vermiculite and Asbestosis

The vermiculite ore formerly mined in Libby, Montana, contains asbestiform amphibole fibers of winchite, richterite, and tremolite asbestos. Because of the public health impact of widespread occupational and nonoccupational exposure to amphiboles in Libby vermiculite, numerous related studies have been published in recent years. Here we review current research related to this issue.. Excess morbidity and mortality classically associated with asbestos exposure have been well documented among persons exposed to Libby vermiculite. Excess morbidity and mortality have likewise been documented among persons with only nonoccupational exposure. A strong exposure-response relationship exists for many malignant and nonmalignant outcomes and the most common outcome, pleural plaques, may occur at low lifetime cumulative exposures.. The public health situation related to Libby, Montana, has led to huge investments in public health actions and research. The resulting studies have added much to the body of knowledge concerning health effects of exposures to Libby amphibole fibers specifically and asbestos exposure in general.

Topics: Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Cohort Studies; Female; Humans; Lung Neoplasms; Male; Mining; Montana; Occupational Exposure; Pleural Neoplasms; Risk Factors

This article reviews the past 90 yr of scientific research directed on multiple aspects of the unique geology and environmental health issues surrounding the vermiculite deposit found at Libby, MT. Hydrothermal alteration and extensive weathering of the ultramafic units resulted in the formation of a rich deposit of vermiculite that was mined for 67 yr and used in numerous consumer products in its expanded form. Later intrusions of alkaline units caused hydrothermal alteration of the pyroxenes, resulting in formation of amphiboles. Some of these amphiboles occur in the asbestiform habit and have been associated with pulmonary disease in former miners and mill workers. Identification of these amphibole asbestos minerals has received little attention in the past, but recent work shows that the majority of the amphibole mineral species present may not be any of the amphibole species currently regulated by government agencies. Epidemiological studies on former miners have, nevertheless, shown that the amphibole asbestos from the Rainy Creek igneous complex is harmful; also, a recent study by the Agency for Toxic Substances and Disease Registry shows that residents of Libby who had not been employed in the vermiculite mining or milling operations also appear to have developed asbestos-related pulmonary diseases at a higher rate than the general public elsewhere. Since November 1999, the U.S. Environmental Protection Agency has been involved in the cleanup of asbestos-contaminated sites in and around Libby associated with the mining and processing of vermiculite.

Topics: Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Environmental Exposure; Geology; History, 20th Century; Humans; Minerals; Mining; Montana; United States; United States Environmental Protection Agency

To evaluate mortality patterns among participants in a community-based screening program for asbestos-related disease.. We calculated standardized mortality ratios (SMRs) and stratified results by exposure group (three occupational exposure groups, household contacts and residents without occupational asbestos exposure) and by radiographic abnormality presence.. All-cause mortality (15.8%; 1,429/8,043) was statistically lower than expected. Asbestosis was statistically elevated in all exposure groups. Lung cancer was moderately associated with vermiculite miner/miller employment. Mesothelioma was elevated in that same exposure group and among residents. Systemic autoimmune disease mortality was also elevated. Radiographic parenchymal abnormalities were associated with lung cancer mortality.. In addition to asbestos-related mortality in occupational exposure groups, this initial follow-up of this cohort also shows elevated mortality for some asbestos-related causes in non-occupational exposure groups.

Topics: Adult; Aluminum Silicates; Asbestos; Asbestos, Amphibole; Asbestosis; Biometry; Cohort Studies; Environmental Exposure; Female; Follow-Up Studies; Humans; Lung; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Montana; Occupational Exposure

During its days of operation (1920s-1990), the world's largest source of vermiculite was extracted from a mine located near Libby, Montana. The material mined at this site was shipped for various commercial applications to numerous sites in the United States. There was a "fibrous" component with toxic potential within the vermiculite deposit that has resulted in "asbestos-like" diseases/deaths being reported in numerous studies involving miners as well as residents of the town of Libby. The present case involves the clinical assessments of an individual who worked at the mine from 1969 to 1990. He had no other known occupational exposures to fibrous materials. He developed a clinical picture that included "asbestos-like" pathological features and eventually an adenocarcinoma. The clinical assessment including radiographic features will be presented. The evaluation will also include the analytical evaluation of the fibrous/ferruginous body composition of the lung tissue. This is to our knowledge the first time such an extensive evaluation has been conducted in a vermiculite miner from Libby, Montana.

