{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:07:09Z","timestamp":1787843229260,"version":"build-2784847793"},"reference-count":155,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institute of General Medical Sciences of the National Institutes of Health","doi-asserted-by":"publisher","award":["R16GM149473"],"award-info":[{"award-number":["R16GM149473"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoX"],"abstract":"<jats:p>Environmental exposures to heavy metals, polychlorinated biphenyls (PCBs), dioxins, and furans have been associated with adverse cardiovascular outcomes, yet their combined effects remain underexplored. This study examined the joint influence of these contaminants on cardiovascular risk indicators in a representative sample of U.S. adults from the 2003\u20132004 National Health and Nutrition Examination Survey (NHANES). Biomarkers of exposure included lead, cadmium, mercury, twelve PCB congeners, seven dioxins, and ten furans. Cardiovascular outcomes were assessed using blood pressure, Framingham Risk Score (FRS), and lipid profiles. Associations were analyzed using multivariable linear regression and Bayesian Kernel Machine Regression (BKMR), adjusting for age, sex, ethnicity, body mass index, smoking, alcohol consumption, and income. The results demonstrated that metals, particularly mercury, were strongly associated with increased blood pressure and altered HDL cholesterol. PCBs were predominantly linked to elevated systolic blood pressure and FRS, with PCB156 and PCB126 identified as principal contributors. Furans exhibited the strongest associations with dyslipidemia, including elevated LDL cholesterol, total cholesterol, and triglycerides. Combined exposure analysis revealed a complex pattern, with increasing pollutant burdens associated with rising blood pressure and risk scores but declining lipid levels. These findings underscore the outcome-specific effects of pollutant mixtures and suggest that chronic low-level exposure to multiple environmental contaminants may contribute to cardiovascular dysfunction in the general population. Further longitudinal research is needed to confirm these associations and guide risk reduction strategies.<\/jats:p>","DOI":"10.3390\/jox15030094","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T05:17:42Z","timestamp":1750396662000},"page":"94","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Combined Effects of Metals, PCBs, Dioxins, and Furans on Cardiovascular Dysfunction"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6404-8900","authenticated-orcid":false,"given":"Bolanle","family":"Akinyemi","sequence":"first","affiliation":[{"name":"Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA"},{"name":"Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3195-706X","authenticated-orcid":false,"given":"Emmanuel","family":"Obeng-Gyasi","sequence":"additional","affiliation":[{"name":"Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA"},{"name":"Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1161\/CIR.0000000000001209","article-title":"2024 Heart disease and stroke statistics: A report of US and global data from the American Heart Association","volume":"149","author":"Martin","year":"2024","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Greenfield, D.M., and Snowden, J.A. (2018). Cardiovascular Diseases and Metabolic Syndrome. The EBMT Handbook, Springer.","DOI":"10.1007\/978-3-030-02278-5_55"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Carreras, E., Dufour, C., Mohty, M., and Kr\u00f6ger, N. (2019). The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies, Springer International Publishing. [7th ed.].","DOI":"10.1007\/978-3-030-02278-5"},{"key":"ref_4","unstructured":"Al-Masaoodi, R.A., Saleh, J.M., and Al-Shemery, M.K. (2021). Determination of Cardiovascular Diseases (CVD) with Importance Biomarkers: Review, Semantic Scholar."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"78","DOI":"10.4103\/1995-705X.185130","article-title":"Framingham Contribution to Cardiovascular Disease","volume":"17","author":"Hajar","year":"2016","journal-title":"Heart Views Off. J. Gulf Heart Assoc."},{"key":"ref_6","first-page":"54","article-title":"A review on the genetic, environmental, and lifestyle aspects of the early-life origins of cardiovascular disease","volume":"44","author":"Kelishadi","year":"2014","journal-title":"Curr. Probl. Pediatr. Adolesc. Health Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1046\/j.1525-139X.2003.16028.x","article-title":"The clinical epidemiology of cardiovascular diseases in chronic kidney disease: Traditional Cardiac Risk Factors in Individuals with Chronic Kidney Disease","volume":"16","author":"Uhlig","year":"2003","journal-title":"Semin. Dial."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1146\/annurev.publhealth.26.021304.144542","article-title":"Psychosocial factors and cardiovascular diseases","volume":"26","author":"Lewis","year":"2005","journal-title":"Annu. Rev. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1161\/CIRCRESAHA.117.311113","article-title":"Psychosocial Factors and Cardiovascular Disease Risk","volume":"120","author":"Okereke","year":"2017","journal-title":"Circ. