Here we provide recent research on the risk that some people may contract ovarian cancer from using body powder products that contained talc that in turn might have contained asbestos.

To help you understand the chances of contracting cancer from using talcum powder or similar products, along with research citations themselves, we include excerpts from the conclusions of these key articles.

Page top photograph: talc particles at 100x in polarized light, photographed by the author [DF] at McCrone Research in Chicago. The author has worked as a forensic micrcoscopist, aerobiologist, and environmental investigator.

Research on Talc & Asbestos in Talc & the Role of Perineal Use of Talc in Ovarian Cancer

Asbestos-containing talc is known to be a respiratory hazard although even pure asbestos-free talc may be hazardous as well. Some of that research is cited in this article.

Because talc was used in or on a wide variety of products and, in some cases, is still used in some products including cosmetics (Gordon 2014), asbestos-containing talc might be on or contained in some of those items.

However not all products containing talc contain detectable asbestos, and some other products using talc (rubber band dust) involved so little talc that, in our opinion, it's not likely that there is a measurable asbestos hazard from their use or presence.

This page supports our separate InspectApedia article:

ASBESTOS in TALCUM POWDER

where you can also read more about recent litigation arguing that talc-containing baby & body powders may be carcinogenic.

 

• 16 CFR Chapter 11, Consumer Products Containing Asbestos, Advance Notice of Proposed Rulemaking", [PDF] U.S. Consumer Products Safety Commission, CPSC, U.S. Federal Register, Vol. 44. No 201, 17 October 1979, Proposed Rules, 60057. This document cites a long list of consumer products that contained asbestos.
• American Cancer Society, TALCUM POWDER and CANCER, What is talcum powder? [PDF], American Cancer Society, 250 Williams Street NW, Atlanta, GA 30303 USA, Tel: 800.227.2345,
  
  Website: https://www.cancer.org retrieved 2017/01/26, original source: https://www.cancer.org/cancer/cancer-causes/talcum-powder-and-cancer.html
  
  Excerpts:
  
  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.
  
  Whether women who apply talcum powder regularly in the genital area have an increased risk of ovarian cancer.
  
  ... Talc that has asbestos is generally accepted as being able to cause cancer if it is inhaled.
  
  Many studies in women have looked at the possible link between talcum powder and cancer of the ovary. Findings have been mixed, with some studies reporting a slightly increased risk and some reporting no increase. Many case-control studies have found a small increase in risk.
  
  But these types of studies can be biased because they often rely on a person’s memory of talc use many years earlier. One prospective cohort study, which would not have the same type of potential bias, has not found an increased risk. A second found a modest increase in risk of one type of ovarian cancer.
  
  For any individual woman, if there is an increased risk, the overall increase is likely to very be small. Many studies in women have looked at the possible link between talcum powder and cancer of the ovary.
  
  Findings have been mixed, with some studies reporting a slightly increased risk and some reporting no increase. Many case-control studies have found a small increase in risk. But these types of studies can be biased because they often rely on a person’s memory of talc use many years earlier.
  
  One prospective cohort study, which would not have the same type of potential bias, has not found an increased risk. A second found a modest increase in risk of one type of ovarian cancer.
  
  For any individual woman, if there is an increased risk, the overall increase is likely to very be small.
• Anthony, John W.; Bideaux, Richard A.; Bladh, Kenneth W.; Nichols, Monte C., eds. (1995). "Talc". Handbook of Mineralogy [PDF] II (Silica, Silicates). Chantilly, VA, US: Mineralogical Society of America. ISBN 0962209716 retrieved 2018/07/12, original source: http://rruff.info/doclib/hom/talc.pdf
• ASBESTOS UNDER the MICROSCOPE [web article]
• Atabey, Dr Eşref. "Environmental Exposure To Asbestos Which Causes Mesothelioma (Pleura Cancer) In Turkey." (2015) Mesothelioma and Medical Geology Practice Center and Research Hacettepe University, Ankara, Turkey. Email: esrefatabey@gmail.com
  Excerpts documenting high levels of asbestos in talc from locations in Turkey:
  
  Koçarlı: In the Kızılkaya Bağları location of which height is 280 m of Kızılkaya district, amphibole asbestos is found in talc schist, chlorite schist, tremolite schist (MTA, 1975).
  
  Dursunbey: There is asbestos mixed with talc in the Örencik Çamı location of which height is 380 m and is located in 4 km east of Hasanlar district (MTA, 1975).
  
  Beylikova: There is an amphibole asbestos at 1000 m height in the Suludere location 250 m northeast of İkipınar neighborhood (MTA, 1975). Amphibole asbestos occurrences in Mihallıççık region have been formed in chlorite- sericite- glaucophane- actinolite- tremolite- talc- epidote ...
• Baan, Robert A. "Carcinogenic hazards from inhaled carbon black, titanium dioxide, and talc not containing asbestos or asbestiform fibers: recent evaluations by an IARC Monographs Working Group." Inhalation toxicology 19, no. sup1 (2007): 213-228.
  
  Abstract: In February 2006, an IARC Monographs Working Group reevaluated the carcinogenic hazards to humans of carbon black, titanium dioxide, and talc, which belong to the group of poorly soluble, low-toxicity particles. The review of the relevant literature and the evaluations by the Working Group will be published in Volume 93 of the IARC Monographs series.
  
  This article summarizes the Working Group's conclusions. Epidemiological studies among workers in carbon black production and in the rubber industry provided inadequate evidence of carcinogenicity.
  
  The overall data from cancer studies in rodents exposed to carbon black provided sufficient evidence of carcinogenicity.
  
  The Working Group evaluated carbon black as possibly carcinogenic to humans, Group 2B. Reviewing the epidemiological studies in the titanium dioxide production industry, the Working Group concluded that there is inadequate evidence of carcinogenicity. Overall, the results from rodent cancer studies with titanium dioxide were considered to provide sufficient evidence.
  
  Titanium dioxide was evaluated as possibly carcinogenic to humans, Group 2B. Epidemiological studies on talc miners and millers provided inadequate evidence of carcinogenicity of inhaled talc not containing asbestos or asbestiform fibers. The evidence from rodent cancer studies was considered limited.
  
