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Demographic and anthropometric characteristics and their effect on the concentration of heavy metals (arsenic, lead, chromium, zinc) in children and adolescents. Heliyon 2023; 9:e13621. [PMID: 36846698 PMCID: PMC9950940 DOI: 10.1016/j.heliyon.2023.e13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Background Biomonitoring is a well-established method for assessing people's exposure to contaminants in the environment. Many non-communicable diseases can be prevented or aggravated by physiologically monitoring heavy metals in biological matrices such as urine, evaluating their association with non-communicable diseases, and attempting to limit exposure to them. The focus of this research was to determine the association between potentially toxic elements (PTE) such as arsenic (As), lead (Pb), chromium (Cr), and zinc (Zn) urine concentrations and anthropometric indices and demographic data in children and adolescents aged 6-18 years in Kerman, Iran. Methods 106 children and adolescents aged 6-18 years in Kerman were randomly selected. A questionnaire was used to acquire demographic information from the participants' parents. Height, weight, and waist circumference (WC) were all assessed, as well as body mass index (BMI) and BMI Z-score. Induced Coupled Plasma Mass Spectrometry (ICP/MS) was used to quantify As, Pb, Cr, and Zn concentrations in participants' urine. Results The geometric mean concentrations were As (38.72 ± 39.30), Pb (19.58 ± 22.91), Cr (1.06 ± 0.28), and Zn (344.72 ± 288.16) μg/creatinine. Boys aged 12-18 years old had higher mean concentration of As than boys aged 6-11 years old (p = 0.019) according to two measurement standards, μg/L, and μg/creatinine, whereas girls had no significant difference. In general, there was a strong association between parental education and metal concentrations of As, Pb, and Cr. As, Pb, and Zn (μg/creatinine) had a significant positive association with BMI z-score and BMI. As, Pb, and Zn metals were shown to have a substantial positive association (p < 0.001). There was no evidence of an association between the metals evaluated and WC. Conclusions The findings of this study generally showed that there was a significant association between demographic characteristics and exposure to these metals in children and adolescents, indicating that these people were exposed to these metals, which can harm their health. As a result, the pathways of exposure to metals must be limited.
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Yu YL, Yang WY, Hara A, Asayama K, Roels HA, Nawrot TS, Staessen JA. Public and occupational health risks related to lead exposure updated according to present-day blood lead levels. Hypertens Res 2023; 46:395-407. [PMID: 36257978 PMCID: PMC9899691 DOI: 10.1038/s41440-022-01069-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 02/07/2023]
Abstract
Lead is an environmental hazard that should be addressed worldwide. Over time, human lead exposure in the western world has decreased drastically to levels comparable to those among humans living in the preindustrial era, who were mainly exposed to natural sources of lead. To re-evaluate the potential health risks associated with present-day lead exposure, a two-pronged approach was applied. First, recently published population metrics describing the adverse health effects associated with lead exposure at the population level were critically assessed. Next, the key results of the Study for Promotion of Health in Recycling Lead (SPHERL; NCT02243904) were summarized and put in perspective with those of the published population metrics. To our knowledge, SPHERL is the first prospective study that accounted for interindividual variability between people with respect to their vulnerability to the toxic effects of lead exposure by assessing the participants' health status before and after occupational lead exposure. The overall conclusion of this comprehensive review is that mainstream ideas about the public and occupational health risks related to lead exposure urgently need to be updated because a large portion of the available literature became obsolete given the sharp decrease in exposure levels over the past 40 years.
