CHALLENGE TO THE PRESIDENT, THE SECRETARY OF
VETERANS AFFAIRS, THE CONGRESSIONAL LEADERS
ON THE SENATE AND
HOUSE VETERANS AFFAIRS COMMITTEES,
ALL CONGRESSIONAL LEADERS,
AND THE BOARD OF VETERANS’ APPEALS
ON TOXIC CHEMICAL ASSOCIATIONS TO DISABLING
CHRONIC AND PERSISTENT PERIPHERAL NEUROPATHY
(POLYNEUROPATHY)
IN OUR VIETNAM VETERANS
04-03-2007
INFORMATION AND CHALLENGE COPIES TO THE
NATIONAL ACADEMY OF SCIENCE INSTITUTE OF
MEDICINE
Several scientists and Congressmen in the 2000 Ranch Hand Oversight
Review indicated they wanted to see other data that had not been
associated with the Department of Veterans Affairs or processed by one
of the major government players.
HERE ARE THE FACTS!
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THE UNITED STATES CAMPAIGNING “ARMY OF
VIETNAM” AND ITS WIDOWS AND ORPHANS
DESERVE “DEEDS”
NOT “WORDS” FROM OUR GOVERNMENT
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ABSTRACT: CHRONIC PERIPHERAL NEUROPATHY ASSOCIATED WITH
EXPOSURES TO THE DIOXIN, TCDD DURING WARTIME SERVICE BY OUR
VIETNAM VETERANS.
In order to determine the ‘VALIDITY’ of legal statements from the Secretary of the
Department of Veterans Affairs and the ‘VALIDITY’ of the works of the National
Academy of Science Institute of Medicine (NAS/IOM) regarding Chronic Debilitating
Peripheral Neuropathy found in Vietnam Veterans, a four-year data search and
analysis was completed.
It was found, during this search and analysis, associations to dioxin exposures and
peripheral neuropathy were ‘statistically significant’ and demonstrated ‘a proven
increased risk of incidence’ with an Odds Ratio of at least OR =2.39. P values of dioxin
association were found at < p - 0.050 and P values of significant differences at p 0.0042.
In the Ranch Hand study used as the Government’s “Gold Standard Study of Denial,”
the statistics were not available. Evidence did find many associations in different yearly
scientific transcripts and statements by Dr. Joel Michalek (one of the leaders on the
Ranch Hand Study)"... WE CONSISTENTLY FOUND A STATISTICALLY
SIGNIFICANT INCREASED RISK OF ALL INDICES OF PERIPHERAL
NEUROPATHY AMONG RANCH HAND VETERANS.”
During this study and analysis, it was found that government processes used in
determining “presumptive associations” were non-determinable as to
qualification and quantification. The evidence found bordered on “scientific
misconduct” and the lack of “scientific intellectual freedom.”
During this study and analysis Veterans did not find the CONGRESSIONAL
MANDATED BENEFIT OF THE DOUBT GIVEN AT ANY LEVEL OF
GOVERNMENT DECISIONS IN THESE UNKNOWN TOXIC CHEMICAL
DAMAGES.
Definition of a “Gold Standard Study”:
Meaning - the most predominant and thought to be the leader in scientific evaluations
with the best, opportunity to discover and document what the study was design to find
in science and statistical data. Other studies, both national and international, use the
gold standard study to evaluate what their studies found in comparison.
In the world of electronic parts this would be called a "gold nugget" where the gold
nugget part defines all parameters and operational characteristics of all other parts that
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follow - all parts are then measured and/or compared to the gold nugget. The gold
nugget is used to set testing parameters and verify test equipment, etc.
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02 April 2007
TO: The President, Senators, Congresspersons, Congressional Staff Members,
Department of Veterans Affairs, and the National Academy of Science Institute of
Medicine, and those individuals/news agencies listed on pages 79 to 82.
FROM:
Please respond to:
Charles Kelley
2078 Eastwood Drive,
Snellville, GA 30078
SP5Kelley2nd94th@aol.com
Cell: 404-641-6477
SUBJECT: The GOVERNMENT CONTROLLED and funded RANCH HAND
STUDY of mortality and morbidity impacts to Vietnam Veterans and their
families based on NAS/IOM and Department of Veterans Affairs decisions regarding
chronic and persistent Polyneuropathy found in these Veterans.
This NOTICE OF DISAGREEMENT and NEW evidentiary scientific and
medical data is submitted on behalf of:
ALL VETERANS OF THE VIETNAM ERA WITH DIAGNOSED
CHRONIC AND PERSISTENT POLYNEUROPATHY
Toxic Chemical Issues and cumulative evidentiary data compiled by
Charles W. Kelley
Veterans Agent Orange Lay Expert.
Author of “Vietnam’s Rain Agents Orange, White, and Blue (Weapons of
Mass Destruction”)
http://www.2ndbattalion94thartillery.com/book/bookorders.htm
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CONTENTS
VETERANS' STATEMENTS pages 6 - 8
OVERVIEW pages 9 & 10
LOGIC pages 11 - 15
EVIDENCE pages 16 - 53
THE GOVERNMENT SLIPPERY SLOPE pages 54 - 65
SUMMARY pages 66 - 73
CONCLUSIONS pages 74 - 76
RECOMMENDATIONS pages 77 – 78
THOSE LISTED pages 79 - 82
REFERENCES pages 83 - 86
DEFINITIONS pages 87 - 97
MEDIA REPORTS pages 98 - 113
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VETERANS' STATEMENTS

The Veterans shall establish SCIENTIFIC, STATISTICAL, and MEDICAL
EVIDENCE demonstrating that their diagnosed condition is “AT LEAST AS
LIKELY AS NOT” medically associated with dioxin, TCDD exposures and/or
the other toxic chemicals involved in WARTIME SERVICE that caused the
degenerating nerve conditions.

The Veterans shall establish that “IT IS AT LEAST AS LIKELY AS
NOT” that a CHRONIC AND PERSISTENT POLYNEUROPATHY
diagnosis is well connected to WARTIME SERVICE IN VIETNAM. In
association to presumptive and/or known exposures to the toxic chemicals in the
herbicides AGENT ORANGE, AGENT WHITE or AGENT BLUE and/or a
combination of all three or in any of the other known 15 toxic chemicals that
were used during the Vietnam War by the UNITED STATES GOVERNMENT.
There is a variance in toxicity from 1.7 parts per million to 70 parts per million
of the dioxin, TCDD.
(NOTE: Comparative evaluation of toxicity = the entire town of Times Beach,
Missouri (CIVILIANS) was evacuated because of pooled stock at <2 parts per million.
(1)

The Veterans shall establish a well-grounded claim by submitting competent
medical and scientific evidence demonstrating that the current diagnosed
“CHRONIC AND PERSISTENT POLYNEUROPATHY” is related to not only
AGENT ORANGE HERBICIDE EXPOSURE but also many of the other toxic
chemicals to which he/she was exposed. (Brock v. Brown, 10 Veterans
Appeal 155 (1997). (McCartt v. West, 12 Veterans Appeal 164 (1999).

The Veterans shall establish THE DEPARTMENT OF VETERANS AFFAIRS
along with the government contracted NAS/IOM’s statements and findings that
ONLY “TRANSIENT ACUTE AND SUBACUTE PERIPHERAL
NEUROPATHY” is associated to WARTIME SERVICE in a dioxins and dioxinlike isomer toxic chemical environment IS ERRONEOUS and BASED ON
FAULTY SCIENTIFIC CONCLUSIONS AND ASSUMPTIONS.

The Veterans shall establish THE RANCH HAND STUDY used by the
government entities as a “GOLD STANDARD STUDY” to deny such nerve
damage and many other Vietnam Veterans mortality and morbidity is flawed in
its assumptions of the “exposed” versus “not exposed” study groups.
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[Medical issues and disorders found at what was determined on THE LOW-END OF
SIGNIFICANT being used by our government that somehow does not meet relevancy is
a MAJOR PREMISE FLAW in the GOVERNMENT’S GOLD STANDARD used to deny
morbidity and mortality. This known flaw would badly SKEW towards the denial of
such relevant findings. A LOW END OF SIGNIFICANCE FINDING could certainly
reach relevancy of a significant finding, increased risk of incidence, or significant
correlation.]
{In the words of one of the major Ranch Hand Scientists, employed by the
Department of Defense, Dr. Joel Michalek, "It's as if you're running a
clinical trial on a new medication, and you found out some of the people who
were in your placebo group were actually taking meds. That would spoil your
whole study. And that's what's going on here in this study."}

The Veterans shall establish that “a dioxin isomer” is never found alone.
Isomer Definition: {A chemical species with the same number and types of atoms as
another chemical species but possessing different properties.}
Government studies used as “GOLD STANDARDS” that mandate for sampling of a
single dioxin isomer IS OF LITTLE VALUE when considering the possible
outcomes in medical causations the Veteran may suffer disability or death from mixed
dioxin compound isomers or dioxin like isomers in the form of furans and/or
polychlorinated biphenyls (PCB’s).

The Veterans Shall establish that protocol violations with regard to many
medical issues found increased at over a 50% increase were not pursed as
relevant findings because of a mandated linear increase to the single dioxin,
TCDD was not met. This mandate was a seriously flawed mandate to dioxin
linear increase to the medical disorders when no detrimental linear increase had
been detected or proven in all medical issues.

The Veterans shall establish that BECAUSE OF THE PRECEDING
GOVERNMENT MANDATE, many disorders found as "SIGNIFICANT
CORRELATION" and/or "INCREASED RISK OF INCIDENCE," some greater
than a 50% cohort increase in comparisons, are not being brought forward.
This has resulted in the Veteran via the Veterans doctor a fair assessment
of his/her health because of government wrong doing and mistakes in toxic
chemical exposure studies, evaluations, and statistical analysis.
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
8
The Veterans' claims are being denied by the DEPARTMENT OF VETERANS
AFFAIRS because of “SERVICE CONNECTION” based on exposure to
herbicides in Vietnam is not warranted for any conditions - other than those for
which “VETERANS AFFAIRS HAS FOUND” a positive association exists
between the condition and such exposure.
(Our Government and Department of Veterans Affairs on behalf of the White House
are too stringent in mandates and opposed to their own previous standards, court
orders and rulings, and outside the realm of current science, as it exists today.)

The Board of Veterans Appeals is inconsistent in rulings on “CHRONIC AND
PERSISTENT POLYNEUROPATHY.” Some cases are identical except for the
Veterans name with diverse outcomes. Awards are diverse and opposite to
include boards rational for denial. Some board rational states The Department
of Veterans Affairs has found “CHRONIC AND PERSISTENT
POLYNEUROPATHY” is not associated to dioxins or wartime service in
Vietnam and others state; Congress has found “CHRONIC AND PERSISTENT
POLYNEUROPATHY” is not associated to dioxins or wartime service in
Vietnam. (Neither are experts in toxicology!)

The Veterans further claim; the statements that deny CHRONIC
PERSISTENT POLYNEUROPATHY made by the Secretary of Veterans Affairs,
VA scientists, and NAS/IOM scientists are baseless as they are not experts in
either the immunotoxicity issues of toxic chemicals (dioxin/furan toxic
chemicals) or the resulting dioxin created autoimmune disorders that develop
many forms of neuropathies.

The Veterans further state that the evidence and facts provided herein
demonstrate that the chronic and persistent polyneuropathy disorder
should be an “automatically associated presumptive disorders.”
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OVERVIEW
The Board of Veterans Appeals (BVA) and the Secretary of the Department of
Veterans Affairs are “inconsistent” in statements of fact of the requirements for the
Veteran to prove service connection. Many studies have shown association of
neuropathies that meet the Veterans Affairs own requirements of such studies. (See 38
C.F.R 1.17 “Evaluation of studies relating to health effects of dioxin and radiation
exposures.”)
Veterans Affairs and the BVA mandate positive association on exposures to
“herbicides.” Then mandates the Veteran prove “dioxin, TCCD” associations.
The Veterans disagree with the Veterans Affairs and/or BVA that all such medical
associations in claims during a toxic chemical environment must be
addressed/associated to the one single by-product of the manufacturing process of (2, 4,
5 trichlorophenoxyacetic acid; 545.4 Kg/m3) {2,4, 5-T} producing the dioxin, TCDD
with that being impure Dioxin (2, 3, 7, 8-tetrachlorodibenzo-p- Dioxin) {2,4,5-T}.
Veterans state that the dioxin, TCDD is a “single toxicant” of a “single component” that
made up the single herbicide with the government nomenclature of “Agent Orange.”
There were more toxic chemicals in Agent Orange than Dioxin alone (2, 3, 7, 8tetrachlorodibenzo-p- Dioxin) since Agent Orange was a 50/50 mixture of (2, 4, 5
trichlorophenoxyacetic acid; 545.4 Kg/m3) {2,4, 5-T} and 4:1 of 2, 4-D (2, 4dichlorophenoxyacetic acid; 239.7 kg/m3) and Picloram (4-amino-3, 5, 6trichloropicolinic acid; 64.7 kg/m3). The additional 50% mixture of this toxic chemical
cocktail had its own set of toxic chemical causations. Picloram was a “convenient” Dow
Chemical Corporation proprietary formula. To this day, neither Veterans nor the
world science organizations know what made up this formula and the toxicity levels at
the time of Vietnam Veterans exposures. (See Page 19 Statements by Dr. Daniel
Teitelbaum, MD)
BVA and its members need to be cognizant and knowledgeable to the scientific facts
that there is no such thing as “a” dioxin. There are over 200 dioxins that are part of a
family of “co-planer” toxicants, which includes dibenzofurans and polychlorinated
biphenyls (PCB’s) and are rarely found alone, if at all, with just a single dioxin isomer.
The facts are - that in science and toxicology the most carcinogenic of all the dioxins,
dibenzofurans, and polychlorinated biphenyls (PCB’s) is (2, 3, 7, 8-tetrachlorodibenzop- Dioxin) {2,4,5-T} found in Agent Orange.
Science compares the carcinogenic severity of other dioxins, dibenzofurans, and
polychlorinated biphenyls (PCB’s) to the dioxin, TCDD that “is” quantified and
qualified as the worst. The key words are “carcinogenic severity of other
carcinogens in this family of toxic chemicals.” Therefore, it is logical the
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Veteran would not only be exposed to the single toxicant of one component but many
toxicants of the many components that make up the “Herbicides.”
Veterans are in disagreement with THE CURRENT ACUTE AND SUBACUTE
TRANSIENT PERIPHERAL NEUROPATHY CONCLUSIONS by the Department of
Veterans Affairs as well as the NAS/IOM which is contracted by the same government
agency the Veteran is now seeking disability compensation from on the issues of
CHRONIC PERIPHERAL NEUROPATHY and those disability issues normally
associated with this chronic degenerating nerve disorder.
At issue is the present Department of Veterans Affairs and the government contracted
Institute of Medicine (IOM) positions on CHRONIC PERIPHERAL NEUROPATHY. It
is biased, scientifically flawed, and assumes integrity of studies conducted by our
government that are flawed not only in science but statistical evaluations based on
flawed cohort exposure levels and the use of a changing Exposure Index.
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LOGIC
On May 23, 1991, the VETERANS' ADVISORY COMMITTEE ON
ENVIRONMENTAL HAZARDS (VACEH) considered the relationship
between exposure to dioxin and the development of this condition. The
Committee concluded that there is a "SIGNIFICANT STATISTICAL
ASSOCIATION" BETWEEN “PERIPHERAL NEUROPATHY” AND
EXPOSURE TO DIOXIN.
To understand this VACEH decision and the resulting illogical VA and NAS/IOM
decisions that made this statistical finding “null and void” for the Nations
Disabled Vietnam Veterans, one must consider the facts.
Peripheral Neuropathy, sometimes referred to as Polyneuropathy, is a generic term
that describes many pathological damages of the lipid nervous system components
within the body and the three major areas of the nervous system. (See Complete
Definition of Peripheral Neuropathy at the end of this Veterans Challenge.)
There are hundreds of diagnosed forms of Peripheral Neuropathy having singular or
overlapping remarkable pathological findings. Some of these have remarkable and
International Codes of Diagnostics (ICD) matched disorders associated with them. In
some cases, the Peripheral Neuropathy remains idiopathic and may be only a symptom
of a more egregious subclinical developing dioxin caused disorder(s) or
variants of a disorder.
Many of our Nation’s most prestigious research hospitals such as Harvard Medical
School has concluded that 33% of all cases of Peripheral Neuropathy will
remain idiopathic with no ICD parallel testing evaluation and conclusion as to
causation. The peripheral neuropathy symptoms may remain idiopathic for life or may
be attributed to but not conclusive to some found testing disorders that have no ICD
equivalent medical world conclusion, i.e. a variant of a disorder that is not conclusive.
For autoimmune neuropathies, diagnosis is vague due to a lack of generally accepted
clinical diagnostic criteria. Vietnam Veterans with autoimmune neuropathies are
diagnosed as having “idiopathic neuropathy” despite the disabling progression of their
disease. On the other hand, they may have a diabetes involvement, which is
automatically associated to the diabetes, rather than the dioxin caused blood
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disorders, immunotoxicity or even the dioxin itself at that point in the Disabled
Veterans progression, subclinical central nervous system damages.
There are many forms of neuropathic conditions and many will overlap the conditions,
findings, and remarkable demonstrations of such variety of symptoms. This logically
would conclude more than one pathology; therefore, it would be associated to various
types of testing in Hematological Disorders, Immune System Disorders, Central
Nervous System Disorders, etc. At this point in the state of science and medicine, the
“more than likely” associated disorder may find overlapping causations of the
different body systems and systemic damages none of which reaches any conclusion
other than testing anomalies found. However, none equate to an ICD disease or
disorder in total. In many cases, these testing disorders remain subclinical and only the
highly specialized diagnostics scientists can determine that underlying subclinical
disorders are even suspected based on what neuropathic conditions are demonstrated.
In some of these areas, in order to understand the pathology, different treatments are
tried to an effort to understand the possible underlying systemic issues. If one
treatment gives even temporary relief then by that alone the researcher can conclude a
possible direction and subclinical cause.
The identified major category disorders normally associated to neuropathic conditions
are:

Central Nervous System Damages

Liver Enzyme Issues

Elevated antinuclear antibodies (ANA)

Immune System Damages or Dysregulation

Hematological Disorders

Diabetic and non-diabetic – insulin resistance

Cancers

Smoldering Cancers

Benign forms of cancer development

Vasculopathy Issues and Disorders

Elevated C-reactive protein should also be tracked in parallel with Lipid
panels for vascular inflammatory involvement in monitoring disease
progression and as a surrogate marker in treatment studies.
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
Stroke Conditions or cerebral dementia indicators.

Lipid Metabolism Disorders/ Metabolic Syndrome (seems to be especially
correlated to increased triglycerides of a level above 150 mg/dl)
All of the preceding conditions have been found in studies associated with dioxins
including the Ranch Hand Study.
Increased triglycerides found associated to dioxin, TCDD in the Ranch Hand
study early on (13a) absent the normal associated markers associated certainly could
have pointed out the developing associated neuropathic issues.
Increased Gamma Glutamyltransferase (GGT) liver enzyme level was found dioxin
level dependant in Ranch Handers. (13b) Gamma Glutamyltransferase is
associated with many disorders Vietnam Veterans have developed including
neurological issues such as Peripheral Neuropathy and more. What the scientists
concluded in not bringing this dioxin linear finding forward will be covered in the
section on “The Government Slippery Slope.”
In diabetic conditions the present established types are:
Type I – associated to autoimmune issues
Type II – associated with old age or aging
Science now concludes there are variants of Type I as in Type Ia.
Another new category Type III has no effects on blood sugar but influences brain
insulin levels.
Recently we find that Type I and Type II may be closer as to the same causation as
previously scientifically thought. Type I considered an autoimmune diseases whereas
Type II was considered an aging issue. Recently in tests, they found these types might
be associated to autonomic sensory nerve damage in the pancreas insulin islets;
including insulin resistance. (See Evidence Section). {For the Vietnam Veteran,
toxic chemically exposed at government high rates and high doses, instead of the
“normal,” or what is looked at as clinical progression of: diabetes > neuropathy. It
might very well be: and associated dioxin causations and neuropathic disorders >
diabetes development.}
Autoimmune disorders are numerous and widespread with many variants under the
one ICD category of a single autoimmune disorder, of which can be associated to
neuropathic conditions, in part or in total.
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The following statement as well as the findings of the many other studies referenced in
the “Evidence Section” of this challenge including statistical significant p- values and
Odds Ratios found.
The Committee concluded that there IS a "significant statistical association"
between “peripheral neuropathy” and exposures to dioxin.
“The VACEH scientific statement” does not conclude or qualify that dioxin directly
caused the Peripheral Neuropathy. The statement DOES CONCLUDE that the data
analysis reveals Peripheral Neuropathy Development IS found associated to
exposures to dioxin. It infers no pathological reasons or pathological system issues
directly. Only that systemically the data shows a found statistical association to
development of Peripheral Neuropathy associated to dioxin exposures, regardless of
pathology - clinical or subclinical!
As anyone can plainly see in the above VACEH statement, this was made 16 years after
the last Veteran left Vietnam. The other studies cited in the Evidence Section were also
completed in the 1990’s and even later, including the governments own found
associations in the Ranch Hand Study to dioxin exposures and to development of
Peripheral Neuropathy. Yet, according to the NAS/IOM and the Secretaries of
Veterans Affairs, the now physically Disabled Veterans have been legally
compromised by the VA court system by their statements of:
“Must manifest “within one year of Vietnam” and the Neuropathy must resolve within
two years of that one year of removing the Veteran from the toxic chemical
environment.” By those statements, Peripheral Neuropathy in our Vietnam
Veterans should no longer exist and certainly, “should not have been found
associated to dioxin exposures” decades after our toxic chemical exposures by
our own government analysis and our own government studies.
Clearly, this is not a science mandate or the studies mandates due to findings, including
the governments own Gold Standard, and are all totally wrong and totally scientifically
inept, scientific misleading, and therefore scientifically fraudulent.
It should be pointed out, this statement as well as other study findings was made
many years prior to any diabetic pronouncement, which in some scientific
circles today are still questionable as to the direct dioxin causations. (Clearly if
there is a paradigm shift in Diabetes Type II causations regarding sensory nerve
damages then of course this questionable causation would be alleviated. More
importantly, it would just add scientific credence to what is discussed in this challenge
regarding neuropathy disabilities of our Vietnam Veterans.)
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The facts are clearly demonstrated “with or without a diabetes diagnoses” that
Peripheral Neuropathy development, regardless of pathology, are associated to dioxin
and dioxin isomer like exposures.
The Board of Veterans Appeals has and continues to adjudicate case decisions based on
NAS/IOM statements and those of the Secretaries of the Department of
Veterans Affairs in overriding Vietnam Veterans claims.
Veterans are legally correct by the preponderance of the scientific evidence
“it is as least as likely as not” that their debilitating Peripheral Neuropathy
conditions are a result of dioxin, TCDD and/or other toxic chemical exposures during
WARTIME SERVICE IN THE REPUBLIC OF SOUTH VIETNAM.
Idiopathic - Any disease or disorder that is of uncertain or unknown origin.
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EVIDENCE
It is imperative that all recipients of this challenge know and understand the history
of this Peripheral Neuropathy (nerve disorder), its association to toxic chemicals, and
the wide variety of biases against this Nation’s Vietnam Veterans while the Department
of Veterans Affairs uses and abuses VA using the power it has in 38 C.F.R paragraph
1.17. This section allows the Secretary to provide “guidelines for establishment of
service connection” then systematically minimizes the effects and costs of the
nerve disorder to make baseless, presumptuous, and erroneous decisions.
On May 23, 1991, the VETERANS' ADVISORY COMMITTEE ON
ENVIRONMENTAL HAZARDS (VACEH) considered the relationship between
exposure to dioxin and the development of this condition. The Committee concluded
that there is a "SIGNIFICANT STATISTICAL ASSOCIATION" BETWEEN
“PERIPHERAL NEUROPATHY” AND EXPOSURE TO DIOXINS. The
Committee qualified this opinion, stating that the association could be said to exist in
the absence of exposure to chemical substances known to cause this disorder.
The Committee members indicated that other risk factors that must be considered are
age and whether the individual suffers from other known causes of peripheral
neuropathy such as diabetes, alcoholism, or Guillain-Barre syndrome. The Committee
also advised that the disorder must become manifest within “ten years” of the last
known dioxin exposure.
The VACEH’s statements CONFIRM:
A FOUND SIGNIFICANT STATISTICAL ASSOCIATION BETWEEN
“PERIPHERAL NEUROPATHY” AND EXPOSURE TO DIOXINS.
The VACEH Committee, in restating the “medically obvious” to even the first year
medical student, stated that associations to other disorders such as alcoholism, GuillainBarre, or diabetes also may cause peripheral neuropathy. This statement no matter
how medically and scientific inept and not even germane to the subject of the stated
found associations directly to Peripheral Neuropathy and dioxin exposures should not
be used as a qualifying statement against the Veterans.

