Baby powder. Who would think such a seemingly innocuous product would be the cause of such a large amount of controversy? But several high-profile court cases and multimillion-dollar verdicts later, it seems that the question of whether or not using talc-containing baby powder increases the risk for cancer is becoming only more pressing—and the potential link may be coming into focus.
In December, Reuters released a report alleging that Johnson & Johnson covered up the presence of asbestos in the talc included in their baby powder products for decades, possibly providing a mechanism by which a series of cancer cases could be traced back to the use of the powder. And a New York Times investigation raised similar concerns.
So what do these revelations mean for consumers? And how do they fit in with what we know about the risks of using talc powder?
Here’s what you should know about the new allegations.
The Reuters investigation alleges that Johnson & Johnson knew that some of their talc was contaminated long after they claimed it was asbestos-free. According to the two investigations, testing over the past several decades of Johnson & Johnson’s talc products turned up positive results for small amounts of asbestos as early as 1957. But, the investigations allege, the company never revealed the presence of asbestos in its talc to the public.
However, Johnson & Johnson firmly denies that the powder was contaminated. For example, the company notes that the Reuters article cited asbestos-contaminated talc in samples from 1984, 1985, and 1986, but those samples (sourced from Windsor Minerals) were from “three California talc properties that we sourced for industrial talc use—not cosmetic. WSI and grade TC-700 have never been associated with Vermont, where we sourced our cosmetic talcs in the 1980s,” Ernie W. Knewitz, vice president of media relations at Johnson & Johnson, tells SELF. “Thousands of tests” by the company and others have shown that their talc does not contain asbestos, he said, directing SELF to the company’s information on talc safety and to two statements and two advertisements defending its products.
The company also notes that it has fully cooperated with the FDA and other global regulators when questions have arisen. According to one of the statements from J&J, the New York Times report “ignores independent, peer-reviewed studies of tens of thousands of women and more than 1,000 men by the nation’s foremost research institutions found that our talc does not cause cancer or asbestos-related disease, while instead pointing to studies 'conducted in the past few years by plaintiffs' lawyers' to support their premise."
Talc isn’t thought to be dangerous, but that could change if it’s contaminated with asbestos.
Scientists have previously been skeptical of the idea that exposure to talc increases the risk for cancer partly because there wasn’t a clear biological mechanism. But the presence of asbestos could change that.
Asbestos occurs naturally as bundles of fibers made up of minerals, according to the American Cancer Society. It's typically found in soil and rock throughout the world. These fibers can come in curly or straight forms, and they have been used in recent years in insulation, roof shingles, some types of cement, and brake parts, among other products. But through the 20th century, it became clear that dust or liquids containing asbestos can be carcinogenic.
The biggest risk identified is lung cancer, as the asbestos is inhaled and can lead to cancer development, potentially due to a process involving inflammation and cell death. Asbestos exposure is the primary risk factor for mesothelioma, a rare form of cancer that affects the thin layer of tissue covering your internal organs, most often the lungs.
Because the talc that’s in talcum powder is also a mineral, some can be naturally contaminated with asbestos. The talc that is used in human cosmetic products is, in theory, free from asbestos contamination since the 1970s, when stricter testing and monitoring of talc began following a report of asbestos in 10 of 19 tested talc products. (It should be noted that the three Johnson & Johnson products tested in that study did not show evidence of asbestos).
But the claim that all talc products have been asbestos-free since this time has come under scrutiny in the latest Reuters investigation and makes the risk calculus much more complicated. Basically, if it’s true that some cosmetic talc products could have been contaminated with asbestos, it’s possible that they could be more dangerous that we previously thought.
Still, the last 30 years of research haven’t been conclusive.
If asbestos has remained in talcum powder in recent decades, this could provide an alternative mechanism for carcinogenesis. That said, epidemiological studies from the past 30 years examining talcum powder use and cancer have failed to conclusively demonstrate an increased risk. The research that has linked talcum powder to ovarian cancer was based on “shaky data,” Mary Jane Minkin, M.D., a professor of obstetrics, gynecology, and reproductive sciences at Yale University, previously told SELF.
