Expert Report

Each report is produced by a committee of experts selected by the Academy to address a particular statement of task and is subject to a rigorous, independent peer review; while the reports represent views of the committee, they also are endorsed by the Academy. Learn more on our expert consensus reports.

In the early 1980s, two water-supply systems on the Marine Corps Base Camp Lejeune in North Carolina were found to be contaminated with the industrial solvents perchloroethylene (PCE), which entered water supplies as a result of spills and improper disposal practices by an off-base dry cleaner, and tricholorethylene (TCE) from on-base spills and leaks from underground storage equipment. Evidence exists that people living or working at Camp Lejeune between the 1950s and 1985 were exposed to the contaminants, which has generated considerable public controversy over potential health consequences, such as various cancers. This report, conducted in response to a request from the U.S. Navy, examines what is known about contamination of the water supplies and whether the contamination can be linked to any adverse health outcomes.

The report finds that, even with today's scientific advances, the complex nature of the Camp Lejeune contamination and the limited data on the concentrations in water supplies allowed for only crude estimates of exposure. The report concludes that strong scientific evidence is not available to link the health problems among those exposed to the contaminants. The report also concludes that further research cannot provide definitive information, so policy changes or administrative actions to address and resolve concerns should not wait until additional health studies are conducted.

In addition to reviewing information specific to Camp Lejeune, the report reviews available epidemiologic and toxicologic studies on associations between these chemicals and adverse health effects. The review shows insufficient evidence to justify a causal inference for any health effects. However, the committee found "limited or suggestive evidence of an association" between chronic exposure to TCE, PCE, or a mixture of solvents and some diseases and disorders, including cancers of the breast, bladder, kidneys, esophagus, and lungs. The majority of the health outcomes reviewed in the epidemiologic studies was placed in the category of "inadequate or insufficient evidence."

Key Messages

  • After reviewing the study plans and feasibility assessments, the committee concluded that most questions about whether exposures at Camp Lejeune resulted in adverse health effects cannot be answered definitively with further scientific study. There are two main reasons for this. First, it is not possible to reliably estimate the historical exposures experienced by people at the base. Second, it will be difficult to detect any increases in the rate of diseases or disorders in the study population.
  • For diseases and disorders where the evidence is limited/suggestive of an association, the committee has concluded that the epidemiologic studies give some reason to be concerned that sufficiently high levels of the chemical may cause the disease, but the studies do not provide strong evidence that they actually do so.
  • Given the multiple uncertainties and likely variation in contaminant concentrations, the committee concluded that the Tarawa Terrace modeling predictions should only be used to provide a general estimate of the timeframe and magnitude of exposure.
  • It cannot be determined reliably whether diseases and disorders experienced by former residents and workers at Camp Lejuene are associated with their exposure to contaminants in the water supply because of data shortcomings and methodological limitations, and these limitations cannot be overcome with additional study.
  • The committee concluded that the evidence provided by this subset of epidemiologic studies needs further support and confirmation before they can be considered significant on their own.
  • The committee found that ATSDR did consider the major issues bearing on the feasibility of the proposed studies and proposed reasonable approaches to conducting the studies, there remain serious, unresolved questions about the feasibility and ultimate value of the studies.
  • The contamination of the Hadnot Point system was more complex than Tarawa Terrace. There were multiple sources of pollutants, including an industrial area, a drum dump, a transformer storage lot, an industrial fly ash dump, an open storage pit, a former fire training area, a site of a former on-base dry cleaner, a liquids disposal area, a former burn dump, a fuel-tank sludge area, and the site of the original base dump.
  • The highest levels of either TCE or PCE measured in the mixed-water samples at Camp Lejeune were much lower than the lowest dose that caused adverse effects in the most sensitive strains and species of laboratory animals. The lower levels of exposure may be of some concern for effects on neurotoxicity and immunotoxicity, but further research is needed to evaluate the specific effects of TCE and PCE and whether they are relevant to humans.