AGENT ORANGE IN VIETNAM :
DAMAGE AND QUESTIONS RAISED
The text that follows presents an overview of problems posed by herbicides and
defoliants, including Agent Orange. This product, containing dioxin, was the most
widely used in Vietnam and today, more than 30 years after the end of the war, its
effects can still be felt.
HERBICIDES AND DEFOLIANTS
Purpose of the use of herbicides and defoliants in Vietnam
During the American war, this was one of the technologies of destruction used by the
United States with the following objectives:
• to destroy the vegetation along roads and trails, on the banks of watercourses in
the interior and on the seashore, to facilitate the surveillance of military installations
as well as of their environs, in order to clear their perimeter,
• to thin out the forests in the interior, to reveal North Vietnamese camps or hiding
places,
• and lastly, to destroy crops in zones held by the Vietcong.
Use of herbicides for military purposes
During 1943 and 1944, military specialists had tested 12,000 chemical products and
adopted 7,000 of them as weapons of war which could be used during conflicts.
In 1945, the Americans drew up a plan of spraying products able to destroy harvests
on the paddy fields surrounding large Japanese population centers, but the end of
the war against Japan came before this program could be implemented.
The use of defoliants and herbicides in Vietnam
In 1960’s, the United States government, increasingly involved in Indochina, had to
cope with popular uprisings and with the growth of a revolutionary movement in
South Vietnam. In the context of the Stanley-Taylor plan to pacify the country and to
gain control of roads and watercourses, it envisaged, with the agreement of the Ngo
Dinh Diem regime, the use of defoliants and herbicides, the best known of which,
used in Vietnam, would be Agent Orange. By extension, various herbicides and
defoliants are sometimes called Agent Orange in some popular articles, although
they are chemically very different from one another and possess different degrees of
toxicity.
On 11 May 1961 during a meeting of the National Security Council, President
Kennedy secured the Council’s consent to provide assistance to the South Vietnam
government via the creation of a War Equipment Development and Testing Center
and authorized the testing of herbicides and defoliants on the Laos / Vietnam border
area, a particularly sensitive zone.
Defoliation, code-named first Operation Trail Dust, became, with respect to its
principal, aerial component, Operation Hades, the ancient Greek god of the dead and
of the underworld, and was later re-baptized Operation Ranch Hand, a more polite
and less aggressive name.
The first spraying operation took place in August 1961, but the proper operation,
decided on by the American government in 1961 during the Kennedy administration,
did not really begin until 1962. It continued during the Johnson presidency and did
not end until 1971 during the Nixon administration as a result of public opinion
pressure and the protests of scientists of various countries, but essentially American
ones.
What is Agent Orange?
Agent Orange is a herbicide, (actually pink brownish), which received its name from
the orange band painted on the product’s cans in order to identify it and to distinguish
it from other herbicides called Agents white, blue, purple, pink or green. This discreet,
almost innocent and indeed poetic nomenclature for highly toxic products, recalls the
"special cans", containing napalm, used elsewhere and in other times.
In chemical terms, Agent Orange is a mixture of equal parts of 2,4-D and 2,4,5-T,
with dioxin as a by-product of its manufacture at a dose of between 3 and 4 mg/liter,
but much higher in the case of large-scale or accelerated manufacture.
WHAT IS DIOXIN OR, MORE APPROPRIATELY, WHAT ARE DIOXINS?
Chemistry
Dioxin, sometimes called Seveso1 is a chemical product whose chemical formula is
2,3,7,8-tetra-chloro-dibenzo-para-dioxin or TCDD.
For the more curious readers, there are, depending on the spatial arrangement and
the number of chlorine atoms in the basic structure, 75 congeneric products (of a
similar chemical structure) of PCDD (polychloro-dibenzo-dioxins) and 135 of PCDF, a
close group of polychloro-dibenzo-furanes of varying toxicity and other related
products, PCB’s (polychloro-biphenyls), which are dioxin-like, 419 chemical products
in all, 29 of which are particularly dangerous, the most toxic being TCDD.
Physico-chemical properties of dioxin
This product is particularly stable, heat-resistant up to 1000°C and indeed higher,
only slightly soluble in water, but is liposoluble, that is to say, soluble in greases and
which is therefore able to accumulate in various tissues or fluids of living organisms,
human or animal and particularly in mothers’ milk, leading to the risk of transmission
to nursing infants.
Noxiousness of dioxin
Dioxin is harmful to living beings, both human and animal, even at infinitesimally
small doses. Experimentally in the laboratory, the lethal (mortal) dose for rodents or
fish is of the order of micrograms, that is to say, millionths of a gram (10-6 g) per
kilogram of body weight and doses of nanograms (one billionth of a gram (10-9 g) can
bring about miscarriages, premature births and births of monstrosities. Long-term
exposure to dioxin causes cancers in laboratory animals.
The lethal dose for a human being, which has not been determined with precision,
would be 0.1mg/kg in the case of massive poisoning, as in the Seveso1 accident or
during direct spraying in Vietnam. On the other hand, a lesser but extended daily
poisoning of any individual may entail health problems as indicated later.
Half-life of dioxin
1
- From the name of the town in Italy, near Milan, where an accident occurred in July 1976 in the Icmesa factory
in a chemical reactor producing chlorophenol, with the emission of vapors containing dioxin.
Half-life is the time needed for half of a substance to disappear, either by being
destroyed, or becoming inactive. In the case of dioxin, half-life was initially estimated
at 3 years, then at between 7 and 8.2 years, but in living beings and in the sediment
of rivers and lakes, it is thought to be longer, 10 to 17 years. In any event, over 30
years after the end of its use in Vietnam, a not negligible quantity remains in certain
specific zones or hot spots (see below).
