Historical exposure to metals in contaminated areas and its impact on cardio- and cerebrovascular health

Environmental pollution is of global concern. In Southeast Sweden, historical glass production has contaminated communities with toxic metals. Long-term residency in these communities and high consumption of local foods may constitute a risk for cardiovascular disease (CVD) or stroke. The current study investigates if residency in these contaminated sites and long-term consumption of local foods is associated with self-reported CVD and stroke. In addition, the body burden of the toxic metals arsenic, cadmium, and lead, as well as inflammatory protein markers, were studied for association with CVD and stroke. From an existing questionnaire cohort and biomonitoring sub cohort (n = 2290/882) of people living in the contaminated areas, self-reported CVD cases (n = 366/166) and stroke cases (n = 78/25) were identified. Individuals were grouped based on their residency within a 2 km radius of glassworks with historical high, moderate, or low air-borne lead emissions. Body burden of arsenic, cadmium, and lead was analyzed using ICP-MS. Inflammatory markers were investigated using electrochemiluminescence. Long-term residency near glassworks with historically high levels of lead emissions, and high consumption of local foods, were associated with CVD. The risk was increasing for each year of residency in high emission areas. Increased body burden of arsenic in blood, and lead in urine, were associated with stroke. Five and two inflammatory markers, respectively, were elevated in CVD and stroke cases after adjusting for confounders. An increased risk for CVD was found in areas with historically high emissions of lead but possibly also other toxic metals. Interestingly, there was an indication of a dose-response relationship with increasing risk for CVD per year of residency time. Inhalation and consumption of local food may constitute major pathways for this association. The study shows that long-term exposure to toxic metals in these contaminated areas is associated with CVD and that there is a need to limit exposure in the general population.