Senate Hearing, 107TH Congress - Asbestos Cleanup in Libby, MT

S. HRG.
1071002
ASBESTOS CLEANUP IN LIBBY, MT
HEARING
BEFORE THE
SUBCOMMITTEE ON SUPERFUND, TOXICS, RISK,

AND WASTE MANAGEMENT
OF THE
COMMITTEE ON ENVIRONMENT AND

PUBLIC WORKS
UNITED STATES SENATE
ONE HUNDRED SEVENTH CONGRESS
SECOND SESSION
ON
TO ASSESS ASBESTOS REMEDIATION ACTIVITIES AND EVALUATE HOME

INSULTATION CONCERNS RELATED TO ASBESTOS
JUNE 20, 2002
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COMMITTEE ON ENVIRONMENT AND PUBLIC WORKS
ONE HUNDRED SEVENTH CONGRESS

SECOND SESSION
JAMES M. JEFFORDS, Vermont, Chairman
MAX BAUCUS, Montana BOB SMITH, New Hampshire
HARRY REID, Nevada JOHN W. WARNER, Virginia
BOB GRAHAM, Florida JAMES M. INHOFE, Oklahoma
JOSEPH I. LIEBERMAN, Connecticut CHRISTOPHER S. BOND, Missouri
BARBARA BOXER, California GEORGE V. VOINOVICH, Ohio
RON WYDEN, Oregon MICHAEL D. CRAPO, Idaho
THOMAS R. CARPER, Delaware LINCOLN CHAFEE, Rhode Island
HILLARY RODHAM CLINTON, New York ARLEN SPECTER, Pennsylvania
JON S. CORZINE, New Jersey PETE V. DOMENICI, New Mexico
KEN CONNOLLY, Majority Staff Director

DAVE CONOVER, Minority Staff Director
SUBCOMMITTEE ON SUPERFUND, TOXICS, RISK AND WASTE MANAGEMENT

BARBARA BOXER, California, Chairman
MAX BAUCUS, Montana LINCOLN CHAFEE, Rhode Island
RON WYDEN, Oregon JOHN W. WARNER, Virginia
THOMAS R. CARPER, Delaware JAMES M. INHOFE, Oklahoma
HILLARY RODHAM CLINTON, New York MICHAEL D. CRAPO, Idaho
JON S. CORZINE, New Jersey ARLEN SPECTER, Pennsylvania
(II)
C O N T E N T S
Page
JUNE 20, 2002
OPENING STATEMENT
Baucus, Hon. Max, U.S. Senator from the State of Montana .............................. 1
WITNESSES
Black, Brad, M.D., Lincoln Community Health Officer and Director, Clinic
for Asbestos Related Disease ............................................................................... 22
Prepared statement .......................................................................................... 93
Cohan, Pat, coordinator, Clinic for Asbestos Related Disease ............................. 20
Falk, Henry, M.D., Assistant Administrator, Agency for Toxic Substances
and Disease Registry ........................................................................................... 12
Horinko, Marianne, Assistant Administrator, Office of Solid Waste and Emer-
gency Response, U.S. Environmental Protection Agency ................................. 8
Konzen, John, Lincoln County Commissioner, Libby, MT ................................... 26
Murray, Hon. Patty, U.S. Senator from the State of Washington ....................... 5
Spence, Michael, M.D., State Medical Officer, Montana Department of Public
Health and Human Services ............................................................................... 18
Report, Medical Testing of Individuals Potentially Exposed to
Asbestoform Minerals Associated with Vermilculite in Libby, MT, Year
2000 ................................................................................................................ 5791
Wagner, Gregory, M.D., Director, Division of Respiratory Disease Studies,
National Institute for Occupational Safety and Health .................................... 10
ADDITIONAL MATERIAL
Statement, Rehberg, Hon. Denny, U.S. Representative from the State of Mon-
tana ....................................................................................................................... 45
(III)
ASBESTOS CLEANUP IN LIBBY, MT
THURSDAY, JUNE 20, 2002
U.S. SENATE,
COMMITTEE ON ENVIRONMENT AND PUBLIC WORKS,
SUBCOMMITTEE ON SUPERFUND, TOXICS, RISK,
AND WASTE MANAGEMENT,
Washington, DC.
The subcommittee met, pursuant to notice, at 9:35 a.m. in room
406, Senate Dirksen Building, Hon. Max Baucus (acting chairman
of the subcommittee) presiding.
Present: Senator Baucus. Also Present: Senator Murray.
OPENING STATEMENT OF HON. MAX BAUCUS, U.S. SENATOR

FROM THE STATE OF MONTANA
Senator BAUCUS. The meeting will come to order, and thank you
all for being here today. I thank Senator Boxer, Senator Chafee
and Senator Reid, members of this committee, for helping arrange
this hearing. I am also a member of this committee, but they hold
leadership positions in this committee, and I want to thank them
for their efforts.
Every community in our country obviously is special, but I must
say that in my State of Montana, even though every community in
Montana is special, I like to speak about one in particular, and
that is Libby, MT. Libby is a small town. Most people there earn
their living in the woods, mills or in the mines. In January 2000,
some very kind people from Libby invited me into their homes to
talk about some of the health problems they were having as a re-
sult of exposure to tremolite asbestos from the defunct W.R. Grace
mine.
I have become very good friends with all these people. They are
wonderful, wonderful people. Their stories over the last couple of
years since I first got involved in this matter have kept me focused
on doing what is right for the people of Libby.
As I stood in the home of Gayla Benefield on a January after-
noon, I met with nearly 30 people from Libby, all suffering from
the effects of asbestos illness or had already lost loved ones due to
the disease. That afternoon, I also met a man in the living room
of Gayla named Les Gramstad. I want to tell you a little about Les.
He is a father, husband and grandfather. He has made his living
at the W.R. Grace mine. Les shared stories with me about return-
ing home at the end of a long workday at the mine, covered com-
pletely with dust. I have to tell you, I have watched these guys get
off the bus. They are just like dust bags. They are just totally filled
(1)
2
with dust. He would go home. His children would climb into his lap
and play with him. He would embrace his wife.
You guessed it. He, not knowing he had contracted asbestosis,
gave asbestos-related diseases unwittingly to his children. He gave
the disease to his wife, as they came in contact with the dust. So
not only is Les dying, but he also has this tremendous guilt that
he has caused his loved ones to also have the disease. As we all
know, this is a disease where once you get it, you just do not know
what the consequences are going to be and it is very long-lasting.
Most people have a very difficult time and many eventually die.
I want to show you a picture of the working mine. It is over to
my left. This picture is from the late 1960s. It is close to the time
that Les worked at the mine. You can just get a sense of the pollu-
tion. As you can tell from the photograph, the mill there is spewing
a lot of dust in the air. That is more than 24,000 pounds of dust
expelled each and every day that the mine operated, and 5,000
pounds of that 24,000 was tremolite dusttremolite asbestos.
There are many, many forms of asbestos. The worst and most
deadly is tremolite. Asbestos is mined at various sites around the
country. There are various forms of asbestos, but the most deadly
is tremolite, and tremolite asbestos is the type of asbestos that is
mined in Libby, MT.
Piles of the dust as waste from the mine were dumped as tailings
that pushed right up into the Kootenai River. That is the river that
runs right alongside Libby, alongside of the mine, and I know it
eventually goes further west into the Columbia River and affects
those States as well.
W.R. Grace gave the stuff away free. Here is what they said,
W.R. Grace at the time, Use it in your garden, in the high school
track. Use it in your driveway. Stuff it in your attic for insulation.
So people did, because the dust was harmless. At least that is what
W.R. Grace told them. There was no one to contradict those com-
pany statementsnot the State, even though there is evidence the
State had that this stuff is poisonous; not the Federal Government,
even though they had evidence as well. No one told the people of
Libby the tailings from the W.R. Grace mine was poison. Nobody
told them that.
Let me show you now what a tremolite asbestos fiber looks like
magnified. That is a tremolite asbestos fiber. As you can tell, it
looks like a long needle. These tiny fibers get into peoples lungs
and their lungs cannot get rid of them. It is like a javelin. It is like
a hook. It just gets into the lungs and it gets into the membrane
and it does not get out because like a javelin, it has that hook in
it. Eventually these fibers cause lung cancer or deadly mesothe-
lioma, a very rare cancer caused only by asbestos; or folks get as-
bestosis and die slowly and painfully as it gets harder and harder
to breathe.
This is a photograph now of a Memorial Day service in May of
this year. Those white crosses clearly represent people who died in
Libby on account of the disease. The first night I visited Les, he
told me he had asbestosis. He was exposed during the short time
he spent working at the mine. Les went on to share, which is the
most troubling part of the story, and I have already mentioned that
not only is Les sick, but so is his wife, Narita and so are their chil-
3
dren who are now in their 20s and 30s. Each one of them was ex-
posed to tremolite asbestos fibers contained in the dust Les carried
home on his clothes. Every time he hugged his kids hello, as I men-
tioned, every time he greeted his wife at the end of a long day, he
was exposing his family to asbestosis poisoning.
Les went on to tell me that his story is not unique. There are
dozens more like him still living in Libby, and many who have al-
ready dieddied because of their exposure to tremolite asbestos
dust. Hundreds more are sick. In fact, the Agency for Toxic Sub-
stances and Disease Registry has found that Libby suffers from as-
bestos-related disease at the rate of 40 to 60 times the national av-
erage. W.R. Grace knew. Federal and State agencies knew. They all
knew that the asbestos that contaminated the vermiculite ore was
deadly.
That afternoon, Les asked me to help him and I told him I
would. I will never forget the next thing he said to me. He is a tall
man, a little taller then than now. He said, Max, I will be watch-
ing you to make sure you keep your word, because I told him I
would do all I could. Les did not have to say that. The instant I
recognized the problems Les and the people of Libby were facing,
by talking to them at Gayla Benefields home that afternoon, I
pledged to myself that I am going to do whatever I possibly can to
help the people of Libby and to make this situation right for them.
That is the most gut-wrenching experience I have encountered in
my recent memory. It was that gripping, that tragic.
Since January 2000, I have visited Libby nine times. I have dedi-
cated one staff person nearly full-time to focus on the issues this
problem has generated. At my direction, that person has visited
Libby 103 times since then. I would like her to stand. Where is Re-
becca? There is Rebecca. She is aces. She runs our Kalispell office,
but she has been up to Libby 103 times in the last 2 years only
on this issue.
I held a field hearing during this committee in Libby 2 years ago
and two town hall gatherings since then. I have opposed the Fair-
ness Asbestos legislation during the 106th Congress, because I
think that legislation would improperly restrict victims rights to
sue for damages. I have heard from the Agency for Toxic Substance
Disease Registry to secure funds to complete two rounds of medical
screening for the community. I have also urged USATSDR to be
sensitive to developing a customized approach for serving Libby be-
cause it is so unique, our situation at Libby. I have asked the
EPAs efforts in Libby to ask EPA to assist by seeing to it that ad-
ditional cleanup dollars are sent to Libbymore than otherwise
would have been the case.
Former Secretary of Health and Human Services, Donna Shalala
has helped secure emergency funding for Libby, and Secretary
Tommy Thompson has also been very helpful.
We are also fortunate to enlist the help of the University of Mon-
tana and their Center for Environmental Health Sciences as they
begin to identify potential cures for asbestos-related disease.
The bottom line is that Libby is left with a massive asbestos con-
tamination problem, both in town and at the mine site. It is every-
where. Another photo hereThis is a picture of the mine site, obvi-
ously from the air. Libby is also left with a huge public health cri-
4
sis, as hundreds upon hundreds of folks will need expensive long-

term medical care. We will hear from some our Montana witnesses
about that. How should care be provided? Who is going to pay for
it? Who is going to insure those who are ill?
I continue to hope that W.R. Grace will step up to the plate, but
Grace has shown again and again that they will step away from
any and all responsibility for what they did to the people of Libby,
MT. Grace has filed for bankruptcy. Grace has been denying claims
for health coverage. It has been reported that Grace has managed
to hide at least $4 billion in assets, that is, transfer at least $4 bil-
lion of assets so the people of Libby cannot seek damages against
the company.
It is just too much to ask a rural community in northwestern
Montana to deal with this all on their own. They need help. That
is what we are here to talk about. I would like to get a sense from
EPA of what they are doing, what they have accomplished so far
in Libby, where they are going, how they plan to get Libby a clean
bill of health. We will also hear from the Agency for Toxic Sub-
stances and Disease Registry about their efforts, particular of in-
spector screenings and care for Libby residents. Dr. Falk testified
at the committees field hearing in Libby back in February 2000.
I will be interested to hear his perspective on how far we have
come, and his taking stock approach and how far we have yet to
go.
I hope to also hear about what has been learned from the trag-
edy in Libby. That is other information that will help us do a better
job of protecting people from the dangers of asbestos. I applaud our
States Governor. She, as we say in the vernacular, fired the silver
bullet. As we know under CERCLA law, a State Governor has one
opportunity to trigger a process which speeds up the determination
of whether EPA will designate a site as on the national list of reg-
istry of sites to be cleaned up. She did that, and I applaud her for
taking that action. I also appreciate Representative Rehbergs ef-
forts on the home insulation issue in Libby, and Senator Burns has
been helpful as well.
So essentially we are here to take stock about what has hap-
pened and to see what else we have yet to do in Libby. Libby needs
our help. We are here to provide it. This issue is particularly im-
portant to me. I am not going to let Les down. I am not going to
let the people of Libby down. I know everyone in this room feels
the same way.
I would also like to introduce our first witness, a terrific Senator,
Senator Patty Murray from Washington. Patty was gracious
enough to let me testify in a hearing that she chairs. That was a
short while ago. It was at that hearing we were able to secure the
promise of various government agencies to come to Montana. We
are very glad that they did. Senator Murray has been extremely
concerned about this issue as it affects her people in the State of
Washington. We are very honored to have you here, Senator. I
know what a fighter you are for your people in Washington. At the
conclusion of your testimony, you are more than welcome to share
the dais and just help your people as we help Montanas.
Senator Murray.
5
STATEMENT OF HON. PATTY MURRAY, U.S. SENATOR FROM
THE STATE OF WASHINGTON
Senator MURRAY. Thank you very much, Mr. Chairman. Thank
you for your passion on this issue and helping us finally get it to
the attention of the Nation as you have seen the struggles in your
State. It is such a critical issue. We would not be at the point we
are without your tremendous work, and I really appreciate your
having this hearing today on Libby, MT and on the health and en-
vironmental problems caused by asbestos contamination from that
W.R. Grace vermiculite mine.
I really appreciate the opportunity to testify before your com-
mittee today as well. Your leadership on this issue has just been
essential, and none of us would be where we are today if it was
not for that, and I really appreciate it.
Senator BAUCUS. Thank you.
Senator MURRAY. Mr. Chairman, I first became interested in this
issue in 1999 because of a series of articles by Andrew Schneider
about Libby in the Seattle Post-Intelligencer. As you know, I can
relate to the people of Libby because my mother grew up in Butte,
MT and like Libby, the main industry in Butte is mining. I know
first-hand that these communities believed the government was
protecting them from health problems caused by air and water pol-
lution from mining.
I also became interested in this issue because Libby is only 160
miles from Spokane, WA and many people from Libby have re-
ceived medical treatment in Spokane. Last year, I chaired a Senate
Health, Education, Labor and Pensions Committee hearing on as-
bestos exposure and worker safety, and Dr. Alan Whitehouse from
Spokane testified. He has treated about 500 patients from Libby.
While most people thought only miners and their families could be
exposed to dangerous amounts of asbestos from mining, many of
his patients are sick just because they lived in Libby. Approxi-
mately 25 percent of his patients did not work in the mine or live
with someone who did. Twenty-four of his patients have died in the
last 3 years, and five who died were sick only from environmental
exposure.
The issue is also relevant to my constituents because like most
other States, Washington has many sites which processed Libby
vermiculite that was contaminated with asbestos. The chart that I
have behind me displays all of the sites in the United States which
have received vermiculite from Libby. This map of the United
States should tell every single Senator that this is not a problem
somebody else has. It is a problem they have.
Of the approximately 300 sites which process this mineral, the
Environmental Protection Agency and the Agency for Toxic Sub-
stances and Disease Registries have determined that 22 sites re-
quire further cleanup. One of these sites is the former Vermiculite
Northwest, Inc. and then-W.R. Grace plant in Spokane. That plant
began producing Zonolite insulation in 1951. Even though the plant
closed down in the early 1970s, recent tests by EPA have found
some soil samples from the site still have asbestos concentrations
of up to 3 percent. EPA is strongly recommending that access to
the site be restricted almost 30 years after that plant closed down.
6
At many plants where vermiculite from Libby was processed,

waste rock left over from the expansion process was given away
free, as the chairman noted. People used that free waste rock in
their yards, in their driveways and in their gardens. The other pic-
ture you see shows Justin and Tim Jorgensen climbing on waste
rock that was given out by Western Minerals, Inc. in Minneapolis,
MN in the late 1970s. According to W.R. Grace records, that rock
they are climbing on contained between 2 and 10 percent tremolite
asbestos. This rock produced airborne asbestos concentrations 135
times higher than OSHAs current standard for workers.
Thankfully, today neither Justin or Tim has shown any signs of
disease, but their risks of developing asbestos diseases, which have
latency periods of 15 to 40 years, are increased from their child-
hood exposures. Mr. Chairman, I showed this picture several days
ago at a press conference that I had, and this morning I came into
the office and received an e-mail message from Lizzie Jorgensen
who is the mother of the two boys in this picture. I want to read
it to the committee this morning.
Greetings. Yes, please eliminate asbestos. Those two boys playing in the free rock
are my sons. Justin and Tims father, Harris Jorgensen, suffered long and hard with
asbestosis and lung cancer. He died June 22, 1991 at the age of 44. An autopsy
shows asbestos in his lungs. We lost that case in Federal court. Like Harris said,
we may not have gotten anything out of this, but maybe it will help someone else.
At this time I wonder, do my sons have to suffer also? It may be too late.
Senator MURRAY. From Lizzie Jorgensen, the mother of the two
boys playing in that rock.
Today, people may still be exposed to harmful amounts of asbes-
tos and vermiculite. Between 12 million and 35 million homes and
businesses may have Zonolite insulation. This may be the case for
up to 150,000 homes in my State alone. EPA has also tested agri-
cultural products, soil conditions, and fertilizers made with
vermiculite and determined that some workers may have been ex-
posed to dangerous amounts.
As I learn more about Libby and how asbestos had ended up in
products by accident, I was shocked to learn that asbestos is still
being used in products on purpose. While some specific uses have
been banned, the EPAs more sweeping ban was never put into ef-
fect because of a lawsuit backed by the asbestos industry. As a re-
sult, new uses of asbestos were banned, but most existing uses
were not banned. Today, asbestos is still used to make roofing
products, gaskets, brakes and other products. In 2001, the United
States consumed 13,000 metric tons of it. Asbestos is still entering
the product stream in America despite all of the known dangers to
human health.
In contrast, asbestos has been banned in at least 20 other coun-
tries. It is time for the United States to ban asbestos, too. I want
to ensure our government does all it can to minimize future suf-
fering and death caused by asbestos. That is why a few days ago
I introduced the Ban Asbestos in America Act of 2002. I want to
thank Senator Baucus for being an original cosponsor and I appre-
ciate the cosponsorship of Senators Cantwell, Dayton and
Wellstone as well.
The Ban Asbestos in America Act of 2002 has four parts which
I would like to just briefly mention. First, this bill protects the pub-
7
lic by requiring the EPA to ban asbestos by 2005. Like the regula-
tions EPA finalized in 1989 under the TSCA, companies may file
for an exemption to the ban. EPA may issue the exemption if there
is no substitute material available and the exemption will not pose
an unreasonable risk of injury to public health or the environment.
I would like to take a moment to point out to the subcommittee
the connection between what happened in Libby and EPAs efforts
to ban asbestos. Last year, the EPAs Inspector General conducted
an investigation into why the Agency did not do a better job of pro-
tecting the people of Libby. I was struck by one of the sections of
the Inspector Generals report in which a letter written by EPA in
1983 is as follows: Asbestos-contaminated vermiculite is consid-
ered a lower priority at this time than problems posed by friable
asbestos-containing materials in school buildings and commercial
and industrial uses of asbestos.
In 1979, EPA had issued an advance notice of proposed rule-
making that it intended to explore options to control asbestos
under Section 6 of the TSCA. In 1982, EPA issued a reporting rule
under Section 8(a) of TSCA to gather information about commercial
and industrial uses of asbestos. EPAs proposed rule to ban asbes-
tos was published in the Federal Register in January 1986 and the
final rule was published in 1989. One of the reasons EPA did not
spend more time focusing on asbestos-contaminated vermiculite
was the Agency was working on the asbestos phase-out and ban
rule. Unfortunately, that rule was overturned by the Fifth Circuit
Court of Appeals in 1991.
There is a clear relationship between EPAs efforts to ban asbes-
tos and the fact that the problems in Libby were overlooked. I am
saddened that EPA did not spend more focused time in Libby, in
part because of a competing effort to limit asbestos exposurean
effort which ultimately failed.
Second, the bill requires EPA to conduct a public education cam-
paign about the risk of asbestos products. We need to warn people
today that their home insulation, if made with vermiculite may be
contaminated with asbestos. While EPA has agreed to remove
vermiculite insulation from homes in Libby, the Agency currently
has no plans to do this nationwide. The Ban Asbestos in America
bill requires EPA and the Consumer Product Safety Commission to
educate consumers about how best to handle this insulation within
6 months. The Ban Asbestos in America Act of 2002 also requires
EPA to conduct a survey to determine which foreign and domestic
products consumed in the United States today have been made
with asbestos. EPA has estimated that as many as 3,000 products
still contain this mineral.
Third, the legislation invests in research, tracking and treatment
of asbestos diseases. It requires a national mesothelioma registry
which would be coordinated with ATSDRs existing efforts per-
taining to Libby, as well as with the National Institute for Occupa-
tional Safety and Health. The bill also authorizes funding for seven
mesothelioma treatment centers nationwide to improve treatments
for and awareness of this fatal cancer.
Finally, the bill requires EPA to expand its Blue Ribbon Panel
on asbestos to address issues beyond the six regulated forms of as-
8
bestos, as EPA originally promised in its response to the Inspector

