US EPA

2079078 

Journal Article 

Descriptive analysis of the respiratory health status of persons exposed to Libby amphibole asbestos 

Winters, CA; Hill, WG; Rowse, K; Black, B; Kuntz, SW; Weinert, C 

2012 

Yes 

British Medical Journal (International Edition)
ISSN: 0959-8146
EISSN: 0959-535X 

BMJ PUBLISHING GROUP 

LONDON 

2 

6 

e001552 

English 

23175736 

10.1136/bmjopen-2012-001552 

WOS:000315081400057 

https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2012-001552
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OBJECTIVE: Describe respiratory health and quality of life in persons exposed to Libby amphibole asbestos (LAA) contaminated vermiculite.

DESIGN: Cross-sectional descriptive.

SETTING: Asbestos-related disease clinic in Libby, Montana USA.

PARTICIPANTS: 329 individuals exposed to LAA; mostly men, married, between 50 and 69 years; two-thirds lived in the surrounding county; one-third lived elsewhere in the state and USA.

PRIMARY OUTCOME MEASURES: Chest radiograph (CXR), pulmonary function data and the St George Respiratory Questionnaire (SGRQ).

RESULTS: Exposure categories included vermiculite workers=7.6%; family/household contact of vermiculite worker=32%; and environmental exposure only=60%. Of the participants, 55% had only pleural abnormalities; 5.4% had only interstitial abnormalities; nearly 21% had both abnormalities and 18% had no lung abnormality on chest x-ray. Mean forced vital capacity (FVC) 95.3% (SD=18.7); forced expiratory volume (FEV(1)) mean 87% (SD=20.2); ratio of FEV1(1)/FVC 95.5% (SD=12.0); and diffusing capacity (DLCO) of 83% (SD=21.7) of the percent predicted. The mean total SGRQ (38.5; SD=22.1) indicated a lower quality of life than healthy persons and persons with other chronic conditions. SGRQ subscale means were Symptoms 52.1 (SD=24.9), activity 49.4 (SD=26.9) and impacts 27.5 (SD=21.9). Participants with normal CXR differed significantly from those with both interstitial and pleural abnormalities on total, activity and impacts scores. For activity alone, subjects with normal CXR differed significantly from those with pleural disease; no differences were found for those with interstitial disease. Significant findings were found for smoking history across all pulmonary measures, and for exposure status, radiographic findings, age and gender for select pulmonary parameters. Subjects with any smoking history had significantly worse average total and subscale scores on the SGRQ.

CONCLUSIONS: Of 329 persons exposed to LAA, the majority (182) had pleural abnormalities identified on CXR. SGRQ scores for persons with abnormalities (pleural, interstitial or both) (269) differed significantly from those with a normal CXR.