Jurnal Hafis Fix Tampil
Jurnal Hafis Fix Tampil
Jurnal Hafis Fix Tampil
2021
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Review Article
Abstract
Talc powder is widely used for different purposes worldwide. Effects of talc on the human health is a concern as it has many chemical
components. This review is an attempt to present the relevant researches in this field and to summarize the current updates about the topic.
Talcum powder exposure has been shown to be a reason in the development of mesotheliomas and carcinoma of the lung in women.
Regular cosmetic powders can get attached to larger particles that would deposit in the upper airways of the human respiratory system. The
alveolar region is the second most exposed region of the respiratory system. Deposition levels in the tracheobronchial region is the lowest.
Cosmetic talc powder, used regularly by women worldwide, can cause detrimental effects on different organ systems of the human body.
Awareness on its harmful effects to the users may be useful to reduce the usage to some extent.
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Website:
www.ijrconline.org How to cite this article: Al Awam KA, Johnson S, Alonazi A, Aleeh
AA, Aldhamen A, Alhaddad A, et al. The effect of cosmetic talc powder
on health. Indian J Respir Care 2019;8:18-21.
DOI:
10.4103/ijrc.ijrc_24_18
6 h/day, for 5 days a week, for 4 weeks. The study reported and improve pulmonary function, though the possibility of
no adverse events or death of the rats that were exposed to relapse exists after the completion of treatment.
talc. A reduction in glucose was seen in male rats exposed
to 50 and 100 mg/m3 of talc. Furthermore, insinuation of Substantial similarity in signs and symptoms and imaging
macrophages both in the walls of the alveoli and spaces and laboratory parameters among patients presenting with
adjacent to the terminal and respiratory bronchioles was pulmonary fibrosis requires a detailed interview and will be
observed during histopathological analysis. Superoxide the key to identification of the disease.
dismutase 2, a classic genetic sign of oxidative damage, was Shinno et al. presented a case series of acute respiratory
present in both male and female rats exposed to 100 mg/m 3 distress syndrome (ARDS) subsequent to pleurodesis with
talc. They concluded that macrophage aggregations were macroparticle size talc (2018). They found out that advance
prompted by the inhalation of talc. In fact, damage to the in the age and presence of any interstitial changes in the
lung could be attributed to the oxidative stress.[13] lung as shown in CT of the chest are the likely risk elements
for the presence of posttalc pleurodesis-ARDS.[15,16] Some
TALC AND PULMONARY DISEASES studies showed successful talc pleurodesis outcomes in
patients with abundant malignant pleural effusion by using
Talc causes four types of pulmonary diseases; three
pleurodesis with thoracoscopic talc insufflations or with talc
associated with aspiration (talcosilicosis, talcoasbestosis,
slurry instillation with similar success rate.[17] Success
and talcosis) and one by intravenous administration of talc.
depends on several factors including female gender,
The latter is seen in drug abusers who inject medications
Karnofsky Performance Score >70, pleural fluid pH ≥7.34,
intended for oral use. Indicatives of pulmonary talcosis seen
adenosine deaminase ≥18 IU/l, and pleural fluid cholesterol
by high-resolution computed tomography (CT) showed ≤82 mg/dl.[18,19]
small centrilobular nodules associated with heterogeneous
conglomerate masses. These consist of high-density A study done in Germany showed a positive association
amorphous areas, with or without panlobular emphysema in between asbestos, talc, carcinoma of the lung, laryngeal
the lower lobes. Histopathologic studies in a case report carcinoma, and carcinoma of the stomach among rubber
showed the presence of birefringent, needle-shaped particles workers. Deaths from noncarcinomatous pulmonary diseases
of talc inside the giant cells with areas of pulmonary fibrosis also increased when exposed to talc.[17,18] Long-term
associated with the use of polarized light in talc exposure to talc powder may cause chronic bronchitis and
pneumoconiosis. The authors concluded that CT plays a pneumocystis.[20-22]
vital role in the diagnosis of pulmonary talcosis, as Talcum powder exposure has been shown to be a reason in
indicative configurations may be seen. [14] If this kind of pattern the development of mesotheliomas and carcinoma of the
is seen in patients with a history of contact with talc or in lung in women.[23,24] Exposure to talc free of silica and asbestos
drug abuser, it is greatly indicative of pulmonary talcosis as causes both pneumoconiosis and chronic respiratory
shown in Figure 1a and b.[2] impairment. There are many researches on the effects of talc
on different organ systems [Table 1]. Miners and millers
PATHOPHYSIOLOGY exposed to talc free of asbestos and silica developed
obstructive pulmonary effects.[25]
The pathophysiology of talcosis may be similar to that of
sarcoidosis. Talc granulomatosis is classically associated
with high concentrations of serum anticholinesterase and a SAFER USE OF TALC
large number of lymphocytes in bronchoalveolar lavage. A Talc is used in the treatment of idiopathic spontaneous
person who has sarcoidosis must go through a pneumothorax although it might result in a mild restrictive
comprehensive interview about exposure to organic or
inorganic dusts. Corticosteroids in the treatment modality
reduce symptoms Table 1: Several studies outlining the effects of talc powder on health
impairment of lung function and pleural thickening as seen et al. Determination of toxic heavy metals in different brands of talcum
in the chest X-ray.[24] powder. Int J Appl Nat Sci 2013;2:45-52.
