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Libby Community Advisory Group
Meeting Summary

July 18, 2002

Introductions

Gerald Mueller and members of the Libby Community Advisory Group (CAG) introduced themselves. A list of the members and guests in attendance is attached below as Appendix 1.

Agenda

Mr. Mueller reviewed an agenda for this meeting, including the following topics:

Public Comment

Mr. Mueller noted that tonight's agenda did not include a discussion with officials from the National Health Network (HNA) of the W.R. Grace Medical Plan. The CAG had changed the date of this meeting from the normal second Thursday of the month to July 18 in an attempt to accommodate attendance by HNA officials. Yesterday, Alan Stringer informed Mr. Mueller that would the HNA officials would not attend this meeting.

Rita Windom Statement

Commission Rita Windom reported that Dr. Michael Spence, Montana's State Medical Officer, has recently received a national special services award from Agency for Toxic Substances and Disease Registry (ATSDR) for his work with the people of Libby to develop long-term testing and tracking of asbestos-related diseases. The award is given to citizens for extraordinary efforts to promote public health. CAG and audience members joined Commissioner Windom in thanking Dr. Spence for his efforts on Libby's behalf and in congratulating him for his award.

State Report

Dr. Spence reported on behalf of the state on following three topics.

State Mesothelioma Data Base - From January 1, 1979 to December 31, 2001, one hundred and seventy-four cases of mesothelioma were diagnosed in Montana and twenty-three in Libby. Of the twenty-three Libby cases, the state has nine death certificates listing mesothelioma as the cause of death, the death certificate for one person with the disease listed lung cancer as the cause of death, and thirteen had no death certificate or were not included in the state tumor registry. Some of the thirteen may still be living. The state is examining employment records of the non-Libby cases to determine how many cases likely originated at Libby. Because several of the mesothelioma cases were located at sites of major railheads such as Great Falls and Havre, the state has theorized that these cases were related to the transport of asbestos from Libby. Additional data will be needed to validate this theory.

Libby Health Resources - Because of the number of people in Libby that have or will develop asbestos-related disease and that have no health insurance and may not also be eligible for Medicaid and Medicare coverage, substantial resources will be needed to address Libby health concerns. One possibility to provide them is a federal white lung program somewhat similar to the black lung program for coal miners. The Libby community should push federal and state political leaders for such a program.

Continued Medical Screening - Last Tuesday, the state submitted an application to ATSDR for funding for an additional five years of medical screening. As proposed, the screening would include the same questionnaire, pulmonary function test, and chest x-rays as in the first two rounds of ATSDR screening. Unlike the previous screening, however, the x-rays would be read by only one B-reader. The screening would be available year-round. Because of the latency period for asbestos-related disease, periodic rescreening will be necessary. The proposal calls for rescreening as follows:

Age Group

Screening Frequency

Asbestos Workers

Non Workers

Over 45 years old

Every year

Every two years

35 - 45 years old

Every 2 years

Every 3 years

Everyone else

Every 5 years

CAG Member Question - Some 150,000 people are afflicted with asbestos-related disease. Would the white lung people address all of them, or just those with disease caused by tremolite asbestos?
Answer - A federal program would probably not be limited to covering tremolite-related disease. The important thing is to begin the program.

CAG Member Question - As I understand it, under the federal black lung program, only those with severe disease are covered; those with less severe disease have had to fight for coverage. Would a white lung program be similar?
Answer - You have asked a good question: who would be covered? Since the white lung program is not yet established, it could be set up with the lessons of the current black lung program in mind. It could be established to cover all asbestos-related disease.

CAG Member Comment - Concerning the white lung program, the circumstances in Libby are unique. One size will not fit all in a white lung program.
Response - Correct. The Libby community must have input into the program development to ensure that Libby's needs would be adequately addressed.

Audience Member Question - Why provide only one B-reader?
Answer - We won't have enough money for more than one reader. To provide three readers, we would have to screen fewer people.

CAG Member Question - Do the twenty-three Libby mesothelioma cases represent recent diagnosis?
Answer - The twenty-three occurred over the twenty year time period beginning in 1979.

