The Libby Community Childhood Health Investigation and Exposure Follow-Up Study (

描述（由申请人提供）：利比MT是一个服务不足的边境社区，从20世纪20年代到1990年开采和加工蛭石矿石。这种矿石被分发到美国各地的245个地点，成千上万的家庭将最终产品用于绝缘和园艺活动。Libby蛭石，又称Libby Amphibole（LA），含有石棉矿物，接触这种矿物会导致肺功能丧失、胸膜和间质性肺病以及呼吸道死亡。一项联邦调查清楚地表明，在利比以及迄今为止调查的所有其他28个地点长大的儿童有许多接触途径。这些途径包括环境空气污染以及住宅区附近的家庭、学校、游乐场和制造业垃圾场的污染。LA对孩子们很有吸引力，因为它的银火花和加热时弹出的能力。回顾性地在一名年仅9岁的儿童中发现了胸膜斑块。然而，几乎没有关于在利比和其他受污染社区长大的儿童的信息，这些儿童正在经历环境暴露。了解到婴儿出生时仅完成了20%的肺泡肺发育，并且清除机制不成熟，因此对儿童期暴露的担忧被放大。由于肺部的生长和发育一直持续到成年早期，儿童可能是最脆弱的群体。利比社区和许多其他受污染的城镇非常关心他们孩子的健康。哮喘相关疾病中心（CARD）自2000年联邦调查开始以来一直是一个以医疗和教育社区为基础的组织，为利比服务。CARD是这项研究的合作伙伴。研究的三个目的是：1）确定儿童期接触LA是否与肺部不良反应显著增加相关; 2）开发和利用综合环境暴露矩阵来描述儿童期暴露特征; 3）开发、实施和评估定义明确的互惠推广和沟通计划。利比年轻的成年人现在有一个足够的潜伏期，可以测量对他们的肺发育的影响，并采取行动，以防止或减少发病率。这项研究的影响远远超过利比的边界，因为许多其他社区也受到污染。此外，这项研究是广泛污染导致长期接触并可能对儿童肺部发育产生直接不利影响的最明显例子之一。 公共卫生相关性：Libby MT是由于开采和研磨含有石棉矿物的蛭石而受到广泛污染的许多社区之一。利比的孩子们记录了由于他们的家园、学校和游乐场受到污染而造成的慢性接触。他们是一个特别脆弱的群体，因为他们的肺在出生时还不成熟，并继续发育，直到成年。该项目将与利比社区的砷相关疾病中心合作，以更好地了解该社区和其他受污染社区对儿童健康的影响。

DESCRIPTION (provided by applicant): Libby MT is an underserved frontier community where vermiculite ore was mined and processed from the 1920s until 1990. This ore was distributed to 245 sites throughout the U.S. and tens of thousands of households used the end-product for insulation and horticulture activities. The Libby vermiculite, referred to as Libby Amphibole (LA), contains asbestos minerals and exposure is associated with pulmonary function loss, pleural and interstitial lung diseases and respiratory mortality. A federal investigation clearly demonstrated that children growing up in Libby as well as all 28 other sites thus far investigated, had numerous pathways of exposure. These pathways included ambient air pollution as well as contamination of homes, schools, playgrounds and manufacturing dump sites near residential areas. LA is attractive to children because of its silver sparkles and ability to pop when heated. Pleural plaques were retrospectively identified in a child as young as nine. Almost no information is available, however, on the children who grew up Libby and other contaminated communities who had on-going childhood environmental exposures. Concern about childhood exposures is amplified by understanding that at birth, infants have completed only 20% of alveolar lung development and have immature clearance mechanisms. As lung growth and development continues until early adulthood, children are likely the most vulnerable group. The Libby community and numerous other contaminated towns are very concerned about their children's health. The Center for Asbestos Related Disease (CARD) has been a medical and educational community based organization serving Libby since 2000 when federal investigations began. CARD is a partner on this study. The three study aims are 1) determine if childhood exposure to LA is associated with a significant increase in adverse pulmonary effects, 2) develop and utilize a comprehensive environmental exposure matrix to characterize childhood exposures and 3) develop, implement and evaluate a well-defined reciprocal outreach and communication program. The Libby young adults have now had a sufficient latency period where effects on their lung development can be measured and actions to prevent or decrease morbidity taken. The impact of this study far exceeds the boundary of Libby, as many other communities also have been contaminated. Further, this study represents one of the clearest examples of widespread contamination resulting in chronic exposure and likely direct adverse impact on the developing lungs of children. PUBLIC HEALTH RELEVANCE: Libby MT is one of many communities with widespread contamination due to mining and milling operations of vermiculite containing asbestos minerals. Children of Libby have had documented chronic exposure due to contamination of their homes, schools and playgrounds. They are a particularly vulnerable population as their lungs are immature at birth and continue to develop until adulthood. This project will work in concert with the Center for Asbestos Related Disease in the Libby community to better understand the health effects on children in that and other contaminated communities.