Pneumoconiosis in a vermiculite end-product user

Recognizing the pleura in asbestos-related pleuropulmonary disease: Known and new manifestations of pleural fibrosis

Pleural thickening (PT) is a major consequence of exposure to all fiber types of asbestos. In recent decades, it is more prevalent than parenchymal asbestosis. Its manifestations occupy a full clinical and radiographic spectrum. Six major manifestations can be identified: (a) acute pleuritis generally with effusion; (b) diffuse PT or fibrous pleuritis; (c) rounded atelectasis; (d) circumscribed PT or plaques; (e) chronic pleuritic pain; and (f) mesothelioma. Review of the experience of workers and community members in Libby, MT to asbestiform fibers in vermiculite has confirmed the appearance of these previously known benign and malignant asbestos-related diseases as well as a unique pleuropulmonary disease characterized as lamellar PT and associated with progressive decline in pulmonary function and pleuritic pain. Despite previous literature asserting that PT represents a marker for asbestos exposure without significant effect on pulmonary function and physiology, the experience of Libby amphibole (LA) disease, along with other studies, indicates that PT plays a role in declining vital capacity in those with prolonged or unusual exposures such as those arising from LA.

Community Exposure to Asbestos From a Vermiculite Exfoliation Plant in NE Minneapolis

Western Mineral Products/W. R. Grace operated a vermiculite plant in a mixed industrial/residential area of northeast Minneapolis from 1936 to 1989. The plant processed vermiculite ore contaminated with amphibole asbestos from a mine in Libby, MT. Air monitoring in the early 1970s found fiber concentrations in excess of 10 fibers per cubic centimeter of air (f/cc), indicating that worker exposure to asbestos was occasionally 100 times the current occupational standard. Residents of the surrounding community also had direct contact with vermiculite processing wastes (containing up to 10% amphibole asbestos) that were made freely available. Children played on waste piles and neighborhood residents hauled the wastes away for home use. In total, 259 contaminated residential properties have been found to date. Reported emission factors and plant process data were used as inputs to model airborne emissions from the plant over several operating scenarios using the U.S. Environmental Protection Agency (EPA) ISC-Prime model. Results estimate short-term air concentrations of asbestos fibers in residential areas nearest the plant may have at times exceeded current occupational standards. Exposure estimates for other pathways were derived primarily from assessments done in Libby by the U.S. EPA. The Northeast Minneapolis Community Vermiculite Investigation (NMCVI) was conducted by the Minnesota Department of Health to identify and characterize the exposures of a cohort of over 6000 people who live or lived in Northeast Minneapolis and may have been exposed to asbestos. This cohort is now being investigated in a respiratory health screening study conducted by the University of Minnesota and the Minnesota Department of Health.

Pleuroparenchymal lung disease secondary to nonoccupational exposure to vermiculite

An unusual case of pleuroparenchymal lung disease caused by the inhalation of vermiculite dust, presumably containing asbestos fibers is described. The uniqueness of the case lies in the very indirect nature of exposure -- the wife of a factory owner, rather than a worker exposed to asbestos, whose factory manufactured vermiculite. The present case illustrates the importance of taking careful occupational histories of all household members when presented with a patient whose chest radiograph exhibits features consistent with asbestos exposure.