Mesothelioma mortality in Europe: impact of asbestos consumption and simian virus 40

Our plain-English summary of Mesothelioma mortality in Europe: impact of asbestos consumption and simian virus 40, by K. Leithner, A. Leithner, H. Clar, et al (Orphanet Journal of Rare Diseases, 2006).

The study

• Authors: K. Leithner, A. Leithner, H. Clar, A. Weinhaeusel, R. Radl, P. Krippl, P. Rehak, R. Windhager, O.A. Haas, H. Olschewski
• Journal: Orphanet Journal of Rare Diseases
• Published: 2006;1:44
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: It is well established that asbestos is the most important cause of mesothelioma. The role of simian virus 40 (SV40) in mesothelioma development, on the other hand, remains controversial. This potential human oncogene has been introduced into various populations through contaminated polio vaccines. The aim of this study was to investigate whether the possible presence of SV40 in various European countries, as indicated either by molecular genetic evidence or previous exposure to SV40-contaminated vaccines, had any effect on pleural cancer rates in the respective countries.

Methods: We conducted a Medline search that covered the period from January 1969 to August 2005 for reports on the detection of SV40 DNA in human tissue samples. In addition, we collected all available information about the types of polio vaccines that had been used in these European countries and their SV40 contamination status.

Results: Our ecological analysis confirms that pleural cancer mortality in males, but not in females, correlates with the extent of asbestos exposure 25 - 30 years earlier. In contrast, neither the presence of SV40 DNA in tumor samples nor a previous vaccination exposure had any detectable influence on the cancer mortality rate in neither in males (asbestos-corrected rates) nor in females.

Conclusion: Using the currently existing data on SV40 prevalence, no association between SV40 prevalence and asbestos-corrected male pleural cancer can be demonstrated.

In plain English

In this ecological study, which compared countries rather than individuals, the authors searched Medline (January 1969 to August 2005) for European studies testing human tissue for simian virus 40 (SV40) DNA. They also gathered reports on which polio vaccines each country used and whether these carried SV40. They compared these with World Health Organization pleural cancer death rates, mostly for 1985 to 1989 (for Turkey, mesothelioma incidence reported in another study), and with per capita consumption of all types of asbestos 25 to 30 years earlier. Across 18 European countries, male pleural cancer mortality correlated with past asbestos consumption (R = 0.603, P = 0.008). Female mortality did not (R = 0.293, P = 0.239). Neither SV40 DNA findings nor past use of SV40-contaminated vaccines showed a statistically significant link with pleural cancer mortality in men (asbestos-corrected rates) or women. The authors concluded that this makes an association of male pleural cancer with SV40 unlikely, though it needs to be confirmed by case-control and cohort studies. They noted that the asbestos data did not separate chrysotile from amphibole asbestos and that pleural cancer rates may be incorrect.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Ecological (country-level) analysis combined with a Medline literature search for SV40 DNA studies and polio vaccine contamination reports
• Who was studied: European countries. Age-standardized male and female pleural cancer (ICD 163) mortality came from the WHO database, mostly for 1985 to 1989. Belgium used WHO mortality for 1995 to 1999. Turkey used mesothelioma incidence in 1996 from another study, because WHO data were not available. The asbestos analysis covered 18 countries. The SV40 DNA analysis drew on 55 articles from 13 countries, of which 12 were analyzed. Vaccine information came from 15 countries, of which 10 were analyzed.
• Exposure: Per capita asbestos consumption 25 to 30 years earlier (production plus imports minus exports of all types of asbestos, from U.S. Geological Survey data; fiber types not distinguished). Country-level SV40 presence was judged from SV40 DNA detection in human tissue samples (cut-offs of 0% or 10% positive samples) and from use of SV40-contaminated polio vaccines (inactivated, IPV, or oral, OPV).
• Main results:
  • In males, pleural cancer mortality correlated with per capita asbestos consumption 25 to 30 years earlier: Spearman R = 0.603, P = 0.008.
  • In females, no linear relationship was shown between pleural cancer mortality and asbestos consumption: R = 0.293, P = 0.239.
  • Detection of SV40 DNA in a country's tumor samples had no effect on pleural cancer mortality at either cut-off. For males (asbestos-corrected rates), SV40-positive versus SV40-negative countries had 0.97 (n = 9) versus 0.81 (n = 3) per 100 000 per year at the 0% cut-off (P = 0.465), and 1.04 (n = 8) versus 0.69 (n = 4) at the 10% cut-off (P = 0.082). For females, the figures were 0.31 versus 0.31 (P = 0.956) and 0.33 versus 0.28 (P = 0.397).
  • Use of SV40-contaminated polio vaccine had no impact on pleural cancer rates. For males (asbestos-corrected), mean mortality was 0.77/100 000 (n = 7) in countries with contaminated vaccines and 0.83/100 000 (n = 3) in countries without them (P = 0.700). For females, the means were 0.24/100 000 (n = 7) and 0.31/100 000 (n = 3) (P = 0.377).
  • No significant differences were found by type of contaminated vaccine. For males (asbestos-corrected), the rate was 0.95/100 000 (n = 3) with contaminated IPV versus 0.77/100 000 (n = 5) in other countries (P = 0.381), and 0.77 (n = 3) with contaminated OPV versus 0.87 (n = 5) (P = 0.619). For females, the rates were 0.23 versus 0.28 for IPV (P = 0.636) and 0.25 versus 0.27 for OPV (P = 0.844).
• The authors' conclusion: The authors concluded that this ecological analysis makes an association of male pleural cancer with SV40 unlikely, that this needs to be confirmed by case-control and cohort studies, and that their results argue against a major role of SV40 in mesothelioma carcinogenesis.
• Limitations the authors state:
  • The authors could not account for different types and particular usage of asbestos.
  • Adjustment for asbestos was crude and did not distinguish chrysotile from amphibole asbestos, so only a strong effect of SV40 could have been detected.
  • Pleural cancer rates may have been incorrect, and this could not be overcome in the study.
  • Some positive SV40 DNA results may have come from contamination or other problems with PCR methods.
  • Infected groups were diluted by people who were not vaccinated during the possible time of infection or who received SV40-free vaccines.
  • The level of exposure to IPV could not be exactly determined for every country.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, SV40, Asbestos Exposure.

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