AGENT ORANGE
Information for Veterans Who Served in Vietnam
GENERAL INFORMATION
Environmental Agents Service
Department of Veterans Affairs
810
Vermont Avenue, N.W.
Washington, DC 20420
JULY 2003
JULY 2003
Agent Orange was used in Vietnam to protect U.S. troops.
Agent Orange was a herbicide
used in Vietnam to kill unwanted plants and to remove leaves
from trees that otherwise
provided cover for the enemy. The name, “Agent Orange,” came from
the orange stripe on the
55-gallon drums in which it was stored. Other herbicides, including
Agent White and Agent Blue,
were also used in Vietnam to a much lesser extent.
When and where Agent Orange was used in Vietnam.
Between 1961 and 1971, the
U.S. military in South Vietnam used more than 19 million gallons
of herbicides for defoliation
and crop destruction. Several types and combinations of chemicals
were used. These mixtures
were identified by the color of the stripe on the storage drums.
The three most common
mixtures were Agent Orange, Agent White, and Agent Blue. Fifteen
different herbicides were
shipped to and used in Vietnam. Most of the herbicides sprayed in
Vietnam were Agent Orange,
which was used between January 1965 and April 1970. Herbicides
other than Agent Orange were
used in Vietnam prior to 1965, but to a very limited extent. The
total area sprayed with
herbicides between 1962 and 1965 was quite small. However, some
of the herbicides used in the
early years contained greater concentrations of dioxin. Spraying
occurred in all 4 military zones
of Vietnam.
Heavily sprayed areas
included inland forests near the demarcation zone; inland forests at the
junction of the borders of
Cambodia, Laos, and South Vietnam; inland forests north and northwest
of Saigon; mangrove forests
on the southernmost peninsula of Vietnam; and mangrove forests
along major shipping channels
southeast of Saigon.
Some Vietnam veterans are concerned about the long-term effects of
exposure to
Agent Orange.
In the 1970’s some veterans
became concerned that exposure to Agent Orange caused health
problems. One of the
chemicals in Agent Orange contained minute traces of TCDD (dioxin),
which caused a variety of
illnesses in laboratory animals. More recent studies have suggested
that the chemical may be
related to a number of cancers and other health problems.
What concerned Vietnam veterans can do.
In 1978, the Veterans
Administration, now known as the Department of Veterans Affairs (VA),
set up the Agent Orange
Registry health examination program for Vietnam veterans concerned
with the possible long-term
medical effects of exposure to Agent Orange. Vietnam veterans
who are interested in
participating in this program should contact the nearest VA medical center
for an examination. More than
315,000 Vietnam Veterans have completed this examination.
What a veteran can expect from this examination.
Veterans who participate in
this examination are asked about their possible exposure to
herbicides in Vietnam. A
medical history is taken, a physical examination is performed, and
a series of basic laboratory
tests, such as a chest x-ray (if appropriate), urinalysis, and blood
tests, are done. If medically
required, consultations with other health specialists are scheduled.
However, no special Agent
Orange tests are offered because there is no way to show that
Agent Orange or other
herbicides used during Vietnam caused individual medical problems.
There are tests that show
body dioxin levels, but VA does not perform them because there is
serious question about their
value to veterans. VA also makes a presumption of Agent Orange
exposure for Vietnam
veterans.
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In its 1994 report on Agent
Orange, the National Academy of Sciences (NAS) concluded that
individual TCDD levels in
Vietnam veterans usually are not meaningful because of background
exposures to TCDD in all
Americans, poorly understood variations among individuals in TCDD
metabolism, relatively large
measurement errors, and exposure to herbicides that did not contain
TCDD.
How a veteran benefits from taking VA’s Agent Orange Registry
examination.
The veteran is informed of
the results of the examination during a personal interview and gets
a follow-up letter further
describing the findings. Each veteran is given the opportunity to ask
for an explanation and
advice. Sometimes a follow-up examination or additional laboratory
tests are scheduled because
of the possibility of previously undetected medical problems being
present. These discoveries
can help veterans get prompt treatment for their illnesses. Some
veterans think they are in
good health, but are worried that exposure to Agent Orange and
other substances may have
caused some hidden illnesses. The knowledge that a complete
medical examination does not
show any problems can be reassuring or helpful to Registry
participants. All examination
and test results are kept in the veteran’s permanent medical
record. These data are
entered into the VA Agent Orange Registry.