ATSDR Report

Dan Strausbaugh introduced Dr. Ginger Gist, Chief of the ATSDR Division of Exposure and Disease Registries. Dr. Gist stated that ATSDR is turning the medical screening is over to the state. ATSDR is also starting to trace former W.R. Grace workers and their families, so that their names can be turned over to the state for screening.

CAG Member Question - Will you expand the registry after identifying all former workers and their families?
Answer - Yes, but we don't know when.

Dan Strausbaugh sought the CAG's advice about the scheduling of three events: a visit by Dr. Vikas Kapil , a September 26 meeting to release ATSDR study results, and a public availability session regarding the Libby public health assessment.

Dr. Kapil Visit - Dr. Kapil , who has taken over responsibility for the ATSDR Libby team leadership from Dr. Lybarger, is planning another visit to Libby on August 20, 21, or 22. Dr. Kapil visited Libby after the June asbestos conference, but was unable to spend as much time here as he wished.

CAG Recommendation - Dr. Kapil should visit Libby on Wednesday, August 21.

September 26 Meeting(s) - ATSDR is planning to release the results of three studies on September 26, 2002: the analysis of the two rounds of medical screening, the CAT-scan study, and the addendum to the mortality study. Mr. Strausbaugh stated that ATSDR policy is to release study results first to community and then to the press. In this case, however, because the Department of Justice needs the information for the EPA-W.R. Grace litigation, results will not be released first in Libby.

CAG Recommendation - ATSDR should schedule two meetings on September 26 in Libby to release the study information, one in the afternoon and one in the evening.

Availability Session - As previously reported to the CAG, ATSDR is conducting a community health assessment associated with the Libby NPL site designation. The agency must hold a public availability session in Libby so that members of the community can identify health concerns related to the asbestos or other chemically-related exposures. The discussions can be confidential.

CAG Member Question - Who will be attending the availability session from ATSDR?
Answer - Jill Dyken, who is leading the assessment and who visited Libby in April, a toxicologist, and public involvement specialists will attend.

Audience Member Question - Will autoimmune diseases be addressed in the assessment and public availability session?
Answer - Yes, autoimmune diseases can be discussed in the assessment and will be covered in the assessment.

CAG Member Question - Why is the availability session necessary? Why not just use the results of the pre-screening questionnaire?
Answer - Not everyone in the community who may have health concerns participated in the medical screening, so we can't rely only on its results. In preparing the assessment, ATSDR will use the entire EPA administrative record including the medical screening results.

CAG Member Comment - I have a report on asbestos disease by Dr. Selikoff. The public health assessment for Libby should provide a breakdown of information similar to that in this report.
Response - The assessment will cover exposure categories and their health outcomes as did the Selikoff report. A draft assessment will be issued so written comments about it can be taken. A sample assessment is available for public review at the EPA Information Center.

CAG Member Question - Will cigarette use and the drug epidemic be addressed in the health assessment?
Answer - These issues can be discussed in the availability session. The assessment is targeted, however, on issues that EPA can clean up rather than law enforcement issues.

EPA Report

Jim Christiansen reported on behalf of EPA on the following subjects.

Staff Availability - Mr. Christiansen is expecting the birth of his first child at the end of August. He and Paul Peronard are also scheduled to work in New York City and Jim must visit Salt Lake City during early August. Mr. Christiansen will therefore not be in Libby during August.

Residential and Business Screening and Cleanups - About 1,000 of the residential and business properties have been screened, so screening is about one-third completed. Results from the soil samples taken during the screening should start to be available in about a month. Only 50 to 60 property owners have denied EPA access for the screening which is a small percentage. So far about 20% of the homes and businesses have Zonolite insulation and vermiculite was sighted in the gardens or yards on about 40% of the properties. 40% is higher than expected. Properties with Zonolite insulation or vermiculite visible on their lots have been included on the list of properties to receive cleanups. Soil sampling may identify additional properties that must be cleaned. Because some properties have both Zonolite insulation and visible vermiculite on their lots, at this point EPA is estimating that a total of about 1,000 properties will require cleanup based on visual inspection alone. Because of problems getting money to contractors, residential cleanups have not started. We hope to have the necessary people and equipment to begin the cleanups in about two weeks.

Screening Plant - Cleanup is on schedule. The clean temporary fill is being replaced with permanent clean fill.

Expansion Plant - An issue between the Millwork West owners and W.R. Grace has delayed moving the planer and demolishing the planer building.

