surprising similarities between diabetes and multiple sclerosis, a central nervous system disease is very concerning for Vietnam Veterans.  Some that started out with a diagnosis of Peripheral Neuropathy end up with a diagnosis of Multiple Sclerosis.

 

One of the leaders of the Ranch Hands studies, Dr. Michalek, in an announcement "Serum dioxin and peripheral neuropathy in veterans of Operation Ranch Hand" stated:


"... we consistently found a statistically significant increased risk of all indices of peripheral neuropathy among Ranch Hand veterans.  ....  Cautious interpretation of these results is appropriate until the relationship between pre-clinical diabetes mellitus and peripheral neuropathy is further evaluated in future examinations."

 

It is clear that the doctors concern in the above statement was "the found increased risk of all indices of peripheral neuropathy found" might be associated with "subclinical diabetes."  Veterans are denied Peripheral Neuropathy damages as associated unless they have a defined case of diabetes.  Yet, clearly this statement concludes that the neuropathy was one of the first disorders found  very early on in Ranch Hand Study and the suspicion later on "long before diabetes was even found associated (which is controversial)" were that subclinical diabetes was the causation. 

 

Peripheral Neuropathy is not controversial in any dioxin study of Vietnam Veterans, it correlates p-values of difference as well as association to dioxin exposures.  The controversy is with the Secretaries of the VA and the NAS/IOM government controlled and seemly mandated Unites States Government bias. 

 

Many Vietnam Veterans have this debilitating nerve damage long before they eventually are diagnosed with a Type II diabetic condition or even an Impaired Glucose Tolerance  which could take years or even decades.  Once again even with overwhelming statistical and medical evidence of "increased risk of incidence", "significant correlation to dioxin exposures" in the most benign form of exposures (skin) our Nations disabled Vietnam Veterans are denied peripheral nerve damage associations and thereby denied service connected compensations.  No, not compensated for the incredible amount of pain and discomfort that accompanies this disorder but not even  compensated for the issues that has and continues to put them at a disadvantage in the work place and at home in disability created by the United States Government.

 

Discussed later will be the additional debilitating issues that accompany this diagnosis of Peripheral Neuropathy in our Vietnam Veterans.

 

If one considers the recent above findings and testing by the Canadian research team in that damaged pancreatic sensory nerves that control insulin seemed to be associated with both Type I and Type II forms of diabetes.  Then Dr. Michalek concern was 180 degrees out phase. 

 

Instead of peripheral neuropathy with only a possible causation of dioxin created diabetes.  It seems this study did not even concern itself with possibilty of a dioxin damaged immune system mediated peripheral neuropathy. The concern in the transcripts and the statement was only for sub-clinical diabetes.  Yet, immune system issues were found.   No concern was generated toward anything else but a possible diabetic involvement causation when during the decades of continuous Peripheral Neuropathy findings no diabetes was found.  Not very logical in a study that was supposed to help decide compensations in morbidity and mortality associated to dioxin regardless of the etiology.

 

Senators, Congresspersons, Government decision makers, and Congressional Staff Members you will note in this evidence that no one has suggested this Peripheral Neuropathy was in any way shape or form of being transient.  To the contrary year after year the findings in the same cohorts got worse.

 

The impacts of the finding by the Canadian Research team may even have wider impacts.  Traditional associated issues normally associated with a diabetic conditions may even be revisited in medical history.  Instead of associated with the diabetic condition causation the wording would have to changed now to the disorders associated to a damaged/confused immune system that created a diabetic condition.

 

Vietnam Veterans will probably not live long enough since there are only half of us left.  However, Veterans do hope that our spouses and our children and grandchildren will be around to tell the non-supporting United States Government;  Our Fathers told you so and you were not only wrong, but you intentionally lied to them, treated them as so much government cannon fodder for government mistakes made, and  you committed scientific misconduct for the sake of budget. 

 

The united States Government; the secretaries of the VA, the nas/iom members, the congress, and president after president have no honor.

 

Diagnosis and Treatment of Chronic Immune- Mediated Neuropathies

 

Norman Latov, MD, PhD. & Kenneth C. Gorson, MD. & Thomas H. Brannagan, III MD. & Roy L. Freeman, MD & Slobodan Apostolski, MD. & Alan R. Berger, MD. & T Walter G. Bradley, DM, FRCP. & Chiara Briani, MD. & Vera Bril, MD Neil A. Busts, MD. & Didier P. Giros, MD. & Marinos C. Dalakas, MD. & Peter D. Donofrio, MD. &  P. James B. Dyck, MD John D. England, MD. & Morris A. Fisher, MD. & David N. Herrmann, MD. & Daniel L. Menkes, MD. & Zarife Sahenk, MD Howard W. Sander, MD. & William J. Triggs, MD.& Jean Michel Vallat, MD.

 

The chronic autoimmune neuropathies are a diverse group of syndromes that result from immune-mediated damage to the peripheral nerves. Our understanding of these disorders has evolved through clinical observations and empiric therapeutic interventions, that were confirmed by independent investigators over the years. For many of these disorders, there are no definitive diagnostic tests, and only a few or no controlled therapeutic trials. Consequently, the diagnoses may be missed and the patients remain untreated. The Medical Advisory Board of the Neuropathy Association therefore reviewed the existing literature regarding the diagnosis and treatment of the immune-mediated neuropathies, with the aim of summarizing and presenting the information in a concise form, so as to help physicians recognize these disorders and decide on the most appropriate therapy. (XXX)

 

 

Guillain Barre Syndrome and Its Variants
Alan R. Berger, M.D.

 

Guillain Barre Syndrome most commonly characterized by some combination of limb paresthesias, generalized weakness, and areflexia. Pathogenesis of GBS not yet fully understood and current thinking is that GBS may not be a single disease, but a variety of acute neuropathies with a number of related immune-mediated pathogenetic mechanisms. Most common immunopathologic finding: endoneurial inflammation in spinal nerves roots, distal nerve segments, or around potential nerve entrapment sites. Target antigens appear to be common to the axon, myelin sheath, or both. The exact antigens, the precipitating event, and the resultant mechanism of injury somewhat unclear. (XXX)

 

 

CLUES TO THE DIAGNOSIS OF CHRONIC IMMUNE-MEDIATED POLYNEUROPATHIES
Norman Latov, M.D., Ph.D.

Autoimmune mechanisms are implicated in several chronic neuropathic syndromes that are amenable to immune therapy (Table I). Collectively, these neuropathies are relatively common; Barohn et al (1998) reported that approximately 13% of consecutive patients with neuropathy seen at their institution had an immune mediated neuropathy, and Verghese et al (2001) found that 6% of their elderly neuropathy patients had a demyelinating inflammatory etiology. M practice, however, many of the autoimmune neuropathies are difficult to diagnose, due to a lack of generally accepted clinical diagnostic criteria, or availability of reliable serological tests. Consequently, many patients with autoimmune neuropathies are diagnosed as having "idiopathic neuropathy" instead, and left untreated despite progression of their disease.
(XXXX)

 

 

Vasculitic Neuropathy
Jose R. Carlo, MD, FAAN

 

The vasculitides are a group of heterogeneous disorders which present with a variable and complex clinical picture. Debates over clinical versus pathological approaches to classification abound in the literature, all these, with recognized limitations given the variable clinical presentations and the overlap between the recognized diagnostic entities. Peripheral neuropathy is an important, and often the presenting clinical feature of the vasculidities. Its recognition can be critical to attain an early diagnosis in these disorders where the ultimate outcome can be greatly influenced by early therapeutic intervention. (XXXXX)

 

Recently the same Dr. Michalek and Dr. Ralph Trewyn (both served on the Ranch Hand Committee) came forward in the media and clearly stated that Ranch Hand assumptions were flawed.

 

"However, hundreds in the comparison group spent time in Vietnam and may have been exposed to herbicides, too, said Joel Michalek, who worked on the study from the beginning and was its principal investigator for 14 years until he left in May.

"It spoils everything," Michalek told The News.  "It's as if you're running a clinical trial on a new medication, and you found out some of the people who were in your placebo group were actually taking meds.  That would spoil your whole study.  And that's what's going on here in this study."


"They referenced those papers, but they left all the data out from those cancer papers that were done that showed the cancer effects," he said.  "It's huge, because then the conclusion is there's no cancer effect, when as part of the study, the same investigators, just analyzing the data in a different way, found that when they did that, lo and behold, then there were significant cancer effects.

"And so for the final report to say there's no cancer effect when the investigators themselves published papers saying there is a cancer effect, that's just flat scientifically wrong."

Without factoring in the new information about the comparison veterans, Trewyn said, the Air Force got the same, predictable results.

"When they use an exposed control group and they say the two groups have roughly the same amount of cancer and so forth, what is that finding good for?  Nothing," said Trewyn, vice provost for research and dean of the graduate school at Kansas State University.

And it doesn't take a scientist to figure that out, he said.

"This is common sense now, a lot of it," he said.  "It's like now wait a minute.  This just does not pass the smell test or the common sense test."

 

Vietnam Veterans would like to point out to the Senators, Congresspersons, Government decision makers, and Congressional Staff Members that the author of this challenge for all Vietnam Veterans, Charles Kelley, pointed this fact out to those in DC in 2004 with evidence; that these cohort assumptions were indeed flawed.  Flawed study assumptions that created and had a direct impact on the statistics, dioxin exposure relativity, and how sick and dying these Veterans actually were.

 

While Dr. Michalek used the example of those in a cohort group that were supposed to be taking placebos and you find out after all the statistics and regressions are completed, that they were taking the medication in question then those gathered statistics are invalid.  To publish such findings knowing this event took place is misleading and fraudulent.  To use that comparison data "you know is invalid" in legal matters of Vietnam Veterans government decisions to deny that claim, not matter what level it is used, is nothing short of government criminal activity against the nations finest in a 1988 beginning "trumped up VA legal system."

