Asbestos in Talc and Mesothelioma: Review of the Causality Using Epidemiology
Main Article Content
Abstract
Talcum powder has long been contaminated with asbestos fibers depending on the source of the talc. Pleural and peritoneal mesothelioma are scientifically established as caused by asbestos exposures. However, when investigating causality of mesothelioma from asbestos fibers in talcum powder, epidemiology is complicated by various methodological issues and inadequacies in existing studies. The occupational and case studies are explored in an effort to bring clarity to the issue of talcum powder usage and mesothelioma. Talc is randomly and sporadically contaminated with asbestos fibers including chrysotile, tremolite and anthophyllite. Case studies of mesothelioma victims whose only asbestos exposure was to talc, found anthophyllite, tremolite and chrysotile asbestos fibers in their tissues. Exposure to all three types of asbestos fibers increases the risk of mesothelioma. The Hill criteria of causality, which considers all aspects of toxicology, biology and epidemiology, are applied to the issue. This analysis results in compelling evidence that asbestos in talcum powder is causative for mesothelioma. Thus, precaution would dictate the avoidance of the use of talcum powders.
Keywords:
talc, asbestos, mesothelioma, tremolite, anthophyllite, pleural, peritoneal, epidemiology
Article Details
How to Cite
KANAREK, Marty S.; LIEGEL, Julia Claire O’Brien.
Asbestos in Talc and Mesothelioma: Review of the Causality Using Epidemiology.
Medical Research Archives, [S.l.], v. 8, n. 5, may 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2097>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v8i5.2097.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Rosner D, Markowitz G, Chowkwanyun M. “Nondetected”: The Politics of Measurement of Asbestos in Talc, 1971–1976. Am J Public Health. 2019;109(7):969-974.
4. IARC. Silica and some silicates. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Vol. 1987;42.
5. Pierce JS, Riordan AS, Miller EW, Gaffney SH, Hollins DM. Evaluation of the presence of asbestos in cosmetic talcum products. Inhal Toxicol. 2017;29(10):443-456.
6. Tran TH, Steffen JE, Clancy KM, Bird T, Egilman DS. Talc, Asbestos, and Epidemiology: Corporate Influence and Scientific Incognizance. Epidemiology (Cambridge, Mass). 2019;30(6):783.
7. IARC. A review of human carcinogens: arsenic, metals, fibres, and dusts. IARC Monograph 100 C. Lyon, France: IARC, 355–406. 2012.
8. Penninkilampi R, Eslick GD. Perineal Talc Use and Ovarian Cancer. Epidemiology. 2018;29(1):41-49.
9. Wagner J, Sleggs C, Marchand P. Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province. Occup Environ Med. 1960;17(4):260-271.
10. Park E-K, Takahashi K, Hoshuyama T, et al. Global magnitude of reported and unreported mesothelioma. Environ Health Perspect. 2011;119(4):514.
11. Stayner L, Welch LS, Lemen R. The worldwide pandemic of asbestos-related diseases. Annu Rev Public Health. 2013;34:205-216.
12. Kanarek MS. Mesothelioma from chrysotile asbestos: update. Ann Epidemiol. 2011;21(9):688-697. Erratum 2012; 22:337.
13. Kanarek MS, Mandich MK. Epidemiology: Open Access. OMICS. 2016;6:2.
14. Kohyama N, Suzuki Y. Analysis of Asbestos Fibers in Lung Parenchyma, Pleural Plaques, and Mesothelioma Tissues of North American Insulation Workers a. Ann N Y Acad Sci. 1991;643(1):27-52.
15. Heller D, Gordon R, Clement P, Turnnir R, Katz N. Presence of asbestos in peritoneal malignant mesotheliomas in women. Int J Gynecol Cancer. 1999;9(6):452-455.
16. Feder IS, Tischoff I, Theile A, Schmitz I, Merget R, Tannapfel A. The asbestos fibre burden in human lungs: new insights into the chrysotile debate. Eur Respir J. 2017;49(6):1602534.
17. Hillerdal G. Mesothelioma: cases associated with non-occupational and low dose exposures. Occup Environ Med. 1999;56(8):505-513.
18. Committee BTSSoC. Statement on malignant mesothelioma in the United Kingdom. Thorax. 2001;56(4):250-265.
19. Welch LS. Asbestos exposure causes mesothelioma, but not this asbestos exposure: an amicus brief to the Michigan Supreme Court. Int J Occup Environ Health. 2007;13(3):318-327.
