Blue Water Navy Study Supports C-123 Dixon Exposure Claim!

The most recent literature regarding Agent Orange issues accepted by the Department of Veterans Affairs is the Institute of Medicine “Blue Water Navy Report” released this year. The relevant part of that report, as it affects C-123 crews, is its premise that:

“the potential for exposure is the best—in fact, the only—available method for assessing and comparing exposure.” (p.89)

 This clearly establishes that service in an aircraft, vehicle or vessel identified by the Air Force as (not potentially, but actually) heavily contaminated with Agent Orange is considered adequate scientific evidence of exposure to Agent Orange. 

Our exposure to dioxin aboard our aircraft was via inhalation, ingestion and dermal contact.

It is also very important to note that unlike Vietnam veterans and Blue Water Navy sailors and the impossibility of testing their actual field conditions and shipboard exposure, we flew aircraft which were individually and repeatedly tested and confirmed by Air Force toxicologists as “extremely contaminated, extremely hazardous and extremely dangerous,” with dioxin contamination 800% greater than federal law permits for building re-entry. 

Toxicology experts have set the building re-entry standard as 85 nanograms per square meter surface area—it was 615 nanograms per square meter inside the first C-123K tested in 1994 (Patches, Tail #362, at the Air Force Museum). We flew Patches and the others for years. Again, not merely potential, but actual exposure.

My own doctor's Prostate Cancer-Agent Orange Study!

I am fortunate to be treated by Dr. Mark Garzotto, who is on staff at both the Portland VA Hospital and the Oregon Health Sciences University. Yesterday, in the afterglow of yet another biopsy, he shared with me his recent article on prostate cancer and Agent Orange. Dr. Garzotto yesterday confirmed he makes no distinction between Vietnam War veterans and those otherwise exposed to Agent Orange!
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June 8, 2011 -- Veterans of the Vietnam War may require more tailored prostate-cancer screening strategies because of Agent Orange exposure, researchers stated here at the 2011 Annual Meeting of the American Society of Clinical Oncology (ASCO).

Agent Orange, a defoliate contaminated with the known carcinogen dioxin, is a serious concern for Vietnam War veterans, and exposure may be associated with a 74% increase in risk of high-grade prostate cancer (HGPCa). The investigators found there was a unique effect on the risk of HGPCa when they looked at Agent Orange exposure, with no significant increase in risk of low-grade prostate cancer.

“Asking our patients if they had Agent Orange exposure may be the most important question you can ask,” explained investigator Mark Garzotto, MD, Oregon Health & Science University, Portland, Oregon, speaking here on June 5. “We typically ask about race and family history, but the thing that was interesting was that if they had Agent Orange exposure, then they had high-grade prostate [cancer].”

“Race and family history are not necessarily tied to grade, and we found that Agent Orange is a marker for lethal prostate cancer,” Dr. Garzotto added.

These veterans are now reaching the age at which prostate cancer is most prevalent. Recent studies suggested that Agent Orange exposure was associated with nearly a 50% increase in the risk of prostate cancer. It was unknown, however, whether Agent Orange exposure increased risks for more a more aggressive phenotype of prostate cancer.

Dr. Garzotto and colleagues examined 2,720 veterans who underwent prostate biopsy, and found that 896 (32.9%) had prostate cancer and 459 (16.9%) had HGPCa. After adjusting for significant confounders, including prostate-specific antigen density, digital rectal examination and age, men with HGPCa were more likely to have had Agent Orange exposure as compared with those with low-grade prostate cancer or no prostate cancer.

This study is one of the largest ever to examine this issue; the results, if validated, could aid in the development of effective prostate-cancer screening strategies for Vietnam-era war veterans.

“It has been a little bit controversial,” Dr. Garzotto commented in an interview with Doctor’s Guide. “Many of the studies, if not all of them, were done with relatively small numbers of patients or done with men at [an] age when they were not likely to develop it.”

[Presentation title: Agent Orange as a Risk Factor for High-Grade Prostate Cancer Detected on Initial Prostate Biopsy. Abstract 4667]

Challenge to VA Position on C-123 Dioxin Contamination

Dr. Fred Berman, Director of the Toxicology Information Center at Oregon Health Sciences University has been carefully looking into the issue of aircrew dioxin exposure aboard the C-123 during the post-Vietnam War years of 1972-1982. After listening to the VA's response to our concerns and the VA position that crews somehow weren't exposed, he and his associates conducted an extensive literature search (described below) and were unable to find any research supporting the VA hypothesis. Indeed, they found exactly the opposite, citing a 2004 study entitled "Surface dust criteria for dioxin and dioxin-like compounds for re-entry to buildings." Basically, this study showed that the C-123 was about 500% MORE contaminated with dioxin than would be permitted in buildings after cleanup following 9/11.


The VA recently "explained" that while the aircraft certainly tested positive as "heavily contaminated" with dioxin, aircrews were miraculously unexposed. Part of their position was that chemical swipes were used to test surfaces...yet that is the standard method of testing! The VA experts actually offered the standard method of testing for dioxin contamination, mentioned repeatedly in their own papers we discussed, as their "proof" to conclude our crews couldn't have been exposed. That's twisting science to win your argument...and that's not science! That's like saying because 105mm shells kill on impact, bullets won't!


They suggest that because solvents were used, solvents are the only way for dioxin exposure to occur. Don't know if they've ever looked at the sweat and oil on a loadmaster's hands, at the normal body oils and soil accumulated after long days of loading, flying, unloading and repairing a filthy C-123 Provider! Plenty of skin solvents to allow dioxin transfer! Dioxin transferred!