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Course of action of dioxin
It has been shown that the toxic effects of dioxin come about by its taking part in a
complex molecular process in cells, in particular reproductive cells, and necessitate
the participation of a specific receptor called Ahr (aryl hydrocarbon receptor), which
would be 10 to 15 times more sensitive in rodents used in laboratories than in human
beings. An extrapolation of the results is therefore not possible and any results
would be debatable.
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There are still many “unknowns” in the chain of cellular chemical reactions and the
results of various studies, sometimes contradictory, do not make it possible to reach
any certain conclusions concerning the toxic role played by dioxin in all the
pathologies where it is nevertheless suspected of being involved.
An Australian study during the 1990’s for example, found no link between dioxin and
cancer in human beings. Certain research scientists are less categorical, others more
affirmative regarding the connection.
Where does dioxin appear?
It may appear during natural phenomena such as volcanic eruptions, forest fires, or
during human activities such as the manufacture of iron and steel, the bleaching of
paper pulp, the manufacture of bleach, the recycling of non-ferrous metals, the
operation of power stations, the incineration of household waste, the burning of peat,
or as a by-product, that is to say as an undesirable, but unavoidable part of the
production of chemical substances, including pesticides and most importantly, of
herbicides. In fact, all natural or human activities involving high temperatures and the
presence of chlorine atoms may involve the production of dioxins or of furans
(chemical products similar to dioxins, with only one oxygen atom instead of two and
of lower toxicity, the principal one being 2,3,7,8 tetrachloro-dibenzo-furan).
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Effects of dioxin
Direct, accidental or intentional exposure produces effects which depend on the
quantity of the toxic substance and the duration of exposure, assessed scientifically
in terms of toxicity equivalents (TEQ - international codification in 1989) and may
cause directly discernible lesions, such as skin lesions recalling acne (chloracne), or
dark diffuse spots, later and more covert alterations of the hepatic function, an
alteration of the immune system, various cancers, an endocrine gland dysfunction
and an alteration of the reproductive function in both men and women.
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According to the Encyclopedia Britannica2, dioxin is a stable compound which
accumulates in the environment, is toxic, carcinogenic and teratogenic (producing
malformations in newborn offspring) during animal experiments.
Contamination routes
• The aerial route, in the case of direct massive spraying or prolonged stays in a
2
- London, 1998 edition printed in the USA.
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chronically polluted zone.
• The transcutaneous route, but repeated contact is necessary.
• The digestive route through the contamination of the food chain, including mothers’
milk, cows’ milk, the consumption of contaminated meat or fish, which concentrate
dioxin in their various fatty deposits or tissues.
Metabolism or the fate of dioxin in a living organism
Dioxin absorbed with food passes into the bloodstream, accumulates in the liver and
the muscles and slowly accumulates in fatty tissues. Eliminated by the gallbladder, it
is liable to be partially reabsorbed by the intestines and its elimination is accordingly
very slow.
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In pregnant women, dioxin may be transmitted to the fetus through the placenta and
in the mother enter her milk and thus into nursing infants. Side effects occurring more
or less later may appear in the fetus, the nursing infant or the child, who are
particularly sensitive to these molecules.
Through analogous processes, dioxin may enter the eggs of hens, ducks and other
birds and the progeny of various domestic and wild animals.
Particularly exposed populations
The populations exposed vary from period to period and according to precautions
taken in the light of increasing knowledge: chemical factory personnel, farmers and
all persons using herbicides and defoliants, paper pulp industry and domestic waste
incineration professionals and lastly populations subjected to spraying for military
purposes as in Vietnam, Laos and Cambodia between 1961 and 1971 and even
1971 and 75, where the most vulnerable appeared and still appear to be fetuses and
nursing infants and therefore the generations following the generation contemporary
with the war.
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Has the toxicity of dioxin resulted in accidents?
In 1957, this toxicity was apparent in a herbicide-manufacturing factory in Germany in
workers, whose skin showed signs of being allergic to products containing dioxin and
in farmers using herbicides.
Then there were accidents in the industrial manufacturing of certain chemical
products, the best-known being that at Seveso in Italy in July 1976, at Yusho in
Japan and at Yu Cheng in Taiwan, with several thousand persons more or less
seriously poisoned (37,000 at Seveso), presenting direct or secondary health-related
consequences.
It should be noted that at Seveso several years after the accident, genetic mutation
occurred in mice, without alteration of reproductive cell chromosomes, but by
exchanges of pairs of chromosomes and therefore, in fact, by the creation of a new
species3.
Finally, the spraying of herbicides and of defoliants in Vietnam produced, apart from
effects on the environment, the poisoning of both the Vietnamese civilian population
and of both Vietnamese and American and allied military personnel. The initial
ignorance of the dangers being incurred led to the obstinate use by the government
of the United States of highly dangerous products, whose noxiousness was being
3
- According to Professor Redi, of the University of Pavia, in a communication in 2000.
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proclaimed by scientists of various nationalities, including Americans.
THE USE OF HERBICIDES AND DEFOLIANTS IN VIETNAM
Quantities of herbicides and defoliants sprayed on Vietnam
According to A. Westing (1984; see also Westing’s text below), between 1961 and
1971, almost 45 million liters of Agent Orange were sprayed over Vietnam to which
must be added almost 20 million liters of Agent White and over 8 million liters of
Agent Blue, equal to 73 million liters of chemical products containing some 170
kilograms of dioxin.