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1038\/nrcardio.2012.45","article-title":"Stress and cardiovascular disease","volume":"9","author":"Steptoe","year":"2012","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.amjms.2017.07.011","article-title":"Socioeconomic, Psychosocial and Behavioral Characteristics of Patients Hospitalized With Cardiovascular Disease","volume":"354","author":"Dupre","year":"2017","journal-title":"Am. J. Med. Sci."},{"key":"ref_12","unstructured":"Papageorgiou, N. (2016). Cardiovascular Diseases: Genetic Susceptibility, Environmental Factors and Their Interaction, Academic Press."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1038\/nrg.2016.160","article-title":"Genetics of coronary artery disease: Discovery, biology and clinical translation","volume":"18","author":"Khera","year":"2017","journal-title":"Nat. Rev. Genet."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11936-006-0025-7","article-title":"Cardiovascular disease: Optimal approaches to risk factor modification of diet and lifestyle","volume":"8","author":"Forman","year":"2006","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1080\/10807039.2021.1925083","article-title":"Risk of cardiovascular disease is driven by different combinations of environmental, medical and behavioral factors: Building a conceptual model for cumulative risk assessment","volume":"27","author":"Kashuba","year":"2021","journal-title":"Hum. Ecol. Risk Assess. Int. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1079\/PHN2003587","article-title":"Diet, nutrition and the prevention of hypertension and cardiovascular diseases","volume":"7","author":"Reddy","year":"2004","journal-title":"Public Health Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11332-023-01118-z","article-title":"Lifestyle modifications for preventing and managing cardiovascular diseases","volume":"20","author":"Samuel","year":"2024","journal-title":"Sport Sci. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1161\/CIRCULATIONAHA.115.018585","article-title":"Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: A comprehensive review","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3109\/10715762.2013.847528","article-title":"Physical inactivity, insulin resistance, and the oxidative-inflammatory loop","volume":"48","author":"Vincent","year":"2014","journal-title":"Free Radic. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s11154-012-9229-1","article-title":"Role of insulin resistance in endothelial dysfunction","volume":"14","author":"Muniyappa","year":"2013","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Chen, W., Zhang, S., Hu, X., Chen, F., and Li, D. (2023). A Review of Healthy Dietary Choices for Cardiovascular Disease: From Individual Nutrients and Foods to Dietary Patterns. Nutrients, 15.","DOI":"10.3390\/nu15234898"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Russo, P., Milani, F., De Iure, A., Proietti, S., Limongi, D., Prezioso, C., Checconi, P., Zag\u00e0, V., Novazzi, F., and Maggi, F. (2024). Effect of cigarette smoking on clinical and molecular endpoints in COPD patients. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25115834"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s11883-022-00998-9","article-title":"How to mitigate risk of premature cardiovascular disease among children and adolescents with mental health conditions","volume":"24","author":"Xu","year":"2022","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ramos Meyers, G., Samouda, H., and Bohn, T. (2022). Short chain fatty acid metabolism in relation to gut microbiota and genetic variability. Nutrients, 14.","DOI":"10.3390\/nu14245361"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e0229098","DOI":"10.1371\/journal.pone.0229098","article-title":"Genetic associations between serum low LDL-cholesterol levels and variants in LDLR, APOB, PCSK9 and LDLRAP1 in African populations","volume":"15","author":"Hayat","year":"2020","journal-title":"PLoS ONE"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/j.cell.2012.03.001","article-title":"Genetics of Human Cardiovascular Disease","volume":"148","author":"Kathiresan","year":"2012","journal-title":"Cell"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1109\/TBME.2013.2244892","article-title":"Challenges and Opportunities in Cardiovascular Health Informatics","volume":"60","author":"Zhang","year":"2013","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/1474515116642594","article-title":"Systematic review of symptom clusters in cardiovascular disease","volume":"16","author":"DeVon","year":"2017","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"de Lacerda, D.A., Honorato, P.F., Lima, L.L.L., Oliveira, A.V.L., de Lira, E.A., de Lira, F.E.A., de Sousa Neto, J.F., de Lacerda, M.A., Siqueira, T.d.O., and Braga, T.R.O. (2024, January 24\u201325). Challenges in the early diagnosis of cardiovascular diseases in primary care in Brazil: Analysis and proposals for solutions. Proceedings of the VI Seven International Multidisciplinary Congress, Online.","DOI":"10.56238\/sevenVImulti2024-113"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e19496","DOI":"10.1016\/j.heliyon.2023.e19496","article-title":"Environmental pollutants and their effects on human health","volume":"9","author":"Shetty","year":"2023","journal-title":"Heliyon"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.11648\/j.ijec.20190302.14","article-title":"Environmental Pollution by Heavy Metal: An Overview","volume":"3","author":"Timothy","year":"2019","journal-title":"Int. J. Environ. Chem."