The impact of metals on atherosclerotic cardiovascular disease (ASCVD) risk in workers occupationally exposed to welding fume remains unclear. We aimed to assess the associations between welding-related metals and 10-year ASCVD risk, and the mediating role of biological aging. Metals including chromium, manganese, nickel, lead, copper (Cu), and iron were detected and biological aging indices, including Klemera-Doubal method biological age (KDM-BA) and Phenotypic Age (PhenoAge), were calculated among 419 male welders in Wuhan, China. The participants had an average age of 42.77 years, of whom 93 (22.2%) fell into the high 10-year ASCVD risk group. Generalized linear models revealed that Cu was associated with elevated 10-year ASCVD risk [OR (95% CI) = 1.051 (1.017, 1.085), P = 0.003]. This association persisted even after adjustment for other metals. Moreover, we found positive associations between biological aging and 10-year ASCVD risk [KDM.Accel: OR (95%CI) = 1.170 (1.070-1.280); PhenoAge.Accel: OR (95% CI) = 1.122 (1.053-1.194)], as well as between Cu and biological aging [KDM.Accel: β (95% CI) = 1.888 (1.130-2.646); PhenoAge.Accel: β (95% CI) = 4.552 (3.406-5.698)]. Further analysis showed significant mediation roles of KDM.Accel and PhenoAge.Accel in the Cu-ASCVD association, with mediating proportions of 29.8% and 43.8%, respectively. We further constructed a lifestyle index, suggesting that a modifiable healthy lifestyle could decelerate aging and reduce the 10-year ASCVD risk. Our findings indicated that Cu was associated with increased ASCVD risk, and biological aging may mediate the Cu-ASCVD association. Adopting healthy lifestyles appears to mitigate biological aging, which is of great public health importance for preventing ASCVD.