General.
Over the years, asbestos has taken a staggering toll on our coun-
try. We have recently been reminded of the dangers posed by as-
bestos because of concerns about asbestos exposure from the dust
and the debris caused by the collapse of the World Trade Center
towers. Had this country acted swiftly to ban asbestos when public
health evidence about its dangers first emerged, the Towers would
not have been built with any asbestos at all. Now, we will need to
wait probably several decades to determine whether asbestos expo-
sures in New York will cause asbestosis, lung cancer, or mesothe-
lioma for our first responders and residents.
I hope this subcommittee, which has primary jurisdiction over
the Ban Asbestos in America Act, will consider holding a hearing
on this bill in the near future, and move it as quickly as possible.
Thank you again, Senator Baucus, for your tremendous efforts on
behalf of the people in your hometown and really across the entire
country.
Senator BAUCUS. Thank you, Senator, for your very, very dedi-
cated work here. You have done a great job, worked very, very hard
on this. That is clear from your testimony, and clear from your
statement. We would be honored to have you come up to the dais.
OK, lets hear from our next panel, which consists of Marianne
Horinko, Assistant Administrator for Superfund at Environmental
Protection Agency; Dr. Henry Falk, Assistant Administrator for the
Agency for Toxic Substances and Disease Registry; and Dr. Gregory
Wagner, Director of the Division of Respiratory Disease Studies at
the National Institute for Occupational Safety and Health.
Ms. Horinko, why dont you proceed? We have a 5-minute rule
here, but due to the nature of this hearing, we may relax that a
little bit. If you could generally stay within 5 minutes, that would
beand your statements automatically will be included in the
record.
STATEMENT OF MARIANNE HORINKO, ASSISTANT ADMINIS-

TRATOR, OFFICE OF SOLID WASTE AND EMERGENCY RE-
SPONSE, U.S. ENVIRONMENTAL PROTECTION AGENCY
Ms. HORINKO. Thank you.
Good morning, Senator Baucus and Senator Murray. I am
Marianne Horinko, Assistant Administrator of EPAs Office of Solid
Waste and Emergency Response. It is a pleasure to have the oppor-
tunity to appear before the subcommittee once again.
Today, I represent Governor Christine Todd Whitman to discuss
EPAs efforts to clean up asbestos contamination in Libby, MT and
describe what steps EPA is taking to address potential asbestos
contamination at other sites throughout the country. I wanted to
let you know that although Governor Whitman could not appear
today, I can assure you that protecting the health of the residents
of Libby remains one of her top priorities.
EPA is committed to working with our State and Federal part-
ners to take the necessary steps to protect public health and the
environment in Libby and at related sites. I want to thank Senator
Baucus particularly for his tireless efforts in helping to ensure that
9
the community of Libby is protected through the cleanup of asbes-

tos contamination.
As we all now know, many decades of mining and processing
vermiculite ore contaminated with asbestos has left the community
of Libby with significant health impacts. Those health impacts in-
clude cases of mesothelioma, an incurable and often fatal cancer of
the chest cavity, increased risks of lung cancer, and the debilitating
respiratory illness asbestosis. To address the asbestos contamina-
tion in Libby and the related health impacts, EPA, working closely
with the Agency for Toxic Substances and Disease Registry or
ATSDR, and the U.S. Public Health Service mobilized an emer-
gency response team to work in Libby. In 1999, ATSDR and PHS,
funded by EPA, started medical investigations in Libby to deter-
mine the magnitude of asbestos-related health impacts. The med-
ical investigations documented evidence of widespread disease and
mortality resulting from asbestos exposure.
Starting in 1999, EPA began emergency investigation and clean-
up activities in Libby. After interviewing numerous residents and
collecting more than 5,000 samples, EPA found high amounts of as-
bestos-contaminated vermiculite at the mine, the mine road, proc-
essing areas, the mine tailings pile and pond, and in residential
areas of the community. In June 2000, EPA started and provided
oversight for the cleanup of two former processing areas to address
some of the highest levels of asbestos contamination. EPA has also
started cleanup actions at the mine road, the high school track and
city park facilities.
EPA plans to start additional cleanup actions at mining facilities
and in the community.
I am pleased to report that on May 9, 2002, EPA approved a new
action memorandum amendment significantly expanding cleanup
work at Libby, including certain residential contamination in
homes with vermiculite insulation. The Agency determined that
this material did fall within our response authorities, particularly
given the unique circumstances found in Libby with both cumu-
lative exposure and also multiple pathways of exposure. EPA also
determined that the remaining asbestos released in Libby would
not have been addressed by any other authority in a timely man-
ner.
EPA is removing vermiculite ores and mining waste from resi-
dential yards and expects to begin removal of vermiculite insula-
tion from homes within 1 week. We expect to complete cleanup at
55 priority properties by the end of this summer. EPA is also work-
ing with ATSDR to study other locations across the country that
received shipments of vermiculite from Libby. The Agency initially
identified 240 locations for study, and has determined that 22 re-
quire additional investigation. EPA is sharing its findings with
other State and Federal agencies to provide the information nec-
essary to decide whether further action is needed.
One example of a situation warranting a shared Federal and
State approach is the asbestos contamination discovered at the
Western Minerals processing site in Minneapolis, MN. Western
Minerals is estimated to have processed more than 100,000 tons of
vermiculite ore from Libby, MT. The waste material generated
from this processing was made available to residents as foam mate-
10
rial for driveways and yards. The State and EPA have conducted
sampling and have been removing asbestos contamination from the
former plant and from residential yards. ATSDR is currently fund-
ing a survey by the Minnesota Department of Health to determine
the health impacts on former plant workers and nearby residents.
In conclusion, you have my commitment and the commitment of
Governor Whitman that EPA will continue its work with other
State and Federal agencies to protect the public health of the resi-
dents of Libby, as well as the health of other communities that may
have been affected by asbestos-contaminated vermiculite from
Libby.
Thank you again for this opportunity to share our work, and I
will be pleased to answer any questions that the subcommittee or
Senator Murray may have.
Senator BAUCUS. Thank you, Ms. Horinko.
Dr. Wagner.
STATEMENT OF GREGORY WAGNER, M.D., DIRECTOR, DIVI-
SION OF RESPIRATORY DISEASE STUDIES, NATIONAL INSTI-
TUTE FOR OCCUPATIONAL SAFETY AND HEALTH
Dr. WAGNER. Good morning, Senator Baucus, members of the
subcommittee, Senator Murray.
I am Dr. Gregory Wagner, Director of the Division of Respiratory
Disease Studies of the National Institute for Occupational Safety
and Health, known as NIOSH. I am pleased to be here today to
provide testimony on health risks to workers from asbestos and to
discuss NIOSH research related to Libby, MT.
NIOSH is a public health research institute in the Centers for
Disease Control and Prevention at the Department of Health and
Human Services. We conduct research and make recommendations
to identify and prevent work-related illnesses and injuries. My tes-
timony today will address our knowledge about health risks to
workers from exposure to airborne asbestos and asbestos-like min-
erals, opportunities for better prevention of asbestos exposure and
disease, past NIOSH findings with respect to asbestos contamina-
tion in Libby, MT, and our ongoing research related to Libby.
Asbestos, as you know, is a term that refers to a group of natu-
rally occurring fibrous minerals. The connection between inhalation
of asbestos fibers and a number of serious and often fatal diseases
is well recognized. Asbestos is a known human carcinogen. The dis-
eases it causes, both malignant and non-malignant, are often fatal
and most are preceded by years of debilitating illness.
Although the use of asbestos has been reduced or eliminated in
many commercial products, asbestos and asbestos-containing mate-
rials are still found in many occupational and industrial settings
and pose a risk of exposure to workers and others. Asbestos is also
found in manufactured products such as gaskets and building ma-
terials. Construction and maintenance workers involved in build-
ing, demolition and renovation or in asbestos removal are at par-
ticular risk for asbestos exposure. In addition, take-home exposures
to families of workers in which exposed workers bring home asbes-
tos on their clothes, hair or shoes is also a well-recognized hazard.
Asbestos is regulated by the Occupational Safety and Health Ad-
ministration, the Mine Safety and Health Administration and the
11
Environmental Protection Agency. Federal regulations define as-

bestos as a half-dozen mineralschrysotile, crocidolite, amosite,
tremolite, actinolite, and anthophyllite. In 1990, testimony to
OSHA, NIOSH broadened its science-based definition of asbestos
beyond the six specified asbestos minerals, basing our definition on
scientific evidence from studies suggesting that fiber dimension,
specifically length and diameter and fiber durability and persist-
ence in the body, are more critical than the specific chemical or ele-
mental composition in causation of asbestos-related disease. The
NIOSH asbestos definition encompasses certain variance of the six
regulated minerals, as well as so called cleavage fragments that
can be generated from non-fibrous mineral forms of these six asbes-
tos minerals.
Our studies of vermiculite workers in Libby began in 1980, when
OSHA asked NIOSH to provide technical assistance to investigate
lung problems in workers at a plant using vermiculite that had
been mined in Libby. Shortly thereafter, the Mine Safety and
Health Administration also requested technical assistance from
NIOSH to investigate the magnitude of health hazards in
vermiculite mines. In response to these requests, NIOSH undertook
epidemiologic studies in Libby, MT between 1980 and 1985. Our
studies showed that occupational exposure to mineral fibers that
contaminated Libby vermiculite caused high rates of asbestos-re-
lated diseases among exposed workers. The mineral fibers included
tremolite, one of the currently regulated asbestos minerals. How-
ever, some recent evidence indicates that only 10 to 20 percent of
the fibrous minerals contained in Libby vermiculite was tremolite.
The remaining 80 to 90 percent of the fiber contaminant has been
characterized as several other similar fibers, such as richterite and
winchite. These fibers are not currently classified as asbestos by
mineralogists or regulated as asbestos.
NIOSH played a pivotal role in documenting the health hazards
associated with occupational exposure to asbestos-contaminated
vermiculite at the Libby mine and made our findings available be-
ginning in 1985 through meetings in Libby with workers and their
representatives, employer representatives and members of the com-
munity. NIOSH also published its findings in several scientific pa-
pers to alert the occupational health community.
It is clear in hindsight that further work remained to be done,
specifically further studies of downstream users of Libby
vermiculite products and better tracking of exposed workers and
others. NIOSH is applying what we learned from our experience at
Libby to our current and future activities, both in Libby and
throughout our program.
NIOSH is following up on potential exposures of workers who use
or process vermiculite from sources other than Libby. The degree
to which vermiculite from these other sources is contaminated with
asbestos is not clear. At OSHAs request, NIOSH is conducting en-
vironmental sampling at expansion plants and horticultural oper-
ations where vermiculite is used. We are also updating our mor-
tality study of the Libby miners studied previously and working
with the EPA on a variety of their studies as well.
Additional research possibilities that NIOSH is considering in-
clude efforts to better determine the physical and/or chemical char-
12
acteristics affecting toxicity of both manufactured and naturally oc-

curring fibers. There is currently no direct evidence by which to at-
tribute particular health effects to each possible fiber type. Epi-
demiologic studies of people exposed to manufactured and natural
fibers would be useful, as well as studies conducted with animals
to obtain mechanistic and other toxicologic data.
Also, the current analytic method for determining airborne fiber
concentrations do not count the fibers that are too small in diame-
ter or length to be detected. Additional work to improve and stand-
ardize the methods for asbestos fiber measurement would further
advance prevention and control measures.
In summary, we know much about the adverse health affects
caused by the inhalation of asbestos fibers. However, many re-
search questions remain. Further research is needed to better char-
acterize the work environments where contaminated vermiculite
may be used and to determine whether vermiculite from sources
other than Libby is also contaminated with asbestos. We need to
increase our understanding of the health effects of fibrous minerals
that fall outside the definition of asbestos and improve tracking of
people potentially exposed to hazardous fibers. While information
continues to be gathered, public health prudence requires that
vermiculite from the Libby mine or products containing vermiculite
originating in Libby be considered potentially dangerous. Proper
precautions should be taken to minimize the generation and inha-
lation of any dust during the handling of these materials until
analysis of the particular vermiculite or vermiculite-containing
product shows that it does not produce an asbestos hazard.
Thank you, Senator Baucus.
Senator BAUCUS. Thank you, Doctor, very much.
Dr. Falk, welcome back.
STATEMENT OF HENRY FALK, M.D., ASSISTANT ADMINIS-
TRATOR, AGENCY FOR TOXIC SUBSTANCES AND DISEASE
REGISTRY
Dr. FALK. Thank you very much, and good morning Senator Bau-
cus, Senator Murray.
My name is Henry Falk and I am the Assistant Administrator
of the Agency for Toxic Substances and Disease Registry, a public
health agency within the U.S. Department of Health and Human
Services. I am accompanied this morning by Sharon Campolucci,
who was the coordinator of our medical testing program in Libby.
Senator Baucus, ATSDR is grateful for the interest and support
given by you and other members of the subcommittee and of the
Montana delegation since we began working in Libby in late 1999.
As you know, we came to Libby in response to concerns expressed
by yourself, community members, former vermiculite mine workers
and the health department. Over the last several years we have
worked very closely with the U.S. EPA, the State of Montana and
others to address these concerns. Without the support of all of you,
we would not be able to report today on the progress that we have
made in evaluating public health issues in the Libby, MT commu-
nity.
We have been actively involved with citizens and public health
and environmental officials to determine the extent of harm to hu-
13
mans from asbestos-contaminated vermiculite that was mined in

Libby. In the earliest phase of our effort, we developed a plan to
help guide our activities in the Libby area, and as we have shared
with you in the past, this public health response plan identified the
areas of responsibilities for the conduct of our health-related activi-
ties. We have worked on that plan with various members of the
community, including officials there to provide input in developing
our public health efforts.
I am going to give a very brief update on a number of activities
that we have undertaken. First and foremost, in the medical test-
ing program, and, as Senator Baucus noted, in the summer of 2000,
we conducted medical tests on 6,149 adults in the Libby area. Of
those, 18 percent showed pleural abnormalities, and of the former
W.R. Grace workers included in that testing, 48 percent showed
such pleural abnormalities. Most of the participants in that effort
reported multiple routes of exposure.
We conducted a second phase of medical testing in the summer
of 2001 with an additional 1,158 participants. The preliminary
analysis of that data does not suggest any significant change in the
prevalence of abnormalities from the first phase.
Again, as Senator Baucus noted, we conducted a mortality review
for a 20-year period which demonstrated that asbestosis rates in
the Libby area were at least 40 to 60 times higher than expected.
The mortality review also suggested mesothelioma occurrence was
elevated, and we expect to release an updated mortality review by
early July.
We have several other investigations, such as looking at the po-
tential value of CAT scans in addition to chest X-rays in evaluating
individuals. Those are nearly complete and will be reported on in
the near future.
We have done detailed planning and preparatory work for devel-
opment of a registry of former Libby area miners and household
contacts; and also, a key source of registrants will be those who
participated in the medical testing program. We sponsored a work-
shop in February to consult with and solicit advice from experts in
respiratory disease and asbestos to help guide the next steps for
the Libby registry. The registry is intended to be a long-term effort
that will not only be a repository of information and facilitate fur-
ther studies, but also enable information that may come about in
the future on treatment and other medical breakthroughs to be
given to all the members of the registry.
We are currently working with the State to support localized
planning addressing future medical needs. There is a need, as you
know, for extended medical testing to continue in some form for
many years. We would like to see the primary responsibility for the
medical testing program transition to the State and local health de-
partments with ongoing technical and resource support from
ATSDR.
We have worked in close cooperation with Region VIII HHS staff
to help the community identify sources of assistance for medical
care. As you know, HHS Deputy Secretary Claude Allen visited
Libby last September and was instrumental in developing the HHS
response. We are very concerned about the other sites that have re-
ceived asbestos-contaminated vermiculite. You have seen the chart
14
this morning of the many sites. We are working together with EPA
to evaluate and prioritize those sites. We will be visiting a number
of these sites this summer and we hope to be able to determine the
extent of exposure and possible health effects from those sites as
we proceed.
One site that has already elicited considerable attention is the
Western Mineral Products site in Minneapolis, MN. We have been
working with the Minnesota health department to collect further
information on exposure and potential health effects at that site.
Weve also developed a protocol for use by State health depart-
ments to review their vital statistics and cancer registry data at
many of these sites. We have cooperative agreements with six
States to look at statistics for sites within their State, and we hope
to involve several more States this year.
In addition, weve been working with four States to evaluate the
mesothelioma data within their States and look for potential rela-
tionships to vermiculite or other sources of asbestos.
In summary, I would like to reiterate that we share your con-
cerns about the situation in Libby. It may seem very dry to sum-
marize results like this very quickly, but we understand the human
impact of these health problems. We share your concerns and we
want to do as much as we can. Much remains to be done.
Our primary goals for the coming year will be to implement the
registry of former workers and family contacts, to establish the
medical testing program on a long-term basis by transitioning pri-
mary responsibility to State and local health departments with
technical and resource support from ATSDR, to conduct further
epidemiologic investigations on the links between environmental
exposures and development of disease, and to provide data on po-
tential health effects in other States that had vermiculite proc-
essing centers that may have led to harmful exposures. Finally, we
continue to work on the mesothelioma surveillance activities, to-
gether with NIOSH.
With your continued support, ATSDR stands prepared to con-
tinue our work and we will do whatever we can to help people in
Libby and in Montana and at any other sites that may have been
afflicted with these problems.
This concludes my testimony. I would be happy to respond to any
questions. Thank you.
Senator BAUCUS. Well, thank you very much, Doctor. I know
youve worked hard on this. We appreciate it.
Senator Murray has another hearing she has to attend, in fact,
chair in about 10 minutes from now. So Im going to turn to her
for questions and give her an opportunity to ask all the questions,
take all the time that you want.
Senator MURRAY. Thank you very much, Mr. Chairman, and
thank you all for being here today to testify before this committee
on this really critical project.
Ms. Horinko, Ill start with you. I did speak a few months ago
with Governor Whitman about this issue, and I am sorry she could
not be with us today. If you could just share with her my concern
again and let her know I appreciate her efforts as we work to clean
up Libby.
15
I am particularly concerned about the other sites throughout the

country which process vermiculite from Libby. Now that Libby has
been declared a Superfund site, do you think that any of the other
sites which require further cleanup, such as the site in Min-
neapolis, MN, will also be declared Superfund sites?
Ms. HORINKO. Senator Murray, at the moment we are working
under our emergency removal authority, which does not require us
to declare a site a Superfund site in order to conduct emergency ac-
tions. That is how we have done the work thus far at Libby. At the
moment, it does not appear that any of the other 22 sites may need
to be declared a Superfund site. Our work at those sites is just
starting, and that may not rule out Superfund site declaration at
some of these others. At the moment, that is not our plan.
Senator MURRAY. At the 22 other sites, you do not think there
is enough contamination at this point that you are going to declare
them to be Superfund sites?
Ms. HORINKO. Not at this point, but let me stress that we are
in the preliminary stages of sampling and cleanup at many of these
sites, and further investigation may reveal contamination that may
lead to listing one of these sites on the NPL, the Superfund Na-
tional Priorities List.
Senator MURRAY. When do you expect us to know that?
Ms. HORINKO. As we continue to collect data, if additional high
levels of contamination turn up at one of these sites, then we will
inform you of that. At the moment, none of the information we
have indicates that Superfund site listing is warranted.
Senator MURRAY. Could you please talk to us today about the
current status of your efforts to work with MSHA to investigate
contaminant asbestos problems at the other mines throughout the
country?
Ms. HORINKO. We have looked at the other three mines in addi-
tion to Libby. We have not found a pattern of asbestos contamina-
tion that in any way approaches what we have seen at Libby at
the other mines. I do not know if you want a comment at all about
some of the work that MSHA or NIOSH has done, but at the mo-
ment none of the other mines appears to even approach the profile
of contamination that we have seen at Libby.
Senator MURRAY. Dr. Falk, do you want to comment on that?
Dr. FALK. I think in general that I would agree with that. We
had contacted early on the State health departments related to
those other mining areas, and they were not seeing the kinds of
problems that were seen in Libby. I do not have the specific infor-
mation with me, but I could get that.
Senator MURRAY. Do you mean that you are not seeing people
who have asbestosis, mesothelioma or
Dr. FALK. It is my understanding from those State health depart-
ments that they were not seeing those kinds of increases.
Senator MURRAY. Just out of curiosity, how do you track that,
since sometimes or a lot of times people move away. Libby has a
fairly high retention of citizens, which is one reason it was seen
early on. Some of these other minesI mean, we are talking 30
years ago. As the people moved away, that public health depart-
ment may not even be aware of it.
16
Dr. FALK. Yes, you are correct. People will be aware of cases that
occurred in that area, and we are not aware of those that may have
moved away. For example, in Libby the asbestosis rates are so
high, and the mesothelioma cases are apparent. So you are correct
that maybe some further formal study might identify cases else-
where, but we are not aware, at least from within those commu-
nities at the moment, without going back and tracking down people
who moved away, of those increases.
Senator MURRAY. Ms. Horinko, is your office currently partici-
pating in EPAs Blue Ribbon Panel on asbestos?
Ms. HORINKO. We are not formal participants in the panel, but
we work very closely with the Office of Pollution Prevention, Pes-
ticides and Toxic Substances which is headed by my counterpart,
Assistant Administrator Steve Johnson.
Senator MURRAY. But your office is not involved in the Blue Rib-
bon Panel itself?
Ms. HORINKO. I do not know if we are formal members of the
panel, but my staff is working very closely with the staff in that
office and we will track the deliberations of this panel very closely
and the research that is gathered.
Senator MURRAY. Can you give me any update on the status of
the panel, where they are?
Ms. HORINKO. My understanding is that the panel will formally
convene its discussions this summer and is expected to produce a
report early in 2003. The panel will also be conducting a web-based
stakeholder outreach and research collection information so that
they can get as much research and as much information as they
can from stakeholders, as well as provide information, disseminate
information about the state of knowledge as we currently under-
stand, as well as information related to safeguards and precautions
that people need to take in dealing with vermiculite products.
Senator MURRAY. Is EPA still planning on limiting the scope of
that panel to just the six regulated forms, or are you looking at ex-
panding it?
Ms. HORINKO. My understanding is that we fully expect the dia-
log to encompass all forms of asbestos contamination.
Senator MURRAY. One more question for youin your testimony,
you said that the activities in Libby will require an additional $21
million in fiscal year 2003. EPAs budget justification for the Super-
fund program does not list sites, as you know. I assume the Admin-
istration included the $21 million needed for Libby in its budget re-
quest?
Ms. HORINKO. We fully expect to spend that $21 million in Libby
in 2003.
Senator MURRAY. Are those funds needed just for Libby, or do
they address the other 22 sites as well?
Ms. HORINKO. Whatever funding we need to address all of the 22
sites, in addition to Libby, we will include in the budget request
for 2003.
Senator MURRAY. Is that part or your request now, or are you
going to be looking for future dollars for that?
Ms. HORINKO. That is included in our current budget assump-
tions.
17
Senator MURRAY. Dr. Wagner, in your testimony you said that