},{"key":"ref_32","first-page":"10","article-title":"Environmental toxins and their effects on A comprehensive review of exposure: Human organs and their accumulation","volume":"8","author":"Ibadi","year":"2024","journal-title":"J. Agric. Environ. Vet. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Hussain, C.M., and Ke\u00e7ili, R. (2020). Environmental pollution and environmental analysis. Modern Environmental Analysis Techniques for Pollutants, Elsevier.","DOI":"10.1016\/B978-0-12-816934-6.00001-1"},{"key":"ref_34","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2020). Toxicological Profile for Lead, U.S. Department of Health and Human Services, Public Health Service."},{"key":"ref_35","first-page":"133","article-title":"Heavy metal toxicity and the environment","volume":"101","author":"Tchounwou","year":"2012","journal-title":"Exp. Suppl."},{"key":"ref_36","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2012). Toxicological Profile for Cadmium, U.S. Department of Health and Human Services, Public Health Service."},{"key":"ref_37","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2022). Toxicological Profile for Mercury, U.S. Department of Health and Human Services, Public Health Service."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1289\/ehp.919171","article-title":"Lead, blood pressure, and cardiovascular disease in men and women","volume":"91","author":"Schwartz","year":"1991","journal-title":"Environ. Health Perspect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/occmed\/kqv018","article-title":"Lead toxicity","volume":"65","author":"Gidlow","year":"2015","journal-title":"Occup. Med."},{"key":"ref_40","first-page":"100094","article-title":"Bioaccumulation of lead (Pb) and its effects on human: A review","volume":"7","author":"Collin","year":"2022","journal-title":"J. Hazard. Mater. Adv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"112025","DOI":"10.1016\/j.envres.2021.112025","article-title":"Children\u2019s exposure to environmental lead: A review of potential sources, blood levels, and methods used to reduce exposure","volume":"204","author":"Swaringen","year":"2022","journal-title":"Environ. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1038\/s41440-022-01069-x","article-title":"Public and occupational health risks related to lead exposure updated according to present-day blood lead levels","volume":"46","author":"Yu","year":"2023","journal-title":"Hypertens. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"82","DOI":"10.18231\/j.ijpp.2020.017","article-title":"Evaluation of some heavy metal levels in blood of lead acid battery manufacturing factory workers in Nnewi, Nigeria","volume":"7","author":"Okpogba","year":"2020","journal-title":"Indian J. Pharm. Pharmacol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1515\/reveh-2018-0037","article-title":"Sources of lead exposure in various countries","volume":"34","year":"2019","journal-title":"Rev. Environ. Health"},{"key":"ref_45","unstructured":"Jyothi, N.R., and Farook, N.A.M. (2020). Mercury toxicity in public health. Heavy Metal Toxicity in Public Health, IntechOpen."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Zafar, A., Javed, S., Akram, N., and Naqvi, S.A.R. (2024). Health risks of mercury. Mercury Toxicity Mitigation: Sustainable Nexus Approach, Springer.","DOI":"10.1007\/978-3-031-48817-7_3"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Mishra, S., Bharagava, R.N., More, N., Yadav, A., Zainith, S., Mani, S., and Chowdhary, P. (2018). Heavy metal contamination: An alarming threat to environment and human health. Environmental Biotechnology: For Sustainable Future, Springer.","DOI":"10.1007\/978-981-10-7284-0_5"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3982","DOI":"10.2903\/j.efsa.2015.3982","article-title":"Statement on the benefits of fish\/seafood consumption compared to the risks of methylmercury in fish\/seafood","volume":"13","author":"Committee","year":"2015","journal-title":"EFSA J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/clinchem\/hvad022","article-title":"Elementary Overview of Heavy Metals","volume":"69","author":"Jannetto","year":"2023","journal-title":"Clin. Chem."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"353","DOI":"10.3961\/jpmph.2012.45.6.353","article-title":"Methylmercury exposure and health effects","volume":"45","author":"Hong","year":"2012","journal-title":"J. Prev. Med. Public Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1289\/ehp.0901757","article-title":"Adverse effects of methylmercury: Environmental health research implications","volume":"118","author":"Grandjean","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"255","DOI":"10.30574\/wjarr.2021.10.3.0249","article-title":"A review on the public health implications of heavy metals","volume":"10","author":"Lawal","year":"2021","journal-title":"World J. Adv. Res. Rev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1590\/S0100-40422001000300016","article-title":"O legado das bifenilas policloradas (PCBs) (The legacy of polychlorinated biphenyls (PCBs))","volume":"24","author":"Penteado","year":"2001","journal-title":"Qu\u00edmica Nova"},{"key":"ref_54","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2025, June 11). Toxicological Profile for Polychlorinated Biphenyls (PCBs), Available online: https:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp17.pdf."