Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
Ministry of Health, Putrajaya, Malaysia.
PeerJ. 2022 Aug 9;10:e13845. doi: 10.7717/peerj.13845. eCollection 2022.
Lung function status can be directly or indirectly affected by exposure to pollutants in the environment. Urinary heavy metals may be an indirect indicator of lung function impairment that leads to various diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to explore the prevalence of lung function impairment as well as its association with urinary heavy metal levels and other influencing factors among the community in Klang Valley, Malaysia. Urinary sampling was done during various community events in the housing areas of Klang Valley between March and October 2019. Only respondents who consented would undergo a lung function test. Urine samples were obtained and sent for Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis for heavy metal cadmium (Cd) and lead (Pb) concentration. Of the 200 recruited respondents, 52% were male and their ages ranged from 18 years old to 74 years old with a mean age of 38.4 ± 14.05 years. Urinary samples show high urinary Cd level in 12% of the respondents ( = 24) whereas none recorded a high urinary Pb level. There was a positive correlation between the levels of urinary Cd and urinary Pb ( = 0.303; = 0.001). Furthermore, a negative correlation was detected between urinary Cd level and forced vital capacity (FVC) ( = - 0.202, = 0.004), force expiratory volume at the first second (FEV1) ( = - 0.225, = 0.001), and also force expiratory flow between 25-75% of FVC (FEF 25-75%) ( = - 0.187, = 0.008). However, urinary Pb did not show any correlation with lung function parameters. Multiple linear regression analysis showed that urinary Cd had a significant negative effect on FVC ( = 0.025) and FEV1 ( = 0.004) based on the predicted value. Additionally, other factors such as education level ( = 0.013) also influenced lung function. However, no interaction was detected between heavy metals or other factors. In short, there was a significant negative linear relationship between urinary Cd and lung function, whereas urinary Pb was not associated with lung function. Beside acting as a biomarker for cadmium exposure level, urinary Cd may also be applied as indirect biomarker for asymptomatic chronic lung function deterioration among the healthy population.
肺部功能状况可能会直接或间接受到环境污染物的影响。尿中重金属可能是导致慢性阻塞性肺疾病（COPD）等各种疾病的肺部功能损害的间接指标。本研究旨在探讨马来西亚巴生谷社区人群中肺部功能损害的流行情况，以及其与尿中重金属水平和其他影响因素的关系。2019 年 3 月至 10 月期间，在巴生谷的住宅区举行各种社区活动期间进行了尿液采样。只有同意的受访者才会接受肺功能测试。采集尿样并进行电感耦合等离子体质谱（ICP-MS）分析，以测定重金属镉（Cd）和铅（Pb）的浓度。在 200 名招募的受访者中，有 52%是男性，年龄在 18 岁至 74 岁之间，平均年龄为 38.4±14.05 岁。尿液样本显示，12%的受访者（=24）尿镉水平较高，而没有尿铅水平较高的情况。尿镉和尿铅水平之间呈正相关（=0.303；=0.001）。此外，还检测到尿镉水平与用力肺活量（FVC）（=−0.202；=0.004）、第一秒用力呼气量（FEV1）（=−0.225；=0.001）和用力呼气量在 25%至 75%肺活量之间（FEF 25-75%）（=−0.187；=0.008）之间呈负相关。然而，尿铅与肺功能参数没有相关性。多元线性回归分析显示，尿镉对 FVC（=0.025）和 FEV1（=0.004）的预测值有显著的负效应。此外，教育程度（=0.013）等其他因素也影响肺功能。然而，没有检测到重金属或其他因素之间的相互作用。总之，尿镉与肺功能之间存在显著的负线性关系，而尿铅与肺功能无关。除了作为镉暴露水平的生物标志物外，尿镉也可作为健康人群无症状慢性肺功能恶化的间接生物标志物。
