%0 Book %A Institute of Medicine %T The Utility of Proximity-Based Herbicide Exposure Assessment in Epidemiologic Studies of Vietnam Veterans %@ 978-0-309-11449-3 %D 2008 %U https://nap.nationalacademies.org/catalog/12059/the-utility-of-proximity-based-herbicide-exposure-assessment-in-epidemiologic-studies-of-vietnam-veterans %> https://nap.nationalacademies.org/catalog/12059/the-utility-of-proximity-based-herbicide-exposure-assessment-in-epidemiologic-studies-of-vietnam-veterans %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 160 %X A fundamental challenge in past studies evaluating whether health problems experienced by Vietnam veterans might be linked to wartime use of Agent Orange or other herbicides has been a lack of information about the veterans' level of exposure to these herbicides. To address that problem, researchers developed a model to assess the opportunity for herbicide exposure among these veterans. The Utility of Proximity-Based Herbicide Exposure Assessment in Epidemiologic Studies of Vietnam Veterans presents the conclusions and recommendations of an Institute of Medicine committee (IOM) that was convened to provide guidance to the Department of Veterans Affairs (VA) about the best use of a model to characterize exposure to the troops based on their proximity to herbicide spraying in Vietnam. This book's assessment is guided by four primary considerations: to be clear about what the assessment model does and does not claim to do; to gain understanding of the strengths and limitations of data on herbicide spraying, troop locations, and health outcomes; to consider whether the model locates spraying and troops accurately to consider the potential contributions and pitfalls of using it in epidemiologic studies. Of particular interest in these deliberations were the degree to which exposure classification might be improved if the model were to be used, and the appropriate interpretation of the results of any such studies. In light of the questions that remain concerning herbicide exposure and health among Vietnam veterans and the array of evidence that has thus far been brought to bear on that issue, The Utility of Proximity-Based Herbicide Exposure Assessment in Epidemiologic Studies of Vietnam Veterans concludes that the application of this model offers a constructive approach to extending knowledge about the effects of herbicides on the health of these veterans and merits the initial steps recommended in our report. %0 Book %A Institute of Medicine %T Epidemiologic Studies of Veterans Exposed to Depleted Uranium: Feasibility and Design Issues %@ 978-0-309-12006-7 %D 2008 %U https://nap.nationalacademies.org/catalog/12200/epidemiologic-studies-of-veterans-exposed-to-depleted-uranium-feasibility-and %> https://nap.nationalacademies.org/catalog/12200/epidemiologic-studies-of-veterans-exposed-to-depleted-uranium-feasibility-and %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 58 %X Depleted uranium, a component of some weapons systems, has been in use by the U.S. military since the 1991 Gulf War. Military personnel have been exposed to depleted uranium as the result of friendly fire incidents, cleanup and salvage operations, and proximity to burning depleted uranium-containing tanks and ammunition. Under a Congressional mandate, the Department of Defense sought guidance from the Institute of Medicine in evaluating the feasibility and design of an epidemiologic study that would assess health outcomes of exposure to depleted uranium. The study committee examined several options to study health outcomes of depleted uranium exposure in military and veteran populations and concluded that it would be difficult to design a study to comprehensively assess depleted uranium-related health outcomes with currently available data. The committee further concluded that the option most likely to obtain useful information about depleted uranium-related health outcomes would be a prospective cohort study if future military operations involve exposure to depleted uranium. The book contains recommendations aimed at improving future epidemiologic studies and identifying current active-duty military personnel and veterans with potential DU exposure. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Whelan, Carolyn %E Beins, Kaley %E Guyton, Kathryn Z. %T Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop %@ 978-0-309-68670-9 %D 2022 %U https://nap.nationalacademies.org/catalog/26538/triangulation-in-environmental-epidemiology-for-epa-human-health-assessments-proceedings %> https://nap.nationalacademies.org/catalog/26538/triangulation-in-environmental-epidemiology-for-epa-human-health-assessments-proceedings %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %P 64 %X Human health risk assessments provide the basis for public health decision-making and chemical regulation in the United States. Three evidence streams generally support the development of human health risk assessments - epidemiology, toxicology, and mechanistic information. Epidemiologic studies are generally the preferred evidence stream for assessing causal relationships during hazard identification. However, the available studies may be limited in scope, subject to bias, or otherwise inadequate to inform causal inferences. In addition, there are challenges in assessing coherence, validity, and reliability during synthesis of individual epidemiological studies with different designs, which in turn affects conclusions on causation. Triangulation aims to address the challenge of synthesizing evidence from diverse studies with distinct sources of bias. Bias is a systematic error that leads to inaccurate study results. Tools for assessing risk of bias provide a structured list of questions for systematic consideration of different domains (such as confounding, selective reporting, and conflict of interest). These tools also provide a structured framework for identifying potential sources of bias and informing judgments on individual studies. The National Academies of Sciences, Engineering, and Medicine convened a workshop to understand and explore triangulation and opportunities to use the practice to enhance the EPA's human health assessments. The workshop was held virtually on May 9 and 11, 2022. This publication summarizes the key presentations and discussions conducted during the workshop. