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Section Contents
 
Learning Objectives
Introduction
Exposure
Dietary Exposure
Smoking
Absorption Effects
Key Points
Progress Check
 
Case Contents
 
Table of Contents
Cover Page
How to Use This Course
Initial Check
Cadmium
Where Found
Exposure Pathways
Safety Standards
Who is at Risk
Biological Fate
Pathogenic Changes
Acute Effects
Chronic Effects
Clinical Assessment
Laboratory Evaluation
Treatment
Patient Instructions
More Information
Posttest
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Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Cadmium Toxicity
What Factors Increase the Risk of Developing Disease from Exposure to Cadmium?


Learning Objectives

Upon completion of this section, you will be able to

  • identify factors that increase the risk of developing disease following exposure to cadmium.

Introduction

Cadmium is widespread throughout the environment due to its industrial uses. Whether or not an individual sustains an unusual exposure depends on many factors such as level in the diet, route of exposure, smoking, age, gender, and other physiological factors.


Level and Duration of Exposure

The body burden of cadmium increases with age due to its minimal elimination from the body (0.001% of cadmium is excreted per day) and its subsequent long half-life of 38years. Especially high exposures can occur through jobs that involve possible exposures to cadmium as well as in certain hobbies such as jewelry making which can increase exposures.


Unusual Dietary Exposure

In the Jinzu River basin in Japan, environmental contamination of cadmium from manmade activities resulted in the uptake of this metal into the local rice crop. This uptake resulted in unusual levels of exposure to cadmium and the development of a severe form of cadmium poisoning in elderly post-menopausal females in that area, called “itai-itai” disease. The intake of rice accounted for 40% of the exposure suffered by the affected people. Middle-aged women in Japan were ingesting 37.5 μg/day of cadmium which was two to three times higher than other populations in southeast Asia. For comparison’s sake, the average daily intake of cadmium is 6.3-27 μg/day in Europe, and 5-15 μg/day elsewhere in Asia (Tsukahara et al. 2003).


Smoking

The tobacco plant preferentially concentrates cadmium regardless of the amount of cadmium in the soil. The average cigarette contains 2 μg cadmium; 2-10% of that dose is transferred by primary cigarette smoke (Mannino et al. 2004). Of that, 10% to 50% of cadmium in cigarette smoke is absorbed by the lungs. Therefore, the average smoker has two times the amount of long term cadmium in their bodies than non-smokers (Satarug and Moore 2004; Waalkes 2003).


Effects on Cadmium Absorption

Cadmium absorption from the intestine increases when the body’s iron stores are depleted. Cadmium absorption is also increased during pregnancy (Satarug and Moore 2004; Akesson et al. 2002).


Key Points

  • The body burden of cadmium increases with age due to its minimal excretion.
  • Smoking increases the body burden of cadmium due to the avidity of the tobacco plant for cadmium.
  • Cadmium absorption increases during certain physiological states such as iron deficiency and pregnancy.

Progress Check

13. Chronic cadmium poisoning has occurred with which of the following?

A. In certain areas of the globe with cadmium contamination.
B. With the practice of certain hobbies such as jewelry making.
C. With skeletal lesions, as in “itai-itai” disease.
D. All of the above.

Answer:

To review relevant content, see Level and Duration of Exposure and Unusual Dietary Exposure in this section.


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Revised 2008-05-12.