Environmental Public Health Disaster: Community Based Participatory Research Results in Successful Response

Decades of vermiculite mining in the northwest corner of Montana resulted in widespread, multigenerational, occupational and environmental exposure to Libby Amphibole Asbestos (LAA). Called “the worst environmental disaster” in U.S. history, exposure to LAA has resulted in 385+ deaths and 1,000s with asbestos related diseases [ARD]).  The EPA designated Libby a Superfund site in 2002 and declared a public health emergency (PHE) in 2009, the only PHE ever declared under Superfund law. The Center for Asbestos Related Disease (CARD) was established as a non-profit community based organization (governed by a volunteer board of community members) to address the public health needs. In 2003, CARD invited academic institutions and agency partners to engage in research to explore the unique properties of LAA, asbestos related disease presentation and trajectory. CARD successfully used community based participatory research (CBPR) with over a dozen academic and agency partners to: 1) create strong, cutting edge ARD and lung cancer screening programs, 2) conduct physical/behavioral health research, 3) develop national policy that entitles people with ARD (resulting from the Libby exposure) Medicare and a Pilot program, and 4) regularly engage local community members in activities to improve understanding of asbestos health issues and research goals and findings. The CBPR strategies (equal partnerships that collaborate in problem identification, proposal/program development, implementation and delivery of outcomes) utilized by CARD and its partners may serve as a model for other rural communities living near contaminated sites or facing public health disasters to address the public health needs of their communities.