{"id":"https://openalex.org/W4410328477","doi":"https://doi.org/10.1186/s12889-025-22753-w","title":"Association of cobalt exposure with all-cause and cardiovascular mortality in U.S. adults","display_name":"Association of cobalt exposure with all-cause and cardiovascular mortality in U.S. adults","publication_year":2025,"publication_date":"2025-05-13","ids":{"openalex":"https://openalex.org/W4410328477","doi":"https://doi.org/10.1186/s12889-025-22753-w","pmid":"https://pubmed.ncbi.nlm.nih.gov/40361032","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12070784"},"language":"en","primary_location":{"id":"doi:10.1186/s12889-025-22753-w","doi":"https://doi.org/10.1186/s12889-025-22753-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12889-025-22753-w","pdf_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-22753-w","source":{"id":"https://openalex.org/S200437886","display_name":"BMC Public Health","issn_l":"1471-2458","issn":["1471-2458"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-22753-w","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Chunhui He","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I183519381","display_name":"Capital Medical University","ror":"https://ror.org/013xs5b60","country_code":"CN","type":"education","lineage":["https://openalex.org/I183519381"]},{"id":"https://openalex.org/I4210119028","display_name":"Beijing Anzhen Hospital","ror":"https://ror.org/02h2j1586","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210119028"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Chunhui He","raw_affiliation_strings":["Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, 100029, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, 100029, China","institution_ids":["https://openalex.org/I183519381","https://openalex.org/I4210119028"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112349213","display_name":"Min Gao","orcid":"https://orcid.org/0000-0002-5592-9349","observed_orcids":["https://orcid.org/0000-0002-5592-9349"]},"institutions":[{"id":"https://openalex.org/I200296433","display_name":"Chinese Academy of Medical Sciences & Peking Union Medical College","ror":"https://ror.org/02drdmm93","country_code":"CN","type":"education","lineage":["https://openalex.org/I200296433"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Min Gao","raw_affiliation_strings":["Beijing Tongrentang Research Institute, Scientific Research Institute of Beijing Tongrentang Co., LTD, Beijing, China","Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing Tongrentang Research Institute, Scientific Research Institute of Beijing Tongrentang Co., LTD, Beijing, China","institution_ids":[]},{"raw_affiliation_string":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China","institution_ids":["https://openalex.org/I200296433"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102010130","display_name":"Ting He","orcid":"https://orcid.org/0000-0001-6171-8225","observed_orcids":["https://orcid.org/0000-0001-6171-8225"]},"institutions":[{"id":"https://openalex.org/I200296433","display_name":"Chinese Academy of Medical Sciences & Peking Union Medical College","ror":"https://ror.org/02drdmm93","country_code":"CN","type":"education","lineage":["https://openalex.org/I200296433"]},{"id":"https://openalex.org/I4210161896","display_name":"Fu Wai Hospital","ror":"https://ror.org/0590dnz19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210161896"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Ting He","raw_affiliation_strings":["Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China","institution_ids":["https://openalex.org/I200296433","https://openalex.org/I4210161896"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5117530655","display_name":"Fuwei Xing","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210093460","display_name":"Sixth Affiliated Hospital of Sun Yat-sen University","ror":"https://ror.org/005pe1772","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210093460"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Fuwei Xing","raw_affiliation_strings":["Department of Cardiology, Biomedical Innovation Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China. xingfw3@mail.sysu.edu.cn"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Biomedical Innovation Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China. xingfw3@mail.sysu.edu.cn","institution_ids":["https://openalex.org/I4210093460"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5117530655"],"corresponding_institution_ids":["https://openalex.org/I4210093460"],"apc_list":{"value":3290,"currency":"USD","value_usd":3290},"apc_paid":{"value":3290,"currency":"USD","value_usd":3290},"fwci":1.4875,"has_fulltext":true,"cited_by_count":4,"citation_normalized_percentile":{"value":0.77778595,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":97},"biblio":{"volume":"25","issue":"1","first_page":"1757","last_page":"1757"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10790","display_name":"Heavy