Talc-associated lung disease can be caused by industrial exposure or more commonly as a result of intravenous administration of talc seen in drug users who inject oral medications containing talc (eg, methadone, pentazocine, amphetamines). It is characterized by dry cough, dyspnea, and pulmonary hypertension. Occupational talc exposure is found in the mining, ceramic, rubber, cosmetic, pharmaceutical, paper, textile, plastic, herbicide, and insecticide industries. It most often occurs in men in the fourth to sixth decades of life.

Presentation ranges from asymptomatic to fulminant disease. Progressive exertional dyspnea and cough can be the first symptoms. Other early signs and symptoms include weight loss, wheeze on auscultation, night sweats, and recurrent spontaneous pneumothorax. Progressively worsened disease case can present with respiratory failure, pulmonary arterial hypertension, emphysema, or cor pulmonale; however, laboratory tests may be remarkably normal.

Management includes cessation of exposure to talc and smoking, treatment of pulmonary hypertension with vasodilators, steroids, and lung transplantation in late-stage disease. See nicotine dependence for information on smoking cessation. Prognosis is generally poor as this condition is found to be progressive and irreversible.