19 November 2011

A Monumental Week! Good and Bad, But Justice Will Triumph!

Is VA Mickey Mouse or What?
We were hit with a board upside the head when the VA announced Thursday that they'd already decided our C-123 aircrews somehow, miraculously, haven't' been exposed to dioxin, despite our decade of flying the contaminated birds.

In their determination to prevent veterans'  Agent Orange exposure claims, the VA has invented a new thing called "dry dioxin transfer" to pevert science and logic to keep us from essential medical care. Yes, they say, the planes were certainly contaminated, but no, dry dioxin transfer by dermal contact was unlikely plus we couldn't have breathed any in via dust...somehow, the special kind of dioxin left in the C-123 didn't hurt us. I'll just bet the VA would be first to state that Agent Orange actually helped us! Made us the men and women we are today, thanks to Dow and Monsanto!

But here's your good news. By coincidence, I was traveling to the Air Force Museum Wednesday when my cell phone rang with a call from the Air Force School of Aerospace Medicine. Seems they've been tasked to look into the issue of C-123 aircrew exposure and they wanted to get our materials. "Surprise, Surprise Surprise" as Gomer Pyle used to say. I was going to be at Wright-Patterson AFB on Thursday anyway, so I suggested we meet. What perfect timing.

Our meeting with USAFSAM did indeed take place the next morning at 0900 at the new building for the 711th Human Performance Wing and included the project leader, his deputy, an AF physician and a bioenvironmental engineer. I provided the project's OIC our large binder with 320 pages of research, plus a DVD of the many source documents. That gentleman was ready with a DVD for us as well, materials he'd researched and some of which we've never seen before. GREAT!!! Unlike our October 27 teleconference with the VA, these guys asked questions instead of telling us where to get off. And even in the face of the VA's new stand against us, on Friday the Air Force has been told to proceed with their investigation. Thanks, Mr. Secretary!

I also was invited to put him him touch with Prof. Jeanne Stellman at Columbia University School of Medicine, researchers at Portland State University who contributed to the Blue Water Navy Institute of Medicine Study, and Dr. Fred Berman who heads the Toxicology Department at Oregon Health Sciences University. These prestigious scientists refute the VA stand! With other scientists and with us, they maintain that the C-123 aircrews have indeed been exposed.

So, fellow veterans, take heart. We've actually moved ahead a step or two because we always knew the VA would oppose any application from us, and now we have their position defined. In addition to the reasons BVA Judge Cohn invented back in 2007 to deny Tim Olmsted (731st TAS) his service connection (couldn't prove his C-123 was used for AO spray in Vietnam and couldn't prove it remained contaminated - both now answered with Air Force documents released under FOIA),  they new invent new objections which we can now begin to research and answer.

Hang in there. Support each other, keep pushing your state and national representatives to not let the VA get away with this injustice. I task each of you to personally walk the halls of your state university to present our cause to the department of medicine or the department of environmental studies to get them to support our position and challenge the stupidity of the VA invention of "dry dioxin transfer."

I love this fight! If it was easy, they'd get some other jerk to do it so why not me?


Get off your butts. You are warriors. You never give up. You never leave an airman behind. You cover your wingman.

Our cause is just and it is important to us and our comrades in arms.

You will prevail. God bless.

Tally Ho!

18 November 2011

VA Nails the Lid on Our Coffin! Denies Agent Orange Exposure

What a surprise to learn that the VA, flying in the face of scientific tests to the contrary, has decided that C-123 aircrews HAVEN'T been exposed to Agent Orange after all. And if we were, we were not exposed to enough to harm us. Great news for all of us who are dying as we can now look for another cause and not cast blame onto the VA.

I guess our 27 October teleconference was, after all, simply a check-off activity from the VA's perspective. It was conducted so they could say they'd opened it up to public and veteran discussion and, carefully weighing the evidence (all of which points in our favor!) they've determined they'll deny us veterans' benefits for AO exposure.

This is a screw job, "plane" and simple. It really hurt to have authors of earlier testing programs drop us from their concern...so much for No Airman Left Behind. Courage must be a quality expected of those of us in flight suits, not other professionals.

