Association Between Cadmium and Nickel Levels in Urine and Cardiovascular Risk in Female Waste Workers
DOI:
https://doi.org/10.58954/epj.v6i3.473Keywords:
Cadmium (Cd),, Nickel (Ni), subclinical cardiovascular risk,, waste workers, FemaleAbstract
Female waste workers are at risk of exposure to cadmium and nickel, which can affect hematological and inflammatory biomarkers and potentially influence cardiovascular risk. This study aims to analyze the relationship between cadmium and nickel levels in urine and MCV, RDW-SD, and PCT in female waste workers. Using a cross-sectional design and a biomonitoring approach, the analysis was conducted by measuring heavy metal levels in urine and hematological and inflammatory biomarkers through complete blood tests. The results showed that cadmium decreased MCV and RDW-SD, while cadmium and nickel increased PCT as an indicator of systemic inflammation. Thus, although changes in MCV and RDW-SD do not directly increase cardiovascular risk, increased PCT confirms the potential toxic effects of heavy metals on the cardiovascular system.
References
Abidin, A. U., Maziya, F. B., Susetyo, S. H., Sulistiyani, A. T., Yoneda, M., Nagaya, T., & Matsui, Y. (2025). Environmental pollution and health risks to informal workers: Exposure to heavy metals in human hair at Indonesian landfills. Environmental Toxicology and Pharmacology. https://www.sciencedirect.com/science/article/abs/pii/S1382668925000602
Badawi, K., El Sharazly, B. M., Negm, O., Khan, R., & Carter, W. G. (2024). Is Cadmium Genotoxicity Due to the Induction of Redox Stress and Inflammation? A Systematic Review. Antioxidants, 13(8), 1–13. https://doi.org/10.3390/antiox13080932
Charkiewicz, A. E., Omeljaniuk, W. J., Nowak, K., & Garley, M. (2023). Cadmium Toxicity and Health Effects — A Brief Summary. 1–16.
Farrokhpour, M., Kiani, A., Mortaz, E., Taghavi, K., Farahbod, A. M., Fakharian, A., Kazempour-Dizaji, M., & Abedini, A. (2019). Procalcitonin and proinflammatory cytokines in early diagnosis of bacterial infections after bronchoscopy. Open Access Macedonian Journal of Medical Sciences, 7(6), 913–919. https://doi.org/10.3889/oamjms.2019.208
Genchi, G., Carocci, A., Lauria, G., Sinicropi, M. S., & Catalano, A. (2020). Nickel: Human health and environmental toxicology. International Journal of Environmental Research and Public Health, 17(3). https://doi.org/10.3390/ijerph17030679
Gul, M., Uyarel, H., Akgul, O., Akkaya, E., Surgit, O., Cakmak, H. A., Pusuroglu, H., Yakisan, T., Aslan, S., & Eksik, A. (2016). Long-term prognostic significance of admission plateletcrit values in patients with non-ST elevation myocardial infarction. Blood Coagulation and Fibrinolysis, 27(6), 696–701. https://doi.org/10.1097/MBC.0000000000000484
Guo, H., Liu, H., Jian, Z., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., Zhao, L., Geng, Y., Ouyang, P., Lai, W., Chen, Z., & Huang, C. (2019). Nickel induces inflammatory activation via NF-kB, MAPKs, IRF3 and NLRP3 inflammasome signaling pathways in macrophages. Aging, 11(23), 11659–11672. https://doi.org/10.18632/aging.102570
Hanum, G. R., Wahyudhi, S. D. Y., & Mauliana, M. I. (2024). Analisis Kandungan Logam Berat Kadmium (Cd) Pada Petani Di Desa Kedung Rejo Kecamatan Megaluh Jombang Berdasarkan Masa Kerja. Jurnal Insan Cendekia, 11(2), 186–192.
