Rapid Progression of Pleural Disease Due to Exposure to Libby Amphibole: Not Your Grandfather's Asbestos Related Disease

BackgroundResidents 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. MethodsFive 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. ResultsThese 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. ConclusionsLA exposure can cause a non-malignant pleural disease that is more rapidly progressive and more severe than the usual asbestos-related disease. Am. J. Ind. Med. 57:1197-1206, 2014. (c) 2014 Wiley Periodicals, Inc.