SRP Researchers Contribute to VA Clinical Guidance for Camp Lejeune Veterans

Acting largely on the basis of Superfund Research Program (SRP) 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 contaminated drinking water.

Drawing from studies conducted at Boston University SPH by Patricia Janulewicz, assistant professor of environmental health and former SRP-trainee and Ann Aschengrau, professor of epidemiology and SRP principal investigator, the committee recommended that the VA consider adding several neurobehavioral effects to the clinical guidance, including those due to neural tube birth defects,  adolescent and adult illicit drug use, bipolar disorder, and problems with contrast sensitivity and color discrimination (1).

Between 1957 and 1987, the drinking water at U.S. 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.

In response to 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. This act provides health benefits to veterans and family members who have fifteen 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 BUSPH studies were conducted among Cape Cod, Massachusetts residents exposed to PCE-contaminated  drinking water in utero and during early childhood.  Collaborators included Roberta White, professor of environmental health, David Ozonoff,  professor of environmental health and BUSRP deputy director, Thomas Webster, professor of environmental health and BUSRP principal investigator,  Veronica Vieira adjunct associated professor of environmental health and BUSRP principal investigator,  Kelly Getz, former SRP trainee, Lisa Gallagher, research assistant professor and former SRP trainee, and Janice Weinberg, professor of biostatistics.


(1) Institute of Medicine. Review of VA Clinical Guidance for the Health Conditions Identified by the Camp Lejeune Legislation. Washington DC: The National Academies Press, 2015.


April 10, 2015