Ambient low-level benzene, genetic factors, and heart failure incidence among urban adults

Ambient benzene, a representative volatile organic compound (VOC) primarily resulting from rapid industrialization and urbanization, is also of great concern as an urban air toxic. The global benzene market is experiencing steady growth, driven by its use in industrial manufacturing. Currently, population epidemiological evidence about the effects of ambient benzene on heart failure (HF) incidence is still inadequate, especially at low levels of long-term exposure. Leveraging data from 277,585 urban residents in the UK Biobank, the study utilized Cox regression models adjusted for potential confounders to evaluate the association between low-concentration benzene exposure and HF risk. The investigation also assessed potential interactions between genetic predisposition and ambient benzene by applying relative excess risk due to interaction (RERI) metrics and interaction significance testing. Furthermore, the effect of ambient benzene on cardiac functional parameters was estimated using multiple linear regression models. This study demonstrated that per interquartile range increment of ambient benzene was related to the elevated HF risk (hazard ratios = 1.22, 95 % confidence interval (CI): 1.07-1.39] from the time-dependent Cox model. An additive interaction between ambient benzene and genetic risk was observed (RERI = 0.18, 95 % CI: 0.01-0.36). Ambient benzene exposure demonstrated significant correlations with modifications in cardiac functional parameters, such as ventricular end-diastolic and end-systolic volumes. Prolonged exposure to low-concentration ambient benzene may elevate the likelihood of developing HF, which provides the necessary evidence for the systematic risk assessment of ambient benzene and promotes the formulation and updating of air quality guidelines worldwide.