MEDSCAPE Comments on Recent Institute of Medicine Agent Orange Report

Agent Orange Exposure Linked to Stroke

Pauline Anderson

December 10, 2013

• Comment

• 
• 
• 
• 
• Print

EDITORS' RECOMMENDATIONS

• Mounting Evidence That Agent Orange Exposure Ups Prostate Cancer Risk
• Graves' Disease Nearly Tripled in Vietnam Vets Exposed to Agent Orange
• Stroke/Cerebrovascular Disease News & Perspectives

Topic Alert

Receive an email from Medscape whenever new articles on this topic are available.

•  Add Stroke to My Topic Alert

DRUG & REFERENCE INFORMATION

• Carotid Artery Stenosis Imaging
• Acute Management of Stroke
• Stroke Imaging

Stroke has been added to the growing list of possible health effects Vietnam veterans may face long term after exposure to Agent Orange.

In response to new evidence showing a statistically significant overall increase in stroke associated with exposure to chemical in Agent Orange, a committee examining these health effects has moved stroke to the "limited and suggestive" evidence category.

However, the published data do not permit distinguishing hemorrhagic from ischemic stroke, said the authors of the updated report, Veterans and Agent Orange: Update 2012 : Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth Biennial Update).

The evidence already suggested an association between exposure to the chemicals and hypertension, ischemic heart disease, and type 2 diabetes, as well as Parkinson's disease and some cancers.

Elsewhere in the 900-page report, the committee concluded that on the basis of newly reviewed evidence and in previous reports, there is also "limited or suggestive" evidence of an association between exposure to the chemicals of interest and Parkinson's disease.

The committee concluded that on the basis of new evidence and previous reports, evidence is inadequate or insufficient to determine whether there is an association between exposure to chemicals of interest and Alzheimer's disease.

Institute of Medicine Releases Newest Agent Orange Review

Released today, the Institute of Medicine's Agent Orange Committee delivered their 2012 update on Agent Orange issues. Because the IOM only considers issues submitted to them by the VA, there was very little controversial coverage...nothing done regarding C-123 or next-generation exposure concerns because these were not in the tasking paid for by the VA in their charge to the IOM.

Instead, the IOM's 2012 report simply noted our January presentation to them and dismissed their involvement with us by stating exposures outside Vietnam were not a part of their VA assignment. True enough, but our presentation to them dealt with the VA's treatment of the concept of "exposure" and the denial of VA benefits because Agent Orange hasn't been shown to be harmful (at least, from the perspective of VA's Compensation and Pension Service which uses that excuse to deny claims.)

We note with humor the fact that most of the committee are scientists, and only two are physicians. Based on earlier directives from Compensation and Pension Services only physicians are qualified to comment on Agent Orange (and none of them, unless they agree with VA perspectives!) so therefore this report shouldn't be acceptable to the VA!

In fact, of course, these committee members are dedicated professionals from science and medicine and their report is well-founded. We only mean to say the VA is highly selective in what input it will accept, and firmly determined to prevent any input which may (as it always does) confirm both the contamination of the C-123 and the exposure of its aircrews and maintenance personnel.

The single new conclusion was that there is limited or suggestive evidence of a scientifically meaningful association of stroke with exposure to the chemicals in question. This could be a tremendously important point, given the positive way Secretary Shinseki treated the IOM's earlier findings on heart disease!