Agent Orange Exposure and Prevalence of Self-reported Diseases in Korean Vietnam Veterans
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Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR,1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR,1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.
Abstract
Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR,1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR,1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.
참고문헌 (26)
- Institute of Medicine, "Veterans and Agent Orange: update 2010", pp.7~10 (2011), National Academy Press
- Kim JS, "Impact of Agent Orange exposure among Korean Vietnam veterans", Ind Health, 41(3), pp.149~157 (2003)
- The 2nd epidemiologic study on the adverse health effects of Agent Orange among Vietnam veterans, "Ohrr H", Yonsei University Health System, 4~5 (2001)
- The 3rd epidemiologic study on the adverse health effects of Agent Orange among Vietnam veterans, "Ohrr H", Yonsei University Health System, 73~78 (2006)
- Decouflé P, "Self-reported health status of Vietnam veterans in relation to perceived exposure to herbicides and combat", Am J Epidemiol, 135(3), pp.312~323 (1992)
- Stellman JM, "A geographic information system for characterizing exposure to Agent Orange and other herbicides in Vietnam", Environ Health Perspect, 111(3), pp.321~328 (2003)
- Institute of Medicine, "The utility of proximity-based herbicide exposure assessment in epidemiologic studies of Vietnam veterans", pp.35~61 (2008), National Academy Press
- Boverhof DR, "Temporal and dose-dependent hepatic gene expression patterns in mice provide new insights into TCDDmediated hepatotoxicity", Toxicol Sci, 85(2), pp.1048~1063 (2005)
- McCauley LA, "Strategies to assess validity of self-reported exposures during the Persian Gulf War. Portland Environmental Hazards Research Center", Environ Res, 81(3), pp.195~205 (1999)
- Young AL, "TCDD biomonitoring and exposure to Agent Orange: still the gold standard", Environ Sci Pollut Res, 11(3), pp.143~146 (2004)
- Young AL, "Assessing possible exposures of ground troops to Agent Orange during the Vietnam War: the use of contemporary military records", Environ Sci Pollut Res, 11(6), pp.349~358 (2004)
- Ginevan ME, "Assessing exposure to allied ground troops in the Vietnam War: a comparison of AgDRIFT and Exposure Opportunity Index models", J Expo Sci Environ Epidemiol, 19(2), pp.187~200 (2009)
- Ginevan ME, "Assessing exposure to allied ground troops in the Vietnam War: a quantitative evaluation of the Stellman Exposure Opportunity Index model", Chemosphere, 75(11), pp.1512~1518 (2009)
- Haapanen N, "Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women", Am J Epidemiol, 145(8), pp.762~769 (1997)
- Beckett M, "Do health interview surveys yield reliable data on chronic illness among older respondents?", Am J Epidemiol, 151(3), pp.315~323 (2000)
- Simpson CF, "Agreement between self-report of disease diagnoses and medical record validation in disabled older women: factors that modify agreement", J Am Geriatr Soc, 52(1), pp.123~127 (2004)
- Oksanen T, "Self-report as an indicator of incident disease", Ann Epidemiol, 20(7), pp.547~554 (2010)
- Kang HK, "Health status of Army Chemical Corps Vietnam veterans who sprayed defoliant in Vietnam", Am J Ind Med, 49(11), pp.875~884 (2006)
- Kang HK, "Pregnancy outcomes among U.S. women Vietnam veterans", Am J Ind Med, 38(4), pp.447~454 (2000)
- O’Toole BI, "The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder", Am J Epidemiol, 170(3), pp.318~330 (2009)
- Lenderink AF, "Review on the validity of self-report to assess work-related diseases", Int Arch Occup Environ Health, 85(3), pp.229~251 (2012)
- Keavney B, "Large-scale test of hypothesised associations between the angiotensin-converting-enzyme insertion", deletion polymorphism and myocardial infarction in about 5000 cases and 6000 controls. International Studies of Infarct Survival (ISIS) Collaborators, 2000, pp.355(9202), 434~442
- Reitz OE, "A comparison of survey methods in studies of the nurse workforce", Nurse Res, 20(4), pp.22~27 (2013)
- Cartwright A, "Interviews or postal questionnaires? Compari sons of data about women’s experiences with maternity services", Milbank Q, 66(1), pp.172~189 (1988)
- Addington-Hall J, "A randomized controlled trial of postal versus interviewer administration of a questionnaire measuring satisfaction with, and use of, services received in the year before death", J Epidemiol Community Health, 52(12), pp.802~807 (1998)
- Edwards PJ, "Methods to increase response to postal and electronic questionnaires", Cochrane Database Syst Rev, (3), pp.MR000008~ (2009)