VA Seal and Newspaper

Veterans Health Administration Update
Agent Orange

Having trouble viewing this email? View it as a Web page.
Veterans on C-123 planes post-Vietnam
Some Veterans who were crew members on C-123 aircraft, formerly used to spray herbicides in Vietnam, have expressed health concerns about possible exposure toAgent Orange residue on plane surfaces. After reviewing available scientific reports, VA has concluded the potential for long-term adverse health effects from Agent Orange residue in these planes was minimal. Even if crew exposure did occur, it is unlikely that sufficient amounts of dried Agent Orange residue could have entered the body to have caused harm.
Visit the Agent Orange homepage to learn more about Agent Orange:www.publichealth.va.gov/exposures/agentorange.   
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15 November 2011

Agent Orange - Justice Delayed is Justice Denied

Museum Visits and Research

Yesterday I visited the Hill AFB Museum and checked out their C-123. Strictly a cargo bird as it seems from the outside...no left-over pipes under the wings in from the engines, anyway.

Thursday I will be at the National Museum of the Air Force to look over Patches again, and hope to also visit their Research Section on the main base to learn more about its decontamination and any details about the post-Vietnam use of the fleet. LtGen Hudson recently wrote us about the dioxin issues involving Patches and I hope to get more particulars about the firm which did the work cleaning up the bird.

Paul Bailey is contacting Dartmouth and University of New Hampshire to get their medical professionals and toxicologists to look over our data and offer opinions as to whether or not we "are as likely to as not" have been exposed to dioxin during our crew days.

Please...ask your own state university or state department of health to look this situation over...letters from them would be extremely persuasive, especially as we head to the first of our disability claim denials or approvals followed by appeals.

08 November 2011

Veterans Day 2011

God Bless our Band of Brothers and Sisters





















I remember: 
Chief Warrant Officer 4 Henry Carter
Brigadier General John W. Carter, Sr.
Captain John Carter, Jr.
LtCol Jessie W. Britt
Major Jack Carne
Private (Acting Sergeant) John Carne
Major Audie Murphy
Master Sergeant Bob Boyd
Staff Sergeant Jimmie Ballinger
Master Sergeant Bill Schindler

Earl Dyer - Rest in Peace

Earl Dyer saved many lives during the Gulf War, and was a tireless medical professional respected by all. God bless him and his family. We're grateful for his many years of dedicated service to the 74th Aeromedical Evacuation Squadron. Heaven is a better place with him serving there.

07 November 2011

Request for Help from Agency for Toxic Substances & Disease Registry

In August I asked the ATSDR for help and was passed off to the DOD...today I wrote again and asked for their compassionate action, not buck-passing.




November 5, 2011

Christopher J. Portier, Ph.D.
Director, National Center for Environmental Health and
Agency for Toxic Substances and Disease Registry
Atlanta, GA  30333

Dear Doctor Portier,

In August you kindly responded to my request for help regarding the dioxin exposure experienced by Air Force C-123 aircrews. The C-123 was the plane which, until the year before we started flying it, was used for spraying Agent Orange in Vietnam. We flew them from 1972-1982.

I have to ask for your help. I have a crewmate, Master Sergeant George Gadbois of Warner-Robins, who is at Emory and who learned last Friday he has perhaps a year of declining health before his death from soft tissue sarcoma, lung cancer and brain cancer. Although he is retired Air Force, he has been denied VA Agent Orange benefits…not because he wasn’t exposed, but because the VA says he can’t prove it at least to a greater than 50% likelihood. Master Sergeant Gadbois was decorated for heroism in responding to a civilian chlorine explosion, but I’m afraid his heroism falters when faced with the VA obstructions.

We have had the final Catch-22 event, with a teleconference arranged by Senator Burr (NC) for me to discuss our aircrews’ exposure with VA representatives. The VA has decided, without specific research, that aircrews inside a “heavily contaminated” airplane could not be exposed via dermal contact because the skin is a good barrier. Neither could exposure occur via inhalation because there wasn’t much dust for the dioxin to adhere to. It seems to me that our skins were quite dirty and oily, adequate to permit transfer, and I certainly remember these cargo airplanes with dirt and dust flying everywhere.

