Talc pneumoconiosis: a report of six patients with postmortem findings

Our plain-English summary of Talc pneumoconiosis: a report of six patients with postmortem findings, by M. Kleinfeld, C.P. Giel, J.F. Majeranowski, et al (Archives of Environmental Health, 1963).

The study

• Authors: M. Kleinfeld, C.P. Giel, J.F. Majeranowski, J. Messite
• Journal: Archives of Environmental Health
• Published: 1963;7:101-15
• Cited by: 40 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. 002516).

In plain English

This article described six men, aged 42 to 67, who had worked as talc miners or millers and were later examined at autopsy. The authors reported each man's symptoms, chest X-rays and autopsy findings. The dust was talc mixed with tremolite and anthophyllite, with a small amount of free silica (an average of 5% in ore analyses). Estimated average dust levels ranged from 29 to 470 million particles per cubic foot during different periods of work. All six had progressive shortness of breath, which began after 18 to 33 years of exposure (average 24 years). X-rays showed plate-like plaques near the diaphragm in every case, and these were confirmed at autopsy. The lungs showed diffuse scarring and bodies the authors called indistinguishable from asbestos bodies. Cor pulmonale, a strain on the right side of the heart, was the major complication in 4 of the 6 men and the mechanism of death in 3. Of the other men, one died of a heart attack, one had chronic lymphatic leukemia, and one shot himself. The authors judged the overall findings similar to asbestosis.

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: case reports of 6 patients with clinical, X-ray and autopsy findings
• Who was studied: Six male talc miners and/or millers, aged 42 to 67 at hospitalization. They were admitted between 1951 and 1961, and all were examined at autopsy. The article does not state where the mine or mill was. The authors were from the Division of Industrial Hygiene, New York State Department of Labor.
• Exposure: Talc dust mixed with tremolite and anthophyllite, containing a small amount of free silica, for an average of 24 years. Free silica averaged 5% in periodic ore analyses over 20 years. Estimated average dust levels ranged from 29 to 470 mppcf (million particles per cubic foot) at different periods, for example 470 mppcf for the man in Case 4 during 20 years of mining.
• Main results:
  • Shortness of breath was present and progressive in all 6 men. It began after 18 to 33 years of talc dust exposure, an average of 24 years.
  • Opaque densities in the region of the diaphragm, which the authors called talc plaques, were seen on X-rays in all cases and confirmed at autopsy.
  • Elongated, clubbed bodies were found in the lung tissue. The authors described them as indistinguishable from the asbestos bodies seen in asbestosis.
  • Cor pulmonale was the major complication in 4 of the 6 cases and the mechanism of death in 3.
  • In Case 5, death was due to acute myocardial infarction.
  • In Case 3, a bone marrow smear was consistent with chronic lymphatic leukemia.
  • In Case 4, the man shot himself the day after discharge from hospital.
  • Silicosis-like nodules were found in 3 cases. The authors interpreted these, and hilar lymph node enlargement in 2 cases, as a reaction to talc modified by free silica.
• The authors' conclusion: The authors concluded that these findings, together with a history of prolonged exposure to high concentrations of talc dust, establish the diagnosis of talc pneumoconiosis. They found the clinical, X-ray and pathological findings generally similar to asbestosis. They also stated in general terms, not from data in these six cases, that pulmonary talcosis has not been associated with an increased incidence of pulmonary carcinoma.
• Limitations the authors state:
  • Exact free silica exposure could not be given for each individual worker.
  • The degree to which free silica modified the disease picture was difficult to determine.
  • No diffusion studies of lung function were made.

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, Pneumoconiosis.

Related studies

• Pulmonary ventilatory function in talcosis of lung — M. Kleinfeld, J. Messite, et al. (1964)
• Effect of tale dust inhalation on lung function — M. Kleinfeld, J. Messite, et al. (1965)
• Talc pneumoconiosis — A.I. McLAUGHLIN, E. Rogers, et al. (1949)
• Talc pneumoconiosis in the textile industry — B. Mann, J.B. Deasy (1954)
• Exposure to asbestos and mesothelioma of the pleura — P.B. Fowler, J.C. Sloper, et al. (1964)
• Mixed pneumoconiosis: silicosis, asbestosis, talcosis, and berylliosis — G.J. Mark, C.B. Monroe, et al. (1979)

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