C-123 & Blue Water Navy: Similar IOM Experiences

C-123 veterans, families and friends are looking forward to the release of the Institute of Medicine C-123 report on January 9 at 11:00 AM in Washington, D.C. The report heavily influences whether or not the Department of Veterans Affairs will permit C-123 veterans to be admitted to VA hospitals for treatment of Agent Orange illnesses associated with their decade flying these former Agent Orange spray aircraft.

The only parallel to this situation is that of the "Blue Water Navy" where deep-water vessels' crews claimed Agent Orange exposure and IOM conducted a study after VA disqualified this group of veterans from "presumptive service connection" for which they'd previously qualified.

Looking over the Blue Water Navy and IOM, we see three events similar to how C-123 veterans have experienced. First, the VA issues a "charge" to the Institute of Medicine. This is a contract with objectives spelled out. The language of the charge is very carefully considered by the VA's Post Deployment Health Section as they seek to guide IOM to specific conclusions and not permit a more comprehensive or wide-ranging response. Second is the announcement by IOM of their findings, and third, the basic analysis of the VA, formed as closely as possible to VA's desired policy objectives.

Below are these three fundamental parts of the process, experienced by the Blue Water Navy veterans and likely to be the same process ahead for C-123 veterans. Veterans hope IOM's report will support our claims for service connection due to proven exposures.  Opposing them, as they have for years via other maneuvers, VA leaders hope the report will dismiss veterans' claims for Agent Orange exposures or at least provide some leeway, call into question, or offer some loophole permitting VA to continue refusing medical care to these veterans seeking care for Agent Orange-caused ailments.

The 9th of January will be an important day, and one we hope not as painful as was the IOM Blue Water Navy report for those worthy veterans! 

From another vet group's editorial addressing IOM's earlier review of Gulf War concerns:

"A final note -- while the IOM may claim it was just doing its job as mandated by the VA, that's not good enough, not for an institution that is part of the National Academies, which calls itself "Advisers to the Nation on Science, Engineering and Health." IOM could just as easily have read their Civil War-era Congressional mandate and told the VA that its request was not in accordance with IOM's mission nor with questions the nation needed answered. 

IOM could and should have informed VA science and the nation's needs would not be confined to the VA's policy-directed "charge," so cleverly phrased by VA to guide IOM to a pre-determined VA objective.

In fact, why didn't they stand up for good science? IOM says it advises "the  nation." 

The nation is not the VA -- the nation is veterans. The nation is not the CDC -- it's families and individuals coping with an autism epidemic. And the nation is certainly not the federal government -- the nation is the people who elected that government to protect and defend them; it's you and me. 

Sadly, IOM is not meeting objectives set forth in the law signed by Abraham Lincoln in 1863. Rather, IOM now meets objectives set by VA policy makers with only a sprinkling of scientific flavoring."

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ONE: The VA Charge to the IOM

Blue Water Navy Vietnam Veterans & Agent Orange Exposure

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Type:	Consensus Study
Topics:	Veterans Health, Environmental Health, Select Populations and Health Disparities
Board:	Board on the Health of Select Populations

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Activity Description

The IOM will conduct a study and prepare a report on whether the Vietnam Veterans in the Blue Water Navy experienced a comparable range of exposures to herbicides and their contaminants (focus on dioxin) as the Brown Water Navy Vietnam Veterans and those on the ground in Vietnam (i.e., specifically with regard to Agent Orange exposure).  The IOM's report is expected to include:

1.    An historical background on:  the Vietnam War; Combat troops (ground troops); Brown Water Navy (includes inland waters); Blue Water Navy; VAO legislation

2.    A discussion of exposures (Blue Water Navy in comparison with ground troops in Vietnam): specifically compare exposures on ground with those on ships (discuss all possible routes of exposure); and examining the range of exposure mechanisms for herbicide exposures (i.e., concentrating toxics in drinking water; air exposure possibly from drift from spraying; food; soil; skin.

3.    A determination, if possible, of the comparative risks for long-term health outcomes comparing Vietnam veteran ground troops, Blue Water Navy veterans, and other "Era" veterans serving during the Vietnam War at other locations (given the possible dioxin exposure).

4.    A review of studies of Blue Water Navy veterans for health outcomes (assuming there are studies specific to that cohort of veterans).

For more information

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TWO: IOM report and press release

Blue Water Navy: 

Veterans’ Risk of Agent Orange‑Related Health Problems Unclear

Released: 5/20/2011

From 1962 to 1971, the U.S. military sprayed herbicides, including Agent Orange, over Vietnam. Exposure to these chemicals is associated with several cancers and a variety of other health problems. The Agent Orange Act of 1991 established that veterans with any of the diseases linked to Agent Orange were presumed exposed during their service, and therefore could claim disability. The law saved veterans from the often impossible task of proving they were exposed to Agent Orange during their service. However, the Department of Veterans Affairs (VA) only compensates veterans who served on the ground or on inland waterways in Vietnam. The “Blue Water Navy”—those who served on deep water vessels—are not automatically eligible for disability benefits.

In response to a growing concern from Blue Water Navy Vietnam veterans that they may have been exposed to Agent Orange during the war, the VA asked the IOM to examine whether the exposure to Agent Orange of Blue Water Navy veterans was similar to the exposure of other Vietnam veterans. Although the IOM found several plausible ways by which Blue Water Navy veterans could have been exposed to herbicides, there was not enough information for the IOM to determine whether Blue Water Navy personnel were or were not exposed to Agent Orange.

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THREE: VA announcement of report w/VA perspective:

Institute of Medicine Report on Agent Orange Exposure

VA asked the National Academy of Sciences' Institute of Medicine (IOM) to review the medical and scientific evidence regarding Blue Water Veterans’ possible exposure to Agent Orange and other herbicides.

IOM’s report Blue Water Navy Vietnam Veterans and Agent Orange Exposure was released in May 2011. The report concluded that "there was not enough information for the IOM to determine whether Blue Water Navy personnel were or were not exposed to Agent Orange."

- See more at: http://www.publichealth.va.gov/exposures/agentorange/locations/blue-water-veterans.asp#sthash.mSYMHdKx.dpuf