This book originated in a series of cross-disciplinary conversations in the years 1984-1990 between the editor, who is a physician-researcher involved in clinical and laboratory research, and a dioxin toxicologist. During the years in which the conversations took place, an extraordinary amount of new scientific literature was published related to dioxins, defined for purposes of this text as the chlorinated dibenzo-p-dioxins, dibenzofurans, polychlorinated biphe nyls (PCB's) and other compounds that are structurally and toxicologically similar to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7 ,8-TCDD), the most extensively studied and most toxic of this group of chemicals. Dioxins also began to interest not only chemists and toxicologists, but also specialists from diverse disciplines such as wildlife and environmental science, immunology, neuroscience,public health, epidemiology, med icine, government, law, sociology, and journalism. Specialists from such varied disciplines, while familiar with their own literature, frequently did not have time to follow the dioxin literature outside their specialty area. In addition, each specialty had unique knowledge, methods, and perspectives. Cross disciplinary conversation was necessary, but all too frequently, specialists from the various disciplines did not speak the same language, resulting in misunderstanding.

Incineration has been used widely for waste disposal, including household, hazardous, and medical wasteâ€"but there is increasing public concern over the benefits of combusting the waste versus the health risk from pollutants emitted during combustion. Waste Incineration and Public Health informs the emerging debate with the most up-to-date information available on incineration, pollution, and human healthâ€"along with expert conclusions and recommendations for further research and improvement of such areas as risk communication. The committee provides details on: Processes involved in incineration and how contaminants are released. Environmental dynamics of contaminants and routes of human exposure. Tools and approaches for assessing possible human health effects. Scientific concerns pertinent to future regulatory actions. The book also examines some of the social, psychological, and economic factors that affect the communities where incineration takes place and addresses the problem of uncertainty and variation in predicting the health effects of incineration processes.

People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: "Is the tap water safe to drink?" "Is it safe to live near power lines?" Unfortunately, physicians often lack the information and training related to environmental health risks needed to answer such questions. This book discusses six competency based learning objectives for all medical school students, discusses the relevance of environmental health to specific courses and clerkships, and demonstrates how to integrate environmental health into the curriculum through published case studies, some of which are included in one of the book's three appendices. Also included is a guide on where to obtain additional information for treatment, referral, and follow-up for diseases with possible environmental and/or occupational origins.

From 1972 to 1982, approximately 1,500-2,100 US Air Force Reserve personnel trained and worked on C-123 aircraft that had formerly been used to spray herbicides in Vietnam as part of Operation Ranch Hand. After becoming aware that some of the aircraft on which they had worked had previously served this purpose, some of these AF Reservists applied to the US Department of Veterans Affairs (VA) for compensatory coverage under the Agent Orange Act of 1991. The Act provides health care and disability coverage for health conditions that have been deemed presumptively service-related for herbicide exposure during the Vietnam War. The VA denied the applications on the basis that these veterans were ineligible because as non-Vietnam-era veterans or as Vietnam-era veterans without "boots on the ground" service in Vietnam, they were not covered. However, with the knowledge that some air and wipe samples taken between 1979 and 2009 from some of the C-123s used in Operation Ranch Hand showed the presence of agent orange residues, representatives of the C-123 Veterans Association began a concerted effort to reverse VA's position and obtain coverage. At the request of the VA, Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft evaluates whether or not service in these C-123s could have plausibly resulted in exposures detrimental to the health of these Air Force Reservists. The Institute of Medicine assembled an expert committee to address this question qualitatively, but in a scientific and evidence-based fashion. This report evaluates the reliability of the available information for establishing exposure and addresses and places in context whether any documented residues represent potentially harmful exposure by characterizing the amounts available and the degree to which absorption might be expected. Post-Vietnam Dioxin Exposure rejects the idea that the dioxin residues detected on interior surfaces of the C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure. Accordingly, this report states with confidence that the Air Force Reservists were exposed when working in the Operation Ranch Hand C-123s and so experienced some increase in their risk of a variety of adverse responses.

Have U.S. military personnel experienced health problems from being exposed to Agent Orange, its dioxin contaminants, and other herbicides used in Vietnam? This definitive volume summarizes the strength of the evidence associating exposure during Vietnam service with cancer and other health effects and presents conclusions from an expert panel. Veterans and Agent Orange provides a historical review of the issue, examines studies of populations, in addition to Vietnam veterans, environmentally and occupationally exposed to herbicides and dioxin, and discusses problems in study methodology. The core of the book presents What is known about the toxicology of the herbicides used in greatest quantities in Vietnam. What is known about assessing exposure to herbicides and dioxin. What can be determined from the wide range of epidemiological studies conducted by different authorities. What is known about the relationship between exposure to herbicides and dioxin, and cancer, reproductive effects, neurobehavioral disorders, and other health effects. The book describes research areas of continuing concern and offers recommendations for further research on the health effects of Agent Orange exposure among Vietnam veterans. This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans organizations, researchers, and health professionals.

Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases.

Persistent organic pollutants (POPs) and toxic elements, such as dioxins, flame retardants, lead and mercury, are substances of major concern for the food industry, the regulator and the public. They persist in the environment, accumulate in food chains and may adversely affect human health if ingested over certain levels or with prolonged exposure. Persistent organic pollutants and toxic metals in foods explores the scientific and regulatory challenges of ensuring that our food is safe to eat.Part one provides an overview of regulatory efforts to screen, monitor and control persistent organic pollutants and heavy metals in foods and includes case studies detailing regulatory responses to food contamination incidents. Part two moves on to highlight particular POPs, toxic metals and metalloids in foods, including dioxins and polychlorinated biphenyls (PCBs), mercury, polycyclic aromatic hydrocarbons (PAHs) and phthalates.Persistent organic pollutants and toxic metals in foods is a standard reference for those in the food industry responsible for food safety, laboratories testing for food chemical safety, regulatory authorities responsible for ensuring the safety of food, and researchers in industry and academia interested in the science supporting food chemical safety. - Includes case studies which detail regulatory responses to food contamination incidents - Considers the uptake and transfer of persistent organic pollutants in the food chain and the risk assessment of contaminates in food - Details perticular persistent organic pollutants, toxic metals and metalloids in foods including polychlorinated biphenyls (PCBs), per- and polyfluoroalkyl substances (PFASs), mercury and arsenic among others