Volume 3, Number 3 March 3, 1989 +---------------------------------------------------------------+ | | | NN NN AAAA MM MM VV VV EEEEEEE TTTTTTTT | | NNN NN AA AA MMM MMM VV VV EE TT | | NN N NN AA AA MM M M MM VV VV EE TT | | NN N NN AA AA MM M MM VV VV EE TT | | NN N NN AAAAAAAA MM MM VV VV EEEEE TT | | NN N NN AA AA MM MM VV VV EE TT | | NN NNN AA AA MM MM V V EE TT | | NN NN AA AA MM MM VVV EEEEEEE TT | | | | The International Newsletter for Vietnam Veterans | +---------------------------------------------------------------+ Editor in Chief: Todd Looney Assistant Editor: G. Joseph Peck NAM VET is a special )| electronic newsletter dedicated to _+|__|_ * VIETNAM |--- --| VETERANS * around the ------------------------=========================== world and \_______________________________________________) provided as a ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ service to participants in the International Vietnam Veterans Echo Con- ference (IVVEC) available on many FidoNet (tm) bulletin boards throughout the United States, Europe, Australia, and Canada. _ Not all of the articles appearing in here | are written by participants in the IVVEC, but NAM VET | is very much an electronic newsletter by, -----/_\----- of, and for Vietnam veterans, their -O==============< : >==============O- friends, wives, and lovers. ( ) (...) ( ) If you are a veteran or anyone else wishing to express yourself concerning our Nation's Vietnam or other related experience, you are invited to submit material for publication to the Vietnam Veterans Valhalla (143/27), VETLink #1 (321/203), or to any BBS carrying IVVEC whose sysop can forward your work from there. NAM VET is published | monthly by Vietnam Veterans Valhalla. The views expressed | are not necessarily those of the NAM VET its staff or any of |____====________ its volunteers. The newsletter is ||__________}____)==================|) made up of =============---------------------===_____ articles and items /| | | | |\\from other newsletters \________|__________|_________|_________|/ and a variety of \\(O)___(O)___(O)___(O)___(O)___(O)// other sources We are not responsible for the content of this information nor are any of the above-mentioned parties. ____________ ======= _________________/|_____... | | " === |_______________| |-----::: |._ - " ) |_|___| / / |___| Duplication and/or distribution is /_/ permitted for noncommercial purposes only For other use, please contact Todd Looney at (408) 947-7668. ================================================================= T A B L E O F C O N T E N T S 1. -=> EDITORIALS <=- Fairness, Decency and Honor ............................. 1 Marching Forth ......................................... 3 2. -=> MEMORIES <=- BOONIE RAT Song!!! ...................................... 4 Let Me Tell You Where I've Been ......................... 6 I Smelt A 'Nam .......................................... 10 Wheeler and Me .......................................... 11 3. -=> VETERANS' SERVICES <=- Agent Orange Update ..................................... 13 Toxic Herbicide Exposure (Agent Orange) ................. 14 Mission and Goals of the VA System ...................... 30 4. -=> GENERAL ARTICLES <=- A Brief History of the Veterans Administration .......... 32 There Oughta Be A Law... ................................ 34 What the LAW says about Burial Benefits ................. 41 MIA records ............................................. 52 It won't happen in America! ............................. 54 Vets battle stress in Vietnam ........................... 57 Viet Nam pledges MIA help ............................... 59 5. -=> VetReach Program <=- VetReach Program ........................................ 60 6. -=> MISCELLANEOUS <=- Official VETNet Nodelist Update ......................... 70 NamVet Subscription Form ................................ 76 7. -=> CALENDAR of EVENTS <=- Calendar of Events ...................................... 77 8. BRING THEM HOME! Some Gave It All! ....................................... 78 NamVet NewsLetter Page i Volume 3, Number 3 March 3, 1989 ================================================================= - = > E D I T O R I A L S < = - ================================================================= Fairness, Decency and Honor Editorial by: G. Joseph Peck Sysop - VETLink #1 FidoNet 1:321/203 AlterNet 7:46/203 The "words" sounded so simple... Fairness. Honor. Decency. I heard them spoken by our new President, George Bush, on March 2 when he was talking about the nomination of John G. Tower as secretary of defense. Fairness. Honor. Decency. "Values" that were hard to find in other than the Kennedy and Carter administrations. ('course the Carter and Ford administrations left some doubt in MY mind concerning draft resistors/evaders).. Maybe there were a few instances of it in other administrations, but many of us found them hard to discover. FAIRNESS. The GI Bill of the WWII and Korean era's seemed fair enough. Politicians gave the same benefits to Vietnam veterans and figured that it was FAIR. It was... but in pre-1954 dollars ($75 a month for tuition plus $500 a year for tuition... President Johnson signed into law a bill that covered BOTH tuition and living expenses of $100 a month) College education for the Vietnam veteran would, for the most part, come only in addition to working "part-time in order to make ends meet." (THE VIETNAM VETERAN - A HISTORY OF NEGLECT Bonior/Champlin/Kolly). If we postponed our education until we were more financially solvent and able to AFFORD it, we soon discovered the 10-year delimitation date. (Some of us DID get to college and graduated only to discover that, at a time of our lives when we should be concentrating and applying our efforts and knowledge, we would just be beginning - in competition, etc., with 19 and 20 year old's just entering the job market...) HONOR. Vaudeville acts in the years after WWI and before WWII more often-than-not portrayed an alcoholic, skid-row bum as being a war veteran. Unfortunately, it was a truism of the times - UNTIL The American Legion empowered many returning able and disabled veterans to bring HONESTY to the feet of the politicians; an HONESTY that revealed soldiers were being discharged disabled with no pensions, no means of caring for themselves or their families, no hospitalization - an HONESTY that revealed our America's lack of HONOR to the promises she had made to those who defended her principles. For a time, the biggest HONOR in being a Vietnam veteran was in NOT saying who you were. That is changing now, slowly but surely, as the hearts and minds of America's nearly 260 million who didn't serve during that era begin to try to understand what we went through, begin to understand that there WAS and IS *HONOR* in our service... begin to realize how many promises to servicemen (AND their families) remain unkept... Today, we don't see too many vaudeville acts and the situation comedies revolve mostly around family life. We DO see televised such programs as Tour of Duty and China Beach which try to portray, in a sense, what it was like (except for the boring, boring days of doin' nothin'...); we DO see movie releases such as Platoon and Hamburger Hill and Full Metal Jacket. But, ya NamVet NewsLetter Page 1 Volume 3, Number 3 March 3, 1989 know, I haven't seen too many love stories, too many "Daddy's returned from the War" stories. COULD BE that America doesn't want to face the fact that there weren't too many "happy endings" and that there WERE *TOO MANY* "tragic beginnings... of homelessness, of incarceration, of Agent Orange repercussions, of fragmented families, of...." DECENCY. I think it would have been "decent" if, when Vietnam veterans returned from duty they could have had their old jobs back; could have appreciated increases in their seniority; could have found the ready acceptance in the employment and housing world that veterans of WWII and Korea did; could have received treatment for their injuries incurred in-service - Agent Orange, PTSD, other disabilities. I think it would have been "decent" if the Vietnam veteran had not have had to go through all they did to address issues in seeking adequate, gainful employment; adequate, helpful and understanding medical treatment and care; adequate and supportive guidance in picking up lives where they were so abruptly interrupted in order to defend what we've all come to believe in: FREEDOM. I think it would have been "decent" if some homeless veterans could have been helped BEFORE they became incarcerated veterans or in other ways totally isolated and alienated from a community which they gave so much for; if some attention to the family's of our veterans would have been paid BEFORE they became ex-'es... Yup... it's a time of our lives when we begin to realize that some dreams of our younger times cannot now be realized; that its TIME to focus and direct our energies, to make OUR lives mean something - to our spouses, children and extended families; to ourselves; a time of OUR lives when WE think about FAIRNESS, HONOR and DECENCY and what WE'LL teach those who follow of their true meanings. Included in this issue are a couple of laws that have been enacted in behalf of the Vietnam veteran... very, very important laws. (We hope to publish more in the near future) If a company or corporation near YOU is a recipient of a Federal contract (in the amounts specified in the Law), it MUST conduct its employment and hiring practices in accordance with those laws. If they don't, we've reprinted some of the specific procedures you can follow to seek compliance - compliance for you, your neighbor and your brother/sister Vietnam veteran. Last year at about this time I was writing an editorial about March 4th being the ONLY day of the year that's a COMMAND to go forward. As March 4, 1989 quickly comes upon us - and another year - how much farther forward HAVE we gone... in helping our 'Nam brothers/sisters care for themselves - in helping them when they CAN'T; in helping the families of our brothers and sisters; in helping America *BE* all that we KNOW it can be? It's time, brothers and sisters... TIME to focus our energies and utilize TOGETHER all that's been done for us and all that we've done for ourselves; TIME to begin DOING; TIME to... Show a brother or sister veteran that YOU care!!! NamVet NewsLetter Page 2 Volume 3, Number 3 March 3, 1989 Marching Forth By: Todd Looney Vietnam Veterans' Valhalla 1:143/27 7:406/27 408-293-7894 Well, I tried to think of some "pearls" of wisdom for this month's NAM VET Newsletter, but I think I'll continue to leave the Pearls Department to my good friend and Assistant Editor Joe Peck. He's better at that. If I can just get him to quit call- ing me "Paul" when we talk on the phone, everything will be just fine (little jab there Joe, couldn't resist it). I just spent four hours paginating the ASCII text formatted Vietnam Veterans Memorial Souvenir Program (all 185k of it) that Joe spent *days* inputting for all of us. It's a real master- piece. It's a national salute to the Vietnam Veteran and should be read by everyone, whether you are a veteran or not. It is file requestable using the magic word SOUVENIR from either the VETLink#1 (1:321/203) or from the Vietnam Veterans' Valhalla (1:143/27). But I'm sure that if you bugged ol' Jerry Hindle at 1:18/6 (7:48/2012), he'd make sure to have it online for you as well if you're into 9600 baud transmission. If you're in Canada, Woody Carmack at 1:153/130 should have it available by the time you read this. Wherever you can get it....get it. It's required reading. If you noticed a little bit different style in the NAM VET this month, it's because I used a new program to compile it. While MAKENEWS has been a good program up until now, it was just a little too restricting and had no mercy when it came to "strange" ASCII or ANSI characters in an article, not to mention article length in general, ElectronicNewsletter (EN.EXE) gave me juuust enough additional power and flexibility that I thought I'd try it out. Let me know what you think. One of the additions this month is a "Calendar of Events". Gee, did you notice that it all seems to be centered around the Valhalla and the NAM VET? Well, that's because those are the only subjects I was familiar with. If you're having a reunion or there is some other special event taking place other vets oughta know about, send me an E-mail message (1:143/27, 7:406/27) and I'll make sure to get it into the next issue of NAM VET. Another addition is the "Miscellaneous" section which will feature services you might be offering veterans, or want ads, etc. "VetReach" is another new area. We've been wanting to get this in for some time. Soooo, all the entries in to the National VETREACH EchoConference (tm) will be entered each month to give them more circulation. Please let Joe and I know what you think of this month's NAM VET...and get your articles in to us for next month. You can enter them into the IVVEC locally, or send 'em in E-mail to any of the nodes listed above...it'll get here. Until next month...show a vet you care (kiss 'em big on the lips and pat