The geographic distribution of trace elements in the environment: the REGARDS study

  • Nicole Rembert
  • Ka He
  • Suzanne E. Judd
  • Leslie A. McClure


Research on trace elements and the effects of their ingestion on human health is often seen in scientific literature. However, little research has been done on the distribution of trace elements in the environment and their impact on health. This paper examines what characteristics among participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study are associated with levels of environmental exposure to arsenic, magnesium, mercury, and selenium. Demographic information from REGARDS participants was combined with trace element concentration data from the US Geochemical Survey (USGS). Each trace element was characterized as either low (magnesium and selenium) or high (arsenic and mercury) exposure. Associations between demographic characteristics and trace element concentrations were analyzed with unadjusted and adjusted logistic regression models. Individuals who reside in the Stroke Belt have lower odds of high exposure (4th quartile) to arsenic (OR 0.33, CI 0.31, 0.35) and increased exposure to mercury (OR 0.65, CI 0.62, 0.70) than those living outside of these areas, while the odds of low exposure to trace element concentrations were increased for magnesium (OR 5.48, CI 5.05, 5.95) and selenium (OR 2.37, CI 2.22, 2.54). We found an association between levels of trace elements in the environment and geographic region of residence, among other factors. Future studies are needed to further examine this association and determine whether or not these differences may be related to geographic variation in disease.


Trace elements REGARDS study Stroke 



This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health, and Human Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis, or interpretation of the data. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at

Additional funding for this work was provided by grants from the National Institutes of Health (R01 ES021735) and National Institutes of Health Heart, Lung, and Blood Institute (T32HL07988).

Compliance with ethical standards

All REGARDS participants provided written informed consent, and Institutional Review Board approval was obtained at all participating institutions (Howard et al. 2005).


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Nicole Rembert
    • 1
  • Ka He
    • 2
  • Suzanne E. Judd
    • 1
  • Leslie A. McClure
    • 3
  1. 1.Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Epidemiology and BiostatisticsIndiana University at BloomingtonBloomingtonUSA
  3. 3.Department of Epidemiology and Biostatistics, School of Public HealthDrexel UniversityPhiladelphiaUSA

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