Topics: Aged; Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Humans; Lung; Male; Mining; Montana; Occupational Exposure; Pulmonary Fibrosis

Community exposure to asbestos from contaminated vermiculite ore from Libby, Montana, occurred in many processing sites in the United States, including a densely populated urban residential neighborhood of Minneapolis, Minnesota.. We examined exposed community residents who never worked at the plant or never lived with a plant worker for radiographic evidence of lung changes consistent with asbestos exposure.. We obtained posteroanterior chest radiographs to identify the prevalence of pleural abnormalities consistent with pneumoconiosis, as determined by consensus of two National Institute for Occupational Safety and Health-certified B-reader radiologists. We estimated cumulative asbestos exposure (fibers per cubic centimeters × months) with air dispersion model data and activity-based modeled exposure estimates for vermiculite processing waste contact. We modeled associations between pleural abnormalities and asbestos exposure using multiple logistic regression to adjust for year of birth, sex, and potential occupational asbestos exposure.. Radiographs were obtained for 461 participants. The prevalence of pleural abnormalities by B-reader consensus was 10.8%. A history of direct contact with the waste and ever playing in the waste piles was associated with pleural abnormalities {odds ratio [OR] 2.78 [95% confidence interval (CI): 1.26, 6.10] and 2.17 (95% CI: 0.99, 4.78), respectively, when adjusted for background exposure}. The regression coefficients for log-transformed measures (fibers per cubic centimeters × months) of background exposure and activity-based exposure were 0.322 (95% CI: 0.078, 0.567) and 0.063 (95% CI: -0.013, 0.139), respectively, when adjusted for each other, and 0.283 (95% CI: 0.104, 0.463) for cumulative exposure from all sources.. These results support the hypothesis that community exposure to asbestos-contaminated vermiculite originating from Libby, Montana, is associated with measurable effects based on radiographic evidence.

Topics: Adult; Aged; Aluminum Silicates; Asbestos; Asbestosis; Environmental Exposure; Female; Humans; Lung; Male; Middle Aged; Minnesota; Montana; Radiography

Topics: Aluminum Silicates; Asbestos; Asbestosis; Environmental Exposure; Female; Humans; Lung; Male; Radiography

Increased incidences of asbestosis have been reported in workers from Libby, MT, associated with exposures to amphibole-contaminated vermiculite. In this study pulmonary and histopathological changes were investigated following Libby amphibole (LA) exposure in a rat model. Rat respirable fractions of LA and amosite (aerodynamic diameter <2.5 μm) were prepared by water elutriation. Male F344 rats were exposed to single doses of either saline (SAL), amosite (0.65 mg/rat), or LA (0.65 or 6.5 mg/rat) by intratracheal instillation. At times from 1 d to 3 mo after exposure, bronchoalveolar lavage (BAL) was performed and right and left lungs were removed for reverse-transcription polymerase chain reaction (RT-PCR) and histopathological analysis, respectively. Data indicated that 0.65 mg amosite resulted in a higher degree of pulmonary injury, inflammation, and fibrotic events than LA at the same mass dose. Exposure to either amosite or high dose LA resulted in higher levels of cellular permeability and injury, inflammatory enzymes, and iron binding proteins in both BAL fluid and lung tissue at most time points when compared to SAL controls. However, mRNA expression for some growth factors (e.g., platelet-derived growth factor [PDGF]-A and transforming growth factor [TGF]-1β), which contribute to fibrosis, were downregulated at several time points. Furthermore, histopathological examination showed notable thickening of interstitial areas surrounding the alveolar ducts and terminal bronchioles. On a mass dose basis, amosite produced a greater acute and persistent lung injury for at least 3 mo after exposure. However, further testing and analysis of LA are needed with regard to the dose metric to fully evaluate its potential fibrogenicity and carcinogenicity.