between 80 to 90 percent of the fibrous minerals in the vermiculite
from Libby are fibers that are currently unregulated. Do you think
the Federal Government should reevaluate regulating these min-
erals?
Dr. WAGNER. I think it is really important to do the scientific
work to be able to understand the importance of durability, bio-per-
sistence and how this creates hazards. At this point, we believe
that fibers that are like asbestos in their physical qualities should
be treated with the same caution.
Senator MURRAY. OK. You said that NIOSH made its findings
about the health affects of vermiculite on workers in Libby avail-
able in the occupational health literature way back in 1985. It took
newspaper articles in 1999 and Senator Baucus leadership to get
Federal agencies to mobilize to really address this problem in
Libby. Share with us what in your opinion why more attention was
not paid to NIOSHs findings way back in 1985 and since then?
Dr. WAGNER. I think that we did what was normal at the time,
which was publication in the scientific literature, communication
with the employers and with the employees and with the commu-
nity residents. The kinds of things that we are doing now involve
a broader communication of the risks that we identified. I think
that the communication was perhaps just pro forma to the regu-
latory agencies, but not with specific meetings and more direct en-
gagement.
Now, I think the coordination and communication among the
government agencies that are interested and involved in the occu-
pational and environmental hazards is really far better than it was
15 or 20 years ago. I think that we have also been more effective
in our public communications. For example, I opened up my USA
Today and saw on the front page a story relating to an investiga-
tion our division is doing on serious lung disease in a popcorn fac-
tory. I think we have been more effective in engaging with the
States, engaging with other Federal agencies, engaging with the
media and with the public, and that these are all important lessons
that we learned that we should have done better back in the
1980s.
Senator MURRAY. Mr. Chairman, I really appreciate you letting
me testify today and ask questions. I do think public education has
got to be part of this because many of these people, it was 30 years
ago that they were exposed. I had a constituent out here 2 days
ago who went to the doctor with lung problems, and the doctor in-
sisted it was not related back to his contamination with asbestos
and absolutely refused to believe it. There is a lot of public edu-
cation that needs to take place. There is a long time between when
somebody was exposed to this, and when they actually come down
with the diseases. Many doctors, hospitals, health care clinics have
no idea unless we educate people so that these people can be diag-
nosed quickly. We need to go back and figure out how to treat peo-
ple and to make sure we are doing the preventive things that we
need to do today, and to make sure doctors are aware of this.
So we have a lot of work ahead of us.
18
Senator BAUCUS. You are right, Senator. In fact, sometimes lis-

tening to this conversation and thinking about it, maybe we need
a Homeland Health Protection Act
Senator MURRAY. Yes, I agree.
Senator BAUCUS [continuing]. To coordinate all the health re-
sources and all the agencies to deal with some of the lethargy.
Senator MURRAY. Well, I hope we can at least ban asbestos so
that 30 years from now we are not having another hearing.
Senator BAUCUS. I very much compliment you for introducing
that legislation.
Senator MURRAY. Thank you.
Senator BAUCUS. Thank you, Senator.
I would like to do something a little bit unconventional here.
That is, in an effort to get to the heart of the matter, I would like
the rest of the panelists here to kind of move over to the end, and
I am going to ask the other panelists to come up and testify right
now. We are going to have a little dialog here among everyone
that is, the current panelists and the second panelistsso that we
are more likely to get at the heart of the matter. We will try and
find some more chairs. Will you all come up please? All of you
Dr. Spence, Dr. Black, Ms. Cohan, and Commissioner John.
[Laughter.]
Senator BAUCUS. OK. I deeply appreciate the other witnesses
and the first panel remaining to be part of this effort. Thank you
very, very much. I appreciate taking the time.
OK, Dr. Spence, why dont you proceed first, and then we will go
on with Dr. Black and Ms. Cohan and Commissioner Konzen.
STATEMENT OF MICHAEL SPENCE, M.D., STATE MEDICAL OF-
FICER, MONTANA DEPARTMENT OF PUBLIC HEALTH AND
HUMAN SERVICES
Dr. SPENCE. Senator Baucus, thank you very much. I appreciate
the opportunity to be here and discuss this very important Mon-
tana issue.
As everyone is well aware, this all started with an article that
appeared in the Seattle Post-Intelligencer in November 1999. I re-
member it well because it was a week before Thanksgiving. We
were having a meeting with Region 8 discussing bioterrorism and
our grant application. We got a phone call from the then-Adminis-
trator, Bill Yellowtail who told us to deploy to Libby and find out
what was going on. We went there. We met with Brad Black. Over
the ensuing months with the help of EPA and ATSDR, we devel-
oped a testing program. The testing program over that period was
based on information that we received by conducting meetings with
several experts throughout the Nation on asbestos, on lung disease,
and on asbestos-related problems.
The bottom line is that as Dr. Falk pointed out, 6,149 people
were screened that first summer. Of that population, 18 percent or
approximately one in five was found to have asbestos-related dis-
ease. That is to say that if you walked into the Libby Cafe, which
is a downtown eating facility, and looked around and there were
60 people in there, which it will hold, somewhere about 5 or 6 of
those individuals have asbestos-related disease. They are suffering
from this entity. They may have mesothelioma. They may have
19
lung cancer, or they may have asbestosis. But that many do have
it.
A second round of testing was conducted the following summer.
Again, we added another 1,000 to that and preliminary results
show that the rates are going to be about the same, as Dr. Falk
pointed out.
We have a major problem in Libby. This was not minor, and this
many people being affected with this severe disease. We take a look
at those individuals in which there is no evidence of a background
of exposure5 percent of the population in Libby have evidence of
asbestos-related disease with no known exposure. That is 2.5 times
higher than previously had been reported in any other study of
populations at large. So we know that the background from just the
fallout of being a resident of Libby is significant and puts you at
increased risk. One in twenty develop severe disease.
We looked at the population at Libby and tried to estimate what
our health care needs are going to be over the future months. One
of the things that became very clearwe did a survey of the people
coming in for the first round of testing and found that 24 percent
of the population is uninsured, have no visible means of insurance.
When you take a look at that sub-population of those people that
are insured, interestingly enough many of them have policies in
which their deductible is in the $500 to $1,000 to $2,000 to even
$5,000 deductiblebasic catastrophic insurance. So we are talking
about a population that is terribly underinsured or uninsured.
Furthermore, the population has an unemployment rate that is
twice the State averageover 11 percent of the population of Libby
are unemployed, where the State average is 5.3 percent. So we are
talking about individuals that have no visible means of support to
get insurance to pay for their health care costs.
How do we pay for those costs? If they qualify for Medicaid, yes,
they can, but not everyone does. As you know, there are many Fed-
eral restrictions on Medicaid. Is a white lung program available?
No, sir, it is not. That might be one of the answers that we may
have to address, because the problems that we are encountering
now are only going to magnify. It is estimated that this will con-
tinue on until the year 2030 at least and maybe thereafter with re-
gard to disease because of the latency of this problem. As I think
you know, asbestos does not affect you immediately. It affects you
over years, and it takes 10 to 20 to 30 years before the ramifica-
tions of this disease become apparent. The disease has three
formsmesothelioma that was pointed out, a very unusual and un-
common tumor, one that causes rapid death. The person that gets
this particular tumor can expect a life expectancy of less than 1
year from date of diagnosis. Cancer of the lung is again another
major problem that we have to worry about because the population
has that. In addition, asbestosisthe most common form of disease
that we see, is one in which there is slow scarring covering the sur-
face of the lung, and the scarring is slow and insidious in onset,
and basically the patient is smothering to death over a long period
of time. It takes 10 to 20 years to die, and all that time they are
getting shorter and shorter of breath. It is not a very pleasant way
to die, I would not imagine.
20
As Dr. Falk pointed out, there has been a tremolite asbestos reg-
istry initiated, and we are working very closely with ATSDR to do
that. In addition to that, we are looking forward to initiating fur-
ther screening in the State of Montana of Libby registrants and
also to try to identify individuals from that registry that might be
willing to come to Montana for screening and doing it locally, using
our resources there. We hope that we can indeed identify the large
number.
Another thing that we have done is we have undertaken a look
at mesothelioma in the State of Montana. Since 1979 when we had
tumor registry statistics, we have found over 150 cases of mesothe-
lioma. Not all of them are in Libby. They are throughout the rest
of Montana, which proves the point of the movement of this ore.
It was transferred over to various screening plants, as was pointed
out on that map. In addition to that, it was transported all over
the United States. What we are finding is cases of mesothelioma
in areas where there are major railheads and also where there was
previous screening. When we look at it county by county, we can
find massive excesses in major ports or major cities in our State,
compared to the rest of the State where indeed asbestos was not
transported or the ore was not transported. This is a major con-
cern.
We have to look at other future health care needs. The Health
Department is also looking at immunizations of these people to pro-
tect them against respiratory diseases such as pneumonia and in-
fluenza and other projects, so there are many health care needs we
are going to meet.
I think as was pointed out by Senator Murray earlier, the Ban
of Asbestos Act, if it were to go into effect today this very minute,
it would not be until the year 2042 until we would start seeing pos-
sibly some relief from this terrible illness.
I want to thank you for the opportunity of being here. That is
the conclusion of my remarks. Thank you very much, Mr. Chair-
man.
Senator BAUCUS. Thank you, Doctor. That was very, very good
testimony. I appreciate that.
Ms. Cohan.
STATEMENT OF PAT COHAN, COORDINATOR, CLINIC FOR

ASBESTOS RELATED DISEASE
Ms. COHAN. Good morning. Thank you for inviting me here.
My name is Pat Cohan. I am a nurse. I have been a nurse for
29 years. For the last 2 years, I have been involved with the health
care needs for a community related to the asbestos exposure. My
introduction to the asbestos disaster was in the year 2000 when I
accepted a grant position funded by HRSA to assist and cooperate
and work with the ATSDR in the screening.
The job was two-fold. One was to serve as the outreach nurse for
the screening, in which I handled any medical emergencies, health
care concerns or urgent referrals relating to the screening. The sec-
ond part of the position was to help create a clinic that would as-
sess, diagnose and educate people with health care concerns related
to the screenings.
21
The Center for Asbestos Related Disease, also called the CARD
Clinic in Libby, was created through St. Johns Lutheran Hospital
and with the cooperation of all the other health care providers in
the area. The volume of calls, drop-in visits, people with frantic
questions and need for education was just unbelievable the first
year. Of the over 6,000 people who were screened, I probably saw
half of them at one point or another just answering questions. The
clinic now has over 1,000 active charts, and of these close to 800
show signs of asbestos-related disease or asbestos-related changes
that may develop into disease. Each of our clients and their family
members have received health information and education related to
pulmonary health.
In my position as a nurse, the breadth and depth of the psycho-
social, the emotional health and financial concerns associated with
this disaster has been without precedent. I have been in most cases
first at hand to see the results of this. As with your introduction
with Les Gramstad, I get to hear a lot of stories that strike home.
To sit and listen to a client talk about going hunting in the hidden
mountain valleys and having accidents because he will not allow
his children to watch him die the way he watched his father die
is pretty hard to take some days.
I have worked to find financial resources for a 47-year-old
woman who never worked at the mine, was the daughter of a
miner, to help her find funding to have a lung biopsy done because
she was suspected of having mesothelioma. This young woman had
quit her job housecleaning because she thought it was the chemi-
cals that were making her short of breath. This person waited over
3 months to hear whether she would even be accepted into the
Grace Medical Plan which right now is a major source of medical
care or help for these folks.
Some of the stories are just so twisted and convoluted it is hard
to sort out what the client really needs. A woman who is approach-
ing 60 who cares for her elderly mother, both of whom have asbes-
tos-related diseases, comes to me with complaints that she has
been washing her dishes in the tub for 2 years because her kitchen
is plastic-sheeted off and duct tape closed because of the leaking in-
sulation in there. It is hard to figure out what she needs first, a
kitchen or a sink or health care needs.
I have a neighbor who resided in Libby for over 40 years. This
gentleman started the ambulance in Libby before there was one.
He has served on every volunteer committee in the townnever
complains, only works hard. He was never a miner. He never gar-
dened with it. The only exposure he could think of was that the
Zonolite was in his home for his insulation. This is a man who has
hiked and skied every mountain in the Cabinet Range and in Gla-
cier before it was the thing to do. He worked tirelessly for our com-
munity in this volunteer role. He can no longer hike. He does not
volunteer. He just sits and breathes.
I have used the word disaster most deliberately. This is a slow-
motion disaster, as we call it. Had a mine had a toxic leak and it
killed 200 people outright and injured another 1,000 with 20 per-
cent of them critically injured, I would not be here. I would be
home in the emergency room. Just because this took 20 to 30 years
22
to come to the surface, does not make it any less of a disaster. It

just makes it slower.
I cannot really talk about what the rock or the mineral prop-
erties are. That is not within my scope of care. I can only talk
about the human disaster that I see and the effects on my neigh-
bors and my friends, and strangers who come to the clinic who rap-
idly become friends because our clinic is about the only place where
people feel safe or comfortable talking about this.
This was notthis disaster did not happen because it was an act
of God. It did not happen because of some ideological conviction or
religious belief or anything. It was created because somebody need-
ed a profit. It was a very profitable enterprise. The people in Libby
did indeed get great benefits from the mine when it was working
and the income because there are not many places to earn a living
back in the north woods. But the people, the miners were treated
with no respect. The citizens of Libby were treated with less regard
than they treated the over-burden of rock up at the mine.
This disaster is not over with. It is going to continue for the next
20 to 30 years. It is not a matter of waiting for the few affected
people right now to die off and the problem to go away. We are
worried about the children and the grandchildren who were ex-
posed up to 2 years ago at the public schools, at the track at the
grade school. We already know the kids and grandchildren were af-
fected financially and emotionally. We are just waiting to see what
the health effects are going to be.
What Libby needs, I see three things. We need research to find
treatment, cure, cause or even a blood test to figure out who has
been exposed. We need health insurance or a health care program
that will be available for the length of time needed. We need the
facility to monitor the health care effects and the progression of
this disease.
I would like to take the opportunity to thank everyone who has
been involved in Libbythe agencies, the ATSDR and the EPA and
Health and Human Services. The representatives that they have
sent in Libby have made an enormous difference in how well this
has progressed. People have come to Libby and rapidly become
adopted Libby citizens just because of the fine job they have done.
I also want to take the opportunity to thank our whole Montana
delegation, and particularly you, Senator Baucus. Your visits, your
care and your concern have been very evident, particularly through
Rebeccas multiple visits. So thank you.
Senator BAUCUS. Thank you very much, Pat. That was one of the
more compelling statements I have heard. I thank you very, very
much.
Dr. Black.
STATEMENT OF BRAD BLACK, M.D., LINCOLN COMMUNITY
HEALTH OFFICER AND DIRECTOR, CLINIC FOR ASBESTOS
RELATED DISEASE
Dr. BLACK. Good morning, Senator Baucus.
I feel very fortunate to be here. This is a privilege to really be
here where I can do something for Libby. Certainly, without your
support, I would not be here, and I appreciate the committee tak-
ing the time to listen to Libby.
23
I have been a physician in Libby for 25 years. I served as the

county health officer for the past 18 years, and have been a very
active community member. I could go on for quite a while based on
my history in Libby. I have a lot of background. But I think I am
going to tell you a brief background story today, and then I would
like to emphasize three points.
Let me start with the background. When I came to Libby in
1977, I was aware of asbestos-related disease in workers because
my partner who was a practicing internist, had related this to me.
It was just somewhat of a surprise because in medical school it had
been indicated that we probably would not see much more of this
disease. They just basically covered the surface on it in medical
school in terms of lung diseases.
So we were both taken back a bit. But he became more inquisi-
tive because he was county health officer then. This is the late Dr.
Richard Irons. In 1978, he started probing into it farther, and en-
tered conversations with the W.R. Grace management. He realized
that they had improved their hygiene some in the mine because
they had put in a wet mill in 1974, but he was still quite concerned
because of the disease he was seeing.
So he actually went all the way to headquarters to try to develop
a working relationship with the company, because he was con-
cerned. He clearly desired to work with them to reduce health risks
from asbestos exposure to the Zonolite workers, their family mem-
bers and the community at large. He was concerned about them.
He recognize the hygiene concerns at that time. I do have that let-
ter, but it was very clear in his statement that those concerns were
there. Unfortunately, they were not acknowledged.
It was shortly after this, in 1980, the EPA did their assessment
and understood the potential hazards with vermiculite-associated
asbestos. Unfortunately, that was not acknowledged either, and I
think there was a lot of presumption by many of the physicians in
the community that since the agencies had been involved, probably
things were going to get betterthat we were not putting people
at risk.
So in 1999, there was a reporter that had come through the com-
munity. I was county health officer. He was starting to ask me
questions, and I was somewhat dumbfounded. I was not expecting
those. The questions were about this wider exposure in Libby. So
when this broke finally in the Seattle Post Intelligencer, as county
health officer, I was still in disbelief that we could get that much
exposure in the community to cause significant lung disease. I was
still one of those doubters that we would have that much disease.
It did not take me long, though, once I started probing, talking
to Dr. Whitehouse, looking at the cases that were showing up that
he had started noticing in the late 1990s. It became very evident
that knowing the activities in Libby and where the ore had gone,
I realized that we were probably into something bigger.
The past several years have been painful, and they have been
very humbling for a person that has been in this community. I
have several friends that have developed lung disease and lost half
their lung function. It was so insidious I did not even realize it. I
was not taking care of them, but it is that subtle a disease, and
insidious. You cannot help but say, Where did we go wrong? What
24
could I have done. That is the difficult thing we have to deal with,
especially when it gets to friendship and the closeness and you re-
alize what has happened.
These people do not complain. I think you know, Max, they are
very hardworking people in Libby. They do not complain about very
much, but people are concerned, of course, now.
Let me make three points out of this. No. 1, I have spent these
last 2 years delving into pulmonary medicine a great deal and
working very closely with Dr. Alan Whitehouse, board-certified
chest physician in Spokane, who has seen a sizable number of peo-
ple from Libby. The Libby exposure was extensive, and you have
heard that already, but Pat and myself follow these people in the
office after the screening. In other words, all the abnormal screens
done by the ATSDRI should not say all of them, but a high per-
centage of thosehave been seen in our clinic. We found that the
screening process has been very effective. Many of the people who
have been screened out have been subsequently diagnosed with as-
bestos-related disease. So the figures that we see there are very
real. That is, we may have up to 1,300 to 1,400 people out of the
first screening that do have asbestos-related disease. That does not
include the 2001 screening.
No. 2, this asbestos-related disease in Libby, you have heard now
that it is caused by a mixture of fibers. Tremolite certainly is one
component. There are several other fibers. They are all very simi-
lar. They are in the amphibole series of asbestos. I know that is
another confusing term, but it is different. We have seen things
with it we have not seen reported in the chrysotile or the commer-
cial asbestos exposures. Our experience has shown it to have a
higher rate of progressive lung disease. Dr. Whitehouse has actu-
ally studied that in a population of his, and has found that there
is up to 70 percent of his people, no matter what they show up with
on X-ray as far as degree of scarring, will tend to progressI
mean, 70 percent of them tend to progress. Some of them progress
very rapidly. I included in this hearing a report on a gentleman ex-
posed in a California expansion plant just one summer, and 50
years later he died of rapidly progressive lung disease from Libby
asbestoswell-documented.
Some of the non-occupationally exposed individuals have worse
lung disease than the Zonolite workers that have been there more
than 15 years. When you go through their exposure history, you
would not expect that. You get this strong feeling of a potency here
that nobody has recognized yet, and I think it is one of those things
that needs to be sorted out. We do not know that for sure. Are the
other exposureswere they unusually high? It is very difficult to
tell. There is great concern over relative potency that is totally dif-
ferent. I think this needs to be looked into very seriously.
No. 3, the incidence of malignant mesotheliomathe big word
is exceedingly high in Libby. The reports have been up to 23 cases.
This is a cancer, of course, that is rareone in a million in the gen-
eral population. In Libby, MT, it is 100 times that. That rate is in-
credibly high. It is an ugly tumor. It is non-treatable and uniformly
fatal. The tumor develops in the lining of either the chest cavity
or the abdominal cavity. Those are the pain-sensitive areas of our
25
bodyvery pain-sensitive. It is an extremely painful and miserable

