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Vermiculite mining in Libby, Montana began in the 1920s. Throughout much of the twentieth century, Libby was the primary source of vermiculite worldwide until the Libby vermiculite operations closed in 1990. The vermiculite ore mined in Libby contains amphibole asbestos and other elongate mineral fibers. In 1999, the Agency for Toxic Substances and Disease Registry (ATSDR) was asked by the Department of Health and Human Services (DHHS) to evaluate human health concerns in Libby that were related to asbestos exposure. DHHS was acting on requests received from the U.S. Environmental Protection Agency (EPA) and the Montana Congressional delegation.
Since that time, ATSDR has worked closely with the community on a number of projects and activities.
A scenic photo shot near Libby, Montana.
Overview of ATSDR Activities in Libby
ATSDR has conducted and continues to conduct a number of activities related to asbestos and Libby. They include:
Amphibole Health Risk Initiative is a series of projects related to Libby, Montana, designed to advance the scientific understanding of amphibole exposures:
The primary project in this initiative is the Libby Epidemiology Research Program (LERP). Under an ATSDR grant, LERP is being conducted by the Mount Sinai School of Medicine. Results from several LERP studies have been published in scientific papers:
- Multiple pathway asbestos exposure assessment for a Superfund community
- Asbestos-associated mesothelial cell autoantibodies promote collagen deposition in vitro
- Mesothelial cell and anti-nuclear autoantibodies associated with pleural abnormalities in an asbestos exposed population of Libby, MT
- Autoimmunity and asbestos exposure
Another major project was studying the health of workers at a plant in Marysville, Ohio that processed vermiculite ore from Libby. This program, funded by ATSDR, was conducted by the University of Cincinnati. Results from studies related to Marysville have been published in scientific papers:
- Low-level fiber-induced radiographic changes caused by Libby vermiculite: a 25-year follow-up study
- Asbestos-related radiographic findings among household contacts of workers exposed to Libby vermiculite: impact of workers' personal hygiene practices
- Mesothelioma associated with commercial use of vermiculite containing Libby amphibole
- Exposure estimates for workers in a facility expanding Libby vermiculite: updated values and comparison with original 1980 values
- A program providing health screening, health education, and outreach services for residents and former residents of Libby and Troy, Montana, as specified under the Affordable Care Act (42 U.S.C. 1397h). Participants with certain medical conditions may be eligible for Medicare benefits. Read more about the results from previous rounds of ATSDR screening in Libby in the scientific paper ‘Radiographic abnormalities and exposure to asbestos-contaminated vermiculite in the community of Libby, Montana, USA’. If you are interested in participating in medical screening being funded by ATSDR, contact the Center for Asbestos Related Disease (CARD) in Libby at (406) 293-9274 or visit the CARD web site (http://libbyasbestos.org/). Former residents unable to go to Libby to participate in screening may be able to take part via long distance screening; contact CARD for more information.
- A mortality review which compared death rates for residents of the Libby area with those in Montana and the United States for selected diseases associated with exposure to asbestos (1979–1998). The review found that for the 20-year period examined, mortality from asbestosis was approximately 40 times higher than the rest of Montana and 60 times higher than the rest of the United States. .
- A Tremolite Asbestos Registry, a listing of individuals with an asbestos-related disease or those at high risk of developing asbestos-related disease because of exposure to asbestos. The registry is used to share information with those in the registry on any new therapies or diagnostic tools developed and to help policymakers and researchers better understand and prepare for treating those with an asbestos-related illness.
- Libby-related ATSDR publications in peer-reviewed journals:
- The usefulness of computed tomography in detecting asbestos-related pleural abnormalities in people who had indeterminate chest radiographs: the Libby, MT, experience
- Select mortality and cancer incidence among residents in various U.S. communities that received asbestos-contaminated vermiculite ore from Libby, Montana
- Libby vermiculite exposure and risk of developing asbestos-related lung and pleural diseases
- Exposure to asbestos-containing vermiculite ore and respiratory symptoms among individuals who were children while the mine was active in Libby, Montana
- Vermiculite worker mortality: estimated effects of occupational exposure to Libby amphibole
- Workers with Libby amphibole exposure: retrospective identification and progression of radiographic changes
- Comparison of digital with film radiographs for the classification of pneumoconiotic pleural abnormalities
- Associations between radiographic findings and spirometry in a community exposed to Libby amphibole
- Association between cumulative fiber exposure and respiratory outcomes among Libby vermiculite workers
- Impact of body mass index on the detection of radiographic localized pleural thickening
- A review of the federal government's health activities in response to asbestos-contaminated ore found in Libby, Montana
- A Tremolite Asbestos Toxicological Profile, which describes the health effects of exposure to tremolite asbestos. Peer-reviewed profiles identify and review the key literature that describes a hazardous substance's toxicologic properties.
Department of Health and Human Services Agencies Involved in Libby
Other HHS agencies also made a major commitment to the Libby community and continue to provide support.
The Health Resources Services Administration (HRSA) http://www.hrsa.gov/ awarded funds for a community health center (CHC) in Libby. The CHC will provide primary care services for all of Lincoln County. Its focus is on providing selected primary care services to those in the community who are medically underserved. According to HRSA officials, the CHC should receive at least $400,000 per year and can continue in perpetuity. The CHC is governed by a community board that decides on services and treatments to be provided through the clinic.
The Substance Abuse and Mental Health Services Administration (SAMHSA) http://www.samhsa.gov/ will provide $80,000 to the hospital for psychological and social services, education, and outreach for those affected by asbestos-related problems. The initial contract is for one year and started in August, 2001. Designation as a "Health Professional Shortage Area" (HPSA) makes the community eligible to compete for HRSA programs that place health professionals in high-need areas through loan repayment incentives.
Exposure to asbestos at sites that received vermiculite from Libby
The Summary Report: Exposure to asbestos-containing vermiculite from Libby, Montana, at 28 processing sites in the United States provides a review and analysis of what ATSDR and state health department partners learned during their evaluations of 28 sites that received asbestos-containing vermiculite from a mine in Libby, Montana. This report (1) offers valuable information about facilities that exfoliated asbestos-containing vermiculite, (2) identifies groups who experienced exposure to asbestos from these sites, and (3) recommends re-evaluating existing data for former exfoliation sites where residual asbestos may be present. The report also proposes important public health activities to increase awareness about this type of asbestos exposure.