Disturbing Long-Term Health Impacts From The Vietnam War

Thousands of Soldiers Caught Infectious Diseases Like Malaria In addition to combat-related injuries, many Vietnam War veterans were also exposed to infectious diseases that can have… Aisha Abdullah - April 20, 2023

Spanning nearly two decades, the Vietnam War claimed millions of lives, including as many as 2 million civilians and over 58,000 U.S. troops. The conflict was the first that allowed people to witness the horrors of war right in their living rooms half a world away, resulting in widespread opposition to the conflict. However, the legacy of the Vietnam War extends far beyond its casualties, with many of the lingering health effects of combat only just beginning to be fully understood. Even now, many veterans are unaware that their health conditions may be related to their time in service. These are some of the long-term health impacts faced by survivors of the Vietnam War.

Brian K. Grigsby / U.S. Department of Defense / The National Archives

The U.S. Military Exposed Millions of Soldiers and Civilians to Agent Orange

During the Vietnam War, the U.S. military used a variety of chemicals called rainbow herbicides to destroy the forest that provided cover to enemy combatants. The most famous is Agent Orange, a chemical dust that contains dioxin, which causes leaves to fall off plants. Dioxin has since been linked to a host of serious health issues, including cancer, diabetes, Parkinson’s disease, and heart disease. For 10 years, the U.S. military sprayed the herbicide over more than 4.5 million acres of land in Vietnam, Laos, and Cambodia, exposing civilians and troops alike to the toxic chemical. Dioxin lingers in the environment for years, seeping into the soil, water, and animal tissue, impacting anyone who eats meat, fish, and other animal products from exposed areas. Agent Orange has even been linked to severe birth defects in the babies of children exposed to the chemical. Moreover, nearly five decades later, the forests in Vietnam have still not been restored to pre-war levels.


Vietnam Made The World Aware of PTSD

Although the medical community had long recognized the lasting psychological effects of combat, soldiers returning from the Vietnam War brought the issue to the public consciousness. Previously called shell shock, the unique set of symptoms experienced by war veterans and others who have been through or witnessed extremely traumatic events eventually come to be known as post-traumatic stress disorder (PTSD). This mental health condition is characterized by flashbacks (reliving of the traumatic event), which can occur while sleeping or awake. These flashbacks are different from memories in that they force the sufferer to feel like they are living through the event again. An estimated 10 to 15 percent of Vietnam vets experienced PTSD at some point. Because the disorder was so poorly understood in the 1960s and 1970s, the true number affected may be much higher. Certain situations can trigger flashbacks, causing PTSD patients to avoid things that may remind them of their trauma. Many vets with PTSD experience an overwhelming sense of negative feelings and hypervigilance, or constant alertness and unease about potential threats. PTSD is a leading risk factor for substance abuse and suicide among veterans.

Getty Images

Fifty Years Later, Vietnam is Still Teaching Us About Traumatic Brain Injury

Serious head injuries cause lasting damage and are, unfortunately, very common in combat. During the Vietnam War, frontline troops were at constant risk of traumatic brain injury (TBI) from shell fragments and shrapnel from explosions. A TBI occurs when a person suffers a severe blow to the head or the body, such as a car crash, resulting in an injury that can cause long-term or even permanent damage to the brain. TBIs cause short-term symptoms like headaches, dizziness, disorientation, and loss of consciousness. In the long term, severe TBIs can lead to cognitive issues like memory loss and may impact speaking ability. People with TBIs may also experience mental health effects such as depression and anxiety, vision changes, mood swings, and seizures. Vietnam veterans have been critical in improving our understanding of TBI. First launched in 1965, the Vietnam Head Injury Study investigates the long-term health impacts of TBIs in a cohort of over 1,200 Vietnam War vets. In the last five decades, the study has produced 150 papers as researchers continue to explore how TBIs impact the brain and why some people are more affected than others.

The Past

Hearing Loss and Tinnitus Are The Most Common Veteran Disability

Exposure to loud noise from explosions, gunfire, aircraft, and heavy machinery left many Vietnam War vets with permanent ear damage and hearing loss. One study found that 60 percent of service personnel exposed to explosions suffered some degree of hearing loss. Tinnitus. a condition that causes continuous ringing or buzzing in the ears, is the most common disability among all veterans. The condition, which is sometimes called a thief of silence, is caused by head injuries and noise damage. Tinnitus is closely linked to hearing loss as well as mental health issues, including PTSD, depression, and anxiety. The disease may not emerge until years after the initial injury. Although many people live normal lives with tinnitus, the condition can cause difficulty sleeping, concentrating, and processing language. Tinnitus has no cure, but noise suppression devices and behavioral therapy can help patients manage their symptoms.

