ArticleBMJ open2015
The dose-response association of urinary metals with altered pulmonary function and risks of restrictive and obstructive lung diseases: a population-based study in China.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Prevalence of non-smoking chronic obstructive pulmonary disease and its risk factors in China: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- A Meta-analysis of Arsenic Exposure and Lung Function: Is There Evidence of Restrictive or Obstructive Lung Disease?Current environmental health reports · 2018Pooled it
- Inorganic arsenic and respiratory health, from early life exposure to sex-specific effects: A systematic review.Environmental research · 2016Pooled it
- Perspective on health and ecological risk assessments of potentially toxic metal(loid)s using aquatic biodiversity as biomonitoring indicators.Toxicology reports · 2025Review
- Environmental Arsenic Exposure, Biomarkers and Lung Function in Children from Yaqui Communities in Sonora, Mexico.Journal of xenobiotics · 2025Article
- Nutritional Support of Chronic Obstructive Pulmonary Disease.Nutrients · 2025Review
- Association Between Dietary Selenium Intake and Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study from the National Health and Nutrition Examination Survey 1999-2018.International journal of chronic obstructive pulmonary disease · 2024Article
- Metal Exposure-Related Welder's Pneumoconiosis and Lung Function: A Cross-Sectional Study in a Container Factory of China.International journal of environmental research and public health · 2022Article
- The Relationship between Metal Exposure and Chronic Obstructive Pulmonary Disease in the General US Population: NHANES 2015-2016.International journal of environmental research and public health · 2022Article
- Association between Concentrations of Metals in Urine and Adult Asthma: A Case-Control Study in Wuhan, China.PloS one · 2016Article
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveReduced pulmonary function is an important predictor of environment-related pulmonary diseases; however, evidence of an association between exposures to various metals from all possible routes and altered pulmonary function is limited. We aimed to investigate the association of various metals in urine with pulmonary function, restrictive lung disease (RLD) and obstructive lung disease (OLD) risks in the general Chinese population.
designA cross-sectional investigation in the Wuhan cohort population.
settingA heavily polluted Chinese city.
participantsA total of 2460 community-living Chinese adults from the Wuhan cohort were included in our analysis.
main outcome measuresSpirometric parameters (FVC, forced vital capacity; FEV1, forced expiratory volumes in 1 s; FEV1/FVC ratio), RLD and OLD.
resultsThe dose-response associations of pulmonary function, and RLD and OLD, with 23 urinary metals were assessed using regression analysis after adjusting for potential confounders. The false discovery rate (FDR) method was used to correct for multiple hypothesis tests. Our results indicated that there were positive dose-response associations of urinary iron with FEV1 and FEV1/FVC ratio, vanadium with FEV1, and copper and selenium with FEV1/FVC ratio, while a negative dose-response association was observed between urinary lead and FEV1/FVC ratio (all p<0.05). After additional adjusting for multiple comparisons, only iron was dose dependently related to FEV1/FVC ratio (FDR adjusted p<0.05). The dose-response association of iron and lead, with decreased and increased chronic obstructive pulmonary disease risk, respectively, was also observed (both p<0.05). Additionally, we found significant association of urinary zinc with RLD and interaction effects of smoking status with lead on FEV1/FVC, and with cadmium on FVC and FEV1.
conclusionsThese results suggest that multiple urinary metals are associated with altered pulmonary function, and RLD and OLD prevalences.
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