Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Cadmium Toxicity
Sources of Additional Information

ATSDR Sources of Information

Sources of information about the adverse effects of cadmium and the management of people exposed to cadmium.

• For emergency situations involving chemical exposures and possible human health effects call

  CDC Emergency Response: 770-488-7100 and request the ATSDR Duty Officer

• For non-emergency situations regarding need for information on health effects of chemicals, contact

  CDC-INFO
  800-CDC-INFO
  800-232-4636
  TTY 888-232-6348
  24 Hours/Day
  E-mail: cdcinfo@cdc.gov

• Please Note

  ATSDR cannot respond to questions about individual medical cases, provide second opinions or make specific recommendations regarding therapy. We can provide toxicological information on chemicals as well as referral sources to specialists in occupational and environmental medicine.

  • ATSDR Toxicological Profile for Cadmium (www.atsdr.cdc.gov/toxprofiles/tp5.html)
  • ATSDR Toxic Substances and Health - Cadmium (www.atsdr.cdc.gov/substances/cadmium)
  • ATSDER Minimal Risk Level – Cadmium (www.atsdr.cdc.gov/mrls/index.html)
  • ATSDR Division of Toxicology and Environmental Medicine (www.atsdr.cdc.gov/dt/)

Additional Sources of Information

Additional sources of information on cadmium.

• American Association of Poison Control Centers (1-800-222-1222 or www.aapcc.org ).

  The Poison Control Center may be contacted for questions about poisons and poisonings. The web site provides information about poison centers and poison prevention. AAPC does not provide information about treatment or diagnosis of poisoning or research information for student papers.

• EPA Search Results - Cadmium.
• FDA Website Search Results - Cadmium
• International Agency for Research on Cancer – Search Results - Cadmium
• NIOSH Safety and Health Topic - Cadmium
• NIOSH Pocket Guide to Chemical Hazards (www.cdc.gov/niosh/npg/).
• National Toxicology Program – Search Results - Cadmium.
• OSHA – Safety and Health Topics - Cadmium
• OSHA Standards - Cadmium - includes a full description of required monitoring and actions required at different cadmium levels.
• World Health Organization – Search Results - Cadmium
• National Library of Medicine Environmental Health and Toxicology.
• State and local health departments.
• University medical centers affiliated with the American Association of Occupational and Environmental clinics (AOEC).

Suggested Reading

General

Baker EL Jr, Peterson WA, Holtz JL, et al. 1979. Subacute cadmium intoxication in jewelry workers: an evaluation of diagnostic procedures. Arch Environ Health 34(3):173–7.

Bernard A, Lauwerys R. 1984. Cadmium in human population. Experientia 40:143–52.

Friberg L, Elinder CG, Kjellstrom T, et al., editors. 1986. Cadmium and health: a toxicological and epidemiological appraisal. Boca Raton (FL): CRC Press.

Hallenbeck WH. 1984. Human health effects of exposure to cadmium. Experientia 40:136–42.

Henson, M. and P. Chedrese (2004). "Endocrine disruption by cadmium, a common environmental toxicant with paradoxical effects on reproduction." Exp Biol Med 229: 383-392.

Johnson, M., N. Kenney, et al. (2003). "Cadmium mimics the in vivo effects of estrogen in the uterus and mammary gland." Nature Medicine 9(8): 1081-1084.

Nishijo M, Nakagawa H, Morikawa Y, et al. 1995. Mortality of inhabitants in an area polluted by cadmium: 15-year follow up. Occup Environ Med 52:181–4.

Safe, S. (2003). "Cadmium's disguise dupes the estrogen receptor." Nature Medicine 9(8): 1000-1001.

Stoeppler M, Piscator M, editors. 1985. Cadmium. New York: Springer-Verlag. (Environmental toxin series, vol. 2).

Yost KJ. 1984. Cadmium, the environment and human health: an overview. Experientia 40:157–64.

Vianene, M., R. Masschelein, et al. (2000). "Neurobehavioral effects of occupational exposure to cadmium: a cross sectional epidemiological study." Occupational and Environmental Medicine 57: 19-27.

