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Agent Orange Review Agent Orange Review Vol. 9, N0. 3 Information for Veterans Who Served in Vietnam September 1992 National Academy of Sciences Project Secretary Edward J. Derwinski Advances on the Agent Orange Issue: VA was cast as the enemy of the veteran. VA had absolutely no credibility on this issue. The National Academy of Sciences (NAS) is making Finally, in recent months, substantial progress on the Agent Orange project undertaken on we began to defuse much of the behalf of VA early this year. NAS officials have been gathering criticism and suspicion by herbicide literature from VA (including VA's 18-volume granting service connection for literature review) and other sources, making contact with conditions science tells us may scientists and other interested parties throughout the country, have been caused by exposure to and assembling a committee of experts to complete the project Agent Orange--such as non-Hodgkin's lymphoma and soft envisaged by Congress in Public Law 102-4, the "Agent tissue sarcomas. Orange Act of 1991." We're still being criticized by some who think we haven't gone far enough, and by some who feel there's not sufficient scientific proof for the decisions we have made. The public reaction~and the general lessening of Initial Committee Meeting tensions~seems to indicate we're right. This may be an important lesson for VA... The NAS Institute of Medicine's Committee to Review Committee Membership the Health Effects in Vietnam Veterans of Exposure to Herbicides held its first meeting on June 26, in Washington, DC. The Committee is chaired by Harold Fallon, M.D., Chair The morning session, which was opened to invited guests and of the Department of Medicine of the Medical College of speakers, was devoted to providing Committee members with Virginia in Richmond, Virginia. M. Donald Whorton, M.D., expectations, interpretations of the congressional charge, and Vice President, ENSR Health Sciences, Alameda, California, is essential background information. Invited speakers included vice-chair. Norman Breslow, Ph.D., Professor and Chairman of officials from the following government entities: VA, the the University of Washington's Department of Biostatistics is Senate and House Committees on Veterans' Affairs, the Office the liaison between the Committee and the Institute of of Technology Assessment, and the Environmental Protection Medicine's Board on Health Promotion and Disease Prevention. Agency. Comments were also received from individuals not All three are members of the Institute of Medicine. Committee members represent a wide range of expertise affiliated with the government. in environmental and occupational medicine, toxicology, Much of the initial meeting was spent planning the pathology, genetics, clinical oncology, psychology, Committee's efforts in the remaining period of the study. A epidemiology, and biostatistics. public meeting on the project is scheduled for early September Individuals seeking information regarding the Committee 1992, in Washington, DC. Announcements will be sent to can contact Ms. Cynthia Abel, Research Associate, Committee veterans' organizations and to scientists and others known to to Review the Health Effects of Vietnam Veterans of Exposure have an interest in Agent Orange and dioxin. This will be to Herbicides, Institute of Medicine, National Academy of followed by a Committee meeting on the next day. Sciences, 2101 Constitution Avenue, NW, Washington, DC Another two-day meeting is planned for December 1992. 20418. Her telephone number is (202) 334-2357. One of these days will be devoted to an open scientific meeting to allow the Committee to meet with scientists with expertise in Legal Requirements various areas. The final Committee meetings will be held in February and April 1993. Section 3 of Public Law 102-4 required VA to seek to enter into a contract with the NAS (or should NAS decline, The Committee has approved a working outline for the another non-government not-for-profit scientific entity) to final report. Assignments for reviewing the literature and review scientific and medical information regarding the health drafting the report have been made. A preliminary plan has effects of exposure to Agent Orange and other herbicides used been developed for assessing the literature and summarizing the in Vietnam. The contract with the NAS was signed on information. January 31, 1992. Department of Veterans Affairs For each disease suspected of being associated with About the Review... exposure to an herbicide, the NAS will review and summarize the relevant scientific evidence and determine (1) whether there The "Agent Orange Review" is prepared by VA's is a statistical association with exposure to the herbicide; (2) the Environmental Agents Service (EAS). The "Review" is increased risk of disease among those exposed to the herbicides published periodically to provide information on Agent Orange during service in Vietnam; and (3) whether there is a plausible and related matters to Vietnam veterans, their families, and biological mechanism or other evidence of a causal relationship