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First Thoughts on the Camp Lejeune ATSDR Study: A Double-Edged Sword

contaminated water

In a recent in-depth discussion at the February 1, 2024 SimplyConvert Camp Lejeune Roundtable, former Centers for Disease Control and Prevention (CDC) epidemiologist William J. Lee, J.D., M.S., MACE delved into the latest findings from the 2024 Camp Lejeune study conducted by senior epidemiologist Frank Bove at the CDC’s Agency for Toxic Substances and Disease Registry (ATSDR).

At face value, this study presents evidence which suggests that military and civilian personnel who lived and worked at Camp Lejeune in North Carolina during the mid-1970s and ‘80s were at a higher risk of developing certain cancers compared to their counterparts stationed at Camp Pendleton, a similar military base in California with no known history of water contamination. This study underscores the long-held concerns regarding the water contamination at Camp Lejeune, which was tainted with cancer-causing chemicals including trichloroethylene (TCE), perchloroethylene (PCE), vinyl chloride, and benzene from 1953 to 1985. Lee’s commentary regarding the study, which currently remains unpublished, explored cancer incidence among individuals exposed to contaminated water at the military base. The analysis according to Lee revealed a mix of outcomes, where certain conditions not previously associated with exposure showed statistically significant increased risk, while others previously identified as presumptive failed to show statistical significance, e.g., non-Hodgkin’s lymphoma, kidney cancer, bladder cancer, and liver cancer.

The methodology of the study was scrutinized by Lee for its unique approach, including the use of quantitative bias adjustment to account for presumed, non-differential exposure misclassification. This adjustment raised concerns about the potential validity of the adjusted hazard ratios, which tended to drive results away from the null.

The conversation also highlighted the complex litigation landscape surrounding the study's findings. During the webcast discussion, Lee was joined by his colleagues Bill Kershaw and Jamie Powers, who discussed how the study's methodology, including quantitative bias adjustment and underlying data limitations, could impact its admissibility in court. The potential for the study to be both a tool for elevating certain conditions to presumptive status and a weapon for defense to challenge established connections was a key focus.

“The challenge we face lies in navigating the complexities of this study with a strategic perspective,” Lee stated in the webcast. “While it's tempting to highlight specific, favorable adjusted hazard ratios as robust evidence, we must acknowledge the study's methodological limitations and null findings. We must critically assess and prepare for potential critiques from a defense standpoint. It's essential to balance our advocacy with a cautious approach to these scientific nuances, ensuring our strategies are resilient against potential counterarguments.”

Furthermore, the implications of the study on the broader understanding of exposure-related conditions at Camp Lejeune were examined. Lee pointed out that while the study introduces new data, it also complicates the narrative by potentially downgrading certain injuries. This duality presents a challenge for legal professionals, plaintiffs, and defendants navigating the complex web of environmental litigation.

The peer review process and the future publication of the study were also discussed, emphasizing the importance of such scrutiny in validating the study's findings. The lengthy peer review process, which can materially alter the study's content and conclusions, underscores the fluid nature of publishing scientific research.

In conclusion, the ATSDR study on Camp Lejeune's contaminated water and cancer incidence adds a new layer to the ongoing discussion about environmental exposure and health outcomes. While it offers valuable insights, its methodology and the potential legal implications require careful consideration. As the study moves through the peer review process, its role in shaping litigation strategies and public policy remains to be seen. The nuanced discussion by Lee and his colleagues underscores the complex interplay between science, law, and public health, highlighting the need for a careful and informed approach to interpreting and utilizing such studies.

Lee leads Kershaw Talley Barlow’s scientific consulting practice and supports its nationally recognized mass tort and class action practices. With a rich background in biomedical research, clinical research, epidemiology, and biostatistics, Lee has carved out a niche in developing scientific and medical evidence, routinely collaborating with leading experts to perform epidemiological and biostatistical analyses across state and federal trial, appellate, and Supreme Court litigations. Lee is an elected member of the American College of Epidemiology, in which he serves on its ethics and policy committee and its Foundation Board of Directors.

You can access the recording by signing up for the SimplyConvert Camp Lejeune Circle here. SimplyConvert’s Camp Lejeune Circle is an online community of leading trial attorneys and other legal professionals from across the country.

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