This proposal responds to the need for a sustained dialogue that promotes public understanding of the social, ethical and legal implications of the gene-environment interactions associated with asbestos-related diseases (ARDs). It is designed to use good science to achieve good community dialogue. The health problems discussed in this narrative were created by high levels of exposure to asbestos fibers (tremolite-actinolite series) from a vermiculite mine, operated in the Libby area, in Lincoln County Montana, from the 1920s through 1991. Exposures to asbestos varied for workers and residents of the community depending on a number of factors. The investigators propose a comprehensive, collaborative and participatory, 5-year initiative that will specifically increase community understanding of the interplay between gene-environment interactions by the following means: 1) assessing community knowledge of health impacts and identifying existing gaps in public understanding of asbestos-related disease; 2) developing and implementing an electronic and on-site, culturally appropriate and accessible educational curriculum that will provide a wide array of resources that help the public understand the risks of environmentally related disease, the ethical and economic implications associated with those risks, and the strategies that protect against discrimination and psychological stress; 3) fortifying and extending the ongoing dialogue between scientists and the public by combining accurate translations of the scientific findings and community knowledge into an educational curriculum that is culturally appropriate and accessible for Libby and other communities dealing with asbestos-related diseases; and 4) assessing the impact of the educational interventions provided during the 5-year project so as to ensure that all methodologies are responsive to evolving needs and can be transplanted to other communities.
