Thirty-three cases of the asbestos-related lung cancer mesothelioma draw attention to talcum powder as a non-occupational source of exposure to asbestos, according to a study in the January Journal of Occupational and Environmental Medicine. 

"Our findings strongly suggest that asbestos exposure through asbestos-contaminated cosmetic talc explains cases once deemed idiopathic or 'spontaneous,'" according to the report by Jacqueline Moline, MD, of Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y., and colleagues.

Mesothelioma is a type of lung cancer that is most often caused by work-related exposure to asbestos. Other cases of mesothelioma have been considered "idiopathic" — meaning simply that the cause is unknown.

Dr. Moline and colleagues report 33 patients with mesothelioma thought to be caused by another source of asbestos: cosmetic talcum powder. All were referred for medico-legal evaluation as part of tort litigation. The patients were 26 women and seven men; most were diagnosed with mesothelioma since 2015. None had any source of occupational asbestos exposure, but all had a long history of talcum powder use — sometimes for decades.

Testing of surgical specimens in six patients revealed asbestos in tumor tissue or lymph nodes. In all cases, the asbestos fibers were consistent with the types identified as contaminants of talcum powder, and with the types of asbestos found in talc.

Asbestos contamination of talcum powder products such as baby powder and cosmetics was first reported in the 1940s, but few clinicians are aware of this potential exposure. Asbestos contamination is thought to occur during the mining process — resulting from the fact that talc deposits overlap or occur close to natural asbestos deposits.

The study is the first large case series to identify talcum powder contaminated with asbestos as the cause of malignant mesothelioma. "Our case study suggests that cosmetic talcum powder use may help explain the high prevalence of idiopathic mesothelioma cases, particularly among women," Dr. Moline and coauthors write. They emphasize the need to collect more detailed information on possible non-occupational sources of asbestos exposure in patients diagnosed with mesothelioma.

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ACOEM (www.acoem.org), an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

About the Journal of Occupational and Environmental Medicine

The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.