Report: Expect cancer epidemic

An epidemic of mesothelioma - a rare but deadly asbestos-related cancer - will descend upon Libby in the next 10 to 20 years, according to a report in the American Journal of Industrial Medicine.

Dr. Alan Whitehouse, a pulmonologist on the front line of asbestos disease treatment in Libby, wrote the report with input from four other doctors, including Dr. Brad Black of the Center for Asbestos Related Disease, or CARD Clinic, in Libby.

Current and former Libby residents continue to battle asbestos disease linked to the now-closed W.R. Grace vermiculite mine that operated for decades near the town.

Whitehouse treated hundreds of asbestos patients from Libby at his practice in Spokane before joining the CARD Clinic in 2004 to focus exclusively on asbestos victims.

"The extent of the epidemic of environmental mesothelioma due to exposures based at Libby will probably not peak for another 10 to 20 years," according to the report. "This is a public health problem of considerable magnitude and points to the need for surveillance and early detection of the disease."

The CARD clinic, which serves as a focal point for diagnosis and treatment of asbestos-related diseases in the region, has documented 15 cases of malignant mesothelioma since 1995 that weren't included in earlier studies. The journal article details 11 cases, including several in which the victim had no direct exposure to asbestos other than spending time in Libby.

A total of 31 cases of mesothelioma cases linked to Libby asbestos have been identified.

Several asbestos-related diseases, such as asbestosis, have been found in Libby residents who had no contact with the mine or miners, but lived in the community.

One of the mesothelioma victims - a 52-year-old woman who was diagnosed in 2000 and died three years later - reported that her car was covered with dust on a daily basis at the end of the workday. The medical and dental office where she worked was five miles southwest of the vermiculite mine and a mile north of Libby. Many of the clinic's patients were mine employees who were seen after a work shift.

Another victim, an 82-year-old man, was diagnosed with mesothelioma in 2002 and died the same year. He lived in Libby for 10 years beginning in the early 1960s, across the Kootenai River from the expansion and bagging plant. He had no other known exposure to asbestos.

Malignant mesothelioma is a disease in which cancer cells are found in the sac lining of the chest, the lining of the abdominal cavity or the lining around the heart. According to the National Cancer Institute, an exposure of as little as one or two months can result in mesothelioma 30 or 40 years later.

That means that Libby residents exposed in the 1940s to the 1970s - decades during which the vermiculite mine was operating at high capacity - are just now being diagnosed with the disease because of the long latency period. Grace operated the mine from 1963 to 1990, when it was shut down. But the Zonolite company operated it for decades prior to that.

Mesothelioma is considered the nastiest and most lethal of asbestos disease. People diagnosed with the disease often are told the expected survival rate is only eight to 12 months. But an early diagnosis can yield a longer survival rate.

THE NUMBER of mesothelioma cases stemming from exposure in Libby likely has been underestimated, Whitehouse said, because it's been difficult to track the large number of workers who built the Libby dam project from 1966 to 1974. Large numbers of employees at the lumber mill in Libby also frequently were transitory workers.

Libby is considered to have the highest mesothelioma rate in the United States. The closest comparison to Libby case is the Wittenoom Gorge crocidolite mine in Western Australia, the journal article pointed out. The blue asbestos mine operated in Australia from 1943 to 1966, and as of 2002, 254 cases of mesothelioma have been reported in mine workers and residents of the nearest town.

Documentation in Whitehouse's journal article is the kind of information needed to expand asbestos research and treatment programs in Libby. In June, the U.S. Department of Health and Human Services and Environmental Protection Agency announced a five-year, $8 million study aimed at understanding the health effects of low-level exposure to asbestos.

The Libby Amphibole Health Risk Initiative, as the study is called, will focus on determining whether such exposure is associated with increased risk of lung disease, cancer, chronic illnesses, autoimmune diseases or other health problems.

More than 200 asbestos deaths have been confirmed in Libby, and the CARD clinic is following about 2,000 additional asbestos cases.

The magnitude of asbestos exposure in Libby came to light in November 1999 when the Daily Inter Lake and Seattle Post-Intelligencer detailed the link between the vermiculite mine and the hundreds of people who were sick and dying because of exposure to the toxic asbestos dust from the mine.

Not long after that, Whitehouse met with members of the Kalispell medical community, warning them to brace for an onslaught of asbestos patients over the next couple of the decades.

Whitehouse issued a haunting prediction in 2000 as he spoke to his peers.

"This is the tip of the iceberg," he said. "God knows how many have been exposed. It could be a horrendous epidemic."

Features editor Lynnette Hintze may be reached at 758-4421 or by e-mail at lhintze@dailyinterlake.com