Cosmetic Talc Research Articles

Historical cosmetic talc consumption and incidence of mesothelioma in the United States

ABSTRACT Jointpoint Regression Software from the National Cancer Institute was used to model age-adjusted male and female pleural and peritoneal mesothelioma rates in the surveillance, epidemiology, and end results (SEER) 8, SEER 12, and SEER 22 cancer registries. Linear mixed models were then used to determine if there was a statistical association between U.S. cosmetic talc consumption and the 30-year lagged age-adjusted mesothelioma rates (1) over the reporting period for each registry and (2) for the periods of time identified by the jointpoint model where changes in the rate of mesothelioma occurred. Regardless of the SEER registry used, from the early-1980s through 2020, rates of peritoneal mesothelioma have remained steady or declined. Female pleural mesothelioma rates were unchanged from the early-1980s until 2017 when rates declined, while male rates peaked in the early 1990s and have since declined. Cosmetic talc consumption was not statistically associated with an increased rate of pleural or peritoneal mesothelioma in males or females, suggesting that the use of cosmetic talc products is not associated with the development of mesothelioma.

Health risks due to the presence of asbestos in cosmetic talcs. An Italian story

The presence of asbestos in cosmetic talc has been reported in the United States since the 1970s. The present article first retraces the Italian case, then focuses on technical features as well as the relevant laws, rules, and regulations, ending with a precautionary evidence-based approach. Research was mainly aimed at retrieving official Italian Health Authority papers on the tests carried out several decades ago, to identify the presence of any asbestos in talc of products for sale. Results show that, in Italy, National Institute of Health (the technical agency of the Ministry of Health) and the Italian Pharmacopoeia (1985) used scanning electron microscopy (SEM) to ascertain the absence of asbestos fibres, following positive identification in several samples they had analysed. In 2008, Italy adopted the EU Pharmacopoeia according to which light microscopy (LM) was sufficient for analysis. Such a technical downgrading clearly went - and goes - against the standard principle of precaution to prevent harm to users' health.Unfortunately, documents on the above-mentioned SEM research that would have contextualized observations were not recovered from the Italian State Archive. Observations and results indicate that in practice levels of attention on the issue underwent a considerable (negative) decline, so much that effective planning of the necessary controls was not possible, which is unfortunately true to this day. Final comments deal with the principle of precaution and possible practical operational solutions.

Assessment of worst-case potential airborne asbestos exposure associated with the use of cosmetic talc: application of an exponential decay model.

Talc is used in cosmetic products to confer desirable properties, such as moisture absorption and smooth texture, to the finished products. Concerns have been raised about the potential presence of asbestos in products containing cosmetic talc. Reconstruction of potential asbestos exposure from the use of cosmetic talc products (assuming a trace level of asbestos) requires consideration of consumer use patterns. Although application generally only lasts seconds, exposure theoretically may continue if the consumer remains in the immediate vicinity. Most published exposure measurements have not adequately characterized the potential for continued exposure. In this analysis, estimates and measurements of airborne asbestos fiber concentrations associated with cosmetic talc use from 10 published studies were used as inputs to an exponential decay model to estimate "worst-case" exposure during and following application. The resulting geometric mean 30-min time-weighted average (TWA) concentrations were 0.006 f/cc for both puff and shaker application, for diapering, 0.0001f/cc (adult applying baby powder) and 0.0002 f/cc (infant), and for makeup application, 0.0005 f/cc. Application of an exponential decay model to measured or estimated asbestos concentrations associated with the use of cosmetic talc products yields a conservative means to comprehensively reconstruct such exposures. Moreover, our results support that, if a cosmetic talc powder product contained a trace level of asbestos fibers, the "worst-case" airborne asbestos exposure associated with its application is low.

Occupational environment and ovarian cancer risk

ObjectivesTo investigate employment in an occupation or industry and specific occupational exposures in relation to ovarian cancer risk.MethodsIn a population-based case–control study conducted in Montreal, Canada (2011–2016), lifetime occupational histories...

Response to the Letter to the Editor From Jeffrey Brent, MD, PhD. Re: Mesothelioma Associated With the Use of Cosmetic Talc.

Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY Conflicts of interest: The author has served as an expert witness in asbestos litigation on behalf of plaintiffs, including in cases in which patients with cosmetic talc exposure developed mesothelioma. Address correspondence to: Jacqueline Moline, MD, MSc, FACP, FACOEM, Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, 175 Community Dr, Suite 206, Great Neck, NY 11021 ([email protected]).

