The Impact of Blood Lead and Its Interaction with Occupational Factors and Air Pollution on Hypertension Prevalence

Large-scale epidemiological studies on the association of blood lead levels with blood pressure and hypertension prevalence are still limited, particularly among lead-exposed workers. The evidence is even more scarce on the interaction of blood lead levels with occupational variables and ambient air pollution levels. We developed mixed-effect models based on a large group of lead-exposed workers (N = 22,002). The results were also stratified by multiple groupings. Compared to participants with blood lead < 20 μg/L, those with levels > 20 μg/L had a 26-37% higher prevalence of hypertension, as well as a 0.65-13.7 mmHg higher systolic and diastolic blood pressure. Workers exposed to high PM10 levels had a 21-28% higher risk. Workers exposed to high temperatures had a 0.41-2.46 mmHg greater increase in blood pressure, and those not exposed to dust had a 1.29-1.65 mmHg greater blood pressure increase. Our findings suggested the negative impact of blood lead on blood pressure and the prevalence of hypertension, with workers exposed to high PM10 concentrations, those exposed to occupational high temperature, and those without dust exposure being more vulnerable.