others with concerns about herbicides used in Vietnam. The between herbicide exposure and the disease. initial newsletter was released in November 1982. Twenty issues have been published to date. The Secretary of Veterans Affairs will establish in The "Review" is prepared approximately one to two regulations a presumption of service connection for diseases months prior to the publication date. This issue was written in that the Secretary determines to have a positive association with early July and does not include developments that occurred exposure to Agent Orange or other herbicides used in Vietnam. during much of July or August 1992. These determinations will be based on sound medical and Comments or questions about the content of the "Review" scientific evidence, taking into account reports from the NAS are encouraged. Suggestions and ideas for future issues of the under Section 3 and all other scientific information available. newsletter should be sent to Donald J. Rosenblum, The NAS also may make recommendations for further Writer/Editor, Agent Orange Review, Environmental Agents studies to resolve areas of continuing scientific uncertainty Service (116A), VA Central Office, 810 Vermont Avenue, NW, about the health effects of exposure to herbicide agents. Washington, DC 20420. Under the term of the contract with VA, the first report by Requests for additional copies of this issue, should also be the NAS is due not later than July 31, 1993. directed to Mr. Rosenblum. Please specify the number of copies requested. A limited supply of the last eight issues (October The initial NAS report is to include recommendations as 1989, May 1990, August 1990, February 1991, April 1991, to whether programs described in sections 6-9 of Public Law August 1991, December 1991, and April 1992) is also available. 102-4 should be implemented. Any VA action on these sections VA facilities should order additional copies from the VA Supply will be based, to a large extent, on the recommendations in the Depot. NAS report. VA updates the "Review" mailing address listing annually The effective date of sections 6-9 is 90 days after receipt based on IRS records. "Review" recipients who have not been of the report unless VA determines that it is not feasible or filing Federal income tax returns annually and have moved to cost-effective to carry out any or all of these programs or that another residence are encouraged to send their old and new implementation would not make a material contribution to the addresses and Social Security number to the Department of body of scientific knowledge concerning the health effects in Veterans Affairs, Automation Center (200/397), 1615 humans of herbicide exposure. If such a determination is made, Woodward Street, Austin, Texas 78772-0001. Questions about the Agent Orange Registry examination VA must notify the Senate and House Committees on Veterans' program should be directed to the Environmental Physician or Affairs. Implementation of each of these programs can begin Agent Orange Coordinator at the nearest VA medical center. only if Congress specifically makes funds available. Questions regarding VA benefit programs, including disability Section 6 requires the compilation and analysis of data compensation, should be referred to a veterans benefits from VA examinations and treatment. counselor at the nearest VA facility. The telephone numbers can Section 7 requires the establishment of an archiving be found in the telephone directory under the "U.S. system for blood and tissue samples contributed voluntarily by Government" listings. Vietnam veterans to facilitate scientific research on the effects of veterans' exposure to dioxin and other agents in herbicides. Vietnam Veteran Designated Acting Section 8 requires VA to establish, in consultation with the Director of VA Agent Orange Program NAS, a program of pilot studies of the feasibility of conducting additional scientific research on health hazards resulting from On July 6, 1992, Susan H. Mather, M.D., Assistant Chief exposure to herbicide agents or service in Vietnam. Medical Director for Environmental Medicine and Public Section 9 requires VA to test for dioxin (TCDD) in any Health, designated Layne A. Drash as Acting Director, blood sample voluntarily provided by Vietnam veterans who Environmental Agents Service. That office is responsible for seek VA health care under priority eligibility based on exposure the development and implementation of national VA medical to Agent Orange. policies and procedures for regarding exposure by military The law also authorizes follow-up reviews by the NAS, to veterans to possible environmental hazards, including Agent the extent that appropriations are available, at least once every Orange. two years for ten years after the initial report. Drash is a veteran of the Navy and Marine Corps. He (For additional information regarding the contract served a 13-month tour in Vietnam in 1965-66. Since 1980, between VA and the NAS, see the April 1992 issue of the Drash has been a manager in the Agent Orange program at VA headquarters in Washington, DC.
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