Abstract: Normal relations between the United States and the Socialist Republic of Vietnam in 1995 permitted scientists, public health experts, and the media to visit Vietnam and assess the impact of the use of Agent Orange on the ecology and peoples of Vietnam. Evaluation of scientific data suggested that exposures to the toxic contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin, TCDD, in2,4,5-T-containing herbicides sprayed on jungle forests and mangroves were minimal for Vietnamese located in villages near combat areas. Although some tactical herbicides were sprayed in rural areas, the largest sources of polychlorinated dioxins and furans (PCDD/Fs) were from biomass-burning, especially from municipal dumpsites. In urban areas, sources of PCDD/Fs were from industrial emissions. Measurable levels of PCDD/Fs in Vietnamese were in those residents associated with dioxin "hotspots", specifically from former airbases where Agent Orange had been stored or loaded on US military aircraft. These hotspots were characterized by high soil and sediments levels of 2,3,7,8-TCDD that persisted in spill sites over 50 years. Movement of low levels of PCDD/Fs into food sources were a continuing source of contamination for residents adjacent to hotspots. However, levels of TCDD in the tissues were generally comparable to other Asian populations. Allegations of cancers, other diseases, and horrific birth defects due to residual dioxins on the public health of those communities have not been validated. The Us and Vietnam have committed to remediation of the hotspots in Southern Vietnam. The Public Health of the Vietnamese continues to improve due to regulatory actions of Vietnam's government to reduce industrial and atmospheric pollution.
Abstract: Confusion and misinformation are common when discussing Agent Orange, a tactical herbicide used in the Vietnam War. This is partially the result of inaccurate news coverage or false information that is purposely spread to deceive veterans. Sensationalized reporting has frequently left the public with a distorted view of what occurred in Vietnam and of the minimal risks related to the use of herbicides in an operational combat environment. However, such a discrepancy between perceived risks and actual risks has also been enhanced by a public policy where historical records and science have been ignored while favoring a policy of "presumptive" compensation promoted by the Agent Orange Act of 1991. The Act has resulted in a narrow focus on tactical herbicides as the key factor in explaining the health risks of Vietnam veterans, ignoring other important risk factors that occurred in the war in Vietnam, namely, widespread endemic tropical diseases and parasites, psychological and impacts of war, and health and lifestyle. Thus, it is not surprising that the controversies surrounding the use of Agent Orange in Vietnam have raged for 40 years. Indeed, more than a million United States veterans and billions of dollars have been spent by the United States Department Veterans Affairs in providing compensation and health care for unrelated diseases where the vast majorities are not deployment-related health problems or related to herbicide exposure but rather to aging and quality of life issues.
Abstract: Physicians and other members of the medical community frequently are asked about "Agent Orange" and potentially "associated" health issues. The Vietnam War officially ended in 1975, but concerns over the legacy of Agent Orange linger to this day. Under the Agent Orange Act of 1991, the United States Department of Veterans Affairs (DVA) recognizes 14 diseases associated with alleged exposure to Agent Orange, its associated dioxin (TCDD) contaminant, and other tactical herbicides used in combat operations in Vietnam during the war. The medical community needs to understand why Agent Orange has become a national public health issue, and be prepared to respond to questions by veterans and the public. Although the Institute of Medicine (IOM) provided recommendations to DVA on medical issues, they were directed by the Act to develop "statistical associations" for human diseases rather than to establish cause and effect relationships. No IOM report determined a consistent, coherent, and credible evidence of a causal connection between a disease and exposure to Agent Orange. The reality is that the current Agent Orange Policy is based on politics driven by public, media, veteran and congressional actions. Special evaluations and considerations must be given to the numerous health studies of our Vietnam Era veterans and what they have indicated. Perhaps we could have been fairer to all Vietnam veterans with a program of 'Vietnam experience' benefits rather than Agent Orange benefits. Greater efforts should have been made to study how societal pressures and politics have played a larger role than the efforts of the scientific and medical communities in providing health answers for our Vietnam veterans and the Vietnamese, all who now continue to suffer the lasting effects of war.
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