Waiting for an Army to Die

by Fred A. Wilcox

  (3) Effect on foliage. WHITE kills foliage in the same manner as ORANGE, since 80 percent of the active ingredient is 2,4-D. PICLORAM is more effective than 2,4-D, but acts slower. WHITE is effective on many plant species, and equal to or more effective than ORANGE on the more woody species. The material must be absorbed through the leaves. The water solution does not penetrate the waxy covering of leaves as well as oily mixtures and is more easily washed off by rain.

  (4) Safety precautions and decontamination. WHITE exhibits a low hazard from accidental ingestion. However, it may cause some irritation if splashed into the eyes. Should eye contact occur, flush with plenty of water. Splashes on the skin should be thoroughly washed with soap and water at the first opportunity. Contaminated clothing should be washed before reuse. When WHITE is used in the same equipment as BLUE, all of the WHITE should be removed before using BLUE. The two agents produce a white precipitate that will clog spray systems.

  COMPOSITION OF MILITARILY SIGNIFICANT ANTIPLANT AGENTS

  Antiplantagent Composition

  ORANGE 50% 2,4-D (n-butyl-2,4-dichlorophenoxyacetate); 50% 2,4,5-T (n-butyl-2,4,5-trichlorophenoxyacetate)

  WHITE 20% picloram (4-amino-3,5,6-trichloropicolinic acid); 80% 2,4-D (triisopropanolamine)

  BLUE (Phytar 560G) 3 pounds per gallon of water of: 65% of cacodylic acid (dimethylarsenic acid); 35% inert ingredients: sodium chloride, sodium and calcium sulfates, water

  AREA TREATED WITH HERBICIDES IN SOUTH VIETNAM 1962-1969

  Year Defoliation Crop Destruction

  1962 4,940 acres 741 acres

  1963 24,700 247

  1964 83,486 10,374

  1965 155,610 65,949

  1966 741,247 101,517

  1967 1,486,446 221,312

  1968 1,267,110 63,726

  1969 (January–March) 356,421 4,693

  - 4,119,960 468,559

  SOURCE: Military Assistance Command Vietnam Reports.

  VA Memo Circulated on May 18, 1978

  Directors, VA hospitals, domiciliary, outpatient clinics, and regional offices with outpatient clinics.

  Subject: Potential exposures of veterans to chemical defoliants during the Vietnam War.

  1. During the Vietnam War, herbicidal war chemicals were utilized for defoliation of vegetation. Recently concern has developed among some scientific and other groups that these chemicals may be capable of producing adverse health effects on individuals who were exposed to the herbicides. Because of their potential impact on a segment of the veteran population, the VA is attempting to develop accurate information on the health-related effects of the defoliants utilized during the Vietnam War.

  2. The four defoliants utilized regularly were picloram, cacodylic acid, 2,4-D and 2,4,5-T. These were mixed in variable proportions and placed in color-coded storage drums which were identified as “Agent Orange,” “Agent White,” “Agent Blue,” and “Agent Purple.” A large number of studies performed on man and several animal species have demonstrated that the four herbicides have a low level of toxicity, both individually and when mixed. Furthermore they appear to be rapidly absorbed and completely excreted in both the human and the animal.

  3. Humans exposed repeatedly to these agents may experience temporary and fully reversible neurological symptoms; however, the only chronic condition definitely associated with such exposure in humans is chloracne. Comprehensive animal studies performed under experimental conditions have demonstrated that very massive doses of these agents produce fatty degeneration of solid organs, gastrointestinal disturbances and thymic atrophy, all of which were reversible after withdrawal of the chemicals.

  4. These studies have failed to confirm the suggestion in the Vietnamese medical literature that liver cancer, frequent abortions, and fetal birth defects occur among those exposed to the defoliants. In addition, no confirmation has been obtained for the experimental studies of one scientist who found that hepatic and pancreatic cancers followed prolonged exposure to one of the chemicals.

