Respiratory exposure to heavy metals is an important
health risk
factor; however, the impact of co-exposure to multiple metals on internal
exposure and health remains unclear. Here, we evaluated the relationship
between exposure to nine metals (K, Ca, Fe, Cr, Mn, Zn, Pb, Se, and
Hg) in PM2.5, PM0.25, and urinary metals with
health biomarkers, i.e., 8-hydroxy-2′-deoxyguanosine (8-OHdG),
vascular endothelial growth factor (VEGF), interleukin-8 (IL-8), and
C-reactive protein (CRP), in rural housewives in Yuncheng City, northern
China. K, Ca, Cr, Mn, Zn, and Hg were primarily present in PM0.25. Fe, Pb, and Se showed the higher concentrations in PM2.5, indicating that these elements mainly existed in the coarser
fraction of PM2.5. The correlation of metals in the two
particle sizes was decent, but only K and Se in PM2.5 and
PM0.25 were significantly correlated with their respective
concentrations in urine. Most metals in the urine were negatively
correlated with biomarkers representing inflammation and oxidative
stress. Based on the Bayesian kernel machine regression mixed effect
model, we found that the co-exposure of nine metals in PM0.25 was significantly negatively correlated with VEGF, with Hg and Cr
having the highest posterior inclusion probability, which may be due
to the synergistic effect of these two metals. We recommend minimizing
the use of solid fuels at home and regularly replacing utensils, which
can have a certain effect on reducing exposure to heavy metals. This
study offers a theoretical foundation and practical exposure case
for quantitatively assessing the effects of particulate matter-bound
metals on human health during the combustion of solid fuels in rural
households.