Introduction: Several metals such as Iron and Zinc were found at high concentration in foundry particulate matter and demonstrated to have procoagulant effects, these effects may occur through epigenetic changes of pro-inflammatory genes. So, Iron and Steel workers are at a high risk for cardiovascular diseases. Aim of work: Evaluation of the risk of thrombosis and cardiovascular diseases among individuals occupationally exposed to Iron and Zinc. Materials and methods: A descriptive cross sectional comparative study was performed on 60 persons working in Iron and Steel factory and 60 subjects used as control group with no history of occupational exposure to Fe or Zinc. All study population was subjected to personal interview with specially designed questionnaire. Serum Iron and Zinc levels together with Endogenous thrombin potential (ETP) test were measured. Assessment of methylated DNA of Endothelin-1 (EDN1) and Nitric-oxide synthase-3 (NOS3) genes were performed. Results: the current study showed highly statistically significant
increase of serum Iron, Zinc levels and percentage of ETP among exposed group when compared to the control with Mean ± SD 125.6±22.9, 110.9±19.2,168±0.5 vs 63.6±15.3, 42.5±7.2, and 102.22±12.36 respectively. There was also a significant decrease of methylated DNA of EDN1and NOS3 genes among exposed group with Mean ± SD 0.71±0.3, 0.75±0.3 versus 1.51±1.01,4.09±0.68 respectively among the control group. Serum levels of Iron and Zinc and percentage of ETP were negatively correlated with methylated DNA of  NOS3 and EDN1 genes r= -0.304, r=-0.450, r=-0.259, r= -0.787, r= -0.866 and r= -0.618 respectively (p value <0.005), while positive correlation were detected between Iron and Zinc levels with ETP (r= 0.692 and r=0.625). It was found that Iron, Zinc and NOS3 are determinants for END1 while the latter is the only predictor for NOS3. Conclusion: The risk of thrombosis and cardiovascular diseases were related to occupational exposure to high levels of Iron and Zinc. So, regular wearing of good quality's personal protective equipment, especially masks and gloves, is highly recommended to decrease exposure to these metals.