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Page: 1 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 listeners. 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 presents. ANNE DELANEY: Would any other group of veterans have had this, sort of, significant health study? Because it's a massive study. Page: 2 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 comprehensive. 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? Page: 3 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 Page: 4 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 Page: 5 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 areas. 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 higher. 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 ... Page: 6 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 Page: 7 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 dividends. 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 effect. Page: 8 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, dva.gov.au. And if Page: 9 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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