Continuous NHANES survey data for environmental ambient and occupational hazard identification—feasibility and preliminary findings for osteoporosis and kidney disease

Abstract

The Continuous NHANES Survey provides detailed health and environmental chemical burden information on the U.S. population. As of 2012, there were data for 72,000 participants. Based on single biomarker determinations, cumulative burdens were estimated. Because age distributions would differ comparing ambient environmental and occupational exposures, a procedure to distinguish ambient from likely occupational exposures was applied. Associations are reported for osteoporosis and kidney disease-related outcomes with cadmium, lead, and other metals. Cumulative cadmium burden (from blood cadmium, ambient and occupational) was a strong predictor of bone fracture risk and ambient tungsten also had a positive association. Cumulative lead (ambient and occupational) had a negative (“protective”) association with fractures as did mercury (occupational). Bone mineral density was statistically significant and similarly predicted by metal exposures. Kidney disease was significantly associated with cumulative lead burdens from both the estimated ambient and occupational sources and with ambient blood cadmium but was most strongly associated with cumulative occupational uranium burden. Systolic blood pressure statistically significantly increased with cumulative ambient and occupational lead (blood) burden and with ambient cadmium and cobalt. Diastolic blood pressure was significantly associated with several cadmium and cobalt metrics along with ambient and occupational cumulative burdens for lead. For environmental substances with burden half-lives measured in years, NHANES offers opportunities for hypothesis generation and confirmation.

Keywords:

• Chemical body burden
• lead
• osteoporosis
• renal insufficiency
• surveillance
• uranium

Acknowledgments

Much of this work was performed at the National Institute for Occupational Safety and Health (NIOSH) prior to the retirement of the first author and during a student practicum of the second author. This work has not been reviewed and cleared for submission as a NIOSH publication and the findings and conclusions in this report are those of the author and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. There was no other funding for this work.

Conflict of interest

The authors report no conflicts of interest in this work.

Data availability

All data were obtained as public-use files from National Center for Health Statistics, https://wwwn.cdc.gov/nchs/nhanes/. The data that support the findings of this study are available from the corresponding author, RMP, upon reasonable request.