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The Association Between Exposure To Fuels, Combustion Products,
Asked by
Guest allan,
Question
Guest allan
PREPUBLICATION COPY-UNCORRECTED PROOFS
TABLE ES.1 Summary of Findings Regarding the Association Between Exposure to Fuels, Combustion Products,
Hydrazines, and Nitric Acid and Specific Health Outcomes
Sufficient Evidence of a Causal Relationship
Evidence is sufficient to conclude that there is a causal association between exposure to a
specific agent and a specific health outcome in humans. The evidence is supported by
experimental data and fulfills the guidelines for sufficient evidence of an association (below).
The evidence must be biologically plausible and satisfy several of the guidelines used to
assess causality, such as: strength of association, dose.response relationship, consistency of
association, and a temporal relationship.
o No conclusions
Sufficient Evidence of an Association
Evidence is sufficient to conclude that there is a positive association. That is, a consistent
positive association has been observed between exposure to a specific agent and a specific
health outcome in human studies in which chance and bias, including confounding, could be
ruled out with reasonable confidence. For example, several high-quality studies report
consistent positive associations, and the studies are sufficiently free of bias, including
adequate control for confounding.
Combustion products and lung cancer
22 GULF WAR AND HEALTH
PREPUBLICATION COPY-UNCORRECTED PROOFS
Limited/Suggestive Evidence of an Association
Evidence is suggestive of an association between exposure to a specific agent and a specific
health outcome, but the body of evidence is limited by the inability to rule out chance and
bias, including confounding, with confidence. For example, at least one high-quality study
reports a positive association that is sufficiently free of bias, including adequate control for
confounding. Other corroborating studies provide support for the association, but they were
not sufficiently free of bias, including confounding. Alternatively, several studies of lower
quality show consistent positive associations, and the results are probably not due to bias,
including confounding.
Cancers
Combustion products and
o Cancers of the nasal cavity and nasopharynx
o Cancers of the oral cavity and oropharynx
o Laryngeal cancer
o Bladder cancer
Hydrazines and lung cancer
Reproductive Effects
Combustion products and
o Low birthweight/intrauterine growth retardation and exposure during
pregnancy
o Preterm birth and exposure during pregnancy
Respiratory Effects
Combustion products and incident asthma
Inadequate/Insufficient Evidence
Evidence is of insufficient quantity, quality, or consistency to permit a conclusion regarding
the existence of an association between exposure to a specific agent and a specific health
outcome in humans.
Cancers
Fuels and
o Cancers of the oral cavity and oropharynx
o Cancers of the nasal cavity and nasopharynx
o Esophageal cancer
o Stomach cancer
o Colon cancer
o Rectal cancer
o Hepatic cancer
o Pancreatic cancer
o Laryngeal cancer
o Lung cancer
o Melanoma
o Nonmelanoma skin cancer
o Female breast cancer
o Male breast cancer
EXECUTIVE SUMMARY 23
PREPUBLICATION COPY-UNCORRECTED PROOFS
o Female genital cancers (cervical, endometrial, uterine, and ovarian cancers)
o Prostatic cancer
o Testicular cancer
o Nervous system cancers
o Kidney cancer
o Bladder cancer
o Hodgkin.s disease
o Non-Hodgkin.s lymphoma
o Multiple myeloma
o Myelodysplastic syndromes
Combustion products and
o Esophageal cancer
o Stomach cancer
o Colon cancer
o Rectal cancer
o Hepatic cancer
o Pancreatic cancer
o Melanoma
o Female breast cancer
o Male breast cancer
o Female genital cancers (cervical, endometrial, uterine, and ovarian cancers)
o Prostatic cancer
o Testicular cancer
o Nervous system cancers
o Ocular melanoma
o Kidney cancer
o Non-Hodgkin.s lymphoma
o Hodgkin.s disease
o Multiple myeloma
o Leukemia
o Myelodysplastic syndromes
Hydrazines and
o Hematopoietic and lymphopoietic cancers
o Digestive tract cancers
o Pancreatic cancer
o Bladder cancer
o Kidney cancer
Nitric acid and:
o Stomach cancer
o Melanoma
o Lymphopoietic cancers
o Pancreatic cancer
o Laryngeal cancer
o Lung cancer
o Bladder cancer
24 GULF WAR AND HEALTH
PREPUBLICATION COPY-UNCORRECTED PROOFS
o Multiple myeloma
Reproductive Effects
Fuels and adverse reproductive or developmental outcomes (including infertility,
spontaneous abortion, childhood leukemia, CNS tumors, neuroblastoma, and
Prader-Willi syndrome)
Combustion products and
o Preterm births and exposure during any specific time period during
pregnancy (for example, the first trimester)
o Low birth weight and intrauterine growth retardation and exposure before
gestation or during any specific period during pregnancy (for example, the
first trimester)
o Specific birth defects, including cardiac effects, and exposure before
conception (maternal and paternal) or during early pregnancy (maternal)
o All childhood cancers identified, including acute lymphocytic leukemia,
leukemia, neuroblastoma, and brain cancer
Neurologic Effects
Fuels and
o Peripheral neuropathy
o Neurobehavioral effects
o Multiple Chemical Sensitivity symptoms
Combustion products and
o Neurobehavioral effects
o Posttraumatic stress disorder
o Nervous system subgroupings (or individual nervous system diseases)
o Multiple Chemical Sensitivity symptoms
Respiratory Effects
Fuels and
o Nonmalignant respiratory disease
o Chronic bronchitis
o Asthma
o Emphysema
Combustion products and:
o Chronic bronchitis (less than1 year of exposure)
o Emphysema
o Chronic obstructive pulmonary disease
Hydrazines and emphysema
Cardiovascular Effects:
Combustion products and ischemic heart disease or myocardial infarction (less
than 2 years of exposure)
Hydrazines and ischemic heart disease or myocardial infarction
Nitric acid and cardiovascular diseases
Dermal Effects:
EXECUTIVE SUMMARY 25
Fuels and dermatitis.irritant and allergic
Combustion products and dermatitis.irritant and allergic
Other Health Effects:
Fuels and sarcoidosis
Combustion products and sarcoidosis
Hydrazines and hepatic disease
Limited/Suggestive Evidence of No Association
Evidence is consistent in not showing a positive association between exposure to a specific
agent and a specific health outcome after exposure of any magnitude. A conclusion of no
association is inevitably limited to the conditions, magnitudes of exposure, and length of
observation in the available studies. The possibility of a very small increase in risk after
exposure studied cannot be excluded.
No conclusions
SOURCE: http://www1.va.gov/environagents/docs/Summ...Propellants.pdf
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