The aetiology of mesothelioma: are risk factors other than asbestos exposure important?

Our plain-English summary of The aetiology of mesothelioma: are risk factors other than asbestos exposure important?, by R. Hubbard (Thorax, 1997).

The study

• Author: R. Hubbard
• Journal: Thorax
• Published: 1997;52(6):496-7
• Type of article: Editorial
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

This editorial asked whether risk factors other than asbestos exposure are important in causing mesothelioma. The author noted that mesothelioma caused over 1000 deaths a year in England and Wales and cited predictions of about 3000 deaths a year by 2020. He commented on a study in the same issue by Yates et al, which reviewed 272 cases diagnosed in south east England, of whom 30 (11%) had no evidence of asbestos exposure. He considered it likely that a few patients develop the disease without asbestos exposure, although under-reporting of exposure and over-diagnosis may explain some cases. He described unrecognised exposure in occupations such as carpentry, electrical and construction work as an important public health issue. As evidence of spontaneous disease, he cited childhood cases: in one survey of 80 children, only two had a history of asbestos exposure. He also cited pleural tumours reported before the industrial use of asbestos. Other possible causes he discussed were erionite fibres in Cappadocia, Turkey, and, from anecdotal reports, sugar cane, ionising radiation and pleural scarring. He reviewed possible co-factors, including genetic susceptibility, smoking (no significant association in a controlled study) and Simian virus 40 (SV40). He concluded that most cases may be explained by asbestos exposure, but that spontaneous disease does occur and that SV40 as a possible co-carcinogen requires further investigation.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This was a short editorial commentary, not a new study. The author gathered no data of their own. It discussed published reports on whether anything other than asbestos causes mesothelioma, starting from a series by Yates et al of 272 patients diagnosed in south east England in 1987, of whom 30 (11%) had no evidence of asbestos exposure. Other studies it cited included a survey of 80 children with mesothelioma, of whom only two had a history of asbestos exposure, and a village in Cappadocia, Turkey, where nearly a quarter of all deaths were from mesothelioma. Rocks there contained erionite. The author also noted a controlled study that found no significant link with smoking, and experiments in which Simian virus 40 (SV40) caused pleural and pericardial mesothelioma in hamsters. The author cautioned that under-reporting of exposure and over-diagnosis may explain some cases without asbestos exposure. The author concluded that most cases may be explained by asbestos exposure, but that spontaneous disease does occur and other mineral and organic fibres may matter in some cases.

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: Editorial commentary discussing published studies (no original data)
• Who was studied: No study population of its own. The commentary centres on the Yates et al series of 272 mesothelioma cases diagnosed in south east England in 1987, and also cites other published reports.
• Exposure: Asbestos, plus possible other risk factors discussed: erionite and other zeolite minerals, sugar cane, ionising radiation, pleural scars, genetic susceptibility, smoking and Simian virus 40 (SV40)
• Main results:
  • In the Yates et al series (cited), 30 of 272 cases (11%) had no evidence of asbestos exposure
  • The Yates et al series (cited) included a high proportion of carpenters, electricians and construction workers. The author saw this as a sign of unrecognised exposure outside the asbestos industry.
  • A cited survey covered 80 cases of mesothelioma in children with a mean age of 9.7 years
  • In that cited survey of 80 children, only two had a history of asbestos exposure
  • In one village in central Cappadocia, Turkey (cited), nearly a quarter of all deaths were due to mesothelioma
  • In a cited family cluster of five mesothelioma cases, four had worked in the building trade, so unrecognised asbestos exposure could not be excluded
  • A cited controlled study found no significant association between smoking and mesothelioma
  • In cited experiments, SV40 induced pericardial and pleural mesothelioma in hamsters
• The authors' conclusion: The author concluded that most cases of mesothelioma may be explained by asbestos exposure, but that spontaneous disease does occur and other mineral and organic fibres may be important in some cases. The author also said the role of SV40 as a possible co-carcinogen with asbestos needs further investigation.
• Limitations the authors state:
  • The author noted that under-reporting of exposure and over-diagnosis may explain some cases recorded as having no asbestos exposure
  • The author noted that some other proposed causes (sugar cane, ionising radiation, pleural scars) were identified only from anecdotal reports

Topics

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

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

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