20. WHO IPCC. Environmental Health Criteria 203. World Health Organization: Geneva. 1998.
21. ATSDR . Toxicological profile for asbestos. In: Georgia; 2001.
22. Rödelsperger K, Jöckel KH, Pohlabeln H, Römer W, Woitowitz HJ. Asbestos and man‐made vitreous fibers as risk factors for diffuse malignant mesothelioma: Results from a German hospital‐based case‐control study. Am J Ind Med. 2001;39(3):262-275.
23. Singhal B, Kohli S, Singhal A, Kumar V. Malignant Pleural and Peritoneal Mesothelioma Consequential to Brief Indirect Asbestos Exposure. J Clin Imaging Sci. 2014;4.
24. Lacourt A, Gramond C, Rolland P, et al. Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma. Thorax. 2014;69(6):532-539.
25. Pinto C, Novello S, Torri V, et al. Second Italian consensus conference on malignant pleural mesothelioma: state of the art and recommendations. Cancer Treat Rev. 2013;39(4):328-339.
26. Magnani C. III Italian Consensus Conference on Malignant Mesothelioma of the Pleura. Epidemiology, Public Health and Occupational Medicine related issues-final document. La Medicina del lavoro. 2015;106(5).
27. Ramazzini C. The 18th Collegium Ramazzini statement: The global health dimensions of asbestos and asbestos-related diseases. Scand J Work Environ Health. 2016;42(1):xi+ 86-90.
28. Tossavainen A. Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution. Scand J Work Environ Health. 2010;23(4):311-316.
29. Markowitz S. Asbestos-related lung cancer and malignant mesothelioma of the pleura: selected current issues. Seminars in Respiratory and Critical Care Medicine 2015;36(3):334-336..
30. Van Gosen BS, Lowers HA, Sutley SJ, Gent CA. Using the geologic setting of talc deposits as an indicator of amphibole asbestos content. Environ Geol. 2004;45(7):920-939.
31. Price B. Industrial-grade talc exposure and the risk of mesothelioma. Crit Rev Toxicol. 2010;40(6):513-530.
32. Finley BL, Benson SM, Marsh GM. Cosmetic talc as a risk factor for pleural mesothelioma: a weight of evidence evaluation of the epidemiology. Inhal Toxicol. 2017;29(4):179-185.
33. Drechsel DA, Barlow CA, Bare JL, Jacobs NF, Henshaw JL. Historical evolution of regulatory standards for occupational and consumer exposures to industrial talc. Regul Toxicol Pharmacol. 2018;92:251-267.
34. Rohl AN, Langer AM. Identification and quantitation of asbestos in talc. Environ Health Perspect. 1974;9:95-109.
35. Lorimer W, Rohl AN, Miller A, Nicholson WJ, Selikoff IJ. Asbestos exposure of brake repair workers in the United States. The Mount Sinai Journal of Medicine, New York. 1976;43(3):207.
36. Gordon RE, Fitzgerald S, Millette J. Asbestos in commercial cosmetic talcum powder as a cause of mesothelioma in women. Int J Occup Environ Health. 2014;20(4):318-332.
37. Ilgren EB, Sartorio C, Hoskins J. Analysis of an authentic historical Italian cosmetic talc sample–further evidence for the lack of cancer risk. Environ Pollut. 2017;6(6).
38. Council NR. A Review of the NIOSH roadmap for research on asbestos fibers and other elongate mineral particles. National Academies Press; 2009.
39. Egilman D, Steffen J, Tran T, Clancy K, Rigler M, Longo W. Health Effects of Censored Elongated Mineral Particles: A Critical Review. In: Detection Limits in Air Quality and Environmental Measurements. ASTM International; 2019.
40. Hill AB. The environment and disease: association or causation? Proc R Soc Med.19;58:295-300.
41. Finkelstein MM. Pneumoconiosis and malignant mesothelioma in a family operated metal casting business that used industrial talc from New York state. Am J Ind Med. 2013;56(5):550-555.
42. Gamble J, Greife A, Hancock J. An epidemiological-industrial hygiene study of talc workers. In: Inhaled Particles V. Elsevier; 1982:841-859.
43. Kleinfeld M, Messite J, Kooyman O, Zaki MH. Mortality among talc miners and millers in New York State. Archives of Environmental Health: An International Journal. 1967;14(5):663-667.
44. Selevan S, Dement J, Wagoner J, Froines J. Mortality patterns among miners and millers of non-asbestiform talc: preliminary report. J Environ Pathol Toxicol. 1979;2(5):273.
