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Center for Asbestos Related Disease In the northwest corner of Montana, in the rural community of Libby, the Center for Asbestos Related Disease ( CARD ) has emerged as a national center of excellence in addressing healthcare issues associated with Libby amphibole ( previously called tremolite ) asbestos. The CARD is a non-profit 501 ( c ) governed by a volunteer community board. CARD operates with the vision of Caring Pathways to Treatment. The CARD is devoted to healthcare, outreach, and research to benefit all people impacted by exposure to Libby amphibole asbestos.Through the clinic, CARD fulfills its' primary mission of providing specialty holistic care for the varied diseases associated with Libby amphibole asbestos. In addition, CARD collaborates with many clinical and basic science researchers acting as the gateway by facilitating research activities in the Libby community. CARD's goal is to stimulate research from around the country to: gain further understanding of disease mechanisms, improve early disease and cancer detection and intervention, and develop effective health management strategies in hope of finding answers to improve health outcomes for individuals and communities.The asbestos related diseases associated with Libby amphibole asbestos has been observed to follow a different pattern than typically observed with commercial asbestos exposure, commonly known as chrysotile asbestos. The scarring of the lung tissue and its lining ( called the pleura ) appears the same, however, the predominate scarring that develops on chest x-ray involves the pleura with scarring in the lung tissue absent or less noticeable. Libby Community Asbestos Screening Program carried out in 2000-2001 by the Agency for Toxic Substances and Disease Registry ( ATSDR ) demonstrated a markedly increased incidence, four to five times the expected rate of pleural abnormalities without a significant increase in lung scarring. This pattern is what has also been observed by physicians in the Libby community. There are no other asbestos exposures in the United States that have caused a pattern similar to Libby amphibole asbestos exposure.Also, clinical observations supported by recent studies in the medical literature have noted that unusually low exposure to Libby amphibole asbestos has caused chest x-ray abnormalities and serious lung disease ( Low level fiber induced radiographic changes caused by Libby vermiculite: A 25 year follow-up study, AJRCCM ; Dec. 6, 2007 )A third observation that has been clearly different than what has been experienced with the commercial asbestos has been the significance of pleural plaques ( localized areas of scarring on the lining of the lung ). Previously, their presence on chest x-ray usually indicated asbestos exposure but did not lead to serious lung disease. That has not been the case with Libby amphibole asbestos ; where it is not unusual for people with plaques to go on to develop serious lung disease. In some of these, the lung disease progresses much more rapidly than previous reports of asbestos disease.