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Subramanian MP, Eaton DB, Labilles UL, Heiden BT, Chang SH, Yan Y, Schoen MW, Patel MR, Kreisel D, Nava RG, Thomas TS, Meyers BF, Kozower BD, Puri V. Exposure to Agent Orange is associated with increased recurrence after surgical treatment of stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 2024; 167:1591-1600.e2. [PMID: 37709166 DOI: 10.1016/j.jtcvs.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/31/2023] [Accepted: 09/02/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE Approximately 3 million Americans served in the armed forces during the Vietnam War. Veterans have a higher incidence rate of lung cancer compared with the general population, which may be related to exposures sustained during service. Agent Orange, one of the tactical herbicides used by the armed forces as a means of destroying crops and clearing vegetation, has been linked to the development of several cancers including non-small cell lung cancer. However, traditional risk models of lung cancer survival and recurrence often do not include such exposures. We aimed to examine the relationship between Agent Orange exposure and overall survival and disease recurrence for surgically treated stage I non-small cell lung cancer. METHODS We performed a retrospective cohort study using a uniquely compiled dataset of US Veterans with pathologic I non-small cell lung cancer. We included adult patients who served in the Vietnam War and underwent surgical resection between 2010 and 2016. Our 2 comparison groups included those with identified Agent Orange exposure and those who were unexposed. We used multivariable Cox proportional hazards and Fine and Gray competing risk analyses to examine overall survival and disease recurrence for patients with pathologic stage I disease, respectively. RESULTS A total of 3958 Vietnam Veterans with pathologic stage I disease were identified (994 who had Agent Orange exposure and 2964 who were unexposed). Those who had Agent Orange exposure were more likely to be male, to be White, and to live a further distance from their treatment facility (P < .05). Tumor size distribution, grade, and histology were similar between cohorts. Multivariable Cox proportional hazards modeling identified similar overall survival between cohorts (Agent Orange exposure hazard ratio, 0.97; 95% CI, 0.86-1.09). Patients who had Agent Orange exposure had a 19% increased risk of disease recurrence (hazard ratio, 1.19; 95% CI, 1.02-1.40). CONCLUSIONS Veterans with known Agent Orange exposure who undergo surgical treatment for stage I non-small cell lung cancer have an approximately 20% increased risk of disease recurrence compared with their nonexposed counterparts. Agent Orange exposure should be taken into consideration when determining treatment and surveillance regimens for Veteran patients.
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Affiliation(s)
- Melanie P Subramanian
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo.
| | - Daniel B Eaton
- Veterans Affairs St Louis Health Care System, St Louis, Mo
| | | | - Brendan T Heiden
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Su-Hsin Chang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Yan Yan
- Veterans Affairs St Louis Health Care System, St Louis, Mo; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Martin W Schoen
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Mo; Division of Hematology and Medical Oncology, Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, Mo
| | - Mayank R Patel
- Veterans Affairs St Louis Health Care System, St Louis, Mo
| | - Daniel Kreisel
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Ruben G Nava
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Theodore S Thomas
- Department of Medical Oncology, Washington University School of Medicine, St Louis, Mo
| | - Bryan F Meyers
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Benjamin D Kozower
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo
| | - Varun Puri
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo
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Discussion to: Exposure to Agent Orange is associated with increased recurrence after surgical treatment of stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 2023; 167:1601-2. [PMID: 37943215 DOI: 10.1016/j.jtcvs.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Indexed: 11/10/2023]
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Ma H, Wan JY, Cortessis VK, Gupta P, Cozen W. Survival in Agent Orange exposed and unexposed Vietnam-era veterans who were diagnosed with lymphoid malignancies. Blood Adv 2024; 8:1037-1041. [PMID: 38033199 PMCID: PMC10920100 DOI: 10.1182/bloodadvances.2023011999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Helen Ma
- Section of Hematology/Oncology, Department of Medicine, VA Long Beach Healthcare System, Long Beach, CA
- Division of Hematology/Oncology, Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
| | - Jia Y. Wan
- Department of Epidemiology and Biostatistics, Samueli School of Public Health, University of California, Irvine, CA
| | - Victoria K. Cortessis
- Department of Clinical Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Pankaj Gupta
- Section of Hematology/Oncology, Department of Medicine, VA Long Beach Healthcare System, Long Beach, CA
| | - Wendy Cozen
- Division of Hematology/Oncology, Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
- Department of Epidemiology and Biostatistics, Samueli School of Public Health, University of California, Irvine, CA
- Department of Pathology, School of Medicine, University of California Irvine, Irvine, CA
- Department of Environmental and Occupational Health, Samueli School of Public Health, University of California Irvine, Irvine, CA
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Van Quang H, Vuong NB, Trang BNL, Toan NL, Van Tong H. Association of UGT1A1 gene variants, expression levels, and enzyme concentrations with 2,3,7,8-TCDD exposure in individuals exposed to Agent Orange/Dioxin. Sci Rep 2024; 14:3315. [PMID: 38332122 PMCID: PMC10853243 DOI: 10.1038/s41598-024-54004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 02/07/2024] [Indexed: 02/10/2024] Open
Abstract
Among the congener of dioxin, 2,3,7,8-TCDD is the most toxic, having a serious long-term impact on the environment and human health. UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a crucial role in the detoxification and excretion of endogenous and exogenous lipophilic compounds, primarily in the liver and gastrointestinal tract. This study aimed to investigate the association of UGT1A1 gene polymorphisms, expression levels, and enzyme concentration with Agent Orange/Dioxin exposure. The study included 100 individuals exposed to Agent Orange/Dioxin nearby Da Nang and Bien Hoa airports in Vietnam and 100 healthy controls. UGT1A1 SNP rs10929303, rs1042640 and rs8330 were determined by Sanger sequencing, mRNA expression was quantified by RT-qPCR and plasma UGT1A1 concentrations were measured by ELISA. The results showed that UGT1A1 polymorphisms at SNPs rs10929303, rs1042640 and rs8330 were associated with Agent Orange/Dioxin exposure (OR = 0.55, P = 0.018; OR = 0.55, P = 0.018 and OR = 0.57, P = 0.026, respectively). UGT1A1 mRNA expression levels and enzyme concentration were significantly elevated in individuals exposed to Agent Orange/Dioxin compared to controls (P < 0.0001). Benchmark dose (BMD) analyses showed that chronic exposure to 2,3,7,8-TCDD contamination affects the UGT1A1 mRNA and protein levels. Furthermore, UGT1A1 polymorphisms affected gene expression and enzyme concentrations in individuals exposed to Agent Orange/Dioxin. In conclusion, UGT1A1 gene polymorphisms, UGT1A gene expression levels and UGT1A1 enzyme concentrations were associated with Agent Orange/Dioxin exposure. The metabolism of 2,3,7,8-TCDD may influence UGT1A gene expression and enzyme concentrations.
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Affiliation(s)
- Ha Van Quang
- Department of Haematology, Toxicology, Radiation, and Occupation, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
- The Center of Toxicological and Radiological Training and Research, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Ba Vuong
- Department of Haematology, Toxicology, Radiation, and Occupation, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Bui Ngoc Linh Trang
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222 Phung Hung, Ha Dong, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hoang Van Tong
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222 Phung Hung, Ha Dong, Hanoi, Vietnam.
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam.
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Liu LW, Wang M, Grandhi N, Schroeder MA, Thomas T, Vargo K, Gao F, Sanfilippo KM, Chang SH. The Association of Agent Orange Exposure with the progression of monoclonal gammopathy of undetermined significance to multiple myeloma: a population-based study of Vietnam War Era Veterans. J Hematol Oncol 2024; 17:3. [PMID: 38191467 PMCID: PMC10773019 DOI: 10.1186/s13045-023-01521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024] Open
Abstract
Herbicide and pesticide exposure [e.g., agent orange (AO)] is associated with an increased risk of multiple myeloma (MM) due to the contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). However, it is unclear whether TCDD/AO exposure (AO exposure hereafter) increases the risk of progression of monoclonal gammopathy of undetermined significance (MGUS) to MM. We sought to evaluate the association in a nationwide study of US Veterans. A natural language processing algorithm was used to confirm MGUS and progression to MM. We included Veterans who were diagnosed with MGUS from 10/1/1999 to 12/31/2021 and served during the Vietnam War Era from 1/9/1962 to 5/7/1975. AO exposure was stratified according to three TCDD exposure levels: high (1/9/1962-11/30/1965), medium (12/1/1965-12/31/1970), or low (1/1/1971-5/7/1975). The association between AO exposure and progression was analyzed using multivariable Fine-Gray subdistribution hazard model with death as a competing event. The analytic cohort included 10,847 Veterans with MGUS, of whom 26.3% had AO exposure and 7.4% progressed to MM over a median follow-up of 5.2 years. In multivariable analysis, high exposure was associated with an increased progression rate (multivariable-adjusted hazard ratio 1.48; 95% confidence interval 1.02-2.16), compared to Veterans with no exposure. This information is critical to inform progression risk in patients diagnosed with MGUS and prior AO exposure. It is also applicable to MGUS patients with occupational TCDD exposure from herbicides and pesticides.
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Affiliation(s)
- Lawrence W Liu
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA
- City of Hope National Comprehensive Cancer Center, 1500 E. Duarte Rd, Duarte, CA, 91010, USA
| | - Mei Wang
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Nikhil Grandhi
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA
- Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8056, St. Louis, MO, 63110, USA
| | - Mark A Schroeder
- Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8056, St. Louis, MO, 63110, USA
| | - Theodore Thomas
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA
- Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8056, St. Louis, MO, 63110, USA
| | - Kristin Vargo
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA
| | - Feng Gao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Kristen M Sanfilippo
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA
- Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8056, St. Louis, MO, 63110, USA
| | - Su-Hsin Chang
- Research Service, St. Louis Veterans Affairs Medical Center, 501 N. Grand Blvd Suite 300, St. Louis, MO, 63103, USA.
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.
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de la Monte SM, Tong M. Agent Orange Herbicidal Toxin-Initiation of Alzheimer-Type Neurodegeneration. J Alzheimers Dis 2024; 97:1703-1726. [PMID: 38306038 DOI: 10.3233/jad-230881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Background Agent Orange (AO) is a Vietnam War-era herbicide that contains a 1 : 1 ratio of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T). Emerging evidence suggests that AO exposures cause toxic and degenerative pathologies that may increase the risk for Alzheimer's disease (AD). Objective This study investigates the effects of the two main AO constituents on key molecular and biochemical indices of AD-type neurodegeneration. Methods Long Evans rat frontal lobe slice cultures treated with 250μg/ml of 2,4-D, 2,4,5-T, or both (D + T) were evaluated for cytotoxicity, oxidative injury, mitochondrial function, and AD biomarker expression. Results Treatment with the AO constituents caused histopathological changes corresponding to neuronal, white matter, and endothelial cell degeneration, and molecular/biochemical abnormalities indicative of cytotoxic injury, lipid peroxidation, DNA damage, and increased immunoreactivity to activated Caspase 3, glial fibrillary acidic protein, ubiquitin, tau, paired-helical filament phosphorylated tau, AβPP, Aβ, and choline acetyltransferase. Nearly all indices of cellular injury and degeneration were more pronounced in the D + T compared with 2,4-D or 2,4,5-T treated cultures. Conclusions Exposures to AO herbicidal chemicals damage frontal lobe brain tissue with molecular and biochemical abnormalities that mimic pathologies associated with early-stage AD-type neurodegeneration. Additional research is needed to evaluate the long-term effects of AO exposures in relation to aging and progressive neurodegeneration in Vietnam War Veterans.
