镉和铅暴露与交通警察心血管疾病风险分数的关联性
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摘要
目的探讨交通警察镉和铅暴露与心血管疾病(cardiovascular diseases, CVDs)风险分数的关联性。方法采用横断面研究设计,在161名交通警察中(51名内勤人员,110名外勤人员)分析血和尿液中镉和铅浓度对CVDs风险分数的影响。对所有研究对象进行职业健康检查。血和尿液中金属浓度分别采用石墨炉原子吸收光谱法和电感耦合等离子体质谱联用仪检测。采用广义线性模型分析镉和铅暴露与CVDs风险分数的关联性。结果外勤组尿镉和铅浓度均高于内勤组(P=0.012和P=0.001)。外勤组和内勤组血镉浓度分别为1.80μg/L和1.05μg/L,差异有临界统计学意义(P=0.094)。血镉、血铅及尿镉浓度分别增加一个四分位数间距,FRS分数分别增加1.78、1.14和1.74(P均=0.001),ICVD分数分别增加0.63、0.48和0.68 (P=0.036、P=0.017和P=0.021),相对危险分数分别增加0.66、0.25和0.31 (P<0.001、P=0.009和P=0.022)。结论血镉、尿镉和血铅浓度与CVDs风险升高有关,提示重金属对交通警察心血管系统的危害性应引起重视。
Objective To investigate the associations between cadmium and lead exposure and cardiovascular diseases(CVDs)risk scores in traffic policemen. Methods A cross-sectional study was performed to assess the effects of cadmium and lead in blood and urine on CVDs risk in 161 traffic policemen(51 of them worked in the office and 110 of them worked on the roads). All subjects accepted occupational health examination. The concentrations of cadmium and lead in blood and urine were assessed by inductively coupled plasma mass spectrometry and graphite furnace atomic absorption spectrometry,respectively. Association analysis was performed by general linear models. Results The concentrations of cadmium in the urine and blood and urinary lead were significantly or marginally significantly higher in the traffic policemen who worked on the road than in those who worked in the offices(P=0.012, P=0.001 and P=0.094). One interquartile range increase in blood cadmium, blood lead, and urinary cadmium was associated with 1.78, 1.14 and 1.74 increase in Framingham risk score,respectively(all P=0.001), 0.63, 0.48 and 0.68 increase in ischemic cardiovascular diseases score, respectively(P=0.036, P=0.017 and P=0.021), and 0.66, 0.25, and 0.31 increase in relative risk score, respectively(P<0.001, P=0.009 and P=0.022).Conclusion Cadmium in blood and urine and lead in blood were associated with increased CVD risks, suggesting that more attention should be paid to the effects of heavy metals on the cardiovascular system.
Objective To investigate the associations between cadmium and lead exposure and cardiovascular diseases(CVDs)risk scores in traffic policemen. Methods A cross-sectional study was performed to assess the effects of cadmium and lead in blood and urine on CVDs risk in 161 traffic policemen(51 of them worked in the office and 110 of them worked on the roads). All subjects accepted occupational health examination. The concentrations of cadmium and lead in blood and urine were assessed by inductively coupled plasma mass spectrometry and graphite furnace atomic absorption spectrometry,respectively. Association analysis was performed by general linear models. Results The concentrations of cadmium in the urine and blood and urinary lead were significantly or marginally significantly higher in the traffic policemen who worked on the road than in those who worked in the offices(P=0.012, P=0.001 and P=0.094). One interquartile range increase in blood cadmium, blood lead, and urinary cadmium was associated with 1.78, 1.14 and 1.74 increase in Framingham risk score,respectively(all P=0.001), 0.63, 0.48 and 0.68 increase in ischemic cardiovascular diseases score, respectively(P=0.036, P=0.017 and P=0.021), and 0.66, 0.25, and 0.31 increase in relative risk score, respectively(P<0.001, P=0.009 and P=0.022).Conclusion Cadmium in blood and urine and lead in blood were associated with increased CVD risks, suggesting that more attention should be paid to the effects of heavy metals on the cardiovascular system.
引文
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[13]刘英莉,钱庆增,周婉笛,等.某市秋冬季大气PM_(2.5)中6种有毒元素的生态风险评价[J].现代预防医学,2018,45(17):3098-3101, 3106.
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[15] Tellez-Plaza M, Navas-Acien A, Menke A, et al. Cadmium exposure and all-cause and cardiovascular mortality in the U.S. general population[J]. Environmental Health Perspectives, 2012, 120(7):1017-1022.
