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September 2, 1988, Vol 260, No. 9 >
ARTICLE | September 2, 1988

Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels in US Army Vietnam-Era Veterans FREE

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Reprint requests to Centers for Disease Control, 1600 Clifton Rd, C-25, Mailstop F-16, Atlanta, GA 30333 (John M. Karon, PhD).


JAMA. 1988;260(9):1249-1254. doi:10.1001/jama.1988.03410090081035
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References

This study investigates whether military records can be used to identify US Army Vietnam veterans who were likely to be exposed to the herbicide Agent Orange. Serum levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a toxic contaminant in Agent Orange, were obtained for 646 ground combat troops who served in heavily sprayed areas of Vietnam and for 97 veterans who did not serve in Vietnam. The distributions of current TCDD levels in Vietnam and non-Vietnam veterans were nearly identical (mean in each group, ≈4 parts per trillion [ppt]). Only two men (both Vietnam veterans) had clearly elevated levels (>20 ppt). Levels of TCDD did not tend to increase with greater likelihood of exposure to Agent Orange, as estimated from either military records or self-reported exposure. This study is consistent with other studies and suggests that most US Army ground troops who served in Vietnam were not heavily exposed to TCDD, except perhaps men whose jobs involved handling herbicides.

(JAMA 1988;260:1249-1254)

REFERENCES

1 +
Young AL, Calcagni JA, Tremblay JW: The Toxicology, Environmental Fate, and Human Risk of Herbicide Orange and Its Associated Dioxin , USAF Occupational and Environmental Health Laboratory technical report TR-78-92. San Antonio, Tex, Brooks Air Force Base, 1978;.
2 +
Hagenmeier H:  Determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin in commercial chlorophenols and related products . Fresenius Z Anal Chem 1986;;325:603-606.
3 +
Review of Literature on Herbicides, Including Phenoxy Herbicides and Associated Dioxins: Analysis of Literature , publication 0-522-609/21. Washington, DC, Veterans Administration, 1981;, vol 1.
4 +
Huff JE, Moore JA, Saracci R, et al:  Long-term hazards of polychlorinated dibenzodioxins and polychlorinated dibenzofurans . Environ Health Perspect 1980;;36:221-240.
5 +
Centers for Disease Control Vietnam Experience Study:  Health status of Vietnam veterans: I. Psychosocial characteristics . JAMA 1988;; 259:2701-2707.
6 +
Centers for Disease Control Vietnam Experience Study:  Health status of Vietnam veterans: II. Physical health . JAMA 1988;;259:2708-2714.
7 +
Centers for Disease Control Vietnam Experience Study:  Health status of Vietnam veterans: III. Reproductive outcomes . JAMA 1988;;259:2715-2719.
8 +
Gross ML, Lay JO, Lyon PA, et al:  2,3,7,8-Tetrachlorodibenzo-p-dioxin levels in adipose tissue of Vietnam veterans . Environ Res 1985;;33: 261-268.
9 +
Kahn PC, Gochfeld M, Rappe C, et al:  Analysis of adipose tissue and blood samples from Vietnam veterans: Project outline and preliminary results . Presented at the Sixth International Symposium on Chlorinated Dioxins and Related Compounds, Fukuoka, Japan, Sept 18,1986 .
10 +
Kahn PC, Gochfeld M, Nygren M, et al:  Dioxins and dibenzofurans in blood and adipose tissue of Agent Orange-exposed Vietnam veterans and matched controls . JAMA 1988;;259:1661-1667.
11 +
