By Scott Simonton
In 1997 I ended up in the ER, and then admitted to the hospital, after I developed some significant pain in my feet and ankles along with a graying of the skin there. Over the next several days, the pain got worse, spread to my knees, and I was tested for everything under the sun – I was even given a pregnancy test, as a positive result for a man would be an indicator of some rare cancer. I was even on the morning teaching rotation, and my condition photographed for a medical article. When I was discharged 5 or 6 days later, I remarked to the nurse about how I lucked out because no one else ended up in the 2-person room I was in. She then informed me it wasn’t because of luck – I had been quarantined because they couldn’t figure out what was wrong with me.
On day 4 or 5, after a ton of tests, a crusty old doc came and looked, and said “that’s sarcoidosis”. He was right.
Sarcoidosis is a disease that results from inflammation in different parts of the body, typically the lungs and lymph nodes. It can also affect other organs such as the skin, eyes, and heart. Sarcoidosis is characterized by the formation of small clusters of cells called granulomas, which are the body’s attempt to fight off foreign substances, but in sarcoidosis, these granulomas can accumulate and lead to tissue damage.
It hadn’t apparently been considered by the other doctors, as the “presentation was abnormal”, and at the time it was not only rare, but also most prevalent in African American women in the south.
I was fortunate – after a long round of steroids and a few more biopsies to make sure it wasn’t something else, I haven’t had any symptoms of sarcoidosis since then. In others it can be incredibly debilitating, even fatal.
Years later, in my professional capacity as an environmental engineer, I learned that there is some evidence to suggest that exposure to chlorinated compounds may be associated with an increased risk of developing sarcoidosis, although the exact link between the two is not fully understood.
Chlorinated compounds are chemicals that contain chlorine, such as chlorinated solvents and pesticides. These compounds are widely used in industry and agriculture and can be found in products such as cleaning agents, plastics, and water disinfectants.
Studies have shown that people who work in jobs that involve exposure to chlorinated compounds, such as farmers, chemical plant workers, and dry cleaners, may be at an increased risk of developing sarcoidosis. Some researchers believe that exposure to these chemicals may trigger an immune response that leads to the formation of granulomas in the lungs and other organs.
This all was particularly interesting – and personal – for me, as I was a young Marine at Camp Lejeune from 1983 to 1986. Camp Lejeune, a United States Marine Corps base in North Carolina, has been associated with environmental contamination due to the presence of various toxic chemicals. The contamination occurred from the 1950s through the 1980s, primarily through the disposal of industrial solvents, fuel, and other hazardous waste. This contamination impacted the base drinking water supply.
One of the most significant environmental contaminants at Camp Lejeune was the chlorinated compound trichloroethylene (TCE), a known carcinogen. TCE was used as a degreaser in the base’s maintenance shops, and its use was widespread. The contamination also included other volatile organic compounds (VOCs), such as vinyl chloride and perchloroethylene – two other chlorinated compounds.
The contamination of Camp Lejeune has been linked to various health problems, including cancer, birth defects, and other chronic diseases. According to the Agency for Toxic Substances and Disease Registry (ATSDR), an estimated 750,000 military personnel and their families were potentially exposed to contaminated drinking water at Camp Lejeune between 1953 and 1987.
The most commonly reported illnesses associated with Camp Lejeune exposure include kidney cancer, liver cancer, non-Hodgkin’s lymphoma, leukemia, and aplastic anemia. Other chronic conditions linked to exposure to Camp Lejeune’s contaminated water include Parkinson’s disease, multiple myeloma, and scleroderma.
Our understanding of the connection between contaminant exposures and adverse health effects is limited. While there are cases with strong associations to particular contaminants like those described above, in many cases we simply don’t have the data for clear connections because of the complexities associated with toxicology.
Our knowledge of the toxicity of contaminants is limited in several ways:
•Limited data: There are thousands of different contaminants, but we only have toxicological data on a fraction of them. Many chemicals have not been thoroughly tested for their potential health effects, and even for those that have, the data may be limited or outdated.
•Complex interactions: Contaminants can interact with each other, making it difficult to predict their combined effects on human health. The interaction between contaminants and other environmental factors, such as diet and lifestyle, can also complicate the picture.
•Individual differences: People may vary in their susceptibility to the effects of contaminants. Factors such as age, gender, genetics, and overall health status can all influence how a contaminant affects an individual.
•Long-term effects: Some contaminants may have long-term effects on human health, but these effects may not be apparent for years or even decades after exposure. This can make it difficult to identify the cause of health problems that develop later in life.
•Animal testing limitations: Toxicology testing is often conducted on animals, but animal models may not always accurately predict the effects of contaminants on human health.
So, while a list of known or suspected Camp Lejeune health impacts has been developed, that list is not and can not be exhaustive. However, that is the list that is used to determine eligibility for care for those Marines, their families, and others exposed to the contamination at Camp Lejeune.
In recent years, there have been several studies that have attempted to link specific health effects to the Camp Lejeune contamination. Overall, these studies suggest that there is a strong link between the Camp Lejeune contamination and various health effects. However, further research is needed to fully understand the nature and extent of this link, as well as to identify any additional health effects that may be associated with the contamination.
Personally, I suspect that my development of sarcoidosis is linked to my exposure to contaminants at Camp Lejeune. Luckily, as of now that is a personal and professional curiosity that hasn’t resulted in any impact to my life outside of a few months in 1997. So far.
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