These figures were recently revised upwards (Stellman et al., 2003), bringing the
total of herbicides sprayed from aircraft on Vietnam to over 77 million liters and an
estimated 386 kg of dioxin with a phenomenal noxiousness capacity, not forgetting to
mention the use of other chemical products such as malathion, 100,000 tons at least
of napalm according to the U.S Department of Defense, white phosphorus and
neurotoxic gases.
The areas sprayed once or several times with herbicides are estimated at 1,360,000
hectares by Westing and at almost 2 million hectares by the Institut d’Inventaire et de
Planning Forestier (FIPI), part of which had remained unsuitable for cultivation or
livestock breeding 30 years later.
Companies which manufactured chemical products
To meet the needs of the United States government, some fifty chemical product
companies were applied to, including mainly Dow Chemical and Monsanto, but also
Ansul, Diamond Alkali, Hercules, Thompson Chemical, Thompson Hayward and
Uniroyal Chemical among others.
The American government in the face of opposition from various sources to the use
of herbicides in Vietnam
• Opposition of scientists
From the very beginning of the use of chemical products in the Vietnam War, there
was opposition of numerous international scientists including Americans, as shown
below by the text of Y. Capdeville.
• Opposition of the Press
In May 1964, The Washington Post published an article by Jim G. Lucas claiming the
accidental destruction of harvests in the village of Cha La (the Mekong delta)
following Operation Ranch Hand. Some days later, the daily demanded the stoppage
of the use of herbicides in South Vietnam as inappropriate against the guerrillas who
had infiltrated a civilian population.
On 30 March 1970, the American publication Express News, published an article
stating that 2,4,5-T could cause malformations in the newborn and was much more
dangerous than thalidomide, the drug which had caused major genetic malformations
in children when prescribed to pregnant women in the 1960’s and whose use has
since been strictly controlled.
The English daily The Times of 28 December 1970 said that "Since 1962, according
to careful estimates, over 5 millions acres (about 2 million hectares) had been
sprayed with herbicides, an equivalent of 1/8th of the area of South Vietnam, at doses
on an average 15 times higher than those authorized for use in the United States by
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the American Department of Agriculture".
The photographer and reporter Philip Jones Griffiths, who covered the Vietnam war
and sent to Press organizations numerous negatives particularly illustrative of events
which he had witnessed and which greatly influenced public opinion to demand an
end to hostilities, wrote: "I maintain that the reason America became involved in Vietnam
and the reason for its failing so dramatically there is because of fundamental
deficiencies within the American System.
This book is not, however, intended to be a list of the tactics which
failed, compiled for the purpose of overcoming the deficiencies and
ensuring success next time. The American miscalculations made in Vietnam
are overshadowed by and stem from the folly of the original view that
deemed it possible for a society like America's to impose itself on that
of the Vietnamese." (Griffiths, 1971)
• Opposition of public opinion
Due to the pressure of public opinion, the 29 October 1969 saw the United States
forced to announce the end of the use of herbicides in highly populated areas.
On 1 January 1970, the use of the chemical product 2,4,5,-T was banned in the
United States, but in South Vietnam the Americans continued to spray it at doses 5 to
10 times higher than those previously used in the USA in agriculture.
Decision to stop Operation Ranch Hand
In April 1970, in the United States, the Department of Health, Education and Welfare
in concert with the Department of Agriculture, announced its decision to stop the use
of 2,4,5-T in agriculture and the Department of Defense announced that it was
considering an end of the use of herbicides in Vietnam.
The use of herbicides and defoliants in Vietnam was not actually stopped until
January 1971 as regards spraying from aircraft and only in September 1971 from
helicopters, but according to Professor Le Cao Dai, the Saigon regime continued to
use, until its fall in April 1975, stocks and equipment belonging to the American army.
Meanwhile, in April 1972, a reserve of 5.2 million liters of Agent Orange left over after
the end of Operation Ranch Hand was put into storage on an American Pacific island
and only destroyed in 1977, two years after the end of fighting in South Vietnam.
WHAT IS THE SITUATION OF THE VICTIMS?
Number of persons affected by herbicides in Vietnam
Recent estimates fluctuate between 2.1 and 4.8 million potential victims, who were
Vietnamese civilians listed in over 20,500 villages between 1961 and 1971, either
affected directly during spraying, who handled toxic chemical products without taking
precautions, or who had lived in contaminated areas.
These estimates do not take into account the progeny of poisoned parents, or
persons who had lived later in contaminated areas, or Vietnamese and American
military personnel and their allies who came to Vietnam in the 1970’s, including
Australians, New Zealanders, South-Koreans, etc. They likewise do not include
Cambodians and Laotians, several million persons in all.
The victims belong to several generations: the contemporaries of the spraying
operations who showed premature toxic affections such as those of the skin or
diseases which came to light later, including different cancers at rates exceeding
those of persons who had not been exposed to the incriminated chemical products
and more recent victims, born after the end of this chemical war and representing the
second and indeed the third generation.
The responsibility of the United States to the Vietnamese people has not yet been
recognized, but it should be noted that, to date, the Vietnamese government has not
wanted to lodge a complaint, in order to be able to re-establish diplomatic relations
with its old adversary and not cast discredit on its exportable products.
A recent reversal of sentiment has been demonstrated by the creation, at the end of
2003, of an association of victims of Agent Orange, chaired by an old political
personality of the first rank and whose twenty seven members (19 adults and 8
children) lodged a complaint individually before a Brooklyn Court at the beginning of
2004. The preliminary investigation of the proceedings began in March 2004 (see the
text of M. Chemillier-Gendreau below).