The head of the Toxicology Department of Oregon Health Sciences University participated in the teleconference and his study, thus far, convinces him that we “most likely” were exposed. The same conclusion was reached by Columbia University School of Public Health.

The problem remains that the VA will not accept these experts’ opinions, but has said they would move only if the Air Force were to tell the VA that the airplanes were contaminated (nobody disputes this fact) and that the aircrews were exposed. The Air Force has said the VA has to make that determination as they will not. So the author Joseph Hiller would be pleased with yet another government Catch-22, but our aircrews are not amused with these agencies each referring us to the other for help…with the VA and AF already knowing that no action will be taken by either. When we flew the sick and wounded in aeromedical evacuation, we never tried to pass off the responsibility for action to others. Never.

I have been studying dioxin since my own cancer diagnosis in April, and cannot avoid the frequent references to both EPA and ATSDR in the literature. I have read your agency’s congressional mandate and mission statement carefully.

I ask that in response to your core value of compassion, that ATSDR look into our exposure issue.

I ask that in response to your goals of protecting the public from environmental hazards and toxic exposures and advancing the science of environmental public health, that ATSDR review the Air Force tests conducted on our airplanes and answer a simple question, vital to whether or not the VA will permit our veterans access to health care:

“Is it as likely to as not (the VA phrasing of an opinion) that aircrews flying “heavily contaminated” C-123 airplanes between the years 1972-1982 were exposed to dioxin?”

If this were a contemporary situation, I’m sure there would be rapid and conclusive government action…no airliner would be allowed to fly with dioxin levels 800% greater than building reentry standards. No agency would permit the public to be thus exposed.

I was Stan/Eval flight examiner for my crew position, and like other Stan/Eval flight examiners the safety of the airplane and the occupants was my primary military, legal, and moral responsibility…if I had known about the dioxin contamination I’d have been guilty of a courts-marshal offense if I’d allowed it to fly. These airplanes were so toxic the Air Force had to shred and smelt them, as they were too contaminated for landfill.  Dr. Ron Porter, the Air Force toxicologist who first surveyed them testified in federal court “they are a danger to public health.”

I’m a soldier, but I’m also a member of the public and deserving, as is Master Sergeant Gadbois, of ATSDR at least commenting specifically on the contaminants I’ve been exposed to, and whether or not I’ve thus been exposed.

Respectfully,
Wesley T. Carter, Major, USAF, Retired

06 November 2011

Long-Term Dermal Exposure to C-123 Agent Orange

DANGERS OF DIOXIN EXPOSURES: ABSORPTION THROUGH THE SKIN.

Traditionally, people concerned about the toxicity of chemicals have mainly worried about the mouth and lungs as a means of entry into the human body. Now new evidence suggests that absorption through the skin may be an important way for some chemicals to enter the body. In addition, the skin of babies may allow more toxics to pass through it than the skin of older humans.

Researchers at the National Institute of Environmental Health Sciences studied the absorption of dioxins and furans in mice and rats. They discovered several new aspects of chemical absorption by the skin: (1) the skin presents a more effective barrier against some chemicals than against others; (2) mice absorb a greater percent of dioxin when lower doses are administered than when higher doses are administered; (3) young adult rats absorbed a greater percentage of the administered dose than did middle-aged rats.

In the past, the theory has been that the skin (which has a total area of 1.8 square meters in the adult human) has served as a passive barrier to chemicals. Now it is apparent that the skin is very active in metabolizing (biologically altering) chemicals and that these metabolic processes affect the way the body absorbs (or does not absorb) a particular chemical. Sweat glands, sebaceous glands (which produce oils), and hair follicles can all contribute to the way chemicals are absorbed through the skin.

Chemicals administered at low doses are more effectively absorbed through the skin than are chemicals administered at high doses. Mice receiving 0.3 micrograms of dioxin per kilogram of body weight absorbed 40% of the dose; mice receiving 32 to 320 micrograms of dioxin per kilogram of body weight absorbed less than 20% of the dose. This may be important for human exposures, which usually occur at low doses over long periods rather than in high doses over short periods.

Three month old rats (young adults) absorbed 16% of dioxin applied to their skin; nine-month-old rats (middle-aged) absorbed less than 5% of a similar dose.

