We wrote last month about the Agency for Toxic Substances and Disease Control’s withdrawal of a report that omitted important information about the contamination of the Camp Lejeune military base in North Carolina – a move that seemed to indicate better prospects for the hundreds of former base residents who used contaminated water and are seeking damages for health problems. On Saturday, however, the National Research Council released a report (commissioned by the U.S. Navy at the direction of Congress) that concludes it may be impossible to know whether contaminants can be linked definitively to diseases like birth defects, childhood leukemia, liver damage, and breast cancer.
Now, five scientists who have served on committees advising ATSDR about how to move forward with Camp Lejeune health studies have come out with a statement saying the NRC report “reached puzzling and in some cases erroneous conclusions.” Here is their complete statement:
We are disappointed and dismayed at the report titled, “Contaminated Water Supplies at Camp Lejeune – Assessing Potential Health Effects,” released by the National Research Council (NRC) on Saturday, June 13, 2009. This report was two years in preparation by scientists, many of whom we know and respect, that reached puzzling and in some cases erroneous conclusions. We are aware of the complex situation regarding availability and access to data, and each of us has participated in committees advising the Agency for Toxic Substances and Disease Registry (ATSDR) about how to move forward with health studies. It is our view that the Marines and their families who were exposed to dangerous chemicals in the Camp Lejeune drinking water over several decades deserve to know if this exposure has had an effect on their health. The most direct way to assess this is to conduct valid epidemiologic studies of those who lived or worked there, and we urge ATSDR to continue their efforts to carry these to conclusion. The overall judgment about the impact of the chemicals on health can then be informed both by the general scientific literature the NRC reviewed, plus findings from directly relevant studies of the exposed population.
Specific areas where we disagree with the NRC report include their assessment of the water distribution modeling, their assessment of the risk caused by exposure to two of the principal contaminants (TCE and PCE), and the likelihood of conducting meaningful epidemiologic studies in this setting. We view the water modeling undertaken by ATSDR and its consultants as “state-of-the-art” and worth carrying through to completion so that it can be used in the on-going and proposed health studies. There may be uncertainties about specific levels of exposure for individual households or people, but these can be described in the study results. We also agree with the National Toxicology Program that TCE and PCE are “reasonably anticipated to be human carcinogens” and reject the characterization of the evidence as “limited/suggestive” as presented in the NRC report. We note that this characterization of solvent mixtures actually steps back from previous work done by the National Academy of Sciences Institute of Medicine in 2003. Finally, we disagree with the thrust of the NRC report that it is unlikely that scientifically informative epidemiologic studies of the Camp Lejeune population can be done. The NRC doubts that “definitive” answers can come from any study, but this sets the bar too high – no one study can provide definitive answers, and all studies must be considered in the light of other scientific evidence. From our experience in other settings, we believe that useful studies of the Camp Lejeune population are possible and furthermore that the Marines and their families deserve our government’s best efforts to carry them out.
For these reasons, we urge the ATSDR to consider this particular NRC report in the context of other expert advice they have received during the past decade and the competent work already done by agency staff. Since the NRC report is at such variance with the recommendations of other water modeling and epidemiologic experts, we believe it should not stand as the final word.
Ann Aschengrau, Sc.D., Professor, Associate Chair of the Department of Epidemiology, Boston University School of Public Health
Richard Clapp, D.Sc., MPH, Professor, Boston University School of Public Health
David Ozonoff, MD, MPH, Professor and Chair Emeritus of the Department of Environmental Health, Boston University School of Public Health
Daniel Wartenberg, Ph.D., Professor, Environmental and Occupational Medicine, Robert Wood Johnson Medical School
Sandra Steingraber, Ph.D., Scholar in Residence, Ithaca College
Senator Kay Hagan of North Carolina (where Camp Lejeune is located) also issued a press release stating that she “cannot stand behind the validity” of the study. She also said, “The resolution of this issue cannot be held hostage to additional scientific studies that may not tell us anything more than we already know.”