Doctors work toward information dissemination
The Libby Area Technical Assistant Group, also known as TAG, had a special presentation by Dr. Aubrey Miller during their monthly meeting in February. Miller is a physician in the U.S. Public Health Service and a Senior Medical Officer and Toxicologist for the U. S. Environmental Protection Agency (EPA)'s Region 8 Office.
Miller is one of the scheduled speakers at the Asbestos Disease Awareness Organization scheduled for March 28-30 in Detroit, Mich.
In July 2007, Miller organized and facilitated a meeting in Denver that was convened with the purpose of prioritizing new epidemiological studies and analyses that could contribute information to support an EPA baseline risk assessment for Libby.
Epidemiological studies are needed to support the baseline risk assessment that will scientifically guide the future determinates of the EPA's clean-up process in Libby.
One study, (University of Cincinnati: Marysville Workers) that was conducted to understand the risk of worker non-cancer asbestos-related lung disease from exposure to Libby Amphibole, will be enhanced with new health endpoints such as CTs and PFTs and has an estimated completion date of December 2009.
Libby CARD Data Management System (EPA region 8), which also has an estimated completion date of December 2009, will allow for health studies of CARD patients (that consent) to help understand the risk factors for disease, improve understanding of disease, and future treatment. The CARD clinic currently has 2,300 patients and a database would be invaluable for populations not only in Libby but worldwide.
New epideminologic investigations would utilize available health and exposure information, data that has been collected by other agencies and new investigations, to address important concerns. Miller said these investigations, which would include data from ATSDR and MASSA, require some design to allow for continued confidentiality and those negotiations are currently underway. The investigations would take about two years from the time the studies were initiated. Investigations would try to understand risks from newer and lower environmental exposures, childhood exposures, other susceptible populations and other health effects.
An investigation asking how the health effects from the exposure of Libby Amphibole are different from other asbestos exposures could take up to one year to complete.
The National Institute for Occupational Safety and Health (NIOSH) is currently conducting a Libby Amphibole Cancer Assessment study to understand risks of cancer from exposure to Libby Amphibole.
Miller explained that the most significant studies would be those done on lung tissue. Fiber Lung Tissue Studies and Dosimetry done with biopsy or autopsy would provide understanding of the specific nature, effects and exposures in human lungs, and relationships between animal toxicology studies. That would be a three-year study from the time of initiation.
TAG is made up of members of the community, some who are able to understand Miller's presentation, and others who may find the science hard to follow, but the purpose of TAG is to hire a technical expert, Dr. Gerry Henningson, to assist them in the translation of technical information to laymen's terminology so that they can give informed advice and direction to EPA and report back to their community.
Henningson was not in attendance at the February TAG meeting, but Miller brought the information to the TAG group in an understandable format for laymen and was available for several informed questions from the group.
Baseline risk assessment is a complex endeavor that will take time and financial support to bring it forward for applied scientific use in Libby. The feasability and economical restraints of such studies are barriers to completing the baseline risk assessment, but EPA's region 8 has experts like Miller working behind the scenes to coordinate the necessary players in the field and also in the community to present the ideas that allow Libby to live in the possibilities.