Libby: the long legacy of a public health disaster

Our plain-English summary of Libby: the long legacy of a public health disaster, by A. van Dorn (The Lancet. Respiratory Medicine, 2017).

The study

• Author: A. van Dorn
• Journal: The Lancet. Respiratory Medicine
• Published: 2017;5(3):174-175
• Type of article: Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a news feature (a 'Spotlight' piece) in The Lancet Respiratory Medicine, not a research study. It reports no original data and relies on interviews and agency estimates. It described Libby, Montana, a town of about 2600 residents, where vermiculite was discovered in 1919 and mined until 1990. The vermiculite was contaminated with Libby amphibole mix, mainly winchite (84%), richterite (11%) and tremolite (5%). Contaminated material was used throughout the town, including in insulation, yards and playground sand. Brad Black, medical director of the Center for Asbestos Related Disease (CARD) clinic, estimated that of around 7500 people screened since 2000, 3400–3500 had some level of asbestos-related disease. Black described less interstitial disease and more progressive pleural scarring than with commercial chrysotile exposure. The article stated that Libby and Lincoln County have a rate of lung disease 50–60 times the national average, possibly an underestimate. The EPA estimated that about 7500 of 8100 properties had been investigated or cleaned up, at a cost of over $560 million. WR Grace was acquitted of criminal charges but agreed to a $250 million clean-up settlement.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: News feature (journalistic 'Spotlight' article) based on interviews with clinicians and EPA staff; not an original research study
• Who was studied: Residents of Libby (and neighbouring Troy), Montana, USA, a town of about 2600 people. This includes former vermiculite mine workers and people exposed environmentally, and around 7500 people screened at the CARD clinic since 2000
• Exposure: Vermiculite from the Libby mine contaminated with Libby amphibole mix, whose principal components were winchite (84%), richterite (11%) and tremolite (5%). Exposure came through mine work and through community use of contaminated material (insulation, yard fill, school track, playground sand, baseball field)
• Main results:
  • Vermiculite was discovered near Libby in 1919, and mining activities at the Libby mine ceased in 1990
  • CARD clinic medical director Brad Black estimated that of around 7500 people screened since the clinic opened in 2000, 3400–3500 had some level of asbestos-related disease
  • The article stated that Libby and surrounding Lincoln County have a rate of lung disease 50–60 times higher than the national average, possibly an underestimate
  • Black described the Libby disease pattern as involving less interstitial disease and more progressive pleural scarring than exposure to commercial chrysotile asbestos
  • The EPA estimated that about 7500 of 8100 commercial and residential properties had been investigated or cleaned up, and that over $560 million had been spent
  • The EPA evaluated more than 150 activities and collected more than 5000 activity-based air samples. Topsoil with 1% or more asbestos was removed to 1 m, and soil with concentrations as low as 0.2% was removed to 0.5 m
  • WR Grace and its executives were acquitted of criminal charges, but the corporation agreed to a US$250 million settlement for clean-up as part of a 2008 bankruptcy settlement
• The authors' conclusion: The author described Libby, with neighbouring Troy, as the site of one of the USA's largest public health and environmental disasters
• Limitations the authors state:
  • The article noted that the reported lung disease rate might be an underestimate because not all death certificates link the cause of death to asbestos

Topics

The National Library of Medicine indexes this study under subjects our site covers: Talc and vermiculite.

Related studies

• A review of the federal government's health activities in response to asbestos-contaminated ore found in Libby, Montana — K. Horton, V. Kapil, et al. (2006)
• The traveling Libby legacy: Minnesota community exhibits nonoccupational health impacts consistent with asbestos damage — T. Tillett (2012)
• Exposure to asbestos-containing vermiculite ore and respiratory symptoms among individuals who were children while the mine was active in Libby, Montana — L.C. Vinikoor, T.C. Larson, et al. (2010)
• A review of scientific literature examining the mining history, geology, mineralogy, and amphibole asbestos health effects of the Rainy Creek igneous complex, Libby, Montana, USA — B.R. Bandli, M.E. Gunter (2006)
• Exposure to airborne amphibole structures and health risks: Libby, Montana — B. Price (2008)
• Exposure matrix development for the Libby cohort — C.W. Noonan (2006)

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