Risk of Parkinson Disease Among Service Members at Marine Corps Base Camp Lejeune.
Level 3 - non-randomized controlled study
Retrospective cohort study comparing exposed and unexposed military populations over longitudinal follow-up.
PubMed 37184848 · doi:10.1001/jamaneurol.2023.1168
What was done
A retrospective population-based cohort study compared Marines and Navy personnel stationed for at least 3 months between 1975 and 1985 at Camp Lejeune, North Carolina (contaminated with trichloroethylene [TCE] and other volatile organic compounds; n = 172,128) against those stationed at Camp Pendleton, California (uncontaminated water; n = 168,361). Follow-up spanned from January 1, 1997, to February 17, 2021, linking Veterans Health Administration and Medicare databases. Parkinson disease (PD) diagnoses were identified via ICD codes and medication records, then confirmed by medical record review. Prodromal PD features were also evaluated.
What was found
Health data were available for 158,122 veterans (46.4% of the cohort). A total of 430 veterans had PD: 279 at Camp Lejeune (prevalence, 0.33%) versus 151 at Camp Pendleton (prevalence, 0.21%). In multivariable models, Camp Lejeune veterans had a 70% higher risk of PD (odds ratio, 1.70; 95% CI, 1.39-2.07; P < .001). No excess risk was found for other forms of neurodegenerative parkinsonism. Camp Lejeune veterans also had a significantly increased risk of prodromal PD diagnoses (including tremor, anxiety, and erectile dysfunction) and higher cumulative prodromal risk scores.
Why it matters
This study provides large-scale epidemiological evidence linking historical environmental exposure to TCE-contaminated water with an increased risk of developing Parkinson disease decades later.
Limits
Health data were available for only 46.4% of the cohort, introducing potential selection and loss-to-follow-up bias. Individual water consumption and personal exposure levels were not directly measured and were inferred from base assignment. The cohort was predominantly male (~95%), limiting generalizability to women.
Cited by
- supports Trichloroethylene contamination in groundwater at Camp Lejeune is linked to higher rates of Parkinson's disease.