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Biziuk, M., and Beyer, A. (2020). Polychlorinated Biphenyls (PCBs). Managing Global Resources and Universal Processes, CRC Press.","DOI":"10.1201\/9780429346132-13"},{"key":"ref_56","first-page":"73","article-title":"Polychlorinated Biphenyls (PCBs) and Their Impacts on Human Health: A Review","volume":"7","author":"Ododo","year":"2019","journal-title":"J. Environ. Pollut. Hum. Health"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"310","DOI":"10.15406\/bij.2018.02.00079","article-title":"Dioxins: Source, origin and toxicity assessment","volume":"2","author":"Rathoure","year":"2018","journal-title":"Biodivers. Int. J."},{"key":"ref_58","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2025, June 11). Toxicological Profile for Chlorinated Dibenzo-p-Dioxins, Available online: https:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp104.pdf."},{"key":"ref_59","unstructured":"Kamrin, M.A., and Rodgers, P.W. (1985). Dioxins in the Environment, Hemisphere Publishing Corp."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"445","DOI":"10.2478\/10004-1254-61-2010-2024","article-title":"Dioxins and Human Toxicity","volume":"61","author":"Rukavina","year":"2010","journal-title":"Arh. Za Hig. Rada Toksikol."},{"key":"ref_61","first-page":"7","article-title":"Medicinal significance of furan derivatives: A Review","volume":"2","author":"Banerjee","year":"2020","journal-title":"Int. J. Rev. Life Sci."},{"key":"ref_62","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2025, June 11). Toxicological Profile for Chlorodibenzofurans (CDFs), Available online: https:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp32.pdf."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"428","DOI":"10.5958\/0974-4150.2015.00069.3","article-title":"Chemistry and Therapeutic Aspect of Furan: A Short Review","volume":"8","author":"De","year":"2015","journal-title":"Asian J. Res. Chem."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"241","DOI":"10.5487\/TR.2015.31.3.241","article-title":"Furan in Thermally Processed Foods\u2014A Review","volume":"31","author":"Seok","year":"2015","journal-title":"Toxicol. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1080\/10408397909527268","article-title":"Furans in foods","volume":"11","author":"Maga","year":"1979","journal-title":"CRC Crit. Rev. Food Sci. Nutr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s10534-018-0091-9","article-title":"The role of heavy metals and polychlorinated biphenyls (PCBs) in the oncogenesis of head and neck tumors and thyroid diseases: A pilot study","volume":"31","author":"Petrosino","year":"2018","journal-title":"Biometals"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"70","DOI":"10.3389\/fchem.2017.00070","article-title":"Synergistic Effects of Heavy Metals and Pesticides in Living Systems","volume":"5","author":"Singh","year":"2017","journal-title":"Front. Chem."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/j.freeradbiomed.2010.07.028","article-title":"Roles of dioxins and heavy metals in cancer and neurological diseases using ROS-mediated mechanisms","volume":"49","author":"Segura","year":"2010","journal-title":"Free Radic. Biol. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.envint.2018.07.037","article-title":"Current EU research activities on combined exposure to multiple chemicals","volume":"120","author":"Bopp","year":"2018","journal-title":"Environ. Int."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"109464","DOI":"10.1016\/j.envres.2020.109464","article-title":"The association between environmental endocrine disruptors and cardiovascular diseases: A systematic review and meta-analysis","volume":"187","author":"Fu","year":"2020","journal-title":"Environ. Res."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Bashir, T., and Obeng-Gyasi, E. (2022). Interaction of per-and polyfluoroalkyl substances and allostatic load among adults in various occupations. Diseases, 10.","DOI":"10.3390\/diseases10020026"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.2174\/1389557523666221213091445","article-title":"Polychlorinated Biphenyls: A Review of Recent Updates on Food Safety and Environmental Monitoring, Health and Toxicological Implications, and Analysis","volume":"23","author":"Zarerad","year":"2023","journal-title":"Mini Rev. Med. Chem."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Lee, H.K., and Pak, Y.K. (2018). Persistent Organic Pollutants, Mitochondrial Dysfunction, and Metabolic Syndrome. Mitochondrial Dysfunction Caused by Drugs and Environmental Toxicants, Wiley.","DOI":"10.1002\/9781119329725.ch44"},{"key":"ref_74","first-page":"1","article-title":"Identification of Sources of Some Priority Heavy Metallic Pollutants Caus-ing Environmental Degradation and It\u2019s Health Implications","volume":"39","author":"Igwe","year":"2023","journal-title":"J. Ind. Pollut. Control"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Pant, A.B. (2024). Nanotoxicology. Dictionary of Toxicology, Springer.","DOI":"10.1007\/978-981-99-9283-6"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"334","DOI":"10.12997\/jla.2020.9.3.334","article-title":"Are persistent organic pollutants linked to lipid abnormalities, atherosclerosis and cardiovascular disease? A review","volume":"9","author":"Lind","year":"2020","journal-title":"J. Lipid Atheroscler."