Abstract
Cadmium (Cd), a carcinogenic metal also related to reproductive and cardiovascular diseases, is contained in tobacco and elevated concentrations of it in humans have been consistently associated with first-hand tobacco smoke; however, there is scarce and inconclusive evidence of the relationship between Cd and secondhand smoke (SHS) exposure. Our aim was to evaluate the association between exposure to tobacco, both active and SHS, with urinary Cd concentrations in Mexican women. In a cross-sectional analysis that included 998 women living in northern Mexico, we measured the concentration of creatinine-adjusted urinary Cd (µg-cadmium/g-creatinine) using inductively coupled plasma triple quadrupole (ICP-QQQ) in tandem mass spectrometry mode (MS/MS). We gathered tobacco smoking information through an in-person interview and formed seven groups: non-smokers without SHS exposure; non-smokers with SHS exposure; ex-smokers without SHS exposure <1 year of quitting; ex-smokers without SHS exposure ≥1 year of quitting, ex-smokers with SHS exposure <1 year of quitting; ex-smokers with SHS exposure ≥1 year of quitting and current smokers. The interview also yielded sociodemographic characteristics. We used linear multivariable regression models to estimate the association between Cd concentrations and tobacco smoke exposure. Compared to non-smokers without SHS exposure, we found higher Cd concentrations in ex-smokers with SHS exposure <1 year of quitting and current smokers (adjusted geometric means 0.51 vs. 1.01 and 0.69 µg-cadmium/g-creatinine, respectively). Our results do not support a conclusion that SHS exposure is a source of Cd body burden.
Highlights
Cadmium (Cd) is a carcinogenic metal widely distributed in the environment that has been associated with Itai-itai disease, kidney dysfunction, and bone damage, as well as alterations in the reproductive and cardiovascular systems [1,2,3]
Compared to non-smokers without secondhand smoke (SHS) exposure, we found a lower percentage of Nuevo Leon residents vs. those from Chihuahua (25.8% vs. 40.3, respectively) among ex-smokers with SHS exposure ≥1 year since quitting and current smokers (25.3% vs. 30.3%, respectively); as well as fewer women living in Sonora
We observed that non-smokers with SHS exposure (66.5%) and ex-smokers with SHS exposure ≥1 year since quitting (71.0%) had a higher percentage of women with breast cancer, as well as a lower proportion of these women among ex-smokers without SHS exposure ≥1 year since quitting (38.3%) and current smokers (30.3%) (Table 1)
Summary
Cadmium (Cd) is a carcinogenic metal widely distributed in the environment that has been associated with Itai-itai disease, kidney dysfunction, and bone damage, as well as alterations in the reproductive and cardiovascular systems [1,2,3]. Cadmium absorption after inhalation is greater than that through ingestion, so its concentrations can be four to five times higher among tobacco smokers compared to non-smokers [3,4,5]. Urinary Cd concentrations among ex-smokers depended on time since quitting smoking [9,10]. Cadmium is an important toxic metal contained in tobacco. This metal enters the tobacco plant either by its absorption from the soil and/or by the application of fertilizers that contain it [11]. Due to the chemical similarity with zinc, Cd shares zinc transporters that distribute Cd in the tobacco plant [12]. Cadmium accumulates in tobacco leaves naturally [13] and is more efficiently transferred to tobacco smoke compared to other
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