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Collective judicial management of mass toxic tort controversies: lessons and issues from the Agent Orange litigation.

Viewing the Agent Orange litigation as a case study, this article explores the feasibility and desirability of strengthening the powers of the courts to manage toxic tort controversies en masse. The Agent Orange lawsuit, brought on behalf of potentially millions of Vietnam War veterans and family members, charged that herbicides used for military purposes during the war caused a wide range of health problems. This article first reviews the current national debate over how mass toxic tort controversies should be handled, including key legislative reform options, and describes how attention is increasingly focused on ways that the court system might better cope with mass toxic torts. The principal events of the Agent Orange litigation are then summarized, by which the litigation was consolidated into a massive class action, the class action was settled, and a streamlined plan for distributing the settlement fund was adopted. The article evaluates the outcome of the litigation, and discusses whether the solution there can and should be broadly applied to other mass toxic tort cases. This question depends, in part, on a series of complex legal and practical issues, but the author suggests that the question will also depend on what institutional role we expect the judiciary to play within society.

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Evaluation of chromosomal damage in males exposed to agent orange and their families.

Agent Orange (AO), a phenoxyherbicide, and dioxin, an impurity found in AO, are considered clastogens, mutagens, and teratogens in plants and animals. AO has come under suspicion in humans following claims that it causes chromosome damage and birth defects in offspring of exposed individuals. No well-designed epidemiological studies are available to support this conclusion. Of ten exposed individuals studied for chromosome breaks and sister chromatid exchange frequencies, eight were ascertained because they had children with congenital defects. No consistent pattern of anomalies was observed. Five children had neurologic deficit, one child had a central nervous system anomaly, and one child was affected with glaucoma. Although all individuals studied had normal karyotypes, a statistically significant increase in chromosome breakage was observed in exposed males compared to their unexposed wives and children; sister chromatid exchange frequency was not increased.

2,4,5-Trichlorophenoxyacetic Acid

Agent Orange exposure and posttraumatic stress disorder.

Evidence of organic psychological deficits in Vietnam veterans exposed to the herbicide Agent Orange was established through a neuropsychological battery. Also, the exposed Vietnam veterans, in contrast to a matched control group of Vietnam veterans, showed a significantly higher rate of posttraumatic stress disorder and its associated features: depression, anxiety, and increased aggression. The latter was subdivided into uncontrollable pressures, verbal violence, violence against objects, assaults, and suicidal thoughts. Active cases of chloracne, a medical indicator, were used to determine Agent Orange exposure.

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Carcinogenicity and teratogenicity vs. psychogenicity: psychological characteristics associated with self-reported Agent Orange exposure among Vietnam combat veterans who seek treatment for substance abuse.

This study asked, "What are the psychological characteristics of Vietnam combat veterans who claim Agent Orange exposure when compared with combat-experienced cohorts who do not report such contamination?" The question was researched among 153 heroin addicts, polydrug abusers, and chronic alcoholics who were seeking treatment: 58 reported moderate to high defoliant exposure while in combat; 95 reported minimal to no exposure while in Vietnam. The null hypothesis was accepted for measures of childhood and present family social climate, premilitary backgrounds, reasons for seeking treatment, patterns and types of illicit drug and alcohol use, interpersonal problems, intellectual functioning, and short-term memory. The null hypothesis was rejected for personality differences, however, those who self-reported high Agent Orange exposure scored significantly higher on MMPI scales F, Hypochondriasis, Depression, Paranoia, Psychasthenia, Schizophrenia, Mania, and Social interoversion. The results suggest that clinicians carefully assess attributional processing of those who report traumatic experience.

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The logic of a controversy: the case of Agent Orange in Australia.

Since 1979 the Vietnam Veterans' Association of Australia (VVAA) has claimed that exposure to the herbicide Agent Orange in Vietnam has adversely affected the health of Vietnam veterans and their families. A campaign for government recognition of diseases and disabilities caused by herbicide exposure led in 1983 to the appointment of the Evatt Royal Commission which, after a 2-year inquiry, comprehensively rejected the VVAA's claim. The Evatt Commission's findings have not been accepted by the VVAA and the claim continues to be defended, albeit in a highly qualified form. This controversy exemplifies the way in which a claim can attract public support, and persist despite rejections by Committees of Inquiry. An understanding of the reasons for the persistence of controversy requires an understanding of the logic of rejecting causal claims, the psychology of everyday inductive reasoning, and the interaction between politics and science.

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Posttraumatic stress disorder among Vietnam veterans on the Agent Orange Registry. A case-control analysis.

Some of the readjustment problems of Vietnam veterans have been attributed to posttraumatic stress disorder (PTSD). This case-control study compared demographic and military characteristics of 374 Vietnam veterans who had PTSD with 373 healthy Vietnam veterans. Veterans were chosen from the Agent Orange Registry, a Department of Veterans Affairs computerized database of approximately 200,000 Vietnam veterans who volunteered for a physical examination. Case patients and control subjects were frequently-matched by age, year of Registry examination, and race. Crude odds ratios (OR) were used to evaluate the risk of PTSD associated with certain characteristics of Vietnam service, as there was no apparent confounding by other military factors. Being wounded in Vietnam (OR, 2.33; 95% confidence interval (CI), 1.49-3.65) and having a combat job in Vietnam (OR, 1.54; 95% CI, 1.15-2.06) were the only risk factors for PTSD. Those who had noncombat jobs but were wounded had the highest risk of PTSD (OR, 3.56; 95% CI, 1.26-10.06).

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Health needs of the Vietnam veteran exposed to agent orange.

This article discusses the use of sprayed herbicides during the Vietnam conflict and the health problems exhibited by the veterans exposed to these chemicals. A short history of health problems attributed to herbicide exposure is given. Experimental research on the effects of dioxin, a byproduct in the manufacture of some herbicides, is limited to laboratory animals. In every instance the tested animal exhibited some ill effects following exposure. The research has shown that the lethal dose varies according to animal species and that the effects of dioxin exposure are cumulative. Reasons are given for the lack of research on the effects of human exposure. Numerous physical and psychological signs and symptoms attributed to agent orange exposure are listed. The stresses on the veteran with these health problems are discussed. The nurse practitioner may be the first health care professional to see these patients. Specific interventions are suggested for the nurse to incorporate into practice.

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Agent Orange studies.

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The Agent Orange controversy after the Evatt Royal Commission.

The Evatt Royal Commission Report on the Use and Effects of Chemical Agents on Australian Personnel in Vietnam has authoritatively rejected the substantive claims that were made by the Vietnam Veterans' Association of Australia about the adverse effects of exposure to phenoxy herbicides in Vietnam on the health of Vietnam veterans and their families. The Commission concluded that Vietnam veterans were not exposed to toxic levels of chemicals in Vietnam; that they are not at any increased risk of fathering children with birth defects, or contracting cancer; and that, although they have slightly higher rates of psychiatric disorder, heart disease, alcoholism and alcohol-related disease, these effects are unconnected with exposure to chemicals in Vietnam. The reasons for these findings deserve to be given the widest possible publicity. Only by doing so is there any prospect of dissolving the misapprehension that Vietnam veterans have been poisoned by herbicides.

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