Talcosis Asbestosis: An Unusual Exposure in the Food Industry

The following is an article translated from Italian, and written by Tomasini M., Forni A, Rivolta G, Mantegazza D, and Chiappino G., Istituto di Medicina del Lavoro, Università degli studi di Milano.

In a 37-year-old female worker who had undergone surgical excision of a segment of the right lower lobe for a chronic aspecific pleuropneumonitis, the histological examination of the excised lung tissue showed asbestos alveolitis with diffuse interstitial fibrosis, and multiple granulomata containing talc particles.

An investigation at the work site showed that the worker had been engaged for 22 years in dusting salami with a mixture of rice flour and talc contaminated with chrysotile asbestos. Thirteen work-mates engaged in the same job were studied.

In two of them, with chest X-rays negative for pneumoconiosis, a functional ventilatory impairment, restrictive in type, associated with a reduced pulmonary diffusion of gases, was demonstrated. In these two cases, bronchoalveolar lavage showed signs of severe exposure to asbestos (which at TEM evaluation revealed to be amphibolic) talc and other fibers, with presence of iron-laden macrophages, indicators of haemorrhagic alveolitis. Moreover, in one of them, a severe macrophagic-lymphocytic alveolitis, with inverted T helper/T suppressor ratio, was presented, possible expression of a hypersensitivity pulmonary reaction. Taking into consideration the length and modality of work, with exposure to talc powder contaminated with asbestos, for the three cases the diagnosis of "pre-radiologic talcosis-asbestosis" was made.

Since the occupational risk was not known in this industry, no ambient and personal preventive and protective measures had been taken; anyway, such type of work has now been stopped. The exposed workers shall be kept under control in the future for surveillance directed toward early diagnosis of possible further asbestos effects.