In Reply to "Malignant Mesothelioma and Its Nonasbestos Causes"

Our plain-English summary of In Reply to "Malignant Mesothelioma and Its Nonasbestos Causes", by R.L. Attanoos, A. Churg, F. Galateau-Salle, et al (Archives of Pathology & Laboratory Medicine, 2019).

The study

• Authors: R.L. Attanoos, A. Churg, F. Galateau-Salle, A.R. Gibbs, V.L. Roggli
• Journal: Archives of Pathology & Laboratory Medicine
• Published: 2019;143(8):911-914
• Type of article: Letter, Comment
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter was the authors' reply to correspondence from Dr Finkelstein about their 2018 review, "Malignant mesothelioma and its non-asbestos causes." Dr Finkelstein had questioned two statements in the review: that most mesotheliomas not clearly attributable to asbestos are spontaneous, and that in North America few mesotheliomas in women at any site are attributable to asbestos. The authors stated that he had cited no contrary peer-reviewed literature. Instead, they said, he relied on Statista market data on US body and baby powder purchasing between 2011 and 2017, and on a fiber burden database obtained through litigation and published without consent from one of the authors. They argued that a fiber burden result must be compared with a laboratory's control reference range before any significance is assigned. They noted that many female mesothelioma subjects in Roggli's data had fiber burdens within the control range. They explained the higher detection of talc and noncommercial amphiboles in women as a result of lower exposures combined with fiber-counting protocols. They also discussed aspect-ratio criteria for telling asbestiform fibers from cleavage fragments. They cited studies of cosmetic talc miners and millers with no confirmed mesothelioma cases, more than 300 talc pleurodesis patients followed for 14 to 40 years with no mesotheliomas, and rat and hamster experiments with no mesotheliomas. They concluded that they found no evidence that cosmetic talc causes malignant mesothelioma. The authors disclosed work as expert witnesses in asbestos and talc litigation.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

In this letter to the editor, the authors replied to Dr Finkelstein's letter questioning statements in their earlier review about spontaneous mesothelioma in North American women. They stated Dr Finkelstein offered no contrary peer-reviewed literature. They argued that a lung fiber burden must at minimum be above background before a case is considered asbestos-related. They noted an earlier report by Roggli, one of the authors, that many women with malignant mesothelioma had fiber burdens within that laboratory's control range. They explained that at low exposures, more typical of women, commercial amphibole asbestos is detected less often, and noncommercial amphiboles and nonasbestos minerals are disproportionately represented. Citing work by others, they wrote that no confirmed mesothelioma was found in epidemiologic studies of cosmetic talc mine and mill workers conducted in Europe or North America, none in more than 300 patients followed 14 to 40 years after pleurodesis with cosmetic/pharmaceutical-grade talc for benign pleuropulmonary conditions, and none in rats given Italian cosmetic-grade talc. The authors concluded they identified no evidence for any causative role of cosmetic talc in malignant mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor (reply to a letter); no new study or original data
• Who was studied: No study population. The letter responded to Dr Finkelstein's commentary on the authors' earlier statements about spontaneous mesothelioma in North American women.
• Exposure: Consumer use of cosmetic talc, possibly contaminated by amphibole minerals (asbestiform or non-asbestiform). The letter also discusses commercial amphiboles (amosite, crocidolite) and noncommercial amphiboles (tremolite, actinolite, anthophyllite).
• Main results:
  • The authors stated that Dr Finkelstein provided no contrary peer-reviewed scientific literature challenging their 2 statements.
  • The authors argued that, in fiber burden studies, an elevation above background is required at a minimum before a case is considered possibly asbestos-related.
  • Citing Roggli's earlier work (in Kraynie et al), the authors stated that many female subjects with malignant mesothelioma had asbestos fiber burdens and asbestos body counts within that laboratory's control reference population.
  • The authors explained that at low exposures, more typical of women, commercial amphibole asbestos is detected less often, and noncommercial amphiboles and nonasbestos minerals are disproportionately represented.
  • Citing other studies, the authors stated that no confirmed case of malignant mesothelioma has been found in epidemiologic studies of cosmetic talc mine and mill workers conducted in Europe or North America.
  • Citing published reviews, the authors stated that no mesotheliomas were identified in more than 300 patients who underwent pleurodesis with cosmetic/pharmaceutical-grade talc for various benign pleuropulmonary conditions, with follow-up of 14 to 40 years.
  • Citing animal studies, the authors stated that rats exposed to high levels of Italian cosmetic-grade talc showed no asbestos-related effects and no mesotheliomas.
• The authors' conclusion: The authors concluded that they identified no evidence for any causative role of cosmetic talc in malignant mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma, Fiber Burden, Talc, Amphibole Group, Asbestiform, Cleavage Fragment, Cosmetic Talc.

Related studies

• Malignant Mesothelioma and Its Nonasbestos Causes — M.M. Finkelstein (2019)
• Malignant Mesothelioma and Its Nonasbestos Causes: Talcum Powder Does Not Create Occult Asbestos Exposure — S.J. Geyer (2019)
• Malignant Mesothelioma and Its Non-Asbestos Causes — R.L. Attanoos, A. Churg, et al. (2018)
• Reply: No indication that mineral wool causes mesothelioma — A. Lacourt (2013)
• Small-airway lesions in patients exposed to nonasbestos mineral dusts — A. Churg, J.L. Wright (1983)
• Nonasbestos pulmonary mineral fibers in the general population — A. Churg (1983)

Browse more research in Archives of Pathology & Laboratory Medicine, or return to medical research.