  5. In contrast to the apparent low toxicity of the four defoliants evidence has been adduced that a contaminant called dioxin found in some of the storage drums has a significant potential toxicity. Although its concentration of dioxin was variable in different drums, it was always found in minute quantities. Experimental evidence from animal studies indicates that this chemical is eliminated from the body fairly rapidly and that it produces its toxic effects rather promptly. All available data suggests that it is not retained in tissues for prolonged periods of time. Accordingly, the recent suggestion by some observers that dioxin might still be detected in the fat tissues of Vietnam veterans exposed to it appears to be implausible.

  6. Despite the generally negative results of human and animal studies of the toxicity potential of the Vietnam defoliants, a great deal of concern has been engendered among veterans and their families by media presentations on these agents. The VA is responding to these concerns by working collaboratively with appropriate experts from the federal and private sectors in order to more adequately define the potential human toxicity of the defoliants for humans. You will be periodically informed concerning the results of these efforts.

  7. Meanwhile, we request that all VA staff who are called upon to deal with veterans who are concerned about toxic effects from a possible exposure to the defoliants adhere to the following protocol:

  A. Every veteran who alleges defoliant exposure must receive prompt, courteous, compassionate consideration.

  B. If the veteran has no objective symptoms or signs, simple reassurance should be offered. The veteran should be told that a record of the medical examination will be kept for future reference, but that if the veteran does not now have symptoms and did not previously experience any, the likelihood of herbicide poisoning is virtually zero.

  C. If the veteran presents with symptoms and signs which are not clearly explicable in terms of definable disease, a detailed history should be recorded on the VA form 10-10m, including such details the veteran may remember concerning his exposure to defoliant agents. This information can be checked against military data, if indicated.

  D. In view of the remaining uncertainties on the long-term effects of the defoliants, all VA personnel should avoid premature commitment to any diagnosis of defoliant poisoning. Similarly, entries in medical records should not contain statements about the relationship between a veteran’s illnesses and defoliant exposure unless unequivocal confirmation of such a connection has been established. Accordingly, veterans in whom defoliant poisoning is suspected should be admitted to a VA hospital for appropriate work-up.

  E. If there is evidence suggestive of defoliant agent poisoning, pertinent data must be forwarded to the ADCMD for operations (II), VACO.

  F. No veterans other than those referred by DVE should be called in for the express purposes of having them examined for possible defoliant poisoning.

  G. All VA forms 10-10m indicating that the veteran or the physician has material concern about the possibility of defoliant poisoning, should be preserved until further notification.

  H. A 3×5 locator card should be developed by MAS so that VA forms 10-10m can be swiftly retrieved if the need develops. MAS staff have received instructions on how to develop these cards. Significant administrative problems may be reported to VACO MAS (136D).

  I. If a patient who already is hospitalized intimates that he or she may have been exposed to defoliants, a statement to this effect should be entered in the medical record. If there are symptoms or signs which cannot be explained in terms of well-known medical entities, these should be appropriately investigated.

  J. Many agricultural and horticultural agents contain the same herbicidal chemicals as were incorporated in the Vietnam defoliants. Whenever there is suspicion of chemical poisoning, therefore, inquiry should be directed to other sources of intoxication as well as the allegations concerning the Vietnam episodes. There also are many industrial sources of chemical intoxication whose manifestations are similar to the s
yndromes ascribed to the defoliants. A careful occupational history therefore is necessary.

  K. Staff of field HFC’s who may be called upon to make public statements concerning the defoliants should not do so before reviewing their proposed expositions with the ADCMD for professional services, whose staff will provide the needed technical guidance.

  8. We trust that the foregoing guidance will be sufficient. If new information indicated a change of policy, additional directives will be issued. Should any problem arise which is not covered by this policy statement additional clarification may be sought by calling VACO Medical Service (Dr. Gerrit Schepers, ext. 389-2550). Any freedom of information request should be coordinated with VACO.

