Neurology in the Vietnam War.

Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians. Their practice included exposure to unfamiliar disorders including cerebral malaria, Japanese B encephalitis, sleep deprivation seizures, and toxic encephalitis caused by injection or inhalation of C-4 explosive. They and neurologists at facilities in the United States published studies on all of these entities both during and after the war. These publications spawned the Defense and Veterans Head Injury Study, which was conceived during the Korean War and continues today as the Defense and Veterans Head Injury Center. It initially focused on post-traumatic epilepsy and later on all effects of brain injury. The Agent Orange controversy arose after the war; during the war, it was not perceived as a threat by medical personnel. Although soldiers in previous wars had developed serious psychological impairments, post-traumatic stress disorder was formally recognized in the servicemen returning from Vietnam.

Historical trends of polychlorinated dibenzo-p-dioxins and dibenzofurans in three dated sediment cores from Mexico.

This paper describes the first report of dioxins and furans (PCDDs/Fs) in sediment cores from Mexico. Sedimentation rates and vertical fluxes were estimated using (210)Pb dating. Two cores correspond to marine sediments and one to an endorheic lake. Concentrations of PCDDs/Fs found in the three sites are typical of non-impacted areas with low concentrations when compared to reference values. However the PCDDs/Fs sediment profiles show an increasing concentration trend in the upper core sections. This behavior is different from that found at many sites around the globe where diminishing concentrations have been reported. A strong predominance of OCDD was observed, and a comparison to typical composition profiles of industrial and other sources did not result in clear origin assignments for these measured compounds. We suggest that local sources may be responsible for the increase in concentration and, because these undetermined sources have not been curtailed, their importance is still growing.

Historical trends of dioxin-like compounds and heavy metals in sediments buried in a reservoir in central Taiwan.

Polychlorinated dibenzo-p-dioxin (PCDD), polychlorinated dibenzofuran (PCDF), polychlorinated biphenyl (PCB) and heavy metal concentrations were analyzed at 1-2 cm intervals in a sediment core collected from a reservoir to evaluate anthropogenic pollution history in central Taiwan. The age of the sediment core was estimated from the sedimentation rate (0.44-0.52 cm year(-1), calculated by (210)Pb and (137)Cs analysis). The highest PCDD/F (4.10 ng TEQ(WHO)kg(-1)d.w.) and PCB (0.345ngTEQ(WHO)kg(-1)d.w.) concentrations occurred around 1985 (i.e. at a downcore depth of 10-12 cm). Our results also demonstrated that PCDD/F and PCB concentrations in the reservoir sediment core started to decrease at a depth of 8-10 cm (estimated year: 1989). This may be attributed to the fact that the Taiwan Environmental Protection Administration (EPA) proposed the regulation of pentachlorophenol (PCP) production and PCB manufacture in 1983 and 1988, respectively. In addition, a linear increasing trend in metal content with time (towards the core top) was observed for several metals (Zn, Cr, Cu, Cd and Pb). Results of the enrichments rates of anthropogenic metals indicated that the metal/alumina (M/Al) ratios of Zn, Cd and Pb in sediment cores exceeded those in crust compositions by 47%, 59% and 78%, respectively. The results revealed that considerable amounts of heavy metals were carried into the reservoir following significant immigration during the Chinese civil war (1950).

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) plasma concentrations in residents of Paritutu, New Zealand: evidence of historical exposure.