Article by Moline et al. Mesothelioma Associated With the Use of Cosmetic Talc.

Distinguished Clinical Professor of Medicine, University of Colorado, School of Medicine, Aurora, CO [email protected] Re: Moline J, Bevilacqua K, Alexandri M, et al. Mesothelioma associated with the use of cosmetic talc. JOEM. 2020;62(1):11–17. I have provided consultative services to Pfizer regarding the clinical toxicology of talc. Pfizer has no knowledge of this submission. I have not discussed it with them, or their representatives, nor have they, or their representatives, been given an opportunity to review this letter. This letter was written on my own time and is uncompensated.

Exposure to cosmetic talc and mesothelioma

AimMesothelioma is associated with asbestos exposure. In this case series, we present 166 cases of individuals who had substantial asbestos exposure to cosmetic talc products as well as some who had potential or documented additional exposures to other asbestos-containing products and who subsequently developed mesothelioma.MethodsData were gathered for all subjects referred to an occupational and environmental medicine specialist as part of medicolegal review. Years of total cosmetic talcum powder usage was noted as well as the latency from the onset of talcum powder use to the mesothelioma diagnosis. Alternate asbestos exposure in addition to the exposure from cosmetic talc was categorized as none, possible, likely, and definite.ResultsIn 122 cases, the only known exposure to asbestos was from cosmetic talc. For 44 cases, potential or documented alternate exposures in addition to the cosmetic talc were described.ConclusionCumulative exposure to asbestos leads to mesothelioma; for individuals with mixed exposures to asbestos, all exposures should be considered. Use of cosmetic talc is often overlooked as a source of asbestos exposure. All individuals with mesothelioma should have a comprehensive history of asbestos exposure, including cosmetic talc exposure.

The Effect of Cosmetic Talc Powder on Health

Talc powder is widely used for different purposes worldwide. Effects of talc on the human health is a concern as it has many chemical components. This review is an attempt to present the relevant researches in this field and to summarize the current updates about the topic. Talcum powder exposure has been shown to be a reason in the development of mesotheliomas and carcinoma of the lung in women. Regular cosmetic powders can get attached to larger particles that would deposit in the upper airways of the human respiratory system. The alveolar region is the second most exposed region of the respiratory system. Deposition levels in the tracheobronchial region is the lowest. Cosmetic talc powder, used regularly by women worldwide, can cause detrimental effects on different organ systems of the human body. Awareness on its harmful effects to the users may be useful to reduce the usage to some extent.

Evaluation of asbestos exposure resulting from simulated application of spiked talcum powders

This study characterizes airborne asbestos exposures resulting from the adult application of cosmetic talc body powders spiked with known concentrations of tremolite. Raw talc ores were spiked with 0.005% and 0.1% asbestiform or non-asbestiform tremolite. Personal samples were collected during 16 simulated events, including puff and shaker application and associated clean-up activities. Airborne fiber levels (PCM) were not significantly different for simulations involving talc spiked with asbestiform and non-asbestiform tremolite (p = 0.6104). For application and clean-up of talc spiked with 0.005% asbestiform tremolite, 2 of 24 (8.3%) samples were above the LOD for TEM (0.003 f/cc). For application of talc spiked with 0.1% asbestiform tremolite, 21 of 24 (87.5%) were above the LOD for TEM. The corresponding mean PCME asbestos concentrations were 0.016 f/cc for puff and shaker for samples collected in the first 15 min, 0.002 f/cc for puff and 0.004 f/cc for shaker in the second 15 min, and 0.005 f/cc for puff and 0.013 f/cc for shaker for the full 30 min. Mean PCME concentrations for samples collected during clean-up following application of talc spiked with 0.1% asbestiform tremolite were 0.003 f/cc for samples collected in the first 15 min following puff application, 0.005 f/cc for samples collected in the second 15 min following shaker application, and 0 f/cc for the remaining clean-up samples. Using the EPA’s exposure factors, we determined the range of cumulative asbestiform fiber exposures that would result from product use, assuming asbestiform tremolite was present at 0.1%.