Another part of the VA maneuver against us was their claim that dust-borne dioxin wasn't inhaled...they say there was no dust. Guess they've never been aboard a rapid cargo or airevac configuration, or an airdrop. Dust and dirt everywhere. Repairs, setting up and tearing down seats, laying and removing the cargo rollers...dust everywhere! Dioxin everywhere! Dioxin inhaled!


The VA has a duty to assist veterans in submitting disability claims, rather than construct arguments to insure they don't qualify. There must be a preponderance of evidence against a veteran's claim, and the benefit of the doubt must rest with the veteran. Thus far, despite the earnest participation of VA experts in the recent teleconference, there has been no assistance. There is no preponderance of evidence against our claim of exposure--there is in fact a preponderance of evidence in support of our claim!

Dr. Berman's Letter to Senator Burr's Staff:

Re: the question of C-123 aircrew dioxin exposure, I have attached a pdf file containing a recent paper on reentry criteria for dioxin-contaminated buildings, which appears to have been written in response to the World Trade Center collapse and resultant environmental contamination. Herein they calculated dioxin re-entry criteria for various exposure scenarios, including adult occupational. For the latter scenario, the re-entry value is approximately 85 nanograms per square meter surface area (C-123 aircrews were exposed to surface concentrations averaging 617 nanograms per square meter).  In my literature search, I have yet to find the term “dry form” to describe dioxins and other chlorinated organic compounds. Nor have I found information to indicates that dioxins in such a dry form on hard surfaces would be any less able to transfer to other surfaces, such as skin, upon direct contact. I would like to have this clarified, if possible, so that I can understand the rationale for determining that C-123 aircrews were not likely to have experienced significant exposure to dioxins.   Respectfully,  Fred Berman DVM, PhD Director, Toxicology Information Center Center for Research on Occupational and Environmental Toxicology Oregon Health and Science University 3181 S.W. Sam Jackson Park Rd., L606 Portland, OR 97239-3086 Ph: 503-494-xxxx More about the Aircrew-VA-Senate teleconference: The VA kindly distributed six documents the day before the teleconference for us to review...documents which were thought to argue against aircrew dioxin exposure. I questioned the author of two of their (three decades old!) documents, Dr. Michael Newton at Oregon State, and he insisted that no conclusions about our aircrew exposure could be made from his research, and therefore two of the VA papers were made useless. (BTW, I've enjoyed our pleasant conversations with this former Infantry officer, following a somewhat heated initial meeting.) I also contacted the author of the most recent 75th Air Base Wing (Hill AFB) study of C-123 dioxin contamination---same situation, insisting no conclusion about aircrew contamination could be drawn from his research. In that paper, I noted on the first page a statement that dioxin levels "would permit short-term worker exposure" and this certainly could be taken to suggest that our own long-term exposure was hazardous! I struggled through the other papers...toxicology is obviously not my field, and only at the very end of one paper reexamining the Ranch Hand aircrews' dioxin exposure noted that it was funded by Monsanto and Dow, the Agent Orange manufacturers!! I learned this paper is typically discounted by Agent Orange experts everywhere. Conclusion: The benefit of the doubt is due us. We have clearly established the dioxin contamination of the aircraft. The exposure of crews over the decade we flew the Provider allowed for dioxin exposure via skin transfer as well as inhalation. The preponderance of evidence is for us, rather than against us. Our exposure, to quote the Toxicology Department of Oregon Health Sciences University, is "most likely."  For the VA to rule otherwise forces a conclusion that they are simply dedicated to preventing valid and persuasive Agent Orange claims rather than justly evaluating them.

What We Need for VA Agent Orange Service Connection

VA leadership, in particular Dr. Michael Peterson, shot at nearly every claim we advanced during last Friday's teleconference. The VA experts have in addition actually suggested three ways they'd consider our C-123 Agent Orange claims:

 1. if the Air Force scientists who conducted the tests in 1994, 1996, 1997, 1998, 2000 or 2009 would step forward and state it is likely that aircrews were exposed to dioxin during our 1972-1982 duties aboard the aircraft or 

2.if scientific interpretation could be offered explaining the exposure to the aircrews from the dioxin on surfaces in the aircraft, or from the dust therein, or 

3.the Air Force should inform the VA that it is "more likely than not" that aircrews were exposed to dioxin during the timeframe of our service aboard specifically-identified Agent Orange spray aircraft

 Dr. Fred Berman, head of the Toxicology Department at Oregon Health Sciences University (and a pilot!) has already made that conclusion. So has Dr. Jeannie Stellman of Columbia University's School of Public Health. Thank goodness for these "wingmen" in this effort, and God Bless them!


Our group of C-123 flyers has scattered to nearly every state in the country. Your state has a state university and nearly every one of those universities has an associated medical and/or veterinary medicine school...with experts who can interpret the test data we've gathered from the Air Force, and help advance reasonable justification for our having been exposed.


Our country is rich with private universities such as Harvard, Dartmouth, Yale, Tufts, Princeton, Rutgers, Emory, Vanderbilt, Stanford, Carnegie-Mellon, MIT, Boston University, Northeastern, Northwestern, and so many others. Universities full of experts able to analyze the Air Force C-123 test results and explain with the prestige of their institutions behind them, in writing addressed to the Secretary of the Air Force and the Secretary of Veterans Affairs, that the dioxin which contaminated our C-123s "more likely than not" exposed the aircrews.


So you need to get involved! You need to gather our set of Agent Orange documents, and start walking the halls of your local university to find these experts. There will be a wonderful Dr. Berman or Dr. Stellman-type person you can find who will help. From what I've seen since April, so many academicians are willing to help...we just have to find them.


From the Air Force, we need organizations like NCOA, AFA, MOAA, ROA and the Association of Military Surgeons of the United States to contact the Chief of Staff of the Air Force to advance our cause. We need the Air Force to task the School of Aerospace Medicine to look over the data and report whether there is a reasonable interpretation of it to allow our VA claims to go forward. 