6. Chen J, Li Z, Xu N, Zhang X, Wang Y, Lin D, et al. Efficacy of
There are articles in the literature which conclude that talc medical thoracoscopic talc pleurodesis in malignant pleural effusion
is not harmful. Genes GSTM1 and GSTT1 in women can be caused by different types of tumors and different pathological
varied and this variation is found to affect the association of classifications of lung cancer. Int J Clin Exp Med 2015;8:18945-53.
7. SI SN, Praveena SM. Hazardous ingredients in cosmetics and personal
the use of genital talc and the risk of ovarian cancer. [26] An care products and health concern: A review. Public Health Res
analysis of authentic historical Italian cosmetic talc sample 2015;5:7-15.
by Ilgren et al. through selected area electron diffraction 8. Genofre EH, Vargas FS, Acencio MM, Antonangelo L, Teixeira LR,
combined with energy dispersive X-ray analysis found that Marchi E, et al. Talc pleurodesis: Evidence of systemic inflammatory
response to small size talc particles. Respir Med 2009;103:91-7.
Pinerolo Italian cosmetic talc does not cause any cancer risk, 9. Dashen MM, Chollom PF, Okechalu JN, Ma’aji JA. Microbiological
which is due to its purity.[27,28] Similarly, French and Austrian quality assessment of some brands of cosmetics powders sold within
talc workers were examined for the effects of talc dust on Jos metropolis, plateau state. J Microbiol Biotechnol Res
respiratory system using pulmonary function test and chest 2017;1:101-6.
10. Nouioui MA, Mahjoubi S, Ghorbel A, Ben Haj Yahia M, Amira D,
X-ray, but neither showed any evidence of detrimental Ghorbel H, et al. Health risk assessment of heavy metals in traditional
effects of talc exposure.[29] cosmetics sold in Tunisian local markets. Int Sch Res Notices
2016;2016:6296458.
Regular cosmetic powders can get attached to larger 11. Nnorom IC, Igwe JC, Oji-Nnorom CG. Trace metal contents of facial
particles that would deposit in the upper airways of the (make-up) cosmetics commonly used in Nigeria. Afr J Biotechnol
human respiratory system. The alveolar region was the 2005;4:1133-8.
12. Ong TH, Takano A. Severe endobronchitis and airway stricture caused
second most exposed region of the respiratory system. by inhalation of cosmetic talc. Chest 2012;142:511-3.
Deposition levels in the tracheobronchial region were the 13. Shim I, Kim HM, Yang S, Choi M, Seo GB, Lee BW, et al. Inhalation
lowest. Both routinely mixed and small talc particles result of talc induces infiltration of macrophages and up regulation of
in an inflammatory response. Both types of particles were manganese superoxide dismutase in rats. Int J Toxicol 2015;34:491-9.
14. Chong S, Lee KS, Chung MJ, Han J, Kwon OJ, Kim TS, et al.
seen to be deposited in the lungs, spleen, liver, and kidneys Pneumoconiosis: Comparison of imaging and pathologic findings.
of animal studies.[30] The medical thoracoscopic talc Radiographics 2006;26:59-77.
pleurodesis is an analgesic and useful remedy for malignant 15. Frank C, Jorge L. An uncommon hazard: Pulmonary talcosis as a result
pleural effusion.[31] Use of talc powder in the perineal area is of recurrent aspiration of baby powder. Respir Med 2011;4:109-11.
16. Shinno Y, Kage H, Chino H, Inaba A, Arakawa S, Noguchi S, et al.
shown to increase the chance of endometrial cancer. This is Old age and underlying interstitial abnormalities are risk factors for
more prevalent among post- menopausal women.[33] development of ARDS after pleurodesis using limited amount of large
particle size talc. Respirology 2018;23:55-9.
17. Rehse DH, Aye RW, Florence MG. Respiratory failure following talc
CONCLUSION pleurodesis. Am J Surg 1999;177:437-40.
