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Table 1 Summary of non-Vietnamese cohort studies, and Vietnamese cohort and cross-sectional studies on the association between Agent Orange and birth defects

First author, year (Country) Study period Exposed Unexposed Exposure definition/data source and measurement Case ascertainment

(a) Non-Vietnamese cohort studies

Lathrop, 1984^a (US)²² 1965–82 3293 conceptions among 1174 Ranch Hand veterans 4106 conceptions among 1531 non-Ranch Hand air force personnel Aerial spraying /handling of Agent Orange/group exposure based on military records All congenital anomalies by self-reports

CDC, 1988 (Sub-study) (US)²⁴ 1965–87 1791 offspring of American-Vietnam veterans 1575 offspring of US non-Vietnam veterans Vietnam military service/group exposure based military records All congenital anomalies by self-reports and verified by hospital records

Field, 1988 (Australia)⁹ 1965–87 357 Australian-Vietnam veterans in Tasmania 281 Australian non-veterans in Tasmania Vietnam military service/group exposure based on military records Self-reports and verified by physician's examination

Wolfe, 1992^a (US)²⁶ 1965–87 2533 conceptions among 791 Ranch Hand veterans 2074 conceptions among 768 non-Ranch Hand air-force veterans Aerial spraying/handling of Agent Orange/individual exposure measured based on military records, serum dioxin levels All types of birth defects/self-reports verified by hospital medical records

Wolfe, 1995 (US)⁸ 1965–92 1006 conceptions among 454 Ranch Hand veterans 1235 conceptions among 570 non-Ranch Hand veterans Spraying and handling of Agent Orange/individual exposure measured based on military records, serum dioxin levels All congenital anomalies noted in hospital and medical records

Kang, 2000 (US)²⁷ 1965–99 4140 US-Vietnam women veterans 4140 US non-Vietnam women veterans Vietnam military service/group exposure based on military records All congenital malformations by self-reports

(b) Vietnamese cohort and cross-sectional studies

Khoa, 1983²⁸ ^a 1965–82 1163 births of 313 families in a heavily sprayed village between 1965–82 587 births of 134 families in an unsprayed village during the same period of time Direct exposure to the spraying/group exposure based on spraying history All types of birth defects by self-reports and medical records

Can, 1983²⁹ ^a 1965–82 11 023 wives of North Vietnam veterans exposed to Agent Orange in the South 29 041 wives of North Vietnam veterans living in the North only Military service in sprayed areas/exposure measured based on self-reports and military records Living children with birth defects by self-reports, hospital records, and physician verification

Phuong, 1983³⁰ 1952–81 7327 pregnancies of 1219 exposed families in a sprayed commune 6690 pregnancies of 1126 unexposed families in an unsprayed district in South Vietnam. Direct exposure to spraying/group exposure based on spraying history All types of birth defects by self-reports and blindly verified by medical examination

Lang, 1983³² ^a 1965–82 1142 veterans having been to the South during the war 613 veterans only living in the North during the war Military service in sprayed areas/exposure measured based on self-reports, military records Living children with birth defects by self-reports, hospital records, and blind physician verification

Tanh, 1987³³^a 1965–85 1023 families in a sprayed village 1087 families in unsprayed village in the South Direct exposure to spraying. group exposure based on spraying history All types of birth defects by self-reports

Phong, 1994³⁵ ^a 1982–92 1122 veterans having been to the South during the war 354 veterans living in the North only Military service in the South/group exposure based on military records, self-reports All types of birth defects by self-reports/medical examination

Phuong, 1994³⁶ ^a 1965–92 394 children of 416 women in a sprayed village born during the spraying time (1964–70) 2272 children of 159 women of the same village born before the spraying time (1938–1963) Intra-uterine or breast milk exposure/group exposure based on spraying history All types of birth defects by self-reports

Dai LC, 1994³⁷ ^a 1965–1992 1576 North veterans have been to the sprayed areas during spraying time 153 North veterans only served in the North during the war Military service in spraying areas/exposure measured based on military records, self-reports All types of birth defects by self-reports and blind medical examination

Dai B, 1994³⁸ ^a 1965–92 533 veteran fathers having been to the sprayed areas in South during spraying time 477 Veteran fathers living in the North during the war Military service in sprayed areas/exposure measured based on military records, self reports Self-reported

10-80 Committee, 2000³⁹ ^a 1965–99 4310 live births in a period from 1965 to 1999 of a heavily contam-inated commune due to spraying and storing of Agent Orange 1423 births in the same period of time in three other less contaminated communes. Direct exposure to spraying/group exposure based on spraying records, dioxin levels in food, soil All types of birth defects self-reported

Hung, 2000⁴⁰ ^a 1999 213 children of 108 veteran fathers having been to the sprayed areas in South during spraying time 210 children of 141 veteran fathers living in the North during the war Military service in the sprayed areas/exposure measured based on self-reports X-ray test to detect spina bifida

^aUnpublished study.

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International Journal of Epidemiology