Herawati, H., Mallongi, A., Daud, A., Syam, A., Amiruddin, R., Ernyasih, E., & Tryanda, S. V. P. (2025). Ecological and Human Health Risks of Nickel Mining: A Systematic Review. Journal of Public Health and Pharmacy, 5(3), 678–694. https://doi.org/10.56338/jphp.v5i3.7283
Katte, J.-C., Kengne, A.-P., Tchapmi, D., Agoons, B. B., Nyirenda, M., Mbacham, W., & Sobngwi, E. (2021). Procalcitonin Correlates With Cardiovascular Risk Better Than Highly Sensitive C-Reactive Protein in Patients With Type 2 Diabetes in Sub-Saharan Africa: Results From a Cross-Sectional Study. Cureus, 13(9). https://doi.org/10.7759/cureus.18357
Kumas, M., Esrefoglu, M., Bayindir, N., Iraz, M., Ayhan, S., & Meydan, S. (2016). Protective Effects of Curcumin on Cadmium-Induced Renal Injury in Young and Aged Rats. Bezmialem Science, 4(3), 92–98. https://doi.org/10.14235/bs.2016.788
Kurtul, A., & Elcik, D. (2017). Procalcitonin is an independent predictor for coronary atherosclerotic burden in patients with stable coronary artery disease. International Journal of Cardiology, 236, 61–64. https://doi.org/10.1016/j.ijcard.2017.02.061
Mansouri, M., Afrashteh, S., Farhadi, A., Moftian, N., Zanganeh, Z., Yazdi, N. B., Arfaeinia, H., Soleimani, F., & Farhadi, M. (2025). Integrated Network Analysis of Toxic Elements Co-exposure and Pathophysiological Changes Triggered by Oxidative Stress/Inflammation in Urban Sanitation Workers. Biological Trace Element Research, 204, 2939–2953. https://link.springer.com/article/10.1007/s12011-025-04866-w
Mayaserli, D. P., & Rahayu, J. S. (2018). Perbandingan Kadar Logam Kadmium (Cd) dalam Urin Perokok. Jurnal Kesehatan Perintis (Perintis’s Health Journal), 5(1), 58–64.
Muhammad Baharul Iman, Akhmad Dwi Priyatno, Muhammad Prima Cakra Randana, Arie Wahyudi, & R.A. Lisna Dwi Rahma. (2025). Analysis of Risk Factors Affecting the Incidence of Hypertension in the Working Area of the Talang Ratu Palembang Health Center. Cendekia Medika: Jurnal Stikes Al-Ma`arif Baturaja, 10(2), 255–275. https://doi.org/10.52235/cendekiamedika.v10i2.505
Mushtaq, H., Shabbir, M., Mukarram, S., & Altaf, M. (2025). Association of Admission Platelet Crit with In-Hospital Outcomes in Non ST-Elevation Myocardial Infarction (NSTEMI). Pakistan Armed Forces Medical Journal, 75, 397–403. https://doi.org/10.51253/pafmj.v75iSUPPL-3.12679
Nurcahyo, R., Habiburrahman, M., & Setyoko, T. A. (2023). Bekas Sebagai Limbah B3 (Number April).