them on the butt and say "Thanks!" NamVet NewsLetter Page 3 Volume 3, Number 3 March 3, 1989 ================================================================= - = > M E M O R I E S < = - ================================================================= The Boonie Rat Song Submitted by: Through the International Vietnam Veterans EchoConference To James and all Brother Vets: I have seen the messages concerning the "Boonie Rat" song, and knew I had it somewhere in my footlocker. Finally went digging and found it, so I will post it up for all to read. AIRBORNE!! ----------------------------------------------------------- I landed in this country: One year of life to give, My only friend a weapon, My only prayer to LIVE. I walked away from freedom and the life that I had known, I passed the weary faces of the others going home. Boonie Rats, Boonie Rats, Scared but not alone, 300 days more or less, then I'm going home. The first few days were hectic as they psyched my mind for war, I often got the feeling They're trying to tie the score. The first day with my unit We climbed a two klick hill, to find an enemy soldier, To capture, wound or kill. Boonie Rats, Boonie Rats, Scared but not alone, 200 days more or less, Then I'm going home. The air was hot and humid the ground was hard and dry. Ten times I cursed my rucksack and wished that I could die. I learned to look for danger In the trees and on the ground, I learned to shake with terror When I hear an A-K round. Boonie Rats, Boonie Rats Scared but not alone, 100 days more or less then I'm going home. Boonie Rats a legend For now and times to come, Wherever there are soldiers They"ll talk of what we've done. Boonie Rats, Boonie Rats, NamVet NewsLetter Page 4 Volume 3, Number 3 March 3, 1989 Scared but not alone, 50 days more or less Then I'm going home. They say there'll always be a war, I hope they're very wrong, To the Boonie Rats of VietNam I dedicate this song. Boonie Rats, Boonie Rats, Scared but not alone, Today I see my Freedom Bird, Today I'm going home. ----------------------------------- There it is guys, hope it brings back the good memories. I sure rushed after reading it, its been too many years. AIRBORNE! NamVet NewsLetter Page 5 Volume 3, Number 3 March 3, 1989 Let me tell you where I've been An interview by Janice Rogovin Input by: Vetlink #1 Pittsfield, MA FidoNet 1:321/203 AlterNet 7:46/203 (413) 443-6313 Thomas J. Murphy III: I joined the Marine Corps when I was eighteen. I went to Vietnam twice, once in the latter part of 1966 and again in 1969. I'm proud of it. That's about it. It's something to be proud of. Back at that time, anybody could join the Marine Corps but not anybody could be a Marine Corps sergeant at the age of twenty. I was the youngest platoon sergeant in the whole regiment. Sometimes that was good, but whenever there was a dirty job to do, I was the one they picked. I wanted to be good. I wanted to make a career out of it. I didn't want to be a private and scrub floors, or do shitty jobs. I wanted to be a sergeant telling privates to do that. I just worked extra hours. I was always up a half hour early to get squared away. I learned how to read a map and compass in Boy Scouts, and that's what really allowed me to go up in rank. And I studied like heck. The only way to get it is to earn it. I didn't have to brown-nose anybody. I got shot on a night ambush, nine times. I laid there for a long time. An Army M.A.S.H. unit finally picked us up. I remember waking up with a tracheotomy and a machine allowing me to breathe. Then they transferred me to Japan to two different hospitals. I got hurt October 4th, 1969 and I arrived in the United States on Halloween night. When I got to Chelsea Naval Hospital, they took off my body cast and weighed me - I only weighed eighty-five pounds. I had a colostomy, and there were hundreds of maggots all over the place. I remember when they were taking it off, one of the nurses saying, "Oh, no," and then running out to throw up. Then they gave me an injection and I went back to sleep. That ended it. They retired me. I got the same medals as everybody else got so no big thing. I wasn't a hero or anything. I hadn't had time to stand out as one. If I didn't get hurt the second time I probably would have went back to Vietnam the third time. I'm an American. My family's made up of veterans. Remember Vic Morrow and the TV show "Combat" that used to be on Thursday nights? He was my hero. He's what I wanted to become. And I did. I was quite proud of that. I reached his rank and even had more responsibility than he did. But he had fights every week, big battles, and we only had them, if we were lucky, maybe once a month. To somebody sitting a hundred miles away we were just a pawn on a big board and he was moving us along. They'd tell us to climb a hill and check it out, and we'd sit down and take our packs off and rest and five minutes later they'd tell us to put our packs back on and walk down the hill and walk up another one. I used to feel useless and tired. Since then I've spend about six years total in and out of the VA hospital. I've had about 154 operations. Even though I had a bum leg, and a bum insides, it didn't stop me from doing the things that I liked doing. I've traveled around the world. I've lived in South America, I've lived in Central America. I was going to settle in Central America, but changed my mind at the last second because I met June. She is my second wife. I married her in 1981. NamVet NewsLetter Page 6 Volume 3, Number 3 March 3, 1989 Then last November I noticed a little pea-sized growth coming from my left buttocks into my anal area. I didn't do anything about it until after Christmas, because my son Tommy from a previous marriage was coming down for the holidays. Right after the holidays June insisted that I go to a doctor. I did. It turned out to be malignant. They gave me what the doctor said is the largest dose of chemotherapy that he's ever given. It was a triple dose. It made me very ill. For months its taken away the feeling in my feet and my fingers - I have a hard time writing. And now I'm having radiation and my bottom is fire-engine red from burns. It really really hurts. I think it's terminal and I'm going to die. It's not a morbid attitude. It comes from reading about what I have. I figure I got cancer from being in an area while they were spraying Agent Orange. There were always planes going over. I remember once a lieutenant told us that they were going to spray something to take the bush down, so that we could see the enemy. Or it could have been from drinking the water, we drank water right out of the stream. I'm really angry that I survived getting shot nine times, having all those operations, spending a sixth of my life in the hospital, and now I might die because of a chemical. And I'm angry that I got cancer from something that Dow Chemical made that was supposed to protect us but was misused. A lot of literature I read says we oversprayed. One other thing I'm really vexed at, all this money that Dow Chemical and the other chemical companies gave out, out of it I was told that I'm only going to get $12,500. In retrospect, I think the war was politically motivated. The chemical companies made a lot of money, the oil companies made a lot of money. And I don't think you should fight a war unless you're going to win it. The United States of America is good for a lot of things, they've just got to have another revolution. Let people with open minds revamp the government. Start with the VA. I'm angry at the VA for not taking proper care of us in the hospital. I'm angry that they used me as a guinea pig. I'm angry about Vietnam but please don't misconstrue this. I'm not against the war in Vietnam. I'm angry that they had me so brainwashed, ever since I was a little boy, that I would automatically be one of the first ones down at the recruiting station. There was never a doubt about joining the marines. But I thought we were going to win. And I really think we could have won. All we had to do was get mad at the enemy instead of trying to have all those talks with them. And I'm really shocked at the way we treat Vietnamese people here. These people that live here weren't our enemies. They were our allies. We made them promises up and down and then we just left them. That's the reason June and I would like to adopt a Vietnamese or Cambodian child. It would be nice to have a little boy or girl around the house. Someone who we can help nurture, grow, and someone who we can help expand their minds, and reach their potential in life. I really believe that we owe them. Even Americans that were against the war. I think they should adopt these people too. We're known for our humanity here in America. We're not showing it. JUNE MURPHY NamVet NewsLetter Page 7 Volume 3, Number 3 March 3, 1989 I thought at first that Tom was a hopeless alcoholic, then I thought that Tom was hopelessly mean and manipulative. It took me years to understand that he was living with this war. We were married in March 1981 in San Antonio. By September we were separated. There have been a lot of separations. The first time was when we were driving somewhere one day, he gave me a black eye. He'd been drinking and he was angry about the war. I don't remember what but something about Vietnam and the VA. He'd just been to the VA in San Antonio. He was livid with rage. We separated and stayed in touch. We knew we were in love with each other but we were both afraid of Tom's rage. We didn't know what to call it then. Tom felt that he didn't have a chance to do anything with his life because of Vietnam. He wanted to go to school and there was some snafu about the paperwork. He was very angry. And he was angry because he'd go to the VA hospital for treatment and there'd be red tape. Almost anything would set him off in those days. I felt that I had to leave for my own safety. Tom was irrational, he was drinking almost all the time and very, very depressed. I think rage was more of a companion to him than I was. It was like being married to rage and anger and bitterness. We were going to get a divorce and we seemed to be on friendly terms. We seemed to have accepted it, that our marriage was not to be. We could get along for short periods of time until an episode of anger would come up. But all of that seemed not to matter anymore when I heard that he was sick. I was in the process of moving to Tallahassee, Florida, where my sister lived, and looking for a job. I called him on his birthday and that's when I heard he had to have the biopsy. He asked me to come the following Monday and I really had mixed feelings about it. I was trying to put our relationship in the past but I couldn't do it anymore. I went back to him because I loved him. In the two years that we were apart I never stopped loving him. I just knew that he had to deal with some things before I could live with him in peace. The only way that I could take care of Tom and retain some or most of my sanity was just to love him and remember that it might not be easy but he's worth it. I think that Tom's life has meant something to other veterans and to other people in general. He has a real tenacious spirit. I think I would have given up a long time ago. It's been hell seeing him suffer and feeling there's so little I can do. But the main thing I can do is love him and comfort him. that's something I can do instead of focusing on what I can't do. I think that there's a sense of doing what's right, and expecting that you won't necessarily be rewarded, but that there will be an outcome that will be fair and just and right. Because that's the way it is. But it wasn't that way. There's no sense of fairness, no meaning, no happy ending. I guess maybe some of the people in ur generation expected that there'd be a happy ending, and there wasn't one. There was no closure to it. We had talked about adopting for awhile, but we've never really gotten our act together enough to do that. We had talked about adopting a Vietnamese or Cambodian child. For myself, there's a special feeling about a Cambodian or Vietnamese child. My heart goes out to them, and I don't think of them as the enemy or as someone to be shuffled off. It would complete it for me, because of what Tom has been through. And I'm not able to have children. It would be a good thing to do. It would keep a certain spirit NamVet NewsLetter Page 8 Volume 3, Number 3 March 3, 1989 alive. And it would say, it's okay. This is over, and this is how we go on with life. JANICE ROGOVIN Tom Murphy was with Charlie Company, First Battalion, Fourth Marines, from the latter part of 1966 until 1967, in the Dong Ha area. During his second tour in Vietnam in 1969, Tom was with the same company but was transferred from the Third to the First Marine Division in the southern part of the country. Tom was wounded in Vietnam in October 1969. He was sent back to the States and from October 1969 until May 1971, he was in the hospital. First he was told that he didn't have very long to live, then, that he would be in a wheelchair for the rest of his life, and that he would never be able to have children. When