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Libby Amphibole Disease: Pulmonary Function and CT Abnormalities in Vermiculite Miners
Albert Miller1, Jaime Szeinuk, Curtis W Noonan
1Mount Sinai Health System, Icahn School of Medicine, New York, New York (Drs Miller, Henschke, Yankelevitz, Liang, Liu, Ms Yip, Ms Linker, Dr Flores); Northwell Health, Department of Occupational Medicine, Epidemiology and Prevention, Great Neck, New York (Dr Szeinuk); University of Montana, Missoula, Montana (Dr Noonan); Montana State University, Bozeman, Montana (Dr Pfau); and Center for Asbestos Related Disease, Libby, Montana (Dr Black, Ms McNew).
Objective:
This article describes radiologic and pulmonary function findings among miners exposed to Libby amphibole. Computed tomography (CT) permits the detection of the characteristic thin, lamellar pleural thickening (LPT).
Methods:
Individuals who worked at the mine for a minimum of 6 months had chest CT and pulmonary function tests.
Results:
Pleural thickening was noted in 223 (87%) of the 256 miners, parenchymal abnormalities in 49 (19%). LPT, found in 151 (68%), was associated with low values of forced vital capacity and diffusion capacity and significantly lower values in all pulmonary function tests when associated with parenchymal abnormalities.
Conclusion:
Eighty-seven percent of miners exposed to Libby Amphibole had pleural abnormalities on CT. LPT alone, and more so with parenchymal abnormalities, resulted in decreased pulmonary function. The importance of this easily missed LPT is demonstrated by its high frequency and significant functional effects.
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