Dr. Linda Birnbaum, who directed the research, says that her work shows that acute toxicity from skin exposure to dioxins and furans is "unlikely." Chronic (longterm) toxicity is a different matter: That's where "you're going to have the potential to build up a body burden" of the toxic chemicals, she says. Her work with young rats also concerns her because there is evidence that the skin of human babies is much more permeable than skin of adults.

The importance of this work to C-123 crews is this: our exposure was cumulative and over a very long term. This paper argues AGAINST the VA pretense that we had no dermal or inhalation exposure to dioxin. Any risk assessments that have been done without considering skin absorption should be redone in light of the new findings.

Get: David Brewster and others, "Comparative Dermal Absorption of 2,3,7,8 Tetrachlorodibenzo-p-dioxin and Three Polychlorinated Dibenzofurans." TOXICOLOGY AND APPLIED PHARMACOLOGY, Vol. 97 (January, 1989), pgs. 156-166. Reprints are free from: Linda S. Birnbaum, Systemic Toxicology Branch, National Institute of Environmental Health Sciences, Research Triangle, North Carolina 27709; phone (919) 541-3212. Ask Ms. Birnbaum for a copy of her unpublished paper on absorption of dioxins by young rats, which she presented at a meeting of the Society of Toxicology in Atlanta, GA, the week of Feb. 27, 1989.
--Peter Montague, Ph.D.

Open Letter to US Senate re: MSgt George Gadbois, USAF Ret.

Today, I wrote George's two senators from Georgia. They will have an interest in aiding him, plus the CDC and ATSDR are located in Atlanta.

Honorable Saxby Chambliss
United States Senate
131 Russell Senate Office Building
Washington, DC 20510

Dear Senator Chambliss,

I am writing on behalf of your constituent, Master Sergeant George Gadbois of Warner-Robins Georgia, who is unable himself to ask your help. Sergeant Gadbois has no family and is gravely ill with cancer throughout his body which is why I am representing him to you and to the Veterans Administration. We seek your immediate assistance regarding his Agent Orange veteran’s benefits which have been denied him by the VA.

Sergeant Gadbois recently retired from the Air Force after a long, distinguished career, and I know him from the days he served as First Sergeant of the 74th Aeromedical Evacuation Squadron, Westover AFB, MA. He was also an Aeromedical Evacuation Technician, flying the C-130 and C-123 aircraft for many years.

He sought disability benefits from the VA due to his Agent Orange exposure while flying the C-123, an aircraft previously used for spraying Agent Orange in Vietnam. Air Force studies (many of them) show his aircraft remained “heavily contaminated”, “extremely hazardous, extremely dangerous, extremely contaminated” and “a threat to public health.” All words from Air Force studies and reports.

Unfortunately, although the Air Force and the VA acknowledge he flew a contaminated aircraft for years, those agencies content that the aircrews were somehow not exposed therein. I have written both agencies and both say to contact the other. Thus, a perfect Joseph Hiller “Catch 22” leaving Sergeant Gadbois abandoned.

Other agencies such as EPA, CDC, Agency for Toxic Substances and Disease Protection, have all deferred to the Veterans Administration when approached for help. For whatever reason, none have taken a stand on whether aircrews that flew these airplanes for a decade would have been exposed to the dioxin on them, and thus meet the VA’s requirement for medical care.

Although the government agencies are timid, universities have not been afraid. In particular, the head of the Toxicology Department of Oregon Health Sciences University and also scientists from Columbia University’s School of Public Health have both weighed in, stating that the aircrew’s exposure was “most likely.”

On behalf of Sergeant Gadbois, I ask that you request a more definitive response from the CDC or the Agency for Toxic Substance and Disease Registry regarding whether aircrews serving aboard heavily contaminated airplanes for many, many years have or have not likely been exposed to the dioxin on them. A simple request, and one seeking a conclusion they’d have no hesitation making regarding a comparable civilian setting.

I cannot imagine CDC, EPA or ATSDR passively allowing a civilian airplane already tested “heavily contaminated” for dioxin to remain in service were it to be still flying today. The Air Force tests are adequate to make such a determination about our C-123. All we ask that the same logic be applied to the determination of whether or not our crews, in the VA’s words, “were as likely to as not” have been exposed.