Pirkle JL, Wolff WH, Patterson DG Jr, et al:  Estimates of the half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin in Ranch Hand Veterans . Presented at the Seventh International Symposium on Chlorinated Dioxins and Related Compounds, Las Vegas, Oct 7,1987 .
12 +
Patterson DG Jr, Hampton L, Lapeza CR Jr, et al:  High-resolution gas chromatographic/high-resolution mass spectrometric analysis of human serum on a whole-weight and lipid basis for 2,3,7,8-tetrachlorodibenzo-p-dioxin . Anal Chem 1987;; 59:2000-2005.
13 +
Patterson DG Jr, Needham LL, Pirkle JL, et al:  Correlations between serum and adipose levels of 2,3,7,8-TCDD in 50 persons from Missouri . Arch Environ Contam Toxicol 1988;;17:139-143.
14 +
Committee on the Effects of Herbicides in South Vietnam: Part A. Summary and Conclusions . Washington, DC, National Academy of Science, 1974;.
15 +
US Army and Joint Services Environmental Support Group: Services Herbs Tape . Washington, DC, US Army, 1985;.
16 +
Buckingham WA: Operation Ranch Hand: The Air Force and Herbicides in Southeast Asia, 1961 to 1971 . Washington, DC, US Air Force, 1982;.
17 +
Crosby DG, Wong AS:  Environmental degradation of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) . Science 1977;;195:1337-1338.
18 +
Nash RG, Beall ML:  Distribution of Silvex, 2,4-D and TCDD applied to turf in chambers and field plots . J Agriculture Food Chem 1980;;28:614-623.
19 +
Jensen DJ, Getzendaner ME, Hummel RA, et al:  Residue studies for (2,4,5-trichlorophenoxy) acetic acid and 2,3,7,8-tetrachlorodibenzo-p-dioxin in grass and rice . J Agriculture Food Chem 1983;;31:118-122.
20 +
DiDomenico A, Viviano G, Zapponi G:  Environmental persistence of 2,3,7,8-TCDD at Seveso , in Hutzinger 0, Frei RW, Merian E, et al (eds): Chlorinated Dioxins and Related Compounds: Impact on the Environment . Elmsford, NY, Pergamon Press Inc, 1982;,pp 105-114.
21 +
Wipf HK, Schmid J: Seveso:  An environmental assessment , in Tucker RE, Young AL, Gray AP (eds): Human and Environmental Risks of Chlorinated Dioxins and Related Compounds . New York, Plenum Publishing Corp, 1983;, pp 255-274.
22 +
Health Assessment Document for Polychlorinated Dibenzo-p-dioxins , publication 600/8-84/ 014f. Cincinnati, Environmental Protection Agency, 1985;.
23 +
The Centers for Disease Control Vietnam Experience Study:  Postservice mortality among Vietnam veterans . JAMA 1987;;257:790-795.
24 +
Lapeza CR Jr, Patterson DG Jr, Liddle JA:  Automated apparatus for the extraction and enrichment of 2,3,7,8-tetrachlorodibenzo-p-dioxin in human adipose tissue . Anal Chem 1986;;58:713-716.
25 +
Patterson DG Jr, Hoffman RE, Needham LL, et al:  Levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin in adipose tissue of exposed and control persons in Missouri: An interim report . JAMA 1986;;256:2683-2686.
26 +
Stephens MA:  Kolmogorov-Smirnov-type tests of fit , in Kotz S, Johnson NL (eds): Encyclopedia of Statistical Sciences . New York, John Wiley & Sons Inc, 1983;, vol 4, pp 398-402.
27 +
Rothman KJ: Modern Epidemiology . Boston, Little Brown and Co Inc, 1986;.
28 +
Schecter A, Constable J, Tong H, et al:  The use of tissue measurements of 2,3,7,8-TCDD to characterize elevated dioxin body burden of dioxin from Agent Orange in U.S. Vietnam veterans up to 20 years after exposure . Presented at the Seventh International Symposium on Chlorinated Dioxins and Related Compounds, Las Vegas, Oct 7,1987 .
29 +
Patterson DG Jr, Fingerhut MA, Roberts DR, et al:  Levels of 2,3,7,8-tetrachlorodibenzodioxin in occupationally exposed workers . Presented at the Seventh International Symposium on Chlorinated Dioxins and Related Compounds, Las Vegas, Oct 8, 1987 .