Vietnam veterans can get medical treatment for Agent
Orange-related illnesses.
Under Section 102, Public Law
104-262, the Veterans’ Health Care Eligibility Reform Act of
1996, VA shall furnish
hospital care, medical services and may furnish nursing home care to
veterans exposed to
herbicides in Vietnam. These veterans will be furnished health care and
without the requirement of a
copayment. There are some restrictions. VA cannot provide such
care for a (1) disability
which VA determines did not result
from exposure to Agent Orange,
or (2) disease which the NAS
has determined that there is “limited/suggestive” evidence of no
association between
occurrence of the disease and exposure to a herbicide agent.
Some Vietnam veterans get disability compensation for Agent
Orange-related
illnesses.
VA pays disability
compensation to Vietnam veterans with injuries or illnesses incurred in or
aggravated by their military
service. Veterans do not have to prove that Agent Orange caused
their medical problems to be
eligible for compensation. Rather, VA must determine that the
disability is
“service-connected.” A Veterans Services Representative, at a VA medical center
or regional office, can
explain the compensation program in greater detail and assist veterans
who need help in applying.
For more information about the VA’s Agent Orange program call
the toll-free helpline:
1-800-749-8387; for disability compensation program information, call
toll-free: 1-800-827-1000.
VA has recognized a number of conditions for “service-connection”
based
on evidence of an association with Agent Orange (or other herbicides
used in
Vietnam).
The number of diseases that
VA has recognized as associated with (but not necessarily caused
by) Agent Orange exposure has
expanded considerably during the 1990’s. The following
conditions are recognized for
service-connection for these veterans: chloracne (a skin disorder),
porphyria cutanea tarda,
acute or subacute peripheral neuropathy (a nerve disorder), type 2
diabetes, and numerous
cancers [non-Hodgkin’s lymphoma, soft tissue sarcoma, Hodgkin’s
disease, multiple myeloma,
prostate cancer, and respiratory cancers (including cancers of the
lung, larynx, trachea, and
bronchus)]. VA is in the process of adding chronic lymphocytic leukemia
to this list. In addition,
Vietnam veterans’ children with the birth defect spina bifida are eligible
for certain benefits and
services. Furthermore, VA was now provides certain benefits, including
health care, for children
with birth defects who were born to female Vietnam veterans.
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Other VA efforts are underway to help Vietnam veterans who were
exposed to Agent
Orange.
In addition to the efforts
described above (that is, Agent Orange Registry examination program,
medical treatment, and
disability compensation), VA is doing research to learn more about the
possible adverse health
effects of military service in Vietnam. The Environmental Epidemiology
Service (EES) is the premiere
office for Vietnam/Agent Orange-related research within VA. EES
investigators have completed
numerous studies on this subject; summaries are available at our
website: www.va.gov/agentorange/.
What other government departments and agencies are doing.
Many other Federal
departments and agencies have pursued and/or are conducting scientific
studies on this subject. The
Centers for Disease Control and Prevention (CDC), Air Force
(USAF), National Institute
for Occupational Safety and Health (NIOSH), National Cancer Institute
(NCI), and Environmental
Protection Agency (EPA) have all been involved in research.
In 1984, the CDC published an
important study, partially funded by VA, regarding Vietnam
veterans’ risks of fathering
babies with birth defects. VA also funded the CDC Vietnam Experience
Study published in 1987 and
1988, and the CDC Selected Cancers Study published in 1990.
For additional information
about the CDC effort, see www.cdc.gov/mmwr/mmwrpvol.html for
August 17, 1984, February 13,
and July 24, 1987, and May 27, 1988. The USAF is conducting
a long-term study of
illnesses and death among the men involved in the herbicide spraying
missions. Air Force
researchers have issued numerous reports regarding their findings in this
ongoing project.
Several states have
undertaken research efforts to learn more about the possible health effects
of Agent Orange and the
Vietnam experience upon our Nation’s veterans.
The National Academy of Sciences’ Institute of Medicine has a
major role in this
issue.
Under Public Law 102-4, the
Agent Orange Act of 1991, the Institute of Medicine (IOM) of National
Academy of Sciences, a
non-governmental organization, has reviewed and continues to evaluate
all relevant scientific
literature and to provide advice to the Secretary of Veterans Affairs on health
effects of herbicides
exposure. The IOM project is being undertaken in accordance with Public
Law 102-4. The IOM reported
its initial findings in July 1993. Updates were released in March
1996, February 1999, April
2001, and January 2003. A special report on type 2 diabetes was
released in October 2000. A
special report on acute myelogenous leukemia in the children of
Vietnam veterans was issued
in February 2002. Future reports are anticipated approximately
every two years. The IOM and
its subcontractor also developed a historical herbicide exposure
reconstruction model that
could be used in Agent Orange-related research efforts. For additional
information and a complete
version of the IOM reports, see www.nap.edu.
