A Trust Betrayed

by Mike Magner

  If there was a sense that Washington was calling the shots at the CDC, it was most certainly felt among staff members at the health agency’s stepchild, the ATSDR, which also was headquartered in Atlanta. Nearly all the tiny agency’s studies dealt with the effects of pollution that had been caused by two of the most powerful forces in the nation’s capital, the US military and corporate America. Researchers working on studies at the ATSDR had to know there would be hell to pay if they pressed too hard to link illnesses or deaths to contamination at a Superfund site where the Pentagon or Big Business had liabilities.

  In the case of Camp Lejeune, the ATSDR was continually being bullied by the Navy. At one point in 2007, the Pentagon simply stopped providing funds for the computer modeling being done by the ATSDR to replicate the flow of contaminants at the base over several decades in order to better understand how many people had been exposed and at what levels. In May 2008, the ATSDR’s deputy director, Thomas Sinks, was forced to remind Navy headquarters that it had not made its promised payments for the agency’s studies at Lejeune in eight months. “You are requested to provide full funding of $1,570,409 to ATSDR by June 1, 2008, and not hold these funds contingent upon final resolution of our project and budget tracking differences,” Sinks said in a letter to the Navy. After the Associated Press obtained Sinks’s letter and reported that the military was stonewalling the ATSDR’s studies at Lejeune, the Navy paid up, and officials dismissed the AP story as exaggerating a routine budgeting delay. Jerry Ensminger knew better. “In a nutshell, the DOD, DON, and the USMC do not want to see the water model for the Hadnot Point and the Holcomb Blvd. water distribution systems at Camp Lejeune to ever be completed,” he said in an e-mail to the ATSDR and others on May 29, 2008.15

  Yet in the midst of all this pressure, there was one senior scientist at the agency who was determined to see the Lejeune studies through to completion. Frank Bove had worked earlier in his career as an epidemiologist at the New Jersey Department of Health, spending years investigating the effects of industrial pollution on people in dozens of communities. He had earned a master’s degree in environmental health science in 1984 and a doctorate in occupational health science and epidemiology in 1987, both at the Harvard University School of Public Health. But more important to his later career, Bove had majored in both political science and philosophy at the University of Pennsylvania and went on to study philosophy in graduate school at Boston University in the late 1970s. During that time, Bove had been an organizer in the Boston area on issues involving the environment, public health, housing, and welfare rights. With that background of social consciousness, he was not just a representative for the ATSDR sitting in dispassionately on more than two dozen meetings of the Community Assistance Panel set up in 2006 to give victims of Camp Lejeune’s contamination input into the agency’s studies. The hundreds of stories about children with cancer, babies born without parts of their brains, former Marines dying of rare diseases, and cases of men with breast cancer had to have an impact on Bove, even with all his training as a scientist to develop strong evidence before drawing firm conclusions.

  On June 23, 2008, Bove and a colleague at the ATSDR, Perri Zeitz Ruckart, issued a document that would give new hope to the victims of Camp Lejeune’s poisoned water. It was a forty-page paper, with almost as many pages of attachments, entitled “An Assessment of the Feasibility of Conducting Future Epidemiological Studies at USMC Base Camp Lejeune.” Partly in response to the recommendations of an independent panel of scientists in 2005, and partly as a result of pressure from Lejeune victims through the Community Assistance Panel, the paper urged the ATSDR to expand its studies of Lejeune’s contamination to include adults who had been exposed to the tainted water. So far, the agency had focused its research solely on the children who had been exposed to the contamination in their early years of development and on babies who had been exposed in utero.16