Agent Orange and American Veterans
• First petitions of the Veterans
After the defeat in Vietnam, the risks of a massive use of herbicides and defoliants
presented a challenge to scientists and to veterans’ organizations. Initially and for
several years, the American government vigorously denied that the chemical
products used during the war could have had harmful effects on human health,
maintaining that herbicides would only have a short-term effect on nature and would
not trigger any illnesses. This position was taken up in 1975 by the Institute of
Medicine of the National Academy of Sciences. Nevertheless, under pressure from
veterans’ associations, a research project was financed by the government without
producing any convincing results.
From 1979 onwards, veterans and their families instituted legal action for damages
for illnesses judged to have been connected with Agent Orange and hence with
dioxin.
• Creation of a compensation fund
On 7 May 1984, the Brooklyn Federal Court in New York, announced an amicable
settlement whereby, in exchange for the suspension of any prosecution, the
companies agreed to pay 197 million dollars into a compensation fund for veteran
victims of Agent Orange, without knowing the exact number of plaintiffs, or the extent
of existing or future damage. The Federal Court appointed an executive committee to
administer the said fund.
In order to obtain compensation, the veterans had to prove that the reported
symptoms were due to Agent Orange and that they had completely lost, not as a
result of war injuries, their ability to work. The occurrence of the handicap had to
predate 31 December 1994.
Out of the 105,000 applications received, 52,000 were accepted, equal to an average
award of 3,800 dollars, the subsidies intended for a person or a family ranging from
256 to 12,800 dollars maximum. The fund closed on 27 September 1997.
• Intervention of Admiral Zumwalt
At the end of the 1980’s, a boost was given to research on Agent Orange following
the intervention by the old Commander-in-Chief of the American Navy during the
Vietnam war, Admiral E.R. Zumwalt, who had decided to have herbicides sprayed
along canals and ditches in order to protect American naval patrol boats under his
responsibility and to prevent ambushes by guerrilla forces.
Tragically for the Zumwalt family, during this period the son, Captain Elmo Zumwalt,
commanded a river patrol boat in a region sprayed with herbicides. He went on patrol
daily on the Quang Nam and Ca Mau rivers and in the afternoon he was in the habit
of swimming in these rivers and of eating in the markets along the river banks.
After his period of service in Vietnam, Captain Zumwalt returned to the United States,
married, had a son whose development was abnormal, the child being mentally
deficient. During the same period Captain Zumwalt developed two different cancers
and died in 1988 (Zumwalt et al. 1986).
• Decision of the American Congress to hold an inquiry into Agent Orange
Following the experience of his own family, in 1987-1988, Admiral Zumwalt induced a
group of scientists to open the files of earlier research programs in which serious
abnormalities had been discovered and led the fight to ask the American Congress to
conduct a public inquiry into the effects of Agent Orange (Zumwalt, 1990). During the
Congressional debate, he testified that according to his own inquiry, up to 28 different
diseases were linked to Agent Orange and dioxin.
• In February 1991, Act PL 102-4 of the United States Congress ordered the
Secretary for Veteran Affairs to demand that the Academy of Science carry out an
independent and exhaustive study and an assessment of medical information on the
side effects of exposure to Agent Orange.
• Lists of diseases attributable or not to Agent Orange appeared
In 1994, the Institute of Medicine was authorized by the National Academy of
Science to publish the first list of diseases and a book of documents (National
Academy of Science, 1994). In these documents, the Institute recognized Agent
Orange for the first time as the cause of certain diseases and recommended that
research should continue in certain directions, promising at the same time that the
results of the research would be published every two years.
The Department of Veteran Affairs was also instructed to pay compensation to
families of those who died, as well as invalids and to pay for medical consultations
and the rehabilitation of victims of Agent Orange.
List of diseases attributable or not to Agent Orange (National Academy of Science,
Update 2002)
• Diseases showing sufficient evidence of association with exposure to herbicides:
chronic lymphocytic leukemia (CLL), soft tissues sarcoma (malignant tumor), nonHodgkin’s lymphoma (malignant blood disease), Hodgkin’s disease (malignant
blood disease), chloracne.
• Diseases showing limited evidence of association with exposure to herbicides:
respiratory cancers (Lungs and bronchi, the larynx, the trachea), cancer of the
prostate, multiple myeloma (malignant tumor), acute or sub-acute peripheral
neuropathy, late porphyria (an affection of the skin with urinary complications), type
2 diabetes, spina bifida (congenital vertebral malformation).
• Diseases showing inadequate or insufficient evidence of association with exposure
to herbicides: hepato-biliary cancer (liver, bile-ducts), nasal or naso-pharyngal
cancer, bone cancer, skin cancers, breast cancer, cancer of the female
reproductive system (neck of the womb, uterus, ovaries), testicular cancer, bladder
cancer, kidney cancer, leukemia (other than CLL), spontaneous abortion, neonatal
malformations (other than spina bifida), stillbirth and neonatal death of nursing
infants, low birth weight, infantile cancer of progeny including acute myeloid
leukemias, abnormal sperm parameters and infertility, cognitive and neuropsychiatric diseases, motor and coordination dysfunctions, chronic diseases of the
peripheral nervous system, gastro-intestinal metabolic and digestive diseases
(alterations of hepatic enzymes, lipid abnormalities, ulcers), diseases of the
immune system (immune deficit and auto-immune diseases), circulatory difficulties,
respiratory affections, primary type AL amyloïdosis, endometriosis, effects on
thyroid function.
• Diseases showing clear evidence of a lack of association with exposure: gastrointestinal tumors (cancer of the stomach, the pancreas, the colon, the rectum),
cerebral tumors.