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Affiliation(s)
- Yu-Ling Yu
- grid.5596.f0000 0001 0668 7884Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- grid.16821.3c0000 0004 0368 8293Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Azusa Hara
- grid.26091.3c0000 0004 1936 9959Division of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Kei Asayama
- grid.264706.10000 0000 9239 9995Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan ,grid.5596.f0000 0001 0668 7884Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium ,Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
| | - Harry A. Roels
- grid.12155.320000 0001 0604 5662Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Tim S. Nawrot
- grid.5596.f0000 0001 0668 7884Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium ,grid.12155.320000 0001 0604 5662Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Jan A. Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium ,grid.5596.f0000 0001 0668 7884Biomedical Science Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
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Al-Naemi HA, Das SC. Cadmium-induced endothelial dysfunction mediated by asymmetric dimethylarginine. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:16246-16253. [PMID: 32124290 PMCID: PMC7192864 DOI: 10.1007/s11356-020-08116-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 02/14/2020] [Indexed: 04/15/2023]
Abstract
Cadmium (Cd) is a naturally occurring toxic heavy metal with no known essential biological functions. Exposure to Cd increases the risk of cardiovascular disease by disrupting vascular homeostasis at the endothelium. The aim of the study was to evaluate the effect of chronic low-dose Cd on vascular structure and function. Fifty adult male Sprague Dawley rats were grouped and assigned to one of two treatments for 14 weeks. The control group received normal water for 14 weeks while the Cd-treated group received 15 mg Cd/kg B.W. as CdCl2 in water for 10 weeks. A subset of the Cd-treated group received 15 mg Cd/kg B.W. as CdCl2 in water for 10 weeks followed by 4 weeks of normal water. Results show an overall decline in vascular function and structure. Withdrawal of Cd treatment showed a considerable restoration of vascular structure and vasorelaxation function. Additionally, asymmetric dimethylarginine (ADMA) bioavailability was found to be lowered over time. Interestingly, the expression of eNOS in the Cd-treated group was found to be significantly elevated during the exposure by more than 3-fold in comparison with that in the control group. This protein expression was similar to the control group after the withdrawal of Cd treatment. Taken together, the results suggest that ADMA, an eNOS inhibitor, may play a role in altering endothelial function in the presence of cadmium. In conclusion, the findings indicate that even at low doses, Cd leads to endothelial dysfunction mediated by ADMA.
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Affiliation(s)
- Hamda A Al-Naemi
- Laboratory Animal Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.
- Department of Biological and Environmental Sciences, College of Arts & Sciences, Qatar University, Doha, Qatar.
| | - Sandra Concepcion Das
- Laboratory Animal Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
- Department of Biological and Environmental Sciences, College of Arts & Sciences, Qatar University, Doha, Qatar
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Staessen JA, Thijs L, Yang WY, Yu CG, Wei FF, Roels HA, Nawrot TS, Zhang ZY. Interpretation of Population Health Metrics: Environmental Lead Exposure as Exemplary Case. Hypertension 2020; 75:603-614. [PMID: 32008462 PMCID: PMC8032208 DOI: 10.1161/hypertensionaha.119.14217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Our objective was to gain insight in the calculation and interpretation of population health metrics that inform disease prevention. Using as model environmental exposure to lead (ELE), a global pollutant, we assessed population health metrics derived from the Third National Health and Nutrition Examination Survey (1988 to 1994), the GBD (Global Burden of Disease Study 2010), and the Organization for Economic Co-operation and Development. In the National Health and Nutrition Examination Survey, the hazard ratio relating mortality over 19.3 years of follow-up to a blood lead increase at baseline from 1.0 to 6.7 µg/dL (10th–90th percentile interval) was 1.37 (95% CI, 1.17–1.60). The population-attributable fraction of blood lead was 18.0% (10.9%–26.1%). The number of preventable ELE-related deaths in the United States would be 412 000 per year (250 000–598 000). In GBD 2010, deaths and disability-adjusted life-years globally lost due to ELE were 0.67 million (0.58–0.78 million) and 0.56% (0.47%–0.66%), respectively. According to the 2017 Organization for Economic Co-operation and Development statistics, ELE-related welfare costs were $1 676 224 million worldwide. Extrapolations from the foregoing metrics assumed causality and reversibility of the association between mortality and blood lead, which at present-day ELE levels in developed nations is not established. Other issues limiting the interpretation of ELE-related population health metrics are the inflation of relative risk based on outdated blood lead levels, not differentiating relative from absolute risk, clustering of risk factors and exposures within individuals, residual confounding, and disregarding noncardiovascular disease and immigration in national ELE-associated welfare estimates. In conclusion, this review highlights the importance of critical thinking in translating population health metrics into cost-effective preventive strategies.
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Affiliation(s)
- Jan A Staessen
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.).,Cardiovascular Research Institute Maastricht, Maastricht University, The Netherlands (J.A.S.).,NPA Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (J.A.S.)
| | - Lutgarde Thijs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.)
| | - Wen-Yi Yang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.).,Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, China (W.-Y.Y.)
| | - Cai-Guo Yu
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.).,Department of Endocrinology, Beijing Lu He Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, China (C.-G.Y.)
| | - Fang-Fei Wei
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.)
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (H.A.R., T.S.N.)
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (H.A.R., T.S.N.)
| | - Zhen-Yu Zhang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.)