  Bove recommended both a mortality study and a cancer incidence study of Marines, Navy personnel, and civilian employees who had been stationed on Camp Lejeune between June 1975 and December 1985. The mortality study would assess “all causes of death” among those who had lived at the base during that ten-year period, while the cancer study would evaluate all confirmed cases of cancer in the study group, using state and federal cancer registries and the results of a separate health survey of former personnel at the base to be conducted under a congressional mandate. And in order to improve the credibility of the studies, the ATSDR would conduct the same surveys on Marines and civilian employees who had been stationed at Camp Pendleton in California from 1975 to 1985. This group would have the same type of population of former military personnel as the Camp Lejeune group, with one key difference—the Camp Pendleton group had not been exposed to volatile organic compounds in its drinking water.17

  It would take some time for Bove’s recommendations to be digested by leaders of the ATSDR and its parent agencies—the CDC and the Department of Health and Human Services—as well as by top brass in the Navy, who would have to find the money to pay for the new studies. In the meantime, while the study proposals slowly worked their way through the pipeline to Washington, a Democratic senator from Illinois, Barack Obama, was ascending to the White House as the nation’s first black president. The stunning results of the 2008 election would bring sweeping changes to Washington, including a transformation in how the civilian leadership viewed the military and national security. The Obama administration would begin to wind down wars in Iraq and Afghanistan, put pressure on the Pentagon to cut its bloated budget, and make a concerted effort to focus more on scientific integrity, rather than economic consequences, in addressing environmental problems, including those at military installations.

  Howard Frumkin, who had been appointed director of the ATSDR in the first year of President Bush’s second term in 2005, could see that change was coming to his agency. Frumkin, already the subject of scathing criticism for his agency’s failure to respond to the concerns of hurricane victims living in formaldehyde-tainted trailers, made what appeared to be a desperate effort to save his job just a few months after Obama took office. He launched what he said would be an eighteen-month “national conversation” to address public concerns about exposure to toxic chemicals and the way his agency had addressed those concerns. “He committed to a voluntary, participatory, inclusive, and transparent process, aligned with President Obama’s commitment to open government,” said an ATSDR description of Frumkin’s plan. Jerry Ensminger wondered why, if the conversation was to be “participatory” and “inclusive,” Frumkin had never contacted anyone from the Camp Lejeune Community Assistance Panel, which had been set up by his own agency just six months after he had taken office, to ask for their input. “I can answer my own question,” Ensminger said in an e-mail to the ATSDR. “Dr. Frumkin does not want anyone who has a dissenting view in attendance at his meetings.”18

  Frumkin’s plan for a public dialogue might have been a publicity stunt, but in May 2009, there was a surprising development at the ATSDR that showed he was listening to some of the concerned scientists within his agency as well as some of the critics outside it. Twelve years after it had issued the Public Health Assessment (PHA) for Camp Lejeune, a document that greatly downplayed the health threats from the base water contamination, the ATSDR posted a statement on its website saying that the 1997 document had been taken down. The notice said that “additional information has emerged related to exposures to volatile organic compounds (VOCs) in drinking water at Camp Lejeune.” Specifically, the agency had learned through its modeling and through other sources that contaminated wells had been used to supply water to the Holcomb Boulevard area of the base for a period longer than acknowledged in the 1997 assessment. This was a reference to the fact that the Marine Corps had failed to tell the agency that the Holcomb Boulevard area had been serviced by contaminated water from the Hadnot Point system before a new treatment plant was built in 1972. As a result of the incomplete data, the ATSDR ha
d missed thousands of exposures to contaminated water in assessing the risks in its 1997 report.19

  More significantly, the ATSDR said it had learned since 1997 that at least one well in the Hadnot Point system had been contaminated with benzene, a known carcinogen found in gasoline and diesel fuel. “The PHA should have stated there were not enough data to rule out earlier exposures to benzene,” the agency admitted in its May 7, 2009, statement.20

