您现在的位置: 纽约时报中英文网 >> 纽约时报中英文版 >> 健康 >> 正文

强生婴儿爽身粉陷致癌风波

更新时间:2016-5-24 20:42:02 来源:纽约时报中文网 作者:佚名

Lawsuits Over Baby Powder Raise Questions About Cancer Risk
强生婴儿爽身粉陷致癌风波

Deane Berg thought she was going to die, and she wanted to know why. She was 49, way too young, she thought, to have advanced cancer in her ovaries.

迪安·伯格(Deane Berg)觉得自己快死了,她想知道为什么。只有49岁的她认为自己还远远不到该得晚期卵巢癌的年纪。

As she scrolled through websites that listed possible causes of ovarian cancer, one jumped out at her: talcum powder. She did not have risk factors like infertility or endometriosis, but she had dusted baby powder between her legs every day for 30 years.

她在网页上查找卵巢癌的可能成因,其中一个跃入眼帘:爽身粉。她没有不孕或子宫内膜异位这些诱发因素,但是30年来,她的确每天都在两腿之间扑些婴儿爽身粉。

“I went into the bathroom, I grabbed my Johnson’s Baby Powder and threw it in the wastebasket,” recalled Ms. Berg, now 59, a physician assistant in Sioux Falls, S.D. “I said, ‘What else could it be?’”

“我走进浴室,拿起我的强生牌婴儿爽身粉,丢进垃圾桶,”现年59岁,在南达科他州苏瀑市担任医生助理的伯格回忆。“我想:‘还能是什么原因呢?’”

Ms. Berg was the first of thousands of women with ovarian cancer to file a lawsuit against the consumer products giant Johnson & Johnson, claiming that Baby Powder caused their disease and pointing to a long trail of studies linking talc to the cancer. The research dates to 1971, when scientists in Wales discovered particles of talc embedded in ovarian and cervical tumors.Since then, numerous studies have linked genital talc use to ovarian cancer, including a report earlier this month that among African-American women, genital use of powder is linked with a 44 percent increased risk for invasive epithelial ovarian cancer.

数千患有卵巢癌的女性对消费品巨头强生公司发起诉讼,称婴儿爽身粉导致她们患病,并指出大量研究表明滑石粉与卵巢癌之间存在关联,伯格是她们中的第一人。这项研究可以追溯到1971年,当时,威尔士的科学家在卵巢和子宫颈的肿瘤内发现了滑石粉微粒。自那以后,许多研究都表明,在生殖器部位使用滑石粉同卵巢癌之间存在关联。本月初有一项报告指出,在非裔美国女性中,生殖器部位使用滑石粉,与侵袭性上皮卵巢癌风险增加44%存在关联。

Johnson & Johnson says its trademark Baby Powder is safe, and it plans to appeal two multimillion dollar jury awards, including $55 million in damages awarded to a cancer survivor earlier this month and a $72 million award in February.

强生公司表示它经过商标注册的婴儿爽身粉是安全的,并计划对两项赔偿金达数千万美元的陪审团判决进行上诉,其中一起判决在本月初做出,赔偿金达5500万美元,用于赔偿一位癌症幸存者;另一项判决于2月做出,赔偿金达7200万美元。

The International Agency for Research on Cancer in 2006 classified talcum powder as a possible human carcinogen if used in the female genital area. But the agency, part of the World Health Organization, has also said pickled vegetables and coffee are possible carcinogens and that hot dogs cause cancer.

2006年,国际癌症研究组织(The International Agency for Research on Cancer)把爽身粉归类为如在女性生殖器区域使用则有可能致癌的物质。但是这家从属于世界卫生组织的机构也称,腌菜和咖啡也是可能的致癌物,而且热狗也能致癌。

Johnson & Johnson says research implicating talcum powder is flawed and points to studies that absolve talc of any cancer risk.

强生公司说,关于爽身粉致癌的研究是有缺陷的,而且亦有研究表明滑石与癌症风险无关。

“We have children ourselves,” said Tara Glasgow, the research and development lead for the company’s baby products franchise worldwide. “We would never sell a product we didn’t believe was safe.”

