Medical Examiner

How Freaked Out Should We Be by the Possibility That There Was Asbestos in Baby Powder?

What we know is a paradox: Asbestos shouldn’t be in baby powder. And most people will not be affected in the least by the fact that it was.

It's a bottle of Johnson & Johnson baby powder
Photo illustration by Slate. Photo by Johnson and Johnson.

Recent blockbuster investigations from Reuters and the New York Times allege that for decades, there was asbestos lurking in bottles of Johnson & Johnson baby powder, that the company knew about it, and that it did not share that information with the public. It sounds terrible: A cover-up, a mineral that can cause cancer after even tiny amounts of exposure, and a contaminated product that is marketed for use on infants. And it is terrible. But none of the reports answered the fundamental question for consumers: If you’ve used Johnson & Johnson baby powder on yourself or your children, just how scared should you be?

Over the last six days, I talked to two experts in the fields of environmental and occupational health, and consulted a slew of papers and fact sheets from independent sources. And while they all agree that the news reports are concerning, the topline takeaway is that individual consumers don’t have to worry as much as the terrifying word salad of “asbestos baby powder” would suggest.

Let’s back up. The Reuters investigation is pegged to the story of Darlene Coker, who sued Johnson & Johnson in 1997, and alleged that the company’s baby powder had given her a rare form of cancer, mesothelioma, which is closely linked to asbestos. Coker lost her case due to a lack of evidence to support the claim that the company’s baby powder contained any amount of the dangerous mineral. She died from mesothelioma in 2009. But now, new suits from thousands of plaintiffs alleging that the company’s products caused their cancers (not just mesothelioma) has forced Johnson & Johnson to share more documents, including a set the company had kept internal during the entire Coker suit. Some of these suggest that the company knew that some samples of baby powder contained trace amounts of asbestos from the 1970s, when the harms of asbestos were clear, into the early 2000s. That’s the cover-up, and it’s bad.

But why would baby powder contain asbestos to begin with? Because it’s made from talc, a natural mineral that is found in the earth, sometimes alongside asbestos. Knowing that, it’s easy to see how some asbestos could wind up in baby powder, and these new documents make clear that it did at least sometimes. But that still doesn’t make it certain that baby powder caused Coker’s cancer. We don’t know how much made its way into how many bottles, and in turn, how much of that contaminated powder Coker used. We don’t know if Coker had other exposures to asbestos.

Has baby powder been proven to cause mesothelioma more generally? We simply don’t know. “You couldn’t even design a study,” says Marc Schenker, founding director of the Center for Occupational and Environmental Health at the University of California–Davis. His stance on baby powder that is known to contain asbestos is clear: “I wouldn’t touch it.” And yet, even among those who do interact with asbestos, like miners and factory workers, mesothelioma remains a rare cancer, which is why multiple experts I spoke to noted that individuals who have used baby powder on their kids should not be too alarmed by this news.

Basically, what we do know is a paradox: Asbestos shouldn’t be in baby powder. And most people will not be affected in the least by the fact that it was. (There’s also no evidence that Johnson & Johnson baby powder currently contains asbestos.)

Mesothelioma is hard to study, both because it’s exceedingly rare, and it tends to take decades after exposure to develop. Each year, there are 14 deaths per 1 million people over the age of 25; more people die in car accidents in a single day than from mesothelioma per year even though, like cars, asbestos is to some extent ubiquitous in our environment—in the air, in car brakes, and in older buildings. We’re all exposed to asbestos “just from living,” says James Kelly, manager of environmental surveillance and assessment at the Minnesota Department of Health. “Obviously, it doesn’t cause everyone to become sick.” Even most asbestos miners do not get mesothelioma: the risk of the disease can increase a hundredfold for miners (the exact number depends on the specific conditions), but the number of people who actually get it is a small percentage of those exposed. In one cohort of 903 miners in Finland, for example, just four got the disease. (It further complicates things that there are different kinds of asbestos, and the type that made those four miners ill—a type also linked to an ore deposit that supplied talc for Johnson & Johnson—was a bit less inclined to cause mesothelioma, researchers concluded.)

How much asbestos reliably causes illness is impossible to pinpoint. There’s a saying: “One fiber can kill.” That’s an exaggeration, but when I pressed experts on exactly how much of an exaggeration it is, they could not offer an answer. The slogan serves to emphasize that even a short exposure can spark cancer years down the line, and therefore asbestos should be avoided at all reasonable costs. Most people who develop mesothelioma have a history of exposure, but some 15 percent can’t recall a clear incident, according to Schenker. They might have been unknowingly exposed to a tiny amount, they might have forgotten about a clearer exposure incident, or they might have developed the cancer spontaneously, without any asbestos at all. This is not to say that dosage does not matter—even though small amounts of exposure can cause mesothelioma, the more exposure you have, the greater the risk. (Mesothelioma is also not the only cancer linked to asbestos exposure, but it is most common one, according to the National Cancer Institute.)

How did Johnson & Johnson justify selling asbestos baby powder? As the recent reporting reveals, the company argued internally that it had successfully met the regulatory standard required by the Occupational Safety and Health Administration. In a test to show that some cancerous fibers here and there were fine, Johnson & Johnson researchers put baby powder on a doll and sampled the air around it to determine how much powder would float up and stand to be inhaled (asbestos is dangerous when it gets into your lungs). Johnson & Johnson researchers determined that exposure would be below the OHSA limit of five fibers per milliliter of air, “even if talc were pure asbestos,” according to meeting minutes from 1974 obtained by Reuters. It’s worth noting that this experiment was conducted by the company rather than an independent party, but it seems to have cleared the bar.

So, bad cover-up and a fatal illness. But—still no clear indication that small amounts of asbestos in baby powder was the cause. Which is why you shouldn’t worry too much if you put baby powder on your kids during the asbestos years, experts say. The chance of a large exposure is slim, and the chance of an exposure causing the disease is slimmer still. “If I’d had used it on my own kids, it wouldn’t bother me appreciably,” says Kelly.

When I asked Slate parents if they had used baby powder on their kids, several told me that they hadn’t, due to some vague sense that it was dangerous. That matches nationwide trends: Johnson & Johnson baby product use has been on the decline in recent years, likely in part due to another Johnson & Johnson scandal (and lawsuits) surrounding the connection between talc and ovarian cancer. (The exact lines of causation in those cases are also quite complicated.) But ultimately, rather than continuing to try to nail down the precise risk baby powder poses, the easier question might be: What is the benefit? In other words, is Johnson & Johnson baby powder essential enough to warrant all this hassle?

Not really. Johnson & Johnson has spent a lot of money trying to convince us that its powder is a wonderful way to bond with our children. But despite having been around for decades, there have always been legitimate questions about how good the powder is at its job: ’”Its absorptive capability is small, its lubricating properties are minimal and its perfume aspects are short-lived,” wrote one doctor in 1985. For years, the company has marketed baby powder as something more than just a talc. But the reality is that there are plenty of other products that will do the same job (soothing diaper rash–y skin). You don’t have to worry about your baby powder usage—but there’s really no good reason to keep using it, either.