An assessment of community exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was undertaken in Paritutu, New Zealand. The suburb lies adjacent to an agrichemical facility that produced 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), between 1962 and 1987. Soil TCDD measurements from 73 nearby addresses demonstrated a pattern of TCDD deposition consistent with an aerial plume following the prevailing local wind patterns and the agrichemical plant as the point source. Blood samples were taken from 52 volunteers having lived for three or more years in Paritutu between 1962 and 1987. Candidate selection focused primarily on individuals who were most likely to show elevated TCDD blood lipid levels when compared to age and gender stratified national average blood concentrations, and secondarily on individuals that provided additional information about specific exposure periods, potential exposures of younger age groups, and specific dietary patterns. A multipathway exposure model was used to estimate serum TCDD levels in each participant. Age and gender-specific TCDD elimination kinetics were also considered. Historical TCDD environmental concentrations were back-calculated from soil concentrations at each residence assuming TCDD releases occurred pre-dominantly between 1962 and 1975. Serum was analysed for chlorinated dibenzodioxins and dibenzofurans, and a subset was analysed for dioxin-like polychlorinated biphenyls. TCDD in serum lipid exceeded two standard deviations above national background levels for 14 participants, and 3 standard deviations for 10 participants. The highest TCDD lipid concentration was 33.3 ng/kg-lipid, or 11 times higher than the comparative 1997 national average. Elevated TCDD concentrations were observed primarily, but not exclusively, in the older study participants who had been in residence in Paritutu before 1968. The study demonstrated TCDD exposure in this community, occurring most likely through the aerial route, and most probably from fugitive emissions during manufacture.

Historical trends of PCDDs, PCDFs, dioxin-like PCBs and nonylphenols in dated sediment cores from a semi-enclosed bay in Korea: tracking the sources.

Two sediment cores, one at middle of the bay (core 1) and another at an outfall of a wastewater treatment plant (WWTP; core 2) were collected in Masan Bay, Korea, to investigate the historical records of contamination by polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), dioxin-like polychlorinated biphenyls (dl-PCBs), and nonylphenols (NPs). Vertical profiles of PCDD/Fs, dl-PCBs, and NPs in the two cores, dated using (210)Pb technique, were different but they had similar vertical profiles within the same core. The overall concentrations of these contaminants were greater in core 2 (0.05-110ng TEQkg(-1) dry wt for PCDD/Fs; 0.02-4.4ng TEQkg(-1) dry wt for dl-PCBs; 1.0-470microgkg(-1) dry wt for NPs) than in core 1 (0.72-8.0ng TEQkg(-1) dry wt for PCDD/Fs; 0.03-1.4ng TEQkg(-1) dry wt for dl-PCBs; 1.3-110microgkg(-1) dry wt for NPs). In particular, PCDD/F concentrations in core 2 were an order of magnitude greater than the concentrations in core 1. The highest concentrations of all target contaminants in cores1 and 2 were found at the surface layer (dated as 2005) and at 8-10cm ( approximately 2000), respectively. For sediment core 2, rapid changes in the concentrations and sources of target contaminants coincide with the establishment and operation of a WWTP; this suggested that discharges from WWTP contributed to contamination by PCDD/Fs, dl-PCBs and NPs in the bay. Analysis of data by non-parametric multidimensional scaling ordination showed that both the cores were influenced by different PCDD/F sources over time. Inventories and fluxes of PCDD/Fs, dl-PCBs, and NPs have rapidly increased since establishment of the WWTP, indicating that the discharge of WWTP is an important source of sediment contamination in aquatic environment.

Historical distribution of PCDDs, PCDFs, and coplanar PCBs in sediment core of Ariake Bay, Japan.

Persistent organic pollutants, particularly polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), coplanar polychlorinated biphenyls (co-PCBs) and toxic equivalent quantity (pg TEQ g(-1)) were determined in sediment samples collected from Ariake Bay, Japan. The total concentration of PCDDs/DFs in surface sediment of the Yabe River (17,000 pg g(-1) dry wt) was approximately 2.5-fold higher than that of the Chikugo River (7,000 pg g(-1) dry wt) which has the highest flow amount of about 40% inputting to the northern Bay. The congener profile suggested that dioxin sources could be close to the study area. The PCDDs concentration (12,000 pg g(-1) dry wt) in the sediment layer, which was corresponding to the 1960s, was reflected on the pentachlorophenol (PCP) contamination occurring at that time in Ariake Bay. The reflecting of PCP in the sediment core was significantly considered by hierarchical cluster analysis. Based on isomer-specific analysis, the tetrachlorodibenzo-p-dioxin composition showed a gradual increase from 1978-1982 toward the surface, indicating that the pollution source at that period might be more influenced by chloronitrofen than PCP. This fact was supported, based on the ratio of Sigma PCDD to Sigma PCDF concentration. The PCDDs/DFs-derived TEQ contributed more than 90% of the SigmaTEQ (PCDDs/DFs and co-PCBs) in all the detected sediment layers. The contribution of PCBs to the total TEQ was low; however, an increasing historical trend of concentration was clearly observed.