In May 1996, President Clinton approved legislation granting real advantages to
American veterans and spoke about "suffering caused involuntarily by our nation to
its own sons and daughters by exposing them to Agent Orange in Vietnam".
On 9 June 2003, The United States Supreme Court gave a ruling allowing American
veterans affected by Agent Orange to institute renewed legal action against the
manufacturers of herbicides and defoliants. This concerns victims whose symptoms
occurred after the 1984 compensation fund had become completely exhausted.
Other results of international research
• Weakening of the immune system
Research in the United States has shown that dioxin affects the capacity of the
organism to defend itself by weakening the immune system, in particular cellular
immunity. According to one study, veterans frequently exposed to herbicides had an
increased rate of anti-nuclear antibodies resulting in an acceleration of the aging
process.
• Endocrinal and metabolic disorders
Recent international research has shown that dioxin causes endocrinal disorders: in
the metabolism of insulin leading to diabetes, of the functioning of the thyroid gland,
of the metabolism of cholesterol and of testosterone and that it can promote
cardiovascular, and coronary affections in particular.
Other veterans
Australian veterans of the Vietnam War instituted legal action against their
government for health damage as did New Zealand veterans against theirs in
December 2003.
RAVAGES OF THE NATURAL ENVIRONMENT
Before the war, South Vietnam was covered by non-deciduous forests, mangroves'
swamps or seaside forests where mangroves and various types of trees acclimatized
to salt water abounded, by rubber plantations and by some 3 million hectares of
farmland.
The ravages of defoliation were considerable and are dealt with in more detail in the
texts of A. Westing and Vo Quy, below. Some important points should be noted.
The forests of the interior
Many of the destroyed forests have not yet returned to life and the trees have been
replaced by thick grasses and by bamboo of little economic value. The destruction of
forests resulted in an ecological imbalance. Its repercussions were felt on the
exploitation of timber, wild fauna, possibilities of reforestation, protection of
nutriments and on the water system with a risk of flash floods and of drought resulting
in the erosion of the soil which becomes depleted and lateritic. The forest of Ma Da in
the province of Dong Naï was particularly affected.
Spontaneous regeneration is difficult and slow and may take 80 to 100 years.
Reforestation was therefore needed and has been launched on a wide scale.
Mangroves
Mangroves normally have a high timber yield. Apart from the drying out of mangroves
by drainage trenches and the destruction of large quantities of shrubs by
flamethrowers, the spraying of herbicides and defoliants was extensive, in particular
in the forest of Sat near Ho Chi Minh City and that on the Ca Mau peninsula. The
many hectares destroyed there resulted in the loss of millions of m3 of timber and of
from 60 to 100 kg of shrimps a year for every hectare, according to Snedaker. The
most important effect on the soil was its oxidation, which left it both acidic and salty
and, therefore, useless.
The natural re-growth of mangroves is long and difficult. The Ministry of Forests
therefore decided to plant trees on numerous sites and animal life gradually
reappeared.
Farmland
The area of cultivated land which had been sprayed with herbicides and defoliants
reached some 200,000 hectares; the soil became eroded and the nutriment content
(nitrogen, phosphates, calcium, magnesium) fell, causing a loss of 40 to 100 % of
productivity of various crops.
Rural population
Before the conflict in South Vietnam, 85 % of the population was rural, leading simple
lives surrounded by a luxuriant countryside. At the end of the war, 3 million of the 17
million inhabitants had become refugees, living in towns, in the heart of a ravaged
countryside a part of which had become desert, useless for the purposes of
agriculture or sylviculture, not to mention the symbolic loss of forest and
watercourses, dwelling places of spirits protecting families (see the texts of J. Maître
and B. Doray below).
Fauna
The massive bombing and the spraying of herbicides contributed to the
disappearance of species of wild animals and to the virtual disappearance of other
species. In the forests, valuable animals were destroyed. On the other hand, harmful
animals were able to prosper, including rodents, which destroy crops, and
mosquitoes, which increase the risk of malaria and of dengue. The destruction of
mangrove forests brought about the death or the flight of rare and precious animals,
such as wolves, alligators, wild boars, monkeys, iguanas, snakes and birds.
Numerous domestic animals were killed or became sick. The war also caused
abnormalities in the progeny; stillbirths, monstrosities and illnesses killed tons of fish.
There was corresponding drop in the production and export of fish and shrimp.
RESEARCH ON DIOXIN IN THE SOIL, FOOD AND IN HUMAN OR ANIMAL
SAMPLES
Interest of research on dioxin
For several reasons, it was important to analyze the quantity of dioxin remaining in
the environment and in living beings in order to study the consequences of chemical
warfare in general and those of the use of Agent Orange in particular: firstly, because
dioxin, a stable compound, persists for a very long time, while herbicides decompose
more rapidly; secondly because dioxin analysis also assists in identifying regions
which remain contaminated, and thus contributing to selecting cleaning and
protection measures for both the population and domestic and wild animals.
Difficulties of research
This analysis is difficult because there are only a few laboratories in the world well
equipped and trained to obtain reliable results and because the analyses are
expensive (cost between US$ 1,000 and 2,000 and even more per sample in 2000).
Moreover it has to be remembered that some 30 years or more have elapsed since
chemical products had been used and that residual quantities have diminished, in
spite of the uncertainties on the subject of the half-life of dioxin depending on where it
is found.
Over the past years and thanks to international cooperation, several thousand
samples (some 4,000 prior to 1999) have been analyzed and the results of these
studies were published in Vietnam and in other countries and reported in numerous
scientific books and reviews.
