Vermiculite Miners
| Cost / Value | Range | Notes |
|---|---|---|
| First-year cost | $150,000–$1,000,000+ | Total typical first-year billed cost of mesothelioma treatment |
| Immunotherapy / year | $150,000–$200,000 | Annual cost of FDA-approved immunotherapy (nivolumab + ipilimumab, CheckMate 743 regimen) |
| Surgery (P/D) | $30,000–$100,000+ | Pleurectomy/Decortication (P/D) procedural cost |
| Chemotherapy course | $10,000–$30,000 per cycle | Standard cisplatin/pemetrexed course (4–6 cycles) |
| Average mesothelioma settlement | $1,000,000–$1,400,000 | Civil lawsuit settlement per Mealey's industry benchmark |
| WRG PI Trust mesothelioma payout | ~$57,190 | W.R. Grace Asbestos Personal Injury Trust at 30.1% payment percentage |
Vermiculite Miners and Asbestos Exposure
Vermiculite miners employed at the W.R. Grace & Co. operation in Libby, Montana between the early 1920s and 1990 faced one of the most extreme occupational asbestos exposures ever documented in U.S. industry. The ore deposit at Vermiculite Mountain was naturally contaminated with a mixture of amphibole asbestos minerals — collectively classified by the U.S. Environmental Protection Agency (EPA) as Libby Amphibole Asbestos (LAA) — at concentrations reaching 26% of the raw ore before milling. Peer-reviewed mortality data document 694 asbestos-related deaths among Libby County Division residents between 1979 and 2011, with worker-specific cohort studies showing a standardized mortality ratio (SMR) of 165.8 for asbestosis and 15.1 for mesothelioma. Former vermiculite miners and their families may file claims under the W.R. Grace Asbestos Personal Injury Trust (WRG PI Trust), qualify for federal benefits programs including the Libby Care provision (CARD Act), and pursue compensation through state-court litigation. For the full Libby community-disaster narrative and post-1990 cleanup history, see Asbestos_Miners; this page focuses on worker exposure and compensation.
What Made Vermiculite Mining Uniquely Dangerous?
Vermiculite is a hydrated laminar silicate mineral in the mica group that expands 10–15 times its original volume when heated, making it commercially valuable for insulation, fireproofing, and soil conditioning. The Libby deposit was unique among commercial vermiculite sources because it was co-located with a tremolite-rich amphibole asbestos formation. Microscopic mineralogical analysis identified the asbestos fibers shipped from Libby as a mixture of winchite (~84%), richterite (~11%), and tremolite (~6%) — three closely related amphibole minerals distinguished primarily by iron content rather than disease-relevant properties.[1]
Two features made LAA particularly hazardous to mine workers:
- Regulatory blind spot. Winchite and richterite — comprising 95% of the LAA mixture — are not individually named in the six commercial asbestos types specified in federal Occupational Safety and Health Administration (OSHA) regulations. Federal asbestos rules historically focused on chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite. Until the EPA designated LAA as a distinct toxicological entity in its risk assessment framework, the workers' actual fiber exposure was technically "unregulated" by name even when concentrations exceeded permissible exposure limits.[2]
- Biopersistence. Amphibole fibers are rod-like and biopersistent. They resist dissolution in lung tissue far longer than chrysotile (serpentine asbestos), giving them more time to cause inflammation, scarring (asbestosis), pleural disease, and eventually mesothelioma. The Libby cohort SMR of 165.8 for asbestosis — meaning workers died of asbestosis at 165 times the rate of the general U.S. population — reflects this biopersistence.[3]
The W.R. Grace Libby, Montana Operation
The Zonolite Company began mining vermiculite at the Libby site in the 1920s. W.R. Grace & Co. acquired Zonolite — including the mine, processing facilities, and the Zonolite trade name — in 1963 and operated the mine until 1990. During peak production years, the Libby operation supplied approximately 80% of the world's vermiculite. Concentrate shipped from Libby went to roughly 240–300 processing (exfoliation) plants across the United States and internationally, where it was further refined into insulation, gypsum board, soil amendments, and a fireproofing product called Monokote.[4][5]
Internal corporate documents and federal indictment evidence later established that W.R. Grace was aware of the asbestos hazard from the earliest years of its ownership:[6][7]
- 1963: Grace observed negative health effects in miners soon after the acquisition and knew the vermiculite contained asbestos.
