TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans SN - DO - 10.17226/10309 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10309/veterans-and-agent-orange-herbicidedioxin-exposure-and-acute-myelogenous-leukemia PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - In 2001, in response to a request by the U.S. Department of Veterans Affairs (DVA), the Institute of Medicine (IOM) called together a committee to conduct a review of the scientific evidence regarding the association between exposure to dioxin and other chemical compounds in herbicides used in Vietnam and acute myelogenous leukemia in the offspring of Vietnam veterans. Based on the scientific evidence reviewed in this report, the committee finds there is inadequate or insufficient evidence to determine if an association exists between exposure to the herbicides used in Vietnam or their contaminants and acute myelogenous leukemia (AML) in the children of Vietnam veterans. This is a change in classification from the recent Veterans and Agent Orange: Update 2000 report, which found limited/suggestive evidence for such an association. ER - TY - BOOK AU - Institute of Medicine A2 - Janet E. Joy A2 - Stanley J. Watson, Jr. A2 - John A. Benson, Jr. TI - Marijuana and Medicine: Assessing the Science Base SN - DO - 10.17226/6376 PY - 1999 UR - https://nap.nationalacademies.org/catalog/6376/marijuana-and-medicine-assessing-the-science-base PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The medical use of marijuana is surrounded by a cloud of social, political, and religious controversy, which obscures the facts that should be considered in the debate. This book summarizes what we know about marijuana from evidence-based medicine—the harm it may do and the relief it may bring to patients. The book helps the reader understand not only what science has to say about medical marijuana but also the logic behind the scientific conclusions. Marijuana and Medicine addresses the science base and the therapeutic effects of marijuana use for medical conditions such as glaucoma and multiple sclerosis. It covers marijuana's mechanism of action, acute and chronic effects on health and behavior, potential adverse effects, efficacy of different delivery systems, analysis of the data about marijuana as a gateway drug, and the prospects for developing cannabinoid drugs. The book evaluates how well marijuana meets accepted standards for medicine and considers the conclusions of other blue-ribbon panels. Full of useful facts, this volume will be important to anyone interested in informed debate about the medical use of marijuana: advocates and opponents as well as policymakers, regulators, and health care providers. ER - TY - BOOK AU - Institute of Medicine TI - Chemical and Biological Terrorism: Research and Development to Improve Civilian Medical Response SN - DO - 10.17226/6364 PY - 1999 UR - https://nap.nationalacademies.org/catalog/6364/chemical-and-biological-terrorism-research-and-development-to-improve-civilian PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues AB - The threat of domestic terrorism today looms larger than ever. Bombings at the World Trade Center and Oklahoma City's Federal Building, as well as nerve gas attacks in Japan, have made it tragically obvious that American civilians must be ready for terrorist attacks. What do we need to know to help emergency and medical personnel prepare for these attacks? Chemical and Biological Terrorism identifies the R&D efforts needed to implement recommendations in key areas: pre-incident intelligence, detection and identification of chemical and biological agents, protective clothing and equipment, early recognition that a population has been covertly exposed to a pathogen, mass casualty decontamination and triage, use of vaccines and pharmaceuticals, and the psychological effects of terror. Specific objectives for computer software development are also identified. The book addresses the differences between a biological and chemical attack, the distinct challenges to the military and civilian medical communities, and other broader issues. This book will be of critical interest to anyone involved in civilian preparedness for terrorist attack: planners, administrators, responders, medical professionals, public health and emergency personnel, and technology designers and engineers. ER - TY - BOOK AU - National Research Council A2 - Ellen Mantus TI - Toxicity-Pathway-Based Risk Assessment: Preparing for Paradigm Change: A Symposium Summary SN - DO - 10.17226/12913 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12913/toxicity-pathway-based-risk-assessment-preparing-for-paradigm-change-a PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Biology and Life Sciences AB - In 2007, the National Research Council envisioned a new paradigm in which biologically important perturbations in key toxicity pathways would be evaluated with new methods in molecular biology, bioinformatics, computational toxicology, and a comprehensive array of in vitro tests based primarily on human biology. Although some considered the vision too optimistic with respect to the promise of the new science, no one can deny that a revolution in toxicity testing is under way. New approaches are being developed, and data are being generated. As a result, the U.S. Environmental Protection Agency (EPA) expects a large influx of data that will need to be evaluated. EPA also is faced with tens of thousands of chemicals on which toxicity information is incomplete and emerging chemicals and substances that will need risk assessment and possible regulation. Therefore, the agency asked the National Research Council to convene a symposium to stimulate discussion on the application of the new approaches and data