This is the second updated review and evaluation of published scientific evidence regarding associations between diseases and exposure to dioxin and other chemical compounds in herbicides used in Vietnam.  For each disease, the IOM was asked to determine, to the extent that available data permitted meaningful determinations:

1. whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiologic methods used to detect the association;
2. the increased risk of the disease among those exposed to herbicides during Vietnam service; and
3. whether there is a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.

In addition to bringing the earlier scientific evidence up to date, the committee has addressed five specific areas of interest identified by the Department of Veterans Affairs (DVA).  These are:

1. the relationship between exposure to herbicides and the subsequent development of diabetes;
2. the issue of the latency between exposure to herbicides and development of adverse health outcomes;
3. the classification of chondrosarcomas of the skull;
4. herbicide exposure assessment for Vietnam veterans; and
5. the potential for using data combination methodologies to informatively reexamine existing data on the health effects of herbicide or dioxin exposure.