History Extra

Exposure to Environmental Hazards Caused Long-Lasting Respiratory Issues

Exposure to dust, smoke, and other hazardous environmental elements throughout the war resulted in various respiratory problems in Vietnam vets. Rainbow herbicides like Agent Orange increase the risk of chronic respiratory illnesses like emphysema by 60 percent. In addition, a study of over 3.6 million Vietnam War vets found they are at a much higher risk than the general population of developing idiopathic pulmonary fibrosis. This rare disease causes scarring of the tissue surrounding the lung airways. The scarring, or fibrosis, causes the lungs to stiffen, making breathing difficult. Veterans who were exposed to Agent Orange were more likely to develop the condition. High blood levels of dioxin, an ingredient in Agent Orange, are also associated with a higher risk of developing lung cancer. Additionally, exposure to smoke, dust, and other environmental hazards during the war may be linked to chronic obstructive pulmonary disease (COPD). The condition causes chronic inflammation of the lung airways. Veterans of multiple wars recently became eligible to receive disability from the Veterans Affairs Office for three respiratory conditions that may be linked to Agent Orange exposure: asthma, rhinitis, and sinusitis.

AFP via Getty Images

Agent Orange Can Cause an Eruption of Skin Problems

A well-known side effect of exposure to Agent Orange is chloracne, an eruption of blackheads, cysts, and other skin lesions. Chloracne is also called metabolizing acquired dioxin-induced skin hamartoma, or MADISH. The chemical dioxin found in Agent Orange is so toxic it was used in the 2004 assassination attempt of former Ukrainian president Viktor Yushchenko, pictured above. Although he survived the poisoning, the toxin left him with permanent, disfiguring scars on his face. Civilians and troops exposed to high levels of dioxin through Agent Orange exposure suffered similar symptoms. Mild chloracne resembles ordinary acne, with oily skin and blackheads along the forehead and cheekbones. But in severe cases, the condition may spread to other parts of the body, including the armpits and groin area, leaving blisters, open sores, and significant scarring. Dioxin poisoning can also cause sweaty palms and feet, skin discoloration, and excessive hair growth.

James Gathany / CDC

Thousands of Soldiers Caught Infectious Diseases Like Malaria

In addition to combat-related injuries, many Vietnam War veterans were also exposed to infectious diseases that can have long-term health impacts. For example, more than 40,000 U.S. troops contracted malaria over the course of the war. When not properly treated, malaria can cause severe illness, kidney failure, seizures, and death. The high number of troops exposed to the disease led to malaria research that produced modern life-saving malaria drugs, like chloroquine and primaquine. Hepatitis was also a major health issue during the war. This viral infection causes inflammation of the liver. Vietnam war vets are at a uniquely high risk of hepatitis C infection, possibly due to exposure to infected blood in combat or a healthcare setting.

National Endowment For the Humanities

Many Vietnam Vets Live With Chronic Pain Their Entire Lives

Many Vietnam War veterans experience chronic pain related to injuries sustained during training or combat. Chronic pain is defined as pain that persists for longer than three months, either continuously or intermittently. Nearly two-thirds of vets report chronic pain, significantly higher than rates in the civilian population. Vietnam War vets are no exception. In Vietnam vets, chronic pain is usually related to bone, muscle, or nerve injuries during service and shrapnel wounds. Chronic joint and back pain are the most common types experienced by veterans. Chronic pain takes a serious toll on a patient’s mental health and is often diagnosed alongside mental health conditions like PTSD and depression.

VA Public Health.

Vietnam Vets Are at Higher Risk for Cardiovascular Disease

Research in the last 15 years has revealed a link between Agent Orange exposure and increased risk for certain cardiovascular diseases. Coronary heart disease, also known as ischemic heart disease, is a condition caused by plaque building up on the arteries, causing them to harden. These hard arteries may make it more difficult for blood and oxygen to flow from the heart to other parts of the body. If enough plaque accumulates, it can completely block the artery resulting in a heart attack. Coronary heart disease is common and one of the leading causes of death in the U.S. and worldwide. Family health history, poor diet, lack of exercise, and higher weights are the main risk factors for coronary heart disease. But, more recently, vets who were exposed to Agent Orange were found to be at an unusually high risk of the disease.

Council On Foreign Relations.

