17. After excluding studies based on exposure route, non-pulmonary outcome, and administration of talc as part of a mixture, three studies remained for study quality evaluation (1719). 16. Tox Appl Pharm. (2009) 48:646790. One exception was Stille and Tabershaw (47), which presented stratified analyses for workers with and without known prior employment where exposure to occupational lung carcinogens might have occurred. Shim I, Kim HM, Yang S, Choi M, Seo GB, Lee BW, et al. The TROG-2 is suitable for use by Speech and Language Therapists, Psychologists and Teachers of the Deaf. (1993) 64:44956. HETA 90-390-2065/MHETA 86-012-2065. An additional 10 epidemiological studies were identified through supplemental searches using narrower terms (e.g., lung cancer, mesothelioma, millers, miners) and considering the tertiary literature (reviews, gray literature). The impact of prior occupational exposure to respiratory carcinogens also was not considered in most studies. 0000059323 00000 n If you would like more information on the assessment please email Specifically, individual study quality ratings were high overall and the studies rated as high quality for the exposure characterization domain failed to demonstrate exposure-response patterns between occupational talc exposure and lung cancer mortality (30, 49). 46. (2000) 12:117. 0000014831 00000 n View 6 excerpts, references background and results, American Industrial Hygiene Association journal. Gyorik S, Erni S, Studler U, Hodek-Wuerz R, Tamm M, Chhajed PN, et al. %PDF-1.4 % Inhal Tox. (1988) 127:12029. Figure 2. Please note that the item can still be purchased. WebTalc is a mineral made up mainly of magnesium, silicon, and oxygen. Lung tumors occurred at very high administered doses that appeared to cause particle overload and using micronized talc (not typical of talc mining or milling exposures, or of cosmetic talcum powder products), limiting the ability to extrapolate these findings to relevant exposures in humans. Examination of talcum products commonly available on retail shelves found fiber contents ranging from 8 to 30% by count, with an average of 19%, and the levels of cobalt, nickel, chromium and manganese were low. Although one meta-analysis (5) reported a statistically significant meta-SMR of 1.45 (95% CI: 1.221.72) for non-asbestiform talc and lung cancer, this review included several occupational cohorts with mixed exposures to possible lung carcinogens such as silica, asbestos, and radon (miners) resulting in high heterogeneity across reported study results. Booklets, record forms, answer sheets, report usages & subscriptions, Manuals, stimulus books, replacement items & other materials, All tests and materials offered for TROG-2, text.product.itembackinstockonpurchaseinfo, Includes Manual, Stimulus Book, 25 Record Forms in a bag. 25. It is widely used in cosmetic products such as baby powder and adult body and facial powders, as well as in a number of other consumer products. (2016) 38:e2016039. doi: 10.1080/01913123.2020.1737286. If you would like any more information on any of the services we offer or would like to book an appointment, do not hesitate to contact us and one of our team will be happy to help. Specifically, markers of inflammation and injury were observed after intratracheal instillation of large doses of talc, exposure conditions that do not correlate with those of humans. Health Hazard Evaluation Report: R.T. Vanderbilt Company, Gouverneur, NY. The Chemical Abstracts Service Registry Number (CAS RN1) for talc is 14807-96-6. *Correspondence: Heather N. Lynch, [email protected], Particles and Health 2021: an International Conference Addressing Issues in Science and Regulation, View all Research Triangle Park, NC: U.S. Dept. Public comments received on the draft screening assessment and risk management scope Of these, 19 epidemiology studies and three animal studies were determined to address pulmonary cancers and included in this systematic review. Wehner AP, Stuart BO, Sanders CL. 24. 20 Articles, This article is part of the Research Topic, https://doi.org/10.3389/fpubh.2022.989111, https://www.frontiersin.org/articles/10.3389/fpubh.2022.989111/full#supplementary-material, Creative Commons Attribution License (CC BY). (2017) 59:65964. Lines are open from9am to 5pmMonday to Friday(excluding bank holidays). 