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Cancer is the second leading cause of death in the United States. Among males aged 45–64, the group that describes most Vietnam veterans, the risk of dying from cancer nearly equals the risk from heart disease, the overall leading cause of death in the United States (U.S. Census, 1999). This year about 552,200 Americans are expected to die of cancer—more than 1,500 people a day. In the United States, one of every four deaths is from cancer (ACS, 2000b).
In this chapter, the committee summarizes and reaches conclusions about the strength of the evidence in epidemiologic studies regarding associations between exposure to herbicides and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and each type of cancer under consideration in this report. The cancer types are, with minor exceptions, discussed in the order in which they are listed in the International Classification of Diseases, Ninth Edition (ICD•9). ICD•9 is a standardized means of classifying medical conditions used by physicians and researchers around the world. Appendix B lists ICD•9 codes for the major forms of cancer.
In assessing a possible relation between herbicide exposure and risk of cancer, one key issue is the level of exposure of those included in a study. As noted in Chapter 5, the detail and accuracy of exposure assessment vary widely among the studies reviewed by the committee. A small number of studies use a biomarker of exposure, for example, the presence of dioxin in serum or tissues; some develop an index of exposure from employment or activity records; and others use a surrogate measure of exposure, such as being present when herbicides were used. Inaccurate assessment of exposure can obscure the presence or absence of exposure-disease associations and thus make it less likely that a true risk will be identified.
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Cancer is the second leading cause of death in the United States. Among males aged 45–64, the group that describes most Vietnam veterans, the risk of dying from cancer nearly equals the risk from heart disease, the overall leading cause of death in the United States (U.S. Census, 1999). This year about 552,200 Americans are expected to die of cancer—more than 1,500 people a day. In the United States, one of every four deaths is from cancer (ACS, 2000b).
In this chapter, the committee summarizes and reaches conclusions about the strength of the evidence in epidemiologic studies regarding associations between exposure to herbicides and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and each type of cancer under consideration in this report. The cancer types are, with minor exceptions, discussed in the order in which they are listed in the International Classification of Diseases, Ninth Edition (ICD•9). ICD•9 is a standardized means of classifying medical conditions used by physicians and researchers around the world. Appendix B lists ICD•9 codes for the major forms of cancer.
In assessing a possible relation between herbicide exposure and risk of cancer, one key issue is the level of exposure of those included in a study. As noted in Chapter 5, the detail and accuracy of exposure assessment vary widely among the studies reviewed by the committee. A small number of studies use a biomarker of exposure, for example, the presence of dioxin in serum or tissues; some develop an index of exposure from employment or activity records; and others use a surrogate measure of exposure, such as being present when herbicides were used. Inaccurate assessment of exposure can obscure the presence or absence of exposure-disease associations and thus make it less likely that a true risk will be identified.
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The outcomes reviewed in this chapter follow a common format. Each section begins by providing some background information about the cancer under discussion, including data concerning its incidence in the general U.S. population. A brief summary of the findings described in the first three Agent Orange reports—Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (hereafter referred to as VAO; IOM, 1994), Veterans and Agent Orange: Update 1996 (hereafter, Update 1996; IOM, 1996), and Veterans and Agent Orange: Update 1998 (hereafter, Update 1998; IOM, 1999) —is then presented, followed by a discussion of the most recent scientific literature and a synthesis of the material reviewed. Where appropriate, reviews are separated by the type of exposure (occupational, environmental, Vietnam veteran) being addressed. Each section concludes with the committee's finding regarding the strength of the evidence in epidemiologic studies, biologic plausibility, and evidence regarding Vietnam veterans.
Expected Number of Cancer Cases Among Vietnam Veterans in the Absence of Any Increase in Risk Due to Herbicide Exposure
To provide some background for the consideration of cancer risks in Vietnam veterans, this chapter also reports information on cancer incidence in the general U.S. population. Incidence rates are reported for individuals between the ages of 45 and 59 because most Vietnam era veterans are in this age group. The data, which were collected as part of the Surveillance, Epidemiology, and End Results (SEER) Program of the National Center for Health Statistics (NCHS), are categorized by sex, age, and race because these factors can have a profound effect on the estimated level of risk. Prostate cancer incidence, for example, is nearly 11 times higher in men age 55–59 than in 45–49-year-olds and more than twice as high in African Americans age 45–59 as in whites of this age group (NCI, 2000). The figures presented for each cancer are estimates for the entire U.S. population, not precise predictions for the Vietnam veteran cohort. It should be remembered that numerous factors may influence the incidence reported here—including personal behavior (e.g., smoking and diet), genetic predisposition, and other risk factors such as medical history. These factors may make a particular individual more or less likely than average to contract a given cancer. Incidence data are reported for all races and also separately for African Americans and whites. The data reported are for 1993–1997, the most recent data available at the time this report was written.
As detailed in Chapter 6, here, and in the following chapters, great uncertainties remain about the magnitude of potential risk from exposure to herbicides and dioxin in the occupational, environmental, and veteran studies reviewed by the committee. Many have inadequate controls for important confounders, and the information needed to extrapolate from the level of exposure in the studies to that of individual Vietnam veterans is lacking. The committee therefore cannot quan-
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tify the degree of risk likely to have been experienced by Vietnam veterans due to exposure to herbicides in Vietnam. It offers qualitative observations where data permit.
As a group, this category includes some of the major cancers in the United States and the world. The committee reviewed the data on colon cancer (ICD•9 153.0–153.9), rectal cancer (ICD•9 154.0–154.1), stomach cancer (ICD•9 151.0– 151.9), and pancreatic cancer (ICD•9 157.0–157.9). According to American Cancer Society estimates, approximately 180,000 individuals will be diagnosed with these cancers in the United States in 2000 and some 97,500 individuals will die from them (ACS, 2000a). Colon cancer accounts for about half of these diagnoses and deaths. Collectively, gastrointestinal (GI) tract tumors are expected to account for 15 percent of new diagnoses and 18 percent of cancer deaths in 2000.
Average Annual Cancer Incidence (per 100,000 individuals) in the United Statesa
Selected Gastrointestinal Cancers
45–49 Years of Age
50–54 Years of Age
55–59 Years of Age
All Races
All Races
All Races
aSEER nine standard registries, crude age-specific rate, 1993–1997.
