title: Rapid progression of pleural disease due to exposure to Libby amphibole: "Not your grandfather's asbestos related disease".
abstract: BACKGROUND
  Residents and mine employees from Libby, Montana, have been exposed to asbestiform amphiboles from the vermiculite mine that operated in this location from the mid-1920s until 1990. Clinical observations show a different form of asbestos-related toxicity than other forms of asbestos.
  
  
  METHODS
  Five illustrative cases from the Center for Asbestos-Related Diseases in Libby were selected. All had clear exposure histories, multiple follow-up visits, illustrative chest radiographic studies, serial pulmonary function tests, and sufficient length of follow-up to characterize disease progression.
  
  
  RESULTS
  These cases developed increasing symptoms of dyspnea and chest pain, progressive radiological changes that were predominantly pleural, and a restrictive pattern of impaired spirometry that rapidly progressed with significant loss of pulmonary function.
  
  
  CONCLUSIONS
  LA exposure can cause a non-malignant pleural disease that is more rapidly progressive and more severe than the usual asbestos-related disease.
authors.affiliation: Center for Asbestos Related Disease, Libby, Montana.
authors.forename: Bradford
authors.initials: B
authors.lastname: Black
authors.forename: Jaime
authors.initials: J
authors.lastname: Szeinuk
authors.forename: Alan C
authors.initials: AC
authors.lastname: Whitehouse
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Levin
authors.forename: Claudia I
authors.initials: CI
authors.lastname: Henschke
authors.forename: David F
authors.initials: DF
authors.lastname: Yankelevitz
authors.forename: Raja M
authors.initials: RM
authors.lastname: Flores
mesh_terms: D017636:Asbestos, Amphibole / Q000633:toxicity*; D018450:Disease Progression; D004781:Environmental Exposure / Q000009:adverse effects*; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009009:Montana; D010995:Pleural Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011653:Pulmonary Diffusing Capacity; D012115:Residual Volume; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity
chemical_list: D017636:Asbestos, Amphibole
keywords: Libby amphibole; asbestosis; disease progression; pleural disease; pulmonary function