Metal Exposure and Toxicity","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10790","display_name":"Heavy Metal Exposure and Toxicity","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10915","display_name":"Trace Elements in Health","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14393","display_name":"Health, Environment, Cognitive Aging","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cobalt-exposure","display_name":"cobalt exposure","score":0.9980000257492065},{"id":"https://openalex.org/keywords/urinary-cobalt","display_name":"urinary cobalt","score":0.925000011920929},{"id":"https://openalex.org/keywords/all-cause-mortality","display_name":"all-cause mortality","score":0.9549999833106995},{"id":"https://openalex.org/keywords/cardiovascular-mortality","display_name":"cardiovascular mortality","score":0.9950000047683716},{"id":"https://openalex.org/keywords/cardiovascular-disease","display_name":"cardiovascular disease","score":0.8159999847412109},{"id":"https://openalex.org/keywords/environmental-metal-exposure","display_name":"environmental metal exposure","score":0.6850000023841858},{"id":"https://openalex.org/keywords/nhanes","display_name":"NHANES","score":0.6990000009536743},{"id":"https://openalex.org/keywords/biomonitoring","display_name":"biomonitoring","score":0.5059999823570251}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9206783771514893},{"id":"https://openalex.org/C140556311","wikidata":"https://www.wikidata.org/wiki/Q214746","display_name":"Biostatistics","level":3,"score":0.8056551814079285},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.6307335495948792},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.6183897852897644},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.5663169622421265},{"id":"https://openalex.org/C142853389","wikidata":"https://www.wikidata.org/wiki/Q744778","display_name":"Association (psychology)","level":2,"score":0.4168770909309387},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.27940475940704346},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.12882426381111145},{"id":"https://openalex.org/C111472728","wikidata":"https://www.wikidata.org/wiki/Q9471","display_name":"Epistemology","level":1,"score":0.0},{"id":"https://openalex.org/C138885662","wikidata":"https://www.wikidata.org/wiki/Q5891","display_name":"Philosophy","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002318","descriptor_name":"Cardiovascular Diseases","qualifier_ui":"Q000401","qualifier_name":"mortality","is_major_topic":true},{"descriptor_ui":"D002423","descriptor_name":"Cause of Death","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003035","descriptor_name":"Cobalt","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true},{"descriptor_ui":"D003035","descriptor_name":"Cobalt","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":true},{"descriptor_ui":"D003035","descriptor_name":"Cobalt","qualifier_ui":"Q000652","qualifier_name":"urine","is_major_topic":true},{"descriptor_ui":"D004781","descriptor_name":"Environmental Exposure","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true},{"descriptor_ui":"D004781","descriptor_name":"Environmental Exposure","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009749","descriptor_name":"Nutrition Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012307","descriptor_name":"Risk Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D055815","descriptor_name":"Young Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1186/s12889-025-22753-w","doi":"https://doi.org/10.1186/s12889-025-22753-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12889-025-22753-w","pdf_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-22753-w","source":{"id":"https://openalex.org/S200437886","display_name":"BMC Public Health","issn_l":"1471-2458","issn":["1471-2458"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Public Health","raw_type":"journal-article"},{"id":"pmid:40361032","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40361032","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC public health","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:48e707eb80cf4edeaddd2c02f60fef82","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/48e707eb80cf4edeaddd2c02f60fef82","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Public Health, Vol 25, Iss 