Laboratories carrying out dioxin analysis
Scientists and laboratories in the United States, Canada, The Netherlands, Finland,
Germany, Japan and France participated in the examination of samples from
Vietnam.
Results of analyses of dioxin present in the soil and in mud from rivers or lakes
• Quantified data
According to estimates, 386 kg of dioxin were sprayed in South Vietnam over an area
of 10,400 km2 according to the Americans and 30,100 km2 according to the FIPI.
The average theoretical concentration of dioxin in the soil was 25 pg/g (pg =
picogram or 10-12 g = a millionth of a millionth of a gram4).
In soil samples taken in 1983 from the forest of Sat near Ho Chi Minh City, dioxin
levels were 3 to 7 times higher than those in industrialized countries.
During the 1985-86 period, 121 soil samples and 8 river mud samples said to be
places of high dioxin concentration revealed the presence of only moderate levels of
dioxin in 25 samples of soil, ranging from 1 to 14 pg/g or ppt and in some samples
from 16 to 59 pg/g. In river mud, dioxin was not found, except in one arm of the
Saigon River, where a very high concentration was present, 210 pg/g, but which may
have been partly due to industrial pollution.
4
- The results of dosages are often expressed as percentages by the abbreviation ppt (parts per trillion, 10
18
12
trillion is 10 in France and England, but 10 in America.
–12
). A
Initiative of the Vietnamese Government
On the scientific level, Vietnam appointed an “International Committee for
Investigating the Consequence of the Chemical War in Vietnam” in October 1980,
whence its name, Committee 10/80, to collaborate with foreign research workers,
participate in symposia throughout the world and publish in international reviews,
notwithstanding the reticence of certain political circles which feared that these
accounts might have an adverse effect on the export of various products.
Nevertheless, research showed that plants growing in soil highly contaminated by
herbicides, did not contain dioxin and that rice, corn, tea, coffee, fruit, etc., were, until
the 1980’s, free from it, in contrast with fish and shrimp.
Long-term effects
These effects formed the subject of research on groups of veterans from the North
who had served in the South and on persons living in zones in the South which had
been sprayed with herbicides. They were reported on in seminars in 1983 and 1986,
then in 1993, with an intermediate protocol in 1990 in a State Report and they
backed up the following topics.
Case of general pathology
Generally speaking, in those who had been exposed to chemical products there was
a statistically significant prevalence of digestive, nervous, dermatological,
cardiovascular or blood-related affections and oro-pharyngeal or liver cancers.
Reproductive abnormalities
More frequent in the families of Vietnamese veterans who had fought in the South
than in control groups, they include
• spontaneous abortions and premature births (2 to 3 times more numerous in the
South)
• stillbirths (60 times more numerous)
• molar pregnancies (with degeneration of the placenta) (7 to 38 more numerous in
the South) and chorio-carcinomas (cancers of the placenta) (25 more numerous in
the South). Nevertheless, a study by Catherine Ha and Sylvaine Cordier,
commissioned by the INSERM, the French medical research institute, does not show
high dioxin levels in women subject to molar pregnancy.
• congenital malformations, monstrous deformities (11 times more numerous in the
South). These include harelip, cleft palate, absent or atrophied members
(phocomelias), malformations of the spinal column including spina bifida,
abnormalities of the eyeball, anencephaly (absence of brain), microcephaly (small
brain), hydrocephalus, defects of the senses (blindness, deafness, numbness),
neuro-psychological abnormalities (mental retardation, idiocy, memory defects).
Research for dioxin in sperm and the germinal (reproductive) cells of American
veterans with abnormal children were sometimes positive.
Lastly, there is the rare phenomenon of Siamese twins, but which occurs throughout
the world. Although precise and reliable statistics are difficult to find, here and there a
frequency of one case per 50,000 to 100,000 births in the world is mentioned.
Nevertheless, the frequency appears to have been higher in Vietnam, where 30
cases of twins joined in different parts of the body were reported, between 1981 and
1985, in four hospitals in the South, Tay Ninh, Dong Naï, Song Be and Tu Du at Ho
Chi Minh City, that is to say a frequency approximately ten times greater.
A recent study by Dr Nguyen Thi Ngoc Phuong, director of the obstetric and
gynecological hospital Tu Du in Ho Chi Minh City deals with data on 372 neonatal
abnormalities out of 22,791 births which occurred between May and December 2001
(there are, in fact, between 30 and 35,000 births a year at Tu Du, often 100 or more a
day). The mothers were classified according to whether or not they had been directly
exposed to herbicides or whether they had lived more or less than 15 years in a
contaminated zone. Overall, abnormalities of the face or of the head (38.4 %), of the
digestive organs (22.5 %), of the members (5.2 %) were noted, cases of trisomy 21
or mongolism (5,5 %), abnormalities of the respiratory organs (2.8 %), of the urogenital organs (8,3 %), other abnormalities (17.3 %). Among the group of women
who were most and longest exposed we observe a decrease in the duration of
pregnancy, more Cesarean sections, more low-weight babies and a lower rate of
survival at 24 hours as compared with the group of women who were not or only
slightly exposed.
Rate of infant mortality
Statistics based on a total of 9,100 children born between 1966 and 1986 show that
under such economic, political, social and health conditions, infant mortality is much
higher in communities in which herbicides and defoliants had been sprayed. The
increase was statistically significant and indicated a risk linked to mothers’ milk
contaminated with dioxin during the war.
Cancer
During the 1989-1992 period, with the cooperation of the INSERM and two Hanoi
hospitals, Hôpital Viet Duc and Hôpital 108, a study was carried out which focused
principally on primary cancer of the liver, on the one hand, and on chorio-carcinoma
during a molar pregnancy, on the other. It found a statistically significant relationship
between the possibility of developing cancer of the liver and the length of service on
the battlefields of the South.