The incidence of stomach, colon, rectal, and pancreatic cancers increases with age for individuals between 45 and 59. In general, incidence in males is higher than in females, and incidence in African Americans exceeds that in whites. Risk factors besides age and race vary for these cancers but always include family history of the same form of cancer, certain diseases of the affected organ, and dietary factors. Cigarette smoking is a risk factor for pancreatic cancer and may also increase the risk of stomach cancer (Miller et al., 1996).
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Infection with the bacterium Helicobacter pylori also increases the risk of stomach cancer.
Summary of VAO, Update 1996, and Update 1998
The committee responsible for VAO found there to be limited or suggestive evidence of no association between exposure to herbicides used in Vietnam or the contaminant dioxin and gastrointestinal tumors. Additional information available to the committees responsible for Update 1996 and Update 1998 did not change this finding. Tables 7-1, 7-2, 7-3, and 7-4 provide summaries of the results of studies underlying these findings and a list of reports that contain details of the research.
Update of the Scientific Literature
Occupational Studies
The largest industrial cohort exposed to dioxins is the group of 5,132 U.S. workers known as the NIOSH (National Institute of Occupational Safety and Health) cohort. This group was assembled from employees of 12 major chemical manufacturers that produced 2,4,5-trichlorophenol, 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), Silvex, Erbon, Ronnel, and hexachlorophene. Workers engaged in production and maintenance were exposed to TCDD as a contaminant of these chemicals. The first study of mortality through 1987 among these workers (Fingerhut, 1991) found a slight excess cancer mortality for all cancers combined (standardized mortality ratio [SMR]=1.2, 95 percent confidence interval [95% CI] 1.0–1.3); however, no elevated risk was observed for cancers of the stomach, colon, rectum, or pancreas. This cohort has been updated through 1993, and an exposure-response analysis on a subcohort (approximately 69 percent of the population) has been conducted (Steenland et al., 1999).
In that study, mortality from cancer of the small intestine and colon (1.2, 0.8–1.6), rectum (0.9, 0.3–1.9), stomach (1.0, 0.6–1.8), and pancreas (1.0, 0.6– 1.6) is not different from expected. Similar results are reported for a subcohort of 608 workers whose medical records stated that they had chloracne, indicating higher TCDD exposures during their working years.
A quantitative exposure assessment was conducted on workers employed in 8 (of a total of 12) plants that had sufficient information on the level of TCDD contamination in their products and detailed work histories. For this subcohort, a job-exposure matrix was constructed, and exposure scores were calculated using three factors: (1) the concentration of TCDD in the process materials, (2) the fraction of the day each worker spent in the specific process that resulted in contact with these materials, and (3) a weighting factor for the level of contact by skin contamination or inhalation of TCDD-containing material. In the analysis of
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this subcohort, several exposure metrics were calculated including a cumulative exposure score, the log of this score, the average exposure score (cumulative divided by duration), and cumulative exposure categorized into septiles.
Excess cancer risk was confined largely to the highest two exposure class septiles, with an all-cancer SMR of 1.5 (1.2–1.8). Site-specific GI cancers are not reported, and for all digestive cancers (ICD•9 150–159), this highest-exposure class (the two highest septiles) had a nonsignificantly elevated excess risk (1.4, 0.9–2.2).
In a study of a cohort of Danish paper mill workers, Rix et al. (1998) examined mortality from a wide range of causes. Substantial dioxin exposure among these workers is unlikely, since paper pulp was never produced at the three mills studied. Rather, they manufactured paper from imported bleached and unbleached pulp. There are no direct measures of exposure for these workers, and a qualitative assessment of chemicals used in paper manufacture by department does not include chlorinated organic compounds, although chlorine, chlorine dioxide, and hypochlorite were used. For two of the mills, the period of follow-up was January 1, 1943, to December 31, 1993, while for the third mill, follow-up started at January 1, 1965. Incident cancer cases were identified from the Danish Cancer Register, and expected numbers of cases were calculated using the rates for the total Danish population by gender, 5-year age group, and calendar time. For cancer sites of specific interest, Poisson regression models were used to analyze by duration and years since first employment and by department of employment.
For GI cancers, no statistically significant excesses were observed in men or women (standardized incidence ratios [SIRs] reported separately for esophagus, stomach, colon, rectum, and pancreas). When analyzed by department of work, men employed in maintenance and repair had a nonsignificantly elevated risk of stomach cancer (SIR=1.5, CI not reported, 15 cases), while men employed in the power station had an SIR of 1.7 (4 cases). For pancreatic cancer, men in the paper machine department had an SIR of 1.6 (6 cases), while men in the storage and transport departments had an SIR of 1.6 (8 cases).
Hooiveld et al. (1998) reported on an update of a mortality study of workers at two chemical factories in the Netherlands. This group is included in the multinational International Agency for Research on Cancer (IARC) study of cancer and exposure to organochlorine compounds. This update of the Dutch cohort added 6.5 years of follow-up to a previous study of these workers (Bueno de Mesquita et al., 1993) and included analysis by estimated maximum TCDD serum level. This value was estimated for each member of the cohort by measuring serum TCDD levels for 144 subjects, including production workers known to be exposed to dioxins, workers in herbicide production, nonexposed production workers, and workers known to be exposed as a result of an accident that occurred in 1963. By assuming first-order TCDD elimination with an estimated half-life of 7.1 years, TCDDmax was extrapolated for 47 of these workers, and a regression model was constructed to estimate the effect of exposure as a result of
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the accident, duration of employment in the main production department, and time of first exposure before (or after) 1970 on the estimated TCDDmax for each cohort member.
For gastrointestinal cancers (esophagus, 1 case; stomach, 3 cases; intestine, 3 cases; rectum, 1 case; pancreas, 4 cases; other sites, 1 case), no excess mortality was observed among 549 exposed male workers by comparison to national (Dutch) death rates. For workers known to be exposed as a result of the 1963 accident, a nonsignificant elevation of cancer of the esophagus was reported (SMR=4.3, 0.1–24.0, 1 case); the other GI sites were not reported. Gastrointestinal cancer was not reported in the results of the comparison between exposed and unexposed male workers in the cohort or by comparison of workers with low, medium, and high levels of predicted TCDDmax.