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1161\/ATVBAHA.123.318771","article-title":"Using genomics to identify novel therapeutic targets for aortic disease","volume":"44","author":"Raghavan","year":"2024","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_78","unstructured":"National Health and Nutrition Examination Survey (2025, June 11). NHANES 2003\/2004, Available online: https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/continuousnhanes\/default.aspx?BeginYear=2003."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0147-6513(03)00049-6","article-title":"Lessons from case studies of metals: Investigating exposure, bioavailability, and risk","volume":"56","author":"Caussy","year":"2003","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.teac.2017.12.001","article-title":"Dioxins and furans: A review from chemical and environmental perspectives","volume":"17","author":"Kanan","year":"2018","journal-title":"Trends Environ. Anal. Chem."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Rice, C.P., O\u2019Keefe, P., and Kubiak, T. (2002). Sources, pathways, and effects of PCBs, dioxins, and dibenzofurans. Handbook of Ecotoxicology, CRC Press.","DOI":"10.1201\/9781420032505.ch18"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.scitotenv.2015.10.162","article-title":"Should the scope of human mixture risk assessment span legislative\/regulatory silos for chemicals?","volume":"543","author":"Evans","year":"2016","journal-title":"Sci. Total Environ."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.envint.2016.11.015","article-title":"Assessment of traditional and improved stove use on household air pollution and personal exposures in rural western Kenya","volume":"99","author":"Yip","year":"2017","journal-title":"Environ. Int."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.envres.2004.02.006","article-title":"Fish and shellfish as dietary sources of methylmercury and the \u03c9-3 fatty acids, eicosahexaenoic acid and docosahexaenoic acid: Risks and benefits","volume":"95","author":"Mahaffey","year":"2004","journal-title":"Environ. Res."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.envint.2014.03.019","article-title":"Heterogeneity in coal composition and implications for lung cancer risk in Xuanwei and Fuyuan counties, China","volume":"68","author":"Downward","year":"2014","journal-title":"Environ. Int."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1006\/enrs.1997.3822","article-title":"Methylmercury Dose Estimation from Umbilical Cord Concentrations in Patients with Minamata Disease","volume":"77","author":"Akagi","year":"1998","journal-title":"Environ. Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1515\/REVEH.2007.22.2.91","article-title":"Mercury in seafood: Mechanisms of accumulation and consequences for consumer health","volume":"22","author":"Baishaw","year":"2007","journal-title":"Rev. Environ. Health"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.chemosphere.2012.06.073","article-title":"Occupational exposure to PCDDs, PCDFs, and PCBs of metallurgical workers in some industrial plants of the Brescia area, northern Italy","volume":"90","author":"Abballe","year":"2013","journal-title":"Chemosphere"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Montano, L., Pironti, C., Pinto, G., Ricciardi, M., Buono, A., Brogna, C., Venier, M., Piscopo, M., Amoresano, A., and Motta, O. (2022). Polychlorinated biphenyls (PCBs) in the environment: Occupational and exposure events, effects on human health and fertility. Toxics, 10.","DOI":"10.3390\/toxics10070365"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"A599","DOI":"10.1289\/ehp.021100599","article-title":"The prevalence of lead-based paint hazards in U.S. housing","volume":"110","author":"Jacobs","year":"2002","journal-title":"Environ. Health Perspect."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1515\/REVEH.2006.21.1.1","article-title":"Carpenter. Polychlorinated Biphenyls (PCBs): Routes of Exposure and Effects on Human Health","volume":"21","author":"David","year":"2006","journal-title":"Rev. Environ. Health"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1016\/j.etap.2012.09.003","article-title":"Exploring QSTR analysis of the toxicity of phenols and thiophenols using machine learning methods","volume":"34","year":"2012","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.envres.2017.11.008","article-title":"A cross-disciplinary evaluation of evidence for multipollutant effects on cardiovascular disease","volume":"161","author":"Luben","year":"2018","journal-title":"Environ. Res."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s002449910045","article-title":"Benzo[a]pyrene Toxicokinetics in Rainbow Trout (Oncorhynchus mykiss) Acclimated to Different Salinities","volume":"38","author":"Seubert","year":"2000","journal-title":"Arch. Environ. Contam. Toxicol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1289\/ehp.11674","article-title":"Adult Women\u2019s Blood Mercury Concentrations Vary Regionally in the United States: Association with Patterns of Fish Consumption (NHANES 1999\u20132004)","volume":"117","author":"Mahaffey","year":"2009","journal-title":"Environ. Health Perspect."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1515\/revac-2022-0034","article-title":"A review of the application of comprehensive two-dimensional gas chromatography MS-based techniques for the analysis of persistent organic pollutants and ultra-trace level of organic pollutants in environmental samples","volume":"41","author":"Vaye","year":"2022","journal-title":"Rev. Anal. Chem."