Guillain-Barr syndrome. Guillain-Barre syndrome may be an autoimmune
disorder in which the body produces antibodies that damage the myelin sheath
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that surrounds peripheral nerves. The myelin sheath is a fatty substance that
surrounds axons. Veterans would also add variants of the Guillain-Barre
Syndrome, as there are variants of this disorder that do not meet the ICD
diagnostics in its entirety and conclusion. This seems to be true in the axonal
variant of Guillain-Barre. Idiopathic SENSORY AXONAL CHRONIC
PERIPHERAL NEOURPATHY seems to be the most common diagnosis in
our disabled Vietnam Veterans with the accompanying manifestations. Some
with chronic peripheral neuropathy have gone on to a more serious diagnosis of
Multiple Sclerosis (MS), Parkinson’s, or Amyotrophic Lateral Sclerosis (ALS)
nerve damage. Whether Central Nervous System Damage (CNS) or Peripheral
Nervous system (PNS), it still equates to TOXIC CHEMICAL NERVE
DAMAGE, which must include those nerve functions that operate
autonomic and autonomous.
(There is an ongoing battle within the scientific community as to whether a subclinical
CNS damage is usually present before clinical PNS damage takes place.)
THE EPA REASSESSMENT OF DIOXIN STATES: (2)
 The EPA has concluded that dioxin is more dangerous than previously thought, even at
extremely low doses. It accumulates in the body fat and once in the body, even at very
minuscule amounts, interferes with cell development.
 The “brain may be particularly vulnerable” to accumulating dioxin into its fat
content. Nervous system tissue itself, with its high lipid content, can also act as a
repository for dioxin.
 Dioxin is now known to interfere with the most delicate balanced biological process in
the body.
 The EPA also emphasized that dioxin
damages the immune system directly
and indirectly. This is the worst of all immune damage scenarios.
With this finding in the toxicology scientific community on dioxin/brain involvement
with its high lipid content, (as well as the spinal chord tissues with its high lipid
content), all subclinical CNS issues must be a consideration in part of any diagnosis of
idiopathic symptoms that normally are associated with some form of CNS damages.
Medically bearing in mind, the Vietnam Veteran is a toxic chemical victim of many
forms and types of toxicity exposures.
With the state of medicine and science, as it exists today exposures to dioxin do in fact
create antibody problems as well as cytokine problems that direct autoimmunity in
many different ways and communication levels. To say this disorder could not produce
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what is called AUTOIMMUNE NEUROPATHIC CONDITIONS would not only
be spurious at best but very unscientific. (See Evidence Section - Immune system)
The VACEH clearly stated as part of its function (supposedly on behalf of the Veterans)
the “FOUND SIGNIFICANT STATISTICAL ASSOCIATION"
BETWEEN “PERIPHERAL NEUROPATHY” AND EXPOSURE TO
DIOXIN and then qualified that with a non-proven and non-justified “ten-year time
limit.” Next, the Secretary of Veterans Affairs immediately changed the time limit to a
“one-year time limit” all but making the government pronouncement of association
useless and by doing so; it now denied all neuropathic conditions in our Vietnam
Veterans associated to the dioxin, TCDD exposures.
The fact, that one scientific pronouncement can go from a 10 year associations to a one
year association by the stroke of pen should tell all who are receiving this Challenge
how ridiculous this finding was manipulated and subjected to Government yearly
budget mandates not science and certainly not the facts. (This exclusion might well
have been 1460 and one-half day’s exclusion, which would make about as much sense.)
To qualify the development time of any disorder associated to dioxins, including
Peripheral Neuropathy, one must understand the medical etiology (pathology) of how
dioxin creates the found statistical association of the condition. All the pathological
roads must be identified. As in many cases, there is more than one pathological
pathway of causations related to dioxins and furans. In addition, the discussion must
now turn to threshold and/or ingestion rate in order to quantify a time limit. Different
forms of ingestions have different rates of body absorption. None of these are known
today much less in 1991 when the 10-year time limit turned into a one-year time limit.
Therefore, the qualifying and the other inept statements, other than the found
statistical association to Peripheral Neuropathy and/or dioxin created medical
conditions, ARE NOTHING MORE THAN “VA/GOVERNMENT
SCIENTIFIC MISCONDUCT” LINKED TO BUDGET CONSTRAINTS;
NOT SCIENCE. In other words, the health and welfare of the Vietnam Veterans
was negatively affected by an edict by a government agency (VACEH) and then
changed by the Secretary of Veterans Affairs (Mr. Derwinski) to save money and the
other associations that may then be associated to neurological damages.
It is impossible to know when “the last dioxin exposures occurred in the Vietnam
Veteran” no matter where he/she resided after the war. It is well known that most of
the world’s population including the United States is exposed to some level of dioxins
and/or dioxin like isomers especially since industrialized nations continue to pollute the
environment.
The questions have always been; what types of harm do these ingestions cause, what
form of ingestions are at risk, what rate of ingestions are at risk, or what cumulative
body threshold over time is required to cause some form of systemic damage to organs
and/or body operating systems or a malignant/benign cancer conditions. The
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Environmental Protection Agency (EPA) in its reassessments of dioxins clearly stated
that dioxin ingestions must be thought of as “cumulative lead ingestions.”
(3) Having many subclinical long-term effects before the damage is discovered or
manifestations began. To even suggest that “only the Vietnams Veterans exposure” to
dioxin or the other dioxin-like furans would or could be the reason for a given low-end
of significant finding is not only wrong spirited but against all scientific logic of how
these cumulative toxicity issues occur.
To the contrary, their exposures to dioxin and dioxin-like furans of super government
toxicity and super increased dose rates should be considered a life catalyst for any
and all disorders connected to such toxicity. These medical conditions must be
considered and described as related to degenerating conditions suffered later in life,
which VA and NAS/IOM, with no evidence to the contrary, continually deny.
Therefore, the government/VA stand on any “time limit” to manifestations of “any
disorder” is totally without merit or Scientific precedence regarding an unknown toxic
chemical and/or a group of unknown toxic chemicals that can have a cumulative effect
not only in body accumulation but systemic damages that occur because of additional
exposures over life is unacceptable and should be corrected.
Government decision makers and especially Congresspersons and Senators must know
or become aware that these dioxins and dioxin-like furans remain in the body attached
to more lipid cells (fat) and only degrade in toxicity at a rate of seven to ten years of
half-life. It should also be noted that our nervous system tissues are about 70% - 80%
lipids and the rest is protein.
In dioxin reassessment reports, EPA identified 18 major U.S. Dioxin Sources. (3) It
should be noted that one of the identified sources of major dioxin contamination was
the toxic chemical 2, 4, -D. Those familiar with the Vietnam Veterans Toxic Chemical
Legacy may recall that 2,4-D was not only used as a separate herbicide with the
nomenclature Agent White but also used as a 50/50 mixture within the herbicide with
the nomenclature Agent Orange. In fact the most widely used dioxins containing
herbicide chemical was Agent White and not Agent Orange. Agent White was the code
name for a mixture of an approximate ratio of 4:1 of 2, 4-D (2, 4-dichlorophenoxyacetic
acid; 239.7 kg/m3) and Picloram (4-amino-3, 5, 6-trichloropicolinic acid; 64.7 kg/m3),
which was used from 1965 to 1971. The toxic chemical 2,4-D is also noted for
attachment to more lipid cells as a repository.
The Herbicide with the nomenclature Agent White (2,4-D) also had other dioxin
isomers as well as closely related furans, which was also used separately, and as a 50/50
mixture with Agent Orange.
In the context of evaluating Agent Orange after having reviewed Dow Chemicals own
documentation, Daniel Teitelbaum, MD, one of the world’s foremost toxicology experts
was concerned about Agent White. A letter written to Admiral Elmo Zumwalt during
the 1989 assessment stated: (4)
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“What I do think...may bear on the Agent Orange issue, is the fact that in review of
Dow’s 2,4-D documentation I found that there are significant concentrations of
potentially carcinogenic materials present in 2,4-D which HAVE NEVER BEEN
MADE KNOWN TO THE EPA, FDA, OR TO ANY OTHER AGENCY.
Thus, in addition to the problem of the TCDD which, more likely than not, was
present in the 2,4,5-T component of Agent Orange, the finding of other dioxins
and closely related furans and xanthones in the 2,4-D formulation was of
compelling interest to me.”
Picloram is a convenient Dow proprietary chemical formula that contained not only
nitrosamines but also a form of benzene toxic chemical known as hexachlorobenzene.
Which would almost guarantee this formula would have other dioxins and dioxin-like
isomers.
For example:
Any of the hexachlorodibenzofuran isomers, hexachlorodibenzo-p-dioxin isomers,
tetrachlorodibenzofuran isomers, tetrachlorodibenzofuran –p-dioxin,
pentachlorodibenzofuran isomers, or pentachlorodibenzo – p-dioxin isomers
It should be noted that the benzene family of toxic chemicals also cause hematological
disorders, including leukemias.
Nitrosamines are carcinogenic chemicals that are known to cause cancers and other
medical problems. Exposure to high concentrations of nitrosamines is associated with
increased mortality from cancers of the esophagus, oral cavity, and pharynx. When
used in pesticides or herbicides they may cause DNA damage and cell death.
In 1985, the EPA ruled that in order for DOW Chemical to gain re-registration of
Picloram, it had to reduce its contamination to less then 200 parts per million (ppm) for
Hexachlorobenzene, and less then 1 percent for Nitrosamine. Dow has reduced
Hexachlorobenzene and now has no (zero) Nitrosamine in Picloram. The toxic
chemical levels used on Vietnam Veterans in the created militarized herbicides are
unknown at this time. This is due in part to the chemical company and
government convenient amnesia.
The specific reasons and rational for the re-qualification of Picloram requiring the
reduction of Hexachlorobenzene and Nitrosamines seem to be conveniently lost in EPA
history. Could the reason have been the medical issues the Vietnam were developing
caused some concern? Certainly, the time line of concern would have been appropriate.
One can readily see that the government mandated to a “cause and effect” of the
one-dioxin isomer, TCDD is illogical given the toxic chemical environment in which
the Vietnam Veterans served. To mandate one medical disorder or a group of medical
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disorders from mixed dioxin compound isomers or dioxin-like isomers in the form of
furans and/or polychlorinated biphenyls (PCB’s) is outside the realm and ability of
science, as we know it at this time. We cannot recreate the Vetearns Toxic Chemical
Legacy in order to ferret out which toxic chemcial or what combination of toxic
chemicals may have caused which specific disorder and/or cancer.
The above White House directed philosphy over the course of serveal presidental terms
has mandated undue hardship on the Veterans of This Nation that served in the
government created toxic chemicals environment.
Veterans Affairs and U.S. Government studies have concentrated solely on the worst
dioxin that being 2, 3, 7, 8-tetrachlorodibenzo-p- Dioxin found in 2, 4, 5-T or, Agent
Orange. Clearly, there are other dioxins, xanthones, and closely related dioxin-like
furan isomers that have never been looked at, identified, or even a Veterans
Affairs/Government concern expressed in over 40 years.
It is further stated by the Vietnam Veterans the Herbicide with the nomenclature Agent
Blue cacodylic acid (dimethyl arsenic acid) symptoms include: (5)
Acute exposure may lead to:









Garlic type odor of breath and feces, and metallic taste in the mouth.
Adverse GI effects predominate with vomiting, abdominal pain and rice-water,
or bloody diarrhea.
GI effects may also include inflammation, vesicle formation, and eventual
sloughing of the mucosa in the mouth, pharynx, and esophagus.
Central nervous system effects that are common include: headache, dizziness,
drowsiness, and confusion.
Symptoms may progress to include muscle weakness, spasms, hypothermia,
lethargy, delirium, coma, and convulsions.
Renal injury manifests as proteinuria, hematuria, glycosuria, oliguria, and
shows up in the urine. In severe poisoning cases, acute tubular necrosis results.
Cardiovascular effects include shock, cyanosis, and cardiac arrhythmia.
Elevated liver enzymes and jaundice may manifest causing liver damage.
Injury to blood-forming tissues may cause anemia, leucopenia, and
thrombocytopenia.
Chronic exposure may lead to:


Muscle weakness, fatigue, anorexia, weight loss.




Peripheral neuropathy, paresthesia, paresis, and ataxia.
Hyperpigmentation, hyperkeratosis.
Inability to coordinate voluntary muscular movements.
Subcutaneous edema in face, eyelids, and ankles.
Stomatitis, white striations across the nails (Mees lines) and sometimes loss of
nails or hair.
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




22
Liver toxicity as indicated by hepatomegaly, jaundice, and cirrhosis.
Renal toxicity leading to oliguria, proteinuria, and hematuria.
EKG abnormalities and peripheral vascular disease.
Hematologic abnormalities.
Cancer.
Carcinogenicity has not been tested adequately, but it should be noted that other
inorganic arsenic compounds have been found associated with liver, lung, skin,
and stomach cancers.
While not in the dioxin family Agent Blue cacodylic acid (dimethyl arsenic acid)
certainly has toxic chemical properties according to our own U.S. EPA. (5)
In 1969, the U.S. State Department became involved in analyzing and minimizing the
effects that were being seen in our Vietnam Veterans. The State Department clearly
indicated in a report that Agent Orange was of very little concern. While Agent
Blue with its arsenic acid base “was a real concern.” (6)
These toxic chemical effects and possible outcomes simply cannot be just government
ignored because Agent Blue was not as widely used as Agent White or Agent Orange.
There were very few areas of Vietnam where only Agent White and Agent Orange were
used and not Agent Blue. In some cases, some firebase areas received more Agent Blue
than Agent White.
In a newly declassified document called ‘Corona Harvest’, the document discusses the
reaction of Agent Orange and Agent Blue when sprayed in series within the spray tanks
clogging up the tanks and spray nozzles. (39) Should this be considered a chemical
reaction that possibly could produce other medical disorders that either one exposed to
separately could not produce? Many such medical questions have never been resolved.
The Vietnam Veteran, in general, is not going to meet the normal genotype population
in background exposure levels used in study assessments and baselines. Not only in
dioxin isomers but also exposures to other toxic chemicals at the exact same time.
A study published in Industrial Health on Dioxin; Exposure-Response Analysis and
Risk Assessment made the following statements: (7)
Abstract:
…In 1997, dioxin was found to be a human carcinogen by the International Agency
for Research on Cancer (IARC), based on four other studies of industrial workers
exposed to high levels. Recently there has been interest in estimating human cancer
risk at “low-level environmental exposures.” Here we review quantitative exposure
– response analysis and risk assessment for low level environmental levels… In the
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US the background risk of cancer death by 75 is 12%, so doubling the background
levels of dioxin exposure risk to somewhere between 12.1 and 13.0%. Our results
agree broadly with results from a German cohort, which is the only other cohort
for which a quantitative risk assessment has been conducted. (7)
This study used 5 part per trillion as a low level assessment.
This study also found that “all cancer sites” were elevated, not just the ones the
government/Veterans Affairs has reluctantly stated are associated. Additional
statements were made that dioxins may be the first manmade “all site” cancerproducing carcinogen. In addition, those cohort individuals that were exposed to
pentachlorophenol (PCP) were excluded from this study. (7)
This study also found that while smoking and asbestos cause cancer at many sites “but
not all.” The fact that the Ah receptor occurs in all parts of the body may be the reason
for the dioxin, TCDD NOT BEING LIMITED to only a few cancer sites but “all
cancer sites.” In addition, SMR for all cancers = 1.46; digestive system cancers = 1.41
(which are still denied by the government/Veteran Affairs); respiratory cancers =
1.67. (7) While not a lot of variance; Vietnam Veterans are still denied at present.
Pentachlorophenol is also a major product of the metabolism of hexachlorobenzene in
mammals. (8)
…the chronic toxicity observed may depend in large measure on the proportion of
chlorodibenzo-p-dioxins present in the mixture. In a 90-day feeding trial in rats,
30 mg/kg/day produced depressed red blood cell and hemoglobin levels as well as
liver degeneration, and even lower doses resulted in irregular blood chemistry and
enzyme levels, along with increased liver and kidney weights. Pure PCP, and
technical PCP without dioxin contamination, produced only slight
enlargement of livers and kidneys. Purified PCP failed to produce toxic effects
such as liver damage and immune system alterations, which had previously been
reported for the technical product. In humans, the most common exposure to PCP
is inhalation in the workplace. Abdominal pain, nausea, fever, and respiratory
irritation, as well as eye, skin, and throat irritation, may result from such exposure
while very high levels may cause obstruction of the circulatory system in the lungs
and cause heart failure. Survivors of toxic exposures may suffer permanent visual
and central nervous system damage. Persons regularly exposed to PCP tend to
tolerate higher levels of PCP vapors than persons having little contact with these
vapors.
While cancer is not the subject of the Veterans denial, cancer risk does play a part in
the rebuttal of denial. It is clinically impossible to have a cancer causing toxicant that
can only produce cancer and not autoimmune derivates of a cancer such as Peripheral
Neuropathy. This will be shown in the dysregulation of B and T cells in the immune
system found associated and the variances found in the cytokines of the immune
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system. (See Evidence Section) Many subclinical autoimmune disorders are associated
with peripheral neuropathies.
The Vietnam Veterans will also demonstrate the association to many such immune
disorders that will cause many forms of neuropathy. Including Veterans evidence will
show that EPA and NAS now agree – “The NAS committee agreed with EPA's
conclusion that dioxins are probably toxic to the human immune system,…” (9)
Congresspersons/Senators/Government decision makers must remember that dioxins
create at least three immune system damages in Immunotoxicology and combination of
damages that the outcomes are multiple in outcomes and severity.
Dioxin created:

Immunodeficiency or suppression

Alteration of the host defense mechanism against antigens and carcinogens (one
theory is that the immune system detects cells altered by antigens or other
carcinogenic triggers and destroys these cells. Thus, an impaired immune
system may not detect and destroy a new forming cancer.)

Hypersensitivity or allergy to the chemical antagonist. Because of dioxin’s
ability to be both an immunosuppression and a carcinogen, as early as 1978
immunologists were suggesting that "agents such as TCDD.. .may be far more
dangerous than those possessing only one of these properties. (10) (11)
Some immunotoxicologists argue that one molecule of a carcinogenic agent, as dioxin in
the right place and at the right time, can create a multitude of outcomes and severity in
immune system damages.
Congresspersons/Senators/Government decision makers must learn from the
referenced study. (7) That when graphed as to which fit the parts per trillion in years
scenario logarithmic and piece-wise linear graph fits the analysis. This is the important
part for those not familiar: a threshold model did not fit the analysis suggesting
there was “NO THRESHOLD OF EXPOSURE LEVEL BELOW, WHICH
THERE WERE NO CANCER RISKS.” (7)
Once again, this study as in the Ranch Hand Study included those exposed by dermal
exposures, which is the most benign of all the exposures. Skin does not absorb the
toxicants very well. Yet, the lungs and gastrointestinal system readily absorb dioxins.
In other words, this study as well as the Ranch Hand Study would be the best-case
analysis not the worst-case, including that many disorders found as increased were not
brought forward for NAS/IOM review because they did not meet the dioxin linear
mandate. This is additional scientific misconduct on the part of our government. No
scientific conclusion has been established that in all dioxin associated disorders a linear
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correlation even exists. Contrary to this Government/Veterans Affairs/NAS-IOM
mandate some studies have demonstrated the facts of a non-linear response.
The Environmental Protection Agency (EPA) as recently as 2005 stated general
exposure levels in its dioxin reassessments, which began in 1992 that while the mid-90’s
levels of exposures is about half of what it was in the 1980’s it is still at 25 parts per
trillion Toxic Equivalent (TEQ) lipid. (3) The Vietnam Veteran was at his/her most
vulnerable for additional cumulative damages in the 1980’s at approximately 55 parts
per trillion Toxic Equivalent (TEQ) lipids. Even on long-term damages, there can be
no time limit from initial massive multiple toxic chemical exposures resulting from the
Veterans wartime service in the parts per trillion range or the parts per million ranges.
Chronic exposures resulting in constant/continuous exposures must be considered; not
some “initial estimated dose” of one toxic chemical isomer of many toxic chemical
isomers involved experienced during only the time spent in Vietnam.
Vietnam Veterans are outside this generic qualification of background exposures. As
anyone can see it might be the additional 20 or 30 years of dioxin accumulation that is
the causation dose or reaches the cumulative body threshold. However, if not for
Service in Vietnam in a toxic chemicals environment that elevated his or her increased
baseline at an early age, then the mortality and disability manifestations caused by the
dioxin, TCDD may not have taken place or had any effect on early mortality or early
disability the Veteran now develops.
It was known that Peripheral Neuropathies and Chronic Fatigue Syndrome (the old
medical term of Neurasthenic Syndrome) were associated to toxic chemical pesticide
and herbicide exposures as far back as the late 1940’s. (See Evidence Section)
An announcement on 3 December 2006: (12)
What are the possible health effects of Dioxin exposures? (12)
At high enough levels, dioxins can cause cancer in humans. They can also damage
the nervous system and weaken the immune system. Dioxins have caused
cardiovascular and respiratory problems, skin disease, birth defects, and other
conditions in laboratory animals. In addition, a new medical finding located in dorsal
root ganglionitis (inflammation in the spinal cord) - was discovered in a two-week
autopsy, with the cause of death listed as Chronic Fatigue Syndrome. This becomes a
“clear physical manifestation” of the disorder in the Central Nervous System.
This new finding seems to confirm what many scientists have been saying for decades
regarding toxic chemical Peripheral Nervous System (PNS) issues and that is before any
PNS issues manifest a Central Nervous System (CNS) subclinical event/causation has
taken place and precedes any PNS manifestations.
While there seems to be a running battle between psychiatrists and medical doctors as
to the cause of this disorder, there is a medical physiological issue associated to toxic
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chemical exposures in our damaged immune systems that create this nerve damage or
inflammation as well as the daily debilitating chronic fatigue issues found in 1984 of
DEGENERATING NEUROLOGICAL ISSUES by our own government’s studies
of those that sprayed the toxic chemicals. (10) (13)
The “Government Bias” has always been that toxic chemical etiolgy must be found
directly to an antigenic response by the body to the toxicant that caused the peripheral
neuropathy. This is a flawed assumption. It is flawed by the assumptions that exposure
to multiple toxic chemical events would force the body to a direct response to the dioxin,
TCDD, or any other toxicant. With a half-life in the body for a decade or longer
thereby demanding the exposures to the various toxic chemicals must be considered as
simultaneous or parallel multiple exposures as opposed to a single serial toxicant
exposure. This clearly demonstrates that any time limit put on a Veteran for diagnoses
is a false conclusion by the government/Veterans Affairs/NAS-IOM in any
disorder.
Dioxin exposures create many systemic body damages such as in the immune system
that will not meet some mandated International Classification of Diseases (ICD). An
undefined toxic chemicals syndrome of organ and/or body system systemic (many times
subclinical) damages in neurological, endocrine, hematological, immunological,
gastrological, cardiovascular, urology, or any combination of each is the result of the
exposure. (See Testimony UNDER OATH of Ranch Hand Study Scientist Dr.
Richard Albanese in 2000) (14) Each one separately can be the cause of chronic and
persistent neuropathies of many types and varieties and even combination of different
neuropathies (autonomic, sensory, and motor).
Because of the exposures and combinations of subclinical systemic damages or damages
that equate to a syndrome such as a connective tissue disorder many Vietnam
Veterans diagnosed with only ischemic peripheral neuropathy become disabled or
limited in the time and scope of work they can do demonstrating other medical issues
that clearly can be attributed to the exposures. (See Media Three part of this
Challenge) {Veteran Affairs scientists Dr. Kang’s recent Veterans Affairs Study report
on Agent Orange found significant increases and dioxin associations to diabetes, heart
and vascular diseases, all cancers, all respiratory problems (COPD), hypertension,
current health is poor - health limits the kind and amount of work that can be
done by the Veteran.}
The Veterans' Advisory Committee on Environmental Hazards did not qualify the
association to “acute or subacute transient peripheral neuropathy” but clearly stated
"significant statistical association" between peripheral neuropathy and
exposure to dioxin did exist as early as 1991, clearly meeting the requirements
in 38 C.F.R. 1.17. While the Committee did put a flawed time limit of 10 years on
the manifestation of the nerve damages, it did not indicate any time of resolution of the
disorder primarily because the conditions in which the nerve damage is being caused is
more than likely not going to be curable such as in autoimmune peripheral
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neuropathy or even some of the smoldering cancer conditions or undiagnosed toxic
chemical caused cancers. This also eliminated the slow progression of the real disorders
and long-term development from being compensated or service connected.
This particular disorder has an even more obvious government/Veteran Affairs bias
and undue hardship on the Vietnam Veteran in that our government put a time limit on
not only the manifestation to one year but also the damage to the nerve myelin matter
would repair itself within two years after removal from the toxic chemicals or resolve
itself. While that may be true for the Department of Defense testing program on
Vietnam Veterans in the use of Dapsone for the harsh type of malaria that was found in
Vietnam is not true of dioxin associated Peripheral Neuropathies. Dapsone is noted for
causing peripheral neuropathy and hematological disorders directly as in a direct
antigenic response to the chemicals in Dapsone (a leprosy treatment medication). This
is especially true in hematological issues, which is the most common adverse effect and
is seen in patients with or without G6PD deficiency. {Glucose 6-phosphate
dehydrogenase (G6PD) deficiency is an enzyme deficiency of the red blood cells. G6PD
deficiency leads to an abnormal rupture (breakage) of the red blood cells called
hemolytic anemia (abnormally low red blood cell count)}. Almost all patients
demonstrate the inter-related changes of a loss of 1-2 g of hemoglobin, an increase in
the reticulocytes (2-12%), a shortened red cell life span and a rise in methemoglobin
with G6PD deficient patients having greater responses. In addition to the warnings and
adverse effects reported above, additional adverse reactions include: nausea, vomiting,
abdominal pains, pancreatitis, vertigo, blurred vision, tinnitus, insomnia, fever,
headache, psychosis, photo toxicity, pulmonary eosinophilia, tachycardia, albuminuria,
the nephrotic syndrome, hypoalbuminemia without proteinuria, renal papillary
necrosis, male infertility, drug-induced Lupus erythematosus, and an infectious
mononucleosis-like syndrome. In general, with the exception of the complications of
severe anoxia from over dosage (retinal and optic nerve damage, etc.) these adverse
reactions have regressed off drug.
Once a medical diagnosis is reached with the patient having these difficulties with red
blood cells or Peripheral Neuropathy and muscle weakness, then the recommend
medical treatment is to remove the patient from the Dapsone. Normally Recovery on
withdrawal is “usually substantially complete.” The mechanism of recovery is reported
by axonal regeneration.
The previous is an example of how the one year or ten year rule would fit the diagnosed
Veterans Affairs/NAS-IOM scenario and even the scenario that in most cases the
medical issues caused by the direct taking of the Dapsone (a direct antigenic
response) should resolve in most patients once removed. This would also fit the
scenario of a poisons such a snakebite, or ingesting a poisonous plant, or even an
untreated tick bite.
This scenario does not fit the secondary Ah receptor toxic chemical damages
done by the dioxin, TCDD, or many toxicants of similar dioxin-like isomer
properties to which the Veteran was exposed.
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Our own Environmental Protection Agency has clearly stated as well as other studies
that dioxins in and by themselves do not cause an antigenic body response such as a
poisonous plant, spider, snake, or even some types of tick bite. Once again, the taking
of Dapsone may produce an antigenic response. In these examples once the body,
which varies in time and methodology the body damage is then over, eliminates the
toxicant and the body as stated will repair itself "to some level."
Common and medical scientific sense mandates that there can be no antigenic response
for the dioxins since the dioxins are in the body 40 years after the exposures and can be
additive. This would also mandate that since there is no antigenic response there could
be no time limit of resolution. This would also mandate that only a
Compensation and Pension examination(C & P) for the damages or the
doctor’s opinion with diagnostics that the damages being done are getting
better or resolving. That is not up to Veterans Affairs or the NAS/IOM for
the individual veteran.
This would have to conclude that somehow our Government/Veteran Affairs/NAS-IOM
has somehow defined the following:

Rate of exposure to manifest this disorder.

Minimum body threshold to create this disorder.

Since a time limit is put on the manifestation of the medical issue, the actual
causation at root cause failure must have clearly defined medically to the dioxin,
TCDD that does not include the cell Ah receptor involvement.

