Associations between blood lead and urinary cadmium concentrations and all-cause and specific causes of mortality: estimating intervention effects using the parametric g-formula
Bibliographic record
Abstract
Abstract Objective Previous studies in the US reported a high mortality risk associated with higher blood lead levels (BLLs) and urinary cadmium (UCd) levels. The aim of this study was to extend the follow-up of the previous analyses and use the parametric g-formula to estimate the 27-year risk of all-cause and specific causes of mortality. Methods We used data on 14,311 adults aged ≥ 20 years enrolled in the NHANES-III between 1988 and 1994 and followed up through Dec 31, 2015. Time and cause of death were determined from the National Death Index records. We used the parametric g-formula with pooled logistic regression models to estimate the relative and absolute risk of all-cause, cardiovascular, and cancer mortality under different potential threshold interventions on BPb and UCd concentrations. Results Median follow-up was 22.5 years, 5,167 (36%) participants died by the end of the study; 1,550 from cardiovascular disease and 1,135 from cancer. An increase of BLLs and creatinine corrected UCd from the 5th (0.70 µg/dL and 0.04 µg/g for BLLs and UCd ) to the 95th percentile (9.70 µg/dL and 1.63 µg/g for BLLs and UCd) was associated with an increased risk of all-cause by 138% (95% CI, 14 to 196) and a 126% (95% CI, 77 to 383). BLLs and UCd were associated with an increase of 109% (95% CI, 4 to 268) and 37% (95% CI, -0.20 to 239) in the risk of cardiovascular mortality when comparing the 5th to the 95th percentiles of exposure. The corresponding increase in risk for cancer mortality was 287% (95% CI, 12 to 691) and 144% (95% CI, -0.34 to 281) for BLLs and UCd, respectively. We found higher risk differences among men and older participants as compared to their counterparts. Conclusion Interventions to reduce historical exposures to lead and cadmium could have prevented several deaths, especially among individuals ≥ 50 years of age as well as in men.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.043 | 0.084 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.010 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".