1. What progress has ATSDR made on its current study of contaminated drinking water at Camp Lejeune?
2. Which conditions does ATSDR's current study include?
3. Why does the current ATSDR study examine only the period from 1968 to 1985?
4. Why does the current epidemiologic study focus only on a few birth defects rather than all birth defects?
5. Can you add me to the current study?
6. Why aren't you studying all diseases?
7. What progress has ATSDR made on the water modeling?
8. How is the study going to help those children who have already been diagnosed with a birth defect or cancer?
9. Can I have any tests done to see if my family might have been affected by these contaminants?
10. I'm sick or my family is sick. Are these contaminants to blame?
11. What about the effects on offspring of those who were exposed to contaminated drinking water in utero (that is, before birth)?
12. I am a Marine Corps/Navy retiree. How can I get copies of my medical records?
13. What is the relationship between ATSDR and the Marine Corps? They’re both part of the federal government, so isn't ATSDR’s investigation of the Marine Corps a conflict of interest?
14. Why wasn’t I notified about the drinking water contamination at Camp Lejeune?

1. What progress has ATSDR made on its current study of contaminated drinking water at Camp Lejeune?

The current study, "Exposure to Volatile Organic Compounds in Drinking Water and Specific Birth Defects and Childhood Cancers at United States Marine Corps Base Camp Lejeune, North Carolina," investigates whether children born from 1968 through 1985 have increased risk for specific health effects. These are children born to mothers who for some time during their pregnancy were exposed to VOC-contaminated drinking water at Camp Lejeune. Participants were interviewed in spring/summer 2005 about where they lived at Camp Lejeune, their medical history, and their personal habits.

Currently ATSDR is also completing its water modeling of the base. Water modeling is a scientific method that will help ATSDR estimate water-system conditions prior to March 1987. Water modeling will help identify where and when certain areas at Camp Lejeune received VOC-contaminated drinking water.

The current study should be completed in 2008.

2. Which conditions does ATSDR's current study include?

A 1999–2002 telephone survey identified 106 parent-reported cases of selected birth defects and cancers in children born to women who for some time during their pregnancies lived at Camp Lejeune between 1968 and 1985. The parents reported

• 35 neural tube defects (NTDs), consisting of anencephaly and spina bifida;
• 42 oral cleft defects; and
• 29 childhood hematopoietic cancers, consisting of childhood leukemias and non-Hodgkin’s lymphoma.

The status of the reported cases is

• Neural Tube Defects (NTDs):
• 17 were confirmed as having NTDs;
• 13 were confirmed as not having NTDs; and
• 1 was ineligible, 2 refused to participate, and medical records could not be obtained for 2 reported cases.
• Oral clefts (consisting of cleft lip or cleft palate):
• 24 were confirmed as having oral cleft defects;
• 11 were confirmed as not having oral cleft defects; and
• 3 refused to participate and medical records could not be obtained for 4 reported cases.
• Childhood hematopoietic cancers, that is, childhood leukemia and non-Hodgkin’s lymphoma:
• 16 were confirmed as hematopoietic cancers;
• 8 were confirmed as not having hematopoietic cancers; and
• 2 were ineligible, 2 refused to participate, and medical records could not be obtained for 1 reported case.

3. Why does the current ATSDR study examine only the period from 1968 to 1985?

The study is restricted to children born between 1968 and 1985 because 1) 1968 is the first year that North Carolina began collecting birth certificate data in a computerized database, and 2) 1985 was when the heavily contaminated wells were shut down. However, any findings from the study would also apply to children born before 1968 if the mothers received contaminated drinking water at Camp Lejeune. Searching for those born prior to North Carolina's system going on-line would have been extremely difficult.

4. Why does the current epidemiologic study focus only on a few birth defects rather than all birth defects?

The current study includes four birth defects: anencephaly, spina bifida, cleft lip, and cleft palate, and two childhood cancers: leukemia and non-Hodgkin's lymphoma. ATSDR chose to study these birth defects and childhood cancers because previous studies suggest that the chemicals in some of the drinking water at Camp Lejeune during 1968–1985 might cause these health effects.

ATSDR had hoped to study additional birth defects. We found, however, that the survey could not reliably identify birth defects other than these four.

Another problem is that birth defect studies do not normally use a survey to identify cases. Studies of birth defects are either hospital-based or collect data from a statewide birth defects registry. Hospital-based studies collect data from hospitals that serve the study area. We could not perform a hospital-based study of birth defects because 1) medical records for those born at Camp Lejeune were no longer available at the base hospital, and 2) during 1968–1985 an estimated 4,000 pregnant women transferred from Camp Lejeune before giving birth. Also, during 1968–1985 North Carolina did not maintain a birth defect registry.

The four birth defects in our study are obvious at birth, and we believe we have identified most if not all of the cases of the defects through the survey. To study other birth defects is not practical if we cannot identify all or most of them, and if we cannot confirm them by medical records.

5. Can you add me to the current study?

The current study is closed. Data collection for this study officially ended in July 2005. However, any findings from the study would also apply to children born before 1968 if the expectant mothers received contaminated drinking water while living at Camp Lejeune.

6. Why aren't you studying all diseases?

An epidemiologic study cannot accurately evaluate all diseases at once. A scientifically credible study must limit its focus to diseases that it can reliably identify and confirm. This way, the study can avoid serious errors and produce useful and accurate data.

Because the unborn young are at a stage in life when they are most sensitive to contaminated drinking water, ATSDR decided to focus first on diseases that might occur in fetuses.