Cosmetic talc powder, used regularly by women worldwide, 18. Debeljak A, Kecelj P, Triller N, Letonja S, Kern I, Debevec L, et al.
Talc pleurodesis: Comparison of talc slurry instillation with
can cause detrimental effects on different organ systems of thoracoscopic talc insufflation for malignant pleural effusions. J BUON
the human body. Awareness on its harmful effects to the 2006;11:463-7.
users may be useful to reduce the usage to some extent. 19. Yildirim H, Metintas M, Ak G, Metintas S, Erginel S. Predictors of talc
Further research is needed to obtain more evidence pleurodesis outcome in patients with malignant pleural effusions. Lung
Cancer 2008;62:139-44.
regarding its effects on the pulmonary system. 20. Straif K, Keil U, Taeger D, Holthenrich D, Sun Y, Bungers M, et al.
Exposure to nitrosamines, carbon black, asbestos, and talc and
Financial support and sponsorship mortality from stomach, lung, and laryngeal cancer in a cohort of
Nil. rubber workers. Am J Epidemiol 2000;152:297-306.
21. Wild P, Leodolter K, Réfrégier M, Schmidt H, Zidek T, Haidinger G,
Conflicts of interest et al. A cohort mortality and nested case-control study of French and
There are no conflicts of interest. Austrian talc workers. Occup Environ Med 2002;59:98-105.
22. Wild P, Réfrégier M, Auburtin G, Carton B, Moulin JJ. Survey of the
respiratory health of the workers of a talc producing factory. Occup
REFERENCES Environ Med 1995;52:470-7.
1. McCarthy E. Talc. Kirk-Othmer Encyclopedia of Chemical 23. Gordon RE, Fitzgerald S, Millette J. Asbestos in commercial cosmetic
Technology; 2000. Available from: talcum powder as a cause of mesothelioma in women. Int J Occup
https://www.doi.org/10.1002/0471238961.20011 20313030301.a01. Environ Health 2014;20:318-32.
[Last accessed on 2000 Dec 04]. 24. Lange P, Mortensen J, Groth S. Lung function 22-35 years after
2. Marchiori E, Lourenço S, Gasparetto TD, Zanetti G, Mano CM, treatment of idiopathic spontaneous pneumothorax with talc poudrage
Nobre LF, et al. Pulmonary talcosis: Imaging findings. Lung or simple drainage. Thorax 1988;43:559-61.
2010;188:165-71. 25. Wegman DH, Peters JM, Boundy MG, Smith TJ. Evaluation of
3. Choosong T, Phakthongsuk P. Health status of workers exposed to respiratory effects in miners and millers exposed to talc free of
talcum powder in hospitals in Southern Thailand. Aerosol Air Qual asbestos and silica. Br J Ind Med 1982;39:233-8.
Res 2006;6:397-405. 26. Gates MA, Tworoger SS, Terry KL, Titus-Ernstoff L, Rosner B,
4. Agarwal R, Paul AS, Aggarwal AN, Gupta D, Jindal SK. A De Vivo I, et al. Talc use, variants of the GSTM1, GSTT1, and
randomized controlled trial of the efficacy of cosmetic talc compared NAT2 genes, and risk of epithelial ovarian cancer. Cancer Epidemiol
with iodopovidone for chemical pleurodesis. Respirology Biomarkers Prev 2008;17:2436-44.
2011;16:1064-9. 27. Ilgren EB, Sartorio C, Hoskins J. Analysis of an authentic historical
5. Rehman G, Bukhari IH, Riaz M, Manzoor HS, Rasool N, Khalid A, Italian cosmetic talc sample–further evidence for the lack of cancer
risk. Environ Pollut 2017;6:6.
20 Indian Journal of Respiratory Care ¦ Volume 8 ¦ Issue 1 ¦ January-June 2019
[Downloaded free from http://www.ijrconline.org on Wednesday, September 9, 2020, IP: 10.232.74.27]
28. Anderson EL, Sheehan PJ, Kalmes RM, Griffin JR. Assessment of
cosmetic powders. Environ Health Perspect 2012;120:885-92.
health risk from historical use of cosmetic talcum powder. Risk Anal
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of acute lung injury and severe hypoxemia in patients undergoing
29. Wild P, Leodolter K, Réfrégier M, Schmidt H, Bourgkard E. Effects
operative talc pleurodesis. Ann Thorac Surg 2006;82:1976-81.
of talc dust on respiratory health: Results of a longitudinal survey
32. Hildick-Smith GY. The biology of talc. Occup Environ Med
of 378 French and Austrian talc workers. Occup Environ Med
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33. Karageorgi S, Gates MA, Hankinson SE, De Vivo I. Perineal use
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of talcum powder and endometrial cancer risk. Cancer Epidemiol
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Biomarkers Prev 2010;19:1269-75.
exposure to engineered nanoparticles from nanotechnology-based
Abstrak
Bedak serbuk telah digunakan secara luas untuk berbagai tujuan di seluruh dunia.
