Cause‐specific mortality and cancer morbidity in 390 male workers exposed to high purity talc, a six‐decade follow‐up

Wergeland, Ebba; Gjertsen, Finn; Vos, Linda; Grimsrud, Tom Kristian

doi:10.1002/ajim.22749

Cited by 30 publications

(18 citation statements)

References 14 publications

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“…The debate sparked by this paper led to several works focusing on this topic until last year with controversial results [ 35 , 37 , 184 , 215 , 216 , 217 , 218 , 219 , 220 , 221 , 222 , 223 , 224 ]. For example, it should be emphasized that no excesses of pleural mesothelioma nor talc pneumoconiosis were found in studies of miners in talc mines [ 177 , 225 , 226 , 227 , 228 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Ovarian Mesothelioma: A Case Series with Electron Microscopy Examination and Review of the Literature

Vimercati

Cavone

Delfino

et al. 2021

Cancers

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Primary ovarian mesothelioma is a rare, aggressive neoplastic disease with a poor prognosis. At onset, the tumor is only rarely limited to the ovaries and usually already widespread in the peritoneum. The rarity of this entity and the difficulties differentiating it from either ovarian carcinoma or peritoneal mesothelioma may lead to frequent misdiagnoses and may raise some concerns about its histogenesis. Thus, reporting such rare cases is fundamental to gain greater awareness of this neoplasm and try to answer unsolved questions. Herein, we described four cases of histological diagnoses of ovarian mesothelioma extrapolated by the regional mesothelioma register of Apulia (southern Italy). In all cases, a detailed medical history was collected according to national mesothelioma register guidelines. A broad panel of antibodies was used for immunohistochemistry to confirm the diagnoses. Moreover, ovarian tissue samples were also examined by transmission and scanning electron microscopy, detecting asbestos fibers and talc crystals in two cases. Because of the few cases described, we reviewed the English literature in the Medline database, focusing on articles about ovarian mesothelioma “misclassification”, “misdiagnosis”, “diagnostic challenge” or “diagnostic pitfall” and on unsolved questions about its histogenesis and possible risk factors.

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Section: Discussionmentioning

confidence: 99%

Primary Ovarian Mesothelioma: A Case Series with Electron Microscopy Examination and Review of the Literature

Vimercati

Cavone

Delfino

et al. 2021

Cancers

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“…Talcs from both locations were considered to have low quartz content ( 36 ). A cohort study in Norway followed 390 talc miners and millers for mortality from 1952 to 2011 ( 38 , 39 ). Norwegian talc reportedly contains only trace amounts of quartz, tremolite and anthophyllite ( 38 ).…”

Section: Epidemiology As a “Reality Check”: Lung Cancer And Occupatio...mentioning

confidence: 99%

“…A cohort study in Norway followed 390 talc miners and millers for mortality from 1952 to 2011 ( 38 , 39 ). Norwegian talc reportedly contains only trace amounts of quartz, tremolite and anthophyllite ( 38 ). A cohort of 427 talc miners and millers in Vermont (US) who began working as early as 1930 were followed for mortality through 2012 ( 35 , 40 ).…”

Section: Epidemiology As a “Reality Check”: Lung Cancer And Occupatio...mentioning

confidence: 99%

Carcinogenicity of Poorly Soluble Low Toxicity Particles: Commentary on Epidemiology as a Risk Assessment “Reality Check”

Mundt

Santamaria

Thompson

et al. 2022

Front. Public Health

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Inhaled particles that are poorly soluble or insoluble and of low toxicity (“poorly soluble low toxicity” or “PSLT” particles), can accumulate in the lung and at lung overload levels induce lung cancers in rats. The question of whether PSLT particles increase lung cancer risk in humans is complicated by large differences between rats and humans and the relatively large particle doses administered in animal studies even when compared with heavy human occupational exposures. We review the findings of epidemiological studies on occupational exposure to each of three different PSLT particles (carbon black, talc and taconite). The epidemiological evidence indicates that at even very high occupational exposure levels at which non-malignant respiratory diseases including pneumoconiosis and even talcosis are observed, lung cancer risks appear not to be elevated. Although positive human cancer risks might be predicted based on extrapolation from overload doses in rats to relevant exposures in humans, the epidemiological “reality check” based on the three examples indicates that these PSLT particles are unlikely to increase lung cancer risk in humans even at high occupational levels of exposure. Therefore, we propose that careful evaluation of the epidemiological evidence can serve as a “reality check” for human risk assessment and help balance the risk evaluation process.

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“…There have been several epidemiology studies of talcexposed miners, millers and others that were considered negative for mesothelioma detection including the studies in Table 1. 44 Wild et al 2002 France 47 Wild et al 2002 Austria 47 Pira et al 2017 Italy 48 Wergeland et al 2017 49 Copyright 2020 KEI Journals. All Rights Reserved http://journals.ke-i.org/index.php/mra However, there have been mesotheliomas, or probable or possible mesotheliomas, found in other studies in talcexposed miners, millers and others (Table 2): Table 2: Mesotheliomas in Talc-Exposed Miners and Millers Kleinfeld et al 1967 New York 1 fibrosarcoma of the pleura and 1 peritoneal mesothelioma 43 Vianna 1981 New York 6 mesotheliomas (miners) 50 Enterline et al 1987 New York 11 mesotheliomas 51 Coggiola et al 2003 Italy 2 peritoneal cancers 52 Hull et al 2002 New York 5 mesotheliomas (miners) 53 Honda et al 2002 New York 2 mesotheliomas 54 Gamble et al 2008 New York 2 mesotheliomas 55 Finkelstein 2012 New York 5 mesotheliomas 56 Sanyal et al 2017 New York 11 mesotheliomas 57 Mirabelli 2018 Italy 1 pleural mesothelioma (talc mill) 58 Issues in the Epidemiology study of Talc There can be bias in the selection of study subjects and controls, in the assessment of exposure and the ascertainment and recording of outcome.…”

Section: Epidemiology Studies Of Miners and Millers And Mesotheliomamentioning

confidence: 99%

Asbestos in Talc and Mesothelioma: Review of the Causality Using Epidemiology

Kanarek

Liegel

2020

MRAJ

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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.

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Cause‐specific mortality and cancer morbidity in 390 male workers exposed to high purity talc, a six‐decade follow‐up

Cited by 30 publications

References 14 publications

Primary Ovarian Mesothelioma: A Case Series with Electron Microscopy Examination and Review of the Literature

Primary Ovarian Mesothelioma: A Case Series with Electron Microscopy Examination and Review of the Literature

Carcinogenicity of Poorly Soluble Low Toxicity Particles: Commentary on Epidemiology as a Risk Assessment “Reality Check”

Asbestos in Talc and Mesothelioma: Review of the Causality Using Epidemiology

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