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Affiliation(s)
- Suzanne M de la Monte
- Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Lifespan Academic Institutions, and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Medicine, Rhode Island Hospital, Lifespan Academic Institutions, and the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ming Tong
- Department of Medicine, Rhode Island Hospital, Lifespan Academic Institutions, and the Warren Alpert Medical School of Brown University, Providence, RI, USA
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Benhammou JN, Leng M, Shah SC, Cholankeril G, Dong TS, Patel AA, Tong MJ. Exposure to Agent Orange and Hepatocellular Carcinoma Among US Military Personnel. JAMA Netw Open 2023; 6:e2346380. [PMID: 38048128 PMCID: PMC10696483 DOI: 10.1001/jamanetworkopen.2023.46380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/24/2023] [Indexed: 12/05/2023] Open
Abstract
Importance Hepatocellular carcinoma (HCC) and its mortality are on the rise. Viral hepatitis and alcohol are leading risk factors; however, other risk factors among veterans are less defined, including Agent Orange (AO), an herbicide linked to several cancers. Objective To assess the association of AO exposure and HCC in a national cohort of Vietnam veterans. Design, Setting, and Participants This retrospective cohort study included Vietnam veterans who served between 1966 and 1975, were male, were older than 18 years at the time of deployment, and had established follow-up in the Veterans Affairs (VA) between 2000 and 2019. Veterans with AO exposure were identified in the disability data via validated clinical surveys. Relevant clinical risk factors for cirrhosis and HCC were collected. Patients were stratified based on cirrhosis status, as defined by consecutive diagnosis found by documented International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision scores or calculated Fibrosis-4 scores. Data were collected from January 1, 2019, to December 31, 2020, and analyzed from December 2020 to October 2023. Main Outcome and Measures Incident HCC was the primary outcome. AO and HCC association was estimated using a multivariable Cox regression analysis, with death and liver transplant as competing events. Results Of the 296 505 eligible veterans (222 545 [75.1%] White individuals and 44 342 [15.0%] Black individuals), 170 090 (57%) had AO exposure (mean [SD] age, 21.62 [3.49] years; 131 552 White individuals [83.2%] and 22 767 Black individuals [14.4%]) and 35 877 (12.1%) had cirrhosis. Veterans who were not exposed to AO were more likely to smoke (109 689 of 126 413 [86.8%] vs 146 061 of 170 090 [85.9%]); use alcohol (54 147 of 126 413 [42.8%] vs 71 951 of 170 090 [42.3%]) and have viral hepatitis (47 722 of 126 413 [37.8%] vs 58 942 of 170 090 [34.7%]). In a multivariable competing risk model, AO exposure was not associated with HCC. Among veterans with cirrhosis, self-identification as Hispanic individuals (aHR, 1.51; 95% CI, 1.30-1.75; P <.001) or Black individuals (aHR, 1.18; 95% CI, 1.05-1.32; P = .004), and having a diagnosis of viral hepatitis (aHR, 3.71; 95% CI, 3.26-4.24; P <.001), alcohol-associated liver disease (aHR, 1.32; 95% CI, 1.19-1.46; P <.001), and nonalcoholic fatty liver disease (NAFLD) (aHR, 1.92; 95% CI, 1.72-2.15; P <.001) were associated with HCC. Among veterans without cirrhosis, hypertension (aHR, 1.63; 95% CI, 1.23-2.15; P <.001) and diabetes (aHR, 1.52; 95% CI, 1.13-2.05; P = .005) were also associated with HCC. Early smoking and alcohol use were significant risk factors for HCC. Conclusions and Relevance In this large nationwide cohort study of Vietnam veterans, AO exposure was not associated with HCC. Smoking, alcohol, viral hepatitis, and NAFLD were the most important clinical risk factors for HCC.
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Affiliation(s)
- Jihane N. Benhammou
- Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Mei Leng
- Greater Los Angeles Healthcare System, Los Angeles, California
- Biomathematics Department, University of California, Los Angeles
| | - Shailja C. Shah
- VA San Diego Healthcare System, La Jolla, California
- Division of Gastroenterology, University of California, San Diego, La Jolla
| | | | - Tien S. Dong
- Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Arpan A. Patel
- Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Myron J. Tong
- Huntington Medical Research Institutes, Pasadena, California
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Gottlieb SH. Agent Orange and Marine Dress Blues. Am J Med 2023; 136:946-947. [PMID: 37150493 DOI: 10.1016/j.amjmed.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/09/2023]
Affiliation(s)
- Sheldon H Gottlieb
- Associate Professor of Medicine Emeritus, Johns Hopkins University School of Medicine, Baltimore, MD.
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Vuong NB, Quang HV, Linh Trang BN, Duong DH, Toan NL, Tong HV. Association of PKLR gene copy number, expression levels and enzyme activity with 2,3,7,8-TCDD exposure in individuals exposed to Agent Orange/Dioxin in Vietnam. Chemosphere 2023; 329:138677. [PMID: 37060958 DOI: 10.1016/j.chemosphere.2023.138677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) is the most toxic congener of dioxin and has serious long-term effects on the environment and human health. Pyruvate Kinase L/R (PKLR) gene expression levels and gene variants are associated with pyruvate kinase enzyme deficiency, which has been identified as the cause of several diseases linked to dioxin exposure. In this study, we estimated PKLR gene copy number and gene expression levels using real-time quantitative PCR (RT-qPCR) assays, genotyped PKLR SNP rs3020781 by Sanger sequencing, and quantified plasma pyruvate kinase enzyme activity in 100 individuals exposed to Agent Orange/Dioxin near Bien Hoa and Da Nang airfields in Vietnam and 100 healthy controls. The means of PKLR copy numbers and PKLR gene expression levels were significantly higher, while pyruvate kinase enzyme activity was significantly decreased in Agent Orange/Dioxin-exposed individuals compared to healthy controls (P < 0.0001). Positive correlations of PKLR gene copy number and gene expression with 2,3,7,8-TCDD concentrations were observed (r = 0.2, P = 0.045 and r = 0.54, P < 0.0001, respectively). In contrast, pyruvate kinase enzyme activity was inversely correlated with 2,3,7,8-TCDD concentrations (r = -0.52, P < 0.0001). PKLR gene copy number and gene expression levels were also inversely correlated with pyruvate kinase enzyme activity. Additionally, PKLR SNP rs3020781 was found to be associated with 2,3,7,8-TCDD concentrations and PKLR gene expression. In conclusion, PKLR copy number, gene expression levels, and pyruvate kinase enzyme activity are associated with 2,3,7,8-TCDD exposure in individuals living in Agent Orange/Dioxin-contaminated areas.
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Affiliation(s)
- Nguyen Ba Vuong
- Department of Haematology, Toxicology, Radiation, and Occupation, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Viet Nam
| | - Ha Van Quang
- The Center of Toxicological and Radiological Training and Research, Vietnam Military Medical University, Viet Nam
| | - Bui Ngoc Linh Trang
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Viet Nam
| | - Dao Hong Duong
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Viet Nam
| | - Nguyen Linh Toan
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Viet Nam
| | - Hoang Van Tong
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Viet Nam; Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Viet Nam.
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van Gerwen M, Vasan V, Genden E, Saul SR. Human 2,3,7,8-tetrachlorodibenzo-p-dioxin exposure and thyroid cancer risk. Toxicology 2023; 488:153474. [PMID: 36868552 DOI: 10.1016/j.tox.2023.153474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/05/2023]
Abstract
Thyroid cancer incidence has been steadily rising since the 1970s and exposure to environmental pollutants, including persistent organic pollutants such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other dioxins, has emerged as a potential explanation for this increase. This study aimed to summarize available human studies on the association between TCDD exposure and thyroid cancer. A systematic review of the literature was performed searching the National Library of Medicine and National Institutes of Health PubMed, Embase, and Scopus databases, through January 2022, using the following keywords: "thyroid", "2,3,7,8-tetrachlorodibenzo-p-dioxin", "TCDD", "dioxin", and "Agent Orange". Six studies were included in this review. Three studies evaluated the acute exposure to the chemical factory accident in Seveso, Italy, and found a non-significant increase in the risk of thyroid cancer. Two studies investigating Agent Orange exposure among United States Vietnam War veterans found a significant risk of thyroid cancer following exposure. No association was found in one study evaluating TCDD exposure through herbicides. The current study highlights the limited information on the potential association between TCDD exposure and thyroid cancer and thus the need for future human studies, especially considering the persistent human exposure to dioxins in the environment.
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Affiliation(s)
- Maaike van Gerwen
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Vikram Vasan
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric Genden
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shira R Saul
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
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Tran HT, Nguyen HM, Nguyen TMH, Chang C, Huang WL, Huang CL, Chiang TY. Microbial Communities Along 2,3,7,8-tetrachlorodibenzodioxin Concentration Gradient in Soils Polluted with Agent Orange Based on Metagenomic Analyses. Microb Ecol 2023; 85:197-208. [PMID: 35034142 DOI: 10.1007/s00248-021-01953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
The 2,3,7,8-tetrachlorodibenzodioxin (TCDD), a contaminant in Agent Orange released during the US-Vietnam War, led to a severe environmental crisis. Approximately, 50 years have passed since the end of this war, and vegetation has gradually recovered from the pollution. Soil bacterial communities were investigated by 16S metagenomics in habitats with different vegetation physiognomies in Central Vietnam, namely, forests (S0), barren land (S1), grassland (S2), and developing woods (S3). Vegetation complexity was negatively associated with TCDD concentrations, revealing the reasoning behind the utilization of vegetation physiognomy as an indicator for ecological succession along the gradient of pollutants. Stark changes in bacterial composition were detected between S0 and S1, with an increase in Firmicutes and a decrease in Acidobacteria and Bacteroidetes. Notably, dioxin digesters Arthrobacter, Rhodococcus, Comamonadaceae, and Bacialles were detected in highly contaminated soil (S1). Along the TCDD gradients, following the dioxin decay from S1 to S2, the abundance of Firmicutes and Actinobacteria decreased, while that of Acidobacteria increased; slight changes occurred at the phylum level from S2 to S3. Although metagenomics analyses disclosed a trend toward bacterial communities before contamination with vegetation recovery, non-metric multidimensional scaling analysis unveiled a new trajectory deviating from the native state. Recovery of the bacterial community may have been hindered, as indicated by lower bacterial diversity in S3 compared to S0 due to a significant loss of bacterial taxa and recruitment of fewer colonizers. The results indicate that dioxins significantly altered the soil microbiomes into a state of disorder with a deviating trajectory in restoration.
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Affiliation(s)
- Huyen-Trang Tran
- Department of Biology, Vinh University, Vinh, Nghe An, 461010, Vietnam
| | - Hung-Minh Nguyen
- Center for responding to climate change, Department of Climate Change, Ministry of Natural Resources and Environment, Hanoi, 125000, Vietnam
| | - Thi-Minh-Hue Nguyen
- Analytical laboratory for Environment, Dioxin and Toxins, Northern Center for Environmental Monitoring, Vietnam Environment Administration, Hanoi, 115000, Vietnam
| | - Chieh Chang
- Department of Life Sciences, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Wei-Ling Huang
- Department of Life Sciences, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Chao-Li Huang
- Institute of Tropical Plant Sciences and Microbiology, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Tzen-Yuh Chiang
- Department of Life Sciences, National Cheng Kung University, Tainan, 70101, Taiwan.
