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Libby Amphibole Asbestos (Draft, 2011)

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  • 1.
    The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
    Peer
    Reviewed
    Journal
    Article
    Grand rounds: asbestos-related pericarditis in a boiler operator
    Abejie, BA; Chung, EH; Nesto, RW; Kales, SN (2008)
    Minus Sign. Click to see only selected choices. CONTEXT: Occupational and environmental exposures to asbestos remain a public health . . . Plus Sign. Click to expand choices. CONTEXT: Occupational and environmental exposures to asbestos remain a public health problem even in developed countries. Because of the long latency in asbestos-related pathology, past asbestos exposure continues to contribute to incident disease. Asbestos most commonly produces pulmonary pathology, with asbestos-related pleural disease as the most common manifestation. Although the pleurae and pericardium share certain histologic characteristics, asbestos-related pericarditis is rarely reported.

    CASE PRESENTATION: We present a 59-year-old man who worked around boilers for almost 30 years and was eventually determined to have calcific, constrictive pericarditis. He initially presented with an infectious exacerbation of chronic bronchitis. Chest radiographs demonstrated pleural and pericardial calcifications. Further evaluation with cardiac catheterization showed a hemodynamic picture consistent with constrictive pericarditis. A high-resolution computerized tomography scan of the chest demonstrated dense calcification in the pericardium, right pleural thickening and nodularity, right pleural plaque without calcification, and density in the right middle lobe. Pulmonary function testing showed mild obstruction and borderline low diffusing capacity.

    DISCUSSION: Based on the patient's occupational history, the presence of pleural pathology consistent with asbestos, previous evidence that asbestos can affect the pericardium, and absence of other likely explanations, we concluded that his pericarditis was asbestos-related.

