The administration of talc particles to the pleural space for the production of symphysis has been practiced for over 70 years with little understanding of the key particle parameters that lead to desired or undesired clinical outcomes. Nevertheless, talc has become the sclerosant of choice for pleuradesis. In addition to its ability to obliterate the pleural space, talc has also been indicated to slow the progression of cancer leading to improved quality of life and longer lifespans for patients suffering from malignant pleural effusions. However, the occurrence of fatal side effects - particularly acute respiratory distress syndrome (ARDS) - has recently raised concerns. The potential influence of the physical properties and chemical state (impurity levels and type) of clinically administered talc on the frequency of ARDS in clinical outcomes is investigated in this study. The outcomes indicate a need for cross-disciplinary collaborations between physicians and particle scientists to yield an improved understanding of the fundamental talc particle properties that instigate therapy and those that induce adverse effects. These developments are expected to lead to further insights into the interactions that occur between particles and tissues, in addition to strategies for engineering multifunctional next-generation pleuradesis agents.