Neurobehavioral Effects

The following is information gathered from a handful of studies on neurobehavioral effects, one of the 15 health conditions for Camp Lejeune victims.

In definition of “neurobehavioral effects”, conditions are of or relating to the relationship between the action of the nervous system and behavior. These may include: poor memory, dementia, depression, poor concentration, post-traumatic stress disorder, insomnia, fatigue, motor problems, and many others. Exposure to TCE and other VOCs has been shown to be linked.

First, a study from East Tennessee State reveals:

Studies at University of Pittsburg showed the effects of solvents on occupationally exposed subjects. These findings included social alienation, poor concentration, anxiety, and impairments in learning and memory. Hyperactivity and behavioral problems among school children has coincided with steadily increasing levels of VOCs found in modern buildings. Standard neurotoxicology texts point out that, behavioral problems may be the earliest sign of chemical toxicity. Case reports and clinical studies of persons with a history of organic solvent exposure have described the presence of post traumatic stress disorder, schizophreniform psychosis, and panic disorder. Epidemiological studies suggested higher frequencies of neurological and psychiatric symptoms for solvent exposed workers compared to non exposed workers. TCE is neurotoxic to humans at high concentrations and the effects can be persistent. Chronic and low-dose exposure to TCE can reportedly result in neurobehavioral impairment (U.S. Public Health Services, 1997).

Second, another NCBI study concludes that long-term exposure to low concentrations of TCE is associated with neurobehavioral deficits. ⁵

Finally, in a prior 2009 report, the NRC only defined the term “neurobehavioral effects” to include such neurobehavioral symptoms as fatigue, lack of coordination, sensory disturbances, confusion, depression, tension, trouble concentrating, and headache; alterations in neurobehavioral tests that indicate deficits in attention, reaction time, visuomotor coordination, motor function, digit symbol, and contrast sensitivity; and certain neuropsychological disorders such as learning or behavioral disorders.

It did not, at the time, include neurologic diseases, such as Alzheimer’s disease and Parkinson’s disease. That changed in 2015, in the Review of VA Clinical Guidance for the Health Conditions Identified by Camp Lejeune Legislation. The review committee now agrees that neurobehavioral effects, including Parkinson’s, should be included and covered by the VA.

The committee concludes that Parkinson’s disease is a neurobehavioral effectthat may have resulted from the consumption of the contaminated drinking water at Camp Lejeune. This conclusion is based on the positive trends of increased risks from occupational and drinking water exposures reported by Goldman et al. (2012), NRC (2009), and Bove et al. (2014b). Despite the limitations of these studies, such as lack of statistical significance, the potential for recall bias, and the lack of incidence data pertaining to Parkinson’s disease, the committee recommends including Parkinson’s disease as an outcome associated with exposure to TCE and PCE. Because of the slow onset of Parkinson’s disease, patients developing it years after their exposure, regardless of their age at exposure, may have not had symptoms at the time of exposure. Patients who have Parkinson’s disease now or who develop it in the future and are otherwise eligible for the Camp Lejeune program should be covered by the guidance for neurobehavioral effects even if the symptoms were not apparent during their time at Camp Lejeune. The committee recommends that VA consider adding Parkinson’s disease in the clinical guidance and in algorithm B as a neurobehavioral effect that may result from exposure to contaminated drinking water at Camp Lejeune.

We’ve included the links to the studies below. Do you have a neurobehavioral issue from drinking contaminated water at Lejeune? Some of you have already asked us about Parkinson’s Disease and why it was not already considered as part of the 15 health conditions (or for that matter, why it has not already been made presumptive).  We want to hear your story. Share in the comments below or click here to submit privately.

Relevant Links:

1. NY Love Canal Report
2. Exposure to Volatile Organic Compounds and Effect on Neurobehavioral Function
3. Neurobehavioral science in hazard identification and risk assessment of neurotoxic agents—what are the requirements for further development?
4. Review of VA Clinical Guidance for the Health Conditions Identified by the Camp Lejeune Legislation (2015) – Chapter: 3 Characterization of Neurobehavioral Effects, starting pg. 35
5. National Center for Biotechnology Information – Neurobehavioral effects of exposure to trichloroethylene through a municipal water supply