01 October 2011

Agent Orange & Type 2 Diabetes

Vietnam veterans (and others like us with established exposure to dioxin) with type 2 diabetes are eligible for disability compensation from the Department of Veterans Affairs (VA) based on their presumed exposure to Agent Orange or other herbicides. In 2000, the VA added type 2 diabetes to the list of "presumptive diseases associated with herbicide exposure." That action followed a report from the National Academy of Sciences that found "limited/suggestive" evidence of an association between the chemicals used in herbicides during the Vietnam War, such as Agent Orange, and type 2 diabetes.
The evidence of a link between exposure to Agent Orange (or dioxin, the problematic contaminant in Agent Orange) and diabetes is modest. Most of the association between Agent Orange and diabetes comes from studies of people who lived near or worked at manufacturing plants that produced large quantities of Agent Orange dioxin. In those cases, there appears to be some relationship between Agent Orange exposure and increased insulin resistance, the precursor to type 2 diabetes. In general the exposure that Vietnam veterans had to Agent Orange was much less than in the populations studied by scientists. Still, the VA has added diabetes to the list of conditions for which Vietnam veterans are eligible for disability compensation.

What is Agent Orange and what is dioxin?

Agent Orange was a herbicide used in Vietnam to kill unwanted plants and to remove leaves from trees which otherwise provided cover for the enemy. In the 1970s some veterans became concerned that exposure to Agent Orange might cause delayed health effects. The concern about Agent Orange focuses not on the active ingredient, an herbicide with little or no effect on animals, but on a trace contaminant in the herbicide, dioxin. Studies have shown that dioxin and dioxin-like compounds (DLCs) can cause a variety of illnesses in laboratory animals. More recent studies have suggested that the chemical may be related to a number of types of cancer and other disorders.
In 1978, the Veterans Administration set up the Agent Orange Registry health examination program for Vietnam veterans who were concerned about the possible long-term medical effects of exposure to Agent Orange. Vietnam veterans who are interested in participating in this Agent Orange program should contact the nearest VA medical center for an examination.
Veterans who participate in the Agent Orange examination program are asked a series of questions about their possible exposure to herbicides or Agent Orange in Vietnam. A medical history is taken, a physical examination is performed, and there is a series of basic laboratory tests. If medically required, consultations with other health specialists are scheduled. However, no special Agent Orange tests are offered since there is no test to show if any individual veteran's medical problem was caused by Agent Orange or other herbicides used in Vietnam. There are tests that show body dioxin levels, but such tests are not done by the VA because there is a serious question about their value to veterans. The VA simply makes a presumption of Agent Orange exposure for Vietnam veterans.
In its 1994 report on Agent Orange, the National Academy of Sciences (NAS) concluded that individual dioxin levels in Vietnam veterans are usually not meaningful because of background exposures to dioxin, poorly understood variations among individuals in dioxin metabolism, relatively large measurement errors, and exposure to herbicides that did not contain dioxin.

Benefits of the Agent Orange examination

The veteran is informed of the results of the Agent Orange 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 reveal previously undetected medical problems. These discoveries permit veterans to get prompt treatment for their illnesses. Some veterans feel 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 problems can be reassuring or helpful to Registry participants. All examination and test results are kept in the veteran's permanent medical record. These data are entered into the VA Agent Orange Registry.
Vietnam veterans can get medical treatment for Agent Orange-related illnesses. Under Section 102, Public Law 104-262, the Veterans' Health Care Eligibility Reform Act of 1996, the VA shall furnish hospital care and medical services, and may furnish nursing home care to veterans exposed to herbicides in Vietnam. There are some restrictions. The VA cannot provide such care for a 1) disability which VA determines did not result from exposure to Agent Orange, or 2) disease which the NAS has determined that there is "limited/suggestive" evidence of no association between occurrence of the disease and exposure to a herbicide agent.
The VA pays disability compensation to 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, the VA must determine that the disability is "service-connected." A Veterans Services Representative, at a VA medical center or regional office, can explain the compensation program in greater detail and assist veterans who need help in applying. For more information about the VA's Agent Orange Program, call the toll-free helpline 1-800-749-8387. For disability compensation program information, call toll-free 1-800-827-1000.
Other Resources
The National Veterans Legal Services Program provides legal services to veterans on matters relating to their service and has further information on the VA's benefits regarding Agent Orange on their website.
Additional information on how the VA is handling Agent Orange claims can be found at http://www.va.gov/agentorange.
The National Academy of Sciences report on Agent Orange and diabetes can be found at http://www.nap.edu/catalog/9982.html.

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