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Abstract
BackgroundTwo drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985.MethodsWe conducted a retrospective cohort mortality study of 4,647 civilian, full-time workers employed at Camp Lejeune during 1973–1985 and potentially exposed to contaminated drinking water. We selected a comparison cohort of 4,690 Camp Pendleton workers employed during 1973–1985 and unexposed to contaminated drinking water. Mortality follow-up period was 1979-2008. Cause-specific standardized mortality ratios utilized U.S. age-, sex-, race-, and calendar period-specific mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune and Camp Pendleton workers and assess the effects of estimated cumulative contaminant exposures within the Camp Lejeune cohort. Ground water contaminant fate/transport and distribution system models provided monthly estimated contaminant levels in drinking water serving workplaces at Camp Lejeune. The confidence interval (CI) indicated precision of effect estimates.ResultsCompared to Camp Pendleton, Camp Lejeune workers had mortality hazard ratios (HRs) >1.50 for kidney cancer (HR = 1.92, 95% CI: 0.58, 6.34), leukemias (HR = 1.59, 95% CI: 0.66, 3.84), multiple myeloma (HR = 1.84, 95% CI: 0.45, 7.58), rectal cancer (HR = 1.65, 95% CI: 0.36, 7.44), oral cavity cancers (HR = 1.93, 95% CI: 0.34, 10.81), and Parkinson’s disease (HR = 3.13, 95% CI: 0.76, 12.81). Within the Camp Lejeune cohort, monotonic exposure-response relationships were observed for leukemia and vinyl chloride and PCE, with mortality HRs at the high exposure category of 1.72 (95% CI: 0.33, 8.83) and 1.82 (95% CI: 0.36, 9.32), respectively. Cumulative exposures were above the median for most deaths from cancers of the kidney, esophagus, rectum, prostate, and Parkinson’s disease, but small numbers precluded evaluation of exposure-response relationships.ConclusionThe study found elevated HRs in the Camp Lejeune cohort for several causes of death including cancers of the kidney, rectum, oral cavity, leukemias, multiple myeloma, and Parkinson’s disease. Only 14% of the Camp Lejeune cohort died by end of follow-up, producing small numbers of cause-specific deaths and wide CIs. Additional follow-up would be necessary to comprehensively assess drinking water exposure effects at the base.
Highlights
Two drinking water systems at U.S Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985
Diseases of secondary interest were identified a priori based on information from literature reviews suggesting possible associations with the contaminants or with solvents in general: aplastic anemia, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), kidney and liver diseases, Parkinson’s disease, and cancers of the connective tissue, brain, pancreas, oral cavity, pharynx, lung, larynx, prostate, breast, colon and rectum [2,4,5,6,7,13,14,15]. Because this was a data linkage study with no smoking information, we evaluated smoking-related diseases not known to be associated with the contaminants to assess possible confounding: cardiovascular disease, chronic obstructive pulmonary disease (COPD) which includes emphysema and chronic bronchitis, and stomach cancer
The Camp Lejeune and Camp Pendleton cohorts were similar on type of occupation, number of months employed at either base, and percent with at least a high school education, but differed somewhat on race and sex (Table 2)
Summary
Two drinking water systems at U.S Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. United States Marine Corps (USMC) Base Camp Lejeune is located in Onslow County, North Carolina. Samples taken during 1980 through 1985 at Camp Lejeune detected solvents in drinking water supplied by the Hadnot Point (HP) treatment plant serving the main area (“mainside”) of the base where most workplaces were located. The HP supply wells were contaminated by an on-base landfill used for chemical dumping as well as underground storage tank leaks and waste disposal practices at the base’s industrial area [1]. The primary contaminant in the HP distribution system was trichloroethylene (TCE) with a maximum detected level of 1,400 micrograms per liter (μg/L). The maximum level of tetrachloroethylene (PCE) in the HP drinking water was 100 μg/L and benzene was detected. Trans-1,2-dichloroethylene (DCE) and vinyl chloride were present in the HP system due to the degradation of TCE in ground water [1]
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