I feel the military and the General Services Administration already stated the C-123s were the source of our dioxin exposure. Report after report, from 1994 on, details the testing and label the aircraft "heavily contaminated," "extremely dangerous, extremely hazardous, extremely contaminated" and "a risk to public health." The problem is these reports didn't detail that our physical contact with the contaminated surfaces in the C-123 should be considered "exposure" for the VA's purposes.

VA Teleconference re: C-123 & Agent Orange

Conference with VA Officials Held 1100 Hrs 27 Oct

We had our conference with the VA's Environmental Health and Benefits Administration folks today, and boy, I got handed my head on a plate.


But most graciously! Thanks to Brooks Tucker, Sen. Burr's staffer and Mr. Carter Moore from the VA's Congressional Liaison Office, Dr. Michael Peterson, Chief of the VA's Environmental Health and reps from the Veterans Benefits Office, supported by many of their very knowledgeable professionals, discussed the wide range of C-123 Agent Orange issues. Bottom line: they feel we have no basis for argument.


For over an hour these folks explained the finer details of dioxin exposure and answered, with grace and patience, my layman's questions. It was great to learn that Dr. Peterson is a retired AF 06, Brooks and Carter are combat veterans, and another physician on Peterson's staff is herself a "tanker doc"...former AF flight surgeon.


Dr. Peterson noted that I'd developed the same type cancer as my father and that familial history plays a role, meaning medical issues. I interjected that indeed it does...I have our family history of five generations of military service, of being warriors, and that I am more proud of that than worried about familial medical trends. 


Are these nice folks against us? No, they are not. However, not a single suggestion was made about how we can get help, other than to go back to the Air Force. The references to "gray area" seemed always to mean not that the benefit of the doubt would rest with the veteran but instead, the VA.


Are they going to help us? No, they are not. They will create every obstacle possible to prevent our claims, having promised "We cannot permit C-123 claims." Not unless convinced of new scientific evidence, or in response to new laws, or in response to the Air Force stating that our aircraft were contaminated with dioxin when we flew and that we were contaminated thereby. Again, not a single suggestion of how anything can be interpreted in support of our position. Their mission yesterday was to oppose us, not support us.


As followers of our blog know, we point to the 1994 AF study of Patches which reports 100 of the swipe samples positive for dioxin, and describes Patches as "heavily contaminated." VHA dismisses that with an explanation that samples were taken using solvents, and the hazmat precautions recommended were because restoration personnel were likely to be grinding metal and doing other dust-creating activities. 


They were not receptive to our response that solvents were used to gather swipe samples because that was the testing protocol selected by the investigators back in 1994, not receptive to the argument that even our skin has solvents on it to which which dioxin would love to attach, or that dioxin-laden dust would be ingested from the dust constantly created in working the aircraft, in its vibration aloft, hard landings and other workaday causes. 


Dr. Peterson explained, along with VBA, that the VA has to look at PROBABILITY. In big, capital letters. Unlike "boots on the ground" Vietnam veterans and Blue Water Navy vets, both of which groups have their presumptive exposure established by law, we must prove the probability that, not only were the aircraft contaminated, but that we were actually exposed thereby. That there was somehow physical introduction of dioxin into our bodies. A vector.


And that they maintain is a case yet to be made. The VA dismisses the 1994 Weisman-Porter study of Patches, saying it has no specific relevance to our 1972-1982 duty days (tests from the other years were not discussed). 


I kept asking whether or not a veteran is obliged to prove only two points...dioxin contamination and Agent Orange presumptive illness, and I believe their negative answer is built around the big obstacle...probability. Not possibility.


My points offered: multiple AF tests stressing the aircraft being "heavily contaminated, extremely hazardous, extremely dangerous, extremely contaminated" and "a threat to public health". Two authors of four reports the VA provided us stated, yesterday by telephone, that no inference could be drawn one way or the other regarding aircrew exposure 1972-1982, leaving most of the cards on the table being the Air Force's own tests.


It seems to boil down to the Air Force. We'd hoped to have two very knowledgeable experts join the teleconference to explain what they earlier told me was their continuing belief that their tests had relevance to our aircrew exposure years earlier. The two gentlemen did not call in to participate. We were offered the skillful and generous support of Dr. Fred Berman, head of the Toxicology Department of Oregon Health Sciences University who contributed mightily to our position.


Dr. Berman has spent months studying the Air Force reports and written the Secretary of the Air Force that aircrew dioxin exposure aboard the C-123 was "most likely." Not just possible or theoretical, but MOST LIKELY. Columbia University School of Public Health and others concur.


This hour-long conference concluded with an understanding that the next move belongs to the Air Force. Without DOD stating that the crews were aboard dioxin-contaminated aircraft, VA won't budge towards service-connection. Without the Air Force stating that their tests "most likely" indicate the probability of aircrew exposure, the VA sticks with its view that no exposure happened.

So remember, dear readers, that the Air Force (Secretary of the Air Force as well as Surgeon General of the Air Force) has directed us to turn to the VA to get help on our C-123 aircrew dioxin exposure. The VA has told us to turn to the Air Force to get help on our C-123 aircrew dioxin exposure. Catch 22. 


That's right...there's only one catch: Catch 22. The VA would consider allowing us Agent Orange medical care if the AF says we've been exposed. The AF says "Go talk to the VA!"

Yossarian - frustrated C-123 flyer!

When Brooks Tucker asked if the VA and AF were talking, there seemed to have been such conversations. When I asked if the VA would directly solicit an Air Force response, that wasn't of interest. 


