After years of ignoring the dangers of asbestos, and the resulting nationwide epidemic of asbestos disease, including mesothelioma, there is a renewed interest in studying this deadly material. This week, the Billings Gazette announced the federal government will fund an $8 million study to understand the health effects of low-level exposure to asbestos. The study will be based in Libby, Montana, where more than 200 people have died to date as a result of asbestos mining operations in the town, and hundreds more people suffer from asbestos related diseases.

The Libby program, dubbed the Libby Amphibole Health Risk Initiative, is funded by the Environmental Protection Agency and the Department of Health and Human Services’ Agency for Toxic Substances and Disease Registry. The study is expected to span 5 years with a goal of expanding knowledge about the potential and real health issues of asbestos exposure.

Libby already has proved a tragically rich source of knowledge about long-term exposure to high levels of asbestos, as the EPA’s initial examination and cleanup of the town focused on miners with direct exposure to the substance in their jobs, as well as people who handled asbestos mineral and were exposed to asbestos dust secondarily on a daily basis.

But, the Gazette reports, too little is know about exposure to lower levels of asbestos. EPA officials hope that results of the study will benefit not only the residents of Libby, but people throughout the country.

In April, the Minnesota state legislature approved $4.9 million for its own five-year study, to be conducted under the direction of the University of Minnesota, in connection with unusually high levels of mesothelioma affecting Iron Range mine workers. A large question in the area is whether dust from the taconite mined there - a fibrous mineral similar to asbestos - could also cause mesothelioma.

A key part of the Minnesota research will be an examination of previous asbestos exposure among mine workers, which will expand the base of knowledge about the affect of asbestos on health, in addition to the new studies about the effect of taconite.

According to the Billings Gazette, among tests to be included in the Libby study are a comparison of film and digital chest X-rays to determine which is best for assessing the lungs, a comparison of the health of people exposed to Libby asbestos in childhood versus people who weren’t, an expanded evaluation of Libby residents who were exposed to asbestos, an assessment of whether the health problems related to asbestos exposure extend beyond lung disease.

Researchers in Libby also hope to make improvements to public health tracking systems and patient health record databases, to better link exposure information to health conditions, the Gazette reports.

Gayla Benefield, perhaps one of the best-known residents of Libby for her early outcry about the health effects of asbestos on the people in her town, says she is happy to see an emphasis on research.

She was a charter member of the board of directors of the Center for Asbestos Related Disease (CARD), a not-for-profit clinic governed by a volunteer community board and devoted to healthcare, outreach, and research to benefit all people impacted by exposure to Libby amphibole asbestos. She only recently retired from her position with that organization.

“This is something I’ve wanted from the onset - more study and more research,” she says. “I’ve been especially interested in how much or how little of the (asbestos) fiber can cause meso, and I’ve been really concerned about the schools having been contaminated.”

The key, Benefield says, is to detect mesothelioma at its earliest stage, when there is still time for treatment to prolong life. When people around her in Libby began being diagnosed, she says, their mesothelioma was so advanced that many died within days of the diagnosis.

“We all - everyone in Libby - live under the threat of developing mesothelioma,” she says. “They’re never going to get all that (asbestos) fiber out of Libby, or anywhere for that matter, homes with asbestos insulation, so the research is the big thing. Any and all research having to do with mesothelioma is fantastic. A dream come true.”

The physical result of mesothelioma and asbestos disease are often all-too evident. People wracked with pain, coughing, unable to catch their breath. But what about the mental toll of this disease?

Perhaps one of the most interesting presentations at the recent Asbestos Awareness Day Conference in Detroit, at least to me, was that of Rebecca J. W. Cline, PhD, a senior scientist in Communication and Behavioral Oncology for the Karmanos Cancer Institute and Associate Professor of Family Medicine at Wayne State University.

Dr. Cline recently conducted a community-based focus group investigation in Libby, Montana, on psychosocial issues related to vermiculite/asbestos exposure. She also is currently leading a related population-based survey investigating that community.

She describes asbestos related disease as a “slow-motion technological disaster,” in which community and social responses have a great deal to do with how people fare, mentally and socially.

The basic definition of a technological disaster is a “catastrophic event caused by humans that results in the toxic contamination of the environment.” This includes asbestos contamination, as in Libby, resulting from decades of vermiculite mining, hence “slow moving,” as well as things like oil spills, which can devastate an area fairly quickly.

Libby is the epicenter of what Dr. Cline calls “the worst environmental disaster in the United States,” with multiple generations affected. She examined in particular how stigma associated with asbestos disease can have an impact on what people do.

Dr. Cline said there are two possible responses to technological disaster – the emergence of an altruistic community, or a community in conflict. The latter, she said, is common where there is human culpability, and it was the result in Libby.

The Libby study, conducted in 2006, included focus groups and some individual interviews with adults who lived and worked in the Libby area for at least the past five years. Interview subjects included people with connections to the mine, people with no connections to the mine, people affected by asbestos disease personally, people with family affected by the disease, and people with no disease in family or person.

She found that people fell into three categories – early believers, those who immediately understood the connection of vermiculite to what was happening to the town; late believers, those who initially resisted the idea that the mine made people sick; and those in denial or conflicted, who still did not or would not believe the mine was responsible.

Dr. Cline found that there was a great deal of stigma attached to asbestos-related disease, which created a barrier to social support. People with mesothelioma or other asbestos-related diseases were often afraid to talk about it, she said, even to close friends.

