Center for Asbestos Related Disease

Libby, MT, United States

Center for Asbestos Related Disease

Libby, MT, United States
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Noonan C.W.,University of Montana | Conway K.,University of Montana | Landguth E.L.,University of Montana | McNew T.,Center for Asbestos Related Disease | And 5 more authors.
Journal of Exposure Science and Environmental Epidemiology | Year: 2015

Libby, MT, USA, was the home to workers at a historical vermiculite mining facility and served as the processing and distribution center for this industrial product that was contaminated with amphibole asbestos. Several pathways of environmental asbestos exposure to the general population have been identified. The local clinic and health screening program collects data from participants on past occupational and environmental exposures to vermiculite and asbestos. Health studies among this population have demonstrated associations between amphibole exposure and health outcomes, but critical questions regarding the nature and level of exposure associated with specific outcomes remain unanswered. The objective of this study was to develop a comprehensive exposure assessment approach that integrates information on individuals' contact frequency with multiple exposure pathways. For 3031 participants, we describe cumulative exposure metrics for environmental exposures, occupational exposures, and residents' contact with carry-home asbestos from household workers. As expected, cumulative exposures for all three occupational categories were higher among men compared with women, and cumulative exposures for household contact and environmental pathways were higher among women. The comprehensive exposure assessment strategies will advance health studies and risk assessment approaches in this population with a complex history of both occupational and environmental asbestos exposure. © 2015 Nature America, Inc. All rights reserved.

PubMed | University of Montana, Montana State University, Center for Asbestos Related Disease, Mount Sinai School of Medicine and North Shore LIJ Health System
Type: Journal Article | Journal: American journal of industrial medicine | Year: 2016

The purpose of Pre-Adult Latency Study was to evaluate lung findings among adults who had been environmentally exposed to Libby Amphibole only during childhood and adolescence.Recruitment was restricted to volunteers who attended primary and/or secondary school, lived in Libby, MT, prior to age 23 years for males and 21 years for females and subsequently left the area. Subjects completed exposure and respiratory questionnaires, underwent pulmonary function tests (PFTs), and chest CT scans. A Pleural Score was calculated for degree and extent of pleural thickening. Logistic regression and multivariate linear regression were used.Of the 219 who met inclusion criteria, 198 participated. Pleural thickening was found in 96 (48%) of 198 participants. In almost half of these, it was of the lamellar type, not generally seen in exposure to other asbestos. Environmental Libby amphibole exposure was associated with pleural thickening, and the likelihood of pleural thickening increased with the number of years lived in the area. An inverse association between Pleural Score and PFT was found, which remained significant for FVC and DLco after additional sensitivity analyses.Cumulative environmental exposure was associated with risk of pleural thickening. Among this cohort, quantitative measures of pleural thickening were associated with decreased PFT. Am. J. Ind. Med. 60:20-34, 2017. 2016 Wiley Periodicals, Inc.

Broaddus V.C.,University of California at San Francisco | Everitt J.I.,Glaxosmithkline | Black B.,Center for Asbestos Related Disease | Kane A.B.,Brown University
Journal of Toxicology and Environmental Health - Part B: Critical Reviews | Year: 2011

Exposure to asbestos fibers is associated with non-neoplastic pleural diseases including plaques, fibrosis, and benign effusions, as well as with diffuse malignant pleural mesothelioma. Translocation and retention of fibers are fundamental processes in understanding the interactions between the dose and dimensions of fibers retained at this anatomic site and the subsequent pathological reactions. The initial interaction of fibers with target cells in the pleura has been studied in cellular models in vitro and in experimental studies in vivo. The proposed biological mechanisms responsible for non-neoplastic and neoplastic pleural diseases and the physical and chemical properties of asbestos fibers relevant to these mechanisms are critically reviewed. Understanding mechanisms of asbestos fiber toxicity may help us anticipate the problems from future exposures both to asbestos and to novel fibrous materials such as nanotubes. Gaps in our understanding have been outlined as guides for future research. Copyright © Taylor & Francis Group, LLC.

Larson T.C.,Agency for Toxic Substances and Disease Registry | Meyer C.A.,University of Cincinnati | Kapil V.,Agency for Toxic Substances and Disease Registry | Gurney J.W.,University of Nebraska Medical Center | And 3 more authors.
Radiology | Year: 2010

Purpose: To assess how early pleural and/or parenchymal abnormalities consistent with asbestos exposure could be ascertained and to identify factors associated with progression. Materials and Methods: Informed consent was obtained under an institutional review board-approved protocol. Multiple sequential chest radiographs obtained between 1955 and 2004 in 84 workers exposed to amphiboles associated with vermiculite in the town of Libby, Montana, were studied. A panel of three NIOSH B readers reviewed each worker's longitudinal chest radiograph series in reverse chronologic order and achieved a consensus reading for each radiograph. Measures of exposure were compared between workers with and those without progression of parenchymal and pleural abnormalities. Results: Because of the way the study was designed, all subjects had pleural(n = 84) and/or parenchymal(n = 26) abnormalities on the most recent chest radiograph. Compared with other investigations that used different methods, this investigation revealed shorter latency periods (defined as the interval between date of hire and date of earliest radiographic detection) for circumscribed pleural plaque (median latency, 8.6 years) and pleural calcification (median latency, 17.5 years). Pleural abnormalities progressed in 64 workers, while parenchymal abnormalities progressed in 14. No significant differences were found with regard to measures of exposure between workers with and those without progression. Conclusion: The latency period for the development of pleural plaques may be shorter than previously reported. Early plaques are subtle and may not be detectable except at retrospective review. © RSNA, 2010.