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Ahn J, Kim NS, Lee BK, Park J, Kim Y. Association of Blood Pressure with Blood Lead and Cadmium Levels in Korean Adolescents: Analysis of Data from the 2010-2016 Korean National Health and Nutrition Examination Survey. J Korean Med Sci 2018; 33:e278. [PMID: 30369859 PMCID: PMC6200904 DOI: 10.3346/jkms.2018.33.e278] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/20/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND We evaluated the association of blood pressure (BP) with blood levels of cadmium, lead, and cadmium and lead together (cadmium + lead) in a representative sample of adolescents from Korea. METHODS We used 2010-2016 data from the Korean National Health and Nutrition Examination Survey. This cross-sectional study enrolled adolescents aged at 10-18 years-old who completed a health examination survey and had blood measurements of lead and cadmium. The association of adjusted mean differences in diastolic and systolic BP with doubling of blood lead and cadmium were estimated by regression of BP against log2-transformed blood metals and their quartiles after covariate adjustment. Adjusted odds ratio for prehypertension were calculated for log2-transformed blood levels of lead and cadmium and their quartiles. RESULTS Our analysis of adolescents in Korea indicated that blood levels of lead and cadmium were not significantly associated with increased BP or risk of prehypertension. However, the cadmium + lead level was associated with prehypertension. Previous studies showed that blood levels of lead and cadmium were associated with increased BP and risk of hypertension in adult populations. We found no such association in Korean adolescents. CONCLUSION We found that the cadmium + lead level was associated with prehypertension. The differences between adults and adolescents are because adolescents generally have lower levels of these blood metals or because adolescents only rarely have hypertension.
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Affiliation(s)
- Jaeouk Ahn
- Department of Medical IT Engineering, Soonchunhyang University, College of Medical Sciences, Asan, Korea
| | - Nam-Soo Kim
- Institute of Occupational and Environmental Medicine, Soonchunhyang University, Asan, Korea
| | - Byung-Kook Lee
- Department of Preventive Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jungsun Park
- Department of Occupational Health, Daegu Catholic University, Gyeongsan, Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Phuc HD, Kido T, Oanh NTP, Manh HD, Anh LT, Oyama Y, Okamoto R, Ichimori A, Nogawa K, Suwazono Y, Nakagawa H. Effects of aging on cadmium concentrations and renal dysfunction in inhabitants in cadmium-polluted regions in Japan. J Appl Toxicol 2017; 37:1046-1052. [DOI: 10.1002/jat.3455] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Hoang Duc Phuc
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Teruhiko Kido
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Nguyen Thi Phuong Oanh
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Ho Dung Manh
- Faculty of Pharmacy; Lac Hong University; No. 10, Huynh Van Nghe Bien Hoa Dong Nai Vietnam
| | - Le Thai Anh
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Yuko Oyama
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Rie Okamoto
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Akie Ichimori
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine; Chiba University; 1-8-1, Inohana, Chuoku Chiba Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine; Chiba University; 1-8-1, Inohana, Chuoku Chiba Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health; Kanazawa Medical University; 1-1 Daigaku Uchinada Ishikawa Japan
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Hoet P, Deumer G, Bernard A, Lison D, Haufroid V. Urinary trace element concentrations in environmental settings: is there a value for systematic creatinine adjustment or do we introduce a bias? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:296-302. [PMID: 25827313 DOI: 10.1038/jes.2015.23] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/28/2015] [Accepted: 01/30/2015] [Indexed: 05/04/2023]
Abstract
Systematic creatinine adjustment of urinary concentrations of biomarkers has been a challenge over the past years because the assumption of a constant creatinine excretion rate appears erroneous and the issue of overadjustment has recently emerged. This study aimed at determining whether systematic creatinine adjustment is to be recommended for urinary concentrations of trace elements (TEs) in environmental settings. Paired 24-h collection and random spot urine samples (spotU) were obtained from 39 volunteers not occupationally exposed to TEs. Four models to express TEs concentration in spotU were tested to predict the 24-h excretion rate of these TEs (TEμg/24h) considered as the gold standard reference: absolute concentration (TEμg/l); ratio to creatinine (TEμg/gcr); TEμg/gcr adjusted to creatinine (TEμg/gcr-adj); and concentration adjusted to specific gravity (TEμg/l-SG). As, Ba, Cd, Co, Cr, Cu, Hg, Li, Mo, Ni, Pb, Sn, Sb, Se, Te, V and Zn were analyzed by inductively coupled argon plasma mass spectrometry. There was no single pattern of relationship between urinary TEs concentrations in spotU and TEμg/24h. TEμg/l predicted TEμg/24h with an explained variance ranging from 0 to 60%. Creatinine adjustment improved the explained variance by an additional 5 to ~60% for many TEs, but with a risk of overadjustment for the most of them. This issue could be addressed by adjusting TE concentrations on the basis of the regression coefficient of the relationship between TEμg/gcr and creatinine concentration. SG adjustment was as suitable as creatinine adjustment to predict TEμg/24h with no SG-overadjustment (except V). Regarding Cd, Cr, Cu, Ni and Te, none of the models were found to reflect TEμg/24h. In the context of environmental exposure, systematic creatinine adjustment is not recommended for urinary concentrations of TEs. SG adjustment appears to be a more reliable alternative. For some TEs, however, neither methods appear suitable.
