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Authors: Mike Magner

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Political pressures were also taking a toll on the federal scientists most responsible for protecting the public against health threats of all kinds, including those in the environment. At the Centers for Disease Control and Prevention and its Superfund branch, the
ATSDR
, more than a dozen top managers and researchers had left between 2004 and 2006, and morale among the remaining staff was in the tank, according to a lengthy story published by the
Atlanta Journal-Constitution
on September 10, 2006. “You're seeing a gradual erosion of the scientific base, and that's very worrisome,” a former
CDC
director, David Sencer, told the newspaper. Sencer and four other past directors wrote a joint letter
to the director at that time, Julie Gerberding, saying they were alarmed by the depth of problems at the
CDC
, which had long been considered one of the premier public health agencies in the world. The paper had obtained a copy of the letter and included quotations from it in the story. “We are concerned that so many of the staff have come to us to express their concerns about the low morale in the agency,” the five former directors had written to Gerberding. “We are concerned about the inability of many of the partners to understand the direction in which
CDC
is headed.”
CDC
employees told the newspaper in interviews that one of the reasons for the low morale was “a general lack of confidence that
CDC
's leadership will ‘do the right thing' when faced with political pressure from Washington.”
14

If there was a sense that Washington was calling the shots at the
CDC
, it was most certainly felt among staff members at the health agency's stepchild, the
ATSDR
, which also was headquartered in Atlanta. Nearly all the tiny agency's studies dealt with the effects of pollution that had been caused by two of the most powerful forces in the nation's capital, the US military and corporate America. Researchers working on studies at the
ATSDR
had to know there would be hell to pay if they pressed too hard to link illnesses or deaths to contamination at a Superfund site where the Pentagon or Big Business had liabilities.

In the case of Camp Lejeune, the
ATSDR
was continually being bullied by the Navy. At one point in 2007, the Pentagon simply stopped providing funds for the computer modeling being done by the
ATSDR
to replicate the flow of contaminants at the base over several decades in order to better understand how many people had been exposed and at what levels. In May 2008, the
ATSDR
's deputy director, Thomas Sinks, was forced to remind Navy headquarters that it had not made its promised payments for the agency's studies at Lejeune in eight months. “You are requested to
provide full funding of $1,570,409 to
ATSDR
by June 1, 2008, and not hold these funds contingent upon final resolution of our project and budget tracking differences,” Sinks said in a letter to the Navy. After the Associated Press obtained Sinks's letter and reported that the military was stonewalling the
ATSDR
's studies at Lejeune, the Navy paid up, and officials dismissed the AP story as exaggerating a routine budgeting delay. Jerry Ensminger knew better. “In a nutshell, the
DOD
,
DON
, and the
USMC
do not want to see the water model for the Hadnot Point and the Holcomb Blvd. water distribution systems at Camp Lejeune to ever be completed,” he said in an e-mail to the
ATSDR
and others on May 29, 2008.
15

Yet in the midst of all this pressure, there was one senior scientist at the agency who was determined to see the Lejeune studies through to completion. Frank Bove had worked earlier in his career as an epidemiologist at the New Jersey Department of Health, spending years investigating the effects of industrial pollution on people in dozens of communities. He had earned a master's degree in environmental health science in 1984 and a doctorate in occupational health science and epidemiology in 1987, both at the Harvard University School of Public Health. But more important to his later career, Bove had majored in both political science and philosophy at the University of Pennsylvania and went on to study philosophy in graduate school at Boston University in the late 1970s. During that time, Bove had been an organizer in the Boston area on issues involving the environment, public health, housing, and welfare rights. With that background of social consciousness, he was not just a representative for the
ATSDR
sitting in dispassionately on more than two dozen meetings of the Community Assistance Panel set up in 2006 to give victims of Camp Lejeune's contamination input into the agency's studies. The hundreds of stories about children with cancer, babies born without
parts of their brains, former Marines dying of rare diseases, and cases of men with breast cancer had to have an impact on Bove, even with all his training as a scientist to develop strong evidence before drawing firm conclusions.

On June 23, 2008, Bove and a colleague at the
ATSDR
, Perri Zeitz Ruckart, issued a document that would give new hope to the victims of Camp Lejeune's poisoned water. It was a forty-page paper, with almost as many pages of attachments, entitled “An Assessment of the Feasibility of Conducting Future Epidemiological Studies at USMC Base Camp Lejeune.” Partly in response to the recommendations of an independent panel of scientists in 2005, and partly as a result of pressure from Lejeune victims through the Community Assistance Panel, the paper urged the
ATSDR
to expand its studies of Lejeune's contamination to include adults who had been exposed to the tainted water. So far, the agency had focused its research solely on the children who had been exposed to the contamination in their early years of development and on babies who had been exposed in utero.
16

Bove recommended both a mortality study and a cancer incidence study of Marines, Navy personnel, and civilian employees who had been stationed on Camp Lejeune between June 1975 and December 1985. The mortality study would assess “all causes of death” among those who had lived at the base during that ten-year period, while the cancer study would evaluate all confirmed cases of cancer in the study group, using state and federal cancer registries and the results of a separate health survey of former personnel at the base to be conducted under a congressional mandate. And in order to improve the credibility of the studies, the
ATSDR
would conduct the same surveys on Marines and civilian employees who had been stationed at Camp Pendleton in California from 1975 to 1985. This group would have the same type of population of former military personnel as the Camp Lejeune group, with one
key difference—the Camp Pendleton group had not been exposed to volatile organic compounds in its drinking water.
17

It would take some time for Bove's recommendations to be digested by leaders of the
ATSDR
and its parent agencies—the
CDC
and the Department of Health and Human Services—as well as by top brass in the Navy, who would have to find the money to pay for the new studies. In the meantime, while the study proposals slowly worked their way through the pipeline to Washington, a Democratic senator from Illinois, Barack Obama, was ascending to the White House as the nation's first black president. The stunning results of the 2008 election would bring sweeping changes to Washington, including a transformation in how the civilian leadership viewed the military and national security. The Obama administration would begin to wind down wars in Iraq and Afghanistan, put pressure on the Pentagon to cut its bloated budget, and make a concerted effort to focus more on scientific integrity, rather than economic consequences, in addressing environmental problems, including those at military installations.