Updated Italian cohort data continues to confirm lack of mesothelioma risk in pooled cohort of international cosmetic talc miners and millers

Objectives To assess potential mesothelioma risk following inhalation of cosmetic talc, we updated previous iterations of a pooled cohort analysis, post-study statistical power analysis, and confidence interval function analysis for a pooled cohort of international cosmetic talc miners/millers given new Italian cohort data. Methods Five cohorts of cosmetic talc miners/millers were pooled. Expected numbers of mesotheliomas for each cohort were reported by the original authors. We based our post-study statistical power analysis on an a priori one-sided significance level of 0.05, and exact Poisson and approximate distribution probabilities. To evaluate the confidence interval function for the observed pooled mesothelioma standardized mortality ratios (SMRs), we calculated the probability for the upper 100(1–2α)% confidence limit that equals various SMRs of interest. Results The pooled cohorts generated a total observation time of 135,524.38 person-years. Overall, 4.14 mesotheliomas were expected (mid-value estimate), though only one case of mesothelioma has been confirmed in the pooled cohort to date. We calculated 71% and 87% post-study power to detect a 2.5-fold or greater and a 3.0-fold or greater increase in mesothelioma, respectively. Our complimentary confidence interval function analysis demonstrated that the probability that the true mesothelioma SMR for the pooled cohort was at or above 2.0 or at or above 3.0 was 0.00235 and 0.00005, respectively. Conclusions Based on the updated results of our various analyses, the current epidemiological evidence from cosmetic talc miner/miller cohort studies continues to not support the hypothesis that the inhalation of cosmetic talc is associated with an increased risk of mesothelioma.

The Definition of Asbestos - A Manufactured Defense to Avoid Regulation and Victim Compensation

Background: The Occupational Safety and Health Administration (OSHA) first identified asbestos as a regulated workplace hazard in 1971. In the half century since, OSHA has fully rescinded only one of its hundreds of regulations, one that happened to regulate a form of asbestos found as an accessory mineral in cosmetic talc. This extremely rare action grew out of a 20-year campaign by Talc Mining and Manufacturing Companies (TM&MCs) to redefine some of the asbestos routinely found in talc as “non-asbestos” to keep talc out of the regulation. Under this new definition, at least 50% of the products sold as asbestos became “non-asbestos.” Methods: We used systematic search techniques and grounded theory to review published studies, government records, corporate documents and public statements. Results: Current asbestos regulations and test methods rely heavily on asbestos geologic definition which determine the majority of asbestos fibers as “non-asbestos.” In essence, this geologic definition defined some asbestos out of existence. However, asbestos regulations should be driven by the health effects of asbestos. Conclusions: TM&MCs funded experts and lobbied OSHA to promote an overly restrictive definition of asbestos and to support inadequate test methods in place of more effective procedures. These companies subsequently relied on these same restrictive definitions and inadequate tests to falsely claim that their cosmetic talcs are free of asbestos. Replacing the restrictive geologic definition of asbestos with a health definition is needed to protect the public from the well-known dangers of asbestos.

X-ray and infrared spectroscopy study on contamination of asbestos in Thai commercial cosmetic talc powder product

It is well-known that asbestos such as asbestosis and mesothelioma is a fiber causing lung diseases. Talc is used for commercial applications for example paints, plastics, papers, ceramics, construction materials, and cosmetics. It is well-known that the cosmetic talc powder is used for preventing diaper rash as a deodorant. The sampling in this work has been done from various commercial products in Thailand. Their microstructure and elemental composition are analyzed using a scanning electron microscope coupled with an energy dispersive X-ray spectrometer (SEM-EDS). A small-angle X-ray scattering (SAXS) and infrared spectroscopy (IR) based on synchrotron radiation are also carried out to determine their phase composition and functional groups. It has been found that fibers with asbestos-like shapes are present in somesamples. The main composition of oxygen, silicon, and magnesium in samples are in the form of the functional groups that associate with absorption band in the range of 3600-3700 cm -1 of IR spectra. It is proposed that there are 6 from 17 samples that possibly have asbestos contamination.

Evidence that cosmetic talc is a cause of ovarian cancer

Evidence that cosmetic talc is a cause of ovarian cancer

A Review of the Talc Industry's Influence on Federal Regulation and Scientific Standards for Asbestos in Talc.

The talc industry and Food and Drug Administration (FDA) have asserted that talc has been asbestos-free since 1976 when the industry created a voluntary specification for the asbestos content of cosmetic talc. However, recent evidence reveals that cosmetic talc is not and never was asbestos-free. This narrative review examines the talc industry’s role in delaying and ultimately blocking federal regulation of cosmetic talc from the 1970s to today. We review primary source material, including corporate documents released in recent litigation and FDA documents released in response to Freedom of Information Act requests. Our results indicate that the talc industry exerted considerable influence over three key areas: regulatory proceedings at the FDA; testing methods and the manipulation of test results (including undisclosed results); and press coverage and the medical literature. The talc companies’ actions and FDA indifference have had a lasting effect on consumer health, including the regulation of talc by other government agencies.