1, Pp 1-11 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s12889-025-22753-w","doi":"https://doi.org/10.1186/s12889-025-22753-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12889-025-22753-w","pdf_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-22753-w","source":{"id":"https://openalex.org/S200437886","display_name":"BMC Public Health","issn_l":"1471-2458","issn":["1471-2458"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4410328477.pdf","grobid_xml":"https://content.openalex.org/works/W4410328477.grobid-xml"},"referenced_works_count":25,"referenced_works":["https://openalex.org/W1859890772","https://openalex.org/W1964043583","https://openalex.org/W1974806088","https://openalex.org/W2000684819","https://openalex.org/W2122916891","https://openalex.org/W2125312145","https://openalex.org/W2156012627","https://openalex.org/W2551807744","https://openalex.org/W2579027505","https://openalex.org/W2617805895","https://openalex.org/W2772875556","https://openalex.org/W2792874077","https://openalex.org/W3020620400","https://openalex.org/W3083240803","https://openalex.org/W3089653246","https://openalex.org/W3125664156","https://openalex.org/W3131705998","https://openalex.org/W3133751471","https://openalex.org/W3187000900","https://openalex.org/W4211191293","https://openalex.org/W4214768398","https://openalex.org/W4214864679","https://openalex.org/W4313682918","https://openalex.org/W4318928980","https://openalex.org/W4384695199"],"related_works":["https://openalex.org/W7167672005","https://openalex.org/W4405837832","https://openalex.org/W2156012627","https://openalex.org/W3133751471","https://openalex.org/W4291493430","https://openalex.org/W4394959190","https://openalex.org/W7130505210","https://openalex.org/W4388125498","https://openalex.org/W2990161631","https://openalex.org/W7167076851"],"abstract_inverted_index":{"BACKGROUND:":[0],"Cobalt":[1],"exposure":[2,19,212],"is":[3,213],"recognized":[4],"as":[5,243],"a":[6,121,155,214,227,244],"potential":[7,143],"risk":[8,157,216,246],"factor":[9,217,247],"for":[10,142,193,202,218,248],"cardiovascular":[11,249],"disease":[12,250],"(CVD).":[13],"However,":[14],"the":[15,27,34,62,71,184,207,233],"impact":[16],"of":[17,64,99,125,158],"cobalt":[18,49,102,107,149,211],"on":[20],"mortality,":[21],"particularly":[22],"concerning":[23],"CVD-related":[24],"deaths,":[25],"in":[26,51,147],"U.S.":[28],"remains":[29],"uncertain.":[30],"METHODS:":[31],"Data":[32],"from":[33,68],"National":[35],"Health":[36],"and":[37,56,82,105,112,161,196,222],"Nutrition":[38],"Examination":[39],"Surveys":[40],"(NHANES)":[41],"spanning":[42],"1999-2018":[43],"were":[44,74,108,187],"utilized":[45],"to":[46,77,138],"assess":[47],"urinary":[48,101,118,148],"levels":[50],"participants":[52,78,132],"aged":[53,79],"20":[54],"years":[55,72,81],"older":[57,83],"(n":[58,84],"=":[59,85],"15,873).":[60],"For":[61,117,181],"analysis":[63],"blood":[65,106,182],"cobalt,":[66,119,183],"data":[67],"NHANES":[69],"covering":[70],"2015-2018":[73],"considered,":[75],"limited":[76],"40":[80],"6,692).":[86],"The":[87,96],"follow-up":[88,123],"period":[89,124],"extended":[90],"until":[91],"December":[92],"31,":[93],"2019.":[94],"RESULTS:":[95],"median":[97,122],"values":[98],"ln-transformed":[100],"(creatinine":[103],"corrected)":[104],"-":[109,113],"1.10":[110],"ln(\u00b5g/g)":[111],"1.90":[114],"ln(\u00b5g/L),":[115],"respectively.":[116],"during":[120],"130.0":[126],"months":[127],"(interquartile":[128],"range:":[129],"70.25-189.0),":[130],"2,304":[131],"died,":[133],"with":[134,154],"613":[135],"deaths":[136],"attributed":[137],"CVD.":[139],"After":[140],"adjusting":[141],"covariates,":[144],"an":[145],"increase":[146],"level":[150],"was":[151],"significantly":[152],"associated":[153],"higher":[156],"all-cause":[159,194,220],"mortality":[160,163,195,221],"CVD":[162,203,223],"(per":[164],"1":[165],"ln-unit":[166],"increment,":[167],"HR:":[168,174],"1.19,":[169],"95%":[170,176],"CI:":[171,177,190,199],"1.07,":[172],"1.32;":[173],"1.30,":[175],"1.06,":[178],"1.60,":[179],"respectively).":[180],"adjusted":[185],"HRs":[186],"1.57":[188],"(95%":[189,198],"1.15,":[191],"2.14)":[192],"2.02":[197],"1.10,":[200],"3.72)":[201],"mortality.":[204,224,251],"CONCLUSIONS:":[205],"In":[206],"U.S.,":[208],"low-level":[209],"environmental":[210],"significant":[215],"both":[219],"SYNOPSIS:":[225],"Cobalt,":[226],"metallic":[228],"element":[229],"commonly":[230],"encountered":[231],"by":[232],"general":[234],"population":[235],"through":[236],"food,":[237],"water,":[238],"or":[239],"air":[240],"inhalation,":[241],"emerges":[242],"novel":[245]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2025-05-14T00:00:00"}