Epidemiology and Infection

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Epidemiology and Infection (2010), 138:174-182 Cambridge University Press
Copyright © Cambridge University Press 2009
doi:10.1017/S0950268809990306

Original Papers

Hepatitis

National mortality rates from chronic liver disease and consumption of alcohol and pig meat


H. R. DALTONa1a2 c1, R. P. BENDALLa3, C. PRITCHARDa4, W. HENLEYa5 and D. MELZERa6

a1 Peninsula College of Medicine and Dentistry, Royal Cornwall Hospital, Truro, UK
a2 Cornwall Gastrointestinal Unit, Royal Cornwall Hospital, Truro, UK
a3 Clinical Microbiology, Royal Cornwall Hospital, Truro, UK
a4 Peninsula Research and Development Support Unit, Royal Cornwall Hospital, Truro, UK
a5 School of Mathematics and Statistics, University of Plymouth, Plymouth, UK
a6 Department of Epidemiology and Public Health, Peninsula College of Medicine and Dentistry, Exeter, UK
Article author query
dalton hr [PubMed]  [Google Scholar]
bendall rp [PubMed]  [Google Scholar]
pritchard c [PubMed]  [Google Scholar]
henley w [PubMed]  [Google Scholar]
melzer d [PubMed]  [Google Scholar]

SUMMARY

A correlation between national pig-meat consumption and mortality rates from chronic liver disease (CLD) across developed countries was reported in 1985. One possible mechanism explaining this may be hepatitis E infection spread via pig meat. We aimed to re-examine the original association in more recent international data. Regression models were used to estimate associations between national pig-meat consumption and CLD mortality, adjusting for confounders. Data on CLD mortality, alcohol consumption, hepatitis B virus (HBV) and hepatitis C virus (HCV) seroprevalence for 18 developed countries (1990–2000) were obtained from WHO databases. Data on national pig-meat and beef consumption were obtained from the UN database. Univariate regression showed that alcohol and pig-meat consumption were associated with mortality from CLD, but beef consumption, HBV and HCV seroprevalence were not. A 1 litre per capita increase in alcohol consumption was associated with an increase in mortality from CLD in excess of 1·6 deaths/100 000 population. A 10 kg higher national annual average per capita consumption of pork meat was associated with an increase in mortality from CLD of between 4 and 5 deaths/100 000 population. Multivariate regression showed that alcohol, pig-meat consumption and HBV seroprevalence were independently associated with mortality from CLD, but HCV seroprevalence was not. Pig-meat consumption remained independently associated with mortality from CLD in developed countries in the 1990–2000 period. Further work is needed to establish the mechanism.

(Accepted May 27 2009)

(Online publication June 29 2009)

Key Words:Chronic liver disease; ethanol consumption; hepatitis E virus (HEV); hepatitis B virus (HBV); hepatitis C virus (HCV); mortality; pork consumption

Correspondence:

c1 Author for correspondence: Dr H. R. Dalton, Cornwall Gastrointestinal Unit, Royal Cornwall Hospital Trust, Truro, Cornwall TR1 3LJ, UK. (Email: harry.dalton@rcht.cornwall.nhs.uk)

Footnotes

Provisional data of this paper were presented to the British Society of Gastroenterology, March 2008.


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