ArticleEnvironmental research2022
Environmental-level exposure to metals and metal-mixtures associated with spirometry-defined lung disease in American Indian adults: Evidence from the Strong Heart Study.
Article in Environmental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 29 citations in OpenAlex.
- Chelation treatment in a novel sub-toxic multi-metal model in rats.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Article
- Risk factors and population attributable fraction for dementia in American Indians: The Strong Heart Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Comprehensive sub-chronic toxicological profiling of illegal artisanal small-scale mining-polluted river bodies in four regions of Ghana.Toxicology reports · 2026Article
- Association between heavy metal exposure and chronic cough: the mediating roles of inflammation.Annals of medicine · 2025Article
- Article
- The mediation effect of Systemic Immunity Inflammation Index between urinary metals and TOFAT among adults in the NHANES dataset.Scientific reports · 2024Article
- The Correlation between Metal Mixed Exposure and Lung Function in Different Ages of the Population.Metabolites · 2024Article
- Association of blood cadmium concentration with chronic obstructive pulmonary disease progression: a prospective cohort study.Respiratory research · 2024Article
- Prenatal exposure to metal mixtures and lung function in children from the New Hampshire birth cohort study.Environmental research · 2023Article
- Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021.Current environmental health reports · 2023Article
- Metal mixtures and DNA methylation measures of biological aging in American Indian populations.Environment international · 2023Article
Corrections and comments
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Authors and funding
10 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundAmerican 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.
methodsWe 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.
resultsParticipants 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.
conclusionsEnvironmental-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.
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