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12
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Kaul B, Lee JS, Glidden DV, Blanc PD, Zhang N, Collard HR, Whooley MA. Agent Orange Exposure and Risk of Idiopathic Pulmonary Fibrosis among U.S. Veterans. Am J Respir Crit Care Med 2022; 206:750-757. [PMID: 35559726 PMCID: PMC9799114 DOI: 10.1164/rccm.202112-2724oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/13/2022] [Indexed: 01/02/2023] Open
Abstract
Rationale: There is limited literature exploring the relationship between military exposures and idiopathic pulmonary fibrosis (IPF). Objectives: To evaluate whether exposure to Agent Orange is associated with an increased risk of IPF among veterans. Methods: We used Veterans Health Administration data to identify patients diagnosed with IPF between 2010 and 2019. We restricted the cohort to male Vietnam veterans and performed multivariate logistic regression to examine the association between presumptive Agent Orange exposure and IPF. We conducted sensitivity analyses restricting the cohort to army veterans (highest theoretical burden of exposure, surrogate for dose response) and a more specific case definition of IPF. Fine-Gray competing risk models were used to evaluate age to IPF diagnosis. Measurements and Main Results: Among 3.6 million male Vietnam veterans, 948,103 (26%) had presumptive Agent Orange exposure. IPF occurred in 2.2% of veterans with Agent Orange exposure versus 1.9% without exposure (odds ratio, 1.14; 95% confidence interval [CI], 1.12-1.16; P < 0.001). The relationship persisted after adjusting for known IPF risk factors (odds ratio, 1.08; 95% CI, 1.06-1.10; P < 0.001). The attributable risk among exposed veterans was 7% (95% CI, 5.3-8.7%; P < 0.001). Numerically greater risk was observed when restricting the cohort to 1) Vietnam veterans who served in the army and 2) a more specific definition of IPF. After accounting for the competing risk of death, veterans with Agent Orange exposure were still more likely to develop IPF. Conclusions: Presumptive Agent Orange exposure is associated with greater risk of IPF. Future research should validate this association and investigate the biological mechanisms involved.
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Affiliation(s)
- Bhavika Kaul
- Department of Medicine and
- Measurement Science Quality Enhancement Research Initiative, San Francisco Veterans Affairs Healthcare System, San Francisco, California; and
| | - Joyce S. Lee
- Department of Medicine, University of Colorado, Aurora, Colorado
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | | | - Ning Zhang
- Measurement Science Quality Enhancement Research Initiative, San Francisco Veterans Affairs Healthcare System, San Francisco, California; and
| | | | - Mary A. Whooley
- Department of Medicine and
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
- Measurement Science Quality Enhancement Research Initiative, San Francisco Veterans Affairs Healthcare System, San Francisco, California; and
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13
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Trang TB, Tai PT, Nishijo M, Anh TN, Thao PN, Hoa VT, Nghi TN, Van Luong H, Nishijo H. Adverse effects of dioxins on cognitive ability and motor performance of 5-year-old children residing in a hotspot of dioxin contamination originating from Agent Orange in Vietnam: A prospective cohort study. Sci Total Environ 2022; 833:155138. [PMID: 35405238 DOI: 10.1016/j.scitotenv.2022.155138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
Bien Hoa airbase is the most dioxin-polluted hotspot in Vietnam. In 2012, a birth cohort living around Bien Hoa airbase was recruited for assessment of physical and neurological development. In the present study, neurodevelopment scores at 5 years of age were assessed by the Kaufman Assessment Battery for Children, Second Edition and the Movement Assessment Battery for Children, Second Edition for 185 children in Bien Hoa and 104 children in Ha Dong (unexposed control group) to clarify the effects of dioxin. 2,3,7,8-tetrachlorodibenzo-p-dioxin concentrations in breast milk of women in Bien Hoa were approximately three times higher than those of women in Ha Dong (2.33 vs. 0.69 pg/g fat, p < 0.001). In general, neurodevelopment scores were lower in Bien Hoa children than in Ha Dong children. In boys, scores differed for number recall (12.6 vs. 14.0, p = 0.036), triangles (10.7 vs. 12.4, p = 0.005), manual dexterity (8.3 vs. 9.7, p = 0.037), balance (7.4 vs. 10.3, p < 0.001), and total movement scores (8.0 vs. 10.1, p = 0.003). After adjusting for covariates, linear regression analysis indicated that the scores of the triangles, balance, and total movement tests were inversely associated with levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin and of toxic equivalency of polychlorinated dibenzodioxins and polychlorinated dibenzofurans. In girls, scores differed for the triangles test (11.0 vs. 12.6, p = 0.005), hand movement test (9.6 vs. 11.3, p = 0.003), and balance test (9.1 vs. 10.7, p = 0.050); toxic equivalency of polychlorinated dibenzofurans was inversely associated with hand movement and balance scores. Overall, perinatal dioxin exposure appears to have a long-term impact on neurodevelopment.
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Affiliation(s)
- Thieu Ban Trang
- Department of Anatomy, Vietnam Military Medical University, 160-Phung Hung, Ha Dong, Ha Noi, Viet Nam
| | - Pham The Tai
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222-Phung Hung, Ha Dong, Ha Noi, Viet Nam.
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan.
| | - Tran Ngoc Anh
- Department of Anatomy, Vietnam Military Medical University, 160-Phung Hung, Ha Dong, Ha Noi, Viet Nam
| | - Pham Ngoc Thao
- Military Hospital 103, Vietnam Military Medical University, 261-Phung Hung, Ha Dong, Ha Noi, Viet Nam
| | - Vu Thi Hoa
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
| | - Tran Ngoc Nghi
- Ministry of Health, 138 A-Giang Vo, Kim Ma, Ba Dinh, Ha Noi, Viet Nam
| | - Hoang Van Luong
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222-Phung Hung, Ha Dong, Ha Noi, Viet Nam
| | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
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14
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Kudryavtseva AD, Shelepchikov AA, Brodsky ES. Fingerprinting and source apportionment of dioxin contamination of soils and chicken eggs in Southeast and Central Vietnam. Environ Sci Pollut Res Int 2022; 29:47137-47147. [PMID: 35175530 DOI: 10.1007/s11356-022-19253-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/12/2022] [Indexed: 06/14/2023]
Abstract
Free-range chicken eggs and topsoil samples from private households in Southeast and South Central Coast of Vietnam were investigated to identify potential PCDD/F sources using Positive Matrix Factorization (PMF) approach. The PMF-extracted egg congener patterns were transformed to soil patterns using bioaccumulation factors and then compared to extracted soil and known dioxin sources patterns described in the literature. Free-range chicken egg PCDD/F profiles allowed to more precisely identify and distinguish potential PCDD/F sources. Five main PCDD/F sources were identified: open burning, vehicle emissions, background atmospheric deposition, Agent Orange, and so-called OCDD dechlorination pattern. The latter is characteristic for natural formation or ultimate weathering under tropical conditions of any primary source with predominant OCDD. Agent Orange source contribution ranged from 48 to 96% in soils, from 9 to 94% in eggs in hotspots, and from 10 to 31% in soil and from 4 to 45% in eggs in sprayed areas, respectively. Contributions of other sources varied significantly between sites.
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Affiliation(s)
| | - Andrey A Shelepchikov
- Severtsov Institute of Ecology and Evolution RAS, Leninsky prosp., 33, Moscow, 119071, Russia
| | - Efim S Brodsky
- Severtsov Institute of Ecology and Evolution RAS, Leninsky prosp., 33, Moscow, 119071, Russia
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15
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López A, Sorenson K, Bamer J, Chichakli R, Boivin T, Moats D. Incremental Sampling Methodology for improved characterization of Agent Orange dioxin in Vietnam soil and sediment. J Environ Manage 2021; 299:113599. [PMID: 34492437 DOI: 10.1016/j.jenvman.2021.113599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/09/2021] [Accepted: 08/21/2021] [Indexed: 06/13/2023]
Abstract
The Danang airport in Vietnam was used heavily by US forces in the 1960s and 1970s. In 2018, the remediation of dioxin contamination at the airport resulting from Agent Orange use and management was completed by the US government. Generation of reliable, defensible, and cost-effective confirmation sampling data over large areas and for large volumes was a significant challenge. Traditional discrete and composite sampling methods were utilized to assess dioxin concentrations and the extent of contamination present at the airport prior to remediation. Confirmation sampling was performed after excavation of contaminated soil and sediment across the entire 28-ha site to demonstrate that remaining concentrations met the Vietnamese standards for the airport site. The volume of excavated soil and sediment was 162,567 m3. Incremental Sampling Methodology (ISM) was used for confirmation sampling to provide a defensible estimate of the mean concentration of dioxin remaining after excavation. The use of ISM revealed that traditional methods underestimated the volume of material requiring treatment. ISM also decreased sampling variability dramatically and provided more reliable estimates of true mean concentrations in an area when compared with traditional methods. The use of ISM: 1) better captured distributional heterogeneity and decreased variability between samples from the same DU by 64%; 2) resulted in low variability between duplicate analyses of the same sample (12%), indicating a reduction in compositional heterogeneity; 3) did not underestimate contaminant levels; and, 4) increased the frequency that excavation boundaries met project goals by 61%, when compared with traditional sampling.
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Affiliation(s)
- Alexis López
- CDM Smith, 75 State Street, Suite 701, Boston, MA, 02109, USA.
| | | | - Jeffrey Bamer
- CDM Smith, 75 State Street, Suite 701, Boston, MA, 02109, USA
| | - Randa Chichakli
- CDM Smith, 75 State Street, Suite 701, Boston, MA, 02109, USA
| | - Thomas Boivin
- Formerly Hatfield Consultants, 107D Meyer Road, Salt Spring Island, B.C., V8K 1X4, Canada
| | - Daniel Moats
- Hatfield Consultants, #200 - 850 Harbourside Drive, North Vancouver, BC, V7P 0A3, Canada
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16
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Affiliation(s)
- Kiem N. Truong
- Department
of Ecology, Faculty of Biology, University
of Science, Vietnam National University, VNU Hanoi, 334 Nguyen Trai, Thanh Xuan, Ha Noi 10000, Vietnam
| | - Khuong V. Dinh
- Section
for Aquatic Biology and Toxicology, Department of Biosciences, University of Oslo, Blindern, PO Box 1066, 0316 Oslo, Norway
- Phone: (+47) 94725058.
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17
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Rytel MR, Butler R, Eliot M, Braun JM, Houseman EA, Kelsey KT. DNA methylation in the adipose tissue and whole blood of Agent Orange-exposed Operation Ranch Hand veterans: a pilot study. Environ Health 2021; 20:43. [PMID: 33849548 PMCID: PMC8045317 DOI: 10.1186/s12940-021-00717-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/08/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Between 1962 and 1971, the US Air Force sprayed Agent Orange across Vietnam, exposing many soldiers to this dioxin-containing herbicide. Several negative health outcomes have been linked to Agent Orange exposure, but data is lacking on the effects this chemical has on the genome. Therefore, we sought to characterize the impact of Agent Orange exposure on DNA methylation in the whole blood and adipose tissue of veterans enrolled in the Air Force Health Study (AFHS). METHODS We received adipose tissue (n = 37) and whole blood (n = 42) from veterans in the AFHS. Study participants were grouped as having low, moderate, or high TCDD body burden based on their previously measured serum levels of dioxin. DNA methylation was assessed using the Illumina 450 K platform. RESULTS Epigenome-wide analysis indicated that there were no FDR-significantly methylated CpGs in either tissue with TCDD burden. However, 3 CpGs in the adipose tissue (contained within SLC9A3, LYNX1, and TNRC18) were marginally significantly (q < 0.1) hypomethylated, and 1 CpG in whole blood (contained within PTPRN2) was marginally significantly (q < 0.1) hypermethylated with high TCDD burden. Analysis for differentially methylated DNA regions yielded SLC9A3, among other regions in adipose tissue, to be significantly differentially methylated with higher TCDD burden. Comparing whole blood data to a study of dioxin exposed adults from Alabama identified a CpG within the gene SMO that was hypomethylated with dioxin exposure in both studies. CONCLUSION We found limited evidence of dioxin associated DNA methylation in adipose tissue and whole blood in this pilot study of Vietnam War veterans. Nevertheless, loci in the genes of SLC9A3 in adipose tissue, and PTPRN2 and SMO in whole blood, should be included in future exposure analyses.
