VA Secretary David Shulkin will decide "on or before" Nov. 1 whether to add to the list of medical conditions the Department of Veteran Affairs presumes are associated to Agent Orange or other herbicides sprayed during the Vietnam War, a department spokesman said Tuesday in response to questions.
Any ailments Shulkin might add to VA's current list of 14 "presumptive diseases" linked to herbicide exposure would make many more thousands of Vietnam War veterans eligible for VA disability compensation and health care.
Ailments under review as possible adds to the presumptive diseases list include bladder cancer, hypothyroidism and Parkinson-like symptoms without diagnosis of that particular disease. High blood pressure and stroke also might be embraced, or ignored, as part of the current review.
The process was sparked by the Institute of Medicine's 10th and final review of medical literature on health effects of herbicide exposure in Vietnam. The 1,100-page report concluded in March 2016 that recent scientific research strengthened the association between herbicide exposure and bladder cancer, hypothyroidism and Parkinson-like symptoms. Specifically, the institute found "limited or suggestive" evidence of an association to herbicide versus its previous finding of "inadequate or insufficient" evidence of an association.
The report also reaffirmed from earlier reviews "limited or suggestive evidence" of an association between herbicide sprayed in Vietnam and hypertension and strokes. That same level of evidence was used in 2010 by then-VA Secretary Eric Shinseki to add ischemic heart disease and Parkinson's disease to the Agent Orange presumptive list. Shinseki had stronger evidence, an institute finding of "positive association" to herbicide for chronic lymphocytic leukemia, which he also added to the list that year.
The Institute of Medicine, renamed the National Academy of Medicine last summer, delivered its Veterans and Agent Orange: Update 2014, to then-VA Secretary Bob McDonald 15 months ago. He immediately ordered a technical working group formed to review findings and original studies it relied on, as well as any new science relevant to Agent Orange ailments. The group's findings then were reviewed by a smaller strategic group, followed by an internal task force of senior VA leaders.
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