Montana Residents--Possibly stricken with Asbestosis from Mining Operation--Helped by National Jewish Respiratory Team
A few miles from Zonolite Mountain, in a modular building set in the parking lot of St. John's Lutheran Hospital in Libby, Montana, four National Jewish Medical and Research Center employees test a steady progression of people for 12 hours each day. Eight hours on Saturday and Sunday.
Mining of vermiculite-contaminated with a naturally-occurring form of asbestos-from Zonolite Mountain for more than 30 years devastated the residents of Libby, causing lung cancer and asbestosis in workers and residents alike. Many people have died, and others have yet to be diagnosed and treated.
Today, National Jewish, along with a team from the local community and several other organizations, is there to help by providing lung function tests for 70-80 people each day through a Centers for Disease Control and Prevention contract.
"We are screening people who were residents of Libby for at least 6 months prior to the plant closing in 1990," said Cecile Rose, MD, who is coordinating the effort from Denver for the Division of Occupational and Environmental Health Sciences.
By the time Bibi Gottschall, MD, a Division physician specializing in pulmonary and occupational lung disease with a research emphasis in asbestos-related lung disease; Tricia Connors, Elaine Daniloff and Amy Oberstadt, also of the Division; and Sue Brown, from the Department of Nursing, leave Libby in mid-September they will have tested 4,200 people, nearly the entire town of 5,000. Early estimates placed the town's involvement at about 3,400 people.
"The participation rate speaks to the concern the people in Libby have about their health," Dr. Rose said.
The tests will help a patient's personal physician gauge the extent of lung damage caused by the asbestos, contained in the vermiculite, which was mined in the town for use in garden supplies, insulation and other consumer products.
For years, plumes of dust containing asbestos would shroud the town at different times, sometimes stopping baseball games, according to news reports. Inhaling asbestos fibers places people at risk for a variety of lung diseases, including lung cancer and scarring of the lungs (asbestosis). Asbestosis typically takes 20 to 30 years to develop.
In addition to spirometry, each participant answers a questionnaire and has several chest X-rays taken. At the end of the day, National Jewish forwards the results of its breathing tests to the National Opinion Research Center at the University of Chicago. Lung function testing, or spirometry, measures airflow into and out of the lungs. A person blows very hard and fast into a tube attached to a spirometer and a computerized sensor calculates results, which shows an individual's air flow rates and lung capacity.
"Each patient will receive a letter with the results of all their tests and recommendations for further follow-up," Dr. Gottschall said. "People who have severely abnormal lung function tests are contacted immediately."
The screening program is funded by the Agency for Toxic Substances and Disease Registry, a branch of the Centers for Disease Control and Prevention.
"They came to us because of National Jewish's reputation in the respiratory and occupational medicine fields," Dr. Rose said.
Patients, as well, have been impressed with the clinic's efficiency and quality of care.
"Most of what we hear in the room is really positive," Dr. Gottschall said. "People will say 'I'm so glad you're here,' and 'Something had to happen.'"
A 1999 Seattle Post-Intelligencer series on the Libby asbestos exposure reported that 192 people in the town died after exposure to vermiculite laced with asbestos; an additional 375 people have been diagnosed with other fatal diseases caused by asbestos exposure; and in 1969, approximately 5,000 pounds of asbestos were released into the air from processing.