In a meta-analysis of occupational exposures and pancreatic cancer, Ojajärvi et al. (2000) surveyed publications for the period 1969–1998, searching Medline, Toxline, and Cancerlit for studies addressing occupational exposure and pancreatic cancer. They reduced the number of studies from 1,902 to 92 studies of 161 populations after excluding studies that did not report on pancreatic cancer, did not include sufficient information for meta-analysis, were not the most recent update, or did not include verifiable information on exposure to one or more of 23 specific chemical and physical agents. This information on exposure may have been direct estimates of risk for one or more of the 23 agents or information on job title that verified exposure to one or more of these agents. Herbicides were among the 23 specific agents included; however this broad class of chemical agents was not stratified by type of herbicide. Other agents of interest included chlorinated hydrocarbon solvents, fungicides, insecticides, and polycyclic aromatic hydrocarbons, as well as several heavy metals (cadmium, chromium, iron, lead, and nickel). The set of studies included in the meta-analysis consisted of 23 studies described as administrative (linkage of administrative records or proportional mortality ratio [PMR], proportionate cancer mortality ratio, or mortality odds ratio studies); 88 studies of industrial cohorts; 7 industry-based nested case-control studies; and 43 population- or hospital-based case-control studies. Most studies included were mortality studies. Studies were analyzed using simple random effects models to calculate meta-risk ratios (MRRs). In cases where excesses were observed, population etiological fractions and etiological fractions among the exposed groups were calculated. Data were reported based on exposed populations rather than by study. For the 10 studies in which herbicide exposure was reported, the MRR was 1.0 (0.8–1.3), and the range of point estimates in these studies was 0.6–5.9. The p-value for heterogeneity by agent (herbicides) was .3. These results were virtually unchanged when stratified for gender and quality of diagnosis (MRR=1.2, 0.8–2.0 for men, not reported for women; 0.9, 0.7–1.2 when gender was unspecified or both). None of the studies included information on the histological verification of the pancreatic cancer diagnosis. When examined by study type, the MRRs for the nine SMR or SIR studies (1.1,
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0.8–1.5) were virtually identical to the one case-control study (0.9, 0.7–1.8). Population etiological fraction and etiological fraction among the exposed groups were not calculated for herbicides. The authors concluded that the meta-analysis suggested increased risk of pancreatic cancer with exposure to chlorinated hydrocarbon solvents, nickel and its compounds, and chromium and its compounds. There was more limited evidence of increased risk for organochlorine pesticides, silica, and aliphatic and alicyclic hydrocarbon solvents. There was no evidence of increased risk with herbicide exposure.
Environmental Studies
In a review of early, mid-term, and long-term health effects, Bertazzi et al. (1998) continued the follow-up of people environmentally exposed to TCDD in the Seveso accident. The events that led to the exposure and the methods used to study this population have been fully described previously. Their 1998 report reviews the full range of indicators of exposure and effects on animal and human health. At least in the case of GI cancer mortality, the report does not appear to add any new information to Bertazzi et al. (1997), which was reviewed in Update 1998. After 15 years' follow-up (1976–1991), death from cancer of the rectum was significantly elevated for men in zone B (relative risk [RR]=2.9, 1.3–6.2, 7 observed deaths). A statistically significant increase in stomach cancer in women in Zone B observed after 10 years (RR=2.4, 1.0–6.0, 5 deaths) was not seen in the 15-year follow-up (RR=1.0, 0.5–2.2, 7 observed deaths). Excess mortality from esophageal cancer (RR=1.6, 1.1–2.4, 30 deaths) was reported among men in zone R (considered to be the low-exposure region). No other significant elevation of death from digestive cancer overall or at any of the GI sites was observed in men or women in any exposure zone.
In another report, Bertazzi et al. (2001) extended the mortality analysis through the end of 1996. They examined mortality from GI cancer and found a pattern of mixed results, similar to those seen in their earlier studies of the Seveso population. In this study, digestive cancer overall (ICD•9 150–159) was not elevated in either zone A or zone B. When examined on a site-specific basis, cancer of the rectum (ICD•9 154) was elevated in zone B (RR=1.9, 1.1–3.5, 11 cases) but not in zone A (1.2, 0.2–8.6, 1 case). Digestive cancers classified as "other" (ICD•9 159) were nonsignificantly elevated in zones A and B, while all other digestive cancer sites had RRs of 1.0 or less. More detailed examination including stratification of the zone A and zone B populations (done both separately and combined) by 5-year intervals of latency did not reveal any significant excess risk estimates, except for an excess in stomach cancer for zone B women in the 10– 14-year latency group (2.5, 1.1–5.7, 6 cases). Cancer of the rectum was also elevated among all zone B men (2.4, 1.2–4.9, 8 cases).
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Vietnam Veteran Studies
In the Air Force Health Study final report (AFHS, 2000), gastrointestinal cancers as a group are not addressed; however, results for esophageal cancer and cancer of the colon and rectum are reported. Because of the absence of cases of malignant neoplasms of the esophagus in Ranch Hands, statistical analysis was not performed. A malignant neoplasm of the esophagus was observed in two members of the comparison group. For malignant neoplasms of the colon and rectum, no excess risk was seen for the Ranch Hand veterans after analyses were adjusted for covariates.
Approximately 50,000 members of the Australian Defence Force and Citizen Military Forces served in the Vietnam theater over the war years. The government of Australia conducted mail surveys of all individuals with Vietnam service, which included those involved in combat, medical teams, war correspondents, entertainers, and philanthropy workers (CDVA, 1998a, b). Questionnaires were mailed to 49,944 male veterans (80 percent response rate) and 278 female veterans (81 percent response rate). The self-reported data gathered were compared with age-matched Australian national data.
The study found that 405 male veterans and 1 female veteran indicated a doctor had told them they had colorectal cancer since their first day of service in Vietnam. For male veterans, this was higher than the expected number of 117 (96–138), while for female veterans, it corresponded to expected community rates. The authors cited possible reporting errors such as misclassification of intestinal and rectal cancers as colon cancers and reporting pre- or nonmalignant polyps as possible explanations for the high number of cases reported by male veterans.