  The Working Group evaluated inhaled talc not containing asbestos or asbestiform fibers as not classifiable as to its carcinogenicity to humans, Group 3. The Working Group noted that prolonged exposure to inhaled particles at sufficiently high concentrations in experimental animals may lead to impairment of normal clearance mechanisms in the alveolar region of the lung, resulting in a continued buildup of particles that eventually leads to excessive lung burdens accompanied by chronic alveolar inflammation.
  
  The inflammatory response may give rise to increased generation of reactive oxygen species, cell injury, cell proliferation, fibrosis, induction of mutations, and, ultimately, cancer. Since many of these steps also occur in workers in dusty jobs, such as coal miners, data on cancer in animals obtained under conditions of impaired lung clearance were considered relevant to humans. In addition, impaired lung clearance in rodents exposed to ultrafine particles occurs at much lower mass concentrations than with fine particles, which adds to the human relevance.
• Caron, Christina, "Courts Reverse 2 Rulings Against Baby Powder Maker", The New York Times, 24 October 2017 p. B4.
• Cen, Kefa, Hua Yang, Kunzan Qiu, Zhanghua Zhou, Ligang Zheng, and Hao Zhou. "Experimental Investigations on Performance of Collision‐block‐type Concentrator Using Fiber Optic Probe." In AIP Conference Proceedings, vol. 914, no. 1, pp. 367-375. AIP, 2007.
• Cook, Linda S., Mary L. Kamb, and Noel S. Weiss. "Perineal powder exposure and the risk of ovarian cancer." American journal of epidemiology 145, no. 5 (1997): 459-465.
  Abstract:
  
  This case-control study evaluated the risk of epithelial ovanan cancer associated with genital exposure to vanous forms of powder application. Cases included all women aged 20–79 years in three counties of western Washington who were diagnosed with borderline or invasive ovarian cancer from 1986 through 1988; 64.3% of eligible cases were interviewed.
  
  A sample of similarly aged women who lived in these counties, identified by random digit dialing, served as controls. The overall response among control women was 68.0%. Information on powder application and other potential risk factors was ascertained during the in-person interview.
  
  Overall, ovarian cancer cases (n = 313) were more likely than controls (n = 422) to ever have used powder (age-adjusted relative risk (RR) = 1.5, 95% confidence interval (Cl) 1.1–2.0). After adjustment for age and other methods of genital powder application (none vs. any), an elevated relative nsk of ovarian cancer was noted only for women with a history of penneal dusting (RR = 1.6, 95% Cl 1.1–2.3) or use of genital deodorant spray (RR = 1.9, 95% Cl 1.1–3.1)
  
  These results offer support for the hypothesis, raised by prior epidemiologic studies, that powder exposure from perineal dusting contnbutes to the development of ovarian cancer, and they suggest that use of genital deodorant sprays may do so as well. Limitations of the present study include the fairly low proportion of eligible women who participated and the potential differential recall of powder usage.
• Cramer, Daniel W., Rebecca F. Liberman, Linda Titus‐Ernstoff, William R. Welch, E. Robert Greenberg, John A. Baron, and Bernard L. Harlow. "Genital talc exposure and risk of ovarian cancer." International journal of cancer 81, no. 3 (1999): 351-356.
  Abstract:
  
  Epidemiologic studies have suggested an increased risk for ovarian cancer associated with the use of talcum powder in genital hygiene, but the biologic credibility of the association has been questioned.
  
  We conducted a population-based case-control study in eastern Massachusetts and New Hampshire involving 563 women with newly diagnosed epithelial ovarian cancer and 523 control women selected either by random digit dialing or through lists of residents. Use of body powders was assessed through personal interview and the exposure odds ratio (OR) for the use of talc in genital hygiene was calculated.
  
  Cases were more likely than controls (45% vs. 36%) to have used talc as a body powder in some manner, and the excess was confined to patients who used talc on the perineum directly or as a dusting powder to underwear or sanitary napkins.
  
  Relative to women who never used body powder or used it only in non-genital areas, the OR (and 95% confidence interval) associated with genital exposure to talc was 1.60 (1.18 and 2.15) after adjustment for age, study location, parity, oral contraceptive use, body mass index and family history of breast or ovarian cancer.
  
  Exposure prior to rather than after a first live birth appeared to be more harmful, and the association was most apparent for women with invasive serous cancers and least apparent for those with mucinous tumors.
  
  We conclude that there is a significant association between the use of talc in genital hygiene and risk of epithelial ovarian cancer that, when viewed in perspective of published data on this association, warrants more formal public health warnings.
• Cramer, Daniel W., William R. Welch, Robert E. Scully, and Carol A. Wojciechowski. "OVARIAN CANCER and TALC. A case‐control study." [PDF] Cancer 50, no. 2 (1982): 372-376. Retrieved 2018/07/18, original source: https://onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142 2819820715 2950 3A2 3C372 3A 3AAID-CNCR2820500235 3E3.0.CO 3B2-S
  
  Abstract
  Opportunities for genital exposure to talc were assessed in 215 white females with epithelial ovarian cancers and in 215 control women from the general population matched by age, race, and residence. Ninety‐two (42.8%) cases regularly used talc either as a dusting powder on the perineum or on sanitary napkins compared with 61 (28.4%) controls.
  
  Adjusted for parity and menopausal status, this difference yielded a relative risk of 1.92 (P < 0.003) for ovarian cancer associated with these practices. women who had regularly engaged in both practices had an adjusted relative risk of 3.28 (p < 0.001) compared to women with neither exposure.
  
  This provides some support for an association between talc and ovarian cancer hypothesized because of the similarity of ovarian cancer to mesotheliomas and the chemical relation of talc to asbestos, a known cause of mesotheliomas. the authors also investigated opportunities for potential talc exposure from rubber products such as condoms or diaphragms or from pelvic surgery.
  
  No significant differences were noted between cases and controls in these exposures, although the intensity of talc exposure from these sources was likely affected by variables not assessed in this study.
  rohl, arthur n., and arthur m. langer. "identification and quantitation of asbestos in talc." environmental health perspectives 9 (1974): 95.
• CPSC 2000. STAFF REPORT ON ASBESTOS IN CHILDREN’S CRAYONS [PDF] U.S. Consumer Product Safety Commission August 2000. : http://www.cpsc.gov//PageFiles/97593/crayons.pdf
• Gamble JF, Fellner W, Dimeo MJ An epidemiologic study of a group of a talc workers. Am Rev Respir Dis 119, 741–53. (1979)
• Gertig, D. M.; Hunter, D. J.; Cramer, D. W.; Colditz, G. A.; Speizer, F. E.; Willett, W. C.; Hankinson, S. E. (2 February 2000). "Prospective Study of Talc Use and Ovarian Cancer" (PDF). JNCI Journal of the National Cancer Institute. 92 (3): 249–252. doi:10.1093/jnci/92.3.249.
  
