Almeida Lopes Ana Carolina Bertin de, Silbergeld Ellen Kovner, Navas-Acien Ana, Zamoiski Rachel, Martins Airton da Cunha, Camargo Alissana Ester Iakmiu, Urbano Mariana Ragassi, Mesas Arthur Eumann, Paoliello Monica Maria Bastos
Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil.
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Environ Health. 2017 Mar 14;16(1):27. doi: 10.1186/s12940-017-0233-5.
Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension. The availability of data on blood lead levels (BLL) in adult Brazilian population is scarce and population-based studies are important for screening the population exposure and also to evaluate associations with adverse health effects. The goal of this study was to examine the association of BLL with blood pressure and hypertension in a population-based study in a city in Southern Brazil.
A total of 948 adults, aged 40 years or older, were randomly selected. Information on socioeconomic, dietary, lifestyle and occupational background was obtained by orally administered household interviews. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to the guidelines VI Brazilian Guidelines on Hypertension. BLL were measured by inductively coupled plasma mass spectrometry technique. Multiple linear and logistic regression models were performed to evaluate associations of BLL with SBP and DBP, and with the chance of hypertension and of elevated SBP and DBP.
The geometric mean of BLL was 1.97 μg/dL (95%CI:1.90-2.04 μg/dL). After multivariable adjustment, participants in the quartile 4 of blood lead presented 0.06 mm/Hg (95%CI, 0.04-0.09) average difference in DBP comparing with those in quartile 1. Participants in the 90th percentile of blood lead distribution had 0.07 mmHg (95% CI, 0.03 to 0.11) higher DBP compared with those participants in the 10th percentile of blood lead. The adjusted OR for hypertension was 2.54 (95% CI, 1.17-5.53), comparing the highest to the lowest blood lead quartiles. Compared with participants in the 10th percentile of blood lead, participants in the 90th percentile presented higher OR for hypertension (OR: 2.77; 95% CI, 1.41 to 5.46).
At low concentrations, BLL were positively associated with DBP and with the odds for hypertension in adults aged 40 or older. It is important to enforce lead exposure monitoring and the enactment of regulatory laws to prevent lead contamination in urban settings.
成年人环境铅暴露可能会升高血压并增加患高血压的风险。巴西成年人群中血铅水平(BLL)的数据稀缺,基于人群的研究对于筛查人群暴露情况以及评估与不良健康影响的关联非常重要。本研究的目的是在巴西南部一个城市开展的基于人群的研究中,检验BLL与血压及高血压之间的关联。
总共随机选取了948名40岁及以上的成年人。通过口头进行的家庭访谈获取社会经济、饮食、生活方式和职业背景信息。根据巴西高血压指南VI测量收缩压(SBP)和舒张压(DBP)。采用电感耦合等离子体质谱技术测量BLL。进行多元线性和逻辑回归模型,以评估BLL与SBP和DBP以及与高血压、SBP升高和DBP升高的可能性之间的关联。
BLL的几何平均值为1.97μg/dL(95%CI:1.90 - 2.04μg/dL)。多变量调整后,血铅处于四分位数4的参与者与四分位数1的参与者相比,舒张压平均差异为0.06mmHg(95%CI,0.04 - 0.09)。血铅分布第90百分位数的参与者与血铅第10百分位数的参与者相比,舒张压高0.07mmHg(95%CI,0.03至0.11)。将血铅最高四分位数与最低四分位数相比,高血压的调整后比值比为2.54(95%CI,1.17 - 5.53)。与血铅第10百分位数的参与者相比,血铅第90百分位数的参与者患高血压的比值比更高(OR:2.77;95%CI,1.41至5.46)。
在低浓度下,BLL与40岁及以上成年人的舒张压以及高血压几率呈正相关。加强铅暴露监测并制定监管法律以防止城市环境中的铅污染非常重要。