• Theodore C Larson, Vinicius C Antao, Frank J Bove, and Caroline Cusack.
• Division of Health Studies, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia 30341, USA. thl3@cdc.gov
• J. Occup. Environ. Med. 2012 Jan 1;54(1):56-63.

ObjectiveTo examine the association between cumulative fiber exposure and health outcomes in workers (n = 336) with Libby amphibole exposure.MethodsExposure-response relationships were explored by the use of logistic regression, with cumulative fiber exposure modeled in categories and as a continuous variable.ResultsThe use of spline functions with lifetime cumulative fiber exposure as a continuous variable showed that the odds of localized pleural thickening were significantly elevated at less than 1 f/cc-y. Odds of parenchymal abnormalities, restrictive spirometry, and chronic bronchitis were also significantly elevated at 108, 166, and 24 f/cc-y, respectively.ConclusionsThe odds of several pulmonary health outcomes are correlated with cumulative exposure to Libby amphibole. That relatively low-lifetime cumulative exposures are associated with localized pleural thickening has implications for the non-cancer-risk assessment for Libby amphibole.

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