The Relationship between Blood Lead Level and Chronic Pain in US Adults: A Nationwide Cross-Sectional Study

Regional concentrations of heavy metals in surface soils and risk of body pain in elderly residential population: a national cohort study in China

BACKGROUND

The accumulation of heavy metals in surface soil raises significant environmental and public health concerns around the world. This study aimed to examine the relationship between exposure to heavy metals in surface soil and the risk of pain among residents.

METHODS

Using national data on eight heavy metals (arsenic, cadmium, chromium, copper, lead, mercury, nickel and zinc) in China's surface soil and a population cohort from 2011 to 2018, we analyzed pain occurrences in various body locations. Logistic regression models were used to assess the association between exposure to heavy metal in soil and pain, as adjusting for gender, age, education level, body mass index, living region, and lifestyle. The study included 13,178 individuals.

RESULTS

Higher exposure to soil arsenic was found to be associated with increased risk of shoulders [adjusted odds ratio (99.99% CI), 1.49 (1.01, 2.19)], wrists [1.68 (1.06, 2.64)] and ankles pain [1.58 (1.01, 2.50)]. No association was found between the remaining seven heavy metals and different types of body pain.

CONCLUSION

Our results indicate that higher soil arsenic exposure is associated with an increased risk of pain in specific body regions. This study is the first examining the associations between multiple heavy metals in surface soil and the risks of pain in different body sites. Our findings provide new insights into the health risks of soil heavy metal exposure.

[Association between weight-adjusted waist index and pain: A cross-sectional study]

OBJECTIVE

To investigate the relationship between the weight-adjusted waist index (WWI) and acute, subacute pain or chronic pain among American adults.

METHODS

There was a cross-sectional study. Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) concerning waist circumference, weight, pain status and covariates (age, gender, race, marital status, education level and income, physical activity, alcohol consumption, smoking status, and diabetes) were extracted for analysis. Multinomial Logistic regression was conducted across the three models to investigate the associations between WWI and acute, subacute and chronic pain. Model 1 did not involve any adjustments. Model 2 involved adjustments for age, gender, race, marital status, education level, and income. Model 3 was further adjusted for physical activity, alcohol consumption, smoking, and diabetes status.

RESULTS

This study involved 12 694 participants with an average age of (50.6±18.7) years. Among all the participants, 9 614 people (75.74%) had no pain, 870 people (6.85%) experienced acute pain, 354 people (2.79%) suffered from subacute pain, and 1 856 people (14.62%) experienced chronic pain. The WWI of all the participants was (10.95±0.85) cm/$\sqrt{\mathrm{kg}}$, divided into four groups based on quartiles: Group Q1 (7.90-10.36) cm/$\sqrt{\mathrm{kg}}$, group Q2 (10.37-10.94) cm/$\sqrt{\mathrm{kg}}$, group Q3 (10.95-11.53) cm/$\sqrt{\mathrm{kg}}$ and group Q4 (11.54-15.20) cm/$\sqrt{\mathrm{kg}}$. With the increase of WWI, the analysis revealed a significant statistical difference in the participants' acute and chronic pain status (all P < 0.001). In Model 1, the prevalence of acute pain was lower in group Q2 and group Q4 compared with group Q1 (group Q2: OR=0.765, 95%CI: 0.615-0.953, P=0.017; group Q4: OR= 0.648, 95%CI: 0.503-0.835, P < 0.001). Compared with group Q1, the prevalence of chronic pain increased in group Q2, group Q3, and group Q4 (group Q2: OR =1.365, 95%CI: 1.149-1.622, P < 0.001; group Q3: OR=1.291, 95%CI: 1.082-1.541, P=0.005; group Q4: OR=1.874, 95%CI: 1.579-2.224, P < 0.001). In Model 2, compared with group Q1, an increase in chronic pain prevalence was still associated with an increase in WWI in other three groups (group Q2: OR=1.359, 95%CI: 1.137-1.624, P=0.001; group Q3: OR=1.260, 95%CI: 1.039-1.528, P=0.019; group Q4: OR=1.735, 95%CI: 1.413-2.132, P < 0.001). In Model 3, group Q4 had a 49.2% increased prevalence of chronic pain compared to group Q1 (OR = 1.492, 95%CI: 1.208-1.842, P < 0.001). However, in Models 2 and 3, no significant relationship was observed between acute pain and WWI (all P>0.05). And none of the three models identified a significant association between subacute pain and WWI (all P>0.05).

