title: Serum dioxin and hepatic abnormalities in veterans of Operation Ranch Hand.
abstract: OBJECTIVE
  We studied hepatic abnormalities and indices of hepatic function in relation to exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) in veterans of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971.
  
  
  METHODS
  The prevalence of ever having liver disease through March 1993, and level of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase (GGT), lactic dehydrogenase (LDH), alkaline phosphatase, and total bilirubin were examined according to serum dioxin levels.
  
  
  RESULTS
  We found an increased risk of "other liver disorders" among veterans with the highest dioxin levels [adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.2 to 2.1], due primarily to increased transaminases or LDH (adjusted OR = 2.7, 95% CI 1.4 to 5.1) and to other nonspecific liver abnormalities (adjusted OR = 1.4, 95% CI 1.0 to 2.0).
  
  
  CONCLUSIONS
  Whether the associations observed were causal is unclear from these data.
authors.affiliation: Air Force Research Laboratory, Brooks AFB, TX, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Michalek
authors.forename: N S
authors.initials: NS
authors.lastname: Ketchum
authors.forename: M P
authors.initials: MP
authors.lastname: Longnecker
mesh_terms: D015085:2,4,5-Trichlorophenoxyacetic Acid / Q000009:adverse effects; D015084:2,4-Dichlorophenoxyacetic Acid / Q000009:adverse effects; D000337:Aerospace Medicine; D000075182:Agent Orange; D000428:Alcohol Drinking / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury; D003678:Defoliants, Chemical / Q000009:adverse effects* / Q000097:blood; D006529:Hepatomegaly / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology; D008111:Liver Function Tests; D008875:Middle Aged; D016017:Odds Ratio; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects* / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D014744:Vietnam; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D003678:Defoliants, Chemical; D000072317:Polychlorinated Dibenzodioxins; D015084:2,4-Dichlorophenoxyacetic Acid; D000075182:Agent Orange; D015085:2,4,5-Trichlorophenoxyacetic Acid; D005723:gamma-Glutamyltransferase