A publication of Vietnam Veterans of America, Inc. ®
An organization chartered by the U.S. Congress

October/November 1998

Acceptable Risks? Dioxin in the 1990s

By Jill Gay

Scientific evidence is mounting that dioxin, the byproduct of Agent Orange, continues to cause serious health problems among Vietnam veterans today. "We all have dioxins in our tissues that are approaching levels that in animals show effects," says Sandra Steingraber in her book. Living Downstream: A Scientist's Personal Investigation of Cancer and the Environment (1998).

New research on veterans and Agent Orange is confirming scientists' worst fears. As Peter Orris, a University of Illinois professor, puts it: "The more science we learn, the more concern we have." VVA member Linda Spoonster Schwartz of Yale School of Medicine reported at an August 1998 conference on dioxin sponsored by the Swedish Environmental Protection Agency that female Americans exposed to Agent Orange in Vietnam have had higher incidences of cancer and reduced fertility than comparable unexposed groups. A recent study reported a correlation between dioxin exposure and diabetes among Air Force veterans.

Scientific research on the impact of Agent Orange on veterans is continuing. This fall, The Institute of Medicine will release Veterans and Agent Orange: Update 1998. Jeanne Stellman of Columbia University's School of Public Health was awarded a contract by the National Research Council, funded by the Department of Veteran Affairs, to develop an exposure-assessment methodology for characterizing the exposure of Vietnam veterans to the major herbicides used by the military in Vietnam for future use in epidemiologic studies. Results are expected in 2001.

This process will include compiling a comprehensive database of specific detailed data on the location of all military units that served in Vietnam, building on the information gathered by retired LTC Richard Christian, who served three tours in Vietnam. Christian says that Stellman's study is "what's been lacking all these years. We need a major epidemiologic study. Veterans are still waiting. The CDC failed to accomplish their mission."

Records compiled by the Environmental Support Group headed by Christian have been available since 1986. Records which could answer the questions Vietnam veterans have been asking for years have just gathered dust—until now. Stellman, recipient of a VVA meritorious award, concurs: "This is fifteen years too late," she says, since many records have out-of-date addresses. "We will not give up—the longer we wait, the harder it gets. We are trying to lay the groundwork for the needed epidemiologic studies to see which vets were exposed to how much Agent Orange. Most studies have not gotten the foggiest notion who was exposed."

Recent scientific research is confirming that, even in tiny amounts, dioxin is harmful to humans and animals. In May 1998, for example, forty specialists from fifteen countries met at the World Health Organization and recommended a lower tolerable daily intake range of 1 to 4 picogrammes/kilogram body weight of TCDD, a principle ingredient of Agent Orange, versus 1990 guidelines of a tolerable daily intake of 10 picogrammes/kilogram body weight. One picogramme equals a millionth of a gram.

George Lucier, director of the Environmental Toxicology Program at the National Institute of Environmental Health Sciences (NIEHS), notes that since the report, Veterans and Agent Orange: Update 1996, scientists have gathered "additional evidence that dioxin is a human carcinogen." Arnold Schecter, a Vietnam-era veteran and professor at SUNY Binghampton, observes that dioxin also causes heart disease. Studies by Dutch scientist Koopman-Esseboom found immune system modifications in women exposed to dioxin and altered behavior in the children they breastfed. Women who are exposed to dioxin while pregnant give birth to children with low birth weight, lower IQs, and more sex and thyroid hormone disruption.

Dioxin is now everywhere—in wildlife and in people thousands of miles from industrial centers. Because dioxin is so widely distributed, no population remains unexposed. "In just six months of breast feeding, a baby in the United States or Europe gets the maximum recommended lifetime dose of dioxin," notes scientist Theo Colburn. Babies, moreover, continue to be exposed to dioxin throughout their lives because food supplies are contaminated with low levels of dioxin.

The old ways of measuring the health hazards of dioxin and other chemicals may no longer be valid. According to an August 31, 1998, New York Times article, the ERA has begun experiments to examine chemicals for their effects on the endocrine system. The impetus for these studies came from public pressure through the publication of Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival? A Scientific Detective Story by Theo Colburn, Dianne Dumanoski, and John Peterson Myers.

Colbum explains: "The host of studies have yielded interesting and sometimes worrisome findings showing that dioxin has a wide range of effects on the body, such as lowering the sperm count in exposed men and suppressing the immune system. Nevertheless, the heated public debate in the United States about the dangers of dioxin focused almost exclusively on whether or not it was, in fact, a potent carcinogen." Dioxin, he said, "might after all be more dangerous than anyone had suspected, but contrary to what many had thought, its greatest threat was not cancer. The newly emerging hazard was its power to disrupt natural hormones."

Scientific experiments on rats found that "while it took an almost lethal dose to impair the reproductive system in adult rats, even small doses did long-term damage to the reproductive system of males exposed in the womb and through their mother's milk. Dioxin acts like a powerful and persistent hormone that is capable of producing lasting effects at very low doses—doses similar to levels found in the human population. Possible effects on the endocrine system or transgeneration effects are rarely, if ever, examined."