  Letter from Gilbert Boger, M.D., to the Editor of the Journal of the American Medical Association,

  November 30, 1979 (Vol. 242, No. 22)

  Symptoms in Vietnam Veterans Exposed to Agent Orange

  To the Editor.—Agent Orange is an herbicide containing equal parts of 2,4-dichlorophenoxyacetic acid and 2,4,5-trichlorophenoxyacetic acid. It was used extensively in Vietnam as a defoliant. A toxic contaminant is dioxin, 2,3,7,8-tetrachlorodibenzo-p-dioxin.

  A ten-month study of 78 Vietnam veterans who claimed exposure to Agent Orange yielded many findings: 85% of the men experienced a rash that was resistant to treatment. Using immunofluorenscence in one patient, a skin biopsy specimen showed intraepithelial and intercellular IgA, IgG, and IgM. In 53% of the patients, the rash was aggravated by sunlight.

  Joint pain occurred in 71%, stiffness in 59%, and swelling in 45%. Hypersomnolence occurred in 44% of the men and extreme fatigue in 80%. Sinus bradycardia and premature ventricular contractions were not infrequent.

  Persistent neurological complains were tingling (55%), numbness (60%), dizziness (69%), headaches (35%), and autonomic dyscontrol (18%). Severe psychiatric manifestations were depression (73%), suicidal attempts (8%), and violent rages (45%). An inability to concentrate occurred in 17% and bouts of sudden lapses of memory were seen in 21%. Patients have described fearful episodes of suddenly not knowing where they were going; it was as if their thoughts had left them. There was also a loss of libido in 47%. Three patients died of cancer. Another 10% have been treated for cancer.

  The Vietnam veterans demonstrated a large number of gastrointestinal ulcerations. Complaints related to the gastrointestinal tract included anorexia (41%), nausea (59%), vomiting (13%), hematemesis (8%), diarrhea (51%), constipation (31%), and abdominal pain (24%). Hepatitis was reported in 10% and jaundice in 5%.

  Nineteen percent of our group had children with gross birth defects. One or more miscarriages were experienced in 13% of the wives. There were reports of sterility; semen analysis showed low sperm counts and abnormal forms.

  The two most frequent genitourinary findings were brown urine (23%) and hematuria (9%). A kidney biopsy specimen in one patient was pathological, with an unknown etiology. Other as yet unexplained symptoms were blurred vision (54%), dyspnea (8%), gynecomastia (4%), and galactorrhea (5%).

  This group of veterans has in general been chronically ill. Patients complained of frequent infections and allergies. The mean age of the group was 31.7 years. Both upper and lower socioeconomic levels were represented.

  The aforementioned information is intended to create an awareness of a substance known as dioxin. This chemical may cause a variety of symptoms, and physicians should be aware of its potential.

  Sixty-Fourth Annual National Convention of the American Legion Chicago, Illinois, August 24–26, 1982

  RESOLUTION: No. 410 (Iowa)

  COMMITTEE: Veterans Affairs and Rehabilitation

  SUBJECT: The American Legion Policy on Agent Orange

  WHEREAS, the chemical herbicide commonly known as Agent Orange was sprayed throughout Vietnam during the years 1962–1971 to defoliate jungle and rice paddies; and

  WHEREAS, the total long-range toxic effects of the defoliant, of which in excess of 10.6 million gallons were reportedly expended by American military forces, remain virtually unknown; and

  WHEREAS, the chemical mixture of 2,4-D and 2,4,5-T, which contains a certain amount of the chemical dioxin, has been subjected to partial bans by the Environmental Protection Agency following reports of spontaneous abortions and stillbirths in areas where heavily used in the United States; and

  WHEREAS, a significant number of service personnel serving in Vietnam were exposed to these toxic chemicals and have subsequently developed cancer, neurological disorders, liver dysfunction. Severe depression, and other life-threatening diseases; and

  WHEREAS, these veterans are now seeking benefits from the VA, to which they believe they are justly entitled, by reason of disease and disability incurred through exposure to Agent Orange; and

  WHEREAS, the American Legion is seriously concerned about the effect of Agent Orange on those veterans who served in Vietnam during the time it was used as a defoliant; and

