%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 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 Gulf War and Health: Volume 2: Insecticides and Solvents %@ 978-0-309-11389-2 %D 2003 %U https://nap.nationalacademies.org/catalog/10628/gulf-war-and-health-volume-2-insecticides-and-solvents %> https://nap.nationalacademies.org/catalog/10628/gulf-war-and-health-volume-2-insecticides-and-solvents %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 616 %X Gulf War and Health, Volume 2, is the second in a series of congressionally-mandated studies by the Institute of Medicine that provides a comprehensive assessment of the available scientific literature on potential health effects of exposure to certain biological, chemical, and environmental agents associated with the Gulf War. In this second study, the committee evaluated the published, peer-reviewed literature on exposure to insecticides and solvents thought to have been present during the 1990-1991 war. Because little information exists on actual exposure levels – a critical factor when assessing health effects – the committee could not draw specific conclusions about the health problems of Gulf War veterans. However, the study found some evidence, although usually limited, to link specific long-term health outcomes with exposure to certain insecticides and solvents. The next phase of the series will examine the literature on potential health effects associated with exposure to selected environmental pollutants and particulates, such as oil-well fires and jet fuels. %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 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 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 2004 %@ 978-0-309-09598-3 %D 2005 %U https://nap.nationalacademies.org/catalog/11242/veterans-and-agent-orange-update-2004 %> https://nap.nationalacademies.org/catalog/11242/veterans-and-agent-orange-update-2004 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 680 %X Sixth in a series of congressionally mandated studies, this book is an updated review and evaluation of the available evidence regarding the statistical assoication between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposure. This book builds upon the information contained in the earlier books in the series: Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (1994) Veterans and Agent Orange: Update 1996 Veterans and Agent Orange: Update 1998 Veterans and Agent Orange: Update 2000 Veterans and Agent Orange: Update 2002 Veterans and Agent Orange: Herbicides and Dioxin Exposure and Type 2 Diabetes (2000) Veterans and Agent Orange: Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans (2002) Veterans and Agent Orange: Update 2004 focuses primarily on scientific studies and other information developed since the release of these earlier books. The previous volumes have noted that sufficient evidence exists to link chronic lymphocytic leukemia, 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 of an association between exposure and respiratory cancers, prostate cancer, multiple myeloma, the metabolic disorder porphyria cutanea tarda, early-onset transient peripheral neuropathies, Type 2 diabetes, and the congenital birth defect spinal 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. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 1998 %@ 978-0-309-06326-5 %D 1999 %U https://nap.nationalacademies.org/catalog/6415/veterans-and-agent-orange-update-1998 %> https://nap.nationalacademies.org/catalog/6415/veterans-and-agent-orange-update-1998 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 624 %X 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. %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. %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 Veterans and Agent Orange: Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans %@ 978-0-309-08338-6 %D 2002 %U https://nap.nationalacademies.org/catalog/10309/veterans-and-agent-orange-herbicidedioxin-exposure-and-acute-myelogenous-leukemia %> https://nap.nationalacademies.org/catalog/10309/veterans-and-agent-orange-herbicidedioxin-exposure-and-acute-myelogenous-leukemia %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 42 %X 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. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Herbicide/Dioxin Exposure and Type 2 Diabetes %@ 978-0-309-07198-7 %D 2000 %U https://nap.nationalacademies.org/catalog/9982/veterans-and-agent-orange-herbicidedioxin-exposure-and-type-2-diabetes %> https://nap.nationalacademies.org/catalog/9982/veterans-and-agent-orange-herbicidedioxin-exposure-and-type-2-diabetes %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 76 %X In response to the concerns voiced by Vietnam veterans and their families, Congress called upon the National Academy of Sciences (NAS) to review the scientific evidence on the possible health effects of exposure to Agent Orange and other herbicides. This call resulted in the creation of the first NAS Institute of Medicine Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides in 1992. The committee published its initial findings in the 1994 report Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. This report is the result of a 1999 request from the Department of Veterans Affairs (DVA) under the aegis of the Veterans and Agent Orange research program. Specifically, DVA asked the committee to examine evidence regarding the association, if any, between Type 2 diabetes and exposure to dioxin and other chemical compounds in herbicides used in Vietnam. Veterans and Agent Orange: Herbicide/Dioxin Exposure and Type 2 Diabetes reviews the scientific evidence regarding the association, if any, between Type 2 diabetes1 and exposure to dioxin2 and other chemical compounds in herbicides used in Vietnam. This report examines, to the extent that available data permitted meaningful determinations, (1) whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiologic methods used to detect the association; (2) the increased risk of the disease among those exposed to herbicides during Vietnam service; and (3) whether there is a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease. %0 Book %A Institute of Medicine %T Damp Indoor Spaces and Health %@ 978-0-309-09193-0 %D 2004 %U https://nap.nationalacademies.org/catalog/11011/damp-indoor-spaces-and-health %> https://nap.nationalacademies.org/catalog/11011/damp-indoor-spaces-and-health %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 368 %X Almost all homes, apartments, and commercial buildings will experience leaks, flooding, or other forms of excessive indoor dampness at some point. Not only is excessive dampness a health problem by itself, it also contributes to several other potentially problematic types of situations. Molds and other microbial agents favor damp indoor environments, and excess moisture may initiate the release of chemical emissions from damaged building materials and furnishings. This new book from the Institute of Medicine examines the health impact of exposures resulting from damp indoor environments and offers recommendations for public health interventions. Damp Indoor Spaces and Health covers a broad range of topics. The book not only examines the relationship between damp or moldy indoor environments and adverse health outcomes but also discusses how and where buildings get wet, how dampness influences microbial growth and chemical emissions, ways to prevent and remediate dampness, and elements of a public health response to the issues. A comprehensive literature review finds sufficient evidence of an association between damp indoor environments and some upper respiratory tract symptoms, coughing, wheezing, and asthma symptoms in sensitized persons. This important book will be of interest to a wide-ranging audience of science, health, engineering, and building professionals, government officials, and members of the public. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam %@ 978-0-309-07529-9 %D 1994 %U https://nap.nationalacademies.org/catalog/2141/veterans-and-agent-orange-health-effects-of-herbicides-used-in %> https://nap.nationalacademies.org/catalog/2141/veterans-and-agent-orange-health-effects-of-herbicides-used-in %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 832 %X Have U.S. military personnel experienced health problems from being exposed to Agent Orange, its dioxin contaminants, and other herbicides used in Vietnam? This definitive volume summarizes the strength of the evidence associating exposure during Vietnam service with cancer and other health effects and presents conclusions from an expert panel. Veterans and Agent Orange provides a historical review of the issue, examines studies of populations, in addition to Vietnam veterans, environmentally and occupationally exposed to herbicides and dioxin, and discusses problems in study methodology. The core of the book presents: What is known about the toxicology of the herbicides used in greatest quantities in Vietnam. What is known about assessing exposure to herbicides and dioxin. What can be determined from the wide range of epidemiological studies conducted by different authorities. What is known about the relationship between exposure to herbicides and dioxin, and cancer, reproductive effects, neurobehavioral disorders, and other health effects. The book describes research areas of continuing concern and offers recommendations for further research on the health effects of Agent Orange exposure among Vietnam veterans. 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. %0 Book %A Institute of Medicine %E Petersdorf, Robert G. %E Page, William F. %E Thaul, Susan %T Interactions of Drugs, Biologics, and Chemicals in U.S. Military Forces %@ 978-0-309-05593-2 %D 1996 %U https://nap.nationalacademies.org/catalog/5515/interactions-of-drugs-biologics-and-chemicals-in-us-military-forces %> https://nap.nationalacademies.org/catalog/5515/interactions-of-drugs-biologics-and-chemicals-in-us-military-forces %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 88 %0 Book %A Institute of Medicine %T Hip Fracture: Setting Priorities for Effectiveness Research %@ 978-0-309-04299-4 %D 1990 %U https://nap.nationalacademies.org/catalog/1630/hip-fracture-setting-priorities-for-effectiveness-research %> https://nap.nationalacademies.org/catalog/1630/hip-fracture-setting-priorities-for-effectiveness-research %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 72 %X %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 1996: Summary and Research Highlights %D 1997 %U https://nap.nationalacademies.org/catalog/9079/veterans-and-agent-orange-update-1996-summary-and-research-highlights %> https://nap.nationalacademies.org/catalog/9079/veterans-and-agent-orange-update-1996-summary-and-research-highlights %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 56 %0 Book %A National Research Council %T Assessing the Human Health Risks of Trichloroethylene: Key Scientific Issues %@ 978-0-309-10283-4 %D 2006 %U https://nap.nationalacademies.org/catalog/11707/assessing-the-human-health-risks-of-trichloroethylene-key-scientific-issues %> https://nap.nationalacademies.org/catalog/11707/assessing-the-human-health-risks-of-trichloroethylene-key-scientific-issues %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %K Health and Medicine %P 448 %X Trichloroethylene is a chlorinated solvent widely used as a degreasing agent in industrial and manufacturing settings. It is also used as a chemical intermediate in making other chemicals and is a component of products such as typewriter correction fluid, paint removers, adhesives, and spot removers. In 2001, EPA issued a draft health risk assessment and proposed exposure standards for trichloroethylene. PA's Scientific Advisory Board (SAB) reviewed the draft and it was issued for public comment. A number