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美国西班牙裔/拉丁裔人群中职业暴露与心血管疾病的关联。

Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos.

机构信息

Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA.

Division of Academic Internal Medicine, Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA.

出版信息

Heart. 2019 Mar;105(6):439-448. doi: 10.1136/heartjnl-2018-313463. Epub 2018 Dec 11.

Abstract

OBJECTIVE

Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers.

METHODS

Cross-sectional data from 7404 employed individuals, aged 18-74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models.

RESULTS

Hispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures.

CONCLUSIONS

Our results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.

摘要

目的

心血管疾病(CVD)是美国死亡和发病的主要原因。尽管许多化学物质具有心脏毒性,但职业暴露于这些化学物质对 CVD 发展的作用很少被研究。因此,我们评估了自我报告的有机溶剂、金属和农药接触与不同西班牙裔/拉丁裔工人 CVD 患病率之间的关联。

方法

对参加西班牙裔社区健康研究/拉丁裔研究(HCHS/SOL)的 7404 名 18-74 岁在职个体的横断面数据进行了分析。来自美国四个城市的参与者提供了问卷数据,并接受了包括心电图在内的临床检查。心血管疾病的定义为以下至少一种情况的存在:冠心病、心房颤动、心力衰竭或脑血管疾病。使用泊松回归模型计算了每种职业暴露与 CVD 以及 CVD 亚型之间的关系的患病率比。

结果

西班牙裔/拉丁裔工人报告在当前工作中接触有机溶剂(6.5%)、金属(8.5%)和农药(4.7%)。总体而言,6.1%的参与者存在某种形式的 CVD,最常见的是冠心病(4.3%),其次是脑血管疾病(1.0%)、心力衰竭(0.8%)和心房颤动(0.7%)。对于报告接触农药的个体,任何 CVD 的患病率比为 2.18(95%CI 1.34 至 3.55),冠心病为 2.20(95%CI 1.31 至 3.71),脑血管疾病为 1.38(95%CI 0.62 至 3.03),心力衰竭为 0.91(95%CI 0.23 至 3.54),心房颤动为 5.92(95%CI 1.89 至 18.61),调整社会人口统计学、文化适应、生活方式和职业特征后。金属暴露与心房颤动的患病率几乎增加了四倍(3.78,95%CI 1.24 至 11.46)。有机溶剂接触没有关联。

结论

我们的结果表明,接触金属和农药可能是西班牙裔/拉丁裔工人 CVD 的危险因素。需要进一步的工作来前瞻性地评估这些关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/6580877/1cb1af6b01f1/heartjnl-2018-313463f01.jpg

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