Environmental Factors – February 2024: A Journey into Science: From Preventive Medicine to Environmental Health Science

Environmental Factors – February 2024: A Journey into Science: From Preventive Medicine to Environmental Health Science

Ana Navas-Acien, MD, PhD, grew up in a desert-like area in Almeria, Spain, where potable water was scarce. For years, her parents relied on a rainwater collection system called an aljibe for drinking and cooking. These early experiences planted the seeds.

Today, Navas-Asian is a physician and epidemiologist who leads research efforts to improve drinking water quality in American Indian communities. At the NIEHS Keystone Science Lecture on Nov. 2, Navas-Acien shared research on the link between arsenic exposure and increased risk of cardiovascular disease in these communities. She is also the senior author of a recent study showing that reduced levels of another metal, lead, are associated with lower blood pressure in American Indians. High blood pressure is the most common risk factor for heart disease.

Environmental Factor recently spoke with Navas-Acien to learn more about her journey to uncovering the impact of metals on health, how she overcame career setbacks, and the interdisciplinary nature of environmental health.

Ana Navas-Acien, MD, PhD
Navas-Assian is a professor of environmental health sciences at Columbia University. (Photo by Timothy Lee/Columbia University)

EF: How did you become interested in environmental health research?

Navas-Assien: During my residency in preventive medicine at the National Center of Epidemiology in Madrid, Spain, I became interested in environmental risk factors that could be addressed at the community level. I learned about cardiovascular disease risk prevention, which is very lifestyle focused. But when I joined Johns Hopkins University as a Ph.D. As a student, I had the opportunity to study environmental factors that influence cardiovascular disease with my mentors, Eliseo Guallar, MD, and Ellen Silbergeld, PhD.We begin a lead-focused project using data from NHANES [National Health and Nutrition Examination Survey]I was stuck with the metal.

EF: What should the average person know about metal exposure as a risk factor for disease?

Navas-Assien: It is important to recognize that metal contact is ubiquitous in the environment. It’s in the water we drink, the air we breathe and the food we eat. Some of these metals are essential – we need them to function properly. Other metals are toxic and interfere with normal physiological pathways, providing opportunities for disease development.

We’ve long known that certain metals cause cancer, but until recently, their role in the development of other diseases remained unclear.Last year, the American Heart Association issued a scientific statement recognizing arsenic, cadmium and lead as contaminant metals and risk factors for cardiovascular disease [see sidebar]. The fact that this is now considered established knowledge with solid evidence is one of my greatest personal satisfactions.

EF: What advice would you give to someone who may be experiencing setbacks in their career?

Navas-Assien: Experiencing setbacks, such as not getting renewal or funding, can be difficult. I advise those who have been rejected to mourn a little, but not to grieve for too long and not to lose energy in depression. Ask yourself, ‘How can I re-strategize?’ What do I really care about, what is the most important science that I really want to advance?

Keep looking for the best way forward. By doing this, some good things will happen, and you may be happy that it doesn’t happen the way you originally wanted because Plan C is probably much better than Plan A.

EF: What do you enjoy most about working in Environmental Health Sciences?

Navas-Assien: This is a dream for anyone interested in solving the complex problems of today’s society. Some people care about similar issues, but each of them has a very different perspective. These include toxicologists, epidemiologists, molecular scientists, engineers, and those focused on policy and implementation. We all work under the same umbrella, interact every day, and collaborate with the community. The opportunity to work with so many different types of people has really helped me advance my science a lot.

EF: What do you most want to explore in the future?

Navas-Assien: I am very interested in better understanding the link between metals, including essential metals, and brain health, particularly cognitive and dementia-related outcomes. I want to continue putting science into action so that it reaches policymakers and influences clinical guidelines, educational interventions, and public health programs.

El Ejido, Almeria
Navas-Asian grew up in the El Ejido region of Almeria, Spain. (Photo courtesy of Ana Navas Assian)

Kuo CC, Balakrishnan P, Gribble MO, Best LG, Goessler W, Umans JG, Navas-Acien A. 2022. Association of arsenic exposure and arsenic metabolism with all-cause, cardiovascular, and cancer mortality in the Strong Heart Study. Environ Int 15:159:107029.

Lamas GA, Bhatnagar A, Jones MR, Mann KK, Nasir K, Tellez-Plaza M, Ujueta F, Navas-Acien A; American Heart Association Committee on Epidemiology and Prevention; Committee on Cardiovascular and Stroke Care; Lifestyle and Cardiometabolism Health Council; Peripheral Vascular Disease Council; and Cardiovascular Disease Renal Council. 2023. Contaminant metals as cardiovascular risk factors: a scientific statement from the American Heart Association. J Am Heart Assoc 4;12(13):e029852.

Lieberman-Cribbin W, Li Z, Lewin M, Ruiz P, Jarrett JM, Cole SA, Kupsco A, O’Leary M, Pichler G, Shimbo D, Devereux RB, Umans JG, Navas-Acien A, Nigra AE. 2024. Contribution of reduced blood lead levels to reduced blood pressure levels: Longitudinal evidence from the Strong Heart Family Study. Journal of the American Heart Association 16;13(2):e031256.

(Lindsay Key is a contract writer for the NIEHS Office of Communications and Public Liaison.)

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