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Seeking justice for veterans, By TOM LAVENTURE, Staff Writer
April 25, 2008 - 11:11am — Tom LaVenture
Filed under: Health News



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Veterans fight to have Parkinson’s declared service connected to Agent Orange

U.S. Military Veterans With Parkinson’s Disease, an organization of about 150 members, is saying the Department of Veterans Affairs should recognize that exposure to Agent Orange and other pesticides during their service has a plausible connection.
They want Parkinson’s added to the VA’s “presumptive list” of Agent Orange connected illnesses.
Jim Graham, 59, a former logger from Littlefork, and one-time Big Falls mayor, was diagnosed with Parkinson’s in 2000. His spouse, Terri, said that around 1999, Jim began to experience tremors and stiffness. These days he can no longer talk on the phone because of the tremors and a developed throat condition called Barrett’s esophagus. Friends are shocked to see the once physically fit logger having difficulty eating and going through normal daily rituals. He continues his walks despite the increasing difficulty with balance and movement.
“We have been through so much in the past year with the changes in Jim and how it has progressed,” said Terri Graham.
Approximately 1.5 million Americans suffer from Parkinson's disease, a presently incurable neurological disorder that researchers believe is caused by the progressive loss of dopamine producing cells, possibly from a combination of genetic and environmental factors.
Jim Graham served in Vietnam as a U.S. Navy jet mechanic from 1968 to 1972. Until a few years ago, the only problems that he related to his service was the occasional jungle rot and the VA gave him a 10-percent service connected disability for tendonitis.
He divided his carrier duty with work at a Danang air base, an area that was heavily sprayed with Agent Orange, a highly toxic, undiluted Dioxin chemical that was produced as a byproduct in the manufacturing of herbicides. The most toxic of the 75 Dioxins, 2,3,7,8 – TCDD, was used to destroy crops and to clear foliage around base perimeters during the Vietnam War.
These chemicals were transported via air and sea in metal barrels and without knowledge of their toxicity, USMVP members said the containers were cut apart and reused in fortifications, for storage, to make grills, latrines and shower bins.
The Grahams believe that Jim's illness is service related. They also believe their two grown children and a daughter from Jim’s previous marriage all have inherited health problems related to his exposure.
“People should know what these vets are going through,” she added.
Terri quit working to be a full-time caregiver for Jim. With their mortgage paid off on their southeast Minnesota home in Dakota, she helps him through the day and they enjoy their grandchildren together.
Without much income, they keep the heat at 60 degrees and Terri qualifies for MinnesotaCare. The VA considers Jim totally disabled and eligible for care at the VA clinic in Tomah, Wis. His symptoms can be treated at various stages through physical therapy, medication and surgery.
The Graham’s application for service connection for Parkinson’s was denied, as was his appeal. A third application will be reviewed in May. They will submit 1,500 pages of research.
“I believe that we will win with the wealth of information,” Terri said. “It is amazing how far we have come in a year.”
Jerry Andre, Koochiching County Veterans Service officer, said that veterans with Parkinson’s do come to him and he encourages them to file service related claims while they wait for legislation to put Parkinson’s on the presumptive diseases list. He said it is also worth checking to see if it was triggered by something else that is service related.
“If medical evidence is supportive of the fact that Parkinson’s was incurred or aggravated during active duty then it will be treated as any other service connected disability,” Andre said.
The VA created an Agent Orange Registry for veterans possibly exposed to dioxin or other toxic substances in herbicides. These veterans include those who served in the Republic of Vietnam between 1962 and 1975; Korea in 1968 and 1969, or anyone exposed during testing, transporting, or spraying herbicides for military purposes.
Several states have introduced bills calling on Congress to add Parkinson’s to the presumptive list. Minnesota Sens. Linda Higgins, Steve Murphy, Don Betzold, Steve Dille and David Tomassoni coauthored a bill in March that is currently in committee. A House companion bill was introduced by Reps. Mary Ellen Otremba and Al Juhnke.
Last year, the Grahams met with Steve Fiscas, a Minneapolis veteran with Parkinson’s who started the USMVP. The group met with House Committee on Veterans Affairs Chairman Bob Filner, D-Calif., at a community meeting sponsored by U.S. Rep. Tim Walz.
Both Walz and the Grahams expressed concern with the issue, but according to Walz’ office, before legislation can be introduced, they need to work within the current budget rules and with input from constituents and national veterans organizations. At that point, they said that a bill would need to navigate the committee process and receive expert testimony before it could get a vote.
