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Herbicide Exposure, Vietnam Service, and Hypertension Risk in Army Chemical Corps Veterans

Cypel, Yasmin S. PhD, MS; Kress, Amii M. PhD, MPH; Eber, Stephanie M. MPH; Schneiderman, Aaron I. PhD, MPH; Davey, Victoria J. PhD, MPH

Journal of Occupational and Environmental Medicine: November 2016 - Volume 58 - Issue 11 - p 1127–1136
doi: 10.1097/JOM.0000000000000876

Objective: We examined hypertension risk in Army Chemical Corps (ACC) veterans who sprayed defoliant in Vietnam.

Methods: We analyzed data from the 2013 health survey of 3086 ACC veterans and investigated the association between self-reported physician-diagnosed-hypertension (SRH) and herbicide-spray-history adjusting for Vietnam-service-status, rank, age, tobacco/alcohol use, race, and body mass index (BMI). Spray-history was verified against serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (n = 636). SRH was confirmed by blood pressure (BP) measurement by trained medical technicians and medical record reviews.

Results: Herbicide-spray-history (ORadjusted[95%confidence interval {CI}] = 1.74[1.44,2.11]) and Vietnam-service-status (ORadjusted = 1.26[1.05,1.53]) were significantly associated with SRH. The association was highest when comparing Vietnam-service-sprayers to non-Vietnam-service-nonsprayers (ORadjusted = 2.21[1.76,2.77]). Serum TCDD was highest for Vietnam-service-sprayers. Mean systolic BPs were significantly higher among veterans with SRH than those without (P ≤ 0.001). Medical records and SRH overall agreement was 89%.

Conclusion: Occupational herbicide exposure history and Vietnam-service-status were significantly associated with hypertension risk.

Epidemiology Program, Post-Deployment Health Services (10P4Q), Office of Patient Care Services, Department of Veterans Affairs, Washington, DC (Dr Cypel, Dr Kress, Ms Eber, Dr Schneiderman); and Office of Research and Development, Veterans Health Administration, Washington, DC (Dr Davey).

Address correspondence to: Yasmin S. Cypel, PhD, MS, Department of Veterans Affairs, Epidemiology Program, Post-Deployment Health Services (10P4Q), Office of Patient Care Services, 810 Vermont Avenue NW, Washington DC 20420 (

This study was funded by the Epidemiology Program, Post-Deployment Health Services, Office of Patient Care Services, Department of Veterans Affairs (VA).

No conflicts of interest for any co-authors are declared.

Copyright © 2016 by the American College of Occupational and Environmental Medicine