(CNN) - After 8 hours of deliberations Thursday, a St. Louis jury awarded $4.69 billion to 22 women who sued pharmaceutical giant Johnson & Johnson alleging their ovarian cancer was caused by using its powder as a part of their daily feminine hygiene routine.
The jury award includes $550 million in compensatory damages and $4.14 billion in punitive damages. It's the largest verdict against the company that has sold Baby Powder and Shower to Shower brand talcum powder for decades.
The jurors sat through weeks of testimony listening to experts who explained the complicated science, workers at Johnson & Johnson who said their product was safe. They also heard from the cancer survivors themselves and the loved ones of six plaintiffs who have died from their cancer.
This is not the first case brought against the company, nor will it be the last. There are thousands of cases currently making their way through court systems all around the country. In five of the cases, women who sued have had a favorable verdict. All of those cases are in various stages of appeal.
A jury ruled in Johnson & Johnson's favor in one lawsuit in California last November. In October, a judge reversed two verdicts in favor of the company. A Missouri appeals court tossed out a $55 million verdict in June citing jurisdictional issues.
The science is still up for debate. Concerns about a link between talc and ovarian cancer started surfacing around 1971, when scientists wrote about finding talc particles embedded in ovarian and cervical tumor tissue.
Since then some studies have shown that there is an elevated risk in women who use talc in their genital area for a long period of time. Other studies have not shown a connection.
In 2006, the International Agency for Research in Cancer, which falls under the World Health Organization, decided to classify the use of talc in the genital area as "possibly carcinogenic to humans." In the US, government agencies and medical associations that track what causes cancer believe the topic needs more research to know for sure.
The US National Toxicology Program, part of the US Department of Health and Human Services, keeps a congressionally mandated list of "agents, substances, mixtures, and exposure circumstances that are known or reasonably anticipated to cause cancer in humans." Talc is not among the 248 listed; however, in 2010, when it was up for consideration to be included in the list, the agency explained that it has not fully reviewed talc as a possible carcinogen.
A separate but related set of lawsuits suggest Johnson & Johnson's powder is contaminated with asbestos. Asbestos, a well-known cancer-causing agent, is often mined near talc. A New Jersey couple was awarded $117 million after after the husband claimed the J&J powder he inhaled gave him mesothelioma, a cancer caused by asbestos exposure.
This latest ovarian cancer case, that was decided on Thursday, was one of the first times that lawyers successfully argued the Baby Powder and Shower to Shower talcum powder contained asbestos. Scientists presented evidence that the tissue with the ovarian cancer cells contained asbestos and talc particles.
"For over 40 years, Johnson & Johnson has covered up the evidence of asbestos in their products," Mark Lanier, lead trial counsel for the women and their families, said in a statement. "We hope this verdict will get the attention of the J&J board and that it will lead them to better inform the medical community and the public about the connection between asbestos, talc, and ovarian cancer."
Doctors have noticed that talc particles have been in cancer tumors for decades, but it's been unclear how the contamination happened and if it led to the cancer. The women in this case claim to have all used talc based powder for decades to keep their bodies smelling fresh and clean, particularly in their genital area.
Lawyers for the women argued that the product should be pulled from shelves or at least carry a warning label.
Johnson & Johnson said in the past no warning label is necessary because there is no concern about their product.
In a statement following the ruling, Johnson & Johnson said it is confident its "products do not contain asbestos and do not cause ovarian cancer,"
The company said it is disappointed with the latest verdict plans to file an appeal.
"Every verdict against Johnson & Johnson in this court that has gone through the appeals process has been reversed and the multiple errors present in this trial were worse than those in the prior trials which have been reversed."
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