June 13, 2023
Long-term exposure to metals like lead, cadmium and arsenic, even at low levels, can increase an individual's risk of developing cardiovascular disease, according to a report published Monday by the American Heart Association.
The report reviews evidence linking low or moderate levels of the metals to cardiovascular diseases like stroke, coronary artery disease and peripheral artery disease. Environmental toxins have not been included among the traditional risk factors for heart disease, though a growing collection of evidence identifies exposure to these common pollutants as preventable risks, according to the American Heart Association.
Exposure to lead, cadmium and arsenic can happen involuntarily, as the metals are often found in air, water, soil and common household items. Lead can be found in old paint, water pipes and groundwater, as well as some electronics and cosmetics. Cadmium can be found in batteries, plastic, ceramics, glassware, construction products and fertilizers. Both are linked to tobacco products and cigarette smoke.
People are most commonly exposed to arsenic through groundwater, which impacts drinking water, soil and food grown in contaminated soil. The risk of exposure to contaminant metals, also called heavy metals, is more common among people who live near highways, industrial sites and hazardous waste. People living in older homes and attending older schools, as is the case in Philadelphia, are also more likely to be exposed.
"These metals interfere with essential biological functions and affect most populations on a global scale," said Dr. Ana Navas-Acien, a professor of environmental health sciences at Columbia University's Mailman School of Public Health. "After exposure, lead and cadmium accumulate in the body and remain in bones and organs for decades. In the U.S. alone, one large study suggested that more than 450,000 deaths annually could be attributed to lead exposure."
The report utilized global research indicating that lead, cadmium and arsenic exposure has been previously linked to premature death, largely due to cardiovascular disease. Among these sources is a separate American Heart Association report recognizing exposure to these metals as a non-conventional risk factor for peripheral artery disease.
A 2018 review published in the British Medical Journal assessed 37 studies of more than 350,000 people, reporting that higher levels of arsenic in urine and lead and cadmium in blood were linked to a 15-85% higher risk for stroke and heart disease. One study in Spain linked cadmium in urine to cardiovascular disease.
The report recommends increasing testing measures for individuals and implementing programs into public health agencies to monitor metal levels in the environment. Reducing metal exposure in tobacco products, encouraging less smoking altogether and enhanced protections for water systems were also included among the recommendations.
While there is no therapy or treatment to counteract the impacts of metal exposure on the vascular system, Dr. Gervasio A. Lamas, chairman of medicine and chief of the Columbia University Division of Cardiology at Mount Sinai Medical Center, said more research into potential medical treatments may help improve cardiovascular health.
There are plenty of ways to prevent or limit exposure to heavy metals. Mayo Clinic recommends washing hands and children's toys regularly, cleaning dust-prone surfaces, removing shoes when coming indoors, running cold water to flush lead pipes and consuming vitamin C, iron and calcium.
People should also eat a balanced diet with nutritious foods, wash rice before cooking and research ingredients in cosmetics to prevent or limit exposure to arsenic, according to Tap Score, a water-testing company and advocacy group. The Food and Drug Administration regularly publishes recommendations for limiting arsenic consumption through food.
Better Health Channel, an Australian health-advice site, recommends people quit smoking or limit exposure to tobacco products, eat a diet with only moderate shellfish and use protective equipment when handling cadmium in order to prevent long-term exposure.