The IOM recently concluded
that with the current technology, a health study of Vietnam veterans
is feasible. However, VA now
makes the presumption of exposure to Agent Orange for Vietnam
veterans. This means that a
Vietnam veteran is not required to prove exposure to herbicides in
Vietnam. Some researchers are
interested in producing better information to accurately estimate the exposure
of individual veterans.
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Certain Vietnam-era veterans who served in Korea also can get the
Agent Orange
Registry examination. So can certain other veterans who were
exposed to herbicides
elsewhere.
In September 2000, VA
recognized that Agent Orange was used in Korea in the late 1960’s and
approved Agent Orange
examinations for U.S. veterans who served in Korea in 1968 or 1969.
VA took this action despite
reports that Republic of Korea troops, not U.S. military personnel,
did the actual spraying.
In March 2001, Secretary
Principi ordered that those examinations be made available to all
other veterans who may have
been exposed to dioxin or other toxic substances in a herbicide or
defoliant during the conduct
of or as the result of testing, transporting, or spraying of herbicides
for military purposes.
Additional information is available.
There is at each VA medical
center an “Environmental Health Clinician” responsible for the
conduct of Agent Orange
Registry exams. These health care providers participate in national
conference calls conducted by
the Environmental Agents Service (EAS), and receive frequent
mailings from VA headquarters
updating them on the latest developments on Agent Orange
issues. Each facility also
has an “Environmental Health Coordinator” to facilitate the Agent
Orange program.
The Agent Orange Review newsletter, prepared by the VA
Environmental Agents Service, provides
updated information on
Federal government studies and activities related to Agent Orange and
the Vietnam experience.
Registry participants are automatically added to the mailing list; others
can contact the EAS at the
address below.
The Agent Orange Brief fact sheets, prepared and updated by
the VA Environmental Agents
Service (EAS), are available
from EAS and at VA medical centers. The following Agent Orange
Briefs are now available:
General:
A1. General Information
A2. Class Action Lawsuit
VA
Programs (Except Research):
B1. Agent Orange Registry
B2. Health Care Eligibility
B3. Disability Compensation
B4. Information Resources
Research:
C1. The Problem Encountered
in Research
C2. Agent Orange/Vietnam
Related Research-VA Efforts
C3. Agent Orange/Vietnam
Related Research-Non-VA Efforts
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Medical
Conditions:
D1. Birth Defects
D2. Chloracne
D3. Non-Hodgkin’s Lymphoma
D4. Soft Tissue Sarcomas
D5. Peripheral Neuropathy
D6. Hodgkin’s Disease
D7. Porphyria Cutanea Tarda
D8. Multiple Myeloma
D9. Respiratory Cancers
D10. Prostate Cancer
D11. Spina Bifida
D12. Diabetes
D13. Chronic Lymphocytic
Leukemia
Copies of the newsletters,
fact sheets, and additional information is available online at www.va.gov/
agentorange. Vietnam veterans
and their families are also encouraged to call the Gulf War/Agent
Orange Helpline. The
toll-free telephone number for the Helpline is 1-800-749-8387.
Contact the EAS (131),
Department of Veterans Affairs, 810 Vermont Ave., N.W., Washington,
DC 20420, for additional
information on Agent Orange.
Veterans service
organizations and State government entities (including Agent Orange
Commissions, Departments or
Divisions of Veterans Affairs, Departments of Health) also help
individuals seeking
information on this subject.
The initial and follow-up IOM
reports are available on-line at www.nap.edu or for purchase from
the National Academy Press,
2101 Constitution Avenue, N.W., Lockbox 285, Washington, DC
20055. The telephone numbers
are 1-800-624-6242 and 202-334-3313. Copies of these books
were sent to all VA medical
center libraries.
Toll-Free Telephone Gulf War/ Agent Orange Helpline
*** 1-800-749-8387 ***
Environmental Agents Service
Department
of Veterans Affairs
810
Vermont Avenue, NW
Washington,
DC 20420
July 2003
IB
10-49
P95203
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