Since a time limit is put on the resolution of the medical issue, the actual
causation at root cause failure levels and the methodology of how removing ones
self from the toxic chemical exposures will allow the medical disorder to resolve
itself; must be identified and understood and defined by someone or some
scientists. (i.e. once removed from the toxicant the damaged myelin nerve
matter, axons will regenerate.)
All of the above is based on the nerve damages “not being caused” by a secondary
response such as a disturbed immune system in long-term damages in the form of
immunotoxicity or neurotoxicity damages, or gastrointestinal issues caused by
dioxins, or blood issues caused by dioxins, or any of the other body systems that are
damaged by the dioxins, of which any or all of them could cause peripheral nerve
damages including a subclinical development of a cancer. They can all or singularly
be associated to many types of peripheral neuropathy which is a general term
describing many forms of nerve damages.
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Therefore, someone, somewhere has determined that direct contact with the dioxin,
TCDD at some level will create a level of “direct peripheral nerve damage only.” A
further determination is then made that does not involve a central nervous system
involvement or any cell DNA or mitochondria cell DNA modifications and they know
how it occurs and what the ingestion rate must be and/or the total body threshold is
regardless of method of ingestions.
Congresspersons/Senators/Government decision makers, Vietnam Veterans find the
Veteran Affairs decisions on peripheral neuropathy disorder to be only transient and
resolution of disorder BASELESS, PRESUMPTUOUS, AND ERRONEOUS
AND NOT SCIENTIFIC AS IT APPLIES TO THE TOXICANTS IN
QUESTION.
On July 1, 1991, Secretary of Veterans Affairs Derwinski announced that VA will
propose rules granting service-connected disability status to certain veterans with
peripheral neuropathy. Proposed rule implementing the Secretary's decision was
published for public comment in the Federal Register in January 1992. (See 57
Fed. Reg. 2236, January 21, 1992). It was anticipated that the final rule would be
published in 1993. However, in July 1993, when the National Academy of Sciences
(NAS) released its comprehensive report, entitled Veterans and Agent Orange Health Effects of Herbicides Used in Vietnam, peripheral neuropathy was not
included in the category "sufficient evidence of an association" or even
"limited/suggestive evidence of an association." Rather, the NAS reviewers
concluded that there is "inadequate or insufficient evidence to determine whether
an association exists between exposure to herbicides (2,4-D; 2,4,5-T and its
contaminant TCDD; cacodylic acid; and picloram) and disorders of the peripheral
nervous system." The NAS report added, "Although many case reports suggest
that an acute or subacute peripheral neuropathy can develop with exposure to
TCDD and related chemicals, reports with comparison groups do not offer clear
evidence that TCDD exposure is associated with chronic peripheral neuropathy.
The most rigorously conducted studies argue against a relationship between TCDD
or herbicides and chronic neuropathy."
Acute is used to mean immediate effect; as opposed to chronic that means an effect
not appearing immediately.
VA asked the NAS, in its follow-up report, to consider the relationship between
exposure to herbicides and the subsequent development of the acute and subacute
effects of peripheral neuropathy (as compared to the chronic effects, which were
focused on in the initial report).
In January 1994, VA published a notice in the Federal Register that Secretary
Brown has determined that a presumption of service connection based on exposure
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to herbicides used in Vietnam is not warranted for a long list of conditions
identified in the NAS report. Peripheral neuropathy was included in this list. (See
59 Fed. Reg. 341, January 4, 1994).
What did the NAS 1996 update conclude about peripheral neuropathy?
When the NAS reviewers separately reviewed chronic persistent peripheral
neuropathy and acute and subacute transient peripheral neuropathy, they found
that there was still inadequate or insufficient evidence to determine whether an
association exists between exposure to herbicides and chronic persistent peripheral
neuropathy. On the other hand, they reported that there is some evidence to
suggest, “neuropathy of acute or subacute onset may be associated with herbicide
exposure.” They included acute and subacute transient peripheral neuropathy
among those conditions they placed in their second category “limited/suggestive
evidence of an association.” (Chronic persistent peripheral neuropathy remained
in category three, “inadequate/insufficient evidence to determine whether an
association exists.”)
What was VA’s response to the NAS 1996 finding about acute and subacute
transient peripheral neuropathy?
After careful review of the report, Secretary Brown decided that VA should add
acute and subacute peripheral neuropathy (when manifested within one year of
exposure) to the list of conditions recognized for presumption of service connection
for Vietnam veterans based on exposure to herbicides. President Clinton
announced this, along with other, decisions, at the White House, on May 28, 1996.
The proposed rule was published for public comment in the Federal Register in
August 1996. (See 61 Fed. Reg. 41368, August 8, 1996). The final rule was
published in the Federal Register in November 1996. (See 61 Fed. Reg. 57587,
November 7, 1996).
What did subsequent NAS updates conclude about peripheral neuropathy?
With regard to chronic persistent peripheral neuropathy, the 1998 report stated,
“No new information has appeared in the intervening two years that alters this (the
1996) conclusion.”
With regard to acute and subacute transient peripheral neuropathy, the 1998
update reported, “The committee is aware of no new publications that bear on this
issue. If TCDD were associated with the development of transient acute and
subacute peripheral neuropathy, the disorder would become evident shortly after
exposure. The committee knows of no evidence that new cases developing long
after service in Vietnam are associated with herbicide exposure.”
In update 2000: For chronic persistent peripheral neuropathy, there is only
inadequate or insufficient evidence to determine whether an association exists
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between exposure to dioxin or the herbicides studied in this report. NAS found that
there was limited/suggestive evidence of an association between exposure to the
herbicides considered in this report and acute or subacute transient peripheral
neuropathy. The evidence regarding association was drawn from occupation and
other studies in which subjects were exposed to a variety of herbicides and
herbicide components. Information available to NAS continued to support this
conclusion.
The Veterans are, with this submittal, proving the NAS wrong with data from the
government’s own studies that prove a peripheral neuropathy association many years
after the war was over and nothing has resolved itself and more to the point, it was and
is degenerating. Of course, we now know that the government’s own Gold Standard
Study was as fraudulent as the chemical company studies were and this was proven in a
court of law. These fraudulent chemical company studies were used by Veterans
Affairs against the Veterans with White House directed bias.
Congresspersons/Senators/Government decision makers, you should remember the
statements made above by the Veterans Affairs and NAS/IOM and the statements
originally made by the committee that decided our fate from 1979 to 1991 (VACEH)
and their findings that there is a "significant statistical association" between
“PERIPHERAL NEUROPATHY” and exposure to dioxin shown in the
Evidence Section. As you go through the Veterans evidence bear in mind, what other
studies have found - even in the government’s exoneration tool the Ranch Hand Study.
Veterans think you will agree that in order for NAS/IOM to make the preceding
statements that a bias seems to be evident in the scientific world of those that are
contracted and controlled by our government.
It would also be imperative to follow these so called NAS “The most rigorously
conducted studies argue against a relationship between TCDD or herbicides and
chronic neuropathy.” In our Vietnam Veterans case, one must follow the money trail of
White House interference as well as political lobby money interference in congress
itself.
Ranch Hand studies used as Gold Dioxin Study Standard Flawed.
Media 1 and Media 2 submitted with this challenge document the most rigorously
controlled gold standard government study and with one flawed assumption has now
rendered 25 years of data and statistics used in Veterans Affairs and NAS/IOM denials
of mortality and morbidity issues useless, baseless, and not based on scientific
study findings at all. Nothing but flawed assumptions used for 25 years to
deny the Vietnam Veteran for government budget control. (See Media 1 and
Media 2 at the end of this Challenge.)
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These assumptions made by the Ranch Hand Study on the cohort exposures that for all
intensive purposes used in government defenses and Veterans denial now lies dead in
the water. Especially, since any statistical data is now skewed away from the Veterans
position, and in favor of denial. Any low-end findings now could very well be high-end
significant findings for Vietnam Veterans and their widows who have said all along in
many disorders including Degenerating Peripheral Neuropathy.
The NAS/IOM must be careful in scientific comparisons of exposures of “militarized
toxicity formulas” of more dioxins, including the dioxin, TCDD and the six to twenty
five times the dose rate to some other form of exposures. We are not talking about
Weed-Be-Gone after 1985 with reduced potency and toxicity because of what our
returning Vietnam Veterans were developing.
NAS/IOM must also take into consideration that “the contractor” of the NAS/IOM has
thwarted, interfered with, tried to stop, and essentially created a “government
fraudulent scientific information void.” For example, an early on egregious report at
one of our most prestigious research centers, MD Anderson Cancer Center a scientist
recanted that the director was interfering with her dioxin research on behalf of friends
in the State Department. (More issues in the Government Slippery Slope)
Veterans will clearly show the neurological condition, chronic polyneuropathy, is
associated to exposures to dioxins as well as the associated Chronic Fatigue Syndrome
(formerly diagnosed as Neurasthenic Syndrome) as a stand alone disorder which should
be “automatically associated” for all Vietnam Veterans with that diagnosis who served
in geographical Vietnam as well as those Veterans that were exposed around the world
to the same “government created toxic chemical formulas and doses.”
The Chronic Fatigue Issues that go with this nerve disorder also found in exposure
victims even in our own government studies that “is just as likely as not” associated
to Central Nervous System damage associated with Chronic Fatigue Immune
Dysfunction Syndrome, or sometimes called Myalgic Encephalopathy.
A recent new finding seems to confirm what many scientists have been saying for
decades now regarding Peripheral Nervous System (PNS) issues and that is before any
PNS issues manifest a Central Nervous System (CNS) subclinical event/causation has
taken place and precedes any PNS manifestations.
This seems to be located in dorsal root ganglionitis (inflammation in the spinal cord) recently discovered in a two-week autopsy, with the cause of death listed as Chronic
Fatigue Syndrome. This becomes a “clear physical manifestation” of the neurological
disorder.
“Evidence reveals that Dow Chemical, a manufacturer of Agent Orange was aware as
early as 1964 that TCDD was a byproduct of the manufacturing process. According to
Dow’s then medical director, Dr. Benjamin Holder, extreme exposure to dioxins could
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result in "general organ toxicity" as well as "psychopathological" and "other systemic"
problems.” (15)
It should be pointed out here that what Dow considered extreme exposures was a
minimum of one part per million (ppm) because the test and evaluation equipment at
the time could only measure > 1 ppm. How low the actually exposures were causing
"general organ toxicity" as well as *"psychopathological" and "other
systemic" problems” are unknown; during this “vague scientific statement.”
*{Psychopathological - The manifestation of mental or behavioral disorders.
Many toxicologists believe that not only do these toxic chemical herbicides cause
peripheral neuropathy (PN) but also CNS issues.
This description of our toxic chemical exposures matches no other toxic chemical
hazard other than the possibility of the Love Canal, New York environmental disaster,
which contained many of the same forms of toxic chemicals to which Vietnam Veterans
were exposed. However, once again the dose rate for Vietnam Veterans is much higher
than even in the Love Canal disaster. The Times Beach, Missouri dioxin exposures
would equal the form of dioxin only exposures but not anywhere close to the levels of
dioxin exposures seen by the Vietnam Veterans.
Simply put dioxin exposure causes damage to the peripheral and central nervous
systems. The association between dioxin and damage to the nervous system is reflected
in a finding by the Veterans' Advisory Committee on Environmental Hazards, which
recommended that the Veterans Affairs compensate Vietnam Veterans for peripheral
neuropathies “as service related.” Many other dioxin studies documented in
this challenge also agree. Already discussed in the formal presentation are
Veterans Affairs constraints that were put on this “obvious toxic chemical caused
disorder” to the point that NO Veteran would qualify.
Effects on the central nervous system occur before gross pathological damage can be
demonstrated in the peripheral nerves. The neuropsychiatric and neuropsychological
symptoms of the central nervous system include depression, anxiety, reduced cognitive
function, poor coordination, etc. (13) One severe consequence of central nervous
system damage by dioxin is higher rates of suicide (shown in dioxin-exposed Vietnam
veterans, chemical production workers, and forestry workers). Another severe
consequence is excess deaths from accidents (also significantly elevated in dioxinexposed chemical production workers and Vietnam Veterans). These accidents could
be caused by neurological malfunction, or also represent disguised suicide to a certain
extent. (13)
Other effects on the central nervous system found in exposed Vietnam veterans and
chemical production workers include depression, anxiety, loss of libido, and other
neuropsychiatric and neuropsychological effects. Effects on the central nervous system
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also have been demonstrated in a dose-related manner in Vietnam veterans and
chemical production workers, providing firm epidemiological evidence that dioxin
caused these effects. (13) In addition, the same range of neuropsychiatric and
neuropsychological effects seen in dioxin-exposed populations have been demonstrated
for exposure to other neurotoxic substances, such as solvents. This demonstrates a
similar biological mechanism between the neuropsychiatric and neuropsychological
effects caused by dioxin and other substances. (13)
Peripheral Nerve and Cerebrovascular Abnormalities
Gross abnormalities of the peripheral and central nervous system serve to indicate
extreme endpoints of the effects of dioxin. More subtle effects on the central nervous
system occur before clinically demonstrable peripheral nerve damage.
PERIPHERAL NERVE AND CEREBROVASCULAR ABNORMALITIES
Gold Standard Government Study Ranch Hand

The Air Force Ranch Hand Study in the scientific transcripts stated a found
dioxin response to chronic polyneuropathy. (16)

“Data showed a significant increase in the index of polyneuropathy.
Another run through the data showed it correlated significantly with
dioxin.” (16)

The study summary of findings that appeared statistically significant was presented:
(16)

An increase in “inflammatory diseases” was noted, and then
debunked by the leader of the study. A significant increase in the index of
“polyneuropathy” found was presented when comparing moderate to none on
all Ranch Handers. Another run thorough the “polyneuropathy data”
correlated significantly with dioxin.

Issues were found with “range of neck motion” and “tendon issues,” especially
under repetitive motion exposure.

The scientist citing the inflammatory disease recanted his oral presentation. He
was clearer about the “significance of find of associations with
inflammatory diseases.”
A significance of finding inflammatory diseases was found. Could that possibly mean and
immune system problem?

“A significant and adverse relationship between peripheral
neuropathy and dioxin body burden was found.” (17)
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
35
One of the leaders of the Ranch Hands studies, Dr. Michalek, in an
announcement "Serum dioxin and peripheral neuropathy in veterans of
Operation Ranch Hand" stated: "... we consistently found a statistically
significant increased risk of all indices of peripheral neuropathy
among Ranch Hand veterans…” (18)
Other studies of Vietnam Veterans

The Korean Agent Orange Impact studies in a totally blind honest study with built in
quality assurance released in 2003, found dioxin related to peripheral
neuropathy at a p-value of 0.039. The study also found a p-value of
difference between Vietnam Veterans and non-Vietnam Veterans with
peripheral neuropathy of a p-value of difference of 0.0042. An odds
ratio (OR) was found of 2.39. (19)

The Korean Agent Orange Impact studies also found cerebrovascular issues as follows:
Brain Atrophy except cerebellum a p-value of 0.0165, Brain Infarction a p-value of
0.0013. In the spinal chord areas, the study found Radiculopathy including herniated
intervertebral disc a p-value of <0.0001, Radiculopathy a p-value of 0.0002 was found
with an odds ratio (OR) of 3.98, Myelopathy a p-value of 0.0851, and in Spondylosis a pvalue of 0.1311 was found. (19)

In a second Korean impact study evaluating the immune system the statement
was made: “Based on the results of two epidemiological studies, Peripheral
Nerve Disease is the most prevalent disease followed by Lung Cancer,
Beurger’s Disease, Larynx Cancer, non-Hodgkin’s Lymphoma, and Chloracne
associated with Agent Orange Exposures. Based on the results of two
epidemiological studies of probably associated with Agent Orange exposure,
Hypertension was the most prevalent disease followed by Diabetes Mellitus,
Seborrheic Dermatitis, Central Nervous Diseases, Liver Diseases, Cancer,
Hyperlipidemia, Cerbrovascular Disease, Ischemic Heart Disease, and other skin
disorders such as Chronic Urticaria and Psoriasis Vulgaris.” (20)
Seveso, Italy

Seveso, Italy Residents in the 15-year mortality/morbidity dioxin
only accident
study found a “three-fold increase” to five-fold increased depending on
age in peripheral neuropathy, obviously at least 15 years after the
accident. (21)
If Senators, Congresspersons, Government decision makers, and Congressional Staff
Members decide to look at a path to justice for this nations government created
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disabled veterans then these accounts and facts can certainly be presented as a separate
paper.
The Veterans will give one more example:
In a dioxin-like train spill, 49 Monsanto workers were sent in to clean up the spill.
Within 12 years, 45 of the workers had peripheral neuropathy and two workers
had committed suicide. It is unknown what happen to the other two. (13)
One should ask: How can the VA/NAS-IOM continue to deny such found relationships
by the government’s own Gold Standard study and many other similar studies? Simply
put - Congress has given the Government entities such as Veterans Affairs and
NAS/IOM so much "corrupt power" over Veterans and control over the mandated
yearly budget including the questionable use of the Board of Veterans Appeals that
denies the Veterans obvious disability based on faulty government statements
of fact.
“The most severe neuropsychological consequence of dioxin exposure is excessive
suicides, which has been demonstrated among exposed Vietnam Veterans, chemical
production workers in the U.S. and European countries, forestry workers, and railroad
workers. Another severe consequence is the excessive death rate from accidents found
among the dioxin-exposed chemical production workers and Vietnam Veterans,
representing either motor neuron malfunction or suicide in disguise.

“In 1977, the Working Group of the International Agency for Research on
Cancer (IARC) found that neurological and behavioral changes were among
the most frequently reported effects in studies of exposures to 2,4,5-T (IARC,
1977a). (13)

IARC identified 6 out of 7 different populations occupationally exposed to
chlorinated phenolic compounds where neuropsychological symptoms such
as neurasthenic or depressive syndromes were established (IARC, 1977b).
(13)

IARC noted that PNS damage was also found in the same six dioxin-exposed
populations, including polyneuropathies, lower extremity weakness, and
sensorial impairments (sight, hearing, smell, taste). (13)

In 1986, the IARC clearly restated it’s finding that dioxin had been found to
be associated with peripheral neuropathies and personality changes
(IARC, 1986). (13)
Veterans need not know the etiology of such manifestations and why they are
becoming neurological disabled from dioxin exposures only that they are and
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it is finally recognized. It is time for the Congress to recognize the ruse being
perpetrated on Vietnam Veterans and their families by Veterans Affairs and
NAS/IOM.
Peripheral Neuropathy by the best scientific minds in our nation remains idiopathic in
about 33% of the cases. Veterans cannot even get this noted medical diagnostic
doubt from our government “so called” friendly government agencies.
Peripheral Neuropathic disorders have many causations to include Type II Diabetes
Mellitus.
Of course, most know of the insulin issues associated with a diabetic involvement and
the pain and suffering.
It should be noted here that in the only honest testing and evaluation done in the
"Veterans Opinion" of Vietnam Veterans and dioxin levels the p-value found on
"neuropathy and diabetes" was only remarkable to 0.2157. This is hardly significant in
any scientific value. Yet, this same study found both diabetes and peripheral
neuropathy independently significant at p <0.5 with respective odds ratios of
OR = 2.69 and OR = 2.39. (19)
These findings "were significant" after adjusting for potential confounders in:
Age
Smoking
Alcohol
Body mass index
Education
Martial status
Health insurance
How much more do the government caused disabled Veterans of this nation
need to prove in order to be compensated in disability for a disorder that has been
proven, repeatedly and then re-proven associated with the dioxin exposures?
Immune system mediation of Peripheral Neuropathy
Immune system mediated, even subclinical immune system mediation can create
neuropathic states. The Ranch Hand gold standard study found increases in IgA
antibodies as well as increase in Natural Killer cells associated. (13) (13a) (13b)
The aforementioned honest second Korean study reported not only found issues in
increased IgA but also IgE as well as a disturbances in IgG1 - IgG4 subclass antibody
homeostasis (well being) levels. (20) This study also found issues in the quality of blood
in number of cells, reduced hemoglobin, and reduced hematocrit. (20) It further found
disturbances in cytokines that direct immune system responses creating a confused
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immune system as to what type of response is required or in some cases rather than one
response both are created by the confused immune system. (20)

Th1 cells drive the type-1 pathway (“cellular immunity”) to fight viruses and
other intracellular pathogens, eliminate cancerous cells, and stimulate delayedtype hypersensitivity (DTH) skin reactions.

