On June 17, 2009 the United States Environmental Protection Agency declared a public health emergency in the towns of Libby and Troy in Northwest Montana. Asbestos-contaminated vermiculite was mined in the town of Libby until 1990. Thousands of asbestos-related diseases have been documented in both Troy and Libby.
Asbestos is a naturally occurring mineral that was used extensively throughout the 20th century for a number of military and industrial applications because of its durability and resistance to fire. Unfortunately, asbestos exposure has been found to be the primary cause of respiratory condition called asbestosis and an aggressive cancer that attacks the linings of the lungs, abdomen or heart known as mesothelioma.
This type of cancer is difficult to treat as it has an unusually long latency period. Mesothelioma symptoms do not begin to show until 20 to 50 years after exposure to asbestos. Also, the initial symptoms can resemble those of less serious respiratory illnesses and can sometimes go unnoticed. Because of the latency period, mesothelioma is typically diagnosed in its later stages and is more difficult to treat effectively.
In general, life expectancy for patients diagnosed with mesothelioma patients is reported as less than one year following diagnosis, however this prognosis is affected by numerous factors including how early the cancer is diagnosed and how aggressively it is treated.
History
The vermiculite in Libby was originally discovered in 1881 by gold miners. In the 1920s the Zonolite Company was formed and began mining the vermiculite. In 1963, W.R. Grace Company bought the Zonolite mining operations. While in operation, the Libby mine may have produced upwards of 80% of the world's supply of vermiculite.
Vermiculite is a shiny mineral, similar to mica, which pops like popcorn when heated. The puffy product is as light as cork and was once a popular form of building insulation. Today it is still used as an ingredient in potting soil. Vermiculite itself is harmless. However, the layers of igneous rock where it is found almost always contain asbestos, exposure to which has been definitively linked to mesothelioma and other fatal lung diseases for more than 70 years. Unfortunately, the vermiculite deposit from the Libby, Montana mine was particularly dangerous because it is contaminated with naturally-occurring asbestos called tremolite-actinolite, the most toxic form of of asbestiform mineral fibers.
Since the official closing of the vermiculite mine in 1990, approximately 400 residents of Libby have passed away from asbestos-related diseases like mesothelioma. Out of the roughly 3,000 residents of the town, nearly 2,000 have become sick because of asbestos. The asbestos has spread so widely over the town that even the tree bark that the residents burn for heath has been contaminated.
A tragic situation
Commenting on the situation in both Troy and Libby, the new EPA Administrator Lisa Jackson said: "This is a tragic public health situation that has not received the recognition it deserves by the federal government for far too long. We’re making a long-delayed commitment to the people of Libby and Troy. Based on a rigorous re-evaluation of the situation on the ground, we will continue to move aggressively on the cleanup efforts and protect the health of the people."
The government will spend more than $130 million on asbestos cleanup efforts and improve the health care system for those with asbestos-related illnesses. Approximately $125 million will come from the EPA over the next five years to clean up both Libby and Troy. An additional $6 million will be spent by the Health and Human Services Department (HSS) on medical assistance.
For more information, read these PubMed abstracts:
- Newman Taylor A. Asbestos, lung cancer and mesothelioma in the British Journal of Industrial Medicine. Occup Environ Med. 2009 Jul;66(7):426-7.
- Factor RE, Dal Cin P, Fletcher JA, Cibas ES. Cytogenetics and fluorescence in situ hybridization as adjuncts to cytology in the diagnosis of malignant mesothelioma.
Cancer Cytopathol. 2009 Jun 17. [Epub ahead of print] - Lee LJ, Chang YY, Wang JD. Impact of malignant mesothelioma in Taiwan: A 27-year review of population-based cancer registry data. Lung Cancer. 2009 Jun 15. [Epub ahead of print]
- Ak G, Metintaş M, Yıldırım H, Metintaş S, et al. Pleurodesis in follow-up and treatment of malignant pleural mesothelioma patients. Tuberk Toraks. 2009 Jan;57(1):22-31.
- Stahel RA, Weder W. Improving the outcome in malignant pleural mesothelioma: nonaggressive or aggressive approach? Curr Opin Oncol. 2009 Mar;21(2):124-30.
- Whitehouse AC, Black CB, Heppe MS, Ruckdeschel J, Levin SM. Environmental exposure to Libby Asbestos and mesotheliomas. Am J Ind Med. 2008 Nov;51(11):877-80.
- Horton DK, Bove F, Kapil V. Select mortality and cancer incidence among residents in various U.S. communities that received asbestos-contaminated vermiculite ore from Libby, Montana. Inhal Toxicol. 2008 Jun;20(8):767-75.
- Webber JS, Blake DJ, Ward TJ, Pfau JC. Separation and characterization of respirable amphibole fibers from Libby, Montana. Inhal Toxicol. 2008 Jun;20(8):733-40.
- Sullivan PA. Vermiculite, respiratory disease, and asbestos exposure in Libby, Montana: update of a cohort mortality study. Environ Health Perspect. 2007 Apr;115(4):579-85. Epub 2007 Jan 3.
- Smartt AM, Brezinski M, Trapkus M, et al. Collagen accumulation over time in the murine lung after exposure to crocidolite asbestos or Libby amphibole. Environ Toxicol. 2009 Feb 13. [Epub ahead of print]
- Kuntz SW, Winters CA, Hill WG, et al. Rural public health policy models to address an evolving environmental asbestos disaster. Public Health Nurs. 2009 Jan-Feb;26(1):70-8.
- Pfau JC, Pershouse M, Putnam EA. Directions and needs in asbestos research: new insights: conference summary. J Immunotoxicol. 2008 Apr;5(2):123-7
For more information:
- EPA: Libby Site Background
- Decades later, asbestos-ravaged town has its day in court (CNN)
- Asbestos cleanup 'emergency' declared in Montana town (CNN)
- Libby, Montana - Mesothelioma and Asbestos Exposure
- Asbestos and Other Mineral Fibers: A Roadmap for Scientific Research
- Wylie AG, Verkouteren JR. Amphibole asbestos from Libby, Montana: Aspects of nomenclature. American Mineralogist; October 2000; v. 85; no. 10; p. 1540-1542
Help your patients understand!
- Mesothelioma - Definition Mayo Clinic
- Mesothelioma - Definition MedLine Plus (Medical Encyclopedia)
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Published Books
- Libby, Montana: Asbestos and the Deadly Silence of an American Corporation
- Asbestos: Risk Assessment, Epidemiology, and Health Effects, Second Edition
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