Debate rages on talcum baby powder’s association with lung, ovarian cancers

                              

The debate on whether the use of the popular talcum powder causes cancer has refused to go away. Indeed, the use of talcum powder has become a controversial issue as growing evidence suggests that its use may be related to an increased risk of ovarian cancer.

Talcum powder is made from talc, a mineral made up mainly of the elements magnesium, silicon, and oxygen. As a powder, it absorbs moisture well and helps cut down on friction, making it useful for keeping skin dry and helping to prevent rashes. 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.

In its natural form, some talc contains asbestos, a substance known to cause cancers in and around the lungs when inhaled.

While mesothelioma is the cancer most often associated with asbestos, there is growing evidence that trace amounts of the mineral in talcum powder could trigger other types of cancer, including ovarian cancer in women.

The Cosmetic, Toiletry, and Fragrances Association, a trade group in the United States that represents manufacturers of these kinds of products, adopted guidelines in 1976 to ensure that talc products would not contain asbestos. The guidelines were voluntary and stated that any asbestos found in natural talc would be removed so that consumer products would not have any detectable levels.

In spite of the guidelines designed to protect consumers from the harm of asbestos found in hygiene and other personal products, studies since the 1970s have found that talcum powder does still often contain the contaminant. One study tested several products and found that many contained asbestos that could easily be inhaled by anyone using them.

In the United States, Johnson & Johnson is being investigated by the US Securities and Exchange Commission after questions surfaced about the safety of the company’s baby powder.

The investigation and subpoenas come on the heels of a Reuter’s report that suggested the company knew for years that its baby powder contained small amounts of asbestos, which is a human carcinogen.

The reason there could be asbestos in baby powder is that one of the primary ingredients is talc: a mineral that is often found and mined near asbestos.

The Guardian investigation revealed that so many talcum powder products are registered by the National Agency for Food and Drug Administration and Control (NAFDAC). The products are in circulation and are used by both the young and the old.

Director General of NAFDAC, Prof. Mojisola Christianah Adeyeye, told The Guardian that the subject of link between talc powder and cancer has been a controversial issue, which continues to divide scientists. “There is no clear scientific evidence on the issue,” she said.

The pharmacist said evidence showing that talc may be carcinogenic remains inconclusive because a school of thought believes that talc in its natural state contains asbestos (a carcinogen) whereas another school of thought believes it does not. From the foregoing, she said, it is the asbestos component of talc, if truly present, that is capable of causing cancer in talc powder. “Generally, facts hold that there are asbestos-free talc as well as asbestos-containing talc, though the evidence about asbestos free talc is less clear” Adeyeye said.

The NAFDAC DG concluded: “So the simple answer is that talc powder made from asbestos-containing talc is capable of causing cancer whereas talc powder made from asbestos-free talc is not expected to cause cancer.

“For asbestos-containing talc powder which may be ‘yes’ and depending on the site of application (say, pubic area of a woman), the talc powder particles may travel through the private part, the fallopian tubes (oviducts) and eventually enter the ovaries to cause irritation and inflammation from which cancerous cells are able to develop. For asbestos-free talc powder which may be ‘no’, the absence of asbestos (the suspected carcinogen) makes it difficult for cancerous cells to develop.”

Adeyeye said NAFDAC conducts analytical tests before registration of all regulated products including talc powder to ensure their fitness (quality and safety) for use. Also, she said, post marketing surveillance activities are being improved with inclusion of post marketing analysis of regulated products to ensure continuous conformity with the standards and requirements precedent to registration of the products at the outset.

In addition, the NAFDAC DG said if an untoward events or reactions are associated with the use of any product, including talc powder, the product can be banned or withdrawn from the circulation through a process of recall.

What is the implication to the health and lives of Nigerians if talc powder can actually cause cancer? Adeyeye said if any talc powder could actually cause cancer it will not be registered for use in Nigeria because the result of its analysis would have revealed that it contains asbestos-containing talc. “As earlier mentioned, if the product is suspected to contain any carcinogen it would be withdrawn from the circulation and/or banned,” she said.

Adeyeye said the summary is that NAFDAC has the responsibility to safeguard the health of the nation hence a case of untoward health implication is being addressed on daily basis by the Agency.

However, researchers are unanimous that talc or talcum powder can cause cancer.

They said talc that has asbestos is generally accepted as being able to cause cancer if it is inhaled. The evidence about asbestos-free talc is less clear.

“The health implication of using talc that contains asbestos is that it causes cancer,” said a consultant epidemiologist, Dr. Anthony Nwaoney.

The epidemiologist told The Guardian that most concerns about a possible link between talcum powder and cancer have been focused on: whether people who have long-term exposure to talc particles at work, such as talc miners, are at higher risk of lung cancer from breathing them in; and whether women who apply talcum powder regularly in the genital area have an increased risk of ovarian cancer.

The International Agency for Research on Cancer (IARC) is part of the World Health Organization (WHO). Its major goal is to identify causes of cancer.

IARC classifies talc that contains asbestos as “carcinogenic to humans.”

Based on the lack of data from human studies and on limited data in lab animal studies, IARC classifies inhaled talc not containing asbestos as “not classifiable as to carcinogenicity in humans.”

Based on limited evidence from human studies of a link to ovarian cancer, IARC classifies the perineal (genital) use of talc-based body powder as “possibly carcinogenic to humans.”

Director General, the Consumer Protection Council (CPC), Babatunde Irukera, told The Guardian: “We have sent out an advisory on this issue. Although the science behind it is inconclusive, there is need to alert consumers of the possibility of talc powder laden with asbestos causing lung and ovarian cancers. The Nigerian public should be well informed so that they can make choices. They can decide that because of the controversy to use powders made with corn starch.”

The CPC had in early February 2019 alerted the public of a fake Johnson & Johnson’s Baby Talc Powder in circulation.

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