Cline R.J.W.,Kent State University | Orom H.,State University of New York at Buffalo | Chung J.E.,Howard University | Hernandez T.,Center for Asbestos Related Disease
American Journal of Community Psychology | Year: 2014

Experiencing a disaster has significant negative effects on psychological adjustment. Case study accounts point to two consistent trends in slowly-evolving environmental disasters: (a) patterns of negative social dynamics, and (b) relatively worse psychological outcomes than in natural disasters. Researchers have begun to explicitly postulate that the social consequences of slowly-evolving environmental disasters (e.g., community conflict) have their own effects on victims' psychological outcomes. This study tested a model of the relationship between those social consequences and psychological adjustment of victims of a slowly-evolving environmental disaster, specifically those whose health has been compromised by the amphibole asbestos disaster in Libby, MT. Results indicate that experiencing greater community conflict about the disaster was associated with greater family conflict about the disaster which, in turn, was associated with greater social constraints on talking with others about their disease, both directly and indirectly through experiencing stigmatization. Experiencing greater social constraints was associated with worse psychological adjustment, both directly and indirectly through failed social support. Findings have implications for understanding pathways by which social responses create negative effects on mental health in slowly-evolving environmental disasters. These pathways suggest points for prevention and response (e.g., social support, stigmatization of victims) for communities experiencing slowly-evolving environmental disasters. © 2014 Society for Community Research and Action.

Cline R.J.W.,Kent State University | Orom H.,State University of New York at Buffalo | Berry-Bobovski L.,Barbara Ann Karmanos Cancer Institute | Hernandez T.,Center for Asbestos Related Disease | And 3 more authors.
American Journal of Community Psychology | Year: 2010

Social support is an important resource for communities experiencing disasters. However, a disaster's nature (rapid- versus slow-onset, natural versus technological) may influence community-level responses. Disaster research on social support focuses primarily on rapid-onset natural disasters and, to a lesser extent, rapid-onset technological disasters. Little research has addressed slow-onset disasters. This study explores social support processes in Libby, MT, a community experiencing a "slow-motion technological disaster" due to widespread amphibole asbestos exposure. A comprehensive social support coding system was applied to focus-group and in-depth-interview transcripts. Results reveal that, although the community has a history of normative supportiveness during community and individual crises, that norm has been violated in the asbestos disaster context. Results are interpreted as a failure to achieve an "emergent altruistic community." Specifically, community-level conflict appears to interfere with previously established social support patterns. The observed phenomenon can be understood as the deterioration of a previously supportive community. © 2010 Society for Community Research and Action.

Black B.,Center for Asbestos Related Disease | Szeinuk J.,Mount Sinai School of Medicine | Whitehouse A.C.,Center for Asbestos Related Disease | Levin S.M.,Mount Sinai School of Medicine | And 3 more authors.
American Journal of Industrial Medicine | Year: 2014

Background: Residents and mine employees from Libby, Montana, have been exposed to asbestiform amphiboles from the vermiculite mine that operated in this location from the mid-1920s until 1990. Clinical observations show a different form of asbestos-related toxicity than other forms of asbestos. Methods: Five illustrative cases from the Center for Asbestos-Related Diseases in Libby were selected. All had clear exposure histories, multiple follow-up visits, illustrative chest radiographic studies, serial pulmonary function tests, and sufficient length of follow-up to characterize disease progression. Results: These cases developed increasing symptoms of dyspnea and chest pain, progressive radiological changes that were predominantly pleural, and a restrictive pattern of impaired spirometry that rapidly progressed with significant loss of pulmonary function. Conclusions: LA exposure can cause a non-malignant pleural disease that is more rapidly progressive and more severe than the usual asbestos-related disease. © 2014 Wiley Periodicals, Inc.