Tom got married in the fall of 1971, he walked down the aisle. His son Tommy, Jr. was born two years later. Tom wasn't physically able to hold a steady job and received 100 percent disability from the government. He pursued various activities that interested him. He organized a drug prevention program and ran for alderman in Reading, his hometown. He went to school to study nursing, marine biology, and psychology. He joined a theater group, and kept a journal of poetry and short stories. He was active in the PTA at his son Tommy's school The cold bothered him terribly so he traveled to warmer climates where he lived for extended period of time - Mexico, Belize, Colombia. Tommy, Jr. would visit or travel with him during summer vacation. Tom was a long-term member of a Vietnam veterans' support group at the Boston Vet Center, where he had very close friends. After his treatment for cancer in Boston in the spring and summer of 1986, Tom and June stayed with his family in Florida for recuperation, and then moved back to their home in Alabama. Tom and June were together, separated and then together again. Both were attending college in the fall of 1987 when Tom went into the hospital in Alabama with a relapse of his cancer. His condition deteriorated steadily and June spent her days with him. He died on January 7, 1988 in his sleep. Tom left instructions that he wanted his body cremated and his ashes sprinkled over Boston Harbor. A memorial service was held on May 22, 1988, attended by friends, family members, and the veteran community. VETLink #1 Note: This is but one of seven interviews contained within this book by Janice Rogovin - Editorial Consultants John Grady and Sarah Rogovin. Many who helped prepare the book are friends of mine and yours. You'll recognize them - they're part of me and you. This first is a companion to the Physician's Guide To Agent Orange that is also in this edition of NAM VET. NamVet NewsLetter Page 9 Volume 3, Number 3 March 3, 1989 I SMELT A 'NAM by Mike Dealey Memories? Yeah, I got 'em. Deep in me, man. Part and parcel of my soul now. I think perhaps the ones I remember most are the aromas indigenous to that particular banana republic. The Nam: Olfactory Goddess of the Orient. Upon a time, my nostrils were filled with enough of Her odoriferous redolence to last for...for...forever. The rearward belch of a diesel truck As it buries its axles in a road paved with muck. Yet everyone knows where the real bouquet's at... Downwind of a rice paddy that's been freshly shat. Yeah, remember ole Honey Bucket Joe? They didn't call him Mr. Stink-san for nothing, ya know. And if you'll indulge me a moment (ahem), The back room of a bordello at 2 a.m. The pungent smell of burning plastique As it vainly attempts to make edible your daily portion of mystery meat. Now here's you one that's really fun: Reeking crotch-rot blisters as they start to run. The scent of green elephant grass a-burning. Dinks racing through it, their legs just a-churning. I remember an entire vil of dry palm leaves burning. Hear the peasants' wail of mournful yearning? A waft of napalm on the breeze at first light. Up and at 'em...your job is to fight. Cordite...cordite...cordite.... A Huey running rich on JP-4. Bloody jungle boots dangling out the door. But the thing that'll drive you to doing pot Is a stench-filled night in a foxhole... With a buddy that's been gut-shot. Don't wanna talk about it anymore this bout. Here be's Boonie Rat...over and out. Copyright 1977, 1989 by Boonie Rat a/k/a Mike Dealey. One-time reproduction permission given to IVVEC newsletter. NamVet NewsLetter Page 10 Volume 3, Number 3 March 3, 1989 Wheeler and Me... By Ed Peterson Pittsfield, MA His back against the wall, positioned so that he could survey all who approached, Jimmy sort of blankly stared at passersby. I hadn't seen him since '68, but the moment I came into his view a glimmer of recognition and acknowledgement stole across his features. For just a brief second, I saw happiness and a glint of a smile streak across his sad face - then sadness returned its wrinkled lines. He didn't wear his age well. Life must have been hard for him. Best friends since high school, I hadn't remembered seeing him around. "Where ya' been?" I asked. "The 'Nam," he said, "seems like I'm there all the time. Let me tell you about one of our days... And Jimmy told me: "We were alone... I was one of 8 men left. We were sent on a simple search mission. We were a company of twelve when we left base. The jungle seemed more damp and quiet that day. The odor of damp moss permeated our noses. The leaves of the trees were hanging limp as the last nights rain had been heavy. We went a bit farther west that day... I remember talking to Woods and him saying "What the hell are we doing out here?" It seems that there was VC activity here, and we were sent to verify if the VC were here. They were..... As we walked past a small clearing, the fire opened up. Scalice, our radio man took the first hit. The VC round passed through the radio, into his heart. He died in moments. The rest of us were frozen. It came so quickly. I saw a ravine about 25 yards from my position, and crawled to it. Wheeler, Costa, and Chinetti were already there. The enemy fire ceased. They were coming to us. DaSilva yelled from a treeline to see who was left. We lost four men. The VC were to the west, east, south and north. It was dim at best. We sat in the ravine for what seemed months, listening to the sounds of the jungle. Our hearts pounding so loud we could hear them..... After 10 minutes or so, I heard Therrien do his usual. He jumped out of his cover, with his AR flashing, yelling, creating cover. Wheeler and I ran to the South. We found another ravine and jumped in, covering ourselves with leaves. We stayed there for what seemed centuries, hearing the gunfire, wondering who of our friends were dying.... All of them died that day. NamVet NewsLetter Page 11 Volume 3, Number 3 March 3, 1989 I believe we laid there for about 8 hours or so, unmoving except for my foot, which was on Wheelers shoulder, each other twitching once an hour or so to help keep track of reality, and that we were both there, together, in this situation. The VC did a scout mission themselves... One passing about 10 yards from us. I remember the sensation of almost passing out because of the lack of oxygen, As I didn't breath for about 60 seconds.. Fighting my body's need to breathe. We made it back to camp about 6 hours later.. Wheeler and me... all that was left... for a simple search mission... Wheeler and me...." The lines on Jimmy's face deepened, his blank stare returned, and his breathing became slow and measured. "Memories, Jimmy... I'm glad you shared 'em with me. We'll talk again soon... Okay?" "Yeah," I heard him mumble, "Yeah... Wheeler and me... Wheeler and me... " NamVet NewsLetter Page 12 Volume 3, Number 3 March 3, 1989 ================================================================= - = > V E T E R A N S ' S E R V I C E S < = - ================================================================= Agent Orange Update From The Air Force Times, Feb. 20, 1989, p. 22. Input by: Friends BBS, 1:14/662, Omaha, Nebraska Veterans who think they are disabled because they were exposed to the defoliant Agent Orange still have a few more weeks to apply for payments from a $170 million compensation fund. March 1 is the new deadline for veterans to send their applications to the Agent Orange veteran Payment Program. A U.S. District Court in New York extended the deadline from Jan. 1 after program officials realized that many veterans who might be eligible for payments had not yet received information or application packets. Extension of the deadline is not expected to delay payments from the fund to people who filed claims before the original deadline, officials said. More than 250,000 people have expressed an interest in filing claims for compensation under the program. About 25,000 claim applications have been received, said Deborah Greenspan, a program spokeswoman. Officials have said they expect 40,000 to 60,000 to qualify for payments by the time all applications are processed. The payments also are available for survivors of veterans whose deaths are attributed to health problems that may have been caused by exposure to Agent Orange. Payments to veterans and their survivors will begin in March and continue until Dec. 31, 1994. In general, claims will be processed in the order that they are received, but claims from survivors will have first priority, Greenspan said. Veterans who become disabled after March 1 still may claim a share of the compensation money, as long as they file their claims within 120 days of becoming disabled. If a veterans dies after March 1, survivors may file claims if they apply within 120 days of the veteran's death and the claim is made before the program ends. Disability payments will be made in annual installments. For an individual veteran, the annual disability payment is expected to average $1,140, with a maximum annual payment of $2,560. The fund was established by chemical companies that made Agent Orange during the Vietnam War, as part of an out-of-court settle- ment between the companies and disabled veterans. U.S. District Court Judge Jack B. Weinstein has appointed officials to oversee the payment program. People who want details about the program or application kits may telephone (800) 225-4712 or write to the Agent Orange Veteran Payment Program, P.O. Box 110, Hartford, Conn. 06104. NamVet NewsLetter Page 13 Volume 3, Number 3 March 3, 1989 Toxic Herbicide Exposure (Agent Orange) The Physician's Resource Prepared for: The Pennsylvania Vietnam Herbicides Information Commission and the Pennsylvania Department of Health By: The Educational and Scientific Trust of The Pennsylvania Medical Society Dick Thornburgh, Governor H. Arnold Muller, M.D., Secretary of Health Input by: VETLink #1 Pittsfield, Massachusetts FidoNet 1:321/203 AlterNet 7:46/203 (413) 443-6313 This Guide is not a standard of medical care. Its purpose is to inform physicians about potential health effects in Vietnam Veterans resulting from Agent Orange exposure. Additionally, this guide encourages thorough medical evaluation, appropriate laboratory studies and referral to Veterans' Administration centers in the event Agent Orange exposure is suspected or encountered. (c) 1984 by The Pennsylvania Department of Health FOREWORD Increased public awareness of possible health effects following Agent Orange exposure has led to rising numbers of Vietnam veterans seeking medical attention for problems they believe are related to Agent Orange. This situation creates diagnostic and management challenges for physicians who may be unfamiliar with concerns related to Agent Orange exposure, or unaware that various resources exist to support their efforts in caring for such patients. This guide, part of a comprehensive program initiated by Governor Dick Thornburgh and mandated by Act 99-1982 of the Pennsylvania Legislature (Vietnam Herbicides Information Commission), is designed to provide physicians with information that raises their awareness regarding potential Agent Orange toxicity. Although existing literature and research relating to the health effects following Agent Orange exposure remain inconclusive and frequently contradictory, it is imprudent to conclude that this substance is harmless. Physicians encountering Vietnam veterans with complaints that may be associated with Agent Orange exposure can help by providing a thorough medical evaluation, objective documentation of history and physical findings and appropriate referral to the Veterans Administration centers for follow-up. H. Arnold Muller, MD Secretary of Health Commonwealth of Pennsylvania MILITARY USE OF AGENT ORANGE The use of defoliants in Vietnam ushered in a new era in modern warfare characterized by major efforts to eliminate not only the enemy's fighting manpower but also the vegetation that protected and fed them. During the conflict in Southeast Asia, the United States government approved the military plan to employ 15 NamVet NewsLetter Page 14 Volume 3, Number 3 March 3, 1989 different herbicides toward three principal objectives: (1) OFFENSIVE -- to facilitate reconnaissance, to impair enemy communication and to assist air strikes and ground operations; (2) DEFENSIVE -- to clear the perimeter of military bases, supply routes and landing sites; and (3) TO DESTROY CROPS.<1> Defoliation was performed after more than 20 years of testing experience with materials believed to be completely safe to humans and animals.<2> In 1967, findings by the Midwest Research Institute, later corroborated by the American Association for the Advancement of Science, concluded that "the possibility of lethal toxicity to humans, domestic animals, or wildlife by the use of herbicides in Vietnam is highly unlikely and should not be a matter of concern."<3> In a contradictory report, however, Irish and Darrow point out that herbicides received considerable unfavorable publicity in the 1960s.