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Neurologic health outcomes and Agent Orange

Institute of Medicine report^*

Department of Neurological Sciences, Rush University/Rush Presbyterian St. Luke's Medical Center, Chicago, IL (Dr. Goetz)
Department of Neurology, Johns Hopkins School of Medicine, Francis Scott Key Medical Center, Baltimore, MD (Dr. Bolla)
Division of Health Promotion and Disease Prevention, Institute of Medicine, National Academy of Sciences, Washington, DC. (S. Rogers)

Article abstract –The National Academy of Sciences' Institute of Medicine conducted an independent scientific investigation to evaluate the strength of evidence for human health effects among veterans exposed to herbicides used in Vietnam and to suggest future research recommendations. Neurologic domains where multiple studies had been performed in military, occupational, or environmental situations were (1) cognitive and neuropsychiatric effects, (2) motor/coordination dysfunction and other central nervous system disorders, and (3) peripheral neuropathy. In all categories, no strong evidence established an association between herbicides used in Vietnam and clinical neurologic disorders. Methodologic weaknesses, long durations between exposure and assessments, and poor exposure measures limited many studies. The committee concluded that the available evidence was insufficient to determine an association between neurologic disorders and exposure to herbicides used in Vietnam. Neurotoxicologic studies available did not suggest strong biological plausibility for neurologic alterations related to herbicide exposure. Furthermore, given the large uncertainties in the epidemiologic studies reviewed and inadequate control for important confounders, the committee could not quantify a degree of risk for neurologic disorders from herbicide exposure likely to be experienced by Vietnam veterans. Although not part of the neurologic report, the risk of brain tumors was considered in the cancer analysis, and the committee concluded that there is limited/suggestive evidence of no association between exposure to herbicides and brain tumors.

Address correspondence and reprint requests to Dr. Christopher G. Goetz, 1725 W. Harrison St., Chicago, IL 60612.

^*Adapted with permission from Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Copyright 1993 by the National Academy of Sciences. Courtesy of the National Academy Press, Washington, DC.

Received August 24, 1993. Accepted for publication in final form November 9, 1993.

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