Looking at the Nurses’ Health Study, over 78,000 women who used talc-containing products were examined for risk of ovarian cancer. A small increased risk was seen for talc users and invasive serous ovarian cancer, but no increase was demonstrated for ovarian cancer overall and no dose-response relationship was found (meaning that those who used talc more frequently were not found to be more likely to develop cancer). A case-control study with fewer women also found a small increased risk only in some cancer types (again, including invasive serous tumors); risk also seemed to vary depending on use of hormone therapy. A study of over 61,000 women in the Women’s Health Study found no increased risk.
There are fewer studies examining mesothelioma risk due to talcum powder. One looked at data from three studies of individuals who were exposed via their occupation as talc miners, and found “no epidemiological evidence to support the hypothesis that exposure to cosmetic talc is associated with the development of pleural mesothelioma.” While this is not the same group who would be using talc cosmetically, presumably miners would be in contact with higher levels of talc over a longer period of time.
Johnson & Johnson is correct that most studies contradict the claims against them. For instance, a recent study examining the presence of asbestos in talcum products from the 1940s to 1970s found no trace of asbestos in the tested products, suggesting that if contamination existed, it was rare. A simulation of exposure to talc products from the 1960s and 1970s found “no appreciable exposure or risk of asbestos-related disease” in their study. And research done by the FDA from 2009-2010 likewise found no asbestos in samples both from talc suppliers nor from talc-containing cosmetics purchased in retail stores. Though several high-profile lawsuits have suggested a link between ovarian cancer and talc use, science is not decided in a court of law.
The FDA did confirm that it’s looking into the allegations. “The FDA takes the possible presence of asbestos in cosmetics very seriously. The FDA will investigate reports related to the presence of asbestos in talcum powder and take appropriate actions to protect consumers,” the agency told SELF in an email.
“We continue to use several means to monitor cosmetic safety generally, including conducting research, to help ensure that cosmetics available to American consumers are safe,” the FDA continued. “We have also formed an interagency working group to reach consensus on the analytical testing methodologies for measuring asbestos in talc samples. Specifically, the work group is focusing its efforts around developing better methods of identification and detection of asbestos as a contaminant in talc. As we move forward in this initiative we will engage with stakeholders and provide opportunities for public input. We look forward to sharing more information in the future.”
One issue is that it’s difficult to tease out the risks associated with talc individually from those associated with asbestos, Daniel Cramer, M.D., an ovarian cancer epidemiologist at Harvard Medical School, tells SELF. Many studies examining talc use and cancer development are limited by “poor detail on the degree of exposure,” he says, and this is even worse when trying to determine exposure to not just talc but also possible asbestos contamination (which may have varied in the past between different products). “To be sure, if asbestos can be documented to be in current products then that would raise regulatory issues likely to take the products off the market,” he explains.
“The questions being raised recently are at what point were we sure that there were no further asbestos contamination issues,” Dr. Minkin told SELF when contacted again for this article. “I am still of the opinion in my read of the literature that pure talc is not an issue, and does not raise the risk of ovarian cancer. But we shall see what further information becomes available as far as asbestos questions.”
So, how worried should you be?
For now, if you have concerns about talcum powder, simply don’t use it. In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends against the use of talcum powder in the vaginal area, even though they note that “There is no medical consensus that talcum powder causes ovarian cancer.”
Similarly, the American Academy of Pediatrics (AAP) discourages use of baby powder, noting that “If inhaled, talcum-containing powders can cause severe lung damage and breathing problems in babies.” Although the AAP doesn’t address inhalational risks of caregivers diapering babies, it seems like an unnecessary risk when diaper cream can be used instead of powder, and products containing cornstarch can be used in lieu of talcum powder.
Ultimately, the decision to use talc is up to you. But if you’re at all concerned, you can talk it through with your doctor and know that you have plenty of other options.