 

Charles Kelley in his example in 2004 used the comparison of a building with two floors that was subjected to toxic fumes or toxic chemicals.  By default the internal areas of the building may have different levels but we do not know exactly what was in the building in total or even in accumulation over time in some areas.  Even when part of the toxicity chemicals or fumes is found out; at that point in time, science has no idea of the etiology of exposure nor the long-term effects of a now what has to be considered as a life catalyst.  The United States Government's idea of justice would be to compare the first floor to second floor then statistically regress the issues and then say, "See we found no medical problem issue difference between the first floor and and the second floor."  Therefore it is a non issue in the building and there were no significant statistical medical disorders found!

 

The United States Government would not compare the data cumulative in the first floor and second floor findings then compare those findings to the identical two story building next door that had no toxic chemicals or toxic fumes.

 

Now we find out that even the participating scientists themselves say this flawed White House directed protocol spoils all the statistics.  Yet, these tainted and fraudulent findings has been used in legal matters against the Vietnam Veterans of The Untied States with purpose and known government directed fraudulent results.       

 

"It spoils everything," Michalek told The News.  "It's as if you're running a clinical trial on a new medication, and you found out some of the people who were in your placebo group were actually taking meds.  That would spoil your whole study.  And that's what's going on here in this study."

 

The scientists above concluded with this flawed cohort assumptions (which made no sense to the Vietnam Veterans to begin with) instead of little or no increase found in cancers found; would now demonstrate statistically at least a two fold increase in all cancers.

 

Senators, Congresspersons, Government decision makers, and Congressional Staff Members, if we now have an unreported finding in the governments gold study standard of a two fold increase or larger in cancer because of flawed cohort assumptions on exposures.  Any logical person should concluded the findings in other mortality and morbidity issues, even issues that were actually found at some low level, are now minimized; more than likely as directed by the United States Government and White House after White House. (Discussed in The Government Slippery Slope.)

 

The typical Vietnam Veteran with diagnosed chronic peripheral neuropathy does not normally have just this one symptom that as you have read above remains ischemic for the many reasons stated by Dr. Norman Latov (one of our nations renowned neuropathy experts and also very well known and recognized world wide).

 

The accompanying issues not in order of significance:

In addition to the above some have:

* In gastro issues - of major concern is the diagnosis of IBS with the symptoms; yet intestinal antibodies associated with lymphoma cancers are not considered in the diagnosis as a toxic chemical exposure Vietnam Veteran victim.

 

A meeting on the discussion of developed celiac allergy by Dr. Joseph Murray leading United States expert on the causes and manifestations to the developed symptoms.

 

Example:  In the immune mediated gastrointestinal problem the same cells that do the damages in the intestines are the same cells that become lymphoma cancers.  The lymphocyte damage in the small intestines not only blocks absorption of critical vitamins and minerals especially such as the B6 and B12 vitamins and A & E vitamins and calcium but also damages the cilia that secrete the enzymes that aide in the digestion of milk and milk products.  Lactose then becomes a laxative.  B12 is essential for nerve function as well as creation.

 

{Ever wonder why the Vietnam Veterans have bone density loss way early in life.}

 

The longer you have this condition the more likely you are to develop a lymphoma cancer.  Which we know is already, at great protest from the government and the VA, admitted as Agent Orange associated.

 

An analogy for this would be the longer you quit smoking the less chance you have of developing lung cancer.  The same scenario exits in the damaging lymphocytes in the intestines that remain benign growing and dividing at an accelerated rate and then something triggers one to turn malignant.

 

This form of gastro problem is also more common in Scleroderma and Sjogren's patients because the diseases all come from the same autoimmune tendencies.

 

Inflammatory Bowel Syndrome which collectively refers to Chron's and Ulcerative Colitis.

 

This autoimmune intestinal condition also causes dermatitis herpetiformis (DH).  As the immune system mounts a challenge it produces antibodies in numbers that often get dumped under the lining of the skin.  At that point they lay in wait for some trigger to set them off, like a land mine.  This can be any number of things from sunlight, some cleaners, etc.  {A few Vietnam Veterans have indicated that if do to much physical activity the attack begins.}   The itching capabilities of this skin eruption seems to totally diminish any contact and the resulting severity of itching of poison oak or poison ivy.

 

Types of Lymphocytes

 

The three major types of lymphocyte are the natural killer (NK) cells, T cells and B cells. NK cells are a part of cell-mediated immunity and act during the innate immune response. They can attack host cells that display a foreign (e.g. viral) peptide on particular cell surface proteins known as MHC class I molecules. Once they determine a cell is infected, the NK cells release cell killing (cytotoxic) granules that will destroy the infected cell. NK cells do not require prior activation in order to perform their cytotoxic effect upon target cells. Like NK cells, the T cells are chiefly responsible for cell-mediated immunity whereas B cells are primarily responsible for humoral immunity (relating to antibodies). T cells are named such because these lymphocytes mature in the thymus; B cells (named for the bursa of Fabricius in which they mature in bird species) are thought to mature in the bone marrow in humans. T and B lymphocytes differ from NK cells in that they are the principal cells involved in the adaptive immune system. These are cell types that retain a memory of a previous infection so that they can respond to the same infectious agent quickly upon re-infection. In the presence of an antigen, B cells can become much more metabolically active and differentiate into plasma cells, which secrete large quantities of antibodies. T cells, after they see an antigen, will also become highly activated and will secrete specific proteins, such as cytokines and cytotoxic granules, depending on their subtype/function.

 

The reason for including the above definitions is germane to the known fact an increase in Natural Killer cells was found although it was dismissed by Ranch Hand. (X)  Whether the new admitted to cohort flaws would change their mind on dismissing the found increase or not probably depends on the direction of our government not science.

 

We also know and has been submitted above studies that show dioxin exposures are associated to B and T cell dysregulation and immune system controlling cytokines (chemical messengers) dysregulaton and confusion.

 

This gastro condition for the Vietnam Veteran even though the conditions may wax and wane is serious in that the continual gastro problem overtime > barrettes esophagus overtime > esophageal cancer.

 

Note:   Many Vietnam Veterans came home with developed gastro problems and intolerances to milk and heavy red meats.  This was almost in the context of the 40 years lag time a moment in time one of the first signs of damage.  Veterans that had no milk product tolerance before they went either in country or shortly after developed milk intolerance. The wax and waning of milk intolerance seems to be the clue to another problem in the Vietnam Veteran.

 

** Many Veterans have lipid metabolism problems which seemed to begin very early with an increase in triglycerides years before the cholesterol issues even show up in testing.  A linear dioxin relationship was found in this triglyceride issue decades ago in the Gold Standard Ranch Hand.  Including it had been previously found in animal studies even prior to that finding.  What is not being considered, thanks to the government's scientific misconduct, is the Highly Sensitive Reactive Protein found in the vascular disorders.  Very possibly also dioxin damaged immune system mediated, yet denied.

 

*** Daily debilitating chronic fatigue was found in the Gold Standard Ranch Hand Study as far back as 1984.  Yet once again this found fact was dismissed and not reported.

 

With the above stated issues in the Vietnam Veterans Evidence Section and the findings specific to immunotoxicity directly caused by the dioxin, TCDD.  Does it not make sense that yes while multiple outcomes are present that the damaged immune system seems to be involved in most of the findings.

 

The chronic fatigue issue found and then not reported in 1984 maybe associated to the old disorder Neurasthenic syndrome. 

 

Neurasthenic syndrome - Some medical historians consider neurasthenia to be the diagnostic predecessor of Chronic Fatigue Syndrome.  Chronic Fatigue Syndrome (CFS) – Is just what the name implies.  A few good days of rest and you still do not recover.  No energy, listless, weakness, waking up and felling fatigued, or shortly after doing any work extreme fatigue.  May show up in the afternoon with almost feeling like you have flu symptoms with a low-grade fever type of fatigue.  At first, some scientists thought this was caused by a nervous disorder therefore the former name neurasthenic syndrome.  Then it was found that the Epstein-Barr virus (EBV) was associated.  High levels of EBV antibodies (disease-fighting proteins) were found in those patients suffering from CFS.  Later diagnosis of CFS of some patients without this high level of disease-fighting proteins indicated there were other causes.  Other causes may be iron-poor blood (anemia), low blood sugar (hypoglycemia), environmental allergy, a body wide yeast infection (candidiasis).  I have seen some theories that those individuals with neuropathy and that type of condition, that CFS is caused by the damaged nerve endings.

 

Today, CFS also is known as myalgic encephalomyelitis, post viral fatigue syndrome, and chronic fatigue and immune dysfunction syndrome.)  Chronic fatigue and immune dysfunction syndrome pointing out this CFS, once again can be attributed to an autoimmune systemic issue caused by toxicant damages the Veterans were and are experiencing.  Immune system dysfunction that can lead to both disorders has clearly been found in dioxin studies.

 

Note:  The problem for Vietnam Veteran with diabetes involvement the VA medical codes only reflect this CFS to an autoimmune code and not other associated issues.  The Veteran with diabetes and peripheral neuropathy regardless if the associations are in order or not; has little chance, about as much as a snowball in the Bahamas of getting the VA to compensate the disorder as associated or as a stand alone disorder as significant as found in the Ranch Hand studies as far back as 1984.  Yet, clearly this debilitating disorder does exist in significant correlation and also increase risk of incidence. 

 

 

The government/va slippery slope

 

Congresspersons/Senators/Government decision makers must remember that the Veterans' Advisory Committee on Environmental Hazards (VACEH) clearly stated above there was significant statistical evidence that found an association to Peripheral Neuropathy and the dioxin, TCDD in 1991.

