A jury in Missouri ordered Johnson & Johnson to pay $4.69 billion in damages to 22 women who claim the company's talcum powder products caused ovarian cancer.

Following an eight-hour deliberation Thursday, jurors awarded the women $550 million in compensatory damages and another $4.14 billion in punitive damages, their attorney, Mark Lanier, said in a news release.

At issue were claims that the pharmaceutical giant sold powder products that were contaminated with asbestos — once a pollutant in talc that has been linked to lung cancer — though there is much debate about whether talcum powder can lead to ovarian cancer.

Johnson & Johnson said in a statement that it is "deeply disappointed in the verdict."

"Johnson & Johnson remains confident that its products do not contain asbestos and do not cause ovarian cancer and intends to pursue all available appellate remedies," it said.

"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."

For decades, talcum powder has been used on babies. Women sometimes use it, too, particularly on genital areas to absorb moisture and reduce odors.

According to the complaint filed last year in the Circuit Court of the City of St. Louis, the women routinely used Johnson's Baby Powder and Shower to Shower, an absorbent body powder, to "dust their perineum for feminine hygiene purposes."

They said they later developed ovarian cancer.

Following Thursday's ruling, the women's lawyer said that the case led to the first talc- and asbestos-included ovarian cancer verdict in the United States.

"For over 40 years, Johnson & Johnson has covered up the evidence of asbestos in their products," Lanier said in the press release.

"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. The company should pull talc from the market before causing further anguish, harm, and death from a terrible disease.

"J&J sells the same powders in a marvelously safe corn starch variety. If J&J insists on continuing to sell talc, they should mark it with a serious warning."

But Johnson & Johnson said in its statement that the trial was "a fundamentally unfair process," noting most of the women were not from Missouri, where the testimonies were heard.

The company added that the verdict "which awarded the exact same amounts to all plaintiffs irrespective of their individual facts, and differences in applicable law, reflects that the evidence in the case was simply overwhelmed by the prejudice of this type of proceeding."

As The Washington Post's Laurie McGinley reported, there is a debate about whether talcum powder can cause ovarian cancer, with many experts, including government researchers, contending the evidence is thin.

Talc is a mineral used in cosmetics and personal-care products, McGinley reported. According to the American Cancer Society, in its natural form, it may contain asbestos, which, when inhaled, may cause cancer in the lungs. However, there are questions about whether asbestos-free talc, which is the form used in modern products, poses a similar risk, according to the association.

Regarding ovarian cancer, in particular, the American Cancer Society states that studies have shown mixed results, "with some studies reporting a slightly increased risk and some reporting no increase."

"For any individual woman, if there is an increased risk, the overall increase is likely to very be small," it said.

And the National Cancer Institute states that the "weight of evidence does not support an association between perineal talc exposure and an increased risk of ovarian cancer."

McGinley explained:

The debate over talc began decades ago. In the early 1970s, scientists discovered talc particles in ovarian tumors. In 1982, Harvard researcher Daniel Cramer reported a link between talcum powder and ovarian cancer.

His study was followed by several more finding an increased risk of ovarian cancer among regular users of talcum powder. Cramer, who at one point advised J&J to put a warning on its products, has become a frequent expert witness for women suing the company.

His studies and the many others that found a relationship used a case-control approach: A group of women diagnosed with ovarian cancer and a group without it were asked to recall their past diet and activities, and the results were then compared.

Critics say these kinds of studies have serious drawbacks, particularly "recall bias." Women may forget what they did or, if diagnosed with cancer, might inadvertently overestimate their use of a suspect substance. People without a serious disease may be less motivated to remember details.

Three other studies — considered cohort studies — did not find any overall link. Unlike the case-control studies, these efforts began with a large group of women who did not have cancer and followed the progress of their health, with participants recording what they were doing in real time.

The results of this approach, most scientists say, are stronger because they aren't subject to the vagaries of memory.

Experts agree that more research needs to be done.

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This article was originally published by The Washington Post.