Researchers Contribute to VA Clinical Guidance for Camp Lejeune Veterans.
Acting largely on the basis of seven School of Public Health studies, the Institute of Medicine committee has recommended that the US Department of Veterans Affairs expand the range of conditions covered by legislation, providing health benefits to veterans and their families who were exposed to drinking water contamination.
Drawing from studies led by Patricia Janulewicz, assistant professor of environmental health, and Ann Aschengrau, professor of epidemiology, the committee recommended that the VA consider adding several neurobehavioral effects to the covered conditions, including those due to neural tube birth defects, adolescent and adult illicit drug use, bipolar disorder, and problems with contrast sensitivity and color discrimination.
Between 1957 and 1987, the drinking water at US Marine Corps Base Camp Lejeune in North Carolina was inadvertently contaminated with industrial chemicals, including the solvents trichloroethylene (TCE) and tetrachloroethylene (PCE). An estimated 500,000 to 1 million active duty personnel, family members, and civilian employees may have used the contaminated water, and many of them have concerns about the long-term health effects that might result from that exposure, Aschengrau said.
In response to health concerns raised by veterans and their families, in 2012 Congress passed the Honoring America’s Veterans and Caring for Camp Lejeune Families Act, also known as the Janey Ensminger Act. The act provides health benefits to veterans and family members and applies to 15 different health conditions, including certain cancers, renal toxicity, and neurobehavioral effects. Janey Ensminger, the daughter of a retired Marine sergeant, died of cancer at age 9.
The Institute of Medicine committee was convened to review the latest scientific literature to ensure that the clinical guidance for the covered conditions was scientifically sound. Members of the committee, which included Janulewicz, were also asked to fully describe the medical conditions that result from renal toxicity due to solvent exposures and to characterize the neurobehavioral effects as mandated for coverage in the law. Based on the literature review and in-depth discussions, the committee found that recent studies warrant the expansion of VA-covered conditions.
The SPH studies were conducted among Cape Cod, Massachusetts, residents exposed to PCE-contaminated drinking water in utero and during early childhood, and were funded by the Superfund Research Program at the National Institute of Environmental Health Sciences.
Collaborators included Roberta White, professor of environmental health; David Ozonoff, professor of environmental health; Thomas Webster, professor of environmental health; Veronica Vieira, former assistant professor of environmental health; Kelly Getz, former doctoral student of epidemiology; Lisa Gallagher, research assistant professor of epidemiology; Janice Weinberg, professor of biostatistics; Michael Winter, associate director of the Data Coordinating Center; Brett Martin, statistical manager of the Data Coordinating Center; and Megan Romano, former research assistant.