A survey of the long-term effects of talc and kaolin pleurodesis

doi:10.1016/0007-0971(79)90054-8

British Journal of Diseases of the Chest

Volume 73, 1979, Pages 285-288

https://doi.org/10.1016/0007-0971(79)90054-8 Get rights and content

Abstract

Of 210 patients who underwent pleurodesis with iodized talc or kaolin 14 to 40 years previously, all but 11 were traced. There was no increased incidence of lung cancer and no case of mesothelioma.

References (13)

R.A.M. Case et al.
Mustard gas poisoning, chronic bronchitis, and lung cancer
Br. J. prev. soc. Med.
(1955)
Cosmetic talc powder
Lancet
(1977)
P.C. Elmes et al.
The clinical aspects of mesothelioma
Q. Jl Med.
(1976)
W.J. Henderson et al.
Identifications of particles in ovarian tissue
W.J. Henderson et al.
Talc and carcinoma of the ovary, and cervix
J. obstet. gynaec. Br. Commonw.
(1971)
G.Y. Hildick-Smith
The biology of talc
Br. J. indust. Med.
(1976)

There are more references available in the full text version of this article.

Cited by (78)

A quantitative weight of evidence assessment of Hill's guidelines for causal inference for cosmetic talc as a cause of mesothelioma
2021, Toxicology and Applied Pharmacology
Cosmetic talc has been suggested to cause mesothelioma. To assess a potential causal relationship between cosmetic talc and mesothelioma, a quantitative weight of evidence analysis was performed in accordance with Hill's nine original guidelines for causal inference using a published empirical model to weight each respective guideline. Various epidemiological, toxicological, and exposure studies related to cosmetic talc and risk of mesothelioma were included in an evaluation of each of Hill's guidelines. Probabilities that the guidelines were true were assigned based on expert judgment. We applied a sensitivity analysis to evaluate the variability of our probability estimates. The overall probability of causality for cosmetic talc and mesothelioma was approximately 1.29% (range: 0.73%–3.96%). This low probability of causality supports the conclusion that cosmetic talc is not related to the development of mesothelioma.
Efficacy, morbidity and morbidity of surgical treatment of a primary spontaneous pneumothorax by videothorascopic talc pleurodesis
2011, Cirugia Espanola
Llamamos neumotórax espontáneo primario (NEP) a la presencia de aire en el espacio pleural sin causa o etiología conocida. La característica principal de esta enfermedad es su alta tendencia a la recidiva. Nuestro estudio tiene como objetivos: 1) conocer la eficacia del tratamiento quirúrgico mediante resección pulmonar por videotoracoscopia y pleurodesis con talco, 2) analizar las complicaciones derivadas del uso del talco.
Se revisa una serie de 130 casos de NEP tratados mediante videotoracoscopia con o sin resección parenquimatosa y pleurodesis con 3 g de talco libre de asbesto (STERITAL^®). Hemos recogido datos epidemiológicos, el método diagnóstico, la indicación quirúrgica, la mortalidad, la morbilidad general y la específica de la pleurodesis con talco, el número de recidivas y su tratamiento.
Nuestros pacientes tienen una edad media de 26,4 años, 84,3% son hombres y el 69% tiene hábito tabáquico. La indicación quirúrgica del NEP fue en el 74,4% por recidiva. Registramos una morbilidad del 7% que representan 9 casos, siendo la complicación más frecuente la fuga aérea. No registramos ninguna complicación específica por el uso del talco, tales como empiema, paquipleuritis o síndrome del distrés respiratorio del adulto (SDRA). Se realiza un seguimiento de 10,1 meses de media, constatándose 4 casos de recidiva que representan el 3%.
El tratamiento del NEP mediante videotoracoscopia y pleurodesis con talco tiene una alta eficacia, superior a otras técnicas empleadas para producir pleurodesis, una baja morbilidad general, mortalidad nula, y no registramos ninguna complicación específica debida al talco.
A primary spontaneous pneumothorax (PSP) is due to the presence of air in the pleural space and is of unknown cause or aetiology. The main characteristic of this condition is its high tendency to re-occur. This study has two objectives: 1) to determine the efficacy of lung resection surgery using a videothorascope and talc pleurodesis, 2) to analyse the complications originating from the use of talc.
A review was carried out on a series of 130 PSP cases treated using videothorascopy, with or without parenchymal resection, and pleurodesis with 3 g of asbestos-free talc (STERITAL^®). Epidemiological data were collected, including the diagnostic method, surgical indication, mortality, general morbidity, and the specific morbidity due to talc pleurodesis, the number of recurrences, and their treatment.
The patients had a mean age of 26.4 years, 84.3% were male, and 69% smoked. The surgical indication of the PSP was recurrence in 74.4% of cases. There was morbidity in 7% (9) cases, with the most frequent complication being an air leak. No specific complication, such as empyema, pachypleuritis or adult respiratory distress syndrome (ARDS, on the use of talc was recorded. The mean follow-up was 10.1 months, during which there was recurrence in 4 (3%) cases.
PSP treatment by videothorascopic talc pleurodesis is highly effective, superior to other techniques use to produce pleurodesis, has a low general morbidity, no mortality, and no specific complications due to the talc.