of scientific issues were raised during the course of these reviews. Assessing the Human Health Risks of Trichloroethylene identifies and assesses the key scientific issues relevant to analyzing the human health risks of trichloroethylene, considering pertinent toxicologic, epidemiologic, population susceptibility, and other available information, including relevant published scientific literature, EPA's 2001 draft health risk assessment of trichloroethylene, scientific and technical comments received by EPA from public and private sources, and additional relevant information to be provided by the sponsoring agencies. This report highlights issues critical to the development of an objective, realistic, and scientifically balanced trichloroethylene health risk assessment. Guidance for hazard characterization of trichloroethylene is presented in Chapters 2 through 10. Chapter 2 provides guidance for evaluating large sets of epidemiologic data. In Chapter 3, the committee applies this guidance as an example in its evaluation of the epidemiologic data on trichloroethylene and kidney cancer, and this example should help guide evaluations of other cancer risks. Chapter 3 also assesses new information on the kidney toxicity of trichloroethylene and its metabolites and potential modes of action. Chapters 4, 5, 6, 7, and 8 evaluate the key issues regarding liver toxicity and cancer, reproductive and developmental toxicity, neurotoxicity, respiratory tract toxicity and cancer, and immunotoxicity, respectively. However, the committee's review focused on mode-of-action information to understand how trichloroethylene might affect certain processes differently in different species. Chapter 9 discusses susceptibility to trichloroethylene and its metabolites, and Chapter 10 describes important factors in considering trichloroethylene in mixtures. Physiologically based pharmacokinetic models are evaluated in Chapter 11, and guidance is provided on future directions for model development. Finally, Chapter 12 considers issues related to dose-response assessment and quantitative assessment of risk. %0 Book %A Institute of Medicine %E Beachy, Sarah H. %E Johnson, Samuel G. %E Olson, Steve %E Berger, Adam C. %T Drug Repurposing and Repositioning: Workshop Summary %@ 978-0-309-30204-3 %D 2014 %U https://nap.nationalacademies.org/catalog/18731/drug-repurposing-and-repositioning-workshop-summary %> https://nap.nationalacademies.org/catalog/18731/drug-repurposing-and-repositioning-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 118 %X Drug development can be time-consuming and expensive. Recent estimates suggest that, on average, it takes 10 years and at least $1 billion to bring a drug to market. Given the time and expense of developing drugs de novo, pharmaceutical companies have become increasingly interested in finding new uses for existing drugs - a process referred to as drug repurposing or repositioning. Historically, drug repurposing has been largely an unintentional, serendipitous process that took place when a drug was found to have an offtarget effect or a previously unrecognized on-target effect that could be used for identifying a new indication. Perhaps the most recognizable example of such a successful repositioning effort is sildenafil. Originally developed as an anti-hypertensive, sildenafil, marketed as Viagra and under other trade names, has been repurposed for the treatment of erectile dysfunction and pulmonary arterial hypertension. Viagra generated more than $2 billion worldwide in 2012 and has recently been studied for the treatment of heart failure. Given the widespread interest in drug repurposing, the Roundtable on Translating Genomic-Based Research for Health of the Institute of Medicine hosted a workshop on June 24, 2013, in Washington, DC, to assess the current landscape of drug repurposing activities in industry, academia, and government. Stakeholders, including government officials, pharmaceutical company representatives, academic researchers, regulators, funders, and patients, were invited to present their perspectives and to participate in workshop discussions. Drug Repurposing and Repositioning is the summary of that workshop. This report examines enabling tools and technology for drug repurposing; evaluates the business models and economic incentives for pursuing a repurposing approach; and discusses how genomic and genetic research could be positioned to better enable a drug repurposing paradigm. %0 Book %A Institute of Medicine %E Mastroianni, Anna C. %E Faden, Ruth %E Federman, Daniel %T Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies: Volume 2: Workshop and Commissioned Papers %@ 978-0-309-05040-1 %D 1994 %U https://nap.nationalacademies.org/catalog/2343/women-and-health-research-ethical-and-legal-issues-of-including %> https://nap.nationalacademies.org/catalog/2343/women-and-health-research-ethical-and-legal-issues-of-including %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 261 %X There is a growing perception that biomedical research has focused more on the health problems of men relative to those of women and that women have been denied access to advances in medical diagnosis and therapy as a result of being excluded from clinical studies. Women and Health Research, Volume 2, addresses issues connected with women's participation in clinical studies: ethical issues related to recruitment, retention, and the inclusion of pregnant women and other women of childbearing age; legal issues such as liability, compensation for injury, constitutional concerns, and federal regulations; and health consequences associated with exclusion or underrepresentation. The commissioned papers focus on the research participation of women from specific racial and ethnic groups and on whether women have been underrepresented in biomedical research, based on a systematic survey of clinical studies reported in a prominent medical journal.