  Even though it removed the 1997 PHA from its website, the ATSDR wouldn’t dismiss it entirely as a flawed document. “The PHA spurred beneficial public health research, including the ongoing water modeling, exposure reconstruction, and epidemiological studies,” the statement said. “Although the drinking water section needs to be updated, the PHA contains valuable and accurate historical information about nine other exposure pathways”—that is, nine of the ten contaminated wells that were shut down in 1984 and 1985. “Much of what we now know about the potential for adverse health effects related to exposures at Camp Lejeune is owed to this 1997 document. Once we have completed the water modeling and exposure reconstruction studies, ATSDR will re-analyze the drinking water pathway for the Camp Lejeune site, communicate findings to the public, and update the public health assessment. Exposures to VOCs in the drinking water occurred at Camp Lejeune. ATSDR declared those past exposures a public health hazard and we maintain that position today.”21

  The fact that benzene contamination had been overlooked in the 1997 PHA infuriated the two senators from North Carolina, Republican Richard Burr and Democrat Kay Hagan. Burr and Hagan wrote to the acting secretary of the Navy at the time, B. J. Penn, demanding to know what had happened. “Nothing is more important than protecting the health and quality of life of our military personnel and families,” the senators told Penn in a May 13, 2009, letter. “Victims and their families have been patiently waiting for closure on this issue for over two decades. There have been persistent delays in ATSDR’s epidemiological studies and water modeling. The inability to provide key documentation delays the completion and accuracy of these studies.”

  Documents uncovered later by Jerry Ensminger and Mike Partain made clear that the Defense Department had had ample opportunity to provide information about the benzene contamination but had failed to do so. It also appeared that officials at the ATSDR had bent over backward in 1997 to make sure the Marine Corps was happy with the results of the Public Health Assessment.

  Two months before the PHA had been publicly released in August 1997, a draft copy of the report had been sent to Rick Raines at Camp Lejeune under a cover letter on ATSDR stationery. (The signature on the June 6, 1997, letter was redacted in the copy obtained by Ensminger. However, a response from the Navy a few weeks later, also obtained by Ensminger, indicated the letter had been written by the ATSDR’s Carole Hossum, an environmental health scientist at the agency.) The June letter had asked for Navy officials to informally review the draft PHA, practically begging for any revisions the Navy’s environmental officials felt were necessary. “Although such a review at this phase of our public health assessment process is not agency policy, I felt that too much time had past [sic] since the last release and additional information added to the document,” the letter to Raines said. It continued:

  Therefore, I expect this to be an informal review. If you prefer a different approach, I ask that you give me your “informal” comments so that I can go ahead and address them in the document, then if you choose to send formal signed comments for the record, the time delay will not affect the release date. I need to receive your “informal” comments by June 23, 1997, preferably by phone. If I haven’t heard from you by then, I’ll call you Tuesday, June 24. Ideally, I’d like to discuss your comments over the phone so that I can make the changes to the document at that time to quicken the process.22

  The request for a review ended up with Katherine Landman at the Naval Facilities Engineering Command, Atlantic Division (LANTDIV), who sent a July 21, 1997, memo to David McConaughy at the Navy Environmental Health Center, forwarding a copy of the ATSDR’s draft PHA along with eight pages of “informal” comments that Landman had already sent to the health agency. The draft PHA, Landman said in the memo, had been provided by Carole Hossum of the ATSDR “for an ‘informal’ review prior to formal issuance of the report.” Landman added, “I have discussed these comments with Ms. Hossum on the phone, and she has indicated to me that substantial changes will be made to the document regarding most issues that I mentioned in my comments. . . . Because Ms. Hossum requested only an informal review from a limited list of people, please provide any comments or concerns you may have about this document to me (informally), and I will forward to ATSDR with additional specific comments of my own that I am still generating.”23

  In her eight pages of comments on the ATSDR’s draft report, Landman provided a list of documents from Camp Lejeune’s Superfund cleanup files. This was in response to the health agency’s request for “updated records for particular sites” on the base. None of the listed documents dealt with the benzene contamination in the Hadnot Point water system. Most of the remaining comments focused on all the efforts Camp Lejeune was making to ensure that contamination never got into the base drinking water again.24

