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Libby Community Advisory Group
Meeting Summary

June 13, 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

Presentation by Dr. Holian and Dr. Pfau

Dr. Andrij Holian and Dr. Jean Pfau of the University of Montana Center for Environmental Health Studies presented results of their research on asbestos-related disease.

Dr. Andrij Holian

Dr. Holian reported on results from three types of studies of asbestos induced lung disease:

  • Mouse in vitro (i.e. outside of the body) studies to examine injury to alveolar macrophage cells;
    Human in vitro studies to examine alveolar macrophage injury and immune system activation;
    Mouse in vivo (i.e. inside of the body) studies to examine lung injury.

The purpose of these studies is to increase understanding of the asbestos disease mechanism, and specifically of the impact of asbestos on lung macrophage cells, so that a cure might be developed.

Alveolar macrophage cells are the body's mechanism for cleaning the surface of the lungs, and they are the first cells that encounter inhaled asbestos particles. Two types of alveolar macrophage cells exist, those that suppress the immune system response and those that activate it. Asbestos particles kill the suppressor macrophage cells which has the effect of removing the brakes from the immune system, which then produces excess fibroblasts. The fibroblasts in turn form collagen that makes the lung more rigid and decreases both lung volume and the ability to deliver oxygen to the blood.

Dr. Holian stated that his work has demonstrated that Libby asbestos produces lung damage similar to the worst known type of asbestos.

He also stated that the sensitivity to asbestos exposure varies; some people get sick and some don't. Additional research is needed to understand the cause of this variability. He asked for additional volunteers from people in Libby to provide biological samples from their lungs and blood samples. Two types of volunteers are needed, those who have been exposed to asbestos but appear to be healthy and people who have asbestos-related lung disease. Six volunteers of both types are needed. Volunteers will be flown to Missoula for the sampling procedure that will be conducted at a doctor's office. The procedure consists of introducing into and then removing a sterile saline fluid from the lung through a tube. Transportation and expenses will be covered and volunteers will be paid $100 for their time. Volunteers should be flown back to Libby the same day. Volunteers must be non-smokers and must not be extremely ill. Arrangement for volunteering can be made through Libby's CARD Clinic.

CAG Member Question - You said that people exhibit greater and lessor sensitivity to asbestos disease. Do you know what fraction of people are more sensitive?

Answer - We don't have enough data to know for sure, but I guess about 20-30% are more sensitive. Sensitivity does appear to be dose dependent.

CAG Member Question - The goal is to shut down or regulate the immune system?

Answer - Yes, we are trying to block production of the agents that stimulate fibroblast production.

CAG Member Question - Would shutting down the immune system cause cancer?

Answer - No.

Dr. Jean Pfau

Dr. Pfau said that her specialty is immunology and that she is conducting research on relationship between asbestos and autoimmune diseases. In autoimmune disease, such as lupus and rheumatoid arthritis, the body's immune system turns against itself. She began her research skeptical about any connection, but is now convinced that asbestos exposure has an effect on autoimmune disease that deserves further study.

Dr. Pfau's research has involved comparing the presence and amount of auto-antibodies in the blood of thirty-six people in Missoula and thirty-six people in Libby with the same sex and age profile. Her research indicates that people from Libby have higher levels of auto-antibodies than people from Missoula and that the amount of the auto-antibodies increases with exposure to asbestos and with asbestos disease severity. She is not yet able to draw firm conclusions about the significance of asbestos exposure to autoimmune disease, but is seeking additional volunteers to for more research.

CAG Question - Are you able to say whether people with autoimmune disease are more susceptible to asbestos disease or vice versa?

Answer - No.

CAG Question - Does the asbestos exposure pathway matter for auto-immune disease?

Answer - Exposure via the lung may causes greater susceptibility.

CAG Question - The latency for asbestos disease is 20 to 40 years. Is there a way to detect auto-immune disease prior to the end of the latency period? I am concerned about children.

Answer - We have not tested children, but we are interested in doing so. We have not recruited any specific population for our research but have relied on people who have visited the CARD Clinic.

Clinton Maynard Statement

Clinton Maynard read the following statement:

On June 6, I engaged in a communication with a fellow concerned citizen who has a very good source for credible information. This citizen is not in government or the medical field and doesn't even live here. In our communication, I was informed of some shocking information. This information was that in the past 3 years there have been 23 cases of mesothelioma diagnosed in Libby.

In disbelief I sought verification of the accuracy of this information, through EPA, who verified this to be the truth. This means that 23 people in our community in the past three years were told that they have 6 months to a year to live. Mesothelioma is almost always a terminal cancer. Generally speaking, this diagnosis is a death sentence.

What I also find shocking is that this vital and pertinent information has been withheld from this community.


This parallels our history that produced this tragedy in the first place-- the withholding of vital information from the people. I would like to make myself perfectly clear on this matter, the withholding of vital information in regard to this asbestos issue is in my view, the equivalent of lying.

I would like to know who all was privy to this information, for how long and why this information has been withheld. When the number was 15, I want to know the date. I want to know if this information was considered, in the recent denial of declaring a Public Health Emergency for Libby. The declaration of a Public Health Emergency would have opened doors for addressing the long term health care issue, opened doors for research funding and would have ensured that ATSDR stayed on board here to finish the work they started.

The fact that this information had to come to me through the grapevine, begs the question, what else are we not being told?

It seems we have a "don't ask, don't tell" need to know basis, in regard to sharing of information. I find this unacceptable and insulting.

We will not be viewed as a bunch of dumb hicks in Northwest Montana, who have no credentials. It was people with credentials who failed to prevent this disaster.

We are the people who are enduring the aftermath, trying to find solutions. We need the information. We need the numbers, we need to know how many cancers and what types, how many immune disorders, how many people are being prescribed medicine for arthritis. It's time we heard the rest of the story. It's time to put this above board and keep it there.

Response by Paul Peronard - While the number of mesothelioma cases is a serious problem, your reaction is out of line. There has not been a coverup of this information. It has been discussed as it has become available in the EPA administrative record and the ATSDR screening report and by Dr. Spence and Dr. Black. If you can tell us what you want and how you want it reported, we can try to figure out how to collect the information and report it. However, medical data are subject to privacy concerns and disclosure laws.

Comment by Clinton Maynard - I would like periodic reporting of clinical data.

Response by Paul Peronard - To the extent that the data are public, we are reporting it. We do not have access to and cannot release clinical data unless people release it to us.

CAG Member Comment - The incidence of mesothelioma in the US population is 1 in 1,000,000. In Lincoln County the incidence is 1 in 1,000.

ATSDR Report

Dan Strausbaugh reported on behalf of ATSDR. He reminded the meeting participants of the asbestos conference at the University of Montana on June 24-25. Dr. Falk and Dr. Lybarger from ATSDR in Atlanta will participate in the conference. Dr. Cappel will shortly be taking over leadership of the ATSDR Libby team and Libby reporting responsibilities from Dr. Lybarger, who is taking a new position within ATSDR. On Thursday, June 26, Dr. Falk, Dr. Lybarger, and Dr. Vick Cappel plan to visit Libby, and will meet with Dr. Spence and Dr. Black. If CAG members or others want to meet with Dr. Falk, Dr. Lybarger, and Dr. Cappel, they can call the Information Office in Libby and arrange a time to do so between 8:30 a.m and 9:45 a.m. on Thursday morning.

EPA Report

Paul Peronard reported on the following topics behalf of EPA.

Asbestos Conference

EPA will pay the way for five people from Libby to attend the asbestos conference. Payment will include travel, hotel, and conference registration costs. The CAG can identify four people to attend, and EPA will designate the fifth. People wishing to attend need to identify themselves tonight so the funding arrangements can be made. The conference presentation on Monday morning addresses Libby and would probably be of most interest to Libby residents. The remaining presentations will be highly technical.