Mental Health Conditions Like Depression and Anxiety Plague Veterans

Vietnam War veterans deal with mental and physical health repercussions of their time in combat. Veterans experience mental health issues at rates far higher than the general population. As many as one in five vets suffer from PTSD, which is often associated with other mental illnesses. Depression rates among veterans are 5 times higher than in civilians. These mental health issues may be directly related to vets’ experiences during combat or a result of managing chronic physical health issues related to combat. Veteran suicide rates are also 1.5 times higher than civilian rates. A recent study found that Vietnam veterans have around 3 to 5 times the rate of psychological distress as non-veterans, with Black and Hispanic veterans reporting the highest rates of PTSD and depression.


Exposure to Agent Orange is Believed to Increase Diabetes Risk

Type 2 diabetes is a chronic disease in which the body either doesn’t produce enough of or respond to the hormone insulin, which helps the body process sugar (glucose) into insulin. Without enough insulin, the amount of glucose in the blood will rise to a dangerous level. In the late 1990s, research demonstrated a potential link between Agent Orange exposure and type 2 diabetes. The study found that Vietnam War veterans who were exposed to high levels of the chemical were nearly 3 times more likely to develop diabetes than veterans who hadn’t been exposed. Moreover, the high-exposure vets started showing symptoms of the disease younger age. Since then, additional research has confirmed the finding that Vietnam War veterans are at higher type 2 diabetes risk.

(AP Photo/Ben Margot)

Liver Disease May Also Be Linked to Agent Orange

According to the U.S. Department of Veterans Affairs, two diseases that affect the liver are among the 19 serious illnesses directly linked to Agent Orange exposure: Hodkin’s disease and porphyria cutanea tarda. Hodkin’s disease (also called Hodkin’s lymphoma) is a cancer of the lymphatic system, which produces white blood cells that protect the body against infections and disease. Lymph tissue is present in the lymph nodes, bone marrow, liver, and spleen. Hodkin’s disease that spreads to liver lymph tissue can cause liver damage. Porphyria cutanea tarda is a rare disease that causes severe blistering of the skin when exposed to sunlight. The condition results from liver dysfunction. More recently, a study found that many Vietnam vets were exposed to tiny parasites called liver flukes, which can cause liver disease and bile duct cancer decades after infection.

Biophoto Associates / Science Photo Library

Agent Orange Exposure Increased Birth Defect Risks

Nearly 50 years after the end of the war, the children of its survivors still live with the consequences. Vietnamese citizens and Vietnam War vets reported increased instances of miscarriages, stillbirths, and birth defects in infants born to parents who were exposed to Agent Orange. But it would be decades before the U.S. government officially recognized that at least one birth defect, spina bifida, is associated with exposure to the chemical. Spina bifida is a condition in which the spinal cord does not develop properly. It may cause severe complications, including spine and skeletal abnormalities and paralysis. One analysis found that the risk of birth defects in babies born to vets exposed to Agent Orange was one-third higher than that for vets not exposed. Despite some evidence linking dioxin limb abnormalities and cleft palates, the U.S. does not recognize these as being associated with the chemical.

International Business Times.

Agent Orange May Increase the Risk of Prostate and Other Cancers

Several cancers have been linked to Agent Orange exposure, including prostate cancer, bladder cancer, and soft tissue sarcoma. Prostate cancer is one of the most common cancers in men, and there is evidence that troops exposed to the herbicide are at increased for the disease. The prostate is a small gland that produces fluid that promotes sperm health. Bladder cancer was only acknowledged as a potential side effect of Agent Orange less than two years ago, after years of pushing from veterans and advocacy groups. Soft tissue sarcomas are rare cancers that affect the body’s soft tissues, including muscles, fat, blood vessels, and tendons. There are over 50 types of soft tissue sarcomas that can occur anywhere in the body. Exposure to dioxin and other herbicides may increase the risk of certain soft tissue sarcomas.

Military Times.

Certain Types of Blood Cancers Have Been Linked to Agent Orange

The U.S. government recognizes a link between Agent Orange exposure and at least four distinct blood cancers, including some leukemia, multiple myeloma, and non-Hodkin’s lymphoma. Chronic B-cell leukemia is a type of cancer that affects B cells, immune cells that produce antibodies to fight off infections. This cancer weakens the immune system and increases susceptibility to infections and other illnesses. Multiple myeloma affects the plasma, which is the liquid part of the blood. Plasma cells are produced in the bone marrow. In people with multiple myeloma, affected plasma cells accumulate in the bone marrow, pushing out healthy immune blood cells and forming multiple tumors in the bones. Like Hodkin’s disease, Non-Hodgkin’s lymphoma is a cancer that affects the lymphatic system. But the disease affects different types of white blood cells, and Non-Hodkin’s is typically more difficult to treat.