Wedeen, R., I. Udasin, et al. (1998). Patterns of tubular proteinuria from metals and solvents. Biomarkers: medical and workplace applications. Washington, DC, Joseph Henry Press: 311-321.

Carcinogenicity

Hengstler, J., U. Bolm-Audorff, et al. (2003). "Occupational exposure to heavy metals: DNA damage induction and DNA repair inhibition prove co-exposures to cadmium, cobalt and lead as more dangerous than hitherto expected." Carcinogenesis 24(1): 63-73.

International Agency for Research on Cancer. 1995. Overall evaluations of carcinogenicity. IARC Monogr Eval Carcinog Risk Chem Hum Suppl 7.

Kazantzis G. 1987. The mutagenic and carcinogenic effects of cadmium: an update. Toxicol Environ Chem 15:83–100.

Lamm SH, Parkinson M, Anderson M, et al. 1992. Determinants of lung cancer risk among cadmium-exposed workers. Ann Epidemiol 2:195–211.

National Toxicology Program. (2004). Report on Carcinogens, Eleventh Edition; U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program.

Sorahan, T. and R. Lancashire (1997). "Lung cancer mortality in a cohort of workers employed at a cadmium recovery plant in the United States: an analysis with detailed job histories." Occupational and Environmental Medicine 54(3): 194-201.

Stayner L, Smith R, Thun M, et al. 1992. A dose-response analysis and quantitative assessment of lung cancer risk and occupational cadmium exposure. Ann Epidemiol 2:335–8.

Waalkes, M. (2003). "Cadmium carcinogenesis." Mutation Research 533: 107-120.

Waisberg, M., Joseph, P., Hale, B., Beyersmann, D. (2003) “Molecular and cellular mechanisms of cadmium carcinogenicity.” Toxicology 192(2-3): 95-117.

Respiratory Effects

Barnhart S, Rosenstock L. 1984. Cadmium chemical pneumonitis. Chest 86:789–91.

Benton DC, Andrews GS, Davies HJ, et al. 1996. Acute cadmium fume poisoning; five cases with one death from renal necrosis. Br J Ind Med 23:292–301.

Davison AG, Fayers PM, Taylor AJ, et al. 1988. Cadmium fume inhalation and emphysema. Lancet 1(8587):663–7.

Skeletal Effects

Alfven, T., C. Elinder, et al. (2004). "Cadmium exposure and distal forearm fractures." Journal of Bone and Mineral Research 19(6): 900-908.

Alfven, T., L. Jarup, et al. (2002). "Cadmium and lead in blood in relation to low bone mineral density and tubular proteinuria." Environmental Health Perspectives 110(7): 699-702.

Nogawa K, Tsuritani I, Kido T, et al. 1987. Mechanism for bone disease found in inhabitants environmentally exposed to cadmium: decreased serum 1α, 25-dihydroxyvitamin D level. Int Arch Occup Environ Health 59:21–30.

Renal Effects

Bernard A, Thielemans N, Roels H, et al. 1995. Association between NAG-B and cadmium in urine with no evidence of a threshold. Occup Environ Med 52:177–80.

Buchet JP, Lauwerys R, Roels H, et al. 1995. Renal effects of cadmium body burden of the general population. Lancet 336:669–702.

Elinder CG, Edling C, Lindberg E. 1985. Assessment of renal function in workers previously exposed to cadmium. Br J Ind Med 42:754–60.

Elinder CG, Edling C, Lindberg E, et al. 1985. α2-Microglobulinuria among workers previously exposed to cadmium: follow-up and dose-response analyses. Am J Ind Med 9:553–64.

Hochi Y, Kido T, Nogawa K, et al. 1995. Dose-response relationship between total cadmium intake and prevalence of renal dysfunction using general linear models. J Appl Toxicol 15:109–16.

Kido T, Honda R, Tsuritani I, et al. 1988. Progress of renal dysfunction in inhabitants environmentally exposed to cadmium. Arch Environ Health 43:213–7.

Ikeda, M., T. Ezaki, et al. (2005). "The threshold cadmium level that causes a substantial increase in urine of general populations." Tohoku J Exp Med 205: 247-261.