A follow-up to the Commonwealth Department of Veterans' Affairs (CDVA) study of male Vietnam veterans was conducted to medically confirm selected conditions reported in the survey study described above (AIHW, 1999). Sources used to validate reported conditions included clinicians, several Australian morbidity and mortality data bases, CDVA data, and documentation provided by veterans. Results from this study showed there was no significant difference in prevalence of colorectal cancer between the veterans and an Australian community standard.
With only rare exceptions, studies on gastrointestinal cancers and exposure to herbicide in production, from agricultural use, from environmental sources, and among veteran populations found RRs close to 1.0, providing no evidence of any increase in risk. Most of the recent studies were occupational.
The updated analysis of mortality among U.S. chemical workers did not report site-specific GI cancers, and there was a nonsignificantly elevated excess
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risk for all GI cancers in the highest-exposed subgroups. A study of Danish paper mill workers found some nonsignificant elevations of GI cancers, but the possible link with dioxin exposure was not well established. An update of a cohort of Dutch chemical workers found no significant excess of GI cancer among the workers exposed to phenoxy herbicides or chlorophenols. A meta-analysis of studies of pancreatic cancer and occupational exposures found no evidence of associations with herbicide exposures. Updates of the Seveso cohort found some statistically significant excess risks, but these were based on relatively small numbers of cases and do not seem to occur with any consistency over the range of latency periods and exposure zones for the cohort. Among studies of Vietnam veterans, there is no significant evidence of an association between exposure and any gastrointestinal cancer.
Strength of Evidence in Epidemiologic Studies
VAO and the previous updates concluded that there is limited/suggestive evidence of no association between exposure to herbicides (2,4-dichlorophenoxyacetic acid [2,4-D], 2,4,5-T and its contaminant TCDD, cacodylic acid, and picloram) and gastrointestinal cancers (stomach, pancreatic, rectal, and colon cancers). The evidence regarding association was drawn from occupational and other studies in which subjects were exposed to a variety of herbicides and herbicide components. There is no evidence found by this committee to suggest that the conclusion of limited/suggestive evidence of no association should be changed.
Biologic Plausibility
No animal studies have found an increased incidence of gastrointestinal cancer. A summary of the biologic plausibility for the carcinogenicity of TCDD and the herbicides in general is presented in the conclusion to this chapter. A discussion of toxicological studies that concern biologic plausibility is contained in Chapter 3.
Increased Risk of Disease Among Vietnam Veterans
The available data on Vietnam veterans do not suggest there is an association between TCDD or herbicide exposure and any gastrointestinal cancers.
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TABLE 7-1 Selected Epidemiologic Studies—Stomach Cancer
Study Population C
Exposed Casesa
Estimated Risk (95% CI)a
New Studies
Steenland et al., 1999
U.S. chemical production workers
1.0 (0.6–1.8)
Hooiveld et al., 1998
Dutch chemical production workers
1.0 (0.2–2.9)
Rix et al., 1998
Danish paper mill workers
1.1 (0.8–1.4)
1.0 (0.4–2.1)
Studies Reviewed in Update 1998
Gambini et al., 1997
Italian rice growers
0.9 (0.7–1.3)
Kogevinas et al., 1997
IARC cohort
Workers exposed to TCDD (or higher-chlorinated dioxins)
0.9 (0.6–1.2)
Workers not exposed to TCDD (or higher-chlorinated dioxins)
0.9 (0.6–1.3)
Workers exposed to any phenoxy herbicide or chlorophenol
0.9 (0.7–1.1)
Becher et al., 1996
German chemical production workers
Plant I
1.3 (0.7–2.2)
Plant II
Plant III
Plant IV
0.6 (0.1–2.3)
Ott and Zober, 1996
BASF cleanup workers
1.0 (0.2–2.9)
TCDD <0. 1 µg/kg body wt
TCDD 0.1–0.99 µg/kg body wt
1.3 (0.0–7.0)
TCDD >1 µg/kg body wt
1.7 (0.2–6.2)
Ramlow et al., 1996
Pentachlorophenol production workers
0-year latency
1.7 (0.4–4.3)
15-year latency
1.8 (0.4–5.2)
Studies Reviewed in Update 1996
Blair et al., 1993
U.S. farmers in 23 states
White males
1.0 (1.0–1.1)
Nonwhite females
1.9 (1.2–2.8)
Bueno de Mesquita et al., 1993
Phenoxy herbicide workers
Collins et al., 1993
Monsanto 2,4-D production workers
Kogevinas et al., 1993
IARC cohort—female
Studies Reviewed in VAO
Ronco et al., 1992
Danish male self-employed farm workers
Swaen et al., 1992
Dutch herbicide appliers
0.5 (0.0–2.7)b
Fingerhut et al., 1991
NIOSH cohort
1.0 (0.5–1.9)
Manz et al., 1991
German production workers
1.2 (0.6–2.1)
Saracci et al., 1991
IARC cohort
0.9 (0.6–1.2)
Wigle et al., 1990
Canadian farmers
0.9 (0.8–1.0)
Zober et al., 1990
BASF production workers—basic cohort
3.0 (0.8–11.8)
Alavanja et al., 1989
USDA forest or soil conservationists
0.7 (0.3–1.3)
Henneberger et al., 1989
Paper and pulp workers
1.2 (0.4–2.8)
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Study Population
Exposed Casesa
Estimated Risk (95% CI)a
Solet et al., 1989
Paper and pulp workers
0.5 (0.1–3.0)
Alavanja et al., 1988
USDA agricultural extension agents
0.7 (0.4–1.4)
Bond et al., 1988
Dow 2,4-D production workers
— (0.0–3.7)
Thomas, 1987
Flavor and fragrance chemical production workers
Coggon et al., 1986
British MCPA production workers
0.9 (0.6–1.3)
Robinson et al., 1986
Paper and pulp workers
1.2 (0.7–2.1)
Lynge, 1985
Danish male production workers
Blair et al., 1983
Florida pesticide appliers
Burmeister et al., 1983
Iowa residents
Farming exposures
1.3 (p < .05)
Wiklund, 1983
Swedish agricultural workers
1.1 (1.0–1.2)c
Burmeister, 1981
Farmers in Iowa
1.1 (p <.01)
Axelson et al., 1980
Swedish railroad workers—total exposure
New Studies
Bertazzi et al., 2001
Seveso residents—20-year follow-up
Zone A males
0.5 (0.1–3.2)
Zone A females
1.4 (0.3–5.5)
Zone B males
1.0 (0.6–1.6)
Zone B females
1.0 (0.5–1.9)
Bertazzi et al., 1998
Seveso residents—15-year follow-up
Zone A females
0.9 (0.1–6.7)
Zone B males
0.8 (0.4–1.5)
Zone B females
1.0 (0.5–2.2)
Studies Reviewed in Update 1998
Bertazzi et al., 1997
Seveso residents—15-year follow-up
Zone A females
0.9 (0.0–5.3)
Zone B males
0.8 (0.4–1.5)
Zone B females
1.0 (0.4–2.1)
Zone R males
0.9 (0.7–1.1)
Zone R females