in risk assessment. The symposium was held on May 11-13, 2009, in Washington, DC, and included presentations and discussion sessions on pathway-based approaches for hazard identification, applications of new approaches to mode-of-action analyses, the challenges to and opportunities for risk assessment in the changing paradigm, and future directions. ER - TY - BOOK AU - National Research Council TI - Life Sciences and Related Fields: Trends Relevant to the Biological Weapons Convention SN - DO - 10.17226/13130 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13130/life-sciences-and-related-fields-trends-relevant-to-the-biological PB - The National Academies Press CY - Washington, DC LA - English KW - Biology and Life Sciences KW - Conflict and Security Issues AB - During the last decade, national and international scientific organizations have become increasingly engaged in considering how to respond to the biosecurity implications of developments in the life sciences and in assessing trends in science and technology (S&T) relevant to biological and chemical weapons nonproliferation. The latest example is an international workshop, Trends in Science and Technology Relevant to the Biological Weapons Convention, held October 31 - November 3, 2010 at the Institute of Biophysics of the Chinese Academy of Sciences in Beijing. Life Sciences and Related Fields summarizes the workshop, plenary, and breakout discussion sessions held during this convention. Given the immense diversity of current research and development, the report is only able to provide an overview of the areas of science and technology the committee believes are potentially relevant to the future of the Biological and Toxic Weapons Convention (BWC), although there is an effort to identify areas that seemed particularly ripe for further exploration and analysis. The report offers findings and conclusions organized around three fundamental and frequently cited trends in S&T that affect the scope and operation of the convention: The rapid pace of change in the life sciences and related fields; The increasing diffusion of life sciences research capacity and its applications, both internationally and beyond traditional research institutions; and The extent to which additional scientific and technical disciplines beyond biology are increasingly involved in life sciences research. The report does not make recommendations about policy options to respond to the implications of the identified trends. The choice of such responses rests with the 164 States Parties to the Convention, who must take into account multiple factors beyond the project's focus on the state of the science. ER - TY - BOOK AU - National Research Council TI - Application of Toxicogenomics to Cross-Species Extrapolation: A Report of a Workshop SN - DO - 10.17226/11488 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11488/application-of-toxicogenomics-to-cross-species-extrapolation-a-report-of PB - The National Academies Press CY - Washington, DC LA - English KW - Biology and Life Sciences KW - Environment and Environmental Studies AB - Some of what we know about the health effects of exposure to chemicals from food, drugs, and the environment come from studies of occupational, inadvertent, or accident-related exposures. When there is not enough human data, scientists rely on animal data to assess risk from chemical exposure and make health and safety decisions. However, humans and animals can respond differently to chemicals, including the types of adverse effects experienced and the dosages at which they occur. Scientists in the field of toxicogenomics are using new technologies to study the effects of chemicals. For example, in response to a particular chemical exposure, they can study gene expression ("transcriptomics"), proteins ("proteomics") and metabolites ("metabolomics"), and they can also look at how individual and species differences in the underlying DNA sequence itself can result in different responses to the environment. Based on a workshop held in August 2004, this report explores how toxicogenomics could enhance scientists' ability to make connections between data from experimental animal studies and human health. ER - TY - BOOK AU - National Research Council TI - Toxicogenomic Technologies and Risk Assessment of Environmental Carcinogens: A Workshop Summary SN - DO - 10.17226/11335 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11335/toxicogenomic-technologies-and-risk-assessment-of-environmental-carcinogens-a-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Health and Medicine AB - Toxicogenomics is a discipline that combines expertise in toxicology, genetics, molecular biology, and environmental health to help understand the response of living organisms to stressful environments. The National Research Council convened a workshop to discuss how toxicogenomic data could be applied to improve risk assessments, particularly cancer risk from environmental exposure to chemicals. Risk assessments serve as the basis of many public-health decisions in environmental, occupational, and consumer protection from chemicals. The workshop provided a forum for communities of experts, including those working in "-omics" and those in the policy arena, to discuss where their fields intersect, and how toxicogenomics could address critical knowledge gaps in risk assessments. ER - TY - BOOK AU - Institute of Medicine A2 - Constance M. Pechura A2 - David P. Rall TI - Veterans at Risk: The Health Effects of Mustard Gas and Lewisite SN - DO - 10.17226/2058 PY - 1993 UR - https://nap.nationalacademies.org/catalog/2058/veterans-at-risk-the-health-effects-of-mustard-gas-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Recently, World War II veterans have