  BACKGROUND: Perineal talc use has been associated with an increased risk of ovarian cancer in a number of case-control studies; however, this association remains controversial because of limited supporting biologic evidence and the potential for recall bias or selection bias in case-control studies. In this study, we conducted a prospective analysis of perineal talc use and the risk of ovarian cancer.
  
  METHODS: The Nurses' Health Study is a prospective study of 121 700 female registered nurses in the United States who were aged 30-55 years at enrollment in 1976. Talc use was ascertained in 1982 by use of a self-administered questionnaire: after exclusions, 78 630 women formed the cohort for analysis.
  
  Three hundred seven epithelial ovarian cancers subsequently diagnosed in this cohort through June 1, 1996, were confirmed by medical record review and met inclusion criteria. Proportional hazards models by use of pooled logistic regression were used to derive relative risks (RRs) and 95% confidence intervals (CIs).
  
  RESULTS: In 1982, 40.4% (n = 31 789) of the cohort reported ever using talc, and 14.5% (n = 11 411) reported ever using talc daily. We observed no overall association with ever talc use and epithelial ovarian cancer (multivariate RR = 1.09; 95% CI = 0.86-1.37) and no increase in risk of ovarian cancer with increasing frequency of use.
  
  There was a modest elevation in risk for ever talc use and invasive serous ovarian cancer (multivariate RR = 1.40; 95% CI= 1.02-1.91). The risk of epithelial ovarian cancer for talc users was not greater among women who had never had a tubal ligation (multivariate RR = 0.97; 95% CI= 0.71-1.32).
  
  CONCLUSION: Our results provide little support for any substantial association between perineal talc use and ovarian cancer risk overall; however, perineal talc use may modestly increase the risk of invasive serous ovarian cancer.
• Gibbs AE, Pooley FD, Griffiths DM, Mitha R, Craighead JE, Ruttner JR Talc pneumoconiosis: a pathologic and mineralogic study. Hum Pathol 23, 1344–54. (1992)
• Gordon, R., S. Fitzgerald, and J. Millette. "Asbestos in commercial cosmetic talcum powder as a cause of mesothelioma in women - CORRECTIONS." [PDF] International journal of occupational and environmental health 21, no. 4 (2015): 347.
• Gordon, Ronald E., Sean Fitzgerald, and James Millette. "Asbestos in commercial cosmetic talcum powder as a cause of mesothelioma in women."[PDF] International journal of occupational and environmental health 20, no. 4 (2014): 318-332. Retrieved 2018/07/12, original source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164883/pdf/oeh-20-04-318.pdf
  Excerpt:
  
  This brand of talcum powder contained asbestos and the application of talcum powder released inhalable asbestos fibers. Lung and lymph node tissues removed at autopsy revealed pleural mesothelioma. Digestions of the tissues were found to contain anthophyllite and tremolite asbestos.
  
  Discussion: Through many applications of this particular brand of talcum powder, the deceased inhaled asbestos fibers, which then accumulated in her lungs and likely caused or contributed to her mesothelioma as well as other women with the same scenario.
• Van Gosen, Bradley S., Heather A. Lowers, and Stephen J. SutleyA USGS Study of Talc Deposits and Associated Amphibole Asbestos Within Mined Deposits of the Southern Death Valley Region, California [PDF] US Geological Survey Open-File Report 1092 (2004): 18.
• Harlow, Bernard L., Daniel W. Cramer, Debra A. Bell, and William R. Welch. "Perineal exposure to talc and ovarian cancer risk." Obstetrics & Gynecology 80, no. 1 (1992): 19-26.
  Abstract:
  
  Objective: We sought to determine whether the use of talc in genital hygiene increases the risk for epithelial ovarian cancer.
  
  Methods: We interviewed 235 white women diagnosed with epithelial ovarian cancer between 1984-1987 at ten Boston metropolitan area hospitals and 239 population-based controls of similar race, age, and residence.
  
  Results: Overall, 49% of cases and 39% of controls reported exposure to talc, via direct application to the perineum or to undergarments, sanitary napkins, or diaphragms, which yielded a 1.5 odds ratio (OR) for ovarian cancer (95% confidence interval [CI] 1.0-2.1). Among women with perineal exposure to talc, the risk was significantly elevated in the subgroups of women who applied it:
  
  1) directly as a body powder (OR 1.7, 95% CI 1.1-2.7),
  
  2) on a daily basis (OR 1.8, 95% CI 1.1-3.0), and
  
  3) for more than 10 years (OR 1.6, 95% CI 1.0-2.7).
  
  The greatest ovarian cancer risk associated with perineal talc use was observed in the subgroup of women estimated to have made more than 10,000 applications during years when they were ovulating and had an intact genital tract (OR 2.8, 95% CI 1.4-5.4); however, this exposure was found in only 14% of the women with ovarian cancer.
  
  Conclusions: These data support the concept that a lifetime pattern of perineal talc use may increase the risk for epithelial ovarian cancer but is unlikely to be the etiology for the majority of epithelial ovarian cancers.
• Harlow, BL; Hartge, PA (Apr 1995). "A review of perineal talc exposure and risk of ovarian cancer". Regulatory toxicology and pharmacology : RTP. 21 (2): 254–60. doi:10.1006/rtph.1995.1039. PMID 7644715.
• Henderson WJ, Joslin CA, Turnbull AC, Griffiths K (1971). "Talc and carcinoma of the ovary and cervix". J Obstet Gynaecol Br Commonw. 78 (3): 266–272. doi:10.1111/j.1471-0528.1971.tb00267.x. PMID 5558843.
• Hess, Harry Hammond. "The problem of serpentinization and the origin of certain chrysotile asbestos, talc, and soapstone deposits." Economic Geology 28, no. 7 (1933): 634-657.
• Bignobn, J., J. Peto & R. Saracci (Editors), IARC, NON-OCCUPATIONAL EXPOSURE to MINERAL FIBRES, [PDF] International Agency for Research on Cancer, WHO, World Health Organization, 150 cours Albert Thomas 69372, Lyon, Cedex 08, France, IARC Scientific Publication No. 90, (1989)
• Dellarco, M., & Viet Westat, "Killer Crayons?." M. Dellarco, Eunice Kennedy Shriver National Institute Child Health and Human Development, Bethesda, MD, S.M. Viet Westat, Rockville, MD
• Hsu, Tiffany, "J&J Says Tests Don't Find Asbestos in Baby Powder", The New York Times, 30 October 2019, p. B2
• Hsu, Tiffany & Roni Caryn Rabin, "Baby Powder is Recalled for Asbestos", The New York Times, 19 Oct. 2019, p. B1,3.
• Industrial Minerals Association. “What is Talc.” [Web article] Industrial mineras Association of North America, retrieved 2018/07/15, original source: http://www.ima-na.org/?page=what_is_talc
  
