Exposure to the heavy metal lead (Pb) is linked with postural balance in workers with elevated exposure, but risks from heavy metals at levels observed in the general population are uncertain. OBJECTIVE: Using a refined balance examination with enhanced sensitivity for a broad age range of participants available in the 2021-2023 National Health and Nutrition Examination Survey (NHANES), we assessed associations...
No actionable clinical change at this time — the findings are observational and do not establish causation or a clear threshold for clinical intervention in audiology or balance practice.
If heavy-metal exposure is confirmed as a modifiable risk factor for balance disorders, it could open new avenues for prevention-focused audiological and vestibular care.
- 01Uses NHANES 2021–2023 nationally representative data to study cadmium and lead exposure vs. postural balance.
- 02Both cadmium and lead are known ototoxic/neurotoxic metals that may affect vestibular and cerebellar pathways.
- 03Cross-sectional design limits causal inference between metal exposure and balance outcomes.
- 04Findings could support screening for heavy-metal exposure in patients presenting with unexplained balance problems.
- 05Adds to a growing body of evidence linking environmental toxin exposure to inner-ear and vestibular dysfunction.
Higher blood cadmium and lead levels are associated with worse postural balance outcomes in the general population.
studypartially supported- PMID
- 42235363
- DOI
- 10.1016/j.jtemb.2026.127900.
- Journal
- Journal of Trace Elements in Medicine and Biology
- Publication type
- research_article
- Evidence level
- 2b
- Population
- General US adult population from NHANES 2021–2023 with measured blood cadmium and lead levels
- Intervention
- Blood cadmium and lead levels (environmental heavy-metal exposure)
- Comparator
- Lower blood cadmium/lead exposure groups within the same cohort
Primary outcomes
Postural balance performance/outcomes