Th2 cells drive the type-2 pathway (“humoral immunity”) and up-regulate
antibody production to fight extracellular organisms: type 2 dominance is
credited with tolerance of xenografts and of the fetus during pregnancy.
Disturbances found were in:
Interlukin 4 and 10
Interferon gamma
Tumor Necrosis Factor alpha
The Interlukin 4 and Interferon gamma ratio was found significantly elevated.
The government's own EPA recently stated that it also found cytokine dysregulaton
issues with dioxin exposures. (3)
In a recent, paper by Dr. Linda Birnbaum of the EPA they also found cytokine changes
associated with dioxin of:
Tumor Necrosis Factor
Interlukin 6
Interlukin 1 beta
Veterans did not find this Interlukin 1 beta and Interlukin 6 in any studies of Vietnam
Veterans but when reviewing our matrix, we did find correlations to the two findings;
the EPA’s as well as our own. This certainly can be a simultaneous event since at the
cytokine level and below at macrophage and monocyte levels - there is cross
communication at real time. Once again, this data is not widely known and doctors
look at one or two tests rather than those that can apply to a toxic chemical victim and a
compromised immune system. Our Veterans’ doctors do not even know to run an
immunoglobulin test on our Nations Government Caused Veteran Victims much less an
“Immune Dysregulaton Panel.” The key here for Senators, Congresspersons,
Government decision makers, and Congressional Staff Members is the one study found
and stated that Military Service in Vietnam and/or Agent Orange Exposures disturbs
immune-homeostasis resulting in dysregulation of B and T cell activities. (20)
Disturbance in the immune homeostasis and the dysregulaton of B and T cell activities
can certainly be concluded "is as at least as likely as not" the reason for the
Veterans Affairs and the NAS/IOM finally but begrudgingly admitting to the few
limited cancers we Veterans have as herbicide exposure associated.
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For the government to conclude, that this found and identified disturbance can only
create “a cancer condition” is not only totally biased against the Vietnam Veterans but
also would be scientific misconduct on the part of the Veterans Affairs and the
NAS/IOM. There are many autoimmune disorders associated to immune
system problems to include the found dysregulaton in B and T cell activities
in exposures to dioxins.
Since the start of its Dioxin Reassessments in 1992, the EPA has concluded the
threshold for dioxin immunotoxicity is much less than that of a dioxin caused cancer.
(3) Therefore, it would be statistically, medically, and scientifically impossible to only
have a few cancers associated by the government and no autoimmune disorders,
standard ICD code or not! Just one of which would be peripheral nerve damages.
More on the other issues, Vietnam Veterans have been saying for 40 years now below
and how this causation can be the cause of many of our issues of government created
death and disability.
This issue of immune system dysregulation found that certainly could be considered
also associated to the neuropathy damage causation is the cardiovascular issues found
significant.
Vasculopathy demonstrated a linear suggestion across the four levels of exposures while
peripheral vasculopathy did not find this slope. Vasculopathy was found as p-value of
difference at 0.0002 while Peripheral Vasculopathy was not significant to dioxin to
<0.050 but remarkable to 0.0628. This is certainly well within the realm of
tolerances considering the amount of regression analysis. (20)
How do these apply to the Vietnam Veterans wide spread Peripheral Neuropathy with
or without diabetes and the known and identified damaged immune system?
Immune Mediated Autonomic Neuropathies (Roy Freeman, MD)
Autonomic nerve fibers are affected in most generalized peripheral neuropathies.
While this involvement is often mild or subclinical, there are a group of peripheral
neuropathies in which the small or un-myelinated fibers are selectively or prominently
targeted. While most generalized peripheral polyneuropathies are accompanied by
clinical or subclinical autonomic dysfunction, there are a group of peripheral
neuropathies in which the small or un-myelinated fibers are selectively targeted. In
these neuropathies, autonomic dysfunction is the primary manifestation. A
constellation of signs and symptoms occur from impairment of
cardiovascular, gastrointestinal, urogenital, thermoregulatory, sudomotor
and pupillomotor autonomic function. (22)
The author of this submittal and challenge on behalf of all Veterans, Charles Kelley,
has challenged "many times" those in the government hierarchy that with the known
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prevalence of peripheral neuropathy found associated not only to dioxin exposures but
the massive amount found in Vietnam Veterans, especially what is called painful axonal
sensory peripheral neuropathy that to conclude Vietnam Veterans diagnosed would
have no autonomic nerve damages would be scientific hypocrisy by the Veterans Affairs
and the NAS/IOM. This hypocrisy continues to this day. (See Abstract by Dr. Freeman
above.)
As you can see from the abstract of Dr. Freedman's article an entire constellation of
signs and symptoms occur from impairment of cardiovascular, gastrointestinal,
urogenital, thermoregulatory, sudomotor and pupillomotor autonomic function. This
becomes even more germane when one looks at the actual findings in dioxin studies
supplemented by what was found in Vietnam Veterans in all of our allies that served in
the toxic chemical environments. Also included are the gastrointestinal issues
(normally diagnosed as IBS), the cardiovascular issues, the breathing rate issues, the
COPD issue from minor > sleep apnea, kidney diseases, sexual dysfunction, etc.
The latest finding adds more fuel to the fire that is raging among our scientific
community in that dioxin exposures directly cause a diabetic condition.
The latest study and testing may just conclude that what later studies verified and our
Veterans have been correct all along. The peripheral nerve damage (by default
autonomic sensory nerve damages must be included) was occurring first and that the
dioxin caused immune mediated nerve damage may even be the reason for (in our
Vietnam Veterans cases) the increases in insulin sensitivity and “especially
insulin resistance.” Therefore, the "scientific purist" may be correct in stating that
diabetes is not a direct result of dioxin exposures but rather the secondary effect of the
dioxin damaged immune system and the mediated sensory nerve damage created in the
endocrine system.
Thus, we have he inevitable scientific and logic question of: Which came first - The
Chicken or the Egg? To the disabled or dying Vietnam Veteran and his/her family with
no support from the government for government created medical issues - it matters
not.
Tom Blackwell, National Post
Published: Friday, December 15, 2006
In a discovery that has stunned even those behind it, scientists at a Toronto hospital say
they have proof the body's nervous system helps trigger diabetes , opening the
door to a potential near-cure of the disease that affects millions of Canadians.
Diabetic mice became healthy virtually overnight after researchers injected a substance
to counteract the effect of malfunctioning pain neurons in the pancreas.
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"I couldn't believe it," said Dr. Michael Salter, a pain expert at the Hospital for Sick
Children and one of the scientists.
"Mice with diabetes suddenly didn't have diabetes any more."
The researchers caution they have yet to confirm their findings in people, but say they
expect results from human studies within a year or so. Any treatment that may emerge
to help at least some patients would likely be years away from hitting the market.
However, the excitement of the team from Sick Kids, whose work is being published
today in The Journal Cell, is almost palpable.
"I've never seen anything like it," said Dr. Hans Michael Dosch, an immunologist at the
hospital and a leader of the studies. "In my career, this is unique."
Their conclusions upset conventional wisdom that Type 1 diabetes, the most serious
form of the illness that typically first appears in childhood, was solely caused by
autoimmune responses -- the body's immune system turning on itself.
They also conclude that there are far more similarities than previously thought between
Type 1 and Type 2 diabetes, and that nerves likely play a role in other chronic
inflammatory conditions, such as asthma and Crohn's disease.
The "paradigm-changing" study opens "a novel, exciting door to address one of the
diseases with large societal impact," said Dr. Christian Stohler, a leading U.S. pain
specialist and dean of dentistry at the University of Maryland, who has reviewed the
work.
"The treatment and diagnosis of neuropathic diseases is poised to take a dramatic leap
forward because of the impressive research."
About two million Canadians suffer from diabetes, 10% of them with Type 1,
contributing to 41,000 deaths a year.
Insulin replacement therapy is the only treatment of Type 1, and cannot prevent many
of the side effects, from heart attacks to kidney failure.
In Type 1 diabetes, the pancreas does not produce enough insulin to shift glucose into
the cells that need it. In Type 2 diabetes, the insulin that is produced is not used
effectively -- something called insulin resistance -- also resulting in poor
absorption of glucose.
The problems stem partly from inflammation -- and eventual death -- of
insulin-producing islet cells in the pancreas.
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Dr. Dosch had concluded in a 1999 paper that there were surprising
similarities between diabetes and multiple sclerosis, a central nervous system
disease. His interest was also piqued by the presence around the insulin-producing
islets of an "enormous" number of nerves, pain neurons primarily used to
signal the brain that tissue has been damaged.
Suspecting a link between the nerves and diabetes, he and Dr. Salter used an old
experimental trick -- injecting capsaicin, the active ingredient in hot chili peppers, to
kill the pancreatic sensory nerves in mice that had an equivalent of Type 1 diabetes.
"Then we had the biggest shock of our lives," Dr. Dosch said. Almost immediately,
the islets began producing insulin normally "It was a shock? Really out of left
field, because nothing in the literature was saying anything about this."
It turns out the nerves secrete neuropeptides that are instrumental in the proper
functioning of the islets. Further study by the team, which also involved the University
of Calgary and the Jackson Laboratory in Maine, found that the nerves in diabetic mice
were releasing too little of the neuropeptides, resulting in a "vicious cycle" of stress on
the islets.
So next, they injected the neuropeptide "substance P" in the pancreases of diabetic
mice, a demanding task given the tiny size of the rodent organs. The results were
dramatic.
The islet inflammation cleared up and the diabetes was gone. Some have remained in
that state for as long as four months, with just one injection.
They also discovered that their treatments curbed the insulin resistance that is
the hallmark of Type 2 diabetes, and that insulin resistance is a major factor
in Type 1 diabetes, suggesting the two illnesses are quite similar.
{This is of primary importance to the Nations Veterans - insulin resistance
that is the hallmark of Type 2 Diabetes; WAS CURBED.}
While pain scientists have been receptive to the research, immunologists have voiced
skepticism at the idea of the nervous system playing such a major role in the disease.
Editors of Cell put the Toronto researchers through vigorous review to prove the
validity of their conclusions, though an editorial in the publication gives a positive
review of the work.
"It will no doubt cause a great deal of consternation," said Dr. Salter about his paper.
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The researchers are now setting out to confirm that the connection between sensory
nerves and diabetes holds true in humans. If it does, they will see if their treatments
have the same effects on people as they did on mice.
Nothing is for sure, but "there is a great deal of promise," Dr. Salter said.
The restated facts above of "surprising similarities between diabetes and
multiple sclerosis, a central nervous system disease is very concerning for
Vietnam Veterans. Some that started out with a diagnosis of Peripheral
Neuropathy end up with a diagnosis of Multiple Sclerosis. This certainly could
explain why Vietnam Veterans have Peripheral Neuropathy long before even an
impaired glucose tolerance (IGT) is diagnosed.
Veterans are denied Peripheral Neuropathy damages as associated unless they have a
defined case of diabetes. Yet, clearly the neuropathy was one of the first disorders
found very early on in the Ranch Hand Study and the suspicion later on "long before
diabetes was even found associated (which is controversial)" were that subclinical
diabetes was the causation.
Peripheral Neuropathy is not controversial in any dioxin study of Vietnam Veterans
because it correlates p-values of difference as well as association to dioxin exposures.
The controversy is with the past and present Secretaries of the Veterans Affairs and the
NAS/IOM government controlled bias.
Many Vietnam Veterans have this debilitating nerve damage long before they
eventually are diagnosed with a Type II diabetic condition or even an Impaired Glucose
Tolerance that can take years or even decades to develop. Once again, even with
overwhelming statistical and medical evidence of “increased risk of incidence,”
“significant correlation to dioxin exposures” in the most benign forms of
exposures (skin) our Nation’s disabled Vietnam Veterans are denied Peripheral Nerve
damage associations and thereby denied service-connected compensations. There is no
compensation for the incredible amount of pain and discomfort that accompanies this
medical disorder. Veterans are not even compensated for the medical issues that have
and continues to put them at a disadvantage in the work place and at home in a
disability created by the UNITED STATES GOVERNMENT.
Discussed later will be the additional debilitating issues that accompany this diagnosis
of Peripheral Neuropathy in our Vietnam Veterans. More than likely the same issues
as described as Kangs report
If one considers the recent above findings and testing by the Canadian research team in
that damaged pancreatic sensory nerves that control insulin seemed to be associated
with both Type I and Type II forms of diabetes. Thus, Department of Defense’s Dr.
Michalek’s concern of subclinical diabetes was and is 180 degrees out phase.
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Instead of peripheral neuropathy with only a possible causation of dioxin created
diabetes. The Ranch Hand study did not even concern itself with the possibilty of a
dioxin damaged immune system mediated peripheral neuropathy. The concern in the
Ranch Hand transcripts and the statement WAS ONLY FOR SUB-CLINICAL
DIABETES. Yet, immune system issues were found. No concern was generated
toward anything else but possible diabetic involvement causation when during the
decades of continuous Peripheral Neuropathy findings no diabetes was
found. This was not very logical in a study that was supposed to help decide
compensations in morbidity and mortality associated to dioxin, regardless of the
etiology.
Senators, Congresspersons, Government decision makers, and Congressional Staff
Members you will note in the evidence that no one has suggested Peripheral
Neuropathy was in any form of being transient. To the contrary, year after year
the findings in the same cohorts got worse with or without diabetes.
The impacts of the finding by the Canadian Research team may even have wider
impacts. Traditional associated issues normally associated with diabetic conditions may
even be revisited in medical history. Instead of associated with the diabetic
condition causation the wording would have to change now to the disorders
associated to a damaged/confused immune system that created a diabetic
condition.
Most Vietnam Veterans probably will not live long enough since about half of us have
died already. However, surviving Vietnam Veterans do hope that our spouses and our
children and grandchildren will be around to tell the non-supporting United States
Government: OUR FATHERS TOLD YOU SO AND YOU WERE NOT ONLY
WRONG, BUT YOU INTENTIONALLY LIED TO THEM, TREATED
THEM AS SO MUCH GOVERNMENT CANNON FODDER FOR
GOVERNMENT MISTAKES MADE, AND YOU COMMITTED
SCIENTIFIC MISCONDUCT FOR THE SAKE OF BUDGETS.
Diagnosis and Treatment of Chronic Immune- Mediated Neuropathies
Norman Latov, MD, PhD. & Kenneth C. Gorson, MD. & Thomas H. Brannagan, III
MD. & Roy L. Freeman, MD & Slobodan Apostolski, MD. & Alan R. Berger, MD. & T
Walter G. Bradley, DM, FRCP. & Chiara Briani, MD. & Vera Bril, MD Neil A. Busts,
MD. & Didier P. Giros, MD. & Marinos C. Dalakas, MD. & Peter D. Donofrio, MD. &
P. James B. Dyck, MD John D. England, MD. & Morris A. Fisher, MD. & David N.
Herrmann, MD. & Daniel L. Menkes, MD. & Zarife Sahenk, MD Howard W. Sander,
MD. & William J. Triggs, MD. & Jean Michel Vallat, MD.
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The chronic autoimmune neuropathies are a diverse group of syndromes that result
from immune-mediated damage to the peripheral nerves. Our understanding of
these disorders has evolved through clinical observations and empiric therapeutic
interventions that were confirmed by independent investigators over the years. For
many of these disorders, there are no definitive diagnostic tests, and only a few or no
controlled therapeutic trials. Consequently, the diagnoses may be missed and the
patients remain untreated. The Medical Advisory Board of the Neuropathy Association
therefore reviewed the existing literature regarding the diagnosis and treatment of the
immune-mediated neuropathies, with the aim of summarizing and presenting the
information in a concise form, to help physicians recognize these disorders and decide
on the most appropriate therapy. (23)
Guillain Barre Syndrome and Its Variants
Alan R. Berger, M.D.
Guillain Barre Syndrome most commonly characterized by some combination of limb
paresthesias, generalized weakness, and areflexia. Pathogenesis of GBS not yet fully
understood and current thinking is that GBS may not be a single disease, but a variety
of acute neuropathies with a number of related immune-mediated
pathogenetic mechanisms. Most common immunopathologic finding: endoneurial
inflammation in spinal nerves roots, distal nerve segments, or around potential nerve
entrapment sites. Target antigens appear to be common to the axon, myelin
sheath, or both. The exact antigens, the precipitating event, and the resultant
mechanism of injury somewhat unclear.
GBS is likely to be multi-factorial, with complex interactions involving
humoral and cellular immunity, complement deposition, cytokines and other
inflammatory mediators. (24)
This statement by Dr. Berger is as exactly as reported in dioxin studies and the
interaction and confusion of dioxin created confusion in humoral and cellular
immunotoxicity. This includes the resulting B & T cell dysregulated activity
culminating in the Veteran’s malignant cancer, any cancer.
CLUES TO THE DIAGNOSIS OF CHRONIC IMMUNE-MEDIATED
POLYNEUROPATHIES
Norman Latov, M.D., Ph.D.
Autoimmune mechanisms are implicated in several chronic neuropathic syndromes
that are amenable to immune therapy (Table I). Collectively, these neuropathies are
relatively common; Barohn et al (1998) reported that approximately 13% of
consecutive patients with neuropathy seen at their institution had an immune mediated
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neuropathy, and Verghese et al (2001) found that 6% of their elderly neuropathy
patients had a demyelinating inflammatory etiology. However, many of the
autoimmune neuropathies are difficult to diagnose, due to a lack of generally
accepted clinical diagnostic criteria, or availability of reliable serological
tests. Consequently, many patients with autoimmune neuropathies are
diagnosed as having "idiopathic neuropathy" instead, and left untreated
despite progression of their disease. (25)
Vasculitic Neuropathy
Jose R. Carlo, MD, FAAN
The vasculitides are a group of heterogeneous disorders, which present with a variable
and complex clinical picture. Debates over clinical versus pathological approaches to
classification abound in the literature, all these, with recognized limitations given the
variable clinical presentations and the overlap between the recognized diagnostic
entities. Peripheral neuropathy is an important, and often the presenting clinical
feature of the vasculidities. Its recognition can be critical to attain an early diagnosis in
these disorders where the ultimate outcome can be greatly influenced by early
therapeutic intervention. (26)
Note: The Korean Agent Orange Impact study found Vietnam Veterans had
significantly higher frequency of vasculopathy. The p-value of difference was found at
0.0628 with none found in the non-Vietnam category. This included Burger’s Disease,
Raynaud’s Syndrome, and other forms of vasculopathy. (19)
“As discussed in later sections, the additional health effects found in this and other Air
Force studies on the veterans of Operation Ranch Hand include excess skin cancers and
other dermatologic abnormalities, elevated lung cancer rates and lung and thorax
abnormalities, excess kidney and bladder cancer, nervous system damage, testicular
atrophy and decreased testosterone levels, diabetes, decreased thyroid function,
abnormal peripheral vascular functions, immune system abnormalities, and
reproductive abnormalities.” (13)
CHRONIC INFLAMMATORY DEMYELINATING NEUROPATHIES
Thomas H Brannagan III, MD
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a common and
under recognized cause of neuropathy. Classically, it is characterized by weakness,
large fiber sensory loss, elevated CSF protein, demyelination that may be detected on
nerve conduction studies or nerve biopsy, and a response to immuno-modulating
treatment. Besides CIDP, there are other acquired demyelinating polyneuropathies,
some of which may be considered variants and others that are distinct disorders. This
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review details the clinical, laboratory; electrophysiological features and treatment
options for CIDP and other acquired demyelinating neuropathies. (27)
“As discussed in later sections, the additional health effects found in this and other Air
Force studies on the veterans of Operation Ranch Hand include excess skin cancers and
other dermatologic abnormalities, elevated lung cancer rates and lung and thorax
abnormalities, excess kidney and bladder cancer, nervous system damage, testicular
atrophy and decreased testosterone levels, diabetes, decreased thyroid function,
abnormal peripheral vascular functions, immune system abnormalities, and
reproductive abnormalities.” (13)
In the Ranch Hand transcripts, found associated medical values were consistent with
what is considered by the science and medicine as chronic inflammatory conditions
(Immune System Issues).
Recently Dr. Michalek (Department of Defense and head of the study for 14
years) and Dr. Ralph Trewyn a two time member of the came forward in the
media and clearly STATED THAT RANCH HAND COHORT EXPOSURE
ASSUMPTIONS WERE FLAWED. (SEE COMPLETE STORY IN MEDIA 1
AND MEDIA 2)
"However, hundreds in the comparison group spent time in Vietnam and may have
been exposed to herbicides, too, said Joel Michalek, who worked on the study from the
beginning and was its principal investigator for 14 years until he left in May.
“It spoils everything," Michalek told The News. "It's as if you're running a
clinical trial on a new medication, and you found out some of the people who
were in your placebo group were actually taking meds. That would spoil your
whole study. And that's what's going on here in this study”
“They referenced those papers, but they left all the data out from those cancer
papers that were done that showed the cancer effects,” he said. “It's huge,
because then the conclusion is there's no cancer effect, when as part of the
study, the same investigators, just analyzing the data in a different way, found
that when they did that, lo and behold, then there were significant cancer
effects.
“And so for the final report to say there's no cancer effect when the investigators
themselves published papers saying there is a cancer effect, that's just flat
scientifically wrong.”
Without factoring in the new information about the comparison veterans,
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Trewyn said, the Air Force got the same, predictable results.
“When they use an exposed control group and they say the two groups have roughly
the same amount of cancer and so forth, what is that finding good for? Nothing,” said
Trewyn, vice provost for research and dean of the graduate school at Kansas State
University.
Moreover, it doesn't take a scientist to figure that out, he said.
“This is common sense now, a lot of it,” he said. “It's like now wait a minute. This
just does not pass the smell test or the common sense test.”
Vietnam Veterans would like to point out to recipients of this study that Charles Kelley
the author of this document speaking for all Vietnam Veterans, pointed this fact out to
those in Washington DC in 2004 with evidence that these cohort assumptions were
indeed flawed. Flawed study assumptions that created and had a direct impact on the
statistics, dioxin exposure relativity, and how sick and dying Vietnam Veterans
actually were in many medical areas, not just cancers. While Dr. Michalek used
the example of those in a cohort group that were supposed to be taking placebos and
find out after all the statistics and regressions are completed, that they were taking the
medication in question then those gathered statistics are invalid. To publish such
findings knowing this event took place is misleading and fraudulent. To use
comparison data “known to be invalid" in legal matters of denying Vietnam
Veterans by not only the initial Veterans Affairs submittal but for BVA use in
government decisions to deny that claim, no matter what level it is used, is nothing
short of government criminal activity against this nations finest men and
women beginning in 1988 and continued to this day.
Charles Kelley, in his example in 2004, used the comparison of a building with two
floors that was subjected to toxic fumes or toxic chemicals. By default, the internal
areas of the building may have different levels but we do not know exactly what was in
the building in total or even in accumulation over time in some areas. Even when part
of the toxicity chemicals or fumes is discovered. Science has no idea of the etiology of
exposure or the long-term effects of a now what has to be considered as a life catalyst.
The United States Government's idea of justice would be to compare the first floor to
the second floor then statistically regress the issues and say, "See we found no medical
problem issue differences between the first floor and the second floor." Therefore, it is
a non-issue in the building and there were no significant statistical medical disorders
found associated to the exposures.
The United States Government WOULD NOT COMPARE the cumulative data in
the first floor and second floor findings then compare those findings to the identical two
stories of a building next door that had no toxic chemicals or toxic fumes.
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Now we find that even the participating scientists themselves say this flawed White
House directed protocol spoils all the statistics. Yet, these tainted and fraudulent
findings have been used in legal matters against Vietnam Veterans with
purpose and known government directed “fraudulent results.”
The scientists concluded with this flawed cohort assumptions that made no sense to
Vietnam Veterans to begin with instead of little or no increase found in cancers found
would now demonstrate statistically at least a two fold increase IN ALL
FORMS OF CANCERS. NOT JUST THOSE CANCERS ON THE BOOKS
NOW AS “ASSOCIATED.”
Recipients of this study, if we now have an unreported finding in the
GOVERNMENTS GOLD STUDY STANDARD of a two fold increase or larger in
cancer because of flawed cohort assumptions on exposures. Then any logical person
should conclude the findings in other mortality and morbidity issues that
have disabled and killed our Vietnam Campaigning Army, even issues that
were actually found at some low level, are now minimized. (Discussed in the
Government Slippery Slope.)
The Vietnam Veterans have already identified in this report Peripheral Neuropathy
found in Ranch Hand studies that correlated to dioxin levels. These were found as
significant as pointed out in the studies own transcripts. (16) – (18) and that was using
fudged numbers for exposure assumptions admitted to by the study scientists. In fact,
we only know significant findings and significant associations were found. If the
exposures assumptions were corrected and data recalculated by an honest firm (not
associated to the United States Government) then who knows how high the level of
association is to dioxin exposures and Peripheral Neuropathy.
The typical Vietnam Veteran with diagnosed chronic peripheral neuropathy does not
normally have just one symptom that as you have read remains idiopathic for the
many reasons stated by Dr. Norman Latov (one of our nations renowned neuropathy
experts and also very well known and recognized world wide).
The accompanying dioxin issues symptoms not in any particular order of significance
includes:

COPD

*Gastrointestinal Issues (normally described and diagnosed as IBS)

Joint pain, weakness, and deterioration with no fever or disfigurement of the
joints. Normally testing for RA is not positive but testing for ANA shows
positive with an increase in titer but not to the level of ICD Lupus.
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Is this the chronic progressive degeneration of the stress-bearing portion of a
joint called “Neurogenic Arthropathy,” with bizarre hypertrophic changes at the
periphery? It is probably a complication of a variety of neurologic disorders,
particularly involving loss of sensation, which leads to relaxation of supporting
structures and chronic instability of the joint. (Dorland, 27th ed).” For the
Vietnam Veteran with peripheral neuropathy and this joint pain, weakness, and
deterioration no one seems to either know or really care.

Sexual Dysfunction

Limb Muscle weakness

Subcutanious tissue wasting (feet, lower legs, thighs, hands, arms, etc)

