The association between urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) and cardiovascular diseases and blood pressure: a systematic review and meta-analysis of observational studies

Particulate matter, polycyclic aromatic hydrocarbons and metals, platelet parameters and blood pressure alteration: Multi-pollutants study among population

Epidemiological findings have determined the linkage of fine particulate matter (PM2.5) and the morbidity of hypertension. However, the mode of action and specific contribution of PM2.5 component in the blood pressure elevation remain unclear. Platelets are critical for vascular homeostasis and thrombosis, which may be involved in the increase of blood pressure. Among 240 high-PM2.5 exposed, 318 low-PM2.5 exposed workers in a coking plant and 210 workers in the oxygen plant and cold-rolling mill enrolled in present study, both internal and external exposure characteristics were obtained, and we performed linear regression, adaptive elastic net regression, quantile g-computation and mediation analyses to analyze the relationship between urine metabolites of polycyclic aromatic hydrocarbons (PAHs) and metals fractions with platelets indices and blood pressure indicators. We found that PM2.5 exposure leads to increased systolic blood pressure (SBP) and pulse pressure (PP). Specifically, for every 10 μg/m3 increase in PM2.5, there was a 0.09 mmHg rise in PP. Additionally, one IQR increase in urinary 1-hydroxypyrene (1.06 μmol/mol creatinine) was associated with a 3.43 % elevation in PP. Similarly, an IQR increment of urine cobalt (2.31 μmol/mol creatinine) was associated with a separate 1.77 % and 4.71 % elevation of SBP and PP. Notably, platelet-to-lymphocyte ratio (PLR) played a mediating role in the elevation of SBP and PP induced by cobalt. Our multi-pollutants results showed that PAHs and cobalt were deleterious contributors to the elevated blood pressure. These findings deepen our understanding of the cardiovascular effects associated with PM2.5 constituents, highlighting the importance of increased vigilance in monitoring and controlling the harmful components in PM2.5.

Human biomonitoring of serum polycyclic aromatic hydrocarbons and oxygenated derivatives by gas chromatography coupled with tandem mass spectrometry

While polycyclic aromatic hydrocarbons (PAHs) are well-known for their potential carcinogenic and mutagenic effects, the health implications of exposure to oxygenated PAHs (OPAHs), which are significant substitutes with increased persistence and bioaccumulation, are less understood. In this work, we compared the background levels of liquid-liquid, solid-phase, and supported-liquid extraction for the determination of serum PAHs and OPAHs. Liquid-liquid extraction demonstrated minimal background interference and was validated and used for human biomonitoring of PAHs and OPAHs in 240 participants using gas chromatography coupled with tandem mass spectrometry. We observed significant positive correlations between these compounds using Spearman correlation analysis. Furthermore, we investigated the concentration levels and compositions of PAHs and OPAHs among different demographic characteristics, including gender, age, and body mass index. Linear regression analysis demonstrated a weak but significant correlation between total concentrations of PAHs and OPAHs and age and body mass index. A multivariate linear regression analysis was then conducted to examine the association of exposure to individual PAHs and OPAHs with the body mass index. Naphthalene exposure and body mass index showed a statistically significant positive correlation, suggesting that higher levels of naphthalene exposure are associated with higher body mass index values. This study establishes a robust method for biomonitoring PAHs and OPAHs in serum, evaluating the exposure levels of these compounds in healthy adults and highlighting their associations with demographic characteristics.

Evaluating the impact of polycyclic aromatic hydrocarbon bioaccumulation in adipose tissue of obese women

Polycyclic aromatic hydrocarbons (PAHs) are widespread across the environment and humans are unavoidably and constantly exposed to them. As lipophilic contaminants, these substances tend to accumulate in fatty tissues as adipose tissue and exposure to these endocrine disruptors has been associated with severe health hazards including prevalence and incidence of obesity. Previous studies have shown significantly higher concentrations of PAHs in adipose tissue compared to other human samples, such as urine and plasma, which are typically used for PAHs assessment. Therefore, conducting biomonitoring studies in adipose tissue is essential, although such studies are currently limited. In this study, the concentrations of 18 PAHs were measured in subcutaneous (scAT) and visceral adipose tissue (vAT) of 188 Portuguese obese females by high performance liquid chromatography (HPLC). The obtained results were then associated with the patient's data namely: 13 clinical, 4 social, and 42 biochemical parameters. Seventeen PAHs were present, at least, in one sample of both scAT and vAT, most of them with detection frequencies higher than 80%. Indeno [1,2,3-cd]pyrene (InP) was the only PAH never detected. Overall higher concentrations of PAHs were observed in scAT. Median concentrations of ∑PAHs were 32.2 ± 10.0 ng/g in scAT and 24.6 ± 10.0 ng/g in vAT. Thirty-six significant associations (7 with social, 18 with clinical, and 11 with biochemical parameters), including 21 Spearman's correlations were identified (12 positive and 9 negative correlations). Indicating the potential effects of PAHs on various parameters such as obesity evolution, body fat, number of adipocytes, total cholesterol, alkaline phosphatase, macrominerals, uric acid, sedimentation velocity, and luteinizing hormone. This study underscores the significance of biomonitoring PAH levels in adipose tissue and their potential effects on metabolic health. Further research is essential to fully comprehend the metabolic implications of PAHs in the human body and to develop strategies for obesity prevention and treatment.

Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefighters

Introduction

Available literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts.

Methods

This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires.

Results

Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 μg/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity.

Conclusion

This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.

Association between polycyclic aromatic hydrocarbon exposure and blood lipid levels: the indirect effects of inflammation and oxidative stress

Although previous studies have indicated polycyclic aromatic hydrocarbons (PAHs) as cardiovascular health risk factors, evidence linking exposure to PAHs and blood lipids is still lacking, and the mechanism remains largely unknown. In this study, we evaluated the association between human internal exposure to PAHs and blood lipid levels in adults, as well as the indirect effects of inflammation and oxidative stress. The internal exposure of PAHs was assessed by determining serum PAHs and their hydroxylated metabolites (OH-PAHs) in the paired urine samples. Multivariable linear regression results demonstrated significant positive associations of individual PAHs and OH-PAHs with blood lipid biomarkers. The Bayesian kernel machine regression model revealed positive joint effects of PAH internal exposure on the fasting blood glucose, low-density lipoprotein cholesterol, total cholesterol, and total triglyceride, as well as an increased ratio of apolipoprotein B to apolipoprotein A1. In evaluating individual effects, serum phenanthrene played the most significant role in the association of increased PAH exposure with elevated fasting blood glucose. Quantile g-computation demonstrated the significant change in the levels of apolipoprotein B, ratio of apolipoprotein B to apolipoprotein A1, low-density lipoprotein cholesterol, and total cholesterol per quartile increase in PAH internal exposure. The restricted cubic spline analysis demonstrated the non-linear relationship between individual PAHs and OH-PAHs on blood lipid biomarkers. The mediation analysis indicated that PAH exposure may affect blood lipids not directly, but rather indirectly through intermediate inflammation and oxidative stress. The results demonstrated a significant association between increased PAH exposure levels and elevated blood lipids, highlighting the indirect effects of inflammation and oxidative stress.

Urine 2-hydroxyphenanthrene is associated with current asthma: evidence from NHANES 2007-2012

OBJECTIVE

The current study aims to explore the effects of nine urine monohydroxy PAH metabolites (OHPAH) including 1-hydroxynaphthalene (1-OHNAP), 2-hydroxynaphthalene (2-OHNAP), 3-hydroxyfluorene (3-OHFLU), 9-hydroxyfluorene (9-OHFLU), 1-hydroxyphenanthrene (1-OHPHE), 2-hydroxyphenanthrene (2-OHPHE), 3-hydroxyphenanthrene (3-OHPHE), and 1-hydroxypyrene (1-OHPYR) on current asthma in people in the United States using a variety of statistical techniques.

METHODS

A cross-sectional examination of a subsample of 3804 adults aged ≥20 from the National Health and Nutrition Examination Survey (NHANES) was conducted between 2007 and 2012. To investigate the relationship between urine OHPAHs levels and current asthma, multivariate logistic regression, Bayesian kernel machine regression (BKMR), and quantile g-computation (qgcomp) were utilized.

RESULTS

In the multivariate logistic regression model, after controlling for confounders, urine 2-OHPHE was associated with current asthma in both male (AOR = 7.17, 95% CI: 1.28-40.08) and female (AOR = 2.91, 95% CI: 1.06-8.01) smokers. In the qgcomp analysis, 2-OHPHE (39.5%), 1-OHNAP (33.1%), and 2-OHNAP (22.5%) were the major positive contributors to the risk of current asthma (OR = 2.29, 95% CI: 0.99, 5.25), and in female smokers, 9-OHFLU (25.8%), 2-OHFLU (21.5%), and 2-OHPHE (15.1%) were the major positive contributors (OR = 2.19, 95% CI: 1.06, 4.47). The results of the BKMR model basically agreed with qgcomp analysis.

CONCLUSION

Our results demonstrate a strong association of urine 2-OHPHE with current asthma, and further longitudinal studies are needed to understand the precise relationship between PAH exposure and current asthma risk.