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Affiliation(s)
- Perrine Hoet
- Louvain centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Gladys Deumer
- Louvain centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
- Department of clinical chemistry, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Alfred Bernard
- Louvain centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Dominique Lison
- Louvain centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Vincent Haufroid
- Louvain centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
- Department of clinical chemistry, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
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Lee MS, Park SK, Hu H, Lee S. Cadmium exposure and cardiovascular disease in the 2005 Korea National Health and Nutrition Examination Survey. ENVIRONMENTAL RESEARCH 2011; 111:171-6. [PMID: 21055738 PMCID: PMC3683977 DOI: 10.1016/j.envres.2010.10.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 10/18/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND Limited epidemiologic data are available concerning the cardiovascular effects of cadmium exposure, although recent studies suggest associations with myocardial infarction and peripheral arterial disease. We examined the associations of cadmium exposure with cardiovascular disease in nationally representative general Korean adults. METHODS We used cross-sectional data on blood cadmium and self-reported diagnoses of ischemic heart disease (IHD), stroke, and hypertension in a sub-sample of 1908 adults, aged 20 years and older, who participated in the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). We used survey logistic regression models accounting for the complex sampling design to estimate the odds ratios (OR), adjusting for age, education, income, alcohol, smoking, body mass index, waist circumference, family history of hypertension, blood pressure, and blood lead. RESULTS The geometric mean of blood cadmium was 1.53 μg/L. After adjusting for potential confounders, an interquartile range (IQR) increase in blood cadmium (0.91 μg/L) was found to be associated with an increased risk for IHD (OR 2.1, 95% confidence interval (CI) 1.3-3.4). An IQR increase in blood cadmium was found to be associated with an elevated risk for hypertension only among men (OR 1.4, 95% CI 1.1-1.8) but not among women. No association was observed with stroke in both genders. CONCLUSIONS These findings suggest that cadmium in blood may be associated with an increased risk for IHD and hypertension in the general Korean adult population.
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Affiliation(s)
- Mi-Sun Lee
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Sundong Lee
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Preventive Medicine, School of Oriental Medicine, Sangji University, Wonju, Kangwon, Republic of Korea
- Corresponding author at: Department of Preventive Medicine, School of Oriental Medicine, Sangji University, Wonju, Kangwon, Republic of Korea. Fax: +82 33 738 7825. (S. Lee)
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Gallagher CM, Meliker JR. Blood and urine cadmium, blood pressure, and hypertension: a systematic review and meta-analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1676-84. [PMID: 20716508 PMCID: PMC3002186 DOI: 10.1289/ehp.1002077] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 08/17/2010] [Indexed: 05/08/2023]
Abstract
BACKGROUND Cadmium exposure has been inconsistently related to blood pressure. OBJECTIVES We updated and reevaluated the evidence regarding the relationships of blood cadmium (BCd) and urine cadmium (UCd) with blood pressure (BP) and hypertension (HTN) in nonoccupationally exposed populations. DATA SOURCES AND EXTRACTION We searched PubMed and Web of Science for articles on BCd or UCd and BP or HTN in nonoccupationally exposed populations and extracted information from studies that provided sufficient data on population, smoking status, exposure, outcomes, and design. DATA SYNTHESIS Twelve articles met inclusion criteria: eight provided data adequate for comparison, and five reported enough data for meta-analysis. Individual studies reported significant positive associations between BCd and systolic BP (SBP) among nonsmoking women [ß = 3.14 mmHg per 1 μg/L untransformed BCd; 95% confidence interval (CI), 0.14-6.14] and among premenopausal women (ß = 4.83 mmHg per 1 nmol/L log-transformed BCd; 95% CI, 0.17-9.49), and between BCd and diastolic BP (DBP) among women (ß = 1.78 mmHg comparing BCd in the 90th and 10th percentiles; 95% CI, 0.64-2.92) and among premenopausal women (ß = 3.84 mmHg per 1 nmol/L log-transformed BCd; 95% CI, 0.86-6.82). Three meta-analyses, each of three studies, showed positive associations between BCd and SBP (p = 0.006) and DBP (p < 0.001) among women, with minimal heterogeneity (I² = 3%), and a significant inverse association between UCd and HTN among men and women, with substantial heterogeneity (I² = 80%). CONCLUSION Our results suggest a positive association between BCd and BP among women; the results, however, are inconclusive because of the limited number of representative population-based studies of never-smokers. Associations between UCd and HTN suggest inverse relationships, but inconsistent outcome definitions limit interpretation. We believe a longitudinal study is merited.