<4> Based upon the research on herbicides from 1944 until 1961 and reinforced by data from the Midwest Research Study, the decision was made to spray more than 20 million gallons of herbicides over 8.5 percent of the countryside of Vietnam.<5> The defoliants used in large quantities were assigned names according to the color of the identification bands painted on each drum. From 1965 until 1971, 11.2 million gallons of herbicide Agent Orange were sprayed.<6> Although herbicide Agent Orange was the most widely used and, therefore, most universally recognized, herbicides White, Blue, Purple, Pink, Orange II and Green were also utilized in spraying operations. Heavily-covered areas included the mangrove forests in the south peninsula, the forests of the demilitarized zone (DMZ), the junction of Cambodia, Laos and South Vietnam and the forests north and west of Saigon. Crop destruction was carried out mostly in the central highlands with the arsenic-containing herbicide Agent Blue. Most herbicides were dispersed by fixed-wing aircraft and the rest by helicopter, river boats and back-pack units. Spraying reached a peak in 1967, leveled off in 1968 and 1969 and stopped completely by the end of 1971, following complaints by the South Vietnamese of increased rates of cancer and birth defects.<7> Residual stocks of Agent Orange were destroyed on the high-temperature incinerator ship Vulcanis off Johnston Island in 1977.<8> CHEMICAL COMPOSITION Agent Orange is a 50/50 mixture of two herbicides, 2,4,5-T (trichlorophenoxyacetic acid) and 2,4-D (dichlorophenoxyacetic acid). A contaminant by-product of phenoxyacetic acid production is TCDD (tetracholorodibenzodioxin) - clearly the most toxic of the 75 dioxin isomers and generally referred to as "dioxin."<9> GENERAL TOXIC EFFECTS IN LABORATORY ANIMALS Studies in laboratory animals implicate TCDD in birth defects; liver, lung, and pharyngeal carcinoma; weight loss; impaired immune function; peripheral neuropathy; gastrointestinal hemorrhage; thymic and testicular atrophy. It addition, chromosomal damage has been demonstrated in bacteria and yeast. Maternally-exposed mice demonstrate teratologic effects (primarily cleft palate and some renal abnormalities).<10> Reproductive or teratogenic effects following TCDD exposure have not been established in humans. Current studies are addressing this issue. Laboratory studies have shown, however, that male and female rats exposed to TCDD have low fertility after exposure. NamVet NewsLetter Page 15 Volume 3, Number 3 March 3, 1989 Animal studies suggest that TCDD may act in a secondary or indirect capacity to enhance carcinogenicity of other substances.<11> EFFECTS ON ENZYMES TCDD is a potent inducer of various enzymes,<12> including delta aminolevulinic acid synthetase (an enzyme responsible for the first step in porphyrin production), carbamyl acid phosphatase (responsible for triglyceride production), and aryl hydrocarbon hydroxylase (responsible for the metabolism of xenobiotics^). The induction of these enzymes is responsible for some toxic effects of this compound. The binding of TCDD to a cell surface receptor is required for enzyme induction. This receptor is a gene product of the Ah locus.<13> ^XENOBIOTIC: A chemical compound (as a drug, pesticide, carcinogen) that is foreign to a living organism. ADVERSE HUMAN HEALTH EFFECTS Before extrapolating toxicologic data from one animal species to another (or to man), researchers must consider adaptive abilities of the species, different metabolic rates, use of higher test doses and various other factors. Still it is important to note that TCDD testing indicates extreme toxic effects in animals. In addition, long term occupational exposure and accidental exposures have been associated with certain adverse health effects in humans. Troop movements, difficulties in extracting information from military records, inaccurate recall about events and places, etc., has made it difficult to determine the frequency and intensity of exposure to which veterans may have been subjected. Also, it should be noted that many of the symptoms that occur with acute exposure may be transitory. CHLORACNE is the only condition universally recognized to have a causal link with dioxin exposure and is considered a clinical marker of such exposure. The disorder may appear as rapidly as two or three weeks after exposure, or development may be delayed for up to a two-year period. Duration of the lesions has been observed for as long as twenty-eight years.<14> Chloracne is clinically similar to acne vulgaris. It is characterized by an acne-like eruption of comedones, cysts, and pustules that usually involves the malar area of the face. Chloracne, however, may involve any area of the body except the palms of the hands and the soles of the feet. When such eruptions occur in the groin or on the eyelids, chloracne should be considered as the diagnosis.<15> Histologic findings in chloracne may include: acanthosis, absence of the sebaceous glands of the dermis, paucity of inflammatory cells and squamous metaplasia of the pilosebaceous glands.<16> Gross dermatological manifestations are phrynoderma (hyperkeratosis of the hair follicles), hyperpigmentation and hypertrichosis (usually demonstrated on the temporal areas of the face and the dorsum of the fingers).<17> Other physical, metabolic and psychologic conditions reported in some people exposed either repeatedly or to brief, high levels of dioxin include: (1) PERIPHERAL NEUROPATHY: numbness and weakness in the toes and fingers with decreased nerve conduction velocities following exposure to 2,4-D.<18> NamVet NewsLetter Page 16 Volume 3, Number 3 March 3, 1989 (2) HEPATIC DYSFUNCTION: no pathognomonic microscopic findings have yet been described. Animals have shown periportal fibrosis.<19> Hypertrophy of the endoplasmic reticulum has been observed in humans.<20> (3) HYPERTRIGLYCERIDEMIA: due to induction of carbamyl acid phosphatase and inhibition of lipoprotein lipase.<21> (4) HYPERCHOLESTEROLEMIA: elevated serum cholesterol levels.<22> (5) NEURASTHENIA: a syndrome of generalized fatigue, headaches, insomnia, irritability, sleep disturbances, and loss of initiative; a latency period of several months to years may occur with this syndrome.<23> Neurasthenia should be differentiated from Post-traumatic Stress, a recognized psychiatric entity recorded in medical literature associated with war. Post-traumatic Stress is preceded by a definite stress- evoking incident such as bombing, an explosion, battle or even incarceration under inhumane conditions. (6) PORPHYRINURIA and PORPHYRIA CUTANEA TARDA: usually uroporphyrins are increased due to the induction of delta aminolevulinic acid synthetase which catalyzes the conversion of glycine and succinyl CoA to form delta aminolevulinic acid. Strik has clearly described a cascading sequence of progressive porphyrinuria in individuals exposed to TCDD in an industrial accident. Asymptomatic coproporphyrinuria progressing to porphyria cutanea tarda (increased uroporphyrin) was observed.<24> (7) CARCINOGENICITY: Research to date is not conclusive that TCDD, 2,4-D and 2,4,5-T exposure in humans is carcinogenic. Studies of exposed Swedish forestry and agricultural workers, however, indicate that a causal relationship between phenoxyacetic acids and the development of soft tissue sarcoma may exist.<25> Other forms of cancer have also been investigated, but the results have been inconclusive. DOCUMENTED HUMAN EXPERIENCES In a 1977 NATO Workshop on Ecotoxicology, Reggiani<26> reported that patients exposed to TCDD in the Seveso accident demonstrated the following findings: hyperpigmentation, hirsutism, liver damage, raised serum hepatic enzyme levels, fat and carbohydrate metabolism disorders, cardiovascular disorders, urinary and respiratory tract disorders, pancreatic disorders, polyneuropathies, weakness in lower extremities and neurasthenic or depressive syndromes. Polyneuritis with progressive symptoms of paresthesias, paralysis, and severe joint pain have been reported in three humans exposed to 2,4-D. Nephropathy, liver damage, gastrointestinal disturbances, and central nervous system irritability have been reported in an individual who accidentally ingested a large dose of 2,4-D. Humans exposed to 2,4,5-T have experienced muscle spasms and difficulty swallowing.<27> Scientific literature documents human exposure to TCDD via industrial accidents. Both high intensity, brief exposures such as those occurring with explosions and long-term repeated exposures have been reported. In Nitro, West Virginia, 122 persons developed chloracne following a trichlorophenol accident in 1949.<28> In addition to chloracne, other symptoms reported after the West Virginia accident were myalgias, fatigue, vertigo, intolerance to cold, dyspnea (acute), decreased libido, nervousness and irritability. Ott evaluated 204 workers exposed to 2,4,5-T during its NamVet NewsLetter Page 17 Volume 3, Number 3 March 3, 1989 production at Dow Chemical Company from 1950-1971.<29> Forty- eight workers developed varying degrees of acne, of which 13 were diagnosed as chloracne. No increase in mortality was recorded. The largest single population of persons (37,000) exposed to TCDD occurred at Seveso, Italy, in 1976. No increased incidence of mortality, cancer, birth defects, or abnormal immune function was reported. Peripheral neuropathy and porphyrin disturbances occurred in a small proportion of the exposed group.<30> Seventy-five workers in a trichlorophenol plant in Ludwigshafen, Germany, were exposed to TCDD during an accident and cleanup. Polyneurities and liver damage were reported: these patients showed no increased incidence of cancer or mortality.<31> Porphyria cutanea tarda was discovered in 11 of 29 workers exposed to 2,4-D and 2,4,5-T at Diamond Alkali's New Jersey plant.<32> Jirasek analyzed 78 people exposed to 2,4,5-T and noted that 76 of them developed chloracne.<33> Other findings included fatigue, weakness, limb pain, sweating, headaches, polyneuropathy, porphyria cutanea tarda, and hepatomegaly with increased alkaline phosphatase levels. Dioxin is a limited cumulative toxin. Individuals exposed on a repeated basis typically demonstrate more adverse health effects (especially porphyria) than those exposed in a single event.<34> Groups subjected to chronic dioxin exposure also tend to have more prolonged disorders than those experiencing a single exposure. In 1977, Vietnam veterans begain complaining about health problems, including liver disorders, headaches, numbness, easy fatigability, loss of concentration, photophobia, joint pain, gastrointestinal disturbances,<35> recurrent infection, rashes, birth defects, and post-traumatic stress disorder which they thought to be chemically induced.<36> ----------------------------------------------------------------- | Information on human health effects from military exposure | | is inconclusive but should be clarified by data which will | | result from studies planned by the federal Centers for | | Disease Control. In the meantime, occupational and | | industrial experiences provide our current state of | | knowledge. | |---------------------------------------------------------------| CONTINUING RESEARCH Several studies are in progress in an attempt to define the effect of herbicide exposure on the health of Vietnam veterans.<37> The United States Centers for Disease Control in Atlanta has received a contract from the Veterans' Administration (VA) to conduct three studies: (1) a cohort study of the health effects of exposure to herbicides in Vietnam (referred to as the "Agent Orange Study"), (2) a cohort study of the long term health effects of military service in Vietnam (referred to as the "Vietnam Experience Study"), (3) a case control study to determine the risks for soft-tissue sarcomas and lymphomas (referred to as the "Sarcoma/Lymphoma Study"). The VA in St. Louis is conducting a study in which 350 pairs of identical twins (one of whom served in Vietnam) will be evaluated. Concurrently, the VA is conducting studies concerning birth defects and chloracne. The Air Force "Ranch Hand Study" has evaluated aircraft crews and support personnel who participated in herbicide spraying in Vietnam from 1962 to 1971. Preliminary reports indicate that the NamVet NewsLetter Page 18 Volume 3, Number 3 March 3, 1989 overall mortality rate of the Ranch Hand and comparison groups are similar. Morbidity data will be available in early 1984. EVALUATION OF EXPOSED PATIENTS It is very important for physicians to secure a detailed medical history and to perform a thorough physical examination. The history should include comprehensive occupational, social and family components. Of particular importance in the physical examination are the skin and the nervous system. The entire skin surface should be inspected meticulously for any lesions. Peripheral neuropathy should be evaluated by testing for vibratory sense. Temperature sensation, proprioception and pin prick response of both upper and lower extremities should be determined. When symptomatology indicates the necessity of further evaluation, physicians should order appropriate laboratory and radiographic studies to develop a differential diagnosis. It should be noted that diagnostic procedures may be costly and most health insurers will not reimburse for injury or illness suspected of being war related. Patients should be referred to Veterans Administration environmental physicians. The laboratory evaluation of the toxic health effects of herbicide exposure should be in keeping with the results of clinical findings. It must be emphasized that abnormal laboratory findings are not necessarily diagnostic of Agent Orange exposure. TREATMENT AND FOLLOW-UP CARE Treatment is still largely supportive in instances of exposure to herbicides. Currently, investigation centers around the efficacy of certain minerals (zinc and selenium) along with special diets, plasmapheresis and the administration of bile salt binders like cholestyramine to rid the body of herbicides.