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1289\/ehp.7640","article-title":"Lipid Adjustment in the Analysis of Environmental Contaminants and Human Health Risks","volume":"113","author":"Schisterman","year":"2005","journal-title":"Environ. Health Perspect."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.neuro.2005.01.008","article-title":"Effects of Homocysteine on the Dopaminergic System and Behavior in Rodents","volume":"26","author":"Lee","year":"2005","journal-title":"NeuroToxicology"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/17576180.2024.2347153","article-title":"2023 White Paper on Recent Issues in Bioanalysis: Deuterated Drugs; LNP; Tumor\/FFPE Biopsy; Targeted Proteomics; Small Molecule Covalent Inhibitors; Chiral Bioanalysis; Remote Regulatory Assessments; Sample Reconciliation\/Chain of Custody (PART 1A\u2014Recommendations on Mass Spectrometry, Chromatography, Sample Preparation Latest Developments, Challenges, and Solutions and BMV\/Regulated Bioanalysis PART 1B\u2014Regulatory Agencies\u2019 Inputs on Regulated Bioanalysis\/BMV, Biomarkers\/IVD\/CDx\/BAV, Immunogenicity, Gene & Cell Therapy and Vaccine)","volume":"16","author":"Baratta","year":"2024","journal-title":"Bioanalysis"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"2935","DOI":"10.1016\/j.jacc.2013.11.005","article-title":"2013 ACC\/AHA Guideline on the Assessment of Cardiovascular Risk","volume":"63","author":"Goff","year":"2014","journal-title":"JACC"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1161\/CIRCULATIONAHA.107.699579","article-title":"General Cardiovascular Risk Profile for Use in Primary Care","volume":"117","author":"Vasan","year":"2008","journal-title":"Circulation"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S0140-6736(04)17018-9","article-title":"Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study","volume":"364","author":"Yusuf","year":"2004","journal-title":"Lancet"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/S0140-6736(16)32380-7","article-title":"Socioeconomic status and the 25 x 25 risk factors as determinants of premature mortality: A multicohort study and meta-analysis of 1.7 million men and women","volume":"389","author":"Stringhini","year":"2017","journal-title":"Lancet"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/S0140-6736(13)61752-3","article-title":"The Framingham Heart Study and the epidemiology of cardiovascular disease: A historical perspective","volume":"383","author":"Mahmood","year":"2014","journal-title":"Lancet"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/biostatistics\/kxu058","article-title":"Bayesian kernel machine regression for estimating the health effects of multi-pollutant mixtures","volume":"16","author":"Bobb","year":"2015","journal-title":"Biostatistics"},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Boafo, Y.S., Mostafa, S., and Obeng-Gyasi, E. (2023). Association of Combined Metals and PFAS with Cardiovascular Disease Risk. Toxics, 11.","DOI":"10.3390\/toxics11120979"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"osae001","DOI":"10.1093\/exposome\/osae001","article-title":"Decoding the exposome: Data science methodologies and implications in exposome-wide association studies (ExWASs)","volume":"4","author":"Chung","year":"2024","journal-title":"Exposome"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1080\/03610926.2022.2121144","article-title":"A robust Spearman correlation coefficient permutation test","volume":"53","author":"Yu","year":"2022","journal-title":"Communications in Statistics Theory Methods"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Akinbode, O.L., and Obeng-Gyasi, E. (2025). Combined Effects of Arsenic, Cadmium, and Mercury with Cardiovascular Disease Risk: Insights from the All of Us Research Program. Int. J. Environ. Res. Public Health, 22.","DOI":"10.3390\/ijerph22020239"},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Zar, J.H. (2005). Spearman rank correlation. Encyclopedia of Biostatistics, Wiley.","DOI":"10.1002\/0470011815.b2a15150"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1161\/01.HYP.37.5.1199","article-title":"Gender differences in the regulation of blood pressure","volume":"37","author":"Reckelhoff","year":"2001","journal-title":"Hypertension"},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Silveyra, P., Al Housseiny, H., and Rebuli, M.E. (2021). Sex and gender differences in the susceptibility to environmental exposures. Sex-Based Differences in Lung Physiology, Springer Nature.","DOI":"10.1007\/978-3-030-63549-7_9"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.cjca.2021.02.005","article-title":"The Importance of Gender to Understand Sex Differences in Cardiovascular Disease","volume":"37","author":"Connelly","year":"2021","journal-title":"Can. J. Cardiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1136\/jech.2008.078659","article-title":"Epidemiology in Latin America: An opportunity for a global dialogue","volume":"62","author":"Pearce","year":"2008","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"e000923","DOI":"10.1161\/JAHA.114.000923","article-title":"Body Mass Index, Sex, and Cardiovascular Disease Risk Factors Among Hispanic\/Latino Adults: Hispanic Community Health Study\/Study of Latinos","volume":"3","author":"Kaplan","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"037003","DOI":"10.1289\/EHP7932","article-title":"Blood Lead Levels in U.S. Children Ages 1\u201311 Years, 1976\u20132016","volume":"129","author":"Egan","year":"2021","journal-title":"Environ. Health Perspect."