 

Congresspersons/Senators/Government decision makers must be aware of during this same time frame in 1989 of our “Vietnam Veterans Toxic Chemical Legacy” a district court found after reviewing the legislative history of the 1984 Act "that Congress intended service connection to be granted on the basis of "increased risk of incidence" or a "significant correlation" between dioxin and various diseases," rather than on the basis of a casual relationship.  - See Nehmer v. U.S. Veterans Admin., 712 F. Supp. 1404, 1408. (N.D. Cal. (1989).

 

The act known as the Veterans’ Dioxin and Radiation Exposure Compensation Standards Act, Pub. L. 98—542, Oct. 24, 1984 was - one could consider nothing but a “public relations act” half hearted congressional attempt at doing something for the nations government damaged Veterans.

 

In recognition of the uncertain state of scientific evidence and the inability to make an absolute causal connection between exposure to herbicides containing dioxin and affliction with various rare cancer diseases, Congress mandated that the VA Administrator resolve any doubt in favor of the veteran seeking compensation

 

VA not only confounded the perceived intent of the Congress, but also directly contradicted its- own established practice of granting compensable service-connection status for diseases on the lesser showing of a statistical association, promulgating instead the more stringent requirement that compensation depends on establishing a "cause and effect relationship."

 

The district court invalidated the VA’s Dioxin regulation, which denied service connection for all diseases other than chloracne; ordered the VA to amend its rules; and further ordered that the Advisory Committee (VACEH) reassess its recommendations in light of the court’s order.32

 

In promulgating such rules, the Dioxin Standards Act required the VA to appoint a Veterans’ Advisory Committee on Environmental Hazards (the "Advisory Committee") -- composed of experts in dioxin, experts in epidemiology, and interested members of the public -- to review the scientific literature on dioxin and submit periodic recommendations and evaluations to the Administrator. 27 Such experts were directed to evaluate the scientific evidence pursuant to regulations promulgated by the VA, and thereafter to submit recommendations and evaluations to the Administrator of the VA on whether "sound scientific or medical evidence" indicated a connection to exposure to Agent Orange and the manifestation of various diseases.28

 

VA did not challenge the courts ruling but instead October 2, 1989, the VA amended 38 C.F.R. Part 1, which among other things set forth various factors for the Secretary and the Advisory Committee to consider in determining whether it is "at least as likely as not" that a scientific study shows a "significant statistical association" between a particular exposure to herbicides containing dioxin and a specific adverse health effect.33

 

The Nations Vietnam Veterans contend that this stated policy has never been the operating philosophy of VA for Vietnam Veterans but instead VA has chosen to operate as a government yearly budget control based on the concluding White House Philosophy of the Reagan /Bush White House that clearly defined; it did not want the financial responsibility for the toxic chemical nightmare inflicted on our Veterans as well as the environmental disasters in the Republic of Vietnam created by other administrations.

 

This led to a memo put out by the White House Bureau of Budget to all federal agencies of government in essence not to find a correlation between Agent Orange and health affects.  Stating that it would be most unfortunate for two reasons: (X)

 

A) The cost of supporting the Veterans.

B) The court liability to which corporations would be exposed.

 

This would also “just as likely as not” conclude the Government was interested in protecting the chemical company industry as well as protecting their own lobby money and not supporting our government damaged Vietnam Veterans and their families.

 

Clearly Congresspersons/Senators/Government decision makers can see that in 1991 the actual committee of experts mandated by congress stated their opinion under the  rules mandated by the court and indeed their finding was statistical association – then five years later in 1996 as VA stalled and stalled the newly congressional appointed National Academy of Science that conveniently had replaced the VACEH then makes the statement: 

 

“Rather, the NAS reviewers concluded that there is "inadequate or insufficient evidence to determine whether an association exists between exposure to herbicides (2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram) and disorders of the peripheral nervous system.”

 

Since during this exact time frame Ranch Hand was finding adverse association to specifically polyneuropathy in its medical transcripts as well as other Nations Vietnam Veterans studies were showing peripheral neuropathy is the most prolific disorder associated to the dioxin, TCDD.  (VV) These NAS conclusions seem biased and spurious at best.

 

This was not the year after Vietnam but three decades after Vietnam, therefore Veterans question the integrity, and the effort put forth by the government contracted NAS/IOM.

 

Veterans also question if NAS and VACEH were using the same court mandated level of associations required to associate such disorders.

 

To add insult to injury of our Nations Veterans and pour salt into our open government caused wounds.  On May 28, 1996 President William Jefferson Clinton stated in a speech on Veterans Announcements:

 

REMARKS BY THE PRESIDENT
IN VETERANS ANNOUNCEMENT
Room 450
Old Executive Office Building

1:22 P.M. EDT

May 28, 1996

 

“THE PRESIDENT: Mr. Vice President, thank you very much, for your very moving remarks and your support of this endeavor.  Secretary Brown, thank you for your service to our country in so many ways, and especially for your work at the Veterans Administration, along with Deputy Secretary Hershel Gober and the others who are here.  Senator Robb, Congressman Evans, and to members of Congress who are not here, including Senator Daschle who worked so hard on this issue; to the Vietnam veterans who are here and all others who are concerned about this matter:

 

This is an important day for the United States to take further steps to ease the suffering our nation unintentionally caused its own sons and daughters by exposing them to Agent Orange in Vietnam.  For over two decades Vietnam veterans made the case that exposure to Agent Orange was injuring and killing them long before they left the field of battle, even damaging their children.

 

For years, the government did not listen.  With steps taken since 1993, and the important step we are taking today, we are showing that America can listen and act.  I'm announcing that Vietnam veterans with prostate cancer and the neurological disorder, peripheral neuropathy, are entitled to disability payments based upon their exposure to Agent Orange.  Our administration will also propose legislation to meet the needs of veterans' children afflicted with the birth defect, spina bifida -- the first time the offspring of American soldiers will receive benefits for combat-related health problems.

 

From the outset, we have pressed hard for answers about the effects of Agent Orange and other chemicals used to kill vegetation during the war in Vietnam.  Once we had those answers, we've looked for practical ways to ease the pain of Americans who have already sacrifice so much for their country.”

 

Congresspersons/Senators/Government decision makers this was a nice way to buy votes.  It was on the other hand a bunch of “presidential lies” to our Nations Veterans while congress stood by for the accolades.

 

President Clinton made a bid deal out of it and by the time VA finished with its less than truthful constraints not one, mind you not one Veteran would ever qualify for any service association to what President Clinton described as a “neurological disorder” which indeed it is.

 

Of course, this was all orchestrated.  WHY?  Because the neurological disorder is associated to immune system damages and those in the White House and VA wanted to stay away from anything that might indicate any association to damaging the immune system even though “it is just as likely as not” the cancers are being created by a damaged immune system.  (See Evidence Section)

 

In other words, we messed up, without thinking and announced this disorder, and lets not do this one because it will lead to more disorders associated with a compromised immune system from exposures to the toxic chemicals (plural).

 

Senators, Congresspersons, Government decision makers, and Congressional Staff Members might say all of this is just coincidental.  Veterans would say this "too coincidental and too convenient."

 

The United States Government and its federal agencies not only had White House direction but also certainly had and continue to have dollar motive for collaboration and collusion.

 

While the Veterans have, had three different committees formed that act as judge and executioner during our 40-year legacy.  It seems our congress is “less than forthcoming” in allowing those Veterans and their families know exactly “how they are being judged,” to “what level they are being judged,” and what “oversight congress is providing” to make sure their purported and publicly stated wishes are carried out by the Presidents and the Secretary of the Department of Veterans Affairs and any associated government possible collaborations in reports and studies as well as direct White House interference in such studies and activities directed against our nations Veterans and their families as in House Report HR-101-672.

 

On March 15th of 2000, the most important government meeting for Vietnam Veterans and their families since our war was over was held.  This was a “government oversight meeting” to discuss the status of the Air Force’s ongoing “dioxin research only” called the Ranch Hand Study. 

 

In March of 2000 during the oversight meeting of Ranch Hand it was obvious that VA, NAS-IOM, and Ranch Hand were not going to answer specific questions by  the congressional membership that bothered to show up.

  

In March of 2000 during the oversight meeting of Ranch Hand it was obvious that VA, NAS-IOM, and Ranch Hand were not going to answer specific questions by the congressional membership that bothered to show up.

 

As with all of our government funded studies, they have been “reduced” or “constrained” to only study the one component of Agent Orange and that being dioxin.  Totally disregarding the other two militarized herbicides of Agents White and Blue, much less the other 15 commercial named herbicides that were used. 

 

When Ranch Hand scientists actually brought this lack of comprehensive evaluations subject up in the transcripts, the answer was,  “That just leaves opportunities for future studies.”

 

Veterans are seeking government help and the medical answers to avoid becoming disabled or taking a dirt nap; the study is looking for “future employment opportunities.”  

 

This flawed study, as well as others totally disregarded evidence from other studies, prevents compensation because illnesses which should be recognized and thereby “service connected” are not recognized.  As well, Veterans are often not given adequate medical treatment for these illnesses in the VA health system. 

 

This meeting  was held as a “government oversight review” of this Air Force study that determines not only our Vietnam Veterans fate but also the fate of many other Veterans by using these controlled and manipulated government studies.  Not only for compensations but also for medical treatment by our nations doctors and being classified as “Service Connected,” which is also tied to many “state benefits for Disabled Veterans.”

 

Out of 62 members of the “Subcommittee on National Security, Veterans Affairs, and International Relations” and “The Committee of Government Reform,” only “three congressmen in total” bothered showing up to challenge this study, and the DOD, and the VA, and the NAS/IOM; as to why this study and the whole process of determining compensations vehemently wanted no congressional oversight!