Hematological disorders

**Lipid metabolism issues

Bone pain and Bone density loss

Loss of Balance

***Chronic Fatigue Syndrome
In addition to the above, some Veterans have:

Vascular and heart issues to include valvular issues

Smoldering cancer issues

Cancer issues
* In gastro issues - of major concern is the diagnosis of IBS with the symptoms. Yet,
intestinal antibodies associated with lymphoma cancers are not considered in the
diagnosis as a toxic chemical exposure Vietnam Veteran victim.
A meeting and discussion of developed celiac allergy by Dr. Joseph Murray leading
United States expert on the causes and manifestations to the developed symptoms.
Example: In the immune mediated gastrointestinal problem the same cells that do the
damages in the intestines are the same cells that become lymphoma cancers. The
lymphocyte damage in the small intestines not only blocks absorption of critical
vitamins and minerals especially such as the B6 and B12 vitamins and A & E vitamins
and calcium but also damages the cilia that secrete the enzymes that aide in the
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digestion of milk and milk products. Lactose then becomes a laxative. B12 is essential
for nerve function as well as creation.
{Ever wonder why the Vietnam Veterans have bone density loss early in life?}
The longer the Veteran this condition the more likely he or she is to develop a
lymphoma cancer. Which we know already, at great protest from the government and
Veterans Affairs, admitted to as Agent Orange associated.
An analogy for this would be the longer a person discontinues smoking the less chance
you have of developing lung cancer. The same scenario exits in the damaging
lymphocytes in the intestines that remain benign growing and dividing at an
accelerated rate and then something triggers one to turn malignant.
This form of gastro problem is also more common in Scleroderma and Sjogren's
patients because the diseases all come from the same autoimmune tendencies.
Inflammatory Bowel Syndrome, which collectively refers to Chron's and Ulcerative
Colitis.
This autoimmune intestinal condition also causes dermatitis herpetiformis (DH). As the
immune system mounts a challenge, it produces antibodies in numbers that often get
dumped under the lining of the skin. At that point, they lay in wait for some trigger to
set them off, like a land mine. This can be any number of things from sunlight, some
cleaners, etc.
{A few Vietnam Veterans have indicated that if do to much physical activity the attack
begins.} The itching capabilities of this skin eruption seem to totally diminish any
contact and the resulting severity of itching of poison oak or poison ivy. (28)
Types of Lymphocytes
The three major types of lymphocyte are the natural killer (NK) cells, T cells and B
cells. NK cells are a part of cell-mediated immunity and act during the innate immune
response. They can attack host cells that display a foreign (e.g. viral) peptide on
particular cell surface proteins known as MHC class I molecules. Once they determine
a cell is infected, the NK cells release cell-killing (cytotoxic) granules that will destroy
the infected cell. NK cells do not require prior activation in order to perform their
cytotoxic effect upon target cells. Like NK cells, the T cells are chiefly responsible for
cell-mediated immunity whereas B cells are primarily responsible for humoral
immunity (relating to antibodies). T cells are named such because these lymphocytes
mature in the thymus; B cells (named for the bursa of Fabricius in which they mature
in bird species) are thought to mature in the bone marrow in humans. T and Blymphocytes differ from NK cells in that they are the principal cells involved in the
adaptive immune system. These cell types retain a memory of a previous infection so
that they can respond to the same infectious agent quickly upon re-infection. In the
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presence of an antigen, B cells can become much more metabolically active and
differentiate into plasma cells, which secrete large quantities of antibodies. T cells, after
they see an antigen, will also become highly activated and will secrete specific proteins,
such as cytokines and cytotoxic granules, depending on their subtype/function.
The reason for including the above definitions is germane to the known fact an increase
in Natural Killer cells was found although it was dismissed by Ranch Hand. (13b)
Whether the new admitted to cohort flaws would change their mind on dismissing the
found increase or not probably depends on the direction of “government
politics,” not science.
We also know by submitted studies that show dioxin exposures are associated to B and
T cell dysregulation and immune system controlling cytokines (chemical messengers)
dysregulaton and confusion.
This IBS gastro condition for the Vietnam Veteran even though the conditions may wax
and wane is serious in that the continual gastro problem overtime > barrettes
esophagus overtime > esophageal cancer. Note: Many Vietnam Veterans came home
with developed gastro problems and intolerances to milk and heavy red meats. This
was almost in the context of the 40-year lag time a moment in time one of the first signs
of damage. Veterans that had no milk product tolerance before they went either in
country or shortly after developed milk intolerance. The waxing and waning of milk
intolerance seems to be the clue to another problem in the Vietnam Veteran.
** Many Veterans have lipid metabolism problems, which seemed to begin very early
with an increase in triglycerides years before the cholesterol lipid issues even show up in
testing. A linear dioxin relationship was found in this triglyceride issue decades ago in
the Gold Standard Ranch Hand Study. Including it had been previously found in
animal studies even prior to that finding. What is not being considered, thanks to the
government's scientific misconduct, is the Highly Sensitive Reactive Protein found in
the vascular disorders and very possibly, a dioxin damaged immune system mediated
issue yet continually denied.
*** Daily debilitating chronic fatigue was found in the Gold Standard Ranch Hand
Study as far back as 1984. Yet, once again, this found fact was dismissed and not
reported.
With the above stated issues in the Vietnam Veterans Evidence Section and the findings
specific to immunotoxicity directly caused by the dioxin, TCDD does it not make sense
that “yes” while multiple outcomes are present that the damaged immune system seems
to be involved in most of the findings? Of course it does.
***The chronic fatigue issue found and then not reported in 1984 may be associated to
the old disorder Neurasthenic syndrome.
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Neurasthenic syndrome - Some medical historians consider neurasthenia to be the
diagnostic predecessor of Chronic Fatigue Syndrome. Chronic Fatigue Syndrome
(CFS) – Is just what the name implies. A few good days of rest and you still do not
recover. No energy, listless, weakness, waking up and felling fatigued, or shortly after
doing any work extreme fatigue. May show up in the afternoon with almost feeling like
you have flu symptoms with a low-grade fever type of fatigue. At first, some scientists
thought this was caused by a nervous disorder therefore the former name neurasthenic
syndrome. Then it was found that the Epstein-Barr virus (EBV) was associated. High
levels of EBV antibodies (disease-fighting proteins) were found in those patients
suffering from CFS. Later diagnosis of CFS of some patients without this high level of
disease-fighting proteins indicated there were other causes. Other causes may be ironpoor blood (anemia), low blood sugar (hypoglycemia), environmental allergy, a body
wide yeast infection (candidiasis). I have seen some theories that those individuals with
neuropathy and that type of condition, that CFS is caused by the damaged nerve
endings.
Today, CFS also is known as myalgic encephalomyelitis, post viral fatigue syndrome,
and chronic fatigue and immune dysfunction syndrome.) Chronic fatigue and immune
dysfunction syndrome pointing out this CFS, once again can be attributed to an
autoimmune systemic issue caused by toxicant damages the Veterans were and are
experiencing. Immune system dysfunction that can lead to both disorders has clearly
been found in dioxin studies.
Note: The problem for Vietnam Veteran with diabetes involvement is the Veterans
Affairs medical codes only reflect this CFS to an autoimmune code and not other
associated issues. The Veteran with diabetes and peripheral neuropathy regardless if
the associations are in order or not has little chance, of getting the Veterans Affairs to
compensate the disorder “as associated” or “as a stand alone disorder” as significant as
found in the Ranch Hand Studies as far back as 1984. Yet, clearly this debilitating
disorder does exist in significant correlation and increased risk of incidence.
Reference Media 3 and Dr. Kang’s report of the following:
VA’S DR. KANG’S RECENT VA REPORT ON AO FOUND SIGNIFICANT
INCREASES AND DIOXIN ASSOCIATIONS TO DIABETES, HEART AND
VASCULAR DISEASES, ALL CANCERS ALL RESPIRATORY PROBLEMS
(COPD), HYPERTENSION, CURRENT HEALTH IS POOR, - HEALTH LIMITS
THE KIND AND AMOUNT OF WORK THAT CAN BE DONE BY THE VETERAN
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THE GOVERNMENT/VETERANS AFFAIRS SLIPPERY SLOPE
Congresspersons/Senators/Government decision makers must remember that the
Veterans' Advisory Committee on Environmental Hazards (VACEH) clearly stated
there was significant statistical evidence that found an association to Peripheral
Neuropathy and the dioxin, TCDD in 1991.
Congresspersons/Senators/Government decision makers must be aware that in 1989 of
our “Vietnam Veterans Toxic Chemical Legacy” showed a district court found after
reviewing the legislative history of the 1984 Act "that Congress intended service
connection to be granted on the basis of "INCREASED RISK OF
INCIDENCE" or a "SIGNIFICANT CORRELATION" between dioxin and
various diseases," rather than on the basis of a casual relationship. - See Nehmer v.
U.S. Veterans Admin., 712 F. Supp. 1404, 1408. (N.D. Cal. (1989).
Unfortunately, Veterans Affairs never challenged the rulings of the court. Instead, the
rulings were ignored and replaced by an order to the Secretary of the Department of
Veterans Affairs “to comply” is simply ignored thereby committing clear obstruction
of justice.
An act known as the Veterans’ Dioxin and Radiation Exposure Compensation
Standards Act, Pub. L. 98—542, Oct. 24, 1984 was - considered nothing but a “public
relations act” and halfhearted congressional attempt at merely doing something for
the nations government damaged Veterans.
In recognition of the uncertain state of scientific evidence and the inability to make an
absolute causal connection between exposure to herbicides containing dioxin and
affliction with various rare cancer diseases, Congress mandated that the Veterans
Affairs Administrator resolve any doubt in favor of the veteran seeking
compensation. Veterans Affairs not only confounded the perceived intent of
Congress, but also directly contradicted its- own established practice of granting
compensable service-connection status for diseases on the lesser showing of a statistical
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association, promulgating instead the more stringent requirement that compensation
depends on establishing a "cause and effect relationship."
An example of this non-compliance practice is referenced in BVA Citation Nr: 0317458,
Decision Date: 07/24/03 (38) wherein everyone at the BVA agreed the Marines Peripheral
Neuropathy was at least with a 50/50 chance the causation of the crippling nerve
disorder. The BVA then said that the Marine’s case is denied based on statements
made by the NAS/IOM and the Secretary of the Department of Veterans Affairs. We
know now and it is proven in this Challenge that the statements made by the NAS/IOM
are questionable at best and that the Secretary of the Department of Veterans Affairs
certainly exhibited bias on the part of him serving in an appointee position by the White
House.
The District Court invalidated Veterans Affairs Dioxin regulation, which denied service
connection for all diseases other than chloracne; ordered Veterans Affairs to amend its
rules; and further ordered that the Advisory Committee (VACEH) reassess all its
past recommendations in light of the court’s order. (29)
In promulgating such rules, the Dioxin Standards Act required the Veterans Affairs to
appoint a Veterans’ Advisory Committee on Environmental Hazards (the "Advisory
Committee") -- composed of experts in dioxin, experts in epidemiology, and interested
members of the public -- to review the scientific literature on dioxin and submit
periodic recommendations and evaluations to the Administrator. (30) Such experts
were directed to evaluate the scientific evidence pursuant to regulations promulgated
by the Veterans Affairs, and thereafter to submit recommendations and evaluations to
the Administrator of the Veterans Affairs on whether "sound scientific or medical
evidence" indicated a connection to exposure to Agent Orange and the manifestation of
various diseases. (30)
Veterans Affairs did not challenge the courts ruling but instead on October 2, 1989,
Veterans Affairs amended 38 C.F.R. Part 1, which among other things set forth various
factors for the Secretary and the Advisory Committee to consider in determining
whether it is "at least as likely as not" that a scientific study shows a "significant
statistical association" between a particular exposure to herbicides containing dioxin
and a specific adverse health effect. (31)
The Nation’s Vietnam Veterans contend that this stated policy has never been the
operating philosophy of Veterans Affairs for Vietnam Veterans. Instead Veterans
Affairs has chosen to operate as a government yearly budget control based on the
concluding White House Philosophy of the Reagan /Bush White House that clearly
defined it did not want the financial responsibility for the toxic chemical nightmare
inflicted on our Veterans as well as the environmental disasters in the Republic of
Vietnam created by other administrations. This led to a memo put forth by the White
House Bureau of Budget to all federal agencies of government in essence not to find a
correlation between Agent Orange and health affects. Stating that it would be
most unfortunate for two reasons: (32)
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A) The cost of supporting the Veterans.
B) The court liability to which corporations would be exposed.
This also would “just as likely as not” conclude the Government was interested in
protecting the chemical company industry as well as protecting its own lobby efforts
and not supporting government damaged Vietnam Veterans and their families.
Clearly, readers of this Challenge should be able to see that in 1991 the actual
committee of experts mandated by Congress stated their opinion under the rules
mandated by the court and indeed their finding was statistical association. Five years
later in 1996 as VA stalled and stalled again the newly Congressional appointed
National Academy of Science that conveniently had replaced the VACEH then makes
this statement:
“Rather, the NAS reviewers concluded that there is ‘inadequate or insufficient evidence
to determine whether an association exists between exposure to herbicides (2,4-D; 2,4,5T and its contaminant TCDD; cacodylic acid; and picloram) and disorders of the
peripheral nervous system’.”
During at this exact time frame Ranch Hand was finding specific adverse association to
polyneuropathy in its medical transcripts as well as other Nations’ Vietnam Veterans
studies were showing peripheral neuropathy as the most prolific disorder associated to
the dioxin, TCDD, as documented in the Evidence Section. The NAS conclusions seem
biased and spurious at best.
When did this occur? It was three decades after the war was over. Therefore, Veterans
question the integrity, and the effort put forth by the government contracted NAS/IOM
and the possible on purpose omission of findings concluded and clearly stated in Ranch
Hand Committee medical transcripts
Veterans also question if NAS and VACEH were using the same court mandated level
of associations required to associate such disorders. To add insult to injury of our
Nations Veterans and pour salt into our open government caused neurological
wounds. On May 28, 1996 President William Jefferson Clinton stated in a speech on
Veterans Announcements:
REMARKS BY THE PRESIDENT
IN VETERANS ANNOUNCEMENT
Room 450
Old Executive Office Building
1:22 P.M. EDT
May 28, 1996
“THE PRESIDENT: Mr. Vice President, thank you very much, for your very moving
remarks and your support of this endeavor. Secretary Brown, thank you for your
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service to our country in so many ways, and especially for your work at the Veterans
Administration, along with Deputy Secretary Hershel Gober and the others who are
here. Senator Robb, Congressman Evans, and to members of Congress who are not
here, including Senator Daschle who worked so hard on this issue; to the Vietnam
veterans who are here and all others who are concerned about this matter:
This is an important day for the United States to take further steps to ease the suffering
our nation unintentionally caused its own sons and daughters by exposing them to
Agent Orange in Vietnam. For over two decades Vietnam veterans made the case that
exposure to Agent Orange was injuring and killing them long before they left the field
of battle, even damaging their children.
For years, the government did not listen. With steps taken since 1993, and the
important step we are taking today, we are showing that America can listen and act.
I'm announcing that Vietnam veterans with prostate cancer and the neurological
disorder, peripheral neuropathy, are entitled to disability payments based
upon their exposure to Agent Orange. Our administration will also propose
legislation to meet the needs of veterans' children afflicted with the birth defect, spina
bifida -- the first time the offspring of American soldiers will receive benefits for
combat-related health problems.
From the outset, we have pressed hard for answers about the effects of Agent Orange
and other chemicals used to kill vegetation during the war in Vietnam. Once we had
those answers, we've looked for practical ways to ease the pain of Americans who have
already sacrifice so much for their country.”
Congresspersons/Senators/Government decision makers this was a nice way to buy
votes. It was on the other hand a bunch of Presidential Lies” to our Nations Veterans
while congress stood by for the accolades.
President Clinton made a big deal out of it and by the time Veterans Affairs finished
with its less than truthful constraints not a single Veteran would ever qualify for any
service association to what the President described as a “neurological disorder.”
Of course, this was all orchestrated. WHY? Because the neurological disorder is
associated to immune system damages and those in the White House and Veterans
Affairs wanted to stay away from anything that might indicate an association to
damaging the immune system even though “it is just as likely as not” that the cancers
are being created by a damaged immune system. (See Evidence Section)
The United States Government and its federal agencies not only had White House
direction but also had and continue to have a budget driven motive for collaboration
and collusion.
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While the Veterans have had three different committees formed that act as judge and
executioner during our 40-year legacy. It seems our past congress has been “less than
forthcoming” in allowing those Veterans and their families to know exactly “how
they are being judged,” to “what level they are being judged,” and what
“oversight Congress is providing” to make sure their purported and publicly stated
wishes are carried out by the various Presidents and politically appointed Secretary of
the Department of Veterans Affairs. Furthermore, any associated government
collaborations in reports and studies as well as direct White House interference in such
studies and activities directed against our nations Veterans and their families as in
House Report HR-101-672 are then dealt with.
On March 15 of 2000, the most important government meeting for Vietnam Veterans
and their families since conclusion of the war was over was held. This was a
“government oversight meeting” to discuss the status of the Air Force’s ongoing “dioxin
research only,” called the “Ranch Hand Study.”
In reviewing the official transcripts of that oversight meeting of Ranch Hand it was
obvious Veterans Affairs, NAS-IOM, and Ranch Hand were NOT GOING TO
ANSWER SPECIFIC QUESTIONS by the Congressional membership that bothered to
show up. (33)
As with all of our government funded studies, they have been “reduced” or
“constrained” to only study the one component of Agent Orange and that being dioxin.
Totally disregarding the other two militarized herbicides of Agents White and Blue,
much less the other 15 commercial named herbicides that were used.
When Ranch Hand scientists actually brought this lack of comprehensive evaluations
subject up in the transcripts, the answer was, “That just leaves opportunities for
future studies.” Veterans are seeking government help and the medical answers to
avoid becoming disabled or taking a dirt nap; the study is looking for “future
employment opportunities.”
This flawed study totally disregarded evidence from other studies, prevented
compensation because illnesses which should be recognized and thereby “service
connected” are not recognized. Furthermore, Veterans are often not given adequate
medical treatment for these illnesses in the Veterans Affairs health system.
This meeting was held as a “government oversight review” of this Air Force study that
determines not only our Vietnam Veterans fate but also the fate of many other Veterans
by using controlled and manipulated government findings. Not only for compensations
but also for medical treatment by our nations doctors and being classified as “Service
Connected,” which is also tied to many “state benefits for Disabled Veterans.”
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Out of 62 members of the “Subcommittee on National Security, Veterans Affairs, and
International Relations” and “The Committee of Government Reform,” only “Three
Congressmen” bothered showing up to challenge this study, and the DOD, and the VA,
and the NAS/IOM; as to why this study and the whole process of determining
compensations vehemently wanted no Congressional oversight!
When Congressman Christopher Shays asked the NAS representative, Dr. David
Butler, Senior Program Officer, Veterans and Agent Orange Reports, Institute of
Medicine, National Academy of Sciences also under oath:
“Is there any scientific level that we could turn to, short of 99 percent, which
would give us some way to come to a conclusion here?”
The leader for the IOM that made the recommendations for mortality and morbidity
associations and compensations for our Nations Toxic Chemical Exposed Veterans then
comes back and said:
“The policy decisions are very clearly outside of the mandate for the
committees, and the committees have never offered an opinion on the policy
decisions, which are made on the basis of that.”
Then Congressman Shays asks, “Are you refusing to give your opinion?
Dr. Butler then said it is Veterans Affairs job to do that as far as policy as to
level of certainty.
The VA leader that was there, Dr. Susan Mather, Chief Public Health and
Environmental Hazards Officer, Department of Veterans Affairs simply stated
Congress had given the “sole power” to the Secretary of the VA and that they
had accepted all that the IOM had recommended.
The bottom line in this political spin – was ----- no one would say at what level
the associations to the toxic chemicals was actually being held and no one
pointed out that only the dioxin; TCDD was being considered by Veterans Affairs and
Ranch Hand in a plethora of toxic chemicals used on Vietnams Veterans.
The above statements are not very comforting to Veterans or their widows, to say the
least.
One of the Special Study leaders then admitted they were still indeed looking for
“cause and effect” and “he thought Congress” had wanted the Veterans to have
some other form of “benefit of the doubt” other than “cause and effect” but
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he was not real clear on what that was and where that fit into the scheme of
things as to recommendations for compensations.
(Chan, Kwai-Cheung, Director, Special Studies and Evaluations, National Security and
International Affairs Division)
Mr. Chan stated: “I would like to raise an issue, which I always felt all along, in doing
this study and the work that we've done in gulf war illnesses, is that to me there's a
fundamental problem between the gathering of the scientific evidence and research in
general, versus policymakers in terms of their intent.
On one hand in science, we really want to understand if there's a relationship, an
association, or correlation. If we find there's a correlation, we then want to make sure
that there is a statistically significant relationship. Once we have that, we want to
make sure there's a linear dose response. THAT MEANS THE MORE STUFF
YOU HAVE THE WORSE YOU GET, IN TERMS OF YOUR PHYSICAL WELLBEING. MOREOVER, ULTIMATELY, WE WANT TO ESTABLISH CAUSE-
AND-EFFECT.
Now what we do here, is keep on raising the bar to achieve that end goal and it's a very,
VERY IMPORTANT PART OF SCIENCE TO PURSUE IN RESEARCH.
Over time the science wants to establish SORT OF A BEYOND A REASONABLE
DOUBT, we are doing the right thing.
On the other hand, I think, Congress, through various legislation including Public Law
102-4, BASICALLY SUGGESTS THAT WE WANTED TO GIVE THE BENEFIT OF
THE DOUBT TO THE VETERANS. THAT IS, IF THEY ARE SICK, BUT WE
CAN'T CLEARLY ESTABLISH CAUSE AND----...”
Congressman Shays asked: We just do not want to wait until they die before we
help them.
{Congressman Shays is very wrong. Everything the DoD/VA/NAS-IOM to
include White House after White House has done is exactly what
Congressman Shays said they did not want to happen.}
Mr. Chan stated: - “I understand.
But my point is that the science doesn't quite support that approach. Giving them "the
benefit of the doubt" means that the risk for the people exposed is higher for than the
normal population. Therefore, the risk means that the percentage of people who are
exposed sick, versus those who were not exposed but sick of the same illness, is greater
than one.
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Science doesn't work that way. It emphasizes in a statistical significance of I want to
make sure that 19 out of 20 times, I'm correct in this decision. So as a result then what
happens is that scientific information that”
Congressman Shays stated: “I would feel more comfortable though, Mr. Chan, if this
scientific research was being done by a party that was not a major player, and I
would have a greater comfort level. And I believe that, as a policymaker, I have the
right to determine that even there's not a shadow of a doubt, there's every
indication that, I'm happy to move forward and commit dollars to helping
people. I JUST THINK YOU GIVE THE BENEFIT OF THE DOUBT.”
{Congressman Shays is wrong. A "policymaker" when it comes to Veterans Issues has
no more power than the Veterans or the Widows of those Veterans to redress any kind
of Justice for Executive Branch caused morbidity and mortality.}
Dr. Linda Schwartz associate research scientist, Yale University
Dr. Schwartz stated: - “If we looked at that as a way in which we could use the data,
which has already been collected, then I say yes, the study should be continued.
But for us to continue to hang our hat on the fact that this is the "ABSOLUTE
GOLD STANDARD" OF WHAT IS HAPPENING TO THE HEALTH OF
VETERANS WHO SERVED IN VIETNAM, NO.”
Congressman Shays stated: - “DO YOU THINK IT BEING HELD UP AS THE
GOLD STANDARD?”
Dr. Schwartz stated: “Yes, it is. I think that when the National Academy of Science
reviews, even though they do mention in their reports some of the things about Ranch
Hand's protocol and study design, that if it's not statistically significant, RANCH HAND
DOES NOT PUBLISH IT. THEREFORE, WE ARE NOT GETTING ALL OF
THE INFORMATION.
If Ranch Hand is publishing, crafting their reports to fit into professional journals, then
we are not seeing the things that probably are greater than a 50 percent chance.
THEREFORE, WE ARE DENYING VETERANS, OR MAYBE WE ARE
DENYING VETERANS SOME COMPENSATION AND DISABILITY FOR
THE FACTS THAT WE HAVE NOT REALLY LOOKED AT ALL.”
The above statements and discussion are also not very comforting to Veterans or their
widows, to say the least and violates the court mandate and the facade of what congress
is saying will be compensated for government damages.
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Does anyone in our government have A STRAIGHT ANSWER ON THIS
SUBJECT FOR THE VETERANS DEAD, DYING, AND DISABLED?
THE CONCLUSION HAS TO BE NO!
The bottom line summary to the above scenario seems to be:
The Congressman asks the contracted entity NAS program manager at what level are
you looking for significance in determining associations for our Nations Veterans. The
contracted entity program manager then says it is not my job but the VA's job to
identify the level significance in determining association. Bearing in mind, the NAS and
now the NAS/IOM have at least four statements of significance they pronounce every
two years.
The normal logically person would say how can anyone or any scientific organization
identify what “is significant or not significant” to four levels or categories of
association. Levels of association that in fact are part of the process by default of the
legal claims of dead and dying Veterans. Yet, NAS's Mr. Butler would not or could not
even give an example of one of the categories and the equivalent level of association
required. Therefore, they are doing something; we are just not sure what or how to
measure what it is they are doing.
Then the VA's Dr. Susan Mather jumps in trying to get NAS's Mr. Butler off the
“Congressional hot seat” of even being committal to anything much other than
his name. Dr. Mather then says the VA has accepted all that NAS/IOM had
recommended.
Again the normal, logically person would conclude how could one say they either do not
know or refuse to give the levels of research they are contracted to do. Then the other
part of, by default, denying the Veterans legal claim, the VA says: whatever
it is, they are doing to whatever level; we have accepted all of it, whatever it
is!
Discussed in the "Conclusions Section" - Reviewing the above on what must be
considered not only medical associations fraud but also by default legal decisions made
against the Veterans Community by the DoD/Veterans Affairs/NAS-IOM/White House
in concert without Veterans having any day in court.
More charges of deceit brought forward in the Ranch Hand Study during
the oversight review:
Congressman Shays asked: “At what level do you think Government should consider
compensation? Should we have a no shadow of a doubt? The reason why I am asking
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the question is I have concluded, based on our work that we have done on gulf war
illnesses, based on our review of Agent Orange, that I have to be honest with our
veterans. By the time we will know the scientific data, you are dead. You will either
have died early or you will have died in your old age in pain, but you will
not get help from the Federal Government.”
Congressman Shays stated: “We just do not want to wait until they die before
we help them.”
Yet, it seems for 40 years that is exactly what our government has been doing!
WAITING FOR THE VIETNAM CAMPAIGNING ARMY TO DIE.
Congressional charges were made that the study was slow to publish findings and that
many suggested that the DOD/Veterans Affairs/Ranch Hand collaboration were less
than forthcoming in the truth regarding many found toxic chemical medical issues with
regard to severity and volume. In one period for over three years, the Ranch Hand did
not even meet while Vietnam Veterans died or became disabled with no government
help. The excuse was no funding by the Congress was available.
One of the scientific advisors to the Veterans Affairs, as well as former and present
members of this scientific study made additional charges under oath concerning the
flaws of the Ranch Hand Study. The areas of most “serious concern” were:

The use of command influence.

Protocol violations and the changing of established protocols and these were
considered quite serious.

The changing of the concluding medical statements after they had been
cleared for publication.

Scientists did not consider themselves intellectually free.

Scientific fraud was being committed.

The study was crafting for publication only.

The study was being used as world gold standard, which is incorrect.

If integrity in this study could not be improved then it was suggested that
this study as well as any future studies be done by an “independent
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organization” NOT CONTROLLED BY AN ENTITY OF OUR OWN
GOVERNMENT.

When discussing birth defects on the paternal side, one of the principal
Ranch Hand scientists concluded the published findings of this study
were a real tragedy.

A principal Ranch Hand scientist also concluded that for twenty years the
Ranch Hand study had not given the Vietnam Veterans a fair assessment of their
health status in many different medical areas. These medical areas were in
cancers, birth defects, heart disease, vascular disease, neurological
ailments, endocrine disturbances, and hematological difficulties.

Cohort selection was questionable. Six years later, we now have more
corroboration by two more Ranch Hand scientist including the lead DoD
scientist who has come forward - the cohort dioxin exposure assumptions
were wrong thereby skewing all statistical analysis in evaluations.

Several scientists and Congressmen indicated that they wanted to see other data
that had not been associated with the DVA. (With this submittal, Veterans
are giving you this chance!)
After reviewing this Congressional transcript and over 600 pages of Ranch Hand
meeting transcripts (not the published reports), as a former components engineer
and working in the failure analysis field; I can certainly understand why this
study and the DVA processes used to correlate compensations wanted no
Congressional oversight.
Also found in Congressional Transcripts were: (33)

Charges of this study being done only to exonerate our own government.

Charges of whole chapters being rewritten to de-emphasize the medical
findings. (This was particularly directed at immune system damages
and immune system dysfunctions.)

Many medical issues found and then not brought forward.