The VA leadership, in a teleconference with me on 27 October (arranged by Brooks Tucker of Senator Burr’s office) requires proof of the contamination source. The VA does not dispute the C-123’s contamination in the face of the AF tests. VA also requires proof of exposure, but has already determined that no exposure could take place by dermal contact or inhalation. Along with scientists from the Oregon Health Sciences University and Columbia University, we say otherwise. We also insist that in a parallel civilian setting, the government would be far more forceful in protecting the public.

Can your office help? Sergeant Gadbois last week learned that his soft tissue sarcoma (an Agent Orange illness) has spread to his lungs and his brain. At best, he was told on Friday, he has a year of rapidly declining health.

George is a brave man. I have personally seen his bravery when, in response to a civilian chlorine explosion, he rushed in to aid others without regard for his own safety. There wasn’t time to get personal protective equipment yet he went to the civilian’s aid, faced with a lethal chlorine cloud. He was decorated for this heroism.

His whole military service has been to care for others, as a medic aboard aeromedical evacuation airplanes and as our beloved First Sergeant. He deserves your forceful advocacy and needs it now.

Thank you for supporting the Military Family Month…George has no family other than the men and women he served with, so as his “family,” a family which loves him very much, we ask your immediate help.

Respectfully
The Military Family of Master Sergeant George Gadbois

Wesley T. Carter, Major, USAF Retired
Chair, C-123 Aircrew Association
http://www.c123kcancer.blogspot.com       

04 November 2011

We're Going to aToxicology Conference!

We're taking our case to the experts! The Society of Toxicology meets in 2012 and we'll be there, or at another professional gathering if better suited to our needs. This week arrangements were investigated for a tabletop display of our C-123 Agent Orange contamination, focusing on the VA explanation that aircrews serving aboard the Provider weren't exposed to dioxin. Basic "flavor" is how could the VA twist contamination studies to conclude against the interest of its veterans and the ethical implications. That last part is under discussion as it might not be territory which the Society wants to address...their call, not ours.

The Society also publishes a journal and we're waiting to see if our one page add will be accepted...it has to meet their editorial approval. As for a professional juried article...that's in the works also with interest expressed by different researchers and their institutions.

Wow...a terrific storm of support for the FACT that C-123 aircrews were MOST LIKELY (we don't say absolutely but use the VA phrase "more likely to than not") exposed to Agent Orange. The planning on the article outline is underway, and we also hope to have a ethical, not just technical perspective.

Ideas, all you budding toxicologists and bioenvironmental scientists?

03 November 2011

Studying Dioxin - & Pondering VA's Assurances We Aren't Exposed

I've been in the VA healthcare system for the last several days, and hope to go home tomorrow...great care from kind, compassionate professionals. As usual. Even tried to do a little nurse and flight surgeon recruiting, plus I had lots of time in bed to think over last week's big teleconference with VHA. It gave me time to look over various Internet articles about dioxin and some of the finer details of Agent Orange contamination. There is so much to learn.


We received official and abundant VA assurances last week that our aircrews have not been exposed to dioxin. But we asked..."Hey, wait...look at all these Air Force toxicology tests. They show heavy contamination, extremely dangerous contamination. What's up?" 


The VA leaders' response was that aircrews couldn't have been exposed via skin (dermal) contact with airplane surfaces because skin is a good barrier to dioxin contamination. VA explained that we couldn't have inhaled (the second path for exposure) any dioxin because there wasn't as much dust as was the case with the workers grinding interior surfaces during Patches decontamination after that alarming 1994 report by Dr. Ron Porter and Lieutenant Colonel (now retired) Wade Weisman, who declared Patches "heavily contaminated."


As for inhalation, VA doesn't want us to worry about that pathway either. One might agree that inhalation of dioxin can be less of a problem indoors than out because most indoor dirt and dust are brought in from outside. Except with our airplane, the dioxin is already inside! The dioxin mostly remained inside, reversing the typical dioxin exposure situation. Thus we have whatever the background concentration is added to the aircraft-specific concentration! Perhaps our VA friends haven't been in a trash-hauler recently to watch crews work, move cargo, configure, do all those dust and particulate producing chores. Chores which for ten years ground our airplane's dioxin from contaminated surfaces and straight into our lungs.