  Website "about" page excerpt:
  The Industrial Minerals Association - North America (IMA-NA) is a trade association created to advance the interests of North American companies that mine or process minerals used throughout the manufacturing and agricultural industries.
  
  Examples of minerals represented by the IMA-NA include ball clay, bentonite, borates, calcium carbonate, feldspar, industrial sand, mica, soda ash, talc and wollastonite. The IMA-NA is open to membership of industrial minerals producers and companies that provide equipment and services to the industry.
• Jablon, Robert, "Judge tosses $417 million award in Johnson & Johnson baby powder cancer case", The Chicago Tribune, 21 October 2017.
• Jadhav, N., A. Paradkar, N. Salunkhe, R. Karade, and G. Mane. "Talc: A versatile pharmaceutical excipient." World Journal of Pharmacy and Pharmacutical Sciences 2 (2013): 4639-4660. retrieved 2018/07/18, original source: http://www.wjpps.com/download/article/1386002938.pdf
  Excerpt: Impurities [in talc]
  
  The most common impurity of the talc is tremolite, 2CaO.5MgO.8SiO2.H2O. The occupational safety and health administration have defined this mineral as an asbestos mineral and may/may not be present in the commercial talc.
  
  Other impurities include chlorite, dolomite, calcite, iron oxide, carbon quartz and MnO2.
  
  Talc is a natural mineral, so it may contain microorganisms therefore it should be sterilized while using in pharmaceuticals and should be asbestos free.
• Johnson & Johnson Corporation: Website: https://www.jnj.com/
• Johnson & Johnson Museum: https://ourstory.jnj.com/
• Kanarek, Marty S. "Mesothelioma from chrysotile asbestos: update." Annals of epidemiology 21, no. 9 (2011): 688-697.
  Excerpt: Chrysotile asbestos, along with all other types of asbestos, has caused mesothelioma and a world-wide ban of all asbestos is warranted to stop an epidemic of mesothelioma.

• Kim, Jungwon, Chulho OAK, TaeWon JANG, MaanHong JUNG, BongKwon CHUN, Eun-Kee PARK, Ken Takahashi, " Lung Cancer Probably Related to Talc Exposure: a Case Report", Industrial Health, 51(2):228-231. (2013) http://www.jstage.jst.go.jp/article/indhealth/51/2/51_MS1385/_article [X-Ray illustration shown just above]
  
  Abstract:
  Industrial talc has been widely circulated in the world for a long time.
  
  The pure talc has little effects on humans, but inhalation of talc contaminated with asbestos can causes severe asbestos-related diseases such as lung cancer and malignant mesothelioma.
  
  Herein, we represent a case of lung cancer after occupational exposure to industrial talc in the rubber manufacturing industry.
• King, Hobart, Talc: The Softest Mineral. [web page] Geology.com. retrieved 2018/07/15, original source: http://geology.com/minerals/talc.shtml
  Excerpt: Geology.com is ... internet ...websites for earth science news and information operated by four people.
  
  Excerpt discussing asbestos:
  Talc and asbestos occur naturally and may occur in close proximity in some metamorphic rocks. Studies published in the 1960s and 1970s identified health concerns about the use of talc that contains asbestos in some cosmetic products.
  
  According to the FDA, "These studies have not conclusively demonstrated such a link, or if such a link existed, what risk factors might be involved."
  
  To address these concerns, talc mining sites are now carefully selected and ores are carefully processed to avoid the presence of asbestos in talc destined for use in the cosmetics industry.
• L.A. Times, Does baby powder cause cancer? Another jury thinks so, awarding $70 million to a California woman. LA Times (2016-10-28), retrieved 2018/07/12, original source http://www.latimes.com/business/la-fi-baby-powder-cancer-20161028-story.html
  Excerpt:
  
  ... a St. Louis jury awarded $70.1 million to Deborah Giannecchini of Modesto, who was diagnosed with advanced ovarian cancer in 2012. Giannecchini, 63, told reporters Friday that before the diagnosis, she had used Johnson's Baby Power for 45 years to keep her genital area dry, as many women do. She has blamed it for her cancer and accused J&J of negligence.
• Merritt, Melissa A., Adèle C. Green, Christina M. Nagle, and Penelope M. Webb. "Talcum powder, chronic pelvic inflammation and NSAIDs in relation to risk of epithelial ovarian cancer." International journal of cancer 122, no. 1 (2008): 170-176.
  Abstract:
  
  Chronic inflammation has been proposed as the possible causal mechanism that explains the observed association between certain risk factors, such as the use of talcum powder (talc) in the pelvic region and epithelial ovarian cancer.
  
  To address this issue we evaluated the potential role of chronic local ovarian inflammation in the development of the major subtypes of epithelial ovarian cancer.
  
  Factors potentially linked to ovarian inflammation were examined in an Australia-wide case–control study comprising 1,576 women with invasive and low malignant potential (LMP) ovarian tumours and 1,509 population-based controls.
  
  We confirmed a statistically significant increase in ovarian cancer risk associated with use of talc in the pelvic region (adjusted odds ratio 1.17, 95% CI: 1.01–1.36) that was strongest for the serous and endometrioid subtypes although the latter was not statistically significant (adjusted odds ratios 1.21, 95% CI 1.03–1.44 and 1.18, 95% CI 0.81–1.70, respectively).
  
