MESOTHELIOMA MORTALITY IN EUROPE
Mesothelioma and asbestos
When we correlated male pleural cancer
death rates in 18 European countries with per capita asbestos
consumption 25 to 30 years earlier, we found a linear relationship
(Figure (Figure1).1). The
Spearman's correlation coefficient of the two variables is R = 0.603 (P
= 0.008). Notably, all European countries with available
information on asbestos consumption and pleural cancer mortality were
included in the analysis (the sources are indicated in the methods
section). For females, no linear relationship could be demonstrated
(Figure (Figure2).2). The
Spearman's correlation coefficient of the two variables is R = 0.293 (P
= 0.239).
Figure 1
Correlation
between per capita asbestos consumption and male pleural
cancer mortality rates (R = 0.603, P = 0.008). In the legend
SV40 detection refers to SV40 nucleic acid detection at a cut-off level
of 10%. Per capita asbestos consumption in a state ...
Figure 2
Per
capita asbestos consumption and female pleural cancer mortality
rates in European countries. In the legend SV40 detection refers to SV40
nucleic acid detection at a cut-off level of 10%.Per capita asbestos
consumption in a state was calculated as ...
SV40 data
According to
our criteria, 55 original articles on SV40 in human tissue samples or
body fluids derived from 13 European countries contained information
relevant to our analysis (Figures (Figures33 and and4,4, Table Table1).1). For all
countries except the U.K., data for pleural cancer mortality and past
asbestos use were available. Thus, 12 countries were included in the
statistical analysis. The cut off level for SV40 detection was set at 0%
or 10% positive tumor samples, respectively (Figure (Figure3).3).
Before analyzing the effect of SV40 prevalence, we corrected male
pleural cancer rates for asbestos consumption because these two
variables are highly correlated. However, whether SV40 DNA had been
detected in tumor samples from a particular country or not, had no
effect on pleural cancer mortality rates at either cut-off level,
neither in males (asbestos-corrected rates) nor in females (Table (Table22).
Figure 3
Frequencies
of SV40 nucleic acid detection in European human tissue samples. Only
reports using polymerase chain reaction or hybridization techniques were
included. The original reports are cited in Table 1. Pleural cancer
mortality data were not available ...
Figure 4
Map
of SV40 nucleic acid detection and historical vaccine contamination
with SV40 in European countries. For nucleic acid detection a cut-off
level of 10% (SV40 positive samples from a country of total examined
samples) was chosen.
Table 1
SV40
nucleic acid detection in human samples
Table 2
Comparison
of pleural cancer mortality rates in countries with or without
molecular genetic evidence of SV40
Poliomyelitis virus vaccines
Information regarding the type of poliomyelitis virus
vaccine (and whether it had been SV40-contaminated or not) was eligible
from 15 countries (Table (Table3).3). In ten
countries, the usage of SV40-contaminated polio vaccines is
unambiguously documented, while in three other countries
SV40-contaminated vaccines had apparently not been used (Table (Table3,3, Figure Figure4).4). For
Spain and Poland, contradictory reports exist (Table (Table3).3). For ten
countries with either positive or negative SV40 contamination of
vaccines, data on asbestos consumption and pleural cancer were available
(see Figure Figure1,1, sources
are indicated in the methods section). Our statistical analyses revealed
that whether the polio vaccine was contaminated or not, had no impact
whatsoever on male asbestos consumption-corrected or female pleural
cancer rates. In males, the mean asbestos-corrected mortality rate was
0.77/100 000 (n = 7) in countries with SV40-contaminated vaccines and
0.83/100 000 (n = 3) in countries without SV40-contaminated vaccines (P
= 0.700). In females, the mean mortality rate was 0.24/100 000 (n =
7) in countries with SV40-contaminated vaccines and 0.31/100 000 (n =
3) in countries without SV40-contaminated vaccines (P = 0.377).
Table 3
SV40
in poliomyelitis virus vaccines in European countries
In addition, we analyzed the impact of the type of vaccine
(IPV or OPV) used between 1957 and 1963 on pleural cancer rates in
Europe. In two of the ten countries (Sweden and Finland), IPV was the
only vaccine used at least until 1996, in two other countries (Denmark
and Norway) OPV was used as well as IPV, but not before 1967, when
Western European vaccines were SV40 free. In four countries, OPV was
used between 1957 and 1963, together with variable exposure to IPV. In
one country (Hungary) the predominant type of vaccine used between 1957
and 1963 is unclear, and in one country (Turkey) apparently no vaccine
has been used between 1957 and 1963. In countries with past use of
contaminated IPV, the mean male asbestos-corrected pleural cancer rate
was 0.95/100 000 (n = 3), and was 0.77/100 000 (n = 5) in all other
countries (P = 0.381). In countries with past use of
contaminated OPV, the mean male asbestos-corrected pleural cancer rate
was 0.77/100 000 (n = 3) and was 0.87/100 000 (n = 5) in all other
countries (P = 0.619). In countries with past use of
contaminated IPV, mean female pleural cancer rate was 0.23/100 000 (n =
3) and was 0.28/100 000 (n = 5) in all other countries (P =
0.636). In countries with past use of contaminated OPV, mean female
pleural cancer rate was 0.25/100 000 (n = 3) and was 0.27/100 000 (n =
5) in all other countries (P = 0.844). Therefore, we did not
find any significant differences in pleural cancer rates from countries
with past use of SV40-contaminated IPV or OPV compared to the other
European countries.
Categories:
Mesothelioma
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