Steven Stellman - Exposure to Agent Orange and occurrence of soft-tissue sarcomas or non-Hodgkin lymphomas: an ongoing study in Vietnam

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      Kramarova, E., Kogevinas, M., Anh, C. T., Cau, H. D., Dai, L. C.,   Stellman, S. D., Parkin, D. M. 106 Suppl 2 671-8-

      Abstract: Agent Orange was the most common   herbicide used in the Second Indochina War in the course of   military operations in the former South Vietnam. Agent Orange is   contaminated by the carcinogen   2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) in mean   concentrations of 2 mg/kg. After much dispute of a causal   association between exposure to herbicides containing TCDD and   occurrence of soft-tissue sarcoma and non-Hodgkin lymphoma, two   simultaneous case-control studies were set up in Vietnam to   examine possible relationships. Subject recruitment is ongoing,   with target numbers of 150 cases of soft-tissue sarcoma and 150   cases of non-Hodgkin lymphoma and diagnoses at the Cancer Center   at Ho Chi Minh City, Vietnam. Two hospital controls are matched   to each case. As in other studies of cancer in persons   occupationally or otherwise exposed to herbicides and their   contaminants, evaluation of past exposure of the recruited   subjects is among the most complicated issues. Because accurate   records are usually unavailable, surrogate measures of likely   exposure are often calculated. As a first approach in our studies   we used the Stellman and Stellman exposure index. The index is   based on matching subjects' history of residence and the   information on times and locations of Agent Orange spraying   recorded on HERBS tape by the U.S. Army and taking into account   the distance from the spraying as well as environmental and   biologic half-life of TCDD. The exposure index is calculated in   two centers, New York and Hanoi, with slightly different   assumptions. In addition, samples of body tissues from the   subjects (20 ml blood, 2 g adipose tissue, and tumor sections in   paraffin blocks) are taken and stored. Their future analysis will   provide additional source of exposure assessment. Strengths and   weaknesses of both exposure measures are discussed in this paper.

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