- 1975–1976: Grace's own industrial hygienist documented environmental asbestos in Libby air at 1.0–1.5 fibers/mL, exceeding contemporaneous OSHA limits.
- 1977: Grace internally drafted a press release announcing the discontinuation of Zonolite insulation due to health hazards, then never released it and continued selling Zonolite until 1984.
- Monokote deception: Internal meetings documented Grace's decision not to disclose asbestos contamination in reformulated Monokote; workers were told the product was asbestos-free and stopped wearing respirators.
The federal criminal trial — described as "the biggest criminal environmental prosecution in U.S. history" — ran for 11 weeks in Missoula, Montana, beginning February 2009. On May 8, 2009, the jury acquitted W.R. Grace and the remaining executive defendants on all counts after less than two days of deliberation. The acquittal does not affect the company's civil liability, its Superfund obligations, or the W.R. Grace asbestos compensation trusts established under its 2014 bankruptcy reorganization plan.[7] Grace agreed in 2008 to pay $250 million to the federal government for environmental cleanup — the largest Superfund settlement at that time.[8] W.R. Grace filed for Chapter 11 bankruptcy in April 2001; its reorganization plan became final on February 3, 2014, establishing both the WRG Asbestos Personal Injury Trust and the Zonolite Attic Insulation (ZAI) Trust.[9]
Exposure Pathways for Vermiculite Mine Workers
Vermiculite miners encountered LAA fibers across every phase of the operation. Job categories with the heaviest documented exposure include:
| Job Category | Exposure Mechanism | Typical Fiber Concentration |
|---|---|---|
| Pit miners (drillers, loaders, blasters) | Direct contact with ore containing up to 26% amphibole minerals before milling | Highest at the source |
| Mill workers (crushing, screening, dry-milling) | Airborne fiber release during ore processing and screening | Documented above 1.0–1.5 fibers/mL in 1975–1976 internal monitoring |
| Exfoliation plant workers | Heating vermiculite ore to expand it; high-temperature processing released LAA-containing dust | Variable; chronic exposure documented across 240–300 U.S. sites |
| Bag house and packaging workers | Manual handling, weighing, and bagging of finished vermiculite concentrate | High in confined spaces |
| Truck drivers and rail loaders | Transferring vermiculite to railcars, trucks, and barges | Lower mean concentration, episodic peaks |
| Maintenance workers | Cleaning, repairing, and modifying dust-collection systems | High during equipment service |
A NIOSH cohort mortality study of 1,672 Libby workers tracked through 2001 confirmed that the heaviest-exposed mine and mill positions carried the steepest disease risk. The study reported the following standardized mortality ratios (SMRs):[3][10]
| Cause of Death | SMR | 95% Confidence Interval (CI) |
|---|---|---|
| Asbestosis | 165.8 | 103.9–251.1 |
| Cancer of the pleura | 23.3 | 6.3–59.5 |
| Mesothelioma | 15.1 | 1.8–54.4 |
| Lung cancer | 1.7 | 1.4–2.1 |
A SMR of 165.8 for asbestosis means Libby workers died of asbestosis at roughly 165 times the rate predicted from the general U.S. population — among the highest occupational SMR values ever published. The mesothelioma SMR of 15.1 understates the long-term burden because the cohort's latency window had not fully matured when the analysis was conducted.
Take-home exposure. Vermiculite miners also carried LAA dust home on work clothes, in hair, and on skin, exposing spouses and children to the same fiber mixture in the household. ATSDR community-screening data from 2000–2001 documented radiographic pleural abnormalities in 17.8% of 6,668 participants, with 6.7% of residents reporting no known occupational or familial exposure still showing radiographic evidence of asbestos-related disease. See take-home asbestos exposure for the broader pattern.[11]
Health Outcomes Among Libby Workers
The disease spectrum among Libby vermiculite workers includes the full range of asbestos-related conditions, expressed at exceptional rates:
- Mesothelioma: The signature cancer of amphibole asbestos exposure. Both pleural and peritoneal forms are documented in the Libby cohort. Latency from first exposure to diagnosis typically spans 20–50 years.
- Asbestosis: Diffuse interstitial pulmonary fibrosis caused by inhaled fibers. The Libby cohort SMR of 165.8 is among the highest reported for any occupational group.
