A clinical assessment and lung tissue burden from an individual who worked as a Libby vermiculite miner

Abstract

During its days of operation (1920s–1990), the world’s largest source of vermiculite was extracted from a mine located near Libby, Montana. The material mined at this site was shipped for various commercial applications to numerous sites in the United States. There was a “fibrous” component with toxic potential within the vermiculite deposit that has resulted in “asbestos-like” diseases/deaths being reported in numerous studies involving miners as well as residents of the town of Libby. The present case involves the clinical assessments of an individual who worked at the mine from 1969 to 1990. He had no other known occupational exposures to fibrous materials. He developed a clinical picture that included “asbestos-like” pathological features and eventually an adenocarcinoma. The clinical assessment including radiographic features will be presented. The evaluation will also include the analytical evaluation of the fibrous/ferruginous body composition of the lung tissue. This is to our knowledge the first time such an extensive evaluation has been conducted in a vermiculite miner from Libby, Montana.

Keywords:

• Libby
• asbestos
• vermiculite
• miner
• lung tissue
• fiber analysis
• amphibole
• ferruginous body

Acknowledgements

The authors would like to acknowledge Dr. Steven J. Nisco of Northwest Heart and Lung Surgical Associates in Coeur d’Alene, Idaho for the collection of tissue and thorascopic photos. The authors would also like to acknowledge Tracy McNew of CARD for her assistance editing and formatting this manuscript.

Disclosure statement

The individual in this case, and thus, the clinical data were generated by clinicians involved in the management of his illness (BB, GL, CH). The authorization for publication of the data discussed in this case was provided by family members of the patient. The pathology (JRB) and tissue assessment (RFD, LWP, JRB) were conducted after a request was received from the primary care physicians involved in the case. The case was not submitted as part of any litigation.

Dr. Black is employed as Medical Director and CEO of the Center for Asbestos Related Disease in Libby, Montana and he sits on boards of asbestos advocacy groups including Mesothelioma Applied Research Foundation and Asbestos Disease Awareness Organization. Dr. Dodson serves as an expert witness/consultant at the request of plaintiffs and defense firms and occasionally directly for the court in asbestos related issues. He has and does serve on panels/workshops for federal and state agencies. Dr. Bruce serves as an expert witness/consultant at the request of plaintiff firms in asbestos related issues. Mr. Poye serves as an expert witness/consultant at the request of plaintiffs and defense firms in cases where exposures to dust including elongated particles are suspected/confirmed. Dr. Claudia Henschke is a named inventor on a number of patents and patent applications relating to the evaluation of pulmonary nodules on CT scans of the chest which are owned by Cornell Research Foundation (CRF). Since 2009, Dr. Henschke does not accept any financial benefit from these patents including royalties and any other proceeds related to the patents or patent applications owned by CRF. Dr. Henschke is the President and serves on the board of the Early Diagnosis and Treatment Research Foundation. She receives no compensation from the foundation. The foundation is established to provide grants for projects, conferences and public databases for research on early diagnosis and treatment of diseases. Recipients include I-ELCAP, among others. The funding comes from a variety of sources including philanthropic donations, grants and contracts with agencies (federal and non-federal), and imaging and pharmaceutical companies relating to image-processing assessments. The various sources of funding exclude any funding from tobacco companies or tobacco-related sources. Dr. Henschke is employed by Mount Sinai Health system and under contract reads CT scans of CARD patients. Dr. Loewen serves as an expert witness/consultant at the request of plaintiff firms in asbestos related issues.

The authors are responsible for the content and writing of the manuscript. They agree with its content.