STATEMENT OF PAT COHAN, RN

Coordinator, Clinic for Asbestos Related Disease

Libby, MT

Testimony for Superfund Senate Subcommittee

June 21, 2002

My name is Pat Cohan. I am a registered nurse with 29 years of experience. For the last two years I have been involved with the health needs of our community related to asbestos exposure. My introduction to the asbestos disaster was in 2000 when I accepted a grant position funded by HRSA for the asbestos health screenings. This position had two integral parts. The first was to be the outreach nurse for the ATSDR’s screenings that summer. Over 6000 respondents were screened and I handled any medical emergencies, health concerns, or urgent referral issues that arose after the chest x-rays were viewed. The second part of the position was to help create a clinic that would assess, diagnose, and educate people with health care concerns resulting from the screening results.

The Center for Asbestos Related Disease (CARD) was created by St. Johns Lutheran Hospital to fill this need. The volume of phone calls, visits, and drop-in visits was incredible. It seemed that everyone in town and their relative was frantic for information. We now have over 1000 active charts and of these over 800 have some asbestos related changes evident. Each of our clients and family members has received health information and education relating to pulmonary health.

The breadth and depth of the psychosocial, emotional, health and financial concerns associated with the amphibole disaster has been without precedent and I have usually been first at hand to hear the many different life stories. To listen to a client calmly speak of hidden mountain valleys and hunting accidents because he will not allow his children to watch him die the way he watched his father suffer and die, is a reality of my job. I have worked to find financial resources for a 47-year-old woman, who has less than half of her normal lung function and no health insurance, so she can afford to have a lung biopsy done. Her chest x-ray was suspicious for a mesothelioma, a type of cancer associated with asbestos exposure. This woman, a daughter of a Zonolite miner, waited over 3 months to hear if she would qualify for Grace’s medical plan.

Some of the stories are so convoluted that it’s hard to sort out what is most urgent. A woman with asbestos related illness, who cares for her mother with asbestosis, has been washing her dishes in the tub for the last two years. Her kitchen is plastic sheeted and duct taped closed to keep the leaking Zonolite insulation from further contaminating her home.

I have a neighbor who has resided in Libby for over 40 years. He never worked at the mine, never gardened with vermiculite, and never had any contact that he knew of other than the insulation in his home. This is a man who started the Libby volunteer ambulance and who has hiked and skied every mountain in the Cabinet Mountains. He has worked tirelessly for the community in every conceivable volunteer role. Because of the asbestos damage to his lungs he can no longer ski, hike, or volunteer. His major activity now is breathing.

I have used the word disaster most deliberately. This is a slow motion disaster. Had a mine leaked a toxin into the air of Libby and 200 people immediately died with 2000 others injured, 20% critically, I would not be here. I would be back home in the emergency room, taking care of the sick and wounded and we would all be trying to figure how quickly the remaining toxins could be removed. We would not be struggling to find health insurance, low cost medicines, or funding for long term care and monitoring. Just because the toxin took 30-50 years to kill and maim our community, it is no less a disaster.

The damage done to this community was not an act of God; it was not for an ideological principle or for a religious conviction. It was done for profit. The exposure and the responsible parties’ disrespect for people need to stop. The miners were treated as a disposable resource and the citizens of Libby were treated with no more regard than the overburden of rock at the mine. The survivors of this disaster continue to be exposed, continue to be at risk for worsening disease, and continue to worry about how they will pay for their health care needs. It is not a matter of waiting a few years for the affected people to die off and for the problem to go away. It is a matter of waiting another 20 years to see if their grandchildren’s health is affected. We already know the children and grandchildren have been affected emotionally, socially and monetarily.

What does Libby need? The need for Libby is research for treatments, for health insurance that will be available for the length of the disease process, and the facility to monitor progression of this disaster for the next twenty years.

I wish to take the opportunity to thank our Montana delegation for all that has been done for the community of Libby. I especially want to thank Senator Baucus for all his attention and efforts in our community.

Thank you.