ATSDR assessment of the evidence for the drinking water contaminants at Camp Lejeune and specific cancers and other diseases
Published Date:January 13, 2017
Description:The Agency for Toxic Substances and Disease Registry (ATSDR) has a unique mandate under the Superfund laws to assess the presence and nature of health hazards at specific Superfund sites, to help prevent or reduce further exposure and the illnesses that result from such exposures, and to expand the knowledge base about health effects from exposure to hazardous substances. As part of its mandate, ATSDR has completed several epidemiological studies to determine if Marines, Navy personnel and civilians residing and working on U.S. Marine Corps Base Camp Lejeune were at increased risk for certain health effects as a result of exposure to water contaminated with volatile organic compounds (VOCS). These studies, two retrospective cohort mortality studies of Marines/Navy personnel and of civilian workers, and a case-control study of male breast cancer among Marines (Bove et al. 2014a, Bove et al. 2014b, Ruckart et al. 2015), used data from extensive water modeling (Maslia et al. 2007, 2013) to reconstruct monthly levels of contaminants in the drinking water. These contaminants included trichloroethylene (TCE), tetrachloroethylene (PCE), benzene, 1,2-dichloroethylene (DCE) and vinyl chloride. The two cohort studies found elevated risks for several cancers, including cancers of the kidney, rectum, prostate, lung, leukemias and multiple myeloma, when compared to similar unexposed cohorts from U.S. Marine Corps Base Camp Pendleton. Parkinson disease was elevated among civilian workers at Camp Lejeune but could not be evaluated in the study of Marines/Navy personnel due to small numbers. Findings from the case-control study suggested possible associations between male breast cancer and being stationed at Camp Lejeune and cumulative exposure to the contaminated drinking water but the study was limited by the small number of cases in the higher exposure categories.
ATSDR integrated the findings from its Camp Lejeune studies with findings from studies of other populations exposed occupationally or environmentally to the chemicals detected in the drinking water at Camp Lejeune: trichloroethylene (TCE), tetrachloroethylene (also known as perchloroethylene or PCE), vinyl chloride and benzene. The purpose was to assess the strength of the evidence supporting causality of adverse health effects from exposures to the drinking water contaminants at Camp Lejeune. This report represents ATSDR’s assessment of the state of evidence at this time.
For this assessment, ATSDR did not conduct any new meta-analyses. Instead, ATSDR reviewed the scientific literature on these contaminants and placed high weight on assessments conducted by other agencies mandated to evaluate the health effects of these chemicals: i.e., the U.S. Environmental Protection Agency (EPA 2011, 2012), the National Toxicology Program (NTP 2015) and the International Agency for Research on Cancer (IARC 100F, 2012; 106, 2014). High weight was also given to meta-analyses conducted by EPA (Scott and Jinot 2011) and other researchers. This report summarizes the evidence for 16 diseases for which there was at least some epidemiological evidence for an association with either TCE or PCE, the primary contaminants in the drinking water systems at Camp Lejeune. The report also assesses the evidence linking these diseases with vinyl chloride and benzene. Two additional diseases, lung cancer and cervical cancer, are not included in this report. ATSDR is currently updating its assessment of these two cancers and will publish the assessment at a later date.
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