4. Cincinnati, OH: U.S. Dept. (1979) 73:2858. (26) sonicated respirable granite and talc dust from a talc mine in Vermont (0.8 m, MMAD of 7.5 m) in saline and intratracheally instilled it into the lungs of Syrian Gold Hamsters at doses of 0.15, 0.75, or 3.75 mg/100 g (single exposure). WebThe greatest ovarian cancer risk associated with perineal talc use was observed in the subgroup of women estimated to have made more than 10,000 applications during years when they were ovulating and had an intact genital tract (OR 2.8, 95% CI 1.4-5.4); however, this exposure was found in only 14% of the women with ovarian cancer. Washington, DC: U.S. Environmental Protection Agency (EPA)-Office of Chemical Safety and Pollution Prevention (2018). In mice, intra-alveolar macrophages were focally aggregated. A cohort mortality and nested case-control study of French and Austrian talc workers. (2014) 11:72. doi: 10.1186/s12989-014-0072-2, 30. of Health Education, and Welfare-Public Health Service-Center for Disease Control-National Institute for Occupational Safety and Health (NIOSH) (1980). No. Analysis of evidence: HL, DL, OL, RF, AI, WT, JC, AU, and KC. Dec., 2013. Malignant mesothelioma following repeated exposures to cosmetic talc: a case series of 75 patients. Analysis of excess lung cancer risk in short-term employees. Pneumologie. (2014) 42:86376. (2003) 44:639. what will happen next? doi: 10.1006/rtph.1995.1036, 22. A nested case-control analysis showed no association of lung cancer with increasing cumulative exposure to talc, after adjusting for smoking, exposure to quartz, and underground work (30). This approval level enables you to buy our assessments requiring A or B qualification levels. As children grow older the curriculum in school requires them to think in a more abstract manner. No. Training, advice, support and strategies for parents, teachers and other professionals. Raw talc ores were, We conducted a systematic review to assess the potential pulmonary carcinogenicity of inhaled talc in humans. We performed literature searches using PubMed and Web of Science and used existing agency reviews as a basis for cross-referencing critical studies. Two animal studies examining inflammation in the lungs reported increased early inflammatory markers. Occupational studies in which talc was known to contain asbestos are not included. (25) reported that talc did not cause significantly increased frequency of sister-chromatid exchange or increased DNA repair synthesis in rat pleural mesothelial cells, relative to positive or negative controls (16). Chang CJ, Tu YK, Chen PC, Yang HY. (6), which reported an alternate pooled Standardized Mortality Ratio (SMR) of 0.242 (90% Confidence Interval [CI]: 0.0121.15) with additional follow up time but no new deaths. All authors contributed to manuscript revision, read, and approved the submitted version. The talc powder contains 95% of hydrated magnesium silicate; associated minerals include chlorites (hydrated aluminum and magnesium silicates), magnesite (magnesium carbonate), Give explanations- how can we tell someone is sad? Talc has been reported to cause fever in 16 to 69% of patients. 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. 37. (2019) 61:91623. Relative to cohort members with the lowest cumulative respirable dust exposure (0 to <95.1 mg/m3), individuals in the two highest cumulative exposure groups had slightly reduced lung cancer risk (RR for cumulative exposure of 95.1-<987 mg/m3 = 0.8; 95% CI: 0.31.9, and RR for cumulative exposure of 987+ mg/m3 = 0.5; 95% CI: 0.21.3). 0000011107 00000 n Overall, in available animal studies, there is indeterminate evidence that talc is associated with lung tumors in rodents based on negative findings in several high-quality studies and species, but positive results in a single species and sex (female rats) exposed to high doses of micronized talc that caused particle overload conditions. What will the Test of Abstract Language Comprehension assess? (2018) 92:25167. As with other particles, one postulated carcinogenic MOA for talc is chronic inflammation resulting from the overwhelming of particle clearance mechanisms (i.e., phagocytosis), long-term tissue irritation and release of inflammatory chemokines and cytokines, and reactive oxygen species (ROS) formation. Poorly Soluble Particles/Lung Overload: Technical Report No. Int J Tox. The authors evaluated, New solutions : a journal of environmental and occupational health policy : NS. 7.2 Exposure assessment. The additional study results are presented in the article/Supplementary material; further inquiries can be directed to the corresponding author. 