Morbidity and mortality in talc-exposed workers

Our plain-English summary of Morbidity and mortality in talc-exposed workers, by E. Wergeland, A. Andersen, A. Baerheim (American Journal of Industrial Medicine, 1990).

The study

• Authors: E. Wergeland, A. Andersen, A. Baerheim
• Journal: American Journal of Industrial Medicine
• Published: 1990;17(4):505-13
• Cited by: 53 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000046).

Abstract

Cancer incidence and cause-specific mortality were studied in a male cohort of 94 talc miners and 295 talc millers, exposed to non-asbestiform talc with low quartz content. No excess risk was found compared with national age-specific incidence. Six cases of lung cancer occurred versus 6.49 expected (miners: observed 2, expected 1.27; millers: observed 4, expected 5.22). There were 3 deaths due to non-malignant respiratory disease against 10.9 expected (miners: observed 1, expected 2.5; millers: observed 2, expected 8.4). Mesothelioma, tuberculosis, or pneumoconiosis were not recorded as causes of death. Pneumoconiosis was noted as a contributory cause in three cases (silicosis two, talcosis one). Further follow-up will reduce any potential impact of "healthy worker" selection.

In plain English

This Norwegian cohort study followed 389 men who had worked with talc: 94 at the Altermark talc mine and 295 at the Knarrevik talc mill, employed up to 1972. The authors described the talc as non-asbestiform with low quartz content. Fibers identified in dust samples taken in 1980 to 1982 included tremolite, anthophyllite and talc. Deaths and new cancers from 1953 to 1987 were compared with rates for all Norwegian men. In total, 117 men died against 155.2 expected. There were 3 deaths from non-malignant respiratory disease against 10.9 expected. There were 46 cancers against 51.32 expected, including 6 lung cancers against 6.49 expected. Miners had more cancers than expected (15 against 10.72), which the authors judged no greater than random variation. No death was recorded as caused by mesothelioma or pneumoconiosis, though pneumoconiosis was noted as a contributory cause in three. The authors concluded the study did not confirm an association between this talc and new lung cancer cases or deaths from respiratory disease. They noted small numbers and possible "healthy worker" effects.

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: Retrospective cohort study comparing observed with expected deaths by cause and new cancer cases, using national rates for Norwegian men
• Who was studied: 389 men in Norway. 94 were miners from Altermark Talc Mine (northern Norway), employed 1944 to 1972 for at least 1 year in talc-exposed jobs. 295 were millers from Knarrevik Talc Mill (western Norway), employed 1935 to 1972 for at least 2 years in talc-exposed jobs. Follow-up ran from 1953 to 1987.
• Exposure: Talc dust described as non-asbestiform talc with low quartz content. Air samples taken in 1980 to 1982 had fiber concentrations from less than 0.2 up to 0.9 fibers/ml. The fibers identified by electron microscopy were tremolite, anthophyllite and talc particles. Dust levels were not measured before 1972.
• Main results:
  • Whole cohort, all causes of death: 117 observed against 155.2 expected (SMR 75)
  • Whole cohort, non-malignant respiratory disease: 3 deaths against 10.9 expected (miners 1 against 2.5; millers 2 against 8.4)
  • Whole cohort, all cancers: 46 new cases against 51.32 expected
  • Whole cohort, lung cancer: 6 new cases against 6.49 expected (miners 2 against 1.27; millers 4 against 5.22)
  • Miners, all cancers: 15 against 10.72 expected. The authors judged this no greater than might be due to random variation.
  • Millers: bladder cancer 7 cases against 2.68 expected; kidney cancer 2 against 1.49 expected
  • Highest dust-exposure category: 6 new cancer cases against 13.55 expected, none of them lung cancer
  • No death had mesothelioma, tuberculosis or pneumoconiosis recorded as its cause
  • Pneumoconiosis was recorded as a contributory cause of death in three cases: silicosis twice (one miner, one miller) and talcosis once (one miller)
• The authors' conclusion: The authors concluded that the study did not confirm an association between exposure to non-asbestiform talc with low quartz content and either lung cancer incidence (new cases) or respiratory disease mortality, in the one mine and one mill studied. They added that further follow-up is needed to lessen any impact of healthy worker selection.
• Limitations the authors state:
  • Numbers were too small to draw inferences about particular cancer types
  • Numbers of respiratory disease deaths were too small for further conclusions
  • Healthy worker selection may have lowered mortality, so further follow-up is needed
  • No smoking information was available for the millers
  • Dust exposure was not measured during the employment period studied (before 1972)
  • Adequate information was available for only one of four mines and one of four mills
  • The study had a 65% probability of detecting a true doubling of lung cancer risk, and 97% for a tripling

Topics

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

Medical terms in this study, explained in our Lexicon: Talc, Non-Asbestiform, Lung Cancer, Mesothelioma, Pneumoconiosis, Silicosis.

Related studies

• Morbidity and Mortality in Talc Granuloma: Report of a Fatal Case — A.J. Swingle (1948)
• Mortality of Talc Miners and Millers From Val Chisone, Northern Italy: An Updated Cohort Study — E. Pira, M. Coggiola, et al. (2017)
• Mortality and cancer morbidity in a cohort of Canadian petroleum workers — R.J. Lewis, A.R. Schnatter, et al. (2003)
• An update of a mortality study of talc miners and millers in Italy — M. Coggiola, D. Bosio, et al. (2003)
• Mortality among talc miners and millers in New York State — M. Kleinfeld, J. Messite, et al. (1967)
• Respiratory effects from industrial talc exposure among former mining workers — R.C. Loyola, A.P. Carneiro, et al. (2010)

Browse more research in American Journal of Industrial Medicine, or return to medical research.