tumor, to say the least.
Just to give you an example of the exposurewe have six people
that have developed mesothelioma due to non-occupational expo-
sures. That is just incredibly high. Right now at this current time,
we lost one gentleman that worked 3 months at the company. He
died this year already. He was diagnosed in January; dead in a few
months. He moved away from the community. I have another gen-
tlemanthe family called from Nevada. He worked in the Forest
Service and was there 15 years; never handled the materials, just
lived across the river and just a little ways up the river from the
processing facility in town.
Our most recent diagnosis was a well-known community mem-
ber, school health nurse, and just a loved one of the community
and now she is currently dying of mesothelioma. This has all hap-
pened since thethese last two have happened since I submitted
testimony in April when the hearing was originally scheduled. So
if that does not impact you as to adverse effects, the community is
having to deal with now that the asbestos-related illnesses that we
were fearful of are happening.
I want to say this real quickly, because there have not been
many people who have studied Libby asbestos. Dr. Alan
Whitehouse is a clinician that really has studied it a lot clinically.
Now, there is another investigator, Dr. Corbett McDonald from
McGillwell, he was at McGill University and was actually
brought in by W.R. Grace to study the workers at the same time
NIOSH was doing their study. In other words, they carried parallel
studies. Their observations were similar. They realized significant
disease in these workers. What is interesting is Dr. McDonald fol-
lowed these same workers since this broke in 1999. He had this to
say, These vermiculite workers suffered severely from malignant
and non-malignant respiratory disease. He found the death rate
from mesothelioma was 10 times higher than it was for chrysotile
minersthat is commercial asbestosin Quebec. His opinion clear-
ly is this stuff is significantly more toxic in terms of causing
mesotheliomas. Once again, he has studied chrysotile extensively
in the Canadian mines also, so he has some background in both fi-
bers. So I think it means a lot when these peoplethe few that
have investigatedrecognize significant potency with Libby asbes-
tos.
In closing, I want to express concern pertaining to how we will
be able to meet the asbestos-related health care needs we are sure
to face over at least 20 or 30 years and maybe longerit is hard
to say. W.R. Grace has been providing funding for our CARD Clin-
icthat is the Center for Asbestos Related Disease that Pat and
myself, where we see people. There is also a Grace insurance pro-
gram; however, these past months has shown their commitment to
caring for affected individuals is waning. It suggests that our sup-
port there is self-limited. Certainly, we need a lot of research and
developing therapies is a high priority for us.
Additional concernsone, the exposures from W.R. Grace export
plants all around in the United States and then areas of California
(not related to Libby asbestos), where release into the environment
of naturally occurring tremolite as a result of large-scale construc-
26
tion activities. Those are concern areas because we do not want

things to happen other places when we know this particular type
of fiber has the potency it does.
I just want to thank you for allowing this opportunity, and I can-
not thank you enough for your persistence and your advocacy for
your Montana family.
Senator BAUCUS. I appreciate that, Brad. Actually, the thanks
goes to all of you; Pat, Dr. Spence, John, and all the others in the
Libby community who have stepped up. I have seen it. You feel it.
It is obvious and I thank you very much for all that you are doing
to help the people.
Mr. Konzen.
STATEMENT OF JOHN KONZEN, LINCOLN COUNTY

COMMISSIONER, LIBBY, MT
Mr. KONZEN. Thank you, Max. Thanks for the opportunity and
for all the work that you have provided on behalf of Lincoln County
and particularly Libby.
Good morning. My name is John Konzen. I am from Troy, MT,
a community just south and west of Libby, and serve as the county
commissioner for Lincoln County. You have already heard about
Libby, a community I have served both as a commissioner and as
a member of the Board of Directors of St. Johns Lutheran Hos-
pital.
Lincoln County is no stranger to the Federal family. Floods and
forest fires dispatch Federal agencies to us regularly. Our county
shares the Canadian border and a reservoir that straddles the
international boundary, feeding the Columbia River Basin. There
are endangered species and every other natural resource issue you
can imagine. We struggle with double-digit poverty and unemploy-
ment rates. On the average day, it is fair to say that we are county
with a lot on our plate.
Before I became a commissioner, I served as a teacher and a
school administrator for many years. I witnessed first-hand the ef-
fects that down cycles have on resource-based communities like the
ones I serve today. I can tell you first-hand how families are af-
fected when mills close or mines shut down. But most of you would
have never heard about Libby or Lincoln County if it were not for
tremolite asbestos.
There was a time when the W.R. Grace mine was a good thing
in our community. It meant jobs and good-paying ones. Men went
to work every day to earn a living for their families. They did not
step away from the responsibility, and I bet a lot of them would
have gone to work every day even if they had known the risk that
they were taking for themselves. That is what husbands and fa-
thers do.
But none of those men would have ever put their familiestheir
wives, their children or their grandchildrenin harms way. Never,
not a single one of us in this room, would have ever done that. But
as you have already heard, Grace has allowed all of that to occur.
There is an old saying that goes, Many hands make light work.
When Grace stepped away from their responsibility, they allowed
the miners and the wives and the children of those men to do all
27
the heavy lifting and to take on the risk Grace was unwilling to
shoulder.
As Grace continues to step away from even the small portion of
responsibility they willingly accepted to help our community cover
prescription drugs, home health and other medical costs, they are
breaking us. Our tiny communitys medical resources are already
stretched very thin.
It is not just our community alone which concerns me and other
Montanans who have traveled here today to speak with you. As
Grace increases the distance between the rightful portion of re-
sponsibility they must bear, they further harm the State of Mon-
tana.
As Senator Baucus is well aware, people are our most precious
resource in Montana. As I travel across Montana for regular meet-
ings with other county commissioners in our State, commissioners
tell me they are too concerned about the far-reaching impact
Graces lack of responsibility will have. Many fear Graces recent
decision to no longer help with medical expenses of folks who have
qualified for their own medical plan has the potential to bankrupt
our own State Medicaid program.
We appreciate the help the Federal family has extended to north-
west Montana. We do not know where we would be without the
help of the Department of Health and Human Services, the Envi-
ronmental Protection Agency, the Agency for Toxic Substances Dis-
ease Registry, and Congress. Everyone is doing the heavy lifting
everyone, it seems, but Grace.
I am here to thank Congress and the hard-working folks across
the country for their support of our community. You have all done
your part, and we cannot begin to thank you enough. But I would
also like to add that W.R. Grace still has a place at our table. We
need them to do their part.
As Grace makes it way through the Federal bankruptcy court,
there are several things I would ask this committee and those
present to consider to set aside a separate trust fund, established
by Grace, to cover the short-term prescription drugs and home
health needs of the folks in Libby who are struggling with asbes-
tos-related disease. I would also ask you to consider establishing a
trust fund for the long-term health care needs and also to continue
the support for the important research.
I appreciate the questions that have been raised about the long-
term funding for cleanup and the statutory authority for removing
insulation in homes in Libby. Good health is all any of us can ask
for. A clean bill of health is the most profound mark our Federal
friends will leave upon our community.
I appreciate your time and thank you on behalf of Lincoln Coun-
ty.
Senator BAUCUS. Thank you very much, commissioner.
I am going to ask questions now, and I would like various of you
to be thinking of questions or points you might want to make to
various other panelists. All of this is in a constructive mode. That
is, we are not here to badger or to criticize, but we are just in a
constructive mode on where do we go from here just to help the
people of Libby. Although I strongly share Commissioner Konzens
view that W.R. Grace is very irresponsible here. They knew that
28
asbestos was there. They knew that it causes disease and did not
adequately warn people about it. They are now also significantly
walking away from their responsibility in the community. So I do
share that criticism with many of the panelists here.
The first set of questions has to do with cleanup. I will ask Mr.
Horinko those questions. Generally, the questions are around, like,
how much? What is the timeframe? How much are you going to
clean up? When do you think you will complete the cleanup? This
is both on the ground and the insulation in the homes. Also the re-
source questionthat is, do you feel you have the resources that
you can dedicate to get the job done in the time that we have es-
tablished? So Ms. Horinko, why dont you address those questions
if you could please?
Ms. HORINKO. Thank you, Senator Baucus.
We have had, as you know, a very aggressive cleanup plan un-
derway now since 1999. In fact, we estimate that from 2000
through the end of this fiscal year, 2002, we will have expended
$60 million.
Senator BAUCUS. I am sorry$16 million?
Ms. HORINKO. Sixty million dollarssixzero.
Senator BAUCUS. Sixty60.
Ms. HORINKO. Six-zero$60 million, and as I said to Senator
Murray, we anticipate spending an additional $21 million in fiscal
year 2003, and have planned for that in our budget assumptions,
as well as planning for followup at the other sites nationwide
where there are Zonolite concerns. As I indicated earlier, we have
already addressed a number of the processing facilities, the mine
roads, sealed off the mine, done work at the city park and the
school tracks, and hope to have those completed shortly. We have
done 12 homes on a pilot basis to see if the insulation could be
safely removed and the dust cleaned. That has led us to believe
that in fact we can do it. We plan next week, as I said, to start
interior cleaning, as well as insulation removal in the homes in
Libby and plan on doing 55 priority properties this summer. We
also plan on working out from the export plant to do additional re-
moval in businesses, yards, parks, as well as interior cleaning of
some businesses and some development work to start a secure
landfill cell for storage of the material, disposal of the material.
Senator BAUCUS. Do you have some kind of a timeframe? Is it
a short-term plan or a long-term? Lets take one at a time here.
Ms. HORINKO. Sure.
Senator BAUCUS. Lets take first the cleanup of the community
and the site and so forth. We will get into the home insulation
next. But lets just talk first about the non-home insulation clean-
up.
Ms. HORINKO. Sure.
Senator BAUCUS. By when do you expect to have completed all
action? Give us timeframe please.
Ms. HORINKO. Sure. In general, we believe in 2 years we will
have completed all of the work that we currently have underway
or are planning to have underway at Libby. Actually, I have got
here a copy of the action memorandum amendment that we signed
in May that I referenced in my testimony. It sets forth detailed ta-
bles, action description and status for each individual property, ex-
29
port plant, screening plant, the Raintree Nursery, the KBC Bus
disposal area, and gives the current status and also our planned
timeline. I will be pleased to make that available for the record.
Senator BAUCUS. Do you have dollar figures representing the dif-
ferent aspects there? The $21 million you mentioned, that is for fis-
cal year 2003. How much do you plan to at least request to the
Congress to spend in the next fiscal year? Do you know?
Ms. HORINKO. In 2003 or 2004?
Senator BAUCUS. In 2004.
Ms. HORINKO. In 2004, we are just in the very preliminary stages
of putting that budget formulation together right now.
Senator BAUCUS. Would you expect it to be about the same?
Ms. HORINKO. I would expect it to be about level, if not more.
Senator BAUCUS. Let me ask Commissioner Konzen, Dr. Black or
Dr. Spence, any questions you have on timetable of cleanup. Does
that fit? Does that seem to be in the ballpark of what you think
can be done or should be done?
Mr. KONZEN. Correct. I think they had some problems with con-
tractors.
Senator BAUCUS. I have heard that, too.
Mr. KONZEN. They got off to a slow spring, but I think they are
talking to the onsite Coordinator Paul that they are moving for-
ward and they expect to do exactly what she is saying now.
Senator BAUCUS. So you feel 2 years is reasonable?
Mr. KONZEN. Two years is very desirable. The quicker we get it
cleaned up, the better we can move forward. I think they are pres-
ently working on our landfill situation and they have started clear-
ing the timber in that area. So I believe there were contract issues.
Senator BAUCUS. So if we could right here establish that our
deadline is within 2 years, that is very much agreed upon and that
is a reasonable deadline to get all that cleanup completed.
Ms. HORINKO. I believe we have committed to Governor Martz
that in fact we will be in and out of Libby as quickly as we possibly
can.
Senator BAUCUS. I know that. I am just trying to find out what
quickly means.
[Laughter.]
Ms. HORINKO. In the Superfund world, 2 years is record time, so
that is EPA thinking.
Senator BAUCUS. We want record time here.
Ms. HORINKO. EPA is placing a very high priority on Libby.
Senator BAUCUS. You have no concern at all about the re-
sourcesthat is, the dollars will be available?
Ms. HORINKO. Libby is one of our highest priority sites. The
Superfund budget in general is level. I do not see any cuts to
Superfund, and so I am very confident that we will be able to move
forward and continue to have Libby be a very high priority.
Senator BAUCUS. Now, lets go to insulation. What is your plan
there?
Ms. HORINKO. With respect to Libby or nationally?
Senator BAUCUS. Libby.
Ms. HORINKO. With respect to Libby, as I said, we will begin in-
terior cleaning including removal of the insulation next week. We
have identified 55 priority properties that we hope to have done by
30
the end of the summer, and we plan on continuing on to any home-

owner or business within Libby that requests and we feel warrants
removal of their insulation. In our action memorandum, we have
planned for and budgeted 800 homes, when all is said and done.
Senator BAUCUS. When do you expect to have completed removal
in all 800 homes?
Ms. HORINKO. In all 800 homes, that will probably take the en-
tire 2-year timeframe.
Senator BAUCUS. Within 2 years. Let me ask again, does that
sound reasonable to you people in Libby?
Mr. KONZEN. No. I think they have a large task at hand, and I
think they have committed the resources to do it if they have the
funding.
Senator BAUCUS. Do you have the funding?
Ms. HORINKO. Absolutely. That is included in this action memo-
randum.
Senator BAUCUS. So the $21 million for fiscal year 2003 is both
is that right?
Ms. HORINKO. That is absolutely right. That encompasses all as-
pects of the cleanup.
Senator BAUCUS. One slight questionthe reason I am asking
these questions is I am picking up that some people in Libby are
wondering whether EPA is beginning to slacken a littlebacking
off. That is, there was a time when EPA was there working hard
and Paul Peronard was, boy, he was just going like gangbusters.
There is a bit of a feeling, and this is just rumor, but stillthat
while Paul is still going like gangbusters, maybe his regional office
and more particularly at the national office, that Libby does not
have the same high priority that it appeared to have a few weeks
ago. Dr. Black, do you want to comment on that at all?
Dr. BLACK. There is clearly a sense in Libby that there has been
some shift, and we sense, at least what we can tell, activities of Re-
gion 8 have been slowed some, but that is a perception we have
had. I left this withhere, we built this trust and it has been
building. We have built a very good trust. The agencies have per-
formed excellentlyEPA and ATSDR. Health and Human Services
has initiated some activities also. It has been, you know, but I
think we all respected Governor Whitman coming, and she came by
the clinic, spent time with us. She understands the problem and I
respect her a great deal. I think her commitment means something
to Libby. I think we are worried about other politics, and Governor
Whitman, we still support strongly her commitments and respect
them. I hope they are carried through. I think that is important to
us.
Senator BAUCUS. That is right. Governor Whitman has been very
good. She has visited Libby a couple of times and demonstrated her
commitment. I have talked to her yesterday about appearing here
today, and she had other business. She could not do it. I mentioned
that same point to her, and the reaction I got was that while, like
all Administrators have, they have a lot on their plate and lots of
things they are thinking about and worrying about isoh, well, gee
thanks, Max, for telling me that; Ill check up on that to make sure
that is not the case.
31
But nevertheless, there is this perception in Libby that maybe

things are starting to slacken off a little. I do not want to get this
next person in trouble, but Paul Peronard has done a heck of a job
in Libby. My view is whatever Paul wants, Paul should get.
[Laughter.]
Ms. HORINKO. I listen to you, Senator, with some bemusement
because all of us here, and you more so than I because he is with
you every day, know Paul very well. I speak to Paul regularly. Any
characterization of Paul as slacking off is just completely incon-
sistent with his personality.
Senator BAUCUS. No, no. It is not Paul. The perception is not
Paul. The perception he is not getting the resources that he needs.
He is not getting the attention that he needs from either the re-
gional or the national office. That is the concern.
Ms. HORINKO. Right. Well, I can assure you that at the national
level, there has been significant attention, and at the senior re-
gional level there has been significant attention. In fact, we have
had regular meetings and conference calls. When I say regular
meetings
Senator BAUCUS. We are not talking about significant attention.
We are talking about full attentionthe same full attention that
Libby has been getting.
Ms. HORINKO. Rightthe same full attention. In fact, I plan on
traveling to Libby July 22 with our new Regional Administrator,
Robbie Roberts, as well as the Deputy Regional Administrator Jack
McGraw who has been out there many times, and doing a complete
site visit and tour and checking up personally on the status of ac-
tivities. So Governor Whitman and I are very concerned about
Libby, regularly meet and discuss the status of what is going on
at Libby, regularly checking with Paul directly. So at the very sen-
ior levels, you have our commitment and assurance. Governor
Whitman generally is a very hands-on Administrator. She is not
distanced from the field. In fact, in my program, the Superfund
Program, she has been significantly involved in the decision to
dredge the Hudson and cleaning up the Hart Building from an-
thrax, and emergency response at the World Trade Center, and
then dealing with Libby.
Senator BAUCUS. I appreciate that, but I just strongly encourage
you and the Governor to directly call up Paul, talk to him and
strongly encourage you to listen very favorably to what he says and
recommends.
Ms. HORINKO. Absolutely.
Senator BAUCUS. We have all known Paul now a couple of years,
and he is one of the best public servants I have ever had the privi-
lege to work with or meet.
Ms. HORINKO. I could not agree more.
Senator BAUCUS. He is so dedicated to do what is right.
Dr. Black.
Dr. BLACK. I was going to say, he is reallythe trust of the com-
munity with the Agency goes through Paul. He has managed to
cross all barriers in the community. I think that we would all say
that, wouldnt we? He has been remarkable in his ability to work
with people of varying opinions and everything. I think he has
everybodys respect in Libby. I sense that.
32
Senator BAUCUS. I appreciate that.

Ms. Horinko also, a slight question about hiring local contractors
and local employees. I would appreciate it if you could address that
concern as well, because there is that concern at Libby that maybe
we are going out of State too much.
Ms. HORINKO. I will look into that, Senator. I am not aware of
the mix of contractors that we are using, but I will talk to Paul and
find out what mix of contractors and the extent to which he has
really tried to reach out to local residents and have them directly
involved in the cleanup.
Senator BAUCUS. Why was it not necessary to declare a public
health emergency with respect to the insulation cleanup?
Ms. HORINKO. Our lawyers looked at the situation and deter-
mined that we had adequate legal authority to go ahead and do the
interior cleaning and remove the insulation without going to the
step of declaring a public health emergency.
Senator BAUCUS. Would anything be gained by making that dec-
laration?
Ms. HORINKO. From a real-world standpoint, it made no dif-
ference. We will be doing exactly the same type of cleanup whether
we declared a public health emergency or not. So from a technical
real-world standpoint, it makes no difference whatsoever to the
quality or the nature or the type of cleanup.
Senator BAUCUS. How can you assure the people of Libby that,
because they know that the Administration or the EPA did not
make a public health emergency declaration? That is probably part
of the concern. If it is not, are they going to work as diligently as
they otherwise might? How can you reassure the people of Libby
that there is no change whatsoever in effect?
Ms. HORINKO. One thing that we can do is share with the com-
munity our work plans for the interior cleanups and the insulation
removal that were developed well before we made the decision not
to declare the public health emergency. You can see that those are
identical to the work plans and the technical specifications that are
contained in our action memorandum today. So the work plans, our
technical expertise, the amount of resources we will bring to bear
are exactly the same as we had planned 6 months ago as they are
today. So seeing that technical information, sitting down with Paul
and the other folks at the site, and reviewing the quality of the
work that we plan to do, and the haste with which we plan to do
it will, I am hopeful, reassure the citizens.
Senator BAUCUS. So the quality, the haste and the resources
dedicated are exactly the same.
Ms. HORINKO. They are identical.
Senator BAUCUS. Does the absence of a public health emergency
designation say anything about the hazards of vermiculite home in-
sulation?
Ms. HORINKO. It does not say anything about the hazards of
vermiculite home insulation. Our Office of Pollution Prevention,
Pesticides and Toxics is currently doing a study on vermiculite
home insulation, and they are planning on releasing that study in
August of this year. So that will be EPAs definitive statement
about the hazards of vermiculite home insulation.
33
Senator BAUCUS. OK, before we move onto other subjects, does

anybody have any questions about the cleanup aspects?
Mr. KONZEN. Max, I have one concern. A lot of these folks work
in about a 20-mile radius of Libby, which includes the community
of Troy and out toward Kalispell. In talking to onsite Coordinator
Paul, I am not sure whether they will go with that. About 20 per-
cent of the workforce lived in my community, Troy. That is not on
the attics to clean up and the homes to clean up. I would like to
urge that that be looked at.
Senator BAUCUS. I am sorry. John, what was that again?
Mr. KONZEN. About 20 percent of the workers that worked at
W.R. Grace lived in my community and traveled. They also trav-
eled the other way, some 15 to 20 miles outside of Libby, toward
Kalispell into the mine. I realize they are very concerned about the
long-reaching effects of this, but these are actual workers. This
community hauled it back to its gardens and yards the same as the
other ones did. That has not been on the plate yet.
Senator BAUCUS. How about that, Ms. Horinko?
Ms. HORINKO. I can promise you that we will look into that, and
if there are actions that are warranted to be taken, we will take
them.
Senator BAUCUS. When can you get back to us as to whether or
not EPA plans to address those concerns as well? What is a reason-
able date?
Ms. HORINKO. Within 1 month, we can get back to you.
Senator BAUCUS. A month from now. OK. If you could let the
committee know, and also the county commissioners at Libby
know.
Yes?
Dr. SPENCE. Senator Baucus, another question I would have of
Ms. Horinko is, we know that the ore was transported to various
areas in Montana, including Great Falls where there was a popular
exfoliating plant. I have no idea as to whether these have been
studied, and I know that they have found hot spots along the rail
line in Libby. Are there other hot spots along other railheads
throughout the State of Montana that might be in need of cleanup?
Senator BAUCUS. Do you know, Ms. Horinko, whether EPA has
addressed that issue?
Ms. HORINKO. I know that we have tracked some 243 other
places in the country where Libby ore was transported, processed
or otherwise came to be located. We tracked that not only relying
upon records that W.R. Grace maintained, but we separately went
back to the Bureau of Land Management at the Department of In-
terior and looked at their records. This is part of this followup
study that Henry Falk alluded to where he is working with a num-
ber of the States. So we can get to you the list of the places that
we have tracked. If we have missed something, then we will cer-
tainly followup.
Senator BAUCUS. Can you within that same month report on the
question that Dr. Spence raised?
Ms. HORINKO. Absolutely. Yes, we will do that.
Senator BAUCUS. I would appreciate that very much.
OK, lets get off now into screening. Let me ask Dr. Spence, Dr.
Black and Dr. Falk, I guess, where are we on screening in your
34
judgment, and what more do we have yet to do? I suppose a lot of

