Agent Orange Herbicidal Toxin-Initiation of Alzheimer-Type Neurodegeneration

Background

Agent Orange (AO) is a Vietnam War-era herbicide that contains a 1 : 1 ratio of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T). Emerging evidence suggests that AO exposures cause toxic and degenerative pathologies that may increase the risk for Alzheimer's disease (AD).

Objective

This study investigates the effects of the two main AO constituents on key molecular and biochemical indices of AD-type neurodegeneration.

Methods

Long Evans rat frontal lobe slice cultures treated with 250μg/ml of 2,4-D, 2,4,5-T, or both (D + T) were evaluated for cytotoxicity, oxidative injury, mitochondrial function, and AD biomarker expression.

Results

Treatment with the AO constituents caused histopathological changes corresponding to neuronal, white matter, and endothelial cell degeneration, and molecular/biochemical abnormalities indicative of cytotoxic injury, lipid peroxidation, DNA damage, and increased immunoreactivity to activated Caspase 3, glial fibrillary acidic protein, ubiquitin, tau, paired-helical filament phosphorylated tau, AβPP, Aβ, and choline acetyltransferase. Nearly all indices of cellular injury and degeneration were more pronounced in the D + T compared with 2,4-D or 2,4,5-T treated cultures.

Conclusions

Exposures to AO herbicidal chemicals damage frontal lobe brain tissue with molecular and biochemical abnormalities that mimic pathologies associated with early-stage AD-type neurodegeneration. Additional research is needed to evaluate the long-term effects of AO exposures in relation to aging and progressive neurodegeneration in Vietnam War Veterans.

Incremental Sampling Methodology for improved characterization of Agent Orange dioxin in Vietnam soil and sediment

The Danang airport in Vietnam was used heavily by US forces in the 1960s and 1970s. In 2018, the remediation of dioxin contamination at the airport resulting from Agent Orange use and management was completed by the US government. Generation of reliable, defensible, and cost-effective confirmation sampling data over large areas and for large volumes was a significant challenge. Traditional discrete and composite sampling methods were utilized to assess dioxin concentrations and the extent of contamination present at the airport prior to remediation. Confirmation sampling was performed after excavation of contaminated soil and sediment across the entire 28-ha site to demonstrate that remaining concentrations met the Vietnamese standards for the airport site. The volume of excavated soil and sediment was 162,567 m³. Incremental Sampling Methodology (ISM) was used for confirmation sampling to provide a defensible estimate of the mean concentration of dioxin remaining after excavation. The use of ISM revealed that traditional methods underestimated the volume of material requiring treatment. ISM also decreased sampling variability dramatically and provided more reliable estimates of true mean concentrations in an area when compared with traditional methods. The use of ISM: 1) better captured distributional heterogeneity and decreased variability between samples from the same DU by 64%; 2) resulted in low variability between duplicate analyses of the same sample (12%), indicating a reduction in compositional heterogeneity; 3) did not underestimate contaminant levels; and, 4) increased the frequency that excavation boundaries met project goals by 61%, when compared with traditional sampling.

First evidence of association between past environmental exposure to dioxin and DNA methylation of CYP1A1 and IGF2 genes in present day Vietnamese population

During the Vietnam War, the United States military sprayed over 74 million litres of Agent Orange (AO) to destroy forest cover as a counterinsurgency tactic in Vietnam, Laos and Cambodia. The main ingredient was contaminated by 2,3,7,8-tetrachlorodibenzo-paradioxin (TCDD). DNA methylation (DNAm) differences are potential biomarker of environmental toxicants exposure. The aim of this study was to perform a preliminary investigation of the DNAm levels from peripheral blood of the present-day Vietnamese population, including individuals whose parents, according to historical data, were exposed to AO/TCDD during the war. 94 individuals from heavily sprayed areas (cases) and 94 individuals from non-sprayed areas (controls) were studied, and historical data on alleged exposure of parents collected. 94 cases were analysed considering those whose father/parents participated in the war (N = 29) and considering the place of residence of both parents (64 living in sprayed areas versus 30 in non-contaminated areas). DNAm levels in CYP1A1 and IGF2 genes were measured (MALDI-TOF technology). The analyses showed that: 1) one CpG site in the CYP1A1 and one in the IGF2 gene showed significant differences in DNAm levels between cases and controls; 2) the CYP1A1 region resulted to be hypomethylated (in 9 out of 16 sites/units; p-val<0.01) in 29 individuals whose father/parents participated in the war in the spray zones; 3) we showed that the place of residence of both parents influenced methylation levels of the CYP1A1 and IGF2 genes (p-val<0.05). In conclusion this study indicates that past environmental exposure to dioxin (AO/TCDD) shapes the DNAm profile of CYP1A1 and that the place of living for parents in former spray zones influences DNAm of CYP1A1 and IGF2 genes. These results open the way to new applications of DNAm as potential biomarker(s) of past human exposure to dioxin.

Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis etiology

BACKGROUND

Factors underlying a possible excess of amyotrophic lateral sclerosis (ALS) among military veterans remain unidentified. Limitations of previous studies on this topic include reliance on ALS mortality as a surrogate for ALS incidence, low statistical power, and sparse information on military-related factors.

OBJECTIVES

We evaluated associations between military-related factors and ALS using data from a case-control study of U.S. military veterans.

METHODS

From 2005 to 2010, we identified medical record-confirmed ALS cases via the National Registry of Veterans with ALS and controls via the Veterans Benefits Administration's Beneficiary Identification and Records Locator System database. In total, we enrolled 621 cases and 958 frequency-matched controls in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study. We collected information on military service and deployments and 39 related exposures. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). We used inverse probability weighting to adjust for potential bias from confounding, missing covariate data, and selection arising from a case group that disproportionately included long-term survivors and a control group that may or may not differ from U.S. military veterans at large.

RESULTS

The odds of ALS did not differ for veterans of the Air Force, Army, Marines, and Navy. We found higher odds of ALS for veterans whose longest deployment was World War II or the Korean War and a positive trend with total years of all deployments (OR=1.27; 95% CI: 1.06, 1.52). ALS was positively associated with exposure to herbicides for military purposes, nasopharyngeal radium, personal pesticides, exhaust from heaters or generators, high-intensity radar waves, contaminated food, explosions within one mile, herbicides in the field, mixing and application of burning agents, burning agents in the field, and Agent Orange in the field, with ORs between 1.50 and 7.75.

CONCLUSIONS

Although our results need confirmation, they are potentially important given the large number of U.S. military veterans, and they provide clues to potential factors underlying the apparent increase of ALS in veteran populations.

Handler, bystander and reentry exposure to TCDD from application of Agent Orange by C-123 aircraft during the Vietnam War

Using validated models and methods routinely employed by pesticide regulatory agencies, the absorbed dosages of Agent Orange (AO) herbicide contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were estimated for mixer/loaders, applicators, and individuals in the vicinity of applications of AO by C-123 aircraft during the Vietnam War. Resulting dosages of TCDD were then transformed to estimates of adipose residues, and compared to population biomonitoring of known mixer/loaders and applicators as well as ground troops in Vietnam and civilians in the U.S. Results demonstrate that mixer/loaders and applicators had the greatest exposures and their measured residues of TCDD in adipose were consistent with the estimated exposures. Further, the potentially exposed ground troops, including those who could have been directly sprayed during aerial defoliation, had measured adipose residues that were consistent with those in civilian U.S. populations with no defined source of exposure exposures and both of those cohorts had orders of magnitude less exposure than the mixer/loaders or applicators. Despite the availability of validated exposure modeling methods for decades, the quantitative TCDD dose estimates presented here are the first of their kind for the Vietnam conflict.

Determination of PCDD/Fs in breast milk of women living in the vicinities of Da Nang Agent Orange hot spot (Vietnam) and estimation of the infant's daily intake

Seventeen toxic congeners of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were determined in breast milks using the high resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS) method. Twenty seven breast milk samples were collected from primiparae who have lived over 5 years in wards namely Chinh Gian, An Khe, Khue Trung, and Hoa Thuan Tay which are located near the Da Nang Agent Orange hot spot (the AO/Dioxin hot spot). The samples were then analyzed for PCDD/F residues in order to assess the human exposure to dioxins from the AO/Dioxin hot spot, especially health risk to the breast-fed infants. The average TEQ levels in the four studied cohorts ranged from 8.1 to 26 pg/g lipid, with the highest level up to 51 pg TEQ/g lipid found in the An Khe ward. The TEQ level was correlated with geographical position and ranking in the order of Khue Trung, Hoa Thuan Tay, Chinh Gian and An Khe. The mean estimated PCDD/Fs infant's daily intake in the cohort of Khue Trung, Hoa Thuan Tay, Chinh Gian and An Khe was about 41, 122, 124, and 134 pg TEQ/kg bw/day, respectively, which are much higher than the tolerable daily intake proposed by the World Health Organization (4 pg TEQ/kg bw/day).

