Objectives: Agent Orange TCDD has been related to serious diseases among Korean veterans who were exposed to it. Decades after the end of the war, however, its effects are still being debated. The object of this study was to examine various unmet needs raised among Agent Orange exposed veterans and their families and to find grounds of a new welfare policy for providing alternative legislation. Methods: Literatures concerning Agent Orange, TCDD, the associated diseases, compensation for veterans and Supreme Court sentencing were searched using PubMed, ProQuest, press news and relevant homepages. Results: Agent Orange exposed veterans are eligible for various benefits from the government, including disability compensation for diseases associated with exposure. The Ministry of Patriots and Veterans Affairs has classified certain diseases into two categories, Agent Orange sequela diseases and sequela suspect diseases and has provided differential benefits based on separated laws. Big differences exist in benefits to veterans and their families between the two laws. The absence of definite standards to classify the Agent Orange associated diseases was confirmed by recent Supreme Court sentencing which ruled in favor of US manufacturers. Conclusion: It appears that the evidence for cause and effect of Agent Orange related diseases would never be perfect. The results suggest a need to change welfare principles from presumptive or indefinite disease basis to exposure experiences combined with integrated disability evaluation. We propose to extend eligibility by enacting a new law for Agent Orange exposed Korean veterans.
Yi SW, Ohrr HC, Lim HS. Agent Orange-related chemical exposure: health effects and compensation policy in Korea. J Environ Health Sci. 2013; 39(3): 197-210.
Min YS, Lim HS, Lee K, Park SA, Lee DH, Ju YS. Analysis of mass screening results among sampled residents around Camp Carroll, Gyeongsangbuk-do, Korea. J Environ Health Sci. 2013; 39(4): 322-34.
Korea Ministry of Government Legislation.Act on the honorable treatment and support of persons etc of distinguished services to the state. Sejong: Korea Ministry of Government Legislation Press; 2013. Act No. 11849. Korea Ministry of Government Legislation.
Korea Ministry of Government Legislation.Act on the Agent Orange sequela suspect disease etc. patient support and the foundation of organization. Sejong: Korea Ministry of Government Legislation Press; 2013. Act No. 11556. Korea Ministry of Government Legislation.
The Widowed Ladies Association of Vietnam Veterans. Available: http://www.vwmf.co.kr [accessed 10 January 2014].
Institute for Military History Compilation. War history of Korean troops dispatching to Vietnam, Vol 10. Seoul: Ministry of Defense Press; 1985. p.517.
Lee HW. Vietnam War in Korean perspectives: issues and arguments. East Asian Studies. 2006; 51: 105-147.
Na JS. Dispatching Korean troops to Vietnam and national development. Seoul: Institute for Military History Compilation Press; 1996. p.309.
Stellman JM, Stellman SD, Christian R, Weber T, Tomasallo C. The extent and patterns of usage of Agent Orange and other herbicides in Vietnam. Nature. 2003; 422(6933): 681-687.
Gye UB. A Study on epidemiological investigation and defoliant sprayed by the Republic of Korea Armed forces during Vietnam War. [master dissertation]. [Suwon]: Kyonggi University; 2008.
Young AL, Cecil PF Sr. Agent Orange exposure and attributed health effects in Vietnam veterans. Mil Med. 2011; 176(7 Suppl): 29-34.
Saracci R, Kogevinas M, Bertazzi PA, Bueno de Mesquita BH, Coggon D, Green LM, et al. Cancer mortality in workers exposed to chlorophenoxy herbicides and chlorophenols. Lancet. 1991; 338(8774): 1027-1032.
Hites RA. Dioxins: an overview and history. Environ Sci Technol. 2011; 45(1): 16-20.
Lucier G, Clark G, Hiermath C, Tritscher A, Sewall C, Huff J. Carcinogenicity of TCDD in laboratory animals: implications for risk assessment. Toxicol Ind Health. 1993; 9(4): 631-668.