- Pleural plaques and pleural thickening: Calcified or fibrotic deposits on the lung lining. Pleural disease is detected on chest imaging in 17.8% of screened Libby residents — far above background prevalence.
- Lung cancer: Worker SMR of 1.7 (statistically significant). Smoking and asbestos act synergistically in lung cancer causation.
- Autoimmune disease: An unusual cluster of autoimmune conditions has been observed in Libby. ATSDR screening reported 6.9% of participants with an autoimmune diagnosis, compared with less than 1% expected nationally.[11]
The Center for Asbestos Related Disease (CARD), which opened in 2000 to provide clinical care and free screening to anyone who lived, worked, or recreated in Lincoln County, Montana for at least six months at least ten years prior, has certified more than 3,400 people with asbestos-related diseases. CARD has received over $20 million in cumulative federal funding, including a 2024 grant to continue operations through at least 2029. CARD's screening and certification is the gateway for several federal benefits described below.[12]
Community and Secondary Exposure (Brief)
For the complete community-exposure narrative — including the EPA's June 17, 2009 declaration of the only Public Health Emergency ever issued under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), the $600M+ Superfund cleanup of more than 2,600 buildings and 7,600 inspections, the eight operable units (OUs) of the Libby Asbestos Superfund Site, and the nationwide Zonolite Attic Insulation hazard (estimated 35 million homes) — see Asbestos_Miners and Zonolite Attic Insulation Trust.
Workers should understand that take-home exposure means spouses and children of vermiculite miners may also qualify for the same federal benefits and trust-fund claims described on this page. CARD screening eligibility extends to family members.[13][12]
The CARD Act and Federal Benefits
The federal response to the Libby disaster created a unique benefits framework not available to most asbestos-exposed workers. Two programs in particular are relevant to former Libby vermiculite miners and their families:
Libby Care (CARD Act Medicare Eligibility)
The Patient Protection and Affordable Care Act of 2010, in Section 1881A, established a Medicare pilot program for individuals exposed to environmental health hazards declared under CERCLA — known informally as "Libby Care" or the CARD Act provision. Under this program:
- Anyone diagnosed with an asbestos-related condition by a CARD-certifying physician becomes eligible for Medicare regardless of age if they lived, worked, or were physically present in the affected area (Lincoln County, Montana) for at least six months prior to June 17, 2009, and have an asbestos-related health condition.
- Coverage includes inpatient and outpatient services, prescription drugs, and Pilot Program supplemental services (transportation, lodging for off-site care, and other ancillary services).
- The Libby Care population is enrolled directly through CARD and the Centers for Medicare & Medicaid Services (CMS) — separate from the standard Medicare age-65 eligibility process.[12]
Other Federal Benefits
- Social Security Disability Insurance (SSDI): Workers diagnosed with mesothelioma typically qualify for expedited Compassionate Allowance review. Mesothelioma is on the Social Security Administration's Compassionate Allowance list, shortening the typical multi-month decision timeline.
- Department of Veterans Affairs (VA) compensation: Former Libby workers who also had qualifying military service-connected asbestos exposure (Navy, shipyard, construction battalion) can pursue VA disability separately. VA compensation does not offset civilian trust-fund or tort recoveries.
- Black Lung Benefits Act: Not applicable to vermiculite miners (the Black Lung program covers coal miners only). Vermiculite-specific cases proceed under the WRG PI Trust and civilian litigation.
Compensation: W.R. Grace PI Trust
The W.R. Grace Asbestos Personal Injury Trust was established under W.R. Grace's 2014 Chapter 11 reorganization plan to process personal injury claims from asbestos exposure related to Grace operations and products. Key trust mechanics:[14]
- Payment percentage: The trust currently pays at approximately 30.1% of scheduled values, a percentage adjusted periodically by the trustees based on claim volume and asset performance.
- Mesothelioma scheduled value: Approximately $190,000 (full scheduled value before payment percentage is applied).
- Average mesothelioma payout: ~$57,190 (30.1% of $190,000).
- Other scheduled diseases: Lung cancer, other cancers, asbestosis, and severe pleural disease each carry their own scheduled values; payment percentage applies uniformly.
