Stanford Health Care Oakland CA.
Department of Medicine Albert Einstein College of Medicine Bronx NY.
J Am Heart Assoc. 2020 Sep;9(17):e016122. doi: 10.1161/JAHA.120.016122. Epub 2020 Aug 26.
Background Our objective was to determine associations of occupational exposures with cardiac structure and function in Hispanic/Latino adults. Methods and Results Employed participants were included (n=782; 52% women, mean age 52.9 years). Occupational exposures to burning wood, vehicle exhaust, solvents, pesticides, and metals at the current and longest-held job were assessed by questionnaire. Survey multivariable linear regression analyses were used to model the relationship of each self-reported exposure with echocardiographic measures of cardiac structure and function. Exposure to burning wood at the current job was associated with decreased left ventricular (LV) ejection fraction (-3.1%; standard error [SE], 1.0 [=0.002]). When the analysis was restricted to exposure at the longest-held job, occupational exposure to burning wood was associated with increased LV diastolic volume (6.7 mL; SE, 1.6 [<0.0001]), decreased LV ejection fraction (-2.7%; SE, 0.6 [<0.0001]), worse LV global longitudinal strain (1.0%; SE, 0.3 [=0.0009]), and decreased right ventricular fractional area change (-0.02; SE, 0.004 [<0.001]). Exposure to pesticides was associated with worse average global longitudinal strain (0.8%; SE, 0.2 [<0.0001]). Exposure to metals was associated with worse global longitudinal strain in the 2-chamber view (1.0%; SE, 0.5 [=0.04]), increased stroke volume (3.6 mL; SE, 1.6 [=0.03]), and increased LV mass indexed to BSA (9.2 g/m; SE, 3.8 [=0.01]) or height (4.4 g/m; SE, 1.9 [=0.02]). Conclusions Occupational exposures to burning wood, vehicle exhaust, pesticides, and metals were associated with abnormal parameters of LV and right ventricular systolic function. Reducing exposures to toxic chemicals and particulates in the workplace is a potential opportunity to prevent cardiovascular disease in populations at risk.
背景 我们的目的是确定职业暴露与西班牙裔/拉丁裔成年人心脏结构和功能之间的关联。 方法和结果 纳入了参与研究的对象(n=782;女性占 52%,平均年龄 52.9 岁)。通过问卷评估当前和最长工作岗位上职业暴露于燃烧木材、车辆尾气、溶剂、农药和金属的情况。采用调查多变量线性回归分析来建立每个自我报告的暴露与超声心动图测量的心脏结构和功能之间的关系。当前工作岗位上接触燃烧木材与左心室射血分数降低(-3.1%;标准误差 [SE],1.0 [=0.002])相关。当分析仅限于最长工作岗位上的暴露时,接触燃烧木材与左心室舒张末期容积增加(6.7 mL;SE,1.6 [<0.0001])、左心室射血分数降低(-2.7%;SE,0.6 [<0.0001])、左心室整体纵向应变恶化(1.0%;SE,0.3 [=0.0009])和右心室节段面积变化减少(-0.02;SE,0.004 [<0.001])相关。接触农药与平均整体纵向应变恶化相关(0.8%;SE,0.2 [<0.0001])。接触金属与 2 腔视图的整体纵向应变恶化相关(1.0%;SE,0.5 [=0.04])、每搏量增加(3.6 mL;SE,1.6 [=0.03])和左心室质量指数增加(BSA 每增加 9.2 g/m;SE,3.8 [=0.01])或身高每增加 4.4 g/m;SE,1.9 [=0.02])。 结论 接触燃烧木材、车辆尾气、农药和金属与左心室和右心室收缩功能的异常参数相关。减少工作场所中有毒化学物质和颗粒物质的暴露是预防高危人群心血管疾病的潜在机会。