A Case Study Exploring Research Communication and Engagement in a Rural Community Experiencing an Environmental Disaster

A Comparison of Environmental Concerns in Two Disparate Montana and Nevada Communities

Asbestos refers to six fibrous minerals that occur naturally in the environment in the United States and throughout the world. Deposits may be found in soil, rocks, and deposits of other minerals such as vermiculite and talc. These naturally occurring asbestos (NOA) minerals belong to the serpentine and amphibole family of minerals. This chapter reports shared components of community-driven environmental concerns related to exposure to NOA in a rural Montana and a suburban Nevada community. The specific aim is to establish an understanding of the community and community member's primary concern(s) related to NOA in both communities. The knowledge that NOA is commonly found in areas across the United States supports the need for additional research into the health effects of environmental exposure and best-practices to reduce exposure risk while allowing communities to thrive economically.

‘Come Back at Us’: Reflections on Researcher-Community Partnerships during a Post-Oil Spill Gulf Coast Resilience Study

This paper presents findings from eight post-hoc interviews with individuals representing the key community partner organizations that facilitated and hosted data collection for an in-person mixed-methods survey about disaster resilience and preparedness in three communities on the Gulf Coast (U.S.) impacted by the Deepwater Horizon oil spill and numerous disasters from natural hazards. We submit our analysis of these follow-up interviews with community partners as a case study to provide a set of recommendations for future community-engaged research practices, particularly in the field of environmental and disaster resilience. Input from community partners stressed the importance of engaging with local community brokers to enhance trust in research; researcher-partner communication; and researcher interaction with community residents that respects local knowledge and culture. The partners indicated that even communities that have often been the subjects of post-disaster studies are receptive to research participation, especially when the effects of disasters are long-term and ongoing. Recommendations include using research methodologies that are congruent with post-disaster community characteristics such as educational attainment; collaborating with community partners to disseminate research findings; and incorporating theories and practices that center critical reflection and consider power dynamics when working with communities that have experienced disaster and trauma.

Case series: rheumatological manifestations attributed to exposure to Libby Asbestiform Amphiboles

An increased risk for Systemic Autoimmune Diseases (SAID) has been reported in Libby, Montana, where extensive exposures to fibrous amphiboles occurred due to mining and use of asbestos-laden vermiculite. In addition, positive antinuclear autoantibody tests are associated with exposure to Libby Asbestiform Amphiboles (LAA) in both humans and mice. Among 6603 subjects who underwent health screening at the Center for Asbestos Related Diseases (CARD, Libby MT), 13.8% were diagnosed with an autoimmune disease, with prevalence values for the most common SAID being significantly higher than expected in the United States. Among the CARD screening population, serological and clinical profiles are diverse, representing symptoms and autoantibodies reflective of systemic lupus erythematosus (SLE), scleroderma, rheumatoid arthritis, and other rheumatic syndromes, including undifferentiated connective tissue disease (UCTD). Based upon screening of medical records by physicians with rheumatology expertise, the evolving nature of rheumatological disease in these patients is often atypical, with mixed diagnostic criteria and with a 1:1 male-to-female ratio. Through the Libby Epidemiology Research Program, cases were identified that illustrate clinical autoimmune outcomes with LAA exposure. Our goal was to better characterize SAID in Libby, MT in order to improve recognition of autoimmune outcomes associated with this exposure. In view of recent discoveries of widespread exposure to fibrous minerals in several areas of the U.S. and globally, it is critical to evaluate rheumatologic manifestations in other cohorts so that screening, surveillance, and diagnostic procedures are able to detect and recognize potential autoimmune outcomes of asbestos exposure.

ABBREVIATIONS

ANA, antinuclear autoantibody; ARD, Asbestos-Related Diseases; ATSDR, Agency for Toxic Substances & Disease Registry; CARD, Center for Asbestos Related Diseases; CCP, Cyclic citrullinated peptide antibody; CREST, limited cutaneous form of scleroderma; CT, computed tomography; DIP, Distal Interphalangeal Joint; DLCO, Diffusing Capacity of the Lung for CO₂; DMARD, Disease Modifying Anti-Rheumatic Drugs; ENA, Extractable Nuclear Antigen antibodies; FVC, Forced Vital Capacity; LAA, Libby Asbestiform Amphiboles; LERP, Libby Epidemiology Research Program; MCP, Metacarpal Phalangeal Joint; PIP, Proximal Interphalangeal Joint; PIP, rheumatoid arthritis; RV, Residual Volume; SAID, Systemic autoimmune diseases; SLE, systemic lupus erythematosus; SSc, Systemic Sclerosis; TLC, Total Lung Capacity.

Principal components analysis to identify influences on research communication and engagement during an environmental disaster

OBJECTIVES

To discern community attitudes towards research engagement in Libby, Montana, the only Superfund site for which a public health emergency has been declared.

STUDY DESIGN

Survey study of convenience samples of residents near the Libby, Montana Superfund site.

PARTICIPANTS

Residents of the Libby, Montana area were recruited from a local retail establishment (N=120, survey 1) or a community event (N=127, survey 2).

MEASURES

Two surveys were developed in consultation with a Community Advisory Panel.

RESULTS

Principal components of survey 1 showed four dimensions of community members' attitudes towards research engagement: (1) researcher communication and contributions to the community, (2) identity and affiliation of the researchers requesting participation, (3) potential personal barriers, including data confidentiality, painful or invasive procedures and effects on health insurance and (4) research benefits for the community, oneself or family. The score on the first factor was positively related to desire to participate in research (r=0.31, p=0.01). Scores on factors 2 and 3 were higher for those with diagnosis of asbestos-related disease (ARD) in the family (Cohen's d=0.41, 0.57). Survey 2 also found more positive attitudes towards research when a family member had ARD (Cohen's d=0.48).

CONCLUSIONS

Principal components analysis shows different dimensions of attitudes towards research engagement. The different dimensions are related to community members' desire to be invited to participate in research, awareness of past research in the community and having been screened or diagnosed with a health condition related to the Superfund contaminant.