A synopsis of 30 years of major accomplishments by the Pennsylvania Department of Health in Environmental Health (Part 1 of 2): the 1980s

This article reviews significant environmental health projects conducted by the Pennsylvania Department of Health, particularly the Division of Environmental Health, during the 1980s. The authors describe lessons learned from dealing with health concerns related to the Vietnam War, Three Mile Island, hazardous waste sites, and radon, as well as emerging issues during that decade.

Serum concentrations of chlorinated dibenzo-p-dioxins and dibenzofurans among former New Zealand trichlorophenol workers

This study examined serum levels of 2,3,7,8-substituted chlorinated dioxins and furans, and 15 PCBs for 346 New Zealand employees who worked at a site that manufactured 2,4,5-trichlorophenol (TCP) and 2,4,5-trichlorophenoxy acetic acid (2,4,5-T). Participants with potential TCP or 2,4,5-T exposures had mean lipid-adjusted 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) levels of 9.9 ng kg(-1) lipid compared to 4.9 ng kg(-1) for workers with no exposure at the site. Among exposed workers, we found evidence of differences in 2,3,7,8-TCDD levels by department and duties. Workers involved in an accidental release had the highest mean 2,3,7,8-TCDD levels, 37.9 ng kg(-1), followed by workers in the trichlorophenol plant, 23.4 ng kg(-1). Workers with potential intermittent exposures to 2,3,7,8-TCDD in construction, maintenance, mechanics, and transport had 2,3,7,8-TCDD levels above New Zealand background levels of 3.9 ng kg(-1), indicating workplace exposures. Among participants with work history indicating no 2,3,7,8-TCDD exposures, we observed some individuals with 2,3,7,8-TCDD levels above background levels. However, in most cases, these workers reported workplace exposures not recorded on their work histories or held other jobs with the potential for 2,3,7,8-TCDD exposures outside the plant. All other dioxin, furan, and PCB levels were similar among the exposed and unexposed workers.

Effect of herbicide concentration and organic and inorganic nutrient amendment on the mineralization of mecoprop, 2,4-D and 2,4,5-T in soil and aquifer samples

The impact of the herbicide concentration (0.10-10,000 microg kg(-1)) and addition of organic and inorganic nutrients on mecoprop, 2,4-D and 2,4,5-T mineralization in aquifer and soil samples was studied in laboratory experiments. Generally, 2,4-D was most rapidly mineralized followed by mecoprop and 2,4,5-T. A shift from non-growth to growth-linked mineralization kinetics was observed in aquifer sediment with 2,4-D concentrations >0.10 microg kg(-1) and mecoprop concentrations >10.0 microg kg(-1). The shift was apparent at higher herbicide concentrations in soil coinciding with a lower bioavailable fraction and a higher herbicide sorption to soil. Herbicide addition did not affect the bacterial density, although 2,4-D and mecoprop applied at 10,000 microg kg(-1) stimulated growth of specific degraders. Generally, nutrient amendments did not stimulate mineralization at the lowest herbicide concentrations. In contrast, the mineralization rate of higher herbicide concentrations was significantly stimulated by the amendment of inorganic nutrients.

Dioxin, dibenzofuran, and polychlorinated biphenyl (PCB) levels in food from Agent Orange-sprayed and nonsprayed areas of Laos

During the Vietnam War, a phenoxy-herbicide mixture called Agent Orange, which was contaminated with 2,3,7,8-tetrachlorodibenzodioxin, or TCDD, was used primarily for destruction of forest and other foliage in order to prevent enemy troop movement and protect American and allied troops and military bases in the south of Vietnam. Smaller areas of Laos and Cambodia were also sprayed with Agent Orange between 1962 and 1971 from fixed-wing aircraft. In 2001, 28 food samples consisting of meat, fish, and dairy products were collected in sprayed and nonsprayed areas of Laos and analyzed for dioxins, dioxinlike dibenzofurans, and selected polychlorinated biphenyl (PCB) congeners by high-resolution gas chromatography/high-resolution mass spectrometry at laboratories in Germany and Canada. Low levels of dioxin and other dioxinlike substances were found in Laotian food, similar to levels present in recent exported Vietnamese food to United States. Vietnam is geographically adjacent to Laos. Total dioxin toxic equivalent (TEQ) levels were similar in samples from sprayed and non-sprayed areas, ranging from 0.009 to 0.851 pg/g or parts per trillion (ppt) in sprayed Sepone, and from 0.022 to 0.537 pg/g or ppt wet weight in non sprayed Vientiane. However, the Laotian fish samples from the Agent Orange-sprayed area had, on average, a higher proportion of total TEQ from TCDD (31.7% vs. 9.4%) compared to the nonsprayed area. Some other food items, duck eggs and pork liver from Sepone, also had severalfold higher TCDD levels than similar food samples from Vientiane, 0.029 vs. 0.011 pg/g and 0.070 vs. 0.004 pg/g wet weight, respectively. There were no substantial differences in levels of dibenzofuran and PCB congeners. In general, elevated TCDD levels were not found in Laotian food samples. It is possible that dioxin-contaminated areas, or "hot spots," exist in Laos as they do in Vietnam, although they have not yet been identified.