Topics: Air Pollutants, Occupational; Aluminum Silicates; Animals; Asbestos, Amphibole; Asbestosis; Biomarkers; Dose-Response Relationship, Drug; Down-Regulation; Iron-Binding Proteins; Lung; Male; Mineral Fibers; Particle Size; Platelet-Derived Growth Factor; Random Allocation; Rats; Rats, Inbred F344; Respiratory Mucosa; RNA, Messenger; Transforming Growth Factor beta1

Topics: Aluminum Silicates; Asbestos; Asbestosis; Environmental Exposure; Female; Humans; Male; Respiratory Tract Infections

In response to the significantly elevated asbestosis mortality rates found in Libby, Montana, in 2000, this analysis evaluated whether other communities throughout the United States that received asbestos-contaminated vermiculite ore from Libby experienced similar excess rates of asbestos-related diseases. Standardized mortality ratios were calculated using state death certificates, and standardized incidence ratios were calculated using cancer registry records for populations living near facilities that processed or received Libby vermiculite. This analysis focused primarily on diseases that are directly associated with asbestos exposure (e.g., asbestosis; cancer of the peritoneum, retroperitoneum, and pleura, including mesothelioma; and mesothelioma). Lung cancer and cancers of the digestive system, also associated with asbestos exposure, were not included in the analysis because they have additional risk factors for which exposure information was not available. Data from 70 unique sites in 23 states were evaluated. No statistically significant excesses of asbestosis mortality similar to those in Libby were noted; however, 11 sites (plus a state with 6 pooled sites that were counted as 1 site) had excess rates of mesothelioma and cancer of the peritoneum, retroperitoneum, and pleura. Further investigation should be conducted at these sites with excess rates of mesothelioma and cancer of the peritoneum, retroperitoneum, and pleura by participating state health departments to determine whether exposure to Libby vermiculite might have been a contributing factor.

Topics: Aluminum Silicates; Asbestos; Asbestosis; Environmental Monitoring; Epidemiological Monitoring; Humans; Incidence; Mining; Montana; Neoplasms; United States

The exposure of Libby MT residents to amphibole-contaminated vermiculite is well known. To explore the gene-environment interactions in the development of asbestos-related diseases (ARD), a mouse model of asbestos exposure using Six-mix (a combination of amphibole fibers gathered from six sites at the Libby vermiculite mine), crocidolite asbestos, or saline as a negative control was used to determine both gene expression responses by using mouse 10,000 oligonucleotide array and to visualize these changes histologically. Mice were sacrificed and whole lungs harvested for histology and microarray analysis six months following exposure via intratracheal instillation. Using an arbitrary cutoff of 1.25-fold change, genes whose RNA expression levels were specifically altered in response to the different amphibole exposures were grouped into categories by a gene ontology analysis program, GoMiner. Our hypothesis was that assessment of asbestos-responsive genes would provide a better understanding of response mechanisms. These experiments have provided new candidates for genes involved in the asbestos response pathways.

Topics: Aluminum Silicates; Animals; Asbestos, Amphibole; Asbestosis; Disease Models, Animal; Electronic Data Processing; Environmental Exposure; Gene Expression Profiling; Gene Expression Regulation; History, 20th Century; Humans; Mice; Mining; Montana; Oligonucleotide Array Sequence Analysis; Software; Time Factors