The Associations between Organophosphate Pesticides (OPs) and Respiratory Disease, Diabetes Mellitus, and Cardiovascular Disease: A Review and Meta-Analysis of Observational Studies

Although some epidemiological studies have identified the associations between exposure to organophosphate pesticides (Ops) and respiratory diseases, diabetes mellitus (DM), and cardiovascular diseases (CVDs), controversial results still exist. In this review and meta-analysis, we aimed to investigate the overall pooled effect estimates and the possible mechanisms of the relationship between OP exposure and adverse health outcomes. In this study, Web of Science, PubMed, Embase, OVID, and the Cochrane Library were systematically searched until September 2022. Nineteen observational studies that focused on the general population or occupational populations examined the associations between OP exposure and respiratory diseases, DM, and CVD were included. Based on the overall pooled results, a significantly positive association was observed between OP exposure and respiratory diseases (OR: 1.12, 95% CI: 1.06-1.19). A significant link was also observed between various individual species of OP exposure and respiratory diseases, with an OR value of 1.11 (95% CI: 1.05-1.18). In particular, there was a significant association of OPs with wheezing and asthma, with OR values of 1.19 (95% CI: 1.08-1.31) and 1.13 (95% CI: 1.05-1.22), respectively. In addition, a significant association was also observed between OP exposure and DM (OR: 1.18, 95% CI: 1.07-1.29). However, no significant association was observed between OP exposure and CVD (OR: 1.00, 95% CI: 0.94-1.05). Exposure to OPs was associated with a significantly increased risk of respiratory diseases and DM, but there was no evidence of a significant association between OP exposure and CVD. Considering the moderate strength of the results, further evidence is needed to confirm these associations.

The association between internal polycyclic aromatic hydrocarbons exposure and risk of Obesity-A systematic review with meta-analysis

Exposure to polycyclic aromatic hydrocarbons (PAHs) is emerging as a risk factor for obesity, but with conflicting findings. The aim of this systematic review is to investigate and summarize the current evidence towards the associations between PAHs exposure and risk of obesity. We conducted a systematic search of online databases, including PubMed, Embase, Cochrane Library, and Web of Science up to April 28, 2022. Eight cross-sectional studies with data from 68,454 participants were included. The present study illustrated that there was a significant positive association between naphthalene (NAP), phenanthrene (PHEN), and total OH-PAH metabolites and risk of obesity, the pooled OR (95% CI) was estimated at 1.43 (1.07, 1.90), 1.54 (1.18, 2.02), and 2.29 (1.32, 3.99), respectively. However, there was no significant association between fluorene (FLUO) and1-hydroxypyrene (1-OHP) metabolite and risk of obesity. Subgroup analyses showed that associations between PAHs exposure and risk of obesity were more apparent in children, female, smokers and developing regions.

Urinary PAHs metabolites in Karakoram Highway's heavy traffic vehicle (HTV) drivers: evidence of exposure and health risk

The current study features PAHs exposure on Karakoram Highway, a route of utmost importance in Pakistan. The drivers of heavy traffic vehicles (HTV) on Karakoram Highway spend long hours amid dense traffic and therefore, inevitably inhale huge amount of PAH carcinogens. The urinary metabolites of PAHs in such drivers (meeting selection criteria n = 48) and a control group (n = 49) were comparatively profiled. The higher urinary biomarkers among ninety-six percent HTV drivers were evident of PAHs exposure. We observed elevated concentrations of urinary benzo[a]pyrene metabolites (3-OH-BaP = 3.53 ± 0.62 ng g^-1 creatinine and 9-OH-BaP = 3.69 ± 0.74 ng g^-1 creatinine) in HTV driver's samples compared to controls (0.85 ± 0.08 and 0.31 ± 0.03 ng g^-1 creatinine, respectively). Interestingly, urinary benzo[a]pyrene metabolites were detected in almost similar amount among HTV drivers irrespective of their working hours. A distinct smoking effect was manifested with rising urinary levels of 1-hydroxypyrene, 2-hydroxyphenanthrene, and 3-hydroxybenzo[a]pyrene with corresponding increase in driving hours per day. These metabolites exhibited characteristic exposures to low molecular weight volatile PAHs that are commonly found in vehicular exhaust. The elevated PAH body burden was directly linked to the nature of their job and the route-long environmental pollution on Karakoram Highway. Additionally, the poor economic status and smoking also increased HTV driver's health vulnerability and significantly declined their health capacity. There was conclusive evidence that HTV drivers were exposed to PAHs during a ride on Karakoram Highway, back and forth, an aspect not reported earlier.

