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The Hon Bruce Billson MP


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The Hon Bruce Billson MP
Interview – ABC Riverina with Anne Delaney, 7 September 2006, 8.40 am
Subject – Vietnam veterans health study

          ANNE DELANEY:             And ask any Vietnam veteran, or members of their
                                    family, and they will tell you that their health has
                                    suffered as a result of them being in the Vietnam
                                    conflict. Well, now we know that a study has
                                    detailed exactly what some of those health concerns
                                    are. The Minister for Veterans Affairs, Bruce
                                    Billson, is my guest this morning.

                                    Morning, minister.

          BRUCE BILLSON:            Good morning to you, Anne and ABC Riverina

          ANNE DELANEY:             Now this is a huge study, I think. the number of
                                    participants alone. How many men were involved in
                                    this study?

          BRUCE BILLSON:            More than 59,000 male Vietnam veterans were
                                    covered in the study for a period of up to 35 years.
                                    There's about 1.9 million person years canvassed in
                                    this work to arrive at the conclusions that the report

          ANNE DELANEY:             Would any other group of veterans have had this,
                                    sort of, significant health study? Because it's a
                                    massive study.
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BRUCE BILLSON:   Well, there's no-one more interested than me and ...
                 or the Department of Veterans Affairs in trying to
                 understand what the impact of military service has
                 on our veterans. There's quite a range of studies we
                 undertake. I think the most recent one that I
                 released prior to this was an examination of the
                 health impacts of people involved in the British
                 nuclear testing; and that went over many years, and
                 canvassed a whole range of considerations. And
                 actually, Anne, it went beyond the military
                 personnel, and looked at the health impacts of
                 public servants, contractors, and the like. So it's not
                 unusual we do these studies. But this one's
                 particularly significant.

ANNE DELANEY:    Now we know the studies called the Australian
                 Vietnam Veterans Mortality and Cancer Incidence
                 Study [sic]. Let's take a look at the mortality area of
                 it first, rather than the cancer. Because I think the
                 whole studies come out in three volumes, that it's so

BRUCE BILLSON:   Yes. There's actually a fourth to come as well,
                 because it's ... that one looks at Dapzone. Some of
                 your listeners would know that was an anti-malarial
                 drug that many of our soldiers took to protect them
                 against malaria. We've just seen what may arise out
                 of an examination of that as well.

ANNE DELANEY:    So generally, mortality for Vietnam veterans, what
                 did the study find?
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BRUCE BILLSON:   Well, the mortality rate was interesting, in that it
                 found a six per cent lower mortality rate for
                 Vietnam veterans compared to the general
                 Australian population of men around a similar age.
                 Now, that might strike you as odd.

ANNE DELANEY:    [Inaudible] surprising.

BRUCE BILLSON:   Well, it is and it isn't, Anne. I guess the key thing
                 to focus on, though, is what we call the healthy
                 soldier effect. The people that may have had
                 congenital conditions that are a part of the broader
                 community, those people aren't able to join the
                 military. So by the selection process, the military
                 recruits the most healthy men, in the case of
                 Vietnam, that are available within the population.
                 What's clear is, the lower mortality rate seems to
                 have a lot to do with the better health status of the
                 men when they joined the military; because the
                 other study actually highlights a higher rate of
                 cancer incidents and cancer related loss of life; but
                 other aspects that might take people's lives are
                 lower amongst Vietnam veterans. So it's quite an
                 interesting thing. But your listeners had best bear in
                 mind what's known as the healthy soldier effect.

ANNE DELANEY:    Let's take a look at that cancer death rate. How
                 does it compare to the general population?

BRUCE BILLSON:   Well, it varies across different cohorts of ... and
                 different kinds of cancers. There's a higher rate of
                 cancer, sort of, oral-related cancers that may be
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                 associated with alcohol, smoking, excessive
                 exposure to sun. Those areas are where there's a
                 higher rate of mortality, or cancer incidents for
                 Vietnam veterans. What we find, though, is there's
                 other areas - worrying areas - that we're focused on.
                 Tragic events like the suicide rate actually shows
                 that Vietnam veterans suicide rate is no different at
                 all from the general population; but one Vietnam
                 veteran taking their own lives is one too many. But
                 I know there's a perception out there that the self
                 harm and suicide rate's much higher.

ANNE DELANEY:    Well, just on that for a moment with the suicide
                 rate, certainly, this study shows that the actual
                 numbers don't differ very much from the wider
                 population; but generally, the mental health of
                 Vietnam veterans, was that looked at?

BRUCE BILLSON:   Yes it was. And one of the thing's that's probably
                 most encouraging is that we had a sense - well, not
                 a sense - we've known from earlier studies that
                 Vietnam veterans seems to be more disposed to
                 having cancers and emotional and mental health-
                 related conditions. And that would make some
                 sense, given the very demanding - both physically
                 and emotionally - the demanding character of their
                 service in Vietnam. So we've had programs
                 available, early intervention programs, and for
                 many years ... and they seem to be making quite a
                 significant difference.