come forward to claim compensation for health effects they say were caused by their participation in chemical warfare experiments. In response, the Veterans Administration asked the Institute of Medicine to study the issue. Based on a literature review and personal testimony from more than 250 affected veterans, this new volume discusses in detail the development and chemistry of mustard agents and Lewisite followed by interesting and informative discussions about these substances and their possible connection to a range of health problems, from cancer to reproductive disorders. The volume also offers an often chilling historical examination of the use of volunteers in chemical warfare experiments by the U.S. military—what the then-young soldiers were told prior to the experiments, how they were "encouraged" to remain in the program, and how they were treated afterward. This comprehensive and controversial book will be of importance to policymakers and legislators, military and civilian planners, officials at the Department of Veterans Affairs, military historians, and researchers. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Veterans and Agent Orange: Update 11 (2018) SN - DO - 10.17226/25137 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25137/veterans-and-agent-orange-update-11-2018 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academies of Sciences, Engineering, and Medicine was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 11 (2018) examines peer-reviewed scientific reports concerning associations between various health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published between September 30, 2014, and December 31, 2017, and integrates this information with the previously established evidence database. ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Length of Presumptive Period for Association Between Exposure and Respiratory Cancer SN - DO - 10.17226/10933 PY - 2004 UR - https://nap.nationalacademies.org/catalog/10933/veterans-and-agent-orange-length-of-presumptive-period-for-association PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - From 1962 to 1971, US military forces sprayed herbicides over Vietnam to strip the thick jungle canopy that helped conceal opposition forces, to destroy crops that enemy forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the majority of the herbicides sprayed. Agent Orange was a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, one form of dioxin) was an unintended contaminant from the production of 2,4,5-T and was present in Agent Orange and some other formulations sprayed in Vietnam.In 1991, because of continuing uncertainty about the long-term health effects on Vietnam veterans of the herbicides sprayed, Congress passed Public Law 102-4, the Agent Orange Act of 1991. In response to the request from the VA, IOM extended the service of the Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides that was responsible for Update 2002 to address the question of presumptive period and respiratory cancer. The charge to the committee was to undertake a review and evaluation of the evidence regarding the period between cessation of exposure to herbicides used in Vietnam and their contaminants (2,4-D, 2,4,5-T and its contaminant TCDD, cacodylic acid, and picloram) and the occurrence of respiratory cancer. ER - TY - BOOK AU - National Research Council A2 - Katherine Bowman A2 - Kathryn Hughes A2 - Jo L. Husbands A2 - James Revill A2 - Benjamin Rusek TI - Trends in Science and Technology Relevant to the Biological and Toxin Weapons Convention: Summary of an International Workshop SN - DO - 10.17226/13113 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13113/trends-in-science-and-technology-relevant-to-the-biological-and-toxin-weapons-convention PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues KW - Policy for Science and Technology AB - This report offers a summary of the substantive presentations during an international workshop, Trends in Science and Technology Relevant to the Biological and Toxin Weapons Convention, held October 31 - November 3, 2010 at the Institute of Biophysics of the Chinese Academy of Sciences. It is meant to provide scientists and other technical experts with factual information about the range and variety of topics discussed at the workshop, which may be of interest to national governments and non-governmental organizations as they begin to prepare for the 7th Review Conference of the Biological and Toxin Weapons Convention (BWC) in 2011. The Beijing workshop reflected the continuing engagement by national academies international scientific organizations, and individual scientists and engineers in considering the biosecurity implications of developments in the life sciences and assessing trends in science and technology (S&T) relevant to nonproliferation. The workshop provided an opportunity for the scientific community to discuss the implications of relevant developments in S&T for multiple aspects of the BWC. Trends in Science and Technology Relevant to the Biological and Toxin Weapons Convention follows the structure of the plenary sessions at the workshop. It begins with introductory material about the BWC and current examples of the types and modes of science advice available to the BWC and other international nonproliferation and disarmament agreements, in particular the Chemical Weapons Convention (CWC). This report includes only a very brief description of the some of the post-presentation discussions held during the plenary sessions - and does not include an account of the small breakout groups - since these were intended to inform the committee's finding and conclusions and will be reflected in the final report. ER - TY - BOOK AU - National Research