What is Agent Orange

Agent Orange was a herbicide, or defoliant, which was used in Vietnam to kill unwanted plant life and to remove leaves from trees which otherwise provided cover for the enemy. Agent Orange was a mixture of chemicals containing equal amounts of the two active ingredients (2,4-D and 2,4,5-T). The name, Agent Orange, came from the orange stripe on the 55- gallon drums in which it was stored. Other herbicides, including Agent White and Agent Blue, were also used in Vietnam to a much lesser extent.

Why are Vietnam Veterans Concerned About Agent Orange?

In the 1970's some veterans became concerned that exposure to Agent Orange might cause delayed health effects. One of the chemicals (2,4,5-T) in Agent Orange contained minute traces of 2,3,7,8-tetrachlorodibenzo-p-dioxin (also known as TCDD or dioxin), which has caused a variety of illnesses in laboratory animals. More recent studies have suggested that the chemical may be related to a number of malignancies and other disorders.

When and where was Agent Orange used in Vietnam?

Fifteen different herbicides were shipped to and used in Vietnam between January 1962 and September 1971. Over 80 percent of the herbicides sprayed in Vietnam was Agent Orange, which was used between January 1965 and April 1970. Herbicides other than Agent Orange were used in Vietnam prior to 1965, but to a very limited extent. The totla area sprayed with herbicides between 1962 and 1965 was small, less than 7 percent of the total acreage sprayed during the Vietnam conflict. Rapid increases in the annual number of acres sprayed occurred from 1962 to 1967. The number of acres sprayed reached a maximum in 1967, leveled off slightly in 1968 and 1969, and declined rapidly in 1970 prior to the termination of spraying in 1971. During this time more than 20 million gallons of herbicides were sprayed over 6 million acres, some of which were sprayed more than once. More than 3.5 million acres of South Vietnam -- approximately 8.5 percent of the country -- were sprayed one or more times. Spraying occurred in all 4 military zones of Vietnam.

Heavily sprayed areas included inland forests near the demarcation zone; inland forests at the junction of the borders of Cambodia, Laos, and South Vietnam; inland forests north and northwest of Saigon; mangrove forests on the southernmost peninsula of Vienam; and mangrove forests along major shipping channels southeast of Saigon. Crop destruction missions were concentrated in northern and eastern central areas of South Vietnam.

What should concerned veterans do?

In 1978, the Veterans Administration, now known as the Department of Veterans Affairs (VA), set up a special examination program for Vietnam veterans who were worried about the long-term health effects of exposure to Agent Orange. Vietnam veterans who are interested in participating in this program, known as the Agent Orange Registry, should contact the nearest VA medical center for an examination. An appointment usually can be arranged within two or three weeks.

What can a veteran expect from this examination?

Veterans who participate in the examination program are asked a series of questions about their possible exposure to herbicides in Vietnam. A medical history is taken, a physical examination is performed, and a series of basic laboratory tests, such as a chest x-ray (if appropriate), urinalysis, and blood tests, are done. If the examining physician thinks it is medically indicated, consultations with other physicians are scheduled.

No special Agent Orange tests are offered since there is no test to show if a veteran's medical problem was caused by Agent Orange or other herbicides used in Vietnam. There are tests that show the level of dioxin in human fat and blood, but such tests are not done by VA because there is serious question about their value to veterans. In January 1992, VA signed a contract with the National Academy of Sciences (NAS) under which, among other things, the NAS considered the feasibility and possible value of dioxin level blood tests for Vietnam veterans who apply for VA medical care or VA disability compensation. In its July 1993 report, the NAS concluded that individual TCDD levels in Vietnam veterans are usually not meaningful because of common background exposures to TCDD, poorly understood variations among individuals in TCDD metabolism, relatively large measurement errors, and exposure to herbicides that did not contain TCDD.

How does a veteran benefit from taking VA's Agent Orange Registery examination?