0000008097 00000 n However, the authors noted that these tumors were metastatic and that there were no primary neoplasms found in the respiratory system. Assume the role of somebody else e.g. A few studies reported excess lung cancer mortality, but lung cancer mortality risk did not increase with increasing talc exposure and the association potentially was confounded by smoking. An overview of our methods is provided below, and an example of their application can be seen in a recent review on ethylene oxide (9). Wrote sections of manuscript: HL, KM, WT, RF, AU, AI, OL, KC, JC, and DL. xb```f``d`c`z B@165vzNh8thz0:&8VmKeXSFQu74UgUi,gBOSuc"8LK?S&6B*i 66/;|r-.R+^ `u(H%p10cc``|9@"TG&c8C6@MX1;D+21t `w`v;"v- #fb[ 6a`;e` This petition was denied.15 In 2000, talc was nominated for review in the NTP 10th Report on Carcinogens because the NTP bioassay Among the most recent mortality updates for the talc miner and miller cohorts (1, 30, 43, 53, 56), Honda et al. Beck BD, Feldman HA, Brain JD, Smith TJ, Hallock M, Gerson B, et al. Version 1, 0. Markers of inflammation also have been observed in the lungs of rats after talc exposure, but one of the only available mechanistic studies utilized a route of exposure (i.e., intratracheal instillation) that is not comparable to inhalation exposures. (30) reported no increased lung cancer mortality among French (SMR = 1.23; 95% CI: 0.761.89) and Austrian (SMR = 1.06; 95% CI: 0.432.19) talc mining and processing employees (30). Mortality experiences among talc workers: a follow-up study. Emory TS, Maddox JC, Kradin RL. The Italian, Norwegian, French, and Austrian talc mines all produced talcs described as non-asbestiform with various accessory minerals including small amounts of chlorite and quartz (30, 50, 52). Our search identified six studies assessing talc exposure and tumor formation in animal models. The information gained from the assessment will be used by our speech and language therapist to create your childs unique therapy programme. 0000051565 00000 n Based on the quality evaluation methods, domains and quality criteria (described above and detailed for all studies in Supplementary Tables 5, 6), most of the studies assessing pulmonary cancer risk among talc miners and millers were rated medium quality. Coggiola et al. doi: 10.1183/09031936.00122106, 36. What information will I receive following a Test of Abstract Language Comprehension? 50. However, the lung tumors occurred only in female rats exposed at a dose also inducing significant chronic lung toxicity and high lung talc burden, such that the maximum tolerable dose may have been exceeded (21). No specific mention of mesothelioma was recorded on the death certificates. 0000007801 00000 n The 17 occupational cohort study reports evaluated for study quality encompassed talc miners and millers in New York State (4147), Italy (1, 4851), Norway (52, 53), France and Austria (30) and Vermont (5456). Can be used to set targets to encourage development of abstract reasoning skills. (56) reported that the death certificate for the single mesothelioma death in the cohort explicitly mentioned exposure to asbestos; yet no additional information was available regarding this potential exposure (56). doi: 10.1080/00039896.1967.10664815. The content and the conclusions of the manuscript are exclusively those of the authors. Numerous validity studies, including studies of the tests sensitivity and specificity, are provided. : 14807-96-6) in F344/N Rats and B6C3F1 Mice (Inhalation Studies). Eur Resp J. Markers of oxidative stress (superoxide dismutase 2) were increased at 100 mg/m3. Three studies (30, 43, 50) were rated high quality for the exposure characterization domain. We followed a modified version of the study quality framework used by U.S. EPA TSCA risk evaluations (11, 12). (1988) 43:55961. exposure to the perineal area from the use of certain products containing talc is a possible cause of ovarian cancer. Animals were exposed to 0, 6, or 18 mg/m3 talc for 6 h/day for 5 days/week until death or until the mortality of any exposure group reached 80% (approximately 2 years). 38. Proposed risk management objectives set quantitative or qualitative targets to be achieved by the implementation of risk management regulations, instrument(s) and/or tool(s) for a given substance or substances. 