(d)all the above, simultaneously
A. Both the VA and the AF reports which address C-123 aircrew dioxin incorrectly dismiss oral exposure to the dioxin which contaminated our C-123 aircraft, even though all aircrew must have had oral exposure from hands touching faces, eating aboard the aircraft, etc. In an approach new to science, and immediately criticized by recognized experts throughout the fields of toxicology and epidemiology, the AF and VA suggest that for the first time, contamination does not equate to exposure!
B. Both the VA and the AF reports incorrectly dismiss inhalation exposure to the dioxin which contaminated our C-123 aircraft. Although the 1979 and 1994 tests, among others, did not assess air samples, later tests did and showed only some C-123's contaminated enough to permit low-levels of inhalation exposure. Let's not forget (although both AF and VA reports ignore the fact!) that no air samples were taken until nearly forty years AFTER we started flying these aircraft...and air contamination must have been much more intense in the earlier years, even though both VA and AF ignored that fact.
C. Both the VA and the AF reports then incorrectly dismiss dermal exposure to the dioxin which contaminated our C-123 aircraft. Both agencies erroneously suggest that the skin is a near-perfect barrier to exposure...what the VA invented a new concept of "dry dioxin transfer" to address. But...
- no attention is paid by either agency to the fact that the C-123 had no sanitary facilities
- no attention is paid by either agency to the fact that aircrew, maintenance and aerial port personnel worked in a sweaty, oily, dusty environment, usually for long duty periods, without being able to wash
- no attention is paid to the fact that virtually every other scientfiic resource dealing with dioxin considers surface contamination to equal dermal exposure - because the skin is NOT a near-perfect barrier to dioxin as erroniously suggested by VHA
- no attention is paid in either agency's report to the fact that vibration while aloft greatly agitated dust particles and encouraged thereby inhalation, ingestion, and dermal exposure
- no attention is paid to the fact that aircrew worked in every area of the aircraft during missions
- no attention is paid to the fact that aircrew frequently slept overnight aboard the aircraft during tactical deployments
And a brand-new observation arises when we read peer-reviewed articles about dioxin, such as Dr John Doull's "Acceptable Levels of Dioxin Contamination in an Office Building Following a Transformer Fire, published by the National Research Council and cited by many subsequent writers, including Wade Weisman and Ron Porter as they conducted the 1994 contamination study of Patches at the Air Force Museum.
Doull makes the point that exposures can be cumulative, and can be simultaneous (dermal at the same time as inhalation and ingestion). If exposures are simultaneous such as while aboard the C-123, Doull states "the associated risks will increase by a factor of 2 with the assumption of a linear dose-response relation at low doses." Both the AF and VA reports ignore the fact of our simultaneous and cumulative exposure to dioxin!
The VA and Air Force reports dealing with C-123 dioxin contamination are faulty in many respects, most importantly because they clearly were written with the predetermined objective of dismissing any possibility of aircrew exposure. They are faulty also in their unscientific assumptions - and it is obvious that while every assumption made is to deny exposure possibility, no assumptions are made which admit that possibility. These reports ignored outside scientific experts, such as those at Columbia University and the Agency for Toxic Substances and Disease Registry, who already postulated that aircrews were "most likely" exposed. Thus we have one government agency (ATSDR) diametrically opposed to two others VA and AF).
The VA report on the C-123 was issued first, and the Air Force report then followed and piggy-backed on much of the VA material. The VA then re-issued their report citing the Air Force! Science does not progress when one report cites the other which cites the first! Absurd! Almost as absurd as Dr. Al's article in which he cites himself ten or twelve times in the recent AMSUS publication. There, he denies dioxin exposure issues by citing the authority of having previously denied it himself!
There is much to learn about C-123 aircrew exposure to dioxin as presented by the Veterans Administration and the US Air Force School of Aerospace Medicine. Unfortunately, these two reports are too slanted to take on their face and subsequent peer-reviewed articles can be expected to correct their deficiencies.