Malignant Mesothelioma and Its Nonasbestos Causes

Our plain-English summary of Malignant Mesothelioma and Its Nonasbestos Causes, by M.M. Finkelstein (Archives of Pathology & Laboratory Medicine, 2019).

The study

• Author: M.M. Finkelstein
• Journal: Archives of Pathology & Laboratory Medicine
• Published: 2019;143(6):659-660
• Type of article: Letter, Comment
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter to the editor, the author responded to a review by Attanoos and colleagues, which had concluded that most mesotheliomas not clearly attributable to asbestos exposure are spontaneous. The author argued that the review did not consider asbestos exposure from talcum powders. He cited earlier studies of consumer talc products. In 1976, Rohl et al reported that 10 of 20 products (50%) contained tremolite and anthophyllite, and other investigators had found asbestiform tremolite or anthophyllite in a popular baby powder ore and a popular body powder. He also cited market research reporting that some 100 million Americans used body and baby powders between 2011 and 2017. The author then drew on a lung fiber-burden database compiled by Victor Roggli, MD, at Duke University Medical Center, covering 566 people with pleural mesothelioma, 75 (13%) of them women. Talc fibers were detected in 332 of 491 men (68%) and 62 of 75 women (83%). Detection of tremolite (P < .001) and anthophyllite (P = .002) was significantly associated with the presence of talc. Talc and associated amphiboles were more common in women than men (odds ratio 3.24; 95% CI 1.65–6.35). The author concluded that, without accounting for amphibole asbestos exposure from baby and body powders, it was inappropriate to conclude that most mesotheliomas not clearly attributable to asbestos are spontaneous. He disclosed that he has served as a consultant to plaintiff's lawyers 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

This is a letter to the editor. The author was responding to a review by Attanoos and colleagues, which concluded that most mesotheliomas not clearly attributable to asbestos exposure are spontaneous. The author argued that the review did not consider asbestos exposure from talcum powders. The author reported data from a lung fiber-burden database compiled by Victor Roggli at Duke University Medical Center. The database covered 566 people with pleural mesothelioma, 75 of them women. Talc fibers were found in 332 of 491 men (68%) and in 62 of 75 women (83%). Finding tremolite, and finding anthophyllite, were each statistically associated with finding talc. Talc and associated amphiboles were more common in women than in men (odds ratio 3.24; 95% CI 1.65 to 6.35). The author called this compatible with women more often using baby and body powders. The author noted that some people were exposed to industrial talc through work and hobbies. The author concluded that, without accounting for amphibole asbestos exposures from baby and body powders, it is inappropriate to conclude that most such mesotheliomas are spontaneous.

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 commenting on a published review, reporting an analysis of an existing database of lung fiber-burden measurements
• Who was studied: 566 people with pleural mesothelioma (491 men, 75 women, or 13% female) whose lung fiber burdens were measured, from a database compiled by Victor Roggli, MD, Duke University Medical Center; time period not given
• Exposure: talc fibers and the amphiboles tremolite and anthophyllite found in lung tissue, treated by the author as markers of exposure to talc-containing dusts such as body and baby powders
• Main results:
  • Talc fibers were detected in 332 of 491 men (68%) and 62 of 75 women (83%) with pleural mesothelioma
  • Detection of tremolite was significantly associated with the presence of talc (P less than .001), as was detection of anthophyllite (P = .002)
  • Talc and associated amphiboles were more common in women than in men (odds ratio 3.24; 95% CI 1.65 to 6.35)
  • The author stated this difference would be expected if women were more likely than men to use baby and body powders
• The authors' conclusion: The author concluded that, without accounting for amphibole asbestos exposures from the use of baby and body powders, it is inappropriate to conclude that most mesotheliomas not clearly attributable to asbestos exposure are spontaneous (idiopathic)
• Limitations the authors state:
  • The author noted that talc in lungs may also come from occupational and hobby exposure to industrial talc in the United States. The author judged this group small compared with users of baby and body powders.

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, Asbestos Exposure, Talc, Tremolite, Anthophyllite, Asbestiform Tremolite, Pleural Mesothelioma.

Related studies

• In Reply to "Malignant Mesothelioma and Its Nonasbestos Causes" — R.L. Attanoos, A. Churg, et al. (2019)
• Malignant Mesothelioma and Its Nonasbestos Causes: Talcum Powder Does Not Create Occult Asbestos Exposure — S.J. Geyer (2019)
• 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)
• Health effects of asbestos and nonasbestos fibers — O.Y. Osinubi, M. Gochfeld, et al. (2000)
• Pulmonary oxidative stress, inflammation and cancer: respirable particulate matter, fibrous dusts and ozone as major causes of lung carcinogenesis through reactive oxygen species mechanisms — A. Valavanidis, T. Vlachogianni, et al. (2013)

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