Aylward LL, Hays SM. Temporal trends in human TCDD body burden: decreases over three decades and implications for exposure levels. J Exposure Anal Environ Epidemiol. 2002; 12: 319-328.
Whitelaw ML, Gottlicher M, Gustafsson JA, Poellinger L. Definition of a novel ligand binding domain of a nuclear bHLH receptor: co-localization of ligand and hsp90 binding activities within the regulable inactivation domain of the dioxin receptor. EMBO J. 1993; 12(11): 4169-4179.
Ma Q, Whitlock JP Jr. A novel cytoplasmic protein that interacts with the Ah receptor, contains tetratricopeptide repeat motifs, and augments the transcriptional response to 2,3,7,8-tetrachlorodibenzo-p-dioxin. J Biol Chem. 1997; 272(14): 8878-8884.
Kazlauskas A, Poellinger L, Pongratz I. Evidence that the co-chaperone p23 regulates ligand responsiveness of the dioxin(Aryl hydrocarbon) receptor. J Biol Chem. 1999; 274(19): 13519-13524.
Denison MS, Soshilov AA, He G, DeGroot DE, Zhao B. Exactly the same but different: promiscuity and diversity in the molecular mechanisms of action of the aryl hydrocarbon(dioxin) receptor. Toxicol Sci. 2011; 124(1): 1-22.
Chung I, Bresnick E. Identification of positive and negative regulatory elements of the human cytochrome P4501A2(CYP1A2) gene. Arch Biochem Biophys. 1997; 338(2): 220-226.
Hao N, Whitelaw ML. The emerging roles of AhR in physiology and immunity. Bio Pharml. 2013; 86(5): 561-570.
Spaulding SW. The possible roles of environmental factors and the aryl hydrocarbon receptor in the prevalence of thyroid diseases in Vietnam era veterans. Curr Opin Endocrinol Diabetes Obes. 2011; (5): 315-320.
Hossain A, Tsuchiya S, Minegishi M, Osada M, Ikawa S, Tezuka FA, et al. The Ah receptor is not involved in 2,3,7,8-tetrachlorodibenzo-p-dioxinmediated apoptosis in human leukemic T cell lines. J Biol Chem. 1998; 273(31): 19853-19858.
Ahmed S, Shibazaki M, Takeuchi T, Kikuchi H. Protein kinase Ctheta activity is involved in the 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced signal transduction pathway leading to apoptosis in L-MAT, a human lymphoblastic T-cell line. FEBS J. 2005; 272(4): 903-915
Kim YH, Shim YJ, Shin YJ, Sul D, Lee E, Min BH. 2,3,7,8-tetrachlorodibenzo-p-dioxin(TCDD) induces calcium influx through T-type calcium channel and enhances lysosomal exocytosis and insulin secretion in INS-1 cells. Int J Toxicol. 2009; 28(3): 151-161.
Olivero-Verbel J, Cabarcas-Montalvo M, Ortega-Zuniga C. Theoretical targets for TCDD: a bioinformatics approach. Chemosphere. 2010; 80(10): 1160-1166.
U.S. Department of Veterans Affairs Agent Orange. Availble: http://www.publichealth.va.gov/exposures/ agentorange/ diseases.asp [accessed 15 December 2013]
Korea Ministry of Government Legislation Agent Orange. Available: http://www.law.go.kr/precSc.do? menuId=3&query= %EA%B3%A0%EC%97%BD%EC%A0%9C#licPr ec170635 [accessed 25 December 2013].
Kim TY. A Preliminary study on the disease aspect analysis and post traumatic stress syndrome of Agent Orange patients. J Safety Crisis Management. 2012; 8(3): 219-234.
Tickner JA. Developing scientific and policy methods that support precautionary action in the face of uncertainty-the institute of medicine committee on Agent Orange. Public Health Reports. 2002; 117: 534-445.
Ham YJ. Aid for Agent Orange victims and issues in the law of civil procedure. Korean Assoc Law Civil Procedure. 2001; 4: 290-320.