AGENT ORANGE: THE PERSISTENT GHOST FROM THE VIETNAM WAR

THE ISSUE THAT WON’T GO AWAY

Meryl Nass, MD

From 1962 to 1970, the US military sprayed 72 million liters of herbicides, mostly Agent Orange, in Vietnam. Over one million Vietnamese were exposed to the spraying, as well as over 100,000 Americans and allied troops. Dr. James Clary, a scientist at the Chemical Weapons Branch, Eglin Air Force Base, who designed the herbicide spray tank and wrote a 1979 report on Operation Ranch Hand (the name of the spraying program), told Senator Daschle in 1988,

What Did We Know About Dioxin, and When Did We Know It?

The first reported industrial dioxin poisoning occurred in Nitro, West Virginia in 1949. The exposed workers complained of rash, nausea, headaches, muscle aches, fatigue and emotional instability. A 1953 accident elsewhere resulted in peripheral neuropathies.

A 1969 report commissioned by the USDA found Agent Orange showed a "significant potential to increase birth defects." The same year, the NIH confirmed that it caused malformations and stillbirths in mice. In 1970, the US Surgeon General warned it might be hazardous to "our health." The same day, the Secretaries of the Departments of Agriculture, the Interior, and HEW jointly announced the suspension of its use around lakes, recreation areas, homes and crops intended for human consumption. DOD simultaneously announced its suspension of all uses of Agent Orange.

When dioxin contaminated material spread on a Missouri farm in 1971, hundreds of birds, 11 cats, 4 dogs and 43 horses died.

In 1978 the EPA suspended spraying Agent Orange in national forests, due to increases in miscarriages in women living near forests that had been sprayed.

A 1979 study published in the JAMA by Bogen et al looked at 78 Vietnam veterans who reported Agent Orange exposures. Eighty percent reported extreme fatigue. Over 60% had peripheral neuropathies, 73% had depression, and 8% had attempted suicide. Forty-five per cent reported violent rages. Sudden lapses of memory were seen in 21%.

A 1981 study by Pazderova et al. found one half of 80 exposed workers had metabolic disturbances, 23% peripheral neuropathies, and the majority, psychiatric changes, primarily depression and fatigue.

In 1979, 47 railroad workers were exposed to PCBs including dioxin in Missouri when cleaning up a spillage from a damaged tank car that had been filled with these chemicals. All were followed medically for six years. Their initial complaints included fatigue and muscle aches. Two committed suicide. Careful evaluations at Rush-Presbyterian Hospital, in Chicago, confirmed peripheral neuropathies (in 96%), depression (69%), tremors (78%), abnormal fatigue (91%), and muscle aches or cramp (51%). Half had cognitive problems, including problems with attention and concentration (50%) and slowed reaction times.

These studies are all consistent with each other, and describe a very significant, multi-system illness affecting all parts of the nervous system, and causing fatigue and muscle aches. Some of the studies documented additional organ dysfunction. This syndrome could be very disabling.

What Did It Take to Forget What We Knew?

By 1983, 9170 veterans had filed claims for disabilities that they said were caused by Agent Orange. The VA denied compensation to 7709, saying that a facial rash was the only disease associated with exposure.

Congress passed the Veterans’ Dioxin and Radiation Exposure Compensation Standards Act of 1984 in response. It required the VA to appoint a ‘Veterans’ Advisory Committee on Environmental Hazards’ to review the literature on dioxin and submit recommendations to the head of the VA.

According to Admiral Elmo Zumwalt, "The VA…directly contradicted its own established practice, promulgating instead the more stringent requirement that compensation depends on establishing a cause and effect relationship," improperly denying the bulk of the claims.

Four groups of impartial scientists were asked by Zumwalt to review the Advisory Committee transcripts. Their comments are telling, and include the following:

• "The work of the Advisory Committee…has little or no scientific merit…"
• "…an inadequate process is being used to evaluate scientific publications for use in public policy…"
• "…less than objective…"

Unfortunately, the flawed scientific reviews didn’t end with the VA committee. The CDC was brought in to add weight to the bogus analysis of dioxin’s effects. After 4 years and $63 million in federal funds, CDC concluded that an Agent Orange study could not be done based on military records, and furthermore concluded, without data, that veterans were never exposed to harmful doses of Agent Orange!

