ESPE Abstracts

Background and objectives: Previous studies on the influence of toxic metals on children's growth have produced mixed results, and research on the joint impact of metal exposure is limited. This study aim ed to investigate the association between exposure to heavy metal mixtures and growth measures in preschool-aged children in Korea.

Methods: This study used data from the Korean National Environmental Health Survey (KoNEHS) cycles 3 (2015-2017) and 4 (2018-2020), focusing on preschool children aged 3-5 years (n = 1149) with measured urinary mercury (Hg) and cadmium (Cd) concentrations. Multivariable linear regression and logistic regression models were employed to assess the associations of individual metal concentrations with children's height z-scores and the risk of stunted growth. Quantile G-Computation was used to examine the joint effects of exposure to metal mixtures.

Results: The proportion of stunted height (defined as a height z-score less than -1.0) in the study population was 4.6%. The analysis revealed a negative association between height z-scores and both Hg and Cd concentrations in single-metal models. An increase in odds ratios for stunted height from lower to higher concentration groups of Hg and Cd was observed, with statistical significance only achieved for Hg concentrations. In the mixture model employing quantile g-computation, Hg demonstrated a greater influence on height than Cd. The Hg and Cd mixture showed a significant negative association with height z-score [β (95% CI): -0.334 (-0.415, -0.254), P <0.001] and a significant positive association with odds ratios for stunted height [OR (95% CI): 2.178 (1.449, 3.164), P <0.001].

Conclusions: These findings suggest that the combined impact of heavy metal mixtures at the preschool age could potentially impair children's height growth.