If only we'd had the authors of the Patches study on the phone with us. Hopefully, we can ask for their input, then ask the AF to stand behind all the reports that Brooks and the School of Aerospace Medicine have done over the years. I know both of them care and are sincere.

The folks from the VA are extremely experienced at dealing with Agent Orange issues. One gets the feeling they are expert enough to construct a truthful argument one way or the other if they wanted to. They have decades of background, not only in their professions, but in explaining to Congress and veterans the whys and wherefores of dioxin exposure. They can always toss bigger missiles against us.


So we turn back to AFRC/CC General Stenner and the AF Chief of Staff and ask that they not leave our flyers alone in this struggle.  Where's our wingman? 


Air Force, get behind us, ask the report authors to explain the relevance of their studies to aircrew exposure, and simply get VA to designate "boots on the airplane" as adequate presumptive eligibility for our crews! 

VA Congressional Liaison Offers Teleconference re: C-123 Agent Orange

The teleconference organized by the VA's Congressional Liaison Office is set for 2PM Eastern on October 27, and limited to those invited by Brooks Tucker of Senator Burr's office.


Senator Burr will be represented by Mr. Tucker. Major Wes Carter, USAF Ret. (74th Aeromedical Evacuation Squadron, 439th MAW) will represent the C-123 aircrews from all squadrons. Offering expert toxicology information and interpretation of Air Force tests will be Dr. Fred Berman who heads the Toxicology Department of Oregon Health Sciences University. Explaining the VA position that C-123 dioxin contamination is not a health concern for aircrew veterans will be Dr. Michael Peterson, Chief Consultant, Environmental Health, Veterans Health Administration, Mr. James Sampsel of the Veterans Benefits Administration will explain why the VA cannot permit medical care for aircrew C-123 dioxin exposure and AO illnesses.


Our C-123K veterans only ask that since we can provide persuasive evidence from a host of government and scientific sources as to the dioxin contamination of our airplane, and can prove that we flew aircraft specifically identified as contaminated with dioxin, that the VA accept disability claims from those who also have Agent Orange-presumptive illnesses. I thought those were the ground rules described on the VA web site...perhaps not. Doesn't it seem wrong to deny veterans benefits not because of the abundant evidence of eligibility provided by the veterans but merely because of VA policy to prohibit such claims? 


Perhaps we can draw some comfort from the assurances of Dr. Peterson that we haven't been exposed to dioxin after all. 



Outside the scope of this teleconference, our small group working on this issue feels compelled to add an additional concern. We expect to eventually prevail (or at least, our widows will) regarding "Boots on the Airplane" so that if we can show service aboard a contaminated C-123 and proof of an AO illness, a claim can be put forward to the VA. Our new effort will be to uncover the confusing reason for the intensity of the VA's dedication in denying our claims....Questions arise:

• why did the Air Force take drastic measures to destroy ("the Navy way...the quiet way" as Mr. Boor of the 505th puts it)the surplus C-123 fleet specifically to prevent aircrews' Agent Orange exposure claims? 
• What right did AF have to take any action designed to prevent qualified veterans from putting claims forward to the VA as cited by Mr. Wm. (Buddy) Boor of the 505th?
• why did versions of the 75 ABW/PA press release about the destruction edit out mention of Agent Orange and dioxin?
• why is the Blue Water Navy's highly theoretical argument regarding Agent Orange reaching out to sea from contaminated Vietnamese rivers accepted by the VA but our proven exposure to dioxin on the airplane ignored by the VA? Where's the benefit of the doubt here?
• why did the Air Force, once dioxin contamination was scientifically established in 1994, fail to notify aircrews of their exposure to hazardous substances, in violation of both state and federal laws?
• why did the Air Force Office of Environmental Law, in 1996, recommend information about the dioxin-contaminated aircraft "be kept in official channels only?"
• why did the Air Force, having scientifically tested and labeled the surplus contaminated aircraft as "extremely dangerous, extremely hazardous, extremely contaminated" and a "threat to public health", one requiring employees to wear hazmat protection...why did the AF support the VA in characterizing AF actions as merely the result of "an overly cautious mindset" so that the severity of decades of Air Force tests, reports, correspondence and actions would be minimized or disregarded when weighing veterans' claims?
• why did the Air Force fail to reveal the dioxin contaminated C-123K/UC-123K aircraft stored in quarantine at Davis-Monthan during the Arizona State EPA Hazardous Material Survey team visit?
• why did the Air Force Office of Inspector General dismiss the aircrew's complaint without investigation?
• why did the Air Force Office of Special Investigations at Davis-Mothan fail to investigate complaints made by knowledgeable officers regarding the Agent Orange issue?
• why did State Department and the AF Security Assistance Center fail to notify foreign governments of sales to them of dioxin-contaminated C-123s? Is that why the VA opposes veterans claims for service aboard those contaminated aircraft..to minimize visibility?
• what role did the attitude of the Senior Consultant to the Office of Secretary of Defense have regarding efforts to prevent aircrew Agent Orange claims? Did his statement labeling them as "trash haulers, freeloaders" affect Air Force actions?
• why were FOIAs to the Air Staff, Air Force Board of Correction of Military Records, Air Force Surgeon General, School of Aerospace Medicine and Air Force Security Assistance Center not answered as required by law?
• why did the VA brief Congress about C-123s and Agent Orange, stating that there had not been any dioxin tests on the aircraft after Vietnam, and fail to reveal the many Air Force tests that were completed?
• what would the VA, EPA, USAF and other agencies say if Patches, in its 1994 degree of contamination, were to be returned to flight status...safe, or unsafe?
• After HQ USAF/IG rejected the aircrews' IG complaint regarding C-123 dioxin contamination it was refiled with DOD/IG in June. Their regulations describe an investigation cycle taking not more than 3 months, yet by the end of October why still no response?

