How a jury determined the most innocent product in America hid a deadly secret

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Talcum powder was once thought safe enough for a baby’s bottom and a lady’s, well…lady parts. It absorbs moisture, minimizes friction, and is used to prevent rashes—US manufacturer Johnson Johnson for many years promoted the powder for infant care and feminine hygiene.

Now, however, the company faces a spate of claims from thousands of women all over the US for failure to warn of talc’s dangers, especially its link to ovarian cancer in scientific studies. The latest such case ended on Aug. 21 with a Los Angeles, California jury awarding plaintiff Eva Echeverria $70 million in compensatory damages and ordering the New-Jersey-based company to pay $347 million in punitive damages, for a total of $417 million.

“We will appeal today’s verdict because we are guided by the science,” Carol Goodrich, a company spokeswoman, said in a statement. The case follows three suits in other states that also ended with the company owing about $300 million in damages. JJ claims that the tie between ovarian cancer and talcum powder is tenuous, however.

According to the American Cancer Society, talc has been linked to cancer because in its natural form, some talc contains asbestos, which is cancerous when inhaled. Yet all talcum products used in US homes have been asbestos-free since the 1970s, says the society, when awareness of asbestos dangers became known. JJ talc has never had a warning label about cancer risk—it’s classified as a cosmetic and is legally required to be labelled informatively and accurately but not to undergo the same Food and Drug Administration review or carry the same disclosures as a drug. Some other talc-based powders do, however, carry labels that mention possible risk of ovarian cancer after regular application for female genital hygiene, CNN reports.

Studies of talc and ovarian cancer have been inconclusive—still, using the product seems to slightly increase the risk of ovarian cancer. The ACS writes:

For any individual woman, if there is an increased risk, the overall increase is likely to be very small. Still, talc is widely used in many products, so it is important to determine if the increased risk is real. Research in this area continues.

Ovacome, a UK organization dedicated to helping women with ovarian cancer, is similarly circumspect in its talc and cancer fact sheet (pdf). After a review of international studies on ovarian cancer and talcum powder, it concludes:

Even if the risk of ovarian cancer is increased, studies suggest that using talc increases the risk of ovarian cancer by around a third. Although this may sound frightening, to put it into context, smoking and drinking increases the risk of esophageal cancer by 30 times. Ovarian cancer is a rare disease, and increasing a small risk by a third still gives a small risk.

Plaintiffs are succeeding in some of their claims against the company nonetheless, despite the inconclusive studies and the fact that talc is now asbestos-free. That’s because some juries agree that JJ knew of risks yet didn’t disclose them. And it marketed talc for feminine hygiene long before baby powder became asbestos-free.

Echeverria, for example, who is 63, was diagnosed with ovarian cancer in 2007. She testified via video in her case that she used Johnson’s Baby Powder from age 11, in the 1950s, until 2016, when she saw a news story about a woman with ovarian cancer who used talc. Now Echeverria is near death, her attorney Mark Rosenberg says, and she wants the company to warn women who used talc for decades of its dangers.

JJ once marketed the powder to women with the jingle, “A sprinkle a day helps keep the odor away.” Whether it keeps the doctor away is another story, one that will continue to play out in US courts.