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Journal Article 
Review Of The Effects Of Agent Orange: A Psychiatric Perspective On The Controversy 
Blackburn, AB 
Military Medicine
ISSN: 0026-4075
EISSN: 1930-613X 
Toxic effects of Agent Orange on Vietnam veterans are reviewed with emphasis on psychiatric implications of the controversy. Agent Orange is a herbicide composed of a 1 to 1 mixture of esters of 2,4-dichlorophenoxy-acetic-acid (94757) and 2,4,5-trichloroacetic-acid (93765) which may have the trace contaminant 2,4,7,8-tetrachlorodibenzo-p-dioxin. Media interest in possible toxic effects of Agent Orange has grown with symptoms reported by veterans of neurologic, reproductive and carcinogenic effects. Toxic effects of dioxin are well documented in animals. Information about human toxic exposure results from industrial accidents. After accidental release of dioxin in Italy in 1976, exposed persons were exhaustively studied. Skin lesions, mostly chloracne, were seen in about 0.5 percent of the exposed population. Subclinical neurological damage has been detected in about 16 percent of the maximally exposed population. Other abnormalities have not been confirmed. Among Vietnam veterans with reported Agent Orange exposure, a variety of symptoms have been attributed to the herbicide, but chloracne has not figured largely among them. Seventy percent of a group of veterans with claims of toxic exposure to Agent Orange were classified psychiatrically as exhibiting post traumatic stress disorder. Human health effects of Agent Orange are essentially not known. The phenoxyacetic-acid herbicides are not harmless but they apparently are not dangerously toxic. The dioxin contaminant is a known potent toxin. It seems unlikely that Vietnam veterans were exposed to great amounts of dioxin or more cases of chloracne would be seen. Additional studies will clarify human toxicity of the herbicide. For some veterans, concern with Agent Orange represents a displacement from a poorly understood awareness of mental disorders. It may be more acceptable to blame the chemical agent than to recognize the logical and psychological consequences of war. The author concludes that alertness to physiological abnormalities must be maintained, but that post traumatic stress must be considered for its role in symptoms attributed to Agent Orange