CONCLUSION

For American adults, there was no significant correlation between WWI and acute pain or subacute pain. However, as WWI increases, so does the prevalence of chronic pain. Further validation of this conclusion through large-scale prospective studies is warranted.

Temporal Changes in Lead and Cadmium Levels in Amanita muscaria Samples Collected in Poland

In recent years, an increasing popularity of consuming Amanita muscaria has been observed in Poland, aimed at reducing various medical symptoms. However, there is a lack of data regarding the impact of variations in the content of toxic elements, such as cadmium (Cd) and lead (Pb), in Amanita muscaria collected during late summer and mid-fall. The aim of this study was to determine the concentrations of Pb and Cd in Amanita muscaria samples collected at different times of the year, compare the concentrations of these elements in samples with and without cap skin, and compare the obtained values to permissible limits in dietary supplements. A total of 44 Amanita muscaria samples were collected during three different harvesting periods (August, September, and October 2023) from Puszcza Biała, located approximately 80 km from Warsaw. The mushrooms were subjected to mineralization using concentrated nitric acid and hydrogen peroxide, followed by the determination of Pb and Cd concentrations using an atomic absorption spectrometer. Significant statistical differences were found in the Pb concentrations of samples collected in three different seasons (η2 = 0.67, p < 0.001), with the concentration increasing progressively, reaching its highest value in October. Similarly, the Cd concentration also increased in the later collections, although the effect of time was weaker (η2 = 0.13, p = 0.03). No significant differences were observed in Pb and Cd concentrations between samples with and without cap skin. The average Cd concentrations in mushrooms were significantly higher than the permissible levels in dietary supplements; they were four times higher in August (p < 0.001), six times higher in September (p < 0.001), and nine times higher in October (p < 0.001). The Pb concentration in the October samples was close to the permissible limit but did not exceed it in a statistically significant manner (p = 0.85). Due to the high Cd concentrations and potentially hazardous levels of Pb, the consumption of Amanita muscaria carries a significant risk of toxicity, which may lead to serious health hazards, particularly in the context of prolonged exposure.

Chronic pain is specifically associated with updating working memory: a longitudinal twin study

ABSTRACT

Worse executive function (EF) is associated with chronic pain and could mechanistically contribute to pain chronification. It is unclear whether there is overall impairment in EFs or whether there are impairments in specific cognitive domains. Furthermore, the possible genetic risk underlying these associations has not been tested. Participants were from the Colorado Longitudinal Twin study; 786 same-sex twins completed a battery of EF tasks at ages 23 and/or 28 and 634 of these twins self-reported chronic pain at mean age = 28.1; prevalence = 27.76% using the Brief Pain History Questionnaire. The EF tasks were used to define a Common EF factor and 2 factors specific to updating working memory and shifting mental set. We estimated the phenotypic and genetic associations of stable EF variance across ages 23 and 28, as well as EF variance unique to age 28, with pain. With respect to stable EF variance, pain phenotypically correlated with the Updating-specific factor ( r = -0.21, P = 0.008) but did not significantly correlate with the Common EF factor ( r = -0.06, P = 0.350) nor with the Shifting-specific factor ( r = -0.03, P = 0.709). There were no significant phenotypic correlations between pain and EF variance unique to age 28. A twin model indicated that pain and Updating-specific variance share genetic risk ( r A = -0.46, P = 0.005) but not environmental risk ( r E = 0.05, P = 0.844). Updating working memory shares a phenotypic and genetic relationship with pain in young adults. Impairments in gating or monitoring pain signals may play a mechanistic role in pain development.

