Overview
Cross-sectional study from the Tobago Health Study examining associations between urinary metal concentrations and uterine fibroid prevalence in 441 African Caribbean women aged 40 to 87. Six metals measured in urine: total arsenic, cadmium, lead (non-essential); copper, manganese, zinc (essential). WQS regression used for mixture analysis. The study is notable for examining a Caribbean population where prior metal-fibroid data were absent, and for disaggregating arsenic species (total arsenic, dimethylarsinic acid, arsenobetaine).
Key numbers
n=441 women, age 40-87. Uterine fibroid prevalence: 48.3%.
Individual metal associations (adjusted logistic regression, per 10-fold increase in urinary concentration):
- Total arsenic: OR=1.61 (95% CI: 1.04, 2.53) for fibroid odds.
- Dimethylarsinic acid: OR=1.84 (95% CI: 1.11, 3.09) for fibroid odds.
- Arsenobetaine: OR=1.38 (95% CI: 1.05, 1.82) for fibroid odds.
- Other metals (cadmium, lead, copper, manganese, zinc): not significantly associated with fibroid prevalence in adjusted models.
WQS mixture analysis: arsenic species were the dominant contributors to any mixture effect on fibroids.
Arsenic species note: arsenobetaine is generally considered less toxic than inorganic arsenicals; the finding that it is independently associated with fibroid odds in this population may reflect co-exposure with more toxic species through seafood consumption rather than a direct arsenobetaine effect.
Evidence Fitness
Context only. Cross-sectional design; temporality not established. Urinary biomarkers reflect recent exposure. The strong arsenic-fibroid association in this population is a mixture-epidemiology finding, not a food concentration measurement. The Caribbean population context may differ from the North American and European populations in other studies in this unit.
Methods (brief)
Tobago Health Study cross-sectional subsample. Urine metals by ICP-MS, Wadsworth Center laboratory. Models adjusted for urinary creatinine, age, BMI, education, and number of live childbirths. WQS regression for mixture analysis. Supplemental creatinine-standardized models adjusted identically except urinary creatinine excluded.
Implications
Certification: Arsenic (particularly organic and inorganic species) as the dominant metal mixture contributor to uterine fibroid risk reinforces total arsenic monitoring relevance.
Courses: Useful for illustrating population-specific differences in dominant metal contributors to mixture effects.
App: No food concentration data.
Microbiome: Not applicable.
Related evidence
- Arsenic, Total
- metals/inorganic-arsenic
- Single-metal regulatory limits systematically underprotect against dietary heavy-metal exposure
Update history
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