KDC Flyway - Cleanup of the Kootenai Development Corporation property is also on schedule and should begin later this summer.

School Tracks - Cleanups of the school tracks are moving forward and should be completed this summer so that track use this fall will not be affected. The contract for the high school track has been awarded.

Stimson Mill - Today's newspaper featured an article with comments by the mill CEO about the adverse financial effects of asbestos-related litigation and workers compensation insurance. These are not EPA issues. EPA is developing an air and soil sampling plan specific to the mill. This sampling will occur this season. During the remainder of this year, EPA will develop a cleanup plan in coordination with the mill. Money for this cleanup will not be available until 2003 at the earliest.

Availability Sessions - The availability sessions in which EPA personnel provide briefings and take questions from the public which have taken the place of the second CAG meeting each month are cancelled for the next two months. They may be resumed after the residential cleanups are underway if there is a need.

Libby National Priorities Listing
The NPL should be finalized this fall. EPA attorneys are considering the responses to comments received on the listing proposal.

Horinko Visit
On July 23, Marian Horinko, Assistant Administrator in charge of the Office of Solid Waste and Emergency Response will be in Libby. She, her deputy, other EPA officials from Headquarters, the Region 8 Administrator, the Montana State Director, and the Montana DEQ Director will tour the cleanup sites and meet with local government officials. From 6 to 7:00 p.m., Ms. Horinko and the other officials will meet with the CAG in the City Hall.

August 8 Meeting Agenda
Tod Trigsted will demonstrate an interactive CD at the August 8, 2002 CAG meeting.
CAG Member Comment - The Burnetts may need EPA's assistance in dealing with W.R. Grace.
Response - EPA is trying to keep the cleanup moving.

CAG Member Question - What happens to the Parker property after cleanup is completed, will the Parkers retain ownership?
Answer - EPA is cleaning the property, but the Parkers will retain ownership.

CAG Member Question - Has EPA determined the standards that will be applied to the Stimson air and soil sampling?
Answer - We have not decided yet what standards to apply.

Audience Member Question - You discussed screening at residences. Schools should have a higher priority. Have all of our schools had additional screening for asbestos?
Answer - The schools have been a priority from the beginning. They were sampled two years ago, and cleanup of school grounds has occurred. At Plummer School, the recent removal of the cottonwood trees brought asbestos contamination to the surface. This contamination will be removed this summer.

Audience Member Comment - We were told that EPA is obtaining new equipment so that the results of residential sampling would be immediate and accurate. Now you are saying that sampling results will be available in about a month.
Response - Sampling is occurring outside residences first. The old method for analyzing soil was polarized light microscopy (PLM), We are developing a new method which we strongly feel will be superior to PLM called infrared spectroscopy (IR). Proving IR is working as planned is taking some time. The United States Geological Service (USGS) has developed testing material to evaluate how the new technique works. USGS has created samples by taking clean soil and adding known amounts of asbestos. It has then sent the samples to laboratories to test their infrared spectroscopy analysis. So far, the laboratories accurately analyzed the samples 90% of the time. We now have a backlog of soil samples from about 900 properties. We expect the analysis of these samples to begin in about a month. While theses samples are being analyzed, we plan to complete the residential and business property screening and continue soil sampling. Soil sample results will continue to lag behind visual screening results.

CAG Member Question - So residential cleanups are not yet underway?
Answer - Correct.

CAG Member Question - I am concerned about the size of your study area. Homes in the Farm to Market Road area have Zonolite insulation.
Answer - The study area includes 120 square miles. We will screen residences until we stop finding asbestos, and we will definitely screen the area you mentioned.

CAG Member Question - What would be an acceptable level of asbestos in school grounds?
Answer - I am not sure of the specific level, but we are not finding any. The only asbestos we know about now is at the Plummer School because of the tree removal, and that site will be cleaned before school starts again. We will check school samples with the infrared spectroscopy technique.

CAG Member Question - You said that the residential cleanups have been delayed by the contracting procedures. Will these procedures be changed as we complete the emergency response?
Answer - The procedures will remain the same through the end of this year, and they will then be changed. We hope to improve procedures in the Superfund cleanup phase based on what we have learned to date.

