title: Self-reported health status of Vietnam veterans in relation to perceived exposure to herbicides and combat.
abstract: The authors examined how the self-reported health of 7,924 US Army Vietnam veterans in 1985-1986 related to the men's perceived exposure to herbicides and combat in Vietnam. The results showed strong, positive associations between the extent of reported herbicide exposure (classified as a four-level ordinal index) and all 21 health outcomes studied, with clear "dose-response" relations in most instances. In contrast, only chloracne and psychological symptoms, including a symptom pattern consistent with posttraumatic stress disorder, were found to be strongly related to the amount of reported combat exposure (classified as a four-level ordinal index). The multiple herbicide/outcome associations seem implausible because of their nonspecificity and because of collateral biologic evidence suggesting the absence of widespread exposure to dioxin-containing herbicides among US Army combat units. These associations may have resulted from long-term stress reactions that produced somatization, hypochondriasis, and increased utilization of medical care among some Vietnam veterans. The available data suggest, however, that the association between reported combat exposure and psychological symptoms consistent with posttraumatic stress disorder may be causal.
authors.affiliation: Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: P
authors.initials: P
authors.lastname: Decouflé
authors.forename: P
authors.initials: P
authors.lastname: Holmgreen
authors.forename: C A
authors.initials: CA
authors.lastname: Boyle
authors.forename: N E
authors.initials: NE
authors.lastname: Stroup
mesh_terms: D005858:Germany; D006304:Health Status; D006306:Health Surveys; D006540:Herbicides / Q000009:adverse effects*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007723:Korea; D008297:Male; D016273:Occupational Exposure; D015995:Prevalence; D013001:Somatoform Disorders / Q000453:epidemiology* / Q000209:etiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States / Q000453:epidemiology; D014728:Veterans; D014744:Vietnam
chemical_list: D006540:Herbicides