 

When Congressman Shays asked the NAS representative, Dr. David Butler, Senior Program Officer, Veterans and Agent Orange Reports, Institute of Medicine, National Academy of Sciences also under oath:

 

“Is there any scientific level that we could turn to, short of 99 percent, which would give us some way to come to a conclusion here?”

 

The leader for the folks at the IOM that make the recommendations for mortality and morbidity associations and compensations for our Nations Toxic Chemical Exposed Veterans then comes back and says:

 

“The policy decisions are very clearly outside of the mandate for the committees, and the committees have never offered an opinion on the policy decisions, which are made on the basis of that.”

 

Then Congressman Shays asks, “Are refusing to give your opinion?  {The answer is of course yes.} 

 

Dr. Butler then says it is the VA’s job to do that as far as policy as to level of certainty.

 

The VA leader that was there, Dr. Dr. Susan Mather, Chief Public Health and Environmental Hazards

Officer, Department of Veterans Affairs just simply stated congress had given the “sole power” to the Secretary of the VA and that they had accepted all that the IOM had recommended.

 

The bottom line in this "let's not answer circle" of political spin - was no one would say at what level the associations to the toxic chemicals is actually being held.  NO ONE!  Including no one pointed out that only the dioxin; TCDD was being considered by VA and Ranch Hand in a plethora of toxic chemicals used on Vietnams Veterans.

 

The above statements and circle of government deceit is not very comforting to Veterans or their widows, to say the least.

 

One of the Special Study leaders then admitted they were still indeed looking for “cause and effect” and  “he thought congress” had wanted the Veterans to have some other form of “benefit of the doubt” other than “cause and effect” but he was not real clear on what that was and where that fit into the scheme of things as to recommendations for compensations.

 

(Chan, Kwai-Cheung, Director, Special Studies and Evaluations, National Security and International Affairs Division)

 

Mr. Chan. I would like to raise an issue which I always felt all along, in doing this study and the work that we've

done in gulf war illnesses, is that to me there's a fundamental problem between the gathering of the scientific evidence and research in general, versus policymakers in terms of their intent.

 

On one hand in science we really want to understand if there's a relationship, an association, or correlation. If we

find there's a correlation, we then want to make sure that there is a statistically significant relationship. Once we have that, we want to make sure there's a linear dose response. That means the more stuff you have the worse you get, in terms of your physical well-being. And ultimately, we want to establish cause-and-effect.

 

Now what we do here, is keep on raising the bar to achieve that end goal and it's a very, very important part of science to pursue in research.

 

Over time the science wants to establish sort of a beyond a reasonable doubt we are doing the right thing.

 

On the other hand, I think, Congress, through various legislation including Public Law 102-4, basically suggests that we wanted to give the benefit of the doubt to the veterans. That is, if they are sick, but we can't clearly establish cause and----...

 

Mr. Shays. We just do not want to wait until they die before we help them.

 

{Congressman Shays is totally wrong.  Everything the DoD/VA/NAS-IOM to include White House after White House has done is exactly what this congressman said they did not want to happen.} 

 

Mr. Chan. - I understand.

 

But my point is that the science doesn't quite support that approach. Giving them "the benefit of the doubt" means that the risk for the people exposed is higher for than the normal population. So the risk means that the percentage of people who are exposed sick, versus those who were not exposed but sick of the same illness, is greater than one.

 

Science doesn't work that way. It emphasizes in a statistical significance of I want to make sure that 19 out of

20 times I'm correct in this decision. So as a result then what happens is that scientific information that----

 

Mr. Shays. I would feel more comfortable though, Mr. Chan, if this scientific research was being done by a party that was not a major player, and I would have a greater comfort level. And I believe that, as a policymaker, I have the right to determine that even there's not a shadow of a doubt, there's every indication that, I'm happy to move forward and commit dollars to helping people. I just think you give the benefit of the doubt.

 

{Again Congressman Shays is wrong.  A "policymaker" when it comes to Veterans Issues has no more power than the Veterans or the Widows of those Veterans to redress any kind of Justice for Executive Branch caused morbidity and mortality.} 

  

Dr. Linda Schwartz associate research scientist, Yale University

 

Dr. Schwartz.  - If we want at that and looked at that as a way in which we could use the data which has already been collected, then I say yes, the study should be continued.

 

But for us to continue to hang our hat on the fact that this is the "absolute gold standard" of what is happening to the health of veterans who served in Vietnam, no.

 

Congressman Shays. - Do you think it being held up as the gold standard?

 

Dr. Schwartz. -  Yes, it is. I think that when the National Academy of Science reviews, even though they do mention in their reports some of the things about Ranch Hand's protocol and study design, that if it's not statistically significant, Ranch Hand does not publish it. Therefore, we are not getting all of the information.

 

If Ranch Hand is publishing, crafting their reports to fit into professional journals, then we are not seeing the things that probably are greater than a 50 percent chance. So we are denying veterans, or maybe we are denying veterans some compensation and disability for the facts that we have not really looked at all.

 

The above statements and discussion are also not very comforting to Veterans or their widows, to say the least and also violates the court mandate and also the facade of what congress is saying will be compensated for government damages.

 

Does anyone in our government have a straight answer on this subject for the Veterans dead and/or dying? 

 

The conclusion has to be NO!

 

The bottom line summary to the above scenario seems to be:

 

The Congressman asks the contracted entity NAS program manager at what level are you looking for significance in determining associations for our Nations Veterans?   The contracted entity program manager then says it is not my job but the VA's job to identify the level significance in determining association.  Bearing in mind the NAS and now the NAS/IOM have at least four statements of significance they pronounce every two years.

 

The normal logically person would say; how can anyone or any scientific organization identify what is significant or not significant to four levels or categories of association.  Levels of association that in fact are part of the process by default of the legal claims of dead and dying Veterans.  Yet, NAS's Mr. Butler would not or could not even give an example of one of the categories and the equivalent level of association required.  So they are doing something we are just not sure what or how to measure what it is they are doing.

 

Then the VA's Dr. Susan Mather jumps in; in trying to get NAS's Mr. Butler off of the Congressional hot seat of even being committal to anything much; other than his name.  Dr. Mather then says, the VA has accepted all that NAS/IOM had recommended.

 

Again the normal logically person would conclude how can one say they either do not know or refuse to give the levels of research they are contracted to do.  Then the other part of, by default, denying the Veterans legal claim, the VA says; whatever it is, they are doing to whatever level;  we have accepted all of it, whatever it is!

 

This seems to a parallel a Military Expression called "FUBAR."  "Fouled Up Beyond All Recognition."

 

 

Discussed in the "Conclusions Section" - Reviewing the above on what must be considered not only medical associations fraud but also by default legal decisions made against the Veterans Community by the DoD/VA/NAS-IOM/White House in concert without Veterans having any day in court.

 

More charges of deceit brought forward in the Ranch Hand Study during the oversight review.

 

Congressman Shays recants; at what level do you think Government should consider compensation? Should we have a no shadow of a doubt?  The reason why I am asking the question is I have concluded, based on our work that we have done on gulf war illnesses, based on our review of Agent Orange, that I have to be honest with our veterans.  By the time we will know the scientific data, you are dead.  You will either have died early or you will have died in your old age in pain, but you will not get help from the Federal Government.

 

Congressman Shays:  “We just do not want to wait until they die before we help them.”

 

Yet, it seems for 40 years that is exactly what our government has been doing!  Waiting for the Vietnam Campaigning Army to Die.

 

Congressional charges were made that the study was slow to publish findings and that many suggested that the DOD/VA/Ranch Hand collaboration were less than forthcoming in the truth regarding many found toxic chemical medical issues with regard to severity and volume.  In one period for over three years, the Ranch Hand did not even meet, while Vietnam Veterans died or became disabled with no government help.  The excuse was no funding by the congress was available.  Now that sounds like a real caring congress.

 

One of the scientific advisors to the VA, as well as former and present members of this scientific study made additional charges concerning the flaws of the Ranch Hand Study.  The areas of most “serious concern” are:

After reviewing this congressional transcript and over 600 pages of Ranch Hand meeting transcripts (not the published reports), as a former components engineer and working in the failure analysis field; I can certainly understand why this study and the DVA processes used to correlate compensations wanted no congressional oversight.

 

Also found were: 

Senators, Congresspersons, Government decision makers, and Congressional Staff Members I can “assure you  that no veteran or veterans’ widow is laughing at this despicable behavior.  We are disabled and dying and this is no laughing matter.

 

The most egregious issue I found was the discovery of liver enzyme issues and then the suggestion was made that they inform the cohorts to tell their personal doctors of this issues and let them handle it.  Never mind the 2.3 million of us that also do exist; or at least did exist.

 

A huge misconception about the Ranch Hand study is that it is studying Agent Orange Herbicides.  This is not the case and is a misconception.  This study had been government reduced to linear dose responses found to the contaminate dioxin (TCDD) only.  Even when a dose response is found and no overt disease or disorder is detected “at that moment in medical time,” these findings are discounted and not brought forward into the light of the medical community. 

 

What was not taken into consideration is the longer-term systemic damages found to dioxin only. 

 

An honest assessment would be that they did find a dose response to certain medical abnormalities, inform the nations doctors of such findings, and let the doctors of our nation decide if it is culpable in the Veterans medical manifestations.

 

When no mandated dioxin dose response is found, even if a 50% or more increase is found in one medical issue, it also is not brought forward.

 

This study was not a fair assessment since there were at least four other toxic chemicals involved.   

 

 

 

Summary

 

For forty years there has been a government history of:

 

Despite Congressional intent to give the veteran the benefit of the doubt, and in direct opposition to the stated purpose of the Dioxin Standards Act to provide disability compensation to Vietnam Veterans suffering with cancer who were exposed to Agent Orange, the VA continues to deny compensation improperly to tens maybe even hundreds of thousands of  veterans with just such claims. In fact, in promulgating the rules specified by Dioxin Standards Act, the VA not only confounded the intent of the Congress, but directly contradicted its- own established practice of granting compensable service-connection status for diseases on the lesser showing of a statistical association, promulgating instead the more stringent requirement that compensation depends on establishing a cause and effect relationship.

