LOS ANGELES – Attorneys representing Johnson & Johnson on Tuesday sought to spread the possible causes of mesothelioma in plaintiff Amy Fong from an incinerator in Hong Kong to include possibly faulty genetics or inheritance and not from baby powder use.
“On the basis of my experience, exposure to baby powder did not cause Amy Fong’s mesothelioma,” said Dr. Richard Attanoos. “Having a habitation in Hong Kong or a naturally occurring disease are important considerations.”
Attanoos said the majority of women in the U.S. who contract mesothelioma do so for naturally occurring reasons.
The trial in the Los Angeles Superior Court is being streamed live courtesy of Courtroom View Network.
Talc is a mineral crushed to be turned into baby powder and has been mined in Italy, Vermont, Korea and China.
Attanoos, an asbestos researcher and pathologist in Wales, appeared Monday and Tuesday for the defendant.
A projected slide shown to a jury stated that of 1,722 miners of talc powder studied over a 60-year period, none developed mesothelioma.
“This is another piece of information that bolsters epidemiological studies that show the same thing – no mesothelioma from cosmetic talc,” Attanoos said.
Attanoos said talc powder has been implanted for decades directly in the lungs of surgical patients to dry excess fluid and is widely known as a safe treatment.
In addition, he said tests done on animals exposed to talc powder and clinical studies supported the finding that talc did not cause an increased risk of mesothelioma.
“Did it (talc use) cause Fong’s mesothelioma, is your answer still no?” asked Kimberly Branscome, an attorney for Johnson & Johnson.
“Yes,” Attanoos said.
Attanoos said a study of tissue specimens taken from Fong revealed no asbestos exposure marker signs like the development of pleural plaques or collagen fibers that indicate exposure.
“It’s very useful to know (pleural plaques),” Attanoos said. "If talc is involved, we can see proof of exposure."
Instead of baby powder, Attanoos said genetic mutations and naturally occurring reasons for Fong’s mesothelioma need to be considered.
“Can mesothelioma develop in a person who has never been exposed to asbestos?” Branscome asked.
“We've all been exposed,” Attanoos answered.
All people breathe in asbestos fibers in ambient air in low levels known as background, which is not dangerous to health, according to defendant witness experts.
“I found no evidence Fong had been exposed to (asbestos) levels above background,” Attanoos said.
Attanoos explained that men more commonly develop mesothelioma as a result of (industrial) asbestos exposure on the job, while women are more apt to get it from naturally occurring reasons such as genetic mutations or family inheritance.
Branscome exhibited a slide that said Hong Kong had experienced an epidemic in the number of mesothelioma cases since the year 2000. Earlier testimony indicated that asbestos had been increasingly imported into Hong Kong during the 1970s for building materials during rapid population growth and a housing boom.
Under cross-examination, Joseph Satterley, Fong’s attorney, gained agreement from Attanoos that discovery of pleural plaques and asbestosis (lung scarring) were not requirements to determine asbestos exposure.
“Different people form different asbestos bodies in different ways and rates,” Satterley said.
“True,” Attanoos responded.
“There is no safe level (asbestos exposure) below which there is no increased risk, correct?” Satterley asked.
“Yes, those documents (saying no safe levels) exist,” Attanoos said.
Satterley added that the New England Journal of Medicine in 1980 stated there was no safe minimum level of asbestos exposure.
“You have not been provided with air sample data on Fong?” Satterley asked.
“I have not,” Attanoos said.
“Tremolite (one of six asbestos minerals) is amphibole asbestos?”
Attanoos indicated that tremolite can be asbestos or non-asbestos.
“You charge $500 an hour (testify),” Satterley said.
“Correct,” Attanoos answered.
“You’ve done thousands of litigations for defendants.”
“Correct.”
“You’ve never testified for a plaintiff.”
“That is correct.”
“You’ve worked with multiple J&J attorneys.”
“Over the past two years.”
“You’ve been in over 30 talc cases.”
“Correct.”
“You’re not a geneticist or toxicologist?”
“That is correct,” Attanoos said.
"You've done no epidemiological studies on Korean talc?"
"I haven't looked at Korean miners and millers," Attanoos said. "I'm not aware of any (Korean talc) study."
"You've not looked at the records of Vermont (talc workers)?"
"That's correct."
"Amy Fong's exposure began as an infant," Satterley said.
"Yes," Attanoos said.
"None of the talc miners began as an infant," Satterley said.
Attanoos agreed he had not reviewed the medical records of Fong's family members and their histories with other types of cancer.
Fong, 48, a resident of Pasadena, sued Johnson & Johnson and its talc powder supplier Imerys Talc America claiming she developed mesothelioma, a deadly cancer of the lungs, as a result of breathing in asbestos-contaminated baby powder over a long period of time.
Fong’s attorneys allege talc powder mined in Korea and inhaled by Fong in Hong Kong where she lived during the 1970s is the cause of her disease.
Johnson & Johnson attorneys argue the woman's mesothelioma could have been contracted from asbestos in fumes inhaled from an incinerator at a landfill near her home in Hong Kong.