Descriptive Analysis of the Health Status of a National Asbestos-Related Cohort

Project funded:
September 2006
Project completed:
August 2009

Injuries from asbestos exposure include asbestosis, pleural abnormalities, mesothelioma, and other cancers. Exact morbidity/mortality projections are complicated by the long latency period, inconsistent state reporting, and the absence of a national registry of fatal and non-fatal asbestos-related disease (ARD). However, national mortality surveillance of occupation-related respiratory diseases designated asbestosis as the leading pneumoconiosis recorded on death certificates from 1982-2000. As of 2002, more than 700,000 individual asbestos related disease claims had been filed in U.S. courts with as many or more claims expected in the future.

Considered one of worst occupational health disasters in U.S. history, a significant source of exposure to asbestos came from contaminated vermiculite ore mined in rural Libby, Montana and then distributed to over 200 regional processing and expanding plants in 32 states, providing nearly 80% of the world's supply of vermiculite. In 2000 the Center for Asbestos Related Disease (CARD) was established in Libby, Montana as a screening and treatment clinic for ARD. Today CARD manages a national cohort of approximately 1800 patients from 32 states. Although the physiological aspects of ARD exposure (asbestosis and mesothelioma) are known, the biopsychosocial and health services implications have not been studied.

The purpose of this descriptive study is to establish a more comprehensive understanding of the biopsychosocial health status and health service needs of persons exposed to Libby asbestos. Using existing clinical data and results from a questionnaire administered to patients of CARD, the following aims will be achieved: (a) describe the biopsychosocial health status of persons exposed to Libby asbestos through an examination of the severity of chronic illness, depression, acceptance of illness, and stress, (b) explore the associations among severity of chronic illness, depression, acceptance of illness, and stress in persons exposed to Libby asbestos, and (c) evaluate access, availability, convenience, and financial aspects of care among the national Libby cohort. Dissemination of the results of this study through publications and presentation will give healthcare providers and policymakers a better understanding of the biopsychosocial effects of this chronic illness and the healthcare needs of rural patients.