Ikeda, M., T. Ezaki, et al. (2003). "Threshold levels of urinary cadmium in relation to increases in urinary β2-microglobulin among general Japanese populations." Toxicology Letters 137: 135-141.

Mueller, P., L. Lash, et al. (1997). "Urinary biomarkers to detect significant effects of environmental and occupational exposure to nephrotoxins. I. Categories of tests for detecting effects of nephrotoxins." Renal failure 19(4): 505-521.

Shaikh ZA, Tohyama C, Nolan CV. 1987. Occupational exposure to cadmium: effect on metallothionein and other biological indices of exposure and renal function. Arch Toxicol 59:360–4.

Reproductive and Developmental

Akesson, A., M. Berglund, et al. (2002). "Cadmium exposure in pregnancy and lactation in relation to iron status." American Journal of Public Health 92(2): 284-287.

Fagher U, Laudanski T, Schutz A, et al. 1993. The relationship between cadmium and lead burdens and preterm labor. Int J Obstet 40:109–14.

Gennart JP, Buchet JP, Roels H, et al. 1992. Fertility of male workers exposed to cadmium, lead, or manganese. Am J Epidemiol 135:1208–19.

Silbergeld, E. and T. Patrick (2005). "Environmental exposures, toxicologic mechanisms, and adverse pregnancy outcomes." American Journal of Obstetrics and Gynecology 192: S11-21.

Zeng, X., T. Jin, et al. (2002). "Alterations of serum hormone levels in male workers occupationally exposed to cadmium." Journal of Toxicology and Environmental Health Part A, 65: 513-521.

Food and Diet

Flanagan PR, McLellan JS, Haist J, et al. 1978. Increased dietary cadmium absorption in mice and human subjects with iron deficiency. Gastroenterology 74:841–6.

Sherlock JC. 1984. Cadmium in foods and the diet. Experientia 40:152–6.

Wilheim, M., J. Wittsiepe, et al. (2005). "Consumption of homegrown products does not increase dietary intake of arsenic, cadmium, lead, and mercury by young children living in an industrialized area of Germany." Science of the Total Environment 343: 61-70.

Laboratory Evaluation

Bernard, A., N. Thielemans, et al. (1995). "Association between NAG-B and cadmium in urine with no evidence of a threshold." Occupational and Environmental Medicine 52(3): 177-180.

Centers for Disease Control and Prevention. (2005). Third National Report on Human Exposure to Environmental Chemicals. Atlanta, Georgia: National Center for Environmental Health.

Roels H, Bernard A, Cardenas A, et al. 1993. Markers of early renal changes induced by industrial pollutants. III: Application to workers exposed to cadmium. Br J Ind Med 50:37–48.

Shaikh ZA, Smith LM. 1984. Biological indicators of cadmium exposure and toxicity. Experientia 40:36–43.

Thun MJ, Clarkson TW. 1986. Spectrum of tests available to evaluate occupationally induced renal disease. J Occup Med 28:1026–33.

Related Government Documents

Agency for Toxic Substances and Disease Registry. 1999. Toxicological profile for cadmium. Atlanta: US Department of Health and Human Services. NTIS Report No. PB/89/194476/AS.

National Institute of Occupational Safety and Health (NIOSH). (2006) Cadmium dust. NIOSH pocket guide. Cincinnati, Ohio: US Department of Health and Human Services.

National Institute of Occupational Safety and Health (NIOSH). (1984). National Occupational Exposure Survey (1981-1983). Cincinnati, Ohio: U.S. Department of Health and Human Services.

National Toxicology Program. 2004. Eleventh annual report on carcinogens. Research Triangle Park (NC): National Toxicology Program.

US Environmental Protection Agency. 1986. Health effects assessment for cadmium. Washington, DC: US Environmental Protection Agency, Office of Health and Environmental Assessment. EPA Report No. 540/1-86-038.

US Environmental Protection Agency. 1985. Cadmium contamination of the environment: an assessment of nationwide risk. Washington, DC: US Environmental Protection Agency. EPA Report No. 440/4-85-023.

Other CSEMs

Case Studies in Environmental Medicine: Cadmium Toxicity is one monograph in a series. For other publications in this series, please go to: http://www.atsdr.cdc.gov/csem/