15 February 2012

Columbia University - Expert Support for C-123 Agent Orange Exposure Claims!

Here is the text for the recent letter of Independent Scientific Opinion received from Columbia University's Mailman School of Public Health. It directly challenges the VA's November claims against us, and validates the 1994 Patches study as well as making the vital conclusion: we were exposed to dioxin! (Bold face emphasis added by webmaster)
News received today: staffers from the Senate Veterans Affairs Committee will be meeting with senior leaders from the Agency for Toxic Substances and Disease Registry late February to discuss the ATSDR's challenging response to the VA's C-123 position (that crews weren't exposed.) We owe much to Senator Burr's staff, particularly Mr. Brooks Tucker, himself a combat veteran.
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February 7, 2012 
Wesley T. Carter (Major, retired)    
Dear Major Carter, 
I am writing this letter in response to your request for assistance in 
establishing evidence of likely exposure to Agent Orange and other military 
herbicides during your years of service as a crew member on C-123 “Provider” 
aircraft. A large number of the Provider aircraft on which you flew had previously 
been used for herbicide missions in Operation Ranch Hand in Vietnam. They 
returned from Vietnam heavily contaminated with herbicide residues.  Indeed, 
their contamination levels were so great that, as a final resolution to the 
contamination problem, it is my understanding that the aircraft were shredded by 
the Air Force in order to avoid further exposure of either military personnel or 
civilians. 
In my opinion, there is every likelihood that you would have been exposed 
to both airborne herbicides and their contaminants, as well as come into contact 
with surfaces contaminated by these toxic substances. In my opinion, the extent 
and manner of exposure is analogous to that experienced by many Vietnam 
veterans, with service in-country.  Such in-country Veterans are eligible for Agent 
Orange-related compensation should they develop a disease that the VA deems 
to be related to such exposures.  My further understanding is that you have 
developed one or more eligible conditions and thus, in my opinion, you should 
qualify for appropriate compensation, just as if you were an in-country Vietnam 
veteran. 
I feel well qualified to render this opinion.  I have extensive experience in 
evaluating exposure opportunity arising from military herbicide exposures.  I 
served for nearly a decade as the Exposure Consultant to the Special Master for 
the Eastern District Court’s Agent Orange Veterans Payment Program.  I was the 
Principal Investigator of the National Academy of Sciences contract for a $5 
million dollar study on developing a methodology for evaluating exposure to 
herbicides in Vietnam. The funding for this study was from the Veterans 
Administration.  My methodology has been strongly endorsed by the Institute of 
Medicine in three separate major published reviews. I am currently the exposure 
consultant on several federally funded health studies that involve evaluating 
herbicide exposures. I have recently been appointed by the Province of Ontario 
to a special panel to evaluate the historical use of 2,4,5-T in the province.  My 
work on military herbicides and other occupational and environmental health 
issues has been widely published and cited in prestigious peer reviewed journals.  
My professional expertise has been recognized in the academic community, as 
well.  I am Professor Emerita and Special Lecturer at Columbia University and 
since 2007 I have also held the position of Professor of Environmental and 
Occupational Health Sciences at the SUNY-Downstate Medical Center in 
Brooklyn N.Y. 
In order to render this opinion, I have carefully examined several scientific 
studies of contamination of C-123 aircraft that had been deployed to Vietnam in 
Operation Ranch Hand, as well as technical guidance documents issued by the 
Department of Defense with regard to indoor and surface contaminants.  I am 
also relying on my extensive research of existing records of herbicides used and 
their consequent exposures in Vietnam (see for example, 1).  
In my opinion, it is highly likely that you and other crew members were 
exposed to the herbicides and to their highly toxic contaminant, 2,3,7,8-
tetrachlorodibenzodioxin (dioxin, for short), although it is not possible to estimate 
the precise levels of exposure because of the failure of the Air Force to carry out 
proper assessments of contamination levels prior to assigning the contaminated 
aircraft to post-Vietnam military operations.  I base my opinion on several sets of 
measurements that were eventually carried out by United States Air Force 
technical personnel (references 2 and 3). The 1979 Air Force air samples clearly 
establish that the herbicides were airborne and hence could be inhaled. The 
1994 wipe samples of surface residues show that the levels of dioxin present 
greatly exceeded the maximum recommended levels of exposure set in the 
technical guidance provided by the U.S. Army Center For Health Promotion And Preventive Medicine regarding potential exposure to indoor contaminants  
(reference 4 ). The Agency for Toxic Substances and Disease Registry concurs 
in this opinion (reference 5). 
I have reviewed the Veterans Administration website (reference 6), which 
states: “VA has concluded the potential for long-term adverse health effects from 
Agent Orange residues in these planes is minimal. Even IF crew exposure did 
occur, it is unlikely that sufficient amounts of dried Agent Orange residue could 
have entered the body to have caused harm.”  The VA further states “But in the 
dry form – for example, adhered to a surface – Agent Orange residue cannot be 
inhaled or absorbed through the skin, and would be difficult to ingest.”  These 
statements, to be blunt, are technically flawed and show insufficient 
understanding of surface contamination and its potential toxic effects, 
as well as of the various routes of entry of toxic substances. The VA 
statements appear to have been made without knowledge of standard 
practice for assessment of contaminated surfaces and uses terminology,
like “dried Agent Orange residue,” that does not reflect insight into the 
nature of surface contamination.  The VA also states “Crew members had reported smelling strong odors but these odors may be attributed to various chemicals associated with aircraft. TCDD, the contaminant in Agent Orange, is odorless.”  In fact, the investigations carried out by the Air Force, following the crew complaints 
of odors, showed measureable quantities of the military herbicides in the air. (See reference 2.) There is no requirement that dioxin be the only exposure that qualifies for compensation.  