VA Responds to Concerns re: C-123 & Congressional Briefing

Yesterday, in a highly unusual response to our concerns being voiced to the VA's Congressional Liaison Office, we were invited to have a teleconference with Senator Burr's staff, the VA Agent Orange experts, and the CLO. We've accepted the invitation and await the details. Maybe something can get moving!!!

their email follows:

Mr. Carter:

Thank you again for bringing your concerns to me, and allowing the VA the opportunity to assist.

After speaking with Mr. Carter Moore, our subject-matter expert on environmental hazards, and Mr. Brooks Tucker, Sr. Policy Advisor for National Security and Veterans Affairs to Senator Burr, I believe we are better positioned to assist with your concerns.

The Veterans Health Administration’s (VHA) Office of Public Health was the organizational unit that provided the briefing with Congressional Staff on the subject of environmental hazards. It was not the Office of Congressional and Legislative Affairs.

Pending your agreement, we would like to set-up a time for a phone conversation between you, Mr. Tucker, and Mr. Moore to further discuss the details of your concern. Mr. Moore is very 

knowledgeable on the issue, so I think it would be appropriate to hold the discussion. We are also able to include folks from VHA’s Office of Public Health to ensure that you and your Veteran colleagues receive comprehensive and complete answers to your concerns.

Would this be something you are interested in?

If so, the point-of-contact would be Mr. Carter Moore at (202) 461-xxxx. Please let me know and we will be happy to assist and facilitate this meeting.

Thanks.

V/R,

Adam Anicich

Assistant Director

Congressional Liaison Service

United States Department of Veterans Affairs

From: Wes Carter [mailto:rustysilverwings@gmail.com] 
Sent: Tuesday, October 18, 2011 12:56 PM
To: Anicich, Adam (CLS-Senate); Brooks_Tucker@burr.senate.gov
Cc: f; Arch Battista; Andrew B Lown; a208773; jrowan; 
Subject: Liaison Office Inaccurate Statements to Sen Burr Staff

Dear Mr. Anicich,

Thanks for your return call this morning and the agreement to look into my issue. I maintain that the VA responded to Sen. Burr's staff with inaccurate and misleading information. The "Letter of Congressional Liaison" is the summary of the issue from my perspective. As chair of our C-123K aircrew veterans, I have posted every document we've uncovered concerning the dioxin contamination of our aircraft at http://www.c123kcancer.blogspot.com

I have found no materials concerning our airplanes which fail to show them as contaminated with dioxin remaining from their spray missions in Vietnam.

Best regards (and thank you for your service!)

    Wes Carter, Major, USAF Retired

    Medical Service Corps

    VA 100% Service Connected

Our complaint to VA Congressional Liaison Office re: Misleading Senator Burr

The VA's Congressional Liaison Office is the interface between that Department and both Houses of Congress. They recently sent representatives to meet with the staff of North Carolina's Senator Burr, ranking member of the Senate Veterans Affairs Committee. Unfortunately, these folks totally twisted facts and figures in their effort to insure veterans who flew and maintain the C-123K are kept from receiving Agent Orange exposure benefits. C-123 veterans' position is that there is a preponderance of evidence confirming our dioxin exposure, certainly well past any threshold the VA might have in affording us the benefit of the doubt. Thus this letter to the CLO Assistant Director: (Oct 26 note--we've been corrected in that it was NOT the CLO meeting with Sen. Burr's staff but rather other VA officials. The CLO has, however, very kindly arranged a teleconference with their experts so we may learn more. Thanks, Carter and Adam!)
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12 October 2011

Mr. Adam Anicich
Assistant Director
Congressional Liaison Service
United States Department of Veterans Affairs
189 Russell – Senate Office Building
Washington, DC 20510

Dear Mr. Anicich,

Members of your staff recently discussed with Senator Burr’s staff the Agent Orange contamination of airplanes my Air Force squadron flew between 1972-1982. This plane was the C-123K, used for spraying Agent Orange in Vietnam until 1971. Our crewmembers’ concern is that the aircraft remained contaminated with dioxin after the war and exposed us to the typical Agent Orange presumptive illnesses.

The VA having denied all claims from our veterans on this issue, I asked my Senator and his staff to evaluate the materials explaining our position and to bring them to the VA’s attention. Your staff responded, in a meeting with Mr. Brooks Tucker, with information I believe was misleading and structured not to be truthful but rather to deny any Agent Orange contamination, constructing whatever argument that might be necessary, however inaccurate. I acknowledge that the details provided Senator Burr by your staff may have originated from the Air Force but the VA has adequate expertise in this subject to have more correctly informed the Senator.

In particular, I object to your representatives characterizing the Agent Orange contamination of the C-123K, saying:

“The scientific analyses of the dioxin TCDD in Agent Orange indicates that it has a very short lifespan once it dries or binds on a surface like metal. In VA’s opinion, it is highly unlikely that TCDD would remain present in a harmful form for a duration of time that would allow it to be persistently present on metal surfaces for years after it dried on that surface. 

Given the lack of testing done on the C-123s in the years following the Vietnam War, it is impossible to determine if TCDD was present in a harmful state during the years you and others were flying and maintaining those aircraft. VA views the Air Force actions relative to the clean-up of Patches and the decision to not sell mothballed C-123s as indicators of an overly cautious mindset within Air Force legal circles that desired to avoid any potential for liability if the aircraft were placed in a museum or sold to a private entity.”

What the heck does a 2000 decision not to sell contaminated C-123 airplanes, already tested as positive for dioxin and labeled by the experts as “heavily contaminated, extremely dangerous, extremely hazardous, extremely contaminated” have to do with our exposure back in 1972-1982 when we flew them? It would have aided us to know of the contamination back during our duty days, but times were more innocent then regarding dioxin. But not now…the airplanes have been repeatedly and expertly tested past any court’s requirement of proof of having been contaminated with dioxin. Multiple expert sources have established that the aircrews aboard them for hundreds and thousands of hours were exposed. 

