title: Diabetes and cancer in veterans of Operation Ranch Hand after adjustment for calendar period, days of spraying, and time spent in Southeast Asia.
abstract: BACKGROUND
  The Air Force Health Study was launched in 1980 as part of a Federal effort to resolve the Agent Orange issue.
  
  
  OBJECTIVE
  To study diabetes and cancer with additional adjustment for days of spraying, calendar period of service, and time spent in Southeast Asia (SEA).
  
  
  METHODS
  This was a longitudinal study of veterans of Operation Ranch Hand, the unit responsible for spraying Agent Orange and other 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-contaminated herbicides in Vietnam from 1962 to 1971.
  
  
  RESULTS
  Associations between TCDD and diabetes and between TCDD and cancer in Ranch Hand veterans are strengthened after adjustment for calendar period of service, days of spraying, and, for cancer, time spent in SEA.
  
  
  CONCLUSIONS
  Calendar period of service, days of spraying, and time spent in SEA are important confounders in the Air Force Health Study.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, Texas 78229, USA. michalekj@uthscsa.edu
authors.forename: Joel E
authors.initials: JE
authors.lastname: Michalek
authors.forename: Marian
authors.initials: M
authors.lastname: Pavuk
mesh_terms: D015085:2,4,5-Trichlorophenoxyacetic Acid / Q000009:adverse effects / Q000097:blood; D015084:2,4-Dichlorophenoxyacetic Acid / Q000009:adverse effects / Q000097:blood; D000368:Aged; D000075182:Agent Orange; D001210:Asia, Southeastern; D015986:Confounding Factors, Epidemiologic; D003678:Defoliants, Chemical / Q000009:adverse effects / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects / Q000097:blood; D016016:Proportional Hazards Models; D012307:Risk Factors; D018426:SEER Program; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D047829:Vietnam Conflict
chemical_list: D003678:Defoliants, Chemical; D004785:Environmental Pollutants; D000072317:Polychlorinated Dibenzodioxins; D015084:2,4-Dichlorophenoxyacetic Acid; D000075182:Agent Orange; D015085:2,4,5-Trichlorophenoxyacetic Acid