24 June 2013

(Received June 24 from the incoming Director of the Agency For Toxic Substances & Disease Registry)

Dear Major Carter,

Thank you for your email and warm welcome regarding my new acting position.  I have recently been briefed about ATSDR actions related to this situation.  I have also reviewed the ATSDR correspondence related to C-123 aircraft and I am in agreement with it.  I understand that the VA has already received our letters and that ATSDR staff have spoken with VA staff about your situation. 

The letter from ATSDR to General Hickey regarding exposures at Camp Lejeune was somewhat different.  We sent that letter after completing an extensive dose-reconstruction model of exposures to volatile organic compounds at Camp Lejeune.  We were obliged to notify the VA because they had been relying on out-of-date information previously generated by us. 

The limited, but high quality, sampling of C-123 aircraft that we reviewed in 2012 confirm that some post-Vietnam era C-123 aircraft were contaminated with TCDD dioxin.   All C-123 aircraft have since been destroyed.  Thus, it is no longer possible to further characterize human exposure pathways through additional sampling.  Without additional environmental sampling information, an official health consultation would not shed additional light on this situation beyond that provided in January 2012 and March 2013.  I understand that United States Air Force restricted entry into these contaminated planes once they were found to be contaminated.  ATSDR concurs with this position and believes it would also have applied to pilots and crew had these planes remained operational. 

I hope this email is helpful.  Thank you again for your service to our country.  

 Robin M. Ikeda, MD, MPH
Deputy Director, Noncommunicable Disease, Injury, and Environmental Health
Acting Director, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry
Centers for Disease Control and Prevention
4770 Buford Highway, MS F-39
Atlanta, GA 30341

From: Wes Carter [mailto:c123kcancer@gmail.com]
Sent: Monday, June 10, 2013 2:55 PM
To: Ikeda, Robin (CDC/ONDIEH/OD)
Cc: Sinks, Tom (CDC/ONDIEH/NCEH)
Subject: Opinion provided earlier by Dr. Sinks and Dr. Portier re: C-123 Agent Orange contamination and exposure

Dear Dr. Ikeda,

Congratulations on your assuming the helm at ATSDR. We are the C-123 Veterans Association, and in the past ATSDR has been very kind to provide opinions over the signatures of Dr. Sinks and Dr. Portier. These opinions confirmed our exposure to Agent Orange for the years we flew the C-123 medium assault transports used earlier in Vietnam for spraying Agent Orange.

Last week I visited with several senators and congressional representatives, as well as with Ms. Amanda Meredith and Mr. Steve Robertson of the Senate Veterans Affairs Committee. We have asked the assistance of both the staff director and the Republican General Counsel in approaching the Department of Veterans Affairs regarding our veterans' claims.

I was asked, and they also asked me, why the previous letters from ATSDR have been disregarded by the VA. In one instance, VA's Compensation Services summarized Dr. Sinks' opinion (without mentioning his conclusion that veterans were exposed) by appending the sentence, "In conclusion there is no conclusive evidence of long-term TCDD harm." In another, the Manchester NH Veterans Affairs Regional Office denied a veteran's claim by grouping Dr. Sinks' and Dr. Portier's findings in the unacceptable "lay evidence" category, and into that group also put the findings by the NIH and US Public Health Service. Dr. Linda Birnbaum is also very familiar with this issue, as is Dr. Jeanne Stellman at Columbia.

Similar official letters from ATSDR have been accepted by VA for Camp Lejeune, and we cannot understand why the VA rejects their merit here. Obviously the issue is critical for us, because most of our veterans are not retired military and not otherwise VA-eligible, so they are turned away when seeking care for typical Agent Orange illnesses by the VA hospitals.

The matter has recently reached the desk of Secretary Shinseki. May I again ask ATSDR's leadership in restating to the General the opinion that we were exposed, and if possible, in the form of an official health consultation? Reading the criteria for an official health consultation, it seems to fit the requirements. 

Because the C-123 contamination had been kept "in official channels only" by the Air Force until released via FOIA in 2010, we only recently began presenting claims to the VA, and in every instance the claims have been denied, and all those reaching the VA's Board of Veterans Appeals a year or more later have been overturned in favor of the C-123 veteran. At our age and with our illnesses, however, we need very much for appropriate decisions to be made on the initial claims, rather than years later in appeal. 

I hope we can continue to count on Dr. Sinks, you and the ATSDR for help.


Wesley T. Carter, Major, USAF Retired

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