The suggestion that bare steel does not retain dioxin contamination over the years does not trump the fact that there were very few bare steel surfaces inside or outside the C-123. Instead, nearly every surface was painted and paint absorbs Agent Orange readily. Although the distillates would evaporate over the years, not the dioxin. And we began service on those airplanes the very year after their last spray missions, and without any decontamination, just broom swept and hosed out. The various fabrics and insulation, tons of it, absorbed Agent Orange. Agent Orange built up in residue in nooks and crannies everywhere, to the point that the depot maintenance experts said the floors and wings would have to be removed to get it all out.

How many tests does it take (and the Air Force did so many of them) to convince the VA that the airplane was contaminated? How many words do I have to type to make the argument perfectly clear? Are the Air Force’s own test results not adequate to move you?

How could the public servants in the Congressional Liaison Office mislead public officials with such intensity and firm dedication in trying to prevent veterans from receiving earned benefits and protections? Can you locate the many toxicologists who tested these airplanes and labeled them “extremely contaminated” so they can help you understand the obvious conflict with the VA’s characterization of the Air Force as having “an overly cautious mindset”? Does anyone, anywhere, use “extremely dangerous”(Air Force words) to mean “overly cautious” (VA characterization of Air Force position)?

Can you locate an ethical person in the VA to explain the Department’s position to me and to the veterans I flew with? We are not presenting a hypothetical situation of water containing dioxin somehow reaching our ship out at sea, but instead the PROVEN contamination of an airplane we were ordered to fly for a decade. And made sick thereby.

Respectfully,

 /signed/

Wesley T. Carter, Major, USAF, Retired
Medical Service Corps   http://www.c123kcancer.blogspot.com

Our Rebuttal of VA Comments to Senator Burr of North Carolina

Our letters to staff of North Carolina's Senator Burr and the staff of Commander, Air Force Reserve, which is supposed to have held a conference call with VA officials (no word back yet on any results). Letter to AF first, letter to Senator second.

--------------------------------------------

Dear Major Broussard,

Senator Burr's staff met with some reps from the VA regarding our C-123K problems, and were told that our Agent Orange exposure didn't happen because the post-Vietnam lifespan of dioxin on metal is short. The VA failed to tell my senator's folks that most of the airplane interior was not bare metal, but painted, and Agent Orange and its dioxin contamination soak into paint, and also soak into the insulation, wiring, web seating, etc, as well as the aviation-grade aluminum (which is more porous and which absorbed dioxin more readily than polished steel). 


They stated that the Air Force was concerned about the Agent Orange contamination of the C-123 in an effort to be overly cautious. They failed to note that the Air Force tests establishing the airplanes as "heavily contaminated, extremely dangerous, extremely hazardous, extremely contaminated" were done in 1994, 1996, 1997, 1998, 2000 and 2008, years before the airplanes were determined to be too toxic for a landfill and with smelting them the only option left. These tests did not use timid words like "cautious"...the official Air Force words were instead "extremely dangerous" and "extremely hazardous." 

The VA people seemed to say because time had passed by the point the aircraft were destroyed thirty years after their retirement, we couldn't have been exposed to dioxin in 1972-1982 (beginning the year after air airplanes' last Agent Orange spray missions during Vietnam), all the tests establishing contamination notwithstanding.

The VA cited the absence of tests done between the retirement of the C-123 in 1982 and their destruction in 2010, failing to note volume upon volume of official Air Force tests as well as Air Force-contracted tests, every single one of which reported positive for dioxin contamination.

A snow job. If it had been done by any military officer aware of the various tests I'm describing, it would be called dishonorable and a prevarication.

Please don't let it happen to you in presenting our concerns to the Secretary of Veterans Affairs. Even their own staff must have snickered at this effort with Senator Burr's people!

And please, what is happening? I was back in the hospital myself last week, and this week, and I'll be back again today. Like my crewmates, I'm gravely ill and would like to wrap this up before they wrap me up.

Regards,

   Wes Carter

--------------my letter to Senator Burr's staff follows: They are the folks who met with the VA and were told by the VA that our claims about Agent Orange exposure are groundless-----------------------------------

rustysilverwings@gmail.com
11 Oct 2011

Mr. Brooks Tucker
Senior Policy Advisor
Office of Senator Burr, North Carolina

Dear Mr. Tucker,

Thank you for explaining the results of your staff’s meeting with officials from the Veterans Administration regarding our aircrew exposure to Agent Orange during the decade we, as Air Force crewmembers, flew the C-123K/UC-123K “Provider”, previously used for spraying Agent Orange in Vietnam for Operation Ranch Hand. The VA’s characterization of the Air Force test results and the VA’s perspective of the Air Force position relative to the reuse of the surplus airplanes as expressed during your meeting could, perhaps, be described as a greatly overdone abundance of caution.

The Air Force and the General Services Administration, however, have instead officially described their position as cautious regarding the dioxin contamination…and absolutely not dismissive of the threat! In fact, totally the opposite as per their 2000 report to a federal judge in which both the AF and GSA both characterized these airplanes as being "heavily contaminated" by the dioxin on them. These two words were not used by a layman or a government attorney, but instead by the Air Force toxicologists who tested the airplanes. Certainly it should have been reasonable for the Air Force to be “cautious” regarding aircrew dioxin exposure, although it was not known to be contaminating our airplanes until the very first test in 1979 after we’d flown them for seven years. 


