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Effect of heavy metals on ventricular repolarization and depolarization in the Metropolitan Manila Development

Zypher Jude G Regencia1, Godofreda V Dalmacion1,2,3, Emmanuel S Baja1,2

  • 1Exposure Assessment, Epidemiology, and Risk Lab, Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines-Manila, City of Manila, Philippines.

Archives of Environmental & Occupational Health
|May 24, 2021
PubMed

Insights

Traffic enforcers exposed to heavy metals showed altered heart rhythms. Blood cadmium (B-Cd) was linked to longer QRS complex duration (QRSc) and corrected QT interval (QTc), particularly in males and never-smokers.

Area of Science:

  • Environmental Health
  • Cardiology
  • Toxicology

Background:

  • Occupational exposure to heavy metals is a concern for cardiovascular health.
  • Electrocardiogram (ECG) markers like QTc and QRSc reflect cardiac electrical activity and repolarization.
  • Understanding the impact of specific heavy metals on cardiac function is crucial for public health.

Purpose of the Study:

  • To investigate the association between blood heavy metal levels (cadmium, mercury, lead) and ECG parameters (QTc, JTc, QRSc).
  • To explore potential effect modification by sex and smoking status on these associations.
  • To assess cardiovascular risks associated with heavy metal exposure in traffic enforcers.

Main Methods:

  • Cross-sectional study involving 60 traffic enforcers.
  • Measurement of blood heavy metals: cadmium (B-Cd), mercury (B-Hg), and lead (B-Pb).
  • Analysis of ECG parameters: corrected QT interval (QTc), JT interval (JTc), and QRS complex duration (QRSc).
  • Regression modeling to estimate associations, adjusted for confounders.
  • Examination of effect modification by sex and smoking status.

Main Results:

  • An interquartile range increase in B-Cd was associated with a 6.6% increase in mean QRSc and a 1.7% increase in mean QTc.
  • Associations between B-Cd and QRSc/QTc were stronger in never-smokers compared to ever-smokers.
  • The association between B-Cd and QRSc was more pronounced in males than females.

Conclusions:

  • Blood cadmium levels are associated with prolonged ventricular depolarization (QRSc) and repolarization (QTc) in traffic enforcers.
  • Smoking status and sex may modify the relationship between cadmium exposure and cardiac electrical parameters.
  • These findings highlight potential cardiovascular risks from heavy metal exposure in occupational settings.

Keywords:
Blood cadmiumMMDA ’ Health Studyblood leadblood mercurysexsmokingtraffic enforcersventricular depolarization and repolarizationtraffic enforcers

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