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Association Between Urinary Cadmium and QRS|T Angle Among Adults in the United States

Thapa, Susan MPH; Delhey, Leanna MPH; Jin, Jing MPH; Abouelenein, Saly MD, MSc; Morad, Wesam MD; Delongchamp, Robert PhD; Faramawi, Mohammed F. MD, PhD, MSc, MPH

Journal of Occupational and Environmental Medicine: August 2018 - Volume 60 - Issue 8 - p e412–e415
doi: 10.1097/JOM.0000000000001382
ORIGINAL ARTICLES
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Objective: Cadmium's effect on QRS|T angle has not been studied. An abnormal QRS|T angle deviation may increase the risk for ventricular dysrhythmias.

Methods: We calculated the orientation of spatial QRS|T angle using QRS and T amplitudes of leads V2, V5, V6, and AVF from the National Health and Nutritional Examination Survey III. Cadmium concentration was measured in urine. We fit weighted unadjusted and adjusted logistic regressions to calculate odds ratios and their corresponding 95% confidence intervals.

Results: A unit increase in the logarithm of urinary cadmium increased the odds of QRS|T angle deviation by 30% [1.30 (1.01 to 1.61)].

Conclusions: Cadmium exposure was associated with an abnormal QRS|T angle in women but not in men. Women exposed to cadmium should be periodically evaluated to detect QRS|T angle deviation, which can predispose them to ventricular dysrhythmias.

Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Ms Thapa, Ms Delhey, Ms Jin, Dr Delongchamp, Dr Faramawi); Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr Abouelenein, Dr Delongchamp, Dr Faramawi); and Department of Preventive Medicine and Epidemiology, National Liver Institute, Menofiya University, Shebin Elkom, Egypt (Dr Morad).

Address correspondence to: Mohammed F. Faramawi, MD, PhD, MSc, MPH, Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 77205 (melfaramawi@uams.edu).

The authors report no conflicts of interest.

Copyright © 2018 by the American College of Occupational and Environmental Medicine