Former HHS worker instrumental in asbestos response

In 1999, when the Libby amphibole asbestos crisis first broke in the Seattle Post-Intelligencer and federal agencies began to respond, one of the first people on the scene was Aubrey Miller, from the U.S. Department of Health and Human Services Region 8 office.

Brad Black, current director of the Center for Asbestos Related Disease, or CARD Clinic, in Libby, was the consulting health officer for Lincoln County, and Miller was one of his first contacts with the federal response.

Black worked with Miller developing a screening program for asbestos related disease.

That program identified abnormalities that could be related to asbestos exposure in 18 percent of the almost 7,000 people screened, Black said.

“With that screening, we knew that there was going to be a larger problem in the community,” Black said. “Aubrey was instrumental in trying to work among multiple agencies to try to bring the resources that they could, to help Libby deal with these challenges.”

That included getting the federal designation needed for a Community Health Center, as well as finding funding to start the CARD Clinic.

Miller said the importance of the CARD Clinic can’t be overstated, both for those who have been exposed and could only show signs of disease in years to come, and because of the research the clinic helps coordinate, growing the understanding of asbestos related disease.

In addition to helping to develop the healthcare infrastructure, Miller also understood the need for a mental health response, Black said.

“Right away, in the first year, we saw how critical it was,” Black said. “It just created chaos in terms of what people perceived and how they reacted to the issue.”

The emotional responses to the suffering of the community from something that was so preventable had to be dealt with just as much as the physical health problems, Black said.

The CARD Clinic was able to hire a licensed counselor through a grant that Miller helped find, Black said. That grant went away after two years, but without it the clinic may never have established a mental health program.

Miller was also the one who developed an overall strategy for trying to better understand the toxic effects of Libby amphibole asbestos, for which there was no existing research, Black said. In 2007 he organized a meeting in Denver that pulled in agencies and entities from all over the country to tackle the task.

That meeting resulted in the first study working with the EPA and University of Cincinnati to get a “dose response” to Libby Amphibole, Black said.

Using meticulous records kept by the Scotts Company in Marysville, Ohio — where workers had been exposed to Libby amphibole — the EPA was able to develop a target for cleanup in the community.

Before Libby, there hadn’t been any study of such a large-scale exposure to asbestos, Miller said.

Given the existing literature and research, Miller said he was stunned to find so many people who had never worked with asbestos suffering from exposure to it.

Without the UC study, there would have been no target for cleanup efforts, Black said.

“Of course, there are a lot of people who deserve credit, but he was spurring all this,” Black said. “It took somebody in the agencies to understand — to be able to know how to push things in the right place to be able to get things done.”

And the entire time Miller was working in Libby, he was based in Denver, as was his family, Black said.

Miller was personally invested in dealing with Libby’s crisis, Black said.

“This was a very unique individual that just really was committed to doing this job, from a public health standpoint,” Black said.

Miller moved from HHS to the EPA to keep working on the problems in Libby, Miller said.

“It went well beyond a job,” Miller said. “Even today I still get choked up.”

Miller said he and his team got to know people Libby, and lost valued friends to asbestos related disease.

“It was beyond a job, and it needed to be,” he said. “And I guess I’m grateful for having the opportunity to work on something that was — that is and was and remains — that’s truly important.”