SciELO - Scientific Electronic Library Online

vol.74Authors’ Reply – Comments: Serum levels of infliximab in Brazilian patients with Crohn's disease: what are the reasons for differences from previous studies?ERRATA: The effectiveness of current informative material in improving awareness and opinion of undergraduate students towards organ donation: a comparative, randomized survey study author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links



Print version ISSN 1807-5932On-line version ISSN 1980-5322

Clinics vol.74  São Paulo  2019  Epub Oct 28, 2019 


Cardiovascular risks in subjects exposed to the Brumadinho dam collapse, Minas Gerais, Brazil

Vitor Engrácia ValentiI  *

David M. GarnerII

ICentro de Estudos do Sistema Nervoso Autonomo, Faculdade de Filosofia e Ciencias, Universidade Estadual Paulista, Marilia, SP, BR

IICardiorespiratory Research Group, Department of Biological and Medical Sciences, School of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford OX3 0BP, United Kingdom

On January 25th, 2019, structural problems with the Dam in Brumadinho, MG, Brazil caused serious fatalities for numerous families. It was responsible for 99 registered deaths and over 250 individuals disappeared, including employees and local residents (1,2). According to a survey by the Oswaldo Cruz Foundation of Brazil, the area concerned affects many kilometers of the Paraopeba River (3). The likelihood of an outbreak of diseases has already been highlighted, including yellow and dengue fevers, leptospirosis and schistosomiasis. Moreover, the short-term effects of heavy metal exposure (for example, aluminum, manganese and iron) are related to symptoms such as dizziness, diarrhea, nausea and vomiting because of the impact on their central nervous systems (4).

As follows, heavy metal exposure can happen in two ways: (a) oral intake; or (b) respiratory exposure via the nasal cavities. By oral intake, heavy metals reach the bloodstream after passing through the gastrointestinal tract (5). When the exposure is through the respiratory pathways, heavy metals enter the bloodstream via the contact of the tiny alveoli with minute blood vessels; to facilitate heavy metal deposits in the bloodstream (6). Within the blood circulation, heavy metals cause increased oxidative stress and lipid peroxidation at the cellular level (7).

Thus, a Japanese study (8) has revealed that heavy metal exposure is responsible for malignant pathophysiological responses to the cell. Amongst these effects, impairments of the blood vessels smooth muscle were detected, enabling the progression of vascular diseases.

Another study conducted in the United States of America (9) has revealed that blood vessels are a serious target for heavy metal exposure toxicity. Furthermore, it has been revealed that the consequences of heavy metals on blood vessels can play key roles in mediating the physio-pathological effects on different body parts; for example the kidneys, lungs and liver. Such exposure compromises the working of these structures.

In 2014, data collected by the Houston Methodist Research Institute (10) demonstrated there is compelling evidence connecting heavy metal toxicity to neuronal dysfunction. In this way, the neurons involvement influences the cardiovascular reflexes, contributing to the development of diseases such as hypertension, cardiac arrhythmias and strokes.

Recently, researchers at NC State University, Raleigh, North Carolina, USA (11) have cited 36 epidemiological studies and shown the negative impact of exposure to heavy metals on the development of Metabolic syndrome; which incorporates diabetes, dyslipidemia, obesity, and hypertension.

So, the references cited indicate a greater degree of risk for the progression of cardiovascular diseases in those exposed to heavy metals in the Brumadinho, MG, Brazil region and, in the vicinity of the Paraopeba River. We seize this opportunity to draw attention to the unfortunate persons in these situations. Critically, their cardiovascular fitness needs monitoring regularly.


1. [Accessed April 7th, 2019] [ Links ]

2. ]

3. [Accessed April 4th, 2019] [ Links ]

4. Rinaldi M, Micali A, Marini H, Adamo EB, Puzzolo D, Pisani A, et al. Cadmium, Organ Toxicity and Therapeutic Approaches: A Review on Brain, Kidney and Testis Damage. Curr Med Chem. 2017;24(35):3879-93. [ Links ]

5. Praveena SM, Omar NA. Heavy metal exposure from cooked rice grain ingestion and its potential health risks to humans from total and bioavailable forms analysis. Food Chem. 2017;235:203-11. [ Links ]

6. Moitra S, Ghosh J, Firdous J, Bandyopadhyay A, Mondal M, Biswas JK, et al. Exposure to heavy metals alters the surface topology of alveolar macrophages and induces respiratory dysfunction among Indian metal arc-welders. Toxicol Ind Health. 2018;748233718804426. [ Links ]

7. Siriwardena AK. Reappraisal of xenobiotic-induced, oxidative stress-mediated cellular injury in chronic pancreatitis: a systematic review. World J Gastroenterol. 2014;20(11):3033-43. [ Links ]

8. Rana MN, Tangpong J, Rahman MM. Toxicodynamics of Lead, Cadmium, Mercury and Arsenic- induced kidney toxicity and treatment strategy: A mini review. Toxicol Rep. 2018;5:704-13. [ Links ]

9. Lin CH, Hsu YT, Yen CC, Chen HH, Tseng CJ, Lo YK, et al. Association between heavy metal levels and acute ischemic stroke. J Biomed Sci. 2018;25(1):49. [ Links ]

10. Mitra J, Vasquez V, Hegde PM, Boldogh I, Mitra S, Kent TA, et al. Revisiting Metal Toxicity in Neurodegenerative Diseases and Stroke: Therapeutic Potential. Neurol Res Ther. 2014;1(2). pii: 107. [ Links ]

11. Planchart A, Green A, Hoyo C, Mattingly CJ. Heavy Metal Exposure and Metabolic Syndrome: Evidence from Human and Model System Studies. Curr Environ Health Rep. 2018;5(1):110-24. [ Links ]

*Corresponding author. E-mail:

No potential conflict of interest was reported.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons License ( which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.