this is a resource questionwhere are the dollars to continue to
screen, because this is a disease that sometimes is not noticed or
is not determined and diagnosed until sometimes later.
Dr. SPENCE. Well, interesting that you should ask this question
because just this past week, I was in Atlanta and met with some
of Dr. Falks staff and we discussed ongoing screening activities.
We will be initiating a requestthey have initiated a request for
proposal and we plan to put one in by July 10, to address screening
in the future years. We hope to look at it for at least the next 5
years minimally, and this could possibly go to the year 2030, as I
indicated when I was making my discussions with them.
We hope to do the screening very similar to what has been done
in the previous two rounds of screeningthat is, to take a look at
individuals that are indeed eligible by the criteria that we estab-
lished when we initiated this process; that is, anyone that lived in
Libby for a period of 6 months or more prior to January 1, 1991.
Once that person is identified as being eligible, then we will re-
quest them to undergo similar screenings such as an epidemiologic
questionnaire, radiographic evaluation, pulmonary function testing,
and then followup looking at the current standards that are em-
ployed by the Occupational Safety and Health Administration for
worker following, for pneumonic diseases.
We would think that these individuals that show no evidence of
any active disease should be screened on a periodic basis based on
their age. At least currently, our thoughts are to put possibly two
plans into effect, one that affected workers or those at highest risk
and then another screening program at periodic intervals that
would affect the nonworker population, but still individuals with
risk based on the data that we have.
Senator BAUCUS. What is this going to cost?
Dr. SPENCE. A lot of money, Senator. I cannot put a dollar value
on it today. I can tell you that to do such screening obviously we
are going to need someone to staff an 800 line because we want
people to call in and identify themselves. We will make the same
services available. We will have the 800 line. We will also need a
coordinator for this programan individual that is knowledgeable
in asbestos-related disease; one that can be assured that the people
get their educational needs met, as well as their health screening
needs met; and that we do the entire testingwe do not just leave
any part out.
We are probably going to have numerous individuals that are
going to call in from all over the United States. We do not think
this is going to be limited to people in Libby or people in Montana
in general. These individuals also are going need to be reassured
and also given instruction in the event that they cannot come to
Libby for the screening as to what they can do to identify whether
they are indeed at risk or have evidence of disease.
Senator BAUCUS. I appreciate that. Dr. Black, do you want to
comment on this plan, please? How does it sound to you?
Dr. BLACK. Well, we just had a moment to briefly talk about it.
I think Dr. Spence knows we have always asked him when is it
going to happen, because we have people coming every day now,
saying, well, we couldnt get into town for the screening. That be-
35
comes a pretty regular question, I think, wouldnt you agree, Pat,

with that? So we have the demand there, and I guess we are all
for getting it going. But once again, it sounds like we are moving
in the right direction.
Senator BAUCUS. So when will this begin? Maybe Dr. Falk, do
you want to chime in here? Were not going to get the proposal for
a little while yet.
Dr. SPENCE. I beg your pardon?
Senator BAUCUS. We are not going to get the proposalthat is,
you are not going to have this plan put togetheror is it now?
Dr. SPENCE. It will not be put together before July 10.
Senator BAUCUS. July 10OK.
Dr. SPENCE. But I anticipate that I will have a written proposal
in the hands of ATSDR on or before July 10 of this year.
Senator BAUCUS. All right. Do you want to comment, please, Dr.
Falk?
Dr. FALK. Yes, thank you. I feel very strongly that we must es-
tablish the screening program to go on over time, and probably a
very lengthy period of time. I think in the acute setting for the last
several years, we have done this as a special feature in the sum-
mertime. We gear up and do it. But I think it is important for the
long term to establish it on an ongoing basis to be done locally. It
does not have to be done just in summer. People can do this
throughout the year. It can be built into the facilities in Libby. We
very much want to work with Dr. Spence and Dr. Black and figure
out the best way to conduct this in Libby. We will be as supportive
as we can of that.
Senator BAUCUS. When do you think you will have this again?
July 10, did you say?
Dr. FALK. Yes, sir.
Senator BAUCUS. How much do you think it is going to cost? Will
you have a price tag?
Dr. FALK. I am assuming a proposal that comes to us will come
with a price tag, yes. We will look for that.
Senator BAUCUS. You might also give some thought to where the
dollars would come from. Be a little creative about that, too. I
would like you to work with me and others in the delegation, be-
cause we have to work together to figure out how we are going to
get the resources and make sure this is all done quickly.
Dr. FALK. Yes, I think once we embark on something of this mag-
nitude, if it is done properly and it should be, that we are not talk-
ing about a 1-, 2-, or 3-year program. We are talking about some-
thing for the next three decades.
Senator BAUCUS. Right.
Ms. Cohan, do you have a reaction to all this? Does it sound right
to you or good to you, or what?
Ms. COHAN. Yes. We get at the clinic an average of four to six
requests a week from people out of town or people in town who for
some reason or other missed the other screenings, who have wor-
ries and concerns about their lung health, but do not have the re-
sources to go in and get a chest X-ray done. At the clinic, we work
with different ways of getting this done, whether they have had a
chest X-ray done in the last several years, and have them send to
us. Dr. Black will review it and I will do an exposure history.
36
So we have been trying to meet the needs in that way of people

who have urgent concerns. I also have a waiting list of people who
are saying, Well, when or if the screening comes up, let me know.
So yes, it is definitely going to be needed. I am not sure what the
volume will be, but it will be steady.
Senator BAUCUS. Have you and Commissioner Konzen addressed
sort of the psychological, social and financial scars at Libby as a
consequence of this disaster, and what we might do to help the
healing?
Ms. COHAN. There is probably not a person in Libby today who
does not know someone, love someone, or hated someone who has
been affected by this disease. Even those people in Libby who do
not believe that it existsthere are still those who believe it has
been blown all out of proportion because it is easier not to believe
than it is
Senator BAUCUS. In denial?
Ms. COHAN [continuing]. In denialdefinitely in denial. But they
still all know somebody who has died of it. So that the psychosocial
impacts have been such that at the clinic we came up with some
key phrases or hand signals when either myself or my assistant,
Ruth, start the interview process of seeing how scared somebody is,
just to you know kind of give a hand clue of how much time it is
going to take to spend with them. In an average medical clinic, it
is very unusual to spend 45 minutes to an hour with each new cli-
ent or individual, but that is common. It is what we need to do just
to get the education and bring the fear level down to a point where
people can hear what you are saying.
They just want to hear yes or no, but if you say yes, I see
changes, then the panic level is so high they do not hear, which is
why the education piece is so high. Through a contract, through
FEMA and SAMSHA, which I think you are aware of, we do have
a person in place who has been working to pull all the resources
in the community together. We call it the C.O.R.A. project, Commu-
nity Outreach Recovery Assistance, the outreach project in which
the clergy, the schools, counselors, everybodysenior citizens cen-
teranybody who will be involved with these people, are actually
pulled together and being educated on the same level so that when
someone comes to them, that the information is there to flow out.
It has been a huge impact. There are third generation kids that
I see who have been affecteddefinitely financially. At the time of
life when most kids look to their parents for future support, getting
through college, buying your first housesomething of that nature,
if your parents have used up all their resources treating an illness,
these young adults do not have the kick-out money that we were
fortunate enough to have to get started in life. So it has been dev-
astated on more levels than just the illness part.
Senator BAUCUS. I also want a comment on the group community
efforts, and your long counseling sessions certainly help. Is there
anything else that comes to mind here? Maybe John, Dr. Spence
or anybody?
Mr. KONZEN. Just a couple of quick commentsthere are still
people in Libby that will not get tested because the ultimate is they
find out they have it and it is incurable and they cannot do any-
37
thing about it, so why do they want to know. That element is still
out there.
We found it difficult to recruit teachers, doctors, forest service
employees who have options where they want to go, when they
hear about Libby. They think it is a valley of death. They want to
stay away from it.
So we need desperately to get that bill of health stamped on

Libby, and we need to get it cleaned up. We need to start re-selling
the community, and we need to make sure people understand that
it is a beautiful place and it is a safe place. If anything, that is the
stigma that is attached to our community. We need to erase that.
Senator BAUCUS. How would you go about erasing it?
Mr. KONZEN. The press has been very friendly for the biggest
part. I think they can play a very important role in doing that,
along with folks in the Federal family who may have expertise in
that area. Maybe we can get some marketing company or some-
thing to come in and help us do that.
Senator BAUCUS. I dont know. Maybe Dr. Wagner, is that some-
thing that NIOSH could do, or Dr. Falkto help out a little bit?
This denial issueor Ms. Horinko, you are raising your hand.
Ms. HORINKO. Senator Baucus, we actually are getting more and
more into the revitalization business at EPA, particularly with the
passage of the new brownfields legislation, which really seeks to
help de-stigmatize these communities. More and more, we are real-
izing our goal is not just to clean up communities, but to help revi-
talize them.
Senator BAUCUS. That is very important, because that is a real
concern.
Ms. HORINKO. When we stamp the cleanup done, we will not
walk away is my promise to you.
Senator BAUCUS. Again, it is one of the problems that the Com-
missioner has mentioned. It is not only that, but you know, if I
have it, do I want to know and it is all that.
Mr. KONZEN. Max, one other thingthe affected population with
tremolite asbestos is in Libby or the large portion of it is in Libby.
I cannot encourage enough that the research occur there. I think
it can be beneficial to the Nation as a whole as a result of that.
Currently, we are going to be flying people to Missoula to have
them tested, as part of the ongoing research at the University of
Montana. I desperately would like to see that occur within our
communityfly the pulmonary folks up to our community and
have them do it there, rather than fly 12 people down there.
Senator BAUCUS. Dr. Wagner, can you help there, too, with the
research? And Dr. Falk? I am just trying to look for some research
efforts her from both of you. I thinkand he makes a good point
the Commissioner makes a good point.
Dr. FALK. It is a very good point. I think that when one looks
at the time that it takes, for example, to develop pleural changes,
it may be as little as 10 to 20 years, but mesothelioma diseases
may take, lets say, 40 years to develop. There is that period of
time between those two stages where people can be greatly bene-
fited if we come up with new ways of intervening to stop progres-
sion of asbestos-related disease.
38
So I think this research is absolutely essential. I am going on

Monday to the conference in Missoula, and basically I would like
to stress that challenge. As I think Dr. Black and Dr. Spence know,
we did a workshop a while back with the National Institutes of
Health to see what they knew about potential drugs or treatments
on the horizon.
Senator BAUCUS. Could we get somebody in Libby, because that
is on the spot. That is where the action is.
Dr. FALK. I think that is a very good point. It came up at one
of the CAG meetings that I attended, and I was really very im-
pressed that people said that they would be very eager to partici-
pate in that kind of research.
Senator BAUCUS. You could work with Dr. Holian for example.
Dr. FALK. Yes, I think maybe as we talk about how to develop
the research program, some facility or some part of the
program
Senator BAUCUS. I want to help, too, because the University of
Montana was recruiting Dr. Holian from Houston a couple, 3 years
ago. So they asked me to call him up so I did. He said, Yes, I
would like to come to the University of Montana, but I need a lab.
How much, $20,000 or $30,000? So we helped to get an appropria-
tion for the lab and we have Dr. Holian. So all I am saying is I
want to help. If you find somebody that we can designate to get up
to Libby full-time on the research that is really good, let me know.
Pat.
Ms. COHAN. Thanks, Max. At this present time, Dr. Black and
I are working with or cooperating with the University of Montana
on a voluntary basis. I collect blood samples and do the histories
and then freeze the samples. When I get enough to justify a trip
to Missoula, I will go down and visit my godson and drop off the
blood samples at the same time, which has helped. They have got
over 200 blood samples. We are working on getting lung washing
samples, which is the flying down to Missoula part, just because
or the expertise needed in having the cells fresh and ready to be
prepared there in Missoula, rather than in Libby, because it is,
particularly in the summer, getting from Libby to Missoula with
dry ice, it is pretty well melted by the time you get down there.
So that having some facilities or a more convenient way of doing
it, having someone who has got dedicated time right now. It is a
voluntary basis that has been
Senator BAUCUS. Who is in charge of getting this aspect to-
gether? We are setting up dates and deadlines and things. We need
somebody in charge of this. Who do you want toDr. Black, or you
Pat, or Dr. Falk or Dr. Spencewho is most appropriate?
Dr. SPENCE. Senator Baucus, this coming week, as Dr. Falk
pointed out, we are going to be meeting in Missoula with Dr.
Holian. In my former life, as I think you know, I was in academic
medicine for 23 years. One of the things I did was a lot of research.
I dealt with patients the last 9 years with HIV disease, and we did
many of the same types of sampling of these individuals with re-
gard to pulmonary samples as was required by this particular pro-
tocol.
39
We did it in a storefront clinic that I had operated, and I think

there are ways that we can do this. So I will look at it and get back
to you.
Senator BAUCUS. I was going to say, you are the man.
Dr. SPENCE. Thank you.
Senator BAUCUS. You have just been designated. You are in
charge. We are talking about 1-month deadlines here. A month
from now is going to be a big day. OK.
Dr. SPENCE. I will call you on the 20th, sir.
Senator BAUCUS. OK, fine.
Dr. Falk, do you have anything to add?
Dr. FALK. I will be happy to work with Dr. Spence.
Senator BAUCUS. OK, I appreciate that.
OK, now a little bit to the help. People get screened. They have
the disease. They need help. They need treatment. I would like to
talk a little bit about that. What is being done? What is available?
What yet is needed? I think the Commissioner talked about a cou-
ple of trust funds. I dont know if that was with respect to this
question or not. But you, Dr. Black, could you kind of lead off in
terms of treatment? How far along are we? What needs yet to be
done? These are people most of whom just do not have the re-
sources to have the proper treatment. Somebody mentioned that 25
percent have no health insurance, and many of those who do are
underinsured, very high deductibles, and the company is backing
off and not helping very much. Why dont you lead off, Doctor?
Dr. BLACK. As I have mentioned before, we have already had a
number through here, and have currently about 850 people with
asbestos-related disease. These people, because of the nature of this
particular disease, we do not discard the so-called plaques or beau-
ty marks that have been described in the past as being insignifi-
cant. We do not deal with them that way. We think these people
need following on a regular basis.
Dr. Whitehouse has indicated once a year. That is not typical.
With chrysolite asbestosis, it is frequent to follow people at longer
intervals. With this particular type of fiber, it requires closerbe-
cause of complications, higher complication rates and progression.
Senator BAUCUS. What treatment is needed now?
Dr. BLACK. The treatment iswell, that isI think by the moni-
toring process, Senator Baucus, by monitoring people and doing the
blood work and looking for markers in the blood and getting lung
cells to study what is going on there with our cells of defense in
trying to understand what is going on in the immune system with
this disease, it will help elucidate some form of treatment. I think
we certainlythere are some drug trials going on right now and
there are things like that, but they are very limited because we
have limited resources. Basically, those are dependent on a phar-
maceutical company for the ongoing studies right now. I guess we
see a need for more clinical research. I think it would be very im-
portant to correlate what is going on with the individuals, what is
going on in their blood, what is going on withthose pieces.
Senator BAUCUS. Lets break this down a little bit. One is, I
guess, needed research. Does the state of medical knowledge now
know enough to know what the treatment should be, given infinite
40
resources? Or do we still need more research to find out what the

treatment should be?
Dr. BLACK. That is right. There is no treatment, certainly for the
fibrosis that occurs with asbestosis and asbestos-related disease,
there is no treatment that has been shown to be effective. We only
have one trial that I am aware of right now that we are looking
at and needs further looking. But no, we are veryit has not been
done, and the past has had poor outcomes in terms of the drug
trials.
Senator BAUCUS. How do we go about getting it done? Who
wants to take a crack at that? Dr. Falk?
Dr. FALK. There are two aspects to treatment. One is how to care
for people who have, lets say, lung cancer or mesothelioma, which
does not require research, but requires a lot of medical care and
attention and time. But effective treatments will require research.
That type of clinical research, I think, by and large has been the
province of NIH and clinical centers. There are medications on the
horizon that are coming along that may be helpful in intercepting
the inflammatory process, the fibrosis process, but it will be an in-
tensive effort to actually test those. I think part of Senator
Murrays proposed legislation involves treatment centers as well.
So I think there needs to be some really focused attention on inter-
vening to prevent progression of these diseases.
Senator BAUCUS. I am asking you as somebody who has worked
in the area what is the best way to go about accelerating treat-
ment? What is the most efficient way and the most effective way
to begin? Maybe Dr. Spence, you have got some thoughts.
Dr. SPENCE. Well, one of my thoughts on treatment, sir, is sec-
ondary prevention. We know that once a person developed the
changes that they will progress, so we cannot prevent what has al-
ready happened to them. But hopefully we can in some ways delay
the onset of some of the terrible aspects of this disease. One of the
things that is a co-factor in the rapid progression of these diseases
and also of asbestosis as well as the development of lung cancer is
tobacco use.
Certainly, we need a more concerted effort. We need more fund-
ing. We need an awful lot of work in the area, because we have
people now that still smoke. We recognize full well that when you
are diagnosed with lung cancer, once you get that diagnosis, you
will probably quit smoking, but most people will smoke right up to
the time they get that diagnosis. We still have many people with
asbestos-related disease or at least asbestos changes in our commu-
nity up there, as well as throughout the Nation, that continue to
smoke cigarettes. I think we need some good smoking education.
Certainly, the tobacco bill has helped to some degree, but as you
know in Montana, that bill does not address all of our needs.
Senator BAUCUS. What about resources? Given what is available
in medical knowledge today, what about resources? Are people able
to have the dollars to spend on theI know the answer already
treatment that is available today? I would like you to just give us
aquantify the inadequacy of resources, if somebody could deal
with that.
Dr. BLACK. Here is an example. We do not know what our fund-
ing will be next year. Will W.R. Grace be there to support the clin-
41
ic? We are seeing really negative directions there. We have uncer-

tainty as to whether our clinic structure willyou know, what is
the support of it? Because around that clinic, it would generate the
capabilities of doing the ongoing screening, the monitoring and the
research. So there are a lot of pieces here that are lacking re-
sources. But the clinics existence, I think, is critical to
Senator BAUCUS. The clinic is one. So what else in addition to
establishing more certainty at the clinicif you all knew the clinic
is going to be there, and well-financed, what other needs are there?
Mr. KONZEN. Well, day one, when this thing first broke, there
was a group of us that worked on a health trust with W.R. Grace,
and never got off base. W.R. Grace would not accept our concept
of a trust. Other companies have done this. We are aware of Asarco
in East Helena and we thought that would have been a good clean
way to take care of this problem.
I just have some quick figures here that the medical plan that
W.R. Grace now has in place, in the year 2000 spent $19,475 on
patient care in Libby. In 2001, it went up to $745,000 and at 2002,
5 months into this year, it is already at $728,000. This gives you
an idea what is going to happen as the sickness progresses along.
That is a very big concern for the long-term health care for these
folks. If there is not a stable source of funding, it is going to bank-
rupt not only the hospital situation, but also our doctors. That is
a tremendous burden to put on them. And now the pharma-
ceuticalsthey spent $171,000 in 2001 and $160,000 in the first 4
months before they came in and started doing their audit.
Senator BAUCUS. Who spent that money?
Mr. KONZEN. That is the medical plan that W.R. Grace has.
Those are the benefits that are being paid out.
Senator BAUCUS. I see.
Mr. KONZEN. The question that we have asked W.R. Grace is,
How long is this health plan going to be in place? Can you give us
some time duration? The health plan is as good as the company,
and the company is in bankruptcy. So what does that tell you?
That scares us.
Senator BAUCUS. Even with the health plan, though, can you ad-
dress the adequacy of the health plan?
Mr. KONZEN. Correct. I think Dr. Black can maybe speak to the
holes within the health plan.
Dr. BLACK. Well, let me go back to when we started this. The
Grace health plan was initiated. There was a lot of trepidation be-
cause the wording in their document really eliminated local physi-
cians from being part of the diagnosis. As we got into the program,
they were very lenient and they actually allowed myself and other
physicians to apply or get people into the health plan. So it was
a very nice gesture on their part to show they wanted to take care
of Libby. I sent them a nice letter in February 2001 and Mr. Cor-
coran, I guess, had responded very favorably, saying it is nice to
get something positive from Libby. I thought maybe they might
change and show some interest in really trying to take care of the
problem.
Unfortunately, since earlier this year, we have seen an interest
now to second-guess, question and utilize outside readers and
42
things that insurance companies generally do not do, to assess

