Journal of Environmental Health Sciences (한국환경보건학회지)

Korean Society of Environmental Health (한국환경보건학회)
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Review of Public Health Aspects of Exposure to Agent Orange

고엽제 노출에 따른 건강위해의 보건학적 고찰

  • Yang, Won-Ho (Department of Occupational Health, Catholic University of Daegu) ;
  • Hong, Ga-Yeon (Department of Occupational Health, Catholic University of Daegu) ;
  • Kim, Geun-Bae (Environmental Health Division, National Institute of Environmental Research)
  • 양원호 (대구가톨릭대학교 산업보건학과) ;
  • 홍가연 (대구가톨릭대학교 산업보건학과) ;
  • 김근배 (국립환경과학원 환경보건연구과)
  • Received : 2012.04.10
  • Accepted : 2012.06.13
  • Published : 2012.06.29
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Abstract

Objectives: Controversy regarding the relationship between exposure to Agent Orange and disease has progressed for more than four decades, both at home and abroad. Recently, the allegation by US veteran Steve House of the burial of Agent Orange at the US Army base Camp Carroll located in Waegwan-eup, Korea, has emerged. We reviewed published articles and reports related to Agent Orange. Methods: Articles and reports were collected online using the keywords 'agent orange' and 'health' and then reviewed. Results: A number of epidemiologic studies have reported disease outcomes due to exposure to Agent Orange, while others were unable to establish a link to the injuries of veterans of the Vietnam War. This can be explained by the fact that accurate exposure assessment should be carried out since exposure misclassification in epidemiologic studies can affect estimates of risk. In the case of the burial of Agent Orange at Camp Carroll, an exposure pathway could be through underground water supplies, which differs from the cases of Vietnam and Seveso in Italy. Conclusion: There still remains a dispute among academics regarding the relationship between exposure to Agent Orange and disease, although Agent Orange is a highly toxic chemical. This dispute indicates that accurate exposure pathway and exposure assessment is needed.

