C-123 Post-Vietnam Aircrew and Maintainers: Agent Orange Exposure CONFIRMED by IOM!

Exposure CONFIRMED! Last hurdle overcome!

In a clear message to the VA and USAF, yesterday the Institute of Medicine dismissed any questions of C-123 post-Vietnam Agent Orange exposure with their press release announcing conclusion of a year-long investigation. IOM confirmed the post-Vietnam exposures of C-123 aircrews and maintenance personnel in their VA-sponsored research.

This is a game-changer as VA has stated, through Under Secretary Allison Hickey, that whichever way the IOM report recommended the VA would likely follow. VA executives were briefed on Thursday and the IOM released their C-123 investigation to the public, legislators and the press on Friday. Following the report's presentation, VA leaders said staff was already working on the implications of the IOM's finding and details were being resolved.

The VA has been hit hard this last year, which with justification will be remembered as the year of the scandals. This is a scandal resolved, through the efforts of the scientific community )to include IOM as well as the independent scientists and physicians who continued to reveal the basis for C-123 veterans' exposure claims,) and VA staff which opened the door and their hearts with determination to resolve this mess.

So the resolution is on its way. We should see changes in VA web pages, communication from VA to their staff, press releases from VA on its views regarding the IOM report, and we hope...claims being released from the current suspended status ordered for all such claims.

Let's hope this is as much as win-win as it seems. In my mind, it leaves all involved a solid justification for feeling their duty to America's veterans has been satisfied. Congratulations!

Current Status - Institute of Medicine C-123 Agent Orange Exposure Committee

Actually, the full name just doesn't quite flow off the tongue, nor is it easily typed...I always have to look it up: Committee to Evaluate the Potential Exposure to Agent Orange/TCDD Residue and Level of Risk Adverse Health Effects for Aircrew of Post-Vietnam C-123 Aircraft."

They've been meeting and working very hard since the spring and apparently are about finished with their draft copy, according to the cryptic summation of the recent committee teleconferences. Once the draft is complete, it begins another process before reaching the Secretary of Veterans Affairs:

• Prior to release, report is reviewed by individuals who are not involved in authoring the report and whose names are not revealed to the committee or the study director during review.
• Reviewers are selected by the major unit responsible for the project, in consultation with the National Academy of Sciences’ Report Review Committee.
• The review is overseen by a review monitor and/or coordinator.
• Each committee must respond to, but need not agree with, reviewer comments in a detailed “response to review” that is examined by the monitor and/or coordinator, who ensure that the report review criteria have been satisfied.
• The report may not be released to sponsor or the public until the chair of the Report Review Committee (or designee) signifies that the review process has been satisfactorily completed.
• The Department of Veterans Affairs will not be given an opportunity to suggest changes in the report.
• The names and affiliations of the report reviewers will be made public when the report is released.

The second bullet could be fatal: VA, as the "major unit responsible" will select reviewers already determined to prevent C-123 exposure claims, so whatever pro-C-123 exposure conclusions will be severely challenged, and whatever anti-C-123 exposure conclusions will be amplified. So whatever the committee itself recommends will be amended in some way at this point to a position more acceptable to the VA's Post Deployment Health Section. And you can bet they've already got their reviewers picked out! Only when its released and too late to be challenged, are the reviewers identified and in any case, nobody sees the committee's draft, or original version.

Remember: VA did not refer this to the IOM because there is any scientific question that we've been exposed. They referred it, and worded the charge to the committee, to create a basis for continuing to deny all C-123 exposure claims even though each C-123 veteran with an Agent Orange-recognized illness is presently legally entitled to presumptive service connection.

A strong point still in our favor is a fundamental IOM rule: In reaching consensus about an association between exposure and health effects, the Committee considers only peer-reviewed, published scientific literature. The committee also realizes that this group of veterans was never tested at any time for dioxin, and that VA rules for the Agent Orange registry actually prohibit such tests.

The committee realizes that our C-123s are unique in that they were tested to be contaminated – "highly contaminated," in the words of the toxicologists, long after we'd retired them to storage. No other such situation...boats, ships, tanks, trucks, helicopters...was ever determined to be contaminated as were our C-123s. "A danger to public health" as AF toxicologists offered in sworn testimony in 2000. And then, all aircraft destroyed as toxic waste, with special note made for this to be done because exposed vets would seek their exposure benefits.

The material gathered by the VA for IOM, including from its $300,000/year Agent Orange consultant and the Dow/Monsanto sponsored letters, was never peer reviewed. Of course, many other documents submitted to the IOM by the VA and the veterans weren't peer-reviewed, either.

And the only peer-reviewed scientific literature available which directly addressed the situation was Lurker, et. al. "Post-Vietnam Military Herbicide Exposures in UC-123K Agent Orange Spray Aircraft."

The committee is doing what it has to. We asked them also to exercise their independence and address the yes/no question of exposure.

We'll wait and hope for the best.We'll look forward with great hope to the end of September or, if delayed, maybe sometime in October bringing us the IOM report.

C-123 Exposure & Health Studies Withheld by USAF in Defiance of Freedom of Information Act

Subject: August Release of Freedom of Information Act materials by the USAF Surgeon General's Office – USAF Defied the Law But Accidentally Let Vital Information Leak*

The C-123 Veterans Association had requested information about the May 2012 USAF C-123 Consultative Letter and how its conclusions were reached, and details about the scientific studies performed. Nothing secret, nothing personal. Stuff we're entitled to!