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations %@ 978-0-309-67910-7 %D 2020 %U https://nap.nationalacademies.org/catalog/25837/respiratory-health-effects-of-airborne-hazards-exposures-in-the-southwest-asia-theater-of-military-operations %> https://nap.nationalacademies.org/catalog/25837/respiratory-health-effects-of-airborne-hazards-exposures-in-the-southwest-asia-theater-of-military-operations %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 270 %X More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Savitz, David A. %E Styka, Anne N. %T Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis %@ 978-0-309-67210-8 %D 2020 %U https://nap.nationalacademies.org/catalog/25688/assessment-of-long-term-health-effects-of-antimalarial-drugs-when-used-for-prophylaxis %> https://nap.nationalacademies.org/catalog/25688/assessment-of-long-term-health-effects-of-antimalarial-drugs-when-used-for-prophylaxis %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 426 %X Among the many who serve in the United States Armed Forces and who are deployed to distant locations around the world, myriad health threats are encountered. In addition to those associated with the disruption of their home life and potential for combat, they may face distinctive disease threats that are specific to the locations to which they are deployed. U.S. forces have been deployed many times over the years to areas in which malaria is endemic, including in parts of Afghanistan and Iraq. Department of Defense (DoD) policy requires that antimalarial drugs be issued and regimens adhered to for deployments to malaria-endemic areas. Policies directing which should be used as first and as second-line agents have evolved over time based on new data regarding adverse events or precautions for specific underlying health conditions, areas of deployment, and other operational factors At the request of the Veterans Administration, Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis assesses the scientific evidence regarding the potential for long-term health effects resulting from the use of antimalarial drugs that were approved by FDA or used by U.S. service members for malaria prophylaxis, with a focus on mefloquine, tafenoquine, and other antimalarial drugs that have been used by DoD in the past 25 years. This report offers conclusions based on available evidence regarding associations of persistent or latent adverse events. %0 Book %A Institute of Medicine %A National Academies of Sciences, Engineering, and Medicine %T Veterans and Agent Orange: Update 2014 %@ 978-0-309-38066-9 %D 2016 %U https://nap.nationalacademies.org/catalog/21845/veterans-and-agent-orange-update-2014 %> https://nap.nationalacademies.org/catalog/21845/veterans-and-agent-orange-update-2014 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 1114 %X 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. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 2012 %@ 978-0-309-28886-6 %D 2014 %U https://nap.nationalacademies.org/catalog/18395/veterans-and-agent-orange-update-2012 %> https://nap.nationalacademies.org/catalog/18395/veterans-and-agent-orange-update-2012 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 1006 %X 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 (NAS) 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 are conducted every two years to review newly available literature and draw conclusions from the overall evidence.Veterans and Agent Orange: Update 2012 reviews peer-reviewed scientific reports concerning associations between health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published in October 2010--September 2012 and integrates this information with the previously established evidence database. This report considers whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association; the increased risk of disease among those exposed to herbicides during service in the Republic of Vietnam during the Vietnam era; and whether there exists a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease. %0 Book %A National Research Council %T Contaminated Water Supplies at Camp Lejeune: Assessing Potential Health Effects %@ 978-0-309-13699-0 %D 2009 %U https://nap.nationalacademies.org/catalog/12618/contaminated-water-supplies-at-camp-lejeune-assessing-potential-health-effects %> https://nap.nationalacademies.org/catalog/12618/contaminated-water-supplies-at-camp-lejeune-assessing-potential-health-effects %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 338 %X In the early 1980s, two water-supply systems on the Marine Corps Base Camp Lejeune in North Carolina were found to be contaminated with the industrial solvents trichloroethylene (TCE) and perchloroethylene (PCE). The water systems were supplied by the Tarawa Terrace and Hadnot Point watertreatment plants, which served enlisted-family housing, barracks for unmarried service personnel, base administrative offices, schools, and recreational areas. The Hadnot Point water system also served the base hospital and an industrial area and supplied water to housing on the Holcomb Boulevard water system (full-time until 1972 and periodically thereafter). This book examines what is known about the contamination of the water supplies at Camp Lejeune and whether the contamination can be linked to any adverse health outcomes in former residents and workers at the base. