title: Neurologic health outcomes and Agent Orange: Institute of Medicine report.
abstract: The National Academy of Sciences' Institute of Medicine conducted an independent scientific investigation to evaluate the strength of evidence for human health effects among veterans exposed to herbicides used in Vietnam and to suggest future research recommendations. Neurologic domains where multiple studies had been performed in military, occupational, or environmental situations were (1) cognitive and neuropsychiatric effects, (2) motor/coordination dysfunction and other central nervous system disorders, and (3) peripheral neuropathy. In all categories, no strong evidence established an association between herbicides used in Vietnam and clinical neurologic disorders. Methodologic weaknesses, long durations between exposure and assessments, and poor exposure measures limited many studies. The committee concluded that the available evidence was insufficient to determine an association between neurologic disorders and exposure to herbicides used in Vietnam. Neurotoxicologic studies available did not suggest strong biological plausibility for neurologic alterations related to herbicide exposure. Furthermore, given the large uncertainties in the epidemiologic studies reviewed and inadequate control for important confounders, the committee could not quantify a degree of risk for neurologic disorders from herbicide exposure likely to be experienced by Vietnam veterans. Although not part of the neurologic report, the risk of brain tumors was considered in the cancer analysis, and the committee concluded that there is limited/suggestive evidence of no association between exposure to herbicides and brain tumors.
authors.affiliation: Department of Neurological Sciences, Rush University/Rush Presbyterian St. Luke's Medical Center, Chicago, IL.
authors.forename: C G
authors.initials: CG
authors.lastname: Goetz
authors.forename: K I
authors.initials: KI
authors.lastname: Bolla
authors.forename: S M
authors.initials: SM
authors.lastname: Rogers
mesh_terms: D015085:2,4,5-Trichlorophenoxyacetic Acid / Q000009:adverse effects*; D015084:2,4-Dichlorophenoxyacetic Acid / Q000009:adverse effects*; D000075182:Agent Orange; D003072:Cognition Disorders / Q000139:chemically induced; D003678:Defoliants, Chemical / Q000009:adverse effects; D004787:Environmental Pollution; D006540:Herbicides / Q000009:adverse effects; D006801:Humans; D009043:Motor Activity / Q000187:drug effects; D009069:Movement Disorders / Q000209:etiology; D009422:Nervous System Diseases / Q000139:chemically induced*; D009784:Occupational Diseases / Q000139:chemically induced; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D010575:Pesticides / Q000009:adverse effects; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects*; D014744:Vietnam; D014857:Warfare
chemical_list: D003678:Defoliants, Chemical; D006540:Herbicides; D010575:Pesticides; D000072317:Polychlorinated Dibenzodioxins; D015084:2,4-Dichlorophenoxyacetic Acid; D000075182:Agent Orange; D015085:2,4,5-Trichlorophenoxyacetic Acid