Association between environmental cadmium exposure and increased mortality in the U.S. National Health and Nutrition Examination Survey (1999–2018)
DC Field | Value | Language |
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dc.contributor.author | Moon, Shinje | - |
dc.contributor.author | Lee, Junghoon | - |
dc.contributor.author | Yu, Jae Myung | - |
dc.contributor.author | Choi, Hoonsung | - |
dc.contributor.author | Choi, Sohyeon | - |
dc.contributor.author | Park, Jeongim | - |
dc.contributor.author | Choi, Kyungho | - |
dc.contributor.author | Kim, Ejin | - |
dc.contributor.author | Kim, Ho | - |
dc.contributor.author | Kim, Min Joo | - |
dc.contributor.author | Park, Young Joo | - |
dc.date.accessioned | 2024-07-02T05:30:49Z | - |
dc.date.available | 2024-07-02T05:30:49Z | - |
dc.date.issued | 2023-11 | - |
dc.identifier.issn | 1559-0631 | - |
dc.identifier.issn | 1559-064X | - |
dc.identifier.uri | https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74515 | - |
dc.description.abstract | Background: Cadmium (Cd) is toxic to human health and increases overall mortality. In this study, we investigated the association between Cd exposure and all-cause, cardiovascular (CVD), and cancer mortality in the general population and the mediating effect of smoking on these association. Methods: We used data from U.S. National Health and Nutrition Examination Survey for 1999–2018. To evaluate the hazard ratio (HR) for mortality, a multiple Cox regression analysis was conducted by adjusting for age, sex, race/ethnicity, body mass index, smoking, alcohol, hypertension, diabetes, hyperlipidemia, and history of CVD and cancer. A causal mediation analysis was performed to estimate the effects of smoking. Results: Among the 31,637 subjects, 5452 (12.3%) died. Blood Cd concentrations were significantly associated with all-cause (HR 1.473, 95% confidence interval [CI] 1.403–1.546, p < 0.001), CVD (HR 1.445, 95% CI 1.344–1.554, p < 0.001), and cancer (HR 1.496, 95% CI 1.406–1.592, p < 0.001) mortality. Urinary Cd concentrations were also significantly associated with them. Using feature selection via machine learning, the importance of Cd in all-cause and cancer mortality was second only to age. The association between Cd concentrations and all-cause mortality was significant in both ever-smokers and never-smokers. The mediating effect of smoking was estimated at 32%, whereas a large proportion (68%) remained a direct effect of Cd. In a subgroup analysis of subjects with cancer history, blood Cd concentrations were significantly associated with cancer-related deaths in those with a history of breast, gastrointestinal, and skin cancers. Conclusion: High Cd exposure is an important risk factor for all-cause, CVD, and cancer mortality among the general population. Cd exposure increased the risk of death even in never-smokers, and its effects unrelated to smoking were substantial, suggesting the importance of regulating other sources of Cd exposure such as food and water. Impact Statement: Using national large-scale data, we found that low-level environmental exposure to cadmium significantly increased the risk of all-cause, cardiovascular, and cancer mortality in the general population even after adjusting for several risk factors. Although smoking is a major source of cadmium exposure, cadmium was nevertheless significantly associated with all-cause mortality in never-smokers, and the mediating effect of smoking on this association was only 32%. Hence, other sources of cadmium exposure such as food and water may be important. © 2023, The Author(s), under exclusive licence to Springer Nature America, Inc. | - |
dc.format.extent | 9 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | Springer Nature | - |
dc.title | Association between environmental cadmium exposure and increased mortality in the U.S. National Health and Nutrition Examination Survey (1999–2018) | - |
dc.type | Article | - |
dc.identifier.doi | 10.1038/s41370-023-00556-8 | - |
dc.identifier.bibliographicCitation | Journal of Exposure Science and Environmental Epidemiology, v.33, no.6, pp 874 - 882 | - |
dc.description.isOpenAccess | N | - |
dc.identifier.wosid | 000995664500001 | - |
dc.identifier.scopusid | 2-s2.0-85158954389 | - |
dc.citation.endPage | 882 | - |
dc.citation.number | 6 | - |
dc.citation.startPage | 874 | - |
dc.citation.title | Journal of Exposure Science and Environmental Epidemiology | - |
dc.citation.volume | 33 | - |
dc.type.docType | Article | - |
dc.publisher.location | 미국 | - |
dc.subject.keywordAuthor | Cadmium | - |
dc.subject.keywordAuthor | Metals | - |
dc.subject.keywordAuthor | Mortality | - |
dc.subject.keywordAuthor | Neoplasms | - |
dc.subject.keywordAuthor | NHANES | - |
dc.subject.keywordAuthor | Smoking | - |
dc.subject.keywordPlus | MEDIATION ANALYSIS | - |
dc.subject.keywordPlus | URINARY CADMIUM | - |
dc.subject.keywordPlus | BREAST-CANCER | - |
dc.subject.keywordPlus | RISK | - |
dc.subject.keywordPlus | POPULATION | - |
dc.subject.keywordPlus | MECHANISMS | - |
dc.subject.keywordPlus | ATHEROSCLEROSIS | - |
dc.subject.keywordPlus | DISEASE | - |
dc.subject.keywordPlus | METALS | - |
dc.subject.keywordPlus | BLOOD | - |
dc.relation.journalResearchArea | Environmental Sciences & Ecology | - |
dc.relation.journalResearchArea | Public, Environmental & Occupational Health | - |
dc.relation.journalResearchArea | Toxicology | - |
dc.relation.journalWebOfScienceCategory | Environmental Sciences | - |
dc.relation.journalWebOfScienceCategory | Public, Environmental & Occupational Health | - |
dc.relation.journalWebOfScienceCategory | Toxicology | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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