| Study/type | Exposed subjects/route | Validated observations | Key limitation | Source DOI/PMID |
|---|---|---|---|---|
| Wegman et al., 1982; primary occupational cohort | 116 Vermont talc miners/millers exposed to ore reported free of silica and asbestos; inhalation | 12/116 workers had radiographic small opacities; 103 were followed for 1 year; FEV₁ and FVC declined more than expected. These are cohort counts, **not population prevalence estimates**. (pqac-00000030, pqac-00000039) | Numerical findings were recovered from the Antao review rather than directly from the original full text; smoking partly explained functional decline. | PMID: [7093149](https://pubmed.ncbi.nlm.nih.gov/7093149/) |
| Ciocan et al., 2022; systematic review/meta-analysis | Seven male mining/milling cohorts; n=5,394; occupational inhalation; 28–74 years of follow-up | Pneumoconiosis mortality: overall SMR 5.62 (95% CI 2.83–11.14), miners 7.90 (2.76–22.58), millers 2.64 (1.40–4.96), and cohorts with quartz >1% 9.55 (7.48–12.18). (pqac-00000015, pqac-00000054, pqac-00000055) | The pooled category is pneumoconiosis among talc-industry workers, **not proven talc-only pneumoconiosis**; quartz/asbestos exposure varied, smoking data were incomplete, and only a few cohorts existed. (pqac-00000055, pqac-00000056) | DOI: [10.3390/toxics10100589](https://doi.org/10.3390/toxics10100589) |
| Escuissato et al., 2017; human case report | 38-year-old woman; single intravenous injection of crushed methadone tablet | SpO₂ 92%; residual volume 127% predicted; DLCO 70% predicted; diffuse bilateral centrilobular/tree-in-bud nodules; biopsy showed giant-cell granulomas with birefringent material. Symptoms and CT remained stable over 3 years without disease-specific treatment. (pqac-00000028) | Single IV-excipient case—not occupational inhalational pneumoconiosis; crushed tablets may contain insoluble excipients other than talc. | DOI: [10.1590/S1806-37562016000000337](https://doi.org/10.1590/S1806-37562016000000337) |
| Sato et al., 2020; primary animal reanalysis | Male hamsters; single intratracheal talc instillation, followed for 14 days | Fibers with aspect ratio ≥3:1 constituted 22% of instilled material, mostly fibrous talc; asbestos and quartz were below detection. Talc particles occurred in macrophages, neutrophils, and multinucleated giant cells, supporting acute inflammation and impaired particle ingestion. (pqac-00000017, pqac-00000031, pqac-00000032) | Instillation does not reproduce chronic occupational inhalation or aerosol deposition; short follow-up, male-only animals, and hamster clearance differs from humans. | DOI: [10.1186/s12989-020-00356-0](https://doi.org/10.1186/s12989-020-00356-0) |
| Calabrese et al., 2024; European Society of Pathology expert opinion | Disease-level expert synthesis; occupational inhalation contrasted with vascular delivery after IV injection of crushed tablets | Inhaled silicates produce patchy/stellate centrilobular interstitial fibrosis with fibroblasts, collagen, and dust-laden macrophages; IV talc produces perivascular granulomas, focal perivascular/peribronchial fibrosis, birefringent particles, and foreign-body giant cells. (pqac-00000012, pqac-00000052) | Expert review rather than a talc-specific cohort; morphology overlaps sarcoidosis and other mineral-dust diseases, so exposure history and mineral analysis remain essential. | DOI: [10.1007/s00428-024-03845-1](https://doi.org/10.1007/s00428-024-03845-1) |


*Table: Compact evidence matrix distinguishing occupational talc pneumoconiosis from intravenous talc granulomatosis and experimental exposure. It emphasizes which quantitative findings are descriptive, pooled, or mechanistic and identifies major attribution limitations.*