TY - JOUR T1 - Who's (still) afraid of talc? JF - European Respiratory Journal JO - Eur Respir J SP - 619 LP - 621 DO - 10.1183/09031936.00001507 VL - 29 IS - 4 AU - M. Noppen Y1 - 2007/04/01 UR - http://erj.ersjournals.com/content/29/4/619.abstract N2 - Any pulmonologist who has ever visited a pleural disease or pneumothorax session at a major international conference or symposium, has heard the famous exclamation of my good friend Prof. Richard Light, one of the “popes” of pleural disease. Prof. Light is an exponent of the (mainly North American) school of pulmonologists who do not like talc as a pleurodesis agent. These pulmonologists do not like it to be used in malignant effusion, and they certainly do not like it to be used in young people with benign diseases, such as spontaneous pneumothorax! The main reason for this is fear. Fear that talc is not safe. Fear that talc induces acute respiratory distress syndrome (ARDS). Fear that talc induces death. Fear that talc excludes eventual pulmonary surgery or transplantation. Fear that talc induces impaired lung function. Fear that talc causes mesothelioma or cancer. Fear that talc makes surgeons angry (now that is one I can understand!). Fear, however, is a bad advisor; knowledge is a much better one. Let us see what is known about talc safety. Although some authors have observed respiratory failure, ARDS and even death after talc pleurodesis 1, 2, others have not, even in large series 3–5. In any case, these serious complications … ER -