Occupational exposure to metals and pesticides may drive and increase the risk for cardiovascular disease (CVD) in US Hispanics/Latinos, according to a cross-sectional study published in Heart.
Patient data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were obtained, including data from 7404 employed US Hispanics/Latinos between the ages of 18 and 74 years. The cohort was comprised of individuals from the Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California. Participants completed an occupational questionnaire to assess work exposures, including exposures to metals and pesticides, as well as estimated duration of such exposures. The patients also underwent clinical examinations. Using these data, researchers assessed whether chemical and/or metal occupational exposure correlated with a risk for CVD and CVD subtypes
Among the Hispanic/Latino workers included in the cohort, the rates of current occupational exposure for solvents, metals, and pesticides were 6.5%, 8.5%, and 4.7%, respectively. Approximately 6.1% of all participants had a form of CVD. Coronary heart disease was found to be the most common CVD type (4.3%), exceeding cerebrovascular disease (1.0%), heart failure (0.8%), and atrial fibrillation (0.7%). Among individuals who reported regular exposure to pesticides, the prevalence of any CVD was more than 2 times the rate than that found among individuals who did not work with pesticides.
Adjusted disease-specific prevalence ratios among pesticide-exposed workers were 2.18 (95% CI, 1.34-3.55) for CVD, 2.20 for coronary heart disease (95% CI, 1.31-3.71), 1.38 for cerebrovascular disease (95% CI, 0.62-3.03), 0.91 for heart failure (95% CI, 0.23-3.54), and 5.92 for atrial fibrillation (95% CI, 1.89-18.61). Additionally, a nearly fourfold greater prevalence of atrial fibrillation was found among individuals who reported regular exposure to metals (prevalence ratio, 3.78; 95% CI, 1.24-11.46).
Limitations of the analysis include the use of self-reported questionnaire data as well as the restriction of data to only Hispanic/Latino individuals, which could limit the findings’ generalizability.
According to the study’s researchers, clinicians should routinely “consider the value of taking an occupational history during medical examinations, as doing so could assist in identifying workplace hazards that need to be controlled.”
Bulka CM, Daviglus ML, Persky VW, et al. Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos [published online December 11, 2018]. Heart. doi: 10.1136/heartjnl-2018-313463