From 1962 to 1971, US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Because of continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Congress passed the Agent Orange Act of 1991. The legislation directed the Secretary of Veterans Affairs (VA) to request the IOM to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam. Veterans and Agent Orange: Update 2010 is the seventh Congressionally mandated biennial update to integrate new biomedical evidence into the findings of the first comprehensive report published in 1994.
Great strides have been made over the last several years in understanding the health effects of exposure to the herbicides used in Vietnam, but there are still many lingering questions. In the 2010 update, the committee recommends that the VA search its own records to look for possible associations between Vietnam service and specific health outcomes, specifically those that are relatively uncommon. The only modification made in this update to disease entries in the categories of association is the notation that early-onset peripheral neuropathy (a condition which has been recognized since Update 1996 as having limited or suggestive evidence of an association with herbicide exposure and must have developed within a year of exposure) is not necessarily transitory. The IOM continues to recommend that laboratory research be conducted to characterize Agent Orange’s potential for inducing epigenetic modifications. Work needs to be undertaken to resolve questions regarding several health outcomes, most importantly COPD, tonsil cancer, melanoma, brain cancer, Alzheimer’s disease, and paternally transmitted effects to offspring.