Odewabi, A. O., & Ekor, M. (2016). Levels of heavy and essential trace metals and their correlation with antioxidant and health status in individuals occupationally exposed to municipal solid wastes. Toxicology and Industrial Health, 33(5). https://doi.org/10.1177/0748233716669276
Peng, S., Li, W., & Ke, W. (2023). Association between red blood cell distribution width and all-cause mortality in unselected critically ill patients: Analysis of the MIMIC-III database. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1152058
Qu, F., & Zheng, W. (2024). Cadmium Exposure: Mechanisms and Pathways of Toxicity and Implications for Human Health. Toxics, 12(6). https://doi.org/10.3390/toxics12060388
Rasin, P., V, A. A., Basheer, S. M., Haribabu, J., Santibanez, J. F., Garrote, C. A., Arulraj, A., & Mangalaraja, R. V. (2025). Exposure to cadmium and its impacts on human health: A short review. Journal of Hazardous Materials Advances, 17(November 2024). https://doi.org/10.1016/j.hazadv.2025.100608
Sakarya, O., Toprak, B., & Bora, R. (2026). Procalcitonin in acute and chronic coronary syndromes: Diagnostic biomarker of coronary inflammation. Biomolecules and Biomedicine, 26(4), 586–597. https://doi.org/10.17305/bb.2025.12915
Tahir, M., Rehman, M. Y. A., & Malik, R. N. (2021). Heavy metal-associated oxidative stress and glutathione s-transferase polymorphisms among E-waste workers in Pakistan. Environmental Geochemistry and Health, 43, 4441–4458. https://link.springer.com/article/10.1007/s10653-021-00926-x
Talarico, M., Manicardi, M., Vitolo, M., Malavasi, V. L., Valenti, A. C., Sgreccia, D., Rossi, R., & Boriani, G. (2021). Red cell distribution width and patient outcome in cardiovascular disease: A real-world” analysis. Journal of Cardiovascular Development and Disease, 8(10). https://doi.org/10.3390/jcdd8100120
Tellez-Plaza, M., R. Jones, M., Dominguez-Lucas, A., Guallar, E., & Navas-Acien, A. (2014). Cadmium Exposure and Clinical Cardiovascular Disease: a Systematic Review. 15(10). https://doi.org/10.1007/s11883-013-0356-2.Cadmium
Wang, H., Yang, G., Zhao, J., & Wang, M. (2020). Association between mean corpuscular volume and severity of coronary artery disease in the Northern Chinese population: a cross-sectional study. Journal of International Medical Research, 48(3). https://doi.org/10.1177/0300060519896713
WHO. (2023). Human health effects of benzene, arsenic, cadmium, nickel, lead and mercury. Who, 23–26.
Wu, T., Fann, J. C., Chen, S. L., Yen, A. M., Wen, C., Lu, Y., Chen, H., & Chiu, S. Y. (2018). Gradient Relationship between Increased Mean Corpuscular Volume and Mortality Associated with Cerebral Ischemic Stroke and Ischemic Heart Disease : A Longitudinal Study on 66 , 294 Taiwanese. Scientific Reports, (July 2017), 1–9. https://doi.org/10.1038/s41598-018-34403-w
Xanthopoulos, A., Giamouzis, G., Dimos, A., Skoularigki, E., Starling, R. C., Skoularigis, J., & Triposkiadis, F. (2022). Red Blood Cell Distribution Width in Heart Failure: Pathophysiology, Prognostic Role, Controversies and Dilemmas. Journal of Clinical Medicine, 11(7). https://doi.org/10.3390/jcm11071951
Yu, L., Sun, J., & Liu, X. (2023). Serum C reactive protein and procalcitonin are valuable predictors of coronary heart disease and poor prognosis in the elderly. American Journal of Translational Research, 15(6), 4188–4195.
Zhang, Z., Gao, S., Dong, M., Luo, J., Xu, C., Wen, W., Huang, Y., Wu, Y., Zhou, J., & Yuan, Z. (2022). Relationship between Red Blood Cell Indices (MCV, MCH, and MCHC) and Major Adverse Cardiovascular Events in Anemic and Nonanemic Patients with Acute Coronary Syndrome. Disease Markers, 2022(Mcv). https://doi.org/10.1155/2022/2193343
Zhou, Z., Lu, Y. H., Pi, H. F., Gao, P., Li, M., Zhang, L., Pei, L. P., Mei, X., Liu, L., Zhao, Q., Qin, Q. Z., Chen, Y., Jiang, Y. M., Zhang, Z. H., & Yu, Z. P. (2016). Cadmium Exposure is Associated with the Prevalence of Dyslipidemia. Cellular Physiology and Biochemistry, 40(3–4), 633–643. https://doi.org/10.1159/000452576
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