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Veterans Affairs Canada Agent Orange Benefits Rev 1.0

Veterans Affairs Canada Agent Orange Benefits Rev 1.0

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Veterans Affairs Canada Agent Orange Benefits Rev 1.0
Veterans Affairs Canada Agent Orange Benefits Rev 1.0

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Published by: Canadian_Veterans_Ad on Jan 14, 2012
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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 A.

GENERAL The following policy is intended to provide guidance in the adjudication of disability benefit applications relating to claims for illnesses or injuries associated with exposure to unregistered US military herbicides, including Agent Orange, at CFB Gagetown and in Vietnam. Agent Orange was an unregistered US military herbicide, contaminated by dioxin. It was produced for, and used heavily by, the US throughout the war in Vietnam for defoliation of the jungle and for crop destruction. Agent Orange was never registered for use or sale in Canada. Both the US Department of Veterans Affairs and VAC accept that Veterans who served in Vietnam were exposed to Agent Orange and other herbicides. However, individuals claiming exposure outside of Vietnam, e.g., on a US military base or at CFB Gagetown, must provide evidence of exposure. From June 14-16, 1966 and again from June 21-24, 1967, the Canadian Department of National Defence cooperated with the US military to test Agent Orange at CFB Gagetown in order to determine the efficacy of Agent Orange on northern species of vegetation found on the Base. This is the only known time and place when Agent Orange was used in Canada. The tests involved small amounts of Agent Orange and were short in duration so limited comparisons can be drawn to Agent Orange as used in Vietnam. In August 2005, the Government announced a research and fact-finding initiative on herbicide use and testing at CFB Gagetown. This initiative, completed in 2007, showed that the Base is safe and most individuals would not have experienced long-term health effects. Page: 1 of 9

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 B. 1. POLICY Direction To be eligible for disability benefits, a Veteran or still-serving CF member must have a medical disability related to their service. For claims under this policy related to the testing of Agent Orange and other unregistered US military herbicides at CFB Gagetown, the applicant must have an illness that VAC accepts as being associated with exposure to Agent Orange; and provide reasonable evidence of service-related exposure consistent with the findings of DND research Task 3A-1, Tier 1 1, a historical human health risk assessment to determine how humans may have been exposed to herbicides and military test chemicals at the time of use, and the potential risks to human health. The findings indicate that unless an individual was involved in an accident, such as a spill or other incident at CFB Gagetown, the individual would not have been at an increased risk for long-term irreversible effects. For claims under this policy related to service in Vietnam, the applicant must have an illness that VAC accepts as being associated with exposure to Agent Orange. VAC accepts that Veterans who served in Vietnam between January 9, 1962 and May 7, 1975 were exposed. Page: 2 of 9

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DND Research Task 3A-1 Tier 1 included the contaminants present in some of the chemicals tested, specifically 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) which was in Agent Orange and Agent Purple, and hexachlorobenzene (HCB) which was in picloram (a component of the products Tordon 22K and Tordon 101). TCDD is one chemical in a group of similar chemicals, generally referred to as dioxins.

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 2 Page: 3 of 9

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It is important to note that the IOM has not concluded that exposure is the actual "cause" of the illnesses. The IOM weighs the strengths and limitations of the available epidemiologic evidence to reach conclusions about the linkages (if any) between exposures and possible health outcomes. To date, no evidence has been found that is strong enough to conclude that the exposure caused the health outcome. The following chart lists the medical conditions accepted by the US Department of Veterans Affairs for which the IOM has concluded there is either “Sufficient”, or “Limited or Suggestive” evidence of an association with exposure to herbicides, including Agent Orange. Veterans Affairs Canada (VAC)’s approach is consistent with the approach taken by the US and accepts the same conditions. Neither the US DVA nor VAC differentiate between Category 1 and Category

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Category 1: Sufficient Evidence of Association; Category 2: Limited or Suggestive Evidence of Association; Category 3: Inadequate or Insufficient Evidence to Determine whether an Association Exists; and Category 4: Limited or Suggestive Evidence of No Association.

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Based on the extensive review of scientific evidence, the IOM has found associations between herbicide exposure and certain illnesses and categorizes them based on the amount and quality of scientific evidence of an association with Agent Orange or other herbicides used in Vietnam.