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Affiliation(s)
- Matthew R. Rytel
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912 USA
| | - Rondi Butler
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Pathology and Laboratory Medicine, Brown University School of Public Health, Providence, RI 02912 USA
| | - Melissa Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912 USA
| | - Joseph M. Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912 USA
| | - E. Andres Houseman
- Statistical Bioinformatics, GlaxoSmithKline, 1250 S Collegeville Rd, Collegeville, PA 19426 USA
| | - Karl T. Kelsey
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Pathology and Laboratory Medicine, Brown University School of Public Health, Providence, RI 02912 USA
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18
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My TTA, Dat ND, Van Langenhove K, Denison MS, Long HT, Elskens M. Evaluation of the dioxin-like toxicity in soil samples from Thua Thien Hue province using the AhR-CALUX bioassay - An update of Agent Orange contamination in Vietnam. Ecotoxicol Environ Saf 2021; 212:111971. [PMID: 33513480 DOI: 10.1016/j.ecoenv.2021.111971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/08/2021] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
In this study, an AhR-responsive reporter-gene cell-based bioassay CALUX was used to assess the biological potency of dioxins and dioxin-like PCBs (dl-PCBs) in top soil samples collected from a former airbase (A-So) and remote regions from urban and agricultural areas in Thua Thien Hue, Vietnam. In top soil collected from A-So airbase, Bioanalytical EQuivalent (BEQ) concentrations of up to 2700 pg 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) per g dry weight (pg BEQ-TCDD g-1 dw) were assessed. Interestingly, while BEQ values for dl-PCBs were found to be up to 13 pg BEQ-TCDD g-1 dw, the dl-PCB activity was not detected in all the hotspot sample extracts. In contrasts, BEQ values for dioxin like compounds from remote regions were much lower and occasionally below the quantification limits of the method. The BEQ activities obtained in this study have a similar trend to the WHO-TEQ results for the samples collected in the A-So airbase. However, BEQ values were higher than those of TEQ, probably reflecting the presence of additional AhR ligands and/or possible non-additive interactions in the sample mixture. This study confirms that after more than 60 years, a strong residual pollution of PCDD/Fs remains on this former air base following the use and storage of Agent Orange during the Vietnam War, raising a health risk for populations exposed in this area because livestock animals graze there.
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Affiliation(s)
- Tran Thi Ai My
- Analytical, Environmental and Geo-Chemistry laboratory (AMGC), Vrije Universiteit Brussel (University of Brussels), Pleinlaan 2, 1050 Brussels, Belgium; Department of Chemistry, University of Sciences, Hue University, Hue 530000, Vietnam.
| | - Nguyen Duy Dat
- Faculty of Chemical & Food Technology, University of Technology and Education, Thu Duc, Ho Chi Minh 700000, Vietnam
| | - Kersten Van Langenhove
- Analytical, Environmental and Geo-Chemistry laboratory (AMGC), Vrije Universiteit Brussel (University of Brussels), Pleinlaan 2, 1050 Brussels, Belgium
| | - Michael S Denison
- University of California, Davis (UC Davis), Department of Environmental Toxicology, One Shields Avenue, Davis, CA 95616, USA
| | - Hoang Thai Long
- Department of Chemistry, University of Sciences, Hue University, Hue 530000, Vietnam
| | - Marc Elskens
- Analytical, Environmental and Geo-Chemistry laboratory (AMGC), Vrije Universiteit Brussel (University of Brussels), Pleinlaan 2, 1050 Brussels, Belgium
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Alrifai A. Legal Liability Arising from the Use of " Agent Orange" in the Kimberley: Registration of 2,4,5-T and 2,4-D in Australia. J Law Med 2020; 27:967-980. [PMID: 32880413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Between 1975 and 1985, the chemicals that make up Agent Orange were used by the Western Australian government in weed-spraying programs across the Kimberley region. A majority of weed-sprayers hired by the government were Aboriginal and worked without personal protective equipment. A large number of former sprayers have died or deal with negative health consequences as a result, yet few sprayers have ever been compensated. This article explores alternative mechanisms for compensating the former sprayers and their families through a two-part question: (1) how were 2,4-dichlorophenoxyacetic acid and 2,4,5-tri-chloro-phenoxy-acetic acid made available for use by Commonwealth and State governments; and (2) were government bodies negligent in allowing the use of these chemicals?
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20
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Pham NT, Nishijo M, Pham TT, Tran NN, Le VQ, Tran HA, Phan HAV, Nishino Y, Nishijo H. Perinatal dioxin exposure and neurodevelopment of 2-year-old Vietnamese children in the most contaminated area from Agent Orange in Vietnam. Sci Total Environ 2019; 678:217-226. [PMID: 31075589 DOI: 10.1016/j.scitotenv.2019.04.425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/28/2019] [Accepted: 04/28/2019] [Indexed: 05/19/2023]
Abstract
Bien Hoa airbase is the most contaminated area of dioxin contamination from Agent Orange in Vietnam, but little is known about the neurodevelopmental effects of perinatal dioxin exposure on children living nearby. We recruited 210 mother-newborn resident pairs in 2012 and 78 pairs in 2015 and followed them for 2 years to assess the children's neurodevelopment. As a control group, we used 120 mother-child pairs recruited in 2014 in the Ha Dong district of Ha Noi City, an unexposed area. Perinatal dioxin exposure levels were indicated by levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and toxic equivalency values of polychlorodibenzodioxins, polychlorodibenzofurans, and nonortho-polychlorinated biphenyls (TEQ-PCDD/Fs/noPCBs) in maternal breast milk. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) were used to assess neurodevelopment, and scores in each domain were compared between children with different exposure levels using general linear regression models and stratification by sex. Decreased expressive and composite language scores in boys and gross motor scores in girls were found in children exposed to TCDD ≥ 5.5 (pg/g lipid) compared with children with TCDD < 1.8. However, in matched pair analysis between children with TCDD ≥ 5.5 and <1.8 (pg/g lipid), lower expressive and composite language scores in boys exposed to TCDD ≥ 5.5 were significant, but lower gross motor scores in girls did not reach statistical significance. In addition, significant association was found between levels of PCDD congeners other than TCDD and gross motor scores in boys. These findings suggest that perinatal exposure of TCDD and other PCDD congeners affects development of language and gross motor skills, respectively, in boys at 2 years of age exposed to dioxins originating from Agent Orange in Vietnam.
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Affiliation(s)
- Ngoc Thao Pham
- Department of Public Health, Kanazawa Medical University, Japan; Biomedical and Pharmaceutical Research Center, Vietnamese Military Medical University, Viet Nam
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Japan.
| | - The Tai Pham
- Biomedical and Pharmaceutical Research Center, Vietnamese Military Medical University, Viet Nam
| | | | - Van Quan Le
- Biomedical and Pharmaceutical Research Center, Vietnamese Military Medical University, Viet Nam
| | - Hai Anh Tran
- Biomedical and Pharmaceutical Research Center, Vietnamese Military Medical University, Viet Nam
| | - Huy Anh Vu Phan
- Department of Health, Dong Nai Prefecture Government, Bien Hoa, Viet Nam
| | | | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine, University of Toyama, Japan
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21
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Giuliani C, Biggs D, Nguyen TT, Marasco E, De Fanti S, Garagnani P, Le Phan MT, Nguyen VN, Luiselli D, Romeo G. First evidence of association between past environmental exposure to dioxin and DNA methylation of CYP1A1 and IGF2 genes in present day Vietnamese population. Environ Pollut 2018; 242:976-985. [PMID: 30373043 DOI: 10.1016/j.envpol.2018.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 06/08/2023]
Abstract
During the Vietnam War, the United States military sprayed over 74 million litres of Agent Orange (AO) to destroy forest cover as a counterinsurgency tactic in Vietnam, Laos and Cambodia. The main ingredient was contaminated by 2,3,7,8-tetrachlorodibenzo-paradioxin (TCDD). DNA methylation (DNAm) differences are potential biomarker of environmental toxicants exposure. The aim of this study was to perform a preliminary investigation of the DNAm levels from peripheral blood of the present-day Vietnamese population, including individuals whose parents, according to historical data, were exposed to AO/TCDD during the war. 94 individuals from heavily sprayed areas (cases) and 94 individuals from non-sprayed areas (controls) were studied, and historical data on alleged exposure of parents collected. 94 cases were analysed considering those whose father/parents participated in the war (N = 29) and considering the place of residence of both parents (64 living in sprayed areas versus 30 in non-contaminated areas). DNAm levels in CYP1A1 and IGF2 genes were measured (MALDI-TOF technology). The analyses showed that: 1) one CpG site in the CYP1A1 and one in the IGF2 gene showed significant differences in DNAm levels between cases and controls; 2) the CYP1A1 region resulted to be hypomethylated (in 9 out of 16 sites/units; p-val<0.01) in 29 individuals whose father/parents participated in the war in the spray zones; 3) we showed that the place of residence of both parents influenced methylation levels of the CYP1A1 and IGF2 genes (p-val<0.05). In conclusion this study indicates that past environmental exposure to dioxin (AO/TCDD) shapes the DNAm profile of CYP1A1 and that the place of living for parents in former spray zones influences DNAm of CYP1A1 and IGF2 genes. These results open the way to new applications of DNAm as potential biomarker(s) of past human exposure to dioxin.
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Affiliation(s)
- Cristina Giuliani
- Department of Biological, Geological, and Environmental Sciences (BiGeA), Laboratory of Molecular Anthropology and Centre for Genome Biology, University of Bologna, Bologna, Italy; School of Anthropology and Museum Ethnography, University of Oxford, UK.
| | - David Biggs
- Department of History and School of Public Policy, University of California, Riverside, USA
| | | | - Elena Marasco
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; Applied Biomedical Research Center (CRBA), S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Sara De Fanti
- Department of Biological, Geological, and Environmental Sciences (BiGeA), Laboratory of Molecular Anthropology and Centre for Genome Biology, University of Bologna, Bologna, Italy
| | - Paolo Garagnani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; Applied Biomedical Research Center (CRBA), S. Orsola-Malpighi Polyclinic, Bologna, Italy; Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet at Huddinge University Hospital, S-141 86 Stockholm, Sweden
| | | | | | - Donata Luiselli
- Department for the Cultural Heritage (DBC), Campus of Ravenna, University of Bologna, Bologna, Italy
| | - Giovanni Romeo
- Medical Genetics Unit, S. Orsola Hospital, University of Bologna, Italy and European School of Genetic Medicine, Italy
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Beard JD, Engel LS, Richardson DB, Gammon MD, Baird C, Umbach DM, Allen KD, Stanwyck CL, Keller J, Sandler DP, Schmidt S, Kamel F. Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival. PLoS One 2017; 12:e0185751. [PMID: 29016608 PMCID: PMC5634564 DOI: 10.1371/journal.pone.0185751] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 09/18/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS) mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases. METHODS We followed 616 medical record-confirmed cases from enrollment (2005-2010) in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study until death or July 25, 2013, whichever came first. We ascertained vital status information from several sources within the Department of Veterans Affairs. We obtained information regarding military service, deployments, and 39 related exposures via standardized telephone interviews. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals. We adjusted for potential confounding and missing covariate data biases via inverse probability weights. We also used inverse probability weights to adjust for potential selection bias among a case group that included a disproportionate number of long-term survivors at enrollment. RESULTS We observed 446 deaths during 24,267 person-months of follow-up (median follow-up: 28 months). Survival was shorter for cases who served before 1950, were deployed to World War II, or mixed and applied burning agents, with HRs between 1.58 and 2.57. Longer survival was associated with exposure to: paint, solvents, or petrochemical substances; local food not provided by the Armed Forces; or burning agents or Agent Orange in the field with HRs between 0.56 and 0.73. CONCLUSIONS Although most military-related factors were not associated with survival, associations we observed with shorter survival are potentially important because of the large number of military veterans.