- Eligibility: Claimants need a confirmed diagnosis from a qualified physician, medical records (chest imaging, pathology where applicable), and documentation of exposure to a W.R. Grace product or operation — including direct mine employment, work at any of the ~300 vermiculite processing plants that received Libby ore, contact with Zonolite insulation, contact with Monokote fireproofing, and take-home exposure from a household member who fell into any of those categories.
- Filing process: Claims are filed through Plaintext Trust Online or a similar trust portal (procedures change periodically; an experienced asbestos firm has the current filing kit).
- Records destruction warning: The W.R. Grace Trust announced plans in January 2025 to destroy claim records older than 10 years, with destruction beginning April 15, 2025 — making timely filing and document preservation essential. Claimants should retain copies of all submitted records independently.[14]
For a complete breakdown of trust mechanics, schedule values, and filing strategy, see W.R. Grace Trust Fund and asbestos trust funds.
Compensation: ZAI Property Trust
The Zonolite Attic Insulation (ZAI) Trust is a separate trust established under the same 2014 reorganization plan, but it addresses property damage from Zonolite insulation rather than personal injury. Mine workers themselves typically pursue the WRG PI Trust for disease-related compensation, but workers who also own a home with Zonolite insulation may file a separate ZAI claim. Key facts:
- Reimbursement: Up to 55% of eligible documented Zonolite abatement costs, with a per-claim maximum of approximately $5,250 (CPI-adjusted).
- Eligibility: Claimants must prove the insulation is Zonolite brand (visual identification plus contractor confirmation) and submit documented abatement expenses from a licensed contractor.
- Duration: The trust operates for a minimum of 20 years from 2014.
- Critical warning: Do-it-yourself removal disqualifies the claim and exposes the homeowner to severe airborne fiber risk. Professional licensed abatement is required.[9][15]
See asbestos trust funds for cross-trust filing strategy and trust fund filing guidance for a step-by-step overview.
Legal Options
Trust-fund filings and lawsuits are not mutually exclusive. Vermiculite mine workers often pursue several pathways concurrently:
- W.R. Grace Trust claim (primary). Direct compensation for personal injury or wrongful death from disease attributed to Grace operations or products.
- Lawsuits against other solvent asbestos defendants. Many Libby workers also handled equipment, gaskets, brake pads, insulation, or fireproofing manufactured by companies other than Grace. Each manufacturer carries its own legal liability and, where solvent, can be sued. Where bankrupt, the manufacturer's Section 524(g) trust handles the claim.
- Babcock & Wilcox Asbestos Trust and similar trusts. Workers in mining-adjacent occupations (boilermakers, pipefitters, steel-mill workers) who serviced equipment containing other manufacturers' asbestos products may file under multiple bankruptcy trusts.
- Premises-liability claims. Where exposure occurred at a worksite owned by an entity that survived bankruptcy, a state-court premises claim may be available.
- Wrongful-death actions. Spouses, children, and dependents of deceased Libby workers may pursue wrongful-death litigation in addition to trust claims.
The team at Danziger & De Llano has more than 30 years of experience building exposure histories from W.R. Grace employment records, NIOSH cohort documentation, CARD certification files, and union records. A free consultation is available at https://www.dandell.com/ or by phone at (855) 699-5441.[16]
Documenting Vermiculite Exposure for Claims
The strongest WRG PI Trust claims combine medical proof of disease with documented exposure history. Workers and families should gather:
- Employment records: Pay stubs, W-2 forms, union cards, retirement plan statements, and W.R. Grace or Zonolite Company personnel records confirming dates of mine, mill, or processing-plant employment.
- Job-specific records: Time cards, shift logs, foreman's reports, OSHA exposure-monitoring records, and any internal Grace industrial-hygiene documentation that has surfaced through litigation discovery.
- CARD certification: For Libby-area residents, a CARD-certified diagnosis from an approved physician strengthens both the trust claim and federal-benefits eligibility. CARD's contact details and screening eligibility criteria are maintained on its program website.
- Medical records: Chest CT or X-ray reports, pathology slides and tissue blocks where biopsy was performed, pulmonary function tests, and complete oncology records including treatment history.
- Household-exposure documentation: For family members claiming take-home exposure, evidence linking the household to a Libby-employed worker — marriage certificate, household residency dates, and documentation of the worker's job category.