The Association Between Blood Lead Levels and Urgency Urinary Incontinence Among Adult Females: A Retrospective Study Based on NHANES 2005-2020

The purpose of this study is to investigate whether blood lead levels influence the risk of urgency urinary incontinence (UUI) in adult females. This study utilized data from the National Health and Nutrition Examination Survey from 2005 to 2020, involving 9509 adult women aged 20 and older. The effect of blood lead levels on UUI was assessed using weighted multivariate logistic regression models. Additionally, the relationship between the two was illustrated using restricted cubic splines. Stratified analyses based on covariate categories were used to explore if factors influenced the relationship between blood lead levels and UUI. Adjusted multivariate logistic regression analysis indicated that for each unit increase in blood lead levels, the risk of UUI increased by 10% (OR = 1.10; 95% CI, 1.02-1.17; P = 0.01). After categorizing blood lead levels into weighted tertiles, compared to the first tertile, the third tertile increased the risk of UUI by 1.34 times in Model 1 (OR = 1.34; 95% CI, 1.13-1.59; P < 0.001). A restricted cubic spline analysis demonstrated a nonlinear relationship between blood lead levels and UUI (P for nonlinearity = 0.016). Stratified analysis revealed that baseline characteristics such as age, BMI, and PIR did not have an impact on the association between blood lead levels and UUI. This study demonstrated a close association between the risk of blood lead levels and UUI in adult women aged 20 and above. High blood lead levels were found to increase the risk of UUI.

The relationships between blood lead levels and nocturia prevalence in adults: A retrospective study

PURPOSE

The purpose of this study was to examine the association between blood lead levels and the prevalence of nocturia in American adults.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020, focusing on individuals aged 20 years or older (n = 11,919). Blood lead levels were categorized into two groups (<2 µg/dL and ≥2 µg/dL), and the presence of nocturia was assessed based on questionnaire responses. We used multivariable logistic regression models to explore the association between blood lead levels and nocturia while adjusting for various covariates, including sex, ratio of family income to poverty (RIP), lipid profile, age, body mass index (BMI), race, citizenship, sleep trouble, diabetes, and hypertension. To verify whether certain covariates influence blood lead levels and the risk of nocturia, we conducted subgroup analyses.

RESULTS

Of the study participants, 31.70% reported experiencing nocturia. Individuals with higher blood lead levels (≥2 µg/dL) exhibited a higher likelihood of experiencing nocturia compared to those with lower levels (<2 µg/dL) in all three models (Model 1: OR 1.46, 95% CI 1.29-1.66, p < 0.0001; Model 2: OR 1.25, 95% CI 1.09-1.44, p = 0.002; Model 3: OR 1.22, 95%CI 1.06-1.41, p = 0.01). Subgroup analyses revealed that factors such as age, sex, sleep trouble, diabetes, hypertension, BMI, RIP, and race did not affect the association between blood lead levels and the risk of nocturia (P for interaction >0.05).

CONCLUSIONS

This study reported the correlation between blood lead levels and nocturia. We found that compared to blood lead levels below 2 µg/dL, when lead levels reached or exceeded 2 µg/dL, the risk of nocturia occurrence increased by 22%.

CLINICAL TRIAL REGISTRATION

This study is based on existing data from a public database and not from a specific clinical trial; hence, clinical registration information is not provided.

Investigating Blood Lead Levels and Its Health Effects on Employees of a Petroleum Industry and the Surrounding Residents: A Case Study of Kirkuk City, Iraq

OBJECTIVE

This study has been aimed to investigate factors associated with elevated blood lead levels (BLLs) across different percentiles in individuals employed in the petroleum industry and residents of Kirkuk City . In addition, to provide evidence-based approaches to mitigate exposure risks and safeguard vulnerable populations.

METHODS

The study involved 357 participants and utilized quantile regression to examine BLL in petroleum industry workers and Kirkuk residents.

RESULTS

Median BLLs were higher among workers (17.5 μg/dL) compared to residents in the city (9.9 μg/dL) and suburbs (7.4 μg/dL). Factors such as smoking, outdoor work, and lower education were associated with elevated BLLs, as confirmed by quantile regression.

CONCLUSIONS

This study found higher BLLs in petroleum workers compared to Kirkuk residents, associated with smoking, outdoor work, and lower education. The results emphasize the need for targeted interventions and policies to mitigate lead exposure risks in this industrial region.

Chronic Pain and Obesity in Community-Dwelling Adults: Findings from the National Health and Nutrition Examination Survey

Background

Chronic pain and obesity, together with their corresponding characteristics, are concerning health issues with high socioeconomic burden. The objective of this study is to ascertain the prevalence of chronic pain among individuals residing in the community and examine its association with obesity.