0000013012 00000 n Lamm SH, Levine MS, Starr JA, Tirey SL. p. 379-88. Talc was administered to both species for 6 h per day, 5 days per week, for a total of 20 exposure days at talc concentrations of 0, 2, 6, or 18 mg/m3. Lung cancer mortality was slightly elevated, but did not achieve statistical significance, in the French (SMR = 1.23; 95% CI: 0.761.89) and Vermont (SMR = 1.44; 95% CI: 0.982.03) talc miners and millers but was close to unity for the Austrian (SMR = 1.06; 95% CI: 0.432.19), Italian (SMR = 1.02; 95% CI: 0.821.27) and Norwegian (SIR = 1.17; 95% CI: 0.731.79) talc miners and millers (1, 30, 53, 56). The available data indicate that talc dust exposure in the modern mining of cosmetic grade talc does not appear to be injurious to health and the significantly lower Our conclusions regarding hazard for each cancer type, based on the IOM classification system (8), are described below and in the protocol, and visualized in Table 2. 8. J Occup Env Med. A survey of the long-term effects of talc and kaolin pleurodesis from the Research Committee of the British Thoracic Association and the Medical Research Council Pneumoconiosis Unit. Histologic evaluation of lung tissue revealed no exposure-related lesions except for a modest, diffuse increase in free macrophages within alveolar spaces of both rats and mice exposed to the highest concentration of talc. A flow chart for the overall tiering approach used for cohort studies is provided as an example in Figure 1. There was one lung carcinoma found in the group exposed to talc for 3 min/day for 30 days, and one lung carcinoma found in the 300-day control group. Dement JM, Zumwalde RD, Gamble JF, Fellner W, DeMeo MJ, Brown DP, et al. We have recently updated our policy. (1979) 2:27384. Selevan SG, Dement JM, Wagoner JK, Froines JR. Mortality patterns among miners and millers of non-asbestiform talc: preliminary report. Integrating the evidence demonstrating a lack of statistically significant increases in mesothelioma in inhalation rodent bioassays, the null findings in the higher-quality epidemiological literature, and the lack of evidence of a plausible MOA, we conclude that there is suggestive evidence of no association between inhaled talc and mesothelioma at human-relevant exposure levels. s xr%LD%U\C The Cosmetic Ingredient Review Expert Panel (Panel) assessed the safety of talc for use in cosmetics. doi: 10.1002/ajim.4700170408, 53. EC No. Brigham and Women's Hospital, Harvard Medical School, United States. Using a lower-tier assessment approach, a small margin of exposure (MOE) of 1.5 was obtained through the comparison of the NOAEC of 2 mg/m 3 to the average WebAppendix 33 Rationale behind speech and language therapists decisions to use assessment tools CELF-P, Clinical Evaluation of Language Fundamentals Preschool; CELF-P-2, Clinical Evaluation of Language Fundamentals Preschool Second Edition; STAP, South Tyneside Assessment of Phonology; STASS, South Tyneside doi: 10.1093/oxfordjournals.aje.a114913. Our systematic review of talc and pulmonary cancers generated suggestive evidence of no association for exposure to talc and lung cancer and pleural mesothelioma. Lamm et al. Mortality of talc miners and millers From Val Chisone. American journal of obstetrics and gynecology, View 3 excerpts, references methods and background, Table 2. 11. The proposed risk management objective for talc is to decrease inhalation and p What is paediatric speech and language therapy? Pulmonary cancer (lung cancer and mesothelioma) mortality generally was ascertained via death certificates coded by certified nosologists. This substance is among those substances identified as priorities for In an in vivo OECD Guideline 478 Dominant lethal test, male Sprague-Dawley rats were exposed via gavage to a single dose or one dose/day for 5 days of 300, 3,000, or 5,000 mg/kg talc. The assessment can be used with children from the age of 2+. Additional searches were run using filters for animal/toxicology studies, and for mechanistic/mode of action (MOA) studies, using search terms including, but not limited to the following: micronuclei, sister chromatid exchange, chromosome aberrations, DNA adduct, DNA methylation, inflammation, mechanism, and MOA. Kleinfeld and coworkers published two proportionate mortality studies on miners and millers in upstate New York potentially exposed to talc with asbestiform or non-asbestiform amphibole minerals, largely in response to reports of fibrogenic pneumoconiosis (44, 45). 55. The SMRs for the eligible cohorts ranged from 0.92 in a Norwegian cohort [] to 4.50 in a Chinese Ierardi AM, Best EA, Marsh GM. Talc concentrations of 10.8 mg/m3 were administered for 7.5 h per day, 5 days per week; 48 animals from each group were exposed for 3 months, 24 animals for 6 months, and 24 animals for 12 months with cumulative doses of approximately 4,100, 8,200, and 16,400 mg/m3-h for the 3-month, 6-month, and 12-month exposure durations, respectively. Inhalation studies with Syrian golden hamsters. Table 1. 