Marisa Sobel1, Ana Navas-Acien2, Martha Powers3, Maria Grau-Perez4, Walter Goessler5, Lyle G Best6, Jason Umans7, Elizabeth C Oelsner8, Anna Podolanczuk9, Tiffany R Sanchez10. 1. Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 West 168th St. NY, NY, 10032, USA. Electronic address: ms5533@cumc.columbia.edu. 2. Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 West 168th St. NY, NY, 10032, USA. Electronic address: an2737@cumc.columbia.edu. 3. Department of Sociology and Anthropology, Northeastern University, 1135 Tremont Street, 900 Renaissance Park, Boston, MA, 02115, USA. Electronic address: m.powers@northeastern.edu. 4. Biomedical Research Institute of Valencia (INCLIVA), C. de Menéndez y Pelayo, 4, 46010, Valencia, Spain. Electronic address: maria.grau.perez@gmail.com. 5. Institute of Chemistry, Universität Graz, Universitätsplatz 3, 8010, Graz, Austria. Electronic address: walter.goessler@uni-graz.at. 6. Missouri Breaks Industries Research, 118 South Willow St, Eagle Butte, SD, 57625, USA. Electronic address: lbest@restel.com. 7. Division of Nephrology and Hypertension, Department of Medicine, Georgetown University Medical Center, 3800 Reservoir Road, N.W, Washington, D.C, USA. Electronic address: jason.umans@gmail.com. 8. Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, 622 W 168th St, New York, NY, 10032, USA. Electronic address: eco7@cumc.columbia.edu. 9. Pulmonary Critical Care Medicine, Weill Cornell Medicine, 425 E 61st St, New York, NY, 10065, USA. Electronic address: ajp9012@med.cornell.edu. 10. Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 West 168th St. NY, NY, 10032, USA. Electronic address: trs2111@cumc.columbia.edu.
Abstract
BACKGROUND: American Indians have a higher burden of chronic lung disease compared to the US average. Several metals are known to induce chronic lung disease at high exposure levels; however, less is known about the role of environmental-level metal exposure. We investigated respiratory effects of exposure to single metals and metal-mixtures in American Indians who participated in the Strong Heart Study. METHODS: We included 2077 participants with data on 6 metals (As, Cd, Mo, Se, W, Zn) measured from baseline urine samples (1989-1991) and who underwent spirometry testing at follow-up (1993-1995). We used generalized linear regression to assess associations of single metals with spirometry-defined measures of airflow limitation and restrictive ventilatory pattern, and continuous spirometry. We used Bayesian Kernel Machine Regression to investigate the joint effects of the metal-mixture. Sensitivity analyses included stratifying by smoking status and diabetes. RESULTS: Participants were 40% male, with median age 55 years. 21% had spirometry-defined airflow limitation, and 14% had a restrictive ventilatory pattern. In individual metal analyses, Cd was associated with higher odds of airflow limitation and lower FEV1 and FEV1/FVC. Mo was associated with higher odds of restrictive ventilatory pattern and lower FVC. Metal-mixtures analyses confirmed these models. In smoking stratified analyses, the overall metal-mixture was linearly and positively associated with airflow limitation among non-smokers; Cd was the strongest contributor. For restrictive ventilatory pattern, the association with the overall metal-mixture was strong and linear among participants with diabetes and markedly attenuated among participants without diabetes. Among those with diabetes, Mo and Zn were the major contributors. CONCLUSIONS: Environmental-level exposure to several metals was associated with higher odds of spirometry-defined lung disease in an American Indian population. Exposure to multiple metals, including Cd and Mo, may have an under-recognized adverse role on the respiratory system.
BACKGROUND: American Indians have a higher burden of chronic lung disease compared to the US average. Several metals are known to induce chronic lung disease at high exposure levels; however, less is known about the role of environmental-level metal exposure. We investigated respiratory effects of exposure to single metals and metal-mixtures in American Indians who participated in the Strong Heart Study. METHODS: We included 2077 participants with data on 6 metals (As, Cd, Mo, Se, W, Zn) measured from baseline urine samples (1989-1991) and who underwent spirometry testing at follow-up (1993-1995). We used generalized linear regression to assess associations of single metals with spirometry-defined measures of airflow limitation and restrictive ventilatory pattern, and continuous spirometry. We used Bayesian Kernel Machine Regression to investigate the joint effects of the metal-mixture. Sensitivity analyses included stratifying by smoking status and diabetes. RESULTS: Participants were 40% male, with median age 55 years. 21% had spirometry-defined airflow limitation, and 14% had a restrictive ventilatory pattern. In individual metal analyses, Cd was associated with higher odds of airflow limitation and lower FEV1 and FEV1/FVC. Mo was associated with higher odds of restrictive ventilatory pattern and lower FVC. Metal-mixtures analyses confirmed these models. In smoking stratified analyses, the overall metal-mixture was linearly and positively associated with airflow limitation among non-smokers; Cd was the strongest contributor. For restrictive ventilatory pattern, the association with the overall metal-mixture was strong and linear among participants with diabetes and markedly attenuated among participants without diabetes. Among those with diabetes, Mo and Zn were the major contributors. CONCLUSIONS: Environmental-level exposure to several metals was associated with higher odds of spirometry-defined lung disease in an American Indian population. Exposure to multiple metals, including Cd and Mo, may have an under-recognized adverse role on the respiratory system.
Authors: Harald C Ott; Christian Prior; Manfred Herold; Markus Riha; Guenther Laufer; Guenter Ott Journal: Wien Klin Wochenschr Date: 2004 Impact factor: 1.704
Authors: Tiffany R Sanchez; Martha Powers; Matthew Perzanowski; Christine M George; Joseph H Graziano; Ana Navas-Acien Journal: Curr Environ Health Rep Date: 2018-06