Ken Olden, director of NIEHS, agrees. Traditionally, he noted, tests looking at "stages of development have been overlooked, but they're critical." Lucier elaborated: "There is no doubt that dioxin is a classic endocrine disrupter. Timing is a critical issue. We know dioxin affects development and differentiation. Therefore, a fetus or a child is more at risk than adults."

NIEHS is developing faster and cheaper methods of testing chemicals, which use fewer animals. Olden observes that as recently as six years ago, it cost two to six million dollars to test a chemical for health effects; now the cost is $110,000. Six years ago, however, industry introduced fifteen new chemicals per year; today thousands of new chemicals are introduced every year. New technologies must be developed to test chemicals faster.

In the United States, the principal controllable sources of dioxin production are waste incinerators. Ironically, hospitals are significant sources of dioxin pollution. According to 1998 EPA draft assessments medical waste incinerators were the third major source of dioxin emissions. As coordinator of Health Care Without Harm, Charlotte Brody, puts it: "The people we're looking to for healing provide a source of environmental harm." In June 1998, the American Hospital Association announced a partnership to reduce hospital waste by 50 percent by 2010. No commitments to dioxin reduction have been made yet, an issue that community groups vow to monitor.

Dioxin emissions from paper and pulp industries have been reduced. In the production of white paper, hydrogen peroxide, an innocent chemical, can be used—rather than chlorine, which results in dioxin emissions.

Nevertheless, activists such as Sandra Steingraber argue that there's no safe level of dioxin and the substance needs to be eliminated. Karen Perry of Physicians for Social Responsibility points out that the EPA is inconsistent: hazardous waste incinerators can emit less dioxin than medical waste incinerators. Kevin Mills, director of Pollution Prevention at the Environmental Defense Fund, says that regulation of dioxin is not sufficient. "We need to shift the burden to those who would expose us to prove that dioxin is safe," he says. Dwain Winters, director of EPA's Dioxin Policy Project, argues that available technology is the basis for standards.

While the anti-dioxin movement was spearheaded by Vietnam veterans, recent activity by citizen groups has highlighted the dangers of dioxin on a global scale. In July 1998, negotiators gathered in Montreal to start work on an unprecedented United Nations treaty to phase out twelve chemicals, including dioxin, to be signed in the year 2000. More than ninety non-government organizations (NGOs) formed the International Persistent Organic Pollutants (POPS) Elimination Network to put pressure on the treaty process to phase out POPS. Cliff Curtis, director of the Global Toxics Campaign at World Wildlife Fund U.S., argues: "No university human research committee would permit pregnant women and unborn children to be exposed to the levels of these chemicals that people around the world now carry their tissues. We need to end the experiment and eliminate these POPS as rapidly as possible."

Other innovations have occurred at a state level. In August 1998, Washington state regulators unveiled a strategy to ban dioxin discharge from new facilities by 2005, to stop dioxin emissions from existing facilities in 2020, and to eliminate the release of dioxin by 2025.

Low-income communities also believe that dioxin needs to be eliminated. Lois Gibbs, executive director of the Center for Health, Environment & Justice, which has worked with some 8,000 community groups on toxic dumps, notes that "most communities where we find discharges of dioxin are low-income, poor, and often of color." Olden, Director of NIEHS, agrees, nothing that "poverty increases the risk of exposure." Charlotte Keys, executive director of Jesus People Against Pollution, who lives in a destitute African-American community where an Agent Orange factory exploded in Columbia, Mississippi, said, "There is a health injustice in poor and working communities exposed to dioxin."

Scientists and citizen action groups universally praise the role Vietnam veterans have played in highlighting the dangers of dioxin. "Scientists worldwide owe a signif icant debt to the veterans who raised this issue early in the 1970's," Peter Orris said. Lois Gibbs notes that Vietnam veterans "paved the way for the rest of us. They were in the front lines and pushed the federal government to research dioxin."

Still, more work needs to be done. "Not everything we need to know can come from the study of Vietnam veterans," explains Steingraber, noting the need to study the health effects of dioxin on women, fetuses, infants, and children. Ellen Silbergeld, a University of Maryland Medical School professor, expressed the hope that "VVA will continue to bring attention to the women who served in Vietnam and the Vietnamese civilian population." Professor Paolo Toniolo of NYU School of Medicine says that it's "important for the United States and Vietnamese governments to foster scientific exchanges" so that studies in Vietnam can determine the health impact twenty and thirty years later on those who were exposed in utero and as infants.

Vietnam has the largest population ever exposed to dioxin. Schecter believes that "Good science is critical to compensation," he said. "We have not done as good a job in convincing Congress to fund research with an oversight board as we need to. VVA is uniquely situated to take the lead."


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