ATSDR Assessment of the Evidence for the Drinking Water Contaminants at Camp Lejeune and Specific Cancers and Other Diseases

Title: ATSDR Assessment of the Evidence for the Drinking Water Contaminants at Camp Lejeune and Specific Cancers and Other Diseases.

Subject of Planned Report: The ATSDR Report reviews the evidence for adverse health effects from drinking water contaminants at Camp Lejeune.

Purpose of Planned Report: The purpose of the assessment is to evaluate the strength of the evidence supporting causality of adverse health effects from exposures to trichloroethylene (TCE), tetrachloroethylene (PCE), and other contaminants that were present in the drinking water at U.S. Marine Corps Base Camp Lejeune from the 1950s through 1985.

Type of Dissemination: ISI

Timing of Review (including deferrals): August 2016

Type of Review (panel, individual or alternative procedure): Individual

Opportunities for the Public to Comment (how and when): No

Peer Reviewers Provided with Public Comments before the Review: No

Anticipated Number of Reviewers: Four

Primary Disciplines or Expertise: toxicology, environmental health, cancer epidemiology

Reviewers Selected by (agency or designated outside organization): CDC/ ATSDR

Public Nominations Requested for Reviewers: No

1. Aschengrau, Ann

Academic and Professional Credentials	ScD
Current Position Title	Professor, Epidemiology
Organizational Affiliation(s)	School of Public Health, Boston University, Boston, Massachusetts
Areas of Expertise, Discipline, Relevant Experiences	Dr. Aschengrau has over 30 years of epidemiologic research on environmental pollution and related diseases, such as relationship between drinking water contaminants and abnormal pregnancy outcomes, neurological disorders and cancer, impact of lead hazard reduction measures among inner-city children, birth defects and stillbirths following prenatal exposure to tetrachloroethylene-contaminated drinking water, etc.. Dr. Aschengrau has published a best selling book on Essentials of Epidemiology in Public Health, served as a member of the Institute of Medicine Committee on Gulf War and Health, and as a consultant to the Environmental Protection Agency, and an associate editor of the journal Environmental Health.
Recommended by Scientific/Professional Society or General Public	No

2. Steven Bayard

Academic and Professional Credentials	PhD
Current Position Title	Consultant, biostatistics and toxicology
Organizational Affiliation(s)	Former health scientist at U.S. Environmental Protection Agency, Occupational Safety and Health Administration, and Consumer Product Safety Commission
Areas of Expertise, Discipline, Relevant Experiences	Dr. Bayard has over 30 years of experience in biostatistics, epidemiology and quantitative risk assessment of toxic chemical hazards, such as quantitative risk assessment process for cancer risk modeling, cancer risk assessments for over 20 chemicals, including dioxin, asbestos, methylene chloride, nickel and nickel compounds, 1,3-butadiene, vinyl and vinylidene chloride, ethylene oxide, and cadmium. Dr. Bayard has also taught risk assessment for the Pan American Health Organization, and co-authored a World Health Organization report on health hazards of environmental tobacco smoke. He has conducted and analyzed studies on private well water quality, air pollution and respiratory health, lung cancer, children’s respiratory health, and others.
Recommended by Scientific/Professional Society or General Public	No

3. Ritz, Beate

Academic and Professional Credentials	MD, PhD
Current Position Title	Professor and Vice Chair
Organizational Affiliation(s)	Department of Epidemiology, School of Public Health and School of Medicine in the University of California (UCLA), Los Angeles CA
Areas of Expertise, Discipline, Relevant Experiences	Dr Ritz is a research expert on the health effects of occupational and environmental toxins such as pesticides, ionizing radiation, and air pollution on chronic diseases including neurodegenerative disorders (Parkinson’s disease), cancers, and adverse birth outcomes and asthma. For example she had investigated the causes of cancer in chemical toxin and radiation exposed workers, the effects of air pollution on adverse birth outcomes as well as asthma in children, and the long-term effects of pesticide exposures on Parkinson’s disease and cancers and many others. Dr. Ritz is an expert in the use of geographic information system (GIS) modeling of environmental exposures including pesticide use and traffic related air pollution, and in investigating the links between genetic susceptibility factors and environmental exposures in populations.
Recommended by Scientific/Professional Society or General Public	No

4. Blair, Aaron

Academic and Professional Credentials	PhD
Current Position Title	Scientist Emeritus
Organizational Affiliation(s)	National Cancer Institute, Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch
Areas of Expertise, Discipline, Relevant Experiences	Dr. Blair holds expertise in genetics, epidemiology and cancer. He has received many prestigious scientific awards such as the NIH Director’s Award, the PHS Special Recognition Award, NIH Merit Award, the John Goldsmith Award for Outstanding Contributions to Environmental Epidemiology from the International Society for Environmental Epidemiology, and the NIH Director’s Award for the Deepwater Horizon Gulf Oil Spill Study. He has served on numerous review groups for IARC, EPA, and other agencies and organizations. Dr. Blair has authored more than 450 publications on occupational and environmental causes of cancer. Dr. Blair’s primary research experience focuses on evaluating cancer and other disease risks associated with agricultural exposures, chemicals in the workplace and the general environment, physical activity and disease, methodologic issues in occupational epidemiology, and studies of under-investigated populations.
Recommended by Scientific/Professional Society or General Public	No

Charge to Peer Reviewers:

1. Are the individual disease tables sufficiently comprehensive to make our case or did we omit an important epidemiological study that should be included in the tables?
2. Are we interpreting the epidemiological evidence and available toxicological information for each exposure-disease relationship appropriately? Particular emphasis on the mechanistic information provided for PCE and bladder cancer.
3. For each exposure-disease relationship covered in our assessment, is the summary of the evidence and concluding classification sufficiently supported by the information provided in the disease table and the discussion that follows the table, or do we need to include additional information (e.g., findings from animal studies), to support our conclusion?
4. Do you have any suggestions on how to strengthen our assessment of the evidence for any of the diseases evaluated (e.g., is their toxicological information that could be added to strengthen the assessment?)

Peer Reviewers’ Comments, CDC/ATSDR’s Response to Reviewers’ Comments [DOC – 33 KB], and The ISI/HISA Dissemination Itself [PDF – 5 MB]