Residential and Business Screening

So far 428 residences and businesses have been screened and of this total135 have been identified for additional followup. Access for the screening has been denied on sixteen properties. EPA plans to screen 3,300 properties by November 2002. One screening team has been assigned to take special screening requests, such as pending property sales or renovations. This team has had 24 requests and has completed the screening on 21 of them. The results of the screening so far has not been surprising. Consistent with previous trends, about two-thirds of the homes and businesses have vermiculite insulation and about half have asbestos in their yards or gardens.

Schedule of Summer Activities

A schedule of planned activities for the summer can be examined at the EPA Information Center. EPA activities are about one and a half months behind where it was hoped to be.

Middle and High School Tracks

Work will begin at the Middle School track next week and paving should begin on June 24. The bid solicitation for the work at the High School track closes tomorrow, and the contract will be awarded and work will begin by July. Both tracks should be fully restored and usable by this fall.

Screening Plant

Remaining restoration work at the screening plant site should be completed by fall.

Export Plant

Movement of Millwork West's planer should begin in a week or two. The planer building will be demolished in July.

KDC Flyway

Trucking to the mine for disposal of 20 to 30 thousand cubic yards of contaminated soil has been temporarily stored on the site should begin in July.

Residential Cleanups

Cleanups will begin at the highest priority sites, i.e. those with significant contamination. There are now 64 properties on the priority list. Cleanup has begun on 3 properties, and EPA plans to have 55 completed by November. EPA will not be able to cleanup everyone's property immediately. We will put you on a list, but you will need to patient.

New Landfill Asbestos Cell

Work to build the new cell at the county landfill to dispose of asbestos contaminated materials such as insulation will begin in July. When the cell is completed, smaller residential cleanups can proceed year round.

Powers Property

The Powers' property includes 12 acres and its cleanup will be a large project. The Powers attempted their own insulation removal, and spread contamination in their house. This situation is an example of why people should not attempt their own cleanup.

Superfund Cleanup Components

The mine site and the Kootenai River system will be cleaned, but they are a lower priority than the residences and businesses. Investigation of the mine and the River will begin next spring.

EPA On-Scene Coordinators

Because of his responsibilities in the cost recovery and bankruptcy court proceedings with W.R. Grace, Mr. Peronard will be spending only one week per month in Libby. The remaining time will be covered by Duc Nguyen and David Romero. A Community Involvement Coordinator will also be available in Libby full time to provide information and solve problems such as relocation issues. Karin Mainzhausen of CDM will share this responsibility with two other people. The telephone number of all contacts will be available at the EPA Information Center.

Local Employment

EPA currently has 10 local hires out of 30. This ratio will change as more laborers are hired.

Expenditure Summary

A summary of all EPA expenditures in and outside of the Libby area should be available at the EPA Information Center in about two weeks.

CAG Member Question - What will be Jim Christiansen's schedule?

Answer - Mr. Christiansen plans to be in Libby two weeks per month.

CAG Member Question - What is the status of National Priorities Listing decision?

Answer - The comment period on the proposed listing closed two weeks ago. Two companies, W.R. Grace and Stimson Lumber, and two individuals commented. EPA headquarters will respond to these comments by the end of the summer. The listing will be finalized shortly afterwards.

Audience Member Question - What is the legal standing of the 'comfort letter' that EPA will provide to residential property owners?

Answer - EPA may issue letters that provide comfort in three areas. First, EPA will promise not to seek recovery of cleanup costs from residential or business property owners. Second, if after the screening no vermiculite insulation or contaminated surface soil is found, EPA will provide a letter so stating. Third, once cleanup of a property is finished, a letter so stating will be provided. These letters will probably be important to home buyers and purchasers. The letters will not guarantee that contaminated materials may not be found below the surface at a later date. By constructing the landfill cell and other actions, EPA is establishing the infrastructure so that remaining problems can be handled locally. EPA letters will not provide immunity from law suits; they should, however, provide comfort to people involved in such suits.

Audience Member Question - A radio interview with Jim Christiansen referred to simplistic tests. What is meant by simplistic?