  On the day the PHA was released, August 4, 1997, the director of the ATSDR’s Division of Health Assessment and Consultation, Robert C. Williams, sent a letter to the commanding general and the brigadier general at Camp Lejeune to notify them about the report. “The data and information in the U.S. Marine Corps Camp Lejeune Military Reservation Public Health Assessment have been evaluated, and ATSDR has placed the U.S. Marine Corps Camp Lejeune Military Reservation in the category of no apparent public health hazard.”25

  Christopher Portier, who took over as director of the ATSDR in August 2010 and left in May 2013, admitted in an interview after his departure that agency researchers could have been more aggressive about tracking down all the contaminants, including benzene, when they started investigating Lejeune’s water problems in the early 1990s. He also admitted the Marine Corps wasn’t exactly screaming that health officials had overlooked significant fuel leaks from underground storage tanks and pipelines in the Hadnot Point area.26

  “My sense of it was that in 1991 we were called in to investigate the ‘Perc’ [perchloroethylene] contamination coming onto the base from ABC Cleaners, and did a fairly good job of that,” Portier said. “But ATSDR did not recognize the magnitude of the contamination that was coming from a different direction, that’s from the underground storage tanks, until later on. It is unfortunate that the team that was looking at it early on dismissed the benzene readings that were right in front of their eyes and did not further investigate it because that might have cut the amount of time spent on this particular issue.” But, Portier added, “there were difficulties getting some of the records over the years that made it hard for us to do our work.”27

  The ATSDR’s acknowledgment that its 1997 report on Camp Lejeune was badly flawed was met with a mixture of relief and concern from both Jerry Ensminger and Mike Partain. Ensminger ridiculed the ATSDR’s statement that it was still trying to determine whether benzene had made it from a contaminated well into the base drinking water. “We have analytical results from samples taken on 6 July 1984 which show high contamination levels of benzene in well HP-602,” Ensminger said in an e-mail to the ATSDR’s deputy director, Thomas Sinks. “By the DON/USMC’s own admission, this well wasn’t removed from service until 30 November 1984. We do know there was benzene contamination in that well when it was still active, [so] why is ATSDR ‘muddying’ the facts here?” Partain noted in an e-mail to Sinks that a test done in December 1985 on finished water from the Hadnot Point water treatment plant showed benzene present in the drinking water at 38 parts per billion.28

  Still, Partain applauded the agency in his note to Sinks for taking a major step toward acknowledgment of the damage done by Lejeune’s contamination. “Withdrawing the PHA as a viable document from
your agency’s database demonstrates a sincere effort to involve the community and not just accept the statements and assertions of the polluters as fact,” Partain said. Ensminger, as usual, was more emphatic than his partner in describing his reaction to the ATSDR’s removal of the 1997 report from its website. “We are in Day 99 of change, and by God we’re starting to see it,” Ensminger told the Associated Press for a story about the agency’s action, roughly a hundred days after Obama had promised a greater emphasis on scientific integrity in his administration.29

  The new optimism that Partain and Ensminger shared was quickly shattered by the June 13, 2009, announcement from the National Academies of Sciences that a lengthy study by a committee of the National Research Council had found no conclusive evidence that illnesses could be directly connected to contaminated drinking water at Camp Lejeune.30

  “It cannot be determined reliably whether diseases and disorders experienced by former residents and workers at Camp Lejeune 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,” reported the NRC committee, which had been funded by the Navy under a mandate from Congress. “Thus, the committee concludes that there is no scientific justification for the Navy and Marine Corps to wait for the results of additional health studies before making decisions about how to follow up on the evident solvent exposures on the base and their possible health consequences. The services should undertake the assessments they deem appropriate to determine how to respond in light of available information.”

  The committee’s 317-page report reviewed epidemiologic studies of solvents and their effects, studies of other communities that had had contaminated water supplies, laboratory research on TCE and PCE, and the studies that had been done so far on the population at Camp Lejeune. In each category, the committee had concluded that there was “inadequate/insufficient evidence to determine whether an association exists” between exposure to the chemicals and adverse health effects.