Occupational Exposure to Talc Increases the Risk of Lung Cancer: A Meta-Analysis of Occupational Cohort Studies

Abstract

Objective Talc is widely used in industrial applications. Previous meta-analyses of carcinogenic effects associated with inhaled talc included publications before 2004, with a lack of data in China, the largest talc-producing country. The safety of workers exposed to talc was unclear due to limited evidence. The objective of this study was to reevaluate the association between inhaled talc and lung cancer. Setting, Participants, and Outcome Measures A meta-analysis was performed to calculate the meta-SMR of lung cancer. We searched the MEDLINE, EMBASE, CNKI, and Wanfang Data databases through March 2017. Data from observational studies were pooled using meta-analysis with random effects models. Results Fourteen observational cohort studies (13 publications) were located via literature search. The heterogeneity of the included data was high (I-squared = 72.9%). Pooling all the cohorts yielded a meta-SMR of 1.45 (95% CI: 1.22–1.72, p < 0.0001) for lung cancer among the study subjects exposed to talc. Subgroup analysis for asbestos contamination showed no significant difference in lung cancer death between subjects exposed to talc with and without asbestos (p = 0.8680), indicating that this confounding factor may have no significance. Conclusions This study provides evidence that nonasbestiform talc might still increase the risk of lung cancer. Further epidemiological studies are required to evaluate the safety of workers with occupational talc exposure.

Efficacy of sirolimus for the prevention of recurrent pneumothorax in patients with lymphangioleiomyomatosis: a case series

“…Therefore, when physicians coadminister sirolimus and anti-tuberculosis drugs, they should individually increase the dose of sirolimus under close monitoring of the plasma levels. In our case series, no patient received talc pleurodesis, considering that previous studies have demonstrated that exposure to talc may increase the risk of lung cancer [ 11 , 12 ]. Therefore, autologous blood or hypertonic glucose is used as a sclerosing agent for chemical pleurodesis in many hospitals in China because of the low medical risk associated with these agents.…”

A case of lung adenocarcinoma complicated by pulmonary talcosis occurring in a patient employed in the confectionery industry

“…Subgroup analysis for asbestos contamination showed no significant difference in lung cancer deaths between participants exposed to talc, with and without asbestos ( p = 0.8680), indicating that this confounding factor may have no significance. They concluded that it is necessary to evaluate the safety of workers with occupational talc exposure . An interesting point of this report is that considerable regional differences existed in the incidence of lung cancer among talc workers.…”

“…They concluded that it is necessary to evaluate the safety of workers with occupational talc exposure. 12 An interesting point of this report is that considerable regional differences existed in the incidence of lung cancer among talc workers. They evaluated meta-analysis data from three regions: Asia, Europe and North America.…”

Analysis of particles from hamster lungs following pulmonary talc exposures: implications for pathogenicity

“…Studies of Yamada et al [19] suggested a correlation between fibrous talc and female lung cancer. A recent study suggested a correlation between talc exposure and lung cancer regardless of whether asbestos is present at detectable levels [20].…”