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Affiliation(s)
- John D. Beard
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States of America
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - David B. Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Marilie D. Gammon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Coleen Baird
- Environmental Medicine Program, US Army Public Health Command, Aberdeen Proving Ground, Maryland, United States of America
| | - David M. Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States of America
| | - Kelli D. Allen
- Durham VA Medical Center, Durham, North Carolina, United States of America
- Department of Medicine and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Catherine L. Stanwyck
- Durham VA Medical Center, Durham, North Carolina, United States of America
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Jean Keller
- Westat, Inc., Durham, North Carolina, United States of America
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States of America
| | - Silke Schmidt
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Freya Kamel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States of America
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Ngo TH, Hien TT, Thuan NT, Minh NH, Chi KH. Atmospheric PCDD/F concentration and source apportionment in typical rural, Agent Orange hotspots, and industrial areas in Vietnam. Chemosphere 2017; 182:647-655. [PMID: 28527418 DOI: 10.1016/j.chemosphere.2017.05.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/06/2017] [Accepted: 05/09/2017] [Indexed: 06/07/2023]
Abstract
Vietnam has a double burden of dioxin from both industrial sources and historical sources. To evaluate the concentration of PCDD/Fs in ambient air in different areas of Vietnam and their possible sources, atmospheric samples were collected from three areas namely Son La (rural area) and Da Nang (harbor - Agent Orange hotspot area), and Ho Chi Minh City (metropolitan - industrial city). Vapor and solid phases of PCDD/Fs were collected and analyzed following the TO-9A sampling method. Principal Component Analysis and Positive Matrix Factorization model were applied to characterize the possible source. The average concentrations of PCDD/Fs were found to be 21.3 ± 13 fg I-TEQ/m3 in Son La (n = 32), 65.2 ± 34 fg I-TEQ/m3 in Da Nang (n = 16) and 139 ± 84 fg I-TEQ/m3 in Ho Chi Minh City (n = 8). The findings of this study targeted open burning (42%) and biomass burning (51%) as the major emission sources of PCDD/Fs in ambient air of Son La, Vietnam. Major possible sources of PCDD/Fs in Da Nang could be transportation activities (64%), however, the other factor (36%) was suspected to be contaminated with 2,3,7,8-TeCDD from Agent Orange. Most of PCDD/Fs emitted in Ho Chi Minh City related to industrial activities (93%).
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Affiliation(s)
- Tuan Hung Ngo
- Institute of Environmental and Occupational Health Sciences, National Yang Ming University, Taipei 112, Taiwan; International Health Program, National Yang Ming University, Taipei 112, Taiwan
| | - To Thi Hien
- Ho Chi Minh City University of Science, 227 Nguyen Van Cu Street, District 5, Ho Chi Minh City, Viet Nam
| | - Ngo Thi Thuan
- Ho Chi Minh City University of Science, 227 Nguyen Van Cu Street, District 5, Ho Chi Minh City, Viet Nam
| | - Nguyen Hung Minh
- Center for Environmental Monitoring, Vietnam Environment Administration, Ministry of Natural Resources and Environment, 556 Nguyen Van Cu Street, Hanoi, Viet Nam
| | - Kai Hsien Chi
- Institute of Environmental and Occupational Health Sciences, National Yang Ming University, Taipei 112, Taiwan.
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24
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Beard JD, Engel LS, Richardson DB, Gammon MD, Baird C, Umbach DM, Allen KD, Stanwyck CL, Keller J, Sandler DP, Schmidt S, Kamel F. Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis etiology. Environ Int 2016; 91:104-115. [PMID: 26923711 PMCID: PMC4876822 DOI: 10.1016/j.envint.2016.02.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/29/2016] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Factors underlying a possible excess of amyotrophic lateral sclerosis (ALS) among military veterans remain unidentified. Limitations of previous studies on this topic include reliance on ALS mortality as a surrogate for ALS incidence, low statistical power, and sparse information on military-related factors. OBJECTIVES We evaluated associations between military-related factors and ALS using data from a case-control study of U.S. military veterans. METHODS From 2005 to 2010, we identified medical record-confirmed ALS cases via the National Registry of Veterans with ALS and controls via the Veterans Benefits Administration's Beneficiary Identification and Records Locator System database. In total, we enrolled 621 cases and 958 frequency-matched controls in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study. We collected information on military service and deployments and 39 related exposures. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). We used inverse probability weighting to adjust for potential bias from confounding, missing covariate data, and selection arising from a case group that disproportionately included long-term survivors and a control group that may or may not differ from U.S. military veterans at large. RESULTS The odds of ALS did not differ for veterans of the Air Force, Army, Marines, and Navy. We found higher odds of ALS for veterans whose longest deployment was World War II or the Korean War and a positive trend with total years of all deployments (OR=1.27; 95% CI: 1.06, 1.52). ALS was positively associated with exposure to herbicides for military purposes, nasopharyngeal radium, personal pesticides, exhaust from heaters or generators, high-intensity radar waves, contaminated food, explosions within one mile, herbicides in the field, mixing and application of burning agents, burning agents in the field, and Agent Orange in the field, with ORs between 1.50 and 7.75. CONCLUSIONS Although our results need confirmation, they are potentially important given the large number of U.S. military veterans, and they provide clues to potential factors underlying the apparent increase of ALS in veteran populations.
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Affiliation(s)
- John D Beard
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marilie D Gammon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Coleen Baird
- Environmental Medicine Program, US Army Public Health Command, Aberdeen Proving Ground, MD, USA
| | - David M Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kelli D Allen
- Durham VA Medical Center, Durham, NC, USA; Department of Medicine and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Catherine L Stanwyck
- Durham VA Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Silke Schmidt
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Freya Kamel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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25
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Gunderson CH, Daroff RB. Neurology in the Vietnam War. Front Neurol Neurosci 2016; 38:201-213. [PMID: 27035455 DOI: 10.1159/000442657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians. Their practice included exposure to unfamiliar disorders including cerebral malaria, Japanese B encephalitis, sleep deprivation seizures, and toxic encephalitis caused by injection or inhalation of C-4 explosive. They and neurologists at facilities in the United States published studies on all of these entities both during and after the war. These publications spawned the Defense and Veterans Head Injury Study, which was conceived during the Korean War and continues today as the Defense and Veterans Head Injury Center. It initially focused on post-traumatic epilepsy and later on all effects of brain injury. The Agent Orange controversy arose after the war; during the war, it was not perceived as a threat by medical personnel. Although soldiers in previous wars had developed serious psychological impairments, post-traumatic stress disorder was formally recognized in the servicemen returning from Vietnam.
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Sun XL, Kido T, Honma S, Okamoto R, Manh HD, Maruzeni S, Nishijo M, Nakagawa H, Nakano T, Koh E, Takasuga T, Nhu DD, Hung NN, Son LK. Influence of dioxin exposure upon levels of prostate-specific antigen and steroid hormones in Vietnamese men. Environ Sci Pollut Res Int 2016; 23:7807-13. [PMID: 26758301 DOI: 10.1007/s11356-015-5931-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/04/2015] [Indexed: 05/09/2023]
Abstract
Most studies on the relationship between Agent Orange and prostate cancer have focused on US veterans of the Vietnam War. There have been few studies focusing on the relationship between levels of prostate-specific antigen (PSA) and dioxins or steroid hormones in Vietnamese men. In 2009-2011, we collected blood samples from 97 men who had resided in a "dioxin hotspot" and 85 men from a non-sprayed region in Vietnam. Then levels of PSA, dioxins, and steroid hormones were analyzed. Levels of most dioxins, furans, and non-ortho polychlorinated biphenyls were higher in the hotspot than those in the non-sprayed region. Levels of testosterone, dehydroepiandrosterone, and estradiol differed significantly between the hotspot and the non-sprayed region, but there were no correlations between levels of PSA and steroid hormones and dioxins in either of the two regions. Our findings suggest that PSA levels in Vietnamese men are not associated with levels of dioxin or steroid hormones in these two regions.
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Affiliation(s)
- Xian Liang Sun
- Department of Public Health, School of Medicine, Jiaxing University, Jiaxing, China
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Teruhiko Kido
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
- Institute of Medical, Pharmaceutical, and Health Sciences, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan, 920-0942.
| | - Seijiro Honma
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Rie Okamoto
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Ho Dung Manh
- Faculty of Pharmacy, Lac Hong University, Bien Hoa, Vietnam
| | - Shoko Maruzeni
- Department of Public Health, Kanazawa Medical University, Kanazawa, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Kanazawa, Japan
| | - Hideaki Nakagawa
- Department of Public Health, Kanazawa Medical University, Kanazawa, Japan
| | - Takeshi Nakano
- Center for Advanced Science and Innovation, Osaka University, Osaka, Japan
| | - Eitetsu Koh
- Department of Urology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Osaka, Japan
| | | | - Dang Duc Nhu
- 10-80 Division, Hanoi Medical University, Hanoi, Vietnam
| | | | - Le Ke Son
- Environment Administration, Ministry of Natural Resources and Environment, Hanoi, Vietnam
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27
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Klickermann F. Legal liability for Agent Orange-related illnesses: a reassessment of the 2005 VAVA case and prospects for new litigation. Med Confl Surviv 2016; 32:138-152. [PMID: 27748632 DOI: 10.1080/13623699.2016.1242044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Attempts through the US courts to hold the corporations responsible for the production of dioxin-contaminated herbicides used by the US military in the 1960s and early 1970s liable for their ongoing health consequences have failed. This article scrutinizes the most recent judgement - that of the United States District Court for the Eastern District of New York handed down in 2005 following a lawsuit brought by the Vietnam Association of Victims of Agent Orange/dioxin (VAVA). It is argued that despite this judgement there is the potential to bring a further legal case, with some prospect of success, on the basis of: (i) debatable legal judgements in the 2005 decision; (ii) new scientific evidence on the health effects of exposure to Agent Orange; and (iii) cases brought in other jurisdictions. The article concludes by noting the underfunding of ongoing remediation efforts, especially for the provision of assistance to affected individuals, and argues that it is desirable to oblige the producers of the herbicides to contribute financially to these efforts.
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28
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Sycheva LP, Umnova NV, Kovalenko MA, Zhurkov VS, Shelepchikov AA, Roumak VS. Dioxins and cytogenetic status of villagers after 40 years of agent Orange application in Vietnam. Chemosphere 2016; 144:1415-1420. [PMID: 26495825 DOI: 10.1016/j.chemosphere.2015.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 09/07/2015] [Accepted: 10/02/2015] [Indexed: 06/05/2023]
Abstract
We have examined cytogenetic status of the rural population living on dioxin-contaminated territories (DCT, TCDD in soil 2.6 ng/kg) compared to the villagers of the control area (TCDD in soil 0.18 ng kg(-1)). The examination took place almost 40 years after the war. The consequences of some confounding factors (years of residence in the region, farming, and aging) has been examined. Karyological analysis of buccal and nasal epitheliocytes among healthy adult males living on DCT and control area (26 and 35 persons) was conducted. A wide range of cytogenetic (micronuclei, nuclear protrusions), proliferative (binucleated cells and cells with doubled nucleus) and endpoints of cell death (cells with perinuclear vacuoles, with damaged nucleus membrane, condensed chromatin, pyknosis, karyorrhexis, karyolysis) had been analyzed. The frequent amount of cells with nuclear protrusions in both epithelia was slightly decreased in the DСT group. Biomarkers of early and late stages of nuclear destruction in buccal epithelium (cells with damaged nuclear membrane, karyolysis) were elevated significantly in DCT. Higher level of the same parameters was also identified in nasal epithelium. The cytogenetic status of healthy adult males on DCT had got "normalization" by present moment in comparison with our early data. Nevertheless, in exposed group some alteration of the cytogenetic status was being registered (mostly biomarkers of apoptosis). Years of residence (and exposure to dioxins) affected the cytogenetic status of DCT inhabitants, whereas no influence of farming factors (pesticides, fertilizers, etc.) had been discovered. Some biomarkers of proliferation and cell death were affected by aging.