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1289\/ehp.8930","article-title":"The Environmental \u201cRiskscape\u201d and Social Inequality: Implications for Explaining Maternal and Child Health Disparities","volume":"114","author":"Shenassa","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1086\/420856","article-title":"A High-Density Admixture Map for Disease Gene Discovery in African Americans","volume":"74","author":"Smith","year":"2004","journal-title":"Am. J. Hum. Genet."},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Wigle, D.T. (2003). Child Health and the Environment, Oxford University Press.","DOI":"10.1093\/oso\/9780195135596.001.0001"},{"key":"ref_120","unstructured":"Kitayama, S., Varnum, M.E., and Salvador, C.E. (2019). Cultural neuroscience. Handbook of Cultural Psychology, The Guilford Press."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/1476-069X-12-108","article-title":"Analysis of the effects of exposure to polychlorinated biphenyls and chlorinated pesticides on serum lipid levels in residents of Anniston, Alabama","volume":"12","author":"Aminov","year":"2013","journal-title":"Environ. Health"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.envres.2007.10.006","article-title":"High serum PCBs are associated with elevation of serum lipids and cardiovascular disease in a Native American population","volume":"106","author":"Goncharov","year":"2008","journal-title":"Environ. Res."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1289\/ehp.1103563","article-title":"Circulating levels of persistent organic pollutants (POPs) and carotid atherosclerosis in the elderly","volume":"120","author":"Lind","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.envres.2008.05.006","article-title":"Association of polychlorinated biphenyls with hypertension in the 1999\u20132002 National Health and Nutrition Examination Survey","volume":"108","author":"Everett","year":"2008","journal-title":"Environ. Res."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1289\/ehp.0901524","article-title":"Long-Term Exposure to Airborne Particles and Arterial Stiffness: The Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"119","author":"Auchincloss","year":"2011","journal-title":"Environ. Health Perspect."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.etap.2017.09.014","article-title":"Low cytotoxicity of anisotropic gold nanoparticles coated with lysine on peripheral blood mononuclear cells \u201cin vitro\u201d","volume":"56","year":"2017","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"A296","DOI":"10.1289\/ehp.1307376","article-title":"Urinary Cadmium as a Marker of Exposure in Epidemiological Studies","volume":"121","author":"Adams","year":"2013","journal-title":"Environ. Health Perspect."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/EDE.0b013e3181cc86e8","article-title":"Protecting Human Health From Air Pollution: Shifting From a Single-pollutant to a Multipollutant Approach","volume":"21","author":"Dominici","year":"2010","journal-title":"Epidemiology"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1210\/er.2011-1050","article-title":"Hormones and Endocrine-Disrupting Chemicals: Low-Dose Effects and Nonmonotonic Dose Responses","volume":"33","author":"Vandenberg","year":"2012","journal-title":"Endocr. Rev."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1289\/ehp.9357","article-title":"Ten Years of Mixing Cocktails: A Review of Combination Effects of Endocrine-Disrupting Chemicals","volume":"115","author":"Kortenkamp","year":"2007","journal-title":"Environ. Health Perspect."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1146\/annurev.pharmtox.43.100901.140223","article-title":"Hormesis: The Dose-Response Revolution","volume":"43","author":"Calabrese","year":"2003","journal-title":"Annu. Rev. Pharmacol. Toxicol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1289\/ehp.02110s125","article-title":"Understanding the human health effects of chemical mixtures","volume":"110","author":"Carpenter","year":"2002","journal-title":"Environ. Health Perspect."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/j.1365-2796.2012.02536.x","article-title":"Can persistent organic pollutants and plastic-associated chemicals cause cardiovascular disease?","volume":"271","author":"Lind","year":"2012","journal-title":"J. Intern. Med."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.taap.2013.01.025","article-title":"Pesticides and human chronic diseases: Evidences, mechanisms, and perspectives","volume":"268","author":"Mostafalou","year":"2013","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tox.2015.01.002","article-title":"Adult exposure to bisphenol A (BPA) in Wistar rats reduces sperm quality with disruption of the hypothalamic\u2013pituitary\u2013testicular axis","volume":"329","author":"Wisniewski","year":"2015","journal-title":"Toxicology"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.envres.2008.01.009","article-title":"Mercury as a serious health hazard for children in gold mining areas","volume":"107","author":"Lettmeier","year":"2008","journal-title":"Environ. Res."