Response to Roggli et al. (2020) "Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation"

Our plain-English summary of Response to Roggli et al. (2020) "Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation", by T. Tran, D. Egilman, M. Rigler (Ultrastructural Pathology, 2020).

The study

• Authors: T. Tran, D. Egilman, M. Rigler
• Journal: Ultrastructural Pathology
• Published: 2020;44(3):314-315
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a study, and it reports no new data. The authors responded to a 2020 paper by Roggli and colleagues on mineral fibers in 65 mesothelioma cases, which, the letter says, dismissed cosmetic talc as a cause of mesothelioma. The authors argued that Roggli and colleagues based a "talc background" of 10,500 fibers per gram of wet lung on one control case (#24) from a 1995 study by Srebro and colleagues, and that no studies establish any background exposure to talc. That control was a male military veteran who died of Alzheimer's disease and whose job and personal history were unknown. The authors argued that the microscope method may have over counted talc and could have mistaken chrysotile for talc. They also argued that Roggli misread the Helsinki criteria by conflating necessity and sufficiency, and that lung fiber levels fall over time without continuing exposure. The authors concluded that a background level cannot be established and cannot be used to rule out talc exposure as a contributing cause of mesothelioma.

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 responding to a published article; no original data
• Who was studied: No people were studied. The letter discusses the analysis by Roggli et al. (2020) and the single control case (#24) from Srebro et al. (1995) that Roggli et al. used to set a talc background level.
• Exposure: Cosmetic talc and talc fibers in lung tissue, along with tremolite, actinolite, anthophyllite and chrysotile
• Main results:
  • The authors argued that Roggli et al. relied on Srebro et al. (1995) for a talc background of 10,500 fibers per gram of wet lung, and that no studies establish any background exposure to talc.
  • The authors stated that the control case used for the background was a male military veteran who died of Alzheimer's disease, whose job and personal history were unknown, and that Srebro et al. did not collect information on industrial or cosmetic talc exposure.
  • The authors argued that Srebro et al. may have over counted talc fibers because the scanning electron microscope method cannot routinely tell anthophyllite with low iron from talc. They also argued that chrysotile could have been misidentified as talc.
  • The authors argued that Roggli misread the Helsinki criteria. In their reading, a lung fiber count above background is sufficient, but not necessary, to relate a pleural mesothelioma to asbestos exposure.
  • The authors stated that, without continuing exposure, lung fiber levels decrease over time depending on fiber type and length.
• The authors' conclusion: The authors concluded that fiber burden analysis is useful for identifying fiber types, but that a background level cannot be established and so cannot be used to rule out talc exposure as a contributing cause of mesothelioma.

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: Talc, Mesothelioma, Mineral Fiber.

Related studies

• Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation — V.L. Roggli, J.M. Carney, et al. (2020)
• A commentary on Roggli's "The So-Called Short-Fiber Controversy" — D. Egilman, T. Tran (2016)
• Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases — V.L. Roggli, A. Sharma, et al. (2002)
• Biological mechanisms of non-linear dose-response for respirable mineral fibers — L.A.T. Cox (2018)
• Effect of size of man-made and natural mineral fibers on chemiluminescent response in human monocyte-derived macrophages — M. Ohyama, T. Otake, et al. (2001)
• Significance of mass and number of fibers in the correlation of V79 cytotoxicity with tumorigenic potential of mineral fibers — L.D. Palekar, B.M. Most, et al. (1988)

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