ALAMEDA – An epidemiologist told an Alameda County Superior Court jury on Wednesday that Johnson & Johnson baby powder presented no increased risk for causing mesothelioma, while attorneys for plaintiff Terry Leavitt tried to show that cases of the deadly disease were virtually nonexistent before the widespread worldwide use of cosmetic talc powder.
“There is no evidence cosmetic talc is associated with an increased risk of mesothelioma,” Dr. Suresh Moolgavkar, a University of Washington epidemiologist, said. Moolgavkar appeared as an expert witness for the defense.
Coverage of the trial is being streamed live courtesy of Courtroom View Network.
Leavitt is suing Johnson & Johnson claiming the baby powder she used for 30 years caused her to develop mesothelioma, an incurable and fatal cancer of the lining of the lungs.
During the two-month trial, Leavitt’s attorneys have argued that asbestos-tainted baby powder, likely in smaller amounts that escaped detection, caused the woman’s disease.
Defense attorneys contend Leavitt’s mesothelioma was spontaneous, contracted for no known reason, or possibly a result of exposure from living in Fremont near a factory that generated a mineral called vermiculite in the production of building materials.
Moshe Maimon, Leavitt’s attorney, displayed documentation that stated only 40 percent of cases of mesothelioma in women could be explained by occupational exposure to asbestos. “Pleural mesothelioma may be caused by non-occupational exposure,” Maimon said.
“I agree with that,” Moolgavkar said.
Maimon referred to a report that a barber who had used talc had been found to have chrysotile and tremolite (asbestos related minerals) in his lungs. “It was perhaps related to the quality of the talc, correct?” Maimon asked.
“That’s what they say (in the report),” Moolgavkar said.
Maimon produced a scientific paper published in 2006 co-authored by Dr. Richard Kradin, a Boston pathologist, that stated more information on the causes of mesothelioma was needed.
“Most malignant mesotheliomas are related to asbestos exposure, did I read that correctly?”’ Maimon asked.
Maimon also displayed a chart showing how of 2,025 autopsies performed between 1883 and 1910, no cases of mesothelioma had been reported. He indicated that the rise of cases in more recent times could be a sign of widespread use of talc powder in the population. “The cases of mesothelioma have been rising over that time (more recent years) ?” he asked.
“Correct,” Moolgavkar said.
Maimon suggested the increasing number of cases reflected inhalation exposure to asbestos fibers. Also, he argued an increase in deaths among people age 55 and older suggested both occupational and environmental exposure to asbestos fibers.
Moolgavkar said risk factors increase with age, age 50 being at greater risk than age 20. Leavitt was 52 when she was diagnosed with mesothelioma.
However, under cross examination by Michael Brown, the attorney for Johnson & Johnson, Moolgavkar said as a person gets older they run a greater risk of contracting any disease.
“It is an accumulation of a sufficient number of (cell) mutations,” he said. “All of us have many mutations and I have more than you (from being older), but I have not developed cancer. It’s the luck of the draw.”
Moolgavkar said an increase in cases of mesothelioma could also result because the population overall is growing and aging and there are more old people than two decades ago. He took issue with the Kradin paper including use of the terminology “special exposure” that he said was vague, and that the authors were making epidemiological judgments they were unqualified to make.
“This paper is totally unreliable,” Moolgavkar said.
Talc for the Johnson & Johnson baby powder came from mines in Italy, Vermont and Korea.
Brown questioned Moolgavkar about a study that said no cancers of the pleura (lungs) typically found in mesothelioma had been detected over a number of years from 1946 through 1995 among 1,722 Italian miners who had dug the talc powder.
Moolgavkar was asked if he agreed with the finding and an accompanying written statement that “No association was found between exposure to talc and mesothelioma.”
“That’s absolutely correct,” Moolgavkar said.
He added that the minimum “latency period,” the time from first exposure to the onset of disease, is about 10 years. Other cases have taken 30 years to develop.
Moolgavkar denied that occupations such as barber or cosmetologist, jobs where talc powder is used, carried greater risk.
“There is no increased risk,” he said. “I did not say no mesothelioma. You can have mesothelioma in all occupations. There is no evidence cosmetic talc is associated with an increased risk of mesothelioma.”
Moolgavkar also said the chart showing autopsies conducted between the years 1883 and 1910 was a time before modern diagnostic techniques were available and so cases of mesothelioma may have failed to be identified.