SMELTERS: ENVIRONMENTAL EXPOSURE TO LEAD AND CARDIOMETABOLIC OUTCOMES

Lead (Pb);systematic review;cardiovascular disease;cardiometabolic diseases;blood pressure;hypertension;kidney disease;renal outcomes;heart rate variability (HRV);autonomic regulation of cardiac function;Epidemiology

Farag, Youssef Mohamed KamelDiener-West, Marie ;

Johns Hopkins University

关键词: Lead (Pb);    systematic review;    cardiovascular disease;    cardiometabolic diseases;    blood pressure;    hypertension;    kidney disease;    renal outcomes;    heart rate variability (HRV);    autonomic regulation of cardiac function;    Epidemiology;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/59159/FARAG-DISSERTATION-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Background: Lead (Pb), a ubiquitous metal with many uses, has been associated with many significant adverse health effects in both children and adults. Objectives: We aimed at systematically reviewing the literature on the available epidemiologic evidence on the association between environmental exposures to lead from lead smelters and cardiovascular and renal outcomes. Furthermore, we aimed at studying the association between lead and heart rate variability, and any interaction with acute stress.Methods: We used the systematic review approach to identify and synthesize the evidence on environmental exposures to lead from lead smelters and cardiovascular and renal outcomes. We used secondary cross-sectional data analysis from Torreon, Mexico to study lead, acute stress and heart rate variability.Results: We included 20 articles in our systematic review. We found consistent findings on the positive association between lead and blood pressure. Higher blood lead levels were also associated with left ventricular abnormalities. We found a strong association between blood lead levels and renal dysfunction, measured by creatinine clearance or estimated glomerular filtration rate, or kidney damage, as measured by proteinuria and other biomarkers. We observed a substantial heterogeneity in study design, sampling as well as the statistical analysis methods and its reporting. On the other hand, there was no observed association between the logn(SDNN) or logn(rMSSD) and doubling of blood lead levels. Furthermore, no evidence of effect modification by acute stress was noted. Conclusions: The evidence supports further studies using longitudinal cohort studies on potential adverse health effects in non-occupational populations exposed to lead from smelters, and also the study of the association between lead, acute stress and heart rate variability in children.