Keywords

References

  1. Gough M. Dioxin, agent orange - the facts. New York: Plenum Press; 1986.
  2. Schecter A, Dai LC, Thuy LTB, Quynh HT, Minh DQ, Cau HD, et al. agent orange and the Vietnamese: the persistence of elevated dioxin levels in human tissues. Am J Public Health. 1995; 85(4): 516-22. https://doi.org/10.2105/AJPH.85.4.516
  3. Helder T. Effects of 2,3,7,8-tetrachlorodibenzo-pdioxin(TCDD) on early life stages of the pike. The Science of the Total Environment. 1980; 14: 255-264. https://doi.org/10.1016/0048-9697(80)90027-3
  4. Steenland K, Deddens J, Piacitelli L. Risk assessment for 2,3,7,8-Tetrachlorodibenzo-p-dioxin(TCDD) based on an epidemiologic study. Am J Epidemiol. 2001; 154(5): 451-458. https://doi.org/10.1093/aje/154.5.451
  5. Tuyet-Hanh TT, Vu-Anh L, Ngoc-Bich N, Tenkate T. Environmental health risk assessment of dioxin exposure through foods in a dioxin hot spot - Bien Hoa city, Vietnam. Int J Environ Res Public Health. 2010; 7: 2395-2406. https://doi.org/10.3390/ijerph7052395
  6. Yang YH, Kim BH, Chang YS. Analysis of PCDD/Fs and PCBs in human blood and characteristics of contaminated sources. Analytical Science & Technology. 2001; 14(2): 147-158.
  7. Zahm SH. Epidemiologic research on Vietnam veterans difficulties and lessons learned. Annals of Epidemiol. 1995; 5(5): 414-416. https://doi.org/10.1016/1047-2797(95)00071-E
  8. Thomas TL, Kang HK. Health status of a self-selected group of 104,000 Vietnam veterans. 22nd Annual Meeting of the Society for Epidemiologic Research; 1989.
  9. Buffler PA, Ginevan ME, Mandel JS, Watkins DK. The air force health study : an epidemiologic retrospective. AEP. 2011; 21(9): 673-687.
  10. Schecter A, Dai LC, Papke O, Prange J, Constable JD, Matsuda M, et al. Recent dioxin contamination from agent orange in residence of a southern Vietnam city. J Occup Environ Med. 2001; 43(5): 435-43. https://doi.org/10.1097/00043764-200105000-00002
  11. Ngo AD, Taylor R, Roberts CL, Nquyen TV. Association between agent orange and birth defects: systematic review and meta-analysis. Int J Epidemiol. 2006; 35(5): 1220-1230. https://doi.org/10.1093/ije/dyl038
  12. Young AL, Cecil PF. Agent orange exposure and attributed health effects in Vietnam veterans. Military Medicine. 2011; 176: 29-34. https://doi.org/10.7205/MILMED-D-11-00082
  13. Young AL. The history, use, disposition and environmental fate of agent orange. Springer; 2009.
  14. Ministry of Patriots & Veterans Affairs. Epidemiologic study for health effects by exposure to herbicide (agent orange); 2006.
  15. Lim JH. Management and health effects of veterans exposed to agent orange. Environmental Forum of National Assembly in Korea. 2000: 282-297.
  16. The final announcement of ROK-US joint investigation result on the alleged burial of agent orange at Camp Carroll. The ROK-US Joint Investigation Team; 2011.
  17. Institute of Medicine of the National Academies. Veterans and agent orange; 2010.
  18. National Academy of Sciences. The effects of herbicides in South Vietnam; 1974.
  19. Newton M, Young AL. The stody of 2,4,5-T: A case study of science and societal concerns. Environ Sci & Pollt Res. 2004; 11(4): 207-208. https://doi.org/10.1007/BF02979626
  20. Young AL, Newton M. Long overlooked historical information on agent orange and TCEE following massive applications of 2,4,5-T-containing herbicides, Eglin Air Force Base, Florida. Environ Sci & Pollt Res. 2004; 11(4): 209-221. https://doi.org/10.1007/BF02979627
  21. Young AL, Giesy JP, Jones PD, Newton M. Environmental fate and bioavailability of agent orange and its associated dioxin during the Vietnam war. Environ Sci & Pollut Res. 2004; 11(6): 359-370. https://doi.org/10.1007/BF02979652
  22. Ministry of Health & Welfare. Epidemiology study of veteran exposed to agent orange; 1996.
  23. Ministry of Patriots & Veterans Affairs. Epidemiology study of veteran exposed to agent orange; 2001.
  24. Ministry of Patriots & Veterans Affairs. Epidemiology study of veteran exposed to agent orange; 2006.
  25. Ministry of Patriots & Veterans Affairs. Epidemiology study of second generation exposure to agent orange; 2010.
  26. Ministry of Patriots & Veterans Affairs: http://www.mpva.go.kr/
  27. Yun CS, Lee JH, Lee JY, Lee KN, Moon JI. Severe bradycardia and hypotension during spinal anesthesia in a patient with agent orange sequela. The Korean Journal of Anesthesiology. 1998; 34: 650-654. https://doi.org/10.4097/kjae.1998.34.3.650
  28. Chun JH, Kim SA, Lee JT, Sohn HS. Evaluation for anxiety and depression relating to agent orange exposure on Korean Vietnam veterans. Inje Med J. 1999; 20(1): 369-384.