 

See Nehmer v. U.S. Veterans Admin., 712 F. Supp. 1404, 1408. (N.D. Cal. (1989). wherein the court found after reviewing the legislative history of the Act "that Congress intended service connection to be granted on the basis of "increased risk of incidence" or a "significant correlation" between dioxin and various diseases," rather than on the basis of a casual relationship.} 

 

The significance of the distinction between a statistical association and a cause and effect relationship is in the burden of proof that the veteran must satisfy in order to be granted benefits. A statistical association "means that the observed coincidence in variations between exposure to the toxic substance and the adverse health effects is unlikely to be a chance occurrence or happenstance," whereas the cause and effect relationship "describes a much stronger relationship between exposure to a particular toxic substance and the development of a particular disease than ‘statistically significant association’ does." Nehmer, 712 F.Supp. at 1416.

 

Thus, the regulation promulgated by the VA established an overly burdensome standard by incorporating the causal relationship test within the text of the regulation itself. 38 C.F.R. 1 3.311(d) ("(s] ound scientific and medical evidence does not establish a cause and effect relationship between dioxin exposure" and any diseases except some cases of chloracne.)

 

As a result, the court invalidated the VA’s Dioxin regulation which denied service connection for all diseases other than chloracne; ordered the VA to amend its rules; and further ordered that the Advisory Committee reassess its recommendations in light of the court’s order.32

 

Thus, on October 2, 1989, the VA amended 38 C.F.R. Part 1, which among other things set forth various factors for the Secretary and the Advisory Committee to consider in determining whether it is "at least as likely as not" that a scientific study shows a "significant statistical association" between a particular exposure to herbicides containing dioxin and a specific adverse health effect.33

 

38 C.F.R. Part 1

 

C.F.R. § 1.17 (d) and determine in his own judgment that the scientific and medical evidence supports the existence of a "significant statistical association" between a particular exposure and a specific disease. 38 C.F.R. § 1.17 (f).

 

    (e) For purposes of assessing the relative weights of valid positive and negative studies, other studies affecting epidemiological assessments including case series, correlational studies and studies with insufficient statistical power as well as key mechanistic and animal studies which are found to have particular relevance to an effect on human organ systems may also be considered.


    (f) Notwithstanding the provisions of paragraph (d) of this section, a "significant statistical association" may be deemed to exist between a particular exposure and a specific disease if, in the Secretary’s judgment, scientific and medical evidence on the whole supports such a decision.

 

As late as the 2000 in Congressional Oversight of Ranch Hand review discussed above, anyone can see that the DoD/VA/NAS-IOM/White House is still not doing what congress intended, not even close. 

 


 

A review of the above Ranch Hand discussion that directly defies what congress, at least on face value, had indicated they wanted for the Nations Vietnam Veterans in this Toxic Chemical Legacy.

 


 

Mr. Chan, the Director Special Studies and Evaluations, National Security and International Affairs Division, in his discussion clearly indicted that instead of increased risk of incidence or a statistical correlation as the court ruled and the congresses intent is or was; a taxpayer paid for scientific project has been on going to not only identify cause and effect, only to the dioxin, TCDD, and that in order of precedence this science project is looking for correlation >statistically significant relationship > linear dose response. (X)

 

Mr. Chan is outside the rule of the courts, the congress, and the VA rules themselves as a "significant correlation" or "increased risk of incidence."  Veterans are not even supposed to need both as the legal description of proof for compensations and service connection is OR not AND!  Vietnam Veterans or their Widows in many disorders have meet both levels identified in many studies of the dioxin, TCDD.

 

Mr. Chan is way outside the realm of science when he states the ultimate goal of a linear response is the ultimate goal of studies.  Dioxins and dioxin like furans the Veterans were exposed are not antigenic poisons that can be verified by a linear response.  Studies have shown, that surprised the study scientists themselves, in exposure levels there is no direct correlation to what dioxins or dioxin like furans will produce in any individual.  There is also no proof that in this non-antigenic toxic chemical that a linear dose response evens exists in any one disorder.

 

Including nothing has been correlated to the severity of outcomes of ingestions related to severity to any disorder in relationship to body mass or even liver mass. 

 

Therefore this is nothing but "compensations stalling" on the part of this White House Controlled federal government entity, waiting for the campaigning Army to die.

 

EPA has conducted studies that should have killed the animal immediately and yet it did not.  Before the animal eventually died it went through "different disorders" to including wasting and eventually death. 

 

In direct violation of the Congressional mandate of Benefit of the Doubt as well as the VA's own regulations, Mr. Chan indicated he and his organization wanted very little doubt.  He then suggests that through legislation congress had wanted something else but he was not real sure what that something else was in totality.

 

{If the Government's director of Special Studies does not understand the job and the application of the job then he should have asked questions!}

 


 

Dr. Linda Schwartz associate research scientist, Yale University...

 

Dr. Schwartz conclusions in a summary of her statements: (X)

 

To continue to use the Ranch Hand study as a Government Gold Standard as it is presently be used is not acceptable.  It is not representative of what is happening to the health of those Veterans who served in Vietnam.

 

The study seems to be crafting for publication.   If it is not statistically significant, Ranch Hand does not publish it. Therefore, we and the NAS are not getting all of the information.

 

We are denying veterans, or maybe we are denying veterans some compensation and disability for the facts that we have not really looked at all.

 

Additional note:  Dr. Schwartz was closer to the real facts of this study than she knew or let on with new admittance of the flaws in Ranch Hand cohort assumption and what Veterans have suggested all along.  Not only was the basic premise of the study flawed and way to stringent with White House interference but now we find that the cohorts selection and assumptions were tragically flawed for many dead and dying Vietnam Veterans.  (See repeated media release below:) (X)

 

Recently the same Dr. Michalek and Dr. Ralph Trewyn (both served on the Ranch Hand Committee) came forward in the media and clearly stated that Ranch Hand assumptions were flawed.

 

"However, hundreds in the comparison group spent time in Vietnam and may have been exposed to herbicides, too, said Joel Michalek, who worked on the study from the beginning and was its principal investigator for 14 years until he left in May.

"It spoils everything," Michalek told The News.  "It's as if you're running a clinical trial on a new medication, and you found out some of the people who were in your placebo group were actually taking meds.  That would spoil your whole study.  And that's what's going on here in this study.


"They referenced those papers, but they left all the data out from those cancer papers that were done that showed the cancer effects, he said.  "It's huge, because then the conclusion is there's no cancer effect, when as part of the study, the same investigators, just analyzing the data in a different way, found that when they did that, lo and behold, then there were significant cancer effects.

"And so for the final report to say there's no cancer effect when the investigators themselves published papers saying there is a cancer effect, that's just flat scientifically wrong.

"Without factoring in the new information about the comparison veterans, Trewyn said, the Air Force got the same, predictable results.

"When they use an exposed control group and they say the two groups have roughly the same amount of cancer and so forth, what is that finding good for?  Nothing," said Trewyn, vice provost for research and Dean of the graduate school at Kansas State University.

"And it doesn't take a scientist to figure that out, he said.

"This is common sense now, a lot of it," he said.  "It's like now wait a minute.  This just does not pass the smell test or the common sense test."

 

Including in the media release, Dr. Trewyn stated not just specific cancer increases were misreported; but all cancer sites.  This has been found in other studies that clearly identified there was little difference in specific cancer sites and all cancer sites associated to dioxin exposures; including low level exposures.

 

The Government's Gold Standard used against Vietnam Veterans is a purposeful fraud!

 

In the above discussion of total fraud we Vietnam Veterans and our widows have found:

 

1. The government director of studies is outside the scientific evidence level for Peripheral Neuropathy (and other disorders) and seems confused on what it is the congress wants.  He is outside the realm of what science can even do or the definition of the toxic chemical dioxin, TCDD and its in body actions and effects. (X)

 

2. The gold standard used in compensations and associations of disorders by VA and NAS/IOM is purposely flawed and that data used to deny our initial VA legal claims as well as BVA claims is fraudulent. (X)

 

3. The NAS program director seems to only want to commit to his name; denying he has any idea of what the level of association is required by government contract.  Not only for the top level of associations but all four levels and their actual levels of associations.  Then states that it is the VA's job of interpretation of association.  This agency is under contract to do something, yet the program manager cannot tell what that something is or how it is in compliance with what should be "a very specific" by the VA contract since the NAS clearly indicated it was the VA's job to determine association requirements "for whatever it is" they are contracted to do. Which, by default is our judge and jury in "Veterans Legal Actions."  This by default is legal actions and the results are used in a legal forum of the individual VA offices as well as the BVA weighted evidence.  Particularly since the BVA uses actual statements of findings by the NAS/IOM in denying the Veteran disability or the widow's DIC.  Vietnam Veterans and their widows would expect a detailed contract of how NAS/IOM is meeting whatever the VA requirements are in the contract and specific to the levels of associations.  This contract should have all the necessary contract requirements for an honest assessment, not subject to the NAS/IOM subjectivity and forbids the use of "Dart Boards and Ouija Boards" as a way of determining levels used against the Vietnam Veterans in legal claims of mortality and morbidity. (X)

 

4. VA states that whatever NAS/IOM has submitted as associated to the four levels or degrees of evidence they have accepted in total.  NAS/IOM under oath will not tell the congress what levels they are looking for and how the NAS/IOM arrives/determines the levels by what they are doing under contract and the processes, other than restating the categories of levels by description.  VA then says they have accepted all of what NAS/IOM has done HOWEVER they arrived at the by default legal conclusions used against the Vietnam Veteran in the governments court of law.  VA has no audits to make sure the contract and by the NAS/IOM own statements should have the levels required in some measurable form and not just NAS/IOM subjectivity since their input of levels determines court rulings as well as the Secretaries of the VA decisions. (X)

 

5. Dr. Schwartz indicates that many of the found issues in the Ranch Hand, at 50% or larger are not even making it in to the reports and/or oral presentations by the Ranch Hand that NAS/IOM uses to determine VA legal actions against the Vietnam Veterans and their Widows. (X)

 

All of these facts do not add up to quite exactly what the Marquee on the Supreme Court  states as "Justice for All."  Justice for All except if you wore the Uniform of the United States Military.

