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

J Basic Clin Physiol Pharmacol. 2025 May 7;36(2-3):203-213. doi: 10.1515/jbcpp-2025-0037. eCollection 2025 Mar 1.

Abstract

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≥2 μg/100 mL (Pb) and ≥0.5 μg/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.

Keywords: Sarno River; cadmium; environmental pollution; heavy metals; lead; psychometric assessment.

MeSH terms

  • Adult
  • Aged
  • Autoimmune Diseases / epidemiology
  • Cadmium* / blood
  • Environmental Exposure* / analysis
  • Environmental Exposure* / statistics & numerical data
  • Environmental Pollutants* / blood
  • Environmental Pollution / statistics & numerical data
  • Female
  • Humans
  • Hypertension / epidemiology
  • Italy / epidemiology
  • Lead* / blood
  • Lipoproteins, HDL / blood
  • Lipoproteins, LDL / blood
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Rivers
  • Surveys and Questionnaires

Substances

  • Cadmium
  • Lead
  • Environmental Pollutants
  • Lipoproteins, LDL
  • Lipoproteins, HDL