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1 +
Young AL, Calcagni JA, Tremblay JW: The Toxicology, Environmental Fate, and Human Risk of Herbicide Orange and Its Associated Dioxin , USAF Occupational and Environmental Health Laboratory technical report TR-78-92. San Antonio, Tex, Brooks Air Force Base, 1978;.
2 +
Hagenmeier H:  Determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin in commercial chlorophenols and related products . Fresenius Z Anal Chem 1986;;325:603-606.
3 +
Review of Literature on Herbicides, Including Phenoxy Herbicides and Associated Dioxins: Analysis of Literature , publication 0-522-609/21. Washington, DC, Veterans Administration, 1981;, vol 1.
4 +
Huff JE, Moore JA, Saracci R, et al:  Long-term hazards of polychlorinated dibenzodioxins and polychlorinated dibenzofurans . Environ Health Perspect 1980;;36:221-240.
5 +
Centers for Disease Control Vietnam Experience Study:  Health status of Vietnam veterans: I. Psychosocial characteristics . JAMA 1988;; 259:2701-2707.
6 +
Centers for Disease Control Vietnam Experience Study:  Health status of Vietnam veterans: II. Physical health . JAMA 1988;;259:2708-2714.
7 +
Centers for Disease Control Vietnam Experience Study:  Health status of Vietnam veterans: III. Reproductive outcomes . JAMA 1988;;259:2715-2719.
8 +
Gross ML, Lay JO, Lyon PA, et al:  2,3,7,8-Tetrachlorodibenzo-p-dioxin levels in adipose tissue of Vietnam veterans . Environ Res 1985;;33: 261-268.
9 +
Kahn PC, Gochfeld M, Rappe C, et al:  Analysis of adipose tissue and blood samples from Vietnam veterans: Project outline and preliminary results . Presented at the Sixth International Symposium on Chlorinated Dioxins and Related Compounds, Fukuoka, Japan, Sept 18,1986 .
10 +
Kahn PC, Gochfeld M, Nygren M, et al:  Dioxins and dibenzofurans in blood and adipose tissue of Agent Orange-exposed Vietnam veterans and matched controls . JAMA 1988;;259:1661-1667.
11 +
Pirkle JL, Wolff WH, Patterson DG Jr, et al:  Estimates of the half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin in Ranch Hand Veterans . Presented at the Seventh International Symposium on Chlorinated Dioxins and Related Compounds, Las Vegas, Oct 7,1987 .
12 +
Patterson DG Jr, Hampton L, Lapeza CR Jr, et al:  High-resolution gas chromatographic/high-resolution mass spectrometric analysis of human serum on a whole-weight and lipid basis for 2,3,7,8-tetrachlorodibenzo-p-dioxin . Anal Chem 1987;; 59:2000-2005.
13 +
Patterson DG Jr, Needham LL, Pirkle JL, et al:  Correlations between serum and adipose levels of 2,3,7,8-TCDD in 50 persons from Missouri . Arch Environ Contam Toxicol 1988;;17:139-143.
14 +
Committee on the Effects of Herbicides in South Vietnam: Part A. Summary and Conclusions . Washington, DC, National Academy of Science, 1974;.
15 +
US Army and Joint Services Environmental Support Group: Services Herbs Tape . Washington, DC, US Army, 1985;.
16 +
Buckingham WA: Operation Ranch Hand: The Air Force and Herbicides in Southeast Asia, 1961 to 1971 . Washington, DC, US Air Force, 1982;.
17 +
Crosby DG, Wong AS:  Environmental degradation of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) . Science 1977;;195:1337-1338.
18 +
Nash RG, Beall ML:  Distribution of Silvex, 2,4-D and TCDD applied to turf in chambers and field plots . J Agriculture Food Chem 1980;;28:614-623.
19 +
Jensen DJ, Getzendaner ME, Hummel RA, et al:  Residue studies for (2,4,5-trichlorophenoxy) acetic acid and 2,3,7,8-tetrachlorodibenzo-p-dioxin in grass and rice . J Agriculture Food Chem 1983;;31:118-122.
20 +
DiDomenico A, Viviano G, Zapponi G:  Environmental persistence of 2,3,7,8-TCDD at Seveso , in Hutzinger 0, Frei RW, Merian E, et al (eds): Chlorinated Dioxins and Related Compounds: Impact on the Environment . Elmsford, NY, Pergamon Press Inc, 1982;,pp 105-114.
21 +
Wipf HK, Schmid J: Seveso:  An environmental assessment , in Tucker RE, Young AL, Gray AP (eds): Human and Environmental Risks of Chlorinated Dioxins and Related Compounds . New York, Plenum Publishing Corp, 1983;, pp 255-274.
22 +
Health Assessment Document for Polychlorinated Dibenzo-p-dioxins , publication 600/8-84/ 014f. Cincinnati, Environmental Protection Agency, 1985;.
23 +
The Centers for Disease Control Vietnam Experience Study:  Postservice mortality among Vietnam veterans . JAMA 1987;;257:790-795.
24 +
Lapeza CR Jr, Patterson DG Jr, Liddle JA:  Automated apparatus for the extraction and enrichment of 2,3,7,8-tetrachlorodibenzo-p-dioxin in human adipose tissue . Anal Chem 1986;;58:713-716.
25 +
Patterson DG Jr, Hoffman RE, Needham LL, et al:  Levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin in adipose tissue of exposed and control persons in Missouri: An interim report . JAMA 1986;;256:2683-2686.
26 +
Stephens MA:  Kolmogorov-Smirnov-type tests of fit , in Kotz S, Johnson NL (eds): Encyclopedia of Statistical Sciences . New York, John Wiley & Sons Inc, 1983;, vol 4, pp 398-402.
27 +
Rothman KJ: Modern Epidemiology . Boston, Little Brown and Co Inc, 1986;.
28 +
Schecter A, Constable J, Tong H, et al:  The use of tissue measurements of 2,3,7,8-TCDD to characterize elevated dioxin body burden of dioxin from Agent Orange in U.S. Vietnam veterans up to 20 years after exposure . Presented at the Seventh International Symposium on Chlorinated Dioxins and Related Compounds, Las Vegas, Oct 7,1987 .
29 +
Patterson DG Jr, Fingerhut MA, Roberts DR, et al:  Levels of 2,3,7,8-tetrachlorodibenzodioxin in occupationally exposed workers . Presented at the Seventh International Symposium on Chlorinated Dioxins and Related Compounds, Las Vegas, Oct 8, 1987 .

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