Pneumoconiosis and malignant mesothelioma in a family operated metal casting business that used industrial talc from New York state

Our plain-English summary of Pneumoconiosis and malignant mesothelioma in a family operated metal casting business that used industrial talc from New York state, by M.M. Finkelstein (American Journal of Industrial Medicine, 2013).

The study

• Author: M.M. Finkelstein
• Journal: American Journal of Industrial Medicine
• Published: 2013;56(5):550-5
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The United States is second only to the People's Republic of China in annual talc production. U.S. talc is used in the production of ceramics, paint, paper, plastics, roofing, rubber, cosmetics, flooring, caulking, and agricultural applications. A number of U.S. talc deposits consistently contain talc intergrown with amphiboles such as tremolite and/or anthophyllite. It has long been recognized that miners and millers of talc deposits are at risk for pneumoconiosis and it has recently been reported that it is prudent, on the balance of probabilities, to conclude that dusts from New York State talc ores are capable of causing mesothelioma in exposed workers. This is a report of the diagnosis of pneumoconiosis and mesothelioma in a husband and wife who operated a small metal casting business that used industrial talc from New York as a parting agent.

Methods: Case reports, including medical records and exposure histories, were provided by an attorney who had also commissioned laboratory investigation of the industrial talc product used in the factory.

Results: Mrs X was diagnosed with pneumoconiosis characterized by interstitial fibrosis and heavily calcified pleural plaques. Mr X had calcified pleural plaques and developed a fatal pleural mesothelioma. Samples of the industrial talc contained fibrous tremolite and anthophyllite.

Conclusions: The author concludes that end users of industrial talc from New York State may be at risk of pneumoconiosis and malignant disease. End users of talcs from other regions of the United States, where talc formation arose from processes driven by regional metamorphism, might also be at risk.

Copyright © 2013 Wiley Periodicals, Inc.

In plain English

This case report described lung disease in a husband and wife who ran a small family metal casting business. Both used metal casting plaster made from New York State industrial talc as a mould medium. Mrs X, who began casting work in 1961, had interstitial lung fibrosis and heavily calcified pleural plaques. In April 2010 her FVC (a breathing measure) was 48% of predicted and her DLCO (a measure of how well the lungs take up gas) was 26% of predicted. Mr X, a match plate maker from 1955 to 2001, had densely calcified pleural plaques. He was diagnosed with mesothelioma from a pleural biopsy and died of the disease in October 2009. Laboratory tests found the talc contained tremolite and anthophyllite. Most tremolite fibers were not of respirable size, but the anthophyllite fibers were. Both spouses may also have been exposed to asbestos while maintaining the family cars, and their lung tissue was not analyzed for fibers. The author concluded that end users of New York State industrial talc may be at risk of pneumoconiosis and malignant disease.

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 report of two people (a married couple), based on medical records and exposure histories from interview and deposition, plus commissioned laboratory analyses of the talc product
• Who was studied: a husband (Mr X) and wife (Mrs X) who operated a small family metal casting business they started in 1958; Mr X worked as a match plate maker from 1955 to 2001, and Mrs X began metal casting work in 1961; location of the business not stated
• Exposure: metal casting plaster (industrial talc from New York State, the Mouldene brand) used as a mould medium for casting metal match plates; both spouses opened bags, scooped and mixed the plaster with water, and handled and cleaned the casts and plates
• Main results:
  • Mrs X had interstitial fibrosis and heavily calcified pleural plaques, which the author described as typical of findings reported in New York State talc workers
  • Mrs X's lung function in April 2010: FVC 48% of predicted and DLCO 26% of predicted
  • Mr X did not have interstitial fibrosis but had large, densely calcified pleural plaques at the right diaphragmatic pleura
  • Mr X was diagnosed with mesothelioma from a pleural biopsy
  • The pathologists called Mr X's tumor biphasic, but the author wrote that the staining findings are consistent with an epithelioid, not biphasic, mesothelioma
  • Mr X died of his disease in October 2009
  • X-ray diffraction of the talc product showed talc, tremolite and anthophyllite as major phases, each approximately 20 to 30% by weight (first analysis, two samples)
  • In the talc samples, the tremolite fibers were generally not of respirable size
  • In the talc samples, the anthophyllite fibers were of respirable size
  • The author judged that the anthophyllite in the talc was consistent with a published definition of amphibole-asbestos fibrils
• The authors' conclusion: The author concluded that end users of industrial talc from New York State may be at risk of pneumoconiosis and malignant disease, and that end users of talcs from some other U.S. regions might also be at risk.
• Limitations the authors state:
  • No analysis of fibers in lung tissue was done for either person
  • Mrs X may also have been exposed to asbestos fibers while helping maintain the family cars from the 1950s until the late 1970s
  • Mr X may also have been exposed to asbestos fibers through car maintenance

Topics

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

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Mesothelioma, Industrial Talc, Talc, Amphibole Group, Tremolite, Anthophyllite, Interstitial Fibrosis.

Related studies

• Mortality among talc miners and millers in New York State — M. Kleinfeld, J. Messite, et al. (1967)
• Malignant mesothelioma incidence among talc miners and millers in New York State — M.M. Finkelstein (2012)
• Talc pneumoconiosis: a report of six patients with postmortem findings — M. Kleinfeld, C.P. Giel, et al. (1963)
• Talc pneumoconiosis — A.I. McLAUGHLIN, E. Rogers, et al. (1949)
• Talc dust pneumoconiosis — A. Berner, B. Gylseth, et al. (1981)
• Talc pneumoconiosis in the textile industry — B. Mann, J.B. Deasy (1954)

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