Dioxin in Vietnam: fighting a legacy of war

Singapore was the site of an East-West convergence over the week of 27 November-1 December 2000. At the behest of their respective governments, scientists from the United States and Vietnam came together for what promises to be the first of many meetings. Their mission: to explore the possibility of launching a joint research program to study the human and environmental health effects resulting from spraying Agent Orange and other herbicides during the Vietnam War.

Effects of spraying the herbicides 2,4-D and 2,4,5-T on a population of the tortoise Testudo hermanni in southern Greece

A population of the tortoise Testudo hermanni near Olympia in southern Greece was studied by mark-recapture from 1975 to 1984. Part of the site was sprayed with the herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) each year from 1980, producing symptoms of poisoning (swollen eyes, fluid discharge from the nose and immobility) in tortoises. Survival rates of tortoises 10 cm or larger were significantly lower in the affected areas, with extra mortality of about 34% year-1, against an annual survival rate of 0.85-0.90 in unaffected areas. Changing population structures showed that juveniles were even more strongly affected, with the proportion of juveniles in samples decreased by half. The population in the sprayed area declined to near zero by 1984, due to mortality rather than to emigration, since more movements were recorded into than out of the affected area. There was no difference in body mass condition between sprayed and unsprayed areas, showing that effects were acute; mortality was not due to starvation from loss of food plants. The scale and pattern of mortality was similar to that from a severe scrub fire; spraying is potentially more catastrophic since often repeated at shorter intervals than burning. Possible physiological mechanisms of death are discussed. The susceptibility of tortoises to 2,4-D and 2,4,5-T (or to associated dioxin impurities) presents a warning for conservation of these late-maturing animals.

Correlation between dioxin levels in adipose tissue and estimated exposure to Agent Orange in south Vietnamese residents

To permit new epidemiologic studies of the effects of dioxin on humans in Vietnam, we evaluated a model for quantifying exposure to Agent Orange (exposure index) based on the residential histories of 27 Vietnamese subjects and on information about spraying from the U.S. Army records (Herbs Tape) and compared this index to the dioxin levels measured in the subjects' adipose tissue. The mean dioxin level was 7.8 ppt, and dioxin and furan isomer profiles were similar to those already reported in industrialized countries. In addition, there was a highly significant correlation between the levels of almost all the isomers, whatever their degree of chlorination. For the group of 27 subjects, we found a Pearson correlation coefficient of 0.36 (P = 0.07) between the dioxin levels and the exposure index after log-transformation of both variables. When the analysis was restricted to the 22 subjects with a positive exposure index, the Pearson correlation coefficient rose to 0.50 (P = 0.02). We conclude that despite the limitations and power conditions of the study, this result is encouraging because it will be useful for future epidemiologic studies in Vietnam.

Current serum levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin in phenoxy acid herbicide applicators and characterization of historical levels

BACKGROUND

Workers who sprayed phenoxy acid herbicides, especially those who sprayed before 1975, may have been exposed to significant amounts of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a potent animal carcinogen present in herbicide preparations as a contaminant.

PURPOSE

The aims of this study were (a) to determine serum levels of TCDD in a representative sample of workers occupationally exposed to the agent during the spraying of phenoxy acid herbicides; (b) to compare serum levels in workers exposed before 1965, when concentrations in herbicide products were unregulated and high, with levels in workers exposed after 1974, when concentrations were lower as a result of government regulations worldwide; and (c) to examine the correlation, if any, between serum levels and duration of employment in spraying.

