WHO Says “Parkinson Disease Is Increasing Faster Than Any Other Neurologic Disorder”
JAMA Network May 9 reported on a large study linking industrial solvent in drinking water to the development of Parkinson Disease (PD) in Camp Lejeune Veterans. The 1987 Safe Drinking Water Act uncovered polluted wells at Camp Lejeune. The main contaminant was a Volatile Organic Compound (VOC) called trichloroethylene (TCE), which came from on-base sources (leaking underground storage tanks, industrial spills, and waste disposal sites) and off-base sources (dry-cleaning businesses). The study compared the prevalence of PD in Marines who had lived on this base during the high-exposure years of 1975-1985, when monthly TCE levels were 70-fold the permissible amount. This cohort was compared to Marines living at Camp Pendleton in CA, where the water had not been contaminated. The study found a 70% higher risk of PD in Camp Lejeune Marines, which may be the tip of the iceberg, since this population is only in their mid-60s.
Industrial solvents are used worldwide and may contaminate water systems for years prior to detection, as occurred in the case of this Marine base. Worldwide, PD cases have increased from 2.5 million people diagnosed with PD in 1990 to 6.1 million in 2016. While aging of populations may explain some of this risk, occult water contamination may be a significant contributory factor. Fortunately, our country has cleaned up our water systems since 1987, but the consequences of environmental contamination with VOCs like TCE will likely be seen in this country for decades as those exposed live into higher-risk ages. For veterans who resided or worked at Camp Lejeune during the exposure years before 1987, the VA determined in 2017 that a diagnosis of PD automatically entitled them to military benefits.
As a Medical Director and attending physician, I’ve cared for many persons with advanced PD in the SNF setting and have been frustrated by our limited ability to improve the quality of life and minimize the common complications of this disorder, which are associated with the failure of so many different systems. We can expect to see many more cases in the coming years.
At this time in my community, I’ve attempted to reach a SNF resident’s neurologist for help managing motor restlessness, delusions, and frequent falls, but after 1 week, haven’t had a return call. In my community, healthcare is still poorly integrated. I suspect this difficulty accessing PD expertise is common throughout our state.
With PD cases on the rise, I hope that SNFs and local health systems will establish accessible centers of PD expertise, that help residents and others living with PD receive optimal care.