    RELEVANCE TO CLINICAL PRACTICE: Similar to pleural thickening and plaque formation, asbestos may cause progressive fibrosis of the pericardium.
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  • 2.
    The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
    Peer
    Reviewed
    Journal
    Article
    Patterns of pulmonary dysfunction in asbestos workers: a cross-sectional study
    Abejie, BA; Wang, X; Kales, SN; Christiani, DC (2010) Journal of Occupational Medicine and Toxicology 5.
    Tag:
  • 3.
    The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
    Peer
    Reviewed
    Journal
    Article
    High-resolution computed tomography of asbestos-related diseases
    Aberle, DR (1991)
    Minus Sign. Click to see only selected choices. There is growing evidence that HRCT can detect both interstitial and pleural disease in advance of conventional . . . Plus Sign. Click to expand choices. There is growing evidence that HRCT can detect both interstitial and pleural disease in advance of conventional clinical or radiographic studies. Limited HRCT scans are roughly competitive in time and cost with 4-view radiographic examinations. The use of limited HRCT for large-scale screening of asbestos-exposed individuals is controversial. Hopefully this will be resolved as we gain greater understanding of the specificity of HRCT and establish guidelines for standardizing technique and interpretation. At present, limited HRCT scans can supplement the chest radiographic evaluation of subjects in whom there is equivocal parenchymal or pleural disease, unexplained abnormalities on pulmonary function tests, or significant coexisting pleural disease that precludes evaluation of the underlying parenchyma. Interstitial abnormalities on HRCT may be reasonably ascribed to asbestos exposure when there is clear historical documentation of significant, remote dust exposure or concomitant evidence of typical bilateral asbestos-related pleural disease. A subpleural distribution of interstitial abnormality in nondependent lung is important to establish the diagnosis of interstitial fibrosis. Although both unilateral pleural and parenchymal fibroses have been reported, lesions should generally be present bilaterally. In individuals with combined asbestos-cigarette smoke exposure in whom symptoms or functional abnormalities are present, HRCT may play a central role in distinguishing emphysematous lung destruction from the peripheral interstitial changes of asbestosis. Finally, in individuals with significant pleural or parenchymal fibrosis, focal lung masses may not be visible on chest radiographs. In these individuals, CT protocols that sample all regions of the thorax are appropriate.
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  • 4.
    The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
    Peer
    Reviewed
    Journal
    Article
    Computed tomography of asbestos-related pulmonary parenchymal and pleural diseases
    Aberle, DR; Balmes, JR (1991)
    Minus Sign. Click to see only selected choices. Computed tomography has acquired an increasingly central role in the evaluation of asbestos-exposed . . . Plus Sign. Click to expand choices. Computed tomography has acquired an increasingly central role in the evaluation of asbestos-exposed individuals. The advantages of increased contrast resolution and axial image display have extended our ability to interrogate areas of the pulmonary parenchyma and pleura that are inadequately seen on chest radiographs. The additional information to be gained from CT evaluation must be balanced by the additional expense and time required, particularly in view of the large numbers of asbestos-exposed individuals who will undergo screening over the coming decades. Ideally, imaging strategies that include CT should emphasize those problematic situations in which additional information will serve a differential or diagnostic function, alter the management or habits of the individuals, modify the working environment, or improve our understanding of asbestos-induced diseases. The chest radiograph is the mainstay in the imaging evaluation of asbestos-exposed individuals, providing an inexpensive and rapid appraisal of the presence of both focal and diffuse abnormalities of the pleura and lung parenchyma. Conventional (whole-thorax) CT may be an important adjunct in the following situations: (1) to clarify the presence of pleural thickening, particularly in distinguishing pleural disease from normal extrapleural soft tissues; (2) to stage and determine tumor extent in malignant pleural mesothelioma; (3) to identify optimal sites for biopsy of suspicious pleural changes; and (4) to detect and characterize lung cancers or other focal masses that may be obscured by extensive pleural or parenchymal fibrosis. Limited HRCT studies are roughly competitive in time and cost with four-view radiographic examinations. There is growing evidence that HRCT can detect interstitial disease in advance of conventional clinical or radiographic studies. However, the application of limited HRCT for large-scale screening is controversial. This issue will be resolved as we gain greater understanding of the specificity of HRCT and establish guidelines for standardizing the technique and image interpretation. At present, limited HRCT scans can supplement the evaluation of subjects in whom there is equivocal parenchymal or pleural disease on radiographs or unexplained abnormalities on pulmonary function tests. In individuals with significant pleural disease, HRCT can effectively define the presence and extent of interstitial fibrosis. In individuals with combined cigarette smoking-asbestos exposure in whom symptoms or functional abnormalities are present, HRCT may play a central role in distinguishing emphysematous lung destruction from the peripheral interstitial changes of asbestosis.
    Tag:
  • 5.
    The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
    Peer
    Reviewed
    Journal
    Article
    Modeling community asbestos exposure near a vermiculite processing facility: Impact of human activities on cumulative exposure
    Adgate, JL; Cho, SJ; Alexander, BH; Ramachandran, G; Raleigh, KK; Johnson, J; Messing, RB; Williams, AL; Kelly, J; Pratt, GC (2011) Journal of Exposure Science and Environmental Epidemiology 21:529-535.
    Minus Sign. Click to see only selected choices. Contaminated vermiculite ore from Libby, Montana was processed in northeast Minneapolis from 1936 to . . . Plus Sign. Click to expand choices. Contaminated vermiculite ore from Libby, Montana was processed in northeast Minneapolis from 1936 to 1989 in a densely populated urban residential neighborhood, resulting in non-occupational exposure scenarios from plant stack and fugitive emissions as well as from activity-based scenarios associated with use of the waste rock in the surrounding community. The objective of this analysis was to estimate potential cumulative asbestos exposure for all non-occupationally exposed members of this community. Questionnaire data from a neighborhood-exposure assessment ascertained frequency of potential contact with vermiculite processing waste. Monte Carlo simulation was used to develop exposure estimates based on activity-based concentration estimates and contact durations for four scenarios: S1, moved asbestos-contaminated waste; S2, used waste at home, on lawn or garden; S3, installed/removed vermiculite insulation; S4, played in or around waste piles at the plant. The simulation outputs were combined with air-dispersion model results to provide total cumulative asbestos exposure estimates for the cohort. Fiber emissions from the plant were the largest source of exposure for the majority of the cohort, with geometric mean cumulative exposures of 0.02 fibers/cc × month. The addition of S1, S2 and S3 did not significantly increase total cumulative exposure above background exposure estimates obtained from dispersion modeling. Activity-based exposures were a substantial contributor to the upper end of the exposure distribution: 90th percentile S4 exposure estimates are ∼10 times higher than exposures from plant emissions. Pile playing is the strongest source of asbestos exposure in this cohort, with other activity scenarios contributing less than from plant emissions.
  • 6.
    Technical Report
    Technical
    Report
    Summary report: Exposure to asbestos-containing vermiculite from Libby, Montana, at 28 processing sites in the United States
    ATSDR (2008) Atlanta, GA: Agency for Toxic Substances & Disease Registry.
    Minus Sign. Click to see only selected choices. This report summarizes what the Agency for Toxic Substances and Disease Registry (ATSDR) and state health . . . Plus Sign. Click to expand choices. This report summarizes what the Agency for Toxic Substances and Disease Registry (ATSDR) and state health department partners learned during their evaluations of 28 sites that received asbestos-containing vermiculite from a mine in Libby, Montana. These 28 site evaluations focused on potential past, current, and future pathways of exposure to the asbestos associated with the Libby mine. Most of the processing facilities at these sites operated for different time periods in the past, during the 1920s to the early 1990s. The purpose of the report is (1) to summarize what we learned during detailed site evaluations, and (2) to provide recommendations that local, state, and federal agencies can use to address similar sites.
    Tag:
  • 7.
    Technical Report
    Technical
    Report
    Health consultation: Former O.C. Scott and Sons Company, 14111 Scottslawn Road, Marysville, Union County, Ohio. EPA Facility ID: OHD990834483
    ATSDR (2005) (PB2008-104070). Atlanta, GA: Agency for Toxic Substances and Disease Registry.
    Details   
  • 8.
    Technical Report
    Technical
    Report
    Report on the expert panel on health effects of asbestos and synthetic vitreous fibers: The influence of fiber length
    ATSDR (2003)
    Details   
  • 9.
    Technical Report
    Technical
    Report
    Libby tests: Lung abnormality rates high
    ATSDR (2002) Atlanta, GA: Agency for Toxic Substances and Disease Registry.
    Details   
  • 10.
    Technical Report
    Technical
    Report
    Year 2000 medical testing of individuals potentially exposed to asbestiform minerals associated with vermiculite in Libby, Montana: A report to the community
    ATSDR (2001) Atlanta, GA: Agency for Toxic Substances & Disease Registry.
    Minus Sign. Click to see only selected choices. During the summer and fall of 2000, 6,149 persons participated in asbestos medical testing sponsored . . . Plus Sign. Click to expand choices. During the summer and fall of 2000, 6,149 persons participated in asbestos medical testing sponsored by the Agency for Toxic Substances and Disease Registry (ATSDR). Those eligible for testing included former W.R. Grace workers from Libby and persons who lived, worked, or played in Libby for at least 6 months before December 31, 1990. A second round of testing was conducted during the summer of 2001, and an additional 1,158 persons were tested. A total of 7,307 participated in the two rounds of testing.
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