Talkumpuder und historische Exposition im Gesundheitsdienst – die versteckte Gefahr von Asbest

Historical exposure to talcum powder in healthcare – the hidden danger of asbestos Objective: Talcum powder, a substance that was formerly utilized in healthcare settings for patient powdering and as an excipient in pharmaceutical manufacturing, possesses a potential for carcinogenic contamination from asbestos. In instances where an asbestos-related occupational disease, such as lung cancer, is suspected, it is imperative to ascertain whether employees were exposed to the harmful effects of asbestos. However, due to the elapsed time, recollections of specific activities may be limited. In such cases, data from exposure registers becomes a crucial source of information. To ascertain the level of inhalation exposure, it is imperative to document the extent of asbestos exposure during various healthcare activities involving talc. Methods: A comprehensive investigation was conducted to ascertain the industry-specific activities and asbestos fiber concentrations. To this end, a thorough evaluation of historical specialist publications and investigation results from occupational disease proceedings was undertaken. In addition, interviews were conducted with representatives of relevant occupational groups and contemporary witnesses, as well as glove manufacturers. Activity-related asbestos fiber concentrations were derived from the level of talcum dust development. Results: The former utilization of talcum powder in Germany in professional domains such as nursing, infant care, pharmacy and veterinary medicine is delineated, accompanied by the respective typical periods of use. The overview also includes exposure possibilities in work areas where medical gloves were prepared or worn. According to the state of the art and taking into account the adaptation of working techniques in the GDR after reunification, activities involving talc in medical care facilities after 1992 can be largely ruled out. From the beginning of 1991, the use of powdered medical disposable gloves containing talcum powder was phased out in the industrial sector. Conclusions: The industry knowledge obtained from long-term activities involving talc in healthcare settings provides a foundation for retrospective exposure assessment of asbestos-related occupational diseases. The differentiation of exposure values for brief periods involving minimal amounts of talc facilitates the estimation of cumulative exposure. Keywords: talcum – asbestos – occupational disease – exposure – healthcare