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.