Efek bedak terhadap kesehatan manusia menjadi perhatian karena banyak komponen
kimia yang terkandung di dalamnya. Review ini merupakan upaya untuk menyajikan
penelitian-penelitian yang relevan dalam bidang ini dan untuk menyimpulkan update
terkini mengenai topik tersebut. Paparan bedak serbuk telah terbukti menjadi
penyebab perkembangan mesothelioma dan karsinoma paru pada wanita. Bubuk
kosmetik biasa dapat menempel pada partikel yang lebih besar yang akan mengendap
di saluran nafas atas dari sistem respirasi manusia. Alveolar adalah regio kedua yang
paling sering terpapar dari sistem respirasi. Tingkat deposisi di area trakeobronkial
yang paling rendah. Bedak serbuk kosmetik, yang digunakan secara rutin oleh wanita
di seluruh dunia, dapat menyebabkan efek yang merugikan pada berbagai sistem
organ di dalam tubuh manusia. Kesadaran konsumen akan efek-efek berbahaya
tersebut pengguna mungkin bermanfaat untuk mengurangi penggunaannya hingga
batas tertentu.
Pendahuluan
Bedak tergolong ke dalam kelompok mineral umum yang berlapis silika yang
tersedia di alam dan tersusun dari kristal hisdorus magnesium silika. Bedak dalam
bentuk kombinasi dengan magnesit tersedia di seluruh dunia. Bedak murni saja juga
memungkinkan untuk ditemukan. Manfaat komersial didapatkan setelah melewati
proses penyortiran, yang mana kristal-kristal bedak digiling atau dimikronisasi
menjadi bubuk-bubuk yang halus. Struktur bedak adalah lembut, secara kimiawi tidak
aktif dan tampilan umum berwarna putih cerah. Warnanya dapat diubah dengan
pewarnaan besi atau melalui proses impurity menggunakan mineral-mineral lainnya.
Secara spesifik badak tidak dianggap berbahaya dan diklasifikasikan sebagai debu
iritan dalam bentuk bubuk.[1]
Dua jenis bedak, industri dan kosmetik, digunakan pada kertas, plastik-plastik, karet,
cat, dan pekerjaan manufaktur kosmetik.[2,3] Selain itu, zat ini telah terbukti efektif
untuk digunakan melalui tabung torakostomi. Termasuk di dalamnya bedak kosmetik
dan iodopovidone. Keduanya dianggap aman digunakan.[4] Bedak kosmetik dikemas
dalam bentuk bedak padat atau bedak serbuk, yang digunakan untuk riasan, dan
mengandung logam-logam berat seperti Cd, Co, Pb, Cu, dan Cr. Sebuah penelitian
terhadap tiga puluh merek bedak serbuk menunjukkan bahwa di dalamnya
terkandung logam-logam dalam batas aman, tetapi penggunaan bedak serbuk yang
berlebihan mempengaruhi kesehatan konsumen.[5] Beberapa penelitian telah
menunjukkan bahwa tingkat paparan bedak kosmetik jauh lebih rendah daripada
bedak-bedak di pabrik dan tambang.[3] Pengawet dan pewangi ditambahkan pada
produk kosmetik untuk menambah aroma dan penyajian yang menarik bagi
pelanggan. Bubuk-bubuk kosmetik memiliki kualitas antimikrobiologis yang buruk.
Bubuk-bubuk kosmetik tersebut dapat menjadi sumber mikroorganisme untuk
tumbuh dan cenderung lebih terkontaminasi oleh jamur dibandingkan oleh bakteri.
