A Trust Betrayed (15 page)

There were other criticisms, including a complaint about the
ATSDR
saying that personnel involved in training exercises could be exposed to harmful contaminants without being specific about what areas of the base and what chemicals posed that threat. Of course, if the Marine Corps had provided full information about contaminated sites, the health agency could have given more precise assessments.
ATSDR
's scientists pressed on, and despite another delay when “the agency's entire file on Camp Lejeune was mistakenly thrown out—tossed in the trash—by a contractor,” as a House investigation found in 2010, a final version of the Public Health Assessment was released to the public in August 1997.
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The report said there were ten sites out of ninety-four potential areas of contamination on the base that had potential for human exposure. And it found three past health hazards: volatile organic compounds in three drinking-water systems (Tarawa Terrace, Hadnot Point, and Holcomb Boulevard), lead in tap water in buildings with lead plumbing, and exposure to pesticides in soils at the former day-care center. On the drinking-water exposures, the agency said solvents including
TCE
and
PCE
“have been documented
over a period of 34 months, but likely occurred for a longer period of time, perhaps as long as thirty years.”

The biggest concern to the scientists was the fetal exposures. The agency said it had already begun investigating “pregnancy outcomes” at the base and had identified about 6,000 infants whose mothers lived in housing with contaminated water supplies. It had found a “statistically significant” decrease in birth weights for males in that group, particularly among babies born to mothers who lived in areas served by the Hadnot Point water system, but also among babies whose mothers lived at Tarawa Terrace. Low birth weights, generally below five and a half pounds, are warning signs of other potential health problems.
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Surprisingly, the
ATSDR
did not express concern about the poisoned aquifer at Camp Lejeune. “Groundwater contamination on base is considered no apparent public health hazard because several programs are in place to detect, monitor, and predict groundwater contamination flow before people could be exposed to any contaminated drinking water,” the agency said. That finding seemed to conflict with a number of previous reports about the base aquifer, such as the 1988 confirmation study for the Navy by Environmental Science and Engineering, Inc., that described “extremely elevated” levels of benzene in water supply wells at Hadnot Point. And it seemed as if the agency was unaware of the large pools of fuel that that were floating on top of the shallow aquifer, fed by leaks from underground storage tanks and pipes at the rate of 1,500 gallons a month.

Nevertheless, the release of the report—with the startling news that federal health scientists had evidence that babies born at Camp Lejeune might have been harmed by contaminated drinking water—generated some newspaper stories and TV coverage in eastern North Carolina. On September 2, 1997, about a month after the report became public, the manager of the environmental
restoration program at the base, Kelly Dreyer, distributed a memo saying that to date, “two individuals have contacted Camp Lejeune regarding abnormalities in their children.” One was a woman who lived at the base in the early 1980s and had two children born with birth defects, Dreyer said. The other was Jerry Ensminger, whose daughter Janey had been conceived at Camp Lejeune in 1976 and died of leukemia in 1985.
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Ensminger, it turned out, had been sitting down to dinner in front of his TV one evening in August 1997 when he caught a report about the
ATSDR
study on a local North Carolina station. When he heard that children at Camp Lejeune had been exposed to cancer-causing chemicals in the water, Ensminger dropped his plate of spaghetti on the floor and stood in stunned silence. The former drill instructor, now retired from the Marine Corps after twenty-five years of service, had agonized for twelve years about his daughter's inexplicable death, and at last there was a possible explanation. “It was like God saying to me, here is a glimmer of hope that you will find your answer,” Ensminger said.

Unknown to Ensminger at the time, the Defense Department was doing everything it could to avoid finding out how its pollution might have affected babies and children. It pushed hard against the
ATSDR
's proposal to study the health of infants born at Camp Lejeune, arguing that a lengthy and expensive investigation would still be inconclusive no matter what was found.

The director of federal programs for the
ATSDR
, Mark Bashor, tried to make a case for the study at the highest levels of the Pentagon. On July 16, 1997, he wrote to Elsie Munsell, deputy assistant secretary of the Navy for environment and safety, expressing concerns about the Defense Department's resistance to investigating possible childhood cancers linked to solvents in the water at Camp Lejeune. “It appears that some of this reluctance may be attributable
to a lack of understanding regarding the need and requirement for the study,” Bashor wrote.
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“
ATSDR
's investigation indicates that more than 6,000 children were probably exposed to
TCE
and
PCE
in utero
between 1968 and 1985 in base housing at Camp Lejeune,” Bashor explained. He went on:

Based on an epidemiologic study recently completed by the Massachusetts Department of Public Health in the town of Woburn, Massachusetts, there is evidence indicating that these children exposed to
TCE
and
PCE
may be at increased risk of adverse health effects. The Woburn study observed an association between the mother's potential for exposure to
TCE
and
PCE
in drinking water and childhood leukemia, particularly when exposure occurred during pregnancy. To our knowledge, no other study has explicitly examined the potential association between the environmental contaminants and childhood leukemia. Although the solvent mixture was slightly different at Woburn than at Camp Lejeune, the levels of solvents found in the drinking water at Camp Lejeune were comparable to, or higher than, the solvents found in wells at Woburn.

Bashor acknowledged that no single study could prove a connection between maternal exposure to the solvents and diseases in the women's offspring, but because of the findings in Woburn, he wrote, “we feel that there is a substantial possibility that the children exposed to solvents
in utero
at Camp Lejeune are at increased risk of childhood cancer.”