The veteran is informed of the results of the examination during a personal interview and gets a follow-up letter further describing the findings. Each veteran is given the opportunity to ask for an explanation and advice. Where medically necessary, a follow-up examination or additional laboratory tests are scheduled. The examination and tests sometime reval previously undetected medical problems. These discoveries permit veterans to get prompt treatment for their illnesses. Some veterans think they are in good health, but are worried that exposure to Agent Orange and other substances may have caused some hidden illness. The knowledge that a complete medical examination does not show any medical problems can be very reassuring or helpful to Registry participants. All examination and test results are kept in the veteran's permanent medical record. This information is also entered into the computerized VA Agent Orange Registry, see Agent Orange Brief, B1.

Can a veteran get treatment for Agent Orange-related illnesses?

Yes. Section 102, Public Law 104-262, the Veterans' Health Care Eligibility Reform Act of 1996, provides that VA is required to furnish hospital care and medical services, and may furnish nursing home care to veterans exposed to herbicides in Vietnam. There are some restrictions. VA cannot provide such care for a (1) disability which VA determines did not result from expsure to Agent Orange, or (2) disease which the National Academy of Sciences has determined that there is "limited/suggestive" evidence of no association between occurrence of the disease and exposure to a herbicide agent. For additional information about eligibility, see Agent Orange Brief, B2.

Can veterans get disability compensation for Agent Orange illnesses?

VA also pays disability compensation to many Vietnam veterans with injuries or illnesses incurred in or aggravated by their military service. Veterans do not have to prove that Agent Orange caused their medical problems to be eligible for compensation. Rather, VA must determine that the disability is "service-connected." A Veterans Benefits Counselor, at any VA medical center or regional office, can explain the compensation program in greater detail and can assist veterans who need hep in applying. For more information about the VA disability compensation program, call 1-800-827-1000 or see Agent Orange Brief, B3.

What else is VA doing?

In addition to the efforts described above (that is, Agent Orange Registry examination program, medical treatment eligibility, and disability compensation), VA is doing research to learn more about the possible adverse health effects of Agent Orange exposure. The Environmental Epidemiology Service (EES), in Washington, DC, is the premiere office for Vietnam/Agent Orange-related research within VA. EES investigators have completed two studies about

possible connections between Vietnam service and specific kinds of cancers called soft tissue sarcomas,

• a large scale study of mortality among Vietnam veterans,
• a study regarding the relationship between Vietnam service and non- Hodgkin''s lymphomas,
• a study of dioxin in adiposs (fat) tissue,
• several mortality study follow-up efforts,
• mortality studies of individuals in the Army Chemical Corps in Vietnam,
• an analysis of post-traumatic stress disorder (PTSD) among Vietnam veterans in the Agent Orange Registry,
• a study of the relationship between Vietnam service and Hodgkin's disease,
• a study of the relationship between military service in Vietnam and the risk of death from trauma and selected cancers,
• an analysis of testicular cancer among Agent Orange Registry participants,
• a study of suicide among wounded Vietnam veterans,
• and a study of the relationship between lung cancer and military service in vietnam.
  

EES had assistance from others on several of these research projects. For information about these studies and ongoing VA research efforts, see Agent Orange Brief, C2.

In 1981, VA published a two-volume report reviewing scientific literature on herbicides in the United States and throughout the world. This publication was updated with an additional two volumes in 1984, 1985, 1986, 1987, 1988, 1989, 1990, 1991, 1992, 1993, and 1994. (These annual updates were discontinued to avoid duplication of the ongoing scientific literature review by the National Academy of Sciences, a non-governmental organization under contract with VA.) Lay language summaries of the VA's scientific reviews havee been published to help non-scientists understand this complex issue. VA has also published a series of monographs regarding Agent Orange- related matters. For additional information on these publications, see Agent Orange Brief, B4.

From 1979 to 1994, VA was part of an interagency group monitoring and coordinating Agent Orange-related and dioxin-related research within the Federal government. The interagency group ceased operation in 1994. VA also has been aided by two VA-administered advisory committees, which made valuable recommendations to the Administrator/Secretary of Veterans Affairs regarding appropriate policy for compensation, research, outreach, and related matters.