STATEMENT OF DR. MICHAEL SPENCE
STATE MEDICAL OFFICER
MONTANA DEPARTMENT OF PUBLIC
HEALTH AND HUMAN SERVICES
Congressional Testimony June 20,
2002
For the record my name is Michael
R. Spence. I am a medical doctor licensed to practice medicine in the state of
Montana. I am currently the chief medical officer in the Montana State
Department of Public Health and Human Services, a position that I have held for
the past five years. In my current capacity I have the charge of addressing
public health issues that impact the citizens of Montana.
In November 1999 a newspaper report indicated that there was a potential, major public health problem in Libby, Montana related to previous mining activities and community contamination. The substance in question of causing the problem was vermiculite ore, a product with many industrial applications and known to be contaminated with asbestos minerals. Large numbers of residents of Libby were described as being ill with asbestos related disease and many were said to have died from this illness. The publication of this report resulted in a team of health professionals being deployed to Libby to assess the situation. The groups of individual that met for the evaluation of the potential problem consisted of members from the Environmental Protection Agency and Health and Human Services from Region 8 located in Denver, Colorado, the Chief Medical Officer for the State of Montana, the Montana State Epidemiologist and the Lincoln County Montana Health Officer.
Over the ensuing weeks, after
meeting and consulting many of the foremost world authorities on asbestos
minerals and related diseases, it was determined that there was a need to
evaluate Libby residents for the presence of asbestos-related,
disease, assess the environmental situation for asbestos mineral contamination and,
if necessary, initiate remediation. The population was assessed, protocols were
developed and in July 2000 the Agency for Toxic Substances and Disease Registry
(ATSDR) initiated a medical screening program for the presence of asbestos
related disease in the Libby population. The medical screening continued into
November of that year and resulted in over 6,000 persons being evaluated. The
initial screening initiative resulted in the ATSDR issuing two reports. The
first was entitled “Preliminary Findings of Medical Testing of Individuals
Potentially Exposed To Asbestoform Minerals Associated with Vermiculite in
Libby, Montana: An Interim Report for Community Health Planning”
and was provided to the community in
February 2001. The second report entitled “Year 2000 Medical Testing
of Individuals Potentially Exposed to Asbestoform Minerals Associated with
Vermiculite in Libby, Montana: A report to the Community August 23, 2001”
included all of the results of the testing activity that took place in
2000. (Exhibit A) In the summer of 2001 a second screening activity took place
and an additional 1,150 persons were evaluated for asbestos-related disease.
It became apparent from the results of the screening
that the problem of asbestos-related disease was not limited to Vermiculite
Mine and Mill workers and their families but was also found in other
individuals in the community. The ways by which these other individuals, that
were neither workers nor family members, acquired their disease, based on
extensive epidemiologic investigation, was thought to be through exposure to
asbestos mineral contaminated vermiculite insulation materials, gardening soil
and ambient dust.
It is well established by medical science that
Asbestos minerals cause three major disease processes. One form is a
restrictive airway disease that results from progressive damage to the lung and
the tissues that surround it. The damage is that of scarring of the membrane or
tissue that surrounds the lung and restricts its’ ability to expand. This form
of disease results in the individual being unable to take deep breaths and
receive enough oxygen to support life. In essence the individual is slowly
smothering to death. A second form is the development of lung cancer. It has been estimated that a person exposed
to asbestos minerals has a significantly greater risk of developing lung cancer
than a person not exposed to asbestos minerals. If the asbestos exposed person
also smokes cigarettes their risk of developing lung cancer is increased even
more. The third major disease is a rapidly fatal cancer, mesothelioma,
which is known to be caused by asbestos. The average time from diagnosis to
death in individuals with mesothelioma is less than one year. An extensive,
epidemiological investigation entitled “Mortality in Libby, Montana,
1979-1998” (Exhibit B) has demonstrated an excess in mortality of Libby
residents from lung cancer, mesothelioma and non-malignant respiratory disease.
Asbestos minerals in causing disease do not act
immediately. There is a latency period between the time of exposure to the
asbestos minerals and the development of disease that is measured in tens of
years with the average period being between twenty (20) and thirty (30) years.
It is for this reason that a person that develops restrictive airway disease
can be exposed to asbestos minerals and remain well for 20-25 years. They will then develop progressive lung
disease that kills them slowly over the next 10 or more years. If they develop
either lung cancer or mesothelioma after the 20-25 year time period they will
usually die more quickly.
The problem of asbestos-related disease in
Montana is not limited to Libby. A recent and ongoing survey of mesotheliomas
that were either reported to the Montana State Tumor Registry or were found as
a result of a search of death certificates of people dying in Montana has
disclosed that there is an increased number of deaths from this asbestos
specific cancer. These deaths are not limited to Libby and distributed
throughout the state of Montana. Most of the deaths from mesothelioma that have
been identified so far have occurred in towns where the asbestos mineral
contaminated vermiculite ore was shipped and/or milled or along major ore
shipping routes. In view of these findings it is important to realize that much
of the ore that was mined in Libby was shipped to over 100 destinations outside
of the state of Montana where it was milled and/or incorporated into insulating
materials for houses and gardening soil.
In summary, asbestos mineral contaminated vermiculite
has been unequivocally established as being causative of a progressive fatal
lung disease as well as a rapidly fatal cancer, mesothelioma, in exposed
individuals. The exposures resulting in the illness and/or death are not
limited to mine and mill workers and their families. The problem is not limited
to Libby, Montana but is widely disseminated throughout the state of Montana
and over 100 sites in the United States.