Steven Stellman - Health and reproductive outcomes among American Legionnaires in relation to combat and herbicide exposure in Vietnam

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      Stellman, S. D., Stellman, J. M., Sommer, J. F., Jr. 47  (2) 150-74-

      Abstract: History of diagnosed illnesses,   medical symptoms, and reproductive outcomes and their relation to   combat intensity and herbicide exposure were studied, via a   mailed questionnaire, among 6810 American Legionnaires who served   during the Vietnam War (42% in Southeast Asia, 58% elsewhere).   Heart disease, venereal disease, and benign fatty tumors were   reported significantly more often by Vietnam veterans than by   controls. Combat intensity was significantly dosage-related to   history of high blood pressure, ulcers, arthritis and rheumatism,   genito-urinary problems, nervous system disease, major injury,   hepatitis, and benign fatty tumors. Agent Orange exposure was   significantly dosage-related to history of benign fatty tumors,   adult acne, skin rash with blisters, and increased sensitivity of   eyes to light. Rates of the latter two conditions and of change   in skin color were especially elevated in men whose military   occupations involved direct handling of herbicides. Five "symptom   complex" scales were constructed via factor analysis to measure   degrees of feeling faint, fatigue or physical depression, body   aches, colds, and skin irritation. Means of all five scales were   significantly higher in Vietnam veterans compared to controls,   and in herbicide handlers compared to nonhandlers. Both combat   and Agent Orange exposure were significant, independent   predictors of each of the five scales. Neither combat nor Agent   Orange exposure was associated with difficulty in conception,   time to conception of first child, or to birthweight or sex ratio   of offspring, but maternal smoking was strongly related to   reduced birthweight. The percentage of spouses' pregnancies which   resulted in miscarriages was significantly higher for Vietnam   veterans than controls (7.6% vs 5.5%, P less than 0.001).   Logistic regression analysis showed that Agent Orange exposure   and maternal smoking were both independently and significantly   associated with miscarriage rates in a dose-related manner.

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