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Affiliation(s)
- Lyudmila P Sycheva
- A.N. Sysin Research Institute of Human Ecology and Environmental Health, Ministry of Health of the Russian Federation, Moscow, Russia.
| | - Nataliya V Umnova
- A.N. Severtsov Institute of Ecology and Evolution, RAS, Moscow, Russia
| | - Maria A Kovalenko
- A.N. Sysin Research Institute of Human Ecology and Environmental Health, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vjacheslav S Zhurkov
- A.N. Sysin Research Institute of Human Ecology and Environmental Health, Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Vladimir S Roumak
- A.N. Severtsov Institute of Ecology and Evolution, RAS, Moscow, Russia
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29
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Noel JK, Namazi S, Haddock RL. Disparities in Infant Mortality Due to Congenital Anomalies on Guam. Hawaii J Med Public Health 2015; 74:397-402. [PMID: 26668770 PMCID: PMC4675364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In the 1970's and 1980's, there were large inter-village disparities in infant mortality due to congenital anomalies on Guam. A village-level analysis was conducted to determine if these disparities can be explained by behavioral (ie, median age of village females, village fertility ratio), structural (ie, population density, persons per household, single mother households per village, married females per village), and environmental (ie, living in a village where Agent Orange (AO) spraying was conducted) factors. Village-level data for live births and infant mortality due to congenital anomalies (1970-1989) was collected from Guam's Office of Vital Statistics. Data on median age of village females, village fertility ratio, population density, persons per household, single mother households, and married females were obtained from the 1980 US Census. Estimates of village-level AO use were provided through personal communications, and villages were dichotomized into AO and non-AO spray areas. Village location was classified by usual residence of the mother. Linear regression was used to determine associations between infant mortality due to congenital anomalies and the behavioral, structural, and environmental factors. The association between AO spray area and infant mortality due to congenital anomalies was statistically significant under univariable (B [95%CI] = 1.88 [0.64,3.11], P = .005) and multivariable conditions (B [95%CI] = 2.02 [0.08,3.96], P = .042). These results suggest that infants born to mothers whose usual residence was in an AO spray area on Guam are at an increased risk of mortality due to congenital anomalies. Further studies using individual-level data are needed to validate these results.
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Affiliation(s)
- Jonathan K Noel
- University of Connecticut School of Medicine, Department of Community Medicine and Health Care, Farmington, CT, (JKN)
| | - Sara Namazi
- University of Connecticut School of Medicine, Department of Community Medicine and Health Care, Farmington, CT, (JKN)
| | - Robert L Haddock
- University of Connecticut School of Medicine, Department of Community Medicine and Health Care, Farmington, CT, (JKN)
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30
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Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft. Mil Med 2015; 180:1019-21. [PMID: 26444461 DOI: 10.7205/MILMED-D-15-00275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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31
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Van Thuong N, Hung NX, Mo NT, Thang NM, Huy PQ, Van Binh H, Nam VD, Van Thuy N, Son LK, Minh NH. Transport and bioaccumulation of polychlorinated dibenzo-p-dioxins and dibenzofurans at the Bien Hoa Agent Orange hotspot in Vietnam. Environ Sci Pollut Res Int 2015; 22:14431-14441. [PMID: 25510612 DOI: 10.1007/s11356-014-3946-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/02/2014] [Indexed: 06/04/2023]
Abstract
The Bien Hoa airbase (south of Vietnam) is known as one of the Agent Orange hotspots which have been seriously contaminated by Agent Orange/dioxin during the Vietnam War. Hundreds of samples including soil, sediment and fish were collected at the Bien Hoa Agent Orange hotspot for assessment of the environmental contamination caused by dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs). The toxicity equivalency quotient (TEQ) concentration of PCDD/Fs in soil and sediment varied from 7.6 to 962,000 and 17 to 4860 pg/g dry wt, respectively, implying very high contamination of PCDD/Fs in several areas. PCDD/F levels in fish ranged between 1.8 and 288 pg/g TEQ wet wt and was generally higher than advisory guidelines for food consumption. 2,3,7,8-Tetrachlorinated dibenzo-p-dioxins (2,3,7,8-TCDD) contributed 66-99 % of TEQ for most of the samples, suggesting 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) from Agent Orange as the major source of the contamination. The vertical transport of PCDD/Fs was observed in soil column with high TEQ levels above 1000 pg/g dry wt (Vietnamese limit for necessary remediation activities- TCVN 8183:2009 (2009)) even at a depth of 1.8 m. The vertical transport of PCDD/Fs has probably mainly taken place during the "Ranch Hand" defoliant spray activities due to the leaks and spills of phenoxy herbicides and solvents. The congener patterns suggest that transports of PCDD/Fs by weathering processes have led to their redistribution in the low-land areas. Also, an estimate for the total volume of contaminated soil requiring remediation to meet Vietnamese regulatory limits is provided.
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Affiliation(s)
- Nguyen Van Thuong
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Nguyen Xuan Hung
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Nguyen Thi Mo
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Nguyen Manh Thang
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Pham Quang Huy
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Hoang Van Binh
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Vu Duc Nam
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Nguyen Van Thuy
- Center for Environmental Monitoring (CEM), Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - Le Ke Son
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
- Office of the National Steering Committee 33, Ministry of Natural Resources and Environment (MONRE), Nr. 83 Nguyen Chi Thanh Street, Dong Da, Hanoi, Vietnam
| | - Nguyen Hung Minh
- Dioxin Laboratory Project, Vietnam Environment Administration (VEA), Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam.
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32
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Blue Water Navy Vietnam Veterans and Agent Orange Exposure. Mil Med 2015; 180:839-41. [PMID: 26226521 DOI: 10.7205/MILMED-D-15-00163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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33
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Department of Veterans Affairs. Presumption of Herbicide Exposure and Presumption of Disability During Service for Reservists Presumed Exposed to Herbicide. Interim final rule. Fed Regist 2015; 80:35246-9. [PMID: 26103644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Department of Veterans Affairs (VA) is amending its regulation governing individuals presumed to have been exposed to certain herbicides. Specifically, VA is expanding the regulation to include an additional group consisting of individuals who performed service in the Air Force or Air Force Reserve under circumstances in which they had regular and repeated contact with C-123 aircraft known to have been used to spray an herbicide agent ("Agent Orange'') during the Vietnam era. In addition, the regulation will establish a presumption that members of this group who later develop an Agent Orange presumptive condition were disabled during the relevant period of service, thus establishing that this service constituted "active, naval, military or air service.'' The effect of this action is to presume herbicide exposure for these individuals and to allow individuals who were exposed to herbicides during reserve service to establish veteran status for VA purposes and eligibility for some VA benefits. The need for this action results from a recent decision by the Secretary of Veterans Affairs to acknowledge that individuals who had regular and repeated exposure to C-123 aircraft that the United States Air Force used to spray the herbicides in Vietnam during Operation Ranch Hand were exposed to Agent Orange.
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Ross JH, Hewitt A, Armitage J, Solomon K, Watkins DK, Ginevan ME. Exposure to TCDD from base perimeter application of Agent Orange in Vietnam. Sci Total Environ 2015; 511:82-90. [PMID: 25531592 DOI: 10.1016/j.scitotenv.2014.11.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 11/09/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Abstract
Using recognized methods routinely employed by pesticide regulatory agencies, the exposures of military personnel that were mixer/loader/applicators (M/L/A) of Agent Orange (AO) for perimeter foliage at bases during the Vietnam War were estimated. From the fraction of TCDD in AO, absorbed dosage of the manufacturing contaminant was estimated. Dermal exposure estimated from spray drift to residents of the bases was calculated using internationally recognized software that accounted for proximity, foliar density of application site, droplet size and wind speed among other factors, and produced estimates of deposition. Those that directly handled AO generally had much higher exposures than those further from the areas of use. The differences in exposure potential varied by M/L/A activity, but were typically orders of magnitude greater than bystanders. However, even the most-exposed M/L/A involved in perimeter application had lifetime exposures comparable to persons living in the U.S. at the time, i.e., ~1.3 to 5 pg TCDD/kg bodyweight.
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Affiliation(s)
- John H Ross
- LLC, 5150 Fair Oaks Blvd. #101-370, Carmichael, CA 95608, United States.
| | - Andrew Hewitt
- Centre for Pesticide Application and Safety, The University of Queensland, Gatton, QLD 4343, Australia; Lincoln University, Christchurch 7640, New Zealand; The University of Nebraska, North Platte, NE, United States
| | - James Armitage
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - Keith Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Deborah K Watkins
- M.E. Ginevan & Associates, 307 Hamilton Ave., Silver Spring, MD 20901, United States
| | - Michael E Ginevan
- M.E. Ginevan & Associates, 307 Hamilton Ave., Silver Spring, MD 20901, United States
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Ferrie JE. 'Knowing is not enough; we must apply. Willing is not enough; we must do.'. Int J Epidemiol 2015; 43:1671-7. [PMID: 25688412 DOI: 10.1093/ije/dyu230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Armitage JM, Ginevan ME, Hewitt A, Ross JH, Watkins DK, Solomon KR. Environmental fate and dietary exposures of humans to TCDD as a result of the spraying of Agent Orange in upland forests of Vietnam. Sci Total Environ 2015; 506-507:621-630. [PMID: 25433383 DOI: 10.1016/j.scitotenv.2014.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 10/20/2014] [Accepted: 11/05/2014] [Indexed: 06/04/2023]
Abstract
The fate and transport of 2,3,7,8-tetrachloro-p-dibenzodioxin (TCDD) released into the environment of South Vietnam (SVN) as a consequence of the aerial application of the herbicidal defoliant Agent Orange (AO) were simulated for a generic upland forest scenario and followed over a 50-year period (1965, 1968 and 1970 onwards). Modeled concentrations of TCDD in the environment were then used as inputs to a human exposure model, which focused on long-term exposures via the food chain. Intake rates and body burdens of TCDD were estimated for adult males over the course of the simulation period and compared to available biomonitoring data. One of the most important factors determining the magnitude of the simulated human exposure to TCDD was the fraction of the chemical deposited directly to soil (where it was assumed to have a degradation half-life of 10 or 15years) relative to the fraction assumed to remain on/in the forest canopy following the spray application (where it was assumed to have a degradation half-life of ≤48h). The simulated body burdens under the various scenarios considered were broadly consistent with the biomonitoring data from SVN collected in the mid-1980s to late 1990s. Taken together, the modeling results and empirical data suggest that highly elevated exposures to TCDD (i.e., body burdens in the several 100s of pg/g lipid range and greater) were not common among people inhabiting upland forest locations in SVN sprayed with AO and that peak and average body burdens were broadly similar to those of the general population of the U.S. in the 1970s and early 1980s. The model-based assessment is consistent with the 'hot spot' hypothesis i.e., potential exposures to TCDD linked to activities conducted on or near former bases where AO was stored are greater than potential exposures in areas subjected to aerial spraying.
