Particle size for differentiation between inhalation and injection pulmonary talcosis

Our plain-English summary of Particle size for differentiation between inhalation and injection pulmonary talcosis, by J.L. Abraham, C. Brambilla (Environmental Research, 1980).

The study

• Authors: J.L. Abraham, C. Brambilla
• Journal: Environmental Research
• Published: 1980;21(1):94-6
• Cited by: 27 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. 002024).

In plain English

This short study asked whether the size of particles found in lung tissue can show how they got there. The authors examined 11 archived cases diagnosed as "talcosis" from the Averill A. Liebow Pulmonary Pathology Collection. Six were inhalation pneumoconiosis (dust breathed in) and five were from drug-addicted patients (material injected). In this study "talcosis" meant strongly birefringent, plate-like particles seen under polarized light, and the authors said it was not specific for talc. In each case they measured the largest dimension of 100 consecutive particles. In the inhalation cases the mean size was 3.7 micrometers, 70% of particles were under 5 micrometers, and 98% were under 10 micrometers. In the injection cases the mean was 14.2 micrometers, with particles up to 50 micrometers and more (P less than 0.001). The two size ranges overlapped somewhat. Still, every inhalation case had at least 50% of its particles in the 0 to 5 micrometer range, and no injection case had more than 25% there. The authors concluded that a majority of particles larger than 5 micrometers strongly suggests injection.

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: Pathology study measuring particle sizes by light microscopy in archived lung tissue cases
• Who was studied: 11 documented cases diagnosed as "talcosis" from the Averill A. Liebow Pulmonary Pathology Collection: 6 inhalation pneumoconiosis cases and 5 cases from drug-addicted patients (injection)
• Exposure: Strongly birefringent, plate-like particles called "talcosis" (not specific for talc), reached either by inhalation or by intravenous injection. Electron microscopy and X-ray microanalysis identified many of the particles as talc, with other silicates also present.
• Main results:
  • Inhalation cases: mean particle size 3.7 micrometers; 70% of particles were less than 5 micrometers and 98% less than 10 micrometers
  • Injection cases: particles varied widely in size (up to 50 micrometers and more), with a mean of 14.2 micrometers
  • The difference in particle size between inhalation and injection cases had P less than 0.001 by the chi-squared test
  • Mean particle diameter plus or minus standard deviation: inhalation cases 3.7 plus or minus 2.9 micrometers; injection cases 14.2 plus or minus 9.0 micrometers
  • No inhalation case had less than 50% of its particles in the 0 to 5 micrometer range. No injection case had more than 25% of its particles in that range.
  • In the inhalation cases, the only particles found just above 10 micrometers were very elongated (fibers), with a length-to-width ratio greater than 10
• The authors' conclusion: The authors concluded that when a major fraction of particles is larger than 5 micrometers (too large to be respirable), this strongly suggests injection of foreign material
• Limitations the authors state:
  • The term "talcosis" as used here means birefringent plate-like particles seen by light microscopy and is not specific for talc
  • The size distributions of the two groups overlapped somewhat
  • Injected material might sometimes consist mostly of respirable-sized particles, although the authors had not yet recognized such a case

Topics

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

Related studies

• Pulmonary ventilatory function in talcosis of lung — M. Kleinfeld, J. Messite, et al. (1964)
• A case of lung adenocarcinoma complicated by pulmonary talcosis occurring in a patient employed in the confectionery industry — K. Kobayashi, N. Watanabe, et al. (2019)
• Mixed pneumoconiosis: silicosis, asbestosis, talcosis, and berylliosis — G.J. Mark, C.B. Monroe, et al. (1979)
• Pulmonary disease caused by the inhalation of cosmetic talcum powder — I.P. Wells, P.A. Dubbins, et al. (1979)
• Commercial talc and talcosis — B. Weiss, E.A. Boettner (1967)
• Bronchiolitis in a patient with talcosis — K. Reijula, P. Pääkkö, et al. (1991)

Browse more research in Environmental Research, or return to medical research.