these people and deny access to the plan.
Let me give you an example, and then maybe it will make more
sense to you. I had a recent case. A gentleman comes in. He had
been short of breath. Anyway, we assessed him and I clearly
thought he had some asbestos-related scarring on his lung, or the
lining of his lung. I did another X-ray because it had been several
years since his screening, actually. That is how late he was coming
in. He had a new nodule, a possible cancer. So I referred him, and
I told him, look clearly, you have plaques not only on your chest
X-ray, but on your scan. So I sent his application into the health
plan. I assumed he would get on the program. I told him I think
they will help you with this, because lung cancers have a strong
association. Especially with smokers, the asbestos exposure tre-
mendously increases the cancer risk.
And so, he had a surgery. Fortunately, we got an early cancer
and it was cured. But also when the surgeon was there, he saw the
plaqueing that I had described, the scarring on the lining of the
lung that I had seen on my studies. I was very shocked when just
a few weeks ago, I got a letter from the health network saying this
gentleman has been denied on our plan. Our expert reader says he
does not have asbestos-related disease, therefore the good news is,
Mr. So-and-So, you do not have that disease that Dr. Black told
you, and you do not qualify for the plan. That is the letter he gets.
We are seeing this over and over, and I think they are going to
question everything that we see. I am not saying we are that great,
but I think we know a lot more about this particular type of scar-
ring on the lung. It is not the typical look you see with the commer-
cial type, and I think if you send a lot of our X-rays out to other
people that are accustomed to looking at them, they miss this dis-
ease. It is subtle. It has a subtle, diffuse, thin scarring that builds
up gradually. It is not seen by a lot of people.
So we are just accustomed to it. I think it is a clinical diagnosis.
They are taking it out of the clinical setting and they are just tak-
ing it to a radiologist, saying, does this person have disease or not?
That is not the way we diagnose asbestosis.
Senator BAUCUS. I appreciate that.
We are going to have to conclude this hearing. I am trying to fig-
ure out, though, in my mind how on July 20 we get a health plan
together here. I guess I will take that responsibility myself, to fig-
ure out how we develop that, but I am going to need a lot of help.
The trust fund idea is a start, if we can persuade Grace to partici-
pate in addition to other appropriations. I do not know what we
can come up here to help people who are suffering through no fault
of their own, particularly as you explained, Commissioner. I agree
with you. Some of these guys, even if they knew what was going
on, they would go to work to put food on the table. But they cer-
tainly would no if they knew they were going to affect their fami-
lies. That is just the nature of the people in Libby. That is really
true.
I thank everybody for coming today. I know you have taken a lot
of time out of your day. Your morning is now over, virtually, so
thank you so very much.
43
Does anybody want to add anything? Has anybody said anything

so outrageous it needs a response? Here is an opportunity to say
something that is constructive and helps addressI see your lean-
ing forward, Doctor.
Dr. SPENCE. I have one parting salvo, Senator Baucus. We might
note that a large number of our people in Libby that have this dis-
ease are over age 65. We have also demonstrated they have low
levels of insurance. Many of them are eligible for Medicare, how-
ever, and they do not have a prescription plan for Medicare and
they need these medications. We need to look at a national effort
to get Medicare to put in a prescription plan.
Senator BAUCUS. I could not agree more. I work as hard as I can
to get that.
Dr. SPENCE. I know you do, sir.
Senator BAUCUS. I am working hard on that. That is another
committeethe Finance Committeethat has jurisdiction over pre-
scription drug benefits under Medicare. I just very much hope that
Members of Congress realize the need and therefore do not politi-
cize this issue as some are inclined to, that is one party blaming
the other for not getting the job done. I am trying so hard to pre-
vent that from happening. Just get the job done and get the bene-
fits because people need the help, and forget the politics. I could
not agree with you more, Doctor, and I am very glad that you made
that point because I will be using that, too, in addition to all the
other ammunition I have to help get the job done.
Thank you very much. You are great Americans and I appreciate
your service to the people of Libby and to our country. Thank you
very much.
[Whereupon, at 12 oclock p.m., the subcommittee was adjourned,
to reconvene at the call of the chair.]
[Additional statements submitted for the record follow.]
STATEMENT OF HON. PATTY MURRAY, U.S. SENATOR FROM THE
STATE OF WASHINGTON
Senator Baucus, thank you for calling todays hearing on Libby, Montana and on
the health and environmental problems caused by asbestos contamination from the
W.R. Grace vermiculite mine there. Thank you also for giving me the opportunity
to testify before this subcommittee. I applaud the leadership you have shown on this
issue on behalf of the people of Montana and the entire country.
I first became interested in this issue in 1999 because of the series of articles by
Andrew Schneider about Libby in the Seattle-Post Intelligencer. I can relate to the
people of Libby because my mother grew up in Butte, Montana. Like Libby, the
main industry in Butte is mining. I know first hand that these communities be-
lieved the government was protecting them from health problems caused by air and
water pollution from mining.
I also became interested in this issue because Libby is only 160 miles from Spo-
kane, Washington, and many people from Libby have received medical treatment in
Spokane. Last year, when I chaired a Senate Health, Education, Labor and Pensions
Committee hearing on asbestos exposure and worker safety, Dr. Alan Whitehouse
from Spokane testified. He has treated about 500 patients from Libby. While most
people thought only miners and their families could be exposed to dangerous
amounts of asbestos from mining, many of his patients are sick just because they
lived in Libby. Approximately 25 percent of his patients didnt work in the mine or
live with someone who did. Twenty-four of his patients have died in the last 3 years,
and five who died were sick ONLY from environmental exposure.
The issue is also relevant to my constituents because like most other states,
Washington has many sites which processed Libby vermiculite that was contami-
nated with asbestos. The chart you see displayed shows all of the sites in the United
States which received vermiculite from Libby. Of the approximately 300 sites which
44
processed this mineral, the Environmental Protection Agency (EPA) and the Agency
for Toxic Substances and Disease Registries (ATSDR) have determined that 22 sites
require further cleanup.
One of these sites is the former Vermiculite Northwest, Inc. and then W.R. Grace
plant in Spokane. The plant began producing Zonolite insulation in 1951. Even
though the plant closed down in the early 1970s, recent tests by EPA have found
some soil samples from the site still have asbestos concentrations of up to 3 percent.
EPA is strongly recommending that access to the site should be restricted almost
30 years after the plant closed down.
At many plants where vermiculite from Libby was processed, waste rock left over
from the expansion process was given away for free. People used this free waste
rock in their yards, driveways and gardens.
The other picture you see shows Justin and Tim Jorgensen climbing on waste rock
given out by Western Minerals, Inc. in Minneapolis, Minnesota in the late 1970s.
According to W.R. Grace records, this rock contained between 2 and 10 percent
tremolite asbestos. This rock produced airborne asbestos concentrations 135 times
higher than OSHAs current standard for workers. Thankfully, neither Justin nor
Tim has shown any signs of disease, but their risks of developing asbestos diseases,
which have latency periods of 15 to 40 years, are increased from their childhood ex-
posures.
Today, people may still be exposed to harmful amounts of asbestos in vermiculite.
Between 12 million and 35 million homes and businesses may have Zonolite insula-
tion. This may be the case for up to 150,000 homes in Washington. EPA has also
tested agricultural productssoil conditioners and fertilizersmade with
vermiculite, and determined that some workers may have been exposed to dan-
gerous amounts.
As I learned more about Libby, and how asbestos has ended up in products by
accident, I was shocked to learn that asbestos is still being used in products on pur-
pose. While some specific uses have been banned, the EPAs more sweeping ban was
never put into effect because of a lawsuit backed by the asbestos industry.
As a result, new uses of asbestos were banned, but most existing uses were not
banned. Today, asbestos is still used to make roofing products, gaskets, brakes and
other products. In 2001, the U.S. consumed 13,000 metric tons of it. Asbestos is still
entering the product stream in America, despite the known dangers to human
health. In contrast, asbestos has been banned in at least 20 other countries.
Now its time for the United States to ban asbestos, too. I want to ensure our gov-
ernment does all it can to minimize future suffering and death caused by asbestos.
That is why yesterday we introduced the Ban Asbestos in America Act of 2002. Sen-
ator Baucus, thank you for being an original cosponsor of this important legislation.
I also appreciate the cosponsorship of Senators Cantwell, Dayton and Wellstone.
The Ban Asbestos in America Act of 2002 has four parts which I would like to
briefly mention. First, this bill protects the public by requiring the EPA to ban as-
bestos by 2005. Like the regulations EPA finalized in 1989 under the Toxic Sub-
stances Control Act (TSCA), companies may file for an exemption to the ban. EPA
may issue the exemption if there is no substitute material available and the exemp-
tion wont pose an unreasonable risk of injury to public health or the environment.
Id like to take a moment to point out to the Subcommittee the connection be-
tween what happened in Libby and EPAs efforts to ban asbestos. Last year, the
EPAs Inspector General conducted an investigation into why the agency didnt do
a better job of protecting the people of Libby. I was struck by one of the sections
of the Inspector Generals Report, in which a letter written by EPA in 1983 is
quoted as follows, . . . asbestos-contaminated vermiculite is considered a lower pri-
ority at this time than problems posed by friable asbestos-containing materials in
school buildings and commercial and industrial uses of asbestos.
In 1979, EPA had issued an Advanced Notice of Proposed Rulemaking that it in-
tended to explore options to control asbestos under Section 6 of the TSCA. In 1982,
EPA issued a reporting rule under Section 8(a) of TSCA to gather information about
commercial and industrial uses of asbestos. EPAs proposed rule to ban asbestos was
published in the Federal Register in January 1986, and the final rule was published
in 1989.
One of the reasons EPA did not spend more time focusing on asbestos-contami-
nated vermiculite was that the agency was working on the asbestos phaseout and
ban rule. Unfortunately, this rule was overturned by the 5th Circuit Court of Ap-
peals in 1991.
There is a clear relationship between EPAs efforts to ban asbestos and the fact
that problems in Libby were overlooked. I am saddened that EPA didnt spend more
time focused on Libby in part because of a competing effort to limit asbestos expo-
surean effort which ultimately failed.
45
Second, the bill requires EPA to conduct a pubic education campaign about the
risks of asbestos products. We need to warn people that their home insulationif
made with vermiculitemay be contaminated with asbestos. While EPA has agreed
to remove vermiculite insulation from homes in Libby, the agency currently has no
plans to do this nationwide.
The Ban Asbestos in America Bill requires EPA and the Consumer Product Safety
Commission to educate consumers about how best to handle this insulation within
6 months. The Ban Asbestos in America Act of 2002 also requires EPA to conduct
a survey to determine which foreign and domestic products consumed in the United
States today have been made with asbestos. EPA has estimated as many as 3,000
products still contain the mineral.
Third, the legislation invests in research, tracking and treatment of asbestos dis-
eases. It requires a national mesothelioma registry, which would be coordinated
with the A.T.S.D.R.s existing efforts pertaining to Libby as well as with the Na-
tional Institute for Occupational Safety and Health. The bill also authorizes funding
for 7 mesothelioma treatment centers nationwide to improve treatments for and
awareness of this fatal cancer.
Finally, the bill requires EPA to expand its Blue Ribbon Panel on Asbestos to ad-
dress issues beyond the six regulated forms of asbestos, as EPA originally promised
in its response to the Inspector General.
Over the years, asbestos has taken a staggering toll on our country. We have re-
cently been reminded of the dangers posed by asbestos because of concerns about
asbestos exposure from the dust and debris caused by the collapse of the World
Trade Center Towers. Had this country acted swiftly to ban asbestos when public
health evidence about its dangers first emerged, the Towers would not have been
built with any asbestos at all. Now well need to wait several decades to determine
whether asbestos exposures in New York will cause asbestosis, lung cancer and
mesothelioma for first responders and residents.
I hope this Subcommittee, which has primary jurisdiction over the Ban Asbestos
in America Act, will consider holding a hearing on the bill in the near future.
STATEMENT OF HON. DENNY REHBERG, U.S. REPRESENTATIVE FROM THE

STATE OF MONTANA
Thank you Mr. Chairman, for the opportunity to provide testimony before the
Committee today.
Mr. Chairman, I have visited the Libby community three times within this past
year to learn first hand of the health crisis that has plagued my constituents for
more than a decade. At my invitation, EPA Administrator Christie Whitman joined
me for a tour of Libby, where she had the opportunity to meet with community lead-
ers and families affected by years of asbestos contamination. Her reaction to the
tragic situation was a common one: she wanted to help.
With each return visit to the community, it has become increasingly clear to me
that this issue reaches far beyond asbestos, Superfund designation, cleanup, or eco-
nomic loss. The situation in Libby is nothing short of a health emergency, spurred
on by corporate greed, that has drastically altered the lives of good, hard working
Montanans.
As we analyze the difficult lessons learned from Libby, Congress cannot lose sight
of the residents and their long-term healthcare needs. As time goes by and as re-
search continues to offer new information, we may find that the tragedy of Libby
is far greater than currently understood. However, regardless of future discoveries,
we must be relentless in our efforts to clean up the contaminated homes, schools
and businesses and provide a more secure future for the people of Libby, Montana.
During my numerous visits to Libby, both as their Congressman and as their Lt.
Governor, I have pledged my steadfast commitment to the residents to see this
through to the end. And as the cleanup is completed and the stigma associated with
this town fades, it is incumbent upon the government to continue to assist the indi-
viduals whose health and quality of life have been affected by asbestos exposure.
Mr. Chairman, I appreciate your efforts in addressing this public health crisis. I
look forward to working with my colleagues in Congress to once and for all bring
about a positive conclusion to the public health nightmare that has plagued the citi-
zens of Libby for more than a decade and to. ensure that the terrible mistakes that
led to this disaster are not revisited on any another American community.
Thank you, Mr. Chairman.
46
STATEMENT OF MARIANNE HORINKO, ASSISTANT ADMINISTRATOR, OFFICE OF SOLID
WASTE AND EMERGENCY RESPONSE, U.S. ENVIRONMENTAL PROTECTION AGENCY
Good morning. I am pleased to appear today to address the cleanup of asbestos
contamination in Libby, Montana, and the Agencys efforts to identify other sites na-
tionwide that received vermiculite from Libby. EPA views the Libby asbestos site
as one of the most significant Superfund sites nationally, and the Agency is com-
mitted to working with our state and Federal partners to take all steps necessary
to protect human health and the environment in Libby and related sites.
BACKGROUND
Libby is a small town of about 2,600 residents in northwest Montana. Approxi-

mately 10,000 more people live in about 2000 homes located in the surrounding val-
ley. Between 1924 and 1991, a vermiculite mine owned originally by the Zonolite
Corporation and purchased by W.R. Grace in 1963, was one of Libbys largest em-
ployers. The now-closed vermiculite mine once produced a large proportion of the
worlds vermiculitewith an estimated output of more than 5 million tons from
1963 to 1990. The processed vermiculite ore mined in Libby has been used as a soil
conditioner and in the manufacture of insulation, packaging and other materials.
Over the years it operated, the mine and related facilities employed a total of
about 2000 workers in Libby. The ore was milled and beneficiated (partly cleaned
of impurities) on the mine property. After milling, the ore was transported to a
screening plant at which the ore was graded prior to shipment by railroad to other
processing plants around the country. It also went to one of two processing plants
which operated in Libby during different periods in the mines history, prior to bag-
ging for shipment.
One of the impurities in the vermiculite ore was asbestos. Contamination result-
ing from operation of the mine and related processing facilities has led to serious
public health impacts among members of the Libby community. Asbestos health ef-
fects include malignant mesothelioma, an incurable and often fatal cancer of the
chest cavity which in many cases is associated with asbestos exposure. Further, as-
bestos exposure is associated with an increased risk of all lung cancers, particularly
when combined with smoking. Asbestos exposure can also cause asbestosis, a debili-
tating respiratory illness caused by progressive scarring of the lung tissue that can
also be fatal.
INVESTIGATIONS AND CLEANUP RELATED TO LIBBY ASBESTOS
EPA is working closely with our Federal partners to address the asbestos con-
tamination and related public health concerns in Libby and other communities
across the country. EPA, the Agency for Toxic Substances and Disease Registry
(ATSDR) and the U.S. Public Health Service (PHS) have mobilized an emergency
response team to work in Libby. Coordinating closely with the community, the team
conducted inspections of the former mine and processing facility, interviewed local
physicians, and collected environmental samples to determine the need for environ-
mental clean up. The team discovered significantly elevated incidence of asbestos-
related disease in Libby, as well as evidence of asbestos contamination in several
areas within the town.
EPA is currently taking action under the Comprehensive Environmental Re-
sponse, Compensation and Liability Act (CERCLA or Superfund) to protect human
health and the environment in Libby. W.R. Grace, an owner and operator of the
vermiculite mine and facilities, filed for Chapter 11 bankruptcy protection in late
2000. The United States continues to pursue reimbursement for Superfund activities
through action in the Montana Federal District Court.
MEDICAL INVESTIGATIONS
In November 1999, ATSDR and the PHS undertook medical investigations in

Libby to determine the magnitude of asbestos-related health impacts in the commu-
nity. These investigations, which were requested and funded by EPA, consisted of
a morbidity/mortality study, development of a formal epidemiological case series,
and health screening.
The mortality study for the period 19781998 showed that mortality in the Libby
community from asbestosis was approximately 4060 times higher than expected for
such a community. ATSDR conducted health screening of roughly 6,200 individuals,
including former workers, family members of workers and current and former resi-
dents of Libby. Preliminary results of the health screening of these groups showed
up to 18 percent with lung abnormalities. Significantly, more than half of this sam-
ple were not former W.R. Grace workers or their family members. In short, all of
47
the medical investigations documented evidence of wide-spread disease and mor-
tality resulting from exposure to asbestos.
ENVIRONMENTAL INVESTIGATIONS AND CLEANUP
EPA initiated a Superfund emergency investigation and cleanup actions in Libby.

The initial investigations focused on the mine and processing areas, residences,
parks and schools. From December 1999 though April 2002, EPA collected more
than 5,000 samples and conducted interviews to characterize the extent and severity
of asbestos contamination in and around the town of Libby. Preliminary results
showed that high amounts of asbestos-contaminated vermiculite remained at the
mine, the mine road, processing areas, the mine tailings pile/pond, and in residen-
tial and shared community areas.
In June 2000, EPA initiated and oversaw cleanup actions at two former proc-
essing areas to address the worst asbestos contamination. EPA has since started
cleanup actions at the mine road, the high school track and city park facilities
where vermiculite ore tailings were found. Cleanup has also started at several resi-
dences where piles of vermiculite or contaminated equipment from the mine were
found. More cleanups are planned to address elevated levels of asbestos, both at
mining facilities and in the community.
Federal agencies have maintained a program of early and meaningful outreach
and coordination with the Libby community. This has included meeting frequently
with the Libby Community Advisory Group, maintaining a storefront office in an
accessible downtown location and frequent one-on-one communication with con-
cerned Libby residents.
On May 9, 2002, EPA approved a new Action Memorandum Amendment for the
Libby Asbestos site, authorizing additional work at known locations and sources, in-
cluding certain residential contamination in homes associated with vermiculite insu-
lation.
EPA determined that it was appropriate to address the insulation in Libby based
upon the unique circumstances in Libby. EPA has determined that this material
does fall within our response authorities, as detailed in the Agencys Action Memo-
randum Amendment of May 2002. In addition to the level of known cumulative ex-
posure and multiple pathways, EPA determined that the remaining asbestos re-
leases in Libby would not have been addressed by any other authority in a timely
manner.
EPA has made progress with residential cleanup in Libby. We have resumed the
removal of vermiculite ores and mining wastes from residential yards. We are start-
ing to address two homes with elevated amphibole asbestos concentrations in inte-
rior dusts. EPA expects to begin the removal of vermiculite insulation from homes
within 1 week. There are currently 55 properties on the priority list for clean up.
These are properties that have high levels of amphibole asbestos in their yards, plus
either vermiculite insulation or interior contamination as well. EPA expects to com-
plete the response at these 55 properties this summer.
In support of these activities, EPA is completing designs, plans, and contracts to
construct an asbestos cell at the Lincoln County Landfill. This will create a perma-
nent disposal location for the vermiculite insulation, and facilitate year round oper-
ations. Region 8 should begin construction in mid-July.
Work is also completing clean up and restoration actions already underway. EPA
expects to finish the restoration of the High School, Middle School, Screening Plant,
Export Plant and remove the remaining contamination at the KDC-Flyway this sea-
son.
EPA has committed more than $60 million in fiscal years 2000 through 2002 for
environmental investigations, cleanup actions and medical investigations in Libby.
Current estimates place fiscal year 2003 needs at approximately $21 million. These
future funding need projections are based upon assumptions about the number of
homes or additional properties which may require clean up, and may be subject to
significant revision as field work progresses.
The ongoing work of EPA and our partners will help determine how best to com-
plete the long-term remediation in Libby. To date, site investigation and cleanup ac-
tivities have taken place under Superfund emergency or removal authorities.
Given the widespread contamination and public health concerns in Libby, the Gov-
ernor of the State of Montana designated the Libby site as the States one-time, top
priority site for cleanup. In response, EPA listed the Libby site on the Superfunds
National Priorities List (NPL) of contaminated sites. EPA is committed to working
with our partners to see that all necessary actions are taken to protect public health
in the Libby community.
48
EPA INVESTIGATIONS AND CLEANUP OUTSIDE OF LIBBY
While EPA is currently taking action under Superfund to protect human health
and the environment in Libby, the Agency is working with ATSDR to study other
locations across the country where vermiculite ore from the Libby mine was shipped
for processing.
Between 1924 and 1991, the Libby mine produced much of the worlds supply of
vermiculite. EPA identified 240 locations across the U.S. that may have received
Libby vermiculite for processing and distribution. Of these locations, EPA deter-
mined that 22 require further investigation by the Agency. When it appears that
another agency may need to be involved, EPA shares its findings with other Federal
or state agencies so that they can determine if additional followup is warranted.
One notable example of a situation warranting a Federal / state agency approach
is the significant asbestos contamination at the Western Minerals site in Min-
neapolis, Minnesota. Western Minerals operated as a vermiculite processing facility
from 1937 until 1989. Between 1964 and 1989, Western Minerals is estimated to
have processed more than 118,000 tons of vermiculite ore from the Libby, Montana
mine. The waste material generated during the processing of vermiculite was made
available to the public for use as fill material for driveways and yards. Since Sep-
tember of 2000, EPA and the State have been sampling and removing asbestos con-
tamination at the former plant site and nearby residential yards. EPA and the Min-
nesota Department of Health (MNDOH) have received many reports of asbestos-re-
lated disease in residents who have lived in the predominantly residential area sur-
rounding the facility. An ATSDR-funded survey is being conducted by the MNDOH
to determine the health impacts in former workers and nearby residents at the
Western Minerals site.
ATSDR is currently working with state health departments to conduct or initiate
reviews of health statistics for asbestos-related disease in areas of former
vermiculite processing facilities across the country. EPA will continue to coordinate
with ATSDR on this effort to identify any additional locations that may require en-
vironmental sampling or cleanup.
RESPONSE TO INSPECTOR GENERAL REPORT
On March 31, 2001, the EPA Office of Inspector General (IG) issued a report ti-
tled, EPAs Actions Concerning Asbestos-Contaminated Vermiculite in Libby, Mon-
tana. The IG report focused on EPAs role in addressing asbestos contamination in
Libby, as well as EPAs role in regulating asbestos. The IG report concludes that
EPAs activities in Libby should continue, and emphasizes the importance of ad-
dressing potential asbestos contamination concerns associated with mining and
other operations unrelated to Libby. EPA is coordinating closely with the Mine Safe-
ty and Health Administration (MSHA) and ATSDR to identify additional asbestos-
contaminated sites associated with Libby or otherwise identified that may require
cleanup actions under Superfund.
CONCLUSION
EPA will continue to work closely with our Federal and state partners to take the
steps necessary to protect the public health of the residents of Libby, Montana, as
well as the health of communities outside of Montana that have been affected by
Libby asbestos.
Thank you for the opportunity to appear before you today to discuss cleanup
issues associated with asbestos in vermiculite ore from Libby, Montana.
STATEMENT OF GREGORY WAGNER, M.D., DIRECTOR, DIVISION OF RESPIRATORY DIS-