1.0 (0.8–1.3)
Svensson et al., 1995
Swedish fishermen, mortality
East coast
1.4 (0.8–2.2)
West coast
0.9 (0.7–1.2)
Swedish fishermen, incidence
East coast
1.6 (1.0–2.4)
West coast
0.9 (0.7–1.2)
Studies Reviewed in Update 1996
Bertazzi et al., 1993
Seveso residents—10-year follow-up, morbidity
Zone B males
1.0 (0.5–2.1)
Zone B females
0.6 (0.2–2.5)
Zone R males
0.9 (0.7–1.2)
Zone R females
1.0 (0.6–1.5)
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Increased Risk of Disease Among Vietnam Veterans
Under the Agent Orange Act of 1991, the committee is asked to determine (to the extent that available scientific data permit meaningful determinations) the increased risk of the diseases it studies among those exposed to herbicides during their service in Vietnam. Chapter 1 presents the committee's general findings regarding this charge. Where more specific information about particular health outcomes is available, this information can be found in the preceding discussions of those diseases.
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AFHS (Air Force Health Study). 1996. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update 1996. Brooks AFB, TX: Epidemiologic Research Division. Armstrong Laboratory. AL/AO-TR-1996–0068. 31 pp.
AFHS. 2000. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. 1997 Follow-up Examination and Results. Reston, VA: Science Application International Corporation. F41624–96-C1012.
AIHW (Australian Institute of Health and Welfare). 1999. Morbidity of Vietnam Veterans: A Study of the Health of Australia's Vietnam Veteran Community, Volume 3: Validation Study. Canberra.
Alavanja MC, Blair A, Merkle S, Teske J, Eaton B. 1988. Mortality among agricultural extension agents. American Journal of Industrial Medicine 14:167–176.
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Office of Homeland Security 2007 HOMELAND SECURITY CONFERENCE AND 78TH ANNUAL STATE FIRE SCHOOL BEING HELD IN LEXINGTON
FRANKFORT, Ky. – The 2007 Homeland Security Conference and State Fire School will kick off this Thursday, June 7, at the Rupp Arena/Lexington Center complex in downtown Lexington. More than 1,000 firefighters, law enforcement, EMS and emergency management officials are expected to attend the event, which will continue through Sunday evening.
Opening ceremonies for the conference will be held Thursday, beginning at 8:30 a.m. Guest speakers will include Governor Fletcher's Chief of Staff Stan Cave, National Fire Protection Association representative Russ Sanders, state Homeland Security Director Alecia Webb-Edgington, State Fire Marshal Rodney Raby, State Fire Commission Executive Director Ronnie Day, and Kentucky Firefighters Association President Chief Troy Newcomb.
This year's Conference offers a wide range of training opportunities for all first response disciplines.
Members of the media are encouraged to attend.
The Rupp Arena/Lexington Center complex is located at West High St. and South Broadway.

subset: commoncrawl


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Has anybody had success setting up a 2x9 to work with all 3 front derailleur stops? I'd like to go 2x9, but if I do, I need to be able to use my whole cassette while in the middle ring. I've never had much luck getting the front der setup to do this without rubbing at one of the extremes. Could I just dial down the top limit screw and tension to give me this shifting pattern in the front - similar to trim adjustments on road triples?
1 - small ring (optimize for no rub on large cogs)
2 - low middle ring (ie. no rub on large cogs)
3 - high middle ring (ie. no rub on small cogs)
Results 1 to 3 of 3
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Dubai opens first remote-controlled terminalThe first remote-controlled electronic container terminal, an $850 million facility which boasts of a four million TEUs (twenty-foot equivalent unit) capacity, was launched at the Jebel Ali port in Dubai. The hitech terminal was i More… |
Gulftainer port wins top EMEA rankingThe Khorfakkan Container Terminal (KCT) in Sharjah, operated by UAE-based Gulftainer, a leading port management firm, has been ranked as number one in the Middle East. The Journal of Commerce (JOC) Port Productivity report awarded More… |
DP World boss holds talks with Peru PMThe chairman of DP World recently toured DP World Callao, the largest container terminal on South America's Pacific Coast, and held talks with the Prime Minister of Peru on the company's role in Peru's growth. Sultan Ahmed Bin Sulayem was More… |
DP World in 20-year financing for London GatewayDubai's DP World has arranged a 20-year, long-term financing with a group of international banks to fund its London Gateway deep-sea container port, it said on its website. The world's third-largest ports operator said the financing for th More… |
DP World plans quay extensionLeading port operator DP World said it plans to construct a 400 metre quay extension at its flagship Jebel Ali Port aimed at boosting the capacity at its facility by one million TEUs (twenty-foot equivalent container units) to More… |
DP World to boost output at Jebel Ali unitDP World said it plans to construct a 400 metre quay extension at its flagship Jebel Ali Port to boost the capacity at the facility by 1 million TEU ( (twenty-foot equivalent container units) to 15 million TEUs. The expansion, ex More… |
DP World to double size of Egypt container opsDP World has signed an agreement with the Red Sea Ports Authority that clears the way to double the size of DP World's container operations in Sokhna Port, Egypt. The new terminal at Sokhna Port, which is located at the southern end of the More… |
DP World extends port deal with MaputoDubai-based global marine terminal operator DP World has extended its concession for the port of Maputo, Mozambique to 2033 with an option to extend for a further 10 years. DP World holds the concession to operate the container terminal at More… |
DP World expands capacity at Jebel Ali terminalDP World has further expanded capacity at its flagship Jebel Ali terminal with the arrival of new giant tandem lift gantry cranes and rail mounted gantry (RMG) cranes for phase two of Container Terminal 2. The cranes are the biggest o More… |


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« Ethiopia - Birtukan freed! Accorded a hero's welcome | Ethiopia - Hailemariam Desalegn Zenawi's prized poodle » |
New Ethiopian Curriculum for Reading 101?