Getty Images / iStock

Sleep Disorders Like Insomnia Are Common Among Vietnam Vets

Sleep problems are common among active duty military and veterans. Other health conditions associated with combat can worsen sleep symptoms. For example, over 90 percent of Vietnam War veterans with PTSD reported experiencing insomnia. People who are successfully treated for PTSD may suffer from lingering sleep issues. Difficulty falling or staying asleep can lead to long-term negative health impacts and worsening overall well-being. Obstructive sleep apnea is also more prevalent in vets with PTSD than in the civilian population or vets without PTSD. This condition is caused by an interruption in breathing when the airway is temporarily blocked, which results in snoring. Sleep apnea is associated with difficulty sleeping, fatigue, moodiness, and high blood pressure. In addition, the condition is a risk factor for other serious diseases, including cardiovascular disease.

Technology Networks.

Nerve Damage From Agent Orange Can Cause Numbness and Tingling

Peripheral neuropathy is a type of nerve damage that can cause pain, numbness, tingling, and weakness in the extremities. The peripheral nervous system is made up of nerves that extend out from the brain and spinal cord to the rest of the body. These nerves carry communications between every part of the body and the brain, including pain and heat sensations. In people with peripheral neuropathy, nerve damage interrupts this communication, causing touch or heat sensitivity, difficulty maintaining balance, and muscle weakness. Peripheral neuropathy has been linked to exposure to dioxin in Agent Orange for about a decade. The condition is commonly associated with diabetes but can occur separately from it.


Agent Orange Has Been Linked to Hormonal Disruptions

In 2021, hypothyroidism was added to the list of presumptive diseases linked to Agent Orange exposure that can receive veteran disability benefits. The addition was the latest in the chemical’s enduring legacy of hormone disruption that still affects babies born in Vietnam. Agent Orange exposure is known to cause hormonal imbalances, specifically in the hormone DHEA, which supports the normal production of sex hormones testosterone and estrogen. As recently as 2017, babies born in parts of Vietnam that were most heavily contaminated with the herbicide have much higher DHEA levels than normal. Veterans and civilians directly exposed to Agent Orange have an increased risk of endocrine diseases, which affect hormone-producing glands like the pancreas and thyroid. For example, Vietnam veterans are at higher risk of a rare thyroid condition called Graves’ disease, which causes anxiety, tremors, weight fluctuations, and bulging, irritated eyes.

Parkinsons Foundation.

Research Suggests Parkinson’s Disease May Be Linked to Agent Orange

Like hypothyroidism and bladder cancer, parkinsonism (the symptoms of Parkinson’s disease) is a relatively new addition to the list of diseases presumed to be caused by exposure to Agent Orange that receive veteran benefits. The change came more than a decade after the symptoms were found to be associated with exposure to the toxin. Parkinson’s disease is a neurodegenerative condition that results from the dysfunction or death of motor neurons, brain cells that control body movements. The loss of these neurons causes tremors, slow movements, muscle stiffness, and difficulty walking, speaking, and carrying out involuntary movements like blinking. Parkinson’s disease is progressive, which means it worsens over time, and there is currently no cure.

Dick Swanson / The LIFE Images Collection / Getty Images

Another Toxic Chemical Called Agent Blue Also Caused Health Issues

Although many of the long-term health impacts of the Vietnam War are related to Agent Orange, the herbicide wasn’t the only toxic chemical troops and civilians were exposed to during the war. Millions of gallons of so-called rainbow herbicides were used to wipe out crops and forests, exposing approximately 4.8 million people to the chemicals’ damaging effects. Agent Blue was another herbicide used during the Vietnam War that contained arsenic, a highly toxic chemical once commonly used as a deadly poison. Those who survive arsenic poisoning face a lifetime of health issues. Arsenic exposure is linked to skin, bladder, and lung cancers, neuropathy, cardiovascular disease, and diabetes. Like Agent Orange, Agent Blue remains in the soil and water of areas dusted with the chemical, ensuring its devastating effects last for generations.

Where Do We Find This Stuff? Here Are Our Sources:

Veterans’ Diseases Associated with Agent Orange

Agent Orange in Vietnam

Agent Orange and Cancer Risk

What Is Agent Orange?

15 Diseases Caused by Agent Orange Exposure

Long-Term Agent Orange Effects