title: Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study.
abstract: BACKGROUND
  Agent Orange (AO) was a mixture of phenoxy herbicides, containing several dioxin impurities including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Various military herbicides, including AO, were sprayed by the US military and allied forces for military purposes during the Vietnam War. This study was performed to identify the associations between the AO exposure and mortality in Korean Vietnam veterans.
  
  
  METHODS
  From 1 January 1992 to 31 December 2005, 180 639 Korean Vietnam veterans were followed up for vital status and cause of death. The AO exposure index was based on the proximity of the veteran's unit to AO-sprayed areas, using a geographical information system-based model. The adjusted hazard ratios and 95% confidence intervals were calculated by Cox's proportional hazard model.
  
  
  RESULTS
  The mortality from all causes of death was elevated with AO exposure. The deaths due to all sites of cancers combined and some specific cancers, including cancers of the stomach, small intestine, liver, larynx, lung, bladder and thyroid gland, as well as chronic myeloid leukaemia, were positively associated with AO exposure. The deaths from angina pectoris, chronic obstructive pulmonary disease and liver disease including liver cirrhosis were also increased with an increasing AO exposure.
  
  
  CONCLUSIONS
  Overall, this study suggests that AO/TCDD exposure may account for mortality from various diseases even several decades after exposure. Further research is needed to better understand the long-term effects of AO/TCDD exposure on human health.
authors.affiliation: Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea.
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Yi
authors.affiliation: Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea canrsy@chosun.ac.kr.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea.
authors.forename: Heechoul
authors.initials: H
authors.lastname: Ohrr
authors.affiliation: Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea.
authors.forename: Jae-Seok
authors.initials: JS
authors.lastname: Hong
mesh_terms: D015085:2,4,5-Trichlorophenoxyacetic Acid; D015084:2,4-Dichlorophenoxyacetic Acid; D000328:Adult; D000075182:Agent Orange; D000787:Angina Pectoris / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D008107:Liver Diseases / Q000401:mortality; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000401:mortality*; D000072317:Polychlorinated Dibenzodioxins; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D056910:Republic of Korea / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D047829:Vietnam Conflict
chemical_list: D000072317:Polychlorinated Dibenzodioxins; D015084:2,4-Dichlorophenoxyacetic Acid; D000075182:Agent Orange; D015085:2,4,5-Trichlorophenoxyacetic Acid
keywords: Agent Orange; Korea; cohort studies; dioxins; herbicides; mortality; veterans