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.