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Journal Article 
Diabetes and cancer in veterans of Operation Ranch Hand after adjustment for calendar period, days of spraying, and time spent in Southeast Asia 
Michalek, JE; Pavuk, M 
Journal of Occupational and Environmental Medicine
ISSN: 1076-2752
EISSN: 1536-5948 
United States 
Background: The Air Force Health Study was launched in 1980 as part of a Federal effort to resolve the Agent Orange issue. Objectives: To
study diabetes and cancer with additional adjustment for days of
spraying, calendar period of service, and time spent in Southeast Asia (SEA). Methods: This was a longitudinal study of veterans of
Operation Ranch Hand, the unit responsible for spraying Agent Orange
and other 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-contaminated
herbicides in Vietnam from 1962 to 1971. Results: Associations between TCDD and diabetes and between TCDD and cancer in Ranch Hand
veterans are strengthened after adjustment for calendar period of service, days of spraying, and, for cancer, time spent in SEA. Conclusions: Calendar period of service, days of spraying, and time spent in SEA are important confounders in the Air Force Health Study. 
Occupational Exposure; Proportional Hazards Models; Humans; United States; Asia, Southeastern; Diabetes Mellitus; Aged; Tetrachlorodibenzodioxin; Longitudinal Studies; Environmental Pollutants; Veterans; Risk Factors; Neoplasms; SEER Program; Time Factors; 2,4-Dichlorophenoxyacetic Acid; Middle Aged; Index Medicus; 2,4,5-Trichlorophenoxyacetic Acid; Confounding Factors (Epidemiology); Vietnam Conflict; Defoliants, Chemical 
2,4,5-Trichlorophenoxyacetic Acid 
2,4-Dichlorophenoxyacetic Acid 
Asia, Southeastern 
Confounding Factors (Epidemiology) 
Defoliants, Chemical 
Diabetes Mellitus 
Environmental Pollutants 
Longitudinal Studies 
Middle Aged 
Occupational Exposure 
Proportional Hazards Models 
Risk Factors 
SEER Program 
Time Factors 
United States 
Vietnam Conflict 
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