When the CDC’s protocols were examined, however, it was found that three changes had been made to its study in 1985, in an apparent attempt to dilute any negative effect that might be found. Congress learned in 1986 that administration officials, not scientists, had forestalled CDC research on the effects of dioxin.

In 1990, Senator Daschle disclosed additional political interference in the Air Force’s Ranch Hand study of Agent Orange effects. A 1984 draft report’s conclusion was substantially altered, and the study was described as "reassuring."

The Ranch Hand study is still ongoing, despite new allegations of fraudulent methodologies coming to light every few years. It will cost taxpayers over $100 million.

Monsanto, a manufacturer of Agent Orange, was happy to duplicate the methods of federally funded studies. By omitting five deaths in the exposed group and putting four exposed workers in the control group, they were able to hide a 65% higher death rate in the workers exposed at the Nitro plant. Another study of workers exposed in 1953 at a BASF plant was also shown to be falsified, as all the data had been supplied by the BASF company.

Thanks to the efforts of Admiral Zumwalt, who as the commanding Navy Admiral in Vietnam was responsible for some of the spraying, and whose son died from lymphoma, probably as a result of dioxin exposure, many more illnesses were finally linked to Agent Orange, and have been made service-connectable over the past decade.

But Zumwalt did not succeed at clearing the air regarding dioxin’s actual toxicity, nor did he stop further scientific shenanigans carried out by government and industry to hide the toxic effects of other products, especially those to which our servicemen and women are exposed.

In April 2000, the National Institute for Environmental Health Sciences tried to release a report listing dioxin as a carcinogen, but it was blocked by a lawsuit filed by an industry group. NIEHS had tried to list dioxin as a carcinogen in 1991, but was not allowed to do so then. John Bucher, deputy director of the NIEHS, says, "Dioxin tends to increase the likelihood of all types of cancers" while industry representatives continue to claim there is insufficient evidence to link dioxin to health problems.

Ellen Silbergeld, a University of Maryland toxicologist, responded, "I think the public should be mad as hell about the [dioxin review] process and the way it’s been abused."

Agent Orange: 2002

US and Vietnamese government scientists and international experts met last week in Hanoi to discuss the effects of the "last significant ghost" of the Vietnam War: Agent Orange.

Vietnam wants US help performing research and obtaining compensation. It blames Agent Orange for tens of thousands of birth defects. The US and Vietnam did sign an agreement during the meeting to carry out joint research studies. But US ambassador Raymond Burghardt noted that developing research studies "that are definitive and address the underlying causes of disease in Vietnam" will be a "difficult task."

Reporting on the conference, Reuters pointed out, "Observers say conclusive research could have far-reaching and expensive consequences in terms of compensation claims for the US and Agent Orange makers, Dow Chemical and Monsanto."

However, the US seems to think it has an ace in the hole. The US embassy made clear, at the time of the conference, that "US-Vietnam relations were normalized in 1995 after Vietnam dropped claims of war reparations/compensation. At the time of normalization, neither compensation nor reparations were granted or contemplated for the future."

And, anyway, the US government has a fallback position. "Washington argues there is no hard evidence showing the defoliant caused specific illness," Reuters reported last week. And US government scientists chimed in that any linkages to birth defects "would take many more years to prove."

The well-documented story of dioxin and scientific perfidy provide a guidepost for how to assess government-sponsored research, advisory committees, and regulatory decisions that impact on the health effects of toxic exposures, especially when the government may be liable for damages.

"Those Who Cannot Remember the Past Are Condemned to Repeat It"

--George Santayana

RECOMMENDED READING

Zumwalt ER. Report to the Secretary of the Department of Veterans’ Affairs on the association between adverse health effects and exposure to Agent Orange. DVA Report, 1990.

Echobichon DJ. Toxic Effects of Pesticides, in Casarett and Doull’s Toxicology. Klaassen CD ed, McGraw-Hill, NY. 1996.

Klawans HL et al. Neurologic problems following exposure to TCDD, dioxin. In Neurotoxins and their pharmacological implications, ed. Jenner P, 1987. Raven Press, NY.

Welch, Craig. Dioxin debate growing hotter. Seattle Times May 29, 2000

Agent Orange help needed now, Vietnam Red Cross says. Reuters, March 5, 2002.

Brunnstrom, David. Hanoi meeting probes "last ghost" of Vietnam War. Reuters, March 3, 2002.