Saving a 'National Treasure'

BY Richard Currey

Grainy films of low-flying aircraft, spewing clouds of defoliant spray over South Vietnam, are among the most indelible images associated with the Vietnam War. Those ubiquitous planes were vectors for the aerial release of highly toxic chemical defoliants in a decade-long American military program of herbicidal warfare known as Operation Ranch Hand.

The spray planes were C-123 aircraft outfitted with tanks holding 1,000 gallons of herbicides per plane. According to the Office of Air Force History, Ranch Hand sorties typically involved between three and five C-123s flying side by side. A single sortie could blanket nearly 10 miles of jungle in just under five minutes. The wide-scale destruction of vegetation and crops that would result had the tactical intention of denying the enemy both ground cover and food.

Perhaps the most infamous of the principal herbicides deployed in Ranch Hand was the one called Agent Orange (so named for the orange stripes on the barrels the mixture was stored and shipped in), which included dioxin, an extremely toxic chemical. Dioxin accumulates in soil, water, and plants and can invade the tissues of wildlife and humans, giving rise to profound congenital abnormalities, cancers, and other illnesses.

“These chemicals were seen as harmless blends of ingredients like those used in common agriculture operations,” said former VVA President Jack McManus, who spent his Vietnam War tour as a ground crewman with the 12th Air Commando Squadron working with herbicide-carrying C-123s. McManus’s duties placed him in near-constant, unprotected exposure to Agent Orange, along with other herbicides with known toxicities.

And although he and his crewmates were reassured about the “harmless blends” they were handling, Agent Orange and other herbicides were in fact some 50 times the strength of standard crop-dusting formulations. During Ranch Hand’s time as an active operation from 1962-71, more than 18 million gallons of Agent Orange and other defoliants were released over South Vietnam, covering nearly a quarter of the country’s total area.

Robert Ohman/AP

The dire human results of Agent Orange exposure (although well-known to scientists long before the Vietnam War) began to publicly emerge in the mid-1970s. As the national outcry about possible links between herbicide exposure and illness in Vietnam War veterans continued to mount, Congress authorized the Air Force Health Study (AFHS, also known as the Ranch Hand Study) to investigate the medical impact on veterans of being exposed to Agent Orange. (For more detailed accounts of the long fight for Agent Orange compensation and benefits – and VVA’s integral role in that effort – see the collection of a dozen feature articles from this magazine online at vvaveteran.org/11005-aocompendium.pdf).

AFHS planning started in 1979 with the enrollment of former Ranch Handers and a control group of Air Force pilots and crews who flew during the war but not on Operation Ranch Hand missions. The study began in 1982, with some 2,700 participants who were tracked over the next 24 years.

Physical exams were conducted, extensive health questionnaires administered, and biospecimens (including whole blood, plasma, semen, and fatty tissue samples) obtained from participants at baseline (the study’s start). These samples were collected again three years later and then again, every five years, through to the study’s conclusion in 2006. Some 200 medical laboratory tests and measures were charted and evaluated, as researchers gathered other health-related information from the participants’ medical records and those of their families.

The AFHS was the longest, most extensive, and most rigorously designed research program ever undertaken to assess whether U.S. military personnel exposed to Agent Orange and other herbicides had experienced adverse health outcomes. As the study came to a close, it was clear the data amounted to an exceptional resource for furthering veteran-related studies and for future research about human health in general.

Horst Faas/AP

The Institute of Medicine (now part of the National Academies of Science, Engineering, and Medicine) endorsed the scientific merit of preserving AFHS data, noting how it could expedite broader scientific access and have applications in many areas of medical research. The VA’s National Research Advisory Council agreed, saying that “open access [to AFHS data] for researchers presents an unprecedented opportunity to further understand the long-term health and transgenerational consequences resulting from exposures in the Vietnam War theater.”

This consensus that AFHS data must be stored, preserved, and made available for future research triggered complex procedural questions. How could the government best store and preserve the data (which required cryogenic “deep freeze” storage facilities for the biospecimens)? Who should the custodian of the data be? Who had the storage capacities to keep the data safe and secure? Who would manage access to the data? And how could we all ensure that this precious scientific resource would be protected?

Congress assigned custody of the AFHS assets to the Institute of Medicine’s Medical Follow-Up Agency. Because IOM did not have the facilities to maintain a large biospecimen collection, MFUA arranged—via CRADAs/interagency agreements and a contract—for the Air Force Research Laboratory to store the AFHS biospecimens at Wright-Patterson AFB, while IOM curated the electronic data. Roughly 86,000–91,000 specimens were housed at Wright-Patterson from 2007–2011 onward, remaining there for well over a decade.

In 2017, then VVA President John Rowan approached McManus about a problem uncovered by Rowan’s special advisor, Linda Schwartz, a former VA Assistant Secretary for Policy and Planning and a longtime veterans’ health advocate. She had become concerned that the AFHS data assets were under threat. Despite the strong consensus for preservation, it was now possible that all the materials could be lost.

McManus had served as Rowan’s lead advisor and advocate for the 2016 Toxic Research Exposure Act and well understood the pressing significance of the problem. “The Air Force was under pressure from the Pentagon to stop overseeing the AFHS specimens and concentrate on current military health issues,” he said. Meanwhile, the VA had failed to budget for the storage, maintenance, and management of the AFHS data and biospecimens. Between the Air Force and the VA, the AFHS materials appeared to be, at best, in uncertain hands.

“These factors were the root cause,” McManus said, “of what became a series of monumental challenges to save the endangered data and biospecimens for future research in a manner that would benefit not only Vietnam War veterans and their progeny, but all humanity.”

Just as VVA had been at the forefront of the effort to secure compensation and care for Agent Orange veterans, the organization assumed a similar role in the effort to save the AFHS study assets.

“Our first big step was to get high-level attention from DoD,” McManus said. “We had to forestall the destruction of data and biospecimens stored at Wright-Patterson.”

McManus and Schwartz held a series of meetings with Air Force leaders and senior representatives from VA, NASEM, and the National Institutes of Health, along with key VVA staff including former Government Relations Directors Sharon Hodge and Rick Weidman, and Communications Department Director Mokie Porter.

“Everybody agreed it would be a tragedy if the AFHS data and biospecimens were lost to future research,” McManus said. “It was at these meetings that we first heard the assets referred to as ‘national treasures’ and the ‘crown jewels’ of military medical research.”

Negotiations hit a slowdown due to Covid-19 pandemic restrictions, but VVA stayed the course. “This VA Special Advisors Marsha Four and LInda Schwartz, who, along with former Agent Orange chair Paul Sutton, and VVA staff, met, for a year, on a weekly basis with members of the U.S. Air Force, the VA , and NASEM that resulted in a new multi-organization Memorandum of Agreement that provides a permanent home for the AFHS data in the VA Science and Health Initiative to Combat Infectious and Emerging Life-Threatening Diseases (VA SHIELD),” McManus said.

“This program now manages the storage, maintenance, and access for future research of this once-in-a-lifetime collection of scientific data and biospecimens.”

The AFHS biospecimens have been successfully transferred to a facility on the campus of the West LA VA where they are being properly maintained and will soon be available for scientific research. The VA, through its SHIELD program, is the official AFHS data custodian. A dedicated review committee evaluates research proposals that request the use of the samples.

“VVA’s efforts to save the scientific data and biospecimens collected during the AFHS study have been intensive, relentless and dedicated,” said McManus. “The use of the AFHS materials in future research programs could provide answers about the long-term outcomes of toxic exposures on Vietnam War veterans and their descendants. The AFHS assets really are ‘national treasures,’ and VVA has been instrumental in saving them.”

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