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Affiliation(s)
- Carolyn M Gallagher
- Doctoral Program in Population Health and Clinical Outcomes Research, Stony Brook University Medical Center, Stony Brook, New York, USA.
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Apinan R, Satarug S, Ruengweerayut R, Mahavorasirikul W, Na-Bangchang K. The influence of iron stores on cadmium body burden in a Thai population. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2010; 32:237-242. [PMID: 19806462 DOI: 10.1007/s10653-009-9280-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 09/18/2009] [Indexed: 05/28/2023]
Abstract
Cadmium is a toxin of increasing public health concern due to its presence in most human foodstuffs and in cigarette smoke. Exposure to cadmium leads to tissue bioaccumulation and, in particular, has nephrotoxic effects. The aim of the present study was to investigate the association between cadmium body burden and iron stores in a Thai population. A total of 182 healthy adult Thai subjects of both genders (89 males, 93 females) aged between 18 and 57 years and weighing 40-95 kg were included in this study. The total amounts of cadmium excreted in urine over 2 h (microg/g creatinine) were used as an index of long-term cadmium exposure. Quantitation of cadmium was performed using electrothermal (graphite furnace) atomic absorption spectrometry. The urinary cadmium excreted displayed a normal frequency distribution. The average urinary cadmium level did not exceed the WHO maximum tolerable internal dose for the non-exposed population (2 microg/g creatinine). Body iron stores reflected by serum ferritin levels did not show any correlation with cadmium burden in both males and females, although a relatively stronger influence of body iron store status on cadmium burden was shown in females. When the levels of serum ferritin were stratified into five levels (<20, 20-100, 101-200, 201-300, and >300 microg/l), a significant difference in total cadmium body burden was observed between females and males only in the group with a low level of serum ferritin of <20 microg/l. The cadmium body burden in females was about twice that in males in this group.
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Cao Y, Chen A, Radcliffe J, Dietrich KN, Jones RL, Caldwell K, Rogan WJ. Postnatal cadmium exposure, neurodevelopment, and blood pressure in children at 2, 5, and 7 years of age. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1580-6. [PMID: 20019909 PMCID: PMC2790513 DOI: 10.1289/ehp.0900765] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 05/26/2009] [Indexed: 05/18/2023]
Abstract
BACKGROUND Adverse health effects of cadmium in adults are well documented, but little is known about the neuropsychological effects of cadmium in children, and no studies of cadmium and blood pressure in children have been conducted. OBJECTIVE We examined the potential effects of low-level cadmium exposure on intelligence quotient, neuropsychological functions, behavior, and blood pressure among children, using blood cadmium as a measure of exposure. METHODS We used the data from a multicenter randomized clinical trial of lead-exposed children and analyzed blood cadmium concentrations using the whole blood samples collected when children were 2 years of age. We compared neuropsychological and behavioral scores at 2, 5, and 7 years of age by cadmium level and analyzed the relationship between blood cadmium levels at 2 years of age and systolic and diastolic blood pressure at 2, 5, and 7 years of age. RESULTS The average cadmium concentration of these children was 0.21 microg/L, lower than for adults in the National Health and Nutrition Examination Survey (NHANES), but comparable to concentrations in children < 3 years of age in NHANES. Except for the California Verbal Learning Test for Children, there were no differences in test scores among children in different cadmium categories. For children with detectable pretreatment blood cadmium, after adjusting for a variety of covariates, general linear model analyses showed that at none of the three age points was the coefficient of cadmium on Mental Development Index or IQ statistically significant. Spline regression analysis suggested that behavioral problem scores at 5 and 7 years of age tended to increase with increasing blood cadmium, but the trend was not significant. We found no significant associations between blood cadmium levels and blood pressure. CONCLUSION We found no significant associations between background blood cadmium levels at 2 years of age and neurodevelopmental end points and blood pressure at 2, 5, and 7 years of age. The neuropsychological or hypertensive effects from longer background exposures to cadmium need further study.
