Agent Orange

During the Vietnam War, the United States sprayed herbicides, including Agent Orange, over large areas of jungle terrain. In the late 1970s, concerns began to emerge about the long-term health problems of Vietnam veterans who had been exposed to these chemicals. Several herbicides, including Agent Orange, contain dioxin, which is known to cause health problems in animals. One key effort to examine the long-term health effects of soldiers' exposure to herbicides in Vietnam is an ongoing Air Force study known as the Ranch Hand Study. This study follows the health and death rates of the Ranch Hands--the nearly 1,300 Air Force personnel who sprayed herbicides from the air in Vietnam--in contrast to those of a comparison group. The 25-year study, which began in 1982 and is scheduled to end in 2006, is estimated to cost more than $140 million. GAO found that the Air Force has conducted many aspects of the Ranch Hand Study in a rigorous manner and that several early problems in study conduct have been remedied. However, several veterans groups and scientists are critical of the study's methods and results and want greater access to study data. In GAO's view, making all study data publicly available would increase the credibility of the study's results. Also, without full access to data, outside scientists cannot perform alternative or additional analyses that would facilitate scientific debate over the merits of the Air Force's methodologies and analyses. The Air Force expects to make all current study data publicly available by 2006, but those interested in the data say that unless the data is available in a more accessible format, such as a compact disc or the Internet, they would have difficulty using it. Moreover, although communication of study limitations to the public has improved over the years, more improvements are possible. GAO believes that publicly accessible documents, such as executive summaries and press releases, should contain more information on the study's limitations. Also, GAO notes that problems remain with the outreach of the Advisory Committee (a panel of nine scientists who oversee the study and independently review its findings) to veterans.

GAO noted that: (1) the Air Force has conducted all scheduled phases of the Ranch Hand study and has periodically reported the results in official reports; (2) however, there have been some delays in the publication of morbidity and mortality findings in scientific journals and in the update of a key report on reproductive outcomes; (3) no journal articles on mortality or morbidity outcomes were published until 1990, even though the first mortality and morbidity reports were published in 1983 and 1984, and the Advisory Committee repeatedly recommended that such articles be published; (4) the Air Force reported preliminary reproductive outcomes in 1984 but did not publish a more detailed update until 1992 because it decided to verify the data extensively and perform additional data analysis without releasing any interim findings; (5) public access to study data is limited by the small amount of data available and because its storage format is difficult to use; (6) the public can access only data the Air Force analyzed in 1987; (7) the Air Force intends to make all other data available by the end of 2000; (8) the Ranch Hand study has a number of inherent limitations, but the Air Force has not clearly or effectively communicated these limitations to the public; (9) two limitations are the difficulty in detecting increases in risks of rare diseases and the fact that the study's findings cannot be generalized to all Vietnam veterans; (10) to ensure independent review and prevent any appearance of Air Force management bias, the study protocol mandated that: (a) an independent group of scientists be established to monitor the study's conduct; and (b) Air Force scientists, subject to review by the monitoring group, have primary responsibility over the scientific aspects of the study; (11) until 1989, the Advisory Committee did not include any veterans' representatives, as required by the study protocol; (12) according to documents GAO reviewed from 1984-1985, Air Force management and the White House at the time, tried to direct some of the Air Force scientists research; (13) although these early problems were resolved through executive and congressional actions with the extent of the Committee's outreach to veterans; and (14) partly on the basis of the study's results, Congress passed legislation providing compensation for veterans' children born with spina bifida.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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