  Other factors potentially associated with ovarian inflammation (pelvic inflammatory disease, human papilloma virus infection and mumps) were not associated with risk but, like others, we found an increased risk of endometrioid and clear cell ovarian cancer only among women with a history of endometriosis.
  
  Regular use of aspirin and other nonsteroidal anti-inflammatory drugs was inversely associated with risk of LMP mucinous ovarian tumours only. We conclude that on balance chronic inflammation does not play a major role in the development of ovarian cancer.
• Mills, Paul K., Deborah G. Riordan, Rosemary D. Cress, and Heather A. Young. "Perineal talc exposure and epithelial ovarian cancer risk in the Central Valley of California." International journal of cancer 112, no. 3 (2004): 458-464.
  Abstract:
  
  Perineal talc use has been suggested as a possible risk factor for ovarian cancer based on its structural similarity to asbestos, a known human carcinogen. A population-based epidemiologic case-control study of epithelial ovarian cancer (EOC) was conducted in 22 counties of Central California that comprise the reporting area for 2 regional cancer registries. ...
  
  Talc use and EOC risk was highest in women with serous invasive tumors (OR = 1.77; CI = 1.12–2.81).
  
  This study provides some support for the hypothesis that perineal talc use is associated with an increased risk of EOC.
• Langer,Arthur M., INORGANIC PARTICLES in HUMAN TISSUES and THEIR ASSOCIATION with NEOPLASTIC DISEASE [PDF], Environmental Health Perspectives, Vol. 9, pp. 229-233, 1974, Retrieved 2018/07/18, original source: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC1475408/ pdf/envhper00499-0224.pdf
  Abstract:
  
  An increased gastrointestinal cancer risk is associated with occupational exposure to asbestos fiber. Examination of tissues obtained from extrapulmonary organs of exposed workmen demonstrates the presence of asbestos fibers and bodies. The amount of fiber present in these tissues is many magnitudes less than encountered in the lung tissues from the same individuals.
  
  Ingestion of asbestos fiber in some environmental instances may approach in magnitude the amount resulting from occupational exposure. Disease factors are discussed.
  
  Excerpt from discussion:
  
  The observation that asbestos fiber may be present in organs which have limited direct contact with the outside environment, by direct ingestion and blood or lymph routes, emphatically demonstrates the ability of asbestos to infect the entire human body.
• Ness, Roberta B., Jeane Ann Grisso, Carrie Cottreau, Jennifer Klapper, Ron Vergona, James E. Wheeler, Mark Morgan, and James J. Schlesselman. "Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer." Epidemiology 11, no. 2 (2000): 111-117.
  Abstract:
  
  Previous epidemiologic observations consistently suggest that suppression of ovulation, tubal ligation, and hysterectomy reduce the risk of ovarian cancer and that perineal talc use increases the risk.
  
  We examined these and other risk factors in the context of a new hypothesis: that inflammation may play a role in ovarian cancer risk.
  
  Ovulation entails ovarian epithelial inflammation; talc, endometriosis, cysts, and hyperthyroidism may be associated with inflammatory responses of the ovarian epithelium; gynecologic surgery may preclude irritants from reaching the ovaries via ascension from the lower genital tract.
  
  We evaluated these risk factors in a population-based case-control study. Cases 20–69 years of age with a recent diagnosis of epithelial ovarian cancer (767) were compared with community controls (1367). We found that a number of reproductive and contraceptive factors that suppress ovulation, including gravidity, breast feeding, and oral contraception, reduced the risk of ovarian cancer.
  
  Environmental factors and medical conditions that increased risk included talc use, endometriosis, ovarian cysts, and hyperthyroidism. Gynecologic surgery including hysterectomy and tubal ligation were protective. Tubal ligation afforded a risk reduction even 20 or more years after the surgery.
  
  The spectrum of associations provides support for the hypothesis that inflammation may mediate ovarian cancer risk.
• Ness, Roberta B., and Carrie Cottreau. "Possible role of ovarian epithelial inflammation in ovarian cancer." Journal of the National Cancer Institute 91, no. 17 (1999): 1459-1467.
  Abstract:
  
  Ovarian cancer is a commonly fatal disease for which prevention strategies have been limited, in part because of a lack of understanding of the underlying biology. This paper reviews the epidemiologic literature in the English language on risk factors and protective factors for ovarian cancer and proposes a novel hypothesis that a common mechanism underlying this disease is inflammation.
  
  Previous hypotheses about the causes of ovarian cancer have attributed risk to an excess number of lifetime ovulations or to elevations in steroid hormones. Inflammation may underlie ovulatory events because an inflammatory reaction is induced during the process of ovulation.
  
  Additional risk factors for ovarian cancer, including asbestos and talc exposure, endometriosis (i.e., ectopic implantation of uterine lining tissue), and pelvic inflammatory disease, cannot be directly linked to ovulation or to hormones but do cause local pelvic inflammation.
  
  On the other hand, tubal ligation and hysterectomy act as protective factors, perhaps by diminishing the likelihood that the ovarian epithelium will be exposed to environmental initiators of inflammation. Inflammation entails cell damage, oxidative stress, and elevations of cytokines and prostaglandins, all of which may be mutagenic.
  
  The possibility that inflammation is a pathophysiologic contributor to the development of ovarian cancer suggests a directed approach to future research
• National Toxicology, Program (1993). "NTP Toxicology and Carcinogenesis Studies of Talc (Non-Asbestiform) in Rats and Mice (Inhalation Studies)". National Toxicology Program technical report series. 421: 1–287. PMID 12616290.
• NIOSH Worker Notification Program, US CDC, HEALTH EFFECTS of MINING & MILLING TALC [PDF] retrieved 2018/07/12, original source: https://www.cdc.gov/niosh/pgms/worknotify/Talc.html
  Excerpt:
  NIOSH recommends that exposure to talc containing asbestos be controlled to the lowest possible concentration. Exposure should be no higher than 0.1 fiber/cc in a 400-liter air sample (fibers more than 5 microns long) averaged over 100 minutes. We recommend that exposure to talc not containing asbestos be no higher than 2 mg/m3 averaged over 10 hours.