Instead, the USAF released two sets (Release One and Release Two) of documents last Friday, each a duplicate of the other, and each redacted past the point of honesty and respect for the law. The only information not redacted was an irrelevant EPA document on radiation assessment....nothing was revealed about the C-123 study of post-Vietnam exposures.

What the heck? President Obama assured the American people on his first public act that a citizen's right to access to information is "a fundamental element of American democracy." The Air Force, perhaps, missed that press release, and also the one where the President ordered Federal agencies to be as open as possible.

Here, in their response to my 2012 FOIA request, and to my October lawsuit filed in the US District Court of Washington DC, the Air Force sent me blank pages, devoid of meaning. Remember – these are publicly-funded studies by the USAF Surgeon General's Office and the USAF School of Aerospace Medicine, about whether or not 2100 veterans were exposed to Agent Orange. Further, the Air Force study is the foundation of the VA refusal to permit a single C-123 veteran's Agent Orange claim to be considered. So...VA refused to permit us to have our cancers treated because of a secret Air Force study...not classified in any way, but still hidden from public view, and denied us as we seek VA benefits, by the USAF Surgeon General.


What arrogance and abuse of discretion. This "Freedom" of Information Act response was anything but freedom! Virtually every line of every page released was redacted, denying C-123 veterans access to USAF School of Aerospace Medicine in May 2012.
the studies completed about our Agent Orange exposure by the Air Force after they agreed to look into our concerns with scientific integrity. That study, however, failed to meet the true definition of scientific integrity, with command interference, unnecessary JAG interventions, and close cooperation with the VA but not with CDC/ATSDR nor NIH.

The AF C-123 study meekly concluded that individual exposure assessments were impossible, but then illogically also concluded that because of that impossibility, the C-123 veterans were probably not exposed to harmful amounts of Agent Orange. What an amazing twist of logic!

* But there was a single paragraph, truly golden hidden among the pages of white, a paragraph that they missed redacting and which perfectly explains our eligibility for Agent Orange exposure care:

"USAFSAM concludes that there is not enough data to evaluate or model individual exposures and performing an epidemiological investigation would not be possible.   They then looked at the results that were available from a general population and occupational perspective and conclude that although dried residuals of dioxins were present, the exposures to anyone encountering the Aircraft either occupationally or from the general public should be within the exposures experienced by the Ranch Hand personnel that were exposed in Vietnam.   The Air Force conducted an extensive epidemiological study of the Ranch Hand personnel (referred to as the Air Force Health Study) and to date the results do not provide evidence of disease in the Ranch Hand veterans caused by elevated levels of exposure to Herbicide Orange."

Read the paragraph's middle carefully, especially the fact that USAFSAM considered post-Vietnam C-123 exposures

"within the exposures experienced by the Ranch Hand personnel that were exposed in Vietnam." That confirms our exposure which is the only issue under the law to be eligible for Agent Orange illness care and benefits. The exposures were not hypothetical, not imaginary, not remotely possible...but "within the exposures experienced by Ranch Hand." There was no conclusion that we were not exposed, only that harm had yet to be proven by the exposures.

The USAFSAM study illogically concluded that because the Ranch Hand spray veterans have not evidence elevated illnesses, then the C-123 veterans must not be harmed either.

The logic failure is in failing to note that post-Vietnam C-123 vets were never tested, as was the Ranch Hand population. Further, our exposures were long term/low dose exposures, and over a ten year period versus a Ranch Hand eleven month tour in Vietnam. We were older, with more women, and during the decade we flew our sick crew members were removed from service when they presented developing Agent Orange illnesses, such as cancers, diabetes, and IHD.

Both groups of aircrews remain distinct from the "general population" in that we had flight physicals, everyone was a high school graduate (or more) if enlisted and a college graduate if commissioned. We had enlistment or commissioning physicals, which separated many who were already ill, used illicit drugs, had significant arrest records, or who did not meet education, physical or mental requirements. We had excellent medical and dental care, constant drug testing, weight control, excellent prospects of post-military graduate education and employment, and in so many ways were healthier and fortunately likely to stay healthier than the general population, Agent Orange issues not withstanding.

Conclusion: both Ranch Hand and post-Vietnam aircrews should be in better health than their contemporaries, and it seems they are. But, the overall group of Vietnam veterans, a large enough population for meaningful epidemiological studies, continues to show the ravages of Agent Orange-releated diseases.

VA even prohibits the kind of testing on us for the presence of dioxin which the Ranch Hand vets have had for decades. Ranch Hand remains the only studied population, one made up of under 2,000 veterans, similar in size to the post-Vietnam C-123 group of about 2,100. Both, too small for meaningful examination. Which is why Congress, in frustration with VA foot-dragging, simply directed with the 1991 Agent Orange Act that all Vietnam veterans, and those veterans able to prove their exposure to Agent Orange, will be treated for recognized illnesses.

Three times the VA "more clearly" explained the agency's policy toward non-Vietnam Agent Orange exposures in the Federal Register. VA stated that exposed veterans would receive the same presumptive service connection for recognized Agent Orange illnesses, providing exposure itself was established. We've done that.

As can be read above, the Air Force established our exposure. ATSDR confirmed the exposure, as did the NIH/National Institute of Environmental Health Sciences and the US Public Health Service. There is a pro-veteran requirement in the VA claims process....we'd like to see some!

USAF and VA: A great partnership in denying responsibility along with denying medical care for the harm done.

By the way, below is an example of the Air Force perspective on what they feel veterans are permitted to see in military studies about us, paid for by the public, requested by the veterans. It is the first page of what AF sent out last week following two years of our actions to compel release of material which should be in the public domain: