LA Case Study: Severe Pleural Disease
Resulting from Low-Dose Childhood Environmental Exposure
Per American Thoracic Society standards, Asbestos Related Disease diagnosis is based on an occupational or environmental history of exposure with adequate latency, combined with structural evidence of disease, and having ruled out other plausible causes.
This patient lived in Troy, 16 miles from Libby, 1965-1984.
Dust that blew from trains loaded with vermiculite made RR tracks an area of significant exposure.
He rarely visited Libby. His home was 150 ft from the RR tracks where he loved to play as he was “fascinated by trains.”
Patient left Montana at 19 yo
No known chronic disease, no hx of chest trauma or surgery, nonsmoker.
Presents at 39yo:
Debilitating DOE, dry cough, recurrent pleural effusions with pleuradesis and development of severe left sided anterior chest pain.
Low levels of LA environmental exposure can be sufficient to cause significant disease.