ArticlePloS one2021
The association of cadmium and lead exposures with red cell distribution width.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 35 citations in OpenAlex.
- Smoking, Nutritional Status, and Their Associations with Hypertension and Hematological Disorders Among Hotel Workers: Implications for Indonesian Occupational Health Nursing.International journal of environmental research and public health · 2026Article
- Air Pollution-Associated Intracellular Metals, Immune Gene Expression, and Erythrocyte Indices in COPD with Anemia.International journal of chronic obstructive pulmonary disease · 2026Article
- Heavy metal(loid) bioaccumulation in fish and its implications for human health.Italian journal of food safety · 2024Article
- Impact of Occupational Cement Dust Exposure on Hematological Health Parameters: A Cross-Sectional Study.Cureus · 2024Article
- Environmental chemical-wide associations with immune biomarkers in US adults: A cross-sectional analysis.Environmental research · 2024Article
- Article
- Prenatal double-hit with aluminium and cadmium mediate testicular atrophy and hypothalamic hypoplasia: the role of oxido-nitrergic stress and endocrine perturbations.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024Article
- Cadmium induces microcytosis and anisocytosis without anaemia in hypertensive rats.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024Article
- Assessing the mediating role of iron status on associations between an industry-relevant metal mixture and verbal learning and memory in Italian adolescents.The Science of the total environment · 2024Article
- The association of manganese levels with red cell distribution width: A population-based study.PloS one · 2024Article
- Iron- and protein rich diets may boost hemoglobin levels among informal electronic waste recyclers exposed to metals at Agbogbloshie, Ghana.Hygiene and environmental health advances · 2023Article
- Associations of a metal mixture with iron status in U.S. adolescents: Evidence from the National Health and Nutrition Examination Survey.New directions for child and adolescent development · 2022Article
- Response of Iron Deficiency Markers to Blood Lead Levels and Synergistic Outcomes at Prenatal Stage.Dose-response : a publication of International Hormesis SocietyArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
Elevated red blood cell distribution width (RDW), traditionally an indicator of anemia, has now been recognized as a risk marker for cardiovascular disease incidence and mortality. Experimental and acute exposure studies suggest that cadmium and lead individually affect red blood cell production; however, associations between environmental exposures and RDW have not been explored. We evaluated relationships of environmental cadmium and lead exposures to RDW. We used data from 24,607 participants aged ≥20 years in the National Health and Nutrition Examination Survey (2003-2016) with information on blood concentrations of cadmium and lead, RDW and socio-demographic factors. In models adjusted for age, sex, race/ethnicity, education, poverty income ratio, BMI, alcohol consumption, smoking status and serum cotinine, RDW was increasingly elevated across progressively higher quartiles of blood cadmium concentration. A doubling of cadmium concentration was associated with 0.16 higher RDW (95% CI: 0.14, 0.18) and a doubling of lead concentration with 0.04 higher RDW (95% CI: 0.01, 0.06). Also, higher cadmium and lead concentrations were associated with increased odds of high RDW (RDW>14.8%). The associations were more pronounced in women and those with low-to-normal mean corpuscular volume (MCV) and held even after controlling for iron, folate or vitamin B12 deficiencies. In analysis including both metals, cadmium remained associated with RDW, whereas the corresponding association for lead was substantially attenuated. In this general population sample, blood cadmium and lead exposures were positively associated with RDW. The associations may indicate hemolytic or erythropoietic mechanisms by which exposure increases mortality risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.