When an individual signs up for the Marines, he or she expects to put their life on the line. They know there is a chance that they will be shot at, be put into dangerous situations, and will sometimes lose friends in the line of duty. What they do not expect is to be in dangerous situations at home or to lose friends to chemical contamination on American soil or on their own base. This is exactly what has happened to veterans of Camp Lejeune for years.
Camp Lejeune, which is located in Jacksonville, North Carolina, is a 246 square-mile Marine Corps base opened in 1941. The base was subject to large scale water contamination due to the disposal practices of an off-base dry cleaning operation and leaking gasoline storage tanks at Hadnot Point. This contamination continued for a number of years. The United States government has recognized that there was continuous exposure between at least 1957 and 1987. It is estimated that as early as 1948 chemicals from the operation infiltrated the water system through at least two of the base’s eight water treatment plants.
The chemicals, known as volatile organic compounds (VOCs), included perchloroethylene (PCE) a dry-cleaning agent, trichloroethylene (TCE), a degreaser and paint stripper, and benzene, a component of gasoline. Agency for Toxic Substances and Disease Registry (ATSDR) studies have shown that TCE contamination was as severe as 1,400 parts per billion (ppb) in May of 1982. (Currently, the accepted limit for TCE in drinking water is only 5 ppb.) This contaminated water was used for everything from drinking to bathing for those stationed at Camp Lejeune. These contaminates have been shown to be associated with the development of a rare autoimmune disease known as scleroderma.
Scleroderma, also known by systemic sclerosis, is a chronic systemic autoimmune disease characterized by hardening (sclero) of the skin (derma). In its most severe form, scleroderma will affect internal organs. Scleroderma is divided into two distinct types: limited and diffuse.
Limited scleroderma manifests mainly through the skin and affects the hands, arms and face. Previously, limited scleroderma was also known as CREST. This came from an acronym of Calcinosis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasias each of which are symptoms of scleroderma. More information on the secondary conditions of scleroderma can be found here.
Diffuse scleroderma is the more aggressive of the types. It can rapidly progress and affects large areas of skin and one more internal organ. Most frequently, scleroderma affects kidneys, esophagus, heart and lungs. Generally speaking, scleroderma is not treated as a singular disease, but rather individual systems are treated for the associated symptoms.
Current medical literature does not recognize a distinct cause for scleroderma. However, there are a number of recognized associations between scleroderma and solvent exposure. Occupational exposure to solvents (TCE, TCA, and benzene) is associated with a statistically significant higher risk of developing scleroderma. This association is strongest in men and in individuals who have the anti-Scl70 auto-antibody. Cumulative exposure to organic solvents in drinking and bath water (such as Camp Lejeune veterans suffered) would be strongly associated with an increased risk of the development of scleroderma.
As of 2012, Congress recognized these risks and passed the Honoring America’s Veterans and Caring for Families of Camp Lejeune Act of 2012 (also known as the Janey Ensminger Act of 2012 after the deceased daughter of Marine master sergeant Jerry Ensminger). The Act required that the VA provide medical care for Lejeune veterans who served at least thirty days at Camp Lejeune during the qualifying period (January 1st, 1957 and December 31st, 1987) for a list of diseases that can be found here.
The reason to begin thinking about this disease and how it affects your or your loved ones is that as of August 3, 2015, the VA has announced that it is opening discussion for the potential of presumptions related to the chemical exposure. On August 19, VA and ATSDR representatives met to begin the discussion of how to establish such presumptions. The VA has claimed they will be working not only with ATSDR, but will also be working in conjunction with the National Academy of Sciences and considering public comments closely when determining what presumptions should be granted.
When these presumptions are established, it is important to get the earliest effective date possible for the condition. By filing now, you have the ability to preserve an effective date for compensation with the VA. While there is no law regarding the effective dates of the coming Camp Lejeune presumptions, one can take note of the Nehmer case with regard to Agent Orange presumptions. This case established that veterans with an AO presumption is entitled to the earliest effective date that he applied for a presumed disease even though said disease was not presumptive at the time. A more in depth discussion of Nehmer can be found here.
Thank you for your service.
 It is also worth noting that these symptoms can sometimes be rated separately from scleroderma as secondary or standalone health problems. Raynaud’s syndrome for instance has its own rating scale and can be rated as a secondary condition of scleroderma.