Agent Orange in war medicine: an aftermath myth

Wartime toxin exposure: recognising the silent killer

Wartime toxin exposures have been implicated in the genesis of malignancy in war veterans. Agent Orange, one toxin among many, has been linked to malignancy and the subcomponent phenoxyacetic acid has been associated with soft tissue sarcomas (STSs). This case demonstrates the association between a wartime toxin exposure (Agent Orange) and subsequent cancer development. Ultimately, we aim to highlight the importance of simple, specific questions in the patient history to account for previous wartime toxin exposures.

From Phenoxyacetic Acids to Cellular Telephones: Is There Historical Evidence for the Precautionary Principle in Cancer Prevention?

In the late 1970s, the author and his colleagues published the first scientific evidence of an association between exposure to phenoxyacetic acids and chlorophenols and certain malignant tumors; the study subjects were also exposed to contaminating dioxins such as 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD). The results have been corroborated in other studies. Over the years, industry and its allied experts have attacked these studies, but in 1997 IARC classified TCDD as a human carcinogen, Group I. The author and colleagues found an increased risk of non-Hodgkins lymphoma (NHL) for subjects exposed to these chemicals or to some persistent organic pollutants; the increasing incidence in Sweden leveled off in about 1990. The author postulated that the regulation of or ban on these chemicals in Sweden in the 1970s contributed to the now decreasing incidence of NHL. Recent findings of an association between cellular telephones and brain tumors have provoked much unfounded criticism from industry and from the Swedish Radiation Protection Authority. Thus the precautionary principle is prohibited and early warnings of a cancer risk ignored. The experience of cancer risks from certain chlorinated phenols may serve as a model of how the precautionary principle could be used to take early warnings seriously. Unfortunately, the lessons of history seem to go unheeded, as exemplified by the case of cellular telephones.

Secret ties to industry and conflicting interests in cancer research

BACKGROUND

Recently it was reported that a Swedish professor in environmental health has for decades worked as a consultant for Philip Morris without reporting his employment to his academic employer or declaring conflicts of interest in his research. The potential for distorting the epidemiological assessments of hazard and risk through paid consultants, pretending to be independent, is not exclusive to the tobacco industry.

METHODS

Documentation is drawn from peer reviewed publications, websites, documents from the Environmental Protection Agency, University reports, Wellcome Library Special Collections and the Washington Post.

RESULTS

Some consulting firms employ university researchers for industry work thereby disguising industry links in the income of large departments. If the industry affiliation is concealed by the scientist, biases from conflicting interests in risk assessments cannot be evaluated and dealt with properly. Furthermore, there is reason to suspect that editors and journal staff may suppress publication of scientific results that are adverse to industry owing to internal conflict of interest between editorial integrity and business needs.

CONCLUSIONS

Examples of these problems from Sweden, UK, and USA are presented. The shortfalls cited in this article illustrate the need for improved transparency, regulations that will help curb abuses as well as instruments for control and enforcement against abuses.