A full description of the study proposal attached to Bashor's letter described childhood leukemia as a disease in which white blood cells accumulate but fail to reach functional maturity, leaving the
victim susceptible to infection, hemorrhage, and “inadequate cellular nutrition.” At the time, the proposal said, there was an annual rate of 7.1 cases per 100,000 children under age four, and the disease was fatal within five years for about a third of the children diagnosed with leukemia before age ten and for half of all victims of the disease diagnosed after age ten.

There had been studies done up to that point linking leukemia to solvents, but most of those involved occupational exposures. Only three studies—all conducted at Woburn—focused on leukemia in children, and the last found “a very strong association” between
TCE
exposure in the womb and childhood leukemia. At Camp Lejeune, there were about 6,000 babies exposed to the solvent during gestation and about 6,000 others born to mothers who lived in areas not affected by the contamination. “This existing database presents a unique opportunity to examine this potential association in a cohort of moderate size where exposure is relatively well-defined,” the study proposal stated.

The
ATSDR
's Jeanetta Churchill also sought support for the study from the White House through the Office of Management and Budget. Leukemia, her report said, was the most common cancer occurring in childhood and was of “tremendous public health concern.” The studies in Woburn had shown an eightfold increase in risk among offspring of women exposed to
TCE
in water during pregnancy, it said.

“Epidemiology is not an exact science that easily lends itself to proving a definite cause-effect relationship between an exposure and outcome,” Churchill's appeal to the
OMB
said. “Before the scientific community can accept the hypothesis that maternal exposure to
VOC
s causes childhood leukemia or birth defects, the cause-effect relationship must be seen consistently among studies. Therefore, this proposed project has the potential to greatly contribute to the body of scientific knowledge by possibly
showing a consistent association between the exposure and outcome.”
¹²

The
ATSDR
's plan was to first locate as many of the children born to residents of the base between 1968 and 1985 as possible. The parents who were contacted would be asked in an interview about health problems to identify those children with cancer or birth defects. Any cases reported would then need to be verified through medical records. But the health agency faced a real challenge—the database of births at Camp Lejeune did not include Social Security numbers for either the children or their parents. So the
ATSDR
decided it would try to have the families come to them “by widely advertising our desire to locate individuals who were born, or whose children were born, at the USMC Camp Lejeune between 1968 and 1985 in publications targeting military personnel.” If the agency did not hear from 80 percent of the 12,000 families with children born at the base hospital during those seventeen years, it would try to track enough others to reach that percentage of respondents, with help from the Navy and possibly credit-rating agencies like Equifax, the proposal said.
¹³

The cost of the survey would be $1.6 million in fiscal year 1998 and another $190,000 in fiscal year 1999, for a total of $1.79 million, Bashor told Munsell in his letter. He argued that under the Superfund law, the Defense Department was responsible for covering those costs.

The Pentagon pushed back hard. Elsie Munsell sent back a terse rejection letter saying that “the volatile organic chemicals found in the water supply under investigation came from an off base source, ABC One Hour Cleaners. According to our investigation, this off site source of contamination is a National Priorities Listed Site under the jurisdiction of the
EPA
. Therefore, in accordance with
CERCLA
107(a), it is more appropriate for you to seek funding for the study from the responsible party.”
¹⁴

In August 1997, Navy Environmental Health Center epidemiologist Jeffrey Hyman picked apart the
ATSDR
's study proposal in a ten-page review. Hyman started out by citing weaknesses in the Woburn studies—the sample sizes were too small, there were other contaminants in the water besides
TCE
, and there were other risk factors that were not evaluated, such as a father working in an industry with chemical exposures or a mother who used alcohol during pregnancy. “Unfortunately, every problem that existed in Woburn and limited the conclusions . . . exists in at least as severe of a form in the Camp Lejeune population,” he said. Even if the
ATSDR
managed to contact 83 percent of the 12,000 families with children born at the base—“which seems virtually impossible,” Hyman noted—“this study would have (at best) no more power than the Woburn studies,” he wrote.
¹⁵

The Navy's epidemiologist also argued that
PCE
, not
TCE
, was the major contaminant in the Tarawa Terrace water system, while the opposite was true at Woburn. Plus, Hyman said, there would be no way to determine through telephone interviews how much water people drank at Camp Lejeune; moreover, the rapid changes in the population at the base made the control group for the study suspect.

“In summary, it is very difficult to see how, even if successfully completed, this study could contribute anything to our understanding of the relationship between
VOC
s and childhood leukemia,” Hyman wrote. The methodology, he said, was “extremely expensive, poorly thought out, has little chance of being successfully completed and providing useful information, and it lacks the detailed information that any competent funding agency would demand before considering it.”

Hyman recommended small “pilot studies” to determine if there was a problem with childhood leukemia at Camp Lejeune. The names of children born at the base could be checked against cancer
registries in states with high military populations, the records of military hospitals could be reviewed, and doctors who worked at Lejeune could be asked for their recollections about childhood cancer cases, he said. “These pilot studies would cost only a small fraction of the cost of the proposed
ATSDR
study,” Hyman said. And if they showed an excess of leukemia cases among children born at the base, “the Armed Forces Epidemiology Board should be asked to offer their opinion on the feasibility of conducting a large study in this population, given the known problems,” he said.

The Navy not only refused to provide money for
ATSDR
studies in 1998 and 1999, but it also refused to help locate residents of Camp Lejeune who gave birth at the base between 1968 and 1985. An official of the Defense Manpower Data Center, which keeps records on past and present military personnel, told the health agency that providing information from its database would violate the federal Privacy Act.
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