Camp Lejeune solvent-water cohort

The research record

This is the project's file for this landmark, as written and checked. Sources are listed at the end; anything not yet confirmed is marked "Not yet verified".

Who

Samuel Goldman, Frances Weaver, Kevin Stroupe, Lishan Cao, Bianca Gonzalez, Kenneth Colletta, Ethan Brown and Caroline Tanner. JAMA Neurology 2023. The authors' disclosures list a grant from the Edward Hines Jr. VA Hospital (Weaver), and pharmaceutical consulting and grants from the Michael J. Fox Foundation and others for Tanner and Brown; none is from the solvent industry. The paper's own funding statement was not read.

What happened

Earlier work had linked TCE to Parkinson's in twins, with wide uncertainty (landmark 25). Camp Lejeune, North Carolina, offered a natural experiment. Cases were found in Veterans Health Administration and Medicare records and confirmed by medical-record review. From 1975 to 1985 its water was contaminated with several volatile organic compounds, with TCE highest (monthly medians more than 70 times the permissible level). Camp Pendleton, California, had clean water.

The team compared 172,128 service members at Lejeune with 168,361 at Pendleton, all there for at least 3 months in 1975–85. Follow-up ran from 1997 to February 2021. Health data were available for 158,122 veterans (46.4%).

• 430 had Parkinson's: 279 at Lejeune (0.33%) and 151 at Pendleton (0.21%).
• Adjusted odds ratio for Lejeune: 1.70 (95% CI 1.39–2.07).
• No excess of other parkinsonian disorders, such as multiple system atrophy.
• Lejeune veterans also had more prodromal (pre-diagnosis) features, such as tremor and anxiety.

Why it moved us toward a cure

Exposure here came from a documented water supply, not from recalled pesticide use, so it avoids the recall bias that weakens the 2011 farmer study. It adds weight to prevention: if solvents drive part of the risk, removing them lowers it. It also gives a cohort in which prodromal signs can be tracked.

Outcome

Open. The result is an association. Individual TCE doses were not measured, only base of residence. About half the cohort lacked health data. It does not show that TCE alone is the cause, because the water held other solvents. The same team later looked at 270 veterans with Parkinson's and found signs of faster progression in those exposed (adjusted hazard ratios above 2 for psychosis, fracture and falls, but with wide intervals that mostly included 1; Goldman et al., Movement Disorders 2024, DOI 10.1002/mds.29922, funded by the VA), and a 2025 Medicare study tied ambient outdoor TCE to Parkinson's risk (Krzyzanowski et al., Neurology, DOI 10.1212/WNL.0000000000214174).

Sources

• Goldman et al., JAMA Neurol 2023;80(7):673–681, DOI 10.1001/jamaneurol.2023.1168 (Europe PMC, PMID 37184848)
• Full text, PMC10186205
• Goldman et al., Mov Disord 2024, DOI 10.1002/mds.29922 · Krzyzanowski et al., Neurology 2025, DOI 10.1212/WNL.0000000000214174 (abstracts read via Europe PMC)
• No correction or retraction is listed on PubMed for the 2023 paper; it has an editorial (Dorsey, Greenamyre and Willis, JAMA Neurol 2023;80:663–665).
• Not yet verified: the paper's full text and funding statement (abstract and disclosures read via PubMed).