Agent Orange, dioxins, and other chemicals of concern in Vietnam: update 2006.

OBJECTIVE: The objective of this study was to find sites in Vietnam where there was human exposure from Agent Orange herbicide sprayed between 1962 and 1971, as determined by congener-specific measurement of dioxins, including 2,3,7,8-tetrachlorodibenzodioxin (TCDD), the dioxin that contaminated Agent Orange, in blood. METHODS: Blood was collected from residents of eight heavily sprayed regions in the south of Vietnam and analyzed for TCDD and in some cases the dioxin-like dibenzofurans and dioxin-like PCBs. RESULTS: Six of the eight newly studied sites did not show substantial or any elevated TCDD in blood. Marked elevation of TCDD in Vietnamese blood was found in one new location with a suggestion of slightly elevated TCDD in a second location. CONCLUSIONS: In newly studied locations in Vietnam, we found some persons with elevation of TCDD consistent with exposure to dioxin from Agent Orange. In our previous studies, we found PCBs, PCDDs, and PCDFs as well as pesticides in human milk, blood, or in food. Health effects from Agent Orange need to be differentiated from effects caused by chemicals other than TCDD from Agent Orange.

Long overlooked historical information on Agent Orange and TCDD following massive applications of 2,4,5-T-containing herbicides, Eglin Air Force Base, Florida.

BACKGROUND: From 1961-1971, The Air Development Test Center, Eglin Air Force Base (AFB), Florida, developed, tested, and calibrated the aerial spray systems used in support of Operation RANCH HAND and the US Army Chemical Corps in Vietnam. Twenty major test and evaluation projects of aerial spray equipment were conducted on four fully instrumented test grids, each uniquely arrayed to match the needs of fixed-wing, helicopter, or jet aircraft. Each of the grids was established within the boundary of Test Area 52A of the Eglin Reservation. METHODS: The tests, conducted under climatic and environmental conditions similar to those in Vietnam, included the use of the military herbicides (Agents) Orange, Purple, White, and Blue. Approximately 75,000 kg of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) and 76,000 kg of 2,4-dichlorophenoxyacetic acid (2,4-D) were aerially disseminated on an area of less than 3 km2 during the period 1962-1970. Data from the analysis of archived samples suggested that an estimated 3.1 kg of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), present as a contaminant, were aerially released in the test area. Because most of the vegetation had been removed before establishing the test site in 1961, there was an opportunity to follow ground-based residues independent of canopy interception, and the resulting high solar exposure of initial residues. Studies of the soils, fauna, flora, and aquatic ecosystems of the test grids and associated perimeters of Test Area C-52A (an area totally more than 8 km2) were initiated in 1969 and concluded in 1984. RESULTS AND DISCUSSION: Data from soil samples collected from 1974 through 1984 suggested that less than one percent of the TCDD that was present in soil when sampling began persisted through the ten-year period of sampling. More than 340 species of organisms were observed and identified within the test area. More than 300 biological samples were analyzed for TCDD and detectable residues were found in 16 of 45 species examined. Examination of the ecological niches of the species containing TCDD residues suggested each was in close contact with contaminated soil. Indepth field studies, including anatomical, histological and ultrastructural examinations, spanning more than 50 generations of the Beachmouse, Peromyscus polionotus, demonstrated that continual exposure to soil concentrations of 0.1 to 1.5 parts-per-billion (ng/g) of TCDD, had minimal effects upon the health and reproduction of this species. CONCLUSIONS: Since Agent Orange with its associated TCDD contaminant was aerially disseminated on the test grids, Test Area C-52A provided a 'field laboratory' for what may have happened in Vietnam, had there been no intercepting forest cover. However, in Vietnam a 'typical' mission would have disseminated 14.8 kg of 2,4,5-T/ha, most of which was intercepted by the forest canopy, versus the 876 kg 2,4,5-T/ha on the test grid at Eglin. Moreover, each hectare on the Eglin test grid received at least 1,300 times more TCDD than a hectare sprayed with Agent Orange in Vietnam. The disappearance or persistence of TCDD is dependent upon how it enters the ecosystem. Spray equipment test and evaluations missions at Eglin were generally scheduled and conducted with environmental conditions that were optimal for spray operations. This suggests that conditions favorable for dissemination of herbicide were the same conditions favorable for photodegradation of TCDD. It was likely that 99 percent of the TCDD never persisted beyond the day of application. No long-term adverse ecological effects were documented in these studies despite the massive quantities of herbicides and TCDD that were applied to the site. Reviews by the US Environmental Protection Agency and the National Academy of Sciences' Institute of Medicine did not address the fate of Agent Orange and TCDD as described in these studies from Eglin AFB, Florida.