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Affiliation(s)
- Yang Cao
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
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Menke A, Muntner P, Silbergeld EK, Platz EA, Guallar E. Cadmium levels in urine and mortality among U.S. adults. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:190-6. [PMID: 19270787 PMCID: PMC2649219 DOI: 10.1289/ehp.11236] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Accepted: 09/03/2008] [Indexed: 05/04/2023]
Abstract
BACKGROUND Cadmium exposure has been associated with increased all-cause, cancer, and cardiovascular disease mortality. However, studies investigating this association have included participants with considerably higher levels of cadmium than those found in the general population. OBJECTIVE We aimed to evaluate the association of creatinine-corrected urinary cadmium levels with all-cause and cause-specific mortality in the U.S. general population. METHODS We analyzed the relationship between cadmium measured in 13,958 adults who participated in the Third National Health and Nutrition Examination Survey in 1988-1994 and were followed through 31 December 2000, and all-cause, cancer, cardiovascular disease, and coronary heart disease mortality. RESULTS The geometric mean levels of urinary cadmium per gram of urinary creatinine in study participants were 0.28 and 0.40 microg/g for men and women, respectively (p < 0.001). After multivariable adjustment, including smoking, a major source of cadmium exposure in nonoccupationally exposed populations, the hazard ratios [95% confidence interval (CI)] for all-cause, cancer, cardiovascular disease, and coronary heart disease mortality associated with a 2-fold higher creatinine-corrected urinary cadmium were, respectively, 1.28 (95% CI, 1.15-1.43), 1.55 (95% CI, 1.21-1.98), 1.21 (95% CI, 1.07-1.36), and 1.36 (95% CI, 1.11-1.66) for men and 1.06 (95% CI, 0.96-1.16), 1.07 (95% CI, 0.85-1.35), 0.93 (95% CI, 0.84-1.04), and 0.82 (95% CI, 0.76-0.89) for women. CONCLUSIONS Environmental cadmium exposure was associated with an increased risk of all-cause, cancer, and cardiovascular disease mortality among men, but not among women. Additional efforts are warranted to fully explain gender differences on the impact of environmental cadmium exposure.
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Affiliation(s)
- Andy Menke
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Paul Muntner
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, New York, USA
| | - Ellen K. Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
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Tellez-Plaza M, Navas-Acien A, Crainiceanu CM, Guallar E. Cadmium exposure and hypertension in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:51-6. [PMID: 18197299 PMCID: PMC2199293 DOI: 10.1289/ehp.10764] [Citation(s) in RCA: 216] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Accepted: 10/30/2007] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Cadmium induces hypertension in animal models. Epidemiologic studies of cadmium exposure and hypertension, however, have been inconsistent. OBJECTIVE We aimed to investigate the association of blood and urine cadmium with blood pressure levels and with the prevalence of hypertension in U.S. adults who participated in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). METHODS We studied participants > or = 20 years of age with determinations of cadmium in blood (n = 10,991) and urine (n = 3,496). Blood and urine cadmium were measured by atomic absorption spectrometry and inductively coupled plasma-mass spectrometry, respectively. Systolic and diastolic blood pressure levels were measured using a standardized protocol. RESULTS The geometric means of blood and urine cadmium were 3.77 nmol/L and 2.46 nmol/L, respectively. After multivariable adjustment, the average differences in systolic and diastolic blood pressure comparing participants in the 90th vs. 10th percentile of the blood cadmium distribution were 1.36 mmHg [95% confidence interval (CI), -0.28 to 3.00] and 1.68 mmHg (95% CI, 0.57-2.78), respectively. The corresponding differences were 2.35 mmHg and 3.27 mmHg among never smokers, 1.69 mmHg and 1.55 mmHg among former smokers, and 0.02 mmHg and 0.69 mmHg among current smokers. No association was observed for urine cadmium with blood pressure levels, or for blood and urine cadmium with the prevalence of hypertension. CONCLUSIONS Cadmium levels in blood, but not in urine, were associated with a modest elevation in blood pressure levels. The association was stronger among never smokers, intermediate among former smokers, and small or null among current smokers. Our findings add to the concern of renal and cardiovascular cadmium toxicity at chronic low levels of exposure in the general population.