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1146\/annurev-physiol-012110-142200","article-title":"Endocrine Disruptors: From Endocrine to Metabolic Disruption","volume":"73","author":"Desvergne","year":"2011","journal-title":"Annu. Rev. Physiol."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/toxsci\/kfl043","article-title":"Estrogen-Like Response to p-Nonylphenol in Human First Trimester Placenta and BeWo Choriocarcinoma Cells","volume":"93","author":"Bechi","year":"2006","journal-title":"Toxicol. Sci."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.taap.2012.12.011","article-title":"Application of a fuzzy neural network model in predicting polycyclic aromatic hydrocarbon-mediated perturbations of the Cyp1b1 transcriptional regulatory network in mouse skin","volume":"267","author":"Larkin","year":"2013","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1289\/ehp.1205485","article-title":"Toxicological Function of Adipose Tissue: Focus on Persistent Organic Pollutants","volume":"121","author":"Merrill","year":"2013","journal-title":"Environ. Health Perspect."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"H454","DOI":"10.1152\/ajpheart.00158.2008","article-title":"Mechanisms of lead-induced hypertension and cardiovascular disease","volume":"295","author":"Vaziri","year":"2008","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1289\/ehp.9785","article-title":"Lead exposure and cardiovascular disease--a systematic review","volume":"115","author":"Guallar","year":"2007","journal-title":"Environ. Health Perspect."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"e029852","DOI":"10.1161\/JAHA.123.029852","article-title":"Contaminant Metals as Cardiovascular Risk Factors: A Scientific Statement From the American Heart Association","volume":"12","author":"Lamas","year":"2023","journal-title":"J. Am. Heart Assoc. Cardiovasc. Cerebrovasc. Dis."},{"key":"ref_144","doi-asserted-by":"crossref","unstructured":"Genchi, G., Sinicropi, M.S., Carocci, A., Lauria, G., and Catalano, A. (2017). Mercury Exposure and Heart Diseases. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14010074"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1111\/j.1751-7176.2011.00489.x","article-title":"Role of mercury toxicity in hypertension, cardiovascular disease, and stroke","volume":"13","author":"Houston","year":"2011","journal-title":"J. Clin. Hypertens."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s11883-013-0356-2","article-title":"Cadmium exposure and clinical cardiovascular disease: A systematic review","volume":"15","author":"Jones","year":"2013","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"127007","DOI":"10.1289\/EHP5272","article-title":"Hypertension in Relation to Dioxins and Polychlorinated Biphenyls from the Anniston Community Health Survey Follow-Up","volume":"127","author":"Pavuk","year":"2019","journal-title":"Environ. Health Perspect."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.envres.2008.06.002","article-title":"Associations of environmental exposure to dioxins with prevalent diabetes among general inhabitants in Japan","volume":"108","author":"Uemura","year":"2008","journal-title":"Environ. Res."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"9029","DOI":"10.1021\/acs.est.2c01204","article-title":"Persistent Problem: Global Challenges to Managing PCBs","volume":"56","author":"Melymuk","year":"2022","journal-title":"Environ. Sci. Technol."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.envres.2017.10.010","article-title":"Association of blood polychlorinated biphenyls and cholesterol levels among Canadian Inuit","volume":"160","author":"Singh","year":"2018","journal-title":"Environ. Res."},{"key":"ref_151","first-page":"625","article-title":"The Seveso studies on early and long-term effects of dioxin exposure: A review","volume":"106","author":"Bertazzi","year":"1998","journal-title":"Environ. Health Perspect."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.envres.2013.12.003","article-title":"Circulating levels of p,p\u2032-DDE are related to prevalent hypertension in the elderly","volume":"129","author":"Lind","year":"2014","journal-title":"Environ. Res."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1038\/nm.3145","article-title":"Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis","volume":"19","author":"Koeth","year":"2013","journal-title":"Nat. Med."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1177\/0748233715587849","article-title":"Polychlorinated biphenyls: New evidence from the last decade","volume":"32","author":"Faroon","year":"2016","journal-title":"Toxicol. Ind. Health"},{"key":"ref_155","first-page":"159","article-title":"Assessment of Weighted Quantile Sum Regression for Modeling Chemical Mixtures and Cancer Risk","volume":"14","author":"Czarnota","year":"2015","journal-title":"Cancer Inform."}],"container-title":["Journal of Xenobiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4713\/15\/3\/94\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:55:21Z","timestamp":1760032521000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4713\/15\/3\/94"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,19]]},"references-count":155,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jox15030094"],"URL":"https:\/\/doi.org\/10.3390\/jox15030094","relation":{},"ISSN":["2039-4713"],"issn-type":[{"value":"2039-4713","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,19]]}}}