“我们自己也是有孩子的人,”公司全球婴儿用品研发部门的负责人塔拉·格拉斯哥(Tara Glasgow)说。“我们绝不会出售我们自己认为不安全的产品。”

So did the juries get it right or wrong? Is it plausible that Johnson’s Baby Powder — that clean-smelling soft stuff that’s a medicine cabinet staple, packaged in milky-white containers and supposedly mild enough for babies’ bottom — can cause cancer?

那么,那些判决是对还是错呢?强生婴儿爽身粉是家庭药箱里的常备物品,这种包装在奶白色容器里的柔滑、气味清爽的粉末,性质温和被认为足以适用于婴儿的臀部,难道它真的会致癌吗?

It’s not an easy question to answer.

这并不是一个容易回答的问题。

“There is no way we’re ever going to know for certain that any exposure is necessarily causal to a disease,” said Dr. Shelley Tworoger, an associate professor of medicine and epidemiology at Brigham and Women’s Hospital and Harvard. “We might be 99 percent sure,” in some cases, she said, “but there’s usually no way to guarantee that what you see is actually the truth.”

“我们永远无法确定,暴露在某种物质之下一定会导致某种疾病,”布里格姆妇科医院(Brigham and Women’s Hospital)与哈佛大学的医药与流行病学副教授雪莉·特沃鲁格医生(Dr. Shelley Tworoger)说。她说,在某些情况下,“我们或许可以做到99%肯定,但通常没有方法保证你看到的一定是真相”。

Cancer is hard to study because it develops over a long period of time and is influenced by many factors, including genes, behaviors and environmental exposures. The best we can do, Dr. Tworoger said, “is look at the preponderance of the evidence.”

癌症非常难以研究,因为它的发展需要很长时间,受到诸多因素影响,包括基因、行为和暴露在何种环境之中。特沃鲁格医生说,我们充其量能做到的,“就是看证据的主要指向”。

Talc is a naturally occurring clay mineral composed of magnesium and silicon. Known for its softness, it is used in cosmetic products like blush because it absorbs moisture and prevents caking. It is also an additive in tablets, chewing gum and some rice. It’s often mined in proximity to asbestos, a known carcinogen, and manufacturers have to take steps to avoid contamination. Many women use the powder on their inner thighs to prevent chafing, while others sprinkle it on their perineum, sanitary pads or underwear to stay “fresh” and dry. A 1980s ad campaign for a once-popular powder promised with a catchy jingle that “a sprinkle a day helps keep odor away.”

滑石是一种天然粘土矿物,由镁元素和硅元素组成。它性质柔滑,被用在腮红等化妆品中,起到吸收潮气和防止结块的作用。它也被添加在药片、口香糖和某些大米之中。开采滑石的地方附近往往有石棉矿,而石棉是一种已知的致癌物,生产者要采取措施,避免受到污染。许多女性在大腿内侧扑上滑石粉,防止擦伤;也有人把滑石爽身粉撒在会阴部、卫生垫或内裤上,保持干燥和“清新”。20世纪80年代,一种曾经非常流行的滑石爽身粉有这样一句上口的广告词:“每日一喷,远离异味”。

There has never been an experiment to see what happens when you deliberately expose women to talcum powder — for practical and ethical reasons, there never will be — so scientists must rely on observational studies that can link an exposure to a disease but cannot determine a cause-and-effect relationship.

不管是由于实际操作的原因还是道德上的原因,故意让女性接触滑石粉会有什么样的后果,这样的实验从来没有人做过,也永远不会有人这样做。所以科学家只能依靠观察,看看接触某种物质是否与某种疾病有关,但不可能确定二者之间的因果关系。

In 1982, a Harvard professor, Dr. Daniel W. Cramer, and his colleagues compared 215 women with ovarian cancer and 215 healthy women who served as a control group. Compared with nonusers, women who used talcum powder were at nearly twice the risk for having ovarian cancer, and those who used it regularly on their genitals and sanitary pads were at more than three times the relative risk.

1982年,哈佛大学教授丹尼尔·W·克拉默(Dr. Daniel W. Cramer)与同事们对比了215个患有卵巢癌的女性与作为对照组的215名健康女性。研究表明,使用滑石粉的女性罹患卵巢癌的风险几乎是不使用滑石粉的女性的两倍。经常在会阴部和卫生垫上使用滑石粉的女性罹患卵巢癌的风险则是对照组的三倍多。

At least 10 subsequent studies echoed the results, with varying degrees of increased risk. But a small number of studies did not find a heightened risk for talc users.

