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

Table 1

Summary characteristics of talc-exposed cohorts eligible for meta-analysis.

Reference/location	Cohort definition	Exposure assessment	Talc exposure	Other exposures	Smoking
Bulbulyan et al., Russia, 1999 [6]	3473 female employees of two printing plants employed >2 years, 1978–93, followed up for cancer incidence from 1979 to 1993	Area air sampling data plus job description data; job type: compositors, press operators, bookbinders, and other	Talc with asbestos contamination	Paper dust, benzene, aromatic hydrocarbons, carbon black, lead	Unknown
Coggiola et al., Italy, 2003 [7]	1795 male employees from Italian talc mine employed >1 year, 1946–1995, followed up from 1946 to 1995	Job histories from plant records; job type: miner versus miller; duration of exposure and time since first exposure (years)	Talc without asbestiform fibers; >200 mppcf in 1950, <5 mppcf in 1965	Quartz, radon (miners)	44%–47% smokers compared to 34% in Italian population (1994)
Fu and Zhang, China, 1992 [8]	1357 male workers in Haichen talc mines employed >1 year in January 1974, followed up through 1988	Job histories from factory records; job type: miner versus miller; medical exam records in local hospitals; duration of exposure and time since first exposure (years)	Talc without asbestiform fibers	Radon (miners)	64% smokers
Honda et al., USA, 2002 [9]	782 male employees from a New York talc mining and milling facility employed >1 day, 1948–1989, followed up from 1950 to 1989	Cumulative respirable dust exposure estimation for individual subjects from a job-exposure matrix consisting of estimates of respirable dust concentrations for all work area and calendar year combinations	Talc with asbestos contamination; 0.1–1.7 mg/m^3	Asbestos, nonasbestiform amphibole, taconite	Unknown
Li and Yu, China, 1998 [10]	934 male and 664 female workers of a Shanghai rubber factory who entered a screening program for heart disease in 1972, followed up from 1973 to 1995	Based on information on work history obtained from the records of a screening program for heart disease	Talc with asbestos contamination was exposed to the workers engaged in the production of tires and inner tubes	Nitrosamine, multiple solvents	63% for male workers and 9% for female workers compared to 46% for men and 5% for women in general population
McLean et al., multinational, 2006 [11]	60,468 workers employed > 1 year in the pulp and paper industry in 11 countries, 1920–1996; followed up through 1996	Exposure was estimated at the department level based on assessments of an international panel of industrial hygiene experts through detailed company questionnaires	Talc with asbestos contamination, categorized into ever-exposure and ever-high-exposure levels	Paper dust, asbestos, multiple volatile, and nonvolatile organochlorine compounds	Unknown
Nie et al., China, 1992 [12]	8654 male and 3564 female pottery workers (412 with talc exposure) employed >1 year, 1972–1974, followed up through 1989	Area air sampling data plus work histories; minerals analyzed by phase contrast microscopy	Talc without asbestiform fibers; 1–18% of total dust	Silica	Unknown
Stern et al., USA, 2001 [13]	12873 males of the Operative Plasterers’ and Cement Masons’ International Association, 1972–1996; followed up through 1996	Potential worker exposures were based on a representative sample of 4,500 U.S. industrial facilities conducted by the USA National Occupational Exposure Survey (NOES) during 1981–1983	Talc with asbestos contamination	Cement dust, 1,1,1- trichloroethylene, quartz, sand, mica, silica, attapulgite, asphalt, brick clay, carbon tetrachloride, dioxane, tetrachloroethylene, fiberglass	Unknown
Selevan et al., USA, 1979 [14]	388 male talc workers from 5 talc producing companies in Vermont employed >1 year, 1940–1969, followed up from 1940 to 1975	Based on historical data that demonstrated past exposure levels far exceeded the standard for nonfibrous talc of 20 mppcf	Talc without asbestiform fibers; commonly >20 mppcf	Quartz (<0.25%)	Unknown
Straif et al., Germany, 2000 [15]	8933 male employees from 5 German rubber plants employed >1 year retired or active in 1981 followed up from 1981 to 1991	Work histories reconstructed from cost center codes plus semiquantitative cumulative exposure	Talc with asbestos contamination	Asbestos, nitrosamines, carbonblack	Unknown
Thomas and Stewart, USA, 1987 [16]	2055 white male workers from American pottery factory employed >1 year, 1939–66; mortality follow-up through 1981	Exposure to silica and talc assessed qualitatively by job title and department by industrial hygienist	Nonfibrous talc (a subgroup of workers exposed only to silica and nonfibrous talc)	Quartz	Unknown
Wergeland et al., Norway, 1990 [17]	389 male employees from a Norwegian talc mill employed >2 years, 1935–1972, followed up from 1953 to 1987	Subjective assessment of exposure by experienced employees; workers classified based on low, medium, high, and unknown exposure by total duration of employment in jobs	Talc without asbestiform fibers. For miners: 0.94–97.35 mg/m^3 peaked at 319 mg/m^3 0.2–0.9 f/ml. For millers: 1.4–54.1 mg/m^3 peaked at 109 mg/m^3 0.2–0.9 f/ml	Radon (miners)	76% smokers (miners)
Wild et al., Austria, 2002 [18]	542 male workers of an Austrian talc producing company employed >1 year, 1972–1995, followed up from 1972 to 1995	Semiquantitative, site-specific job-exposure matrix based on personal dust measurements and descriptions from employees	Talc without asbestiform fibers; >30 mg/m^3 before 1960, 5–30 mg/m^3 until 1980, <5 mg/m^3 thereafter	Quartz (<3%)	42% smokers
Wild et al., France, 2002 [18]	945 male employees from a French talc mill employed >1 year, 1945–1994, followed up from 1968 to 1995	Semiquantitative, site-specific job-exposure matrix based on personal dust measurements and descriptions from employees	Talc without asbestiform fibers; >30 mg/m^3 before 1970s, 5–30 mg/m^3 until 1990, <5 mg/m^3 thereafter	Quartz (<3%)	59% smokers compared to 39% French population (1986)