A Critique of Helsinki Criteria for Using Lung Fiber Levels to Determine Causation in Mesothelioma Cases.

Asbestos is a known human carcinogen and the chief known cause of mesothelioma. In 1997, a group of experts developed the Helsinki Criteria, which established criteria for attribution of mesothelioma to asbestos. The criteria include two methods for causation attribution: 1) a history of significant occupational, domestic, or environmental exposure and/or 2) pathologic evidence of exposure to asbestos. In 2014, the Helsinki Criteria were updated, and these attribution criteria were not changed. However, since the Helsinki Criteria were first released in 1997, some pathologists, cell biologists, and others have claimed that a history of exposure cannot establish causation unless the lung asbestos fiber burden exceeds "the background range for the laboratory in question to attribute mesothelioma cases to exposure to asbestos." This practice ignores the impact on fiber burden of clearance/translocation over time, which in part is why the Helsinki Criteria concluded that a history of exposure to asbestos was independently sufficient to attribute causation to asbestos. After reviewing the Helsinki Criteria, we conclude that their methodology is fatally flawed because a quantitative assessment of a background lung tissue fiber level cannot be established. The flaws of the Helsinki Criteria are both technical and substantive. The 1995 paper that served as the scientific basis for establishing background levels used inconsistent methods to determine exposures in controls and cases. In addition, historic controls cannot be used to establish background fiber levels for current cases because ambient exposures to asbestos have decreased over time and control cases pre-date current cases by decades. The use of scanning electron microscope (SEM) compounded the non-compatibility problem; the applied SEM cannot distinguish talc from anthophyllite because it cannot perform selected area electron diffraction, which is a crucial identifier in ATEM for distinguishing the difference between serpentine asbestos, amphibole asbestos, and talc.

Serous Ovarian Cancer Caused by Exposure to Asbestos and Fibrous Talc in Cosmetic Talc Powders-A Case Series.

OBJECTIVE: Asbestos is a known cause of ovarian cancer. We report 10 cases of serous ovarian cancer among users of Johnson & Johnson (J&J) asbestos-containing "cosmetic" talc products. METHODS: We conducted an asbestos exposure assessment during talc application and analyzed surgical tissues and talc containers for asbestos and talc. RESULTS: Talc was found in all cases and tremolite and/or anthophyllite asbestos was found in 8/10 cases. The asbestos fibers found in the "cosmetic" talc containers matched those found in tissues. We estimated inhaled asbestos dose ranged from 0.38 to 5.18 fiber years. CONCLUSION: We provide evidence that the inhaled dose of asbestos/fibrous talc from "cosmetic" talc use causes ovarian cancer. The unique combination of the types of asbestiform minerals detected in cancerous tissue and "cosmetic" talc is a fingerprint for exposure to asbestos-containing talc.

Exposure to fluoropolymers and VOCs during spray sealant product use.

Fluoropolymer based tile and fabric spray sealants were evaluated for the release of airborne fluoropolymer constituents and volatile organic compounds (VOCs) during typical product use scenarios in a simulated bathroom and a simulated recreational vehicle. Fluoride was quantified after oxygen bomb digestion of airborne spray collected from personal, area, and surface samples. VOCs were quantified by gas chromatography/mass spectrometry (GC/MS) and gas chromatography/flame ionization spectrometry (GC/FID). Tile grout sealant contained approximately 1% acrylic fluoropolymer resin and 90% VOCs not including propellants. VOCs were short- and medium- chain methylated isoparaffinic hydrocarbons. When horizontally spraying a bathroom shower floor, grout spray sealant released a non-detectable amount of fluoride (<0.8 µg/m3) and 400-1400 mg/m3 total VOCs. When vertically spraying a shower wall, up to 2.0 µg/m3 of fluoride and from 1000 to 2300 mg/m3 total VOCs were detected. Fabric spray sealant contained 1% acrylic fluoropolymer resin and approximately 90% VOCs including perchloroethylene (PERC). Fabric spray released from 0.5 to 2.3 µg/m3 fluoride inside a recreational vehicle in the absence of crosswinds and less than 0.5 µg/m3 fluoride in the presence of a 10 mph crosswind. VOC release measured 240-938 mg/m3 without crosswinds and 161-522 mg/m3 with crosswinds. These studies show that fluoropolymer constituents from fluorinated spray sealants were near non-detectable levels in the breathing zone in nearly all samples while VOCs were measured at elevated levels (>400 mg/m3). The toxicological consequences of elevated VOCs during sealant spraying and the effects of certain fluoropolymer constituents are discussed.

Emission of diacetyl (2,3 butanedione) from natural butter, microwave popcorn butter flavor powder, paste, and liquid products.

Diacetyl (2,3 butanedione), a butter-flavored diketone, has been linked to a severe lung disease, bronchiolitis obliterans. We tested a total of three natural butters and artificial microwave popcorn butter flavorings (three powders, two pastes, and one liquid) for bulk diacetyl concentration and diacetyl emissions when heated. Pastes and liquid butter flavors contained the highest amount (6% to 10.6%) while natural butter possessed up to 7500 times less diacetyl. All artificial butter flavors studied emitted diacetyl. Dry powders emitted up to 1.62 ppm diacetyl; wetted powders up to 54.7 ppm diacetyl; and pastes emitted up to 34.9 ppm diacetyl. The liquid butter flavor emitted up to 17.2 ppm diacetyl. Microwave popcorn flavoring mixtures emitted up to 11.4 ppm diacetyl. At least 93% of the dry powder particles were inhalable. These studies show that microwave butter flavoring products generate concentrations of diacetyl in the air great enough to endanger those exposed.