List of Agent Orange-related diseases may expand

Patricia Kime, Military Times 3:38 p.m. EDT April 8, 2016

The Veterans Affairs Department is weighing whether to add several diseases to the list of health conditions presumed in Vietnam veterans to be caused by exposure to Agent Orange.

A VA working group is studying a report issued in March by the Institute of Medicine to determine whether bladder cancer, hypothyroidism and Parkinson’s-like symptoms — illnesses the IOM said may be more strongly linked to exposure than previously thought — should automatically make a Vietnam veteran eligible for VA disability benefits and health care.

According to Dr. Ralph Erickson, VA's chief consultant for post-deployment health services, the group will make a recommendations to VA Secretary Robert McDonald on whether the diseases should be added to a list of 15 already in place.

“We are in the midst of a deliberative process, carefully looking at all the IOM committee put in the report and additional information that has come out since,” Erickson said. “We will be putting tougher (together?) a VA response that will be brought before senior leaders and ultimately brought before the secretary.”

The process could take up to two years, a VA spokeswoman added.

Roughly 1 million Vietnam veterans are enrolled in the VA health system, according to the department. Based on a review of data for one year, 5,484 of these veterans have been diagnosed with bladder cancer, 15,983 suffer from hypothyroidism and an estimated 1,833 have Parkinson’s-like symptoms.

The working group also is looking into the role, if any, Agent Orange exposure has played in the development of hypertension in Vietnam veterans. According to VA, 307,324 Vietnam veterans in the Veterans Health Administration have high blood pressure.

“Hypertension has been a question that has been asked,” Erickson said. “The cohort of men and women who heroically served their country in uniform and went to Vietnam are in their 60s, 70s and 80s, and these individuals, merely because of their age, are starting to accrue chronic diseases that come with aging. It’s a delicate matter to tease out whether someone has hypertension because of their age or whether it would be related to an exposure to Agent Orange.”

VA began recognizing diseases associated with herbicide exposure in Vietnam beginning in 1991, naming 15 diseases as presumed to be related, including Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, early-onset peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers, soft-tissue sarcoma, chloracne, type-2 diabetes mellitus, light chain amyloidosis, ischemic heart disease, chronic B-cell leukemias, Parkinson’s disease, and spina bifida in offspring of veterans.

The most recent IOM report actually downgraded spina bifida in the children of Vietnam veterans, saying research does not support a previously held belief that the disease occurred in offspring of exposed veterans at higher rates.

But the change of spina bifida from "limited or suggestive evidence" it is related to exposure to “inadequate or insufficient” evidence should not affect disability payments to the 1,153 descendants of Vietnam veterans who receive them, Veterans Benefits Administration senior adviser for compensation services Brad Flohr said.

VA recommends that veterans who have an illness they believe is related to Agent Orange exposure file a claim; they are considered on a case-by-case basis if the illness is not on the presumptive condition list.

Should new diseases be added to the list, the regulation would go into effect 30 days after it is published in the Federal Register.

If a veteran dies of a condition determined to be a presumptive condition after the veteran’s death, VA will provide dependency and indemnity compensation benefits to eligible spouses, children and parents of that veteran.

Patricia Kime covers military and veterans health care and medicine for Military Times. She can be reached at pkime@militarytimes.com.

New Studies Not Needed- C-123 Agent Orange Benefits NOW!

Mention was made of a possible need for additional statistical or epidemiological studies of C-123 aircrews and maintenance personnel to better understand our dioxin exposure. The following note was submitted to two of the scientists who've looked into the situation:

Argument Against Time-Wasting Further Analysis:

A study could have been a good idea back in 1994 when the AF Museum/Brooks Armstrong Labs first identified the degree of toxicity on Patches. Studies could have been a good thing back in 1996 when, instead, the AF Office of Environmental Law directed that the info should "be kept in official channels only." In 1994 and 1996 most of us were still available to participate in a study, assuming enough veterans were existent to lend any accuracy to the study. It would have been decent...in fact, the only moral and legal decision, to alert our veterans so we could consider precautions and know to watch for AO-type symptoms. It would have been a better study if the veterans who've died before this problem was exposed in April 2011 had been able to participate - Lou Paskowitz, Paul Huffman, Bob Boyd, George Gadbois, Tim Olmsted, Warner Jones...all the others. 

I ask the VA and other government people to imagine what the public outcry would be if some large company exposed thousands of employees to dioxin (however innocently), learned about the exposure after the fact, and spent decades preventing notification of the affected employees...and even took steps to shred and smelt the evidence? This would be evening news headline matter...such criminal behavior would be meat for the grand jury! What would government employee unions do if workers had spent ten years inside a building with a 200-times greater risk of cancer due to dioxin exposure...and the government kept the information from them and even fought to prevent access to medical care when the news leaked? 

Imagine a whistleblower leaking an email in which managers labeled exposed employees "freeloaders", as our aircrews have been described by a VA consultant who has received support from the chemical industry for articles and served as an official of the Secretary of Defense office--he expressly cited the need to destroy the stored C-123s to prevent veterans' benefits from being awarded.

The last comprehensive study of contaminated aircraft at Davis-Monthan found half of the tested airplanes still hazardous in 2009 (nearly forty years after their last spray missions) except for short-term exposure!

It is flat-out unconscionable for VA to take any action that fails to recognize C-123 veterans' exposure NOW by citing cost, difficulty, small population or any other time-killer suggestion regarding further statistical or epidemiological studies, and unconscionable for VA to delay our care for the time to design, conduct, evaluate and obtain peer-review of such a study. Wasting still more time (what the Army veterans call "waiting for an Army to die") would obviously penalize the veterans by denying us essential medical coverage just so the VA could burn away a couple years for more studies followed by outside review of those studies.

The military completely failed to address the problem when it first surfaced, worrying only about the stored airplanes and avoiding EPA fines and bad publicity.Today, there can be no further failure of the AF or VA to promptly recognize our exposure to TCDD. There can be no further delay to conduct more "studies." Time enough is wasted in the VA application (FYI my own has gathered dust for 332 days so far.)

The studies have been done. The results have been validated by federal court, the GSA, the Air Force, the ATSDR and outside scientific experts. Crews and maintenance personnel were exposed to harmful amounts of dioxin....case closed!

The requirement for veterans (outside the Boots on the Ground Vietnam group) seeking service-connection for TCDD exposure is simply reasonable proof of exposure. That proof was developed in multiple tests by the Air Force, and substantiated by the GSA, federal court, ATSDR and reputable scientists. That proof has been offered, and substantiated, in spades!

We're not mad, but those of us still alive are sick as hell and we're not going to take it any more!