Winters C.A.,Montana State University | Hill W.G.,Montana State University | Rowse K.,Center for Asbestos Related Disease | Black B.,Center for Asbestos Related Disease | And 2 more authors.
BMJ Open | Year: 2012

Objective: Describe respiratory health and quality of life in persons exposed to Libby amphibole asbestos (LAA) contaminated vermiculite. Design: Cross-sectional descriptive. Setting: Asbestos-related disease clinic in Libby, Montana USA. Participants: 329 individuals exposed to LAA; mostly men, married, between 50 and 69 years; two-thirds lived in the surrounding county; one-third lived elsewhere in the state and USA. Primary outcome measures: Chest radiograph (CXR), pulmonary function data and the St George Respiratory Questionnaire (SGRQ). Results: Exposure categories included vermiculite workers=7.6%; family/household contact of vermiculite worker=32%; and environmental exposure only=60%. Of the participants, 55% had only pleural abnormalities; 5.4% had only interstitial abnormalities; nearly 21% had both abnormalities and 18% had no lung abnormality on chest x-ray. Mean forced vital capacity (FVC) 95.3% (SD=18.7); forced expiratory volume (FEV1) mean 87% (SD=20.2); ratio of FEV11/ FVC 95.5% (SD=12.0); and diffusing capacity (DLCO) of 83% (SD=21.7) of the percent predicted. The mean total SGRQ (38.5; SD=22.1) indicated a lower quality of life than healthy persons and persons with other chronic conditions. SGRQ subscale means were Symptoms 52.1 (SD=24.9), activity 49.4 (SD=26.9) and impacts 27.5 (SD=21.9). Participants with normal CXR differed significantly from those with both interstitial and pleural abnormalities on total, activity and impacts scores. For activity alone, subjects with normal CXR differed significantly from those with pleural disease; no differences were found for those with interstitial disease. Significant findings were found for smoking history across all pulmonary measures, and for exposure status, radiographic findings, age and gender for select pulmonary parameters. Subjects with any smoking history had significantly worse average total and subscale scores on the SGRQ. Conclusions: Of 329 persons exposed to LAA, the majority (182) had pleural abnormalities identified on CXR. SGRQ scores for persons with abnormalities (pleural, interstitial or both) (269) differed significantly from those with a normal CXR.

PubMed | Center for Asbestos Related Disease and Montana State University
Type: Journal Article | Journal: BMJ open | Year: 2016

To discern community attitudes towards research engagement in Libby, Montana, the only Superfund site for which a public health emergency has been declared.Survey study of convenience samples of residents near the Libby, Montana Superfund site.Residents of the Libby, Montana area were recruited from a local retail establishment (N=120, survey 1) or a community event (N=127, survey 2).Two surveys were developed in consultation with a Community Advisory Panel.Principal components of survey 1 showed four dimensions of community members attitudes towards research engagement: (1) researcher communication and contributions to the community, (2) identity and affiliation of the researchers requesting participation, (3) potential personal barriers, including data confidentiality, painful or invasive procedures and effects on health insurance and (4) research benefits for the community, oneself or family. The score on the first factor was positively related to desire to participate in research (r=0.31, p=0.01). Scores on factors 2 and 3 were higher for those with diagnosis of asbestos-related disease (ARD) in the family (Cohens d=0.41, 0.57). Survey 2 also found more positive attitudes towards research when a family member had ARD (Cohens d=0.48).Principal components analysis shows different dimensions of attitudes towards research engagement. The different dimensions are related to community members desire to be invited to participate in research, awareness of past research in the community and having been screened or diagnosed with a health condition related to the Superfund contaminant.

Ryan P.H.,University of Cincinnati | Lemasters G.K.,University of Cincinnati | Burkle J.,University of Cincinnati | Lockey J.E.,University of Cincinnati | And 2 more authors.
Journal of Exposure Science and Environmental Epidemiology | Year: 2015

Residents of Libby, MT were exposed to amphibole asbestos through multiple environmental pathways. Previous exposure characterization has primarily relied on qualitative report of these exposure activities. The objectives of this study were to describe available data from the US EPA preremediation actions for Libby amphibole (LA) exposure in Libby, MT and develop an approach to characterize outdoor residential exposure to LA among children. Homes in Libby, MT included in the US EPA preremediation Contaminant Screening Survey (CSS) were categorized by the presence of interior and/or exterior visible vermiculite and concentrations of LA were measured in samples of dust and soil. Airborne exposure to LA while digging/gardening, raking, and mowing were estimated using US EPA activity-based sampling (ABS) results. Residential histories and frequency/duration of childhood activities were combined with ABS to demonstrate the approach for estimating potential exposure. A total of 3154 residential properties participated in the CSS and 44% of these had visible exterior vermiculite. Airborne concentrations of LA where there was visible vermiculite outdoors were 3-15 times higher during digging/gardening, raking, and mowing activities compared with homes without visible outdoor vermiculite. Digging and gardening activities represented the greatest contribution to estimated exposures and 73% of the participants reported this activity before the age of 6 years. This methodology demonstrated the use of historical preremediation data to estimate residential exposures of children for specific activities. Children younger than age 6 years may have been exposed to LA while digging/gardening, especially at homes where there is visible outdoor vermiculite. This approach may be extended to other activities and applied to the entire cohort to examine health outcomes. © 2015 Nature America, Inc. All rights reserved.

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