When one scientist suggested he and the others did not want to review the drafts
until the Air Force made all their changes from the scientific draft, the leader
then stated, we do not want to say, ‘changed.’ The scientists then stated
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OK, how about ‘air brushed?’ At this point laughter broke out in the
meeting room.
Senators, Congresspersons, Government decision makers, and Congressional Staff
Members I can “assure you that no Vietnam Veteran or Veterans’ widow is
laughing at this “despicable study behavior.” We are disabled and dying
and this is no laughing matter except it seems to be to those that have
perpetrated scientific fraud against the Vietnam Veterans.
The most egregious issue I found was the discovery of increased GGT liver enzyme
issues and then the suggestion was made that they inform the cohorts to tell their
personal doctors of these issues and let them handle it. Never mind the 3.2 million
of us that also do exist or at least did exist. {Our numbers are down now to
about 1.4 million thanks to the United States Government and its created
information void.}
A huge misconception about the Ranch Hand Study is the studying of Agent Orange
Herbicides. This is in correct. This study had been government reduced to linear dose
responses found to the contaminate dioxin (TCDD) only. Even when a dose response is
found and no overt disease or disorder is detected “at that moment in medical
time,” these findings are discounted and not brought forward into the light of the
medical community. What was not taken into consideration is the longer-term systemic
damages found in dioxin only.
An honest assessment would be - they did find a dose response to certain
medical abnormalities, inform the nations’ doctors of such findings, and let
the doctors of our nation decide if it is culpable in the Veterans medical
manifestations. When no mandated dioxin dose response is found, even if a
50% or more increase is found in one medical issue, it also is not brought
forward.
This study was not a fair assessment since there were at least four other
very toxic chemicals involved.
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Summary
FOR FORTY YEARS THERE HAS BEEN A GOVERNMENT HISTORY OF
DECEIT:
Despite Congressional intent to give the Veteran the benefit of the doubt, and in direct
opposition to the stated purpose of the Dioxin Standards Act to provide disability
compensation to Vietnam Veterans suffering with cancer who were exposed to Agent
Orange, Veterans Affairs continues to deny compensation improperly to tens maybe
even hundreds of thousands of veterans with just such claims.
Department of Defense scientists Dr. Joel Michalek: “The comparison veterans are
similar to average Vietnam Veterans, from nurses to truck drivers, who spent most
of their time in base camps. The comparisons' data also should be studied further.
The results could matter greatly to thousands of Vietnam War veterans who've
never received compensation for debilitating illnesses that earlier Ranch Hand
study findings said couldn't be linked to Agent Orange.”
In fact, in promulgating the rules specified by Dioxin Standards Act, the Veterans
Affairs not only confounded the intent of the Congress, but also directly contradicted its
own established practice of granting compensable service-connection status for diseases
on the lesser showing of a statistical association, promulgating instead the more
stringent requirement that compensation depends on establishing a “cause and effect
relationship.”
{ See Nehmer v. U.S. Veterans Admin., 712 F. Supp. 1404, 1408. (N.D. Cal. (1989).
wherein the court found after reviewing the legislative history of the Act "that Congress
intended service connection to be granted on the basis of "increased risk of incidence"
or a "significant correlation" between dioxin and various diseases," rather than on the
basis of a casual relationship.}
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The significance of the distinction between a statistical association and a cause and
effect relationship is in the burden of proof that the Veteran must satisfy in order to be
granted benefits. A statistical association “means that the observed coincidence in
variations between exposure to the toxic substance and the adverse health effects is
unlikely to be a chance occurrence or happenstance,” whereas the cause and effect
relationship “describes a much stronger relationship between exposure to a particular
toxic substance and the development of a particular disease than ‘statistically
significant association’ does.” Nehmer, 712 F.Supp. at 1416. Thus, the regulation
promulgated by Veterans Affairs established an overly burdensome standard by
incorporating the causal relationship test within the text of the regulation itself. 38
C.F.R. 1 3.311(d) ("(s] ound scientific and medical evidence does not establish a
CAUSE AND EFFECT RELATIONSHIP between dioxin exposure" and any
diseases except some cases of chloracne.) As a result, the court invalidated Veterans
Affairs Dioxin regulation, which denied service connection for all diseases other than
chloracne; ordered the VA to amend its rules; and further ordered that the Advisory
Committee reassess its recommendations in light of the court’s order.
Thus, on October 2, 1989, the VA amended 38 C.F.R. Part 1, which among other things
set forth various factors for the Secretary and the Advisory Committee to consider in
determining whether it is “AT LEAST AS LIKELY AS NOT” that a scientific study
shows a “significant statistical association” between a particular exposure to
herbicides containing dioxin and a specific adverse health effect.
38 C.F.R. Part 1
C.F.R. § 1.17 (d) and determine in his own judgment that the scientific and medical
evidence supports the existence of a “significant statistical association” between a
particular exposure and a specific disease. 38 C.F.R. § 1.17 (f).
(e) For purposes of assessing the relative weights of valid positive and negative
studies, other studies affecting epidemiological assessments including case series,
correlational studies and studies with insufficient statistical power as well as key
mechanistic and animal studies which are found to have particular relevance to an
effect on human organ systems may also be considered.
(f) Notwithstanding the provisions of paragraph (d) of this section, a "significant
statistical association" may be deemed to exist between a particular exposure and a
specific disease if, in the Secretary’s judgment, scientific and medical evidence
supports such a decision.
As late as the year 2000 in the Congressional Oversight of Ranch Hand review
discussed above, anyone can see that the DoD/Veterans Affairs/NAS-
IOM/White House is still not doing what Congress intended.
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The Veterans’ data submitted within this Challenge certainly concludes in
accordance with d., e., and f., above - Peripheral Neuropathy should be
approved as a stand-alone disabling disorder associated to toxic chemical
exposures of the dioxin, TCDD or other toxic chemicals used in Vietnam by
the Government.
A review of the above Ranch Hand discussion that directly defies what
Congress, at least on face value, had indicated they wanted for the Nations
Vietnam Veterans in this Toxic Chemical Legacy is hereby submitted.
Mr. Chan, the Director Special Studies and Evaluations, National Security and
International Affairs Division, in his discussion clearly indicated that instead of
‘increased risk of incidence’ or a ‘significant correlation’ as the court ruled and the
Congress’ intent is or was, a taxpayer paid-for scientific project has been on going to
not only identify ‘cause and effect,’ only to the dioxin, TCDD, and that in order of
precedence this science project is looking for correlation >statistically significant
relationship > linear dose response. (14)
Mr. Chan in his discussion is outside the rule of the courts, the congress, and Veterans
Affairs regulations themselves as a "significant correlation" or "increased risk of
incidence." Veterans are not supposed to need both as the legal description of proof for
compensation and service connection is OR not AND! Vietnam Veterans or their
Widows in many disorders have met both levels identified in many studies of the dioxin,
TCDD.
Mr. Chan is way outside the realm of science when he states the ultimate goal of a linear
response is the ultimate goal of studies. Dioxins and dioxin like furans the Veterans
were exposed to are not antigenic poisons that can be verified by a linear response.
Studies have shown, that surprised the study scientists themselves, in exposure levels
there is no direct correlation to what dioxins or dioxin-like furans will produce in any
individual. There is also no proof that in this non-antigenic toxic chemical that a linear
dose response even exists in any one disorder.
Nothing has been correlated to the severity of outcomes of ingestions related to severity
to any disorder in relationship to body mass or even liver mass. Therefore, this is
nothing but "compensations stalling" on the part of the White House Controlled
federal government entity, waiting for the campaigning Army to die.
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EPA has conducted studies that should have killed the animal immediately and yet it
did not. Before the animal eventually died it went through "different disorders" to
including wasting and eventually death.
In direct violation of the Congressional mandate of Benefit of the Doubt as well as
Veteran Affairs own regulations, Mr. Chan indicated he and his organization wanted
very little doubt. He then suggests that through legislation, Congress had wanted
something else but he was not very sure what that something else was in totality.
{If the Government's director of Special Studies does not understand the job and the
application of that job then he should have asked questions!}
Dr. Linda Schwartz associate research scientist, Yale University...
Dr. Schwartz conclusions in a summary of her statements: (14)
To continue to use the Ranch Hand study as a Government Gold Standard as it is
presently being used is NOT ACCEPTABLE. It is not representative of what is
happening to the health of those Veterans who served in Vietnam.
The study seems to be crafting for publication. If it is not statistically significant, Ranch
Hand does not publish it. Therefore, the NAS and we are not getting all of the information.
We are denying veterans, or maybe we are denying veterans some compensation and disability
for the facts that we have NOT REALLY LOOKED AT ALL.
Additional note: Dr. Schwartz was closer to the real facts of this study than she knew
or let on with new admittance of the flaws in Ranch Hand cohort assumption and what
Veterans have suggested all along. Not only was the basic premise of the study flawed
and way to stringent with White House interference but now, we find that the cohorts
selection and assumptions were tragically flawed for many dead and dying
Vietnam Veterans. (See Media 1 -3 Releases at end of challenge)
Recently the same Dr. Michalek and Dr. Ralph Trewyn (both served on the Ranch
Hand Committee) came forward in the media and clearly stated that Ranch Hand
assumptions were flawed. “However, hundreds in the comparison group spent time in
Vietnam and may have been exposed to herbicides, too, said Joel Michalek, who worked
on the study from the beginning and was its principal investigator for 14 years. “It
spoils everything," Michalek told The News. "It's as if you're running a clinical trial on
a new medication, and you found out some of the people who were in your placebo
group were actually taking meds. That would spoil your whole study. And that's
what's going on here in this study.” “They referenced those papers, but they left all the
data out from those cancer papers that were done that showed the cancer effects, he
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said. It's huge; because then the conclusion is there's no cancer effect, when as part of
the study, the same investigators, just analyzing the data in a different way, found that
when they did that, lo and behold, then there were significant cancer effects. “And
so for the final report to say there's no cancer effect when the investigators themselves
published papers saying there is a cancer effect, that's just flat scientifically wrong.
“Without factoring in the new information about the comparison veterans, Trewyn
said, the Air Force got the same, predictable results.”
“When they use an exposed control group and they say the two groups have roughly
the same amount of cancer and so forth, what is that finding good for? Nothing," said
Trewyn, vice provost for research and Dean of the graduate school at Kansas State
University. “And it doesn't take a scientist to figure that out, he said. “This is
common sense now, a lot of it," he said. "It's like now wait a minute. This just does
not pass the smell test or the common sense test."
Included in the media release, Dr. Trewyn stated not just specific cancer increases
were misreported BUT ALL CANCER SITES. This has been found in other
studies that clearly identified there were little differences in specific cancer sites and all
cancer sites associated to dioxin exposures, including low-level exposures.
THE GOVERNMENT'S GOLD STANDARD USED AGAINST VIETNAM
VETERANS IS FRAUDULENT!
In the above discussion of total fraud our widows and we Vietnam Veterans have
found:
1. The government director of studies is outside the scientific evidence level for
Peripheral Neuropathy (and other disorders) and seems confused on what it is the
Congress wants. He is outside the realm of what science can even do or the definition of
the toxic chemical dioxin, TCDD and its in body actions and effects. (14)
2. The gold standard used in compensations and associations of disorders by Veterans
Affairs and NAS/IOM is flawed. Data used to deny our initial Veterans Affairs
legal claims as well as BVA claims is fraudulent. (14)
3. The NAS program director seems to only want to commit to his name denying he
has any idea of what the level of association is required by government
contract and not only for the top level of associations but all four levels and their
actual levels of associations. He then states that it is Veterans Affairs job of
interpretation of association. This agency is under contract to do SOMETHING, yet
the program manager cannot tell what that SOMETHING IS or how it is in
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compliance with what should be "a very specific" Veterans Affairs contract since the
NAS clearly indicated it was Veterans Affairs job to determine association
requirements “for whatever it is” they are contracted to do.
This lack of commitment and knowledge by default are our judge and jury in
"Veterans Legal Actions.” The results are used in a legal forum of the individual
Veterans Affairs offices as well as the BVA weighted evidence. Particularly since the
BVA uses actual statements of findings by the NAS/IOM in denying the Veteran
disability or the widow's DIC. Vietnam Veterans and their widows would
expect a detailed explanation of how NAS/IOM is meeting whatever the VA
requirements are and specific to the levels of association.
This explanation should have all the necessary requirements for an honest assessment.
4. Veterans Affairs states that whatever NAS/IOM has submitted as associated to the
four levels or degrees of evidence it has accepted in total. NAS/IOM, then under oath,
will not tell the Congress what levels it is looking for and how it arrives/determines the
levels by what they are doing under contract and the processes, other than restating the
categories of levels by description. Veterans Affairs it has accepted all of what
NAS/IOM has done HOWEVER it arrived at the conclusions used against the
Vietnam Veteran in the Veterans Affairs court of law. Veterans Affairs has no audit
system to make sure the agreement with NAS/IOM’s, own statements should have the
levels required in some measurable form and not just NAS/IOM subjectivity since their
input of levels determines court rulings as well as decisions made by Secretary
of Veterans Affairs.
5. Dr. Schwartz indicates that many of the found issues in the Ranch Hand Study at
50% or larger are not making it in to the reports and/or oral presentations by the
Ranch Hand that NAS/IOM uses to determine VA legal actions against the Vietnam
Veterans and their Widows. (14)
Not all of these facts add up to what the Marquee on the Supreme Court
building states as “Justice for All.” What we have is an Executive Branch that
manipulates its own legal system empowered by our legislative branch. This totally
violates the separation of powers demanded by our constitution.
Our government's response to the statements that the entire Ranch Hand study was
used as a GOLD STANDARD for over 25 years at the cost of millions of dollars has
been a spoiled study manipulated by multiple presidential administrations and now
even the scientists conclude it was fraudulent in its assumptions has been less than
forthcoming. This flawed study by default has been used as legal actions against
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Vietnam Veterans and their widows for decades by Veterans Affairs as well as
The Board of Veterans Appeals.
Vietnam Veterans and many in the scientific community have stated since day one this
sponsored Ranch Hand study has always been an exoneration tool only and has never
been a study for Agent Orange by the use of changing exposure indexes. As Admiral
Elmo Zumwalt exclaimed in 1989 Ranch Hand might as well been a study of eating too
many beer nuts at the Officers and NCO clubs.
When the controlling Air Force government entity stated they are not going to include
the new data in the published reports and then told the scientists to destroy the
data, as if none of this ever happened.
What has been the response from our elected officials? NOT ONE WORD and NO
ACTIONS TAKEN TO STEM THE TIDE OF WHITE HOUSE/VETERANS
AFFAIRS MANIPULATION AGAINST VETERANS AND WIDOWS.
"The Air Force has no plans to publish the new cancer findings in any Air
Force report or scientific journal, Col. Karen Fox told the civilian advisory
committee during a meeting in Maryland in response to spirited and sustained
questioning during the panel's final meeting.
Fox said the Air Force instructed the scientist who conducted the analysis to
destroy the data.
Michael Stoto, committee chairmen and a professor at Georgetown University,
said the new analysis included "some interesting and potentially important
findings" about the health of airmen involved in herbicide spraying missions
during the Vietnam War. "
What is our elected officials response in the House and Senate and from the President?
TOTAL SILENCE!
Vietnam Veterans have come to expect the President’s silence over the decades because
of protecting White House mistakes and of its uncovered philosophy of "not supporting
our Nations' Vietnam Veterans.” Until recently, Vietnam Veterans did not understand
the lack of support by those we elected. By all historical accounts created in our form
of government to protect those that White House Philosophy has chosen to commit
fraudulent activities and a form of tyranny over those constituents.
In the civilian world of REAL JUSTICE, this kind of fraudulent activity would have
been met with prison time for those that perpetrated the fraudulent medical activity
that has continued to allow mortality and morbidity by their own lack of integrity and
purpose.
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Vietnam Veterans also note that the Secretaries of Veterans Affairs have been
reluctant to use their legal power defined in C.F.R. § 1.17 (d) to associate these
many disorders that other studies have proven not only "increased risk of
incidence" but also significant p-values of difference to those exposed and
those not exposed in similar cohort military occupational specialties
(MOS). Instead, they default to White House directed policy not to compensate for
morbidity or mortality that "IS AT LEAST AS LIKELY AS NOT” PROVEN
many times over, including this crippling disorder of peripheral nerve
damage as a stand-alone disease with its associated disorders.
The following are comments and statements made by Admiral Elmo Zumwalt (now
deceased) in 1989 as special pro bono assistant to the Secretary of the Veterans
Administration:
Hearings before the Human Resources and Intergovernmental Relations
Subcommittee on July 11, 1989 revealed the design, implementation, and
conclusions of the CDC study were so ill-conceived as to suggest that political
pressures once again interfered with the kind of professional, unbiased review
Congress had sought to obtain.
As early as 1986, the Subcommittee on Oversight and Investigations of the
Committee on Energy and Commerce documented how untutored officials of the
Office of Management and Budget (OMB) interfered with and second-guessed
the professional judgments of agency scientists and multidisciplinary
panels of outside peer review experts effectively to alter or forestall CDC
research on the effects of Agent Orange, primarily on the grounds that
"enough" dioxin research had already been done. (34)
Dr. Philip Landrigan, the former Director of the Environmental Hazards branch at
the CDC, upon discovering the various irregularities in CDC procedures concluded
that the errors were so egregious as to warrant an independent
investigation not only of the methodology employed by the CDC in its
validation study, but also a specific inquiry into what actually transpired
at the Center for Environmental Health of the CDC. (35)
These Agent Orange Hearings revealed additional examples of political
interference in the CDC's Agent Orange projects by members of the White House
Agent Orange Working Group. (36)
Political interference in government-sponsored studies associated with Agent
Orange has been the norm, not the exception. In fact, there appears to have been a
systematic effort to suppress critical data or alter results to meet preconceived
notions of what alleged scientific studies were meant to find. (37)
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On March 9, 1990 Senator Daschle disclosed compelling evidence of additional
political interference in the Air Force Ranch Hand study, a separate government
sponsored study meant to examine the correlation between exposure to Agent
Orange and harmful health effects among Air Force veterans who participated in
Agent Orange spraying.
Senator Daschle questioned Air Force scientists on why discrepancies existed
between an Air Force draft of the Ranch Hand Study and the final report actually
released to the press; the answers suggested not merely disagreements in data
evaluation, but the perpetration of fraudulent government
conclusions.
CONCLUSIONS
Recipients of this Challenge must recognize that Vietnam Veterans and their widows
for over 40 years have been dealt death blow after death blow by our own government
in withholding and manipulating medical evidence and findings. Ten’s of thousands or
more disabled Veterans have not been supported because of government interference
and manipulation of medical findings that have causes their disabilities.
The Vietnam Veterans state with the evidence submitted that by all definitions as
defined by Veterans Affairs regulations and what Congress intended hereby have been
proven:

Peripheral Neuropathies are a direct result of their toxic chemical legacy in their
wartime service to this nation by having served in Vietnam. The dioxin, TCDD
has been statistically found associated and that the p-values found in those
exposed versus those not exposed exceeds the scientific statistical
value requirement for automatic associations by the United States Government.
(See Evidence Section)

