ATSDR Camp Lejeune Survey of Childhood Cancers and Birth Defects Webcast Transcript

ATSDR Camp Lejeune Survey of Childhood Cancers and Birth Defects Webcast Transcript

A Progress Report on the Survey of Childhood Cancers and Birth Defects Among Children Whose Mothers Were Pregnant While Living at U.S. Marine Corps Base Camp Lejeune, North Carolina, 1968-1985.

Good day. My name is Dr. Wendy Kaye.

I'm an epidemiologist at the Agency for Toxic Substances and Disease Registry, also known as ATSDR. Today I'd like to give you an overview of our Camp Lejeune survey.

ATSDR is a public health agency responsible for evaluating toxic substances in the environment and how they affect people. We do assessments on all superfund and other hazardous waste sites.

As part of this process, we identified the drinking water problem at Camp Lejeune that needed further study. Some of the water at Camp Lejeune was found to be contaminated with volatile organic compounds used for degreasing and dry cleaning, trichloroethylene - TCE and perchloroethylene - PCE. Three water distribution systems that served family base housing, Hadnot Point, Hospital Point, and Tarawa Terrace, were affected.

Volatile organic compounds were found in the drinking water in 1982. We don't know exactly when the contamination got into the water; it could have been many years earlier. There were no drinking water standards available in 1982 to determine if the level of the contamination was a problem. Additional sampling was done in 1984 and the wells were closed in 1985. Currently and since 1985 the water has been fine.

ATSDR's assessment indicated that the major health concerns for exposure to the drinking water were adverse birth outcomes and cancer in children who were exposed to these compounds in utero, that is while the child was in the mother's womb. This group was thought to be the was most sensitive to the exposures. ATSDR recommended that studies be done of the relationship between the drinking water exposures and specific birth defects and childhood cancers.

The first step in conducting the study was to identify children with the specific birth defects and childhood cancers. We were concerned about those children who were conceived or carried in utero while their mothers lived in on-base housing at Camp Lejeune between 1968 and 1985. 1968 was chosen as the start of the study period because it was the first year that birth certificates were computerized in the state of North Carolina. The year 1985 was chosen as the end date of the study because the contaminated wells were shut down in February of 1985.

Eligible children included those whose mothers lived in base housing at the time of their birth. There were approximately 12,500 of these births. The others had mothers who were pregnant while living in base housing but born after they were transferred from Camp Lejeune. We estimated there were about 4,000 of these births.

We used a variety of ways to find people to ask them to take part in the survey. We used information from the birth certificates and the Marine Corps to help us find the current addresses. We used a mass media campaign to alert parents to call us. We decided to focus the study on specific birth defects and childhood cancers because previous studies had identified an association between these conditions and exposure to drinking water contaminated with TCE and PCE. Additionally, these conditions could be identified through a survey. The specific conditions are neural tube defects - spina bifida and anencephaly; oral clefts - cleft lip and cleft palate; and childhood cancers - Acute Lymphocytic Leukemia and Non-Hodgkin's Lymphoma.

The survey took place between September 1999 and January 2002. The survey asked questions about the mother's date of pregnancy and where she lived while she was pregnant. She was also asked about the child-- whether the child had had any birth defects or childhood cancers diagnosed by a doctor before the age of 20. The total number of children included in the survey was 12,598. We were able to interview about 80 % of the parents whose children were born while they lived in on-base housing. We were also able to interview between 64 and 73 % of the parents who were no longer at Camp Lejeune when their children were born. The overall participation rate was close to 80 %.

The survey cast a very broad net to make sure that we didn't miss anyone with a condition we wanted to study. We identified 103 children who possibly had the specific birth defects and childhood cancers we are studying. We have obtained the medical records for 46 of them, or about 45%. We are still in the process of verifying these records and will make every attempt to contact the other 57 people and obtain permission to review the medical records. The specific numbers of childhood birth defects and cancer reported among those who completed the survey are 33 neural tube defects, 41 oral clefts, 22 with leukemia, and 7 with childhood lymphoma.

However, what the survey could not tell us is whether these birth defects or cancers are in any way associated with the mother's using the contaminated water.

An epidemiologic study is necessary to determine whether exposure during pregnancy to drinking water contaminated with PCE and TCE at Camp Lejeune is associated with an increased risk of specific birth defects and childhood cancers. The survey was only the first step in conducting this study. It was necessary to do the survey to find and identify people with specific birth defects and childhood cancers.

There are additional steps that need to be done as part of the study. We need to complete confirming the birth defects and childhood cancers that were reported to us, do an interview, and model the water distribution system at Camp Lejeune. The people who will be included in this study are all the children who had the childhood outcomes of interest born to mothers who resided at Camp Lejeune during their pregnancies. All of them will be contacted and asked to take part in the study. We will also ask a sample of mothers who completed the survey and whose children did not have any of the outcomes we are studying to be in the study as a comparison group.

The study will consist of an in-depth telephone interview asking where people lived, their medical histories, what water they consumed during their pregnancies, and information on their occupations. We will also do extensive modeling of the water distribution systems at Camp Lejeune so that we can see which water went to which base housing. In order to do the study, we must develop a scientific protocol. This is already started and in fact is almost complete. Once the protocol is completed, it must go through a series of reviews. This includes scientific peer review, a review by the Office of Management and Budget, and Human Subjects Review. We expect these reviews to begin within the next few weeks and to be completed by the end of the calendar year. A few months after we have obtained all the needed clearances, we will begin contacting people to ask them if they would be willing to take part in the study.

I want to thank you again for your interest in ATSDR's work at Camp Lejeune. For information or questions, you can contact ATSDR or the Marine Corps at the numbers and e-mails provided. Thank you.