Abstract
Cadmium, lead, and mercury are nephrotoxic metals that are commonly found as hazardous pollutants in many areas of the USA. We examined the relationship between exposure to cadmium, lead, and mercury with the occurrence of urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) in women. This study was conducted using data on women > 20 years of age, collected between 2005 and 2016, who reported experiencing urinary incontinence in the National Health and Nutrition Examination Survey (NHANES). Restricted cubic spline analysis was used to characterize a dose–response relationship between continuous exposure to different nephrotoxic metals and the occurrence of UUI and SUI. A total of 4406 women were included in this study, with 2624 (59.6%) suffering from SUI and 3177 (72.1%) suffering from UUI in the weighted population. The results of our multivariate analysis indicated that age, race, marital status, body mass index (BMI), and exposure to nephrotoxic metals were risk factors for developing UI. The odds ratio (OR; 95% confidence interval) for developing UI was positively correlated with the exposure to cadmium and lead in women. The OR of SUI occurrence increased with increasing levels of cadmium in blood, with a peak at 4 µg/L. The OR of UUI occurrence increased with increasing levels of blood and urinary lead, with peaks at 7 µg/dL and 5 µg/L, respectively. The presence of mercury was not significantly correlated with the occurrence of SUI or UUI. Exposure to high levels of cadmium and lead, which are nephrotoxic metals, is associated with the occurrence of UI in women.
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Data availability statement
The data that support the findings of this study are available from the corresponding author, Bo Peng, upon reasonable request.
Change history
23 March 2023
A Correction to this paper has been published: https://doi.org/10.1007/s11356-023-26634-w
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We thanked Bullet Edits for editing this manuscript.
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We are very grateful to all the participants in this research project. This work was supported by the National Key R&D Program of China (Grant No. 2021YFC2009304); the National Natural Science Foundation of China (Grant No. 81870517 and 32070646); Shanghai Association for Science and Technology Commission (Grant No. 19140905700 and 19140905402).
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Conception and design: JN, ZL, WM, and BP. Administrative support: YL, HZ, JX, and GW. Provision of study materials or patients: YW, JX, YZ. Collection and assembly of data: WM, KW, and BP. Data analysis and interpretation: JN, ZL, and KW.
Manuscript writing: All authors. Final approval of manuscript: all authors.
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The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study used previously collected deidentified data, which was deemed exempt from review by the Ethics Committee of the Tenth People’s Hospital of Shanghai.
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Supplementary file1 (JPG 208 KB) Figure S1: Flow chart depicting the criteria used in this study to include or exclude data collected in the NHANES 2005–2016.
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Ni, J., Li, Z., Lu, Y. et al. Relationship between exposure to cadmium, lead, and mercury and the occurrence of urinary incontinence in women. Environ Sci Pollut Res 29, 68410–68421 (2022). https://doi.org/10.1007/s11356-022-20598-z
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DOI: https://doi.org/10.1007/s11356-022-20598-z