45. Moline J, Bevilacqua K, Alexandri M, Gordon RE. Mesothelioma Associated With the Use of Cosmetic Talc. J Occup Environ Med. 2020;62(1):11-17.
46. Emory TS MJ, Kradin RL. Malignant mesothelioma following repeated exposures to cosmetic talc: A case series of 75 patients. American Journa of Industrial Medicine. 2020:1-6.
47. Wild P, Leodolter K, Refregier M, Schmidt H, Zidek T, Haidinger G. A cohort mortality and nested case-control study of French and Austrian talc workers. Occup Environ Med. 2002;59(2):98-105.
48. Pira E, Coggiola M, Ciocan C, et al. Mortality of talc miners and millers from Val Chisone, Northern Italy: an updated cohort study. J Occup Environ Med. 2017;59(7):659-664.
49. Wergeland E, Gjertsen F, Vos L, Grimsrud TK. Cause‐specific mortality and cancer morbidity in 390 male workers exposed to high purity talc, a six‐decade follow‐up. Am J Ind Med. 2017;60(9):821-830.
50. Vianna N. Epidemiologic patterns in New York State. NY State J Med. 1981.
51. Enterline PE, Henderson VL. Geographic patterns for pleural mesothelioma deaths in the United States, 1968–81. J Natl Cancer Inst. 1987;79(1):31-37.
52. Coggiola M, Bosio D, Pira E, et al. An update of a mortality study of talc miners and millers in Italy. Am J Ind Med. 2003;44(1):63-69.
53. Hull MJ, Abraham JL, Case BW. Mesothelioma among workers in asbestiform fiber-bearing talc mines in New York State. Ann Occup Hyg. 2002;46(suppl_1):132-135.
54. Honda Y, Beall C, Delzell E, Oestenstad K, Brill I, Matthews R. Mortality among workers at a talc mining and milling facility. Ann Occup Hyg. 2002;46(7):575-585.
55. Gamble JF, Gibbs GW. An evaluation of the risks of lung cancer and mesothelioma from exposure to amphibole cleavage fragments. Regul Toxicol Pharmacol. 2008;52(1):S154-S186.
56. Finkelstein MM. Malignant mesothelioma incidence among talc miners and millers in New York State. Am J Ind Med. 2012;55(10):863-868.
57. Sanyal S, Abraham JL, Crawford JA, Burnett B. Mesothelioma With No Evidence Of Commercial Amphibole Asbestos Exposure--35 Cases With Chrysotile, Non-Commercial Amphibole Or Asbestiform Talc By Lung Fiber Burden Analysis. In: B58. Occupational lung disease: case studies, epidemiology, and mechanisms. American Thoracic Society; 2017:A3863-A3863.
58. Mirabelli D. Letter on:“mortality of talc miners and millers from Val Chisone, Northern Italy”. J Occup Environ Med. 2018;60(1):e72.
59. Wojcik NC, Schnatter AR, Huebner WW. Mesothelioma in occupational cohort studies: methodological considerations. J Occup Environ Med. 2014;56(1):47-51.
60. Selikoff IJ, Hammond EC, Seidman H. Mortality experience of insulation workers in the United States and Canada. 1943‐1976. Ann N Y Acad Sci. 1979;330(1):91-116.
61. Selikoff IJ, Seidman H. Asbestos‐associated deaths among insulation workers in the United States and Canada, 1967–1987. Ann N Y Acad Sci. 1991;643(1):1-14.
62. Rubino GF, Scansetti G, Piolatto G, Romano CA. Mortality study of talc miners and millers. J Occup Med. 1976;18(3):187-193.
63. Rubino G, Piolatto G, Newhouse ML, Scansetti G, Aresini G, Murray R. Mortality of chrysotile asbestos workers at the Balangero Mine, Northern Italy. Brit J Ind Med.. 1979;36(3):187-194.
64. Finkelstein MM. Re: Mortality of Talc Miners and Millers From Val Chisone, Northern Italy. J Occup Environ Med. 2017;59(10):e194.
65. Pira et al. Response to Letter to the Editor on the Miners and Millers. J Occup Med. 2018;60(1):73.
66. Davis J, Addison J, Mclntosh C, Miller B, Niven K. Variations in the carcinogenicity of tremolite dust samples of differing morphology In: The Proceedings of the Third Wave of Asbestos Disease: Exposure to asbestos in place. Public Health Control, Landrigan, PJ, Kazemi, H(eds). 1991.
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