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Environmental exposure
Original research
Comprehensive analysis of environmental exposure to hazardous trace elements and lung function: a national cross-sectional study
  1. Yun-Jiang Yu1,
  2. Tong Zheng1,
  3. Jennifer L Perret2,3,
  4. Yajing Han1,
  5. Hongyan Li1,
  6. Wenjie Meng1,
  7. Dinh Bui2,
  8. Qi-Zhen Wu4,
  9. Chenyin Dong1,
  10. Qiu-Ling Fang4,
  11. Zhenchi Li1,
  12. Hongxuan Kuang1,
  13. Xiaowen Chen1,
  14. Mingdeng Xiang1,
  15. Xiaodi Qin5,
  16. Shyamali C Dharmage2,
  17. Guang-Hui Dong4,
  18. Yang Zhou1,4
  1. 1State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
  2. 2Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3Respiratory and Sleep Medicine, Austin Hospital, Melbourne, Victoria, Australia
  4. 4Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
  5. 5Institute for Chemical Carcinogenesis, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
  1. Correspondence to Dr Yang Zhou, State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Guangzhou 510655, Guangdong, China; zhouyang{at}scies.org

Abstract

Background There is growing interest in the joint effects of hazardous trace elements (HTEs) on lung function deficits, but the data are limited. This is a critical research gap given increased global industrialisation.

Methods A national cross-sectional study including spirometry was performed among 2112 adults across 11 provinces in China between 2020 and 2021. A total of 27 HTEs were quantified from urine samples. Generalised linear models and quantile-based g-computation were used to explore the individual and joint effects of urinary HTEs on lung function, respectively.

Results Overall, there were negative associations between forced expiratory volume in 1 s (FEV1) and urinary arsenic (As) (z-score coefficient, −0.150; 95% CI, −0.262 to –0.038 per 1 ln-unit increase), barium (Ba) (−0.148, 95% CI: −0.258 to –0.039), cadmium (Cd) (−0.132, 95% CI: −0.236 to –0.028), thallium (Tl) (−0.137, 95% CI: −0.257 to –0.018), strontium (Sr) (−0.147, 95% CI: −0.273 to –0.022) and lead (Pb) (−0.121, 95% CI: −0.219 to –0.023). Similar results were observed for forced vital capacity (FVC) with urinary As, Ba and Pb and FEV1/FVC with titanium (Ti), As, Sr, Cd, Tl and Pb. We found borderline associations between the ln-quartile of joint HTEs and decreased FEV1 (−20 mL, 95% CI: −48 to +8) and FVC (−14 mL, 95% CI: −49 to+2). Ba and Ti were assigned the largest negative weights for FEV1 and FVC within the model, respectively.

Conclusion Our study investigating a wide range of HTEs in a highly polluted setting suggests that higher urinary HTE concentrations are associated with lower lung function, especially for emerging Ti and Ba, which need to be monitored or regulated to improve lung health.

  • Respiratory Measurement
  • Clinical Epidemiology

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/thorax-2022-219839

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • XQ, SD, G-HD and YZ contributed equally.

    • Contributors Study concept and design: G-HD, Y-JY. Acquisition of data: YZ, G-HD, TZ, HL, WM, Q-ZW, Q-LF, CX, YH. Analysis and interpretation of data: Y-JY, YZ, JLP, DB, CD, HK, SCD, G-HD. Drafting of the manuscript: YZ, JLP. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: Y-JY, YZ, JLP, DB, CD, HK, SCD, G-HD. Obtained funding: Y-JY, G-HD, YZ, QX. YZ is the guarantor, fully responsible for the work's integrity, had data access, and oversaw publication decisions.

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    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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