Getting down and dirty with boots on the ground is one trait of a successful community organizer. It could also describe the work of the most-skilled epidemiologists. ATSDR scientist Frank Bove, ScD’s past experience with the first—an organizer from 1975 to 1982–makes him especially effective at the second.

Last month, Bove was recognized by the Boston University School of Public Health with the 2014 David Ozonoff Unsung Hero Award for his work. Bove has been the lead researcher in the Agency for Toxic Studies and Disease Registry’s (ATSDR) investigation of U.S. Marine Corps base Camp Lejeune. For nearly a decade, ATSDR has been examining the relationship between adverse health effects of former residents of Camp Lejeune and the association with contaminants in their drinking water. Between the 1950’s and late 1980’s the water provided to residents from the base’s water treatment plants were contaminated with high concentrations of TCE, PCE, vinyl chloride and benzene.  Our colleague Dick Clapp has written about the Camp Lejeune here and also testified before Congress about it.

David Ozonoff, MD, MPH for whom the award is named, witnessed Bove’s expertise on the Camp Lejeune project as the ATSDR scientist maneuvered as both an epidemiologist and the community organizer. Ozonoff served in 2005 on an expert panel that made recommendations to Bove’s team on the feasibility and usefulness of conducting additional health studies of the Camp Lejeune population. One of the panel’s seven recommendations, in fact, the first one listed was “future studies should be conducted in full partnership with the exposed community.” The panel wrote:

“In contrast with many other places where toxic contamination of the environment has been a concern, the population at Camp Lejeune is relatively transient. Most of the population of potentially exposed individuals from Camp Lejeune is now widely spread throughout the United States and in some instances, around the world. This creates challenges in tracking individuals, in contacting and interviewing them where necessary, in gaining permission for access to their medical records (if necessary), and in communicating study findings to them. …Community members, with a personal involvement and concern about health effects associated with their past exposures, must be fully involved in any future research effort. These individuals can work closely with researchers and serve a liaison function with members of the more broadly exposed population(s) from Camp Lejeune.”

Some researchers would cringe at this directive. They’d say of the residents “they aren’t scientists, they aren’t capable.” Bove disagrees.  He told me:

“Community participation always—always—improves the science. It makes the science relevant to the community.”

ATSDR established a community assistance panel which first met in February 2006. Meeting three to four times per year, the CAP has held 29 meetings. Bove has attended each and every one of them. I was hard pressed to identify many other participant, except the key community leaders, with such a stellar record of attendance.  (Dick Clapp, DSc, MPH, who served as a technical adviser to the community group, had nearly a perfect record. Clapp’s philosophy of community-based research mirrors Bove’s.)

I can see another, more important practical reason to embrace the participation of engaged and vocal representatives of the effected community. They, better than ATSDR or most other government agencies with hat-in-hand, can convince lawmakers to not only be supportive of the cause, but to demonstrate support in the most concrete way: $$$.  The Camp Lejeune study could not be done on the cheap.

The body of literature developed by Bove’s work is impressive. Besides the government reports, Bove and colleagues have published some of their work, most recently: “Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study,” (February 2014); “Evaluation of exposure to contaminated drinking water and specific birth defects and childhood cancers at Marine Corps Base Camp Lejeune, North Carolina: a case-control study, ” (December 2013)

In total, more than 750,000 individuals lived at Camp Lejeune during the four-decades of contamination. A slew of specific adverse health conditions, such as leukemia, breast cancer and miscarriage, including from pre-natal exposure, have been associated with exposure to the contaminated water. 

The decades long saga of water contamination at the U.S. Marine Corps’ Camp Lejeune has been the subject of national news stories, the film “Semper Fi: Always Faithful,” and a new book “A Trust Betrayed: The Untold Story of Camp Lejeune and the Poisoning of Generations of Marines and Their Families.” Those who’ve followed the story will recognize the names: Jerry Ensminger, Mike Partain, and Tom Townsend. They are the key protagonists are who have made their mission holding the Marine Corps and DOD responsible for poisoning residents of the military base. Their efforts, and clearly the scientific evidence provided by Bove’s team, led Congress to pass “The Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012.”

Ensminger and the others are deserving of the credit they’ve received for seeing that the Marine Corps and DOD are held responsible for their misdeeds related to the poisonings at Camp Lejeune.  It’s hard to imagine they’d have had the same success without Frank Bove, ScD’s involvement. He may be unsung, but certainly a public health hero.