Clinical significance of detectable blood lead and cadmium in the Sarno river basin population: results from the PREVES-STOP study

Objectives: The Sarno river basin (Italy) is a region characterized by significant environmental pollution, raising concerns about heavy metal exposure in residents. The PREVES-STOP Initiative aims to address these concerns. This study investigates the prevalence of detectable blood lead (Pb) and cadmium (Cd) in a cohort of adults from this area and examines associations with key health indicators. Methods: This study analyzed data from 75 adults (aged 30-65) participating in the PREVES-STOP Initiative. Participants completed comprehensive questionnaires assessing demographics, medical history, lifestyle factors (smoking, physical activity), and psychometric measures (fatigue, anxiety/depression, sleep quality). Blood samples were analyzed for Pb and Cd using established methods, with detectable levels defined as≥2μg/100mL (Pb) and ≥0.5μg/L (Cd). Results: Detectable Pb (18.67% of participants) was significantly associated with higher systolic blood pressure, hemoglobin, and MCH, and inversely correlated with HDL cholesterol. Poorer sleep quality was also associated with detectable Pb. Detectable Cd (28% of participants) was significantly associated with higher systolic blood pressure, LDL cholesterol, neutrophil count, and with higher odds of having a history of autoimmune diseases. Multivariate regression models, adjusting for age, sex, smoking status, and BMI, were used to determine these associations. Conclusions: This study demonstrates that even low-level exposure to Pb and Cd in the Sarno river basin is associated with adverse clinical outcomes. The PREVES-STOP Initiative provides a valuable framework for community-based health assessment and intervention in areas affected by environmental pollution.