• NIOSH, ASBESTOS FIBERS AND OTHER ELONGATE MINERAL PARTICLES: STATE OF THE SCIENCE AND ROADMAP FOR RESEARCH [PDF] U.S. National Institute for Occupational Safety and Health, April 2011. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health 4676 Columbia Parkway Cincinnati, Ohio 45226–1998 USA, Retrieved 2018/08/07, Source: www.cdc.gov/niosh/docs/2011-159/pdfs/2011-159.pdf
  
  Photograph shown just above: Transitional particle from upstate New York identified by the United States Geological Survey
  
  Excerpts:
  Since 1990, several persistent concerns have been raised about the revised NIOSH recommendation. These concerns include the following:
  ...
  The revised definition of airborne asbestos fibers does not explicitly encompass EMPs from asbestiform amphiboles that formerly had been mineralogically defined as tremolite (e.g., winchite and richterite) or other asbestiform minerals that are known to be (e.g., erionite and fluoro-edenite) or may be (e.g., some forms of talc) associated with health effects similar to those caused by asbestos.
  
  Epidemiological evidence clearly indicates a causal relationship between exposure to fibers from the asbestos minerals and various adverse health outcomes, including asbestosis, lung cancer, and mesothelioma. However, NIOSH has viewed as inconclusive the results from epidemiological studies of workers exposed to EMPs from the nonasbestiform analogs of the asbestos minerals.
  
  Populations of interest for possible epidemiological studies include workers at talc mines in upstate New York and workers at taconite mines in northeastern Minnesota.
  
  Others include populations exposed to other EMPs, such as winchite and richterite fibers (asbestiform EMPs identified in vermiculite from a former mine near Libby, Montana), zeolites (such as asbestiform erionite), and other minerals (such as fluoro-edenite). Future studies should include detailed characterizations of the particles to which workers are or have been exposed.
• Paoletti L, Caiazza S, Donelli G, Pocchiari F Evaluation by electron microscopy techniques of asbestos contamination in industrial, cosmetic, and pharmaceutical talcs. Regul Toxicol Pharmacol 4, 222–35. (1984)
• Public Justice, News Release: Proposed Settlement with CBS and Toy Retailers to Give Refunds for ‘CSI’ Toy Fingerprint Kits That May Contain Asbestos. July 1, 2009. Source: http://www.asbestosdiseaseawareness.org/archives/303
• Rabin, Roni Caryn& Tiffany Hsu, "Baby Powder’s Possible Asbestos Link Worried Johnson & Johnson for Years - Johnson & Johnson says its product is safe. But asbestos, a carcinogen that can exist underground near talc, was a concern inside the company for decades.", The New York Times, 14 December 2018, original source: www.nytimes.com/2018/12/14/business/baby-powder-asbestos-johnson-johnson.html
  Excerpt:
  
  But Aviam Elkies, who was a doctoral candidate and testified that Johnson & Johnson had funded him to work in Mr. Lewin’s lab in 1972 analyzing samples from talc mines supplying the company, said he and Mr. Lewin had detected asbestos in at least half the samples they tested.
  
  “It appeared randomly in samples taken from the same mines,” Mr. Elkies said in an interview in Israel, where he lives. “It appeared in different concentrations. There was no pattern, no way to predict.”
• Reuters, "Recalled Baby Powder Will be Pulled, CVS Says", The New York Times, 25 October 2019 p. B2
  
• Reuters, "Special Report: J&J Knew for Decades That Asbestos Lurked in Its Baby Powder", in The New York Times, 14 December 2018, original source: www.nytimes.com/reuters/2018/12/14/us/14reuters-johnson-johnson-cancer-special-report.html
• Rohl, Arthur N. & Arthur M. Langer, "IDENTIFICATION and QUANTIFICATION of ASBESTOS in TALC " [PDF] Environmental health perspectives Vol 9, pp. 95-109, 1974, Retrieved 2018/07/18, original source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475418/pdf/envhper00499-0104.pdf
  
  Abstract Excerpt: The currently used analytical methods for identification, characterization and quantitation of asbestos fib er in consumer talcum productgs include polarized light microscopy, c-ray diffraction analysis, transmission electronh microscoy with selected area electron diffraction, and electron microprobe techniques.
  
  Light microscope methods have severe limitations imposed by the ultimate size resolution of the light-optical system. Small particles go unresolved; those marginally resolved may posess optical properties different from those properties cited in the literature; most optical properties, e.g. indices of refraction are difficult to measure on small particles.
  
  In addition to these difficulties, talc fibers often possess optical properties different from those of talc plates, which further confound analysis.
  
  Light microscopy is recommended for use only as a preliminary tool on limited, large-sized samples. Transmission electron microscopy
  
  Excerpt: Talc deposits include asbestos minerals such as chrysotile and amphiboles that may be carried over into consumer products. Optical microscopy and x-ray diffraction analyses may not reveal their presence. Examples are given of electron microscopy procedures that permit detection and measurement.
• Roselli, Maria. The ASBESTOS LIE. The past and present of an industrial catastrophe [PDF] ETUI, European Trade Union Institute, Brussels, Belgium, ISBN 978-2-87452-313-7, 2014.
• Schneider A, Smith C Major brands of kids’ crayons contain asbestos, tests show. Seattle Post-Intelligencer, May 23, 2000. Source: www.seattleP-I.com/national/cray23.shtml
• Schneider, Andrew, "Talc woes vex FDA", Times Union, Albany NY, (2 November 2014), retrieved 2018/08/07, original source: https://www.timesunion.com/living/article/Talc-woes-vex-FDA-5865578.php
  Excerpts:
  
  For example, in April 2009, South Korea's Food and Drug Administration responded almost instantly after testing showed that hundreds of pharmaceutical and cosmetic products were contaminated with dangerous talc. Immediately, tens of thousands of individual items — of more than 1,100 different products — were ordered from store shelves and banned from future sale. They included finished products that were imported from China or made in South Korea from raw Chinese talc.
  
  The South Korean government said the imported talc had "dangerously high, completely unacceptable, levels of asbestos." As word of the South Korean action spread to the U.S. public health community, FDA was asked whether it was sure that talc used here was asbestos-free. The agency repeated its talc mantra that it "relies on mine operators, importers and cosmetic and consumer product makers to ensure the safety of what they sell."
  
  Import Genius, a commercial operation which tracks shipping activity of millions of products around the world, provided data that showed that in the last 18 months more than 1,400 shipments of talc or talc products were sent into the U.S. from 34 countries. China is the largest supplier by far.
  