I would hope that the Air Force is “cautious” regarding any airplane, any crew, any possible hazard. In our case, the contamination having been established, the word should be alarmed!

Last week I asked experts for help regarding the VA statements that the surface aging of dioxin would make aircrew exposure to the toxin inconsequential. I sought opinions from two members of the Agent Orange Committee of the Institute on Medicine of the National Academy of Sciences, and scientists at both Oregon State University and Columbia University.

In particular, I sought the advice of Dr. Fred Berman, head of the Toxicology Department of Oregon Health Sciences University. In his May 2011 report to the Secretary of the Air Force, he evaluated (and validated) the Air Force test results and provided the University’s finding that our aircrews had been exposed during the timeframe 1972-1982. Yesterday, he replied:

Major Carter, Regarding the stance that the VA is maintaining (that dioxins would have degraded within a short time after service in VN had ended), you could reason that, if indeed the dioxins had rapidly degraded, and in light of the fact that dioxins were detected in significant concentrations on and inside Patches in 2000, then aircrews would likely have been exposed to much higher levels of dioxin between 1970-1980 than suggested in my letter to the Secretary of the Air Force (i.e. The dioxin concentrations immediately after service in Viet Nam would have had to have been very very high to begin with). Fred Berman From: Fred  Berman <bermanf@ohsu.edu>

Please, Brooks, in your representation of us to the VA, defend the position that we have indeed been heavily exposed.Air Force tests done in 1994 on Patches, our most famous C-123K/UC-123K which my squadron flew, reported it"heavily contaminated" with 100% of the swipe tests showing positive for dioxin. Not hypothetical...not degraded, not aged, not anything except "heavily contaminated." This test was done twelve years AFTER we last flew the series. Nobody could believe the aircraft was more contaminated in 1994 than it was in 1972-1982...the VA's own faulty information about surface contamination and aging of dioxin would argue against that conclusion! And no laboratory report concluding an aircraft to be "heavily contaminated" could possibly be seen as in agreement with the VA's description of the Air Force's view of dioxin contamination being so insignificant that the Air Force shredded and smelted the entire valuable fleet for a merely hypothetical risk. 

Please note also that the airplane tested last sprayed Agent Orange in 1969, yet it still tested 100% positive for dioxin, "heavily contaminated" on every single surface examined in 1994. The test did not reveal modest contamination,hypothetical contamination, degraded contamination, significant contamination, or any contamination other thanHEAVILY contaminated. The C-123K’s were even MORE heavily contaminated when we flew them over a decade earlier. Please compare this finding with the suggestions from the VA reps who you met with and you'll see the error of their logic and the blatant effort at disinformation. One should consider their argument here a clear prevarication and deception.

Lieutenant General John Hudson, USAF Retired and Director of the National Museum of the Air Force, wrote me that "before my tenure as Director the aircraft (Patches, Tail 362) was found to be contaminated with dioxin (and) was decontaminated by a contractor." The decontamination, to make it safe for the airplane to be brought inside the Museum, cost $52,000, and required striping all paint from the exterior, removing all insulation and other dioxin-laden materials, and sealing the airplane for all but very limited interior access.

Please remember that we flew Patches, and our other dioxin-contaminated aircraft, in our normal lightweight flight suits, without hazmat protection, without respirators, and without post-flight decontamination. We flew the airplanes for hundreds of hours, we worked on them in flight and on the ground for thousands of hours. We ate in them. slept in them, and were very, very exposed in them. Further, in flight the incessant vibration of the aircraft caused particles to become airborne and thus inhaled.

In 1996 the 355th AMDS/SGPB at Davis-Monthan AFB contracted with Alta Labs to evaluate the aircraft stored at Davis-Monthan, and nearly all tested positive for dioxin (some results were lost, and some were tested incorrectly with the lab determining that actual dioxin contamination might actually be higher than their test results first indicated). In 1997 Armstrong Labs from the Air Force Institute for Operational Health completed tests on C-123K’s stored at Davis-Monthan with similar results but adding the Lab’s concern that the dioxin toxicity could be severe enough to also contaminate the ground beneath the airplanes. AMARC employees were at this point in time directed to wear rubber gloves, a face shield, at least a half-face respirator, and Tyvek coveralls to avoid dioxin exposure, per instructions of Dr. Ronald Porter, Air Force toxicologist.

In 1997, aware of the health threat posed by the toxin, HQ AFMC directed via their memo that

the surplus “dioxin contaminated aircraft” (their words) be sealed and relocated within a “fenced area within the…security area. They will be completely out of view.” (their words). The quarantine effort, necessary for preventing additional personnel exposure, was also done with the specified goal of reducing the public awareness of the 21 remaining “dioxin airplanes”. This effort cost $160,000. Mr. Thomas Lorman, HQ/AFMC/LG-EV, wrote in 1997 that these airplanes are “likely to be contaminated with dioxin from defoliation operations…The Air Force can be up front and warn owners of possible contamination. JAV states the Air Force is at great risk.” (emphasis mine). Certainly this leaps the VA’s barrier of “as likely to as not” regarding any C-123K aircrew veteran’s disability claims! The Air Force’s description of these planes as too toxic for a landfill should also mean that the VA’s barrier of “as likely to as not” regarding our exposure has been greatly exceeded.

In 2008, four aircraft were selected at random and each tested positive for trace levels (or higher) of dioxin, and the test cycle was halted to save the $750-1500 cost per airplane, as well as to prevent characterization of the surplus fleet as "100% contaminated." Messages were exchanged stating that because of the high visibility of "the Agent Orange airplanes", this round of testing could state that four of eighteen aircraft tested positive, rather than continuing the testing and getting an even higher and more visible percentage. Further, AFMC had already decided to destroy all the remaining aircraft.

