title: Lung function, radiological changes and exposure: analysis of ATSDR data from Libby, MT, USA.
abstract: In 2000, the Agency for Toxic Substances and Disease Registry (ATSDR; Atlanta, GA, USA) investigated lung disease in those exposed to the tremolite-contaminated vermiculite mine in Libby, MT, USA. Previously unreported spirometric results are presented here in relation to exposure and radiographic findings. 4,524 study participants were assigned to one of seven mutually exclusive exposure categories. Associations among radiographic findings, spirometric results and exposure were investigated, along with the effect of a reduction in exposure potential when production was moved to a wet process mill in the mid 1970s. Spirometry data for the total population by smoking status and age were within the normal range. Prevalence of pleural plaque increased with age, but was lowest in the environmentally exposed group (0.42-12.74%) and greatest in the W.R. Grace & Co. mineworkers (20-45.68%). For males, there was a significant (4.5%) effect of pleural plaques on forced vital capacity. For W.R. Grace & Co. workers and household contacts, a reduction in plaque (0.11 versus 1.64%) and in diffuse pleural thickening or costophrenic angle obliteration (1.94 and 0.13%) was noted for those exposed after 1976. These analyses do not support a clinically important reduction in spirometry of this cohort. The 1976 reductions in exposure have led to decrease in radiographic changes.
authors.affiliation: Division of Pulmonary and Critical Medicine, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305-5236, USA. dweill@stanford.edu
authors.forename: D
authors.initials: D
authors.lastname: Weill
authors.forename: G
authors.initials: G
authors.lastname: Dhillon
authors.forename: L
authors.initials: L
authors.lastname: Freyder
authors.forename: J
authors.initials: J
authors.lastname: Lefante
authors.forename: H
authors.initials: H
authors.lastname: Glindmeyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000538:Aluminum Silicates / Q000633:toxicity; D017636:Asbestos, Amphibole / Q000633:toxicity*; D015331:Cohort Studies; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008906:Mining / Q000706:statistics & numerical data; D009009:Montana / Q000453:epidemiology; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015995:Prevalence; D011859:Radiography; D012129:Respiratory Function Tests; D012907:Smoking / Q000453:epidemiology
chemical_list: D000538:Aluminum Silicates; D017636:Asbestos, Amphibole; C003760:vermiculite; C005846:tremolite