![]() ![]() The toxicologic evidence was strongest for the associations between trichloroethylene (TCE) and kidney cancer and between PCE and kidney cancer. These conditions were included in the legislation because of evidence presented in the 2009 National Research Council (NRC) report, which concluded that there was “limited/suggestive evidence of an association” between chronic exposure to solvents, particularly perchloroethylene (PCE), and cancers of the breast, bladder, kidneys, esophagus, and lungs (NRC, 2009). ![]() The Janey Ensminger Act lists eight malignant neoplasms (esophageal cancer, lung cancer, breast cancer, bladder cancer, kidney cancer, leukemia, multiple myeloma, and non-Hodgkin’s lymphoma) and myelodysplastic syndromes among the 15 conditions covered by the act. Discussion of VA’s decision-making process for the health conditions listed in the act, including screening and secondary health conditions, is presented in Chapter 5. ![]() Where applicable, algorithms have been revised to highlight the committee’s suggested changes. The description and discussion of each outcome includes a brief overview, a review of the documentation and algorithm, and the committee’s recommendations for improvement. These other outcomes are presented here in the same order as in the guidance: cancer, scleroderma, miscarriage and infertility, and hepatic steatosis. These conditions are detailed in the VA guidance and accompanying algorithms to help clinicians and administrators make decisions about whether or not veterans and family members are eligible for health care benefits under the Camp Lejeune Program. Department of Veterans Affairs (VA) will pay for the treatment of 13 other medical conditions specified in the Janey Ensminger Act. ![]() In addition to the renal toxicity and neurobehavioral effects discussed in the preceding chapters, the U.S. ![]()
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