Malignant mesothelioma following exposure to cosmetic talc: Association, not causation

Our plain-English summary of Malignant mesothelioma following exposure to cosmetic talc: Association, not causation, by S.J. Geyer (American Journal of Industrial Medicine, 2020).

The study

• Author: S.J. Geyer
• Journal: American Journal of Industrial Medicine
• Published: 2020;63(7):649-650
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a study, and it reports no new data. The author criticized an article by Emory and co-authors that described 75 patients with malignant mesothelioma after repeated exposures to cosmetic talc. The author argued that the article did not address recall bias in cases identified through sworn testimony. The author also argued that the methods gave no analysis showing that any talc product the patients used contained asbestos, and that an aspect ratio of 3:1 or more is not enough to define asbestiform fibers. Other points were that contamination controls and background reference ranges were not described, and that fiber burden data covered only nine individuals, which the author said limits the report to case reports. The author noted that the cases came from a medical-legal consultation practice and questioned studies the article cited. The author concluded that these problems cast doubt on the claim that cosmetic talc may cause mesothelioma. The author disclosed serving as a pathology expert and consultant to defense attorneys in asbestos and talc litigation.

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 another published article (Emory, Maddox and Kradin, 2020); no new data
• Who was studied: No study population of its own; the letter discusses an article describing 75 patients with malignant mesothelioma
• Exposure: Cosmetic talc, which the criticized article reported as the subjects' only known asbestos exposure
• Main results:
  • The author argued that the criticized article, whose cases were identified through sworn deposition testimony and interrogatory answers, did not address recall bias
  • The author argued that the methods included no analysis of any cosmetic talc product used by the patients, and so no evidence that the products contained asbestos
  • The author argued that an aspect ratio of 3:1 or more is an insufficient definition of asbestiform fibers, and that methods must tell asbestiform fibers apart from nonasbestiform analogs
  • The author argued that the article described no controls against contamination of reagents and filters, and no reference range based on background asbestos levels
  • The author argued that fiber burden data were presented for only nine individuals, limiting the report to case reports, and that scanning electron microscopy results were not reported
  • The author noted that the cases were selected from a medical-legal consultation practice and asked whether opposing parties' fiber analyses existed and had been disclosed
  • The author questioned studies cited by the article, including the Rohl studies, whose methods, according to the author, did not distinguish asbestos from nonasbestiform mineral fragments
  • The letter discloses that its author has served and continues to serve as a pathology expert and consultant to defense attorneys in asbestos and talc litigation
• The authors' conclusion: The author concluded that the problems described cast doubt on the article's assertion that cosmetic talc may cause malignant mesothelioma, and stated that the author and others find no evidence in the medical literature for a causative role of cosmetic talc

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Cosmetic Talc, Causation.

Related studies

• Authors' response to "malignant mesothelioma following exposure to cosmetic talc: Association, not causation" — T.S. Emory, J.C. Maddox, et al. (2020)
• Evidence Does Not Support Exposure to Cosmetic Talc as Cause of Malignant Mesothelioma — S.J. Geyer (2020)
• Cosmetic talc and ovarian cancer — D.L. Longo, R.C. Young (1979)
• A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis — R. Agarwal, A.S. Paul, et al. (2011)
• Mesothelioma Associated With the Use of Cosmetic Talc — J. Moline, K. Bevilacqua, et al. (2020)
• Cosmetic talc as a risk factor for pleural mesothelioma: a weight of evidence evaluation of the epidemiology — B.L. Finley, S.M. Benson, et al. (2017)

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