A quantitative weight of evidence assessment of Hill's guidelines for causal inference for cosmetic talc as a cause of mesothelioma

Cosmetic talc has been suggested to cause mesothelioma. To assess a potential causal relationship between cosmetic talc and mesothelioma, a quantitative weight of evidence analysis was performed in accordance with Hill's nine original guidelines for causal inference using a published empirical model to weight each respective guideline. Various epidemiological, toxicological, and exposure studies related to cosmetic talc and risk of mesothelioma were included in an evaluation of each of Hill's guidelines. Probabilities that the guidelines were true were assigned based on expert judgment. We applied a sensitivity analysis to evaluate the variability of our probability estimates. The overall probability of causality for cosmetic talc and mesothelioma was approximately 1.29% (range: 0.73%–3.96%). This low probability of causality supports the conclusion that cosmetic talc is not related to the development of mesothelioma.

Inhalation Toxicity of Talc.

Respirable talc powder (RTP) is a complex mineral mixture of talc along with accessory minerals, including tremolite, anthophyllite, quartz, magnesite, dolomite, antigorite, lizardite, and chlorite. The industrial mining, milling, and processing of talc ore is associated with elevated incidences of fibrotic and neoplastic diseases, which are also seen among workers exposed to RTP in secondary industries and individuals using processed cosmetic talc for personal use. There is controversial evidence of a link between the talc-induced lung diseases and a potential contamination with asbestos fibers. This controversy is fueled by inadequate exposure data and the complex mineralogy and terminology of the accessory minerals. Talc aerosols exhibit a wide range of mineral habits, including particulates and fibrous structures that have dimensional and compositional characteristics related to the development of asbestos-related lung disease. The inhalation toxicology of RTP is based on the analysis of occupational hygiene and animal inhalation studies conducted between the 1940s and the 1990s and more recent mechanistic studies conducted both in vivo and in vitro. The review of talc toxicity studies reveals that the occupational studies provide only equivocal links between any of the components of the aerosols and the development of pulmonary cancer; however, there is substantial evidence of an association between the aerosols and pleural and pulmonary fibrosis and the development of nonmalignant respiratory disease. The animal inhalation and implantation studies appear to be less than optimal, which also appears to be true for the in vivo and in vitro studies. The mechanistic studies have identified the key pathogenic characteristics of asbestos to be long and thin fibers that are durable in lung tissues and fluids. Talc toxicity studies show that talc particles and fibers are durable and can remain in the lung for up to 40 years after the end of exposure. This extended tissue residence is considered to constitute a continuing tissue exposure that is capable of inducing the documented inflammatory and proliferative response. There is less consensus as to whether there is a threshold fiber length effect, as long, thin fibers (>5 μm) form only a small fraction of talc aerosols and the possible role of fibers >5 μm in the translocation from the lung to the pleura and their association with pleural fibrotic and carcinogenic lesions. Long, thin fibers are preferentially deposited in hot spots in the lung, such as airway bifurcations, areas typically associated with the development of lung cancer. The platy structures typical of talc can form oblate structures behaving more as fibers in the air stream, and these have also been shown to deposit preferentially in such locations. The review of the inhalation toxicity of talc provides a plausible explanation for the carcinogenic potential of RTP.

Confidence interval function analysis to evaluate the risk of mesothelioma among an expanded international cohort of cosmetic talc miners and millers

We used pooled data from international cosmetic talc miner/miller cohorts to determine whether hypothesized increased mesothelioma risks are consistent with the observed data. We evaluated the confidence interval function for the observed pooled mesothelioma SMRs (observed = 1; expected = 3.17, 3.34, or 3.60), and calculated the value of α for the upper 100(1 – 2α)% confidence limit that equals various SMRs of interest (1.5, 2.0, 2.5, 3.0). Using the mid-value estimate of expected number of cases (3.34), the probability (α) that the true mesothelioma SMR is at or above 2.0, or at or above 3.0 is 0.0096 and 0.0005, respectively. Thus, a mesothelioma SMR ≥2.0 is not compatible with the observed pooled data, providing further support for our conclusion that cosmetic talc exposure is not associated with an elevated risk of mesothelioma.

