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Independent and combined associations of multiple-heavy-metal exposure with lung function: a population-based study in US children

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Abstract

Previous research has found relationships between some single metals and lung function parameters. However, the role of simultaneous multi-metal exposure is poorly understood. The crucial period throughout childhood, when people are most susceptible to environmental dangers, has also been largely ignored. The study aimed to evaluate the joint and individual associations of 12 selected urinary metals with pediatric lung function measures using multi-pollutant approaches. A total of 1227 children aged 6–17 years from the National Health and Nutrition Examination Survey database of the 2007–2012 cycles were used. The metal exposure indicators were 12 urine metals adjusted for urine creatinine, including arsenic (As), barium (Ba), cadmium (Cd), cesium (Cs), cobalt (Co), mercury (Hg), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (Tl), tungsten (Tu), and uranium (Ur). The outcomes of interest were lung function indices, including the 1st second of a forceful exhalation (FEV1), forced vital capacity (FVC), forced expiratory flow between 25 and 7% of vital capacity (FEF25–75%), and peak expiratory flow (PEF). Multivariate linear regression, quantile g-computation (QG-C), and Bayesian kernel machine regression models (BKMR) were adopted. A significantly negative overall effect of metal mixtures on FEV1 (β = − 161.70, 95% CI − 218.12, − 105.27; p < 0.001), FVC (β = − 182.69, 95% CI − 246.33, − 119.06; p < 0.001), FEF25–75% (β = − 178.86 (95% CI − 274.47, − 83.26; p < 0.001), and PEF (β = − 424.17, 95% CI − 556.55, − 291.80; p < 0.001) was observed. Pb had the largest negative contribution to the negative associations, with posterior inclusion probabilities (PIPs) of 1 for FEV1, FVC, and FEF25–75%, and 0.9966 for PEF. And Pb’s relationship with lung function metrics showed to be nonlinear, with an approximate “L” shape. Potential interactions between Pb and Cd in lung function decline were observed. Ba was positively associated with lung function metrics. Metal mixtures were negatively associated with pediatric lung function. Pb might be a crucial element. Our findings highlight the need for prioritizing children’s environmental health to protect them from later respiratory disorders and to guide future research into the toxic mechanisms of metal-mediated lung function injury in the pediatric population.

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Abbreviations

FEV1 :

1st second of a forceful exhalation

FVC:

Forced vital capacity

FEF25–75% :

Forced expiratory flow between 25 and 75% of vital capacity

PEF:

Peak expiratory flow

As:

Arsenic

Ba:

Barium

Be:

Beryllium

Cd:

Cadmium

Cs:

Cesium

Co:

Cobalt

Hg:

Mercury

Mo:

Molybdenum

Pb:

Lead

Pt:

Platinum

Sb:

Antimony

Tl:

Thallium

Tu:

Tungsten

Ur:

Uranium

NCHS:

National Center for Health Statistics

NHANES:

National Health and Nutrition Examination Survey

ATS:

American Thoracic Society

PIR:

Income-to-poverty ratio

BMI:

Body mass index

ICP-MS:

Inductively coupled plasma–mass spectrometry

ICP-DRC-MS:

Inductively coupled plasma dynamic reaction cell–mass spectrometry

LOD:

Limit of detection

SD:

Standard deviation

QG-C:

G-computation model

WQS:

Weighted quantile sum

BKMR:

Bayesian kernel machine regression

MCMC:

Markov chain Monte Carlo

PIP:

Posterior inclusion probabilities

CI:

Confidence interval

PAH:

Polycyclic aromatic hydrocarbon

ROS:

Reactive oxygen species

MDA:

Malonaldehyde

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Funding

This work was supported by National Natural Science Foundation of China [82273651, 81874266], the public health sub-project of the construction of high-level local colleges and universities project (E1-2602-21-201006-6) from College of Public Health, Shanghai University of Medicine and Health Science.

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Author notes

  1. Yiting Chen and Anda Zhao should be regarded as joint First Authors.

Authors and Affiliations

  1. School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, China

    Yiting Chen, Rong Li, Wenhui Kang, Shilu Tong & Shenghui Li

  2. Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Anda Zhao

  3. Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    **hong Wu, Yong Yin & Shilu Tong

  4. School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China

    Shilu Tong

  5. School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia

    Shilu Tong

  6. MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Shenghui Li

  7. College of Public Health, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Highway, Pudong New Area, Shanghai, 201318, China

    Jianyu Chen

Authors
  1. Yiting Chen
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  2. Anda Zhao
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  3. Rong Li
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  4. Wenhui Kang
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  5. **hong Wu
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  6. Yong Yin
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  7. Shilu Tong
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  8. Shenghui Li
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  9. Jianyu Chen
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Contributions

YC was involved in conceptualization, methodology, software, data curation, writing—original draft, and writing—reviewing and editing. AZ was responsible for software, writing—original draft, and writing—reviewing and editing. RL contributed to formal analysis and Software. WK participated in visualization and software. JW carried out the formal analysis. YY took part in software and resources. ST was involved in methodology and writing—reviewing and editing. SL was responsible for funding acquisition, conceptualization, methodology, and writing—reviewing and editing. JC contributed to funding acquisition, methodology, and writing—reviewing and editing. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Shenghui Li or Jianyu Chen.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was approved by the National Center for Health Statistics Research Ethics Review Board.

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Informed consent was obtained from all individual participants included in the study.

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Chen, Y., Zhao, A., Li, R. et al. Independent and combined associations of multiple-heavy-metal exposure with lung function: a population-based study in US children. Environ Geochem Health 45, 5213–5230 (2023). https://doi.org/10.1007/s10653-023-01565-0

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