VA Disability Compensation: Dioxin & Ischemic Heart Disease Statement by Dr Linda Birnbaum

Statement by
Linda S. Birnbaum, Ph.D., DABT, ATS
Director
National Institute of Environmental Health Sciences
National Institutes of Health
Director, National Toxicology Program
Department of Health and Human Services

on
VA Disability Compensation: Presumptive Disability Decision-Making 

before
Committee on Veterans’ Affairs
United States Senate

Thursday September 23, 2010 (note: updated June 2013)

Mr. Chairman and distinguished members of the Committee—I am pleased to appear before you today to present testimony on the relationship between dioxin exposure and the risk of ischemic heart disease. My name is Linda Birnbaum; I am the Director of the National Institute of Environmental Health Sciences (NIEHS), of the National Institutes of Health, an agency of the Department of Health and Human Services, and Director of the National Toxicology Program (NTP), an interagency program, housed at NIEHS, whose mission is to evaluate agents of public health concern by developing and applying tools of modern toxicology and molecular biology. The program maintains an objective, science-based approach in dealing with critical issues in toxicology and is committed to using the best science available to prioritize, design, conduct, and interpret its studies.

Understanding the role that environmental and occupational exposures play in the development of chronic diseases can be challenging, particularly for diseases that have significant risk factors in addition to the chemical exposure. Thus, the task of estimating the quantitative role of Agent Orange and dioxin exposure in the development of ischemic heart disease in Vietnam Veterans is clouded by the contributions of other risk factors such as age, smoking, family history, body mass index, serum lipid concentrations, and other factors. In 2008, my colleagues and I published a systematic review that evaluated the evidence of an association between dioxin exposure and cardiovascular disease mortality in humans.¹ We found that the studies in the highest-quality group found consistent and significant dose-related increases in ischemic heart disease mortality and concluded that there is an association between dioxin exposure and mortality from ischemic heart disease and cardiovascular disease.