In 1993, a study carried out by Sylvaine Cordier and Denis Bard led to the conclusion
that an increased risk of hepato-cellular carcinoma (cancer) existed in Vietnamese
who had served 10 years or longer in South Vietnam during the period of the
spraying of Agent Orange by the American army.
What was only lately the standard used for determining victims of Agent Orange in
Vietnam?
As far as we are aware, two criteria were and still are required:
1/ that the persons concerned must have been exposed to herbicides used by the
Americans during the Vietnam War
2/ that they must have one of more of the illnesses listed in the table below
(affections marked with an asterisk* are illnesses recognized by the American
National Academy of Sciences as having a possible link with Agent Orange
• Cancers: Primary cancer of the liver, soft tissue sarcoma*, Hodgkin’s disease*,
non-Hodgkin lymphoma*, respiratory cancers* (larynx, trachea, bronchi and lungs),
prostate cancer*, multiple myeloma*
• Metabolic disorders: Lipidic (cardio-vascular, coronary, cerebral affections), glucidic
(diabetes)
• Nervous system diseases: Peripheral neuropathy*
• Skin diseases: Chloracne*, retarded porphyria* (a dermatological affection with
urinary symptoms)
• Abnormal births: Spontaneous abortions, premature births, stillbirths, molar
pregnancy, chorio-carcinoma
• Malformed fetuses and in the case of one or more children, congenital
malformations may also appear in the next generation (grandchildren).
INVENTORY OF THE CONSEQUENCES OF THE USE OF HERBICIDES AND
DEFOLIANTS IN VIETNAM AND REPARATORY MEASURES
Interest of an inventory
The use of herbicides and defoliants in massive and repeated quantities during the
Vietnam War had a destructive and prolonged impact on the environment, the
ecology and the health of several generations of the population. It is accordingly
essential to draw up an inventory of the consequences. This question concerns the
Vietnamese population and also several hundred thousand veterans in the United
States, Australia, New Zealand and South Korea, the countries whose soldiers
participated in the Vietnam War, as well as Canadian veterans taking part in a
personal capacity although their country was not an official participant in the conflict.
Moreover, dioxin is a new environmental problem for all inhabitants of industrialized
countries, due to the potential hazards to which it subjects the population living near
sources of emission. Poisoning may be covert, developing quietly and manifesting
itself by various affections whose abnormal prevalence (frequency over a lapse of
time) can only be demonstrated by epidemiological studies.
Decontamination of the environment
Although the dioxin levels in areas of the South which had been sprayed may
sometimes still be higher than in areas of the North where no spraying had taken
place, they are not sufficiently high in the majority of soil and mud samples from the
South to necessitate decontamination. The dioxin levels are often similar to those
found in industrialized countries, i.e., 10 to 30 pg/g.
Attention must however be given to certain “hot spots” at airports and their environs
such as those of Da Nang and Bien Hoa, near Ho Chi Minh City, in areas of storage
of chemical product containers and handling and filling areas, on the battlefield in the
community of A So in the district of A Luoi, on the Ho Chi Minh trail, province of Thua
Thien Hue. There, soil dioxin levels were one thousand times higher than the
maximum acceptable contamination and in blood samples, dioxin levels were 30 to
40 and even 100 times higher than the average present in the population of the North
(Le Cao Dai, 2000).
To neutralize the effects of dioxin, it is possible to envisage
• slow natural destruction by intensive rays of the sun (photodecomposition or
photolysis) taking years, since dioxin starts on the surface of the soil, but gradually
sinks and it is now 30 years after it had been sprayed,
• destruction by micro-organisms (bacteria, moss, fungi) as far as we are aware only
tested in the laboratory,
• the use of chemical products which absorb dioxin, such as Bentonite and claybased preparations,
• destruction by heat, by heating, with the addition of quicklime (CaO), the
contaminated soil to 300°C instead of 1,200°C recommended earlier. This
technique could be contemplated for the “hot spots”; in 2000, a mobile unit of an
Australian company was able to purify 400 m3 a day at a cost of from 100 to 200
US$ per m3. As far as we are aware, this destruction has already started and at
present, March 2004, will continue at certain “hot spots”.
Restoration of forests in the interior and mangroves
Reforestation is possible, even in zones in which destruction was extensive.
Depending on the region, programs may link together sylviculture and agriculture or
sylviculture and fishing. The selection of trees depends on the soil, the climate, the
habits of the population and, of course, cost.
Dealing with chemical product drums scattered mainly in forests
These are containers of over 200-litre capacity (55 US gallons, 208 liters, to be exact)
most frequently containing herbicides or defoliants, but also other chemical products,
asphyxiating gases and tear gas, not all of which have been found and destroyed.
The chemical products may still be active and harmful to the population, either
directly or via water pollution. Their destruction is regulated; in the case of Agent
Orange, for example, where transportation is prohibited and burying with quicklime
advised.
Drawing up an inventory of the effects of Agent Orange on human health
• The list of the various diseases which dioxin may cause in human beings should
periodically be reviewed due to the progress in research techniques and
knowledge.
• Analyses of dioxin carried out late and, therefore, often and paradoxically negative
and costly, are not widely used at present for clinical diagnosis. Nevertheless,
several aspects have to be underlined:
- the body dioxin load, i.e., the blood, fatty tissues and more rarely sperm dioxin
levels, is an appropriate indicator for relating effects to exposure. In dead animals,
it is possible to link these effects to the dioxin level of the intestines.