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Affiliation(s)
- Maria Tellez-Plaza
- Department of Environmental Health Sciences and
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences and
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Address correspondence to A. Navas-Acien, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Rm. W7033B, Baltimore, Maryland 21205 USA. Telephone: (410) 502-4267. Fax: (410) 955-1811. E-mail:
| | - Ciprian M. Crainiceanu
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Departments of Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
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Staessen J, Amery A, Bernard A, Bruaux P, Buchet JP, Claeys F, De Plaen P, Ducoffre G, Fagard R, Lauwerys RR. Effects of exposure to cadmium on calcium metabolism: a population study. BRITISH JOURNAL OF INDUSTRIAL MEDICINE 1991; 48:710-714. [PMID: 1931731 PMCID: PMC1012065 DOI: 10.1136/oem.48.10.710] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The objective was to investigate the hypothesis that environmental exposure to cadmium may affect calcium metabolism in the population at large. The 1987 participants (965 men and 1022 women), from 20 to 80 years old, constituted a random sample of the population of four Belgian districts. The urinary excretion of cadmium, a measure of lifetime exposure, averaged 9.3 nmol/24 h in men (range 0.4-324 nmol/24 h) and 7.1 nmol/24 h (range 0.1-71 nmol/24 h) in women. Serum alkaline phosphatase activity and the urinary excretion of calcium correlated significantly and positively with urinary cadmium excretion in both men and women, and serum total calcium concentration negatively with urinary cadmium excretion in men only. The regression coefficients obtained after adjustment for significant covariates indicated that when urinary cadmium excretion increased twofold, serum alkaline phosphatase activity and urinary calcium excretion rose by 3-4% and 0.25 mmol/24 h respectively, whereas in men serum total calcium concentration fell by 6 mumol/l. After adjustment for significant covariates the relation between serum total calcium concentration and urinary cadmium excretion was not significant in women. The findings suggest that even at environmental exposure levels calcium metabolism is gradually affected, as cadmium accumulates in the body. The morbidity associated with this phenomenon in industrialised countries remains presently unknown and requires further investigation.
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Affiliation(s)
- J Staessen
- Department of Pathophysiology, University of Leuven, Belgium
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Whittemore AS, DiCiccio Y, Provenzano G. Urinary cadmium and blood pressure: results from the NHANES II survey. ENVIRONMENTAL HEALTH PERSPECTIVES 1991; 91:133-40. [PMID: 2040243 PMCID: PMC1519365 DOI: 10.1289/ehp.9191133] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Relationships between urinary cadmium levels and blood pressure were examined in a sample of 951 adult men and women who participated in the Second National Health and Nutritional Examination Survey (NHANES II). Among all participants, positive relationships were seen between urinary cadmium levels and both systolic and diastolic blood pressure (p less than 0.05 and p less than 0.01, respectively), after adjusting for age, sex, race, relative body weight, smoking status, and hypertensive medication use. However, analyses for subgroups determined by sex and smoking status were inconsistent. Among current smokers, urinary cadmium levels were significantly positively associated with both systolic and diastolic blood pressure for women, and with diastolic blood pressure for men. Yet among former smokers and lifelong nonsmokers of both sexes, urinary cadmium was not significantly associated with either systolic or diastolic blood pressure. Evidence that some hypertensive medications increase urinary cadmium excretion suggests that the positive associations seen among current smokers may reflect high urinary cadmium levels among hypertensives induced by hypertensive treatment. After treated hypertensives were removed from the analysis, regression coefficients relating blood pressure to cadmium dropped by a factor of two and lost statistical significance. We conclude that the present data provide little support for a causal association between systemic cadmium and hypertension at nonoccupational exposure levels. Further, conflicting results of previous studies may reflect failure to control adequately for age, smoking status, and hypertensive treatment.
