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Agent Orange and Spontaneous Abortions

Ralph R. Cook, MD, MPH
JAMA. 1980;243(14):1423. doi:10.1001/jama.1980.03300400013013.
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To the Editor.—  I read with interest the recent MEDICAL NEWS column "Plenty of Fuel for Agent Orange Dispute" (242:593, 1979). As indicated, the Environmental Protection Agency (EPA) recently implemented an emergency suspension of the herbicide 2,4,5-trichlorophenoxy acetic acid (2,4,5-T), citing as justification the Alsea study. Unfortunately, The Journal article erroneously reported "130 spontaneous abortions [occurred] within three months (following the spraying of 2,4,5-T)." In fact, during the entire 72-month period covered by this EPA research, only 188 spontaneous abortions were reported to have occurred in the study area—about 2.6 per month.I suspect Mr Gunby meant 130 spontaneous abortions per 1,000 live births. Even this deserves comment. The rate presumes the researchers had valid data for both the numerator (spontaneous abortions) and the denominator (live births). They had neither. For spontaneous abortions, they used hospitalized early spontaneous abortions (less than 20 weeks' gestation) and thus produced numbers for study and


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