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 2010 %@ 978-0-309-21447-6 %D 2012 %U https://nap.nationalacademies.org/catalog/13166/veterans-and-agent-orange-update-2010 %> https://nap.nationalacademies.org/catalog/13166/veterans-and-agent-orange-update-2010 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 836 %X 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. %0 Book %A Institute of Medicine %T Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam: Final Report %D 2003 %U https://nap.nationalacademies.org/catalog/10819/characterizing-exposure-of-veterans-to-agent-orange-and-other-herbicides-used-in-vietnam %> https://nap.nationalacademies.org/catalog/10819/characterizing-exposure-of-veterans-to-agent-orange-and-other-herbicides-used-in-vietnam %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 60 %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Controlled Human Inhalation-Exposure Studies at EPA %@ 978-0-309-45249-6 %D 2017 %U https://nap.nationalacademies.org/catalog/24618/controlled-human-inhalation-exposure-studies-at-epa %> https://nap.nationalacademies.org/catalog/24618/controlled-human-inhalation-exposure-studies-at-epa %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %P 158 %X The U.S. Environmental Protection Agency (EPA) has a mission and regulatory responsibility to protect human health and the environment. EPA’s pursuit of that goal includes a variety of research activities involving human subjects, such as epidemiologic studies and surveys. Those research activities also involve studies of individuals who volunteer to be exposed to air pollutants intentionally in controlled laboratory settings so that measurements can be made of transient and reversible biomarker or physiologic responses to those exposures that can indicate pathways of toxicity and mechanisms of air-pollution responses. The results of those controlled human inhalation exposure (CHIE) studies, also referred to as human clinical studies or human challenge studies, are used to inform policy decisions and help establish or revise standards to protect public health and improve air quality. Controlled Human Inhalation-Exposure Studies at EPA addresses scientific issues and provides guidance on the conduct of CHIE studies. This report assesses the utility of CHIE studies to inform and reduce uncertainties in setting air-pollution standards to protect public health and assess whether continuation of such studies is warranted. It also evaluates the potential health risks to test subjects who participated in recent studies of air pollutants at EPA’s clinical research facility. %0 Book %A Institute of Medicine %T Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan %@ 978-0-309-21755-2 %D 2011 %U https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan %> https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 192 %X Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases. %0 Book %A National Research Council %T Analysis of Cancer Risks in Populations Near Nuclear Facilities: Phase 1 %@ 978-0-309-25571-4 %D 2012 %U https://nap.nationalacademies.org/catalog/13388/analysis-of-cancer-risks-in-populations-near-nuclear-facilities-phase %> https://nap.nationalacademies.org/catalog/13388/analysis-of-cancer-risks-in-populations-near-nuclear-facilities-phase %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 424 %X In the late 1980s, the National Cancer Institute initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States. The results of the NCI investigation were used a primary resource for communicating with the public about the cancer risks near the nuclear facilities. However, this study is now over 20 years old. The U.S. Nuclear Regulatory Commission requested that the National Academy of Sciences provide an updated assessment of cancer risks in populations near USNRC-licensed nuclear facilities that utilize or process uranium for the production of electricity. Analysis of Cancer Risks in Populations near Nuclear Facilities: Phase 1 focuses on identifying scientifically sound approaches for carrying out an assessment of cancer risks associated with living near a nuclear facility, judgments about the strengths and weaknesses of various statistical power, ability to assess potential confounding factors, possible biases, and required effort. The results from this Phase 1 study will be used to inform the design of cancer risk assessment, which will be carried out in Phase 2. This report is beneficial for the general public, communities near nuclear facilities, stakeholders, healthcare providers, policy makers, state and local officials, community leaders, and the media. %0 Book %A Institute of Medicine %E Fulco, Carolyn E. %E Liverman, Catharyn T. %E Sox, Harold C. %T Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines %@ 978-0-309-07178-9 %D 2000 %U https://nap.nationalacademies.org/catalog/9953/gulf-war-and-health-volume-1-depleted-uranium-sarin-pyridostigmine %> https://nap.nationalacademies.org/catalog/9953/gulf-war-and-health-volume-1-depleted-uranium-sarin-pyridostigmine %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 426 %X The men and women who served in the Gulf War theater were potentially exposed to a wide range of biological and chemical agents. Gulf War and Health: Volume 1 assesses the scientific literature concerning the association between these agents and the adverse health effects currently experienced by a large number of veterans. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Veterans and Agent Orange: Update 11 (2018) %@ 978-0-309-47716-1 %D 2018 %U https://nap.nationalacademies.org/catalog/25137/veterans-and-agent-orange-update-11-2018 %> https://nap.nationalacademies.org/catalog/25137/veterans-and-agent-orange-update-11-2018 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 738 %X 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. %0 Book %A National Research Council %T Review of the Styrene Assessment in the National Toxicology Program 12th Report on Carcinogens %@ 978-0-309-30178-7 %D 2014 %U https://nap.nationalacademies.org/catalog/18725/review-of-the-styrene-assessment-in-the-national-toxicology-program-12th-report-on-carcinogens %> https://nap.nationalacademies.org/catalog/18725/review-of-the-styrene-assessment-in-the-national-toxicology-program-12th-report-on-carcinogens %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %P 192 %X Many people in the United States are exposed to styrene. Sources of environmental exposure included food (from migration of styrene from polymer packaging materials), cigarette smoke, vehicle exhaust and other forms of combustion and incineration of styrene polymers. Occupational exposure to humans can occur during the industrial processing of styrene. It is used to create a broad spectrum of products, including latex paints and coatings; synthetic rubbers; construction materials, such as pipes, fittings, and lighting fixtures; packaging; household goods, such as synthetic marble, flooring, and molded furnishings; and automotive parts. In 2011, the National Toxicology Program (NTP) listed styrene as "reasonably anticipated to be a human carcinogen" in its 12th Report on Carcinogens, marking the first time that the substance was listed. Congress directed the Department of Health and Human Services to arrange for the National Academy of Sciences to independently review the substance profile of styrene and it listing in the NTP report. Review of the Styrene Assessment in the National Toxicology Program 12th Report on Carcinogens concurs with the NTP determination that there is limited but credible evidence that exposure to styrene in some occupational settings is associated with an increase in the frequency of lymphohematopoietic cancers. Additionally, the NRC report authoring committee independently reviewed the scientific evidence from studies in humans, experimental animals, and other studies relevant to the mechanisms of carcinogenesis and made level-of-evidence conclusions. Based on credible but limited evidence of carcinogenicity in traditional epidemiologic studies, on sufficient evidence of carcinogenicity in animals, and on convincing evidence that styrene is genotoxic in exposed humans, this report finds that compelling evidence exists to support a listing of styrene as, at a minimum, "reasonably anticipated to be a human carcinogen." %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Length of Presumptive Period for Association Between Exposure and Respiratory Cancer %@ 978-0-309-09188-6 %D 2004 %U https://nap.nationalacademies.org/catalog/10933/veterans-and-agent-orange-length-of-presumptive-period-for-association %> https://nap.nationalacademies.org/catalog/10933/veterans-and-agent-orange-length-of-presumptive-period-for-association %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 74 %X 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. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 2000 %@ 978-0-309-07552-7 %D 2001 %U https://nap.nationalacademies.org/catalog/10098/veterans-and-agent-orange-update-2000 %> https://nap.nationalacademies.org/catalog/10098/veterans-and-agent-orange-update-2000 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 622 %X 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. %0 Book %A Institute of Medicine %T Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants %@ 978-0-309-09527-3 %D 2005 %U https://nap.nationalacademies.org/catalog/11180/gulf-war-and-health-volume-3-fuels-combustion-products-and %> https://nap.nationalacademies.org/catalog/11180/gulf-war-and-health-volume-3-fuels-combustion-products-and %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 516 %X The third in a series of congressionally mandated reports on Gulf War veterans’ health, this volume evaluates the long-term, human health effects associated with exposure to selected environmental agents, pollutants, and synthetic chemical compounds believed to have been present during the Gulf War. The committee specifically evaluated the literature on hydrogen sulfide, combustion products, hydrazine and red fuming nitric acid. Both the epidemiologic and toxicologic literature were reviewed. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 2002 %@ 978-0-309-08616-5 %D 2003 %U https://nap.nationalacademies.org/catalog/10603/veterans-and-agent-orange-update-2002 %> https://nap.nationalacademies.org/catalog/10603/veterans-and-agent-orange-update-2002 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 638 %X This book updates and evaluates the available scientific evidence regarding statistical associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam, focusing on new scientific studies and literature.