<38> These techniques, although interesting, still require additional study to prove or disprove their efficacy. Vitamin A (administered topically and systemically) has been used with dermabrasion to treat stubborn chloracne.<39> The condition generally is resistant to the usual anti-acne regimen of tetracycline and ultraviolet light. The newer anti-acne drug Accutane (isotretinoin), a vitamin A derivative, may be efficacious in treating chloracne, but additional testing is needed before isotretinoin is included in a routine chloracne regimen. To assure proper guidance and follow up in treatment of neurasthenia, appropriate therapy should be performed by mental health professionals familiar with the entity but especially with the special problems of the Vietnam veteran.<40> Psychotropic drugs, particularly benzodiazepines (which may cause additional memory loss with long term use) and the phenothiazines (which may cause extraphyamidal symptoms) should be used with caution. In the absence of complete toxicologic information of Agent Orange and specific therapeutic modalities the physician may understandably feel frustrated in managing Vietnam veterans who may have been exposed to Agent Orange. Enough information is available about Agent Orange, however, to warrant thorough evaluation of those Vietnam veterans exhibiting health problems. VA AGENT ORANGE EXAMINATION The VA provides a continuing program for examining Vietnam veterans concerned about the possible health effects of exposure NamVet NewsLetter Page 19 Volume 3, Number 3 March 3, 1989 to Agent Orange. Veterans who elect to undergo this examination receive a comprehensive physical examination and complete an in- depth questionnaire about their duty in Vietnam. The findings of these examinations are entered into and become part of the permanent data base in the VA Agent Orange Registry. As noted earlier, diagnostic procedures may be costly and most health insurers will not reimburse for injury or illness suspected of being war related. Referral to Veterans Administration environmental physicians should be encouraged. The scope of diagnostic measures will be at the discretion of the VA physician evaluating the patient. PENNSYLVANIA VETERANS ADMINISTRATION MEDICAL CENTERS Pennsylvania veterans can receive examinations at the following VA medical centers: Altoona VA Medical Center Butler VA Medical Center Pleasant Valley Blvd. New Castle Road Altoona, PA 16603 Butler, PA 16011 Phone: (814) 943-8164 Phone: (412) 287-4781 Coatesville VA Medical Center Erie VA Medical Center Black Horse Road 135 East 38th Street Coatesville, PA 19320 Erie, PA 16501 Phone: (215) 384-7711 Phone: (814) 868-8661 Lebanon VA Medical Center Philadelphia VA Medical Center State Drive University & Woodland Avenues Lebanon, PA 17042 Philadelphia, PA 19104 Phone: (717) 272-6621 Phone: (215) 382-2400 Pittsburgh VA Medical Center Pittsburgh VA Medical Center University Drive C Highland Drive Pittsburgh, PA 15240 Pittsburgh, PA 15206 Phone: (412) 683-3000 Phone: (412) 363-4900 Wilkes-Barre VA Medical Center 1111 East End Blvd. Wilkes-Barre, PA 18711 Phone: (717) 824-3521 VA OUTPATIENT CLINICS IN PENNSYLVANIA Allentown VA Outpatient Clinic Harrisburg VA Outpatient Clinic 2937 Hamilton Blvd. 228 Walnut St. Federal Bldg Allentown, PA 18104 Harrisburg, PA 17108 Phone: (215) 776-4304 Phone: (717) 782-4590 Philadelphia VA Outptnt Clinic Pittsbgurgh VA Outptnt Clinic 1421 Cherry Street 1000 Liberty Avenue Philadelphia, PA 19102 Pittsburgh, PA 15222 Phone: (215) 597-3311 Phone: (412) 644-6750 GOVERNOR'S VETERANS OUTREACH AND ASSISTANCE CENTERS Veterans who have further concerns or questions, or who wish assistance in arranging a VA Agent Orange Examination, can contact one of the "Governor's Veterans Outreach and Assistance Centers" listed below: Governor's VOAC Governor's VOAC NamVet NewsLetter Page 20 Volume 3, Number 3 March 3, 1989 12923 Penn-Lincoln Highway 916 Peach Street North Huntingdon, PA 15642 Erie, PA 16501 Phone: (412) 864-7220 or 7221 Phone: (814) 453-5719 Toll Free #: (800) 442-6815 Toll Free #: (800) 352-0915 Governor's VOAC Governor's VOAC 45 West Market Street 205 Market Street Wilkes-Barre, PA 18773 Harrisburg, PA 17101 Phone: (717) 825-7343 Phone: (717) 234-1681 Toll Free #: (800) 432-9735 Toll Free #: (800) 932-0930 Governor's VOAC 18 South Rohland Street Pottstown, PA 19464 Phone: (215) 326-5233 Toll Free #: (800) 247-2323 VIETNAM HERBICIDES INFORMATION COMMISSION COMMONWEALTH OF PENNSYLVANIA In response to veterans' concerns and their perceived lack of federal action, Governor Thornburgh proposed legislation to create the Veitnam Herbicides Information Commission. The Pennsylvania legislature subsequently passed House Bill 1575 to provide for creation of the 15 member commission. The bill was signed into law in April 1982. One mandate of the new law was the development of a professional education program addressing the effects of herbicide exposure. In addition, the commission is attempting to reach out to veterans through media releases, veterans' organizatons, and personal contact via the toll free "VHIC Hot Line," 1(800)222-1993. The Pennsylvania Department of Health is preparing a registry of exposed veterans. Registry input will consist of two components: a Herbicide Exposure and Health History Questionnaire intended for completion and submission by individual veterans. The Physician's Medical Report Form is to be completed by the physician at the request of the veteran and is designed as a companion to the questionnaire. Success of the program depends upon receipt of all components. The Physician's Medical Report Form is included with this booklet and may be easily reproduced by copy machine. (If your physician needs a computer copy of this form, please contact VETLink #1 - data: (413)443-6313) Copies are also available from the Vietnam Herbicides Information Commission, Division of Environmental Health, Pennsylvania Department of Health. For additional information contact: Toll Free VHIC Number (800) 222-1993 or the Pennsylvania Department of Health Division of Environmental Health (717) 787-1708 REFERENCES <1> JRB Associates, REVIEW OF LITERATURE ON HERBICIDES, INCLUDING PHENOXY HERBICIDES AND ASSOCIATED DIOXINS, 1980, Volume I, Chapter 2. <2> Young, A.L., Calcagni, J.A., Thalken, C.E., and Tremblay, J.W., THE TOXICOLOGY, ENVIRONMENTAL FATE, AND HUMAN RISK OF HERBICIDE ORANGE AND ITS ASSOCIATED DIOXIN, 1978, Chapter 5, p.13 NamVet NewsLetter Page 21 Volume 3, Number 3 March 3, 1989 <3> House, W.B., Goodson, L.H., Gadberry, H.M., and Dockter, K.W. (1967) ASSESSMENT OF ECOLOGICAL EFFECTS OF EXTENSIVE OR REPEATED USE OF HERBICIDES. Midwest Research Institute (Kansas City, Missouri). Sponsored by Department of Defense, ARPA Order No. 1086, p. 369. <4> Irish, K.R., Darrow, R.A., and Minarik, C.E. (1969) INFORMATIONAL MANUAL FOR VEGETATION CONTROL IN SOUTHEAST ASIA. Misc. Public. 33. Department of the Army, Fort Detrick, Frederick, Maryland. P. 71. <5> JRB Associates, Volume I, Chapter 2. <6> JRB Associates, Volume I, Chapter 2. <7> JRB Associates, Volume I, Chapter 2. <8> Young, et al, p. 29. <9> Heylin, Michael (Ed.), "The Dioxin Phenomenon." CHEMICAL & ENGINEERING NEWS, June 6, 1983, p. 64. <10> JRB Associates, Volume I, Chapter 8. <11> JRB Associates, Volume I, Chapter 10. <12> Poland, A., and Glover, E., (1973) "2,3,7,8- Tetrachlorodibenzo-p-dioxin: A Potent Inducer of Delta- aminolevulinic Acid Synthetase." SCIENCE 179:467-477. <13> Poland, A., and Glover, E., (1980) "2,3,7,8- Tetrachlorodibenzo-p-Dioxin: Segregation of Toxicity with the Ah Locus," MOLEC. PHARMACL. 17:86-94 <14> Crow, K.D. (1980) Direct testimony before the U.S. Environmental Protection Agency FIFRA Docket No. 415, et. al., Nov. 14. <15> Crow, KI.D. (1978) "Chloracne: the chemical disease." NEW SCIENTIST, pp.78-80. <16> Taylor, J.D. (1979) "Environmental Chloracne: Update and Overview." ANN. N.Y. ACAD. SCI. 320:295-307. <17> Young, p. 10-11. <18> Goldstein, N.P., Jones, P.H., and Brown, J.R. (1959) "Peripheral Neuropathy after Exposure to an Ester of Dichlorophenoxyacetic Acid." JAMA 171 (10): 1306-1309. <19> Kimbrough, R.D., Carter, C.D., Liddle, J.A., Cline, R.E., and Phillips, P.E. (1977) "Epidemiology and Pathology of a Tetrachlorodibenzo dioxin Poisoning Episode." ARCH. ENVIRON. HEALTH 32(2):77-86 <20> Guzelian, P.S., (1981) "Environmental Toxins and the Liver." PRACTICAL GASTROENTEROLOGY, 5(4):pp.24-30. <21> Walker, A.E., and Martin, J.V. (1979) "Lipid Profiles in Dioxin-Exposed Workers. LANCET (1):446-447. <22> Ibid., p. 446-447. <23> JRB Associates, Volume I, Chapter 1, page 8. <24> Strik, J.J.T.W.A. and Koeman, J.H.(Ed.), CHEMICAL PORPHYRIA IN MAN, 1979, Elsevier/North-Holland Biomedical Press, Amsterdam, New York, Oxford. <25> JRB Associates, Chapter 8. <26> Reggiani, G. (1977) "Toxic Effects of TCDD in Man" NATO Workshop on Ecotoxicology, Guilford, England. <27> Hayes, W.J. (1963) CLINICAL HANDBOOK ON ECONOMIC POISONS, U.S. Public Health Service, U.S.D.H.E.W., Revised Edition,Publication No. 476, U.S. Gov't Printing Office, Washington, DC. <28> Suskind, R.R. (1979) A STUDY OF WORKERS INVOLVED IN THE MANUFACTURE OF 2,4,5-T. PROTOCOL FOR NITRO, WEST VIRGINIA STUDY, JUNE 1979. Prepared by the Department of Environmental Health, Kettering Laboratory, Cincinnati, Ohio, 29pp. <29> Ott, M.G., Holder, B.B., and Olson, R.D. (1980) "A Mortality Analysis of Employees Engaged in the Manufacture of 2,4,5- NamVet NewsLetter Page 22 Volume 3, Number 3 March 3, 1989 trichlorophenoxyacetic Acid." J. OCCUP. MED. 22(1):47-50. <30> Reggiani, G. (1979) "Estimation of the TCDD Toxic Potential in the Light of the Seveso Accident." ARCH. TOXICOL. 2:291-302. <31> JRB Associates, REVIEW OF LITERATURE ON HERBICIDES, INCLUDING PHENOXY HERBICIDES AND ASSOCIATED DIOXINS, 1980, Volume II, page 348. <32> Bleiberg, J., Wallen, M., Brodkin R., Applebaum, I. (1964) "Industrially Acquired Porphyria." ARCH. DERMATOL. 89(6):793-797. <33> Jirasek, L., Kalensky, J., Kubec, K., Pazderova, J., and Lukas, E. (1974) "Acne Clorina, PorphyriaCutanea Tarda and Other Manifestations of General Intoxication During the Manufacture of Herbicides." Part II, CESK. DERMATOL. 49(3):145-157. <34> JRB Associates, Volume I, Chapter 1. <35> Petryka, Z., Codario, R.A., "Reverse Phase Profiles of Urinary Prophyrins in Patients Exposed to Agent Orange." PROCEEDINS, AMERICAN CHEMICAL SOCIETY, New Orleans, April 1982. <36> Bogen, G. (1979) "Symptoms in Vietnam Veterans Exposed to Agent Orange." JAMA 242(22): 2391 <37> Veterans Administraton, "Agent Orange Review," August 1983, Vol. 2, No. 3, p. 3. <38> Cohn, W.J., Boy7lan, J.J., Blanke, R.V., Fariss, M.W., Howell, J.R., and Guzelian, P.S. (1978) "Treatment of Chlordecone (Kepone) Toxicity with Cholestyramine." NEW ENGLAND JOURNAL OF MEDICINE, 298:243-248. <39> Taylor, J.S., p. 295-307. <40> Howard, S., (1976) "The Vietnam Warrior: His Experience, and Implications for Psychotherapy." AMERICAN JOURNAL OF PSYCHOTHERAPY 30 (1): 121-135. BIBLIOGRAPHY (BY SUBJECT) USE OF HERBICIDES IN VIETNAM Collins, C.V. (1967) HERBICIDES OPERATIONS IN SOUTHEAST ASIA, JULY 1961 - JUNE 1967. DTEC 67-0020. Pacific Air Force, APO San Francisco DTIC No. AD 779796. 76pp. Esposito, M.P., Tiernan, T.O., and Dryden,F.E. (1980) DIOXINS. U.S. Enviornmental Protection Agency, Industrial Environmental Research Laboratory, Office of Research and Development. US-EPA, Cincinnati, Ohio. 351 pp. Young, A.L., Calcagni, J.A., Thalken, C.E., and Tremblay, J.W. (1978( THE TOXICOLOGY, ENVIRONMENTAL FATE, AND HUMAN RISK OF HERBICIDE ORANGE AND ITS ASSOCIATED DIOXIN. USAF Occupational and Environmental Health Laboratory Report No. USAF OEHL-78-92.62 pp. ENVIRONMENTAL FATE OF TCDD Matsumura, F., and Benezet, H.J. (1973) "Studies on the Bio- accumulation and Microbial Degradation of 2,3,7,8- Tetrachlorodibenzodioxin." ENVIRON. HEALTH PERSPEC. 5:253-258 Young, A.L., Thalken, C.E. Arnold, E.L. Cupello, J.M., Cockerham, L.G.(1976) FATE OF 2,3,7,8-TETRACHLORODIBENZO-P-DIOXIN (TCDD) IN THE ENVIRONMENT: SUMMARY AND DECONTAMINATION RECOMMENDATIONS. Headquarters Air Force Logistics Command Report No. AFA-TR-76-18. METABOLISM AND MECHANISM OF ACTION Poland, A., Greenlee, W.F., and Kende, A.S. (1979) "Studies on the Mechanism of Action of the Chlorinated Dibenzo-p-dioxins and Related Compounds." ANN. N.Y.ACAD.SCI 320:214-230 Poland, A., and Glover, E. (1973) "2,3,7,8-Tetrachlorodibenzo- NamVet NewsLetter Page 23 Volume 3, Number 3 March 3, 1989 p-dioxin: A Potent Inducer of Delta-Aminolevulinic Acid SCIENCE 179:476-477 Poland, A., and Glover, E. (1980) "Studies on the Mechanism of Toxicity of the Chlorinated Dibenzo-para-dioxins." ENVIRON. HEALTH PERSPEC. 