Exploring the Impact of E‑Waste Exposure on Childhood Blood Pressure: Metabolomics Analysis and Risk Prediction

The alarming burden of hypertension in electronic waste (e-waste) recycling areas (EA) constitutes a pressing public health challenge. While growing evidence links changes in blood pressure to volatile organic compounds (VOCs) and metal-(loid) exposure, knowledge gaps persist in understanding the molecular mechanisms and developing operational screening tools. We aim to investigate the effects of VOC and metal-(loid) coexposure on the blood pressure of children in EA, uncover metabolic mechanisms via urinary metabolomics, and develop a machine learning algorithm-driven predictive model for identifying children with potential hypertension risks. We measured systolic (SBP) and diastolic (DBP) blood pressures, urinary VOC metabolites (mVOCs), metal-(loid)-s, and metabolomic profiles in EA children (n = 426). Results showed that the hypertension prevalence in our study population (12.7%) significantly exceeded the nationally representative estimate of 3.11%. Elevated levels of urinary 4 mVOCs and 5 metal-(loid)-s were associated with increased SBP or DBP (p < 0.05). Principal component analysis identified the positive association between mVOC-dominated mixture and SBP and DBP, where 2-aminothiazoline-4-carboxylic acid (ATCA) contributed most substantially (p < 0.05). Urinary metabolomics revealed N-phenylacetyl-l-glutamine (PAGln) and pyroglutamic acid as pivotal mediators linking VOC and metal-(loid) exposure to childhood blood pressure elevation, suggesting gut microbiota metabolism and γ-glutamyl cycling may play important roles in pollutant-associated hypertension. Notably, our predictive model achieved 83% accuracy in differentiating children with a potential hypertension risk, with androstane glucuronide (steroid metabolism) and PAGln being top-ranked features. These results collectively indicated that VOC and metal-(loid) exposure may contribute to elevated blood pressure in EA children via disturbing gut microbiota metabolism, γ-glutamyl cycling, and steroid metabolism. This study significantly advances our understanding of the potential mechanisms between VOC and metal-(loid) exposure and childhood blood pressure elevation while providing practical tools for early risk detection and intervention.