  The tally included 289 million pounds of raw talc as well as hundreds of shipping containers filled with eye shadow, mascara, foundations, body powders, dry shampoos, antiperspirants and other consumer items.
  
  "I would be particularly worried about talc-containing products that are imported, especially from China," said Castleman. "No one is checking products made abroad and exported here to chains to sell at low profits to fly-by-night outlets."
• Stanton, Mearl F., Maxwell Layard, Andrew Tegeris, Eliza Miller, Margaret May, Elizabeth Morgan, and Alroy Smith. "Relation of particle dimension to carcinogenicity in amphibole asbestoses and other fibrous minerals." Journal of the National Cancer Institute 67, no. 5 (1981): 965-975.
• Terry KL et al 2013. Genital Powder Use and Risk of Ovarian Cancer: A Pooled Analysis of 8,525 Cases and 9,859 Controls. Cancer Prevention Research. (6):811. August 2013. Source: http://cancerpreventionresearch.aacrjournals.org/content/6/8/811.full?sid=1d7897eb-05ef-40f8-bd1c-d6f4d798a69b
• U.K. Committee on Carcinogenicity, Statement on the Relative Vulnerability of Children to Asbestos Compared to Adults. United Kingdom Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment. Available: www.gov.uk/government/publications/relative-vulnerability-of-children-to-asbestos-compared-to-adults
• U.S. FDA, TALC INGREDIENTS & ASBESTOS CONCERNS [PDF] retrieved 2018/07/12, original source: https://www.fda.gov/cosmetics/productsingredients/ingredients/ucm293184.htm
  
  Excerpts: Under the Federal Food, Drug and Cosmetic Act (FD&C Act), cosmetic products and ingredients, with the exception of color additives, do not have to undergo FDA review or approval before they go on the market. Cosmetics must be properly labeled, and they must be safe for use by consumers under labeled or customary conditions of use.
  
  Cosmetic companies have a legal responsibility for the safety and labeling of their products and ingredients, but the law does not require them to share their safety information with FDA.
  
  Published scientific literature going back to the 1960s has suggested a possible association between the use of powders containing talc and the incidence of ovarian cancer. However, these studies have not conclusively demonstrated such a link, or if such a link existed, what risk factors might be involved. Nevertheless, questions about the potential contamination of talc with asbestos have been raised since the 1970s.
  
  To prevent contamination of talc with asbestos, it is essential to select talc mining sites carefully and take steps to purify the ore sufficiently.
• Walker, Bill, & Sonya Lunder, "Tests Find Asbestos in Kids’ Crayons, Crime Scene Kits", [web article] Asbestos Nation, EWG Action Fund, 1436 U Street NW, Suite 101, Washington DC 20009 USA Tel: (202) 667-6982, retrieved 2018/08/07, original source: http://www.asbestosnation.org /facts/ tests-find-asbestos-in-kids-crayons-crime-scene-kits/
• Weissberg, Dov, and Ilan Ben-Zeev. "Talc pleurodesis. Experience with 360 patients." The Journal of thoracic and cardiovascular surgery 106, no. 4 (1993): 689-695.
• Whittemore, Alice S., Marion L. Wu, Ralph S. Paffenbarger Jr, Dorien L. Sarles, James B. Kampert, Stella Grosser, Dexter L. Jung, Samuel Ballon, And Michael Hendrickson. "Personal and environmental characteristics related to epithelial ovarian cancer: II. Exposures to talcum powder, tobacco, alcohol, and coffee." American Journal of Epidemiology 128, no. 6 (1988): 1228-1240.
  Abstract:
  
  ... Vaginal exposures to talc and other particulates may play an etiologic role in epithelial ovarian cancer.
  
  Surgical sterilization may protect against ovarian cancer by blocking entry of such particulates into the peritoneal cavity.
  
  The authors assessed histories of talcum powder use, tubal sterilization, and hysterectomy with ovarian conservation in 188 women in the San Francisco Bay Area with epithelial ovarian cancers diagnosed in 1983–1985 and in 539 control women. To investigate the roles of blood-borne environmental exposures on ovarian cancer risk, they assessed lifetime consumption of coffee, tobacco, and alcohol in these women.
  
  Of the 539 controls, 280 were hospitalized women without overt cancer, and 259 were chosen from the general population by random digit telephone dialing. Ninety-seven (52%) of the cancer patients habitually used talcum powder on the perineum, compared with 247 (46%) of the controls. Adjusted for parity, the relative risk (RR) = 1.40, p = 0.06.
  
  There were no statistically significant trends with increasing frequency or duration of talc use, and patients did not differ from controls in use of talc on sanitary pads and/or contraceptive diaphragms. ...
  
  Although risk ratios relating duration of coffee drinking to ovarian cancer were unaffected by adjustment for several characteristics, further study is needed to exclude potential confounding by other unmeasured characteristics.
• BLACK LIGHT & UV LIGHT USES describes use of that device to show talcum powder on surfaces
• MEDICAL USE of ASBESTOS is described in ASBESTOS OTHER PRODUCTS where, citing Rosato we note that asbestos was used in temporary dental fillings and in medical foot powder made with equal weights of boro-salicylated talc dusting powder (RB) and powdered asbestos.

...

---

---

ADVERTISEMENT

---

---

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs

Reader Question: Really worried about recent J&J baby powder asbestos warnings: Please Help Me

I have used baby powder since i was baby what are the chances of getting mesothelioma

I used talcum powder until I was 45 years old and I am really worried. I am really really worried about the recent J&J baby powder asbestos warning. Please help. Thank you joe - On 2018-12-18

Reply by (mod) - what are the chances of getting mesothelioma vs other hazards vs health effects of worry & stress?

Joe,

The cancer risk for an individual who used J&J talc is not something for which I can find a single simple answer, but is a question you should discuss with your doctor. S/he and you know your personal risk factors besides age, such as family history of cancer, exposures to other environmental hazards etc.

The actual presence of asbestos in talc sold by J&J appears to have varied from none detected to extremely low (some researchers chose not to report it at all, claiming the level was too low to be meaningful), to possibly significant - according to conflicting research reports.

Watch out: don't let anxiety about this become its own health risk for you, and more urgently, don't let worry about a statistically unlikely (though I agree horrible) cancer illness to so distract you that you fail to attend far more likely hazards to life and health.

