concerns of Montana's tribal nations to indoor air
investigation through, for example, a health
quality.
surveillance or epidemiologic study.
The Montana Environmental Health Association,
Human exposure to tremolite asbestos in
with city, county, state, and tribal organization mem-
contaminated vermiculite has been recognized as
a potential public health problem. Exposures to
agreement with the National Environmental Health
tremolite asbestos have occurred among people
working at, living near, and otherwise in contact
evaluation, planning, de-
with, vermiculite mined
sign, and implementation
and processed at the
of environmental health
W.R. Grace mine in
Libby. Exposures have
education program to
respond to the significant
also occurred at other
threat of chemical terror-
facilities that processed
ism.
the vermiculite ore
from Libby, and at other
ATSDR's regional rep-
vermiculite mining and
resentative in Helena
processing facilities in the
provides support and as-
United States. In 1999,
sistance to state and county
a regional pulmonary
public health officers in
physician reported a large
Montana with chemi-
caseload of patients from
cal exposure information.
Libby with asbestos-
Exposure concerns often
related disease. Following
involve pesticides, dioxins, Scenic view entering Libby.
are recent activities
and releases from indus-
related to asbestos
trial facilities. ATSDR's regional representative also
exposures in Libby.
assisted EPA and other federal agencies in provid-
Medical Testing--People who lived, worked, or
ing risk communication and pesticide training to the
played in Libby were provided the opportunity
Crow Nation and to the Confederated Salish and
to participate in medical testing during summer
Kootenai Tribes in Montana.
and fall 2000 and summer 2001. The first phase
Association of Occupational and
of testing (in 2000) included 6,149 participants.
The second phase was completed on September
Environmental Clinics
7, 2001, and included 1,158 participants, bringing
ATSDR provides financial and technical support to
the total participants tested to 7,307. Notification
members of the Association of Occupational and
letters have been mailed to the final participants.
Environmental Clinics (AOEC). This support is
The results of the year 2000 testing program
provided to improve education and communication
were summarized in a community report and
related to surveillance, diagnosis, treatment, and
provided to the Community Assistance Group
prevention of illness or injury related to exposure to
(CAG) on August 23, 2001. A preliminary report
hazardous substances. The AOEC member institu-
of the results of the combined testing was made
tion in Montana is St. Patrick Hospital Occupational
available to the community on September 26,
Health Services in Missoula.
2002, at two public meetings. The final
manuscript for combined medical testing has
Health Studies
undergone peer review and has been published
online (Environ Health Perspect doi:10.1289/
Health studies are conducted to determine the
ehp.6346).
relationships between exposures to hazardous
Mortality review--ATSDR completed the
substances and adverse health effects. Health studies
review of asbestos-related mortality in the Libby
also define health problems that require additional
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