Courtesy of Zerihun Zewdie Daharar's facebook page
What a funny sentence ?I like the funny part of it ,but at the same time it has its own methaphore if you try to look conciously. anyway good to express ideas in diffrent ways.
Life is expansive all over the world!!!!
Not only in ethiopia.
Ethiopian unemployment rate is 72% for last 65 years there is nothing new and population grow it makes it harder for the people to survive.
Lazy ethiopian people.
Stop compiling and start working.
Long live ethiopia
Death to eritrea
"ashasi'ya hade derfu" this is tigrigna qote if u know…!
It is bitter,when one is grinded and squeezed in dry hands,it is revolt that comes out of a bitter life.
I wonder how many of the "Woyane Generation" undestand the Irony! Anyway, I found it soooooo Funy. Please let us know when " Chebude" get laid off from his " Tasa Mateb" job.
ወይ ጉድ!! ኑሮ እንዲህ ይርከስ በል ኬክህን ብላ ሰዉ ሁሉ በጨጞራ በሽታ አልቖል በቸግር ይሁን በ በፖለቲካ አይታወቅም የሆነው ሆኖ በሶ ለጨጞራ በሽታ ይጠቅማል
yenuro wedneten lemastekakel aba he is trying to add one more fasting program
k chat tera yedersen zena new
CNN, If Ethiopians are lazy, why are they successful in America and all over the world? If Ethiopians are lazy, your parents are to blame because they have raised a good Ethiopian such as YOU. I am Ethiopian but why do you wish death to Eritrean? I will have them as Ethiopians over your ignorant ass any day. WEDI Mengistu- I know a good quote in English, "Don't argue with fools because people from a far knows who is who". METFFO TIGRE.
it is better to say benuro wedenet mekeneyat chala temenja chebete
WHO CARES for Boso, long live the green leaves(Kat, Chaat) says Mele the goat, Yefeyel wotete,
hiihihihiihhiii haha h aha ha
WHO CARES for Boso, long live the green leaves(Kat, Chaat) says Mele the goat, Yefeyel wotete,
hiihihihiihhiii haha h aha ha
@ one
Why u changing the subject? I'm talking about people in ethiopia.
And I'm not tigre I'm ethiopian.
Death to eritrea
Death to tplf
Death to Egypt
Death to CIA
Long live ethiopia
Diro "reading 101″ arat yeteleyayu fideloch bicha neberung ahun gin asra sidist ( betikikil kekoterkuu) yeteleyayu fidelochin yakatital. yihe malet engidih kibdetu 400% chemere malet new. tiru new. gobizewal malet new. yihichi gin "!" diro alneberechim. Demo sesost gize belay medigem tikikil ayidelem. mefekir yimesilal.
Ethiopians should be prepared for the worst. Ethiopia is ruled by a black fascist who systematically is doing to enrich only the Tigreans and some HODAMS by starving others. It is only an Ethiopian government who serves all fairly what Ethiopia and Ethiopians need.
Meles chat yekemal sibale le 20 amet seman gen ewenet new?
nuro ketewedede beso bekagn endet yelale? be nuro wedenet mekiniyat abebe tomun adere would make more sense.


text:
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Clients utilizing in-house counsel may not have the same rights to claim attorney-client privilege as clients who engage retained counsel, and counsel must be careful not to serve the client as both an attorney and business adviser.
This "oldie but goodie" - in which I, personally, was the subject - suggested that standards of attorney-client privilege for in-house counsel were not as sacrosanct as those for retained counsel. The court also held that attorneys who provide both business as well as legal advice may compromise privilege as to the latter.
While this decision has been the subject of much subsequent scholarship, and its holding has been refined in subsequent cases, it is the case of first impression on the issue of the scope of attorney-client privilege in the SDNY. Thus, it is worth a look.
As an aside, my deposition was subsequently reconvened so that I could provide verbal answers to those questions the Court found were not subject to attorney-client privilege. Amusingly, after receiving my verbal answers, counsel for the plaintiff asked if there were documents memorializing my advice. There were, and the plaintiff demanded their production, which I refused on the grounds of privilege. These documents - which added nothing to my verbal testimony - were reviewed by the Court in camera. The judge exploded, "Counsel, you can't obtain these documents. They're privileged." So, perhaps written advice is subject to greater protection than oral advice?
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Parikh, Jignashu and Murty, Narasimha M (2002) Adapting Question Answering Techniques to the Web. In: Language Engineering Conference, 2002. LEC 2002, 13-15 December, Hyderabad,India, pp. 163-171.
adapting.pdf Download (296Kb) |
The Web has emerged as a huge information repository that can be used for various knowledge based applications, an important one being question answering (QA). The paper discusses the issues involved in using Web as a knowledge base for question answering involving simple factual questions. It also proposes some simple but effective methods to adapt traditional QA methods to deal with efficient these issues and lead to an accurate and efficient question answering system. The paper discusses the architecture and design of our system. The empirical results obtained on the current system are encouraging.