[16] Tellez-Plaza M, Guallar E, Howard BV, et al. Cadmium exposure and incident cardiovascular disease[J]. Epidemiology, 2013, 24(3):421-429.
[17] Peters JL, Kubzansky LD, Ikeda A, et al. Lead concentrations in relation to multiple biomarkers of cardiovascular disease:the normative aging study[J]. Environmental Health Perspectives, 2012, 120(3):361-366.
[18] Kim KR, Lee SW, Paik NW, et al. Low-level Lead exposure among South Korean Lead workers, and estimates of associated risk of cardiovascular diseases[J]. Journal of Occupational and Environmental Hygiene, 2008, 5(6):399-416.
[19] Nemmiche S. Oxidative signaling response to Cadmium exposure[J].Toxicological Sciences, 2017, 156(1):4-10.
[20] Vaziri ND. Mechanisms of lead-induced hypertension and cardiovascular disease[J]. American Journal of Physiology. Heart and Circulatory Physiology, 2008, 295(2):H454-H465.
[2] Chen WW, Gao RL, Liu LS, et al. China cardiovascular diseases report 2015:a summary[J]. Journal of Geriatric Cardiology:JGC, 2017,14(1):1-10.
[3] Liu B, Feng W, Wang J, et al. Association of urinary metals levels with type 2 diabetes risk in coke oven workers[J]. Environmental Pollution, 2016, 210:1-8.
[4] Peters JL, Perlstein TS, Perry MJ, et al. Cadmium exposure in association with history of stroke and heart failure[J]. Environmental Research, 2010, 110(2):199-206.
[5] Prokopowicz A, Sobczak A, Szula-Chraplewska M, et al. Effect of occupational exposure to lead on new risk factors for cardiovascular diseases[J]. Occupational and Environmental Medicine, 2017, 74(5):366-373.
[6] Tomei F, Ricci S, Giammichele G, et al. Blood pressure in indoor and outdoor workers[J]. Environmental Toxicology and Pharmacology,2017, 55:127-136.
[7]田凤石,闫筠,彭佳,等.天津市交通警察心理健康状况调查[J].中华流行病学杂志,2012,33(10):1095-1096.
[8]杨烈,段丹萍,段传伟,等.广州市2013年度交通警察健康状况分析[J].中华劳动卫生职业病杂志,2014,32(6):418-420.
[9] Feng W, He XS, Chen M, et al. Urinary metals and heart rate variability:a Cross-Sectional study of urban adults in wuhan, China[J].Environmental Health Perspectives, 2015, 123(3):217-222.
[10] Wilson PW, D'agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories[J]. Circulation, 1998, 97(18):1837-1847.
[11] Wu YF, Liu XQ, Li X, et al. Estimation of 10-year risk of fatal and nonfatal ischemic cardiovascular diseases in Chinese adults[J]. Circulation, 2006, 114(21):2217-2225.
[12] Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice:executive summary:Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice(Constituted by representatives of nine societies and by invited experts)[J]. European Heart Journal, 2007, 28(19):2375-2414.
[13]刘英莉,钱庆增,周婉笛,等.某市秋冬季大气PM_(2.5)中6种有毒元素的生态风险评价[J].现代预防医学,2018,45(17):3098-3101, 3106.
[14] Ja咬rup L, Akesson A. Current status of cadmium as an environmental health problem[J]. Toxicology and Applied Pharmacology, 2009, 238(3):201-208.
[15] Tellez-Plaza M, Navas-Acien A, Menke A, et al. Cadmium exposure and all-cause and cardiovascular mortality in the U.S. general population[J]. Environmental Health Perspectives, 2012, 120(7):1017-1022.
[16] Tellez-Plaza M, Guallar E, Howard BV, et al. Cadmium exposure and incident cardiovascular disease[J]. Epidemiology, 2013, 24(3):421-429.
[17] Peters JL, Kubzansky LD, Ikeda A, et al. Lead concentrations in relation to multiple biomarkers of cardiovascular disease:the normative aging study[J]. Environmental Health Perspectives, 2012, 120(3):361-366.
[18] Kim KR, Lee SW, Paik NW, et al. Low-level Lead exposure among South Korean Lead workers, and estimates of associated risk of cardiovascular diseases[J]. Journal of Occupational and Environmental Hygiene, 2008, 5(6):399-416.
[19] Nemmiche S. Oxidative signaling response to Cadmium exposure[J].Toxicological Sciences, 2017, 156(1):4-10.
[20] Vaziri ND. Mechanisms of lead-induced hypertension and cardiovascular disease[J]. American Journal of Physiology. Heart and Circulatory Physiology, 2008, 295(2):H454-H465.