 

What we have here is Executive Branch judicial manipulation of the legal system given to the Executive Branch by our Legislative Branch.   This totally violates the separation of powers demanded by our constitution.

 


 

What has been our government's response to the statements that the entire Ranch Hand study used as a government GOLD STANDARD for over 25 years and the cost of millions of dollars has been a White House spoiled study and now even the scientists conclude it was fraudulent in its cohort assumptions.  Which by default once again has been used as legal actions against our Vietnam Veterans and their widows.  NOT ONE WORD! 

 

Vietnam Veterans and many in the scientific community have stated since day one an exoneration tool only and has never been a study for Agent Orange by the use of changing exposure indexes and so forth and as Admiral Elmo Zumwalt exclaimed in 1989 might as well been a study of eating too many beer nuts at the Officers and NCO clubs.

 

What has been the response from our elected officials?  NOT ONE WORD!  NOT ONE!

 

When the controlling Air Force government entity stated they are not going to include the new issues in the published report and then told the scientists to destroy the data. (X)

 

"The Air Force has no plans to publish the new cancer findings in any Air Force report or scientific journal, Col. Karen Fox told the civilian advisory committee during a meeting in Maryland in response to spirited and sustained questioning during the panel's final meeting Thursday. 

                    

Fox said the Air Force instructed the scientist who conducted the analysis to destroy the data.

Michael Stoto, committee chairman and a professor at Georgetown University, said the new analysis included "some interesting and potentially important findings" about the health of airmen involved in herbicide spraying missions during the Vietnam War. "

 

What is our governments elected officials response in the house and senate and from the President?  SILENCE!  And then more DEAFENING SILENCE!

 

Vietnam Veterans have expected the Presidents silence over the decades because of protecting White House mistakes and of their uncovered philosophy of "not supporting our Nations' Vietnam Veterans." 

 

Until recently we Vietnam Veterans did not understand the lack of support of those we elected that are by all historical accounts created in our form of government to protect those that White House Philosophy has chosen to commit fraudulent activities and a form of tyranny over those constituents. 

 

Should it matter to congress that we Vietnam Veterans "as constituents" once wore a uniform?

 

In the civilian world of real justice, this kind of fraudulent activity would have been met with prison time for those that perpetrated the fraudulent medical activity that continued to allow mortality and morbidity by their own lack of integrity and purpose.

 

Vietnam Veterans also note that the Secretaries of the VA have been reluctant to use their legal power defined in C.F.R. § 1.17 (d) to associate these many disorders that other studies have proven not only "increased risk of incidence" but also significant p-values of difference to those exposed and those not exposed in similar cohort military occupational specialties (MOS).  Instead they default to White House directed policy not to compensate for morbidity or mortality that "is at least as likely as not proven many times over."  Including this crippling disorder of peripheral nerve damage as a stand alone with its associated disorders.

 

The Secretaries of the VA have had no honor in our Toxic Chemical Legacy!

 

Hearings before the Human Resources and Intergovernmental Relations Subcommittee on July 11, 1989 revealed, the design, implementation and conclusions of the CDC study were so ill conceived as to suggest that political pressures once again interfered with the kind of professional, unbiased review Congress had sought to obtain.42

As early as 1986, the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce documented how untutored officials of the Office of Management and Budget (0MB) interfered with and second-guessed the professional judgments of agency scientists and multidisciplinary panels of outside peer review experts effectively to alter or forestall CDC research on the effects of Agent Orange, primarily on the grounds that "enough" dioxin research had already been done.58 These Agent Orange Hearings revealed additional examples of political interference in the CDC's Agent Orange projects by members of the White House Agent Orange Working Group.59

 

Political interference in government sponsored studies associated with Agent orange has been the norm, not the exception. In fact, there appears to have been a systematic effort to suppress critical data or alter results to meet preconceived notions of what alleged scientific studies were meant to find.61 As recently as March 9, 1990 Senator Daschle disclosed compelling evidence of additional political interference in the Air Force Ranch Hand study, a separate government sponsored study meant to examine the correlation between exposure to Agent Orange and harmful health effects among Air Force veterans who participated in Agent Orange spraying.

 

Yet, when Senator Daschle questioned Air Force scientists on why discrepancies existed between an Air Force draft of the Ranch Hand Study and the final report actually released to the press, the answers suggested not merely disagreements in data evaluation, but the perpetration of fraudulent conclusions. (X)

 

 

Conclusions

 

Senators, Congresspersons, Government decision makers, and Congressional Staff Members must recognize that Vietnam Veterans and their widows for 40 years has been dealt death blow after death blow by our own government in withholding and manipulating medical evidence and findings.  Including creating 10's of thousands or more disabled Veterans who have not been supported because of government causations of their disability or disabilities.

 

The Vietnam Veterans state with the evidence submitted that by all definitions as defined by VA law and what congress intended have proven:

If Senators, Congresspersons, Government decision makers, and Congressional Staff Members with the above evidence submitted do not find that the crippling disorder of Peripheral Neourpathy is not automatically associated to the exposures in Vietnam as a catalyst for degenerating life long conditions. >>>>>>>>Then the United States Vietnam Veterans and their spouse/widow and/or orphans demand an accountability as to why the data we as a Vietnam Veterans have submitted with this submittal and many times before to the VA as our judge and jury does not meet the established requirements and the portrayed intent of congressional requirements regarding this crippling nerve disorder and the associated medical issues.

 

Other issues that Vietnam Veterans or their widows can prove it is at least as likely as not associated to wartime service in a toxic chemical environment:

 

Non-Hodgkin’s lymphoma, chloracne and other skin disorders, lip cancer, bone cancer, soft tissue sarcoma, birth defects (physical and mental), skin cancer, porphyria cutanea tarda family of disorders and other liver disorders (such as biliary disorders), Hodgkin’s disease, hematopoietic diseases, multiple myeloma, neurological defects {such as neuropathy (any form}, and cognitive disorders and deficits), autoimmune diseases and disorders (defined and undefined medical codes), leukemia (both CLL and AML), lung cancer and forms of obstructive airway diseases, kidney cancer, malignant melanoma, pancreatic cancer, stomach cancer, colon cancer, nasal/pharyngeal/esophageal cancers, prostate cancer, testicular cancer, liver cancer, brain cancer, neuropsychological effects, gastrointestinal diseases, amyloidosis (primary, secondary, or toxic chemical tertiary), macroglobulinemia (in any form), forms of  osteoporoses and/or bone loss, bone tumors and cancer, avascular necrosis, spondylosis, radiculopathy (including herniation of the nucleolus pulposus), brain atrophy, brain infarction, ischemic heart disease, hypertension, vasculopathy, vascular diseases, valvular heart disease, MS, ALS, and Parkinson’s. 

    

Many of these disorders in common causation can be found associated to the systemic damages in the body processes instead of what the United States Government/VA/NAS-IOM has done in order to stall and forgo the cumulative multiple disorders.  Instead then taking each individual diagnostics code and trying to ferrite out what linear dose caused the individual medical disorder instead of a syndrome or the associated disorder caused by i.e. vasculitis.  As in cancers everyone is not going to develop the same form of cancer or even severity or time to manifestation.  Vasculitis may produce a variety of ICD codes and not all vasculopathy victims will have the exact same damages.  To add insult to the Vietnam Veterans and their Widows insult to mortality and morbidity they have been using government corrupted and we now know flawed scientific conclusions and statistics.

 

As Dr. Trewyn stated related to cancers and he is a 25 year cancer research expert:

 

{"...Trewyn, vice provost for research and dean of the graduate school at Kansas State University, said cancers caused by exposures in Vietnam could show up anywhere.

 

"Some people are going to be susceptible to one type of cancer versus another," he said. "Having done research on cancer, it doesn't surprise me at all that you find this at a whole host of different sites."}  (V)

 

The sum total of this Vietnam Veterans' challenge with the data submitted, the identified interference by the government itself, the lack of any legitimate identified scientific rational process used in legal denials (judicial branch activity) by the scientist at the VA and the NAS/IOM, the pointed out flaws in the Gold Standard used is:

 

That it is "more than just as likely as not:" the Vietnam Veterans debilitating chronic peripheral neuropathy and the associated disorders to that degenerating nerve disorder was caused by his or her toxic chemical exposures during his or her wartime service to this nation and should be an "inclusive disorder" to wartime service; regardless if the veteran has diabetes or not!

 

 I am recently reminded by a Disabled Vietnam Veteran of a verse in Galatians 4:16 written in the form of a challenge.

 

In paraphrasing that challenge:

 

Are the Nation's Veterans now the government's enemy for telling "The Truth" about how we are treated by elected and appointed government representatives? 

 

As Doctor Ronald Trewyn, (A wounded Vietnam Veteran of III Corps) Dean of the Graduate School and Vice Provost of Research for Kansas State University, and, a member of the Agent Orange Ranch Hand Advisory Committee stated in the congressional 2000 Government Oversight review: (V)

 

“…this is more than a Veterans Affairs issue.  It is, in fact, a “national security issue.”  Because if the country continues to treat their veterans poorly and, in some cases, abominably as has been the case with the veterans suffering from adverse health outcomes from Vietnam, from the Persian Gulf, we're not going to meet the recruitment and retention needs in this new era of needing highly educated, highly technically proficient people.  They aren't going to stay in because why should they, when they know what's going to happen going out the other end?” 