- the concentration of dioxin in mothers’ milk is a good indicator of fetal exposure,
as stated earlier.
- differentiating between past exposure and that in progress is difficult.
• Research on biological or diagnostic indicators of immunity-related affections have
not proved very conclusive to date.
• Too partial statistics presented by the Vietnamese at international conferences
have proved difficult to exploit and rigorous epidemiological studies are necessary.
• Personalized surveys or accounts of the lives of various family members, parents or
grandparents in whom malformations or diseases appear to the second and even
the third generation, have begun to try and find a link between exposure to products
said to be toxic and unusual handicaps in one or more descendants (see below the
text of B. Doray and J. Maître).
Assistance for victims
This is a major, difficult and costly problem. Priority should be given to the quality of
life by acting on the environment, lifestyle, health monitoring, family planning, early
detection of abnormalities during pregnancy, correction of infirmities and so on. Nor
should one forget psychological support for suffering and often guilt-ridden families
as well as material and financial support to help in social rehabilitation.
Work of scientific research
Dioxin disappears slowly from the environment and from the human body via natural
processes, but its effects may be lasting. The war transformed Vietnam into a "large
human laboratory for studying the effects of dioxin on human health" and it is true to
say that in no other area of the world were there several million persons likely to be
affected to varying degrees and over several decades, as was the case of the
population of Vietnam.
Essential international assistance
International cooperation is needed for scientific research and to provide assistance
on human, social, ecological, environmental, technical and financial consequences of
this chemical attack which had unforeseen results. In his memoirs, Robert
McNamara, former U.S. Secretary of State writes: "We committed an error, a terrible
faux pas. We have to explain to future generations how such an error was
committed"5.
Practical proposals include
• conducting scientifically irreproachable epidemiological studies complying with
international standards, with precise and reliable statistical data able to be
compared with maps of intensively sprayed or polluted zones (particularly residual
"hot spots");
• utilizing accounts of the lives of families where major or minor, frequent or unusual
handicaps appeared in descendants;
• promoting various kinds of scientific research, in particular into potential genetic
mutations which occurred in laboratory animals but not to date found in human
beings, although a structural mutation of gene P53 was mentioned by a research
worker dealing with persons exposed Agent Orange/dioxin.
• informing and sensitizing populations and institutions of all countries on the problem
of dioxin.
• assisting Vietnam on implementing a social policy
• considering compensation for victims by legal recourse, which has already begun,
but only on a very inadequate scale.
CONCLUSION
The use of herbicides and defoliants by the Americans in South Vietnam caused in
the short- medium- and long-term, health, social, ecological and economic damage to
human beings, which that country had and still has to deal with.
Dioxin is a known human carcinogen. Moreover, epidemiological studies have linked
non-cancerous multiple pathologies such as diabetes or cardiovascular diseases to
5
- McNamara (R. S.), 1998, "In Retrospect, the tragedy and lessons of Vietnam, New York Times Books.
dioxin exposure. Lastly, laboratory animal experiments have shown that it can also
be mutagenic, that is to say bring about genetic modifications and thus transmit new
and sometimes monstrous characteristics to the generations to follow.
Dioxin is a case complicated by scientific doubts and questionings by research
workers including those of Professor Apfelbaum: "A powerful carcinogen in laboratory
animals, but at very high doses of dioxin, the studies are contradictory, the estimated
risk per unit dose being able to vary from 1 to 10 million".
The various abnormalities, the more or less serious handicaps found may be
explicable by the affection of different tissues during the development of the embryo,
or during the growth of the young child, in relation to the date of occurrence of the
poisoning. It is possible, even probable, that the amounts of poisons able to cause
serious and irreversible lesions are relatively low, due to a particular sensitivity at
these moments of life.
Lastly, the use of chemical products whose immediate and long-term toxicity is not
known, the length of persistence in nature, the risk of absorption by living organisms,
the mode of action and the metabolism if they penetrate into the latter, seems to be
one of those difficultly acceptable aberrations of which man is capable and which
may recur. The adventure of dioxin and its dramatic and unforeseen or hidden
consequences must serve as a model to be avoided.
Dr Jean Meynard
Vice-President of the Association "Vietnam, the children of dioxin"
With the collaboration of Nguyen Xuan Phuong and Nguyen Phong Quang
BIBLIOGRAPHY
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Le Cao Dai, 2000, "Les effets durables de l'agent orange durant la guerre du
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National Academy of Science, Institute of Medicine, Committee to Review the Health
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the following references (the list is deliberately limited and, therefore, incomplete):
"Dioxin 2003, Boston, 23rd International Symposium on Halogenated Organic &
Persistent Organic Pollutants, Boston, Massachusetts, U.S.A., August 24-29, 2003",
1 CD-ROM. [http://www.dioxin2003.org]
INSERM, 2000, "Expertise Collective. Dioxines dans l’environnement : quels risques
pour la santé ?", Les Éditions de l'Inserm, Paris.
Le Cao Dai, 2000, "Agent Orange in the Viet Nam War. History and Consequences",
Vietnam Red Cross Society, Hanoi, 202 p.
"Long-Term Consequences of the Vietnam War. Report to the Environmental
Conference on Cambodia, Laos and Vietnam – Stockholm, 26-28 July 2002", "Public
Health", 14 p., "Ecosystems", 17 p., "Ethics, Law, Policy", 98 p.
[http://www.nnn.se/vietnam/environ.htm]
"United States-Vietnam Scientific Conference on Human Health and Environmental
Effects of Agent Orange/Dioxins, March 3-6 2002, Hanoi, Vietnam".
[http://www.niehs.nih.gov/external/usvcrp/project1.htm]