EASE STUDIES, NATIONAL INSTITUTE OF OCCUPATIONAL SAFETY AND HEALTH CEN-
TERS FOR DISEASE CONTROL AND PREVENTION, U.S. DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Mr. Chairman and members of the subcommittee, I am Dr. Gregory Wagner, an
occupational health expert at the National Institute for Occupational Safety and
Health (NIOSH), Centers for Disease Control and Prevention (CDC). I am pleased
to appear before you today to provide this testimony on behalf of NIOSH.
NIOSH is a research institute within CDC, a part of the Department of Health
and Human Services. CDC, through NIOSH, is the Federal agency responsible for
conducting research and making recommendations to identify and prevent work-re-
lated illness and injury.
My testimony today will address the current scientific knowledge about health
risks to workers from exposure to airborne asbestos. I also will discuss NIOSHs
49
past findings and current research related to asbestos contamination in Libby, Mon-
tana.
BACKGROUND
Asbestos is a term that is generally used to refer to a group of fibrous minerals

with exceptional resistance to degradation by heat, acids, bases, or solvents. The
minerals are not combustible and have a high melting point and low thermal and
electrical conductivity. These and other useful properties had resulted in the devel-
opment of thousands of commercial uses for asbestoscontaining materials by the
early 1970s. However, as the use of asbestos dramatically increased, the lethal ef-
fects of airborne asbestos became clear. Regulatory action and liability concerns re-
lated to the now well-established connection between inhalation of asbestos fibers
and a variety of serious and often fatal diseases have reduced or eliminated the use
of asbestos in many commercial products. However, asbestos and asbestos-con-
taining materials are still found in many residential and commercial settings and
pose a risk of exposure to workers and others.
Asbestos is defined in Federal regulations as the minerals chrysotile, crocidolite,
amosite, tremolite, actinolite, and anthophyllite. The Occupational Safety and
Health Administration (OSHA), the Mine Safety and Health Administration
(MSHA) and the Environmental Protection Agency (EPA) regulate these six min-
erals. All of the minerals, except for actinolite, have been used commercially. The
results from epidemiologic studies of workers exposed to these minerals provide the
scientific evidence of a causal relationship between exposure and adverse health ef-
fects in humans.
ASBESTOS-RELATED DISEASES
Exposure to asbestos significantly increases the risk of contracting several dis-

eases. These include:
(1) Asbestosisa disease characterized by scarring of the air-exchange regions of
the lungs;
(2) Lung cancerfor which asbestos is one of the leading causes among non-
smokers, and which occurs at dramatically high rates among asbestos-exposed
smokers;
(3) Malignant mesotheliomaan almost invariably fatal cancer of the tissue lining
the chest or abdomen for which asbestos and similar fibers are the only known
cause; and
(4) Nonmalignant pleural diseasewhich can appear as a painful accumulation of
bloody fluid surrounding the lungs, but which more commonly is seen as thick and
sometimes constricting scarring of the tissue surrounding the lungs.
In addition, asbestos exposure is associated with excess mortality due to cancer
of the larynx and cancer of the gastrointestinal tract. The malignant diseasesthe
cancers including mesotheliomaare often fatal within a year or a few years of ini-
tial diagnosis. In contrast, asbestosis deaths typically occur only after many years
of suffering from impaired breathing.
We do not know exactly how asbestos fibers cause disease. We do know that mi-
croscopic fibers can become airborne during various industrial processes or from
handling of asbestos-containing materials and can then be inhaled and/or swal-
lowed. As much as 50 percent or more of inhaled asbestos fibers can remain lodged
in the lungs, where it is almost impossible for the body to eliminate them. Asbestos
fibers are extremely resistant to destruction in body fluids, and many of these fibers
are too long to be engulfed and removed by the cells that normally scavenge and
remove particles that happen to deposit in the lungs. Generally, as the burden of
retained fibers increases in the body, so does the likelihood of disease. Most asbes-
tos-related diseases, particularly the malignant ones, have long latency periods often
extending 1040 years from initial exposure to onset of illness. While asbestos-re-
lated lung cancer and mesothelioma are frequently not curable, they and other as-
bestos-related diseases are clearly preventable by eliminating or limiting exposures
to asbestos. The amount and duration of exposure are factors that can determine
the risk of adverse health effects.
THE DEFINITION OF ASBESTOS
In 1990 testimony before OSHA, NIOSH broadened its science-based definition of

asbestos as a result of concerns about the microscopic identification of the six reg-
ulated asbestos minerals. The six minerals can also occur in a non-fibrous (so-called
massive) form. The non-fibrous mineral forms of the six asbestos minerals can be
found geologically in the same ore deposits in which the fibrous asbestos minerals
occur or in deposits where other commercially exploited minerals are mined (e.g.,
50
industrial grade talc). Cleavage fragments can be generated from the non-fibrous
forms of the asbestos minerals during their handling, crushing, or processing, and
these cleavage fragments are often microscopically indistinguishable from typical
asbestos fibers of the (fibrous) minerals.
The elemental composition of the six asbestos minerals can vary slightly as a re-
sult of geological conditions such as pressure, temperature, or proximity of other
minerals. Recognizing these variations in elemental composition, NIOSH believes
that the six asbestos minerals can be defined by their solid-solution mineral series.
For example, the mineral series tremolite-ferroactinolite contains the asbestos min-
eral actinolite. These mineral series are considered solid-solutions in which cations
(i.e., sodium, calcium, magnesium, iron, etc.) are replaced by other cations which can
affect the elemental composition of the mineral without significantly altering the
structure.
NIOSH bases this expanded asbestos definitionencompassing the entire solid-
solution mineral series for each of the six currently regulated asbestos minerals and
including cleavage fragments from the non-fibrous forms of these minerals-on sci-
entific evidence from cellular and animal studies suggesting that dimension, specifi-
cally length and diameter, as well as durability, may be more critical factors in
causing disease than chemical or elemental composition.
NIOSH STUDIES OF VERMICULITE WORKERS IN LIBBY, MONTANA
In June 1980, OSHA asked NIOSH to provide technical assistance to investigate

lung problems in workers at a plant using vermiculite that had been mined in
Libby. Shortly thereafter, MSHA also requested technical assistance from NIOSH
to investigate the magnitude of health hazards in vermiculite mines. MSHA was
particularly concerned about two reported cases of dust-related lung disease in
workers at the Libby mine.
In response to these requests, NIOSH initiated epidemiological studies in Libby,
Montana. The epidemiological studies carried out by NIOSH between 1980 and 1985
showed that occupational exposure to mineral fibers that contaminate Libby
vermiculite caused high rates of asbestos-related diseases among exposed workers
at the Libby mine complex. The fibers these workers were exposed to included
tremolite, one of the minerals within the definition of asbestos as currently regu-
lated. Some recent evidence indicates that only 10 to 20 percent of the fibrous min-
eral content of the Libby vermiculite was tremolite. A much higher proportion80
to 90 percentof the fiber contaminant in this vermiculite has been characterized
as several other similar fibers that are not currently regulated as asbestos, such as
richterite and winchite. Richterite and winchite are fibrous minerals that are not
classified as asbestos by mineralogists.
NIOSH played a pivotal role in documenting the health hazard associated with
occupational exposure to asbestos-contaminated vermiculite at the mine in Libby,
Montana. NIOSH made its findings available beginning in 1985 through meetings
in Libby with workers and their representatives, employer representatives, and
members of the community. NIOSH also published its findings in several scientific
papers to alert the occupational health community about the identified problem. It
is clear in hindsight that further work remained to be done, in particular, with re-
spect to further studies of downstream users of Libby vermiculite products. NIOSH
is applying what we learned from our Libby investigations to our current and future
activities both in Libby and throughout our program.
CURRENT NIOSH STUDIES
At present, NIOSH is following up on potential exposures of workers who use or

process vermiculite from other sources. Since closure of the Libby mine in 1990,
most of the vermiculite now being produced for domestic use is obtained from one
of four mines, three of them domestic and one located in South Africa. The degree
to which the vermiculite from these other sources is contaminated with asbestos is
not clear. At OSHAs request, NIOSH is conducting environmental sampling at ex-
pansion plants and horticultural operations where vermiculite is used. NIOSH will
complete asbestos exposure assessments at two expansion plants for each
vermiculite ore supplier, along with a number of horticultural sites. We expect the
field data collection to be completed by the end of 2002. At present, field sampling
has been completed at four expansion plants and three horticultural operations.
From these studies we expect to learn the degree to which an asbestos exposure
hazard exists in vermiculite from sources other than Libby, Montana. Once these
studies are completed, we plan to produce and disseminate a technical report that
describes the extent to which newly mined or imported vermiculite presents an as-
51
bestos risk to current vermiculite worker. Based on the findings, we may issue fur-
ther guidance for protective measures to be taken.
FUTURE RESEARCH ACTIVITIES
Additional research possibilities that NIOSH is considering include efforts to bet-

ter determine physical and/or chemical characteristics affecting toxicity of fibers in-
cluding those occurring naturally and those manufactured. Direct evidence by which
to attribute particular health effects to each possible fiber type is not currently
available. Epidemiological studies of people exposed to naturally occurring or manu-
factured fibers would provide important new information, and studies conducted
with animals could provide mechanistic and other toxicologic data.
Asbestos fibers have many different lengths and diameters. Additional work to
improve and standardize the methods for asbestos fiber measurement is being con-
sidered because it would help advance prevention and control efforts to protect ex-
posed workers. Human assessment of risk and occupational exposure limits is based
on airborne fiber concentrations determined by the use of phase contrast microscopy
(PCM). This analytical method leaves an undetermined number of asbestos fibers
collected on each sample uncounted because many fibers are too small in diameter
to be detected and because the standard procedure for counting fibers using PCM
takes into account only fibers longer than 5 micrometers in length. Current asbestos
exposure risk assessment is based only on a subset of fibers that can be detected
using PCM techniques. More sensitive analytical methods are currently available,
but these methods could benefit from better standardization.
CONCLUSION
In summary, we know much about the adverse health effects caused by the inha-
lation of asbestos fibers. Increased understanding of the health effects of fibrous
minerals that fall outside the existing definitions of asbestos will help us find ways
to provide appropriate protection for workers exposed to those materials. Further
identification of workplace sources of vermiculite exposure and the tracking of per-
sons potentially exposed to fiber-contaminated vermiculite and other contaminated
materials will help us develop appropriate public health strategies for preventing
exposure to these materials. While information continues to be gathered, public
health prudence requires that vermiculite from the Libby mine or products con-
taining vermiculite originating in Libby be considered potentially dangerous and
that proper precautions be taken to minimize the generation and inhalation of any
dust during the handling of these materials until analysis of the particular
vermiculite or vermiculite-containing product shows that it does not produce an as-
bestos hazard.
STATEMENT OF HENRY FALK, M.D., M.P.H., ASSISTANT ADMINISTRATOR, AGENCY FOR

TOXIC SUBSTANCES AND DISEASE REGISTRY, U.S. DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Good morning, I am Dr. Henry Falk, and I am the Assistant Administrator of the
Agency for Toxic Substances and Disease Registry (ATSDR), a public health agency
within the U.S. Department of Health and Human Services (HHS). I am accom-
panied by Sharon Campolucci, RN, MSN, Deputy Director of the ATSDR Division
of Health Studies; she was coordinator of the medical testing program in Libby.
Senator Baucus, ATSDR is grateful for the interest and support given by you and
other members of the Montana delegation since we began working in Libby in late
1999. As you know, we came to Libby in response to concerns expressed by yourself,
community members, former vermiculite mine workers, and the health department.
Over the last several years, we have worked very closely with the U.S. Environ-
mental Protection Agency (EPA) to address these concerns. Without the support of
all of you we would not be able to report today on the significant progress we have
made in evaluating the public health issues in the Libby, Montana, area.
Congress created ATSDR in 1980 under the Comprehensive Environmental Re-
sponse, Compensation, and Liability Act (CERCLA), or what is more commonly
known as the Superfund legislation. CERCLA mandates of ATSDR a broad, national
program of Superfund site health assessments, health investigations, surveillance
and registries, applied research, emergency response, health education, and toxi-
cological data base development. Broadly speaking, ATSDRs responsibilities under
Superfund, the Resource Conservation and Recovery Act (RCRA), and other Federal
statutes are to assess the effects of toxic substances on community populations and
to recommend interventions to protect public health where they are needed. This
52
may include medical screening and epidemiologic investigations of health effects of
community populations exposed to hazardous substances; ATSDR undertook these
activities in Libby. We also conduct investigations to measure human exposure to
toxic substances released from waste sites or other sources of release. We conduct
our work in close collaboration the U.S. Environmental Protection Agency (EPA),
state health departments, local health agencies, and affected communities.
Since being called upon in November 1999, ATSDR has been actively involved
with the citizens and public health and environmental officials to determine the ex-
tent of harm to humans from asbestos-contaminated vermiculite that was mined in
Libby.
In the earliest days of our involvement in Libby, we developed a plan to help
guide site-related public health activities. As we have shared with you in the past,
this Public Health Response Plan identifies the areas of responsibilities for the con-
duct of our health-related activities. All stakeholders, including officials and the af-
fected community, provided input throughout the process of both developing and im-
plementing the Public Health Response Plan. The plan describes specific activities
that are designed to prevent exposures and to mitigate or prevent adverse health
effects. Key elements targeted in the plan were:
(1) to provide community-based medical testing to determine the health status of
exposed people;
(2) to assess disease and illness trends to characterize the impact of the environ-
mental exposure;
(3) to provide a public health education program to assist residents in obtaining
full and up-to-date information on asbestos-related risks and diseases; and
(4) to collect and analyze medical and epidemiologic data to better characterize
the nature and extent of asbestos-related disease in the community.
Following are updates on activities that resulted from this action plan.
MEDICAL TESTING
From July to November 2000, ATSDR staff conducted medical tests on current
and former residents of the northwest Montana town. Participants included 6,149
adults who lived, worked, or played in Libby for at least 6 months before December
31, 1990. Components of the testing included an in-depth questionnaire to build an
exposure history for each of the participants, three X-ray views to identify changes
in the lungs and lung lining that might be the result of asbestos exposure, and a
spirometry test that measured air flow in and out of the lungs to measure lung func-
tion. Of those 5590 study participants 18 years of age and older who were eligible
for X-ray testing, 18 percent (994) showed pleural abnormalities (chest wall scar-
ring). According to data reported in the literature, the rates of pleural abnormalities
in the United States among groups without known exposure to asbestos range from
0.2 to 2.3 percent.
Additional findings included:
Forty-eight percent (159 of 328) of former W.R. Grace employees who partici-
pated in the medical testing had pleural abnormalities.
Most participants reported multiple routes of exposure (household contact, occu-
pational, recreational, and other) to the asbestos-contaminated vermiculite. For ex-
ample, 24 percent of participants who reported six or more routes of exposure had
pleural abnormalities.
Five percent (6 of 122) of those participants who reported no apparent exposure
had pleural abnormalities.
The second phase of initial medical testing was conducted between July and Sep-
tember 2001, and included 1,158 participants. Notification letters have been sent to
these participants, and ATSDR is in the process of analyzing these new data and
combining them with results from those tested in 2000. Once the analysis is com-
pleted, ATSDR will produce and make available to the community a final report
combining results from both medical testing phases. The preliminary analysis of
this combined data does not indicate any significant change in the prevalence of ab-
normalities when compared to data from the first phase of testing.
ATSDR is working to localize the medical testing programtransitioning it to
the state and local health departments with our ongoing technical and resource sup-
port.
MORTALITY REVIEW
In addition, after consultation with the National Institute for Occupational Safety
and Health (NIOSH), CDC, we investigated an association between contaminated
vermiculite and human health through a mortality review in which we compared
death rates for residents of the Libby area with those in Montana, and the United
53
States, for selected diseases that have been associated with asbestos. ATSDR staff
reviewed death certificate data from 1979 to 1998 for the Libby community. The re-
view focused on the underlying cause of death in Libby-area residents. We found
that mortality from asbestosis in the Libby area was at least 40 to 60 times higher
than expected. We also found that death from mesothelioma appeared to be ele-
vated. This mortality review is continuing; additional data are being reviewed to
support these early findings. We expect to release this mortality review by early
July.
These two investigative toolsthe medical testing and mortality reviewclearly
indicated a public health problem in Libby. Based on these findings, ATSDR rec-
ommended many followup activities, several of which already have been initiated.
Working with a local pulmonary physician who treats referrals from the Libby
area, ATSDR has conducted a focused review of patients with an asbestos related
diagnosis and no known link to vermiculite mining. This review was conducted to
address community concerns about environmental asbestos exposure outside the
workplace. Final revisions for the report are now in progress and preliminary re-
sults will be released later this month.
A computerized tomography (CT) scan study is nearly complete. This study was
designed to evaluate the sensitivity of the medical screening tool (chest X-rays) and
to help in planning possible future medical testing activities. All 353 scans have
been completed and reviewed by expert CT radiologists, and letters providing indi-
vidual scan findings have been sent to participants and their physicians. Analysis
of these data for the study report is underway.
Detailed planning and preparatory work has begun on the development of a reg-
istry to track former Libby-area miners and their household contacts. This focuses
on the members of this community who were at greatest risk based on exposure lev-
els and on the results of the medical testing program; a key source of registrants
would be those who participated in the medical testing program. ATSDR sponsored
a workshop in February to consult with and solicit advice from experts in
pulmonology and asbestos-related disease to help guide the next steps for the Libby
registry. The recommendations from this group will assist in addressing the con-
cerns of the Libby community while also meeting ongoing surveillance needs and
in the collection of valuable scientific data. In addition, the registry will help us stay
in contact with all of the identified individuals and provide updated information on
diagnosis and treatment options. The registry is intended to be a long-standing fix-
ture that will not only be a repository of information about the registrants, but will
also be a source of the latest information about treatments and other medical break-
throughs.
ATSDR is working with the State to support localized planning to address fu-
ture medical needs. Extended medical testing will need to continue in some form
for many years. People who have tested positive will need to be followed to note any
progression in the course of the disease. People who have tested negative to date,
but who were substantively exposed, will also need periodic testing, but probably
on a different schedule. Primary responsibility for the medical testing program will
be transitioned to the State and local health department with ongoing technical and
resource support from ATSDR.
ATSDR worked in close cooperation with HHS Region VIII staff to help the
community identify sources of assistance for medical care. In fact, HHS Deputy Sec-
retary Claude Allen personally visited Libby last August and was instrumental in
developing an HHS response. HHS now supports the Community Health Clinic
(CHC) in Libby which provides primary health care services to people in the Libby
area. ATSDR has also worked cooperatively with the Center for Asbestos Related
Disease (CARD) in Libby. This facility, operated by St. Johns Hospital, provides on-
going medical care for persons diagnosed with asbestos related medical conditions
or those requiring further evaluation after undergoing initial medical testing.
The Lincoln County Department of Environmental Health and the University
of Montana in Missoula, in cooperation with ATSDR and the Montana Department
of Public Health and Human Services, are organizing a research conference for later
this month (June 2426) to discuss current asbestos-related research and plan for
future projects. Conference co-sponsors include EPA, the National Institute for Envi-
ronmental Health Sciences, and the National Science Foundation.
This June to facilitate development of the future research agenda related to the
Libby site.
54
ADDITIONAL ACTIVITIES PLANNED FOR NEXT YEAR
Now that cases have been identified through the various methods I have outlined
(e.g., mortality review, case series review, and medical testing), other recommended
activities include:
epidemiologic studies to better evaluate the relationship of exposures and expo-
sure pathways to disease;
follow-up evaluation of individuals in the medical testing program who were re-
ferred for medical care to assure that this referral worked effectively; and
a better determination of the clinical course and natural progression of pul-
monary disease related to tremolite asbestos.
OTHER SITES THAT RECEIVED ASBESTOS-CONTAMINATED VERMICULITE
Processing of vermiculite ore shipped from Libby has occurred at approximately

