Evidence map›Paper›PMID 41912635›Full record

ArticleJournal of exposure science & environmental epidemiology2026

Risk factors associated with urinary metal concentrations in middle-aged and older Caribbean adults: the Tobago Health Study.

Natalie F Price, Ryan Cvejkus, Victor Wheeler, Patrick J Parsons, Elizabeth J Mullin, Chris Gennings, Aaron Barchowsky, Joseph M Zmuda, Alison P Sanders, Iva Miljkovic

Abstract read
In one paragraph

Article in Journal of exposure science & environmental epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Natalie F PriceDepartment of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA. nfp9@pitt.edu.
Ryan CvejkusDepartment of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Victor WheelerScarborough General Hospital, Scarborough, Trinidad and Tobago.
Patrick J ParsonsDivision of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY, USA.
Elizabeth J MullinDivision of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY, USA.
Chris GenningsDepartment of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Aaron BarchowskyDepartment of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Joseph M ZmudaDepartment of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Alison P Sanders *Department of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Iva Miljkovic *Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetal exposures are increasingly recognized as a major risk factor for chronic diseases, yet very few prior studies have comprehensively characterized metal concentrations in the Caribbean.

objectiveThis study characterized urinary metal concentrations and their associations with demographic characteristics and other lifestyle factors among middle-aged and older Tobagonian adults.

methodsWe quantified urinary concentrations of 18 metals and metalloids (referred to here as "metals") in 896 adults from a subsample of the Tobago Health Study, including 466 men and 430 women. Morning spot urine samples were collected from men in 2014-2016, and from women in 2019-2020. Metal concentrations were compared to studies of adults from other populations. Metal exposure risk factors included demographics, body composition, and lifestyle, including diet. We used sex-stratified partial least squares (PLS) regression to identify risk factors associated with metal concentrations.

resultsTwelve metals including arsenic (As), barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), copper (Cu), molybdenum (Mo), lead (Pb), tin (Sn), thallium (Tl), uranium (U) and zinc (Zn) were detected in >87% of participants in both men and women. Compared to other populations, Zn and Tl concentrations were higher among Tobagonian men and women. We observed distinct urinary metal concentration patterns among men and women that varied by age, education, body composition and lifestyle factors. SIGNIFICANCE: A mix of non-modifiable and modifiable risk factors associated with urinary metal concentrations were identified. These findings can inform future studies to identify vulnerable populations and tailor public health messaging to reduce exposure risk. Future research is needed to understand sex differences and how these exposures may contribute to adverse health outcomes. IMPACT: This study provides the first comprehensive characterization of urinary metal concentrations among middle-aged and older adults in Tobago, identifying both modifiable and non-modifiable factors associated with exposure. Twelve metals, including arsenic, cadmium, lead, and thallium, were detected in most participants, with some concentrations exceeding those reported in other populations. Distinct urinary metal concentration patterns that varied by demographics and lifestyle factors were observed among men and women. The exposure profiles of adults from Tobago can inform targeted public health strategies and lay the groundwork for future research on the health impacts of metal exposures in this understudied population.

Indexed as

Environmental ExposureEnvironmental PollutantsMetalsAgedCaribbean RegionFemaleHumansLife StyleMaleMiddle AgedRisk FactorsEnvironmental PollutantsMetalsBiomonitoringDietary ExposureMetals

Identifiers

PMID41912635
PMCPMC13331741

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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.