Beberapa bahan senyawa kimia ditambahkan untuk menghindari pertumbuhan
mikroba. Namun, mikroorganisme dapat menyebabkan kerusakan atau perubahan
kimiawi dari produk kosmetik tersebut.[5-8] Beberapa komponen dalam kosmetik
dapat memasuki kulit dan menyebabkan efek-efek sistemik.[9]
Pada tahun 2005, telah dilakukan penelitian terhadap beberapa kosmetik wajah yang
tersedia di Nigeria dan menunjukkan bahwa penggunaan kosmetik secara rutin dapat
menyebabkan peningkatan jumlah jejak logam pada tubuh manusia melebihi batas
keamanan, terutama apda sistem organ penglihatan.[10,11] Pada tahun 2012, kasus
pertama endobronkitis berat akibat penggunaaan bedak serbuk dilaporkan pada pasien
wanita.[12]
Sebuah penelitian pada tikus dilakukan oleh Shim et al. mengenai bedak, yang
melibatkan tikus Sprague - Dawley jantan maupun betina melalui paparan toksik
selama 4 minggu berulang melalui rute inhalasi ke seluruh tubuh. Tikus diberi bedak
uji (inhalasi) dengan konsentrasi yang berbeda seperti 0, 5, 50, dan 100 mg / m3
selama 6 jam / hari, selama 5 hari dalam seminggu, selama 4 minggu. Penelitian
tersebut melaporkan tidak ada adverse events atau kematian tikus yang terpapar
bedak. Penurunan pada glukosa terlihat pada tikus jantan yang terpapar bedak hingga
50 dan 100 mg / m3. Selanjutnya pergerakan makrofag pada dinding alveoli maupun
ruang yang berdekatan dengan bronkiolus terminal dan bronkiolus respiratorik dapat
diamati dalam analisis histopatologi. Superoksida dismutase 2, sebuah tanda genetik
khas dari kerusakan oksidatif, muncul pada tikus jantan dan betina yang terpapar
bedak 100 mg / m3. Mereka menyimpulkan bahwa agregasi makrofag dipicu oleh
inhalasi bedak. Faktanya, kerusakan pada paru dapat dikaitkan dengan stres oksidatif.
[13]
Bedak menyebabkan empat jenis penyakit paru; tiga diantaranya terkait aspirasi
(talcosilicosis, talcoasbestosis, dan talcosis) dan satu akibat pemberian bedak secara
intravena. Jenis yang terakhir disebutkan terjadi pada pemakai narkoba yang
menyuntikkan obat yang seharusnya dikonsumsi melalui oral. Tanda talcosis paru
dilihat dari computed tomography (CT) resolusi tinggi yang menunjukkan nodul-
nodul sentrilobular kecil yang terkait dengan massa konglomerat heterogen. Temuan
ini terdiri dari area amorf yang memiliki kepadatan tinggi, dengan atau tanpa disertai
emfisema panlobular di lobus bawah. Penelitian-penelitian histopatologi dalam
sebuah laporan kasus menunjukkan adanya birefringent, partikel-partikel bedak
berbentuk jarum di dalam sel-sel raksasa dengan area-area fibrosis paru terkait
penggunaan polarized light pada talc pneumokoniosis. Penulis menyimpulkan bahwa
CT berperan penting dalam diagnosis talcosis paru, yang mana terlihat seperti
gambaran seperti yang disebutkan sebelumnya.[14] Jika pola seperti ini terlihat pada
pasien yang memiliki riwayat kontak dengan bedak atau pengguna obat-obatan
terlarang, maka sangat erat kecurigaan pada talcosis paru seperti yang ditunjukkan
pada Gambar 1a dan b.[2]
Patofisiologi
Bedak serbuk kosmetik biasa dapat menempel pada partikel yang lebih besar yang
akan tersimpan pada saluran nafas bagian atas dari sistem pernapasan manusia.
Alveolar adalah regio terbesar kedua yang paling terpapar dari sistem pernapasan.
Tingkat deposisi terendah yaitu pada regio trakeobronkial. Kedua zat tersebut, bedak
dan partikel yang lebih besar, akan terus bercampur dan partikel-partikel bedak yang
kecil menyebabkan respon inflamasi. Kedua jenis partikel tersebut tampak
terendapkan di paru-paru, limpa, hati, dan ginjal pada penelitian-penelitian pada
hewan coba.[30] Medical thoracocopic talc pleurodesis merupakan analgesik dan
terapi yang bermanfaat untuk mengobati efusi pleura ganas.[31] Penggunaan bedak
serbuk di daerah perineum terbukti meningkatkan peluang kanker endometrium.
Kejadian ini lebih sering terjadi pada wanita pascamenopause.[33]
Kesimpulan
Bedak serbuk kosmetik, digunakan secara rutin oleh wanita di seluruh dunia, dapat
menyebabkan efek merugikan pada sistem organ yang berbeda dari tubuh manusia.
Kesadaran akan efek berbahaya bagi konsumen akan bermanfaat untuk mengurangi
penggunaan hingga batas tertentu. Penelitian lebih lanjut diperlukan untuk
mendapatkan lebih banyak bukti tentang pengaruhnya terhadap sistem pernafasan.