Abstract
Background:
Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the US. Acute, high-dose exposures to some solvents, metals, and pesticides can be cardiotoxic, but little is known about the cardiovascular effects of chronic, low-level exposures. Thus, we evaluated cross-sectional associations of self-reported occupational exposures to solvents, metals, and pesticides with CVD prevalence among diverse Hispanics/Latinos in the US.
Methods:
The analyses included baseline data from 7,404 currently employed participants, ages 18-74 years, from the HCHS/SOL. CVD was defined as the presence of one or more of the following: coronary heart disease (self-reported angina, myocardial infarction, coronary bypass surgery, balloon angioplasty, or stent placement in coronary arteries, or electrocardiogram [ECG] evidence of major Q wave abnormalities or minor Q, QS waves with ST, T abnormalities); atrial fibrillation (self-reported or ECG evidence of atrial fibrillation or flutter); heart failure (self-reported); or cerebrovascular disease (self-reported stroke or transient ischemic attack). Survey-weighted Poisson regression models were used to estimate prevalence ratios (PR) and 95% confidence intervals (CIs) for each occupational exposure, adjusted for sociodemographic (age, gender, field center, Hispanic/Latino background, health insurance), acculturation (language, years of duration in the US), lifestyle (smoking, alcohol, physical activity, diet), and occupational (full- or part-time employment) characteristics.
Results:
Overall, 6.1% of participants had any prevalent CVD; coronary heart disease (4.3%) was most common, followed by cerebrovascular disease (1.0%), heart failure (0.8%), and atrial fibrillation (0.7%). Current occupational exposures to solvents, metals, and pesticides were reported by 6.5%, 8.5%, and 4.7% of participants, respectively. The prevalence of any CVD (PR: 2.18, 95% CI: 1.34-3.55), coronary heart disease (PR: 2.20, 95% CI: 1.31-3.71), and atrial fibrillation (PR: 5.92, 95% CI: 1.89-18.61) were significantly elevated for participants who reported current occupational pesticide exposure compared to no exposure. Current occupational metal exposure was associated with a greater prevalence of atrial fibrillation (PR: 3.78, 95% CI: 1.24-11.46). Further adjustment for hypertension, hypercholesterolemia, diabetes, or body mass index did not appreciably change the results. Current occupational solvent exposure was not associated with CVD prevalence.
Conclusions:
Occupational exposure to pesticides and metals is associated with higher CVD prevalence at baseline. These cross-sectional associations do not appear to be attenuated by hypertension, hypercholesterolemia, diabetes, or obesity. Further research is needed to examine other biologic mechanisms that may underlie these associations.