She said that the stigma came from a variety of sources. Conflicts included concerns about the economic disaster that the loss of the mine signified for the town, for which it was the main industry and source of jobs and security. People feared that if the mine were blamed for illness and deaths in the community there would be a decline in property values, loss of jobs, and a lost way of life.

As a part or a result of that, conflict also grew from a concern about what was the truth. There was a suspicion among neighbors that people claiming illnesses were phony, money-grubbing, greedy or opportunistic, making up illnesses to get a part of a financial settlement from the mining company.

People suffering from asbestos disease personally or within their family were afraid to talk about it out of fear that they would be ostracized and shunned by their neighbors and their community.

Dr. Cline told the story of two women, best friends for years, who bumped into each other in the Center for Asbestos Related Disease, which had been established in Libby to test, diagnose and treat patients. “What are you doing here?” one whispered. “I have the asbestos,” the other whispered back. “Me too,” came the whispered response. Best friends, but afraid at the core to admit to having asbestos disease.

On top of this, people who are ill or whose family members are ill fear the health and medical disaster itself, which was already upon them. They said they felt a lack of hope for survival, not just for themselves or their immediate family, but for generations.

Some of those in denial, or conflicted, still refuse to be tested for asbestos disease. They don’t want to know, Dr. Cline says, or they do not believe the mine could harm them.

There appears to be one universal in Libby.

“Across the groups, people felt like the community as a whole had been stigmatized, that everyone ‘knew about Libby’ and it had been given a bad reputation,” Dr. Cline said.

In addition to the physical toll, the mental toll of asbestos disease in Libby has been incalculable, she said.

The Associated Press has reported that Monday (April 7, 2008) W.R. Grace & Co. “announced it has reached an agreement to resolve current and future asbestos claims against the company, which would allow it to emerge from bankruptcy without further obligations for asbestos injury.” The settlement is estimated at $3 billion in cash and equity, the AP reports.

W.R. Grace operated the vermiculite mine that is most notably associated with causing asbestos disease, including mesothelioma, in the town of Libby, Montana, affecting generations of residents in that area.

The AP story reports millions of tons of asbestos-contaminated vermiculite ore were shipped from the mine near Libby between 1923 and the early 1990s, reaching more than 250 processing plants across the U.S., where it was used in manufacturing insulation, fireproofing, gardening and other products.

According to the AP report, “Monday’s agreement calls for the company to pay $250 million in cash into a trust fund for asbestos victims, followed by deferred payments of $110 million per year for five years beginning in 2019 and $100 million per year for 10 years beginning in 2024.”

Companies formerly affiliated with Grace, including Sealed Air Corp. and Fresenius Medical Corp., also will contribute to the fund.

When Grace filed for bankruptcy in April 2001, it had been named in 110,000 asbestos personal injury claims. It is not known how many more claims may be filed after the establishment of the trust.

Attorneys representing Libby said settlement amounts for plaintiffs there have yet to be determined, but they expect that each case will depend on the severity of injury resulting from asbestos exposure.

Judge Judith Fitzgerald, who presided over the settlement hearing, must still approve the agreement.

This announcement follows on the heels of an announcement in March that Grace would reimburse the Environmental Protection Agency $250 million for the investigation and asbestos cleanup in Libby.

Read the complete story here, in the Flathead Beacon, which serves Western Montana and the Flathead Valley.

Yesterday officials with the U.S. Justice Department and the U.S. Environmental Protection Agency announced an agreement with W.R. Grace & Co. in which the company agrees to pay $250 million for government cleanup costs in the town of Libby, Montana.

W.R. Grace operated a vermiculite mine and processing plant in and near Libby from 1963 to 1990. The vermiculite was contaminated with high levels of asbestos.

According to a story by Tristan Scott in the Missoulian, the agreement settles the 2001 claim brought by the federal government under the Superfund law to recover past and future costs related to asbestos removal from homes, businesses, schools and playgrounds in Libby. More than 200 Libby residents have died from asbestos-related diseases.

It is estimated that the EPA has spent about $168 million removing asbestos-contaminated soils and other materials near Libby, according to the Missoulian story.

Reporter Scott said the settlement requires W.R. Grace to pay the $250 million within 30 days of approval by a federal bankruptcy court.

The money also will be used to resolve a 2003 judgment against Grace in which a judge ordered the company to pay the EPA $54.5 million to cover costs of asbestos cleanup in Libby, but which the company could not pay due to bankruptcy status.

This settlement will not have a bearing on pending criminal charges against W.R. Grace, whose senior corporate officials allegedly conspired to hide the dangers of asbestos and obstructed justice during the EPA’s investigation and cleanup. The criminal trial is expected to open in Missioula, Montana, in April or June, Scott reports.

For more information, read the complete story online.

To learn more about Libby and what happened there, visit this PBS web site, which has a wealth of information about the town.

High Plains Films, a documentary production company, produced an excellent film about the town, which you can view or purchase by visiting their web site.

This story is so sad. A whole town was basically destroyed by asbestos. People brought asbestos home from the factory and put it in their gardens. It was used to pave a running track at the school. It was everywhere. Still is.

The EPA estimates they’ll be cleaning in and around Libby for at least another 5 years, and even then they doubt they’ll be able to remove all the asbestos.