Update of agent orange/dioxin and human health

Background – The health effects of Agent Orange and its dioxin contaminants have been assessed over the past four decades by investigators in many countries in a variety of exposed populations. Cancer and non-cancer health effects have been evaluated by U.S. and international expert panels and agencies and there is strong evidence of a variety of health effects. Methods – Recent epidemiologic studies are reviewed, including new analyses of Air Force Ranch Hand veterans, Seveso Italy residents, Chepaevsk Russia children and adults, and workers in Europe and North America. The latest evaluation National Academies of Science Veterans and Agent Orange report is reviewed and summarized. The 2012 EPA reassessment of non-cancer health effects of dioxin is also reviewed and summarized. Results – The body of evidence now supports a causal role for Agent Orange and dioxin in a range of cancer and non-cancer health effects. In addition to several individual cancer types, there is increasing support for an all-cancer effect. There are new epidemiologic studies indicating developmental effects in children, reproductive effects in adult women, and endocrine effects. Conclusion – The body epidemiologic literature over the past forty years has matured and demonstrates a wide range of adverse human health effects from exposure to Agent Orange and its dioxin contaminants.