The Government's own Gold Standard that we now know was statistically
flawed in bias against the Vietnam Veteran concluded in many transcripts,
found associations to Peripheral Neuropathy as far back as 1984. (See Evidence
section and also statement by Dr. Michalek "... we consistently found a
statistically significant increased risk of all indices of peripheral
neuropathy among Ranch Hand veterans. .... )
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If Senators, Congresspersons, Government decision makers, and Congressional Staff
Members with the above evidence submitted do not find that the crippling disorder of
Peripheral Neourpathy is not automatically associated to the exposures in Vietnam as a
catalyst for degenerating life long conditions; then the United States Vietnam Veterans
and their spouses, widow, and/or orphans demand an accountability as to why the
data we have submitted in this challenge and many times before to the
Veterans Affairs does not meet the established requirements and the
portrayed intent of Congressional requirements regarding this crippling nerve
disorder and the other disabling associated medical issues.
Other issues that Vietnam Veterans and/or their widows can prove “it is at least as
likely as not associated” to wartime service in a toxic chemical environment:
Non-Hodgkin’s lymphoma, chloracne and other skin disorders, lip cancer, bone cancer,
soft tissue sarcoma, birth defects (physical and mental), skin cancer, porphyria cutanea
tarda family of disorders and other liver disorders (such as biliary disorders),
Hodgkin’s disease, hematopoietic diseases, multiple myeloma, neurological defects
{such as neuropathy (any form}, and cognitive disorders and deficits), autoimmune
diseases and disorders (defined and undefined medical codes), leukemia (both CLL and
AML), lung cancer and forms of obstructive airway diseases, kidney cancer, malignant
melanoma, pancreatic cancer, stomach cancer, colon cancer,
nasal/pharyngeal/esophageal cancers, prostate cancer, testicular cancer, liver cancer,
brain cancer, neuropsychological effects, gastrointestinal diseases, amyloidosis
(primary, secondary, or toxic chemical tertiary), macroglobulinemia (in any form),
forms of osteoporoses and/or bone loss, bone tumors and cancer, avascular necrosis,
spondylosis, radiculopathy (including herniation of the nucleolus pulposus), brain
atrophy, brain infarction, ischemic heart disease, hypertension, vasculopathy, vascular
diseases, valvular heart disease, MS, ALS, and Parkinson’s.
Many of these disorders in common causation can be found associated to the systemic
damages in the body processes instead of what the United States Government/Veteran
Affairs/NAS-IOM has done in order to stall and forgo the cumulative multiple
disorders. Instead, it takes each individual diagnostics code and tries to ferret out what
linear dose caused a specific medical disorder instead of a syndrome or the associated
disorder caused by e.g. vasculitis. As in cancers, not everyone is going to develop the
same form of cancer or even severity or time for manifestation. For example, vasculitis
may produce a variety of ICD codes and not all vasculopathy victims will have the exact
same damage. To add insult to the Vietnam Veterans and their Widows insult to
morbidity>mortality they have been using government corrupted, and flawed scientific
conclusions and statistics.
Dr. Trewyn, a 25-year cancer research expert stated regarding the Ranch Hand Study
new findings in cancers.
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"Some people are going to be susceptible to one type of cancer versus another.”
Having done research on cancer, it doesn't surprise me at all that you find
this at a whole host of different sites."
The sum total of this Challenge with the data submitted, the identified
interference by the government, the lack of any legitimate identified scientific
rational process used in legal denials (judicial branch activity) by the
scientists at Veterans Affairs and the NAS/IOM, the pointed out flaws in the
Gold Standard used, is:
That it is "MORE THAN JUST AS LIKELY AS NOT." The Vietnam
Veterans DEBILITATING CHRONIC PERIPHERAL NEUROPATHY AND
ASSOCIATED WERE caused by toxic chemical exposures during WARTIME
SERVICE TO THIS NATION AND SHOULD BE AN "INCLUSIVE
DISORDER" TO WARTIME SERVICE REGARDLESS IF THE VETERAN
HAS DIABETES OR NOT!
Are the Nation's Veterans now the government's enemy for telling
"The Truth" about how we are treated by “elected and appointed”
government representatives?
As Doctor Ronald Trewyn, wounded Vietnam Veteran of III Corps and Dean of the
Graduate School and Vice Provost of Research for Kansas State University, and, a
member of the Agent Orange Ranch Hand Advisory Committee stated in the
congressional 2000 Government Oversight review: (14)
“…this is more than a Veterans Affairs issue. It is, in fact, a “national
security issue.” Because if the country continues to treat their veterans
poorly and, in some cases, abominably as has been the case with the
veterans suffering from adverse health outcomes from Vietnam, from the
Persian Gulf, we're not going to meet the recruitment and retention needs
in this new era of needing highly educated, highly technically proficient
people. They aren't going to stay in because why should they, when they
know what's going to happen going out the other end?”
It is obvious our national media has abandoned Vietnam Veterans dead, dying, and
disabled since about year one in the Vietnam War. Whether this lack of support is due,
in part to White House Pressure is unknown. There have been some examples of
Presidential manipulation found regarding this subject. It is obvious with available
data that White House after White House has abandoned an entire ten-year
wartime campaigning Army.
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Sadly with our government caused toxic chemical deaths and wounds it
now seems that our own Congress and any form of our Constitutional
Judicial System has all but abandoned this government’s created dead and
dying assets, its own Veterans.
RECOMMENDATIONS
It is imperative for those Vietnam Veterans that are left alive and those widows and
soon to be widows that the both the Senate and House Veterans Affairs Committees
look very closely, at what has gone on against the Nations Vietnam Veterans for over
four decades now and is still continuing to this day.
In that…The United States Government, The Department of Veterans Affairs, The
VACEH, and the NAS/IOM having demonstrated a disturbing bias in their review to
date of the scientific literature related to Agent Orange and the Dioxin, TCDD and
other toxic chemicals involved either separately or in synergy that is concluded by the
Nation’s Vietnam Veterans that 1. The House and Senate working committees call for the Department for The Veterans
Affairs explanation that with this challenge and the scientific, statistical, medical, and
study evidence presented can still lead to a denial of such increased risk of incidence
and significant correlation demonstrated in the Veterans Challenge.
2. The House and Senate working committees call for the National Academy of Science
Institute of Medicine Affairs membership explanation that with this challenge and the
scientific, statistical, medical, and study evidence presented can still lead to a denial of
such increased risk of incidence and significant correlation demonstrated in the
Veterans Challenge.
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This Veterans matter requires prompt attention and is of grave emergency by those
individuals and Committees listed. No different than congress did on a weekend and
holiday and even the President of the United States flew back early from Texas in case
legislative-judicial support for the individual Teri Shavo.
It is also put forth that this activity does not require the usual common mode of the
Department of Veterans Affairs of “Let’s do another study of such duration” as to
allow more and more Veterans to die off at the “Direction of our own White House
since when they die their claim dies with them; or suffer the indignities of disability
with no support from government caused disability.
These government agencies have to have some level of data that was not purely
subjective and they used that data whatever it was against the United States Veteran. It
should not take years for those agencies to find the data they used in denial that is
scientific, an/or medical, and/or statistical. If they cannot find that data in a few weeks
then congress must conclude it was a mockery and charade to begin with; and only
subjective to political issues from the White House direction or the Department of the
Veterans Affairs singular initiatives to deny the Veterans.
This must be a congressional action alone, as the Veterans of this Nation no longer trust
the White House and its political pawn the Department of Veterans Affairs and its’
Executive Branch appointed Secretary.
As a self-educated dioxin “lay expert” with a background in failure analysis and as Dr.
Trewyn (two time member of the Ranch Hand Committee) stated, “this is all pretty
much common sense now.”
Congress does not have to be the scientific PhD making compensation decisions and
compensation laws – just the use of some common sense will suffice.
Charles W. Kelley - and all Vietnam Veterans medically
afflicted with Government caused neurological damages
DMZ Vietnam 67-68
The Toxic Chemical Corridor of QL9
Army Commendation Medal
2nd Battalion 94th Artillery 175mm SP
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Those Listed:
President George Bush
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Congressman Bob Filner
Chairman
House Veterans Affairs Committee
U.S. House of Representatives
2428 Rayburn House Office Building
Washington, DC 20515
Senator Daniel Akaka
Chairmen
Senate Veterans Affairs Committee
Senate Office Building
Washington D.C. 20510
FOR CONGRESSMAN BUYER
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CO Mr. Jeff Phillips
Communications Director
House Veterans Affairs Committee
U.S. House of Representatives
335 Cannon House Office Building
Washington, DC 20515
FOR SENATOR CRAIG
CO Mr. Jeff Schade
Communications Director
Senate Veterans Affairs Committee
412 Russell
Senate Office Building
Washington D.C. 20510
Congressman Christopher Shays
Oversight Ranch Hand
1126 Longworth Building
Washington, DC 20515-0704
Mr. Jim Nicholson
Secretary - Department of Veterans Affairs
810 Vermont Avenue, NW, Room 1000
Washington, D.C. 20420
Current Director
Compensation & Pension Service
VA Central Office
810 Vermont Avenue,
Washington, D.C. 20420
Mr. William McLemore
Deputy Assistant Secretary
Intergovernmental and International Affairs
Department of Veterans Affairs
810 Vermont Avenue N.W. Suite 915
Washington, DC 20420
Mr. Len Sistek
U.S. House of Representatives
Committee on Veterans Affairs
Oversight and Investigations
Room 333
Cannon House Office Building
Washington, DC 20515
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Mr. Chris McNamee
U.S. House of Representatives
Committee on Veterans Affairs
Professional Staff Member
Subcommittee on Disability Assistance
337 Cannon HOB
Washington, DC 20515
Mr. David Abbot
Staff Member
Compensation & Pension Service
VA Central Office
810 Vermont Avenue,
Washington, D.C. 20420
Congressman John Linder
1026 Longworth House Office Building
Washington, DC 20515-1007
Senator Saxby Chambliss
416 Russell Senate Office Building
Washington, DC 20510
Senator Johnny Isacson
Senate Office Building
Washington, DC 20510
Dr. Michelle Catlin, PhD
National Academy of Sciences
500 Fifth Street, NW
Washington, DC 20001
Dr. Mary Paxton, PhD
Senior Program Officer
Population Health and Public Health Practice
Institute of Medicine
Keck 871, 500 Fifth St., NW
Washington, DC 20001
Senator Patty Murray
173 Russell Senate Bldg.
Washington, D.C. 20510
The Entire House Committee on Veterans' Affairs
335 Cannon House Office Building
Washington, D.C. 20515
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(202) 225-9756
(Congressman Filner please provide copies to all Committee Members)
The Entire Senate Committee on Veterans' Affairs
412 Russell
Senate Office Building
Washington D.C. 20510
(202) 224-9126
(Senator Akaka please provide copies to all Committee Members)
Senator Jim Webb
Senate Russell Building, C1
Washington, DC 20510
RAC-Gulf War Veterans' Illnesses (T-GW)
Reference: Vietnam Veterans Toxic Chemical Legacy
U. S. Department of Veterans Affairs
2200 S.W. Gage Blvd.
Topeka, KS 66622
House Committee on Oversight and Government Reform
Subcommittee on National Security, Veterans Affairs and International Relations,
U.S. House of Representatives
2157 Rayburn House Office Building
Washington, D.C. 20515
Attn: Congressman Henry Waxman Chairman (Please distribute this Veterans
challenge to your appropriate Committee Membership)
NEWS OUTLETS:
Washington Post
Atlanta Journal and Constitution
New York Times
Knight Ridder News
ABC News
CBS News
NBC News
Cable News Network
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Fox News Network
REFERENCES (Can be furnished upon request)
(1) EPA Collusion with Industry: A Very Brief Overview, by Liane C. Casten,
Environmental Task Force Chair of Chicago Media Watch.
(2) Re-Evaluation of Dioxin A Presentation by Dr. Linda Birnbaum, Director Environmental
Toxicology Division U.S. Environmental Protection Agency (EPA) To the 102nd Meeting of the
Great Lakes Water Quality Board, Chicago, Illinois
(3) Power-Point Presentation, 2005, Dr. Linda Birnbaum, EPA dioxin expert.
(4) Department of Veterans Affairs Report “Classified Confidential Status 1, not for
Publication and Release to the General Public.” A report regarding adverse health
affects from exposure to Agent Orange; Dated May 5 1990.
(5) Recognition and Management of Pesticide Poisoning, 5th edition, U.S. EPA, Chapter
14.
(6) The Story of Agent Orange as reported in the U.S. Veteran Dispatch Staff Report
November 1990 Issue.
(7) Industrial Health 2003, 41, 175-180 – Dioxin: Exposure-Response Analysis and Risk
Assessment. (Low-level exposure analysis)
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(8) Extension Toxicology Network Pesticide Information Profiles, Oregon State
University, Revised June 1996
(9) National Academy of Science Dated July 11, 2006, contact Bill Kearney, Director of
Media Relations – news@nas.edu EPA
(10) Department of Veterans Affairs Report “Classified Confidential Status 1, not for
Publication and Release to the General Public.” A report regarding adverse health
affects from exposure to Agent Orange; Dated May 5 1990.
(11) Inadvertent Modification of the Immune Response — The Effect of Foods, Drugs,
and Environmental Contaminants; Proceedings at the Fourth FDA symposium; U.S.
Naval Academy (August 28-30, 1978), p. 78.
(12) SOURCES: National Institute of Environmental Health Sciences, federal Agency
for Toxic Substances and Disease Registry
(13) Lawsuit in the United States District Court for the Eastern District of New York,
Ivy versus Shamrock Chemicals Company, Affidavit of Cate Jenkins, PH.D. {“The
evidence from the 1990 Ranch Hand study (Thomas, et al., 1990) is particularly
compelling in demonstrating CNS damage from Agent Orange exposure.
“Significant psychological deficits were found among Ranch Hand veterans in several subscales
in a battery of psychological tests. In contrast, none of the typical dioxin-related psychological
deficits were ever found in statistical excess among matched controls. Ranch Hand
Veterans experienced a statistically significant excess of great or disabling
fatigue during the day, a condition found among many other populations
exposed to dioxin.)
(13a) (52) August 26-27, 1999 Ranch Hand Advisory Committee Meeting transcripts.
(13b) 1999 OCTOBER RANCH HAND TRANSCRIPTS
(14) March of 2000, House of Representatives, Subcommittee on National Security,
Veterans Affairs, and International Relations, Committee on Government Reform,
Washington, DC, ;Oversight review of the Ranch Hand Study. (Testimony under oath
of Dr. Albanese, Senior Medical Research Officer, U.S. Air Force, former Ranch Hand
Principal Investigator; Veterans not getting a fair assessments of systemic body
damages, cancers, and birth defects.
(15) See L. Casten, Patterns of Secrecy: Dioxin and Agent Orange (1990) (unpublished
manuscript detailing the efforts of government and industry to obscure the serious
health consequences of exposure to dioxin).
(16) October 14-15, 1999 Ranch Hand Advisory Committee Meeting, transcripts.
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(17) October 19-20, 2000 Ranch Hand Advisory Committee Meeting, transcripts from
day one.
(18) Serum dioxin and peripheral neuropathy in veterans of Operation Ranch Hand,
2001 Aug 22 (4): 479-90, Pub Med A Service of The National Library of Medicine and
the National Institute of Health.
(19) Impact of Agent Orange Exposure among Korean Vietnam Veterans – Industrial
Health 2003, 41, 149-157.
(20) Immunotoxicological Effects of Agent Orange Exposure to the Vietnam War
Korean Veterans – Industrial Health 2003, 41, 158-166
(21) Short and Long Term Morbidity and Mortality in the Population Exposed to
Dioxin after the Seveso Accident – Industrial Health 2003, 41, 127-138
(22) Immune Mediated Autonomic Neuropathies, Dr. Roy Freeman, Department of
Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
Massachusetts
(23) Diagnosis and Treatment of Chronic Immune-Mediated Neuropathies, Journal of
Clinical Neuromuscular Diseases, Volume 7, Number 3, March 2006
(24) Guillain Barr Syndrome and Its Variants, Dr. Alan R. Berger, Professor and
Associate Chairman, Department of Neurology, University of Florida/Jacksonville.
(25) Clues to the Diagnosis of Chronic Immune-Mediated Polyneuropathies, Dr.
Norman Latov, Professor of Neurology and Neuroscience, Director Peripheral
Neuropathy Center, Weill Medical College of Cornell University.
(26) Vasculitic Neuropathy, Dr. Jose R. Carlo FANN
(27) Chronic Inflammatory Demyelinting Neuropathies, Dr. Thomas H. Brannagan,
Cornell University.
(28) A meeting and discussion of developed celiac allergy by Dr. Joseph Murray leading
United States expert on the causes and manifestations to the developed symptoms.
November 1996.
(29) Nehmer, 712 F. Supp at 1423.
(30) Veterans’ Dioxin and Radiation Exposure Compensation Standards Act, Pub. L.
98—542, Oct. 24, 1984, 98 Stat. 2727 (hereinafter the Dioxin Standards Act) Section 6.
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(31) 38 C.F.R. 1.17 (b) & (d). 38 C.F.R. 1.17 - also allows the VA Secretary to override
any scientific conclusions on behalf of the VA or the appointee of the Secretary who
now has a conflict of interest – The President of the United States.
(32) Taped interview by Moon Callison with Admiral Zumwalt on July 26th 1999
discussing his role in the Department of Veterans Affairs Report “Classified
Confidential Status 1, not for Publication and Release to the General Public.” A report
regarding adverse health affects from exposure to Agent Orange; Dated May 5 1990.
(America’s Defense Monitor (ADM's) Moon Callison interviews the former Chief of
Naval Operations, for "Environmental Impact of War").
(33) March of 2000, House of Representatives, Subcommittee on National Security,
Veterans Affairs, and International Relations, Committee on Government Reform,
Washington, DC, ;Oversight review of the Ranch Hand Study, official transcripts
(34) OMB Review of CDC Research: Impact of the Paperwork Reduction Act; A
Report Prepared for the Subcommittee on Oversight and Investigations of the
Committee on Energy and Commerce, 99th Cong. 2nd Sess. (October 1986).
(35) Agent Orange Hearing at 229 and 330
(36) See Agent Orange Hearing at 49-54 (Testimony of Dr. Vernon Houk).
(37) See generally Agent Orange Nearing; Congressional Record, S 2550 (March 9,
1990); Congressional Record, (November 21, 1989) (Statements of Senator Thomas
Daschle).
(38) Reference BVA Citation Nr: 0317458, Decision Date: 07/24/03, Archive Date: 07/31/03
(39) Former Top Secret Declassified “Corona Harvest” Defoliation operations in
Southeast Asia’ Released in 1970
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DEFINITION
PERIPHERAL NEUROPATHY
The Essay Author is Julia Barrett.
DEFINITION
The term peripheral neuropathy encompasses a wide range of disorders in which the
nerves outside of the brain and spinal cord--peripheral nerves--have been damaged.
Peripheral neuropathy may also be referred to as peripheral neuritis, or if many nerves
are involved, the terms polyneuropathy or polyneuritis may be used.
DESCRIPTION
Peripheral neuropathy is a widespread disorder, and there are many underlying causes.
Some of these causes are common, such as diabetes, and others are extremely rare, such
as acrylamide poisoning and certain inherited disorders. The most common worldwide
cause of peripheral neuropathy is leprosy. Leprosy is caused by the bacterium
Mycobacterium leprae, which attacks the peripheral nerves of affected people.
According to statistics gathered by the World Health Organization, an estimated 1.15
million people have leprosy worldwide.
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Leprosy is extremely rare in the United States, where diabetes is the most commonly
known cause of peripheral neuropathy. It has been estimated that more than 17 million
people in the United States and Europe have diabetes-related polyneuropathy. Many
neuropathies are idiopathic, meaning that no known cause can be found. The most
common of the inherited peripheral neuropathies in the United States is CharcotMarie-Tooth disease, which affects approximately 125,000 persons.
Another of the better-known peripheral neuropathies is Guillain-Barr syndrome, which
arises from complications associated with viral illnesses, such as cytomegalovirus,
Epstein-Barr virus, and human immunodeficiency virus (HIV), or bacterial infection,
including Campylobacter jejuni and Lyme disease. The worldwide incidence rate is
approximately 1.7 cases per 100,000 people annually. Other well-known causes of
peripheral neuropathies include chronic alcoholism, infection of the varicella-zoster
virus, botulism, and poliomyelitis. Peripheral neuropathy may develop as a primary
symptom, or it may be due to another disease. For example, peripheral neuropathy is
only one symptom of diseases such as amyloid neuropathy, certain cancers, or inherited
neurologic disorders. Such diseases may affect the peripheral nervous system (PNS)
and the central nervous system (CNS), as well as other body tissues.
To understand peripheral neuropathy and its underlying causes, it may be helpful to
review the structures and arrangement of the PNS.
NERVE CELLS AND NERVES
Nerve cells are the basic building block of the nervous system. In the PNS, nerve cells
can be threadlike--their width is microscopic, but their length can be measured in feet.
The long, spidery extensions of nerve cells are called axons. When a nerve cell is
stimulated, by touch or pain, for example, the message is carried along the axon, and
neurotransmitters are released within the cell. Neurotransmitters are chemicals within
the nervous system that direct nerve cell communication.
Certain nerve cell axons, such as the ones in the PNS, are covered with a substance
called myelin. The myelin sheath may be compared to the plastic coating on electrical
wires--it is there both to protect the cells and to prevent interference with the signals
being transmitted. Protection is also given by Schwann cells, special cells within the
nervous system that wrap around both myelinated and un-myelinated axons. The effect
is similar to beads threaded on a necklace.
Nerve cell axons leading to the same areas of the body may be bundled together into
nerves. Continuing the comparison to electrical wires, nerves may be compared to an
electrical cord--the individual components are coated in their own sheaths and then
encased together inside a larger protective covering.
PERIPHERAL NERVOUS SYSTEM
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The nervous system is classified into two parts: the CNS and the PNS. The CNS is
made up of the brain and the spinal cord, and the PNS is composed of the nerves that
lead to or branch off from the CNS.
The peripheral nerves handle a diverse array of functions in the body. This diversity is
reflected in the major divisions of the PNS--the afferent and the efferent divisions. The
afferent division is in charge of sending sensory information from the body to the CNS.
When afferent nerve cell endings, called receptors, are stimulated, they release
neurotransmitters. These neurotransmitters relay a signal to the brain, which
interprets it and reacts by releasing other neurotransmitters.
Some of the neurotransmitters released by the brain are directed at the efferent division
of the PNS. The efferent nerves control voluntary movements, such as moving the arms
and legs, and involuntary movements, such as making the heart pump blood. The
nerves controlling voluntary movements are called motor nerves, and the nerves
controlling involuntary actions are referred to as autonomic nerves. The afferent and
efferent divisions continually interact with each other. For example, if a person were to
touch a hot stove, the receptors in the skin would transmit a message of heat and pain
through the sensory nerves to the brain. The message would be processed in the brain
and a reaction, such as pulling back the hand, would be transmitted via a motor nerve.
NEUROPATHY NERVE DAMAGE
When an individual has a peripheral neuropathy, nerves of the PNS have been
damaged. Nerve damage can arise from a number of causes, such as disease, physical
injury, poisoning, or malnutrition. These agents may affect either afferent or efferent
nerves. Depending on the cause of damage, the nerve cell axon, its protective myelin
sheath, or both may be injured or destroyed.
CLASSIFICATION
There are hundreds of peripheral neuropathies. Reflecting the scope of PNS activity,
symptoms may involve sensory, motor, or autonomic functions. To aid in diagnosis and
treatment, the symptoms are classified into principal neuropathic syndromes based on
the type of affected nerves and how long symptoms have been developing. Acute
development refers to symptoms that have appeared within days, and subacute refers to
those that have evolved over a number of weeks. Early chronic symptoms are those
that take months to a few years to develop, and late chronic symptoms have been
present for several years.
The classification system is composed of six principal neuropathic syndromes, which
are subdivided into more categories that are specific. By narrowing down the possible
diagnoses in this way, specific medical tests can be used more efficiently and effectively.
The six syndromes and a few associated causes are listed below:
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
Acute motor paralysis, accompanied by variable problems with sensory and
autonomic functions. Neuropathies associated with this syndrome are mainly
accompanied by motor nerve problems, but the sensory and autonomic nerves
may also be involved. Associated disorders include Guillain-Barr syndrome,
diphtheritic polyneuropathy, and porphyritic neuropathy.

Subacute sensorimotor paralysis. The term sensorimotor refers to neuropathies
that are mainly characterized by sensory symptoms, but also have a minor
component of motor nerve problems. Poisoning with heavy metals (e.g., lead,
mercury, and arsenic), chemicals, or drugs are linked to this syndrome.
Diabetes, Lyme disease, and malnutrition are also possible causes.

Chronic sensorimotor paralysis. Physical symptoms may resemble those in the
above syndrome, but the time scale of symptom development is extended. This
syndrome encompasses neuropathies arising from cancers, diabetes, leprosy,
inherited neurologic and metabolic disorders, and hypothyroidism.

Neuropathy associated with mitochondrial diseases. Mitochondria are
organelles--structures within cells--responsible for handling a cell's energy
requirements. If the mitochondria are damaged or destroyed, the cell's energy
requirements are not met and it can die.

Recurrent or relapsing polyneuropathy. This syndrome covers neuropathies
that affect several nerves and may come and go, such as Guillain-Barr
syndrome, porphyria, and chronic inflammatory demyelinating polyneuropathy.

Mononeuropathy or plexopathy. Nerve damage associated with this syndrome is
limited to a single nerve or a few closely associated nerves. Neuropathies related
to physical injury to the nerve, such as carpal tunnel syndrome and sciatica are
included in this syndrome.
CAUSES AND SYMPTOMS
Typical symptoms of neuropathy are related to the type of affected nerve. If a sensory
nerve is damaged, common symptoms include numbness, tingling in the area, a
prickling sensation, or pain. Pain associated with neuropathy can be quite intense and
may be described as cutting, stabbing, crushing, or burning. In some cases, a nonpainful stimulus may be perceived as excruciating or pain may be felt even in the
absence of a stimulus. Damage to a motor nerve is usually indicated by weakness in the
affected area. If the problem with the motor nerve has continued over a length of time,
muscle shrinkage (atrophy) or lack of muscle tone may be noticeable. Autonomic nerve
damage is most noticeable when an individual stands upright and experiences problems
such as light-headedness or changes in blood pressure. Other indicators of autonomic
nerve damage are lack of sweat, tears, and saliva; constipation; urinary retention; and
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impotence. In some cases, heart beat irregularities and respiratory problems can
develop.
Symptoms may appear over days, weeks, months, or years. Their duration and the
ultimate outcome of the neuropathy are linked to the cause of the nerve damage.
Potential causes include diseases, physical injuries, poisoning, and malnutrition or
alcohol abuse. In some cases, neuropathy is not the primary disorder, but a symptom
of an underlying disease.
DISEASE
Diseases that cause peripheral neuropathies may either be acquired or inherited; in
some cases, it is difficult to make that distinction. The diabetes-peripheral neuropathy
link has been well established. A typical pattern of diabetes-associated neuropathic
symptoms includes sensory effects that first begin in the feet. The associated pain or
pins-and-needles, burning, crawling, or prickling sensations form a typical "stocking"
distribution in the feet and lower legs.
Other diabetic neuropathies affect the autonomic nerves and have potentially fatal
cardiovascular complications.
Several other metabolic diseases have a strong association with peripheral neuropathy.
Uremia, or chronic kidney failure, carries a 10-90% risk of eventually developing
neuropathy, and there may be an association between liver failure and peripheral
neuropathy. Accumulation of lipids inside blood vessels (atherosclerosis) can choke-off
blood supply to certain peripheral nerves. Without oxygen and nutrients, the nerves
slowly die. Mild polyneuropathy may develop in persons with low thyroid hormone
levels. Individuals with abnormally enlarged skeletal extremities (acromegaly), caused
by an overabundance of growth hormone, may also develop mild polyneuropathy.
Neuropathy can also result from severe vasculitides, a group of disorders in which
blood vessels are inflamed. When the blood vessels are inflamed or damaged, blood
supply to the nerve can be affected, injuring the nerve.
Both viral and bacterial infections have been implicated in peripheral neuropathy.
Leprosy is caused by the bacteria M. leprae, which directly attack sensory nerves.
Other bacterial illness may set the stage for an immune-mediated attack on the nerves.
For example, one theory about Guillain-Barr syndrome involves complications
following infection with Campylobacter jejuni, a bacterium commonly associated with
food poisoning. This bacterium carries a protein that closely resembles components of
myelin. The immune system launches an attack against the bacteria; but, according to
the theory, the immune system confuses the myelin with the bacteria in some cases and
attacks the myelin sheath as well. The underlying cause of neuropathy associated with
Lyme disease is unknown; the bacteria may either promote an immune-mediated attack
on the nerve or inflict damage directly.
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Infection with certain viruses is associated with extremely painful sensory neuropathies.
A primary example of such a neuropathy is caused by shingles. After a case of
chickenpox, the causative virus, varicella-zoster virus, becomes inactive in sensory
nerves. Years later, the virus may be reactivated. Once reactivated, it attacks and
destroys axons. Infection with HIV is also associated with peripheral neuropathy, but
the type of neuropathy that develops can vary. Some HIV-linked neuropathies are
noted for myelin destruction rather than axonal degradation. In addition, HIV
infection is frequently accompanied by other infections, both bacterial and viral, that
are associated with neuropathy.
Several types of peripheral neuropathies are associated with inherited disorders. These
inherited disorders may primarily involve the nervous system, or the effects on the
nervous system may be secondary to an inherited metabolic disorder. Inherited
neuropathies can fall into several of the principal syndromes, because symptoms may
be sensory, motor, or autonomic. The inheritance patterns also vary, depending on the
specific disorder. The development of inherited disorders is typically drawn out over
several years and may herald a degenerative condition--that is, a condition that
becomes progressively worse over time. Even among specific disorders, there may be a
degree of variability in inheritance patterns and symptoms. For example, CharcotMarie-Tooth disease is usually inherited as an autosomal dominant disorder, but it can
be autosomal recessive or, in rare cases, linked to the X chromosome. Its estimated
frequency is approximately one in 2,500 people. Age of onset and sensory nerve
involvement can vary between cases. The main symptom is a degeneration of the motor
nerves in legs and arms, and resultant muscle atrophy. Other inherited neuropathies
have a distinctly metabolic component. For example, in familial amyloid
polyneuropathies, protein components that make up the myelin are constructed and
deposited incorrectly.
PHYSICAL INJURY
Accidental falls and mishaps during sports and recreational activities are common
causes of physical injuries that can result in peripheral neuropathy. The common types
of injuries in these situations occur from placing too much pressure on the nerve,
exceeding the nerve's capacity to stretch, blocking adequate blood supply of oxygen and
nutrients to the nerve, and tearing the nerve. Pain may not always be immediately
noticeable, and obvious signs of damage may take a while to develop.
These injuries usually affect one nerve or a group of closely associated nerves. For
example, a common injury encountered in contact sports such as football is the
"burner," or "stinger," syndrome. Typically, a stinger is caused by overstretching the
main nerves that span from the neck into the arm. Immediate symptoms are numbness,
tingling, and pain that travels down the arm, lasting only a minute or two. A single
incident of a stinger is not dangerous, but recurrences can eventually cause permanent
motor and sensory loss.
POISONING
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The poisons, or toxins, that cause peripheral neuropathy include drugs, industrial
chemicals, and environmental toxins. Neuropathy that is caused by drugs usually
involves sensory nerves on both sides of the body, particularly in the hands and feet,
and pain is a common symptom. Neuropathy is an unusual side effect of medications;
therefore, most people can use these drugs safely. A few of the drugs that have been
linked with peripheral neuropathy include metronidazole, an antibiotic; phenytoin, an
anticonvulsant; and simvastatin, a cholesterol-lowering medication.
Certain industrial chemicals have been shown to be poisonous to nerves (neurotoxic)
following work-related exposures. Chemicals such as acrylamide, allyl chloride, and
carbon disulfide have all been strongly linked to development of peripheral neuropathy.
Organic compounds, such as N-hexane and toluene, are also encountered in workrelated settings, as well as in glue-sniffing and solvent abuse. Either route of exposure
can produce severe sensorimotor neuropathy that develops rapidly.
Heavy metals are the third group of toxins that cause peripheral neuropathy. Lead,
arsenic, thallium, and mercury usually are not toxic in their elemental form,
but rather as components in organic or inorganic compounds. The types of
metal-induced neuropathies vary widely. Arsenic poisoning may mimic GuillainBarr syndrome; lead affects motor nerves more than sensory nerves; thallium
produces painful sensorimotor neuropathy; and the effects of mercury are seen in both
the CNS and PNS.
MALNUTRITION AND ALCOHOL ABUSE
Burning, stabbing pains and numbness in the feet, and sometimes in the hands, are
distinguishing features of alcoholic neuropathy. The level of alcohol consumption
associated with this variety of peripheral neuropathy has been estimated as
approximately 3 L of beer or 300 mL of liquor daily for three years. However, it is
unclear whether alcohol alone is responsible for the neuropathic symptoms, because
chronic alcoholism is strongly associated with malnutrition.
Malnutrition refers to an extreme lack of nutrients in the diet. It is unknown precisely
which nutrient deficiencies cause peripheral neuropathies in alcoholics and famine and
starvation patients, but it is suspected that the B vitamins have a significant role. For
example, thiamine (vitamin B1) deficiency is the cause of beriberi, a neuropathic disease
characterized by heart failure and painful polyneuropathy of sensory nerves. Vitamin
E deficiency seems to have a role in both CNS and PNS neuropathy.
DIAGNOSIS
Clinical symptoms can indicate peripheral neuropathy, but an exact diagnosis requires
a combination of medical history, medical tests, and possibly a process of exclusion.
Certain symptoms can suggest a diagnosis, but more information is commonly needed.
For example, painful, burning feet may be a symptom of alcohol abuse, diabetes, HIV
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infection, or an underlying malignant tumor, among other causes. Without further
details, effective treatment would be difficult.
During a physical examination, an individual is asked to describe the symptoms very
carefully. Detailed information about the location, nature, and duration of symptoms
can help exclude some causes or even pinpoint the actual problem. The person's
medical history may also provide clues as to the cause, because certain diseases and
medications are linked to specific peripheral neuropathies. A medical history should
also include information about diseases that run in the family, because some peripheral
neuropathies are genetically linked. Information about hobbies, recreational activities,
alcohol consumption, and work place activities can uncover possible injuries or
exposures to poisonous substances.
The physical examination also includes blood tests, such as those that check levels of
glucose and creatinine to detect diabetes and kidney problems, respectively. A blood
count is also done to determine levels of different blood cell types. Iron, vitamin B12,
and other factors may be measured as well, to rule out malnutrition.
More specific tests, such as an assay for heavy metals or poisonous substances, or tests
to detect vasculitis, are not typically done unless there is reason to suspect a particular
cause.
An individual with neuropathy may be sent to a doctor that specializes in nervous
system disorders (neurologist). By considering the results of the physical examination
and observations of the referring doctor, the neurologist may be able to narrow down
the possible diagnoses. Additional tests, such as nerve conduction studies and
electromyography, which tests muscle reactions, can confirm that nerve damage has
occurred and may be able to indicate the nature of the damage. For example, some
neuropathies are characterized by destruction of the myelin. This type of damage is
shown by slowed nerve conduction. If the axon itself has suffered damage, the nerve
conduction may be slowed, but it will also be diminished in strength.
Electromyography adds further information by measuring nerve conduction and
muscle response, which determines whether the symptoms are due to a neuropathy or
to a muscle disorder.
In approximately 10% of peripheral neuropathy cases, a nerve biopsy may be helpful.
In this test, a small part of the nerve is surgically removed and examined under a
microscope. This procedure is usually the most helpful in confirming a suspected
diagnosis, rather than as a diagnostic procedure by itself.
TREATMENT
Treat the cause
Attacking the underlying cause of the neuropathy can prevent further nerve damage
and may allow for a better recovery. For example, in cases of bacterial infection such
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as leprosy or Lyme disease, antibiotics may be given to destroy the infectious bacteria.
Viral infections are more difficult to treat, because antibiotics are not effective against
them. Neuropathies associated with drugs, chemicals, and toxins are treated in part by
stopping exposure to the damaging agent. Chemicals such as
ethylenediaminetetraacetic acid (EDTA) are used to help the body concentrate and
excrete some toxins. Diabetic neuropathies may be treated by gaining better control of
blood sugar levels, but chronic kidney failure may require dialysis or even kidney
transplant to prevent or reduce nerve damage. In some cases, such as compression
injury or tumors, surgery may be considered to relieve pressure on a nerve.
In a crisis situation, as in the onset of Guillain-Barr syndrome, plasma exchange,
intravenous immunoglobulin, and steroids may be given. Intubation, in which a tube is
inserted into the trachea to maintain an open airway, and ventilation, may be required
to support the respiratory system. Treatment may focus more on symptom
management than on combating the underlying cause, at least until a definitive
diagnosis has been made.
SUPPORTIVE CARE AND LONG-TERM THERAPY
Some peripheral neuropathies cannot be resolved or require time for resolution. In
these cases, long-term monitoring and supportive care is necessary. Medical tests may
be repeated to chart the progress of the neuropathy. If autonomic nerve involvement is
a concern, regular monitoring of the cardiovascular system may be carried out.
Because pain is associated with many of the neuropathies, a pain management plan may
need to be mapped out, especially if the pain becomes chronic. As in any chronic
disease, narcotics are best avoided. Agents that may be helpful in neuropathic pain
include amitriptyline, carbamazepine, and capsaicin cream.
Physical therapy and physician-directed exercises can help maintain or improve
function. In cases in which motor nerves are affected, braces and other supportive
equipment can aid an individual's ability to move about.
PROGNOSIS
The outcome for peripheral neuropathy depends heavily on the cause. Peripheral
neuropathy ranges from a reversible problem to a potentially fatal complication. In the
best cases, a damaged nerve regenerates. Nerve cells cannot be replaced if they are
killed, but they are capable of recovering from damage. The extent of recovery is tied
to the extent of the damage and a person's age and general health status. Recovery can
take weeks to years, because neurons grow very slowly. Full recovery may not be
possible and it may also not be possible to determine the prognosis at the outset.
If the neuropathy is a degenerative condition, such as Charcot-Marie-Tooth disease, an
individual's condition will become worse. There may be periods of time when the
disease seems to reach a plateau, but cures have not yet been discovered for many of
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these degenerative diseases. Therefore, continued symptoms, potentially worsening to
disabilities are to be expected.
A few peripheral neuropathies are eventually fatal. Fatalities have been associated with
some cases of diphtheria, botulism, and others. Some diseases associated with
neuropathy may also be fatal, but the ultimate cause of death is not necessarily related
to the neuropathy, such as with cancer.
PREVENTION
Peripheral neuropathies are preventable only to the extent that the underlying causes
are preventable. Steps that a person can take to prevent potential problems include
vaccines against diseases that cause neuropathy, such as polio and diphtheria.
Treatment for physical injuries in a timely manner can help prevent permanent or
worsening damage to nerves. Precautions when using certain chemicals and drugs are
well advised in order to prevent exposure to neurotoxic agents. Control of chronic
diseases such as diabetes may also reduce the chances of developing peripheral
neuropathy.
Although not a preventive measure, genetic screening can serve as an early warning for
potential problems. Genetic screening is available for some inherited conditions, but
not all. In some cases, presence of a particular gene may not mean that a person will
necessarily develop the disease, because there may be environmental and other
components involved.
KEY TERMS
Afferent

