From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 2014 is a cumulative report of the series thus far. Table of ContentsFront MatterSummary1 Introduction2 Evaluating the Evidence3 Exposure to the Herbicides Used in Vietnam4 Information Related to Biologic Plausibility5 Epidemiologic Studies: Compendium of New Publications6 Epidemiologic Studies: Background on Multiply Referenced Populations7 Immune-System Disorders8 Cancers9 Effects on Veterans' Fertility and Reproductive Success10 Effects on Veterans' Descendants11 Neurologic Disorders12 Cardiovascular and Metabolic Outcomes13 Other Chronic Health Outcomes14 Conclusions and RecommendationsReferencesAppendix A: Issues Raised by the Public and Agendas of Public Meetings Held by the Committee and Other Written Submissions to the CommitteeAppendix B: Short-Term Adverse Health ResponsesAppendix C: Clarification of Cancer Groupings Used in Reporting Results, with Correspondence to National Institute for Occupational Safety and Health Cause-of-Death Codes and International Classification of Diseases Codes for CancersAppendix D: Committee and Staff Biographies
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