ATSDR is currently assessing the feasibility of conducting additional studies of other populations who lived or worked at the base, including adults and children. Studies under consideration include a mortality study and a cancer incidence study.

7. What progress has ATSDR made on the water modeling?

ATSDR’s analysis shows that former Marines and their families who lived in Tarawa Terrace family housing units from November 1957 through February 1987 were exposed to contaminated drinking water containing tetrachloroethylene (PCE), a dry-cleaning solvent. Levels of PCE in the drinking water during most of the months in this period exceeded 5 parts per billion, the limit currently set by the Environmental Protection Agency (EPA) under the Safe Drinking Water Act.

ATSDR is in the process of completing its water modeling for other areas on base.

8. How is the study going to help those children who have already been diagnosed with a birth defect or cancer?

Only a small number of studies have looked at the risk of birth defects and childhood cancers among children born to mothers exposed during pregnancy to volatile organic compounds (VOCs) in drinking water. The current epidemiological study will evaluate the possibility of a link between the drinking water contaminants found at Camp Lejeune and specific childhood cancers and birth defects.

While those children potentially harmed by the contaminated drinking water at Camp Lejeune will receive no direct benefit from the study, the information gained during the current study will help advance research on this topic and could help children in the future.

9. Can I have any tests done to see if my family might have been affected by these contaminants?

Usually, VOCs leave the body within a week after the last exposure, which at Camp Lejeune was probably many years ago. Thus testing will not determine whether you were exposed to these contaminants at Camp Lejeune.

Consequently, no specific medical tests are recommended for these exposures. Instead, we recommend that you monitor your health by having regular medical check ups. We encourage you to discuss this information with your physician, who can advise you on your personal health questions.

10. I'm sick or my family is sick. Are these contaminants to blame?

Exposure to the drinking water contaminants TCE and PCE and other VOCs found at Camp Lejeune have been linked with some types of cancer, birth defects, and other health problems. Still, even if you were exposed, ATSDR cannot confirm that these health problems are a result of that exposure. Many persons exposed to these contaminants do not suffer any health problems, but others do. Whether someone will or will not develop any health problems depends on several factors, including

• the chemicals to which you were exposed,
• the dates you were exposed (the levels varied over time in the drinking water system),
• when you were exposed (e.g., as a fetus, a child, or an adult),
• how much exposure you received (if you were exposed as a fetus, this would depend on your mother’s exposure),
• how long you were exposed,
• your genes,
• any other exposures to environmental or occupational hazards you have received during your lifetime,
• your lifestyle—for example, your diet, your tobacco or alcohol use, and your physical activity,
• illnesses you may have had from other causes, and
• medications you have taken during your lifetime.

We encourage you to contact your family physician regarding any concerns you may have regarding your health or your family's health.

11. What about the effects on offspring of those who were exposed to contaminated drinking water in utero (that is, before birth)?

At this time, ATSDR knows of no scientific evidence that says these offspring could be affected.

12. I am a Marine Corps/Navy retiree. How can I get copies of my medical records?

You can get your medical records by contacting the National Personnel Records Center. The National Personnel Records Center, Military Personnel Records (NPRC-MPR) is the repository for personnel, health, and medical records of discharged and deceased veterans of all services while they were in the military. NPRC-MPR also stores medical treatment records of retirees from all services, as well as records for dependent and other persons treated at naval medical facilities. To the extent allowed by law, information from the records is made available upon written request (with dated signature). Requests must contain sufficient information to locate the record. This information includes

• Complete name as it appears on the service records
• Service number or social security number
• Branch of service, and
• Dates of service.
• Date and place of birth may also be helpful, particularly if the service number is unknown.

If the request pertains to a record that may have been involved in the 1973 Records Center fire, also include place of discharge, last unit of assignment, and place of entry into the service, if known. Send the written request to the following address:

National Personnel Records Center
Military Personnel Records
9700 Page Avenue
St. Louis, MO 63132-5100

The NPRC-MPR Web site has additional information. Its address is www.archives.gov/facilities/mo/st_louis/military_personnel_records.html

13. What is the relationship between ATSDR and the Marine Corps? They’re both part of the federal government, so isn't ATSDR’s investigation of the Marine Corps a conflict of interest?

ATSDR is an independent agency under the U.S. Department of Health and Human Services. It is a federal public health agency that assesses potential human health effects of hazardous substances found at or near toxic waste sites. Because of a concern about conflict of interest, Congress, through the Superfund law, made ATSDR a separate agency responsible for health consultations, assessments, and studies at toxic waste sites. This includes toxic substances found on property owned by other parts of the government, in this case the Marine Corps. Although the Marine Corps cooperates with ATSDR’s requests for information, ATSDR’s activities—including its conclusions and recommendations regarding the Camp Lejeune water contamination problem—remain independent.

14. Why wasn’t I notified about the drinking water contamination at Camp Lejeune?

For questions about notification, contact the Marine Corps. The Call Center staff can be reached at 877-261-9782, Monday through Friday, between 8:30 a.m. and 5 p.m., or by email at clwater@usmc.mil.

Former residents and employees of Camp Lejeune can now register at the official Marine Corps water study website for notification and information regarding past drinking water contamination. The address is https://clnr.hqi.usmc.mil/

The web registration is a tool intended to assist the Marine Corps in obtaining current addresses of Marines, dependents and civilians that lived or worked at Camp Lejeune prior to 1987. Former base residents are encouraged to register online or contact the USMC Camp Lejeune Water Study Call Center for assistance or additional information.