 

It is obvious our National Media has abandoned we Vietnam Veterans dead and dying since about year one in 1962.  Whether this is also do to White House Pressure is unknown.  There have been some examples found.

 

It is more painfully obvious with data that White House after White House has abandon an entire ten year wartime campaigning Army. 

 

To add salt to our government caused toxic chemical deaths and wounds it now seems that our own Congress and any form of Constitutional Justice has all but abandon the government created dead and dying used up government assets - The Vietnam Veterans of our Nation and their Widows and Orphans.  

 

Charles W. Kelley - and all our Vietnam Veterans Medically Afflicted

 

DMZ Vietnam 67-68

Army Commendation Medal

2nd Battalion 94th Artillery 175mm SP

 

Numbers are not in order yet  and additions in references need to be Fixed and additions created.

 

REFERENCES (Can be furnished upon request)

 

(1) 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.

 

(2) October 26-27, 1998 Ranch Hand Advisory Committee Meeting, transcripts.

 

(3) August 26-27, 1999 Ranch Hand Advisory Committee Meeting, transcripts.

 

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

 

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

 

(6) October 19-20, 2000 Ranch Hand Advisory Committee Meeting, transcripts from day two.

 

(7) January 22-24, 2001 Ranch Hand Advisory Committee Meeting, Transcripts.

 

(8) March 12, 2003, Ranch Hand Advisory Committee Meeting Transcripts.

 

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

 

(10) 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.

 

(11) House Report 101-672 -“The Agent Orange cover-up: a case of flawed science and political manipulation.” 

 

(12) Taped interview by Moon Callison with Admiral Zumwalt on July 26th 1999 discussing his role in the 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.  (America’s Defense Monitor (ADM's) Moon Callison interviews the former Chief of Naval Operations, for "Environmental Impact of War").

 

 (13) American Legion Magazine dated June of 2004 – “Agent Orange Haze of Deception,” by Mr. James V. Carroll.

 

(14) See L. Casten, Patterns of Secrecy: Dioxin and Agent Orange (1990) (unpublished manuscript detailing the efforts of government and industry to obscure the serious health consequences of exposure to dioxin).

 

(15) EPA Collusion with Industry: A Very Brief Overview, by Liane C. Casten, Environmental Task Force Chair of Chicago Media Watch.

 

(16) Impact of Agent Orange Exposure among Korean Vietnam Veterans – Industrial Health 2003, 41, 149-157

 

(17) Short and Long Term Morbidity and Mortality in the Population Exposed to Dioxin after the Seveso Accident – Industrial Health 2003, 41, 127-138

 

(18) Health Effects of Dioxin Exposure:  A 20-Year Mortality Study – American Journal of Epidemiology Vol. 153: 1031-1044

 

(19) Immunotoxicological Effects of Agent Orange Exposure to the Vietnam War Korean Veterans – Industrial Health 2003, 41, 158-166

 

(20) 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

 

 

Additional references not cited:

 

(21) Industrial Health 2003, 41, 215-230 – Developmental Neurotoxicity of Dioxin and Its Related Compounds.  (If dioxin can have this much disastrous effect on the developing brain then to not say it cannot effect the developed brain once it crosses the brain blood barrier would be meet no logical scientific conclusions.)

 

(22) Industrial Health 2003, 41, 175-180 – Dioxin:  Exposure-Response Analysis and Risk Assessment.  (Doubling background levels of dioxin increases the risk of cancer by at least 13%.  However, one must consider the levels that Vietnam Veterans were exposed in the range of parts per million not the standard of 5 parts per trillion.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Possible data to use

 

 

_______________________

    62 See Congressional Record S 2550 (March 9, 1990)

33

 

flawed.

Recent evidence also reveals that Dow Chemical, a manufacturer of Agent Orange was aware as early as 1964 that TCDD was a byproduct of the manufacturing process. According to Dow’ s then medical director, Dr. Benjamin Holder, extreme exposure to dioxins could result in "general organ toxicity" as well as "psychopathological" and "other systemic" problems. 73 In fact, a

_______________________

    71 Friedemann Rohleder, "Dioxins and Cancer Mortality Reanalysis of the BASF Cohort," presented at the 9th International Symposium on Chlorinated Dioxins and Related Compounds, Toronto, Ontario (Sept. 17-22, 1989). BASF recently published a study in an attempt to refute the allegations that the original studies related to the accident were fraudulent. See Zobier, Messerer & Huber, "Thirty Four Year Mortality Follow Up of BASF Employees, 62 Occupational Environmental Health 139-157, (Oct. 19, 1989). While the company states that "there was no significant increase in deaths from malignant neoplasms," the study does conclude that:

There was, however, a significant excess for all cancers combined among the chloracne victims 20 or more years after initial exposure when an excess would be most likely to occur. In addition, there is the notable finding on one case of liver cancer without cirrhosis in a worker with an exceptionally high level of TCDD in the blood.

    Id. at 155. See also id. at 139 ("In general, our results do not appear to support a strong association between cancer mortality and TCDD, but they do suggest that some hazard may have been produced.) (emphasis added) and 149 ("Although TCDD blood levels were available for only 5 of the 10 subjects, the three highest levels were found in subjects with liver cancer, leucosis and Merkell—cell carcinoma of the skin.").

    72 Wanchinski, "New Analysis Links Dioxin to Cancer," New Scientist, (Oct. 28, 1989) p. 24.

    73 See L. Casten, Patterns of Secrecy: Dioxin and Agent Qrange (1990) (unpublished manuscript detailing the efforts of government and industry to obscure the serious health consequences of exposure to dioxin).

39

 

recent expert witness who reviewed Dow Chemical corporate documents on behalf of a plaintiff injured by exposure to dioxin who successfully sued Dow74 states unequivocally that "the manufacturers of the chlorphenoxy herbicides have known for many years about the adverse effects of these materials on humans who were exposed to them."75

VI. CURRENT SCIENCE ON HEALTH EFFECTS OF HERBICIDES AND DIOXIN

Despite its poor record in carrying out its responsibility to ascertain the health effects of exposure to Agent Orange, the CDC has been candid in some of its findings. As early as 1983, for instance, the CDC stated in the protocol of its proposed Agent Orange Studies "(t)hat the herbicide contaminant TCDD is considered to be one of the most toxic components known. Thus any interpretation of abnormal findings related to 2,4,5—T must take into consideration the presence of varying or undetermined

_________________

 

74 Peteet v. Dow Chemical Co., 868 F.2d 1428 (5th Cir. 1989) cert...denied 110 S.Ct. 328 (1989).

CONCLUSIONS

As many of the studies associated with Agent Orange and dioxins attest, science is only at the threshold of understanding the full dimension of harmful toxic effects from environmental agents on various components of the human immune system. 93 In

_________________________

    91 Report of the Agent Orange Scientific Task Force of the American Legion, Vietnam Veterans of America, and the National Veterans Legal Services Project, reported by McAllister, "Viet Defoliant Linked to More Diseases, Washington Post, May 1, 1990 at AS, col. 4. The report also found that there are other disorders for which there is evidence suggesting an association with exposure to Agent Orange, but for which statistically significant evidence is not currently available. Those diseases include: leukemias, cancers of the kidney, testis, pancreas, stomach, prostate, colon hepatobiliary tract, and brain, psychosocial effects, immunological abnormalities, and gastrointestinal disorders.

    92 Weisskopf, "EPA Seeking to Reduce Dioxin in White Paper: Cancer Risk Said to Justify Mill Restrictions," Washington Post, May 1, 1990 at AS, col. 1.

    93 A recent report in the Washington Post suggests that there is an inherent uncertainty in trying to measure the dangers posed by the chemicals humans eat, drink and breathe. Since human experimentation is impossible to assess the effect of varied doses of a chemical on human health, scientists are ultimately required

47

 

fact, a whole new discipline — immunotoxicology — has developed to explore further the effects of environmental chemicals on human health and to relate animal test results to humans.94

    Immunotoxicology has established, however, at a minimum that at least three classes of undesirable effects are likely occur when the immune system is disturbed by environmental exposure to chemicals such as dioxin, including: 1) immunodeficiency or suppression; 2) alteration of the host defense mechanism against mutagens and carcinogens (one theory is that the immune system detects cells altered by mutagens or other carcinogenic trigger and destroys these cells. Thus, an impaired immune system may not detect and destroy a newly forming cancer); and 3) hypersensitivity or allergy to the chemical antagonist. Because of dioxin’s ability to be both an immunosuppressant and a carcinogen, as early as 1978 immunologists were suggesting that "(a) gents such as TCDD.. .may be far more dangerous than those possessing only one of these properties."95

    While scientists are not in agreement, some immunotoxicologists argue that one molecule of a carcinogenic agent, like dioxin in the right place and at the right time can

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to speculate or guess as to the health effects of a given chemical to the human body. See Measuring Chemicals’ Dangers: Too Much Guesswork?" Washington Post, March 23, 1990.

    94 Silbergeld & Gaisewicz, "Dioxins and the Ah Receptor," 16 American Journal of Industrial Medicine 455, 468—69 (1989).

    95 Inadvertent Modification of the Immune Response — The Effect of Foods, Drugs, and Environmental Contaminants; Proceedings at the Fourth FDA symposium; U.S. Naval Academy (August 28-30, 1978), p. 78.