Video-assisted thoracoscopic bullectomy and talc poudrage for spontaneous pneumothoraces: Effect on short-term lung function
2010, Journal of Thoracic and Cardiovascular Surgery
Citation Excerpt :
As to the oncologic risk, the use of asbestos-free talc seems to remove the risk of mesothelioma or lung cancer. In an older study of 210 patients who had undergone pleurodesis with either talc or kaolin 14 to 40 years before data collection, Chappel and coworkers11 identified no increase in rates of lung cancer and no cases of mesothelioma. No cases were recorded in a study of more than 800 patients by Cardillo and associates,2 although their mean follow-up was only 52.5 months.
We measured lung function before and after video-assisted thoracoscopic apical bullectomy and talc poudrage in patients with spontaneous pneumothoraces.
Seventy-two patients were prospectively followed up for 12 months. The indications for surgery were recurrent pneumothoraces (n = 58), bilateral pneumothoraces (n = 8), and persistent air leak (n = 6). There were 46 males and 26 females with mean age of 29 years (range 15–61 years). The results were analyzed using paired t tests.
There were no recurrences. There were 4 complications (5.6%): 1 wound infection, 1 case of pneumonia, and 2 persistent air leaks each lasting 1 week. There were no conversions to open surgery. Preoperative and 6-month pulmonary function test results were available on 41 patients, and 35 patients completed 12-month pulmonary function tests. Twelve-month values (mean percent ± SD) were as follows: Forced expiratory volume in 1 second fell from 95 ± 19 to 89 ± 16 (P = .02); forced expiratory volume in 1 second/forced vital capacity ratio was unchanged, 95 ± 12 versus 94 ± 13 (P = .9); total lung capacity fell from 106 ± 19 to 98 ± 12 (P = 0.002); vital capacity fell from 100 ± 22 to 96 ± 16 (P = .05); residual volume fell from 126 ± 32 to 107 ± 29 (P = .002); and diffusion capacity for carbon monoxide corrected for alveolar volume was unchanged, 88 ± 15 versus 91 ± 17 (P = .07). Flow rates and diffusion capacities were preserved, but lung volumes were slightly reduced at 1 year.
Video-assisted thoracoscopic apical bullectomy and talc poudrage is an effective treatment for spontaneous pneumothoraces with a low complication rate and recurrence rate and only minor changes in pulmonary function at 1 year.
Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: A single-institution experience in 861 cases
2006, Journal of Thoracic and Cardiovascular Surgery
We sought to evaluate the outcome of 861 patients treated with videothoracoscopic talc poudrage for primary spontaneous pneumothorax.
From September 1995 through January 2004, a total of 861 patients (578 male, 283 female, mean age 28.6 years) underwent videothoracoscopy for recurrent and complicated primary spontaneous pneumothorax. Patients were treated with videothoracoscopic talc poudrage only (group A: Vanderschueren’s stage I, 196 patients; stage II, 112 patients) or videothoracoscopic talc poudrage plus stapling of the blebs/bullae (group B: stage III, 391 patients; stage IV 162 patients). Follow-up included clinical interview and chest radiography (805 patients). In 26 patients (follow-up longer than 5 years), respiratory function was investigated to determine residual volume and diffusing lung capacity.
No operative deaths occurred. No patient had adult respiratory distress syndrome. Postoperative complications occurred in 29 patients (3.36%). The conversion rate to an open procedure was 0.46% (4/861). After a mean follow-up of 52.5 months, 14 patients had recurrences (1.73%). The recurrence rate was 2.41% (7/290) in group A and 1.359% (7/515) in group B (χ² value: 1.207389; P:.27; odds ratio: 0.56; 95% confidence interval: 0.20-1.62). Results of respiratory function tests were within normal ranges (80% or more of predictive value) in all 26 patients.
Videothoracoscopic talc poudrage achieves a high success rate in the treatment of primary spontaneous pneumothorax with a very low morbidity rate. Recurrences show a statistically significant relationship (P:.037) with smoking habits.
Video-assisted thoracoscopic surgery management of spontaneous pneumothorax - long-term results
2011, European Journal of Cardio-thoracic Surgery
Long-term lung function following videothoracoscopic talc poudrage for primary spontaneous recurrent pneumothorax
2007, European Journal of Cardio-thoracic Surgery

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^∗: Members of the subcommittee were A. G. Chappell (chairman), A. Johnson (coordinator), J. Charles, J. C. Wagner, R. M. E. Seal, G. Berry and D. Nicholson.

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General articleA survey of the long-term effects of talc and kaolin pleurodesis

Abstract

Mustard gas poisoning, chronic bronchitis, and lung cancer

Br. J. prev. soc. Med.

Cosmetic talc powder

Lancet

The clinical aspects of mesothelioma

Q. Jl Med.

Identifications of particles in ovarian tissue

Talc and carcinoma of the ovary, and cervix

J. obstet. gynaec. Br. Commonw.

The biology of talc

Br. J. indust. Med.

General article
A survey of the long-term effects of talc and kaolin pleurodesis