Item Type: | Conference Paper |
Additional Information: | Copyright 1990 IEEE. Personal use of this material is permitted. However, permission to reprint/republish this material for advertising or promotional purposes or for creating new collective works for resale or redistribution to servers or lists, or to reuse any copyrighted component of this work in other works must be obtained from the IEEE. |
Department/Centre: | Division of Electrical Sciences > Computer Science & Automation (Formerly, School of Automation) |
Date Deposited: | 24 Jan 2006 |
Last Modified: | 19 Sep 2010 04:23 |
URI: | http://eprints.iisc.ernet.in/id/eprint/5188 |
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1Environment Canada
2Secretaria de Medio Ambiente, Recursos Naturales
3U.S. Fish & Wildlife Service
Roberto Solis Calderón Director de la Reserva de la Biosfera Mariposa Monarca Av. Revolución # 1425 nivel 25 Col. Tlacopac C.P. 01040 Tel. 56 24 33 44
Issue: Hawksbill sea turtle dialogue
SEMARNAT provided update on the logistics of the upcoming CITES meeting on Hawksbills, to be held on May 15-17, 2001 in Mexico City, Mexico.
Action: No action required.
Issue: PREP Marine Turtles
INE presented its National Program for Protection, Conservation, Research and Management of sea turtles in Mexico, presented publicly in May 2000. This program intends to coordinate all efforts and initiatives from various agencies involved in sea turtle activities in Mexico.
Issue: Other sea turtles
The Inter-American Convention for the Protection and Conservation of Sea Turtles enters into force in May 2001. Twelve nations are signatories, of which nine have ratified the Convention.
Recommendation: Upon entering into force, the Convention should be open for accession by states in the Americas. The Convention provides an excellent venue to discuss complex regional sea turtle issues and problems and opportunities to collaborate on solutions. Mexico and the US have ratified the Convention, and Canada is urged to consider acceding to the Convention
Issue: Black Sea Turtles
FWS provided a report on the decline of the Black Sea Turtle population, apparently partly caused by overfishing of more than 8,000 sea turtles in Baja California, Mexico.
Action: Mexico, through the University of Baja California South, will evaluate the status and impact of overfishing of sea turtles.
Issue: Leatherback/ Loggerhead in the North Atlantic
FWS provided a report on long-line fisheries in the North Atlantic that have negative impact on these turtle populations. At least 23 nations, including the U.S. and Canada, operate longline fisheries for tuna and billfish throughout the western North Atlantic. These fisheries also accidentally catch significant numbers of loggerhead and leatherback turtles and are undermining recovery efforts for these species.
Recommendation: The U.S. Fish and Wildlife Service, U.S. Marine Fisheries Service, Environment Canada, and Department of Fisheries and Oceans Canada should cooperate to implement the necessary measures to identify the full magnitude of this incidental take and mortality and to develop measures to reduce or eliminate incidental take within these fisheries.
Issue: Black-footed Ferrets
FWS gave an update on the joint reintroduction program of the ferret into the Janos area of Chihuahua, Mexico.
Recommendation: The Shared Species table requests that the Executive Committee continue its support of the UNAM proposal to reintroduce ferrets into the Janos area of northern Chihuahua.
Action: Mexico will provide information to the FWS on their plans regarding publicity surrounding the release of the ferret into the Janos area.
Issue: Black-tailed prairie dogs
FWS gave an update on the status of prairie dog populations and Federal listing. INE reported on the creation of Mexico's recovery group for the prairie dog.
Recommendation: Shared Species working table requests that the Executive Committee reiterate its recognition of the biological significance of the largest remaining prairie dog complex in the world, which is located in the Janos area of northern Chihuahua.
Issue: Ocelots
FWS reported on their bi-national ecosystem approach and the possibility of reintroducing two Mexican ocelots in the Rio Grande area.
Action: Mexico will provide existing information on ocelot populations in the Tamaulipas area.
Recommendation: Request from the Executive Table for endorsement of the reintroduction of two ocelots from Mexico into the Laguna Atascosa area.
Issue: Mexican wolves
FWS gave update on the status of their Mexican wolf reintroduction program and the plans to revise the composition of the Mexican Wolf Recovery Team to become bi-national. Mexico provided an update on a wolf caught in Zacatecas two or three years ago, whose blood is being analyzed by the FWS to determine its genetic purity as a Mexican wolf.
Action: FWS will obtain the report on the blood analysis and provide to Mexico as soon as possible.
Issue: Pronghorn antelope
FWS presented an update on the status on the Sonoran pronghorn populations in the US and Mexico and the results of the first joint aerial survey. FWS also provided information on the amendments to the Sonoran Pronghorn Recovery Plan and future revisions to the plan to officially include Mexico. Shared Species table participants support a more active recovery approach.
Action: The Recovery Team will conduct an evaluation of the applicability of a captive breeding program and provide more specific plans to the Shared Species table.
Action: The Recovery Team will reestablish biological studies, including radio telemetry, in Mexico.
Action: The Recovery Team will evaluate the possibility of translocating individuals between populations to strengthen genetic lines.
Recommendation: The Shared Species table recommends that the Executive Table support an increase in frequency of joint aerial surveys.
Issue: Report on NACEC funding requests nominated by the Shared Species Table
NACEC provided background information on their funding priorities this fiscal year and NACEC's strategy for promoting tri-national collaboration and community involvement.
Action: Each country will request, through their NACEC liaison, that NAFEC focus next year's funding on Species of Common Conservation Concern.
Issue: California Red-legged Frog
FWS provided an update on captive rearing efforts. FWS requested from Mexico their approval to obtain genetic material from wild red-legged frogs in northern Baja California.
Action: FWS will provide to Mexico the name of the researcher who will collect samples, and any other necessary information, and Mexico will assist in obtaining the necessary permits.
Issue: Swift Fox
FWS gave an update on swift foxes and the recent population assessment that determined there were more than previously known. This allowed FWS to remove swift foxes from the candidate species list. Canada lists it as endangered.
Issue: Sonoran Joint Venture
FWS gave an update on the history and status of the SJV. This is a bi-national bird conservation program between Mexico and the U.S. that is proving highly successful.
Recommendation: Shared Species Table recommends Trilateral endorsement for the bi-national work, including the goals and objectives being accomplished by the SJV.
Issue: California Condor
FWS discussed the history of the condor reintroduction program and explained the plans and needs for a proposed reintroduction of condors into northern Baja California.
Recommendation: The Shared Species Table recommends continued Trilateral endorsement for the FWS-assisted bi-national condor recovery plan in Baja California.