Associations between concentrations of serum α-klotho and selected urinary monohydroxy metabolites of polycyclic aromatic hydrocarbons: data for US adults aged 40-79 years

For the first time, the associations between urinary concentrations of oxidant polycyclic aromatic hydrocarbon (PAH) metabolites and serum concentrations of anti-oxidant α-klotho were estimated for US adults aged 40-79 years. Multivariate regression models with α-klotho as dependent variable and one of the urinary metabolite of PAH as independent variables were fitted. In the absence of albuminuria and normal (eGFR > 90 mL/min/1.73 m²) kidney function, 10% increases in concentrations of 2-hydroxynaphthalene, 9-hydroxyfluorene, and ∑PAH were associated with 0.25%, 0.32%, and 0.19% decreases in serum α-klotho concentrations. In the absence of albuminuria and near normal (60 <  = eGFR < 90 mL/min/1.73 m²) kidney function, 10% increases in concentrations of 1-hydroxynaphthalene, 9-hydroxyfluorene, 1-hydroxyphenanthrene, and ∑PAH were associated with 0.17%, 0.38%, 0.34%, and 0.18% decreases in serum α-klotho concentrations. To what degree, these mild decreases in α-klotho are a matter of concern, is a subject ripe for discussion and additional investigations. When kidney function was normal or near normal but albuminuria was present, the associations between α-klotho and different metabolites of PAH were, more or less, randomly positive or negative and none reached statistical significance. To conclude, exposure to polycyclic aromatic hydrocarbons may result in reduced concentrations of α-klotho, an antiaging protein.

Association between polycyclic aromatic hydrocarbon exposure and hypertension among the U.S. adults in the NHANES 2003-2016: A cross-sectional study

The global burden of hypertension, the major cause of cardiovascular disease (CVD) globally, remains unresolved. Exposure to PM2.5 has been linked to hypertension (HTN) in adults and the elderly globally according to previous studies. Nonetheless, evidence on the association of polycyclic aromatic hydrocarbon (PAH) exposure and HTN risk in the general adult population in the United States was limited. To investigate the relationship between PAH exposure and HTN in adults in the United States, cross-sectional data during 2003 and 2016 from the National Health and Nutrition Examination Survey (NHANES) on a stratified multistage random sample of the civilian non-institutionalized population were utilized. After eliminating individuals with incomplete information of interest, the final analysis contained 8951 subjects aged ≥20. In the multivariate logistic regression model, 1-hydroxynaphthalene and 2-hydroxyfluorene were found positively associated with increased risk of HTN among overall participants after adjusting for the covariates. 1-hydroxynaphthalene and 2-hydroxynaphthalene showed positive associations with HTN risk among overweight participants. In the Bayesian kernel machine regression (BKMR) model, 1-hydroxynaphthalene and 2-hydroxyfluorene presented great importance to HTN risk among overall individuals. In the male subgroup analyses by BKMR, 2-hydroxyfluorene presented a positive effect on HTN risk when the remaining OH-PAHs were set at their 25th, 50th, and 75th percentile. Our findings highlight the complexities of estimating the risk of HTN associated with mixed PAH exposure, and additional longitudinal studies are required to determine the exact link between PAH exposure and HTN risk, as well as the underlying mechanisms.

Association of urinary polycyclic aromatic hydrocarbon metabolites and cardiovascular disease among US population: A cross-sectional study

OBJECTIVE

The main aim of the study was to illustrate the association between urinary polycyclic aromatic hydrocarbons (PAHs) and their metabolites with cardiovascular diseases (CVDs), including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and stroke among the US population.

METHODS

The National Health and Nutritional Examination Survey (NHANES) 2003-16, nationally representative data were utilized for this study. A cross-sectional observational study was designed to assess the strength of the association between urinary PAH and CVDs. The NHANES survey used a stratified multistage probability sample strategy for obtaining representative samples. Logistic regression analysis was performed to evaluate the association between PAH and the prevalence of CVDs.

RESULTS

In our study, the average ages of the three different PAHs tertiles were 42.56 ± 19.68, 42.21 ± 19.51, and 43.39 ± 17.99 years, respectively. A positive association was found between the second and third tertile of urinary PAH and increased prevalence of coronary heart disease (tertile-2: OR = 1.24, 95% CI = 1.09-1.42; tertile-3: OR = 1.97, 95% CI = 1.69-2.28), angina (tertile-2: OR = 1.3, 95% CI = 1.13-1.49; tertile-3: OR = 2.07, 95% CI = 1.76-2.42), heart attack (tertile-2: OR = 1.28, 95% CI = 1.12-1.47; tertile-3: OR = 1.71, 95% CI = 1.48-1.96) and stroke (tertile-2: OR = 1.17, 95% CI = 1.02-1.33; tertile-3: OR = 1.66, 95% CI = 1.43-1.93) in total participants, respectively, with p-values less than 0.05.

CONCLUSION

In conclusion, this study found a positive association between urinary PAHs and the prevalence of various CVDs among the US population.