Joint associations between 10-year average residential proximity-based pesticide exposures and cardiometabolic markers among women from an agricultural region

Background Chronic exposure to multiple agricultural pesticides may influence cardiometabolic disease risk. Objective We examined joint associations between long-term, residential proximity-based exposure to seven pesticide classes and cardiometabolic risk factors among women from an agricultural region using complementary mixture methods. Methods Women participating in the Center for the Health Assessment of Mothers and Children of Salinas Maternal Cognition Study completed anthropometric measurements, blood collection, and interviews in 2022–2024. Using participant-reported addresses and California’s Pesticide Use Reporting database, we estimated average agricultural use (kg/year) of seven pesticide classes within 1 km of homes in the 10 years preceding outcome assessment. We used quantile g-computation (QGCOMP) and Bayesian kernel machine regression (BKMR) to estimate joint associations with cardiometabolic risk factors and explore the relative contributions of pesticide classes to joint exposure effects. Results Participants ( n = 459) were 48.4 ± 5.5 years old at outcome assessment. Using QGCOMP, a joint one-quartile increase in pesticide exposures was associated with higher systolic blood pressure ( β = 1.82 mm Hg, 95% CI = 0.38, 3.25), higher pulse pressure ( β = 1.59 mm Hg, 95% CI = 0.56, 2.63), and lower HDL cholesterol ( β = –1.35 mg/dL, 95% CI = –2.61, –0.10; <50 mg/dL or self-report cholesterol medication: RR = 1.12, 95% CI = 1.02, 1.23). BKMR results were generally consistent, with modest nonlinearity for blood pressure (e.g., pulse pressure: p25 to p50: β = 0.32, 95% CrI = –1.65, 2.29; p50 to p75: β = 3.46, 95% CrI = 1.35, 5.57) and elevated risk of low HDL cholesterol (p25 to p50: RR = 1.09, 95% CrI = 1.01, 1.18; p50 to p75: RR = 1.03, 95% CrI = 0.93, 1.13). In exploratory analyses, we found the most consistent agreement for glyphosate herbicide’s contribution to the joint associations with low HDL cholesterol and, to a lesser extent, continuous pulse pressure. Joint associations with other outcomes, including body mass, blood sugar, and inflammatory markers, were null. Impact This study evaluates the cardiometabolic impacts of long-term, residential proximity-based exposure to various agricultural pesticide classes among midlife women from an agricultural region. Using two complementary mixture modeling approaches, we demonstrate robust joint associations between chronic pesticide exposure and adverse cardiometabolic outcomes, specifically higher blood pressure and lower HDL cholesterol. Our findings highlight the relevance of ambient, non-occupational pesticide exposure to cardiometabolic disease risk and underscore the importance of considering correlated exposure mixtures when assessing environmental health risks. To our knowledge, this is the first study to examine long-term, joint exposure to current-use pesticides in association with a wide range of cardiometabolic outcomes.