Rapid progression of pleural disease due to exposure to Libby amphibole: “Not your grandfather's asbestos related disease”
Background Residents and mine employees from Libby, Montana, have been exposed to asbestiform amphiboles from the vermiculite mine that operated in this location from the mid-1920s until 1990. Clinical observations show a different form of asbestos-related toxicity than other forms of asbestos.
Methods Five illustrative cases from the Center for Asbestos-Related Diseases in Libby were selected. All had clear exposure histories, multiple follow-up visits, illustrative chest radiographic studies, serial pulmonary function tests, and sufficient length of follow-up to characterize disease progression.
Results These cases developed increasing symptoms of dyspnea and chest pain, progressive radiological changes that were predominantly pleural, and a restrictive pattern of impaired spirometry that rapidly progressed with significant loss of pulmonary function.
Conclusions LA exposure can cause a non-malignant pleural disease that is more rapidly progressive and more severe than the usual asbestos-related disease.