POST-VIETNAM DIOXIN EXPOSURE |
Committee to Evaluate the Potential Exposure to
Agent Orange/TCDD Residue and
Level of Risk of Adverse Health Effects for
Aircrew of Post-Vietnam C-123 Aircraft
Board on the Health of Select Populations
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Contract/Grant No. VA241-P-2024 between the National Academy of Sciences and the Department of Veterans Affairs. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.
International Standard Book Number-13: 978-0-309-30890-8
International Standard Book Number-10: 0-309-30890-9
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Suggested citation: IOM (Institute of Medicine). 2015. Post-Vietnam Dioxin Exposure in Agent Orange–Contaminated C-123 Aircraft. Washington, DC: The National Academies Press.
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INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
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Advisers to the Nation on Science, Engineering, and Medicine
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COMMITTEE TO EVALUATE THE POTENTIAL EXPOSURE TO AGENT ORANGE/TCDD RESIDUE AND LEVEL OF RISK OF ADVERSE HEALTH EFFECTS FOR AIRCREW OF POST-VIETNAM C-123 AIRCRAFT
ROBERT F. HERRICK (Chair), Harvard School of Public Health
ROBERT CANALES, University of Arizona
KENNY S. CRUMP, Independent Consultant
MELISSA GONZALES, University of New Mexico
JOHN C. KISSEL, University of Washington
LINDA A. MCCAULEY, Emory University
CLIFFORD P. WEISEL, Rutgers University
IOM Staff
MARY BURR PAXTON, Co-study Director, Senior Program Officer
JENNIFER A. COHEN, Co-study Director, Program Officer
HEATHER L. CHIARELLO, Research Associate
FREDERICK J. ERDTMANN, Director, Board on the Health of Select Populations
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Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Richard A. Fenske, University of Washington
Michael A. Gallo, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School
Melissa J. Perry, George Washington University
Martin A. Philbert, University of Michigan
Dale Sandler, National Institute of Environmental Health Sciences
Lauren Zeise, California Environmental Protection Agency
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Kristine M. Gebbie, Flinders University of South Australia. Appointed by the National Research and the
Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
Acknowledgments
This report was greatly enhanced by the participants of the workshop that was held as part of this study. The committee would like to acknowledge the efforts of those who gave presentations and who provided materials to the committee during the course of the study’s information-gathering period: Wesley Carter (C-123 Veterans Association), Jeffrey Driver (RiskScience.net), Patrick Finley (Sandia National Laboratories), Harry Heist II (Air Mobility Command Museum, Dover, Delaware), Peter Kahn (AESOP, Rutgers University), Peter Lurker (Germantown Consultants, LLC), Thomas McKone (University of California, Berkeley), William Nazaroff (University of California, Berkeley), Brian Nicklas (National Air and Space Museum Archives), Thomas Sinks (Agency for Toxic Substances and Disease Registry), Jeanne Stellman (Columbia University), and Alvin Young (A.L. Young Consulting, Inc.). The information that was provided helped to set the stage for fruitful discussions in the closed session that followed. The committee greatly appreciates the contribution of Roberta Wedge (Institute of Medicine) in providing experienced, but fresh eyes to the report. The committee would also like to acknowledge and thank Chensheng (Alex) Lu (Harvard School of Public Health) for his participation as a committee member before resigning in September 2014.
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2,4-D |
2,4-dichlorophenoxyacetic acid |
2,4,5-T |
2,4,5-trichlorophenoxyacetic acid |
ADI |
acceptable daily intake |
AF (USAF) |
US Air Force |
AFB |
Air Force Base |
AFHS |
Air Force Health Study |
AHR |
aryl hydrocarbon receptor |
AMARC |
Aerospace Maintenance and Regeneration Center |
AMARG |
Aerospace Maintenance and Regeneration Group |
AME |
aero-medical evacuation |
AO |
Agent Orange (general term for all herbicide formulations containing TCDD) |
atm |
atmosphere (measure for vapor pressure) |
ATSDR |
Agency for Toxic Substances and Disease Registry |
CAG |
Cancer Assessment Group (EPA) |
CHPPM |
US Army Center for Health Promotion and Preventive Medicine |
CVA |
C-123 Veterans Association |
ECG |
electrocardiogram |
EPA |
US Environmental Protection Agency |
HO |
Herbicide Orange (equivalent to Agent Orange) |
IOM |
Institute of Medicine |
LOAEL |
lowest-observed-adverse-effect level |
lpm |
liters per minute |
MAP |
Military Assistance Program |
MASDC |
Military Aircraft Storage and Disposal Center |
MDI |
mean daily intake |
mg/m3 |
milligrams per cubic meter |
NAS |
National Academy of Sciences |
ng/m2 |
nanograms per square meter |
NIEHS |
National Institute of Environmental Health Sciences |
NIOSH |
National Institute for Occupational Safety and Health |
NMDOH |
New Mexico Department of Health |
NOEL |
no-observed-effect level |
NRC |
National Research Council |
ORH |
Operation Ranch Hand (military codename for operation that |
sprayed herbicides during the Vietnam War) |
|
ORH C-123 |
UC-123 aircraft formerly used in ORH |
PCB |
polychlorinated biphenyl |
PCDD |
polychlorinated dibenzo-p-dioxin |
PCDF |
polychlorinated dibenzofuran |
ppm |
parts per million |
PUF |
polyurethane foam (vapor phase collection method) |
QA/QC |
quality assurance/quality control |
RfD |
noncancer reference dose |
RH |
Ranch Hand (name for individuals who served in ORH) |
SVOC |
semi-volatile organic compound |
SWSL |
surface wipe screening level |
TAG |
Tactical Airlift Group |
TAS |
Tactical Airlift Squadron |
TC |
transfer coefficient |
TCDD |
2,3,7,8-tetrachlorodibenzo-p-dioxin |
TDI |
tolerable daily intake |
TEF |
Toxicity Equivalency Factor |
TEQ |
Toxicity Equivalency Quotient (weighted total of TEFs) |
TG 312 |
Technical Guide 312 (CHPPM, 2009) |
TSCA |
Toxic Substances Control Act |
µg/kg |
microgram per kilogram |
µg/kg-d |
microgram per kilogram per day (format for “mass per |
kilogram-body weight per time unit”) |
|
µg/m2 |
microgram per square meter (= 0.01 µg/100 cm2) |
USAF |
US Air Force |
USAFSAM |
US Air Force School of Aerospace Medicine |
VA |
Department of Veterans Affairs |
VAO |
Veterans and Agent Orange (IOM report series) |
WHO |
World Health Organization |
WTC |
World Trade Center |
y0 |
gas-phase concentration immediately above contaminated surface |