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cause the human immune system to turn on itself, manifesting such breakdowns in the form of cancer. Indeed, even some courts have accepted this theory of causation in matters specifically related to exposure to dioxin.96

    With additional evidence from Vietnam suggesting that Agent Orange contaminants have the ability to migrate away from actual spray locations via river channels and the food chain, the opportunity for a Vietnam Veteran to have been exposed to dioxin contaminant molecules increases significantly.97

    It cannot be seriously disputed that any large population exposed to chemical agents, such as Vietnam Veterans exposed to Agent Orange, is likely to find among its members a number who will develop malignancies and other mutagenic effects as a result of being exposed to harmful agents.

    To be sure, decisions today with regard to the seriousness of Agent Orange health effects must be made while the science of

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    96 See Peteet V. Dow Chemical Co. , 868 F.2d 1428, 1433 (5th Cir. 1989) cert denied 110 S.Ct. 328 (1989).

    97 See e.g. Schecter, et. al., "Levels of 2,3,7,8—TCDD in Silt Samples Collected Between 1985—86 From Rivers in the North and South of Vietnam," 19 Chemosphere 547—550 (1989) (suggestive findings that the predominant dioxin isomer in Agent Orange has moved into downstream rivers in the South of Vietnam); Olie, et. al., "Chlorinated Dioxin and Dibenzofuran Levels in Food and Wildlife Samples in the North and South of Vietnam," 19 Chemosphere 493-496 (1989) (food and wildlife specimens in South Vietnam had a higher relative abundance of 2,3,7,8-TCDD suggesting contamination from Agent Orange); Schecter, et · al. "Chlorinated Dioxin and Dibenzofuran Levels in Food Samples Collected Between 1985—87 in the North and South of Vietnam," 18 Chemosphere 627—634 (1989) (Agent Orange contaminants, specifically 2,3,7,8-TCDD found at relatively elevated levels in food and wildlife samples 15-2 5. years after environmental contamination with compound in South of Vietnam

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immunotoxicology is in its infancy. After having evaluated and considered all of the known evidence on Agent Orange and dioxin contaminants, it is evident to me that enough is known about the current trends in the study of dioxins, and their linkage with certain cancers upon exposure, to give the exposed Vietnam Veteran the benefit of the doubt.

    This benefit of the doubt takes on added credence given two separate means for determining exposure to Agent Orange — 1) HERBs and Service HERBs tapes establishing troop location for comparison with recorded Ranch Hand spraying missions; and 2) blood testing from living Veterans,to ascertain elevated dioxin levels. The inexplicable unwillingness of the CDC to utilize this data has had the effect of masking the real increase in the rate of cancers among the truly exposed. There is, in my opinion, no doubt that had either of these methods been used, statistically significant increased rates of cancer would have been detected among the Veterans for whom exposure can still be verified.

    Since science is now able to conclude with as great a likelihood as not that dioxins are carcinogenic directly and indirectly through immunosuppression, and since a large proportion of those exposed to dioxin can be so ascertained, I am of the view that the compensation issue for service—related illnesses associated with exposure to Agent Orange should be resolved in favor of Vietnam Veterans in one of the two following ways:

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COMPENSATION FOR SERVICE RELATED ILLNESSES

Alternative 1:

    Any Vietnam Veteran, or Vietnam Veteran’s child who has a birth defect, should be presumed to have a service—connected health effect if that person suffers from the type of health effects consistent with dioxin exposure and the Veteran’ s health or service record establishes 1) abnormally high TCDD in blood tests; or 2) the veteran’s presence within 20 kilometers and 30 days of a known sprayed area (as shown by HERBs tapes and corresponding company records); or 3) the Veteran’ s presence at fire b se perimeters or brown water operations where there is reason believe Agent Orange have- occurred.

    Under this alternative compensation would not be provided for those veterans whose exposure came from TCDD by way of the food chain; silt runoff from sprayed areas into unsprayed waterways; some unrecorded U.S. or allied Agent Orange sprayings; inaccurately recorded sprayings; or sprayings whose wind drift was greater than 20 kilometers. Predictably, problems generated by the foregoing oversights, the mass of data to be analyzed as claims were filed, and the known loss of many service records would invalidate many veterans’ legitimate claims

Alternative 2:

    Any Vietnam Veteran or child of a Vietnam Veteran who experiences a TCDD—like health effect shall be presumed to have a service—connected disability. This alternative is admittedly

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broader than the first, and would provide benefits for some veterans who were not exposed to Agent Orange and whose disabilities are not presumably truly service—connected. Nevertheless, it is the only alternative that will not unfairly preclude receipt of benefits by a TCDD exposed Vietnam Veteran.

    Furthermore, this alternative is consistent with the Secretary’s decision regarding the Service—connection of non— Hodgkin’s lymphoma, as well as legal precedent with respect to other diseases presumed by the Department of Veterans Affairs to be connected to one or more factors related to military service (i.e. veterans exposed to atomic radiation and POW’s with spastic colon).

PRESUMPTIONS OF AGENT ORANGE RELATED HEALTH EFFECTS

    I have also given considerable thought to which health effects are to be presumed likelier than not to be related to TCDD exposure and therefore service—connected. Any such determination must be made in light of: 1) the review of the scientific literature, including animal studies where human data does not exist or has been manipulated; 2) the inappropriate processes of the Veterans Advisory Committee on Environmental Hazards; 3) the past political manipulations of Ranch Hand and CDC studies; and 4) the recent discoveries of manipulation by scientists hired by chemical manufacturers of dioxin contaminants to evaluate the potentially best epidemiological data concerning TCDD’s effects on humans.

My evaluation of the evidence has been made with just such

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considerations in mind. Additionally, I have conferred with several experts in the field. After evaluating all the evidence and material of record, I am convinced that there is better than "an approximate balance of positive and negative evidence" on a series of Agent Orange related health effects.

    It can, in my judgment, be concluded, vith a very high degree of confidence, that it is at least as likely as not that the following are caused in humans by exposure to TCDD: non—Hodgkin’ s lymphoma, chloracne and other skin disorders, lip cancer, bone cancer, soft tissue sarcoma, birth defects, skin cancer, lung cancer, porphyria cutanea tarda and other liver disorders, Hodgkin’s disease, hematopoietic diseases, multiple myeloma, neurological defects and auto—immune diseases and disorders.

    In addition, I am most comfortable in concluding that it is at least as likely as not that liver cancer, nasal/pharyngeal/esophageal cancers, leukemia, malignant melanoma, kidney cancer, testicular cancer, pancreatic cancer, stomach cancer, prostate cancer, colon cancer, brain cancer, psychosocial effects, and gastrointestinal disease are service-- connected.

    I have separated the two foregoing subsets subjectively only because there is somewhat more data to support the former than the latter. Nonetheless, immunological and toxicological theory supports both subsets and fully justifies, in my view, the inclusion of both subsets of the foregoing health effects in determining a service--connected injury.

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    Such a resolution of the embarrassingly prolonged Agent Orange controversy would be on the order of decisions to compensate U.S. soldiers who contracted cancer after exposure to radiation from atomic tests and U.S. soldiers involved, without their knowledge, in LSD experiments. With the scientific basis now available for it to be stated with confidence that it is at least as likely as not that various health effects are related to wartime exposure to Agent Orange, there is the opportunity finally to right a significant national wrong committed against our Vietnam Veterans.

RECOMENDATIONS

    1. That the Secretary undertake a prompt reevaluation of the compensation decision impacting on Vietnam Veterans exposed to Agent Orange in light of accumulating scientific evidence that discredits earlier "findings" of an insufficient linkage between dioxin contaminants in Agent Orange and rare disease, such as cancer illnesses.

    2. To the extent that the Secretary deems it necessary to use the Veterans’ Advisory Committee on Environmental Hazards to assist in his reevaluation, the current members should be dismissed -— having demonstrated a disturbing bias in their review to date of the scientific literature related to Agent Orange and dioxin -- and new members should be appointed in accordance with Section G of the Veterans’ Dioxin and Radiation Exposure Compensation Standards Act, including persons with recognized scientific and medical expertise in fields pertinent

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to understanding the health effects of exposure to dioxin. The Committee meeting currently scheduled for May 16th and May 17th should be cancelled.

    3. That the Secretary in making his decision regarding Agent Orange compensation for Vietnam Veterans do so on the basis of his independent evaluation of the existing scientific and medical evidence on the health effects of exposure to dioxins, as cataloged and discussed in this Report, and in full recognition that the standard to be applied -- as mandated by both Congress and the courts -- requires the resolution of doubts as to a number of cancers linked to dioxins in favor of the Vietnam Veterans.

 

 55 See Kahn, "Dioxins and Dibenzofurans in Blood and Adipose Tissue of Agent Orange Exposed Vietnam Veterans and Matched Controls," 259 Journal of the American Medical Association 1661 (1988). This report found that "Vietnam veterans who were heavily exposed to Agent Orange. exceeded matched control subjects in both blood, and adipose tissue levels of 2,3,7, 8—tetrachlorodibenzo-p— dioxin (TCDD) but not in the levels of the 12 other 2,3,7,8-substituted dioxins and dibenzofurans that were detected. Since only TCDD among these compounds was present in Agent Orange but all are present in the population of the industrialized world, it is likely that the elevated TCDD levels arose from wartime exposure."

    56 Patterson, "Levels of Polychlorinated Dibenzo-p-dioxins and Dibenzofurans in Workers Exposed to 2,3,7,8 --tetrachlorodibenzo-p—dioxin,. 16 American Journal of Industrial Medicine 135, 144 (1989).

    57 See generallv, Agent Orange Hearing (Testimony of Dr. Vernon Houk) at 44--50.

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effectively to alter or forestall CDC research on the effects of Agent Orange, primarily on the grounds that "enough" dioxin research had already been done.58 These Agent Orange Hearings revealed additional examples of political interference in the CDC~s Agent Orange projects by members of the White House Agent Orange Working Group.59

. RANCH HAND STUDY