CAG Member Comment - I was contacted today by a homeowner with Zonolite insulation who is concerned that holes will be drilled through his new siding to remove the insulation from his walls.
Response - Removing insulation from walls is a challenge. We will not be able to remove insulation from every wall. We may be able to remove the siding, drill the holes, vacuum out the insulation, and replace the insulation and the siding. It is our goal to remove the insulation and restore the property to its original condition. However, we estimate the cost of doing so for just the houses we have identified as having the insulation so far at $20 - 30 million.

CAG Member Comment - People need information about the cleanup process.
Response - We agree. Examples of actual work will be helpful in allaying people's concerns.

CAG Member Question - If cleaning up just the homes identified to date will cost $20 - 30 million, and cleanup has not yet started, is it realistic to expect that cleanup will be completed in the two to three year time frame promised the governor?
Answer - We are committed to trying to complete the cleanup of the bulk of the residences within the two to three year time frame, but doing so will be challenging. EPA will not trade safety and quality for speed. Finishing in another two years will require cleaning 500 homes per year. The most I have ever completed in one year before is 150 homes. Marianne Horinko, EPA's Assistant Administrator in charge of the Office of Solid Waste and Emergency Response, has committed to Senator Baucus that $21 million will be available to fund the cleanup next year. EPA will also delete portions of the town from the Superfund list as cleanup progresses.

CAG Member Question - Is there an update on ambient air monitoring?
Answer - I am not able to give an update on the ambient air monitoring data. We will provide this information.

St. John's Lutheran Hospital Report

Kerry Beasley reported on behalf of the Hospital on a recent trip to Washington D.C. A group met with Senator Baucus to emphasize the need for funding for research on asbestos-disease and for the Libby community health trust fund.

TAG Update

George Keck reported that the Technical Assistance Grant application has been submitted to EPA. A copy of the application will be available in the EPA Information Center.

Public and CAG Member Comment

CAG Member Question - Today's The Western News included a story in which Stimson Lumber Company CEO Andrew Miller proposed using a portion of the federal timber receipts from the Kootenai National Forest be dedicated to the community's health trust. What does the County think of this idea?
Answer by Commissioner Windom - Timber receipts from the 25% fund are retained in the county where they were generated; however, the money goes to the state first and then back to the county. The receipts are allocated 2/3 for roads and 1/3 for schools. The schools' shares are returned to the state equalization pot, and then the schools across the state receive funds from the state equalization. Changing the formula so that an amount above the existing 25% level could be used for the health trust may be a good idea. However, Timber sales in Lincoln County have decreased to under 70 million board feet and are likely to continue to decrease. As a result, not much timber money may be available for the health trust. The County currently receives federal dollars related to National Forest lands from the secure schools and counties bill (SB2389, better known as 1608 money) rather than from Lincoln County timber sales in because of the low volume of federal timber sales.

I have visited with Todd O'Hair in Governor Martz' Office about Stimson's concerns and our health care funding needs. The Governor is aware of our problem and is forming a work study group to consider how the state and the federal government by help finance Libby's health care needs.

CAG Member Comment - Some of the economic development funds should be put in the community health care trust.

Next Meeting

The next meeting is scheduled for Thursday, August 8, 2002 at 7:00 p.m. in the Ponderosa Room of Libby City Hall.

Appendix 1

CAG Member & Guest Attendance List
July 18, 2002

Members

Group/Organization Represented

Mick Mills

Lincoln County Health Officer

Brad Black

Libby Fire Department

Gayla Benefield

LCAVRO

Norita Skramstad

Asbestos Victim

George Keck

Technical Advisory Committee

Craig French

DEQ

George Bauer

City of Libby

Gary Spencer

Citizen

Sandy Wagner

Community Health Center

Clinton Maynard

Area Asbestos Research Group

Ken Hays

Senior Citizens

David F. Latham

The Montanian Newspaper

Jim Christiansen

EPA

LeRoy Thom

Former Grace Employee

Don Wilkins

Lumber & Sawmill Workers

Eileen Carney

State Representative

Kerry Beasley

St. John's Lutheran Hospital

Visitors

Dr. Michael Spence

State Medical Officer

Dr. Ginger Gist

ATSDR Exposure and Disease Registries Division Chief


Photos courtesy of Dudley Dana, Dana Gallery