If there is a risk of ovarian cancer from heavy regular and prolonged use of asbestos-containing talc, that risk is likely to be small but we absolutely acknowledge that in ensuing ligitation a large class of claimants has formed.

Still, statistically you're FAR more likely to die in an automobile accident or to suffer serious illness by falling down stairs, perhaps exacerbated by driving an unsafe car or using unsafe stairs missing handrailings and stair guards.

According to the ACS American Cancer Society ( https://www.cancer.org/cancer/cancer-causes/talcum-powder-and-cancer.html )
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.

Whether women who apply talcum powder regularly in the genital area have an increased risk of ovarian cancer.

Talc that has asbestos is generally accepted as being able to cause cancer if it is inhaled.

Many studies in women have looked at the possible link between talcum powder and cancer of the ovary. Findings have been mixed, with some studies reporting a slightly increased risk and some reporting no increase.

Many case-control studies have found a small increase in risk. But these types of studies can be biased because they often rely on a person’s memory of talc use many years earlier. One prospective cohort study, which would not have the same type of potential bias, has not found an increased risk. A second found a modest increase in risk of one type of ovarian cancer.

For any individual woman, if there is an increased risk, the overall increase is likely to very be small.

Findings have been mixed, with some studies reporting a slightly increased risk and some reporting no increase. Many case-control studies have found a small increase in risk. But these types of studies can be biased because they often rely on a person’s memory of talc use many years earlier.

Recent reports updating the status of asbestos, talc litigation involving Johnson & Johnson:

• Rabin, Roni Caryn& Tiffany Hsu, "Baby Powder’s Possible Asbestos Link Worried Johnson & Johnson for Years
  
  Johnson & Johnson says its product is safe. But asbestos, a carcinogen that can exist underground near talc, was a concern inside the company for decades.", The New York Times, 14
  
  December 2018, original source: https://www.nytimes.com/2018/12/14/business/baby-powder-asbestos-johnson-johnson.html
  Excerpt:
  
  But Aviam Elkies, who was a doctoral candidate and testified that Johnson & Johnson had funded him to work in Mr. Lewin’s lab in 1972 analyzing samples from talc mines supplying the company, said he and Mr. Lewin had detected asbestos in at least half the samples they tested.
  
  “It appeared randomly in samples taken from the same mines,” Mr. Elkies said in an interview in Israel, where he lives. “It appeared in different concentrations. There was no pattern, no way to predict.”
• Reuters, "Special Report: J&J Knew for Decades That Asbestos Lurked in Its Baby Powder", in The New York Times, 14 December 2018, original source: https://www.nytimes.com/reuters/2018/12/14/us/14reuters-johnson-johnson-cancer-special-report.html
  

Reader Question: Thinks it's difficult for post-shower talcum powder use to be cause of ovarian cancer

In order for post-shower talcum powder use to have been the cause of ovarian cancer: think about it, even with daily use, there was a small quantity of asbestos fibers in the powder, applied in small quantities, then the asbestos fibers have to travel up the reproductive tract to the ovaries and accumulate in enough quantity to cause inflammation and cellular damage over years.

Wouldn’t there also be more peritoneal, vaginal, uterine, and fallopian tube cancer occurrences?

As well as the typical inhalation resultant issues? - On 2018-12-16 by ShelliG -

Reply by (mod)

Shelli

you are certainly touching on a topic which you probably knew received a lot of media attention recently including in the New York Times.

Confusing and disturbing were reports with conflicting comments and statements about whether or not asbestos was present in talcum powder sold by J&J.

Some of the article quoted very disturbing reports and conflicting interests when it came to funding some of the studies.

Separate from those concerns your question is one that's been touched on before.

Neither of us is the medical expert on the topic and should not just rust our intuition. It's entirely possible that different body tissues respond differently to fibers are other contaminants.

The argument you raise is similar to one that has been made by some of the manufacturers.

...

Continue reading at ASBESTOS in TALCUM POWDER or select a topic from the closely-related articles below, or see the complete ARTICLE INDEX.

Or see ASBESTOS in TALCUM POWDER FAQs - questions and answers posted originally at this page.

Or see these

Recommended Articles

• ASBESTOS IDENTIFICATION IN BUILDINGS
• ASBESTOS LIST of PRODUCTS
• ASBESTOS UNDER the MICROSCOPE
• ASBESTOS in TALCUM POWDER
  • BOTTOM LINE: ASBESTOS MAY BE PRESENT in SOME TALC PRODUCTS ... OR NOT
  • DOES CURRENT BABY POWDER CONTAIN TALC?
  • DOES TALC ALWAYS CONTAIN ASBESTOS?
  • TALC-ASBESTOS LITIGATION / SETTLEMENT STATUS
  • OTHER SMALL PARTICLE HAZARDS in TALC
  • WHAT PRODUCTS USED TALC?
  • RELATION of TALC & ASBESTOS to OVARIAN CANCER
• FORENSIC & IAQ LAB MICROSCOPE TECHNIQUES

Suggested citation for this web page

RELATION of TALC & ASBESTOS to OVARIAN CANCER at InspectApedia.com - online encyclopedia of building & environmental inspection, testing, diagnosis, repair, & problem prevention advice.

Or see this

INDEX to RELATED ARTICLES: ARTICLE INDEX to ASBESTOS HAZARDS

Or use the SEARCH BOX found below to Ask a Question or Search InspectApedia

Or See

INDEX to RELATED ARTICLES: ARTICLE INDEX to BUILDING FORENSICS

Or use the SEARCH BOX found below to Ask a Question or Search InspectApedia

Ask a Question or Search InspectApedia

Questions & answers or comments about what building products and common in-building products, appliances, mechanical components were produced using asbestos materials.

Try the search box just below, or if you prefer, post a question or comment in the Comments box below and we will respond promptly.

Note: appearance of your Comment below may be delayed: if your comment contains an image, photograph, web link, or text that looks to the software as if it might be a web link, your posting will appear after it has been approved by a moderator. Apologies for the delay.

Only one image can be added per comment but you can post as many comments, and therefore images, as you like.
You will not receive a notification when a response to your question has been posted.
Please bookmark this page to make it easy for you to check back for our response.
Our Comment Box is provided by Countable Web Productions countable.ca

Citations & References

In addition to any citations in the article above, a full list is available on request.

---

ADVERTISEMENT

---