5:245-251 Poland,A., and Glover, E. (1980) "2,3,7,8-Tetrachlorodibenzo-p- dioxin: Segregation of Toxicity with the Ah Locus." MOLEC. PHARMACL. 17:86-94. TERATOGENICITY Bage, G., Cekanova, E., and Larsson, K.S. (1973) "Teratogenic and Embryotoxic Effects of the Herbicides Di - and Trichlorophenoxyacetic Acids (2, 4-D and 2,4,5-T)." ACTA PHARMACOL. TOXICOL. 32:408-416 Emerson, J.L., Thompson, D.J., Strebing, R.J., Gerbig, C.G., and Robinson, V.B. (1971) "Teratogenic Studies on 2,4,5- Trichlorophenoxyacetic Acid in the Rat and Rabbit." FD. COSMET. TOXICOL. 9:395-404 Epstein, S.S. (1973) "Teratological Hazards Due to Phenoxy Herbicides and Dioxin Contaminants." ENVIRONMENTAL SCIENCE RESEARCH SERIES. 2:708-729. Faith, R.E., and Luster, M.I. (1979) "Investigations on the Effects of 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) on Parameters of Various Immune Functions." ANN. N.Y. ACAD. OF SCI. 302:564-571. Field, B., and Kerr, C. (1979) "Herbicide Use and Incidence of Neural Tube Defects." LANCET. 1 (8130):1341-1342. Hood, R.D., Patterson, B.L., Thacker, G.T., Sloan, G.L., and Szczech, G.M. (1979) "Prenatal Effects of 2,4,5-T, 2,4,5- Trichlorophenol and Phenoxyacetic Acid in Mice." J. ENVIRON. SCI. HEALTH (3c) 13:189-204 Khera, K.S. and McKinley, W.P. (1972) "Pre-and Post Natal Studies on 2,4,5-Trichlorophenoxyacetic Acid, 2,4- Dichlorophenoxyacetic Acid and their Derivatives in Rats." TOXICOL. APPL. PHARMACOL. 22:14-28. Lamb, J.C., Moore, J.A., and Marks, T.A. EVALUATION OF 2,4- DICHLOROPHENOXYACETIC ACID, 2,4,5-TRICHLOROPHENOXYACETIC ACID, AND 2,3,7,8-TETRACHLORODIBENZO-P-DIOXIN TOXICITY IN MIDE: REPRODUCTION AND FERTILITY IN TREATED MALE MICE AND EVALUATION OF CONGENITAL MALFORMATIONS IN THEIR OFFSPRING. National Toxicology Program, Research Triangle Institute, Research Triangle Park, NC, Report No. NTP-80-44. 55pp. Moore, J.A., Gupta, B.N., Zinkl, J.G., and Vos, J.G. (1973) "Postnatal Effects of Maternal Exposure to 2,3,7,8- Tetrachlorodibenzo-p-dioxin (TCDD)." ENVIRON. HEALTH PERSPEC. 5:81-85. Schwetz, B.A., Sparschu, G.L., Gehring, P.J. (1971) "The Effect of 2,4-Dichlorophenoxyacetic Acid and Esters of 2,4-D on Rate Embryonal Fetal, and Neonatal Growth and Development." FD. COSMET. TOXICOL. 9:801-817. Sparschu, G.L., Dunn, F.L. and Rowe, V.K. (1970) "Teratogenic Study of 2,3,7,80Tetrachlorodibenzo-p-dioxin in the Rat." TOXICOL. APPL. PHARMACOL. 17:317. MUTAGENICITY Babbit, B., Risch, S., Choffnes, E., Kalis, J., Zupanic, M., et. al. (1973) "Effects on 2,4,5-T on Human Chromosomes." GENETICS 71 (suppl):53. Fujita, K., Fujita, H.M., and Funazaki, Z. (1975) "Chromosomal Abnormality caused by 2,4,5-T." J. JPN. ASSOC. RURAL MED. NamVet NewsLetter Page 24 Volume 3, Number 3 March 3, 1989 24(2):77-79. Hussain, S., Ehrenberg, L., Lofroth, G., and Gejvall, T. (1972) "Mutagenic Effects of TCDD on Bacterial Systems." AMBIO 1:32-33. Ramel, C. "Genetic Effects of Phenoxyacetic Acids in Animals." CHLORINATED PHENOXY ACIDS AND THEIR DIOXINS. (Ecol. Bull. No. 27, Stockholm: Swedish Natural Science Research Council, 1978a)p 182- 185. Reggiani, G. (1980) "Acute Human Exposure to TCDD in Seveso, Italy." J. TOXICOL. ENVIRON. HEALTH 6:27-43. CARCINOGENICITY Axelson, O., and Sundell, L. (1977) "Phenoxy Acids and Cancer." LAKARTIDNINGEN 74(35):2887-2888. Eriksson, M., Hardell, L. Berg, N.O., Moller, T., and Axelson, O. (1979) "Case Control Study on Malignant Mesenchymal Tumors of the Soft Tissue and Exposure to Chemical Substances." LAKARTIDNINGEN 76:3872-3875. Hardell, L. (1979) "Malignant Lymphoma of Histiocytic Type and Exposure to Phenoxyacetic Acids or Chlorophenols." LANCET 1(8106):55-56. Hardell, L., Eriksson, M., and Lenner, P. (1980) "Malignant Lymphoma and Exposure to Chemical Substances, Especially Organic Solvents, Chlorophenols, and Phenoxy Acids." LAKARTIDNINGEN 77(4):208-210 Hardell, L., and Sandstorm, A. (1979) "Case Control Study: Soft Tissue Sarcomas and Exposure to Phenoxy Acids or Chlorophenols." BR. J. CANCER 39:711-717. Honchar, P.A., and Halperin, W.E. (1981) "2,4,5-T, Trichlorophenol, and Soft Tissue Sarcoma." LANCET Jan. 31; 1(8214):268-269. Kociba, R.J. Keyes, D.G., Beyer, J.E., Carreon, R.M., Gehring, P.J. (1979) "Long Term Toxicological Studies of 2,3,7,8- tetrachlorodibenzo-p-dioxin (TCDD) in Laboratory Animals." ANN. N.Y. ACAD. SCI. 320:397-404. Tung, T.T. (1973) "Primary Cancer of the Liver in Vietnam." CHIRURGIE 99(7):427-436. TOXIC EFFECTS ON VARIOUS ORGANI SYSTEMS IN HUMANS AND ANIMALS DERMATOLOGICAL EFFECTS Allen, A.M. (1977) "Skin Diseases in Vietnam, 1965-72." INERNAM MEDICINE IN VIETNAM. U.S. Army, Washington, DC pp. 1-13, 29-51, 125-129. Crow, K.D. (1978) "Chloracne - an Up-To-Date Assessment." ANN. OCCUP. HYG. 21:297-298 Crow, K.D. (1978) "Cloracne: the Chemical Disease." NEW SCIENTIST pp. 78-80. Taylor, J.S. (1979) "Environmental Chloracne: Update and Overview." ANN. N.Y. ACAD. SCI. 320-296-307. Taylor, J.S. (1974) "Chloracne - a Continuing Problem." CUTIS 13:585-591. Zelikov, A.K., and Danilov, L.N. (1974) "Occupational Dermatoses (acne) in Workers Engaged in Production of 2,4,5- Trichlorophenol." SOV. MED. 7:145-146. NEUROLOGICAL EFFECTS Nerkley, M.C., and Magee, K.R. (1963) "Neuropathy Following Exposure to a Dimethylamine Salt of 2,4-D." ARCH. INT. MED. 111:133-134. Boeri, R., Bordo, B., Crenns, P., Filippini, G., Massetto, M., NamVet NewsLetter Page 25 Volume 3, Number 3 March 3, 1989 and Zecchini, A. (1978). "Preliminary Results of a Neurological Investigation of the Population Exposed to TCDD in the Seveso Region." RIV. PAT. NERV. MENT. 99:111-128. Danon, J.M., Karpati, G., Carpenter, S. (1978) "Subacute Skeletal Myopathy Induced by 2,2-Dichlorophenoxyacetate in Rats and Guinea Pigs." MUSCLE AND NERVE (1) Mar/Apr:89-102. Desi, I., and Sos, J. (1962) "The Effect of 2,4- Dichlorophenoxyacetic Acid and Triorthocressyl Phosphate on the Function of the Upper Part of the Central Nervous System (Bioelectric Activity and Conditioned Reflexes)." GIG. SANIT. (12):38-46. Desi, I., and Sos, J., and Nikolits, I. (1962) "New Evidence Concerning the Nervous Site of Action of a Chemical Herbicide Causing Professional Intoxication." ACT. PHYSIOL. 22:73-80. Desi, I., Sos, J., Loasz, J., Sule, F., and Markus, V. (1962) "Nervous System Effects of a Chemical Herbicide." ARCH. ENVIRON. HEALTH 4:101-108. Foissac-Gegoux P., LeLievre, A., Basin, B., and Warot, P. (1962) "Polyneuritis After Use of a Herbicide: 2,4-D Acid." LILLE. MED. 7:1049-1051 Goldstein, N.P., Jones, P.H., and Brown, mJ.R. (1959) "Peripheral Neuropathy After Exposure to an Ester of Dichlorophenoxyacetic Acid." JAMA 171(10):1306-1309. Wallis, W.E., Vanpoznak, A., and Plum, F. (1970) Generalized Muscular Stiffness, Fasciculations, and Myokymia of Peripheral Nerve Origin. ARCH. NEUROL. 22:430-439. GASTROINTESTINAL EFFECTS (INCLUDING PORPHYRIA) Bleiberg, J., Wallen, M., Brodkin, R., and Applebaum, I.L. (1964) "Industrially Acquired Porphyria." ARCH. DERMATOL. 89:793-797. Bogen, G. (1979) "Symptoms in Vietnam Veterans Exposed to Agent Orange." JAMA 242(22):2391 Buu-Hoi, N.P.N., Chanh, P.H., Sesque, G., Azum-Gelade, M.C., and Saint-Ruf, G. (1972) "Organs as Targets of Dioxin (2,3,7,8- Tetrachlorodibenzo-p-dioxin) Intoxication." NATURWISSENSCHAFTEN 59(4):174-175. Carter, C.D., Kimbrough, R.D., Liddle, J.A., Cline, R.E., Zack, M.M., Barthel, W.F., Koehler, R.E., and Phillips, P.E. (1975) "Tetrochlorodibenzodioxin: an Accidental Poisoning Episode in Horse Arenas." SCIENCE 188(4189):738-740. Goldstein, J.A., Hickman, P., Bergman, H., and Vos, J.G. (1973). "Hepatic Porphyria Induced by 2,3,7,8-Tetrachlorodibenzo- p-dixoin." RES. COM. CHEM. PATH. PHARMACOL. 6(3):919-928. Jones, G. (1975) "A Histochemical Study of the Liver Lesion Induced by the 2,3,7,8-Tetrachlorodibenzo-p-dioxin (Dioxin) in Rats." J. PATHOL. 116:101-105. Jones, G., and Butler, W.H. (1974) "A Morphological Study of the Liver Lesion Induced by 2,3,7,8, Tetrachlorodibenzo-p-dioxin in Rats." J. PATHOL. 112(2):93-97. Jones, G., and Greig, J.B. (1975) "Pathological Changes in the Liver of Mice Given 2,3,7,8-Tetrachlorodibenzo-p-dioxin." EXPERIENTA 31:1315-1317. Jones, K.G., and Sweeney, G.D. (1979) "Iron Deficiency Prevents Liver Toxicity of 2,3,7,8-Tetrachlorodibenzo-p-dioxin." FED. PROC. FED. AM. SOC. EXP. BIOL. 38(3):536. Jirasek, L., et al. (1976) "Chloracne, Porphyria Cutanea Tarda and Other Intoxications by herbicides." DER HAUTARZT 27:328-333. Kimbrough, R.D., Carter, C.D., Liddle, J.A., Cline, R.E., and Phillips, P.E. (1977) "Epidemiology and Pathology of a NamVet NewsLetter Page 26 Volume 3, Number 3 March 3, 1989 Tetrachlorodibenzodioxin Poisoning Episode." ARCH. ENVIRON. HEALTH 32(2):77-86. Pazderova-Vejlupkova, J., Lukas, E., Nemcova, M., Pickova, J., and Jirasek, L. (1980) "Chronic Poisoning by 2,3,7,8- Tetrachlorodibenzo-p-dioxin." PRACOV. LEK. 32:204-209. Poland, A.P., Smith, D., Metter, G., and Possick, P. (1971) "A Health Survey of Workers in a 2,4-D, and 2,4,5-T Plant, with Special Attention to Chloracne, Porphyria Cutanea Tarda, and Psychological Parameters." ARCH. ENVIRON. HEALTH 22(3):316-327. Schiller, C.M. (1979) "Chemical Exposure and Intestinal Function." ENVIRON. HEALTH PERSPEC. 33:91-100. Stellman, S., and Stellman, J. (1980) "Health Problems Among 535 Vietnam Veterans Potentially Exposed to Toxic Herbicides." SOCIETY FOR EPIDEMIOLOGICAL RESEARCH: ABSTRACTS. AMER. J. EPID. 112(3):444. Strik, J.J.T.W.A. (1979) "Porphyrins in Urine as an Indication to Exposure to Chlorinated Hydrocarbons." ANN. N.Y. ACAD. SCI. 320:308-310. Sweeney, G.D., Jones, K.G., Cole, F.M., Basford, D., and Kretstynski, F. (1979) "Iron Deficiency Prevents Liver Toxicity of 2,3,7,8-Tetrachlorodibenzo-p-dioxin. SCIENCE 204(4390)332-335. Walker, A.E., and Martin, J.V. (1979) "Lipid Profiles in Dioxin Exposed Workers." LANCET 1:446-447. IMMUNOLOGICAL AND HEMATOLOGICAL EFFECTS Hinsdill, R.D., Thomas P.T., and Couch, D. "Immunotoxicity Assessment of Dioxins. Inadvertent Modification of the Immune Response. The Effects of Foods, Drugs, and Environmental Contaminants." Office of Health Affairs, FDA, Washington, DC pp.76-79. Luster, M.I., Clark, G., Lawson, L.D., and Faith, R.E. (1979) "Effects of Brief in Vitro Exposure to 2,3,7,8- Tetrachlorodibenzo-p-dioxin (TCDD) on Mouse Lymphocytes. J. ENVIRON. PATHOL. TOXICOL. 1:965-977. Luster, M.I., Faith, R.E. (1979) "Assessment of Immunologic Alterations Caused by Halogenated Aromatic Hydrocarbons." ANN. N.Y. ACAD. SCI. 320:572-578. Luster, M.I. Faith, R.E., and Clark, G. (1979) "Laboratory Studies on the Immune Effects of Halogenated Aromatics." ANN. N.Y. ACAD. SCI. 320:473-486. Sharma, R.P., and Gehring, P.J. (1979) "Effects of 2,3,7,8- Tetrachlorodibenzo-p-dioxin (TCDD) on Splenic Lymphocyte Transformation in Mice After Single and Repeated Exposures." ANN. N.Y. ACAD. SCI. 320:487-497. Thigpen, J.E., Faith, R.E., McConnell, E.E., and Moore, J.A. (1975) "Increased Susceptibility to Bacterial Infection as a Sequela of Exposure to 2,3,7,8-Tetrachlorodibenzo-p-dioxin." INFECTION AND IMMUNITY 12(6):1319-1324. Thigpen, J.E., McConnell, E.E., Moore, J.A., and Faith, R.E. (1977) "Effects of 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) on Host Resistance to Infectious Agents." ENVIRON HEALTH PERSPEC. 20:245. Vos, J.G. (1977) "Immune Suppression as Related to Toxicology." CRC CRITICAL REVIEWS IN TOXICOLOGY 5(1):67-101. Vos, J.G., Kreeftenberg, J.G., Engel, H.W., Minderhoud, A., and Van Noorle Jansen, L.M. (1978) Studies on 2,3,7,8- Tetrachlorodibenzo-p-dioxin Induced Immune Suppression and Decreased Resistance to Infection: Endotoxin Hypersensitivity, Serum Zinc Concentrations and Effect of Thymosin Treatment. TOXICOLOGY 9:75-86. NamVet NewsLetter Page 27 Volume 3, Number 3 March 3, 1989 Vos, J.G., Moore, J.A., and Zinkl, J.G. (1973) Effect of 2,3,7,8-Tetrachlorodibenzo-p-dioxin on the Immune System of Laboratory Animals. ENVIRON. HEALTH PERSPEC. 5:149-162. RENAL EFFECTS Stroo, W. E., McCormack, K.M., and Hook, J.B. (1979) "Renal Functional Effects of 2,4,5-Trichlorophenoxyacetic Acid and Silvex After Acute and Prolonged Exposure." J. TOXICL. ENVIRON. HEALTH 5(5):845-854. CARDIOVASCULAR Allen, J.R., Barsotti, D.A., Van Miller, J.P., Abrahamson, L.J., and Lalich, J.L. (1977) "Morphological Changes in Monkeys Consuming a Diet Consuming Low Levels of 2,3,7,8- Tetrachlorodibenzo-p-dioxin." FD. COSMET. TOXICOL. 15:401-410. Bauer, H., Schultz, K.H., and Spiegelberg, V. (1961) "Berufliche vergiftungen bei der herstellung von chlorphenol- verbindungen." ARCH. GEWERPATH. 