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Affiliation(s)
- James M Armitage
- Department of Physical & Environmental Sciences, University of Toronto Scarborough, Toronto, ON M1C 1A4, Canada.
| | - Michael E Ginevan
- M.E. Ginevan & Associates, 307 Hamilton Ave, Silver Spring, MD 20901, USA
| | - Andrew Hewitt
- Centre for Pesticide Application and Safety, The University of Queensland, Gatton, QLD 4343, Australia; Lincoln University, Christchurch 7640, New Zealand; The University of Nebraska, North Platte, NE, USA
| | - John H Ross
- risksciences.net, LLC, 5150 Fair Oaks Blvd. #101-370, Carmichael, CA 95608, USA
| | - Deborah K Watkins
- M.E. Ginevan & Associates, 307 Hamilton Ave, Silver Spring, MD 20901, USA
| | - Keith R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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Ross JH, Hewitt A, Armitage J, Solomon K, Watkins DK, Ginevan ME. Handler, bystander and reentry exposure to TCDD from application of Agent Orange by C-123 aircraft during the Vietnam War. Sci Total Environ 2015; 505:514-525. [PMID: 25461054 DOI: 10.1016/j.scitotenv.2014.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 06/04/2023]
Abstract
Using validated models and methods routinely employed by pesticide regulatory agencies, the absorbed dosages of Agent Orange (AO) herbicide contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were estimated for mixer/loaders, applicators, and individuals in the vicinity of applications of AO by C-123 aircraft during the Vietnam War. Resulting dosages of TCDD were then transformed to estimates of adipose residues, and compared to population biomonitoring of known mixer/loaders and applicators as well as ground troops in Vietnam and civilians in the U.S. Results demonstrate that mixer/loaders and applicators had the greatest exposures and their measured residues of TCDD in adipose were consistent with the estimated exposures. Further, the potentially exposed ground troops, including those who could have been directly sprayed during aerial defoliation, had measured adipose residues that were consistent with those in civilian U.S. populations with no defined source of exposure exposures and both of those cohorts had orders of magnitude less exposure than the mixer/loaders or applicators. Despite the availability of validated exposure modeling methods for decades, the quantitative TCDD dose estimates presented here are the first of their kind for the Vietnam conflict.
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Affiliation(s)
- John H Ross
- risksciences.net, LLC, 5150 Fair Oaks Blvd. #101-370, Carmichael, CA 95608, United States.
| | - Andrew Hewitt
- Centre for Pesticide Application and Safety, The University of Queensland, Gatton QLD 4343, Australia; Lincoln University, Christchurch 7640, New Zealand; The University of Nebraska, North Platte, NE, United States
| | - James Armitage
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
| | - Keith Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Deborah K Watkins
- M.E. Ginevan & Associates, 307 Hamilton Ave., Silver Spring, MD 20901, USA
| | - Michael E Ginevan
- M.E. Ginevan & Associates, 307 Hamilton Ave., Silver Spring, MD 20901, USA
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Pham DT, Nguyen HM, Boivin TG, Zajacova A, Huzurbazar SV, Bergman HL. Predictors for dioxin accumulation in residents living in Da Nang and Bien Hoa, Vietnam, many years after Agent Orange use. Chemosphere 2015; 118:277-283. [PMID: 25463251 DOI: 10.1016/j.chemosphere.2014.09.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 09/02/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
Agent Orange (AO) was the main defoliant used by the US in Vietnam from 1961 to 1971; AO was contaminated with dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin, or TCDD). Three major dioxin “hot spots” remain from previous AO storage and use at former US bases at Bien Hoa, Da Nang, and Phu Cat, posing potential health risks for Vietnamese living on or near these hot spots. We evaluated potential risk factors contributing to serum TCDD levels in Vietnamese residents at and near contaminated sites in Da Nang and Bien Hoa, Vietnam. We used multiple linear regression to analyze possible associations of blood dioxin concentrations with demographic, socioeconomic, lifestyle, and dietary risk factors for residents living on or near these hot spots. For the Da Nang study, fish farming on the site, living on property flooded from monsoon rains, and age were among the factors showing significant positive associations with serum TCDD concentrations. For the Bien Hoa study, fish farmers working at this site and their immediate family members had significantly higher serum TCDD concentrations. Our results suggest that water-related activities, especially fish-farming, at the hot spots increased the risk of exposure to dioxin.
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Hoang TT, Traag WA, Murk AJ, Hoogenboom RLAP. Levels of polychlorinated dibenzo-p-dioxins, dibenzofurans (PCDD/Fs) and dioxin-like PCBs in free range eggs from Vietnam, including potential health risks. Chemosphere 2014; 114:268-274. [PMID: 25113212 DOI: 10.1016/j.chemosphere.2014.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 06/03/2023]
Abstract
Chicken and duck eggs collected from three different areas in Vietnam were examined for polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). These regions included a background area, an area sprayed with Agent Orange and the Bien Hoa airbase area where Agent Orange was handled by the US Army. The latter area now is inhabited and people keep their own laying hens. Egg samples were first screened with an in vitro reporter gene bioassay and a selection was analyzed by GC/HRMS. Samples from Bien Hoa airbase showed very high PCDD/F levels, up to 249 pg dioxin-equivalents (TEQ)/g fat, mainly due to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). In the sprayed areas, levels (3.2-8.2 pg TEQ g(-1)) were comparable to those observed in background areas (3.2-8.2 pg TEQ g(-1) fat). The estimated average consumption of 22 g d(-1) of the highly contaminated eggs will result in a 2-fold exceedance of the current exposure limits for adults and 5-fold for children, even without considering other contaminated food sources. This indicates a potential health risk from consumption of these highly contaminated eggs, which were not yet considered as a source for exposure to PCDD/Fs of people living in the highly contaminated areas.
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Affiliation(s)
- Thu T Hoang
- RIKILT Wageningen UR, Akkermaalsbos 2, Wageningen, The Netherlands
| | - Wim A Traag
- RIKILT Wageningen UR, Akkermaalsbos 2, Wageningen, The Netherlands
| | - AlberTinka J Murk
- Section Toxicology, Wageningen University, Wageningen IMARES, The Netherlands
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Chang ET, Boffetta P, Adami HO, Cole P, Mandel JS. A critical review of the epidemiology of Agent Orange/TCDD and prostate cancer. Eur J Epidemiol 2014; 29:667-723. [PMID: 25064616 PMCID: PMC4197347 DOI: 10.1007/s10654-014-9931-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 06/16/2014] [Indexed: 11/21/2022]
Abstract
To inform risk assessment and regulatory decision-making, the relationship between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and prostate cancer requires clarification. This article systematically and critically reviews the epidemiologic evidence on the association between exposure to TCDD or Agent Orange, a TCDD-contaminated herbicide used during the Vietnam War, and prostate cancer risk. Articles evaluated include 11 studies of three cohorts, four case-control or cross-sectional studies, and three case-only studies of military veterans with information on estimated Agent Orange or TCDD exposure; 13 studies of seven cohorts, one case-control study, and eight proportionate morbidity or mortality studies of Vietnam veterans without information on Agent Orange exposure; 11 cohort studies of workers with occupational exposure to TCDD; and two studies of one community cohort with environmental exposure to TCDD. The most informative studies, including those of Vietnam veterans involved in Agent Orange spraying or other handling, herbicide manufacturing or spraying workers with occupational TCDD exposure, and community members exposed to TCDD through an industrial accident, consistently reported no significant increase in prostate cancer incidence or mortality. Only some potentially confounded studies of Vietnam veterans compared with the general population, studies with unreliable estimates of Agent Orange exposure, and analyses of selected subgroups of Vietnam veterans reported positive associations. Overall, epidemiologic research offers no consistent or convincing evidence of a causal relationship between exposure to Agent Orange or TCDD and prostate cancer. More accurate exposure assessment is needed in large epidemiologic studies to rule out a causal association more conclusively.
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Affiliation(s)
- Ellen T Chang
- Health Sciences Practice, Exponent, Inc., 149 Commonwealth Drive, Menlo Park, CA, 94025, USA,
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Hue NTM, Nam VD, Thuong NV, Huyen NT, Phuong NTH, Hung NX, Tuan NH, Son LK, Minh NH. Determination of PCDD/Fs in breast milk of women living in the vicinities of Da Nang Agent Orange hot spot (Vietnam) and estimation of the infant's daily intake. Sci Total Environ 2014; 491-492:212-218. [PMID: 24613651 DOI: 10.1016/j.scitotenv.2014.02.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/10/2014] [Accepted: 02/10/2014] [Indexed: 06/03/2023]
Abstract
Seventeen toxic congeners of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were determined in breast milks using the high resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS) method. Twenty seven breast milk samples were collected from primiparae who have lived over 5 years in wards namely Chinh Gian, An Khe, Khue Trung, and Hoa Thuan Tay which are located near the Da Nang Agent Orange hot spot (the AO/Dioxin hot spot). The samples were then analyzed for PCDD/F residues in order to assess the human exposure to dioxins from the AO/Dioxin hot spot, especially health risk to the breast-fed infants. The average TEQ levels in the four studied cohorts ranged from 8.1 to 26 pg/g lipid, with the highest level up to 51 pg TEQ/g lipid found in the An Khe ward. The TEQ level was correlated with geographical position and ranking in the order of Khue Trung, Hoa Thuan Tay, Chinh Gian and An Khe. The mean estimated PCDD/Fs infant's daily intake in the cohort of Khue Trung, Hoa Thuan Tay, Chinh Gian and An Khe was about 41, 122, 124, and 134 pg TEQ/kg bw/day, respectively, which are much higher than the tolerable daily intake proposed by the World Health Organization (4 pg TEQ/kg bw/day).
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Affiliation(s)
- N T M Hue
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - V D Nam
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - N V Thuong
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - N T Huyen
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - N T H Phuong
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - N X Hung
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - N H Tuan
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam
| | - L K Son
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam; Office of National Steering Committee 33, Ministry of Natural Resources and Environment, Nr. 83 Nguyen Chi Thanh, Hanoi, Vietnam
| | - N H Minh
- Dioxin Laboratory, Centre for Environment Monitoring, Vietnam Environment Administration, Nr. 556 Nguyen Van Cu, Long Bien, Hanoi, Vietnam.
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Durant JT, Boivin TG, Pohl HR, Sinks TH. Public health assessment of dioxin-contaminated fish at former US airbase, Bien Hoa, Vietnam. Int J Environ Health Res 2014; 25:254-264. [PMID: 25087452 DOI: 10.1080/09603123.2014.938026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ponds at the former US airbase at Ben Hoa, Vietnam are contaminated with Agent Orange. The ponds had been used for aquaculture, and in all likelihood, fish from those ponds have been sold to the public. We assessed human exposure to 2,3,7,8-tetrachloro-dibenzo-dioxin (2,3,7,8-TCDD) in fish samples from the ponds. For on-base tilapia, muscle concentrations 2,3,7,8-TCDD ranged from 1.4 to 32.7 pg/g. Fat concentrations ranged from 73.3 to 3990 pg/g. Estimated human exposure doses exceed international guidelines and exceed 2,3,7,8-TCDD's lowest adverse effect levels. The Bien Hoa fishponds are a completed human pathway for TCDD exposure.
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Affiliation(s)
- James T Durant
- a Agency for Toxic Substances and Disease Registry , Division of Community Health Investigations , Atlanta , GA , USA
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Yi SW, Hong JS, Ohrr H, Yi JJ. Agent Orange exposure and disease prevalence in Korean Vietnam veterans: the Korean veterans health study. Environ Res 2014; 133:56-65. [PMID: 24906069 DOI: 10.1016/j.envres.2014.04.027] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/21/2014] [Accepted: 04/22/2014] [Indexed: 06/03/2023]
Abstract
Between 1961 and 1971, military herbicides were used by the United States and allied forces for military purposes. Agent Orange, the most-used herbicide, was a mixture of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid, and contained an impurity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Many Korean Vietnam veterans were exposed to Agent Orange during the Vietnam War. The aim of this study was to evaluate the association between Agent Orange exposure and the prevalence of diseases of the endocrine, nervous, circulatory, respiratory, and digestive systems. The Agent Orange exposure was assessed by a geographic information system-based model. A total of 111,726 Korean Vietnam veterans were analyzed for prevalence using the Korea National Health Insurance claims data from January 2000 to September 2005. After adjusting for covariates, the high exposure group had modestly elevated odds ratios (ORs) for endocrine diseases combined and neurologic diseases combined. The adjusted ORs were significantly higher in the high exposure group than in the low exposure group for hypothyroidism (OR=1.13), autoimmune thyroiditis (OR=1.93), diabetes mellitus (OR=1.04), other endocrine gland disorders including pituitary gland disorders (OR=1.43), amyloidosis (OR=3.02), systemic atrophies affecting the nervous system including spinal muscular atrophy (OR=1.27), Alzheimer disease (OR=1.64), peripheral polyneuropathies (OR=1.09), angina pectoris (OR=1.04), stroke (OR=1.09), chronic obstructive pulmonary diseases (COPD) including chronic bronchitis (OR=1.05) and bronchiectasis (OR=1.16), asthma (OR=1.04), peptic ulcer (OR=1.03), and liver cirrhosis (OR=1.08). In conclusion, Agent Orange exposure increased the prevalence of endocrine disorders, especially in the thyroid and pituitary gland; various neurologic diseases; COPD; and liver cirrhosis. Overall, this study suggests that Agent Orange/2,4-D/TCDD exposure several decades earlier may increase morbidity from various diseases, some of which have rarely been explored in previous epidemiologic studies.
