Congressional Agent Orange Review Committee Announces Update Led by UA Health Sciences Physician-Scientist Dr. Kenneth S. Ramos

Dr. Kenneth Ramos calls for continuity in the monitoring of the health status of Vietnam veterans, further research into the biology of service-connected diseases and the integration of efforts with ongoing research initiatives designed to create large-scale medical databases and archiving of biological specimens and health information.

A Congressional report released yesterday regarding potential health problems linked to exposure to Agent Orange and other herbicides used during the Vietnam War has resulted in a change of categorization for bladder cancer and hypothyroidism to “limited or suggestive evidence” that there could be a link to exposure and increased health risk for these diseases.

The review committee was led by Kenneth S. Ramos, MD, PhD, PharmB, associate vice president for precision health sciences at the University of Arizona Health Sciences and professor of medicine at the University of Arizona College of Medicine – Tucson. Dr. Ramos is the director of the UA Health Sciences’ Center for Applied Genetics and Genomic Medicine and is a member of the National Academy of Medicine.

Announced yesterday, the latest and final report in a series of congressionally mandated biennial reviews of the evidence of health problems that may be linked to exposure to Agent Orange and other herbicides used during the Vietnam War has resulted in a change to the categorization of health outcomes for bladder cancer, hypothyroidism and spina bifida and includes clarification on the breadth of the previous finding for Parkinson’s disease. 

The Veterans and Agent Orange: Update 2014 indicates that bladder cancer and hypothyroidism were moved to the category of “limited or suggestive” evidence of an association from their previous positions in the default “inadequate or insufficient” category. A finding of limited or suggestive evidence of an association means that the epidemiologic evidence indicates there could be a link between exposure to a chemical and increased risk for a particular health effect. A finding of inadequate or insufficient evidence indicates that the available studies are of insufficient quality, consistency, or statistical power to permit a conclusion regarding the presence or absence of such a link. 

For both bladder cancer and hypothyroidism, new results from a large study done in Korea on Korean War veterans who served in the Vietnam War were compellingly suggestive of an association. In combination with pre-existing supportive epidemiologic findings and substantial biologic plausibility, the new information provided evidence to merit a change in category of association for these two outcomes.

Dr. Ramos is chair of the Institute of Medicine Committee on Veterans and Agent Orange and its 2014 update for the National Academies of Sciences, Engineering and Medicine. As committee chair, Dr. Ramos addressed the senior leadership of the U.S. Department of Veterans Affairs and the committee staff for the U.S. House of Representatives and Senate, calling for continuity of the monitoring of the health status of Vietnam veterans, further research into the biology of service-connected diseases and the integration of efforts with ongoing research initiatives designed to create large-scale medical databases and archiving of biological specimens and health information. 

This is the final report update mandated by the Agent Orange Act and the committee developed recommendations for future actions to advance the wellbeing of Vietnam veterans, including that the Department of Veteran Affairs (VA) continue epidemiologic studies of the veterans; develop protocols that could investigate paternal transmission of adverse effects to offspring; and design a study to focus on specific manifestations of dioxin exposure in humans with compromised immunity, which have been clearly demonstrated in animal models.

The committee also called for a careful review of evidence concerning whether paternal exposure to any toxicant has definitively resulted in abnormalities in the first generation of offspring. In addition, the committee made recommendations for improved assembly and evaluation of information necessary for monitoring possible service-related health effects in all military personnel, including creating and maintaining rosters of individuals deployed on every mission and linking U.S. Department of Defense and VA databases to systematically identify, record and monitor trends in veterans’ diseases.

The study by the National Academies of Sciences, Engineering, and Medicine was sponsored by the U.S. Department of Veterans Affairs.  The academies are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.  For more information, please visit http://national-academies.org

About the University of Arizona Health Sciences

The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. The UA Health Sciences includes the UA Colleges of Medicine (Phoenix and Tucson), Nursing, Pharmacy and Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the growing Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, the UA Health Sciences reaches across the state of Arizona and the greater Southwest to provide cutting-edge health education, research, patient care and community outreach services. A major economic engine, the UA Health Sciences employs almost 5,000 people, has nearly 1,000 faculty members and garners more than $126 million in research grants and contracts annually. For more information: http://uahs.arizona.edu

Jennifer Walsh, 292-334-2183, Office of News and Public Information at the National Academies of Sciences, Engineering and Medicine