                 So whilst things like the cancer incident rate is
                 actually higher, the loss of life because of cancer is
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                 actually lower, which suggests that that early
                 identification,   the    non-liability-free  cancer
                 treatment that's available for all Vietnam veterans
                 seems to be making quite a profound difference.
                 And even in the emotional health area, outstanding
                 services like the Vietnam veterans counselling
                 service, that provides free emotional and
                 counselling support for Vietnam veterans. Those
                 early intervention and preventative programs are
                 incredibly important, and I think this study shows
                 that we must continue to focus our work in those

ANNE DELANEY:    Was there any difference across the services. Navy,
                 army, and air force.

BRUCE BILLSON:   Yes, there was. There was a couple of incidences,
                 and again, the study points to a couple of interesting
                 findings. I mean, the navy veterans suffered higher
                 levels of poor health outcomes compared to their
                 army and air force personnel. The nature of those
                 conditions, many of them seem to have been related
                 to the work environment itself; you know, people
                 being on naval ships; many of the guys, gentlemen,
                 are just running around in their shorts, so there's
                 issues about skin cancers and the like that are

                 Smoking related issues ... and the smoke in
                 contained work environments. Interesting to look at
                 dioxin. I know a number of your listeners would be
                 aware that dioxin exposure has been a focus of ...
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ANNE DELANEY:    That's been quite a concern.

BRUCE BILLSON:   Yeah it is. And one of the things that was
                 interesting in this report is that we looked at
                 whether any particular ships had higher rates of
                 incidents of cancer or other health impacts; or
                 whether the amount of time spent in Vietnam
                 waters actually had a greater impact on the health of
                 navy personnel.        Interestingly, nothing came
                 through that suggested that there was a higher
                 degree of dioxin exposure from the consumption of
                 water that had been pot... drinking water that had
                 been created out of the estuaries and the airport
                 facilities. Nothing emerged there, but we continue
                 to look at that area, because I know it is a particular
                 concern to listeners and veterans particularly.

ANNE DELANEY:    Now I suppose some of the big things that you can
                 use this report for is, certainly, the Vietnam
                 veterans themselves can learn from it, they can
                 almost feel vindicated by some of the studies
                 results. But how will this study influence how,
                 perhaps, we deal with the other soldiers and the
                 sailors and the air force members of ... today, who
                 might be in Iraq or Afghanistan or Indonesia. How
                 do we use this information to better look after the
                 next generation of veterans?

BRUCE BILLSON:   Anne, we've got so much to thank our Vietnam
                 veterans for. Not only their service, but the insights
                 that they've already shared with the nation and with
                 their colleagues. It was actually the Vietnam
                 veterans themselves that recognised the need for the
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counselling service, and that's now a service that's
available to all veterans, all serving members of the
ADF as well, and for the sons and daughters of
Vietnam veterans.

So that 1800 011 046 Vietnam veteran counselling
service is an example of how, once we've identified
these higher occurrences of certain conditions,
services and programs need to be put in place to
respond to those.

And the early intervention is key, Anne. We've
seen clearly that early screening and treatment is
having a significant impact. I've indicated I want to
do more work in the area of prostate cancer. That
was significant hi... significantly higher than the
general population. Your listeners would know
more people die with prostate cancer, rather than
from it; and that some of the ... there's a debate
within the medical community about the benefits
screening. But I want to know more about that.
Because these studies certainly show that early
screening, early treatment, early intervention pays

The other thing, Anne, which is the report we
haven't talked about, is the one that looks
specifically at the national service veterans. Those
veterans actually provided the perfect control group,
in that to j... to be a nasho [sic], to be accepted, you
had to meet a certain level of health requirement,
and therefore, all Nashos had that healthy soldier
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                 But only some of the Nashos actually went and
                 served in Vietnam. So we're able to do a direct
                 comparison between like men, of equal health
                 status, some who served and some who didn't; and
                 that shows us, very clearly, that military service,
                 and particularly combat service in Vietnam does
                 have adverse health effects; and that validates the
                 fact that we have a repatriation system that provides
                 a ... recognises a higher duty to those veterans that
                 have been in warlike circumstances.

                 This report is quite internationally significant in
                 drawing out that very clear distinction; and the
                 numbers are quite profound.

ANNE DELANEY:    Minister, good to talk to you this morning. Thank
                 you very much.

BRUCE BILLSON:   Thank you, Anne.

ANNE DELANEY:    Bruce Billson, who is the Minister for Veterans
                 Affairs this morning, taking a look at the Vietnam
                 veterans health study. It's a big one. Mortality and
                 cancer incident study. You can find out more, too.
                 You can go to the website. DVA, which is
                 Department of Veterans Affairs, And if
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you click on some links around the
website - just follow the links - and
you should be able to find yourself a
copy of the report to have a look at.
And that number again, the
counselling number, 1800 011 046.
1800 011 046.

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