Absence of mesothelioma risk maintained in an expanded international cohort of cosmetic talc miners and millers

Objectives: Based on novel information for the Vermont cosmetic talc miner/miller cohort, including a reported case of mesothelioma, we sought to update our prior pooled statistical power analyses of mesothelioma incidence among European cosmetic talc miners/millers. With the inclusion of the Vermont cohort, we expanded our pooled analysis by 17,170 person-years of observation.Methods: Cosmetic talc miner/miller cohort studies conducted in Italy, Norway, France, Austria, and Vermont were pooled. The expected numbers of mesothelioma cases for each cohort as reported in these studies were used. Our statistical power analysis was based on an a priori one-sided significance level of 0.05 and Poisson distribution probabilities.Results: A total of 130,514 person-years of observation was generated across the five cohorts. One case of mesothelioma was observed (in the Vermont cohort), while approximately 3.34 cases (a mid-value estimate) were expected overall. Thus, we found that the pooled cohorts had 59% and 78% power to detect a 2.5-fold or greater and a 3.0-fold or greater increase in mesothelioma, respectively. The work history characteristics of the one mesothelioma case, which included mention of prior asbestos exposure on the case’s death certificate, do not support a causal link with cosmetic talc exposure.Conclusions: Despite the recent finding of one case of mesothelioma in the Vermont cohort (a case unlikely related to talc exposure), we continue to conclude that the epidemiological evidence from the cosmetic talc miner/miller cohort studies does not support the hypothesis that cosmetic talc exposures are associated with an increased risk of pleural mesothelioma.

Mineralogical and Geochemical Characterization of Talc from Two Mexican Ore Deposits (Oaxaca and Puebla) and Nine Talcs Marketed in Mexico: Evaluation of Its Cosmetic Uses

The detailed mineralogical, physical and chemical characterization of nine samples of imported cosmetic talc and of two samples of talc from currently non-productive Mexican ore deposits (Oaxaca and Puebla States) is presented. The imported cosmetic talc was classified into two groups, considering whether they are packed in the country of origin or in Mexico and considering their price. X-ray diffraction, infrared short wave, thermogravimetric analysis and scanning electron microscopy were used for mineralogical characterization. For the physical characterization, colorimetry and laser granulometry were used. The chemical composition (major, trace elements) was studied by ICP-MS. It was concluded that only the highest priced and imported in packaged form talcs meet the specific purity requirements for a talc of cosmetic type. The talcs that are packed in Mexico and the talc of the studied Mexican deposits present mineralogical and chemical impurities that make their use difficult in the manufacture of high-quality cosmetic talc. The low-price talc should not be sold as cosmetic talc, and the regulations in Mexico on this subject should be reviewed and updated.

Malignant mesothelioma following repeated exposures to cosmetic talc: A case series of 75 patients.

BackgroundAsbestos is the primary known cause of malignant mesothelioma. Some cosmetic talc products have been shown to contain asbestos. Recently, repeated exposures to cosmetic talc have been implicated as a cause of mesothelioma.MethodsSeventy‐five individuals (64 females; 11 males) with malignant mesothelioma, whose only known exposure to asbestos was repeated exposures to cosmetic talcum powders, were reviewed in medical‐legal consultation. Out of the 75 cases, 11 were examined for asbestiform fibers.ResultsAll subjects had pathologically confirmed malignant mesothelioma. The mean age at diagnosis was 61 ± 17 years. The mean latency from exposure to diagnosis was 50 ± 13 years. The mean exposure duration was 33 ± 16 years. Four mesotheliomas (5%) occurred in individuals working as barbers/cosmetologists, or in a family member who swept the barber shop. Twelve (16%) occurred in individuals less than 45 years old (10 females; 2 males). Forty‐eight mesotheliomas were pleural (40 females; 8 males), 23 were peritoneal (21 females; 2 males). Two presented with concomitant pleural and peritoneal disease. There was one pericardial, and one testicular mesothelioma. The majority (51) were of the epithelioid histological subtype, followed by 13 biphasic, 8 sarcomatoid, 2 lymphohistiocytoid, and 1 poorly differentiated. Of the 11 individuals whose nontumorous tissues were analyzed for the presence of asbestiform fibers, all showed the presence of anthophyllite and/or tremolite asbestos.ConclusionsMesotheliomas can develop following exposures to cosmetic talcum powders. These appear to be attributable to the presence of anthophyllite and tremolite contaminants in cosmetic talcum powder.