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From: JR
Date: 10 Feb 2006
Time: 14:44:12
Remote Name: 24.9.226.81
Below is a series of email exchanges I had with Mary Burr Paxton, PhD, DABT Senior Program Officer, Population Health and Public Health Practice , Institute of Medicine -- on the review team that will be writing the VETERANS AND AGENT ORANGE: UPDATE 2006. This is a rather long post and is presented in chronological order, starting with my first question and ending in the latest reply. I believe it holds a possibility of addressing the Agent Orange problems SPECIFIC TO the blue water navy. (It may have bad formatting because I'm just cutting and pasting these together...) ********** From: John Paul Rossie [ mailto:johnr@rossie.com ] Sent: Thursday, February 02, 2006 7:02 PM To: IOMWWW Cc: John Paul Rossie Subject: request for information clarification Can you direct this query to the proper individual who will be able to provide an answer to the questions found below? Thank you for your assistance. I am inquiring about information in the http://www.iom.edu/CMS/3793/4689/25476.aspx On page 308 there is information contained in Table 6-44 regarding BLUE-WATER NAVY veterans and the Estimated Relative Risk. Your table indicates a Relative Risk factor for this group as 2.2 (1.2-3.9) This appears to be a high Relative Risk factor compared to any other group listed on that page. Can you expand upon this information as to how to interpret this "high risk factor"? Can you provide information or links to information or documentation that would provide a more complete picture of the dioxin risk level for this specific group (Blue-Water Navy veterans)? Thank you for any information you might be able to provide. Respectfully, -John Paul Rossie ***************8 At 04:19 PM 2/9/2006, Dear Mr. Rossie, The individual entry you mention in Table 6-44 of Veterans and Agent Orange: Update 2004 on non-Hodgkin's Lymphoma (NHL) is a piece of evidence that has been carried forward from IOM's first review of this material, as reported in Veterans and Agent Orange published in 1994. The estimated relative risk for blue-water Navy Vietnam veterans is from the "Selected Cancers Study" conducted by the Centers for Disease Control (CDC) and published in 1990. It is indeed among the highest risks listed for studies of veterans. The Veterans' Administration (VA) has recognized NHL as a compensable exposure-presumed service-related illness for Vietnam veterans since IOM's 1994 report, but, now that you bring this to my attention, I would wonder whether the "blue-water Navy" individuals comprising this statistic would themselves be considered eligible under the VA's condition that the Vietnam veteran must have served on land to be compensated for the conditions identified by IOM. On page 542, the 1994 report comments on this subgroup of the 32 cases noted for the Navy overall (RR=1.9, 95% CI 1.1-1.32): "No cases occurred among naval personnel stationed on river and near-shore ships, and only four among shore personnel. No explanation is known for the high blue water Navy odds ratio (OR=2.2, CI 1.2-3.9) [for the other 28 cases]. The study's authors feel that it is unlikely to be the result of occupational exposures aboard ship." I am not aware of any follow-up that has been conducted on this particular set of study subjects, but I am grateful to have had this example brought to my attention and I intend to look into it further. If you have additional information on Vietnam veterans who were members of the "blue-water Navy," it would be of interest to the committee currently forming to conduct Veterans and Agent Orange: Update 2006. Sincerely, Mary Paxton Mary Burr Paxton, PhD, DABT Senior Program Officer Population Health and Public Health Practice Institute of Medicine Keck 871, 500 Fifth St., NW Washington, DC 20001 (202) 334-1731 fax: (202) 334-2939 ********************************* From: John Paul Rossie [ mailto:johnr@rossie.com Sent: Friday, February 10, 2006 12:10 PM To: Paxton, Mary Subject: RE: request for information clarification Dear Dr. Paxton, Thank you for your response regarding the Agent Orange Studies and the relationship to "blue water navy" personnel. You are correct in suspecting that "blue water navy" personnel have been excluded from Agent Orange-related compensation (and even treatment) even though they exhibit essentially identical symptomology as "in-country" veterans. I believe that a review of available data will indicate that further study regarding the "blue water navy" personnel and known Agent Orange (and other toxic) symptoms should be undertaken and expanded. There appears to be clear and ample evidence that this class of veterans (blue-water navy) has been wrongfully excluded from past medical reports and that further investigation will reveal several things: - naval personnel in general were exposed to the Agent Orange that washed down rivers and tributaries and eventually entered the South China Sea where the blue-water navy lived and worked; - the operation of water treatment equipment on-board US naval vessels was very similar to, if not identical to, the equipment mentioned in a study conducted by the Australian National Research Centre for Environmental Toxicology published in 2002 which can be found here: http://www.dva.gov.au/adf/health_studies/dva_nrcet_final_report.pdf . This study clearly concludes that sailors were actually exposed to higher levels of dioxin and other toxins because of the on-board water distillation processes. These veterans literally ate, drank and bathed in contaminated water. This study by the DVA-Australia < http://www.dva.gov.au/adf/health_studies/dva_nrcet_final_report.pdf > provides good detail on the distillation process on-board ships as to how it actually increases and enriches the concentration of waterborne contaminants for personnel aboard ships using that water; - nearly all blue-water naval personnel, including those on aircraft carriers and in support roles for aircraft carriers, were in direct contact with AO since many of the spraying missions originated on those aircraft carriers and affected both those personnel and the personnel assigned to ships which patrolled in conjunction with the carriers. I have taken the liberty of forwarding this email to several veterans of the "blue water navy" who may contact you regarding their personal experiences with Agent Orange symptoms. I hope this might provide an incentive for the medical investigative committee to give serious consideration to the relationship that exists between these individuals and the root cause of their illnesses as outlined above. Thank you for this opportunity to present information that might lead to the recognition of further evidence of the risks of dioxin exposure by this specific class of Vietnam veterans - the "blue water navy". Very respectfully, John Paul Rossie ******************************* At 10:44 AM 2/10/2006 Dear Mr. Rossie, I'm glad to hear back from you confirming my guess that this was the issue concerning you. You are certainly welcome to share my response with "blue water Navy" veterans. I am sharing yours with Jennifer Cohen, my assistant in staffing the Committee on Veterans and Agent Orange: Update 2006, which is currently being formed. I am also copying Keith Horsley, whom we have been encouraging to have the Australian paper on ship-board distillation published in a peer-reviewed journal, so that it will meet this criterion for formal consideration by our committee. As we initiate an new cycle of our review, we plan for our committee members to hear from individual veterans who will be affected by their deliberations, in addition to representatives of the VA and of the veterans' service organizations. We will be holding an open session the afternoon of Thursday, March 30, at the committee's first meeting, which will be held in DC. In order to make the committee more accessible to veterans in other parts of the country, we plan to hold our second meeting in Phoenix June 15-16, when at least half a day will be allocated to an open session for statements from interested parties. We welcome your input, Mary Paxton