Libby, Montana is the site of a large vermiculite deposit that was mined between 1920 and 1990 to extract vermiculite for commercial applications such as insulation, gardening products, and construction materials. The Libby vermiculite deposit also contains amphibole minerals including tremolite, actinolite, richterite, and winchite. Historically, Libby mine workers experienced high exposures to amphibole structures, and, as a group, have experienced the health consequences of those occupational exposures. It has been suggested that Libby residents also have been and continue to be exposed to amphibole structures released during the vermiculite mining operations and therefore are at increased risk for disease. The Agency for Toxic Substance and Disease Registry (ATSDR) conducted two epidemiological-type studies of residents living in Libby and the surrounding areas to assess these risks. The Environmental Protection Agency (EPA) collected and analyzed exposure data in Libby and used those data to project risks of asbestos-associated disease for Libby residents. The EPA has placed the Libby Asbestos Site, which includes the mine and the town of Libby, on its National Priority List of hazardous waste sites in need of clean up. This article presents a review of the exposure studies conducted in Libby and an analysis of health risks based on the data collected in those studies. Libby mine workers have experienced elevated levels of asbestos-associated disease as a consequence of their occupational exposures to amphibole structures. Libby residents' exposures typically are substantially lower than mine workers' historical exposures, and the health risk projections for residents are, accordingly, substantially lower.

Topics: Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Environmental Exposure; Hazardous Waste; Humans; Mineral Fibers; Mining; Montana; Occupational Exposure; Risk Assessment

Vermiculite from the mine near Libby, Montana, is contaminated with tremolite asbestos and other amphibole fibers (winchite and richterite). Asbestos-contaminated Libby vermiculite was used in loose-fill attic insulation that remains in millions of homes in the United States, Canada, and other countries.. This report describes asbestos-related occupational respiratory disease mortality among workers who mined, milled, and processed the Libby vermiculite.. This historical cohort mortality study uses life table analysis methods to compare the age-adjusted mortality experience through 2001 of 1,672 Libby workers to that of white men in the U.S. population.. Libby workers were significantly more likely to die from asbestosis [standardized mortality ratio (SMR) = 165.8; 95% confidence interval (CI), 103.9-251.1], lung cancer (SMR = 1.7; 95% CI, 1.4-2.1), cancer of the pleura (SMR = 23.3; 95% CI, 6.3-59.5), and mesothelioma. Mortality from asbestosis and lung cancer increased with increasing duration and cumulative exposure to airborne tremolite asbestos and other amphibole fibers.. The observed dose-related increases in asbestosis and lung cancer mortality highlight the need for better understanding and control of exposures that may occur when homeowners or construction workers (including plumbers, cable installers, electricians, telephone repair personnel, and insulators) disturb loose-fill attic insulation made with asbestos-contaminated vermiculite from Libby, Montana.

Topics: Aged; Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Cohort Studies; Humans; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Mining; Montana; Occupational Exposure; Pleural Neoplasms; Retrospective Studies

An unusual case of pleuroparenchymal lung disease caused by the inhalation of vermiculite dust, presumably containing asbestos fibers is described. The uniqueness of the case lies in the very indirect nature of exposure -- the wife of a factory owner, rather than a worker exposed to asbestos, whose factory manufactured vermiculite. The present case illustrates the importance of taking careful occupational histories of all household members when presented with a patient whose chest radiograph exhibits features consistent with asbestos exposure.

Topics: Aged; Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Environmental Exposure; Female; Humans; Mineral Fibers; Radiography

Vermiculite ore is a naturally occurring fibrous mineral widely used in various consumer products, such as attic insulation, lawn and garden products, and fireproofing material. While most vermiculite ore and products do not pose a health hazard, the vermiculite mined from Libby, MT was contaminated with naturally occurring asbestos. The federal Agency for Toxic Substances and Disease Registry (ATSDR) has documented a significant number of asbestos-related deaths among Libby residents. Additionally, as part of the ongoing investigation, ATSDR has learned that this contaminated ore was shipped to hundreds of locations around the United States for processing. While the Libby mine is now closed, studies from ATSDR and elsewhere show that people who worked in the Libby mine or vermiculite processing facilities may have been exposed to hazardous levels of asbestos while the facilities were in operation. People who lived or worked near these sites also may have been exposed to asbestos if they came into contact with contaminated vermiculite. Prolonged exposure to asbestos can cause serious and life-threatening health conditions, including asbestosis, lung cancer, and mesothelioma. In response, ATSDR has initiated 10 different activities to help evaluate the potential health effects among Libby residents and populations throughout the United States who might have been exposed to the asbestos-contaminated ore found in Montana. Some of these activities include conducting environmental exposure evaluations, health statistics reviews, community screenings, and disease-specific surveillance. This article presents the various follow-up activities that have been conducted to date by ATSDR and partnering state health departments.