Methods

The present study employed a cross-sectional design and analyzed data from three cycles of the National Health and Nutrition Examination Survey (NHANES). Univariate and multivariate logistic regression analysis were performed to examine the relationship between chronic pain and obesity. To evaluate the potential nonlinear association of chronic with body mass index (BMI), the restricted cubic spline (RCS) analysis was performed in multivariable-adjusted models. The researchers conducted subgroup analyses in order to investigate the potential influence of different confounding factors on the relationship between chronic pain and obesity.

Results

Our final analysis included a sample size of 13,700 participants with higher prevalence of chronic pain with higher BMI, older age, female sex, lower educational level, smoking, and other pathologies. The prevalence of chronic pain in different BMI groups was 17.0% (underweight), 11.8% (normal weight), 12.9% (overweight), and 17.9% (obesity), respectively. In the fully adjusted model, obesity was associated with a 45% increase in the risk of chronic pain compared with the normal weight. The RCS analyses revealed a nonlinear and J-shaped positive association between BMI and chronic pain (OR 1.45, 95% CI 1.27-1.66, all P for nonlinearity < 0.05). The results of the subgroup analyses indicate that the presence of osteoporosis significantly influenced the relationship between obesity and chronic pain, as evidenced by a statistically significant interaction effect (OR 2.25, 95% CI 1.38-3.68, P for interaction = 0.019).

Conclusion

The presence of obesity was found to be significantly correlated with an increased likelihood of experiencing chronic pain among adults living in the United States.

Association between waist circumference and chronic pain: insights from observational study and two-sample Mendelian randomization

Background

Current research offers limited clarity on the correlation between waist circumference and chronic pain prevalence.

Objective

This investigation seeks to elucidate the potential relationship between waist circumference and chronic pain and their causal association.

Methods

An observational study was conducted, leveraging data from the National Health and Nutrition Examination Survey (NHANES) collected between 2001 and 2004. The multivariable logistic regression was used to assess the relationship between waist circumference and chronic pain. Furthermore, a meta-analysis of Mendelian Randomization (MR) was applied to explore a causal relationship between waist circumference and pain.

Results

The observational study, post multivariable adjustment, indicated that an increase in waist circumference by 1 dm (decimeter) correlates with a 14% elevation in chronic pain risk (Odds Ratio [OR] = 1.14, 95% Confidence Interval [CI]: 1.04-1.24, p = 0.01). Moreover, the meta-analysis of MR demonstrated that an increased waist circumference was associated with a genetic predisposition to pain risk (OR = 1.14, 95%CI: 1.06-1.23, p = 0.0007).

Conclusion

Observational analysis confirmed a significant relationship between increased waist circumference and the incidence of chronic pain, and results based on MR Study identified increased waist circumference as potentially causal for pain.

Association between HDL-C and chronic pain: data from the NHANES database 2003-2004

Objective

High-density lipoprotein cholesterol (HDL-C) has been reported to be associated with pain symptoms of various diseases, and its anti-inflammatory and antioxidant mediation is related to the pathogenesis of chronic pain. This study aims to evaluate the relationship between HDL-C levels and chronic pain in American adults.

Methods

This cross-sectional study used data from American adults aged 20 and above during the 2003-2004 National Health and Nutrition Examination Survey (NHANES) cycle. Participants were divided into 4 groups based on HDL-C quartiles. We used chi-square tests and Student's t-tests or Mann-Whitney U tests to analyze categorical variables and continuous variables to compare differences between groups. Multivariate logistic regression analysis was used to study the association between HDL-C levels and the risk of chronic pain. Likelihood ratio tests were used to assess interactions between subgroups, and sensitivity analyses were conducted.

Results

Our final analysis included 4,688 participants, of which 733 (16.4%) had chronic pain. In the multivariate logistic regression model adjusted for covariates, there was a negative correlation between HDL-C levels and chronic pain. Specifically, for every 20 unit increase in HDL-C, the risk of chronic pain decreased by 26%. Compared with the lowest HDL-C quartile (< 43 mg/dL), the highest HDL-C quartile (≥ 64 mg/dL) was associated with a 24% reduction in the risk of chronic pain. No interaction factors affecting the relationship between HDL-C and chronic pain were found in the subgroup analysis.

Conclusion

This study demonstrates a negative association between HDL-C levels and chronic pain in US adults, providing insights into the pathogenesis of chronic pain and potential improvements in chronic pain management strategies.