Environmental Cadmium and Mortality from Influenza and Pneumonia in U.S. Adults

Autor: Sung Kyun Park, Matti J. Siren, Coralynn Sack, Howard Hu
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
National Health and Nutrition Examination Survey
Health
Toxicology and Mutagenesis

Population
chemistry.chemical_element
010501 environmental sciences
Lung injury
01 natural sciences
03 medical and health sciences
0302 clinical medicine
Internal medicine
Influenza
Human

medicine
Humans
030212 general & internal medicine
Prospective Studies
education
Letter to the Editor
0105 earth and related environmental sciences
Aged
Proportional Hazards Models
Aged
80 and over

Cadmium
education.field_of_study
business.industry
SARS-CoV-2
Research
Hazard ratio
Public Health
Environmental and Occupational Health

COVID-19
Environmental exposure
Environmental Exposure
Pneumonia
Middle Aged
medicine.disease
Nutrition Surveys
United States
chemistry
Environmental Pollutants
Female
business
Body mass index
Zdroj: Environmental Health Perspectives
ISSN: 1552-9924
Popis: BACKGROUND: Environmental cadmium exposure is widespread. In humans, cadmium is poorly excreted, triggers pulmonary inflammation, reduces pulmonary function, and enhances lung injury by respiratory syncytial virus. OBJECTIVES: We examined the association of cadmium burden with mortality related to influenza or pneumonia. METHODS: This prospective analysis of the National Health and Nutrition Examination Survey (NHANES) included 7,173 and 8,678 participants ≥45 years of age enrolled in NHANES-III and NHANES 1999-2006, respectively. Associations were evaluated between cadmium and mortality from influenza or pneumonia during a median follow-up of 17.3 y (NHANES-III, based on creatinine-corrected urine cadmium) and 11.4 y (NHANES 1999-2006, based on blood cadmium). Survey-weighted Cox proportional hazard models were used to compute hazard ratios (HRs) comparing the mortality of individuals at the 80th vs. the 20th percentile of cadmium concentrations. RESULTS: In NHANES-III, after adjustment for sex, race/ethnicity, education, body mass index, serum cholesterol, hypertension, and NHANES phase (or cycle), the HR comparing influenza or pneumonia mortality among participants with creatinine-corrected urinary cadmium in the 80th vs. 20th percentile was 1.15 (95% CI: 1.05, 1.26; p=0.002) in the population as a whole and 1.27 (95% CI: 1.12, 1.43; p=0.002) among never smokers. In NHANES 1999-2006, adjusted HRs for the 80th vs. 20th percentile of blood cadmium were 1.14 (95% CI: 0.96, 1.36; p=0.15) for the overall population and 1.71 (95% CI: 0.95, 3.09; p=0.07) in never smokers. DISCUSSION: Among middle-aged and older adults in the United States, higher cadmium burdens are associated with higher mortality from influenza or pneumonia. This raises the possibility that cadmium may worsen outcomes from COVID-19 infections. https://doi.org/10.1289/EHP7598.
Databáze: OpenAIRE