Answer - Some may describe the testing program as simplistic because it will be based on available information. EPA has decided to conduct detailed sampling only at the 'in between' properties. Properties with visible vermiculite on the grounds or vermiculite insulation will be cleaned up without extensive sampling before hand. Experience indicates that newer properties, or houses located farther from the city without visible vermiculite are not likely to be contaminated. We therefore do not plan detailed sampling of such properties. More detailed sampling will be limited to those properties not evidently clean or contaminated.

Audience Member Question - How many residences have signed up to be tested?

Answer - There is not a sign up for testing. EPA will have people visiting and screening every property. So far, EPA has been denied permission to sample 16 out of 428 properties. Sampling is voluntary.

Community Health Center Report

Sandy Wagner reported on behalf of the Community Health Center (CHC). She thanked the community for its support of the CHC. She stated that to date, the CHC has had 773 patients and 1,062 patient visits. Of the 773 total, 205 patients have been served on a sliding fee schedule, and 403 patients have had no health insurance. CHC patients have tended to be very sick people who have gone without primary health care for periods up to 15 years.

St. John's Lutheran Hospital Report

Rick Palagi reported on behalf of the Hospital. He stated that the Hospital is continuing to work with W.R. Grace to discuss W.R. Grace Medical Plan coverage denials in an attempt to resolve them in favor of patients. Mr. Palagi invited everyone to the Hospital's June 10 grand reopening.

W.R. Grace Medical Plan

Gerald Mueller reported that, as directed by the CAG at its last meeting, he wrote to Alan Stringer inviting HNA's Dr. Flynn to this meeting so that the CAG could continue its discussion of the W.R. Grace Medical Plan with Dr. Flynn and Dr. Black. However, Dr. Flynn sent an email stating that he was not able to attend this meeting, and did not respond to an email by Mr. Mueller asking about his availability at a future CAG meeting.

CAG Member Question - On July 19, 2002, W.R. Grace and HNA will convene a meeting at the VFW Hall from 8:00 a.m. to 4:00 p.m. What is the purpose of this meeting?

Answer by Alan Stringer - The purpose of the meeting is to provide people enrolled in the plan an opportunity to discuss it with HNA officials. The meeting will be similar to one held last year. A letter about the meeting will be mailed to Plan members.

CAG Member Question - We have heard that 10% of those currently enrolled are being dropped from the Plan as not qualified. Can you confirm this percentage?

Answer by Alan Stringer - I am not sure what the disqualification rate is.

CAG Member Question - Would the HNA officials be amenable to meeting with the CAG about the Plan the night before the July 19 meeting?

Answer by Alan Stringer - I will find out.

Public and CAG Member Comment

CAG Member Comment - Thank you to those that helped with the Memorial Day service, and particularly to Leroy Billadeau and Eva Thompson who laid out the grid for the crosses. About 100 to 150 people attended.

Next Meeting

The next meeting was re- scheduled for Thursday, July18, 2002 at 7:00 p.m. in the Ponderosa Room of Libby City Hall.

Appendix 1

CAG Member & Guest Attendance List
June 13, 2002

Members

Group/Organization Represented

K.W. Maki

Libby School District #4

Sandy Wagner

Community Health Center (CHC)

Mick Mills

George Keck

CHC

Gary Spencer

Business Community/Citizen

Mike Switzer

Asbestos Victim

Bob Dedrick

Asbestos Victim

George Bauer

City of Libby

Gary Spencer

Business

Wendy Thomi

EPA Community Involvement

Paul Peronard

EPA On-Scene Coordinator

LeRoy Thom

Former Grace Employee

Gayla Benefield

LCAVRO

Eileen Carney

State Representative

Dan Strausbaugh

ATSDR

Gary D. Swenson

Libby Volunteer Fire Department

Clinton Maynard

Area Asbestos Research Group

David F. Latham

The Montanian Newspaper

Dr. Brad Black

CARD Clinic/Lincoln County Health Officer

Rick Palagi

St. John's Lutheran Hospital

Visitors

Group/Organization Represented

John Wardell

EPA

Dr. Andrij Holian

UM Center for Environmental Health Studies

Dr. Jean Pfau

UM Center for Environmental Health Studies


Photos courtesy of Dudley Dana, Dana Gallery