0000018556 00000 n T: 01245 467 355 E: [emailprotected] It has been concluded that there was an inadequate evidence of carcinogenicity in experimental animals and the degree of evidence in short-term tests for genetic activity has been found to be inadequate. 0000015861 00000 n Reported functions of talc in cosmetics include abrasive, Viskum K, Lange P, Mortensen J. Inhalation of talc induces infiltration of macrophages and upregulation of manganese superoxide dismutase in rats. A systematic approach for evaluating the quality of experimental toxicological and ecotoxicological data. In both the talc and chrysotile exposure groups, fibrosis was observed to a similar extent, with minimal to no fibrosis observed in the air-exposed control group. 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. The estimated average SMR for lung cancer was 1.45 (95% CI: 1.221.72, ) among the workers exposed to talc.Figure 2 shows the forest plot corresponding to the summary lung cancer SMR calculated in the meta-analysis. Systematic review of the scientific evidence on ethylene oxide as a human carcinogen. The tiering system allows for preferentially weighting specific quality domains (e.g., exposure characterization) first, followed by more secondary determinants of study quality. (1987() 87:22234. Detailed data abstraction and study quality evaluation, adapting the US Toxic Substances Control Act (TSCA) framework, were central to our analysis. Chemically, talc is a hydrous magnesium silicate with a chemical formula of Mg 3 Si 4 O 10 (OH) 2. According to information reported under section 71 Phone: +1 (800) 627-7271 (2002) 46:57585. (41) studied the same plant, but their NIOSH Health Hazard Evaluation Report mentioned no mesothelioma. Washington,DC: Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency (EPA) (2020). The increased risk among those hired before 1955 was strongest among miners (SMR = 3.94; 95% CI: 2.336.22, based on 18 cases) and not elevated among millers (SMR = 1.28; 95% CI: 0.512.63, based on 7 cases). Our systematic review methods adhere to Preferred Reporting Items for Systematic Reviews, International journal of environmental research and public health. National Academies of Sciences, Engineering, and Medicine (2008). Application of Systematic Review in TSCA Risk Evaluations. Pickrell et al. This assessment presents information relevant to the safety of talc as used in cosmetic formulations. Email [email protected] or call 0330 088 2298. Treatment following a Test of Abstract Language Comprehension. [email protected] Washington, DC: U.S. Environmental Protection Agency (EPA)-Office of Chemical Safety and Pollution Prevention (2021). (2015) 34:66S129S. (2017) 29:44356. 0000055192 00000 n Overall conclusions were derived for each cancer: sufficient evidence of a causal relationship; sufficient evidence, suggestive evidence, or inadequate/insufficient evidence of an association; or suggestive evidence of no association. 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. ICP-AES/ICP-MS) Assessments for 0000001325 00000 n doi: 10.1097/JOM.0000000000001700, 57. Absence of mesothelioma risk maintained in an expanded international cohort of cosmetic talc miners and millers. Download HL4() Mp3 Courtesy in from Top Song with 0 and 1 & 03:41 just only in beta.ustaflorida.com doi: 10.1097/JOM.0000000000001723, 40. 646 0 obj <>stream European Food Safety Authority. Lynch, H. N., Lauer, D. J, Thompson, W. J., Leleck, O. M., Freid, R. D., Collins, J., et al. Talc was negative in a reverse mutation assay Salmonella typhimurium strains TA1530 and G46. what should we do now? Brown DP, Sanderson W, Fine LJ. doi: 10.1080/08958378.2022.2053251. WebEach of the five DAYC-2 domains Cognition, Communication, Social-Emotional Development, Physical Development, and Adaptive Behavior reflects an area In:Dusts Disease, Lemen R, Dement JM, , editors. This might have introduced confounding, as short-term or transient workers tend to have a higher prevalence of smoking and other health risk factors (46). (1989) 43:1056. Further, some aspects of the physiology and function of the respiratory system of rodents (e.g., a delicate balance of pulmonary surfactants, as well as smaller and fewer macrophages relative to humans) make them highly susceptible to high doses of solid particles relative to humans (29). 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