Council TI - Validation of Toxicogenomic Technologies: A Workshop Summary SN - DO - 10.17226/11804 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11804/validation-of-toxicogenomic-technologies-a-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Biology and Life Sciences AB - Beginning in the early 1980s, new technologies, began to permit evaluation of the expression of individual genes. Recent technological advances have expanded those evaluations to permit the simultaneous detection of the expression of tens of thousands of genes and to support holistic evaluations of the entire genome. The application of these technologies has enabled researchers to unravel complexities of cell biology and, in conjunction with toxicologic evaluations, the technologies are used to probe and gain insight into questions of toxicologic relevance. As a result, the use of the technologies has become increasingly important for scientists in academia, as well as for the regulatory and drug development process. ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Update 2000 SN - DO - 10.17226/10098 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10098/veterans-and-agent-orange-update-2000 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - Veterans and Agent Orange: Update 2000 examines the state of the scientific evidence regarding associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. It is the fourth in a series of comprehensive reviews of epidemiologic and toxicologic studies of the agents used as defoliants during the Vietnam War. Over forty health outcomes in veterans and their children are addressed. Among the report's conclusions is that there is sufficient evidence of a link between exposure and the development of soft-tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne in veterans. Additionally, it found that scientific studies offer "limited or suggestive" evidence of an association with other diseases in veterans—including Type 2 diabetes, respiratory cancers, prostate cancer, multiple myeloma and some forms of transient peripheral neuropathy—as well as the congenital birth defect spina bifida in veterans' children. ER - TY - BOOK AU - National Research Council A2 - Katherine Bowman A2 - Jo L. Husbands A2 - Ben Rusek TI - The 2nd International Forum on Biosecurity: Summary of an International Meeting SN - DO - 10.17226/12525 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12525/the-2nd-international-forum-on-biosecurity-summary-of-an-international PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues AB - The 2nd International Forum on Biosecurity, held in Budapest, Hungary on March 30 - April 2, 2008, represents the efforts of a number of individuals and organizations, over the last five years, to engage the international community of life scientists in addressing how to reduce the risk that the results of their work could be used for hostile purposes by terrorists and states. The participants who gathered in Budapest were already engaged in this challenging task, and, therefore, the focus of the meeting was on what had been accomplished and what challenges remained. There was no attempt to achieve consensus, since there exist real and important differences among those involved concerning the appropriate policies and actions to be undertaken. But there was a serious effort to identify a range of potential next steps, and also an effort to identify opportunities where international scientific organizations could make substantive contributions and offer their advice and expertise to policy discussions. The Forum's presentations, discussions, and results are summarized in this book. ER - TY - BOOK AU - National Research Council TI - Overcoming Challenges to Develop Countermeasures Against Aerosolized Bioterrorism Agents: Appropriate Use of Animal Models SN - DO - 10.17226/11640 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11640/overcoming-challenges-to-develop-countermeasures-against-aerosolized-bioterrorism-agents-appropriate PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues KW - Biology and Life Sciences AB - The National Institute of Allergy and Infectious Diseases (NIAID) gives the highest priority to developing countermeasures against bioterrorism agents that are highly infective when dispersed in aerosol form. Developing drugs to prevent or treat illnesses caused by bioterrorism agents requires testing their effectiveness in animals since human clinical trials would be unethical. At the request of NIAID, the National Academies conducted a study to examine how such testing could be improved. Overcoming Challenges to Develop Countermeasures Against Aerosolized Bioterrorism Agents provides recommendations to researchers on selecting the kinds of animal models, aerosol generators, and bioterrorism agent doses that would produce conditions that most closely mimic the disease process in humans. It also urges researchers to fully document experimental parameters in the literature so that studies can be reproduced and compared. The book recommends that all unclassified data on bioterrorism agent studies--including unclassified, unpublished data from U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID)--be published in the open literature. The book also calls on the U.S. Food and Drug Administration to improve the process by which bioterrorism countermeasures are approved based on the results of animal studies. ER - TY - BOOK AU - Institute of Medicine AU - National Research Council A2 - Joseph P. Newhouse A2 - John Mendelsohn A2 - Hellen Gelband A2 - Roger Herdman TI - Federal Agency Roles in Cancer Drug Development from Preclinical Research to New Drug Approval: The National Cancer Institute and the Food and Drug Administration DO - 10.17226/11257 