Refers to peripheral nerves that transmit signals to the spinal cord and the
brain. These nerves carry out sensory function.
Autonomic

Refers to peripheral nerves that carry signals from the brain and that control
involuntary actions in the body, such as the beating of the heart.
Autosomal dominant or autosomal recessive

Refers to the inheritance pattern of a gene on a chromosome other than X or Y.
Genes are inherited in pairs--one gene from each parent. However, the
inheritance may not be equal, and one gene may overshadow the other in
determining the final form of the encoded characteristic. The gene that
overshadows the other is called the dominant gene; the overshadowed gene is the
recessive one.
Axon
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
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A long, threadlike projection that is part of a nerve cell.
Central nervous system (CNS)

The part of the nervous system that includes the brain and the spinal cord.
Efferent

Refers to peripheral nerves that carry signals away from the brain and spinal
cord. These nerves carry out motor and autonomic functions.
Electromyography

A medical test that assesses nerve signals and muscle reactions. It can determine
if there is a disorder with the nerve or if the muscle is not capable of responding.
Inheritance pattern

Refers to dominant or recessive inheritance.
Motor

Refers to peripheral nerves that control voluntary movements, such as moving
the arms and legs.
Myelin

The protective coating on axons.
Nerve biopsy

A medical test in which a small portion of a damaged nerve is surgically
removed and examined under a microscope.
Nerve conduction

The speed and strength of a signal being transmitted by nerve cells. Testing these
factors can reveal the nature of nerve injury, such as damage to nerve cells or to
the protective myelin sheath.
Neurotransmitter

Chemicals within the nervous system that transmit information from or between
nerve cells.
Peripheral nervous system (PNS)
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
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Nerves that are outside of the brain and spinal cord.
Sensory

Refers to peripheral nerves that transmit information from the senses to the
brain.
FOR YOUR INFORMATION
The Essay Author is Julia Barrett.
MEDIA REPORTS
Here are three recent Media Reports on the admitted to flaws of the Gold Standard the
White House and the Department of Veterans Affairs uses in denial of compensation
for morbidity and mortality associated with Herbicide Exposures.
In one finds that the comparison group was tainted in the finding of cancers then
certainly statistics used for other medical issues found and then denied based on faulty
cohort assumptions would be just a flawed.
Instead of comparing apples to oranges as the study was supposed to do. The study
now finds it has been comparing apples to apples and oranges to oranges and the
outcomes were predictable. There is little difference if any that would have
been identified as to what Vietnam Veterans, their widows, and the
orphaned and damaged offspring have been saying for 40 years now.
Exactly what the White House, The Department of Veterans Affairs, and even
some our elected Congress wanted them to find – VERY LITTLE.
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MEDIA ONE
Agent Orange study findings called flawed
Two scientists involved in 25-year, $140 million study say it may underestimate cancer
risks for Vietnam vets
By Clark Brooks
STAFF WRITER
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A design flaw in the federal government's $140 million study of the health effects of
Agent Orange on Vietnam veterans has resulted in a quarter-century of
inaccurate findings, two scientists involved with the study told The Greenville
News.
Begun in 1978 to help settle compensation claims, the Air Force Health Study will end
this week as it began, in controversy, with tens of thousands of veterans still seeking
answers to chronic illnesses they attribute to herbicides used during the Vietnam War.
Agent Orange and other herbicides sprayed in Vietnam to destroy enemy crops and
jungle cover contained cancer-causing dioxin. The U.S. Air Force, however, is closing
up shop on the study having found no increased incidence of a serious illness other than
diabetes.
The study has compared airmen directly involved with the spraying missions, called
Operation Ranch Hand, to Air Force veterans who served in Southeast Asia but had no
role in spraying.
However, hundreds in the comparison group spent time in Vietnam and may have been
exposed to herbicides, too, said Joel Michalek, who worked on the study from the
beginning and was its principal investigator for 14 years until he left in May.
"It spoils everything," Michalek told The News. "It's as if you're running a clinical
trial on a new medication, and you found out some of the people who were in your
placebo group were actually taking meds. That would spoil your whole study.
And that's what's going on here in this study."
Michalek co-authored two articles published in the Journal of Occupational and
Environmental Medicine in 2004 and 2005 that found significant rates of cancer
in the Ranch Hand and comparison groups.
Air Force spokesman Ed Shannon declined to make officials available for comment.
Shannon was asked why Michalek's analysis published in the Journal showing cancer
trends in the comparison group of veterans was not used in the analysis for the final Air
Force report published last year.
The Air Force noted in an e-mail reply that a "recently published analysis" showed an
increased cancer risk in Ranch Hand and comparison veterans. Shannon said
Saturday there would be no further Air Force analysis.
In a follow-up e-mail, the Air Force said the final report included only the veterans who
attended the last round of medical tests in 2002 and that all physical examination
reports follow the same basic analytical plan.
Michalek's finding of cancer in the comparison group was not used in the
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analysis for the Ranch Hand report.
Michalek said he followed up on the cancer articles with an analysis that allowed for the
exposed control group and other factors and found a doubling of cancer in the
Ranch Hand group.
Further research needs to be done to strengthen these findings and figure out what
other diseases the Air Force scientists may have missed because of the exposed
comparison group, Michalek said.
The comparison veterans, he said, are similar to average Vietnam veterans, from nurses
to truck drivers, who spent most of their time in base camps. The comparisons' data
also should be studied further, he said.
The results could matter greatly to thousands of Vietnam War veterans
who've never received compensation for debilitating illnesses that earlier
Ranch Hand study findings said couldn't be linked to Agent Orange.
A Department of Veterans Affairs analysis in 1998 found 92,276 Agent Orange claims
for compensation had been filed by veterans and their survivors. Of those, 5,908 had
been approved.
The analysis was done before diabetes was added to the list of diseases eligible for
compensation, which would make both columns much higher today, said Jim Benson, a
VA spokesman. {My comment would be Jim Benson is defending the low approval
rate, which would reflect White House mandated Budget Control – NOT JUSTICE!}
The VA no longer tracks Agent Orange claims because many veterans apply for more
than one type of compensation per claim, he said. {Another misleading statement by
Mr. Benson.}
The Ranch Hand study has followed about 1,000 Ranch Hand veterans and some 1,300
comparison airmen who served in Southeast Asia.
Although the study will end Saturday for the Air Force, legislation pending in Congress
would turn over all the data and specimens to the Institute of Medicine's Medical
Follow-up Agency, which would collaborate on analyses with scientists outside the
government. {Just think another 25 years of study until all Vietnam Veterans are
dead.}
Michalek left his civilian Air Force job for the University of Texas Health Science
Center in San Antonio. He said he would apply on behalf of the school to be a
collaborator.
Greer soldier sprayed
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The U.S. military sprayed more than 18 million gallons of herbicides over 3.6 million
acres of South Vietnam from 1962 to 1971. Nearly two-thirds of it was Agent Orange.
Richard Leoffels of Greer saw the planes spraying overhead when he was an Army
infantryman with the 1st Cavalry Division in 1968-69. Sometimes the wind blew it onto
him and his buddies as they set up for ambushes, he said.
He didn't give it much thought, he said, even as he occasionally crawled through areas
saturated with herbicides. He was more concerned about the enemy.
"I didn't know anything about Agent Orange until I came back, did some reading and
saw a couple specials on TV," he said.
Red blotches appeared on his legs in 1969, just a minor annoyance, he said. Later, he
would suffer a litany of more serious conditions.
The Air Force has announced in periodic updates since 1984 that the Ranch Hand
veterans are about as healthy as the comparisons and have no significant increase in
cancer or heart disease or any other serious illness except diabetes.
Ranch Hand and comparison veterans were thoroughly examined every three to five
years, beginning in 1982. The results were recorded in thick Air Force reports.
The final one of those, published last year, presented the results from the sixth and last
round of testing, conducted in 2002. It concluded the cancer analysis "did not suggest
an adverse relation between cancer and herbicide exposure."
Ron Trewyn, a biochemist and member of the Ranch Hand study advisory committee,
reviewed that report's cancer chapter.
He argued strongly during advisory committee meetings that the cancer chapter should
include all the cancer data used to write the 2004 and 2005 articles in the Journal of
Occupational and Environmental Medicine. It didn't happen, he said.
"They referenced those papers, but they left all the data out from those cancer papers
that were done that showed the cancer effects," he said. "It's huge, because then the
conclusion is there's no cancer effect, when as part of the study, the same investigators,
just analyzing the data in a different way, found that when they did that, lo and
behold, then there were significant cancer effects.
"And so for the final report to say there's no cancer effect when the investigators
themselves published papers saying there is a cancer effect, that's just flat
scientifically wrong."
Without factoring in the new information about the comparison veterans, Trewyn said,
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the Air Force got the same, predictable results.
"When they use an exposed control group and they say the two groups have roughly the
same amount of cancer and so forth, what is that finding good for? Nothing,"
said Trewyn, vice provost for research and dean of the graduate school at
Kansas State University.
And it doesn't take a scientist to figure that out, he said.
"This is common sense now, a lot of it," he said. "It's like now wait a
minute. This just does not pass the smell test or the common sense test."
Trewyn, who said he began wondering about exposures in the comparison group in
1999, did cancer research for 20 years.
Because many comparisons were exposed to the same environmental conditions as the
Ranch Hand veterans, all major health outcomes need to be re-examined, he said.
"There have been industrial studies related to dioxin where as they looked back at it
they thought they had a few exposed in the control group and so the statistics went
to hell," he said.
In the Ranch Hand study, it's more than a few. At least 600 members of the
comparison group spent time in Vietnam, Michalek said.
New rates found
Michalek said the breakthrough that led to the new data analysis came when he started
to look not just at the numbers but also at the men behind them. Where in Southeast
Asia did the Ranch Hand and comparison veterans serve? For how long?
He learned some Ranch Hand veterans didn't take part in spraying because none was
done while they were there, and those who served earlier in the war had higher levels of
dioxin.
When he factored in that information along with the exposed comparison group,
Michalek said he found a doubling of cancer among Ranch Hand veterans with
the highest dioxin exposures. He also found cancer increasing with dioxin
exposure, the first time such a trend has been seen in the Ranch Hand study,
he said.
Michalek said he also found a stronger showing than previously for diabetes.
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Advisory committee members wanted him to get the new cancer and diabetes findings
published in a scientific journal, and he told them he intended to, according to minutes
from the June 2005 committee meeting.
However, Col. Karen Fox said during the committee's final meeting this month in
Rockville, Md., that the Air Force has no plans to publish the new findings in any
Air Force report or scientific journal, The News reported earlier this month.
Fox, responding to extensive questioning from advisory committee members,
said the Air Force told Michalek to destroy the data.
Fox, who succeeded Michalek as principal investigator of the study, declined to be
interviewed by The News during breaks in the meeting.
She said during the meeting the Air Force "tried to enter into a relationship" with
Michalek to write the cancer and diabetes papers, but "he elected not to do that."
Michalek said the Air Force told him he would have to contract with Science
Applications International Corp., which does data analysis for Ranch Hand study
reports. He said he negotiated with SAIC but wasn't hired.
Maurice Owens, a project manager for SAIC, told The News the company decided it
would be a conflict of interest to work with Michalek because he had been a scientist for
the Air Force.
There is precedent for such a hire, however. Col. George D. Lathrop, who helped design
the Ranch Hand study, moved to SAIC during the 1980s after he retired from the Air
Force.
Owens said he couldn't comment on that.
Michalek said he began writing the cancer paper without pay. He said he finally gave
up when he got a letter from the Air Force dated July 6, 2006, ordering him to
delete the data.
(Now the above statement is what Government Justice is for its Nations
Vietnam Veterans “DELETE THE INCRIMINATING DATA.” SOUNDS
LIKE PRE WAR GERMANY CIRCA 1939 FOR CHRIST SAKES!}
{CONGRESS ALLOWS THIS INJUSTICE TO CONTINUE TO THIS DAY.}
Rick Weidman, who has monitored the Ranch Hand advisory committee meetings for
Vietnam Veterans of America, said he believes the Air Force had no intention of
letting Michalek write the cancer paper on his own.
"They didn't want him to publish because they wanted to be able to censor
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it," Weidman said. "That's just plain as day to us."
Getting compensation
Because Ranch Hand study reports had said the health of the Ranch Hand and
comparison veterans was about the same; some members of Congress sought other
ways to settle compensation claims. The Agent Orange Act of 1991 established a
compensation list.
The first entries were non-Hodgkin's lymphoma, soft-tissue sarcoma and chloracne, a
skin condition. The act also authorized the National Academy of Sciences to evaluate
dioxin research from a host of studies, mostly of civilians.
Using the results of that research, the Department of Veterans Affairs has added nine
diseases, mostly cancers.
Leoffels suffered his first of three strokes in 1998. They were minor as strokes go, but
for a time, he couldn't control his left leg.
He was working as a letter carrier for the post office, a good job, he said, but not one a
person can stagger through.
"People were calling the post office and saying, 'Hey, the mailman is walking around
drunk,'" he said.
Circulatory disorders are on the long list of diseases and conditions for which the NAS
has not found enough evidence of a dioxin association to be included for compensation.
Leoffels, 58, does receive compensation for type 2 diabetes, he said, $112 a month. It's
the one illness on the list that might owe its spot to the Ranch Hand study, said David
Tollerud, an epidemiologist who headed the NAS research during the 1990s.
Spina bifida, a birth defect, is the only other condition on the list that received an assist
from the Ranch Hand study, he said.
'Flawed design'
Tollerud, a professor of public health at the University of Louisville, chaired the IOM
panel that recently recommended the Ranch Hand data and specimens be saved for
study outside the Air Force.
He briefed the Ranch Hand advisory committee during a meeting in February. He
called the biological specimens accumulated over 25 years "a trove of valuable research
material," according to the minutes from that meeting.
Tollerud also pointed out some study limitations, including the study's "flawed
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design and execution" and "potential herbicide exposures in the comparison
populations," the minutes show. {Just as the author of this challenge Charles
Kelley did in 2004 in Washington, DC.}
In an interview with The News, Tollerud said his comments were not meant to be
condemning but to recognize limitations that future researchers need to take into
account.
As for the exposed comparison group, he said, "The general result of that kind of a
complication in a study design would be to do what we call bias it toward the null,
meaning that it might make it less likely that you would observe findings that
were really there."
Leoffels said he is in favor of continuing the Ranch Hand study as long as it is done
outside the Air Force.
"Why throw away $140 million?" he said.
Leoffels said he lost his job as a letter carrier to post-traumatic stress disorder. The VA
compensates him for it, offsetting what he believes he should be getting for Agent
Orange damage, but isn't.
He helps other vets navigate the VA, though many get discouraged the first time they
are turned down and never go back, he said.
Leoffels said it shouldn't be so difficult for veterans to get the help they need.
"I think what the government wants is for us to die off so they don't have to
pay us anything," he said.
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MEDIA TWO
Agent Orange cancer findings won't get in report, Air Force says
Study's chairman raises questions about decision to leave data out
Published: Sunday, September 10, 2006 - 6:00 am
By Clark Brooks
STAFF WRITER
ROCKVILLE, Md. -- Cancer findings described as potentially significant by the
chairman of an advisory committee won't be in the final report of a 25-year government
study of the effects of Agent Orange on Vietnam veterans.
The $140 million study of airmen who sprayed herbicides in a series of missions called
Operation Ranch Hand was designed to be used as a basis for compensation for
thousands of veterans. It ends Sept. 30.
The analysis showed a doubling in cancer rates among the highest-exposed
veterans, according to information submitted to the advisory committee.
The Air Force has no plans to publish the new cancer findings in any Air Force report
or scientific journal, Col. Karen Fox told the civilian advisory committee during a
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meeting in Maryland in response to spirited and sustained questioning during the
panel's final meeting Thursday.
Fox said the Air Force instructed the scientist who conducted the analysis to destroy the
data.
Michael Stoto, committee chairman and a professor at Georgetown University, said the
new analysis included "some interesting and potentially important findings" about the
health of airmen involved in herbicide spraying missions during the Vietnam War.
"Frankly," Stoto said at one point in the hearing, "when it shows a significant
finding and it seems to have been suppressed, that doesn't add credit to the
study.” However, Stoto said later in the hearing he perhaps should not have used the
word "suppressed."
In an interview during a break in the meeting, Stoto said the discussion was triggered
by questions The Greenville News posed to him about the status of the unpublished
data the week before the meeting.
The U.S. military sprayed 18 million gallons of herbicides over 3.6 million acres of
South Vietnam from 1962 to 1971 to destroy enemy crops and hiding places and to clear
areas for American base camps. The majority of it was Agent Orange, which contained
cancer-causing dioxin.
Agent Orange and other herbicides, some of which also were tainted with dioxin, were
named for the color of the stripe around their 55-gallon storage drums.
Sapp Funderburk, an Air Force veteran who lives in Taylors, recalls loading orangestriped drums on aircraft in 1969 when he was an airfreight sergeant in charge of
special handling at Phu Cat Air Base.
"They told us they were Agent Orange, so wear these gloves," he said. "They were big,
heavy rubber gloves like you see in a science fiction movie."
Funderburk, who was diagnosed with cancer of the larynx in December 2001, said that
in the tropical heat and humidity, the instant he lowered his hands, the gloves slid off.
He had to unscrew a plug to open a hole to relieve the pressure in the drums, he said,
and Agent Orange sloshed over him.
Veterans complaining of health problems they said were caused by Agent Orange began
filing claims in the late 1970s, and Congress funded the Ranch Hand study to
investigate the health effects of herbicides. The study, also known as the Air Force
Health Study, began in 1982.
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Although the study is ending for the Air Force, the Institute of Medicine wants the
government to preserve the data sets and frozen biological specimens of about 1,000
Ranch Hand veterans and 2,000 comparison airmen who did not spray herbicides.
A recent IOM report said the materials are valuable and should be studied further.
Legislation pending in Congress would turn everything over to the IOM's Medical
Follow-up Agency, which would collaborate on analyses with other scientists and
research centers.
The Air Force scientists never reported significant incidences of cancer in any of the
study's periodic reports on the participants, who were examined every three to five
years.
Nor has the Ranch Hand data ever yielded a finding of cancer increasing
with dioxin exposure until the new analysis that was the topic of discussion at
last week's advisory committee meeting.
That analysis showed a doubling of cancer among Ranch Hand veterans who have the
highest blood-serum levels of dioxin. Committee members were aware of the findings
because the work was done by Joel Michalek, a civilian scientist with the Ranch Hand
study from the beginning and its principal investigator for 14 years.
Stoto said in an interview the week before the meeting that the cancer analysis, which
Michalek presented to the advisory committee in a June 2005 meeting, "really needs to
be published."
Michalek's data analysis, as detailed on slides presented at that meeting, shows cancer
increasing with dioxin exposure. A separate analysis showed a stronger diabetes
finding among Ranch Hand veterans than previously, Michalek said. Ranch Hand
scientists reported a significant risk of diabetes among exposed veterans seven
years ago.
Michalek, who did not attend the meeting, told The Greenville News he did the analyses
before he left the Air Force in May 2005 for a job as a professor at the University of
Texas Health Science Center at San Antonio. He said he wants to use a similar
approach to examine a variety of other health outcomes in the Ranch Hand group.
In his cancer analysis, Michalek said he took into consideration that there were
intervals during the war when no spraying was done, and that Agent Orange and other
herbicides may have been more heavily contaminated with dioxin earlier in the war.
Fox, who succeeded Michalek as principal investigator, told the advisory committee she
had doubts about his analyses.
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"I don't think there was a hypothesis before he started crunching the data," she said.
Michalek disagrees.
"We tried to question all of our assumptions and incorporate external information
about the war to once again test the underlying hypothesis that exposure to Agent
Orange may be related to the risk of cancer," he said. "I hope the new custodian will
find a way to give other researchers access to the study material so these methods and
results can be peer-reviewed."
Fox, responding to questions from the advisory committee, said that in spite of her
misgivings about Michalek's analyses, the Air Force tried to work with him on the
cancer and diabetes papers after he left, but Michalek didn't follow through.
"We tried to enter into a relationship with him for him to write those papers," Fox
said. "He did not do that."
Michalek said he negotiated with Maurice Owens, a project manager for Science
Applications International Corp., which is under contract to do data analysis for Ranch
Hand study reports. Owens, who attended the advisory committee meeting last week,
told The Greenville News that SAIC decided working with Michalek would be a conflict
of interest because he had been a scientist for the Air Force.
Michalek said he has since done as ordered and deleted the Ranch Hand data that was
in his possession.
Fox declined to be interviewed during breaks in the meeting.
Ron Trewyn, a biochemist and member of the Ranch Hand study advisory committee,
said during the meeting that if Michalek had left one university for another, he would
have been able to complete unfinished research papers. He asked Fox why Michalek
couldn't do that for the Air Force.
The scientist is "more than welcome" to talk to whatever entity winds up as custodian
of the data and specimens, Fox said.
Trewyn, a Vietnam veteran, said in an interview that getting the new cancer analysis
published is important to veterans who are not yet being compensated for
cancers and other illnesses related to their service in Vietnam.
The Agent Orange Act of 1991 established a compensation list. The first entries were
non-Hodgkins lymphoma, soft-tissue sarcoma and chloracne, a skin condition. The act
also authorized the National Academy of Sciences to evaluate medical and scientific
data about the health effects of dioxin exposure from a host of studies, mostly in the
civilian population.
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Based on NAS research, the Department of Veterans Affairs has added nine diseases,
among them diabetes and respiratory cancers, which include cancer of the larynx.
Prostate cancer and multiple myeloma are also on the list.
Among those the NAS is studying that have not yet made the list are bone cancer,
melanoma, testicular cancer, urinary bladder cancer, breast cancer, and most
leukemias.
The Department of Veterans Affairs no longer keeps statistics on Agent Orange claims
because of variables such as veterans applying for more than one type of compensation
per claim, said Jim Benson, a VA spokesman.
The San Diego Union-Tribune reported in 1998 that 92,276 Agent Orange claims had
been filed by veterans and their survivors, and 5,908 of them had been approved.
Funderburk, the Taylors veteran, receives compensation in the form of monthly checks
from the VA. Nevertheless, he thinks it's unfair that thousands of other Vietnam
veterans with cancer are not getting help.
Trewyn, vice provost for research and dean of the graduate school at Kansas State
University, said cancers caused by exposures in Vietnam could show up anywhere.
"Some people are going to be susceptible to one type of cancer versus
another," he said. "Having done research on cancer, it doesn't surprise me
AT ALL THAT YOU FIND THIS AT A WHOLE HOST OF DIFFERENT
SITES."
Or, as Funderburk put it, "To me, cancer is cancer is cancer."
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MEDIA THREE
AGENT ORANGE EXPOSURE TIED TO ILLS IN VIETNAM VETS
Thu Nov 9, 10:49 AM ET
NEW YORK (Reuters Health) - Vietnam veterans who sprayed the herbicides like
Agent Orange decades ago in Vietnam are at an increased risk of developing heart
disease, diabetes, high blood pressure, and chronic breathing problems, a new
study shows.
Agent Orange, a week killer containing dioxin, was widely used during the Vietnam
War, Dr. Han K. Kang of the Department of Veterans Affairs in Washington, DC and
colleagues note in the American Journal of Industrial Medicine. Overall, two thirds of
the herbicides used during the conflict-contained dioxin.
To understand the long-term effects of exposure to the chemicals, Kang and his team
compared 1,499 members of the US Army Chemical Corps to 1,428 vets who had
worked in chemical operations jobs but did not serve in Vietnam. The Chemical Corps
members had been responsible for spraying herbicide around base camp perimeters, as
well as aerial spraying of the chemicals from helicopters.
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Study participants were surveyed by telephone in 1999 and 2000.
Tests of a subset of the study participants, including 795 Vietnam vets and 102 nonVietnam vets, showed the Vietnam vets had higher levels of dioxin in their
blood.
The researchers analyzed the effects of Vietnam service and herbicide exposure
separately, and found that hepatitis was the only health problem linked to serving in
Vietnam per se. {Veterans are still not compensated for liver problems or liver disease
associated to Agent Orange or Service in Vietnam. To the Veterans and their spouses it
makes little difference how the VA or the congress wants to associate the liver problems
as associated for mortality and morbidity compensations. It seems to be only an excuse
not to compensate even though data proves the Vietnam Veterans was correct all along
and that by at least 5 to 1 in increased liver mortality and morbidity than the rest of the
United States Population.}
However, exposure to herbicides among Vietnam veterans conferred a 50 percent
increased risk of diabetes, a 52 percent greater heart disease risk, a 32
percent increased risk of hypertension and a 60 percent greater likelihood
of having a chronic respiratory problem such as emphysema or asthma.
An increased cancer risk also was seen among the Chemical Corps members, but this
was not significant from a statistical standpoint.
"Almost three decades after Vietnam service," the researchers conclude, "US Army
veterans who were occupationally exposed to phenoxyherbicide in Vietnam
experienced significantly higher risks of diabetes, heart disease, hypertension,
and non-malignant lung diseases than other veterans who were not exposed
to herbicides.”
You will notice the VA is very careful in stating non-malignant lung disease and not using the
medical term Chronic Obstructive Pulmonary Disorder (COPD) that has been found in dioxin
exposures as well as Vietnam Veterans. While the concert of VA and BVA directed by our
White House has continuously denied this disease of the processes associated with pulmonary
functions.
SOURCE: American Journal of Industrial Medicine, November 2006.
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