The more expedient process is through the bi-annual Institute of Medicine of the National Academy of Sciences report to the VA, required by Congress as part of the Agent Orange Act of 1991. The VA is directed to regard the findings among other evidence in using a five-tier structure to consider additions to the presumptive connections list. They range from definite link, to possible, inconclusive, improbable, and no link at all.
The most recent 2006 Institute of Medicine report considered current evidence “inadequate or insufficient” to determine an association with Parkinson’s and herbicide exposure.
The IOM committee called for specific research on disease progression and suggested epidemiologic studies using VA data on unusual health outcomes and for potential metabolic syndrome – multiple health issues – among exposed veterans. It requested investigations into exposure related birth defects and developmental cognitive disease in offspring and grandchildren.
The report also recommended collaborative studies on the Vietnamese people, which continue to exhibit long-term health consequences of exposure to the same chemicals.
Given the response to past reports and studies, USMVP members are doubtful the IOM study will impact change as legislation would. The 1990 Admiral Zumwalt Jr. report to the VA noted ample evidence to link illnesses to exposure, and accused a VA special committee with failing to act impartially toward the evidence. Parkinson’s is not mentioned in the report, as it had not yet appeared in veterans in the 1980s.
“We believe it is a matter of time,” said Alan Oates, another USMVP member who served a full military career and retired to run a business in Edinburg, Virginia. He began a petition to get the VA to add Parkinson's to the presumptive list.
Oates is concerned that along with the IOM reports, the VA needs to consider the evidence presented from at least three other credible sources on agricultural pesticide exposure and comparison studies. He feels Parkinson’s would easily fall within the presumptive spectrum if they did. Even if it were a close call, he said the VA is charged to side with the veteran in such cases.
The VA has opened six Parkinson's Centers around the country since 2001. These research, education and clinical institutes also serve to train VA providers nationwide who in turn treat approximately 40,000 veterans with Parkinson's. Current VA studies on Parkinson’s include deep brain stimulation and adult stem cell research in addition to determining whether exposure to neurotoxins is a trigger.
Oates feels that the Parkinson’s centers are evidence to show the VA expects to see larger numbers of Vietnam veterans with Parkinson’s. He has had little luck getting access to VA data.
USMVP is conducting a member survey to find out dates of service in Vietnam, along with their Parkinson’s diagnosis dates and other service and health information. Oates hopes that the results will reveal early onset Parkinson’s, with a consistent diagnosis date of around 32 years after service in Vietnam. Veterans can request a survey via their website at www.usmvp.org.
“We also have a high rate of risk for other diseases already presumed associated with Agent Orange,” he added.
Christopher Reid, a physician and scientist in Neurobiology at Charles University in Los Angeles, said despite the lack of data available to public health specialists to investigate a possible link, that there is a growing consensus that environmental exposures are important to the development of the disease in some of patients.
He noted a 2006 Mayo study and a 2007 National Institute of Environmental Health Sciences report, which indicated that certain pesticides may increase the risk of developing Parkinson's more than others.
Reid said the difficulty with discerning cause-and-effect relationships with diseases is that it can take years or even decades to appear after exposure to a toxin. He said this should encourage health scientists to think creatively about how they collect and analyze data.
As a West Point graduate from a military family, Reid said that if science has been slow to investigate and remediate the full impact of Agent Orange on veterans and those abroad, then this society is responsible now, “to do something significant in the lives of those affected.”
“The scientific process is often instrumental and indispensable in seeking and doing justice,” said Reid. “A great example is DNA testing in criminal cases. I think it is often the failure to fully engage in the scientific process that produces injustice.”

Agent Orange exposure
Diseases being studied as triggered from exposure to Agent Orange and other herbicides: Parkinson’s, tonsil and breast cancers, melanoma, amyotrophic lateral sclerosis, lupus, ischemic heart disease and stroke.

Service connected diseases
The current VA presumptive list of service connected diseases from exposure to Agent Orange includes: chloracne or other acneform disease similar to chloracne; porphyria cutanea tarda; soft-tissue sarcoma, other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma or mesothe-lioma; Hodgkin’s disease; multiple myeloma; respiratory cancers such as lung, bronchus, larynx, trachea; non-Hodgkin’s lymphoma; prostate cancer; acute and subacute peripheral neuropathy; Type 2 diabetes; mellitus; and chronic lymphocytic leukemia.