{"title":"Environmental PM<sub>2.5</sub> Exposure: An Ignored Factor Associated with Blood Cadmium Level in Hemodialysis Patients.","authors":"Ching-Wei Hsu, Ming-Jen Chan, Cheng-Hao Weng, Tsung-Yu Tsai, Tzung-Hai Yen, Wen-Hung Huang","doi":"10.2147/TCRM.S496491","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The negative impacts of particulate matter with an aerodynamic diameter of 2.5 μm or less (PM<sub>2.5</sub>) are well known. Patients undergoing maintenance hemodialysis (HD) have significantly higher blood cadmium levels (BCLs) than healthy individuals. As elemental cadmium can be found in the PM<sub>2.5</sub> particle fraction, we conducted this study to assess the effect of environmental PM<sub>2.5</sub> exposure and other clinical variables on BCLs in maintenance HD patients.</p><p><strong>Patient and methods: </strong> This cross-sectional study included 754 hD patients who had previously participated in a BCL study. Demographic, hematological, biochemical and dialysis-related data were collected for analysis. For each patient, the mean PM<sub>2.5</sub> concentrations in the living environment during the previous 12 and 24 months were recorded and analyzed.</p><p><strong>Results: </strong>Of all patients, the median BCL of was 0.36 µg/L (range: 0.21, 0.79 µg/L). The mean PM<sub>2.5</sub> concentration was 28.45 ± 3.57 μg/m<sup>3</sup> during the 12 months and 29.81 ± 3.47 μg/m<sup>3</sup> during the 24 months, respectively. From a multivariate linear regression analysis, log BCL was positively associated with the mean PM<sub>2.5</sub> concentration during the previous 12 and 24 months. In addition, log BCL was positively associated with the number of days with PM<sub>2.5</sub> concentrations above the standard level during the previous 12 and 24 months. Moreover, according to the tertiles of days with a daily mean PM<sub>2.5</sub> concentration above the normal limit in the previous 24 months, patients with the highest exposure days exhibited a significantly higher BCL than those in the other two patient groups.</p><p><strong>Conclusion: </strong>Chronic environmental exposure to PM<sub>2.5</sub> is significantly associated with BCLs in maintenance HD patients, and exposure to PM<sub>2.5</sub>-bound cadmium may contribute to the harmful effects on health in this population. Further studies are needed to confirm these observations and to explore the underlying mechanisms.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1-13"},"PeriodicalIF":2.8000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706018/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutics and Clinical Risk Management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/TCRM.S496491","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The negative impacts of particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) are well known. Patients undergoing maintenance hemodialysis (HD) have significantly higher blood cadmium levels (BCLs) than healthy individuals. As elemental cadmium can be found in the PM2.5 particle fraction, we conducted this study to assess the effect of environmental PM2.5 exposure and other clinical variables on BCLs in maintenance HD patients.
Patient and methods: This cross-sectional study included 754 hD patients who had previously participated in a BCL study. Demographic, hematological, biochemical and dialysis-related data were collected for analysis. For each patient, the mean PM2.5 concentrations in the living environment during the previous 12 and 24 months were recorded and analyzed.
Results: Of all patients, the median BCL of was 0.36 µg/L (range: 0.21, 0.79 µg/L). The mean PM2.5 concentration was 28.45 ± 3.57 μg/m3 during the 12 months and 29.81 ± 3.47 μg/m3 during the 24 months, respectively. From a multivariate linear regression analysis, log BCL was positively associated with the mean PM2.5 concentration during the previous 12 and 24 months. In addition, log BCL was positively associated with the number of days with PM2.5 concentrations above the standard level during the previous 12 and 24 months. Moreover, according to the tertiles of days with a daily mean PM2.5 concentration above the normal limit in the previous 24 months, patients with the highest exposure days exhibited a significantly higher BCL than those in the other two patient groups.
Conclusion: Chronic environmental exposure to PM2.5 is significantly associated with BCLs in maintenance HD patients, and exposure to PM2.5-bound cadmium may contribute to the harmful effects on health in this population. Further studies are needed to confirm these observations and to explore the underlying mechanisms.
期刊介绍：
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.
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