kidney disease (elevated serum creatinine,
elevated serum cystatin C, and decreased
creatinine clearance) at followup. This longitu-
dinal study confirmed the utility of four urinary
kidney biomarker tests as markers of preclinical
organ dysfunction among adults with certain
pre-existing medical conditions.
Medical Testing Program for
People Exposed to Asbestos-
Contaminated Vermiculite,
Chest x-ray
Libby, Montana
ment of Environmental Health assisted ATSDR
During fiscal year 2000, ATSDR initiated a
with the screening program.
program to screen for asbestos-related illness
among residents of Libby, Montana, who may
ATSDR used multiple communication strategies
have been exposed to asbestos contained in a
and methods to reach the general public in
mineral mined in Libby for many years. Ver-
Libby. These included mailing flyers, putting up
miculite, a natural mineral used to make insula-
tion materials and garden soil additives, was
open houses and public availability sessions,
mined in Libby, Montana, from the 1920s until
making presentations at Community Advisory
1990. The vermiculite ore mined at Libby has
Group meetings, and setting up displays at local
been shown to be contaminated with asbestos.
health fairs and events, such as the July 4
The vermiculite ore was surface mined, milled,
celebration. ATSDR staff members also conducted
heated to expand its volume, and shipped
face-to-face outreach in the community, gave
throughout the nation, and used as play and fill
interviews on local radio stations, and ran
material locally. Many people were potentially
announcements on the local cable television
exposed to the asbestos in the vermiculite.
station.
In response to public health concerns about
Community participation in the medical testing
cases of asbestos-related illnesses in Libby,
program was very high. More than 6,000 Libby
ATSDR instituted a medical screening program
residents--twice as many as ATSDR had
for the residents and former residents of the
projected--participated in the testing program.
town. Those who participated in the screening
Testing began in early July 2000 and consisted
included former miners, household members
of spirometry, chest x-rays, and an exposure and
who may have been exposed to dust on the
health questionnaire. More than 90% of the
clothing of mine workers, people who played in
scheduled interviews were kept. Testing at the
the vermiculite during childhood, and former
clinic was conducted through November 2000.
Libby residents exposed to the airborne emis-
About 5% of those tested were immediately
sions of dust from vermiculite processing. EPA,
referred for a follow-up examination because of
the Montana Department of Health and Human
health conditions found as a result of the chest
Services, the Lincoln County Environmental
x-ray or spirometry test. ATSDR has worked
Health Department, and the Montana Depart-
with the DHHS Region 8 Office to facilitate
chapter 3 41
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