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The Relationship Between Occupational Metal Exposure and Arterial Compliance

Wong, Jason Y.Y. ScD; Fang, Shona C. ScD; Grashow, Rachel PhD; Fan, Tianteng ScD; Christiani, David C. MD, MPH

Journal of Occupational and Environmental Medicine: April 2015 - Volume 57 - Issue 4 - p 355–360
doi: 10.1097/JOM.0000000000000427
Original Articles

Background: The objective of this study was to evaluate the relationship between cumulative occupational exposure to various metals and arterial compliance in welders.

Methods: The observational follow-up study consisted of 25 subjects. Levels of nickel (Ni), lead, cadmium, manganese, and arsenic from toenails were assessed using mass spectrometry. Arterial compliance as reflected by augmentation index (AIx) was measured using SphygmoCor Px Pulse Wave Analysis System. Linear regression models were used to assess the associations.

Results: For every 1 unit increase in log-transformed toenail Ni, there was a statistically significant 5.68 (95% confidence interval, 1.38 to 9.98; P = 0.01) unit increase in AIx. No significant associations were found between AIx and lead, cadmium, manganese, and arsenic.

Conclusions: Cumulative Ni exposure is associated with increased arterial stiffness in welders and may increase risk of adverse cardiovascular outcomes.

From the Division of Endocrinology, Gerontology, and Metabolism, Stanford University School of Medicine (Dr Wong); Veterans' Affairs Palo Alto Health Care System (Dr Wong), Calif; New England Research Institute (Dr Fang), Watertown; Department of Environmental Health (Drs Fang, Grashow, Fan, and Christiani), Harvard School of Public Health; Department of Medicine (Dr Christiani), Harvard Medical School—Massachusetts General Hospital, Boston; Adheris Health (Dr Fan), Burlington, Mass.

Address correspondence to: Jason Y.Y. Wong, ScD, Division of Endocrinology, Gerontology, and Metabolism, Stanford University School of Medicine, 1300 Pasteur Dr Stanford, CA 94304 (

This project was made possible by funding from the National Institute of Environmental Health Sciences (NIEHS) grants R01ES009860 and P50ES00002, in addition to a grant from the American Heart Association (AHA).

Authors Wong, Fang, Grashow, Fan, and Christiani have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2015 by the American College of Occupational and Environmental Medicine