Topics: Aluminum Silicates; Asbestos; Asbestosis; Cause of Death; Environmental Exposure; Environmental Health; Federal Government; Female; Humans; Male; Mining; Montana; Mortality; Public Health; Public Health Administration; State Government

The Libby, MT, cohort includes current and former residents with potential historical exposure to asbestos-contaminated vermiculite. This cohort includes individuals with a broad range of exposure experiences and work histories. While both occupational and nonoccupational exposure pathways were found to be relevant in recent investigations of health effects among this cohort, there has not been a comprehensive approach to characterizing these varied exposure pathways. Any approach toward assessing historical exposures among this population must account for three general categories: (1) occupational exposures, (2) residential exposures, and (3) exposures related to a variety of nonoccupational activities thought to be associated with vermiculite/asbestos exposure in this community. First, a job exposure matrix is commonly used in occupational epidemiology to assess historical worker exposures, allowing for the incorporation of numerous occupational categories and weighting factors applied to specific jobs for different time periods. Second, residential exposures can best be quantified by integrating individuals' residential histories with data on environmental asbestos contamination in the community. Previous soil or sediment sampling as well as air modeling could inform estimates of time- and spatial-dependent exposure concentrations for a residential exposure matrix. Finally, exposure opportunities due to nonoccupational activities could be weighted by factors such as time, geography, environmental sampling, and an assessment of the relative importance for each pathway. These three matrices for occupational, residential, and activity exposure pathways could be combined or used separately to provide a more comprehensive and quantitative, or semiquantitative, assessment of individual exposure in future epidemiological studies of this cohort.

Topics: Aluminum Silicates; Asbestos; Asbestosis; Cohort Studies; Environmental Monitoring; Epidemiological Monitoring; Family Health; Mining; Montana; Occupational Exposure; Public Health

The authors report the case of a 65-year-old accountant whose only asbestos exposure was during a summer job 50 years earlier in a California vermiculite expansion plant. Vermiculite is a silicate material that is useful in building and agriculture as a filler and insulating agent. He developed extensive fibrocalcific pleural plaques and end-stage pulmonary fibrosis, with rapidly progressive respiratory failure. Careful occupational and environmental history revealed no other source of asbestos exposure, and the initial clinical diagnosis was idiopathic pulmonary fibrosis; open lung biopsy shortly before his death confirmed asbestosis. Electron microscopic lung fiber burden analysis revealed over 8,000,000 asbestos fibers per gram dry lung, 68% of which were tremolite asbestos. Additional asbestiform fibers of composition not matching any of the standard asbestos varieties were also present at over 5,000,000 fibers per gram dry lung. Comparison analysis of a sample of Libby, Montana, vermiculite showed a similar mix of asbestiform fibers including tremolite asbestos. This case analysis raises several concerns: risks of vermiculite induced disease among former workers of the more than 200 expansion plants throughout the United States; health effects of brief but very high-intensity exposures to asbestos; and possible health effects in end-users of consumer products containing vermiculite.

Topics: Aged; Aluminum Silicates; Asbestosis; Humans; Lung; Male; Occupational Exposure; Radiography; Time Factors

Topics: Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Humans; Maximum Allowable Concentration; Mining; Neoplasms; United States; United States Environmental Protection Agency

Topics: Aluminum Silicates; Asbestosis; Health Education; Humans; Minnesota; Risk Factors