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Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study.

Abstract

BACKGROUND

Agent Orange (AO) was a mixture of phenoxy herbicides, containing several dioxin impurities including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Various military herbicides, including AO, were sprayed by the US military and allied forces for military purposes during the Vietnam War. This study was performed to identify the associations between the AO exposure and mortality in Korean Vietnam veterans.

METHODS

From 1 January 1992 to 31 December 2005, 180 639 Korean Vietnam veterans were followed up for vital status and cause of death. The AO exposure index was based on the proximity of the veteran's unit to AO-sprayed areas, using a geographical information system-based model. The adjusted hazard ratios and 95% confidence intervals were calculated by Cox's proportional hazard model.

RESULTS

The mortality from all causes of death was elevated with AO exposure. The deaths due to all sites of cancers combined and some specific cancers, including cancers of the stomach, small intestine, liver, larynx, lung, bladder and thyroid gland, as well as chronic myeloid leukaemia, were positively associated with AO exposure. The deaths from angina pectoris, chronic obstructive pulmonary disease and liver disease including liver cirrhosis were also increased with an increasing AO exposure.

CONCLUSIONS

Overall, this study suggests that AO/TCDD exposure may account for mortality from various diseases even several decades after exposure. Further research is needed to better understand the long-term effects of AO/TCDD exposure on human health.

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  • Authors+Show Affiliations

    ,

    Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea.

    ,

    Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea canrsy@chosun.ac.kr.

    ,

    Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea.

    Department of Preventive Medicine and Public Health, Kwandong University College of Medicine, Gangneung, Republic of Korea, Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea and Health Insurance Review and Assessment Service, Seoul, Republic of Korea.

    Source

    International journal of epidemiology 43:6 2014 Dec pg 1825-34

    MeSH

    2,4,5-Trichlorophenoxyacetic Acid
    2,4-Dichlorophenoxyacetic Acid
    Adult
    Agent Orange
    Angina Pectoris
    Cause of Death
    Cohort Studies
    Environmental Exposure
    Humans
    Liver Cirrhosis
    Liver Diseases
    Middle Aged
    Mortality
    Neoplasms
    Polychlorinated Dibenzodioxins
    Proportional Hazards Models
    Pulmonary Disease, Chronic Obstructive
    Republic of Korea
    Veterans
    Vietnam Conflict

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25186308

    Citation

    Yi, Sang-Wook, et al. "Agent Orange Exposure and Risk of Death in Korean Vietnam Veterans: Korean Veterans Health Study." International Journal of Epidemiology, vol. 43, no. 6, 2014, pp. 1825-34.
    Yi SW, Ryu SY, Ohrr H, et al. Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study. Int J Epidemiol. 2014;43(6):1825-34.
    Yi, S. W., Ryu, S. Y., Ohrr, H., & Hong, J. S. (2014). Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study. International Journal of Epidemiology, 43(6), pp. 1825-34. doi:10.1093/ije/dyu183.
    Yi SW, et al. Agent Orange Exposure and Risk of Death in Korean Vietnam Veterans: Korean Veterans Health Study. Int J Epidemiol. 2014;43(6):1825-34. PubMed PMID: 25186308.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study. AU - Yi,Sang-Wook, AU - Ryu,So-Yeon, AU - Ohrr,Heechoul, AU - Hong,Jae-Seok, Y1 - 2014/09/02/ PY - 2014/9/5/entrez PY - 2014/9/5/pubmed PY - 2015/9/10/medline KW - Agent Orange KW - Korea KW - cohort studies KW - dioxins KW - herbicides KW - mortality KW - veterans SP - 1825 EP - 34 JF - International journal of epidemiology JO - Int J Epidemiol VL - 43 IS - 6 N2 - BACKGROUND: Agent Orange (AO) was a mixture of phenoxy herbicides, containing several dioxin impurities including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Various military herbicides, including AO, were sprayed by the US military and allied forces for military purposes during the Vietnam War. This study was performed to identify the associations between the AO exposure and mortality in Korean Vietnam veterans. METHODS: From 1 January 1992 to 31 December 2005, 180 639 Korean Vietnam veterans were followed up for vital status and cause of death. The AO exposure index was based on the proximity of the veteran's unit to AO-sprayed areas, using a geographical information system-based model. The adjusted hazard ratios and 95% confidence intervals were calculated by Cox's proportional hazard model. RESULTS: The mortality from all causes of death was elevated with AO exposure. The deaths due to all sites of cancers combined and some specific cancers, including cancers of the stomach, small intestine, liver, larynx, lung, bladder and thyroid gland, as well as chronic myeloid leukaemia, were positively associated with AO exposure. The deaths from angina pectoris, chronic obstructive pulmonary disease and liver disease including liver cirrhosis were also increased with an increasing AO exposure. CONCLUSIONS: Overall, this study suggests that AO/TCDD exposure may account for mortality from various diseases even several decades after exposure. Further research is needed to better understand the long-term effects of AO/TCDD exposure on human health. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/25186308/Agent_Orange_exposure_and_risk_of_death_in_Korean_Vietnam_veterans:_Korean_Veterans_Health_Study L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyu183 DB - PRIME DP - Unbound Medicine ER -