Baseline associations between exposure to metals and systolic and diastolic blood pressure among women in the household air pollution intervention network trial
Year: 2026
Type: article
Abstract: Lead (Pb) and cadmium (Cd) are metals that occur naturally in the environment and are present in biomass fuels, such as wood. When these fuels are burned, they can release Pb and Cd into the air, leading to exposure through inhalation. Studies of exposure to metals and health outcomes suggest harmful impacts, including cardiovascular diseases. We assessed baseline associations between Pb and Cd concentrations in dried blood spots with systolic and diastolic blood pressure (SBP, DBP) among women in the household air pollution intervention network (HAPIN) trial. We analyzed data from three of the four HAPIN randomized controlled trial sites (Guatemala, Peru, and Rwanda), focusing on women aged 40–79 years living in households reliant on biomass cooking. Dried blood spots were analyzed for Pb and Cd exposure; SBP and DBP were measured following international guidelines. Demographic, socioeconomic, and dietary variables were collected via standardized questionnaires administered by local field staff. Statistical analyses included multivariable linear regression to examine associations between Pb and Cd, separately, and SBP and DBP, adjusting for covariates. Additional analyses assessed effect modification by age and research site. Among 272 women, median SBP and DBP values were higher in Rwanda (116.3 mmHg, 73.0 mmHg) and Guatemala (113.3 mmHg, 68.3 mmHg) compared to Peru (106.0 mmHg, 63.3 mmHg). Pb exposure showed positive associations with both SBP and DBP. For each log-unit increase in Pb concentration, we observed increases of 2.36 mmHg SBP (95% CI 0.51, 4.20) and 1.42 mmHg DBP (95% CI 0.16, 2.67). Cd was not associated with SBP or DBP in this analysis. Pb exposure from biomass smoke inhalation may be an important risk factor for increased SBP and DBP, markers of cardiovascular disease risk.
Source: Environmental Research Health
Authors: Patrick Karakwende, Dana Boyd Barr, William Checkley, Thomas Clasen, Amy E Lovvorn, Carmen Lucía Contreras, Anaite Diaz-Artiga, Ephrem Dusabimana, Lisa de Las Fuentes, Shirin Jabbarzadeh, Michael Johnson, Egide Kalisa, Miles A Kirby, John P McCracken, Florien Ndagijimana, Adolphe Ndikubwimana, Theoneste Ntakirutimana, Jean de Dieu Ntivuguruzwa, Jennifer L Peel, Ajay Pillarisetti, Victor G Davila-Roman, Ghislaine Rosa, Lance A Waller, Jiantong Wang, Lisa M Thompson, Maggie L Clark, Bonnie N Young
Institutions: University of Rwanda, Emory University, Johns Hopkins University, Universidad del Valle de Guatemala, Berkeley Air Monitoring Group (United States), Harvard University, University of Georgia, Colorado State University, Washington University in St. Louis, Liverpool School of Tropical Medicine
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $2,515
OpenAlex ID: W7148273083