Of Talc, Cancer, and Chemophobia

The known cancer risk of talc is on par with that of aloe vera and gingko biloba extract. Juries say it causes ovarian cancer just the same.

Two weeks ago, a jury decided that Johnson & Johnson’s baby powder caused a woman’s ovarian cancer, and ordered the company to pay her $55 million. Her attorney said the case against talc, the principal ingredient in the powder, was clear:  “Science has been simple and consistent over the last 40 years,” he told the jury, according Bloomberg News. “There’s an increased risk of ovarian cancer from genital use of talc.”

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The company, which was ordered to pay $72 million in a separate ovarian cancer case in February, responded aggressively, posting “A Message About Talc” on its website following the jury’s decision, which Johnson & Johnson says it plans to appeal. “After 30 years of studies by medical experts around the world, science, research and clinical evidence continues to support the safety of cosmetic talc,” the company noted, pointing to two recent studies – one from the Harvard School of Public Health, and another published last fall in the Journal of the National Cancer Institute — that showed no association between talc and ovarian cancer.

“We also know that some epidemiology studies have reported an association between talc and ovarian cancer,” the company conceded. “However, various governmental and non-governmental agencies as well as other expert panels have reviewed and analyzed all available data, and none have concluded that talc can cause cancer.”

The scientific truth about the carcinogenicity of talc is, well — there is no accepted black-and-white truth, and that’s the problem, with this and many industrial substances. The evidence linking talc to ovarian cancer is sketchy – the American Cancer Society notes that important research is still needed to sort out the connection, and if there is one, the risk for any given person is tiny – but there are enough hints to prompt the International Agency for Research on Cancer to rate talc as “possibly carcinogenic to humans.”

That sounds scary, but such a rating from IARC means the evidence is thin, and it puts talc in the same category as aloe vera, gingko biloba extract, and goldenseal root powder, which haven’t set off alarm bells (yet). It’s also the same category for several things that certainly have raised alarms, including chlordane (a pesticide), and perfluorooctanoic acid (PFOA), the chemical used to make Teflon.

There haven’t been a lot of lawsuits alleging that aloe vera or gingko biloba cause cancer, but there have been several making that charge about PFOA and chlordane — and now the legal focus is turning to talc, a naturally occurring mineral. But if the evidence for each suspected substance is equally equivocal, why are some of these possible toxins targeted while others aren’t?  Shouldn’t they all evoke the same degree of concern?

Scientifically, perhaps. But risk perception is emotional — a combination of the facts and how those facts feel. That’s the foundation of chemophobia, an instinctive fear of chemicals — particularly those that are (or feel) human-made. It’s a potent enough fear that we often overlook important scientific details that determine whether something is a risk and how much of a risk it might be. These include the precise dose of a chemical that causes certain levels of risk, whether we are actually exposed to those doses, at what age, and whether we’re exposed just once or regularly.

These pivotal details are rarely reported by the media, and they are ignored by environmental advocates. Perflourooctanoic acid sounds scary. Gingko biloba doesn’t.  Chemical and pharmaceutical companies sound scary. Organic farms don’t.

But chemophobia cannot be blamed on the media (although their incomplete risk reporting makes it worse), nor on environmentalists, who quite rightly want to protect human and environmental health from the harm that industrial chemicals certainly have done (though environmentalist chemo-alarmism makes things worse too).  Fear of industrial chemicals is an inherent feature of human psychology.

Research by Paul Slovic and Baruch Fischhoff and others long-ago established that we instinctively fear human-made risks more than natural ones. Radiation from nuclear power plants is scarier than carcinogenic radiation from the sun, for example. The side effects of industrial pharmaceuticals scare us more than the side effects from natural and herbal remedies. Bacillus thuringiensis (Bt) is a naturally occurring pesticide used on organic farms. Using genetic engineering to get the Bt gene into corn or soy creates plants that don’t need to be sprayed with as much industrial pesticide — but it also suddenly makes Bt sounds scarier.

Chemophobia is also fueled our instinctive fear of risks that are imposed on us by others, as opposed to those risks we take on knowingly, and voluntarily. It doesn’t feel like nature imposes risks on us, for example, but it sure feels like DuPont and Johnson & Johnson and Monsanto do. Most of the lawsuits that target industrial chemicals blame the companies that foisted them on us for knowing about the risks and not warning us. That was the central claim in the talc case against Johnson & Johnson, and it is at the heart of the 1,200 lawsuits that the company still faces.

But chemophobia is more than just a form of science ignorance that ought to be corrected with better education. It’s dangerous. It drives us to ban things that feel scary but have far more benefit than risk — like fluoridated drinking water.  It drives us to ban some substances, only to end up with alternatives that are even worse: We got rid of toxic gasses used as refrigerants, like methyl chloride and sulfur dioxide, for example, and ended up with chlorinated fluorocarbons and a hole in the ozone layer. Chemophobia drives us to spend lots of money on higher-priced items that are marketed as “natural,” but which confer no demonstrable health benefit (see: organic fruits and vegetables.)

Reverse chemophobia is dangerous too. “Natural” does not automatically mean “safe,” yet we don’t regulate herbal and natural medicines nearly as much as we do industrial pharmaceuticals, though both are biologically active substances that sometimes have harmful side effects. You may recall the lawsuits against Merck’s painkiller Vioxx (Merck withdrew it and paid nearly $5 billion to settle 27,000 legal claims). But you’d be hard-pressed to find lawsuits concerning St. John’s Wort, despite evidence that it increases sun sensitivity and the risk of skin cancer, or demands from environmental groups to ban soy products, which are far more estrogenic than the bisphenol A — that chemical in plastic that was banned from baby bottles in 2012.

Talc isn’t human-made, of course. It’s a natural mineral under attack mostly because the very speculative risk of ovarian cancer it raises has been imposed on us by a big, greedy industry that we mistrust — and that attorneys can get rich suing. Yes, their lawsuits feed chemophobia too. Like the media and environmental advocates, the plaintiff’s bar is only taking advantage of an inherent facet of human nature.

Ours is an emotion-based risk perception system, and to give it its due, this system mostly gets things right. Let’s not forget, after all, that plenty of the industrial chemicals we’ve worried about over the years have been proven to do plenty of harm. But when this human reflex gets things wrong, it can become a risk all by itself, and chemophobia can end up being just as much a threat to our health as the industrial chemicals we all so readily fear.

That alarm should be raised too.

 

David Ropeik is an author and risk-perception consultant assisting businesses, governments, non-profits, and other organizations in their understanding of human perceptions of risk, and in navigating the challenges of effective risk communication. A full list of his current and former clients is available here. The views expressed in this op-ed are his own.

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