Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos

Heart. 2019 Mar;105(6):439-448. doi: 10.1136/heartjnl-2018-313463. Epub 2018 Dec 11.


Objective: Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers.

Methods: Cross-sectional data from 7404 employed individuals, aged 18-74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models.

Results: Hispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures.

Conclusions: Our results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.

Keywords: cardiac risk factors and prevention; epidemiology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acculturation
  • Adult
  • Aged
  • Cardiotoxins* / analysis
  • Cardiotoxins* / toxicity
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / classification
  • Cardiovascular Diseases* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Life Style / ethnology
  • Male
  • Metals / toxicity*
  • Middle Aged
  • Occupational Exposure* / adverse effects
  • Occupational Exposure* / analysis
  • Occupational Exposure* / prevention & control
  • Pesticides / toxicity*
  • Prevalence
  • Risk Factors
  • Socioeconomic Factors
  • United States / epidemiology


  • Cardiotoxins
  • Metals
  • Pesticides