Issue: Yuma Clapper Rail
FWS provided a status update and recent survey of Yuma Clapper Rails for the Lower Colorado River and Delta and the biology of the species.
Recommendation: The Shared Species recommends continued Trilateral endorsement for the ongoing survey work and expansion of the work to include to include additional coastal wetlands of Sonora.
Issue: Cactus Ferruginous Pygmy Owl
FWS presented a history of the listing of the species in the U.S. and the current status in the U.S. and northern Sonora. Currently there are fewer than 20 individuals in the U.S. and more than 300 in Sonora. As part of their research, the Arizona Game and Fish Department is radio-marking the owls in the Arizona borderland. Occasionally these birds enter Mexico and AGF needs to monitor these birds to determine habitat use and reproductive status.
Recommendation: The Shared Species Table recommends the Trilateral support for the continuation of FWS's survey work in the eventual recovery of the species.
Recommendation: The Shared Species Table recommends approval for AGF to obtain appropriate permits from Mexico for aerial and ground surveys for marked birds.
Issue: Southwestern Willow Flycatcher
FWS presented the status and history of the SWF, the loss of habitat to agriculture along the Lower Colorado River and Delta, the importance of wetlands along the coast of Sonora as migratory stopovers, and the work currently being accomplished.
Recommendation: The Shared Species Table recommends the Trilateral support for the continuation of this work and expansion to the coast and northern Sonora.
Issue: Bald Eagle
FWS described the cooperative efforts with Mexico for monitoring the small population of Bald Eagles in Sonora, which is the only population in Mexico other than the Baja California population.
Action: The Shared Species Table recommends the Trilateral support for the continuation of this important monitoring work in the eventual recovery of the species.
Issue: Grasslands Workshop and Initiative
CEC presented the results of the SCCC workshop on grasslands held in Nuevo Casa Grandes, Chihuahua in March 2001.
Recommendation: The table recommends that the CEC working group devise a strategy for achieving the vision established by the Chihuahua grasslands workshop.
Issue: Monarch Butterflies
FWS reported that the monarch group studied the list that came from the meeting in Morelia and determined that many issues remained to be addressed. Therefore, a meeting in May has been planned in Kansas. The Shared table recognizes the excellent work on the part of Mexico in establishing the Biosphere Reserve.
Recommendation: The Shared Species Table recommends continued support of the monarch reserve in Mexico.
Recommendation: The three countries should participate in the monarch meeting in May in Kansas.
Issue: Quino Checkerspot Butterfly
FWS would like to work along the California-Mexico border to map butterfly colonies, distribution of habitat patches and host plants; assess threats; and establish a working relationship with Mexican government and non-governmental agencies.
Action: INE will review the FWS's proposal and provide a reply within 30 days on their support of the project and a list of expert contacts (governmental and non-governmental) in Mexico.
Issue: Marine Mammals
Mexico proposed to broaden the agenda of the Shared Species Table to include marine mammals.
Recommendation: The Shared Table recommends that marine mammals be included for discussion at this table.
Recommendation: Mexico would like information from the other countries to help them develop a project to determine what is causing the whales (particularly gray and humpback whales) to die when they arrive in Mexico.
Action Item: Each agency will identify a contact with their sister agency to provide the above information.
Issue: Continued support of species work in Mexico
A list was presented by FWS of species that are ongoing, temporarily halted, or new projects in Mexico for endorsement by Mexico.
Recommendation: The table reviewed the list approved advancing the list for endorsement with the caveat that fieldwork would require approval of a proposal by the appropriate Mexican authority: Tarahumara frog, masked bobwhite, Yuma clapper rail, Yaqui fish (catfish, chub, and trout), Sonoran pronghorn, desert pupfish, black-tailed prairie dog, black-footed ferret, southwestern willow flycatcher, California condor, yellow-billed cuckoo, ocelot, jaguarundi, ferruginous pygmy owl, jaguar, Mexican wolf, piping plover, burrowing owl, aplomado falcon, California rail, Sonoran neotropical migrants, monarch butterfly.
Issue: Next mid-year table meeting
Recommendation: The table agreed to have a meeting in Vancouver in the third week of September.
Update of Bald Eagle Sonoran Project by Robert Metsa (FWS/SJV)
1. Issue—Population surveys and ecological studies of a small bald eagle population
2. Action—Co-chairs endorsed continuation of the project
Information about status and for burrowing owl populations given by Geoff Holroyd (CWS/CBORT)
1. Issue—Determine continental status of this declining and potentially endangered species and conservation actions need to reverse the decline
2. Action—Within 30 days, the 3 wildlife agencies will identify contacts of people working with burrowing owls and start working on determining the continental status of the species. Several contacts in Mexico were suggested
Information about status and concerns for piping plover populations given by Geoff Holroyd on behalf of J. Paul Goossen (CWS/PPPRT)
1. Issue—Determine threats to piping plovers in their wintering grounds in Mexico
2. Action—Within 60 days, the 3 countries will identify contacts to work with piping plovers in their wintering grounds
Information about peregrine falcon management given by Steve Wendt (CWS)
1. Issue—Peregrine falcon permits for falconry in Mexico
2. Action—Within 60 days, Mexico will provide information to US and Canada about the number of permits available for falconry in the country
Information about recovery program for golden eagles in Mexico given by Mauro Reyna (INE)
Update of meeting about eagle feathers use by indigenous people and transport across US, Canada, and Mexico borders given by Patricia Dwyer (CWS/AATW)
1. Issue—Eagle feathers transport between US, Canada, and Mexico, and culturally sensitive issues
2. Action—The migratory bird table recommends that, as quickly as possible, a subcommittee be established to explore issues and options related to transport of eagle feathers across US, Canada, and Mexico borders. Mauro Reyna was designated as the contact person for Mexico
Presentation about CEC and its activities given by Jurgen Hoth (CEC)
1. Issue—Need for tri-national collaboration to conserve shared species of concern and their habitats
2. Action—Shared Species Table supports activities conducted by CEC such as meetings and other activities facilitating tri-national collaboration towards the conservation of shared species, particularly those listed as common concern and their grassland habitats. Also, supports recommendations made by the Workshop on Grassland Species of Common Concern conducted in Chihuahua, Mexico, in March 2001
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