  WHEREAS, the American Legion is strongly supportive of the studies and research being conducted by the Air Force, the Center for Disease Control, the Armed Forces Institute of Pathology, the Veterans Administration, etc., on Agent Orange, and has urged the administrator of veterans affairs, the VA Advisory Committee on Health-Related Effects of Herbicides, and the VA Central Office Ad Hoc Committee on the Toxic Effects of Herbicides to proceed without delay using all resources available, to ascertain with scientific validity the effects of Agent Orange on veterans who were exposed to it during their active military service; and

  WHEREAS, section 307 of the Veterans Health Programs Extension and Improvement Act of 1979 (Public Law 96-151) mandated the Veterans Administration to undertake a scientific study of the effect of dioxin exposure on veterans; and

  WHEREAS, the Veterans Administration negotiated a contract with the UCLA School of Public Health on May 1, 1981, for the design of the protocol of the Agent Orange study mandated by Public Law 96-151; and

  WHEREAS, the protocol has been designed, has undergone peer review and was revised as a result thereof, and preliminary steps are being taken to proceed with a pilot study; and

  WHEREAS, the American Legion feels strongly that the study itself should be conducted by an independent scientific entity rather than by the Veterans Administration as the results would be more readily acceptable by the Vietnam veterans who were exposed, their families, and the scientific community; and

  WHEREAS, the American Legion is aggressively assisting and counseling veterans in the filing and development of claims for benefits provided under title 38, United States Code, and referring those individuals claiming exposure to the persons responsible for the Agent Orange examination program at the nearest VA medical center or outpatient clinic for an appropriate examination; and

  WHEREAS, because of the fact that very few claims for service connection have been granted, the American Legion has continually called upon the administrator of veterans affairs and the Department of Veterans Benefits to take a more objective approach in the adjudication of claims for benefits for disease and disabilities resulting from exposure to Agent Orange, until such time that conclusive scientific evidence is available, and to resolve all reasonable doubt in favor of veterans, their dependents and survivors, in claims for benefits based on exposure to Agent Orange, but such urging has been to little or no avail; and

  WHEREAS, a significant number of Vietnam veterans have expressed displeasure with the manner in which they were attended to during their Agent Orange examination at a VA medical facility; now therefore, be it

  RESOLVED, by the American Legion in National Convention assembled in Chicago, Illinois, August 24, 25, 26, 1982, that the American Legion sponsor and support legislation in the Congress of the United States to amend section 307 of Public Law 96-151 by assigning the responsibility of conducting the epidemiological study of Vietnam veterans who were exposed to any of the class of chemicals known as “the dioxins” produced during the manufacture of the various phenoxy herbicides, including Agent Ora
nge, to an independent scientific agency; and, be it further

  RESOLVED, that the American Legion support legislation to amend title 38, United States Code, to establish a mechanism for presumption of service connection for certain disabilities traced to Agent Orange exposure once such presumption is justified by conclusive scientific evidence; and, be it further

  RESOLVED, that the American Legion disseminate the most current responsible information on Agent Orange to Legionnaires, Vietnam veterans and their families, and the public through all resources available to transmit such information; and, be it finally

  RESOLVED, that the American Legion continue to make careful observation of the Veterans Administration’s Agent Orange examination program to determine whether or not Vietnam veterans reporting to VA medical care facilities claiming exposure are being appropriately examined, and that the examining physicians demonstrate both compassion and thoroughness in the way they receive, examine and treat all Vietnam veterans who present themselves alleging dioxin exposure.

  APPROVED

  BIBLIOGRAPHY

  Brown, Michael. Laying Waste: The Poisoning of America by Toxic Chemicals. New York: Pantheon, 1980.

  Carson, Rachel. Silent Spring. New York: Fawcett, 1962.

  Dux, John, and P.J. Young. Agent Orange: The Bitter Harvest. Sydney: Hodder and Stoughton, 1980.

  Ensign, Tod, and Michael Uhl. GI Guinea Pigs: How the Pentagon Exposed Our Troops to Dangers More Deadly Than War. New York: Playboy Press, 1980.

  Fuller, John G. The Poison That Fell from the Sky. New York: Random House, 1977.