High urinary tungsten concentration is associated with stroke in the National Health and Nutrition Examination Survey 1999-2010.
BACKGROUND
In recent years there has been an exponential increase in tungsten demand, potentially increasing human exposure to the metal. Currently, the toxicology of tungsten is poorly understood, but mounting evidence suggests that both the elemental metal and its alloys have cytotoxic effects. Here, we investigate the association between tungsten and cardiovascular disease (CVD) or stroke using six waves of the National Health and Nutrition Examination Survey (NHANES).


METHODS
We investigated associations using crude and adjusted logistic regression models in a cohort of 8614 adults (18-74 years) with 193 reported stroke diagnoses and 428 reported diagnoses of CVD. We also stratified our data to characterize associations in a subset of younger individuals (18-50 years).


RESULTS
Elevated tungsten concentrations were strongly associated with an increase in the prevalence of stroke, independent of typical risk factors (Odds Ratio (OR): 1.66, 95% Confidence Interval (95% CI): 1.17, 2.34). The association between tungsten and stroke in the young age category was still evident (OR: 2.17, 95% CI: 1.33, 3.53).


CONCLUSIONS
This study represents the most comprehensive analysis of the human health effects of tungsten to date. Individuals with higher urinary tungsten concentrations have double the odds of reported stroke. We hypothesize that the pathological pathway resulting from tungsten exposure may involve oxidative stress.
European Centre for Environment and Human Health, University of Exeter Medical School, Truro, United Kingdom.
Jessica
J
Tyrrell
Tamara S
TS
Galloway
Ghada
G
Abo-Zaid
David
D
Melzer
Michael H
MH
Depledge
Nicholas J
NJ
Osborne
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000652:urine*; D014414:Tungsten / Q000009:adverse effects / Q000652:urine*; D014481:United States / Q000453:epidemiology
D014414:Tungsten