Indeed, nothing more than the 1979 measuresments are needed in order to 
establish that crew that flew the C-123 Provider aircraft were likely to have been 
exposed to military herbicides. 
The inconsistency in the VA’s policy with respect to military herbicide 
exposures is not defensible.  No minimal levels of exposure to herbicides have 
been set for veterans who served in-country, Vietnam and exposures have NOT 
been limited to dioxin. 
Please let me know if I can be of further assistance. 
      Sincerely, 
     (signed)
References cited 
                                                

1
 Stellman, JM, Stellman, SD, Christian RC, Weber, TW and Tomasallo, C. The extent 
and patterns of usage of Agent Orange and other herbicides in Vietnam. Nature,422, 
681-687, 2003
2
  Conway, William W. Aircraft Sampling Westover AFB MA. Technical Report 79-59. 
USAF Occupational & Environmental Health Laboratory. Brooks AFB TX. September 
1979. 
3
 Weisman, WH and Porter, RC. Consultative Letter AL/OE-CL-1994-0203, Review of 
Dioxin Sampling Results from C-123 Aircraft, Wright-Patterson AFB, OH and 
Recommendations for Protection of Aircraft Restoration Personnel. USAF, Armstrong 
Laboratory, Brooks AFB, TX.  19 December 1994. 
4
 U.S. Army Center For Health Promotionand Preventive Medicine.  Technical Guide 312 
Health Risk Assessment Methods and Screening Levels for Evaluating Office Worker 
Exposures to Contaminants on Indoor Surfaces Using Surface Wipe Data. June 2009 
(http://phc.amedd.army.mil/topics/envirohealth/hrasm/Pages/EH RAP _ 
TechGuide.aspx) 
5
 Sinks, Thomas. Official Correspondence to Wesley T. Carter. Agency for Toxic 
Substances and Disease Registry (ATSDR).  Atlanta GA. January 25, 2012. 
6
 http://www.publichealth.va.gov/exposures/agentorange/residue-c123-aircraft.asp 

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