212403 Review and update of American Vietnamese Agent Orange public health research

Monday, November 9, 2009: 2:30 PM

Arnold Schecter, MD, MPH , University of Texas, School of Public Health at Dallas, Dallas, TX
Justin A. Colacino, BS , Dallas Regional Campus, University of Texas School of Public Health, Dallas, TX
Hoang Trong Quynh, MD, PhD , Institute for Sustainable Agriculture, Hai Ba Trung district - Hanoi, Vietnam
John D. Constable, MD , Harvard Medical School/Mass. General Hospital, Sherborn, MA
American university involvement in public health research on Agent Orange in Vietnam began in 1968 and continued through the early 1970s when teams from several universities including Harvard collected human milk and fish from heavily Agent Orange sprayed areas in the south of Vietnam. They analyzed TCDD for the first time in biological specimens and reported markedly elevated dioxin levels in nursing mothers' breast milk and in fish from Vietnam. The levels in nursing mothers' breast milk were far higher than in American mothers' milk. The highest level was approximately 1800 ppt in milk, lipid normalized. After the American Vietnam War ended in 1975 at an international conference held in 1982 in Ho Chi Minh City, formerly Saigon, John Constable of Harvard Medical School and Maureen Hatch, then of Columbia Univ. School of Public Health, attended and wrote their comments on Vietnamese human research of possible effects from Agent Orange. Two years later in 1984, John Constable and Arnold Schecter began collecting human and biological specimens for dioxin analysis. During the following 25 years, working with Vietnamese physician researchers as well as colleagues from many countries, they determined that there was marked elevation of dioxin from Agent Orange in a number of Vietnamese people, in food and wildlife as well as in sediment and soil. This US university-based research is ongoing. The National Institute of Environmental Health Sciences of the National Institutes of Health has funded one human health study to be performed in Vietnam concerning birth defects. This study did not progress and was shut down. The US EPA helped bring an older Gas Chromatography/Mass Spectrometry instrument from the Centers for Disease Control for dioxin and other chemical analyses to Vietnam where it is now part of one of the 3 dioxin labs in Vietnam. More recently the Ford Foundation helped fund Agent Orange research and encouraged other NGOs to fund health work in Vietnam. The US government has allocated $6 million over a number of years for study of remediation of Agent Orange's dioxin in Vietnam. Recently, an NGO has announced funding of another, the fourth, dioxin laboratory in Vietnam. The Institute of Medicine of the National Academy of Sciences along with universities will be continuing the Ranch Hand Health Study of sprayers of Agent Orange to determine health effects of exposure. American universities and schools of public health have become active in exchanges of Vietnamese students to the USA and of faculty from the USA to Vietnam. These educational exchanges involve many academic fields.

Learning Objectives:
Describe the initial efforts by American researchers to determine the levels of contamination of the Vietnamese people, wildlife, and environment with the dioxin contaminant from Agent Orange. Describe current efforts by American researchers, government agencies, and non-governmental organizations to determine long term health effects of dioxin exposure and remediate dioxin contaminated land in Vietnam.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published over 100 artricles on Vietnam and Agent Orange.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.