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Affiliation(s)
- Sang-Wook Yi
- Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Beomil-ro 579-beongil 24, Naegok-dong, Gangneung, Gangwon-do 210-701, Republic of Korea.
| | - Jae-Seok Hong
- Research Department, Health Insurance Review & Assessment Service, 22 Banpo-daero, 11F, Seocho-gu, Seoul 137-927, Republic of Korea.
| | - Heechoul Ohrr
- Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Repulbic of Korea.
| | - Jee-Jeon Yi
- Institute for Occupational and Environmental Health, Kwandong University College of Medicine, Beomil-ro 579-beongil 24, Naegok-dong, Gangneung, Gangwon-do 210-701, Republic of Korea.
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Lurker PA, Berman F, Clapp RW, Stellman JM. Post-Vietnam military herbicide exposures in UC-123 Agent Orange spray aircraft. Environ Res 2014; 130:34-42. [PMID: 24566076 DOI: 10.1016/j.envres.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 01/31/2014] [Accepted: 02/01/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND During the Vietnam War, approximately 20 million gallons of herbicides, including ~10.5 million gallons of dioxin-contaminated Agent Orange, were sprayed by about 34 UC-123 aircraft that were subsequently returned to the United States, without decontamination or testing, to three Air Force reserve units for transport operations (~1971-1982). In 1996, observed dioxin contamination led to withdrawal of these UC-123s from public auction and to their smelting in 2009. Current Air Force and Department of Veterans Affairs policies stipulate that "dried residues" of chemical herbicides and dioxin had not lead to meaningful exposures to flight crew and maintenance personnel, who are thus ineligible for Agent Orange-related benefits or medical examinations and treatment. Sparse monitoring data are available for analysis. METHODS Three complementary approaches for modeling potential exposures to dioxin in the post-Vietnam war aircraft were employed: (1) using 1994 and 2009 Air Force surface wipe data to model personnel exposures and to estimate dioxin body burden for dermal-oral exposure for dried residues using modified generic US Environmental Protection Agency intake algorithms; (2) comparing 1979 Air Force 2,4- dichlorophenoxyacetic acid and 2,4-5-trichlorophenoxyacetic acid air samples to saturated vapor pressure concentrations to estimate potential dioxin exposure through inhalation, ingestion and skin contact with contaminated air and dust; and (3) applying emission models for semivolatile organic compounds from contaminated surfaces to estimate airborne contamination. RESULTS Model (1): Body-burden estimates for dermal-oral exposure were 0.92 and 5.4pg/kg body-weight-day for flight crew and maintainers. The surface wipe concentrations were nearly two orders of magnitude greater than the US Army guidance level. Model (2): measured airborne concentrations were at least five times greater than saturated vapor pressure, yielding dioxin estimates that ranged from 13.2-27.0pg/m(3), thus supporting the likelihood of dioxin dust adsorption. Model (3): Theoretical models yielded consistent estimates to Model 2, 11-49pg/m(3), where the range reflects differences in experimental value of dioxin vapor pressure and surface area used. Model (3) results also support airborne contamination and dioxin dust adsorption. CONCLUSIONS Inhalation, ingestion and skin absorption in aircrew and maintainers were likely to have occurred during post-Vietnam use of the aircraft based on the use of three complementary models. Measured and modeled values for dioxin exceeded several available guidelines. Deposition-aerosolization-redeposition homeostasis of semivolatile organic compound contaminants, particularly dioxin, is likely to have continually existed within the aircraft. Current Air Force and Department of Veterans Affairs policies are not consistent with the available industrial hygiene measurements or with the widely accepted models for semivolatile organic compounds.
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Affiliation(s)
| | - Fred Berman
- The Center for Research on Occupational and Environmental Toxicology, Oregon Health and Science University, Portland, OR, USA
| | | | - Jeanne Mager Stellman
- Department of Health Policy & Management, Mailman School of Public Health, Columbia University, 600 West 168th Street, 6th floor, New York, NY, USA.
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Manh HD, Kido T, Okamoto R, Xianliang S, Anh LT, Supratman S, Maruzeni S, Nishijo M, Nakagawa H, Honma S, Nakano T, Takasuga T, Nhu DD, Hung NN, Son LK. Serum dioxin levels in Vietnamese men more than 40 years after herbicide spraying. Environ Sci Technol 2014; 48:3496-503. [PMID: 24552243 DOI: 10.1021/es404853h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Recent studies have found elevated dioxin levels inside some U.S. military former air bases in Vietnam, known as hotspots. Many studies of Agent Orange have been done in U.S. veterans; however, there is little known about Vietnamese men. In 2010, we collected blood samples from 97 men in a hotspot and 85 men in an unsprayed area in Northern Vietnam. Serum concentrations of not only TCDD but also other dioxins (PCDDs), furans (PCDFs), and nonortho polychlorinated biphenyls (PCBs) were significantly higher in the hotspot than in the unsprayed area. In the hotspot, three subareas were demarcated, based on their proximity to the air base. The total toxic equivalents (TEQ) of PCDDs/PCDFs+PCBs was 41.7 pg/g lipid in the area closest to the air base, while it was around 29 pg/g lipid in the other two subareas. In the unsprayed area, the dioxin levels were no different between men who went to the South during the Vietnam War and those who remained in the North, with TEQs PCDDs/PCDFs+PCBs of around 13.6 pg/g lipid. Our findings suggested that people living close to the former U.S. air bases might have been exposed to both Agent Orange and other sources of dioxin-like compounds.
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Affiliation(s)
- Ho Dung Manh
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University , 5-11-80 Kodatsuno, Kanazawa 920-8640, Japan
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Kido T, Dao TV, Ho MD, Duc Dang N, Pham NT, Okamoto R, Pham TT, Maruzeni S, Nishijo M, Nakagawa H, Honma S, Le SK, Nguyen HN. High cortisol and cortisone levels are associated with breast milk dioxin concentrations in Vietnamese women. Eur J Endocrinol 2014; 170:131-9. [PMID: 24123093 DOI: 10.1530/eje-13-0410] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Dioxin (polychlorinated dibenzodioxins+polychlorinated dibenzofurans) is one of the most toxic chemical substances known. Although it is suspected to cause endocrine disruption, very few epidemiological studies have been carried out on its effects on human steroid hormones. The aim of this study was to elucidate the association of dioxin exposure with steroid hormone levels in the saliva and serum of Vietnamese women. STUDY DESIGN Two areas, namely Phu Cat (hot spot) and Kim Bang (nonexposed area), were selected for the study. The study subjects consisted of 51 and 58 women respectively. Saliva, blood, and breast milk samples were collected from the subjects in both the areas. METHODS Cortisol, cortisone, DHEA, androstenedione, estrone, and estradiol levels in serum and saliva were determined by liquid chromatography-tandem mass spectrometry; dioxin concentrations in breast milk were measured by gas chromatography-mass spectrometry. RESULTS Dioxin concentrations in the breast milk of women from the dioxin hot spot were three to four times higher than those in the breast milk of women from the nonexposed area. Good correlations were found between the levels of six steroid hormones in saliva and those in serum respectively. Salivary and serum cortisol and cortisone levels in women from the dioxin hot spot were significantly higher than those in women from the nonexposed area (P<0.001) and those in all the subjects were positively associated with dioxin concentrations in Vietnamese women (P<0.01). CONCLUSION These results suggest that dioxin influences steroidogenesis in humans. Saliva samples can be used for hormone analysis and are therefore excellent specimens in epidemiological studies.
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Affiliation(s)
- Teruhiko Kido
- School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
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Hoenemeyer LA. Urologic cancer risks for veterans exposed to Agent Orange. Urol Nurs 2013; 33:87-99. [PMID: 23734554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Agent Orange, an herbicide widely used during the Vietnam War, has been linked to various health risks, including urologic malignancy. Exposed veterans are at risk for prostate cancer and may be entitled to compensation if diagnosed with prostate cancer. Current research studies are aimed at mitigating prostate dysplasia and prostate cancer
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Affiliation(s)
- Lori A Hoenemeyer
- Department of Urology, James A. Haley Veterans Administration Hospital, Tampa, FL, USA
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Abstract
Persistent organic pollutants (POPs) are a group of chemical substances that have the common properties of resistance to biodegradation, wide-range transportation, high lipophilicity, bioaccumulation in fat, and biomagnification in the food chain. POPs are persistent in the environment worldwide and have potential adverse impacts on human health and the environment. Polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and polychlorinated biphenyls (PCBs) are well known chemicals that are considered as POPs. The association between high-level exposure to dioxins and type 2 diabetes among U.S. Air Force veterans who had been exposed to Agent Orange contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) during the Vietnam War was reported in the late 1990s. This association has been supported by similar epidemiologic studies, whose subjects were exposed to high doses of dioxins in their places of work involving phenoxyacid herbicide production and spraying, and in the industrial accident in Seveso, Italy. Recently, low-level exposure to dioxins and PCBs has been reported to be linked to type 2 diabetes. Cross-sectional studies in the U.S. general population and Japanese general population showed that body burden levels of some dioxins and PCBs were strongly associated with the prevalence of type 2 diabetes. Very recently, following these cross-sectional studies, several prospective studies have suggested that low-level exposure to some PCBs predicted the future risk of type 2 diabetes in the general population. Environmental exposure to some dioxins and PCBs, which mainly accumulate in adipose tissue, may play a role in the development of type 2 diabetes.
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Affiliation(s)
- Hirokazu Uemura
- Department of Preventive Medicine, the University of Tokushima Graduate School, Japan.
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MESH Headings
- 2,4,5-Trichlorophenoxyacetic Acid/chemistry
- 2,4,5-Trichlorophenoxyacetic Acid/history
- 2,4,5-Trichlorophenoxyacetic Acid/toxicity
- 2,4-Dichlorophenoxyacetic Acid/chemistry
- 2,4-Dichlorophenoxyacetic Acid/history
- 2,4-Dichlorophenoxyacetic Acid/toxicity
- Agent Orange
- Benzofurans/chemistry
- Benzofurans/history
- Benzofurans/toxicity
- Dibenzofurans, Polychlorinated
- Dioxins/chemistry
- Dioxins/history
- Dioxins/toxicity
- Environmental Pollutants/chemistry
- Environmental Pollutants/history
- Environmental Pollutants/toxicity
- Environmental Pollution/history
- History, 20th Century
- Polychlorinated Dibenzodioxins/analogs & derivatives
- Polychlorinated Dibenzodioxins/chemistry
- Polychlorinated Dibenzodioxins/history
- Polychlorinated Dibenzodioxins/toxicity
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Affiliation(s)
- Ronald A Hites
- School of Public and Environmental Affairs, Indiana University, Bloomington, Indiana, USA.
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