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

Systematic review of the scientific evidence of the pulmonary carcinogenicity of talc

“…Because the one malignant mesothelioma in the Vermont cohort was identified following a focused search of death certificates for the cohort but not the referent group, its inclusion results in a conservative bias. These findings were confirmed in Ierardi et al ( 6 ), which reported an alternate pooled Standardized Mortality Ratio (SMR) of 0.242 (90% Confidence Interval [CI]: 0.012–1.15) with additional follow up time but no new deaths. When considered together, the moderate confidence in study findings, large study populations, long duration of follow up, and consistency of null findings indicate that talc exposure is not associated with mesothelioma.…”

“…In summary, no excess of malignant mesothelioma has been reported in any of the available epidemiological studies of talc miners and millers heavily exposed to talc. Although some of the individual cohorts were small, the collective number of workers followed was substantial ( 6 ) and the cohorts were followed for many decades. These workers were clearly and highly exposed to the talcs: all except the Norwegian cohort reported statistically significant excess mortality due to pneumonoconiosis, a group of non-malignant respiratory diseases caused by heavy exposure to dusts.…”

“…In its most recent review of talc, the International Agency for Research on Cancer (IARC) concluded “[t]here is inadequate evidence in humans for the carcinogenicity of inhaled talc” ( 4 ). They also concluded “[t]here is limited evidence in experimental animals for the carcinogenicity of talc not containing asbestos or asbestiform fibers.” This review is now 12 years old, and several studies and reviews on talc exposure and pulmonary cancer risk have been published since the 2010 IARC Monograph ( 1 , 5 , 6 ). The objective of this paper was to apply systematic review methods to critically evaluate and synthesize the scientific evidence addressing the possible relationship(s) between exposure to talc occupationally and from exposure to talc-containing products (primarily talcum powders and cosmetics) and pulmonary cancers, specifically lung cancer and pleural mesothelioma, integrating epidemiology, toxicology, and studies informing potential underlying modes of action.…”

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

“…Even without consideration for smoking, a pooled-SMR of lung cancer for the five cohorts with high historical exposures to talc conducted in five different countries was 1.13 (95% CI: 0.97–1.31). Furthermore, there is no increase in pleural cancer/mesothelioma in studies of talc miners and millers in talc with no known or detectable contamination by asbestiform minerals ( 42 ). This finding is not surprising due to the lack of a credible level of biological plausibility as well as the lack of substantial exposure to amphibole asbestos associated with these talc mining and milling operations.…”

Authors’ response to the letter to the editor on “characterization of asbestos exposures associated with the use of facial makeups”

“…Additionally, Ilgren et al (2017) found no asbestos in their analysis, only non-asbestiform tremolite cleavage fragments. It is reassuring, indeed, that a robust body of epidemiological studies at Italian mines have supported this conclusion, consistently showing no association with mesothelioma and lung cancer risk (Ciocan et al, 2022;Coggiola et al, 2003;Ierardi et al, 2022;Marsh et al, 2019;Pira et al, 2017;Rubino et al, 1976Rubino et al, , 1979.…”