Mesothelioma Associated With the Use of Cosmetic Talc

Our plain-English summary of Mesothelioma Associated With the Use of Cosmetic Talc, by J. Moline, K. Bevilacqua, M. Alexandri, et al (Journal of Occupational and Environmental Medicine, 2020).

The study

• Authors: J. Moline, K. Bevilacqua, M. Alexandri, R.E. Gordon
• Journal: Journal of Occupational and Environmental Medicine
• Published: 2020;62(1):11-17
• Cited by: 33 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: To describe 33 cases of malignant mesothelioma among individuals with no known asbestos exposure other than cosmetic talcum powder.

Methods: Cases were referred for medico-legal evaluation, and tissue digestions were performed in some cases. Tissue digestion for the six cases described was done according to standard methodology.

Results: Asbestos of the type found in talcum powder was found in all six cases evaluated. Talcum powder usage was the only source of asbestos for all 33 cases.

Conclusions: Exposure to asbestos-contaminated talcum powders can cause mesothelioma. Clinicians should elicit a history of talcum powder usage in all patients presenting with mesothelioma.

In plain English

This was a case series of 33 people with malignant mesothelioma, mostly women, whose cases were referred to one author for medico-legal evaluation as part of lawsuits. Using medical records and sworn deposition testimony, the authors reported that they identified no source of asbestos other than cosmetic talcum powder for any of the 33. Six cases were described in detail, with tissue analyzed by electron microscopy. These were five women and one man; four had pleural and two had peritoneal mesothelioma. In all six, the authors reported anthophyllite, tremolite and/or chrysotile asbestos fibers in lung, lymph node or peritoneal tissue, at 920 to 34,500 fibers per gram. Some results equaled the stated limit of detection. No amosite or crocidolite was found. In comparison samples from people with no known asbestos exposure, 6 of 35 contained asbestos, and the authors reported that all six cases had higher fiber burdens. The authors concluded that asbestos-contaminated talcum powder can cause mesothelioma. They noted that exposure information came from depositions and records rather than structured interviews and was self-reported.

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: Case series (33 cases referred for medico-legal evaluation in tort litigation), with tissue fiber analysis in six cases and comparison with background control tissue samples
• Who was studied: 33 individuals with pathology-confirmed malignant mesothelioma, predominantly women, with no identified asbestos exposure other than talcum powder. Six of them (5 women, 1 man; 4 pleural, 2 peritoneal) had tissue digestions.
• Exposure: Use of cosmetic talcum powder products (for example body powder, baby powder, face powder), including personal use, application by parents, and in some cases occupational use by hairdressers
• Main results:
  • For all 33 cases, the authors identified no asbestos exposure other than talcum powder
  • Case 1 (pleural): anthophyllite fibers in lung tissue at a calculated 3,286 fibers per gram
  • Case 2 (pleural): anthophyllite and tremolite fibers in lymph node tissue at 34,500 fibers per gram wet weight (limit of detection 11,500); anthophyllite in lung tissue at 8,625 fibers per gram wet weight
  • Case 3 (pleural): no asbestos fibers in lung tissue above the limit of detection; tremolite in lymph node tissue at 9,409 fibers per gram wet weight, equal to the limit of detection
  • Case 4 (peritoneal): chrysotile fibers in peritoneal tissue at 920 fibers per gram wet weight, equal to the limit of detection
  • Case 5 (peritoneal): no asbestos fibers in omental tissue above the limit of detection; chrysotile and anthophyllite in lymph node tissue at 20,700 fibers per gram wet weight
  • Case 6 (pleural, male): anthophyllite and tremolite in lymph node tissue at 17,250 fibers per gram wet weight
  • No amosite or crocidolite was found in the six cases' tissue
  • In background control samples from people with no known asbestos exposure, 6 of 35 contained chrysotile and non-commercial amphibole asbestos
  • The authors reported that the six talc-exposed patients' fiber burdens were all greater than the controls'
  • Three of the cases were female hairdressers who regularly used talcum powder at work
• The authors' conclusion: The authors concluded that exposure to asbestos-contaminated talcum powders can cause mesothelioma and that clinicians should ask all mesothelioma patients about talcum powder use
• Limitations the authors state:
  • Data came from medical records and deposition transcripts rather than structured in-person interviews
  • Exposure information was self-reported and subject to possible recall bias

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Cosmetic Talc, Malignant Mesothelioma, Asbestos Exposure, Tissue Digestion.

Related studies

• Cosmetic talc and ovarian cancer — D.L. Longo, R.C. Young (1979)
• 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)
• Serous Ovarian Cancer Caused by Exposure to Asbestos and Fibrous Talc in Cosmetic Talc Powders-A Case Series — J.E. Steffen, T. Tran, et al. (2020)
• Evaluation by electron microscopy techniques of asbestos contamination in industrial, cosmetic, and pharmaceutical talcs — L. Paoletti, S. Caiazza, et al. (1984)
• Amphibole content of cosmetic and pharmaceutical talcs — A.M. Blount (1991)
• Cosmetic talc and ovarian cancer — D.L. Longo, R.C. Young (1979)

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