Historical trends of PCDD/Fs and CO-PCBs in a sediment core collected in Sendai Bay, Japan.

The vertical distribution of dioxins in a sediment core was investigated to elucidate historical trends of dioxins discharged into Sendai Bay, Japan. The dioxin concentration was 410 pg/g dry weight (dw) in sediments deposited in the mid-1930s and 3870 pg/g dw in those deposited in the mid-1980s. Dioxin fluxes increased from the mid-1930s and then reached a maximum in the mid-1980s. 1,3,6,8-TeCDD+1,3,7,9-TeCDD, OCDD, and Co-PCB concentrations were 110, 140, and 26 pg/g dw, respectively, in mid-1930s sediments, and reached maximums of 1800, 1100, and 200 pg/g dw, respectively, in mid-1980s sediments. Shipments to Miyagi Prefecture of CNP and PCP products, the major sources of 1,3,6,8-TeCDD+1,3,7,9-TeCDD and OCDD, were highest in 1975 (4700t) and 1970 (3100t), respectively; and in Japan, the amount of PCBs, the major source of Co-PCB congeners, used was highest (11,100t) in 1970. Thus, the period for which the maximum concentrations of 1,3,6,8+1,3,7,9-TeCDD, OCDD, and Co-PCBs were measured in the sediment core (mid-1980s) did not correspond to the time of maximum use of CNP, PCP, or PCB products, but lagged behind by more than 10 years. We attributed this time lag to the time required for the movement of dioxins from Miyagi Prefecture to Sendai Bay.

Observations on historical, contemporary, and natural PCDD/Fs.

PCDD/Fs were determined in samples of archived surface soils collected from different locations around the world in the early 1880s, in contemporary surface soils from around the world, in archived subsurface soils collected at Rothamsted Experimental Station in the 1870/1880s, and in sections of peat core deposited between 5000 BP and the present. PCDD/Fs were detected in most of the samples. The potential sources and implications of the levels and mixtures of PCDD/Fs present in the samples are discussed. The homologue and isomer patterns observed in most of the contemporary European surface soils are commonly observed for European air samples and soil samples. The homologue pattern in the Rothamsted surface soils collected in the 1800s was similar, suggesting that similar sources of atmospheric emissions of PCDD/ Fs were operating in the UK in the 1800s as currently. Very different patterns, dominated by OCDD and with contributions of HpCDD and HxCDD, were found in some other samples. It is proposed that the PCDD/Fs present in the subsurface Rothamsted soils, archived (1880s) surface soils from Illinois and the Congo, clay beneath the peat bog (deposited approximately 5000 BP), and possibly surface soil samples from Thailand and Australia are of a natural origin. The most abundant TeCDD/F congeners measured in the peat samples here were also those observed by previous workers who studied a Canadian peat bog and are consistent with the microbially mediated oxidative coupling of chlorophenols. The study provides evidence for the widespread occurrence of PCDD/Fs in the environment prior to 1900 and for a complex array of sources (including natural) and environmental transformation processes.