The possibility of long-term health effects includingadverse reproductive health outcomes resulting frommilitary service in Vietnam has been a subject of researchinterest in the United States over the past two decades [CDCVietnam Experience Study, 1988; Stellman et al., 1988].The U.S. Congress, responding to concerns of many womenVietnam veterans, legislatively mandated a comprehensive health study of women Vietnam veterans.
This mandate ledto three separate but related epidemiologic studies of women Vietnam era veterans: (1) post-Vietnam servicemortality follow-up; (2) assessment of psychologic healthoutcomes; and (3) reproductive health outcomes. Resultsof the ®rst two studies were published or submitted to Congress previously [Thomas et al., 1991; Dalager andKang, 1996]. The present report deals with the thirdstudy.
The studies of reproductive outcomes among maleveterans have been mostly negative in that service inVietnam was not associated with the risk of fathering a childwith birth defects, spontaneous abortion, stillbirth orneonatal death [Erickson et al., 1984; Donovan et al.,1984; Aschengrau and Monson, 1989, 1990]. However, inthe recent “Ranch Hand study”, neural tube defects (spinabi®da, anencephaly) were reported in four children of U.S.Air Force personnel who sprayed Agent Orange and other herbicides in Vietnam, while none was observed among children of control veterans [Wolfe et al., 1995].
Further-more, when the CDC birth defects study was reanalyzedusing the exposure opportunity index based upon interview data, the risk of spina bi®da was signi®cantly associatedwith the highest estimated level of Agent Orange exposure[Erickson et al., 1984]. Based on these data and others, anInstitute of Medicine panel suggested an associationbetween herbicide exposure in Vietnam and an increased risk of spina bi®da in children [IOM, 1996]