18:538-555. Buu-Hoi, N.P., P.H., Sesque, G., Azum-Gelade, M.C. and Saint-Ruf, G. (1972) "Organs as Targets of dioxin (2,3,7,8- Tetrochlorodibenzo-p-dioxin) Intoxicaiton." NATURWISSENSCHAFTEN 59(4)173-175. ENDOCRINE & METABOLIC Bastomsky, C.H. (1977) "Enhanced Thyroxine Metabolism and High Uptake Goiters in Rats After a Single Dose of 2,3,7,8- Tetrachlorodibenzo-p-dioxin." ENDOCRINOLOGY 101:292-296. Walker, A.E., and Martin, J.V. (1979) "Lipid Profiles in Dioxin Exposed Workers." LANCET: 446-447. POST TRAUMATIC STRESS DISORDER American Psychiatric Association. DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (Third Edition). Washington, DC 1980. Cavenar, J.C. & Nash, J.L. "The Effects of Combat on the Normal Personality: War Neurosis in Vietnam Returnees." COMPREHENSIVE PSYCHIATRY, 17:647-653. Figley, C.R. (Ed.) STRESS DISORDERS AMONG VIETNAM VETERANS. New York: Brunner/Mazel, 1978. Freudenberger, H.J. "The Psychology of the Vietnam Veteran and Drug Addiction." PSYCHIATRIC OPINION, 1975, 12:34-38. Horowitz, M. (1974) "Stress Response Syndromes." ARCHIVES OF GENERAL PSYCHIATRY 31:768-781. Howard, S. (1976) "The Vietnam Warrior: His Experience, and Implications for Psychotherapy." AMERICAN JOURNAL OF PSYCHOTHERAPY 30(1):121-135. Perlman, M.S. (1975) "Basic Problems of Military Psychiatry: Delayed Reaction in Vietnam Veterans." INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 19:129-138. Zarcone, V.P., Scott, N.R. & Kauvar, K.B. (1977) "Psychiatric Problems of Vietnam Veterans: Clinical Study of Hospital Patients." COMPREHENSIVE PSYCHIATRY 18:41-53 PENNSYLVANIA VIETNAM HERBICIDES INFORMATION COMMISSION P. O. BOX 8380 HARRISBURG, PA 17105 H. ARNOLD MULLER, MD, CHAIRMAN Major General Richard M. Scott Daniel H. Fraley NamVet NewsLetter Page 28 Volume 3, Number 3 March 3, 1989 Raymond Seltser, MD Gary L. Lage, PhD Michael Milne Kurt N. Judeich Ferne Moore, MD Fred O. Rush, Jr. Robert Aber, MD Senator Tim Shaffer Harold A. Gennaria William E. Speck Representative John Cordisco John C. Slobodnik TERRY L. HERTZLER, EXECUTIVE DIRECTOR DEPARTMENT OF HEALTH - COMMONWEALTH OF PENNSYLVANIA P. O. Box 90 Harrisburg, PA 17108 Donald Reid, MD James Fox, MD Charles W. Hays, MD, MPH Kandiah Sivarajah, PhD James N. Logue, Dr. PH, MPH Robert Stroman, RPh Barbara D. Goun, MPH EDUCATIONAL AND SCIENTIFIC TRUST OF THE PENNSYLVANIA MEDICAL SOCIETY 20 Erford Road Lemoyne, PA 17043 LeRoy Erickson, BS, Executive Director Sandra Ritchie, RN, MSEd, Project Director Ronald Codario, MD, Project Consultant Mark Berger, MD, Project Consultant NamVet NewsLetter Page 29 Volume 3, Number 3 March 3, 1989 Mission and Goals of the VA System From the June 1984 VA Employee Handbook -Input by: VETLink #1 FidoNet 1:321/203 AlterNet 7:46/203 (413) 443-6313 VETERANS ADMINISTRATION ======================= MISSION & GOALS =============== The mission of the Veterans Administration is to serve America's veterans and their families with dignity and compassion and to be their principal advocate in ensuring that they receive the care, support and recognition earned in service to this Nation. MEDICAL ======= TO ENSURE that quality medical care is provided on a timely basis within the law to all authorized veterans. BENEFITS ======== TO ENSURE that an appropriate level of benefits is provided within the law to eligible veterans and beneficiaries. MEMORIAL AFFAIRS ================ TO ENSURE that the memorial affairs of eligible veterans are appropriately provided for and conducted in a dignified manner which recognizes the honorable status of veterans. LEADERSHIP ========== TO SERVE as the leader within the Federal Government on all matters directly affecting veterans and their families and to be their advocate in representing their just needs. HUMAN ===== TO ENSURE that the people of the Veterans Administration receive NamVet NewsLetter Page 30 Volume 3, Number 3 March 3, 1989 quality leadership, adequate compensation, decent working conditions, necessary training and education, equal opportunity, and earned recognition. MANAGEMENT ========== TO PROVIDE timely, high quality health care, benefits, and services to veterans and their families as efficiently as possible. ========================================== | America is # 1 Thanks to our Veterans | ========================================== NamVet NewsLetter Page 31 Volume 3, Number 3 March 3, 1989 ================================================================= - = > G E N E R A L A R T I C L E S < = - ================================================================= A Brief History of the Veterans Administration From the June 1984 VA Employee Handbook -Input by: VETLink #1 FidoNet 1:321/203 Alternet 7:46/203 (413) 443-6313 BACKGROUND In early America, the Colonies gave benefits to those injured in military service. In fact, the first colonial law, which was enacted in 1636 by the Pilgrims of Plymouth, provided that "if any man shalbee sent forth as a souldier and shall return maimed, hee shalbee maintained competently by the collonie during his life." The Continental Congress in 1776 sought to encourage enlistments during the Revolution by providing pensions for those who became disabled. The U.S. Government paid benefits to veterans of the American Revolution and their dependents until 1911. During the Civil War, in his second inaugural address (1865) President Abraham Lincoln called upon Congress and the American people "to care for him who shall have borne the battle, and for his widow, and his orphan." This has become the motto of the VA. When America entered World War I in 1917, Congress established a new system of veterans benefits: programs of disability compensation, insurance, a family allotment program for servicemen, and vocational rehabilitation. The establishment of the Veterans Administration came in 1930 when Congress authorized the President to " consolidate and coordinate government activities affecting war veterans. " Three separate Federal agencies, administering veterans benefits at that time, then became component bureaus within the VA. Over 4.7 million veterans were served by the newly-created agency with its comparatively small staff of 31,500 employees and 54 hospitals. During World War II a gigantic expansion of VA facilities quickly became necessary not only because of the vast increase in the veteran population, but also because of the large number of new benefits enacted by the Congress. The World War II "GI Bill", for educational benefits, signed into law June 22, 1944, is said to have had more impact on the American way of life than any law since passage of the Homestead Act almost a century before. The Korean conflict and Vietnam era service added more veterans to the veteran population and new benefits and services. By September 1982, the estimated total of veterans in civilian life was 28.5 million. The number of hospitals devoted to caring for America's veterans has also grown enormously, from VA's original 54 to 172, plus more than 400 clinics, nursing homes, and domiciliaries. In addition to its vast network of health care facilities, the VA operates an outstanding medical research program that has made significant progress in improving rehabilitation for veterans and in the treatment of numerous health problems for the entire NamVet NewsLetter Page 32 Volume 3, Number 3 March 3, 1989 population. Two VA career research scientists, Dr. Rosalyn S. Yalow of the Bronx VA Medical Center and Dr. Andrew V. Schally of the New Orleans VA Medical Center, were awarded the 1977 Nobel Prize in the field of medicine. These two Nobel prizes are among the very few that have ever gone to scientists employed by the U.S. Government. MISSION The mission of the Veterans Administration is to serve America's veterans and their families with dignity and compassion and to be their principal advocate in ensuring that they receive the care, support and recognition earned in service to this Nation. ORGANIZATION The VA is organized on the basis of its major purposes: health care; benefit programs such as compensation, pension, educational assistance, insurance, and guaranteed home loans; and operation of national cemeteries and the provision of headstones and markers. DEPARTMENTS Health care is the responsibility of the Department of Medicine and Surgery (DM&S) headed by the Chief Medical Director. This department administers the VA's vast system of hospitals, clinics, domiciliaries, and nursing care units. The VA's numerous non-medical benefit programs are administered by the Department of Veterans Benefits (DVB) under the Chief Benefits Director. The field system of this department consists primarily of a nationwide network of regional offices. The Department of Memorial Affairs under the Chief Memorial Affairs Director is responsible for the operation of all national cemeteries and miscellaneous burial plots under the Veterans Administration. The department also procures and distributes headstones and markers for eligible decedents who are buried in national and private cemeteries. CENTRAL OFFICE The Veterans Administration Central Office (VACO) is in Washington, D.C. This is the agency headquarters, where the offices of the Administrator of Veterans Affairs, the Deputy Administrator, the four Associate Deputy Administrators - for Congressional and intergovernmental Affairs, Public and Consumer Affairs, Information Resources Management, and Logistics - and the three Department Heads are located. Various Staff Offices, such as Inspector General, General Counsel, Budget and Finance, Personnel and Labor Relations, Equal Employment Opportunity, Program Planning and Evaluation, Data Management and Telecommunications, Information Management and Statistics, Procurement and Supply, and Construction, also provide management support functions for the agency. NamVet NewsLetter Page 33 Volume 3, Number 3 March 3, 1989 There Oughta Be A Law-- There is Produced by: MAINSTREAM, INC. 1200 15th Street, N.W. Washington, D.C. 20005 202/833-1136 -- Input by VETLink #1 FidoNet 1:321/203 Alternet 7:46/203 (413) 443-6313 1. What laws protect the handicapped in employment? 2. Who is defined as handicapped under the regulations? 3. Why are non-visible handicaps covered by the law? 4. How are individuals with hidden handicaps protected? 5. Should applicants or workers declare their handicaps? 6. How are these regulations enforced? This brochure was prepared under a grant from the Employment and Training Administration of the U.S. Department of Labor. It is one in a series of brochures for disabled consumers and federal contractors explaining the different aspects of Section 503 of the Rehabilitation Act of 1973 and Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974. Other brochure topics include the basics of affirmative action programs, job accommodations, accessibility, and enforcement of the regulations. These free publications may be obtained in single copies, as a series, or in bulk orders through Mainstream, Inc. Mainstream, Inc. is a nonprofit agency which acts as an educational bridge between disabled consumers, the private sector and the federal government. Through national conferences and publications, Mainstream encourages a spirit of cooperation in the process of compliance with affirmative action laws for the handicapped. Mainstream's toll-free hotline, called "Mainstream On-Call", answers questions on compliance with Sections 503 and 402 on the specific issues surrounding the protection of workers with hidden handicaps. The hotline number, also available to hearing and speech- impaired persons through a TTY is 800-424-8089. This free and confidential service is available Monday through Friday, from 9 a.m. to 5 p.m. Eastern Time. 1. WHAT LAWS PROTECT THE HANDICAPPED IN EMPLOYMENT? Section 503 of the Rehabilitation Act of 1973 and Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 prohibit any form of discrimination in the employment of qualified handicapped individuals and disabled and Vietnam-era veterans by federal contractors and subcontractors. Section 503 specifically says that a business receiving a federal contract of $2,500 or more cannot deny employment to qualified disabled persons and must develop affirmative actions plans to recruit, hire and promote qualified handicapped individuals. Contractors doing business with the federal government in excess of $50,000 annually must have written affirmative action plans that are updated NamVet NewsLetter Page 34 Volume 3, Number 3 March 3, 1989 annually and open to inspection. Section 402 requires those who receive $10,000 in federal contracts to actively include qualified disabled and Vietnam-era veterans in all levels of the work force. Affirmative action requirements under these regulations include these major points: (1) contractors must undertake active outreach and recruitment to find qualified handicapped and veteran workers; (2) the entire personnel process must be made accessible to those with mobility or perceptual impairments; (3) accommodations must be made if needed to perform the job; (4) wages, benefits and promotions must be determined through job-related criteria only and cannot in any way discriminate against the handicapped or veteran worker. In determining the extent of a contractor's accommodation obligation, these items may be considered by the contractor: (1) business necessity and (2) financial cost and expenses. Reasonable accommodation must be made for qualified handicapped workers unless the contractor can show that the accommodations would impose undue hardships on the conduct of the business. These regulations are designed to protect individuals with all levels of disability and Vietnam-era veterans from discrimination in any phase of the employment process, from application and interview, to promotions and pensions. 