Occupational and Environmental Lung Diseases: Occupational and Environmental Lung Disease |

Asbestos Exposure and Health Screening in Libby, Montana: Past, Present, and Future FREE TO VIEW

Tracy McNew, MPA; Tanis Hernandez, MSW; Charles Black, MD
Author and Funding Information

Center for Asbestos Related Disease, Libby, MT

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):931A. doi:10.1016/j.chest.2016.08.1032
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SESSION TITLE: Occupational and Environmental Lung Disease

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: A comprehensiveoverview of asbestos exposure, disease outcomes, and future trajectory of asbestos-related disease in Libby, MT will be presented.

METHODS: Libby, MT was the site of community-wide asbestos exposures from about 1919-1990 due to local mining of contaminated vermiculite. The mine closed in 1990, and in 1999 news broke of potential community-wide asbestos exposures and deaths. EPA and CDC responded to conduct initial environmental and human health investigations. After asbestos contamination was confirmed, in 2002 Libby became an asbestos Superfund site. EPA's clean-up of asbestos in Libby continues to present.

RESULTS: In 2009, the Libby Superfund site was the first site ever declared by EPA as an environmental public health emergency because of the effects on human health. A recent Agency for Toxic Substances and Disease Registry (ATSDR) study identified 694 deaths from asbestos-related diseases in the area due to Libby exposure between 1979-2011.

CONCLUSIONS: ATSDR's initial 2000-2001 health screening for asbestos-related health effects found that 18% of over 7,000 residents screened had evidence of asbestos-related changes on CXR B read. The Montana Asbestos Screening and Surveillance Activity (MASSA) conducted screenings from 2003-2008 in Libby and reported 28% of over 4,300 screenings with asbestos related pleural abnormalities identified on CXR B read. Since 2009, the Center for Asbestos Related Disease (CARD) has carried out asbestos health screening in the Libby community under a federal grant. Screening conducted by CARD from 2011-2015 included 3,449 screenings wth a 41% diagnosis rate based on radiologist's CT scan reads. Most individuals screened re[prted only environmental (non-occupational) exposure to Libby asbestos.

CLINICAL IMPLICATIONS: EPA has established a new reference concentration of asbestos specific to Libby which is significantly lower than other asbestos reference concentrations verifying the toxicity of the Libby fibers. Asbestos will remain after clean-up is complete, and local institutional controls to mitigate ongoing exposures are still being developed. With 10-40 years latency between time of exposure and development of disease, and significant exposures continuing until clean-up began in 2000, asbestos health screening and ongoing treatment will be important for the forseeable future in Libby, MT.

DISCLOSURE: The following authors have nothing to disclose: Tracy McNew, Tanis Hernandez, Charles Black

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