随后至少有10项研究得出了与之相符的结果,只是风险的增加程度有所不同。但是也有少量研究结果并未发现使用滑石粉会增加患病风险。

When researchers pooled the results of similar studies involving nearly 20,000 women, they found powder use was associated with a 24 percent increased risk for ovarian cancer, an uncommon disease but one that is often fatal. If the finding is true, it means that for every five or six talcum powder users who develop ovarian cancer, one may be a result of talcum powder use, Dr. Steven A. Narod, an expert in cancer genetics from Toronto, said.

研究者把涉及近2万名女性的类似研究的结果汇总起来,发现滑石粉的使用与卵巢癌风险上升24%存在关联。卵巢癌并不是一种常见疾病,但通常是致命的。如果这项发现是真实的,那么它意味着每五到六名使用滑石粉的卵巢癌患者中,就有一人是由于使用滑石粉而罹患这种疾病,多伦多癌症基因学专家史蒂文·A·纳洛德(Steven A. Narod)说。

Why talc use might lead to cancer is not clear. Studies have shown that talc crystals can move up the genitourinary tract into the peritoneal cavity, where the ovaries are. Indeed, a pathology report on Ms. Berg’s tumor found talc particles embedded in the tissue.

使用滑石粉为什么有可能导致癌症,目前尚不清楚。研究表明,滑石晶体可以从泌尿生殖道进入卵巢所在的腹膜腔。事实上,伯格的肿瘤病理报告表明,她的肿瘤组织上就嵌有滑石微粒。

There is also a plausible mechanism, Dr. Tworoger said, because talc particles can set off inflammation, and inflammation is believed to play an important role in the development of ovarian cancer

特沃鲁格医生说,还有一种合理的致病机制,因为滑石微粒可以导致炎症,而炎症被认为在卵巢癌发展过程中起着重要作用。

Although Johnson & Johnson’s talc supplier added warning labels in 2006, J&J did not add similar warnings to its products, according to litigation documents. Baby powder does carry a warning to keep it out of the reach of children and many pediatricians discourage its use on babies, who can become ill or die after breathing in the particles. Inhalation studies in female rats demonstrated carcinogenicity, according to the National Toxicology Program. Condom and surgical glove makers have stopped dusting their products with talc.

尽管强生公司的滑石粉供应商在2006年开始增添警示标志,但是法律文件表明,强生公司并没有在自己的产品上增添类似标识。它的婴儿爽身粉上的确有警示标识,告知用户将产品放在儿童拿不到的地方。许多儿科医生也不推荐给婴儿使用婴儿爽身粉,因为如果吸入颗粒,可能导致生病或死亡。根据国家毒理学计划(National Toxicology Program)所做的研究,雌性大鼠吸入滑石粉会致癌。避孕套和外科手套制造商已经不再在产品上使用滑石粉。

“Talcum powder is an interesting case, because it’s not something that’s necessary,” said Dr. Anne McTiernan, an epidemiologist with the Fred Hutchinson Cancer Research Center in Seattle. “If there’s any doubt, why should anyone use it?”

“滑石粉是个有趣的案例,因为它并不是必需品,”西雅图弗莱德·哈钦森癌症研究中心的流行病学家安妮·麦克蒂尔南医生(Dr. Anne McTiernan)说,“如果人们对它有任何怀疑,那么为什么还要继续使用?”

As for Ms. Berg — the Sioux Falls woman with advanced ovarian cancer — she won her lawsuit against Johnson & Johnson, but the jury did not award damages. She hopes other talc lawsuits will raise awareness.

苏瀑市的晚期卵巢癌患者伯格打赢了告强生的官司,但陪审团没有判决强生支付赔偿。她希望其他有关滑石的诉讼能让更多人了解情况。

“I knew nothing about this before,” she said. “I figured baby powder is for babies, it must be safe.”

“我以前完全不知道。我以为,婴儿爽身粉是婴儿用品,一定是安全的,”她说。

“全文请访问纽约时报中文网,本文发表于纽约时报中文网(http://cn.nytimes.com),版权归纽约时报公司所有。任何单位及个人未经许可,不得擅自转载或翻译。订阅纽约时报中文网新闻电邮:http://nytcn.me/subscription/”

相关文章列表