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11257/federal-agency-roles-in-cancer-drug-development-from-preclinical-research-to-new-drug-approval PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Federal Agency Roles in Cancer Drug Development from Preclinical Research to New Drug Approval is an authored background paper describing the federal role in cancer drug development. This report is a part of a project of the National Cancer Policy Board to analyze every aspect of the way new agents to fight cancer are developed and to search for ways to streamline the process. This paper provides useful background detail for those interested in exploring issues that will be informed by how the FDA and NCI act and interact to develop cancer drugs from preclinical research to new drug approval. ER - TY - BOOK AU - National Research Council A2 - Elizabeth Stallman Brown A2 - Laurence Yeung A2 - Keegan Sawyer TI - Sustainable Infrastructures for Life Science Communication: Workshop Summary SN - DO - 10.17226/18728 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18728/sustainable-infrastructures-for-life-science-communication-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Biology and Life Sciences KW - Education AB - Advances in the life sciences - from the human genome to biotechnology to personalized medicine and sustainable communities - have profound implications for the well-being of society and the natural world. Improved public understanding of such scientific advances has the potential to benefit both individuals and society through enhanced quality of life and environmental protection, improved K-12 and undergraduate science education, greater understanding of human connections to the natural world, and more sustainable policies and regulations. Yet few systems of support exist to help life scientist communicators share their research with a broad range of public audiences, or engage the public in discussions about their work. Sustainable Infrastructures for Life Science Communication is the summary of a two-part workshop convened in December 2013 and January 2014 by the National Research Council Roundtable on Public Interfaces of the Life Sciences to identify infrastructure-related barriers that inhibit or prohibit life scientists from communicating about their work and characteristics of infrastructure that facilitate or encourage scientists to engage with public audiences. The workshop featured both formal presentations and panel discussions among participants from academia, industry, journalism, the federal government, and nonprofit organizations. The presentations highlighted the motivations of and challenges to life scientist communicators, theoretical approaches to science communication, examples of different types of infrastructure to support science communication, and the need for building more sustainable science communication infrastructures. This report considers communication infrastructure across a range of life science institutions, including federal agencies, academia, industry, and nonprofit organizations and explores novel approaches to facilitate effective science communication. ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Update 1998 SN - DO - 10.17226/6415 PY - 1999 UR - https://nap.nationalacademies.org/catalog/6415/veterans-and-agent-orange-update-1998 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Third in a series of six congressionally mandated studies occurring biennially, this book is an updated review and evaluation of the available scientific evidence regarding the statistical association between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposures. As part of the review, the committee convened a workshop at which issues surrounding the reanalysis and the combination of existing data on the health effects of herbicide and dioxin exposure were addressed. This book builds upon the information developed by the IOM committees responsible for the 1994 original report, Veterans and Agent Orange, and Veterans and Agent Orange: Update 1996, but will focus on scientific studies and other information developed since the release of these reports. The two previous volumes have noted that sufficient evidence exists to link soft tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne with exposure. The books also noted that there is "limited or suggestive" evidence to show an association with exposure and a neurological disorder in veterans and with the congenital birth defect spina bifida in veterans' children. This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans organizations, researchers, and health professionals. ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine TI - Veterans and Agent Orange: Update 2014 SN - DO - 10.17226/21845 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21845/veterans-and-agent-orange-update-2014 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 2014 is a cumulative report of the series thus far. ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Update 2010 SN - DO - 10.17226/13166 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13166/veterans-and-agent-orange-update-2010 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Because of continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Congress passed the Agent Orange Act of 1991. The legislation directed the Secretary of Veterans Affairs (VA) to request the Institite of Medicine to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam to be followed by biennial updates. The 2010 update recommends further research of links between Vietnam service and specific health outcomes, most importantly COPD, tonsil cancer, melanoma, brain cancer, Alzheimer's disease, and paternally transmitted effects to offspring. ER -