Howard Frumkin, who had been appointed director of the
ATSDR
in the first year of President Bush's second term in 2005, could see that change was coming to his agency. Frumkin, already the subject of scathing criticism for his agency's failure to respond to the concerns of hurricane victims living in formaldehyde-tainted trailers, made what appeared to be a desperate effort to save his job just a few months after Obama took office. He launched what he said would be an eighteen-month “national conversation” to address public concerns about exposure to toxic chemicals and the way his agency had addressed those concerns. “He committed to a voluntary, participatory, inclusive, and transparent process, aligned with President Obama's commitment to open government,” said an
ATSDR
description of Frumkin's plan. Jerry Ensminger wondered why, if the conversation was to be
“participatory” and “inclusive,” Frumkin had never contacted anyone from the Camp Lejeune Community Assistance Panel, which had been set up by his own agency just six months after he had taken office, to ask for their input. “I can answer my own question,” Ensminger said in an e-mail to the
ATSDR
. “Dr. Frumkin does not want anyone who has a dissenting view in attendance at his meetings.”
18

Frumkin's plan for a public dialogue might have been a publicity stunt, but in May 2009, there was a surprising development at the
ATSDR
that showed he was listening to some of the concerned scientists within his agency as well as some of the critics outside it. Twelve years after it had issued the Public Health Assessment (
PHA
) for Camp Lejeune, a document that greatly downplayed the health threats from the base water contamination, the
ATSDR
posted a statement on its website saying that the 1997 document had been taken down. The notice said that “additional information has emerged related to exposures to volatile organic compounds (
VOC
s) in drinking water at Camp Lejeune.” Specifically, the agency had learned through its modeling and through other sources that contaminated wells had been used to supply water to the Holcomb Boulevard area of the base for a period longer than acknowledged in the 1997 assessment. This was a reference to the fact that the Marine Corps had failed to tell the agency that the Holcomb Boulevard area had been serviced by contaminated water from the Hadnot Point system before a new treatment plant was built in 1972. As a result of the incomplete data, the
ATSDR
had missed thousands of exposures to contaminated water in assessing the risks in its 1997 report.
19

More significantly, the
ATSDR
said it had learned since 1997 that at least one well in the Hadnot Point system had been contaminated with benzene, a known carcinogen found in gasoline and diesel fuel. “The
PHA
should have stated there were not
enough data to rule out earlier exposures to benzene,” the agency admitted in its May 7, 2009, statement.
20

Even though it removed the 1997
PHA
from its website, the
ATSDR
wouldn't dismiss it entirely as a flawed document. “The
PHA
spurred beneficial public health research, including the ongoing water modeling, exposure reconstruction, and epidemiological studies,” the statement said. “Although the drinking water section needs to be updated, the
PHA
contains valuable and accurate historical information about nine other exposure pathways”—that is, nine of the ten contaminated wells that were shut down in 1984 and 1985. “Much of what we now know about the potential for adverse health effects related to exposures at Camp Lejeune is owed to this 1997 document. Once we have completed the water modeling and exposure reconstruction studies,
ATSDR
will re-analyze the drinking water pathway for the Camp Lejeune site, communicate findings to the public, and update the public health assessment. Exposures to VOCs in the drinking water occurred at Camp Lejeune.
ATSDR
declared those past exposures a public health hazard and we maintain that position today.”
21

The fact that benzene contamination had been overlooked in the 1997
PHA
infuriated the two senators from North Carolina, Republican Richard Burr and Democrat Kay Hagan. Burr and Hagan wrote to the acting secretary of the Navy at the time, B. J. Penn, demanding to know what had happened. “Nothing is more important than protecting the health and quality of life of our military personnel and families,” the senators told Penn in a May 13, 2009, letter. “Victims and their families have been patiently waiting for closure on this issue for over two decades. There have been persistent delays in
ATSDR
's epidemiological studies and water modeling. The inability to provide key documentation delays the completion and accuracy of these studies.”

Documents uncovered later by Jerry Ensminger and Mike Partain made clear that the Defense Department had had ample opportunity to provide information about the benzene contamination but had failed to do so. It also appeared that officials at the
ATSDR
had bent over backward in 1997 to make sure the Marine Corps was happy with the results of the Public Health Assessment.

Two months before the
PHA
had been publicly released in August 1997, a draft copy of the report had been sent to Rick Raines at Camp Lejeune under a cover letter on
ATSDR
stationery. (The signature on the June 6, 1997, letter was redacted in the copy obtained by Ensminger. However, a response from the Navy a few weeks later, also obtained by Ensminger, indicated the letter had been written by the
ATSDR
's Carole Hossum, an environmental health scientist at the agency.) The June letter had asked for Navy officials to informally review the draft
PHA
, practically begging for any revisions the Navy's environmental officials felt were necessary. “Although such a review at this phase of our public health assessment process is not agency policy, I felt that too much time had past [
sic
] since the last release and additional information added to the document,” the letter to Raines said. It continued:

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