Snafu Puts Hold On Compensation For Some Vietnam Vets

By Todd Zwillich

WASHINGTON, Oct 18, 2001 (Reuters Health) - A gaffe by Australian researchers has forced the US Department of Veterans Affairs (VA) to temporarily cancel plans to compensate Vietnam veterans for cancers linked to the infamous herbicide Agent Orange.

A faulty survey questionnaire distributed to 50,000 ex-soldiers in Australia has called into question a major study that led experts last spring to link Agent Orange exposure to rare but highly fatal acute myelogenous leukemia (AML) in children of vets.

Now the agency has withdrawn its request that Congress allow federal payments for the cancers and has ordered a new review of the evidence linking the defoliant to the illness.

"We upset the apple cart a bit," Dr. Paul Jelfs, a researcher with the Australian Institute of Health, told Reuters Health. Jelfs and his colleague, Dr. Keith Horsley, had to travel from Canberra, Australia to Washington, DC to present their corrected data to an Institute of Medicine panel Thursday.

Those data now show that the association between Agent Orange exposure in Vietnam vets and AML in their offspring is not as strong as once thought.

The Australians" original study concluded that AML was three to six times more common in vets" children than in the children of men who did not serve during Vietnam. But that was before researchers discovered in June that the questionnaires they had distributed to the families of the 50,000 vets in the study were not uniform.

One version sent to ex-vets asked them to identify all cases of AML in their children, whether those children were living or not. Researchers came up with 12 verified cases.

But another sent to a comparison group of non-Vietnam vets asked them only to identify living children with the disease. Originally that turned up only three cases, making a fourfold difference between the groups.

Once the study was redone with corrected questionnaires, the number of AML cases in the comparison group rose to nine. The result is that AML is still more common in children of Vietnam vets but that the results no longer reach the threshold of statistical significance.

"It put those findings into question," Dr. Mark Brown, the VA"s director of environmental agents, said in an interview. VA"s payment decision is now "on hold," he said.

AML affects about 1 in 100,000 US children, and accounts for about 8% of all childhood cancers. The disease strikes 600 to 700 children per year and is about 60% fatal. Agent Orange has already been linked to birth defects like spina bifida in veterans" children and has also been associated with increased rates of diabetes in veterans themselves.

Jelfs and Horsley told Reuters Health that they were embarrassed by the goof, and pointed out that their agencies in Australia issued retraction of the study and an apology as soon as the mistake was discovered.

The Institute of Medicine is working on a new report and is expected to issue its findings early in 2002.

But even with the new Australian study, there could be one more twist. Researchers may have a hard time using a survey to establish a definitive link between Agent Orange exposure in Australian vets and AML in their biological children.

That, according to Jelfs, is because Australian men who believe they are their children"s biological fathers are only right 95% of the time.


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