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Review
. 2022 May;29(22):32545-32565.
doi: 10.1007/s11356-022-18866-z. Epub 2022 Feb 22.

Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis

Qiang-Ji Bao  1 , Kai Zhao  1 , Yu Guo  1 , Xin-Ting Wu  1 , Jin-Cai Yang  1 , Ming-Fei Yang  2
Affiliations
Review

Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis

Qiang-Ji Bao et al. Environ Sci Pollut Res Int. 2022 May.

Abstract

The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well established. We conducted a systematic review of the relationship between five metals (arsenic, mercury, copper, cadmium, and lead) and stroke. First, we comprehensively searched 3 databases (Pubmed, EMBASE, and Cochrane) from inception until June 2021. Random-effects meta-analyses, pooled relative risks (RR) and 95% confidence intervals (CI) were applied to evaluate the effect value. We finally identified 38 studies involving 642,014 non-overlapping participants. Comparing the highest vs. lowest baseline levels, chronic exposure to lead (RR = 1.07; 95%CI,1.00-1.14), cadmium (RR = 1.30; 95%CI,1.13-1.48), and copper (RR = 1.19; 95%CI,1.04-1.36) were significantly associated with stroke risks. However, the other two metals (arsenic and mercury) had less effect on stroke risk. Further analysis indicated that the association was likely in a metal dose-dependent manner. The results may further support the possibility that environmental toxic metal contaminants in recent years are associated with the increased risk of stroke.

Keywords: Arsenic; Cadmium; Copper; Lead; Mercury; Meta-analysis; Stroke.

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