As as for the third path for exposure, ingestion, VA states there probably wasn't too much dioxin dust which settled on our food, coffee and water, even though we virtually lived in the Provider for a decade. And that a lotta inflight meals, cups of coffee, gallons of water. But still, VA says there wasn't any. No studies, no research, no science to say so, but that's their view and they're stickin' to it!


So why is it that the EPA doesn't view a citizen's dioxin exposure as casually as does the VA looking at veterans? Why is the VA so confident in telling us veterans, their target population, that they have a preponderance of evidence (none of it published, none of it peer-reviewed, perhaps none of it even done?) against us having been exposed even though we'd been in close contact with our dioxin-comtaminated airplanes? Why do they offer Monsanto-Dow sponsored articles to pacify us? 


Maybe Air Force dioxin is a special, different, kinder type of dioxin, one less worrisome to the VA than the dangerous kind of dioxin the EPA worries about. Ya think? Get real!


The worries EPA has about dioxin are described in their 2003 publication Estimating Exposures and Risks, Section 2. EPA worries so much about dioxin because, especially for the dermal pathway, the absorption of dioxin through the skin has been estimated to range from 0.5 to 3.0% (EPA, 1992a), with assessments typically (conservatively) assuming 3.0%. That's a lot when you see the concentrations reported by Porter-Weisman aboard Patches


The plain truth here is exactly what Vietnam and Blue Water Navy veterans have learned before us: VA refuses to recognize any and all dioxin contamination until Congress directs otherwise. If you don't have the data to show contamination, they'll say there is no dioxin there. If you do happen to have contamination data, VA then pretends there is no chance of exposure. It is not science when the researcher proceeds with a conclusion already determined...and boy, the VA has its conclusion already on its rubber stamp "NO DIOXIN EXPOSURE HERE."


In our case, we showed VA adequate testing data to establish our exposure aboard dioxin-contaminated airplanes. We supported our approach with concurring opinions from respected professionals. We showed our Agent Orange presumptive illnesses.


But they have blinders on. "NO DIOXIN EXPOSURE HERE."

Agent Orange & the C-123 - A Toxicology Review for Aircrews

The VA has explained, during our October 27 teleconference, that aircrews weren't exposed to dioxin even though the Air Force determined our airplanes to be "heavily contaminated, extremely dangerous, extremely hazardous, and a danger to public health." Their mission, pursued with great dedication, is prevention of our claims for Agent Orange exposure...we advance our claims because we've been exposed and must seek medical care! 


Consider...the VA did not challenge the Air Force studies which established the dioxin contamination...instead, they claimed that we could not have been exposed to the contamination. A fine point, emphasized with the VA key word of PROBABILITY.


So let's sit back and review toxicology, contamination and dioxin and how all this mess affects us and our VA claims.


I believe we can make clear the PROBABILITY of our Agent Orange exposure. Dr. Fred Berman, Director of the Toxicology Department of Oregon Health Sciences University agrees that we have been exposed. Somehow, we need to challenge the DOD and VA positions with a convincing argument.


A while back, I wrote the US Agency for Toxic Substances and Disease Registry for help answering the VA's objections. The Director of the ATSDR responded, complimented our research, and recommended that DOD carefully investigate the situation. Today I started reading documents in the ATSDR collection, and this posting is to cover a few of the basics, as best I can understand them, of Agent Orange contamination and exposure.


This is from the ATSDR's documents explaining how dioxin contaminants can cause exposure.


Human Exposure Pathways 
To determine whether people are or could be exposed to contaminants associated with a property, ATSDR evaluates the environmental and human components that lead to human exposure. An exposure pathway contains five major elements: 

1) a source of contamination, 
2) contaminant transport through an environmental medium, 
3) a point of exposure, 
4) a route of human exposure, and 
5) a receptor population. 
An exposure pathway is considered a complete pathway if there is evidence that all five of these elements are, have been, or will be present at the property.
But dioxin can be found everywhere and while it is dangerous, there must be a point below which no action need be taken, and a contamination point above where action should be taken. 