  29. Kim JS, Kang HK, Lim HS, Cheong HK, Lim MK. A study on the correlation between categorization of the individual exposure levels to agent orange and serum dioxin among the Korean Vietnam veterans. Korean J Prev Med. 2001; 34(1): 80-88.
  30. Mo HJ, Park HJ, Kim JH, Lee JY, Cho BK. A study about the skin and general disease pattern of the Vietnam veterans exposed to dioxin. Korean Dermatological Association. 2002; 40(6): 634-638.
  31. Kim JS, Lim HS, Cho SI, Cheong HK, Lim MK. Impact of agent orange exposure among Korean Vietnam veterans. Industrial Health. 2003; 41: 149-157. https://doi.org/10.2486/indhealth.41.149
  32. Lee S, Chun SH, Bak H, Jeon SY, Ahn SK. A case of epidermodysplasia verruciformis related with agent orange. Korean J. Dermatol, 2003; 41(9):1268-1270.
  33. Kang WU, Kim HG, Jeong MH, Cho SC, Jung AD, Cho YC, et al. Is cardiovascular disease more common in Vietnam veterans exposed to agent orange?. Korean J Prev Med. 2007; 73(3): 299-306.
  34. Chang M, Kim T. A preliminary study on the psychopathological protocols of the Vietnam war agent orange patients and Korean civil war wound soldier. The Korea Academia-Industrial Cooperation Society. 2009; 10(9): 2492-2500. https://doi.org/10.5762/KAIS.2009.10.9.2492
  35. Kang GS, Hwang SM, Kim DM, Suh MK, Kim JH, Jang TJ. Multiple merkel cell carcinoma in Vietnam veteran exposed to agent orange. Korean Dermatological Association. 2011; 49(2): 191-194.
  36. Yi S, Won JU, Hong JS, Ohrr H. A proposal of study designs and methods for evaluating the adverse health effects of agent orange among Korean Vietnam veterans. Korean J Prev Med. 2001; 34(3): 228-236.
  37. Sull JW. Pesticide use and cancer incidence in Korea. Master's thesis of Yonsei University; 2001.
  38. Kang HK, Dalager NA, Needham LL, Patterson DG, Lees PSJ, Yates K, et al. Health status of army chemical corps Vietnam veterans who sprayed defoliant in Vietnam. Am J Ind Med. 2006; 49: 875-884. https://doi.org/10.1002/ajim.20385
  39. Young AL, Cecil PF, Guilmartin JF. Assessing possible exposures of ground troops to agent orange during the Vietnam war : the use of comtemporary military records. Environ Sci & Pollut Res. 2004; 11(6): 249-358.
  40. Pollitt F. Polychlorinated dibenzodioxins and polychlorinated dibenzofurans. Regul. Toxicol Pharmacol. 1999; 30: S63-68. https://doi.org/10.1006/rtph.1999.1328
  41. Kumagai S, Koda S, Miyakita T, Ueno M. Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in serum samples of workers at intermittently burning municipal waste incinerators in Japan. Occup Environ Med. 2002; 59(6): 362-368. https://doi.org/10.1136/oem.59.6.362
  42. Fingerhut MA, Haperin WE, Marlow DA, Piacitelli LA, Honghar PA, Weeney MH, et al. Cancer mortality in workers exposed to 2,3,7,8-Tetrachlorodibenzo-p-dioxin. The New England Journal of Medicine. 1991; 324(4): 212-218. https://doi.org/10.1056/NEJM199101243240402
  43. Michalek JE, Tripathi RC. Pharmacokinetics of TCDD in veterans of operation ranch hand: 5-year follow-up. J Toxicol Enviorn Health Part A. 1999; 57: 369-378. https://doi.org/10.1080/009841099157584
  44. Young AL. TCDD biomonitoring and exposure to agent orange : still the gold standard. Environ Sci & Pollut Res. 2004; 11(3): 143-146. https://doi.org/10.1007/BF02979667
  45. Kim JS, Lee HS, Lee HB, Lee WY, Park YJ, Kim SS. A preliminary epidemiologic study on Korean veterans exposed to herbicides in Vietnam war. Korean J Prev Med. 1994; 27(4): 711-734.
  46. Stellman JM, Stellman SD, Weber T, Tomasallo C, Stellman AB, Christian R. A geographic information system for characterizing exposure to agent orange and other herbicides in Vietnam. Environmental Health Perspectives. 2003; 111(3): 321-328.
  47. Stellman SD, Stellman JM. Exposure opportunity models for agent orange, dioxin, and other military herbicides used in Vietnam, 1961-1971. Journal of Exposure Analysis and Environmental Epidemiology. 2004; 14: 354-362. https://doi.org/10.1038/sj.jea.7500331
  48. Warner N, Mocarrelli P, Samuels S, Needham L, Brambilla P, Eskenazi B. Dioxin exposure and cancer risk in the Seveso women's health study. Environmental Health Perspectives. 2011; 119(12): 1700-1705. https://doi.org/10.1289/ehp.1103720
  49. California EPA, USA. Public Health Goal for TCDD in drinking water; 2005.
  50. Revich B, Aksel E, Ushakova T, Ivanova I, Zhuchenko N, Klyuev N, et al. Dioxin exposure and public health in Chapaevsk, Russia. Chemosphere. 2001; 43: 951-966. https://doi.org/10.1016/S0045-6535(00)00456-2