Introduction

Exposure to cadmium, cobalt, lead, and manganese has been associated with decreased pulmonary function in adults. Little is known about the magnitude of these associations among children in the United States.

Objectives

We evaluated cross-sectional associations of blood and urinary concentrations of cadmium, cobalt, lead, and manganese with pulmonary function measures [forced expiratory volume in one second (FEV1; milliliters), forced vital capacity (FVC; milliliters), ratio of FEV1 to FVC (FEV1:FVC), and mid-exhalation forced expiratory flow rate (FEF 25–75%; milliliters/second)] in a sample of 1234 6–17 year olds, who participated in the 2011–2012 survey cycle of the National Health and Nutrition Examination Survey (NHANES).

Methods

Survey-weighted linear regression was used to estimate beta coefficients and 95% confidence intervals (CIs) for the associations between metal exposure tertiles or quartiles and pulmonary function test parameters, with adjustment for relevant covariates.

Results

Blood manganese concentration was inversely associated with FVC (β for highest versus lowest quartile = −97.1, 95% CI = −230.6, 36.4; p for trend = 0.03). Urinary manganese was inversely associated with FEV1:FVC and FEF 25–75% (p for trend = 0.05 and 0.02, respectively). Urinary lead was inversely associated with FEF 25–75% (p for trend = 0.01). The associations between blood manganese and both FEV1 and FVC differed by age (p for interaction = 0.04 and 0.04, respectively), indicating an inverse trend that was strongest among older youth.

Conclusions

Environmental exposure to manganese and lead may adversely impact the pulmonary function of young people in the United States. Our findings highlight a need to prioritize children's environmental health and evaluate these associations prospectively.

中文翻译：

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重金属与儿童和青少年肺功能的关联：国家健康与营养检查（NHANES）结果

介绍

成年人接触镉，钴，铅和锰与肺功能下降有关。在美国，儿童之间的这些关联的程度知之甚少。

目标

我们通过肺功能测量[一秒钟的呼气量（FEV1；毫升），强制肺活量（FVC；毫升），FEV1与尿液的比率）评估了血液和尿液中镉，钴，铅和锰的横断面关联性FVC（FEV1：FVC）和呼气中强制呼气流速（FEF 25–75％；毫升/秒）]参加了2011-2012年美国国家调查周期的1234名6-17岁儿童的样本健康和营养检查调查（NHANES）。

方法

使用调查加权线性回归来估计金属暴露三分位数或四分位数与肺功能测试参数之间的关联的beta系数和95％置信区间（CIs），并调整相关的协变量。

结果

血锰浓度与FVC呈负相关（最高四分位数与最低四分位数的β= -97.1，95％CI = -230.6，36.4；趋势p = 0.03）。尿锰与FEV1：FVC和FEF的比例为25-75％呈负相关（趋势p分别为0.05和0.02）。尿铅与FEF 25–75％成反比（趋势p = 0.01）。血锰与FEV1和FVC的关联因年龄而异（相互作用的p分别为0.04和0.04），表明在年长青年中这种趋势最强。

结论

在环境中，锰和铅可能会对美国年轻人的肺功能产生不利影响。我们的研究结果表明，需要优先考虑儿童的环境健康并进行前瞻性评估。