300 sites in 40 states over the last 5090 years. These sites are being reviewed to
consider the potential for health problems similar to those experienced by Libby-
area residents and former mine workers. ATSDR staff have been working with EPA
to determine if any of these sites pose a public health hazard. This review has in-
cluded site visits to assess the extent of current or past operations, and to determine
the extent of human exposure and possible pathways of exposure to the asbestos.
One site that has already elicited considerable attention is the Western Mineral
Products site in Minneapolis, Minnesota.
This Minnesota site was used for insulation products manufacturing from 1936
to 1989. The plant received vermiculite ore from Libby, Montana, and processed the
ore into insulation, fireproofing material, and other vermiculite products. Under a
cooperative agreement with ATSDR, the Minnesota Department of Health (MDH)
conducted a health consultation to identify health concerns related to asbestos expo-
sure from the site. Plant workers were exposed to levels of asbestos in excess of cur-
rent occupational standards for much of the time the plant was in operation, and
cases of asbestos-related disease have been reported in former workers. Addition-
ally, approximately 100 properties around the former plant have been identified as
contaminated with asbestos containing wastes from the site. The EPA is in the proc-
ess of removing asbestos-contaminated soil from these properties and adjoining
alleys.
The extent of past and current exposures to asbestos is difficult to estimate at this
time. Based on available information, past exposure to workers in the plant, resi-
dents who lived near the site and children who played on piles of vermiculite waste
material may have been at risk for asbestos exposure. To address this concern,
MDH initiated the Northeast Minneapolis Community Vermiculite Investigation
(NMCVI), a population survey to identify and characterize asbestos exposure in a
community cohort. This study involves a door-to-door interview and visual inspec-
tion of properties in the immediate vicinity of the Western Mineral Projects Plant
in Minneapolis, as well as a telephone interview of former residents in the target
area and other individuals who may have had exposure to vermiculite. This inves-
tigation will determine the size and demographics of the population at risk. The
EPA, Minnesota Pollution Control Agency, and MDH will continue to investigate
and clean up the site and surrounding community.
ATSDR staff have developed a protocol for use by the state health departments
to review vital statistics and cancer registry data to determine if there might be a
health impact in any affected community that warrants further investigation. Dur-
ing fiscal year 2001, ATSDR developed cooperative agreements with six states
(Utah, Colorado, Massachusetts, California, Louisiana, and Wisconsin) to conduct
health statistics reviews around sites that received asbestos contaminated
vermiculite from Libby and to determine whether there is an excess of asbestos re-
lated disease. Later this summer, other states will have an opportunity to apply for
support of similar health-related activities; we anticipate supporting up to four addi-
tional states. In addition, ATSDR has awarded funds to conduct evaluation of meso-
thelioma cases in three states (New York, New Jersey and Wisconsin). This surveil-
lance process enables states to use their cancer registry data to identify all mesothe-
lioma cases and then look backward to see if the disease in any portion of the cases
could be associated with asbestos exposure from contaminated vermiculite or
vermiculite insulation from Libby. ATSDR staff also is working with health officials
in Montana to review mesothelioma cases in that state.
I would like to reiterate that ATSDR shares your concerns about the situation in
Libbyboth the environmental contamination and the health concerns. While we
have done a great deal of work in Libby, much remains to be done. To summarize,
our primary goals for this coming year are:
(1) implement the registry of former workers and family contacts;
55
(2) establish the medical testing program on a long-term basis by transitioning
primary responsibility to State and local health departments, with technical and re-
source support from ATSDR;
(3) conduct epidemiologic studies to formally investigate the links between the
various environmental exposures and the development of disease;
(4) provide data on potential health effects in other states that had vermiculite
processing centers that led to harmful exposures; and
(5) pilot mesothelioma surveillance activities, in coordination with NIOSH.
With your continued support, ATSDR stands prepared to continue the important
work we have begun and do whatever we can to help the Montana and Libby com-
munity, and any other sites that may be identified with similar problems.
Mr. Chairman, this concludes my testimony; I would be happy to respond to any
questions you may have.
STATEMENT OF MICHAEL R. SPENCE, M.D., CHIEF MEDICAL OFFICER, MONTANA

STATE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES
Madam Chairperson and members of the committee, for the record my name is
Michael R. Spence. I am a medical doctor licensed to practice medicine in the state
of Monlana. I am currently the chief medical officer in the Montana State Depart-
ment of Public Health and Human Services, a position that I have held for the past
5 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 con-
taminated with asbestos minerals. Large numbers of residents of Libby were de-
scribed 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 profes-
sionals 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 Envi-
ronmental Protection Agency and Health and Human Services from Region 8 located
in Denver, Colorado, the Chief Medical Officer for the State of Montana, the Mon-
tana 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 nec-
essary, 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 initia-
tive resulted in the ATSDR issuing two reports. The first was entitled Preliminary
Findings of Medical Testing of Individuals Potentially Exposed To Asbestoform Min-
erals Associated with Vermiculite in Libby, Montana: An Interim Report for Com-
munity Health Planning and was provided to the community in February 2001.
The second report entitled Year 2000 Medical Testing of Individuals Potentially Ex-
posed 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 screen-
ing 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 fam-
ilies 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 mate-
rials, 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 progres-
sive 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 slow-
56
ly 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 great-
er 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 di-
agnosis to death in individuals with mesothelioma is less than 1 year. An extensive,
epidemiological investigation entitled Mortality in Libby, Montana, 19791998
(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
2025 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 2025 year time period they will usually die more quickly.
The problem of asbestos-related disease in Montana is not limited to Libby. A re-
cent 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 distrib-
uted 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 con-
taminated 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 rap-
idly 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.
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STATEMENT OF PAT COHAN, COORDINATOR, CLINIC FOR ASBESTOS RELATED DISEASE
My name is Pat Cohan. I am a registered nurse with 29 years of experience. For
the last 2 years I have been involved with the health needs of our community re-
lated to asbestos exposure. My introduction to the asbestos disaster was in 2000
when I accepted a grant position funded by HRSA for the asbestos health
screenings. This position had two integral parts. The first was to be the outreach
nurse for the ATSDRs screenings that summer. Over 6,000 respondents were
screened and I handled any medical emergencies, health concerns, or urgent referral
issues that arose after the chest X-rays were viewed. The second part of the position
was to help create a clinic that would assess, diagnose, and educate people with
health care concerns resulting from the screening results.
The Center for Asbestos Related Disease (CARD) was created by St. Johns Lu-
theran Hospital to fill this need. The volume of phone calls, visits, and drop-in visits
was incredible. It seemed that everyone in town and their relative was frantic for
information. We now have over 1,000 active charts and of these over 800 have some
asbestos related changes evident. Each of our clients and family members has re-
ceived health information and education relating to pulmonary health.
The breadth and depth of the psychosocial, emotional, health and financial con-
cerns associated with the amphibole disaster has been without precedent and I have
usually been first at hand to hear the many different life stories. To listen to a cli-
ent calmly speak of hidden mountain valleys and hunting accidents because he will
not allow his children to watch him die the way he watched his father suffer and
die, is a reality of my job. I have worked to find financial resources for a 47-year-
old woman, who has less than half of her normal lung function and no health insur-
ance, so she can afford to have a lung biopsy done. Her chest X-ray was suspicious
for a mesothelioma, a type of cancer associated with asbestos exposure. This woman,
a daughter of a Zonolite miner, waited over 3 months to hear if she would qualify
for Graces medical plan.
Some of the stories are so convoluted that its hard to sort out what is most ur-
gent. A woman with asbestos related illness, who cares for her mother with asbes-
tosis, has been washing her dishes in the tub for the last 2 years. Her kitchen is
plastic sheeted and duct taped closed to keep the leaking Zonolite insulation from
further contaminating her home.
I have a neighbor who has resided in Libby for over 40 years. He never worked
at the mine, never gardened with vermiculite, and never had any contact that he
knew of other than the insulation in his home. This is a man who started the Libby
volunteer ambulance and who has hiked and skied every mountain in the Cabinet
Mountains. He has worked tirelessly for the community in every conceivable volun-
teer role. Because of the asbestos damage to his lungs he can no longer ski, hike,
or volunteer. His major activity now is breathing.
I have used the word disaster most deliberately. This is a slow motion disaster.
Had a mine leaked a toxin into the air of Libby and 200 people immediately died
with 2000 others injured, 20 percent critically, I would not be here. I would be back
home in the emergency room, taking care of the sick and wounded and we would
all be trying to figure how quickly the remaining toxins could be removed. We would
not be struggling to find health insurance, low cost medicines, or funding for long
term care and monitoring. Just because the toxin took 3050 years to kill and maim
our community, it is no less a disaster.
The damage done to this community was not an act of God; it was not for an ideo-
logical principle or for a religious conviction. It was done for profit. The exposure
and the responsible parties disrespect for people need to stop. The miners were
treated as a disposable resource and the citizens of Libby were treated with no more
regard than the overburden of rock at the mine. The survivors of this disaster con-
tinue to be exposed, continue to be at risk for worsening disease, and continue to
worry about how they will pay for their health care needs. It is not a matter of wait-
ing a few years for the affected people to die off and for the problem to go away.
It is a matter of waiting another 20 years to see if their grandchildrens health is
affected. We already know the children and grandchildren have been affected emo-
tionally, socially and monetarily.
What does Libby need? The need for Libby is research for treatments, for health
insurance that will be available for the length of the disease process, and the facility
to monitor progression of this disaster for the next twenty years.
I wish to take the opportunity to thank our Montana delegation for all that has
been done for the community of Libby. I especially want to thank Senator Baucus
for all his attention and efforts in our community.
Thank you.
93
STATEMENT OF BRAD BLACK, M.D., LINCOLN COUNTY HEALTH OFFICER, LIBBY,
MONTANA, MEDICAL DIRECTOR OF CENTER FOR ASBESTOS-RELATED DISEASE
Good morning Chairperson Boxer, committee members, and our Montana Senator
Max Baucus. As a physician and community member of Libby, Montana for 25
years, I could orate a lengthy story, but with 5-minute time constraints, I would like
to tell a brief background story and then emphasize 3 important points as they re-
late to the Libby asbestos exposure.
I became aware of the occurrence of ARD in workers in 19771978-my first year
in Libby. In 1978, my medical practice partner, the late Dr. Richard Irons, had en-
gaged in conversations with WR Grace management pertaining to his desire to work
with them to reduce health risk for asbestos exposure to Zonolite workers, their
family members of the community. Unfortunately his concerns were not acknowl-
edged. Nor were the EPAs concerns regarding the 1980 assessment of vermiculite-
associated asbestos acknowledged. In 1999, a Seattle PI article depicted a broad
scale asbestos exposure in Libby. As Lincoln County Health officer, my first re-
sponse was disbelief that any widespread environmental exposure could cause lung
disease. Subsequently, the past several years have been a painful and humbling
educational process for myself. During the past few years I have seen numerous
community workers whose lives have been significantly impacted by asbestos-re-
lated disease. Several friends have developed lung disease and have lost over one-
half of their lung function. From this experience, I would like to share with you the
three important observations.
(1) The Libby exposure was extensive. The ATSDR has conservatively and effi-
ciently screened for ARD. As Medical Director of CARD in Libby, we have followed
up a large number with abnormal screens and evaluations. I have recently done
analysis of our patient population and found the ATSDRs observations to be very
accurate. Somewhere between 1,300 to 1,400 individuals are very likely to have as-
bestos-related abnormalities. This does not include the ATSDRs screening in 2001,
which could add another 200300 individuals.
(2) The ARD related to Libby asbestos has appeared different then that related
to commercial asbestos called chrysotile. Experience has shown it to have a higher
rate of causing progressive lung disease. Dr. Alan Whitehouse has studied a group
of Libby patients and observed a progression of disease in 70 percent of diagnosed
patients. Some patients develop a rapidly progressive lung disease (note included
case report). Nonoccupationally exposed individuals have developed lung disease
that is more severe than WR Grace employees of >15 yrs. work.
(3) The incidence of malignant mesothelioma is exceedingly high. This type of
tumor involves the lining of the chest or abdominal cavities. This invasive cancer
eats into the chest wall and spinal column causing severe pain and is uniformly
fatal. It has a high causal relationship to asbestos exposures and is termed the sen-
tinel tumor of asbestos exposure. The occurrence of this tumor is 1 in 1 million in
the general population. In Libby we are experiencing 100 times this expected inci-
dence. Twenty-three mesotheliomas have occurred as a result of Libby asbestos ex-
posure, with six having resulted from non-occupational exposure. Since I had sub-
mitted testimony for this hearing in April, two more individuals have been diag-
nosed. Their exposure history was living in Libby, one working as a forest service
administrator and the other as a school health nurse. Another lady with the tumor
was exposed simply working in a professional office where Zonolite workers at-
tended appointments in dusty work clothing. Mesotheliomas can occur with rel-
atively low asbestos exposure.
Few investigators have studied or observed the health effects of Libby asbestos.
In addition to Dr. Alan Whitehouse (Board-certified chest physician, Spokane, WA)
whom I mentioned, Dr. Corbett McDonald (McGill University) has familiarity.
At the request of WR Grace, Dr. McDonald studied a group of Zonolite workers
in 1986. Subsequently, he has done a followup of this group and noted these
vermiculite workers suffered severely from malignant and non malignant res-
piratory disease. Death from mesothelioma was 10 times higher than commercial
(chrysotile) asbestos miners in Quebec. He concludes that study of workers exposure
to Libby tremolite is important in that it is the only study that quantifies the risk
of exposure to tremolite-like asbestos in the absence of any other fiber types.
In closing, I want to express my concern pertaining to how we will be able to meet
the asbestos-related health care needs we are sure to face over the next 2030
years. WR Grace has been providing funding for the CARD Clinic and an insurance
program. However, their commitment to caring for affected individuals is waning
and suggests that their support is short-lived. The need for research and developing
therapies is high priority.
94
Additional concerns extend beyond Libby to: (1) exposures from WR Grace export
plants all around the US (2) areas of California where release into the environment
of naturally occurring tremolite is a result of large-scale construction activities.
I thank the Superfund subcommittee for allowing us this opportunity, and our
Montana delegation for their support, and special thanks to Max with his persever-
ance in advocating for Montanans.
STATEMENT OF JOHN KONZEN, COUNTY COMMISSIONER FOR LINCOLN COUNTY

My name is John Konzen. I am from Troy, Montana and serve as County Com-
missioner for Lincoln County. You have already heard about Libby, a community
I serve both as an elected County Commissioner and as a member of the Board of
Directors for St. Johns Lutheran Hospital in Libby.
Lincoln County is no stranger to the Federal family. Floods and forest fires dis-
patch Federal agencies to us regularly. Our county shares the Canadian border and
a reservoir that straddles the international boundary, feeding the Columbia River
Basin. There are endangered species and every other natural resource issue you can
imagine. We struggle with double-digit poverty and unemployment rates. On an av-
erage day, its fair to say we are a county with a lot on our plate.
Before I became a commissioner I served as a teacher and a school administrator
for many years. I witnessed first hand the effects down cycles have on resource-
based communities like the ones I serve today. I can tell you first hand how families
are affected when mills close or mines shutdown.
Most of you would have probably never heard about Libby or Lincoln County if
it werent for tremolite asbestos and a mine operated by W.R. Grace.
There was a time when the W. R. Grace Mine was a good thing in our community.
It meant jobs and goodpaying ones. Men went to work every day to earn a living
for their families. They didnt step away from their responsibility. And I bet a lot
of them would have gone to work every day even if they had known of the risk they
were taking on for themselves. Thats what husbands and fathers do.
But none of those men would have ever put their familiestheir wives, children
or grandchildrenin harms way. Never. Not a single one of us in this room would
have done that. But as you have already heard, Grace allowed all of that to occur.
There is an old saying that goes: Many hands make light work. When Grace
stepped away from their responsibility, they allowed the miners and the wives and
children of those men, to do all the heavy lifting, and to take on the risks Grace
was unwilling to shoulder.
And as Grace continues to step away from even the small portion of responsibility
they willingly accepted to help our community cover prescription drug, home health
care and other medical costs, they are breaking us. Our tiny communitys medical
resources are already stretched too thin.
But it isnt just our community alone which concerns me and the other Mon-
tanans who have traveled here today to speak with you. As Grace increases the dis-
tance between the rightful portion of responsibility they must bear, they further
harm the State of Montana.
As Senator Baucus is well aware, people are our most precious resource in Mon-
tana. As I travel across Montana for regular meetings with other county commis-
sioners in our state, commissioners tell me they too are concerned about the far-
reaching impact of Graces lack of responsibility. Many fear Graces recent decision
to no longer help with medical expenses of folks who had qualified for their own
medical plan, has the potential to bankrupt our own state Medicaid program.
We appreciate the help the Federal family has extended to northwest Montana.
We dont know where we would be without the help the Department of Health and
Human Services, the Environmental Protection Agency, the Agency for Toxic Sub-
stance Disease Registry and Congress have provided us. Everyone is doing
heavylifting. Everyone it seems, but Grace.
I am here to thank Congressand hard-working folks across the country for sup-
porting our community. You have all done your part and we cant begin to thank
you enough But I would also like to add that W.R. Grace still has a place at our
table. We need them to do their part too.
As Grace makes its way through Federal bankruptcy court there are several
things I would ask this committee and those present to consider to set aside a sepa-
rate trust fund, established by Grace to cover the short-term prescription drug and
home-health needs of folks in Libby who are struggling with asbestos-related dis-
ease. I would also ask you to consider establishing a trust fund for longer-term
health care needs. I appreciate the questions that have been raised about long term
funding for cleanup and the statutory authority for removing insulation in homes
95
in Libby. Good health is all any of us can ask for. A clean bill of health is the most
profound mark our Federal friends will leave upon our community.
I appreciate your time and on behalf of Lincoln County, I thank you for this op-
portunity.

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Senate Hearing, 107TH Congress - Asbestos Cleanup in Libby, MT

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S. HRG.

ASBESTOS CLEANUP IN LIBBY, MT

SUBCOMMITTEE ON SUPERFUND, TOXICS, RISK,

COMMITTEE ON ENVIRONMENT AND

TO ASSESS ASBESTOS REMEDIATION ACTIVITIES AND EVALUATE HOME

JUNE 20, 2002

For sale by the Superintendent of Documents, U.S. Government Printing Office

ONE HUNDRED SEVENTH CONGRESS

KEN CONNOLLY, Majority Staff Director

SUBCOMMITTEE ON SUPERFUND, TOXICS, RISK AND WASTE MANAGEMENT

JUNE 20, 2002

THURSDAY, JUNE 20, 2002

OPENING STATEMENT OF HON. MAX BAUCUS, U.S. SENATOR

sis, as hundreds upon hundreds of folks will need expensive long-

At many plants where vermiculite from Libby was processed,

bestos, as EPA originally promised in its response to the Inspector

STATEMENT OF MARIANNE HORINKO, ASSISTANT ADMINIS-

the community of Libby is protected through the cleanup of asbes-

Environmental Protection Agency. Federal regulations define as-

acteristics affecting toxicity of both manufactured and naturally oc-

mans from asbestos-contaminated vermiculite that was mined in

I am particularly concerned about the other sites throughout the

Senator MURRAY. Dr. Wagner, in your testimony you said that

Senator BAUCUS. You are right, Senator. In fact, sometimes lis-

STATEMENT OF PAT COHAN, COORDINATOR, CLINIC FOR

to come to the surface, does not make it any less of a disaster. It

I have been a physician in Libby for 25 years. I served as the

bodyvery pain-sensitive. It is an extremely painful and miserable

tion activities. Those are concern areas because we do not want

STATEMENT OF JOHN KONZEN, LINCOLN COUNTY

the end of the summer, and we plan on continuing on to any home-

But nevertheless, there is this perception in Libby that maybe

Senator BAUCUS. I appreciate that.

Senator BAUCUS. OK, before we move onto other subjects, does

judgment, and what more do we have yet to do? I suppose a lot of

comes a pretty regular question, I think, wouldnt you agree, Pat,

So we have been trying to meet the needs in that way of people

So we need desperately to get that bill of health stamped on

So I think this research is absolutely essential. I am going on

We did it in a storefront clinic that I had operated, and I think

resources? Or do we still need more research to find out what the

ic? We are seeing really negative directions there. We have uncer-

things that insurance companies generally do not do, to assess

Does anybody want to add anything? Has anybody said anything

STATEMENT OF HON. DENNY REHBERG, U.S. REPRESENTATIVE FROM THE

Libby is a small town of about 2,600 residents in northwest Montana. Approxi-

In November 1999, ATSDR and the PHS undertook medical investigations in

EPA initiated a Superfund emergency investigation and cleanup actions in Libby.

STATEMENT OF GREGORY WAGNER, M.D., DIRECTOR, DIVISION OF RESPIRATORY DIS-

Asbestos is a term that is generally used to refer to a group of fibrous minerals

Exposure to asbestos significantly increases the risk of contracting several dis-

In 1990 testimony before OSHA, NIOSH broadened its science-based definition of

In June 1980, OSHA asked NIOSH to provide technical assistance to investigate

At present, NIOSH is following up on potential exposures of workers who use or

Additional research possibilities that NIOSH is considering include efforts to bet-

STATEMENT OF HENRY FALK, M.D., M.P.H., ASSISTANT ADMINISTRATOR, AGENCY FOR

Processing of vermiculite ore shipped from Libby has occurred at approximately

STATEMENT OF MICHAEL R. SPENCE, M.D., CHIEF MEDICAL OFFICER, MONTANA