METHODS

Thirty-seven subjects were randomly selected from a group of 654 men who had sprayed the herbicides 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) and 2,4-dichlorophenoxyacetic acid (2,4-D) in Australia for at least 12 months. The workers were classified as follows: eight who sprayed only before 1965, nine who sprayed only during the period after 1964 and before 1975, and 20 who sprayed during the period after 1974 and before 1991. Serum from the workers was analyzed for TCDD by high-resolution gas chromatography and high-resolution mass spectrometry at a detection limit of 0.6 parts per trillion (ppt) on a lipid-weight basis. In addition, rates of exposure to TCDD were estimated, as were TCDD serum concentrations at termination of employment and intensity of herbicide use.

RESULTS

Only one worker, with a serum TCDD level of 34 ppt, had a serum level higher than the maximum level of 26 ppt reported for the general population. Assuming a half-life of 7.1 years, we estimated the mean exposure rates to be 2.7, 2.3, and 0.06 ppt/mo for the three epochs, respectively. We found the highest serum level of TCDD at the time of cessation of employment to be 329 ppt. Calendar period and intensity of use of 2,4,5-T and 2,4-D were statistically significant determinants of rate of exposure to TCDD, but 2,4-D was associated with exposure rate only for the pre-1975 periods. Estimated rates prior to 1965 were more than an order of magnitude higher than those after 1974.

CONCLUSION

The highest estimated exposure rate was 20.7 ppt/mo, which suggests that some sprayers may have been exposed to levels comparable with those that produce cancer in laboratory animals.

Health status of Air Force veterans occupationally exposed to herbicides in Vietnam. I. Physical health

The Air Force Health Study is a 20-year comprehensive assessment of the health of Air Force veterans of Operation Ranch Hand, the unit responsible for aerial spraying of herbicides in Vietnam. The study compares the health and noncombat mortality of Ranch Hand veterans with a comparison group of Air Force veterans primarily involved with cargo missions in Southeast Asia but who were not exposed to herbicides. This report summarizes the health of these veterans as determined at the third in a series of physical examinations. Nine hundred ninety-five Ranch Hands and 1299 comparison subjects attended the second follow-up examination in 1987. The two groups were similar in reported health problems, diagnosed skin conditions, and hepatic, cardiovascular, and immune profiles. Ranch Hands have experienced significantly more basal cell carcinomas than comparison subjects. The two groups were not different with respect to melanoma and systemic cancer.

Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin levels in US Army Vietnam-era veterans. The Centers for Disease Control Veterans Health Studies

This study investigates whether military records can be used to identify US Army Vietnam veterans who were likely to be exposed to the herbicide Agent Orange. Serum levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a toxic contaminant in Agent Orange, were obtained for 646 ground combat troops who served in heavily sprayed areas of Vietnam and for 97 veterans who did not serve in Vietnam. The distributions of current TCDD levels in Vietnam and non-Vietnam veterans were nearly identical (mean in each group, approximately equal to 4 parts per trillion [ppt]). Only two men (both Vietnam veterans) had clearly elevated levels (greater than 20 ppt). Levels of TCDD did not tend to increase with greater likelihood of exposure to Agent Orange, as estimated from either military records or self-reported exposure. This study is consistent with other studies and suggests that most US Army ground troops who served in Vietnam were not heavily exposed to TCDD, except perhaps men whose jobs involved handling herbicides.

Correlates of self-reported and objectively determined exposure to Agent Orange

The authors examined the relationship between 100 Viet Nam veterans' self-reported and objectively determined exposure to the herbicide Agent Orange and the relationship between self- or objective ratings and self-reported psychological and medical problems. Veterans who believed they had been exposed reported more psychological and medical problems than the other veterans but did not differ on "success at living" indices; the medical problems many reported suggested psychosomatic etiologies. Grouped according to objective ratings of herbicide exposure, the veterans did not show such differences in psychological or medical problems. No differences on neuropsychological testing appeared, no matter how the subjects were grouped.

Medical and morbidity surveillance findings among employees potentially exposed to TCDD

Available medical and morbidity surveillance findings from 1976 to 1978 for two employee cohorts potentially exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were compared with those of matched unexposed employees. The medical surveillance findings were derived from a screening programme offered to all active employees and included an analysis of various medical history questions and blood chemistry results. Group medical insurance claims served as the source of morbidity surveillance data and the period prevalence of selected diseases was analysed. Few significant differences between the exposed and unexposed were detected. Among the cohort of employees potentially exposed during the manufacture of 2,4,5-trichlorophenoxyacetic acid (2,4,5,-T), a significantly greater frequency of x-ray proved ulcer was reported and significantly more members of this group had diseases of the digestive system diagnosed. Such findings were absent in the more highly TCDD-exposed cohort engaged in 2,4,5-trichlorophenol production, making it unlikely that dioxin was a cause.