Workplace Exposure to Toxic Substances Found to Be Associated With Abnormal Cardiac Structure and Function

LA PAZ, BOLIVIA – AUGUST 28: Woods burn outside a store at “Mercado de Las Brujas” (Witches’ Market) on August 28, 2020 in La Paz, Bolivia. August is considered the month of Mother Earth (Pachamama) and Bolivians prepare offerings and celebrations throught the month closing on the last friday. The “Mercado de Las Brujas” is the main place to get everything needed for a proper offering. (Photo by Gaston Brito/Getty Images)
Occupational exposures may be associated with abnormal echocardiographic measures of cardiac function and structure.

Occupational exposures to burning wood, vehicle exhaust, pesticides, and metals may be associated with abnormal echocardiographic measures of cardiac function and structure, according to a study published in the Journal of the American Heart Association.

In this study 782 Hispanic/Latino adult workers (mean age, 52.9 years; 52% women) in the United States were asked to complete a questionnaire to assess occupational exposure to burning wood, vehicle exhaust, solvents, pesticides, and metals at the participants’ current and longest-held jobs. Of those 782 participants, 168 (21%) reported an occupational/environmental exposure to 1 or more toxic substances at their current job, with vehicle exhaust the most frequently reported.

Exposure vs lack of exposure to burning wood at the current job was associated with decreased left ventricular ejection fraction (−3.1%; standard error [SE], 1.0; P = .002). When examining occupational exposure in the longest-held job only, burning wood was associated with increased left ventricular diastolic volume (6.7 mL; SE, 1.6; P < .0001), decreased left ventricular ejection fraction, worse left ventricular global longitudinal strain, and decreased right ventricular fractional area change. Individuals with vs without occupational exposure to vehicle exhaust at the longest-held job had a decrease in tricuspid annular plane systolic excursion (−0.1 cm; SE, 0.04).

Exposure to pesticides at the longest-held job was associated with worse average global longitudinal strain (0.8%; SE, 0.2; P < .0001). Metal exposure was associated with worse global longitudinal strain in the 2-chamber view (1.0%; SE, 0.5; P = .04), as well as increased stroke volume and increased left ventricular mass indexed to body surface area or height.

Overall, occupational exposures at participants’ longest-held jobs were more strongly associated with differences in echocardiographic measures of cardiac structure and function, and men were more likely to report occupational exposures than women. High levels of physical activity, increased alcohol use, and lower educational attainment were more frequently reported by persons with vs without occupational exposures. Exposure to wood and automobile combustion smoke was associated with many abnormal parameters of cardiac structure and function regardless of tobacco smoking status.

Study limitations include its cross-sectional and observational nature, which prevents from assessing the causal relationship between occupational exposures and cardiac function/structure.

“Occupational/environmental exposures to toxic substances potentially pose a threat to the cardiovascular health of working-aged individuals who are exposed,” noted the researchers. “Measures to reduce occupational and environmental exposures are potential important public health interventions that may decrease the risk [for] clinical and preclinical heart failure.”


Burroughs Peña MS, Uwamungu JC, Bulka CM, et al. Occupational exposures and cardiac structure and function: ECHO-SOL (echocardiographic study of Latinos). J Am Heart Assoc. 2020;9:e016122.