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Medical Conditions The US Institute of Medicine (IOM) is considered an expert on the health effects of Agent Orange and other herbicides used in Vietnam. The IOM is a highly respected, independent, non-governmental, nonprofit scientific review organization that provides unbiased, evidencebased and authoritative information and advice concerning health and science policy. Its original report on Agent Orange was issued in 1994 and it continues to issue updates every two years.

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 Page: 4 of 9

2 medical conditions in the adjudication of disability benefit claims.
Category 1 Sufficient evidence of an association soft-tissue sarcoma; non Hodgkin’s lymphoma; chronic lymphocytic leukemia (CLL) (including hairy cell leukemia and other chronic B cell leukemias) 3 ; Hodgkin’s disease; and chloracne

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Additional information on the diseases/conditions accepted by VAC as
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On July 27, 2007, the US Institute of Medicine (IOM) released an update of the categories of illnesses associated with exposure to Agent Orange (Update 2006). Hypertension and AL amyloidosis (a rare condition) were added to Category 2, which includes health outcomes having limited but only suggestive association with Agent Orange. Effective May 7, 2009, the US Department of Veterans Affairs presumes that AL amyloidosis in Veterans who were exposed to Agent Orange in Vietnam was caused by their military service. Based on the direction taken by the US, Veterans Affairs Canada has decided to remain consistent with the approach taken by the US and, effective May 7, 2009, accepts AL amyloidosis as a condition connected to service for Vietnam Veterans. On July 24, 2009, IOM released an update of the categories of illnesses associated with exposure to Agent Orange (Update 2008). Hairy cell leukemia and other chronic B cell leukemias were added to Category 1, which includes health outcomes with sufficient evidence of an association; Parkinson’s disease and Ischemic heart disease were added to Category 2, which includes health outcomes having limited but only suggestive association with Agent Orange. Effective August 31, 2010, the US Department of Veterans Affairs presumes that B cell leukemias such as hairy cell leukemia, Parkinson’s disease; and ischemic heart disease in Veterans who were exposed to Agent Orange in Vietnam was caused by their military service. Based on the direction taken by the US, Veterans Affairs Canada has decided to remain consistent with the approach taken by the US and, effective August 31, 2010, accepts B cell leukemias such as hairy cell leukemia, Parkinson’s disease; and ischemic heart disease as conditions connected to service for Vietnam Veterans.

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It should be noted though that VAC’s legislative authorities do not provide for the payment of disability benefits related to illness/injuries for the children of Veterans. As such, the condition “spina bifida in offspring of exposed individuals” ,which the IOM has determined to be in Category 2, is not used by VAC in the adjudication of disability benefit applications.

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Category 2 Limited or suggestive evidence of an association

- respiratory cancers; prostate cancer; multiple myeloma; type 2 diabetes; porphyria cutanea tarda; acute and sub-acute transient peripheral neuropathy; - AL amyloidosis 2 ; - Parkinson’s disease; and ischemic heart disease 3

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 Page: 5 of 9

associated with Agent Orange exposure is provided in Appendix A. 3. Canadian Research - CFB Gagetown The DND Fact-Finding Initiative was completed in August 2007. All of the research reports have been released to the public and incorporated into VAC’s decision-making processes for disability benefit applications. Task 3A-1 was a historical human health risk assessment to determine how humans may have been exposed to herbicides and military test chemicals at the time of use, and the potential risks to human health. This study was done in three tiers. Tier 1 concentrated on the contaminants related to the 1966 and 1967 testing of unregistered military chemicals. Tiers 2 and 3 concentrated on all other years of registered herbicide use. The research concluded that the military chemicals tested at CFB Gagetown in 1966 and 1967, the known contaminants in the herbicides used at CFB Gagetown during the annual spray program in the period prior to the late 1960s, and the active ingredients in the herbicides used at CFB Gagetown during the annual spray program posed no long-term risk to human health and safety for most individuals. Those who were directly involved during applications or who worked in the bush immediately after application may have some increased risk.