Please remind the Air Force and the VA that the quarantine of the contaminated aircraft, in which they were placed in a separately fenced area with HAZMAT signs prohibiting access, cost over $150,000. This was not done "just in case" the airplanes were contaminated, but because the base safety officials required it, and both the base medical organization and the AF Surgeon General dictated that workers wear hazmat clothing, respirators, head covers and decontaminate after working. This level of protection is appropriate for "heavily contaminated, extremely dangerous, extremely hazardous" contamination...just as these airplanes were described by Air Force test results.

Remind the VA that the General Services Administration as well as the Air Force testified before a federal judge in 2000 concerning the government's cancelation of a C-123 sale. Both agencies told the judge that these airplanes represented a danger to public health. They were characterized by the Air Force toxicologist, Dr. Ronald Porter, as “extremely hazardous waste requiring special handling, and his recommendation was to decontaminate each airplane (this recommendation submitted 16 years after we last flew them, 16 years in which their degree of contamination was reduced) at a cost of $15,000 apiece. They did not state that the danger was hypothetical, “overly cautious” or that the danger existed only in Vietnam. These officials testified that the airplanes were contaminated and should not be sold. As you know, two had already been sold to Disney for movies. Continuing on Page 11 of the judge’s ruling, the Air Force reminded the federal judge, and the judge cited as a finding, eight dangers of dioxin contamination from these airplanes, crediting the Agency for Toxic Substances and Disease Registry and the United States Public Health Service.

The director of the Agency for Toxic Substances and Disease Registry, Dr. Christopher Porter, wrote me on August 11, 2011, saying our collection of dioxin contamination materials concerning the C-123K is “remarkable”, and recommending that the information be “carefully considered by the Department of Defense”. Because his Agency was cited in 2000 as part of the scientific proof that the surplus C-123K fleet was dioxin contaminated, I strongly recommend that Dr. Porter be consulted for his specific recommendation that the aircraft were indeed contaminated a decade earlier when we flew them!

I personally will pay the travel expenses for Dr. Fred Berman, Dr. Christopher Porter, Dr. Jeanie Stellman of Columbia, or any other reputable expert to be by your side at any future meeting with the VA. Invite them and let me know their expenses. Dr. (name removed) is on the Agent Orange Committee of the Institute of Medicine/National Academy of Science... very, very familiar with the C-123K situation, has studied the multitude of tests done on the airplanes, and states that the aircrews were exposed. As you probably know, members of the Agent Orange committee cannot independently publish on the topic, but they certainly can answer questions...so ask (name removed) at (email address removed for privacy)

Please also remember that Judge Stephen Cohn of the Board of Veterans Appeals denied the late Lieutenant Colonel Aaron Olmsted's VA claim for Agent Orange exposure. Aaron ("Tim") Olmsted's VA claim was denied by Judge Cohn who cited two deficits in the claim: As reported by Connecticut Public Television, in summarizing Olmsted's denial, Judge Cohn ruled:

 1. Olmsted couldn’t prove that the airplanes he flew were the ones used for spraying Agent Orange during Vietnam and

 2. Olmsted couldn’t prove that there was any (my emphasis) dioxin contamination on the airplanes.

He should have had available both proofs...the tail numbers of contaminated airplane assigned to our squadrons have been researched and confirmed by AFRC, and the contamination is established by multiple Air Force tests, although these documents were not available to Olmsted when he filed because they were "kept in official channels only." Denying a veteran necessary documents to approach the VA for medical care cannot be characterized, as the VA has done to you, as "an overabundance of caution." 

I remind you that I was a Stan/Eval flight examiner in my crew position, certified by the Air Force as one of the three most knowledgeable individuals in my AFSC, yet neither I nor any other crew member ever was "official channels" enough to be told of this contamination. It was manifestly my duty to have known everything affecting my aircrew and my student’s health and safety. I have spoken to several state fire marshals who agree with Oregon’s state fire marshal that withholding this kind of information about toxin-endangered employees is a crime. Consider having a senior firefighter from the D.C. department or the Pentagon sit in with your next VA meeting. The only concern I'd have if having genuine toxicology or public health experts with you as the VA "explains things" is that the laughter from them over VA efforts at misinformation would disrupt your otherwise serious meeting.

As you know, the Air Force in 2010 finally smelted the toxic aircraft. In their approval memo, AMARG officials (505 ACSS and 74 CEG) stated “this can be done discretely. This option avoids all contact with or exposure to the public and the aircraft are not made available for commercial sale. This option can happen quickly. Smelting is necessary for these 18 aircraft so the Air Force will no longer be liable for ‘presumptive compensation’ for anyone who ever works around this “Agent Orange” metal…If the Air Force wants quick and quiet disposal, the Navy option is preferable.”

I am offended that these individuals took “quick and quiet” actions to prevent our veterans’ justified claims for “presumptive compensation”, especially considering that our exposure had already taken place.

Senator Burr and Mr. Tucker, you can see that our aircrews worked with this “Agent Orange” metal for a decade. We have been sickened by it as well as by the VA’s construct of any argument at hand, twisted out of context as much as necessary, to insure denial of our proven exposure. I am amazed that they can twist the Air Force initial test results ofPatches being “heavily contaminated” into merely, as you put it, “an overly cautious mindset.” In all the documents I’ve uncovered from the Air Force, there has been no such timid phrase used…the phrases used by the Air Force have been “Agent Orange airplanes”, “extremely contaminated,” “heavily contaminated”, “extremely dangerous”, “danger to the public” and similar language. These should be the words also used by the Department of Veterans Affairs in addressing our concerns.

We are gravely ill from this disaster. Please defend us with all your ability.

Respectfully,

For the Veterans of the C-123K

Wesley T. Carter, Major, USAF Retired

Medical Service Corps