2. WHO IS DEFINED AS HANDICAPPED UNDER THE REGULATIONS? Sections 503 and 402 protect individuals with hidden handicaps as well as those with visible handicaps. Section 503's definition of a handicapped individual is any person who: (1) has a physical or mental impairment which substantially limits one or more major life activity; (2) has a record of such an impairment, or (3) is regarded as having such an impairment. The regulation adds that a handicapped individual is "substantially limited" if he or she is likely to experience difficulty in securing, retaining or advancing in employment because of a handicap. Section 402 defines a disabled veteran as a person who is entitled to disability compensation under laws administered by the Veterans Administration for a rated disability, or a person whose discharge or release from active duty resulted from a disability incurred or aggravated in the line of duty. A Vietnam-era veteran is a person who served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975, and was discharged or released with other than a dishonorable discharge. The regulations' broad protections can be illustrated with the following example: an individual who has had a stroke that has left him or her with a paralyzed arm is visibly handicapped and substantially limited in major life activities. That person is protected against discrimination by Section 503. So is the person who has fully recovered from a stroke with no physical limitations because that individual has a history of a handicapping condition. Additionally, the person's employment rights are protected if others (such as NamVet NewsLetter Page 35 Volume 3, Number 3 March 3, 1989 an employer) perceive the person as a candidate for another stroke and thus treat the worker as if he or she were handicapped. 3. WHY ARE NON-VISIBLE HANDICAPS COVERED BY THE LAW? In the past, the handicapped have been seen as those with severe physical limitations such as persons using wheelchairs, crutches or canes, or those individuals who are blind or deaf. However, not all limiting handicaps are visible. Those persons whose handicaps are not apparent often are the victims of employment discrimination. Hidden handicaps is a popular term used to describe disabilities such as diabetes epilepsy, heart disease and cancer. Persons with a history of mental or emotional illness or alcohol or drug abuse are also included in the hidden handicap category. It is unfortunate but true that the myths surrounding individuals who have hidden handicaps prove to be more disabling in daily life than the physical restraints of the handicaps themselves. - Misinformation about epilepsy and other seizure disorders prevents many persons with those conditions from being fully accepted by members of their community. In many circumstances, it also prevents them from obtaining gainful employment. - The stereotypes associated with mental illness often prevent persons with a psychiatric history from getting jobs. Employers frequently say they fear unpredictable behavior from these workers. - Persons with a history of cancer say that employers are so concerned about the possibility of a recurrence of that condition that they are reluctant to hire the workers even though doctors say the applicants are cured. - Recovered alcoholics often must fight an employer's belief that they have high absentee and low productivity rates. However, in defining handicapped individuals under the Rehabilitation Act and the Vietnam Era Veterans Readjustment Assistance Act, Congress made clear that myths about disability cannot justify the denial of a job to a qualified person. Broad medical standards which deny employment to all persons with a particular disability are prohibited by law. Each individual's qualifications and the particular requirements of each job are the only factors which can be used when considering whom to hire. The regulations specifically protect "qualified handicapped" workers. That term denotes a person who is capable of functioning in the work environment and of performing a particular job with the assistance, where appropriate, of reasonable accommodations to the worker's handicap. Employers must look at job applicants and employees as individuals with qualifications - not as diabetics, alcoholics or epileptics. Eliminating a qualified job applicant who has epilepsy because of another's fear of that condition is outlawed. So is denying a job to a qualified worker with diabetes because of an assumption that all diabetics need complicated treatment. The 1978 amendments to the Rehabilitation Act clarified NamVet NewsLetter Page 36 Volume 3, Number 3 March 3, 1989 the definition of a qualified handicapped worker. They state that any individual whose current use of alcohol or drugs prevents that individual from performing the duties of the job, or whose employment by reason of such current alcohol or drug abuse would constitute a direct threat to the property or safety of others, is not protected under Section 503. This has been interpreted to mean that active drug or alcohol abusers who may have high rates of absenteeism, may be disruptive on the job or who allow their alcoholism or drug abuse to interfere in other ways while on the job, are not considered qualified workers. However, rehabilitated alcoholics or drug abusers are protected by the regulations and should be included in an affirmative action program. The regulations do not require a contractor to lower established standards of work excellence or job behavior. Employees who are handicapped are expected to meet the reasonable attendance and performance standards set for all employees. 4. HOW ARE INDIVIDUALS WITH HIDDEN HANDICAPS PROTECTED? The regulations prohibit questions on application forms or in job interviews that relate directly to disability. Only job-related questions may be asked. Thus an interviewer could not ask an applicant if he or she has epilepsy. If an applicant faces a question about disability that is clearly not job-related, he or she does not have to answer the question unless doing so would be in the applicant's best interest. The applicant may wish to point out to the employer that random questions about disability are outlawed under Section 503. (However, if the applicant answers the question falsely, he or she may be subject to dismissal for falsifying the job application.) A company's medical standards and pre-employment medical testing procedures must be designed to obtain job-related information only. These cannot systematically exclude handicapped applicants who are qualified for a job. If a company physician discovers a disability during an employment physical, that information must be kept confidential and cannot be used to deny the applicant the job unless the condition has a direct bearing on job-related performance or safety. In many cases, the existence of a disability has no relation to job performance. In a precedent-setting court case involving this issue, a federal judge ordered the Tampa, Florida police department to hire a job applicant who had a history of epilepsy. The applicant had passed written and oral examinations but was not allowed to take the Tampa Civil Service Board physical examination required of all applicants. The judge said that the Civil Service Board's medical standards excluded all persons with epilepsy, and ordered that Tampa provide the applicant with an individual determination of his medical condition. Court testimony showed that the applicant had not had a seizure in 16 years and the ruling, which also included a back pay award, reaffirmed Section 503's provision against discrimination related to a history of a handicap. What this case reaffirms is the prohibition of categorical disqualification because of assumptions of disability. Under the 503 program, each applicant's NamVet NewsLetter Page 37 Volume 3, Number 3 March 3, 1989 qualifications must be used to determine their job fitness. Employers cannot screen out all applicants with certain handicapping conditions. An employer may not assume that an applicant with diabetes may slip into a coma during the work day or that a worker with a history of mental illness cannot handle the pressures of the job. Under the regulations, persons with hidden handicaps are entitled to job accommodations. For instance, workers with kidney ailments who require dialysis may be given the accommodation of time away fro work for treatment, if the treatment cannot be arranged off-work hours. (They do not have to be paid for time away from the job.) A flexitime work schedule may also be arranged with the employer as a reasonable accommodation. The same accommodation could be made for rehabilitated drug or alcohol abusers who are participating in continuing therapy programs. Persons with epilepsy may need accommodations that include rest periods after a seizure or after taking medication. 5. SHOULD APPLICANTS OR WORKERS DECLARE THEIR HANDICAPS? Under the regulations, employees and applicants with handicapping conditions must be invited by the employer to declare their handicaps. By volunteering this information, the worker will be protected by the employer's affirmative action program. But for many persons with hidden disabilities, the decision whether or not to inform their employers about a handicapping condition can be a difficult one. Many people fear they will be treated differently by co-workers, that they will be the object of ridicule and discrimination. Employees who have recovered from mental illness cite examples of isolation once their past history is known. Persons who acknowledge a history of alcohol abuse say their employers never really trust them. Workers who have decided to keep their handicap a secret feel the decision will probably result in acceptance by their supervisors and allow them to be comfortable around their fellow workers. But since their handicap is not declared, these workers are not afforded the protection of the regulations. If their employers discover their handicaps and dismiss them or deny them a promotion, the workers can file complaints of discrimination under the 503 program because their handicaps have become known. A worker, however, can declare his or her handicap at any time. It may be at the time he or she applies for a job, or even after several years of employment. Once the information is given, it must be kept confidential and the regulations encourage the contractor to seek the worker's advice regarding appropriate placement and accommodations. Only supervisors and managers may be informed of the reasons for restrictions on the work or duties of the handicapped person. First aid and safety personnel can be informed if the person's handicap may require emergency treatment. There are many factors to consider when deciding whether to declare a handicap to the employer. One important consideration is whether the applicant or employee feels he or she will need the protection of the regulations. If a person declares and meets the definition of handicapped under the regulations, his or her employment rights are protected. The worker also gains access to a grievance process to check any NamVet NewsLetter Page 38 Volume 3, Number 3 March 3, 1989 suspected forms of discrimination due to handicap (see next chapter). The employee or applicant may also wish to read the employer's affirmative action plan and ask other handicapped employees how they feel the program is implemented. Making sure the information on handicap is kept confidential is another factor that should be weighed when making a decision. The general attitude of employer, supervisory personnel and co-workers toward the handicapped and veteran programs should also be taken into account. Those persons with hidden handicaps who have positive attitudes towards their handicaps and their work qualifications may find that their attitude helps dispel any ill feelings the employer has about disability. Increasing numbers of employers are finding that the existence of a handicap holds little relevance, that it is a person's qualifications that count. 6. HOW ARE THESE REGULATIONS ENFORCED? If applicants or employees with hidden handicaps suspect they have been the victims of employment discrimination or believe a contractor has not fulfilled its affirmative action obligation, the Office of Federal Contract Compliance Programs (OFCCP) of the U.S. Department of Labor has initiated a written complaint procedure through which the alleged violation can be investigated. OFCCP has its main headquarters at 200 Constitution Ave., N.W., Washington, D.C. 20210. The national director oversees a network of ten regional offices and over 60 area offices, a listing of which appears at the end of this chapter. OFCCP also conducts corporate compliance reviews to make sure that federal contractors are fulfilling t