We all have some amount of dioxin in our bodies. Eating animal fat is the major route of exposure for most people...which is why the AF should have alerted crews of our Agent Orange exposure back in '94...we'd have known to take precautions! For most people, eating a varied, balanced, low-fat diet results in reduced dioxin exposure via ingestion...it will also help your blood pressure, diabetes risks and certain cancers. 


Here is the decision chart upon which the ATSDR bases its approach on how much dioxin is too much dioxin:



ATSDR's Decision Framework for Sites Contaminated with Dioxin and Dioxin-Like Compounds.

Screening Level

£ 50 ppt TEQs
Evaluation Level

>50 ppt but < 1,000 ppt TEQs
Action Level

³ 1,000 ppt TEQs
Health effects are unlikely and further evaluation is not necessary, unless there are community health concerns.Evaluation of site-specific factors, such as
  • Bioavailability
  • Ingestion rates
  • Pathway analysis
  • Soil cover
  • Climate
  • Other contaminants
  • Community concerns
  • Demographics
  • Background exposure
Potential public health actions considered, such as
  • Surveillance
  • Research
  • Health studies
  • Community education
  • Exposure investigations
(De Rosa et al. 1997a)

When contamation is considered, one must also consider the amount of time spent subjected to that contamination at that helps determine exposure. The ATSDR states: 

There are three exposure periods - 
  • acute (less than 15 days) 
  • intermediate (15–364 days)
  • chronic (365 days or more)
In the case of our aircrews, we fall into the "chronic" period regarding contamination exposure because of the full decade we flew the contaminated C-123s.


The VA position is that our crews couldn't have been exposed by contact with the airplane's dioxin-contaminated surfaces...Post Deployment Health stated that the skin is an effective barrier to dioxin. So, if the VA eliminates our dermal exposure, that means they are saying the Vietnam vets were exposed solely via inhalation and ingestion. Sorry, VA...there way too many government studies showing that the principal method of suspected exposure in Vietnam was physical contact with dioxin-contaminated surfaces.


The ATSDR defines exposure pathway:


The route a substances takes from its source (where it began) to its end point (where it ends), and how people can come into contact with (or get exposed to) it. An exposure pathway has four parts:

  •  a point of exposure, such as surface, water well, structure
  •  an environmental media an transport mechanism, such as movement through air or water
  •  a point of exposure, such as eating, drinking, breathing or touching
  •  a receptor population (people potentially or actually exposed)

When all four parts are present, the exposure pathway is termed a completed exposure pathway.


So it seems to me, we have met all four parts of the requirements for a completed exposure pathway. Therefore, we have been exposed. And our exposure was chronic!


Now let's look at the ways we were exposed. First, by physical contact of our skin to dioxin-contaminated surfaces. The 1994 study of Patches made clear its contamination, with dioxin 800% greater than standards for reentering buildings after fires. The EPA reports the absorption of dioxin through the skin has been estimated to range from 0.5 to 3.0% (EPA, 1992a), with assessments typically (conservatively) assuming 3.0%. The 1994 Patches report identified  an average of 617 nanograms per square meter...the "safe" average should be about 85 nanograms per square meter!


Another method of exposure is via inhalation. Dioxin deadly attaches to dust, which then gets kicked up and breathed in.


The final method of exposure likely to happen to aircrews is ingestion...eating the stuff. This would come from eating food which had been in contact with a dioxin-contaminated surface, or drinking water into which dioxin-contaminated dust may have settled. Or one of those great Monsanto Agent Orange Candy Bars!


Of these three methods of exposure, the most likely and the most intense route for aircrews is probably dermal...skin contact. The oils naturally present on our skin readily permit contamination, even though the skin is normally a good protective barrier.


Note that exposure is cumulative. Exposure via the three pathways, exposure for ten years...it all adds up. And there is nothing in the literature from EPA, CDC, ATSDR or any other alphabet department which considers dioxin- contaminated surfaces (such as we had in the C-123) safe...to the contrary, they are identified as unsafe.


For the VA to describe dioxin-contaminated C-123s as aircraft which did not EXPOSE crews to dioxin is stretching science all out of shape. We were exposed. We were exposed. We were exposed!