On February 6, 1991, President George H. W. Bush signed the
Agent Orange Act of 1991. This act was the first piece of legislation to officially establish a group of presumptive conditions for Vietnam Veterans exposed to herbicides, meaning that Veterans with non-Hodgkin’s lymphoma, soft tissue sarcomas, and chloracne could now receive medical benefits from the Veterans Administration (VA) as a result of their service in Vietnam.
This legislation was applauded by Veterans groups, government officials, and the general public. Yet, it was rooted in over a decade of fierce debate, VA institutional resistance, and confusion over the long-term health effects of Agent Orange and dioxin exposure.
Agent Orange was the most common of the so-called Rainbow Herbicides used during Operation Ranch Hand in the Vietnam War. It was made up of a 50:50 mixture of 2,4-D and 2,4,5-T, the latter of which contained a contaminant known as TCDD, a type of dioxin or organic pollutant. The herbicide was remarkably effective at clearing jungle foliage and depriving Viet Cong forces of both cover and workable farmland. Operation Ranch Hand lasted from 1962 until 1971.
By the time the Air Force ceased these herbicide spraying missions, Agent Orange alone accounted for 11.22 million of the over 18 million gallons of herbicide sprayed in Southeast Asia. Many Veterans still recall being sprayed with Agent Orange but were instead "treated" with malathion, sprayed from C-123 Tail Number 362 for insect control. Planes spraying for insect control had the green paint removed as the malathion would foul the surfaces.
By the late 1970s, the public was seriously questioning the health effects of dioxin exposure. Many Veterans claimed (and VA totally denied) Agent Orange or other herbicides were behind their chronic fatigue, vision loss, numbness, cancer, birth defects in their children, and a myriad of other health concerns. VA began receiving medical claims from Veterans alleging dioxin exposure at least as early as 1977, but, as
media coverage on the issue grew, so did the number of claims. At the time, only chloracne, a rare skin condition, had been scientifically linked to dioxin exposure. If Veterans claimed that contact with herbicides was the cause for any other illnesses, VA ultimately denied all their medical claims "due to the lack of scientific evidence."
However, VA did take some baby steps to address the issue, mostly because of Veteran pressure, some press coverage, and a determined Veteran's advocate named Maude DeVictor. In 1978, VA established an internal Agent Orange Registry and began conducting in-depth medical examinations for Veterans claiming they were exposed to Agent Orange. They also assigned “environmental health physicians” at each of their medical centers who were specifically tasked with gathering information related to chemical exposures. In 1979, they established the VA Advisory Committee on Health-Related Effects of Herbicides, and in the early 1980s, they also created the Agent Orange Projects Office, the Chloracne Task Force, the Data Analysis Task Force, and the Agent Orange Research and Education Office, each of which were tasked with studying various aspects of Agent Orange exposure among Veterans.
Under Congressional pressure, VA also launched multiple weak-kneed outreach efforts related to dioxin exposure. The Agent Orange Bulletin was launched in December 1980 and provided updates on Agent Orange activities for VA medical center staff. For Veterans themselves, VA released a 30-minute videotape titled Agent Orange: A Search for Answers, as well as pamphlet titled “Worried About Agent Orange?” which was distributed to all Veterans during their Agent Orange medical examinations. Both the videotape and pamphlet emphasized the fact that chloracne remained the only known medical condition directly attributable to herbicide exposure.
In November 1982, VA also introduced the Agent Orange Review, a recurring newsletter meant to keep Veterans up to date on the latest developments on Agent Orange research and policies. Even so, official VA policy still called for physicians in VA medical centers to refrain from prematurely attributing a Veteran’s ill-health to Agent Orange exposure until more concrete evidence proving association became available: VA physicians were prohibited from offering opinions on Agent Orange-suspected illnesses.
Multiple agencies, including VA, began publishing the results of dioxin-related studies throughout the 1980s. Most of these initial studies maintained that there was no link between dioxin exposure and long-term health problems, although it was difficult to prove which had Veterans had been exposed while in the service. In 1990, however, studies by the CDC and VA’s Advisory Committee on Health-Related Effects of Herbicides determined that non-Hodgkin’s lymphoma and soft tissue sarcomas among Vietnam Veterans were “at least as likely as not” connected to herbicide exposure.
VA’s secretary at the time, Edward J. Derwinski, was especially invested in the Agent Orange issue. The day after each of these studies were released, he classified each respective illness as service-connected for Vietnam Veterans. These classifications officially became law with the Agent Orange Act of 1991.
Upon the passage of the bill, Derwinski noted that “VA has [always had] one overriding goal in this area: providing, as best we can, the truth for our Vietnam Veterans about the effects of exposure to Agent Orange. Because, in our opinion, that is the goal of this fine legislation, we are pleased to offer our support.” Derwinki’s “open mind” on the Agent Orange debate was lauded by the public and members of Congress alike. Representative Thomas Daschle, who had previously been critical of VA efforts concerning herbicide exposure, commented that Derwinki’s “willingness to listen to Veterans, to reexamine the scientific evidence, and to give Veterans the benefit of the doubt has been crucial to the effort to redefine the federal government’s response to the Agent Orange problem.”
Still, neither Derwinki nor the VA moved on Agent Orange benefits until Congress shoved the 1991 Agent Orange Act down the VA's throat.
While many of the questions surrounding Agent Orange remained, the Agent Orange Act of 1991 was a turning point in providing Vietnam Veterans with needed care, and over the following decades, VA classified over a dozen additional conditions as presumptive for Veterans who were exposed to herbicides.