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Affiliation(s)
- A S Whittemore
- Stanford University School of Medicine, Department of Health Research and Policy, CA 94305
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Elwood PC, Davey-Smith G, Oldham PD, Toothill C. Two Welsh surveys of blood lead and blood pressure. ENVIRONMENTAL HEALTH PERSPECTIVES 1988; 78:119-121. [PMID: 3203630 PMCID: PMC1474621 DOI: 10.1289/ehp.8878119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The relationship between blood pressure and blood lead was examined in two population samples. One of these consisted of 1137 men aged 49 to 65 years, the other of 865 men and 856 women aged 18 to 64 years. Neither population had any known important exposure to lead, and the 95% ranges of blood lead levels were 6 to 26 micrograms/100 mL and 6 to 23 micrograms/mL in the men and 5 to 18 micrograms/100 mL in the women. No significant relationship between blood pressure and blood lead was detected in either of the population samples, and the regression coefficients suggest that if there were a real effect, then the mean difference in blood pressure per 10 micrograms difference in blood lead is likely to be 0.7 mm Hg in both systolic and diastolic pressures. In the survey of 1137 men, the rise in blood pressure was measured during the cold pressor test. This test is likely to be affected if lead were to affect neurogenic mediators of blood pressure. The mean change in systolic pressure was 24 mm Hg and the 95% range was -6 to 60 mm Hg, but there was no evidence of any association with blood lead level.
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Staessen J, Bruaux P, Claeys-Thoreau F, DePlaen P, Ducoffre G, Lauwerys R, Roels H, Rondia D, Sartor F, Amery A. The relationship between blood pressure and environmental exposure to lead and cadmium in Belgium. ENVIRONMENTAL HEALTH PERSPECTIVES 1988; 78:127-9. [PMID: 3203631 PMCID: PMC1474599 DOI: 10.1289/ehp.8878127] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The question whether in the general population environmental exposure to lead and cadmium influences blood pressure after controlling for confounding factors remains debated. The environmental exposure of the Belgian population to both lead and cadmium is high as compared with other countries. The Cadmibel Cooperative Study was therefore designed to elucidate whether environmental exposure to lead and cadmium has any effect on blood pressure and renal function in the population at large. Before embarking on the large Cadmibel project, a small study was conducted. Blood pressure and the 24-hr urinary excretion of cadmium (CdU) and lead (PbU) were determined in a random 4% sample of the population of a small Belgian town. CdU averaged 0.27 micrograms/24 hr in 46 youths (mean age 14 +/- 3 years, +/- SD), increased with age, and was higher in 57 adult men (age 41 +/- 14 years), as compared with 59 adult women (age 39 +/- 14 years) (1.05 vs. 0.81 micrograms/24 hr; p less than 0.01). PbU averaged 5.8 micrograms/24 hr in youths and similarly increased with age; adult men excreted more lead than women (13.3 vs. 8.3 micrograms/24 hr; p less than 0.001). Among men, manual workers excreted more cadmium (1.4 vs. 0.8 micrograms/24 hr; p less than 0.05) but a similar amount of lead (7.0 vs. 6.9 micrograms/24 hr) as compared with office workers. In simple regression analysis, CdU was positively correlated with both systolic (r = 0.30; p less than 0.05) and diastolic (r = 0.38; p less than 0.01) blood pressure in women.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Staessen
- Hypertension and Cardiovascular Rehabilitation Unit, Katholieke Universiteit van Leuven, Belgium
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Sharp DS, Becker CE, Smith AH. Chronic low-level lead exposure. Its role in the pathogenesis of hypertension. MEDICAL TOXICOLOGY 1987; 2:210-32. [PMID: 3298924 DOI: 10.1007/bf03259865] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Lead is a common element in the earth's crust, serving useful purposes in industry, but serving no purpose in the human body. Increase in blood pressure is an important public health problem with numerous factors contributing to many facets of the disease. The relationship of lead exposure and increased blood pressure has long been considered, but only recently critically investigated. Reports of subtle changes in calcium metabolism and renal function, as well as in vitro studies examining end-arteriolar smooth muscle contractility, link lead exposure and increased blood pressure. This paper critically examines the evidence associating chronic low-level lead exposure and increased blood pressure. The review focuses on epidemiological, clinical, and toxicological data. The epidemiological evidence is consistent with low-level exposure to lead causing an elevation in blood pressure. The strength of that association, and the dose-response characteristics, are less certain. Individual resistance and susceptibility could affect the degree of blood pressure elevation. The results of animal and in vitro studies are consistent with the epidemiological evidence, and suggest biologically plausible mechanisms for the association. The most probable mechanisms are intracellular perturbations in calcium metabolism mediated by direct lead effects at the end-arteriole, and indirect effects via renal dysfunction. Better indices of lead exposure and lead activity are needed to quantify these effects in humans. New and safer methods of chelating lead suggest interesting approaches for studying the relationship between lead and hypertension. This link could have significant implications in determining what constitutes a 'safe' level of environmental lead exposure, and whether a proportion of essential hypertension could be 'cured' by chelation therapy.
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