- Witness statements: Co-worker affidavits confirming the claimant's job duties, the specific Grace products handled, and on-site dust conditions.
See evidence preservation for general documentation strategy and corporate asbestos concealment for the broader pattern of withheld manufacturer knowledge.
Frequently Asked Questions
What is Libby Amphibole Asbestos and how is it different from regular asbestos?
Libby Amphibole Asbestos (LAA) is a naturally occurring fiber mixture consisting of approximately 84% winchite, 11% richterite, and 6% tremolite — three closely related amphibole minerals distinguished by iron content. Winchite and richterite are not individually named in the six commercial asbestos types regulated by federal Occupational Safety and Health Administration (OSHA) rules, which historically focused on chrysotile and five other amphibole types (crocidolite, amosite, tremolite, actinolite, anthophyllite). EPA later classified LAA as a distinct toxicological entity in its risk assessment framework. Biologically, LAA causes the same spectrum of asbestos-related disease as other amphibole asbestos — at exceptionally high rates given the cumulative Libby exposures.[1][2]
Do family members of vermiculite miners qualify for compensation?
Yes. Take-home (secondary) asbestos exposure from vermiculite miners is a well-documented pathway. Spouses, children, and other household members who developed mesothelioma, asbestosis, or other asbestos-related disease as a result of the worker's clothes, hair, or skin transferring LAA fibers into the home are eligible to file W.R. Grace Personal Injury Trust claims in their own right. Wrongful-death claims are available where the affected family member is deceased. CARD screening eligibility extends to family members of Libby workers.[12][11]
Does EEOICPA cover Libby vermiculite workers?
The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) covers workers at Department of Energy nuclear weapons facilities. The Libby vermiculite mine was not a DOE site, so EEOICPA does not apply directly to vermiculite-only exposure. However, former Libby workers who later worked at a covered DOE site may have separate EEOICPA claims for that subsequent exposure. The primary federal benefit for Libby-exposed workers is Medicare eligibility via the Libby Care provision of the Affordable Care Act (Section 1881A), accessed through CARD certification.
How long is the latency between vermiculite exposure and mesothelioma diagnosis?
Latency for amphibole-related mesothelioma typically ranges from 20 to 50 years between first exposure and diagnosis. The Libby cohort confirms this latency window: workers exposed during W.R. Grace's 1963–1990 ownership are now in the peak diagnosis age range. New Libby-related mesothelioma cases continue to emerge in the 2020s from exposures that occurred 30–40 years ago. Latency means a present-day diagnosis is fully consistent with mine, mill, or take-home exposure from the W.R. Grace era.[17]
What is the average payout from the W.R. Grace Personal Injury Trust?
The W.R. Grace Asbestos Personal Injury Trust pays mesothelioma claims at approximately $57,190 on average — the trust's $190,000 scheduled mesothelioma value multiplied by the current 30.1% payment percentage. Payment percentages adjust periodically based on claim volume and trust assets. Mesothelioma claimants frequently combine the W.R. Grace Trust payout with claims against other bankrupt manufacturers' trusts and lawsuits against solvent defendants, raising total recovery substantially above the WRG figure alone.[14]
Why didn't W.R. Grace get criminally convicted for Libby?
The federal criminal trial — United States v. W.R. Grace et al. — ended on May 8, 2009 with the jury acquitting Grace and the remaining executive defendants on all counts after an 11-week trial. The acquittal was significantly influenced by the trial judge's mid-trial limitations on certain prosecution evidence and an instruction to view a key government witness with "great skepticism" after a previously undisclosed close relationship with prosecutors came to light. The acquittal does not affect W.R. Grace's civil liability, its $250 million Superfund obligation, or the asbestos trust funds it established in its 2014 bankruptcy reorganization plan. Workers and families retain full rights to file civilian compensation claims.[7]
Where do I start if I or a family member was a vermiculite miner?
Three concurrent steps:
- Obtain a CARD certification (or a qualifying diagnosis from any qualified physician if you are outside Lincoln County, Montana).
- Gather employment records, household exposure documentation, and medical records as listed in the "Documenting Vermiculite Exposure" section above.
- Contact an experienced asbestos firm such as Danziger & De Llano (https://www.dandell.com/, (855) 699-5441) for a free consultation on WRG Trust filing and parallel solvent-defendant litigation strategy.
Related Pages
- Mining_and_Extraction_Workers — parent hub covering all mining occupational categories.
- Asbestos_Miners — sibling page covering the full Libby community-disaster narrative.
- W.R. Grace Asbestos Personal Injury Trust — detailed trust mechanics.
- Babcock & Wilcox Asbestos Trust — related trust for mining-adjacent occupations.
- Take-Home Asbestos Exposure — household exposure pathways for family members.
- Asbestos Trust Funds — full active-trust directory.
- Trust Fund Filing Guidance — step-by-step filing process.
- Evidence Preservation — exposure-history documentation strategy.
- Corporate Asbestos Concealment — pattern of withheld manufacturer knowledge.
External Links
- EPA Superfund: Libby Asbestos Site — Official EPA cleanup progress and community updates.
- ATSDR Libby Asbestos Site — Public health assessments and exposure studies.
- Lincoln County Asbestos Resource Program (LCARP) — Local government program coordinating cleanup, health resources, and resident assistance.
References
- ↑ 1.0 1.1 Meeker GP et al. (2003), American Mineralogist. Identifies Libby amphibole composition as winchite (84%), richterite (11%), tremolite (6%).
- ↑ 2.0 2.1 Exposure to Asbestos-Containing Vermiculite from Libby, Montana — Summary Report, ATSDR (2024). Summarizes mortality review and standardized mortality ratios.
- ↑ 3.0 3.1 Sullivan PA. Vermiculite, respiratory disease, and asbestos exposure in Libby, Montana: update of a cohort mortality study. Environmental Health Perspectives. 2007;115(4):579-585. PMID 17450227. PubMed
- ↑ Public Health Assessment: Libby Asbestos NPL Site, ATSDR (May 2003). Documents mine production history and public health findings.
- ↑ Asbestos Contamination: Past, Present, Future — Congressional Hearing, Government Publishing Office. Documents 240+ EPA-identified processing locations.
- ↑ U.S. v. W.R. Grace et al. — Federal Indictment, EWG document repository. Documents Zonolite Company history and 1963 W.R. Grace acquisition.
- ↑ 7.0 7.1 7.2 Jury Acquits W.R. Grace and Former Execs in Landmark Criminal Asbestos Case, ABA Journal (May 8, 2009). Documents acquittal on all counts after 11-week trial.
- ↑ W.R. Grace Settles Cleanup Case With U.S. for $250 Million, The New York Times (March 12, 2008). Documents 2008 Superfund settlement.
- ↑ 9.0 9.1 Zonolite Attic Insulation Trust, official trust website. Documents trust mechanics, reimbursement structure, and eligibility criteria.
- ↑ Vermiculite, Respiratory Disease, and Asbestos Exposure in Libby, Montana — full text, Sullivan (2007). Open-access version of the worker cohort SMR analysis.
- ↑ 11.0 11.1 11.2 Follow-Up of the Libby, Montana Screening Cohort, PMC (2021). Peer-reviewed analysis of ATSDR screening program results including 17.8% pleural abnormality rate and 6.9% autoimmune disease prevalence.
- ↑ 12.0 12.1 12.2 12.3 Center for Asbestos Related Disease (CARD), CARD program website. Documents 3,400+ certified asbestos-related disease cases, screening eligibility, and Libby Care Medicare access.
- ↑ EPA Announces Public Health Emergency in Libby, Montana, U.S. EPA (June 17, 2009). First-ever Public Health Emergency declaration under CERCLA.
- ↑ 14.0 14.1 14.2 Mesothelioma Asbestos Trust Fund Payouts — Danziger & De Llano. Documents W.R. Grace Trust payment percentage (30.1%), mesothelioma scheduled value ($190,000), and 2025 records-destruction notice.
- ↑ Zonolite Attic Insulation Trust — FAQs, official trust website. Documents 55% reimbursement, ~$5,250 maximum, and 20-year duration.
- ↑ Libby Montana Asbestos Claims — Danziger & De Llano. Firm overview of Libby exposure litigation and trust filing.
- ↑ Mortality from asbestos-associated disease in Libby, Montana 1979–2011, Naik SL et al. (2016), Journal of Exposure Science and Environmental Epidemiology. Documents 694 asbestos-related deaths among Libby County Division residents over 33 years.