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Association between blood ethylene oxide levels and the risk of cardiovascular diseases in the general population

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Abstract

Ethylene oxide (EtO) is a highly reactive organic compound that is mainly used as a sterilizing agent. However, to date, the effects of EtO on the cardiovascular system are not clear. We aimed to explore the association between blood EtO levels and the risk of cardiovascular disease (CVD) in the general US population. We obtained information on blood levels of EtO and CVD outcomes in 3,410 participants from the National Health and Nutritional Examination Survey (NHANES) 2013–2014 and 2015–2016. Logistic regression models were applied to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between EtO and risk of all CVD as well as subtypes of CVD. Linear regression analyses were used to estimate the associations of EtO with potential mechanistic parameters of CVD, including blood pressure, blood lipid levels and inflammatory parameters. Higher blood levels of EtO were associated with an increased risk of all CVD (p for trend = 0.003), with an adjusted OR (95% CI) in the highest quartile of 1.94 (1.24, 3.02) compared with the lowest quartile as a reference. Higher concentrations of EtO were positively associated with the risk of angina (p for trend = 0.04) and heart attack (p for trend = 0.011). In addition, the concentration of EtO was positively associated with the levels of triglycerides, white blood cells, lymphocytes, monocytes, neutrophils and eosinophils (p = 0.003 for eosinophils and p < 0.001 for the others) and negatively associated with the level of high-density lipoprotein cholesterol (p < 0.001). We found that exposure to EtO was associated with angina, heart attack and all CVD in a large representative US population. Furthermore, EtO may induce CVD through the inflammatory response and abnormal fatty acid metabolism.

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Availability of data and materials

The datasets used and analysed during the current study are available from https://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm.

Funding

This work was supported by funding from the Medical Science and Technology Development Foundation, Jiangsu Provincial Commission of Health and Family Planning (grant no. ZDRCA2016073) and Key Project of the Jiangsu Commission of Health (ZDA2020004).

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Children’s Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China

    Guowei Zeng, Qi Zhang & Kai-Hong Wu

  2. Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

    Xiaowei Wang

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  1. Guowei Zeng
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  2. Qi Zhang
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Contributions

K.H.W.: conceptualization, methodology. Q.Z.: data curation, project administration. Q.Z.: writing—original draft preparation and editing. G.W.Z. and K.H.W.: supervision, investigation. X.W.W.: validation. G.W.Z. and K.H.W.: writing—review and editing.

Corresponding author

Correspondence to Kai-Hong Wu.

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Ethics approval and consent to participate

The consent form was signed by the survey participants, and the participants consented to storing specimens of their blood for future research. The CDC/NCHS Ethics Review Board approved the NHANES study and gave approval for public dissemination.

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Not applicable. There is no individual-level data in our publication.

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The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Zeng, G., Zhang, Q., Wang, X. et al. Association between blood ethylene oxide levels and the risk of cardiovascular diseases in the general population. Environ Sci Pollut Res 28, 64921–64928 (2021). https://doi.org/10.1007/s11356-021-15572-0

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