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4. Evolving Research As new evidence or research becomes available, including new releases of IOM updates, the results will be evaluated and adjustments will be made to this policy as appropriate. 5. Presence on the Base at CFB Gagetown It is important to note that an individual’s mere presence at CFB Gagetown in June of 1966 or 1967 during the testing of unregistered US military herbicides, including Agent Orange, does not constitute exposure that would place an individual at an increased risk for long-

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 term, irreversible health effects. 6. Benefit of Doubt - CFB Gagetown All decisions are rendered in accordance with subsection 5(3) of the Pension Act and section 43 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act which provide that any doubt that may arise in weighing uncontradicted, credible evidence and all reasonable inferences that may arise from that evidence, shall be resolved in the applicant’s favour. In circumstances where there is insufficient evidence to relate the claimed IOM condition to the service exposure, Benefit of Doubt can be used to bridge the gap between the presence of the IOM condition and the documented exposure. However, Benefit of Doubt cannot be used as a substitute for lack of reasonable evidence of exposure. For example, in the case of an individual who was on the Base during the previously noted period, but with no evidence of exposure, Benefit of Doubt cannot bridge that gap in evidence. Page: 6 of 9

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 Page: 7 of 9

APPENDIX A Illnesses/Medical Conditions Accepted by Veterans Affairs Canada (VAC) as Associated with Agent Orange Exposure

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Acute and Subacute Transient Peripheral Neuropathy - a nervous system condition that causes numbness, tingling, and motor weakness.

B cell leukemias -describes several different types of lymphoid leukemia which affect B cells.

Hodgkin's Disease - a malignant lymphoma (cancer) characterized by progressive enlargement of the lymph nodes, liver, and spleen, and by progressive anemia. Ischemic Heart Disease - a disease characterized by reduced blood supply to the heart muscle, usually due to coronary artery disease.

Non-Hodgkin's Lymphoma - a group of cancers that affect the lymph glands and other lymphatic tissue.

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Parkinson’s Disease - a degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills, speech and other functions. Porphyria Cutanea Tarda - a disorder characterized by liver dysfunction and by the thinning and blistering of the skin in sun-exposed areas. Prostate Cancer - cancer of the prostate; one of the most common cancers among men.

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Multiple Myeloma - a cancer of specific bone marrow cells that is characterized by bone marrow tumours in various bones of the body.

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Diabetes Mellitus (Type 2) - a disease characterized by high blood sugar levels resulting from the body’s inability to respond properly to the hormone insulin.

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Chronic lymphocytic leukemia (CLL) - a disease that progresses slowly with increasing production of excessive numbers of white blood cells.

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Chloracne - a skin condition that occurs soon after dioxin exposure and looks like common forms of acne seen in teenagers.

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AL amyloidosis - a rare disease caused when an abnormal protein, amyloid, enters tissues or organs. It is not a cancer, but it can occur because of some cancers.

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Veterans may be eligible for disability benefits and related health care benefits for illnesses/medical conditions that VAC recognizes as associated with exposure to Agent Orange and other herbicides.

EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 Page: 8 of 9

Respiratory Cancers - cancers of the lung, larynx, trachea and bronchus. Soft-Tissue Sarcomas - a group of different types of cancers in body tissues such as muscle, fat, blood and lymph vessels and connective tissues.

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EXPOSURE TO AGENT ORANGE - DISABILITY BENEFITS New: 2010-12 Page: 9 of 9

APPENDIX B DND Research Task 3A-1, Tier 1 and Tier 2 Findings Task 3A-1 was one of the health studies undertaken to assess the historical risks to human health posed by exposure to the herbicides tested and used over the past 50 years at the Base. This work was conducted using a tiered approach. < Tier 1 focused on the dioxins and other impurities in the unregistered US military herbicides tested in 1966 and 1967. The final report was released on August 10, 2006. The contractor concluded that no long-term health effects resulted from activities involved in testing of unregistered herbicides. The contractor also concluded that there could be an exception if there were accidents, such as spills; however, there is no evidence that any occurred during the tests. Tier 2 focused on the contaminants in all herbicides used from 1952 to 2004. The final report was released on December 7, 2006. The contractor concluded that, only under specific and worst case conditions, the following individuals may have been at increased risk for long-term, irreversible illness, including certain cancers: (a) those directly involved with applying herbicides; and (b) those involved in post-application activities immediately after the herbicide application prior to the late 1960s (when 2,4,5-T was a component in the herbicides used). Tier 3 focused on active ingredients in registered herbicides used since 1956. The final report was released on June 21, 2007. The findings indicated that the active ingredients in the herbicides used at CFB Gagetown during the annual spray program posed no risk to human health and safety, with the exception of a limited number of individuals in certain exposure scenarios such as those directly involved in the application of herbicides and clearing of brush immediately after spraying.

One Veteran One Standard

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Overall Conclusion

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The DND-led Research and Fact-finding initiative showed that the Base is safe and most individuals would not have experienced long-term health effects.

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