Urinary metal/metalloid levels in relation to hypertension among occupationally exposed workers

Occupational exposure to metals can have an adverse effect on the cardiovascular system. However, epidemiological studies of the associations of metals expose with hypertension among occupationally exposed workers were limited. The aim of this study was to investigate the potential association between urinary metal levels and the risk of hypertension among molybdenum miners and iron and steel foundry workers. The cross-sectional study had 395 participants. Urinary metal levels were determined by inductively coupled plasma mass spectrometry. Log-binomial regression model and two-piece-wise regression model were applied to assess the dose-response relationship between metal exposure and hypertension. We observed that increased prevalence ratios for hypertension among the quartile of urinary concentrations of molybdenum, arsenic and lead were positive (all P for trend <0.05). Compared with the lowest quartiles, participants in the highest quartiles of molybdenum, arsenic and lead had a 2.58-fold, 4.30-fold and 4.85-fold increased probability of having hypertension, respectively. In the threshold effect analyses, we found the relationship was nonlinear between urinary molybdenum, cobalt, cadmium, arsenic and lead concentrations and the prevalence of hypertension. In addition, Pb, Mo, As and Co may have joint effect, and a strong positive correlation with the prevalence of hypertension. Conversely, the association between the joint effect of Cd, Pb and Mo versus the prevalence of hypertension is not significant. We provide reference levels of molybdenum, cobalt, cadmium, arsenic and lead that can be used to assess the effects of occupational metal exposure on hypertension.